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Science Policy Around the Web – July 3rd, 2019

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By Neetu Gulati, Ph.D.

Image by Arek Socha from Pixabay 

The US opioid epidemic is driving a spike in infectious diseases

Opioid use has skyrocketed in the US in the past 20 years, and addiction kills tens of thousands of people each year. Now, opioid use has been linked to an increase in infectious diseases as well, which may pile on to an already extreme public health concern.

One cause for concern is that opioids themselves may be making people more susceptible to infection, though the reason for this is unclear. One study found that people treated at veterans’ health facilities who took medium or high doses of prescribed opioids for pain management were more susceptible to pneumonia, for example. Another cause for concern is that unsafe injection practices may mean that users of illicit opioids could lead to an increase of infections. Bacterial infections, such as those caused by Staphyloccocus aureus, can enter the bloodstream of opioid users through non-sterile needle usage or unclean sites of injection. If these bacteria reach the heart, it can lead to damage and possibly the need for a transplant. For example, a study done in North Carolina found a tenfold increase in heart infections among drug users in the state over a 10-year period.

As if the increase in infections was not bad enough, another major challenge is that the pattern of outbreaks associated with drug use may not be the same as that of non-drug-affiliated outbreaks, meaning it is difficult to predict where and when infections might occur. Furthermore, as Georgiy Bobashev, a data scientist at RTI International, pointed out, drug users “don’t have good practices and they don’t have good connections with people who have been injecting drugs for a long time.” In tackling the problem, it will be important to consider the social component of predicting outbreak patterns among drug users. It will also be important to treat opioid use as a disease without stigmatizing drug users, commented Carlos Del Rio, a global-health researcher at Emory University.

(Sara Reardon, Nature)

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July 3, 2019 at 3:13 pm

Science Policy Around the Web – January 8, 2019

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By: : Jennifer Patterson-West, Ph.D.

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Source: Wikimedia

The world debates open-access mandates

 Plan S is a European-backed program devised to ‘accelerate the transition to full and immediate Open Access to scientific publications’ that is schedule to take effect on January 1st, 2020.

Open access mandates are not a new concept, 74 research funders in Europe already require that paper be made free at some point. The key difference between these existing mandates, which typically permit a 6- or 12-month delay after publication, and Plan S is that article funded by Plan S will be immediately available.

Shortly after the announcement of the program on September 4th, 2018, DeltaThink, a U.S. based consulting firm, began estimated the market influence of the program.  They released a news post stating that the initial 11 European funding agencies in the program accounted for roughly 3.3% of articles published in 2017, and their funding represent less than 1% of the approximately $2 Trillian spent globally on Research and Development (R&D). These metrics are not adequate to drive a global shift toward immediate Open Access.

Thus far, 16 funders have formally joined the program, including the Bill and Melinda Gates Foundation which was the first participant outside Europe. The program has also drawn support from many scientists that would welcome a transformation of the current system that keeps research publications behind paywalls.

Brian Hitson, the Director of the U.S. Department of Energy (DOE) Office of Scientific and Technical Information which is responsible for the agency’s public access policy has stated, “We don’t anticipate making any changes to our model.”  Current policies implemented by U.S. Federal agencies require that all peer-reviewed paper on funded work be made freely available within 12 months of publications. This policy allows published work to remain behind a paywall after initial publication restricting immediate access to the results.  The U.S. isn’t the only federal research funders that plan to maintain currently policies, both Canada and the Russian Science Foundation have indicated that they do not plan to join Plan S.

However, statements released last month by China’s largest government research funder and two national science libraries supporting the goals outlined by Plan S came as a surprise to many.  China accounts for 18.6% of articles published globally in 2016, more than any other country.  Therefore, a similar Open Access policy in China could have a profound impact on the publishing industry even if China doesn’t formally join Plan S.

Another impending participant is India, the third biggest producer of scientific paper globally. The Principal Scientific advisor to India’s government, Krishnaswamy VijayRaghavan, stated that they will “very likely” join Plan S.

As more funding agencies consider joining Plan S, others wait to see how other details of the program are settled.  One concern is the cap on Author Charges that funders will pay for Open Access publications, which Plan S has yet to announce.  If Plan S succeeds in gaining enough support then a shift toward a fairer publishing system and a worldwide transition to Open Access will become more probable.

(Tania Rabesandratana, Science)

 

NIH hospital’s pipes harbored uncommon bacteria that infected patients

 

Last month, a publication in the New England Journal of Medicine written by National Institutes of Health (NIH) researchers disclosed that at least 12 patients at the NIH clinical center were infected with Sphingomonas koreensis from 2006 through 2016.

S. koreensis is an uncommon waterborne bacteria previously reported in only two clinical cases. The first report of a S. koreensis as a human pathogen was a case study of a single patient in 2015.

A clustered outbreak of S. Koreensis of six inpatient individuals at the NIH clinical center over a six-month period in 2016 prompted an epidemiological investigation to identify the source of the infection and determine effective intervention strategies.

Isolates from these patients indicated that four patients were infected with multidrug-resistant S.koreensis. Eight additional clinical isolates containing S.koreensis were identified during the investigation dating back to 2006, only one year after the new hospital opened.

Genetic testing of the bacteria indicated that all isolates shared >99.8% identity suggesting a shared reservoir. Extensive testing of facilities found S.koreensis on sink faucets in patient rooms as well as in the water they came out, but not in the municipal water entering the hospital.  To eliminate the reservoir, the free chlorine concentration and hot-water temperature were adjusted resulting in no further infections since December 2016.

Dr. Tara Palmore, one of the NIH researchers, points out that although S. Koreensis is a weak bacterium, it have the potential to cause additional illness in highly immunosuppressed patients.  This outbreak in which three infected patients ultimately died during inpatient treatment demonstrates how even abundant and often nonthreatening bacteria can severely impact the health of immunosuppressed patients.

(Ike Swetlitz, STATnews)

 

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January 8, 2019 at 12:05 pm

Science Policy Around the Web – December 21, 2018

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By: Mohor Sengupta, Ph.D.

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Medical Detectives: The Last Hope For Families Coping With Rare Diseases

Rare diseases affect far fewer people than other diseases, and consequently many are difficult to diagnose or may even not be identified yet. Current approaches seek to identify rare diseases by examining genetic mutations at one gene at-a-time, picking the gene by roughly informed guesses based on the symptoms. This method may soon be a thing of the past, thanks to Undiagnosed Diseases Network (UDN). UDN is a research study on a never-ending scale. It collects genomic data from persons with rare diseases and identifies the culprit mutation/s. The findings are cataloged, and doctors encountering novel symptoms in their patient can go to the UDN database and dig out the disease that matches most with the symptoms. That would give them a possible starting point. In this respect, the sole purpose of UDN is to find solutions for rare medical challenges where doctors are not able to.

UDN is made up of three components: A coordinating center based at the Department of Biomedical Informatics at Harvard Medical School, twelve clinical sites in the USA, including the NIH Undiagnosed Disease Program at Bethesda and core facilities. UDN is backed by the National Institutes of Health Common Fund that seeks to provide answers for patients and families affected by mysterious conditions.

There are more than 6000 known rare diseases, and combined these affect fewer than 200,000 Americans at a given time. Eighty percent of all known rare diseases are genetic in origin and half of all rare diseases affect children. Symptoms of a single rare disease may vary from patient to patient, and the disease itself is often masked by common symptoms. This confounds appropriate diagnosis of a rare disease greatly. For many rare diseases there is no knowledge of the underlying cause and information of disease progression is limited. Without the correct intervention, patients and their families experience a decline in the quality of life over time.

Research on rare diseases need to be collaborative across nations, and a global network of physicians and researchers is needed to facilitate knowledge sharing about these diseases. There needs to be a comprehensive approach in the understanding of rare diseases, analogous to virtual knowledge bases like the UDN database and Orphanet. Happily, progress is being made in this direction. Several countries have appropriate policies in place, and there are organizations that are the voice of patients with rare diseases, such as ERORDIS in the EU, the National Organization for Rare Disorders in USA and the Organization for Rare Diseases in India. It is imperative that these cohorts have greater interaction and knowledge sharing among one another.

Finally, public awareness is crucial. The patient community plays a crucial role in addressing awareness. They form the voice of the rare disease community and the starting point for development of policies. Rare Disease Day was created by EURORDIS in 2008, and February 28th, the rarest day, was chosen to mark our combat against rare diseases and our support for those living with it. On its tenth anniversary last year, 94 countries and regions from every corner on the globe commemorated the day, and 2018 saw the addition of five more countries into the group.

As a person afflicted with a rare disease myself, I would say, we may be only a few but with your support, we have the best shot at it!

(Original article by Lesley McClurg covers UDN, NPR)

 

Will We Survive Climate Change?

 

The holidays are upon us and many will head out to different directions outside the city. Writing the last blog for this year, I thought we could ponder over some rather worrying issues and offer solace to one another.

It’s December and today is winter solstice. The day with the longest night arrived amidst torrential rains. Each year we are seeing more storms than the last. Hurricanes like Florence and Mangkhut have rocked the world with damage and destruction. The temperature on Earth is already at 1 degree Celsius above pre-industrial levels. Record number of people have experienced extreme heat wave in 2018. Countries like Canada and Japan got much warmer summers than they are used to, and July 2018 ranked as one of the hottest months in Europe. Changing wind patterns and drier climate have ravaged the state of California with wild fires. A total of 8,434 fires burnt an area of 1,890,438 acres (765,033 ha), the largest amount of burned acreage recorded in a fire season, according to the California Department of Forestry and Fire Protection and the National Interagency Fire Center, as of December 6. From June through mid-July, severe downpour in southwestern Japan caused devastating floods and mudflows, killing nearly 300 people. A month later, the southern Indian state of Kerala was slapped by an unusual monsoon, causing the worst flood in nearly a century in the state with traditionally high rainfall. It left nearly 500 people dead.

The Paris Climate Accord has set a goal of keeping global temperatures from rising more than 2 degrees above pre-industrial levels. At 2 degrees above, things are this bleak:

Icebergs in the Arctic waters are ten times more likely to vanish in the summers.

Most of the world’s coral reefs are to disappear.

37 percent of all people on Earth are to experience extreme heat waves.

411 million people are to experience severe urban draught.

80 million people will be threatened by rising sea levels.

However, at 0.5 degrees Celsius lower, many of these situations seem slightly less devastating. Arctic ocean ice is more likely to survive the summers. Coral reefs will not be wiped out completely. 14 percent of people will be exposed to extreme heat waves and 20 million will be exposed to urban drought.

Seems slightly better? Yet, no industrialized nation is expected to meet the 2 degrees goal, let alone the 1.5 degrees mark, as per their current consumption of fossil fuels. The effects of today’s atmospheric carbon dioxide will be felt by generations to come.

Enough of grim talk. As stated in John Schwartz’s article, “there is no scientific support for inevitable doom”.

Reducing the amount of greenhouse emissions could address the most troubling issues of global warming. Many countries are making efforts to rely on renewable, cleaner energy sources like solar energy. There are increased efforts to use public transportation in some countries. Cars run by electricity are trending. The world is changing. Only not as fast as we want it to.

Let us resolve to consciously cut down on fossil fuel consumption in 2019. No one way is the perfect solution for this self-created menace and not everyone will be touched by this problem in the same manner. But collective awareness and efforts can go down a log way for everyone and for the Earth.

(John Schwartz, New York Times)

 

 

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Written by sciencepolicyforall

December 21, 2018 at 11:20 am