Thursday, May 10, 2012

Lab Rat on the Loose: A Scientist's Defining Summer


It was an unusual place for a toxicologist-in-training to find herself.  But there I was, among a select group of Milwaukee Journal Sentinel health reporters and editors poised to meet with the city’s mayor.  The morning agenda:   to discuss strategies for covering the city’s infant mortality problem. 
There was an irony about our meeting place, a history-steeped room in the downtown Journal Communications Building named for Agnes and Lucius Nieman.  The Niemans were an unlikely coupling of a Milwaukee socialite and a Chicago newsman.   Unlike Agnes who enjoyed life among Milwaukee’s upper crust, her husband Lucius overcame an impoverished childhood to become editor and eventually owner of Milwaukee’s largest newspaper.   To me, the Niemans’ story typifies Milwaukee:  a beautiful lakeside city with a rich history, a heartbreaking back story, but a will to overcome. 
At the heart of Milwaukee’s particular back story:  babies in certain parts of the city were failing to live beyond infancy, instead dying in neglected inner city neighborhoods just miles from affluent suburbs.  In recent years, the number of infant deaths in Milwaukee had become too staggering to ignore.  In certain zip codes within the city, death within the first year of life rivaled the infant mortality rate of Botswana.  The worst rates of infant death--11 infant deaths/1000 live births-- were observed from 2005-2008.  In one downtown zip code, the rate was 19.5 deaths/1000 live births.  Milwaukee babies of African American descent were dying disproportionately—15.7 deaths/1000 live births—which was over twice the infant mortality rate among Milwaukee’s Caucasian population.  The reasons for these astounding statistics are as complex as Milwaukee itself, a highly segregated city with an especially high unemployment rate.  Poverty, poor healthcare, psychosocial stress, and co-sleeping contribute to the city’s high infant mortality.

In 2011, Journal Sentinel editors knew that their reporters had the power to help turn these statistics around.  Perhaps inspired by the Niemans’edict to elevate journalism by “telling the news fully and truthfully”, Journal Sentinel reporters told the story of infant mortality in Milwaukee through a series of articles collectively called “Empty Cradles” (http://www.jsonline.com/news/119882229.html).

The Empty Cradles series was an intriguing opportunity outside the context of the lab to interview clinician scientists and dig deeply into clinical literature.  My objective was to give researchers an opportunity to use their data to weigh in on the city’s vexing problem of infant mortality.  For the series, I did what I believe I did best at the newspaper that summer:  I told the stories of researchers on the front lines of fetal and maternal health.    My first Empty Cradles piece reported on research in primates, which demonstrates that even a modest decrease of nutritional food may predispose a fetus to adult onset disease (http://www.jsonline.com/features/health/124574774.html).  Another article I wrote took a local approach and reported what Milwaukee-based basic and translational research is revealing about genetic susceptibilities in preterm infants or toxicant-exposed fetuses (http://www.jsonline.com/features/health/127784268.html).   By writing about research, I discovered the many ways bench science is translated to bedside application.   What I didn’t expect was the extent to which the AAAS Mass Media Fellowship would reignite the passion for research that I had misplaced somewhere along the way to earning a Ph.D.    
My assignment as an AAAS Mass Media Fellow came at a difficult crossroad in graduate school.  Just weeks before arriving to Milwaukee, I had been in the throes of my dissertation research.  As research often does, mine was spinning in what seemed at the time a series of less-than-meaningful concentric circles.  Although grateful for access to an array of mouse models during my graduate studies, my work in rodents was offering little of what I craved most:  research translation.   Unlike many Mass Media Fellows who aspire to transition from science to journalism, I hung tightly to the notion that I would remain in science, but I badly needed the perspective only a summer spent away from the lab could provide.  The AAAS Mass Media fellowship gave me time and space to consider the direction my research trajectory would take.

After the summer I returned to the lab eager to tell the story of my own research.  That fall I defended my dissertation.  As I searched for postdoctoral positions, I looked for ways to apply my basic science training to clinical or population level problems.  My experience as an AAAS Mass Media Fellow was one of many inspirations to pursue postdoctoral research that seeks to identify a biological link between chemical exposures and preterm birth.   How profoundly a summer "on the loose" can shape a path in science.  

In many respects, the summer I spent in Milwaukee defined the type of scientist I have become.  I welcome opportunities to connect with both journalists and lay audiences and see collaboration and engagement with colleagues, clinicians, healthcare workers, and stakeholders as an integral and important part of any scientist’s job description.  My summer spent in the newsroom serves as a reminder to reach out beyond the lab in some small way.  Indeed, the AAAS Mass Media Fellowship not only grooms the next generation of science communicators, it fosters more engaged scientists.

Kelly Hogan, Ph.D., M.S., M.E.S. is a Research Fellow in Environmental Toxicology in the Department of Environmental Health Sciences at the University of Michigan School of Public Health.  Dr. Hogan is a member of the National Association of Science Writers and frequently tweets about toxicology…with a reproductive health twist (@Loose_Lab_Rat).

Sunday, August 21, 2011

Last Day in Milwaukee...















For a gallery of my visit to the Harley Davidson Museum in Milwaukee:  http://www.flickr.com/photos/66620290@N07/

Women as an Untapped Resource in the STEM Workforce

ARTICLE:  "Women sparse in math, science:  females an untapped resource, says US report"  Milwaukee Journal Sentinel [Milwaukee] 16 August 2011, E-1-2.

http://www.jsonline.com/features/health/127784503.html

TAKE HOME MESSAGE:  Always strike up a conversation with your seat mate on a flight; s/he may be your next source.  Sources (i.e. experts) are found in all sorts of contexts!

INTERVIEWS:
I asked one question of the Department of Commerce:  are there actually STEM jobs available in this sagging economy?

My outside source was a fascinating woman with a Ph.D. in higher education who works along with the NSF to improve opportunities for women in STEM fields, particularly those in the academy educating the next generation of STEM workers.  She was my seat mate from DC to Detroit on my way to Milwaukee.  We struck up a conversation, realized we had a few things in common, and she gave me her business card.  When this story came my way, I thought of her.  She was an ideal source because of her particular expertise.

The Empty Cradles Series: a newspaper's effort to confront Milwaukee's infant mortality problem

ARTICLE:  "Milwaukee-based researchers study prenatal exposure to toxins:  tiniest preemies appear more susceptible"  Milwaukee Journal Sentinel [Milwaukee] 16 August 2011, E1-2.

http://www.jsonline.com/features/health/127784268.html

TAKE HOME MESSAGE:  This year the Journal Sentinel is focusing on addressing the issue of infant mortality in some of Milwaukee's most impoverished zip codes.  This idea to profile basic and translational research that may one day improve this situation was mostly inspired by a meeting I attended with the mayor of Milwaukee and a small group of reporters.  I walked away wondering how I could contribute to this important undertaking.  I did the one thing I think I did best this summer:  I told researchers' stories.


INTERVIEWS:

Investigator #1


1)      Are you thinking that the mechanisms by which TCDD is modulating developmental programming might be epigenetic?  If so (and if you’d allow it), it would be fun to describe the concept of the epigenome. 

2)      Can I discuss findings that are “unpublished” or “observed” in very general terms?  (eg hematopoietic stem cells undergoing senescence; increased susceptibility of disease in mice)

3)      What is the significance of stem cells senescing (as opposed to undergoing apoptosis)?

4)      I’m curious about your models (in vitro, in vivo) and the types of techniques or equipment you use in the lab routinely?  (I like to try to communicate something about technology used in research.)

5)      Can you give me some context for describing the rise in the incidence of immunological based diseases in children?  Any review papers that might summarize some of these findings?

6)      I’m interested in the types of translational questions you could ask if your hypotheses prove true.

7)      So what motivates you to pursue these types of questions?  I’m always intrigued by how one ends up choosing a particular line of research.

Investigator #2

1)      I’m not sure if this is explicitly stated, but NFKB1 (g-24519delATTG) sounds like it codes for the NFKB1 promoter region?

2)      This seems like a functional polymorphism or isn’t it?  I noticed that in Table 2 there is no change to the peptide.  So what role (if any) does this variant play in the actual pathophysiology of NEC?

3)      Is NEC a phenotype of the variant allele?

4)      You state that this variant is necessary but not sufficient to produce NEC.  What sort of environmental factors would interact with this gene variant to render preterm infants more susceptible to NEC?

5)      Susceptibility is a difficult concept to explain to a lay audience.  How do you describe the term?

6)      Would you say that polymorphic NFKB1 is a reasonable biomarker of NEC susceptibility?

7)      Could this variant contribute to other factors leading to preterm labor—perhaps alter the response of gestational membranes to bacteria?

8)      What type of mechanistic studies are going on to better understand how this variant is contributing to NEC susceptibility? 

9)      In Table 1, were more infants African American because of demographics or because preterm African American infants are more likely to develop NEC?  In other words, is this a disease where there is  racial disparity?

10)  NEC is described as a sign of disease, but is not itself consider a disease?  Is this the consequence of unresolved inflammation?

11)  Can you describe some of the behavioral aspects of NEC?  Do infants exhibit pain?

12)  Can you describe some of the medical or surgical interventions for NEC?

13)  Can you describe how NEC is diagnosed?

14)  If these infants survive—and it appears that many can die--what is their prognosis in adulthood?

15)  Tell me how this work led to your focus on oxygen toxicity—obviously, a real concern in preterm infants.

16)  How is oxygen toxicity associated with environmental exposures?  Can you describe some of those exposures?   Is this something that is mediated by over-production of ROS, say, during uncontrolled inflammation?

17)  What types of studies are you proposing?

Outside Source

I am interested in an outside perspective on Dr. Sampath’s work, which has implications for NEC susceptibility.  I am wondering if you are willing to comment on some of the implications of this work.  I am also interested in knowing how this work progresses the field; what some of the pitfalls of this type of research might be; and how these findings may be applied to other conditions in the very low birth weight infant.

Center Grant Director

Would you be willing to offer me just a few lines I can quote regarding the role this grant money plays in research that may one day help lower the infant mortality rate in Milwaukee and beyond?

 

Calling all Milwaukee's Strong Babies

ARTICLE:  “Wanted, poster child of baby health:  ads to address infant mortality.”  Milwaukee Journal Sentinel [Milwaukee] 10 August 2011, B3.

http://www.jsonline.com/news/milwaukee/127354988.html

A photo gallery of the babies who came to the casting call:
http://www.jsonline.com/multimedia/photos/127558958.html


TAKE HOME MESSAGE:  Sometimes press releases about ad campaigns can be about life or death...and unexpected generosity.

I was duped once during the summer by a press release about a new test of male infertility.  Behind its facade of offering hope for couples who couldn't conceive, the test turned out to be something re-purposed and hardly novel...and I felt silly for taking the bait, exhaustively researching the product, and involving tons of outside sources who were hardly impressed by this product.  The project was dropped and an important lesson was learned.

This press release was different--a casting call for a public health department ad campaign spearheaded by the all volunteer, non-profit ad agency SERVE Marketing.

INTERVIEWS
These interviews really did happen on the fly.  My editor wanted to get this into the paper quickly so that parents and their babies could plan to participate.  I spoke to the city health department and to the creative director of SERVE and pulled it together.

POST SCRIPT
And the winners of Milwaukee's next strong baby campaign are:  http://www.jsonline.com/features/health/129490038.html.
 

Saturday, August 6, 2011

Loose Lab Rat Makes Front Page: Expect the Unexpected

ARTICLE:  “New bacteria linked to ticks:  deer parasites blamed for Lyme disease cause new worry.”  Milwaukee Journal Sentinel [Milwaukee] 4 August 2011, A1+.

http://www.jsonline.com/features/health/126733503.html

TAKE HOME MESSAGE:  Keep an eye on EurekAlert and be prepared to reconfigure your week so that can cover breaking news, particularly when it's of local import.

Access to embargoed scientific breakthroughs:  Priceless.

INTERVIEW:

      Lead Author

1)      Were any of the 4 patients who turned up positive for the WI species also positive for Borrelia burgdorferi?

2)      Two of the 4 patients were immunocompromised.  Was the WI species more virulent in these patients?

3)      If so, might the status of the immune system predict the outcome of infection with the new species?

4)      What are the consequences of untreated infection of this new Ehrlichia species?

5)      Do you believe that co-infection with this new species and B. burgdorferi might explain some of the complications observed in some people who develop long lasting or undiagnosed Lyme disease?
      
6)      If a rash accompanies infection with this new species—and my understanding is that it usually doesn’t—what might that rash resemble?

7)      Why the high elevation of liver enzymes?  Does this suggest that the bacteria or bacterial toxins damage the liver?

8)      Are most labs equipped to test for this new species?  Would that amount to PCR with sequence-specific primer/probe set?

9)      How can patients request this test, particularly if a doctor hasn’t been informed of it?

10)  Can this new species be detected years after infection or is the titre likely to decrease after time?

      Outside Source 

What do these studies mean clinically for people bitten by ticks and for doctors encountering patients with certain symptoms who may have been exposed to ticks?

      Surprise Sources

Sometimes unexpected sources emerge.  A press person calls you with a patient or a technician on the other line willing to speak.  In these moments, you wing it.  Embrace the opportunity, imagine the possibilities to make your story a better one, and make it a great conversation.  These interviews will often afford you priceless quotes that end up highlighted in the story.


POST SCRIPT
There is always another angle to a story--an aspect that is compelling to you as a scientist.  Your editors, on the other hand, may not see it the same way.  Learn to let go.  They know better than you, they really do.

Sunday, July 31, 2011

Blog Posts: No Outside Sources Need Respond

SCIENCE AND HEALTH TODAY BLOG POST Distant female bosses may reflect a sexist workplace

http://www.jsonline.com/blogs/news/124623334.html

TAKE HOME MESSAGE:  Health and Science Today blog posts at the Journal Sentinel require no outside source.  This is a great way to highlight the research of new investigators.

INTERVIEW 

1)   The Queen Bee response sounds a little like a “male” coping mechanism—distancing oneself from people considered outside the “in” crowd.  Can you speculate as to why Queen Bees would choose this particular type of coping mechanism in the work place?

2)   Do you think that Queen Bees behave this way out of fear of losing what she has earned?

3)   Do you speculate that Queen Bees feel as though their positions have been hard-earned, and therefore believe that other women should “pay their dues” rather than be mentored.

4)   Do you think those who identified with gender were more able to muster compassion for other women?

5)   Can you recommend some strategies for organizations who want female leadership that is more inclusive toward female members of organization?