This unsettling image of a doll meeting her untimely end, carries a deadly serious purpose. It is a close up portrait of one the twenty miniature crime scenes created by American heiress and criminologist Frances Glessner Lee in the 1940s and 50s. Termed ‘The Nutshell Studies of Unexplained Death’, each of these macabre dollhouse scenes was based on a composite of actual crimes. Their purpose was to train police investigators in a more methodical approach when observing and collecting evidence, while encouraging better interaction between law enforcement and the medical community. The Nutshells are still used for police training in Baltimore today.
Our featured image this week was created by artist and author Corinne May Botz, who spent several years photographing the Nutshells and researching the work and life of Glessner Lee. She was particularly fascinated by the ways in which these meticulously crafted crime scenes, created by a self-taught, wealthy socialite, subvert the notion of the home as a safe haven, especially for their (mostly female) victims. Her photographs magnify Glessner Lee’s miniature worlds of domestic violence to an unnervingly human scale.
A selection of Corinne May Botz’s compelling photographs are on display, alongside one of Glessner Lee’s original Nutshell studies, as part of Wellcome Collection’s new (and free!) exhibition ‘Forensics: The anatomy of crime’, which opened this week.
There is an increasing body of evidence to suggest that significant quantities of medicines and medical products, especially in low and middle-income countries, are of poor quality. Malaria researcher and drug quality expert Professor Paul Newton, of the Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit in Laos, explains the latest research findings and explores some of the recommendations to improve medicine provision for clinical trials…
Substandard medicines (due to errors in factory production) and falsified medicines (due to criminal fraud) are profoundly neglected global health problems. Poor quality drugs have the potential to deny patients and their families the full and expected benefits of modern medicine.
Global and national health policy decisions are often made using evidence generated from clinical trial reports. Until recently it was believed that trials were immune from the issue of medicine quality. However, recent research investigations suggest worrying evidence of poor quality medicines administered during patient trials.
Clinical trials are the trusted method of providing the results needed to make important policy decisions about whether medicines are safe, efficacious and provide value for money. Patients who volunteer to participate in trials do so with the knowledge that the results will be reported transparently, and without bias, so that ultimately many other patients can benefit from the scientific findings.
Policy guidelines have improved the practice of medical research, especially clinical trials, and helped to ensure that trials are more carefully planned, implemented and reviewed. However, some guidelines need to be strengthened further to include clear guidance on how to monitor and safeguard the quality of medicines used in patient trials.
Working with a team of international medical experts, we recently compiled a number of findings published today in the British Medical Journal. The results highlight the apparent inadequacies of existing clinical trial guidelines, and the absence of sufficient checks in place to safeguard the quality of medicines used during patient trials.
One report of antimalarial drugs that were planned to be used in pregnant women in Africa, describes that one of the brands contained less than 90% of what the label stated. Our study also describes problems with a trial of the efficacy of vitamin A in Tanzania, Africa. Thirteen months into the trial it was found that the amount of Vitamin A supplement had deteriorated to only 32% of the stated amount of vitamin A, despite appropriate storage conditions.
Perhaps surprisingly for some, our research team found that the issue is not just confined to the developing world. A cardiac drug shipment worth £1 million was sent from the UK to a pharmaceutical company in the USA in 2007, for use as a comparator in a clinical trial. Suspicions raised by the tablets’ weight led to the discovery that the entire consignment was falsified, containing only 50-80% of the drug stated in the consignment.
As a global health community we should call for urgent changes in the guidance for checking the quality of clinical trial medicines. Guidelines such as the Consolidated Standards of Reporting Trials (CONSORT) and the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) guidelines, be adapted to require that researchers clearly state the quality of medicines and any other medical products used in their clinical trials.
In addition, global health bodies should review more closely the current pharmaceuticals market, where globalisation of production, coupled with insufficient regulatory overview, has created a situation where medicines may be of wildly varying qualities.
If the standards aren’t tightened, it is likely that poor quality medicines used in medical research may lead to wrongful conclusions that useful medicines are not useful and that harmful medicines are safe to use.
If these critical amendments are made, the chain of evidence for health policy decision-making should be significantly reinforced, less money on trials will be wasted and patient confidence restored in the quality of medicines being used in clinical trials.
Read the full research findings in the British Medical Journal, and discover more of Paul Newton and colleagues’ work on Antimalarial Drug Quality at the Worldwide Antimalarial Resistance Network (WWARN).
After four hours of intense debate in the House of Lords, peers have voted to approve regulations that will allow mitochondrial donation to be licensed for use. The techniques, pioneered by scientists at the Wellcome Trust Centre for Mitochondrial Research at the University of Newcastle, give hope to families suffering from mitochondrial disease. Wellcome Trust Director, Dr Jeremy Farrar shares his thoughts on this momentous decision…
Families who know what it is like to care for a child with a devastating disease are the people best placed to decide whether mitochondrial donation is the right option for them.
Parliament is to be commended for a considered and compassionate decision to give these families that choice, with proper safeguards under the UK’s internationally-admired regulatory system.
Parliament’s decision is a credit to the patients, scientists, doctors and ethicists who have worked so hard over the past decade to explain this complex research to politicians, the public and the media, and to the exemplary process for reviewing scientific, ethical and public opinion led by the Human Fertilisation and Embryology Authority.
We have again seen how science advances most effectively through engagement with wider society.
If you want to find out more about the techniques, scientific and ethical reviews and the public consultation that were mentioned today’s debate before the vote to allow the technique to be used, check out the Wellcome Trust policy pages. The first applications to the HFEA for mitochondrial donation could come later this year, you can read our previous posts on the subject on our blog.
In a climate of rising fear over the diminishing efficacy of antibiotics, Wellcome-supported microbiologists have looked back at the bacteria-killing substances of the pre-antibiotic era – toxic metals. Jemima Hodkinson looks at how resistance to these metals may be linked to drug resistance in bacteria…
Dr Jon Hobman, University of Nottingham, and Dr Lisa Crossman, from the University of East Anglia, recently published a review of bacterial antimicrobial metal ion resistance in the Journal of Medical Microbiology. Their article concludes that the ancient pathways of resistance that bacteria have evolved against metals such as mercury, copper, arsenic and silver may be intimately linked to the antibiotic resistance genes that are circulating in bacterial populations today.
Metals and metallic compounds have been used for medical and biological purposes for millennia: as antiseptics, diuretics, and dental fillings; cosmetics, tonics and chemical weapons. Most are indiscriminately toxic, and you have to wonder whether some of these historical cures were actually worse than the ailments they were intended to treat. Mercury-laced teething powder, anyone?
Metals and their ions can damage cells in multiple ways: binding to enzymes, DNA and membranes, disrupting their function; taking part in reactions that generate harmful free radicals; or binding to the cell’s pool of antioxidants that usually protects against free radicals. It is the lethal damage that these mechanisms can inflict on bacterial cells that underlies the utility of metal compounds in controlling infections in plants, animals and humans.
However, bacteria have evolved their own defences against the toxic effects of antimicrobial metals, as they have also done with modern antibiotics. Some methods are generic, such as stress response mechanisms and efflux pumps, which try to bail toxic molecules out of the cell faster than they can come in.
Others are specific weapons against particular metals or ions: these are controlled by a response regulator, a neat signalling system that turns on the genes for the cell’s defensive response when it senses the ion present in the environment. For example, the method that bacteria use to protect themselves against mercury ions involves a protein which ferries the ion into the cell, then hands it over to an enzyme that converts it into non-toxic mercury molecules, which can then diffuse out of the cell. Scientists have identified related mechanisms for several other metals; many are ancient, evolved over millennia in response to metal ions present naturally in the environment.
Today, use of all but a few metals in medicine has now been phased out, superseded by safer, more effective modern antibiotics. Should we care that E. coli is resistant to arsenic, or that mercuric chloride might no longer cure your syphilis?
Thanks to a dramatic increase in available microbial genome sequences, there is increasing evidence that metal ion resistance and antibiotic resistance are linked by being carried on the same mobile genetic elements that are capable of being moved between bacterial species and strains. Antimicrobial metal resistances could be contributing to the more pressing problem of resistance to modern antibiotics.
When mercury resistance was beginning to be reported in clinically important bacteria in the 1960s, it was found to be genetically linked to penicillinase plasmids in S. aureus. Comparing these clinical isolates with samples from the ‘pre-antibiotic era’ – some from 10,000 year old Siberian permafrost, others from the first half of the 20th century – leads the authors of this review to conclude that the Tn21 family of mercury resistance transposons – a type of mobile genetic element – could have evolved stepwise into multi-drug resistance transposons, eventually carrying genes conferring resistance to streptomycin, chloramphenicol and tetracycline as well as mercury.
This evidence for the co-carriage – and potential for co-selection – of metal ion resistance and antibiotic resistance genes could be important when thinking about approaches to combat antibiotic resistance, particularly given the increasing use of metals with antimicrobial properties in consumer products, from plasters to water filters.
It could also provide a worrying glimpse into the future of resistance to modern antibiotics. Current advice emphasises the need to limit use of antibiotics, on the assumption that reducing the pressure for bacteria to carry resistance genes will lead to their loss by natural selection. However, mercury resistance has persisted despite the fact that antimicrobial use of mercury compounds has all but stopped – a phenomenon that the authors admit is surprising.
Could antibiotic resistance genes persist in bacterial populations in a similar way, even if use declines?
Hobman and Crossman’s article also reminds us that microbiology can often take a human-centric view. While antibiotic resistance to modern antibiotics is usually seen as a problem of treatment failure, the way that resistance genes spread is an ecological problem. Understanding this could provide important lessons for future attempts to manage antibiotic resistance.
You can read the full article, Bacterial antimicrobial metal ion resistance, in the Journal of Medical Microbiology. Jemima Hodkinson is on the Wellcome Trust Graduate Development Programme and you can find more details of the scheme on the Wellcome Trust website. This post was originally published on Microbe Post – the blog from the Society of General Microbiology.
Image Credits: Top: Mercury byLa Belle Lumière on Flickr, CC-BY-NC-ND, Arsenic and Treatise on Mercury from Wellcome Images
Our fortnightly round-up of work from the Wellcome Trust community…
The secret life of pollinators in the city
Cities should not be overlooked as important havens for bees according to research by a team of scientists from universities across the UK.
Pollinators such as bees play an important role in ecosystems but very little is known about how they interact in urban landscapes. With more and more people living in cities, researchers decided to compare and contrast pollinator populations in urban, agricultural and protected landscapes around the UK.
The study, published recently in Proc. R. Soc. B, surveyed 12 large urban centres in the UK. For each city, a nearby nature reserve and farmland site was also surveyed. They recorded a total of 7,412 insects which were visiting flowers. In the study, 11 rare or scarce species were recorded, four of which were found in urban habitats. The ‘species richness’ of bees – the number of species in a given area – was found to be higher in urban zones than farmland site, although there were fewer hover-flies in urban areas.
The team, led by Dr Katherine Baldock of the University of Bristol, said urban landscapes deserve more attention in the drive to protect bees from decline. “Urban areas could be managed in a way to be good to pollinators. What we need to know next is which habitats within urban areas are good for pollinators”, she said.
The research was funded by the Insect Pollinators Initiative, a joint venture between the BBSRC, Defra, NERC, the Scottish Government, the Wellcome Trust, and LWEC.
Genes identified as drug targets for allergies and asthma
34 new genes that make people more likely to suffer from allergies and asthma have been identified, some of which could be targets for new drugs.
This research, published in Nature and led by scientists at Imperial College London, could lead to new treatments for allergic diseases, and help to predict who will respond best to currently available treatments.
The work, involving researchers in the UK, US, Canada and Sweden, studied the genes that regulate the immune response in allergic reactions and asthma. The team looked at ‘epigenetic changes’, which do not affect the genetic code itself but which influence the activity of genes.
Using this approach, the team were able to locate genes that regulate the antibody involved in triggering allergic responses. This antibody, called immunoglobin E (IgE), was known to researchers already but until now scientists had been unable to identify which genes control its activities.
They found strong associations between IgE and increased activity in 34 genes. In people with asthma, these genes are overactive, making them produce more IgE, which contributes to symptoms of asthma.
Professor Miriam Moffatt, Wellcome Trust Senior Investigator and one of the study’s authors said: “The genes we identified represent new potential drug targets for allergic diseases as well as biomarkers that may predict which patients will respond to existing expensive therapies”.
Their research was supported by the Wellcome Trust.
Study predicts Ebola cases in Sierra Leone
A model produced by an international team of researchers suggests that cases of Ebola have peaked in Sierra Leone.
Between August and November 2014, the incidence of Ebola rose dramatically in several districts of Sierra Leone, meaning treatment centres were stretched past capacity and were lacking beds. During December, additional beds were introduced, and incidence declined in many areas. This study, published in PLoS Current Outbreaks, aimed to measure patterns of future demand to help doctors better prepare.
To do this, researchers based in the UK, Switzerland and Sierra Leone and led by the London School of Hygiene and Tropical Medicine used a mathematical model of Ebola infection to estimate how the extent of transmission in the nine worst affected districts of Sierra Leone changed between 10th August 2014 and 18th January 2015. Using the model, they forecasted the number of cases that could occur until the end of March 2015, and compared bed requirements with expected future capacity.
They found that, although Ebola incidence has varied over time and space in Sierra Leone, results suggest that the epidemic may have now peaked. Current numbers of beds appear to be sufficient to keep the epidemic under control in most districts.
The research was funded by R2HC, which is a partnership between the Department for International Development (DFID) and the Wellcome Trust, aimed at improving health outcomes by establishing a strong base of evidence about public health interventions during humanitarian crises.
In other news…
Last week saw the performance of songs developed through partnerships between young people, sexologists and songwriters from across the UK, looking at how sex and sexuality is represented in music and lyrics. You can listen and read about their work here and our most recent image of the week is also about the project.
Brain signatures of intrusions of thought while falling asleep are reported in a paper by Trust-supported researchers in Frontiers in Psychology Research.
A Wellcome Trust funded film about Antoine Yates, who kept a tiger called Ming and a large alligator in his high-rise New York apartment for several years, was screened last Wednesday at the Tate. You can see the trailer here.
Image credits: Wellcome Images
“[It] was the best day of my life… I’d do anything to live that day again!” – A young artist talks about Sounds of Sexology
This picture shows a group of artists performing their music at Sounds of Sexology showcase earlier this week at the Roundhouse. The event was the culmination of months of hard work, talent and passion, as five groups of young performers – from Manchester, Glasgow, Brighton, Havant and London – have worked in partnership with songwriters, sex researchers and incredible youth music organisations on a nationwide Sexology Songwriting project that saw explorations of sex and relationships transformed into touching (and at times provocative) musical works.
Topics like lust, love and consent; the history of sex research; relationships and sexuality inspired an evening of music that touched everyone there (and everyone watching on the live-stream at home). One of the groups looked at young people’s sexual values and experiences, and came up with tracks that championed the right to feel confused and conflicted about relationships. Another focussed on LGBTQ issues and poked fun at the notion that the legalising of homosexual marriage might provoke freak weather incidents…
Event host Greg Foot, one of our Public Engagement Fellows, introduced the aims of the project and welcomed each group in turn, getting them to say a little about the experience of being involved in this project – even the shy ones. As the young artists took to the stage, it became obvious that the songs had personal importance to each and every one of them, and their performances took on extra levels of meaning – there were definitely some leaky eyes in the audience. The evening was neatly rounded off with a special guest performance from Dan Gillespie Sells, songwriter and frontman of UK band The Feeling, who gave an insight into his personal experiences with sexuality as well.
The audience were blown away by the talent of the young artists, who despite having totally different musical styles and experiences – from rap and spoken word poems, to acoustic guitar numbers and indie tracks with multi-part harmonies – threw themselves into their performances and made everyone involved feel truly proud.
All the songs from the project will be made available on the Wellcome Collection website soon, but in the meantime, you can catch a selection of the performances on the Roundhouse website, or visit The Institute of Sexology to hear some of the songs at listening posts in the exhibition that inspired the project.
Image credit: Level Up, the group from Manchester, courtesy of Roundhouse Rising, Daily Motion
Dharavi in Mumbai, India, is one of the largest informal settlements in the world. This month, it was transformed into the Alley Galli Biennale, a festival of art, health and recycling. The festival is the culmination of two years of passionate collaboration and has been supported by the Wellcome Trust. Helen Latchem looks after the Wellcome Trust’s international public engagement work and she visited the Biennale for its opening. This collection of vibrant photographs captures the spirit of the festival – the artists, scientists and activists who are taking part - and Helen explains why international engagement is so important…
Community engagement with biomedicine in low-income settings is fundamentally important, not only because health research is best directed and informed by people who are facing health challenges every day, but also because researchers working in areas like Dharavi need ways of engaging people with their research and ultimately changing things for the better.
This project began by looking at women’s health issues but has developed into something much deeper which delves into the underlying systems from which these problems, and many others, are born. It reveals, questions and celebrates many of the factors at play in a vast community like Dharavi, both medical and personal, but also environmental, cultural, economic and political.
I was only in Mumbai for two days, and I’m finding myself struggling to convey the power that this type of project has in portraying the complexity of the lives of Dharavi residents. It not only uncovers some of the intricacies of how people navigate the challenges and opportunities of their world, but also beautifully demonstrates that it is a world of huge contrasts.
As part of the festival, a stunning modern installation by artist Nitant Hirlekar called ‘Hope and Hazard’ explored the positive impact that Dharavi-based industry has on India’s economy, yet at the same time highlights the negative impact much of this labour has on the health and wellbeing of the residents. Workers in Dharavi are fundamentally connected to the system but yet in many ways as ‘slum’ dwellers, they are not recognised by it.
This project has grown into something bigger and more far-reaching than I think anyone ever expected. Beauty, art and telling stories have caught the imagination of people in Dharavi and this is spreading out into Mumbai and the rest of the world. Nayreen Daruwalla and David Osrin – the project directors – the core project team, local creatives and volunteers should be immensely proud.
I arrived at the inauguration event on Sunday, having been told on the way that the audience was modest like a ‘small wedding’, and was faced with hundreds of people engrossed by a drama piece about TB using giant puppets. It not only made me realise that weddings must be huge here but also that there was more interest and enthusiasm in that giant dusty ‘theatre’ than I’d seen at a lot of UK engagement events.
The exhibition spaces of the Biennale are tucked away in the alleys of Dharavi and visitors can happen upon them whilst going about their day. I found that the volunteers at each exhibition were so keen to articulate to me, despite the language barrier, the value and importance of the artworks to them. In particular with the images of women in colourful saris from a project ‘Provoke and Protect’ which were like magic eye pictures – on first viewing so happy and vibrant – until the Hindi was translated for me, and the message became clear: “Stop Rape”.
Image credits: Benita Fernando ©Dharavi Biennale, Sneha
Dr Daniel Streicker is a Wellcome Trust/Royal Society Sir Henry Dale Fellow at the University of Glasgow. His research looks at the way that pathogens are transmitted between species, with a hope that a better understanding of the ecological and evolutionary factors will allow us to prevent disease spread in future. Daniel has spent time in Peru investigating the frequency that vampire bats spread rabies to humans and livestock – and not managed to escape their bites! Here he shares his passion for his work, and some great advice from his former lab…
What are you working on?
Some of the most important emerging infectious diseases occur when pathogens are transmitted between species. Dramatic examples include the ongoing Ebola outbreak, the SARS outbreak of 2003 (both likely seeded by bats) and HIV (originally from non-human primates). But, the same epidemiological phenomenon underlies major public health and agricultural burdens from pathogens that don’t necessarily spread in humans or domestic animals, but recurrently emerge from other species.
Which pathogen will emerge next, from which host species, and where it will happen? These are some of the biggest questions at the interface of ecology, evolution, public health and veterinary medicine. We are applying tools ranging from field ecology, to molecular phylogenetics, metagenomics and bioinformatics, to mathematical modelling to try to answer fundamental questions about disease emergence between species and improve prospects for control of known zoonoses.
We focus our work around bats, a key group for both newly emerging and well-established zoonotic diseases. Some of the most exciting questions we are addressing right now are: Is culling an effective tool for the control of vampire bat transmitted rabies in Latin America? What ecological and evolutionary factors govern the diversity of viruses in bats and which of these pose the greatest threats to domestic animals? And are there generalisable genomic signals of RNA virus host range and human adaptation.
What does your average day involve?
Since starting my fellowship, my average day has changed quite a lot. The day-to-day management of a big field project in Peru and the usual routine of preparing talks, analysing data and writing papers still keeps me busy, but having a growing team of researchers in my group is an exciting change, particularly considering the diversity of projects going on. So, one minute I could be talking about sampling strategies to collect bat faeces, the next I could be talking about legal agreements with foreign ministries, or the odd things that go on in RNA virus genomes. This requires a good deal of coffee.
Why is your work important?
In a paper in 2009 in Science, Jamie-Lloyd Smith and colleagues wrote: “Models incorporating spill-over transmission—the defining process of zoonotic dynamics—are dismayingly rare.” That situation is beginning to change, but we still have very few success stories in preventing disease emergence between species and many more instances where we seek to intervene without a solid understanding of the ecological dynamics underlying emergence.
The consequences are severe. Every year it is estimated that over one billion people become ill due to the pathogens of other species, with up to one million deaths. I think ecological and evolutionary approaches can help alleviate this burden by devising control strategies that are grounded in understanding the dynamics of host-pathogen systems.
The work in Peru has particular significance because of the extraordinary frequency of contact between vampire bats and the humans and livestock that they feed on. A recent presentation from the Ministry of Health reported that over 20,000 people were bitten by vampire bats between 2009 and 2013 and many many thousands of domestic animals are bitten nightly.
This is a tremendous force of infection that causes rabies outbreaks and creates the perfect ecological scenario for other bat viruses to emerge. We want to know how to manage this risk in landscapes undergoing rapid environmental change due to livestock intensification, deforestation and mining.
What do you hope the impact of your work will be?
I believe our work sheds light on the ecological and evolutionary factors that allow viruses to jump between species. This moves us one step closer to understanding the origins and outcomes of disease emergence, and eventually prevention.
In parallel, I want to improve the situation for long-neglected disease problems like vampire bat rabies in Latin America by providing and effectively communicating an evidence base for rational control programs that can be adopted by local authorities.
How did you come to be working on this topic/in this field?
When I was an undergraduate at the University of Virginia, I quickly lost enthusiasm for my major in psychobiology, which involved doing a lot of unfriendly things to lab rats. In my second year, I had the good fortune to volunteer as a field assistant for a study of gut parasites in wild rodents. Over that summer, I was struck to learn both that working on wildlife diseases in beautiful places was a career that could directly or indirectly impact human health and that there were so many unanswered (but completely fundamental) questions about how pathogens are transmitted between species. I quickly changed the course of my studies.
The background I got in infectious disease ecology and evolution over the next two years under the mentorship of Amy Pedersen and Janis Antonovics provided a foundation for my later work on bats, to find a nice middle ground between fundamental question-driven science and the more applied world of bat virology.
How has Wellcome funding helped you/your research/your career?
Receiving the Sir Henry Dale Fellowship had a massive impact. I was in the difficult position of having established during my PhD a field system and international collaborations that I did not want to abandon, but at an early career stage, very few career paths provide the level of independent financial support and the flexibility that I needed. The fellowship enabled a perfect alternative to a postdoc in someone else’s lab or a lectureship/assistant professorship that would have given me additional administrative and teaching responsibilities. Instead, I find myself working in two highly interactive and exciting institutes at Glasgow with a growing team of students and postdocs who bring even more exciting questions.
What’s the most frequently asked question about your work?
Working on vampire bats, I get a lot of questions about bites and blood feeding: do they really drink human blood? Do people sleep through being bitten? Have I been bitten myself? The answer to all three is “yes.”
Which question about your work do you most dread – and why?
How are your permits applications going? I bring this a question on myself by griping about it all the time, but it is a constant challenge with so many levels of bureaucracy that I feel like I need a white board to answer appropriately.
I attended a workshop recently and was repeatedly reminded of another question I dread: “What is so special about bats as viral reservoirs?” I may be one of the few people who still aren’t totally convinced that bats are actually so special. I’d love to see more science and less hype around that question.
Tell us something about you that might surprise us…
As a wedding gift for a fellow rabies researcher, I once burned a phylogeny of rabies virus with its various host species into an antique table. My grandfather was a physician who took x-rays of plants in his spare time and my dad built a wall out of used wine bottles and test tubes, so I see this as something of a family tradition.
What keeps you awake at night?
When I’m in Peru, it’s mostly the alarm that goes off every half an hour to check nets for captured bats. In the UK, I must make up for that deprivation because I sleep quite well (aside from jet lag, of course).
What’s the best piece of advice you’ve been given?
“Tenacity in the face of adversity…to a point.”
This was the Antonovics lab motto if I recall correctly. It might not sound totally serious, but it does reflect that in science we all have to work hard, but should not do that at the expense of everything else in our lives. It also reminds me of the importance of flexibility – sometimes a change in course pays off a lot more than an endless uphill battle.
The chain reaction question – posed by previous spotlit researcher, Dr Rachel Freathy – is this: If you had the opportunity to meet one scientist (living or dead), who would it be and what would you talk about?
I’ll have to go with Louis Pasteur. I’d want to hear about his early experiments on rabies vaccines and the dramatic ways that he countered disbelief with evidence.
You can find out more about Daniel’s work on the Streicker Group website and by following him on Twitter. You may also be interested in the following articles: Vampire bats remain a holdout on the global stage of rabies control and Host Phylogeny Constrains Cross-Species Emergence and Establishment of Rabies Virus in Bats.
Radio – the ‘theatre of the mind’ – entertains, informs and can transport us to different worlds through powerful storytelling brought to us via the airwaves. Today, on World Radio Day, Senior Portfolio Developer Marta Tufet looks at how Wellcome Trust funded researchers are trying to determine whether radio might be even more powerful than you might first think. Could radio reduce mortality in children under five?
“This is the United Nations calling the peoples of the world”
That was the first ever message transmitted by UN Radio 69 years ago today. To celebrate the anniversary of the establishment of UN Radio – and raise awareness of the importance of broadcast radio around the globe – World Radio Day is marked on 13th February each year. It’s a welcome chance for broadcasters and listeners to talk about what makes radio so special – and why we need it now more than ever.
Even in today’s modern world of smartphones and wireless internet, when it comes to improving global health and reaching out to those most in need, it seems that radio, coupled with science, can exert a unique power that even the most sophisticated media platforms can’t match.
With support from the Wellcome Trust and the Planet Wheeler Foundation, Development Media International (DMI) together with researchers at the London School of Hygeine and Tropical Medicine (LSHTM) are keen to prove that mass radio campaigns can significantly reduce child mortality. They are using a robust, scientific, randomised control trial in Burkina Faso, to show that radio really does have the power to change, and indeed save, lives.
Previous studies have demonstrated that health-messaging campaigns can change knowledge, but whether this translates into behavioural change, and subsequent reduced mortality is still not clear. Billions of dollars have been invested in attempts to reduce child mortality, through the delivery of drugs and vaccines, hospital revamps, and deployment of doctors and nurses. Although these investments are working well in some areas, limited progress has been made towards the Millennium Development Goal 4: to reduce child mortality by two-thirds by 2015.
Unfortunately, despite this big financial investment, getting people to change their behaviour and proactively use available services (e.g. seeking care for pneumonia) or adopt life-protecting measures (e.g. sleeping under a bed-net to avoid malaria) has proved a difficult nut to crack.
But how do you change someone’s behaviour? DMI and LSHTM think they have found the answer: saturation, science and stories. They explain this idea an article describing their work, which is published in the Lancet today.
The team’s unique radio campaigning involves research on which behaviours are predicted to save most lives, coupled with intensive broadcasting of creative stories that aim to touch emotions as a means to change deeply engrained beliefs. For the past 35 months they have been campaigning uninterrupted despite numerous challenges, including a people’s coup to topple the country’s leader – who after 27 years appeared to have overstayed his welcome! They are now in the process of rigorously evaluating the success of their intervention with results expected in the last quarter of 2015.
Like the UN in 1946, DMI is calling to all the peoples of the world through radio. They predict that combining science and creative communication, if these campaigns were implemented in ten African countries for five years, the lives of a million children under five could be saved.
Stayed tuned to find out how they get on with this ambitious aim!
This week sees the opening of ‘History is Now: 7 artists take on Britain’ at the Hayward Gallery, featuring the first ever art exhibition to explore the BSE crisis and how it affected the UK in the 1990s – and ever since.
One of the images featured in the exhibition is by Laurène Pijulet-Balmer, an illustrator whose series ‘Under Your Skin’ couples microscopic detail of diseases and viruses with classic fashion and cinematic illustration styles. The series was an attempt by Laurène, a self-confessed hypochondriac, to overcome her own fear of disease by finding the beauty in the shapes and colours revealed under a microscope, and then inserting them into a face, where they cannot be hidden away or ignored.
This image above is based on the human equivalent of BSE, variant Creutzfeldt-Jakob Disease (vCJD), and others in the series include herpes, rotavirus and toxoplasmosis. Each illustration is the product of painstaking research into microscopic disease imaging, looking at different scales, colours, layers and shapes.
The idea for the series sprang from a design project that involved drawing virus-inspired shapes, based on Ernst Haeckel’s 1862 book “Art Forms from the Ocean” – one of the earliest examples of illustrative art and science. At the same time Laurène was working on a portrait for a friend when she began drawing cells instead of the face. She’s not sure why, but we’re glad she did!
She took this further, and later combined her work on viruses with illustrations of faces, as a way of presenting microorganisms in a more familiar light, and bringing them out of the unknown.
Image credit: Laurène Pijulet-Balmer / Wellcome Images
Wellcome Images is one of the world’s richest and most unusual collections, with themes ranging from medical and social history to contemporary healthcare and biomedical science. Over 100,000 high resolution images from our historical collections are now free to use under the Creative Commons-Attribution only (CC-BY) licence.
The most recent Wellcome Trust annual report showed healthy returns on our investment portfolio, which should allow us to spend in excess of £4 billion in the period 2014-2019. But where do we spend our money? Today, we are releasing the latest data on our grants portfolio and institutional application rates. Alyson Fox, Head of Grants Management at the Wellcome Trust, explains why it’s important for us to be so open…
Anyone who has applied to the Wellcome Trust for funding will know that our assessment process is rigorous and challenging, but it is also important to us that it is open and transparent.
As part of our continued commitment to openness, we are (for the second year running) publishing a range of infographics that show data on our recent funding decisions and our active portfolio of research. We are proud of our varied portfolio and we think that it is important to be transparent about what we fund.
The current value of our active funding portfolio comes in at more than £2.5 billion. Through our broad variety of schemes, funding individuals or teams of researchers, over 10,000 people are employed on Wellcome Trust grants.
Our funding is not limited to the UK, but in fact reaches 77 different countries. There are 424 different organisations (in the UK and overseas) that currently hold Wellcome Trust grants.
To explore the data for yourself, you can look at all of our grant spending infographics on the Wellcome Trust website. We hope that you find this information useful, and we hope to make this data even more accessible in future.
You can find all the infographics on the Grants Management pages of the Wellcome Trust website. If you’re interested in applying for Wellcome Trust funding you can check out the wide-range of funding we offer across science, the humanities and social sciences, and public engagement.
The £1 million Hub Award is a groundbreaking initiative that provides space and resources to researchers (and other creative minds!) to collaborate on interdisciplinary projects linked to the Trust’s vision of improving human and animal health. Hub Awards last for two years and we are currently open for applications for the 2016-2018 term. The inaugural recipients of the award, currently resident in The Hub space at Wellcome Collection, are the team behind Hubbub. Dr Felicity Callard, Hubbub group leader, tells us how their multifaceted collaboration came about, and why they are so interested in the notion of “busy-ness” and rest…
Our research collective (five core group members and over 30 collaborators) is investigating rest and its opposites by drawing on a wide range of different methods and modes of enquiry from the humanities, social sciences, arts and sciences.
Hubbub’s large group of collaborators includes historians of science and medicine, clinicians, public engagement professionals, social scientists, activists, artists, neuroscientists and broadcasters. We wanted to ensure that our scientific and artistic experiments about rest could benefit from an intense ‘hubbub’ of voices, perspectives and modes of working.
Hubbub’s core group came to the problem of rest and its opposites from a range of directions. I had been collaborating with leading resting state neuroscientist Daniel Margulies since 2008 to understand the emergence and exponential growth of ‘resting state’ functional neuroimaging research. I also brought along with me a long-standing, social scientific interest in concepts of the body in states of rest and non-rest (whether through explorations of Marx’s ‘The working day’ or via the study of clinical investigations of anxious or panic-stricken bodies).
James Wilkes, as a poet and humanities researcher, has long explored the aesthetics of voice, silence, and noise. Charles Fernyhough has been preoccupied with improving the methods used to investigate and capture ‘inner experience’ within psychological and neuroscientific paradigms. And Claudia Hammond had previously investigated the experiences of temporality in Time Warped: Unlocking the Mysteries of Time Perception.
We start from the contention that rest is a phenomenon that is curiously hard to define – but one that is of deep cultural, medical, phenomenological, political and scientific interest.
Our work ranges from developing new interdisciplinary neuroscientific paradigms to better investigate states of ‘rest’ in the mind and brain, to tracing the long histories of practices of relaxation. We’re also developing new artistic work that pushes beyond usual aesthetics of noise, silence, signal, and stillness and challenging current practices of ‘workfare’.
It’s not our aim to finally resolve what rest is – and there have undoubtedly been many lively cross-disciplinary arguments since we arrived in the Hub! But I certainly hope our scientific and creative experiments – conducted in collaboration with members of the Wellcome Trust as well as members of the public (in and beyond London) – allow us all to be more attuned to the textures, heterogeneity and contradictions of mental, bodily, and socio-political ‘rest’.
Four months in, we are at the point in which the work plan that the core group designed on paper (in the application phase) is being productively deformed both by our operations, and by the emergence of unpredictable and devolved projects emerging ‘bottom up’ from collaborators. It will be exciting to see where this new phase of experimentation will go.
I suppose our modes of inhabiting The Hub are actings-out of some of the dilemmas and preoccupations of our research. How, for example, do rest and play exist in the interstices of work? How does living ‘inside’ our funder, the Wellcome Trust, open new opportunities – for us and for the Trust – relating to practices of interdisciplinarity?
How does our rich, dispersed, network of collaborators – who are often in different time zones from one another – help to foment and, at times, retard the emergence of interdisciplinary insights?
As someone whose initial disciplinary training was geography, I am fascinated with how our Hubbub residency inhabits and realises the ‘space’ of the Hub. Our collaboration network extends widely beyond Wellcome Collection into other parts of London – as well as to Durham (the grant-holding organisation), York, and Leipzig (the site of Daniel Margulies’ Neuroanatomy and Connectivity Max Planck Independent Research Group). The question of what and where the Hub is – is it a node within a network, a utopia, a curated space, a field-site, an experimental laboratory? – is always in my mind.
At its starkest, rest – or lack of rest – is, today, one of the most potent of political sites, given the changing nature of work, the unevenness with which any entitlement ‘to rest’ is distributed, as well as the increased surveillance experienced by those not undertaking paid work.
Scientifically, the underspecification of ‘rest’ in cognitive psychology and cognitive neuroscience is a stumbling block for those interested in modelling and conceptualising ‘thought’. That is why we’re developing new methods and paradigms – that draw from the humanities and the arts – to enrich those currently used in the sciences.
There is a lot currently at stake as regards the promise of interdisciplinarity. Many of us within Hubbub have been thinking hard about how to move beyond stale invocations of this term. My hope is that Hubbub, as an experiment in interdisciplinarity, is able to open up different ways of working across the disciplines from those that (explicitly or implicitly) overly constrain the contributions that the arts, humanities and social sciences can make to interdisciplinary research that involves the life sciences.
To keep abreast of Hubbub’s work, and to find out how you might participate in their experiments, follow Hubbub at hubbubgroup.org and on Twitter. Applications for The Hub Award 2016-2018 are now open and we are hosting open days 10th February and 4th March – register your interest here.
Our fortnightly round-up up of news from the Wellcome Trust community…
Vaccination combats severe diarrhoea in Malawi
Research published in Lancet Infectious Diseases has found that the introduction of a rotavirus vaccine in Malawi has significantly reduced the number of hospital admissions of young children with severe diarrhoea.
Rotavirus is the leading cause of severe, acute gastroenteritis among infants and young children throughout the world and is responsible for an estimated 453,000 deaths among children under age five each year. To combat this, a vaccine for rotavirus was added to the schedule of immunisation routinely given to babies in Malawi by the WHO in 2012.
However, no evaluation of the vaccine in real-world use had been carried out. Now, a four year Wellcome Trust-supported programme that involved more than 1,400 children presenting with diarrhoea at the Queen Elizabeth Central Hospital, Malawi, has found that the rotavirus vaccine reduced the risk of severe diarrhoea by 64%, as well as the total community burden of rotavirus hospitalisation by 43%.
Dr Naor Bar-Zeev, who led the research team at the Malawi-Liverpool-Wellcome Trust Clinical Research Programme, said: “Our new data show that these efforts are now resulting in really positive outcomes for the health and wellbeing of children in Malawi. The success of this vaccine demonstrates the significant impact it can have on countries with a high burden of diarrhoeal disease, particularly when it is introduced into childhood immunisation programmes at the earliest stage possible.”
The next stage of the research will examine the duration of protection afforded by the vaccine and its effectiveness against different genetic forms of rotavirus.
Two and a half thousand women could benefit from mitochondrial donation in the UK
Almost 2,500 women of child-bearing age in the UK are at risk of transmitting mitochondrial disease to their children, according to the most recent estimates published in the New England Journal of Medicine.
The research offers the most recent evidence yet of how many families could potentially be helped by new IVF techniques to prevent mitochondrial diseases. Mitochondrial diseases are caused by inherited mutations in the DNA contained in mitochondria – tiny structures present in every cell that generate energy. Mitochondrial diseases can be devastating and particularly affect tissues that have high energy demands – brain, muscle (including heart), liver and kidney.
New IVF-based techniques have been developed which have the potential to prevent the transmission of serious mitochondrial disease. Known as ‘mitochondrial donation’ the techniques involve removing faulty mitochondria inherited from the mother and replacing them with the healthy mitochondria of another woman. The nuclear DNA, containing 99.9% of genetic material from the mother and father, remains unchanged.
Researchers at the Wellcome Trust Centre for Mitochondrial Research at Newcastle University have now calculated how many women have disease-causing mutations in their mitochondrial DNA in order to estimate how many could potentially benefit.
They calculate that 2,473 women in the UK, and 12,423 women in the US, aged between 15 and 44 years, are at risk of passing on potentially lethal mitochondrial DNA disease to their children. This equates to an average of 152 births per year in the UK, and 778 births per year in the US.
On Tuesday 3rd February 2015, MPs in the House of Commons voted overwhelmingly in favour of a motion to allow further research on mitochondrial donation and eventual licensing of the technique by the HFEA.
Different patterns in “switch off” of genes in developing male and female brains in the womb
New research published in the journal Genome Research has revealed differences in developing male and female brains in the womb.
The study focussed on epigenetic changes, or molecular “switches” that regulate the way that genes are activated. Researchers particularly focused on an epigenetic change called ‘DNA methylation’ to try and understand how differences in this process in male and female brain development may contribute to sex differences in behaviour, brain function and disease.
DNA methylation is the best understood epigenetic process: a chemical modification to one of the four bases that make up our genetic code. In this study significant changes in DNA methylation across brain development were found at more than 7% of the 400,000 genomic sites assessed.
Professor Jonathan Mill, of the University of Exeter Medical School and King’s College London, who led the study, said: “The prenatal period is a time of dramatic plasticity, when the brain is laying down the structures that control neurobiological function across life. Understanding the way in which genes are activated during this important period in the brain could teach us about the origins of disorders with a neurodevelopmental component, such as autism and schizophrenia.”
The study analysed over 200 brain tissue samples from the MRC/Wellcome Trust Human Developmental Biology Resource taken from foetuses 23 to 184 days after conception to find changes in the way that genes are regulated during human brain development
In other news…
Sir William Castell, Chairman of the Wellcome Trust, was awarded the BioIndustry Association (BIA) Lifetime Achievement Award at the BIA’s Gala Dinner at the Natural History Museum.
Syncona LLP, an independent subsidiary of the Wellcome Trust, has invested an extra £5 million in gene therapy start up NightstaRx Ltd (“Nightstar”) to treat choroideremia.
The Wellcome Trust Sanger Institute has announced a collaboration with AstraZeneca to exploit the full potential of innovative CRISPR technology in the field of drug discovery. CRISPR technology, sometimes known as ‘genetic scissors’, allows scientists to make precise changes to genes.
Image credits: Top: University of Liverpool, Middle: The Lily Foundation, Bottom: Bill McConkey, Wellcome Images. Bill Castell – Wellcome Library
Handily (do you see what we did there?) this week’s image, ‘Raynaud’s Phenomenon’, coincides with Raynaud’s awareness month 2015. The image is a thermogram- or thermal image – and shows the hand of a person experiencing symptoms of Raynaud’s next to one from a person who is unaffected.
Do you have any idea which is which?
Raynaud’s phenomenon (also referred to as Raynaud’s syndrome or Raynaud’s disease) affects the bodily extremities, most commonly the hands and feet. On exposure to cold or stress, the blood vessels at the extremities constrict, restricting the flow of blood, this is called vasoconstriction. When this happens in the hand, fingers will often be seen to change colour, becoming very pale as less blood reaches the surface of the skin. The reduction of warm blood flowing through these areas results in less radiation of heat from the affected area – as seen in this image.
The condition has been visualised using thermal infrared, which allows us to visualise thermal energy or radiation, more commonly referred to as heat. This type of energy is within the infrared region of the electromagnetic spectrum.
The different colours in the images represent different levels of thermal energy being emitted from the skin’s surface. In this case the yellow and orange colours show a high level of thermal energy while the black, pink and blue show a low level. Looking at the colour pattern in this image allows us to tell that it is the hand on the right is the one, which belongs to a person with Raynaud’s.
Image credit: Thermal Vision Research/Wellcome Images. (Text by Carly Dakin.)
Wellcome Images is one of the world’s richest and most unusual collections, with themes ranging from medical and social history to contemporary healthcare and biomedical science. Over 100,000 high resolution images from our historical collections are now free to use under the Creative Commons-Attribution only (CC-BY) licence.
On Tuesday, MPs in the House of Commons voting overwhelmingly in support of mitochondrial donation – a new IVF technique that could allow families with mitochondrial disease to have healthy children. Despite some protestations that this was “rushed”, the vote represented the culmination of a decade’s work by researchers, policymakers, and families, which included an unprecedented number of scientific and ethical reviews and a public consultation on the issue. Despite this positive vote, the amendment still needs to pass in the House of Lords before coming into effect. The Trust’s digital communities editor Kate Arkless Gray describes waiting for this important result…
Feeling like you’ve helped to make a difference is great, but unlike my colleagues around the Trust who fund exciting scientific research (to the tune of hundreds of millions of pounds a year) or provide direct support for researchers, I’m usually more involved in telling the resultant stories. It’s not just those who make decisions on funding, but people around the Trust who work hard to create a positive environment for science, be it through policy, education, or public engagement work.
Over the past few months, I’ve been privileged to be part of a team made up of people from across the Trust, researchers at the University of Newcastle, and families affected by mitochondrial disease. Our aim was to ensure that MPs voting in the House of Commons debate on mitochondrial donation were able to cast an informed vote – one which we all hoped would see the approval of secondary legislation to allow further research on the technique and eventual licensing by the HFEA for its use in humans.
Since the announcement of the debate – at ~1030am last Thursday – we’ve had our work cut out. Explaining the science behind the technique, countering the fear invoked by headlines labelling resultant children as “three parent babies”, answering genuine questions about DNA, ethics and the lengthy process – three scientific reviews, a public consultation run by the Department of Health and an ethics review by the Nuffield Council on Bioethics – in the lead up to this point.
The researchers in Newcastle have been inundated for requests to explain their work, the founders of the Lily Foundation, who have both lost children to mitochondrial disease, shared their stories and supported other families who wished to show the effect it has on them. We saw the publication of letters of support from Nobel laureates, ethicists and academics from the UK and the rest of the world, willing us to ensure that UK law caught up with the pioneering techniques that our scientists have developed. There was discussion, debate, strong words from the Church of England and the moving stories told by those who had lost children to mitochondrial diseases. Countless articles covered the subject and many people took to social media to express their views.
From my desk, with Twitter streams galore cascading information and opinion down my screen, I was able to interact with MPs, scientists, ethicists, parents, journalists and members of the public, encouraging them to take a moment to learn a bit more about mitochondrial donation, the difference between mitochondrial and nuclear DNA, and the robust process of consultation and review that had taken place, together with the stringent regulatory structure of the HFEA.
With colleagues, I watched the parliamentary debate, and saw how just as the debate was going on in the Commons, people were discussing it online as they too watched the live stream of the debate.
I didn’t know which way the vote would go, and waited nervously as votes were cast and counted. Just as I heard “The Ayes, three-hu” my computer starting buffering the stream. I couldn’t be sure that I’d heard correctly – it certainly didn’t look like there were so many MPs present from the coverage. Then it was confirmed, “the ayes-382, the noes-128″. There was a moment’s pause and then those of us watching from Trust HQ broke into spontaneous applause.
My colleague in the media team, Clare Ryan, (who had been doing sterling work arranging media interviews for lead scientist Prof Doug Turnbull and several families affected by mitochondrial disease) was in the public gallery in parliament. She sent me a message shortly after the announcement to say there had been tears of relief from those she was with. These are the families who are campaigning so hard to be allowed to choose whether to use this technique that brings real hope to them. Also present was Professor Doug Turnbull, the clinician who has lead the development of this technique, and been involved in numerous reviews and evaluations of the research over the past few years.
Later on, Trust head of communication Mark Henderson and I met with colleagues from policy – whose unstinting work over the last decade helped us get to this point – Clare, Prof Doug Turnbull and, media stars of the day, Vicky and baby Jessica, who has mitochondrial disease. At 13 months old, with a feeding tube and a cosy little white hat, Jessica was in her grandmother’s arms, melting the hearts of all around her.
The Commons vote to support mitochondrial donation takes us a step closer to a day when she could have a healthy brother or sister. A day when ground-breaking new science can leave the lab and be used in the clinic, allowing families choice and a chance of having healthy children. There’s still a long way to go before the first use of mitochondrial donation can be licensed by the HFEA – the motion needs to pass through the House of Lords – and there is still a lively debate around the issue.
Prof Turnbull told me he’ll never forget the cheer from the public gallery when the votes were announced. It was a cheer not only from people like him, who have invested years of their life on the science and policy work, but from the very people it could directly benefit. I may not be the one doing the science, or making the difference, but this is one story that I’m proud to tell. Thank you to all those of you who took an interest in this work, shared your views and took the time to contact your MPs – public discussion of these issues is important, and you all in your own way helped to make a difference.
Mitochondrial donation will now be debated and voted on in the House of Lords motion later this month. Full text of the parliamentary debate and a list detailing the ways MPs voted can be found on Hansard. The Wellcome Trust policy pages have detailed information about the consultations, background information and expressions of support mentioned above and you can read our previous posts on the subject on our blog.