How anyone can be a Scientist

 

What is Citizen Science and why should I care?

Citizen science is a brand new area of scientific research that has only received proper acknowledgement in the last few decades, and it is an area in which everyone can get involved.

In particular, areas such as bird-watching (ornithology) or astronomy lend themselves to this form of work. This is both because the number of interested non-scientists far outweigh the number of scientists in these fields, and because the scientific method can be simple. The value of such research to generate big data is undeniable!

In a world where even academic research is often directed at only those projects that industry is willing to fund, it is essential that we still support the less economically viable work.

How can I be involved?

What a good question!

There are a massive amount of projects you can get involved in, and many of them are on the website Scistarter in the US, Countryside JobsCitizen Science or even on Wikipedia.

I have been involved with Sea Hero Quest, a game that aids Dementia research through assessing the spatial memory of players. This sort of data is valuable to determine a baseline for what goes wrong in Dementia. This is important because our scientific community is currently struggling to find an effective cure or even a treatment for Dementia and Alzheimer’s disease, and that is partially due to difficulties in early diagnosis.

If you happened to read my post from last week, you may be interested to know that there are also projects involving taking samples from volunteers. uBiome is a company that sequences Microbiome data from paying volunteers. This data could have a massive impact on our understanding of the Microbiome and its connections to human diseases.

Other projects can involve surveys, such as OPAL surveys to assess the state of our environment, bug surveys by Buglife to keep an eye on our insect populations, BirdTrack to give our airbourne friends some help, Treezilla, which is a project to record all of the country’s trees and the list goes on… I’ve just documented some of the nature-related surveys and projects in which I’ve taken part – there are hundreds of projects relating to pretty much any area of science!

 

A note from the author: As I sometimes write on emotive subjects, comments are disabled after 14 days. This is because ongoing discussions tend to stagnate.

References:

  1. BBC article on Citizen science
  2. The UK Environmental Observation Framework’s details on Citizen Science

Microbiomes and Moods

Our Friendly Gut Bacteria

The recent discovery of the importance of our Microbiome (our “friendly” gut bacteria) has served as a critical reminder to medical researchers that the body does not exist as a series of disconnected notes or phrases, but as a wondrous song with many interconnected melodies and harmonies that each play an essential part. Of course, this is what makes the human body so interesting and wonderful, but it’s incredibly difficult to take into account as a researcher. In fact, a lot of good research comes out of being able to tease out the causal relationship between individual factors and their response.

There are few areas where this is more evident than in mental health research. Various studies have linked depression to inheritance, social factors, general health, drugs, alcohol, hormone levels and the list goes on… But unfortunately a physician cannot counter all these different issues. They require complex intervention that amends all aspects of a person’s life, in many cases.

 

Using the Microbiome in Medicine

Sometimes this can be all too overwhelming. How can we treat something that is no more under our personal control than government legislation? And this is before we take into account the diagnosis. Mental health practitioners cluster certain behaviours under the umbrella of a certain disease type so as to be able to try certain treatments that have worked for people with those conditions in the past.

carrot-kale-walnuts-tomatoes

The recent research into the Microbiome has suggested that it may serve as a valuable fingerprint, as another way in which we can identify specific areas in which a person’s body deviates from the “healthy norm”. Using this data we could look for critical changes in bacteria levels that may account for nutritional deficiencies or changes in hormone/chemical levels. And this can all be altered by simply altering what we consume.

This gut-fingerprint would simply mean taking a sample of stool from a patient and analysing the different bacteria levels, and then treating their abnormalities with probiotics or even just bacteria. This has been proven to work by several landmark studies into “faecal transplants” wherein unhealthy mice were given healthy stool to successfully fix various disorders.1

What About Mental Health?

So let’s get back to the original premise. Depression in particular is a challenging disorder to treat because patients are idiosyncratic. Unlike in many disorders, it is hard to tell which treatments would be successful. So what if we could find a potential cause of depression by looking at someone’s poop?(1)

black-and-white-person-woman-girl

That’s just what has been done by several research groups.(2) Many neurotransmitters (used by our brain to talk to itself and other tissues in the body) are produced by bacteria. In particular, serotonin is produced almost exclusively by our Microbiome in adults (80-90% of the body’s serotonin can be found in the intestines). This means that changes in the levels of the serotonin-producing bacteria of an adult can seriously alter the levels of serotonin in their brain. This link is key because serotonin is a key mood regulator in our brain. Specifically, low levels of serotonin or less receptors for serotonin has been implicated in depression, as well as anxiety, panic and anger disorders.

Other work has implicated the Microbiome in GABA-signalling. GABA action is related to calming nerves and treating anxiety. Mice that are stressed during their pregnancy pass on less of a GABA-secreting bacteria to their pups: and these pups thus have lower levels of GABA.

It’s hard to measure depression in mice, as unfortunately they do not respond particularly well to counselling and certainly will not tell you in detail how they have been feeling since you last saw them. But there are certainly some factors we can look at, such as behaviour. Researchers can clearly see if mice are acting less sociable with their peers. They can also do experiments to see if mice give up on impossible tasks earlier, such as in a test where they are unable to escape a tank of water. Those who give up earlier display a higher level of “behavioural despair”.

Mice that are not exposed to the normal levels of serotonin- or GABA-producing bacteria show adverse effects in these behavioural tests, which are reversed upon application of probiotics. Other research undertaken elsewhere has shown the effects of the gut bacteria Bacteroides fragilis in autism, and how mice with “autistic traits” such as repetitive behaviour acted more normally with probiotics. These results have implications in the treatment of autism.

Research has thus shown that the gut Microbiota are affected by stress, development and diet. In turn (in just this look at mental health) the Microbiota can have an affect on our hormone and chemical levels, which has widespread effects on signalling in the brain. This research has massive implications in the types of therapies we could use in these disorders in the future. Much of what is currently used affects receptors in the brain – whereas these therapies could, in theory, target chemical level imbalances at the source.

Our little bacterial friends, in only the short time in which we have been focusing our research on them, have already proven to have massive effects. I’m sure we can look forward to even more advances in the future!

A note from the author: As my posts sometimes touch on emotive subjects, comments are disabled after 4 days. This is because, at this stage, I feel that ongoing discussions tend to stagnate.

 

Postscript: Going Forward with Mental Health Research

The evidence for trying probiotic treatments for mental disorders in humans looks good! It could be argued that the evidence for this has existed for a long time, and it has. A lot of the chemicals we use in our bodies originate in our gut, and from food we eat. Approximately 50% of patients with Irritable Bowel Syndrome (a condition that requires sufferers to restrict their diet) have anxiety and depression, and this makes sense.

So why have we not considered this before now? Really, interest in research into mapping the human Microbiome only fully began since the Human Microbiome Project plans began in 2007. Why did we not consider before looking into something that weighs about as much as our brain? It’s hard to imagine, but we have only very recently (within the last century) begun to understand a lot about our bodies, particularly the brain. Medical research has come on leaps and bounds since the 19th century, and it is accelerating.

The problem with mental health research is that, in some ways, it has lost its way. In many disorders we have psychopharmaceuticals and psychiatric therapy, and these two unrelated things are combined. The value of both of these two avenues is indisputable, but they are diverging. Alas, the nature of cross-discipline research does not necessarily end itself to cross-discipline therapy. Practitioners trained in one or the other find it difficult to cross over, or may not even want to. It’s the same as asking a heart surgeon to treat an infectious disease, effectively. But it shouldn’t be. Modern medicine is moving ever onwards towards personalised therapy, where every aspect of a patient should be considered in every aspect of their treatment.

In this way, I see this probiotic research as being a bridge that reminds us of what we already know: that considering the patient as a whole rather than a sum of parts is essential to medical practice.

As a special note for this postscript, I would like to point out that I am a chemistry lab researcher with some experience working in clinical science laboratories and with medics. This article is written from my own knowledge, my own experience, and therefore any alternative views are very welcome!

 

 

References:

Independent Article

NY Times Article

(1) Michaelides, M., and Hurd, Y. L. (2015) More than a Gut Feeling : the Microbiota Regulates Neurodevelopment and Behavior The realization of the importance of the. Neuropsychopharmacology 40, 241–242.

(2) Kelly, J. R., Clarke, G., Cryan, J. F., and Dinan, T. G. (2016) Brain-gut-microbiota axis : challenges for translation in psychiatry. Ann. Epidemiol. 26, 366–372.

If you’re interested in more information, please have a look at the work of the researchers at University College Cork and McMaster University, there is some fantastic stuff :D.

 

Ars Medendi reads: Do No Harm

The Book

Do No Harm – Stories of Life, Death and Brain Surgery

Henry Marsh

Weidenfeld & Nicolson, 2014

What it’s about: A Summary

I don’t want to spoil the book by giving too much away in this summary. I would simply say that, if you are looking into a career in the medical profession, this book is an excellent resource.

Simply, Do No Harm is the memoirs of a senior neurosurgeon, from the beginning to near the end of his career. It encompasses the good, the bad and the ugly of his field and medicine as a whole.

I would not say that Henry Marsh is a good role model for budding doctors. I would instead say that he acts as a reminder to all that doctors are as human as the rest of us.

On the Author:

Henry Marsh is one of the UK’s foremost neurosurgeons. It should be noted that, although I felt that only a cursory amount of attention is paid to his work in Ukraine in the book, the film The English Surgeon details this in far more detail. If you find this book to your tastes, it is worth giving the film a watch.

 

The Review:

“It is not surprising that we invest doctors with superhuman qualities as a way of overcoming our fears. If the operation succeeds the surgeon is a hero, but if it fails he is a villain.”

Henry Marsh is only human. In his memoirs he publishes truly honest, sometimes disturbingly honest, stories of his daily life and work. In it, he challenges the basis of the age-old Hippocratic oath “Do No Harm”, by reminding us that, in their humanity, doctors and even surgeons make mistakes more often than we care to admit. Even truly excellent ones! In fact, all fields of medicine and all treatments come with risks that cannot always be accounted for. Walking along the corridors of a nursing home, he recognises “at least five” of the residents as his own failures. And these failures are what populate the book from page 1. “The idea that neurosurgery is some kind of calm and rational appliance of science… is utter crap.”

In fact, Marsh provides a window into his world in a very honest sense. Neurosurgeons must, on a daily basis, make life-changing, or life-saving, decisions that could lead to immense success or utter failure. It is with this dilemma that Marsh presents us.

In the course of the book, we also can see the sacrifices made in the pursuit of becoming an excellent neurosurgeon. The career served to shape Marsh’s character, such that he feels a certain entitlement as a result of his importance at work. One particularly memorable example of this is the moment in the book where, after performing a protracted operation, he expresses frustration at the menial world outside the hospital by imagining asking the person in front of him in a supermarket queue “What did you do today?” It is this frank self-awareness of how pompous he sounds that makes Marsh somehow so relatable.

Marsh, conversely, approaches the subject of being treated as a patient by his colleagues, and seeing his close family treated as well. It is through this intense vulnerability that he understands the plight of his patients. Through the connection Marsh makes to his patients, we can see the powerful exhilaration in performing a successful procedure to save a life. It is the wonder that Marsh feels that we also feel, even starting as a trainee first working on the brain, “a mystery… as great as the stars at night and the universe around us.”

And yet, the book still feels like a cautionary tale of the old ways of medicine: strict hierarchies where the senior doctor’s word was law. The world Marsh trained in, whose values are so ingrained in his practice, is gradually fading away, turning him into an “impotent and angry victim of government targets”. And it is being replaced with fresh bureaucracy, new management structures, corporate training programmes and regulation of junior doctors’ working hours. We can all certainly relate to the bizarre frustration he feels at current juniors being free of the excessively-long hours he endured as a trainee, but he also describes with understandable anguish administrative staff brought in purely to police government policies and agency staff that do not know the whereabouts of their patients.

It is with these thoughts that the book ends. It is an appropriate finish to a book that encompasses the daily thoughts, successes and failures of a human being who is also a surgeon. And really that, in itself is poignant in this new era of personalised medicine: in the same way that doctors must view patients as human beings, we must acknowledge that doctors, too, are people with their own hopes, desires and full lives.

 

A note from the author: As my posts sometimes touch on emotive subjects, comments are disabled after 14 days. This is because, at this stage, I feel that ongoing discussions tend to stagnate.

Ars Medendi reads: The Man Who Mistook His Wife for a Hat

The Book

The Man Who Mistook His Wife for a Hat

Oliver Sacks

Picador, 1986

What it’s about: A Summary

Welcome to the world of a neurologist. Oliver Sacks compiles many case studies he has published in medical case journals. These serve both as incredibly insightful looks at particular neurological disorders.

This is the only one of Sacks’ books I have read, but it is the most iconic. And it is worth a read for anyone interested in the subject area. In fact, I would recommend it as a window into the personal nature medicine takes on especially in matters of the brain, our most misunderstood organ.

The Review:

“Constantly my patients drive me to question, and constantly my questions drive me to patients – thus in the stories or studies which follow there is a continual movement from one to the other.”

Throughout the book, Sacks refers to Luria’s neurological case work, and he uses his extensive knowledge to craft the cases, peppering them with appropriate quotations and scientific context. And yet throughout, the patients are depicted as profoundly human and deeply sympathetic. It is these patients that lie at the centre of the book, and at the centre of Sacks’ life.

Oliver Sacks’ book is varied by the different tales in it. Therefore it stands to reason that a review should look into each section separately.

Losses

This section of the book encompasses the deficits, or the “A”s – Aphasia, Ataxia, Agnosia etc. It is this section which includes the iconic “The Man Who Mistook His Wife for a Hat” – the true story of a man unable to visually process shapes and assign them with identify. It is for this reason that, during his interview with Sacks, he “took hold of his wife’s head and tried to put it on”. This section of the book explores the impact of memory disorders. Another story “The Lost Mariner” describes a man trapped in his past, unable to form new memories or understand his present.

Excesses

This section is perhaps the opposite to Losses, comprising of manias and hyper-activities of the brain such as Tourette’s. Striking is the story of one man plagued with the latter (“Witty, Ticcy Ray”), wherein the patient decides that he will only undergo treatment by Haldol for his condition on certain days of the week. It is in this way that we can understand how intrinsic the workings of the brain are to a person’s personality and creative ability; such that, perhaps, we cannot treat the former without affecting the latter to a degree.

Transports

This section is exactly as it sounds. Stories of patients transported elsewhere by their brains. “A Passage to India” is a story of an Indian girl with a malignant tumour that expanded to compress areas of her brain. It is at once a melancholic and beautiful tale. In a way, her visions of India were her salvation from an impossible prognosis, as understood fully only by her: “I like these dreams – they take me back home.”

The World of the Simple

It is this section that explores the world of the “autistic savant”: those dismissed due to their placement on the autistic spectrum, but who have intense creative or mathematical talents. “A Walking Grove” is the story of a man with severe developmental deficiencies able to ”retain an opera or an oratorio on a single hearing”. Is it through these abilities that he develops with relationship with his musical father, despite being unable to express himself through other means.

Bottom line: if any of these cases sounds interesting to you, I highly recommend picking up this book. It is truly extraordinary.

 

A note from the author: As my posts sometimes touch on emotive subjects, comments are disabled after 14 days. This is because, at this stage, I feel that ongoing discussions tend to stagnate.

Ars Medendi reads: The Noonday Demon

The Book

The Noonday Demon – An Atlas of Depression

Andrew Solomon

Scribner, 2003

What it’s about: A Summary

First of all, I have to say: the book is LONG. Very long. It took me maybe two months to read, but then I don’t have much time to read in the evenings after work. Despite it’s length, I highly recommend it.

As suggested in the title the book is an entire atlas of the disorder: providing insight into all relevant areas of context from a personal to a society-wide level. What the title doesn’t tell is how beautifully written it is.: “In depression, the meaninglessness of life itself, becomes self-evident. The only feeling left in this loveless state is insignificant”.

I would recommend a read for anyone suffering from depression, or interested in the disorder.

On the author

Andrew Solomon is a journalist, and this is evident from the sheer volume of research and detail going into the book. In the book, he often brings in his own experience into the writing, laying bear his vulnerabilities and the devastation depression has wrought to his life.

The Review:

“My depression has grown on me as that vine had conquered the oak; it had been a sucking thing that has wrapped around me, ugly and more alive than I. It had had a life of its own that bit by bit asphyxiated all of my life out of me.”

The strength and power of The Noonday Demon lies with the dozens of stories that feed into it. Each is the story of an individual, but they together give valuable insight into the understanding of one of the world’s most prevalent diseases.

Although the author admits he is not a scientific expert of any kind, his dedication to studying depression is shown through his detailed exploration of the disorder from its historical, cultural and political roots, to its chemical pathways and various treatments. And, as I mentioned before, the writing is at once compelling and stunning. The story of the author is interwoven with an exploration of all the aspects of our modern day (and historical context) that cause so many to suffer from depression.

In Breakdowns, the author explains the debilitating acute condition, and it is a powerful read. The author then goes on to describe talking therapies (those which come out of traditional psychoanalysis and are subscribed to by psychiatrists) and the physical interventions (from psychopharmacological therapies to harsher therapies such as electroshock therapy).

Both types rely on restoring a “normal” balance to the patient, both in encouraging positive thought and constructive action, and in restoring chemical balance. And both are personalised to the idiosyncratic patient’s needs, and must work together. In particular, antidepressants are chosen primarily based on their side-effects, something which is at once paradoxical and essential as many are incredibly unpleasant even now: “you take antidepressants like you take radiation for cancer.” Solomon also does not avoid discussing alternative medicines. This is particularly important due to the tendency to hail Prozac or nothing, despite the availability of alternative therapies of all types.

The next sections describe the various aspects of a person’s life experience that can lead to the depressive condition. It is in these sections that the stories of depressives truly shine and make the reader understand the importance of different cultural prejudices, addictions and poverty. He does not overdramatize or sweep these issues under the Prozac blanket as is so often tempting in the media. And yet he depicts the cycle of depression experienced by all too many people in our society.

Overall this is an honest, stark text depicting the often under-represented truths about depression as well as those we have heard often. Aptly, the final chapter is simply title Hope.

“Some people suffer mild depression and are totally disabled by it’ others suffer severe depression and make something of their lives anyway.” It is hope that makes the difference.

 

A note from the author: As my posts sometimes touch on emotive subjects, comments are disabled after 14 days. This is because, at this stage, I feel that ongoing discussions tend to stagnate.