Aileen Marshall

“Anthony S. Fauci, M.D., was appointed Director of NIAID in 1984. He oversees an extensive research portfolio of basic and applied research to prevent, diagnose, and treat established infectious diseases such as HIV/AIDS, respiratory infections, diarrheal diseases, tuberculosis and malaria as well as emerging diseases such as Ebola and Zika.” Caption and photo credit: NIAID

We have all seen Dr. Anthony Fauci, currently the Director of the National Institute of Allergy and Infectious Diseases (NIAID), on television providing facts about the COVID-19 pandemic in recent months. It was a long road to this critical position, but Fauci’s path may be somewhat familiar to many people here in the Tri-Institutional community.

Dr. Fauci is a native New Yorker. He was born in December of 1940, and grew up in Dyker Heights, Brooklyn. His father was a pharmacist with his own store on 13th Avenue near 83rd Street. As a boy, Fauci worked in the pharmacy, ringing up customers and delivering prescriptions, and lived upstairs with his parents and two sisters. As a teenager, Fauci attended Regis High School on East 84th Street in Manhattan. Athletic from an early age, Fauci was captain of the basketball team, even though he was not particularly tall. He later attended College of the Holy Cross in Worcester and earned a degree in Classics with a pre-med concentration. Fauci went on to Cornell University Medical College, where he graduated first in his class. He completed his internship and residency right here at New York Hospital-Cornell.

In 1968, Fauci joined the National Institutes of Health (NIH) in the Laboratory of Clinical Investigation, where he became a specialist in infectious diseases. Fauci mostly treated patients with autoimmune disorders and observed that many cancer drugs lowered a patient’s autoimmune response. He devised a protocol to give autoimmune patients very low doses of the cancer drugs, which lowered their autoimmune response to a point that prevented them from getting symptoms. This protocol is now a standard treatment for a category of diseases called vasculitis, which cause inflammation of blood vessels.

Fauci also performed basic research in the NIH Laboratory of Immunoregulation. In 1980 he became head of that lab and examined how immunosuppressive drugs change the human immune response. He also studied how HIV infects the body, particularly how the virus suppresses the immune system. In 1984, Fauci accepted the position of Director of the NIAID, under the condition that he be allowed to keep his research lab. He has served in both positions ever since. From 1983 to 1986, Deborah Birx, the United States Global AIDS Coordinator and Fauci’s recent counterpart in COVID-19 press conferences, completed two fellowships in clinical immunology in the areas of allergies and diagnostics in Fauci’s lab.

Fauci has published over 1,300 papers, is the 41st most cited researcher on Google Scholar, and ranks 4th in immunology on Web of Science. He has received many awards, including the Albany Medical Center Prize in Medicine and Biomedical Research, the Mary Woodward Lasker Award for Public Service, the National Medal of Science, and the Presidential Medal of Freedom.

During the beginning of the AIDS crisis in the 1980s, Fauci came under much criticism from AIDS activists who claimed he was withholding experimental treatments from patients. Fauci invited his most vocal critic, Larry Kramer, to his office to learn what the AIDS community needed and to build a relationship with them. He wound up becoming a leading activist himself, creating protocols for patients to receive drugs still in trials and pushing Congress for funding for AIDS research. In the end, Fauci received public praise from Kramer. Under George W. Bush, Fauci helped develop the President’s Emergency Plan for AIDS (PEPFAR), which facilitated alleviating the AIDS pandemic in Africa.

After the September 11th attacks, Fauci established an NIH lab to study potential biological agents terrorists might use. He was the government lead, working with the Center for Disease Control (CDC), during the anthrax scares, the West Nile, Zika, and Ebola virus outbreaks, the 2002 SARS epidemic, and the swine flu pandemic. In January of 2020, he recognized that COVID-19 would be a global threat and started an NIH research team to develop a vaccine.

On January 29, 2020, a White House Coronavirus Task Force was formed, with Fauci being among the initial members. He appeared regularly during the frequent press briefings that were held during the first couple of months of the pandemic. He quickly gained a reputation for speaking to the public calmly but factually, and often delivered updates on new scientific understandings of the disease. He is often heard asking for compliance with regulations and recommendations to slow the spread of the virus, including to stay home whenever possible, to social distance and wear masks, and to wash your hands frequently. On July 31, he testified before Congress saying he was ““cautiously optimistic” a COVID-19 vaccine would be ready by the end of the year.

Fauci often tactfully fact-checks statements from politicians about the virus. Some have accused him of changing his mind about the virus and of destroying the economy. It’s been noted that Fauci did not appear at the later task force press conferences and reported that he is not invited to task force meetings. At one point the current president seemed to offer support for his firing. The head of NIH, Francis Collins, has said firing Fauci “would be unimaginable.” Fauci has received death threats against him and his family, and had to get a Secret Service detail. Asked if he would resign due to the politics he said “No. I think the problem is too important for me to get into those kinds of thoughts and discussions. I just want to do my job.”

Even though he is known for having sixteen hour work days, Fauci stays athletic, running seven miles during his lunch hour for almost his entire career. Recently, due to his extra responsibilities during the pandemic, he has cut the run down to three and a half miles. An avid Washington Nationals fan, he threw out the ceremonial first pitch at their home opener on July 23. Now he often appears wearing a face mask with the team’s logo.

Fauci has had a long and distinguished career in the areas of basic research, medicine, and developing government healthcare policies. Although he will turn eighty this December, he shows no signs of slowing down.

Aileen Marshall

With so many more significant stories in the news recently, you may have only vaguely noticed stories about murder hornets. Is this yet another thing we should worry about? It turns out, not as much as the name would imply. While they might look very frightening, they aren’t going around killing people. However, they may be a problem for our already threatened bee population. 

The insects referred to as murder hornets in the media are officially called Asian giant hornets, or Vespa mandarinia. They are found all over Asia and far eastern Russia, but most commonly in Japan, where they are called giant sparrow bees. In 2008 the name murder hornet appeared in some Japanese news stories. That name was picked up by a New York Times article and has spread ever since. 

The name probably evolved because of their formidable appearance. They can be up to two inches long with a wingspan of up to three inches and a stinger a quarter of an inch long. The thorax is dark brown and the abdomen has contrasting stripes of dark brown to black alternating with yellow to orange bands. The queens are larger than the males, also known as drones or workers. The males do not have a stinger. They can be distinguished from the common hornets found in the United States, Vespa crabro, not only by their size, and also by their different color patterns. A dark brown anterior abdomen and a yellow posterior abdomen with dark brown spots is found on our native hornets.

In September of 2019, a nest of Asian giant hornets was found on Vancouver Island, Canada. That December, there were four confirmed sightings in the state of Washington, with one dead specimen found. The nest in Vancouver was immediately destroyed by the Canadian Ministry of Agriculture. There were two more sightings, one each in Vancouver and Washington as of May 29. The United States Department of Agriculture (USDA) is telling Washington residents to report any sightings. DNA tests showed that the nest in Vancouver and the hornet in Washington came from two different colonies.

While the sting from an Asian giant hornet can be very painful, it is very rarely fatal. Only about forty people a year die from these hornet stings in all of Asia, always from multiple stings. In contrast, sixty to eighty people die from bee stings in this country alone. These hornets are not aggressive and only sting if their nest is threatened. What makes their sting so painful is that a peptide in the venom, mastoparan, stimulates the enzyme phospholipase, which degrades tissue. It also contains mandaratoxin, a neurotoxin. It takes a high volume for this venom to be fatal. It has a lethal dose measurement (LD50) of 4 mg/kg, while the venom of our southern yellowjacket has an LD50 of 3.5 mg/kg. In Asia, people who have died had an average of fifty-nine stings, while most have survived with an average twenty-eight stings. 

These hornets have a life cycle similar to other hornet species. Over the winter, queens hibernate and all the male hornets in the nest die. In the spring, fertilized queens will leave the old nest and start looking for a new spot to build. Asian giant hornets almost always build their nest underground, often in abandoned rodent tunnels. They also like to nest under tree roots, or in the bottom of a hollow of a dead tree. In contrast, our native hornets build their nests well above ground, in tree branches or under roof eaves. After the queen establishes a spot, unfertilized females build the cells in the nest and raise the workers. Then the workers go out and get tree sap to feed to the queens. There is a hierarchy among queens and the alpha queens get fed first. Around July, the unfertilized females stop leaving the nest and die, and the workers continue to go out and get food. By August the nest is usually at its peak of about one hundred workers. 

Asian giant hornet. Photo courtesy of Wikimedia Commons

From August through October, the workers switch to hunting other insects for food, as a source of protein: bees, other hornets, and mantises. A worker will find a beehive and release a pheromone to attract other workers. Japanese bees have evolved a defense mechanism. They will let the hornet in, then many bees will surround it, beating their wings. This generates heat and CO2, which suffocates the hornet. European honeybees that have been introduced into Japan do not have this defense. A single bee will attack the hornet outside the hive, but because of the difference in size, it does not have a chance. The Asian giant hornet will take apart the bee, only carrying its protein-rich thorax back to its nest. If more than one hornet attacks a hive, they go into what is called a slaughter phase. They will keep killing the bees instead of returning to their nest, until all the bees are dead. Then they enter the occupation phase, where they go inside the hive and prey on the larvae. They can kill a whole hive in one to two days. It is not known how bees in this country would react since they have not encountered Asian giant hornets before.

In the fall the fertilized queens produce both male and female larvae and care for them. From October to November males and new queens leave the nest and mate. This is their most active time. Their colors get more intense and queens grow an average of twenty percent larger. Workers then change their food source from proteins to carbohydrates. 

There are two main ways to get rid of these hornets. One way is to burn or apply pesticide to the nests at night when they are asleep. The other way is to set bait traps. These traps have a sweet solution to attract the hornets, but the hornets can’t exit the trap. These are often used by beekeepers to help prevent loss of their colonies. 

There is no need for people to worry about being attacked and killed by these insects. The USDA is vigilant about not letting them become a new invasive species. However if they do take hold in North America, they could be a threat to our bee population, which is already threatened by nicotinamides and colony collapse disorder.

Japanese honeybees (Apis cerana japonica) form a “bee ball” in which two hornets (Vespa simillima xanthoptera) are engulfed and heated. Yokohama, Kanagawa prefecture, Honshu Island, Japan. Photo courtesy of Wikimedia Commons

Aileen Marshall

Not many of us around the Tri-Institutional community have experienced a pandemic situation like COVID-19. News pundits and politicians are saying this is “unprecedented.” But is it? The word “pandemic” reminded me of references to the so-called Spanish Flu of 1918. Though that event was caused by an influenza virus, from a different family than the current SARS-CoV-2 coronavirus, there are similarities between that outbreak and the current one. Perhaps we can learn lessons from the pandemic that happened almost 100 years ago. 

The influenza pandemic started in the spring of 1918 and lasted until the spring of 1919 during World War I. The Allied countries didn’t want people to panic or to distract from the war effort, so they censored reports of the new virulent flu. Spain was neutral, so most reports of the flu came from their newspapers; thus, it became known as the Spanish flu. However, the actual origin of the flu is still unclear.

There are three current hypotheses as to where the 1918 influenza virus started: Kansas, France, or China. A flu-like illness started appearing in Camp Funston in Fort Riley, Kansas in late 1917. It was first reported on March 11th, 1918. At that point more than 100 soldiers had gotten sick and it was spreading quickly. Troops from this camp were shipped to Europe shortly after. Some say that this was not the origin because there was a deadlier flu in New York City at the same time. A 2018 review of the origins of the 1918 pandemic suggests that viral haemagglutinin proteins found in the samples from Kansas were older than those of the 1918 flu. Some think the virus first showed up in Étaples, France in late 1917 where there was an English military camp that was overcrowded with hundreds of thousands of soldiers passing through every day. Pigs and poultry were also kept at the camp, animals suspected of being carriers of the flu strain. And some think this flu started in China, although it’s hard to tell given that records from the country at the time are very sparse. There was a mild flu there at the time, and tens of thousands of Chinese workers toiled behind the French and English lines of the war. A 2018 study by evolutionary biologist Michael Worobey showed that there was no evidence of this flu along the routes the Chinese migrants traveled to Europe, suggesting that China might not have been the origin. This first wave lasted through the spring of 1918. 

The second wave started in August of that year and was deadlier than the first. New flu cases started appearing in France, Sierra Leone, and the United States. This time, predominantly young adults were affected. At Army and Navy training camps outside of Boston, almost half of the soldiers died. Worsening the spread, sick soldiers were often sent on crowded trains to crowded hospitals. In September of 1918, New York City started mandating that flu diagnoses be reported and requiring sick patients to be isolated at home. Many cities closed theaters, schools, churches, and bars and banned public gatherings. Philadelphia, however, decided to go ahead with a war bonds parade. Within days of the parade, tens of thousands were sick, and within ten days, over 1,000 people died. October of 1918 was the deadliest month of the pandemic. The United States recorded 195,000 deaths from the flu. Regulations banning spitting in public were passed. In November, news articles about the disease started appearing more frequently as the virus moved from France to Spain. Quarantine signs were put on the homes of people diagnosed with the flu. Yet this same month, people gathered in large numbers to celebrate Armistice Day. As the second wave ended in December, public health campaigns appeared instructing people to put their tissues in the garbage after sneezing into them. Officials asked businesses to stagger their opening and closing times and for people to walk to work to limit crowding on mass transit. The death rate overwhelmed morgues and bodies piled up. 

Three pandemic waves: weekly combined influenza and pneumonia mortality, United Kingdom, 1918–1919 (figure courtesy of Centers for Disease Control and Prevention)

A third, but smaller wave began in February of 1919. In New York City, only about 700 diagnoses and sixty-seven flu deaths were recorded. During this wave, city hospitals around the country set up studies of treatments for influenza. Efforts were made to implement more nursing school programs to address the nursing shortage created by the pandemic. It is now recognized that this shortage was partially due to a societal reluctance to hire African-American nurses. Near the end of the pandemic, President Woodrow Wilson collapsed during the Versailles Peace Conference in April of 1919; it is thought that he also contracted the flu. 

Thanks to studies over the last few decades, we now know that the 1918 influenza virus was an H1N1 strain, the same type that caused the swine flu epidemic in 2009. Our knowledge of the strain comes from preserved bodies in the permafrost in Alaska, where the pandemic had been particularly lethal to Native Americans, wiping out entire Inuit villages. In 2008, scientists were able to exhume one of the bodies and obtain tissue samples containing the virus. Because of the extreme cold, the viral particles were relatively well-preserved, and they were able to sequence its genome. A study by the Armed Forces Institute of Pathology, the United States Department of Agriculture, and Mount Sinai Medical School determined that a set of three genes enabled the virus to weaken bronchial tubes, which allowed for secondary bacterial infection, such as pneumonia. 

It is now thought that the 1918 flu virus spread so easily throughout the world due to several factors, including military troop movements. Many military installations were overcrowded, and more soldiers died from the flu than in battle. Malnutrition and poor hygiene were more common than today. Interestingly, the flu particularly struck people under age 65, which accounted for almost 90% of the fatalities. This was because influenza caused what is called a “cytokine storm,” an overreaction of the immune system, so young adults with stronger immune systems had stronger overreactions. Furthermore, the disease was not well-diagnosed, as it often caused bleeding in mucus membranes, a symptom not usually characteristic of the flu. There were no antiviral drugs available at the time. It is estimated that about 500 million individuals around the world were infected during the course of the pandemic, or about 25% of the world population. In the U.S., about 28% of the population, almost twenty-nine million, became infected. 

Global fatality estimates run from seventeen million to 100 million, or from 1% to 5% of the world. Estimated deaths for the U.S. run from 500,000 to 675,000, or around 0.5 % of the country’s population. Doctors would prescribe 8-30 grams of aspirin, which we now know is toxic. In fact, many deaths were due to aspirin poisoning. There was a high fatality rate among pregnant women. Studies have shown that children born to infected women had lower education levels and socioeconomic status than the general population. 

Research has shown that cities like Saint Louis, which had early and sustained practices of social distancing and quarantining the sick, were effective in reducing the spread and had very low fatalities. Saint Louis is often compared to the aforementioned situation in Philadelphia that had little intervention and high numbers of deaths. While these effective practices are similar to the situation with COVID-19 today, a significant difference is that influenza was infectious only during onset of symptoms, not like the asymptomatic transmission that is thought to be possible with this current coronavirus. While there are many parallels between the 1918 flu and COVID-19 pandemics, as of this writing, the global number of deaths from SARS-CoV-2 is 128,000 with 26,000 in the U.S., representing about 0.002% of the current population, five hundred times lower than during the flu pandemic a hundred years ago. Nutrition, hygiene, medicine, and communication have significantly improved during the last century. Remember to wash your hands several times a day, avoid touching your face, and distance yourself from crowds so that hopefully this current pandemic will become part of the history books soon.

Face masks made of gauze were widely used but offered little real protection. Nonetheless, these Red Cross workers in Boston assembled masks. “It is our duty to keep people from fear,” said Chicago’s health commissioner. “Worry kills more people than the epidemic.”
(image courtesy of National Archives)

Miguel Crespo

If you thought Dr. Frankenstein was just a figment of Mary Shelley’s imagination, history is about to turn against you. If you believed connecting heads to different bodies was just a gimmick of old-school science fiction comics, here is a slap in the face from destiny. After successfully transplanting hands and even faces, neurosurgeons are now trying to live up to the ultimate challenge of transplanting a head. Yes, you read correctly, this is not a typo.

Dr. Sergio Cavanero in Italy and Dr. Xiaoping Ren in China have already been trying to get around the legal and ethical hurdles that concern such a procedure, and they claim they can make it with more than a 90% chance of success. Detractors call him bombastic, but Dr. Cavanero pays no heed to critics. Most likely, the surgery will have to take place in China because no other country seems willing to permit it yet. Dr. Canavero is known to make unfounded claims and promote his work largely through the media. However, he is an accomplished surgeon with a solvent publication record in top-notch journals.

Dr. Sergio Canavero, who plans to carry out the world’s first human head transplant in December this year.

A similar procedure has already been carried out in mice by Dr. Ren where the spinal cord was sectioned with a diamond blade and the nerves glued back. The miracle was made possible by a chemical known as PEG, poly ethylene glycol by its full name. This amber fluid can break open the lipid membrane, which lines the neurons and fuse together two different cells, thereby allowing them to function as a single hybrid cell.

History is punctuated with attempts of head transplants in dogs and monkeys. The first “two-headed” dog came into being in St. Louis Missouri back in 1908. The bicephalic beast was again generated in the Soviet Union, and lived for 23 days.  In the 1970s, a surgeon named Robert White transplanted the heads of several rhesus monkeys onto others’ bodies. And in January this year, Dr. Ren was able to duplicate the feat. Unfortunately, these animals couldn’t do much more than blink, breathe, and follow objects with their eyes.

The first human to volunteer was 31 year old Russian, Valerey Spiridov. Paralyzed from the neck down, he can barely eat, type, or move the joystick that sets his chair in motion. He suffers from a rare muscle wasting disease. In spite of the surgeons’ optimism, concerns of all kinds have been raised. In the first place, the procedure entails the concert of 80 surgeons working together on the order of days. The limiting step in the process is keeping the brain cold after the head has been removed in order for it to be transplanted onto the donor’s body. The brain suffers irreversible damage within minutes of losing blood flow; cooling the brain can delay damage for up to one hour.

In this procedure, only one hour is available by injecting a liquid into the head blood vessels and recirculating it throughout. Once the surgeons get that down, then comes the rest of the procedure joining of the arteries, veins, muscles, and, ultimately, the skin. Such a procedure requires a great deal of choreography and its cost is estimated at $10-100 million, depending on where it takes place.

Is it worth it? Well, Spiridov himself initially said that he was not signing up for an expensive euthanasia and would not go through the operation unless success is guaranteed. But as the date approached, he announced he will not undergo the surgery.

However controversial, if successful, this procedure would bring hope to those who become immobilized from spinal lesions. But this raises more questions than answers: if according to Drs. Ren and Canavero this technology is available, why not apply it to remedy spinal lesions?

Many scientists and ethicists have slammed the project, accusing the surgeons involved of promoting junk science and raising false hopes. However shaky, others find scientific foundation in the project.

What we know so far is that hearts, livers, kidneys, lungs, uteruses, voice boxes, tongues, penises, hands, and faces can be transplanted. So there’s good reason to think that the next logical step would be the head. However, in this case immunological rejection becomes more of an issue than in the previous instances. And who is rejecting who anyway? Is it the body donor who receives a head transplant? Or is it the head donor who receives a new body from a neurologically dead donor?

Yet another way to look at it, what would happen if an older head was transplanted onto a younger body? Would we be at the gates of life extension technology? Another aspect to take into consideration would be personality. It is known that hormones produced by the body have an effect on the brain. Would this result in a body changing the person’s mood, a head commanding a new body, or a mixture of both? And if so, would the head donor be inheriting the ways of a dead person or imposing his on a corpse?

There’s no previous evidence to back up claims in any direction, and, unfortunately, there is only one way to know.

Aileen Marshall

Most of us here at The Rockefeller University, and the Tri-Institutions, do basic research: figuring out the molecular mechanisms of various life forms. Many of us also do translational research: taking that basic research and applying it towards a product. However, we all do our work for the betterment of the human race, to paraphrase Rockefeller’s motto. We are all concerned in some way, of different aspects of human health. Most of us have probably dealt with some data from the World Health Organization (WHO) at some point in our careers. How many of you know that WHO is currently in the process of electing a new head, the title of Director-General? How much of an impact this will have on our work remains to be seen, but WHO’s work effects many people around the world in some way.

In 1945, Chinese United Nations (UN) delegate, Dr. Sze, proposed the creation of an international health agency under the UN to focus on public health. WHO was finally ratified on April 7, 1948. It was the first specialized UN agency to which every member pledged. In its early years, WHO ran programs to give mass vaccinations for tuberculosis and started a malaria and small pox eradication programs. They started an epidemiological information service that has become a standard today. In 1977, they released their first list of essential medicines: a list of drugs that WHO believes all countries around the world should have on hand. This can be very helpful to healthcare workers and advocates around the world in order to petition their governments for funding for these medications. In 1979, WHO reported that small pox had been eradicated, and with that, it became the first disease to be eliminated by human intervention. In 1986, WHO started its global program on the prevention and treatment of HIV/AIDS around the world.

WHO is currently focused on many areas, primarily communicable diseases such as AIDS, Ebola, malaria, and tuberculosis. It also has programs promoting reproductive and occupational health, nutrition, healthy aging, and substance abuse prevention. WHO encourages countries to develop reporting methods, promotes cooperation between scientific and medical groups, and help governments develop research agendas. Today, it is known as the organization that puts health statistics from around the world in a unified system.

Besides these accomplishments, WHO has also endured controversy and criticism. It reproached the Vatican’s ban on condoms as being dangerous considering the AIDS pandemic, and it has been criticized for its classification of red meat and cell phone signals as possible carcinogens. In recent years, they have had negative media attention for a slow response to the Ebola crisis. Some say their focus is too wide and that the organization engenders too much bureaucratic red tape and internal politics. There have been calls for more accountability and transparency within WHO. There has also been a lack of funding for many of their efforts.

Located in Geneva, Switzerland, today WHO has 194 member states, and offices in Congo, Egypt, Denmark, India, the Philippines, and the United States. It is financed by contributions from member states, the largest contributor being the United States. WHO’s policy making branch is the World Health Assembly, which member states appoint delegates to. The delegates meet annually, usually in May, to vote on matters of policy and budget, and they elect a new Director-General every five years. The next election will have taken place by the time of this publication (at the end of May). The current Director-General is Margaret Chan, a physician from Hong Kong. Currently there are three candidates for the new head: Tedros Adhanom Ghebreyesus, from Ethiopia, Sania Nishtar from Pakistan, and David Nabarro of the United Kingdom. Whomever is elected will take office on July 1, 2017.

DR. TEDROS ADHANOM GHEBREYESUS ALL PHOTOS FROM WIKIMEDIA COMMONS

Tedros Ghebreyesus, 52, was born in Eritrea, and received a Bachelor’s in Biology from the University of Asmara in Ethiopia. He has a Master’s of Science in Immunology of Infectious Diseases from the London School of Hygiene and Tropical Medicine and a Ph.D. in Community Health from the University of Nottingham. He is the only non-medical doctor of the three candidates. Ghebreyesus’ first job out of college was as a junior public health expert for the Ministry of Health of Ethiopia where he worked on methods of malaria prevention. Then Ghebreyesus worked as the head of a Regional Health Bureau. He is recognized for a 20% reduction in AIDS and 70% reduction in malaria cases in that region during his tenure. In 2005, he was appointed Minister of Health. As Minister, he hired over 30,000 health extension workers throughout the country, increased hospital staffing and connected hospitals to the internet. He initiated a program that distributed 20 million insecticide-treated nets throughout Ethiopia. During his time as Minister of Health, deaths from malaria decreased by 50%, new AIDS infections by about 90%, and infant mortality by almost 30%. In 2012, he was appointed Minister of Foreign Affairs where he encouraged Ethiopia to adhere to WHO guidelines during the Ebola epidemic. He is known for having published many papers on malaria. As a candidate for Director-General, Gheebreyesus has stated that he supports strengthening health care systems and universal health care coverage.

SANIA NISHTAR

Sania Nishtar, 54, was born in Peshawar, and received her medical degree in cardiology from Khyber Medical College in Pakistan. She earned a Ph.D. in Medicine from King’s College London. After medical school, she worked as a cardiologist at the Pakistan Institute of Medical Sciences. In 1999, she founded Heartfile, a health policy think tank based in Islamabad, focused on ways to improve Pakistan’s health care system. She has served as an advisor to WHO on many occasions, most prominently co-chairing the WHO Commission on Ending Childhood Obesity. Nishtar wrote Choked Pipes: Reforming Pakistan’s Mixed Health Systems, a book that was published in 2010. In 2013, she was a Federal Minister in the Government of Pakistan, overseeing the Ministries of Science and Technology, Education and Training, and Information Technology and Telecom. In this role she helped establish a Ministry of Health. Nishtar is a member of the Lancet and Rockefeller Foundation Commission on Planetary Health and the Working Group on Private Sector Health Systems established by Results for Development and the Rockefeller Foundation, among many other boards.

DAVID NABARRO

David Nabarrro, 68, is from the United Kingdom and obtained his medical degree from the University of Oxford. In his early years, he was a Medical Officer for Save the Children in Iraq and a District Child Health Officer in Nepal. Later, he became South Asia Regional Manager for Save the Children. Nabarro joined WHO in 1999, first as a project manager for Roll Back Malaria, a partnership among countries to coordinate efforts against malaria. Next, he helped start their Global Fund to Fight AIDS, Tuberculosis, and Malaria. In 2003, he moved to WHO’s Sustainable Development and Healthy Environments division. He was the UN Special Envoy on Ebola in 2014. In 2015, he was Chair of an advisory group on WHO’s responses to outbreaks and emergencies. Now he is special advisor to the UN Secretary-General on sustainable development and climate change, and leading the UN’s response to the Cholera outbreak in Haiti. Nabarro has said that if he is elected WHO Director-General, his four goals would be: sustainable development goals, responses to outbreaks and emergencies, building relations with member states, and people-centered health policies.

By the time this issue comes out, it may be publicly known which of these candidates will be the next Director-General of WHO. Whichever one of the three candidates is elected Director-General, let’s hope WHO keeps up their high standards of statistic reporting and encouraging collaboration between scientific groups.

Yvette Chin

Rebooting the traditional food production model to improve climate and environment is driving innovative entrepreneurs to pursue a vegan path. The resulting alt-foods are, unlike alt-facts, solidly grounded in science, as the personnel list at these companies—data scientists, bioinformaticians, chemists, biologists, nutritionists and chefs—attests. While we already have soy-based meat alternatives, such as tofurky and veggie duck, the challenge lies in faithfully replicating, and even exceeding, the appearance and taste of animal-derived food products using solely plant-derived substitutes.

The most prominent/poster child of these is the Impossible Burger created by Impossible Foods – a one hundred percent vegan burger made with potatoes, beets, coconut oil, and most importantly, a plant version of heme protein—a distinctive component of animal muscles, which gives meat its distinctive taste. The founder of Impossible Foods is aware of the high threshold he has to overcome to win over die-hard meat-lovers. But undaunted, that is his goal—to not simply improve food options for vegans and vegetarians but to convert red in tooth and claw carnivores. So far, the feedback is encouraging with comparisons to turkey burgers.

The Impossible Burger isn’t alone—Beyond Meat, another startup, has a handful of pea- or soy-based “meat” offerings, including the Beyond Burger, Beyond Chicken Strips, and Beyond Beef Crumble that can be cooked just like the meat items they aim to replace. For those of you who failed to celebrate National Hamburger month (May) this is your chance to make amends. The Impossible Burger is served at several establishments countrywide, including BareBurger & Saxon+Parole here in NY. The Beyond Burger is available in grocery stores, including Whole Foods Market.

The stronger green credentials of Impossible Foods’ and Beyond Meat’s approaches are to be appreciated when compared with the efforts of Modern Meadow, a Brooklyn-based biotech company that aims to grow meat and leather in the lab using cultured cells from livestock. While noteworthy and arguably a more difficult undertaking to grow meat from scratch, the trouble with cultured mammalian cells is the requisite fetal bovine serum—a vital elixir for their sustained growth & nourishment—derived from unborn calves’ blood which doesn’t exactly circumvent the environmentally wasteful and greenhouse gas-emitting livestock industry.

Evidently, eggs from cage-free and pastured chickens weren’t sufficiently humane for the founders of Hampton Creek—they decided to get rid of eggs altogether, substituting them with a yellow pea protein as the emulsifier in their vegan Just Mayo. The company has other vegan offerings (salad dressing, cookie dough) and a mission to mine the cornucopia of thousands of plants to create cheaper, healthier and more stable foods than those that are animal-derived.

Living in NY, we are quite spoiled for dietary choice. Even so, one can imagine there can be moments when nothing appeals to the taste buds and yet life must be sustained. At such times, one can reach for Soylent—a completely animal-free food that provides a nutritionally complete meal from soy, algae and other plant-derived components in several easy to consume formats: bottled drink, powder, bar, and best of all, coffiest—breakfast + coffee in one drink. It seems like it was designed with busy New Yorkers in mind—no cutlery or flapping containers to deal with, just chug or chomp and go! For those of us who are neither culinarily gifted nor inclined, Soylent can replace hours of schlepping groceries, prepping ingredients and slaving over a stove before finally indulging in a meal. To some ardent foodies however, Soylent seems abhorrent (not least owing to the sci-fi reference) and only to be resorted to in a food desert.

Our industrial food system provides bountiful affordable nutrition and so the pressure to embrace these innovations is not yet urgent. Do we have this luxury? The human population is set to climb from 7 billion to just under 10 billion by 2050. The climate change debate is raging but the disappearing summer Arctic ice signifies a stark reality. However, a noble impetus to save the earth cannot force adoption of the healthier and sustainable foods 2.0. Ultimately, their success will be determined by the most important factor—taste.

Guadalupe Astorga

April is National Autism Awareness Month. April 2 is a day meant to create consciousness, tolerance and acceptance of people with autism spectrum disorder (ASD). A better inclusion in society is essential to increase their quality of life and expectations.

Autism spectrum disorder encompasses a vast range of behaviors, genetic mutations and neurophysiological conditions. For this reason, it is difficult to find common traits that unanimously describe people with ASD.

It is well known that those with autism have a different perception of the world. They have a strong sensitivity to sensorial stimulus, such as light and sound, that is mild for most people. As these stimuli can be extremely disturbing for people with ASD, they may consequently avoid them with behaviors that appear incomprehensible from the outside. However, it is a natural reflex in all living beings to elude harmful stimuli, it is probably one of the adaptive behaviors that enabled us to survive on earth. How different would these behaviors appear if we were all aware of the reason behind them? Were that the case, we would probably support them instead of meeting them with a frightened expression. It is therefore crucial to generate awareness in society about the sensorial hypersensitivity of people with autism in order to integrate and accept them, instead of excluding them due to ignorance.

There are also notable differences in people with ASD in their ability to localize their attention on single tasks. While it is generally challenging to captivate their attention with things they don’t find interesting, once something has caught their attention they can spend long periods of time focusing on such activities. A great example of this is the number of outstanding artists and musicians with ASD. An open question for scientists and physicians is whether this ability to focus on one thing at a time is also related to their social withdrawal. Understanding the brain circuits required to localize attention as well as those required to establish social interactions and empathy with other people is certainly essential to developing therapies to integrate people with ASD into society. However, understanding and societal acceptance is also crucial to reduce their social withdrawal.

A rather worrisome subject concerns the general panic originated almost twenty years ago about a possible relation between autism and vaccines, in particular the measles, mumps, and rubella (MMR) vaccine. This controversy was originated by a biomedical research article that intended to show that this vaccine caused several behavioral and physiological disorders, including autism. However, strong irregularities during data collection and analysis were found in this work, and it had to be retracted by the authors after no other group could reproduce the results. Extensive research in the past fifteen years demonstrated that there is no evidence for a relationship between vaccines (including ingredients present in them) and autism. Unfortunately, the unfounded belief that vaccines can cause autism continued to grow and spread around the world causing a large number of parents to stop vaccinating their children. This leaves both children and adults vulnerable to severe complications including pneumonia, encephalitis, blindness, diarrhea, ear infections, paralysis, and death.

As vaccine-preventable diseases are nowadays rarely found in several countries, one may think that they have already been eradicated. However, the infectious agents that cause them are still present in some parts of the world and can easily spread and infect anyone who is not immunized. This has already lead to significant measles outbreaks in unvaccinated populations in Austria, Belgium, Denmark, France, Germany, Italy, Spain, Switzerland, and the United Kingdom as well as the United States. This could have easily been prevented by vaccination. We cannot go backwards in history and waste years of medical and scientific advances. The risk of not taking vaccines far surpasses that of taking them. It depends on us to make responsible and informed decisions about vaccination in order to protect ourselves as well as those around us.

Iamge Courtesy of Autism Society of America

Jim Keller

As I’ve said many times one can liken the Oscar race to a horserace with each studio betting on its thoroughbreds hoping to place in the end. The studio is the owner, public relations is the jockey, and the horse is the actor or film in the analogy. Here I’ve included my rankings as they stood on Oscar nominations eve—the number in parentheses indicates my placement following nominations. I chose eight nominees for Best Picture out of a possible ten. All other categories reflect five nominees. The picks that appear in black text within the table were my nominee picks, those in red represent actual nominees that I had not selected.

It’s worth mentioning that from the moment I saw Nocturnal Animals, I knew that Michael Shannon would get a nomination, as evidenced in last month’s column. But as the race headed toward the finish line, Aaron Taylor-Johnson started appearing on the precursor circuit with a win at the Golden Globes and a British Academy of Film and Television Arts (BAFTA) nomination, so I went with him.

With that, I give you my predictions as they currently stand:

Modified from Dr Case/ Kid Image CC

Guadalupe Astorga

When my younger brother was a child, he had a hard time following the teacher’s instructions at school. He was not intellectually incapable, but a restless and vivacious youngster. When the teachers found themselves unable to create any method to capture the interest and attention of this little creature, he was evaluated by a psychiatrist. The result was categorical—he was one of the unfortunate kids diagnosed with attention deficit hyperactivity disorder (ADHD). My mother had to choose between dealing with a lively child or having to medicate him with psychostimulants such as amphetamines. The risk behind these drugs is not only that they do not improve learning abilities or memory, but essentially that they cause strong addiction, psychosis, heart attacks, dysfunction of heart tissue, and even sudden death.

While brain disorders affect as many as one out of every five people, over-diagnosis boosts these numbers due to the lack of specific biological markers in the field, resulting in millions of people over-medicated with antipsychotics, psychostimulants, pain relievers, and tranquilizers.

Particularly alarming is the dramatic increase in antipsychotic prescriptions in children under eighteen, including infants between one and two years old. Stimulants like amphetamines are chronically prescribed to adults, children, and toddlers diagnosed with ADHD in order to improve their concentration capabilities. But, why obsess over a toddler’s concentration? Do they need to be under the effect of one of the most addictive and destructive drugs to receive love and adequate boundaries as they grow up?

For a kid that is constantly bombarded with excessive information, duties and activities, focusing is not trivial. When I was a child (and that now feels like a long time ago), children had tons of free time to play and socialize with other kids, to struggle with their homework, to develop their creativity by building new toys from old pieces of wood or cardboard, and to think about the failures and victories in their hitherto short lives. Nowadays, modern society has brought technology deeply into our intimate spaces, even those of children. Surrounded by tons of electronic devices, video games, and TV shows, kids no longer struggle to create their own entertainment, they are constantly bombarded with more information than they can assimilate, and they don’t have time to get bored. If we also consider that couples are having babies at older ages, often helped by fertility treatments, the scene looks very scary, with kids being a precious trophy that must be protected at any price. This is a well-known psychosocial phenomenon known as “helicopter parents”, middle class couples that behave in an over-protective way, hovering above their kids at every moment, making them insecure, anxious, highly dependent and depressed.

We should ask ourselves as a society, as a health care and educational community, whether this form of parenting is responsible for the high levels of anxiety, depression and attention deficits shown by our children. How can we justify giving psychostimulant medication, such as Adderall or Ritalin, to toddlers? These drugs will not increase their learning capabilities, nor their memory capacities. Isn’t this a case where the remedy is worse than the disease?

Before prescribing a stimulant drug to a toddler or a child, we must be aware of their psychosocial environment and ask ourselves whether chronic medication is going to make their lives better.

Fernando Bejarano

Leslie Vosshall Photo by Fernando Bejarano

Last year, gender inequality in science hit the headlines of numerous major scientific journals. Several remarks from notable scientists about their thoughts on women working in science brought up again the dearth of women in STEM (science, technology, engineering and math) fields to the public consciousness. According to the US Bureau of Labor Statistics, nowadays women make up almost half of the total US workforce and half of the college-educated workforce. However, women are much less represented in STEM fields, holding less than a quarter of the STEM jobs.

It is known that women hold a low share of undergraduate STEM degrees. It is curious that women with STEM degrees are less likely than their male counterparts to become STEM professionals. On the other hand, women with STEM majors are twice as prone as men to work in healthcare or education. One imagines that there are many factors contribute to this disparity of men and women in STEM fields, such as gender stereotyping, lack of female role models, less family-friendly flexibility, motherhood or even gender biased hiring.

There is considerable research demonstrating gender biased hiring practice in a variety of fields, but do these practices also plague the science field? A study published by Moss-Racusin et al. in PNAS (2012), tells us that these types of practices not only occur in science but they are more common than we imagine, happening frequently in a field where its members have been rigorously trained to be objective. You may be surprised to know that if your name is Jennifer your chances of working in science, technology, engineering or math are considerably lower than if your name is John. It won’t make much difference if your name is Mary, Lisa or Amy. There is a disparity when you compare yourself with other male opponents such as Charles, James or Brian. You will also make less money for the same job, and if you ever get a tenure track position in an elite institution you will be surrounded by many male colleagues. Such is the worrisome situation of women in science presented by this study.

However, looking at the career of our guest, you could think that things would be different if your name was Leslie Vosshall. Success seems to follow her around. She managed to thrive in a challenging environment, while achieving a meteoric rise to excellence in science. Her career could be considered as a perfect illustration of gender equality pursuit in biosciences. Born and raised in New York City, Vosshall received her B.A. in biochemistry from Columbia University, and her Ph.D. in molecular genetics from The Rockefeller University (RU). After graduate school she returned to Columbia University for her postdoc under the mentorship of Nobel Laureate Richard Axel. Leslie Vosshall has made important discoveries in the field of olfaction since her early days in as a neuroscientist. She started by decoding the olfactory sensory map of the very cute fly Drosophila melanogaster. Her scientific discoveries continue to unveil the mysteries of the brain, covering a variety of models from insect to human. After a successful postdoc, she came back to RU as an assistant professor, where she currently holds the position of Head of the Laboratory of Neurogenetics and Behavior. She spent years having fun with pheromone perception, odorant receptors, chemotaxis behavior, odor memories, and building a molecular architecture of smell in flies, mosquitoes and vertebrates. In another era, she could have been the most prosperous perfume chemist in all of Europe. Let’s say that with her proficiency, she would have blown away the sense of smell of Louis XIV! With the Sun King in her favor, I imagine her as one of the most influential people in the eighteenth century Versailles Court.

Once again, knowledge is power and whether in the eighteenth or the twenty-first century, it is no doubt that she is an outstanding female role. As a sign of quality, we can observe a consistency in her publications in top peer-reviewed journals. She also manages to share time with her family, including two children. During her career she has been the recipient of many awards and honors: the Prize for Innovative Research in Neuroscience by Duke University, the New York City Mayor’s Award for Excellence in Science and Technology and the Presidential Early Career Award for Scientists and Engineers (PECASE) among others. In 2015 she was elected to the National Academy of Sciences, quite an outstanding achievement reserved only for top leading researchers, and where every year only a few women are picked to be part of this select group of scientists.

I am certain that her career path was not easy; that it was hell until she got here; but also despite the draining effort, she enjoyed it all along. I assure you that she would not switch places with any male coworker, or have chosen a non-STEM career. Leslie Vosshall would do it all over again for gender equality in science, for a more family-friendly environment in STEM careers and for the future generations of women participating in life sciences.

This is what Leslie told us: Continue reading →