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March 2018 in Genomics with Nathan & Laura: DTC BRCA and Revisiting All of Us

23andMe steals the headlines yet again.

“If somebody is worried about breast cancer susceptibility in their family, they should certainly not be using this test.”

That’s our monthly commentator and genetic counselor, Laura Hercher, talking about BRCA going DTC. But wait a minute. Then she says the test could be good in some instances.

Fellow commentator Nathan Pearson cracks us up with his new term for the NIH’s All of Us Research Program. We question the big science project after the New York Times reveals that several major institutions, including Geisinger and Kaiser, are pulling out.

It’s Nathan and Laura back to offer their inside take on the lead genomic stories of the past month.

And no matter what, we won’t mention 23andMe again next month. We hope.

February 2018 in Genomics with Nathan & Laura: 23andMe Goes for the Gold, Trump Year One

Booking 26 million viewers, the voice of Warren buffet, the endorsements of Olympians Joey Cheek and Tara Lipinski—this company was going for the gold with their ads during the Olympics this year. Of course, we’re talking of the direct-to-consumer genetic testing company, 23andMe. What was the take of our monthly commentators, Nathan Pearson of Root and Laura Hercher of Sarah Lawrence College?

Also, for all the doomsday predictions, has Donald Trump been any worse after one year for our industry than the biohacker?

Join us for this month’s look back over the headlines.

George Church on What Comes After CRISPR

George Church joins us today. He’s the Robert Winthrop Professor of . . . . well, he’s George Church. And he confirms that, yes, a movie called “Woolly" is being made about his lab. In the next breath, he reminds us (and himself?) that less than 1% of his press is about the woolly mammoth.

George was honored this year as one of Time Magazine's "Time 100 List", and we’re curious about what topics of conversation come up when he’s with non-scientists. What does he think of Trump (or what he calls “the new politics”)? Is he tempted to join the wave of scientists running for office?

“In China, about 80% of their top government officials have a degree in science or engineering, while in the United States it's closer to 1%,” he deadpans.

We cover some scientific ground today as well. George says CRISPR has been overhyped as the step between Zinc Fingers/Talens and the next gene editing tool. So what is the next CRISPR? And what ever came of his 3-D sequencing?

Enjoy.

Is Population Medicine Failing Us? Michel Accad

Is health the same thing for an individual as it is for a population? This question goes to the foundation of how we practice medicine today and that of most of genomic research.

Michel Accad is a cardiologist in San Francisco and the author of a new book, Moving Mountains: A Socratic Challenge to the Theory and Practice of Population Medicine, in which he uses Socrates to spar with Geoffrey Rose, a British physician and one of the architects of modern medicine.

As early as the 1950’s, Rose advocated for the idea that individuals should be treated based on bell curves of an entire population, essentially risk based medicine. This philosophy would lie at the heart of not only the British National Health Service but many public health programs. It informed the famous Framingham studies here in the U.S. In fact, the term “population medicine” is a very positive term for those working in healthcare today. Genomic medicine has been an outgrowth of population medicine.

Michel says this philosophy is failing us at the level of individual health. Third party payers, be they governments or insurance companies, are in their offices working a system based on large datasets. They develop algorithms using all kinds of risk studies. But these payers have little to no contact with the actual patients. Ironically, he says, we call it personalized medicine. Michel points to hypertension, a disease area where sixty years after Rose pushed for risk studies, cardiologists are still divided into camps over whether to treat a patient if their blood pressure lies above the average. Michel argues that population medicine is utilitarian and ultimately utopian. What are framed as scientific studies are really social engineering.

What about clinical trials, we ask Michel. Don't population studies bring doctors and patients many good drugs?

In the second half of the interview, Michel points out that a mechanistic view of biology dominates clinicians and scientists today. It’s true. Our guest last week, a well known geneticist from Stanford, compared people to cars, arguing for the need to wear health data gathering sensors.

"Right now among philosophers of science, there’s a recognition that “mechanism” is inadequate to explain cellular organisms."  The study of biology also has often been developed with tautologies, he says.  "For example, say you’re studying the beaver and you ask what is a beaver. The standard answer is to go to the genetic sequence. From the genetics, you say you have a beaver. But you have to know what beavers are in the first place in order to study a beaver. It’s a circular argument."

So what other models might we use in biology? And what can we do in healthcare if we’re not using large population studies--go back to blood letting?

Over $1 Billion Invested this Past Year: Synthetic Biology in 2017 with John Cumbers

What does it take to make it in synthetic biology in 2017?

Working as a bio engineer at NASA, John Cumbers founded SynBioBeta, the primary “activity hub” for the synthetic biology community. SynBioBeta will be putting on their sixth conference this year in San Francisco, along with conferences in London and Singapore. The young industry has seen a flourish of startups working on new genome engineering tools and a dizzying array of applications that include synthetic animal meat and synthetic human skin. Last month John partnered with Data Collective to launch a new seed stage fund for this space.

John is not only interested in startups. Currently writing a book with the working title, “What’s Your Bio Strategy?”, he is provoking existing companies to consider using biology as technology.

“The book is designed to be something we could take into [Apple CEO] Tim Cook’s office, and ask him what’s your bio strategy. And he says, 'I don’t have a bio strategy.' So you put the book on his desk and say give me a call if we can help you to develop one.”

When we first talked with John, he was heading up a program at NASA to develop building materials for use on Mars. Five years later, is John's number one goal in life still to settle the solar system?

With 50 Million Users, Is Academia.edu Speeding Up Science?

Today we follow up with Richard Price, the founder and CEO of the most popular social sharing site for the academic sector, Academia.edu. When we talked to Richard almost five years ago, the site had 1.5 million users, mostly academics sharing their own papers so that their peers had access without any paywalls. Today the site boasts over 50 million users and serves as a laboratory for the future of academic publishing.

It’s not hard to understand the site's phenomenal growth. Weathering the hit back by Elsevier and other prestige publishing houses, Academia.edu has been able to open up access to millions of scholarly papers which otherwise would not have been accessible. And the papers are not only available to academics. Anyone can get an account for free. Richard recently found a farmer from Sub-Saharan Africa downloading a paper on water conservation.

In addition, many users now choose to publish on the site rather than with an established journal. An emeritus professor at Berkeley told Richard this:

“If I publish in a journal, it takes two years to come out and seventeen people read the paper. If I upload to Academia, I get 100 views in the first week."

It's a success story in terms of uptake by the scholarly sector, but what does this success mean to Richard and the company, and to its users and the future of publishing?

So far revenue sources are limited. Experiments with a premium service have had mixed results with users pushing back and arguing that "open access to scholarship should be a human right, not a business model." How will the site, which requires huge infrastructure, sustain itself?

Richard said before that the site could speed up science. Has it?

Join us behind the scenes with the mastermind of Academia.edu.

A Republican Staffer on the Gottlieb Hearing

This week at a Senate hearing Scott Gottlieb defended his nomination to be FDA commisioner.  Last night at happy hour we caught up with a Republican staffer who was willing to be candid in exchange for remaining unnamed.

 

Staffer:  Oh, yeah, the Gottlieb nomination.  Sweet little thing.  The nomination, I mean.  Seems like the hearing was weeks ago with this whole “nuclear” warfare going on in the Senate over Gorsuch.  

Mendelspod:  The Republicans looked pretty pleased with Gottlieb, as did some of the Democrats.

Proposed NIH Cuts, Undermining GINA, and Game Changing Drugs: March 2017 with Nathan and Laura

The largest cut to NIH budget ever, rolling back genetic non-discriminatory law—the bad news continues to roll from Washington. But there was great news this month as well.

Both Nathan and Laura are fuming about HR 1313, or a Republican bill to roll back GINA protections. Laura points out that the proposed law builds on an exemption in GINA for wellness programs—a category difficult to define. And Nathan reminds us that families and children could be hurt by the new bill. Theral asks since when did privacy become partisan? GINA passed in ’08 with a vote of 95-0 in the Senate, 414-1 in the House (Ron Paul playing the weirdo there), and it was signed by George Bush.

Then on to some “game changing” drugs for multiple sclerosis and eczema and a successful gene therapy trial for severe sickle cell anemia. Not only are there new therapies, drug manufacturers seem to be getting the message on pricing.

Art in the Lab (Falling in Love with Bacteria)

Today’s guest makes time to create beauty in the lab. Memo Berkmen is a bacterial artist along with being a staff scientist at New England Bio Labs. He and his colleague, Maria Penil, were the winners of the American Society for Microbiology’s agar art contest in 2015. Their felicitous relationship with the unseen, often unnoticed, world of ancient organisms fills us with wonder and inspiration.

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Bacteria art by Memo Berkmen, Maria Penil

Democracy and Science Have Tea at the White House

The wheels on his navy blue Toyota Prius could be heard squeeling as Science wound down the parking structure in Bethesda.  Yes, it's true, Science's parking spot involved two stories and some undwinding to get out on the open road.  Today Mr. Science was headed to the White House for tea with Ms. Democracy.

As it happens, on this particular day, our Mr. Science is a religious man.  One doesn't know how it happened.  It just happened.



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