A cross-sectional study of HPV vaccine acceptability in Gaborone, Botswana

Background

Cervical cancer is the most common cancer among women in Botswana and elsewhere in Sub-Saharan Africa. We sought to examine whether HPV vaccine is acceptable among parents in Botswana, which recently licensed the vaccine to prevent cervical cancer.

Methods and Findings

We conducted a cross-sectional survey in 2009, around the time the vaccine was first licensed, with adults recruited in general medicine and HIV clinics in Gaborone, the capital of Botswana. Although only 9% (32/376) of respondents had heard of HPV vaccine prior to the survey, 88% (329/376) said they definitely will have their adolescent daughters receive HPV vaccine. Most respondents would get the vaccine for their daughters at a public or community clinic (42%) or a gynecology or obstetrician''s office (39%), and 74% would get it for a daughter if it were available at her school. Respondents were more likely to say that they definitely will get HPV vaccine for their daughters if they had less education (OR = 0.20, 95% CI = 0.07–0.58) or lived more than 30 kilometers from the capital, Gaborone (OR = 2.29, 95% CI = 1.06–4.93). Other correlates of acceptability were expecting to be involved in the decision to get HPV vaccine, thinking the vaccine would be hard to obtain, and perceiving greater severity of HPV-related diseases.

Conclusions

HPV vaccination of adolescent girls would be highly acceptable if the vaccine became widely available to the daughters of healthcare seeking parents in Gaborone, Botswana. Potential HPV vaccination campaigns should provide more information about HPV and the vaccine as well as work to minimize barriers.     

Freedom of Choice About Incidental Findings Can Frustrate Participants' True Preferences

Ethicists, regulators and researchers have struggled with the question of whether incidental findings in genomics studies should be disclosed to participants. In the ethical debate, a general consensus is that disclosed information should benefit participants. However, there is no agreement that genetic information will benefit participants, rather it may cause problems such as anxiety. One could get past this disagreement about disclosure of incidental findings by letting participants express their preferences in the consent form. We argue that this freedom of choice is problematic. In transferring the decision to participants, it is assumed that participants will understand what they decide about and that they will express what they truly want. However, psychological findings about people's reaction to probabilities and risk have been shown to involve both cognitive and emotional challenges. People change their attitude to risk depending on what is at stake. Their mood affects judgments and choices, and they over‐ and underestimate probabilities depending on whether they are low or high. Moreover, different framing of the options can steer people to a specific choice. Although it seems attractive to let participants express their preferences to incidental findings in the consent form, it is uncertain if this choice enables people to express what they truly prefer. In order to better understand the participants' preferences, we argue that future empirical work needs to confront the participant with the complexity of the uncertainty and the trade‐offs that are connected with the uncertain predictive value of genetic risk information.     

Joan Heath interviews Suzanne Cory and Joan Steitz: a female perspective of science in the swinging ‘60s

Prompted by the occasion of International Women''s Day, Joan Heath and DMM reunited Professors Suzanne Cory and Joan Steitz via Zoom to discuss their extraordinary careers and joint experiences in science. They also delve into past and present challenges for women in science, and discuss the role of scientists in a post-pandemic world.

Suzanne Cory, Joan Steitz and Joan Heath (from left to right) As one of Australia''s most eminent molecular biologists, with a school in Melbourne bearing her name, Professor Suzanne Cory has been both Director of The Walter and Eliza Hall Institute of Medical Research in Australia (WEHI) and President of the Australian Academy of Science. She earned her PhD at the Medical Research Council (MRC) Laboratory of Molecular Biology (LMB) in Cambridge, UK, with postdoctoral training at the University of Geneva. She continues her research at WEHI as an honorary distinguished research fellow, investigating the genetics of the immune system in the development of blood cancers and the effects of chemotherapeutic drugs on cancer cells.Joan Steitz – currently Sterling Professor of Molecular Biophysics and Biochemistry at Yale University, and for 35 years the recipient of a Howard Hughes fellowship – is best known for her seminal work in RNA biology. She was the first female graduate student to join the laboratory of James Watson at Harvard University and proceeded with her postdoctoral training at the MRC LMB in Cambridge. Her pioneering research delved into the fundamental mechanisms of ribosome and messenger RNA interactions, as well as RNA splicing, heralding the phenomenon of alternative RNA splicing. A recipient of many awards and honours, she is also involved in international projects aimed at supporting women in science.Host Joan Heath heads a laboratory at WEHI in Australia. She received her undergraduate degree from the University of Cambridge, followed by her PhD at the Strangeways Research Laboratory also in Cambridge, then just across the road from the MRC LMB. After postdoctoral positions in bone biology and osteoporosis research, Joan joined the Ludwig Institute for Cancer Research where she became a laboratory head, and changed her focus to cancer research using zebrafish to identify genes that are indispensable for the rapid growth and proliferation of cells during development. She joined the WEHI in 2012. There she showed that the same developmental genes are also required by highly proliferative, difficult-to-treat cancers, including lung, liver and stomach cancer, paving the way for translational research targeting these genes in novel cancer therapies. Joan H: How long have you two known each other? Suzanne: I was calculating that this morning and I was astonished because it seems like only yesterday, but it has been 55 years since we met in Cambridge. It has been a voyage in science and a voyage in the world because we have always made a point to meet up in beautiful places and go hiking. That is how we''ve been able to renew our friendship over all these years. Joan H: Where were you when you first met? Joan S: We both were working at the MRC LMB in Cambridge, England. Suzanne was doing her PhD and I arrived slightly later for a postdoc.Suzanne: We had a pre-meeting in the sense that Joan, Jerry Adams (my future husband) and Tom Steitz (Joan''s husband), were all graduate students together in Harvard. So, when Joan and Tom came to Cambridge, it was natural that we would all start doing things together. And Joan and I ended up sharing a lab bench.Joan S: The reason that I did a postdoc in the mecca of X-ray crystallography was that I had married a crystallographer – and there was no other place that he could possibly go. They very much wanted to have my husband at the Cambridge MRC lab, but there wasn''t a clear plan for me. Francis Crick suggested that I do a literature project in the library, but I knew that theory was not my forte in comparison to experiments. I started talking to the many people working in the lab and found a project that no one wanted, because it was so challenging. But it was a very interesting problem, so I decided to take it on – and it turned out to be a great project.Joan H: That''s amazing. You were obviously determined to overturn other people''s expectations of you.Suzanne, even now, it''s extremely unusual for a young person to leave their home country to do their PhD. It''s still a brave thing to do but all those years ago it was really courageous. You told me that you ended up there because you wrote a simple letter, which was a complete shot in the dark.Suzanne: It certainly was. During my master''s degree at the University of Melbourne, I became more and more interested in doing science and decided I would do a PhD. But I had a counteracting desire to travel and see Europe. So I decided that I would do my PhD overseas to give myself the opportunity of travelling. I had fallen in love with DNA during my undergraduate studies. So, I wrote a letter to Francis Crick in Cambridge, and asked if he would take me on as a PhD student. Much to my amazement, I eventually got a letter back saying yes. I think that my professor of biochemistry might have also visited Cambridge while he was travelling and spoken up for me. However, I was still extraordinarily fortunate that Francis had agreed because there weren''t many PhD students in the LMB at that time. It made such a difference to my entire life. I look back on that letter and think, “How did you have the audacity to write that letter and aim to go to that laboratory?”. I think it was partly naivety.Joan H: That''s a lesson for everyone, to go for your dreams, and don''t assume people won''t take notice of you. It is more difficult now, when scientists receive hundreds of e-mail applications from prospective PhD students in their inbox. You would have written a letter with a stamp on it that probably took three weeks to arrive, but it just shows you that you should be audacious. Did you have a different experience to Joan when you arrived? Was there a proper project already lined up for you?Suzanne: I was interviewed by Francis Crick and Sydney Brenner, who were the joint directors of the department. They decided that I would work on the structure of the methionyl-tRNA that puts methionine into internal positions in polypeptides. After they described the project – which involved doing counter-current distribution fractionation of bulk tRNAs, in which I had no experience whatsoever – Sydney in his very characteristic monotone said, “Do you think you''re up to it?”. I sort of gulped to myself and said, “Yes, I think I could do that”. I then went to Brian Clark''s laboratory, who was going to be my PhD supervisor, and started the project. Like always in life, if you learn from people and just go from one day to the next, you actually get there in the end.Joan H: So, persistence was key. Were there many other women at the LMB at the time?Suzanne: I don''t remember any female scientists who had official senior positions. There were certainly some strong female scientists there, but I don''t think they were given the recognition or the status that they actually deserved.Joan S: Later, some were given more recognition, crystallographers in particular, but not so much the molecular biologists.Suzanne: I think, as women, we both pioneered in that department.Joan H: Given the fact that you both agreed to take on projects you had very little previous experience with and that the male supervisors thought you weren''t going to have the mettle to carry it through, once you were there, did you feel that you had to work the whole time? Or did you still manage to have lots of fun and partake in opportunities that Cambridge had to offer at the time?Joan S: We certainly partook in a lot of those things. My husband and I got interested in antique furniture, antique paintings, and used to scour the countryside for little antique shops. We saw lots of England, then a little bit of Scotland and Wales. It was wonderful. A real adventure.Suzanne: I worked really hard most of the time that I was in Cambridge, as the work was very exciting. But I would take holiday periods, camping and youth hostelling all over Europe with a girlfriend from Melbourne and later, travelling with Jerry. We also would go to London for the opera and looking for amazing clothes on Carnaby Street and Chelsea Road (this was the Beatles era, late 60s). Jerry once came back with a purple velvet suit, which was his prized possession for many years. There was lots of fun but also lots of work.Open in a separate windowJoan Steitz, Tom Steitz, Jerry Adams and Suzanne Cory (from left to right) in the Swiss Alps, 1970. Image courtesy of Mark Bretscher. This image in not reproduced under the terms of the Creative Commons Attribution 2.0 Generic license. For permission to reproduce, contact the DMM Editorial office. Joan H: Can you remember the first moment in that part of your career that gave you the most pleasure? Joan S: I worked on a project for about a year, and it turned out that I was doing the wrong fractionation method to get the material that I needed to analyse. Then I had a conversation with Sydney Brenner telling him that I was going to give this one more try with a new method, and then I was going to give up. I remember Sydney saying, “Sometimes, like with a bad marriage, you have to give experiments one last try before you give them up.” Then I tried again, and it worked. This is often the case in science, that you try something new, that''s a little bit different, and it makes all the difference. Then you''re running.Suzanne: The same thing happened to me. I was labouring away on the counter current distribution machines fractionating methionine tRNA, with the goal of sequencing it by the laborious procedure recently published by Robert Holley. However, Fred Sanger, in the department upstairs, had invented a totally new method for sequencing using ³²P-labelled RNA. I desperately wanted to try this, so I managed to persuade my supervisor that we should change techniques. That change was key to my future because the approach was successful. I still remember to this day exactly where I was in Cambridge, walking on a Sunday afternoon, when the last piece of the puzzle dropped into place in my mind, and I had the entire sequence. In that moment, I was extremely joyful, because I knew I had my PhD and that I had succeeded. So that was my eureka moment.Joan H: Obviously, these were extremely productive years, and you''ve mentioned several Nobel Prize winners in your midst. It must have been the most inspiring environment, which I''m sure had a big impact on what you did next. By this stage in your career, were you already feeling ambitious or was it still your scientific curiosity that was driving your path?

“I expected that I would go back to the United States and be a research associate in some man''s lab […]. Then it turned out that people were more impressed than I thought and started offering me junior faculty jobs.”

Joan S: I had gotten a lot of recognition for having sequenced a piece of mRNA, using the same methods that Suzanne used to sequence tRNA. However, I had no expectations, because I had never seen a woman as a science professor, or head of a lab. I expected that I would go back to the United States and be a research associate in some man''s lab, and maybe they''d let me guide a graduate student. Then it turned out that people were more impressed than I thought and started offering me junior faculty jobs.My husband had already secured a junior faculty job in Berkeley before we even went to England, so we went back there after two years. My husband went to the chair of the department in Berkeley and put down letters on his desk of job offers that both of us had received for independent, junior faculty positions from several universities. The Chairman then said to Tom, “But all of our wives are research associates in our labs, and they love it”. This tore at my pride, as there had been a couple of universities that offered us both faculty jobs, and Berkeley was only offering one. So, we didn''t stay at Berkeley, and we came to Yale, which was wonderful.Suzanne: It''s really amazing to think that they gave you up. How foolish they were.Joan H: They''ve lived to regret it a million times over. Suzanne, at that point were you ready to climb this very difficult ladder?Suzanne: Like Joan, I didn''t have any expectations. For me, it was a matter of being able to continue discovering things in science. Jerry had already arranged to start a postdoc in Geneva. So, I applied for a postdoctoral fellowship, and obtained one. We went off together to Geneva to start our married life, and that was the beginning of us doing science together, which we''ve done ever since. I think without Jerry guiding me at that stage in my life, I would have probably drifted out of science. I don''t think I had the scientific confidence to ever think that I would be running a lab. For me, it was just continuing a voyage of discovery; and being lucky to end up in a wonderful scientific partnership and, through that partnership, my confidence grew over the years. Joan H: How many years after your postdoctoral training was it before you looked around your environment and had the confidence to think that you could be a lab or department head or could run an Institute? Joan S: I would say that confidence just grew. Tom and I were part of a departmental overhaul that involved hiring about six new people at Yale. We all stuck together, supported each other and were very collegial even though we worked in different areas. I think the collegial nature of the department in Yale helped me gain confidence. It was very scary at first because I didn''t know if I could write grants or direct people.Suzanne: Cambridge had an incredible influence, certainly over me, and I''m sure over Joan, Tom and Jerry, too. We looked around and saw all these amazing Nobel laureates, but also all these very ambitious, talented postdocs from around the world. I don''t think anyone thought about being the head of a department at that stage. We were simply striving to make discoveries and we gave each other mutual confidence, and stiff competition, too.The other thing that Cambridge gave us, was a new technology. For Joan and me, it was RNA sequencing. Being able to do that technology opened doors all around the world. I now always advise young people to go to the best place in the world to train in your chosen subject and acquire a new technology, because that will open the door to many opportunities in the future.Jerry and I made some excellent discoveries in Geneva, which were published in front-rank journals. Then it was time to move to full independence. I really wanted to go back to Australia but, as Jerry is an American, it was not at all obvious that he should take the big leap of moving to the bottom of the world and starting a lab there. I owe him a tremendous debt because he decided that he would take that risk.Earlier, whilst on our honeymoon, we had visited various labs in Australia. Although WEHI was an institute for immunology, a field we knew little about at that stage, it had the same atmosphere as the LMB in the sense that everyone was striving at the frontiers of science and competing with the rest of the world. We decided this was the only place in Australia that we would work at and that we would attempt to persuade the new director Gus Nossal that he needed molecular biologists. We had an interview with him in Switzerland and he offered us jobs as postdocs. Again, we were probably very naive and audacious but we told him we didn''t want to be postdocs – we wanted to run our own lab. And he agreed and we launched our fledgling lab together in 1971. What drove us was always discovery, rather than career ambitions.Joan H: You''ve both described these amazing sets of circumstances that were challenging but, nevertheless, very satisfying. However, a lot of things have since changed. What do you think are the main remaining barriers to women in science?Joan S: There is an important phenomenon called social identity threat, or stereotype threat, that I think still impedes women in proceeding in their careers. The phenomenon is described by cognitive psychologists as a reaction that all people experience if they feel that they are part of an undervalued minority. And so, by definition, since there are fewer women in science than there are men, women are being subjected to stereotype threat. Cognitive psychologists have studied the physiological manifestations of this, including increased heart rate and perspiration but, psychologically, they''ve also documented that cognitive learning and memory are impaired when one has these feelings.I first learned about this in 2007 and I looked back and realized why, for 30 years, when I''d been on committees as the only woman amongst ten men, I wouldn''t dare say anything – because I was frightened stiff. Men undergo this response, too, if they''re put into the situation of being undervalued. If you understand why you''re reacting the way you''re reacting and know that this is a normal human response, I think it helps you to overcome your own feelings of insecurity and allows you to go ahead. I always tell young women who I''m rooting for in science about this, because I want them to know that they will very likely end up feeling this way, and it''s a normal human response.

“One thing I sometimes get frustrated about is that we often need men to change things […] but what we really need are women in those high-level positions, so that they can be the champions of change.”

Joan H: There are other terms describing other relevant phenomena, such as unconscious bias, imposter syndrome and champions of change. One thing I really relate to is imposter syndrome. I''ve listened to webinars on this topic and they all reach a similar conclusion that we all feel the same. On the one hand, at the end of the webinar, you do feel somewhat elated to know that it''s not just you, and that it''s normal. But, on the other hand, it doesn''t really change things. It''s a recognition of what we feel, and we all get some help from that, but you really need opportunities to change things at a higher level. One thing I sometimes get frustrated about is that we often need men to change things, leading to this concept of male champions of change. I admire those men; but what we really need are women in those high-level positions, so that they can be the champions of change. Not having 50% of university departments and medical research institutes run by women still limits our full potential.Joan S: I certainly agree with you, Joan. It''s very important to have realistic role models. Suzanne being head of the WEHI for all those years has engendered all sorts of admiration.Joan H: During that period, Suzanne not only did fantastic science but our Institute doubled in size.It''s transformative when you have women making up 50% of people around the table. It''s no help just having a token female because that poor person''s not going to be able to change everything on her own. In American scientific institutions, are there any firm quotas for female scientists and other people that are underrepresented in science?Joan S: In recent years there has been a push in that direction. Sometimes it''s successful and sometimes it''s not. It is very different now compared to when there was no consciousness that this was unfair or that things could be better if we had real representation.Suzanne: I agree with both of you in everything that''s been said. While reflecting at this moment, what it says to me is that what''s really needed is societal change, and that we need to give courage to girls from the very earliest age. It should come naturally, they shouldn''t feel inferior, and others should not look at them as inferior. They should expect to have careers as well as families, be able to manage both and have somebody alongside them who helps them manage both.I think that affirmative action for women in science is necessary because the pace of change has been so slow. However, I also think quotas can be detrimental to the cause of women, in the sense that it''s then possible for people to say you only made it because there was a quota – which is very destructive. If I look back on our careers in science, it is clear that things have changed tremendously. Today there are more opportunities for women because many universities and institutes are bending over backwards to equalise things. The downside of this is that talented men may miss out on positions because of this policy and the pendulum could swing back.Joan H: The evidence shows that when more women are involved in things, those things go better. For instance, boards that have more women on them are more productive. Obviously, what you alluded to is there are lots of fantastic male scientists as well. The real issue here is there''s not enough funding to go round to support all the great men and women. But there are clearly enough good women around to be represented at the 50% level, without disproportionately disadvantaging male scientists.Joan S: Men and women are now operating on a more even playing field, which doesn''t mean that the men are missing out. They''re just in a more-competitive situation – as they should be. Joan H: Suzanne previously covered the specific advice she would give to young female researchers. Joan, do you have any other suggestions? Joan S: I encourage them to try lots of different things in science, and when they find something that really grabs them, then go for it and be persistent. We all know that science is very up and down. But if you keep pushing when you''re in a trough, it will always go back up again and you will succeed. That''s harder for a young person, who hasn''t experienced these troughs, to understand.Joan H: Yes, and the period when women scientists start having children is the hardest part. It''s still a choice that some women make, to take some years off and come back with a less ambitious plan for their career. Obviously, things like maternity leave payments and so on are improving but there''s no question that, in most circumstances, the research will slow down during that period.Suzanne: What I say to young women at that stage of their careers is that you have to be very focused, you must spend the time that you do have in a very focused manner, so that you can be the most productive you can be. But you have to be supported at home by your partner. If you''re both scientists it''s easier because you can appreciate why the other person is rushing into the lab late at night, for example, but for most people, that''s not true. So, what is really important is equal sharing of responsibilities from both partners when young families are around. And I think employers need to give both of those partners a longer time to achieve the kind of papers that they need to progress in their careers. That''s a period when it is much harder to be productive, and we need to continue to support people during that difficult phase of their careers because we''ve invested so much in them. They have so much to offer to science and to society, so to let them slip out at that stage is a great waste.Joan H: Let''s change tack a little bit and think about some of the broader challenges in science. What do you think the COVID-19 pandemic has taught us about the importance of clear scientific communication and real engagement with the community?Joan S: Whenever I talk to people about this, I very clearly make the point that it was decades of fundamental research that led to the development of the COVID-19 vaccine. If it hadn''t been for those fundamental discoveries in how cells and mRNA work, it would never have only taken 63 days from sequencing the virus to phase one clinical trials at Moderna. I try to point out to people that all the different discoveries coming in from different angles made that possible. I personally find it absolutely remarkable that all that knowledge could be harnessed, so very quickly. I''ve been doing fundamental research my entire life and I never expected to see it materialise in the way it has. It''s a wonderful reward. Joan H: Do you think this has resulted in the community appreciating scientists more? Joan S: I don''t think we''re far enough downstream to know that. In the US, there has been a congressional vote to abandon our maintenance of vigilance and preparedness for future pandemics – which seems ridiculous. Now we have all these procedures set up, all we have to do is maintain them for the next one. Whereas, if we just let go of these procedures, we''ll have to start over again for future pandemics. I guess we''re not good enough at communicating some of these things at this point.Joan H: Millions of people died from the virus and yet, if we hadn''t had the vaccines, the scale would have been even more horrific. If we were able to convey this information effectively to the public, then, hopefully, people would recognise that – as well as spending a fixed percentage of the gross domestic product on defence, for example – we should spend at least the same amount on science. Not only for pandemics but for tackling climate change and other pressing issues. I like to think this is an auspicious time but I don''t know whether we are really taking advantage of it.Suzanne: The pandemic has brought science and scientists to the forefront, and there has been a period of great respect for scientists having developed the vaccine. It''s an absolute miracle that it was done so fast and effectively. We''re very fortunate but, as Joan said, that was not luck. It was through investment in basic science for decades. We have to keep conveying this message, to our politicians in particular, so that they will keep supporting all kinds of scientists, because we never know what''s around the corner.Joan H: Certainly, people like Anthony Fauci in the US and Catherine Bennett in Melbourne, spoke eloquently and had a real talent for communicating things clearly and in a nutshell. That''s not something we''re all good at and it''s not something that is easy to train into people either. I think we all need to try to capture the attention of the community at large, by speaking plainly. I don''t think people understand that scientists are underfunded and could do so much more if funding was more generous.

“All I can say to young people is, if you really love science and have a passion for it, keep trying – because you will succeed if you put your whole heart and soul into this career path.”

Suzanne: I think the general public has no appreciation of how tenuous the life of a scientist can be, and how we are losing so many great minds entering the field because young people just finishing their PhDs look with dismay at how hard it is to support a career in science and get enough funding. There''s a tremendous waste of talent. All I can say to young people is, if you really love science and have a passion for it, keep trying – because you will succeed if you put your whole heart and soul into this career path.Joan H: This has been an absolutely fantastic discussion and it''s such a delight to talk to women who, after all these years, are still as passionate as ever and are pursuing their scientific subjects with the same vigour as they have all along.Suzanne: It''s been wonderful to talk with you, Joan, and I hope that we see each other soon, no matter what continent. And thank you, Joan Heath for getting us together and giving us this opportunity.     

碳税和硫税治理下中国未来的碳排放趋势

基于气候治理背景,计算模拟了征收碳税和硫税后的经济影响和减排效果。结果发现,基准情景下,中国经济将保持不断增长的趋势,到2100年,GDP总量将达到69.95万亿美元,碳排放呈现环境库兹涅茨曲线特征,高峰值出现在2034年,碳排放高峰为3832Mt C。在收税治理策略下,无论单独征收硫税还是单独征收碳税,我国的GDP均会受到影响,碳排放都会减少。同时征收碳税和硫税,碳排放显著降低,碳排放高峰出现在2031年,峰值估计为3111Mt C,较基准情景下碳排放高峰降低了721Mt C,高峰值出现的年份也提前了3a,完全满足2030年左右实现碳高峰的承诺。     

Walking between academia and industry to find successful solutions to biomedical challenges: an interview with Geoffrey Smith

Geoffrey W. Smith is currently the Managing Director of Mars Ventures. He actually started his studies with a Bachelor of Arts degree and a Doctorate in Law but then, in part by chance and in part by following in his family footsteps, he stepped into the healthcare and biotech field. Since then, he has successfully contributed to the birth of a number of healthcare companies and has also held academic positions at the Icahn School of Medicine at Mount Sinai and at The Rockefeller University in New York, teaching about the interface between science and business. During 2014 he served as Senior Editor on Disease Models & Mechanisms, bringing to the editorial team his valuable experience in drug development and discovery. In this interview, Geoff talks to Ross Cagan, Editor-in-Chief of Disease Models & Mechanisms, about how he developed his incredibly varied career, sharing his views about industry, academia and science publishing, and discussing how academia and industry can fruitfully meet to advance bioscience, train the scientists and stakeholders of the future, and drive the successful discovery of new therapeutics to treat human disease.Geoffrey W. Smith was born in 1965. He obtained a Bachelor of Arts degree from Williams College in Williamstown, MA. After a stint as a Research Associate at Harvard Business School, he graduated from the University of Pennsylvania Law School. Following a federal court clerkship and first job experiences in law, he joined a healthcare services start-up named Advanced Health as one of its first employees. Geoff then co-founded various healthcare and technology companies, including Interbind and Ascent Biomedical Ventures, and is still a Managing Partner at the latter. In 2012, he joined the Icahn School of Medicine at Mount Sinai, first as Professor in the Department of Population Health Science And Policy, and then as Director and co-founder of the Design, Technology, and Entrepreneurship PhD program. Until December 2014, he was a Senior Editor at Disease Models & Mechanisms. Geoff is now Managing Director of Mars Ventures.Let''s start with your background. You have a Bachelor of Arts degree and a law degree. How is it exactly that you ended up working in biotech and pharma?My career path has been anything other than linear. I was actually pursuing my legal career when two entrepreneurs turned up at the law firm I was working for with an idea for a new technology-based company focused on more effectively managing healthcare services. I was a new associate without much to do, so I got assigned to work with the start-up and after about a year they asked me to come and join the company, Advanced Health. I had grown up in a very medically oriented family – my father was a medical school professor, my older sister was a PhD, and my younger sister is a medical doctor – and so to a certain extent joining a start-up in the healthcare space was a bit like joining the family business.We had a fair amount of success with that company. A little less than 2 years after I joined it, we had a successful initial public offering, and that started me down the road of participating in the start-up environment around healthcare.It sounds like it was not a surprising path for you. Which key people influenced you?Actually, it is somewhat surprising in that I had really prepared for and expected a career in law. Certainly, the work I did in law school and the first jobs I had after that started me on a different career. I was really focused on international relations and international law. The twist was that I got brought back into the healthcare arena, and ultimately the biotech arena, by a serendipitous connection – one of the entrepreneurs who started Advanced Health had trained at Brigham Women''s Hospital where my father was the Chief of Cardiology. It was through this connection that I became more than just an associate drafting legal documents and really began to build a close relationship with the founders, which ultimately led to me joining that business. This taught me that you can spend much of your time preparing, and thinking that your schooling is going to take you in one direction, but individual relationships can change your path and take you somewhere else altogether. In my case, these particular relationships stemmed from my father, who clearly had an enormous influence on me. He was both a practising clinician and a basic researcher, studying basic biology related to the function of sodium and potassium in the heart, but he also did applied research. He helped develop a radioimmunoassay test to measure digitalis levels in the blood and ultimately was involved in developing a drug called Digibind, an antidote to digitalis toxicity, which was one of the first drugs to use antigen-binding fragments [Fab] as the basis for a drug. Watching him manage these different activities in his career had a big influence on me.

“This taught me that you can spend much of your time preparing, and thinking that your schooling is going to take you in one direction, but individual relationships can change your path and take you somewhere else altogether”

I think that each of my sisters – as I said, one of whom went down a PhD route and one of whom went down a medical training route – had a big influence on me, as well. Watching the challenges that they had to face in those areas in some ways pushed me to go off towards law school and take a different path. It also brought me back to one of the aspects that I think is the most rewarding in the bioscience field, which is that you can have a profound impact on a large number of people through your efforts, whether they be purely research-based, academic-based or commercially-based.One of the things I was constantly impressed by is that you always seem to have a good feel for the health field and the biology field. Is this because it is something of a family business?I think so. Growing up at my dinner table, I was just privileged to get to meet and interact with a lot of incredibly successful clinicians and researchers. For me those were comfortable conversations: these were friends and so there was a comfort level being involved in that environment. I didn''t feel a lot of intimidation from it, which I think sometimes people who come from the outside do.One of the aspects I really like about the bioscience field is the impact of ideas. Success is really about one''s ideas and ability to execute them, and that was very appealing to me. It wasn''t about how much money you had or where you went to school, it was really about the ability to think deeply about a problem or a potential advancement and figure out a way to find a way forward. It is also a very people-driven process because it is not only about thinking deeply yourself but also about thinking deeply with those in your field or adjacent to your field. Lots of different personality types can succeed in this field, but I think it is certainly easier for people who have an affinity for sitting with people and thinking about a common area of interest.To that point, you actually have walked between business and scientists. What do you see is the difference? Some of the priorities are obvious, but what are the differences in terms of what motivates people in the two? Are the personalities that you come across different between the basic science world, the translating science world and the business world?I don''t think the personalities are particularly different. I think you find introverts and extroverts and everything in between in each of these areas. I am not sure that personality is necessarily a good predictor of success. I think it''s a question of what toolset you are most comfortable using to get at a problem, and where in the lifespan of a problem you''re interested in working.For example, scientists in academia very often are interested in working at an early stage of a problem. They understand something fairly basic about a process or something earlier in the understanding of a field. People who gravitate towards industry, instead, are more excited about working on the later part of a process, so, rather than trying to understand what the fundamental working mechanism is, they want to understand how to work that mechanism in a way that is predictable and repeatable.Obviously people in the commercial realm are often highly influenced by money, but even that I don''t think is really particularly the differentiator. There are plenty of academics who are driven by money as well. I really think it has much more to do with where on the spectrum of understanding one is interested in working. Industry is geared to solving practical problems and, if a lot is understood about a problem, to getting down to the ability to repeatedly and safely intervene, whereas academia really lends itself more towards understanding the front end of a problem or of an unknown mechanism to understand it first and at a more basic level.What about working in teams versus individually? Do you see a difference there?I think that has changed over time. I think it is very hard in academia today to be the brilliant solo investigator. I''m not saying it''s impossible but, considering the increasing size of the data sets one is working with, the statistical methods one has to use, the complexity of different fields overlapping with each other, it''s just very hard to handle all the necessary aspects of modern science as an individual. Increasingly, working in teams isn''t a choice: I think it''s a necessity in order to be effective. The difference may be that, in academia, often the teams are teams of collaborators (meaning they have influence but not necessarily power over all people participating in the team) who may work for different institutions, whereas, more commonly in industry, teams are working within a single corporate structure. In industry more often there are hierarchical relationships, which may allow for more directive behavior. Again, I''m not sure I would draw as much distinction between team or not team and between industry and academia, but I might draw somewhat of a distinction between how those teams function and how one manages a team. I think they are a bit different between the two realms.

“Increasingly, working in teams isn''t a choice: I think it''s a necessity in order to be effective”

Let''s turn to Disease Models & Mechanisms [DMM], where you have been a Senior Editor. What did your experience at DMM teach you about science publishing that perhaps you hadn''t thought about, and has it made you think more deeply about what goes into a good scientific piece of work? What were some of the surprises?Watching the detailed process that is necessary to take a piece from an initial submission through to a published article gave me comfort and respect for the level of diligence and the level of attention that the reviewers brought to the vast majority of the pieces. It gave me a good feeling that the science community can be a strong self-reinforcing organization that takes its responsibility to heart and only publishes the best of the work available. I think that was very reassuring.An interesting question for me was: is there a different function that the publication process could play in helping to galvanize new ideas or new interactions among different fields? That seemed to be challenging because people don''t want to rush out there without their ideas and data being fully thought-out and fully vetted. But still, somewhere in my mind is this notion that there should be an option in the publishing world to play a little bit earlier in the generation of new ideas.Do you mean journals having an earlier relationship – earlier in the experimental process with a laboratory – to work with them to provide advice?I don''t know if it''s to provide advice. One of the things I was struck by at DMM is that there are these different siloed research communities – for example, the fly and the fish communities – in which interactions and relationships in the individual fields are so well established and routinized. And the outcome from a publishing standpoint is still the canonical academic paper that has been relatively unchanged over a long period of time. Yet, we have had these tremendous changes in information and communication technology such that the manner of knowledge production and the methods of communicating in other parts of society have changed dramatically. It feels like there hasn''t been nearly as big a concomitant communication change in the biomedical sciences, and so the silos and the standard paper remain the way things are done.The publication process, because of its preciseness, can take quite a long time, so the musing here is whether there is a way that the publishing industry could facilitate an earlier, more speculative communication of interesting results in a way that would positively impact the field by turning over new information sooner. If you look at an area like maths, for example, and their pre-print servers, there is more of a notion of putting ideas out in the community that acts as a kind of peer-review process and a way to get the community interacting on new ideas early. That doesn''t seem to get a lot of attention in the life sciences area. It seems to me that even journals like the PLOS journals that are pushing towards a more open world of communication are still ending up being pulled back into the canonical paper form to communicate.

“…the musing here is whether there is a way that the publishing industry could facilitate an earlier, more speculative communication of interesting results in a way that would positively impact the field by turning over new information sooner”

I guess one of the issues on the biology side is that there is a real emphasis on trying to get your paper into the most prestigious journal, so people don''t want to drop that paper until it is as far along as possible to aim at high-impact journals.That of course becomes a self-reinforcing system. If the yardstick used in the life sciences industry is publication in high-impact-rated journals, then you are going to get that behavior. But if you''re interested in the generation of new knowledge and in moving your field forwards, it is at least plausible that publishing in a quicker fashion or with at least some outlet to move more creative ideas ahead would be attractive.There are clearly challenges to that. But I do think it''s remarkable that if you look at almost every other media area there has been a huge amount of change since the advent of the internet era, but there really has been very limited change around life sciences publishing. It''s been surprisingly conservative to me. I am wishing there would be more experimentation to find other ways to communicate information sooner and in a way that could spur more creativity.Of course, when you tie publishing back to industry, for competitive and intellectual property protection reasons, industry tends to not really want to get out in the front with its most interesting work too early. I think that a lot of things being published out of industry are not the most interesting stuff that is happening. But again it seems to me that another area that science publishing should be thinking about is how they could come up with other solutions that might provide for a more creative interaction between publishing and industry.Talking about old models versus new models, let''s move to issues of training. Another area that you''ve been impressive at is the training of scientists. You''ve had your hand in creating a new PhD track at Mount Sinai called Design, Technology, and Entrepreneurship [DTE]. What is your view about how we train scientists, what we''re doing better these days and what you would like to see being done better to train them?It seemed to me that there was a remarkably small amount of experimentation in academia around thinking about how to train biomedical PhDs, and that academia had missed the opportunity to provide a better set of tools to PhDs to allow them to be effective across a wider range of potential career outcomes. The majority of biomedical PhDs are not ending up in tenure-track faculty positions but rather in the ‘alternative career track’. It seemed to be disingenuous to train them solely for the academic track if in reality the majority were going to some other career track.So what I was really excited about in putting together the DTE program was trying new ways to train PhDs to be effective askers of questions and proposers of solutions, and to create an environment where they could gain experience in how to solve a variety of problems effectively.

“…what I was really excited about in putting together the DTE program was trying new ways to train PhDs to be effective askers of questions and proposers of solutions, and to create an environment where they could gain experience in how to solve a variety of problems effectively”

This meant that our students had to be rigorously trained as scientists, but this was an ‘and’ opportunity and not an ‘or’ opportunity. In addition to being trained as excellent basics scientists, we wanted to give them some training in how engineers think about problems, how designers approach issues, what tools those people use and how that impacts how they try to solve a problem. Hopefully over time this would produce students that are better suited for interacting and influencing other parts of society – be it industry, government or policy – and better positioned to compete in what is a very competitive job market.What were some of the things you did in the DTE training to get at this?We really tried to teach theory in the context of real problems. Virtually all the classes of the DTE curriculum were problem-driven. We created a class that we called ‘The Q.E.D. Project’ that followed along from efforts at Stanford and elsewhere to teach students how to identify an unmet need. We then asked them to form a team to address the unmet need, and then helped them understand how to build a prototype to address that need. Along the way, we also talked about what kind of roles people in their team need to play. Should your team be very diverse or very deep in a given area? How do we integrate people who have different cultural backgrounds or how do we integrate medical students with PhD students? We brought in a lot of people out of the non-academic environment who were practitioners and experts in their various areas and we tried to get students to think about the full range of stakeholders they would have to engage with to bring a solution to bear.We did not want to spend a lot of time lecturing the students in a purely didactic way. We wanted to engage them in a process where they were solving important problems as part of the class. Whether that was a class on modelling or an engineering-focused class, or how to think about scientific problems, the core of DTE was built around getting the students to grapple with a real world problem and let all the learning hang off that.How did the students respond to that? Do you think you were successful?Based on the number of students signing up to take the courses and the student evaluations after the classes were over, I think we really struck a chord. I wouldn''t say it was necessarily the right answer for every student but I think there is clearly a group of students for whom this is a really effective and motivating approach.Let''s now move to drug discovery and development – the focus of the new online Special Collection from DMM. What would you say are some of the most urgent challenges in drug development that you have seen?I think one of the most urgent challenges is to begin to break free of some of our ‘old’ ways of thinking and take advantage of new scientific insights. For example, if you look at the traditional organization in a medical school environment, they are centered around departments devoted to organs (liver, heart, kidney). I think our increasing scientific understanding is that there are disease processes that may impact multiple organ systems but ultimately it is understanding the process, and drugging the process, that becomes important and not drugging the organ.I think that moving towards a process-oriented understanding of what common mechanisms are implicated in a given disease state or therapeutic challenge will help us be a little more creative and a little bit more interdisciplinary in how we think about these challenges.One of the difficulties with those new approaches is that pharmaceutical companies and academic institutions have not had a great track record of working together. Do you think that''s true? And why do you think it''s been so difficult to move ideas from the bench to the clinics?I think this is complicated. If you take the academic researchers'' point of view, their early identification of a problem and early identification of a potential solution feels like they have moved the ball very far forward towards the end solution. If you take industry''s point of view, the identification of the target or even the identification of a potential chemical compound is really just barely beginning to get to the starting line; the bulk of the time and the bulk of the dollars that will ultimately be needed to create a product come after the academic work and these will be spent by industry. I think that this differing point of view around where and how value is created has a lot to do with many of the challenges that arise when academia and industry are speaking to each other.Is it important to bridge this gap or is everybody playing their role?I think there''s an opportunity for academia to continue in its current role but to carry the potential solution further. I think in certain areas the access to tools and to patients allows academics to maybe carry projects further and closer to ‘proof of concept’ than they did historically, and that will continue to add value to the academic institution. That would ultimately help to bridge this gap because if you''ve taken something closer to proof of concept while still within the academic institution, you have created more value, you are able to engage with industry differently, and maybe the value perception gap is closed somewhat.What industry is really good at is organizing and managing late-stage research and clinical trials in an effective manner, and what academia is really good at is understanding basic questions, finding targets and sometimes finding early chemical compounds. Again, I think that the perception in academia of where value has been created is in part related to the fact that many academics haven''t been given the exposure or the training to actually understand the full breadth of the drug-development process. While they may have a general sense of it – we have all seen the same diagrams showing the steps and the funnel narrowing down from a million compounds to something getting onto the market – only those with real exposure to the work in industry understand it at a visceral or experiential level. One of the opportunities for academia is to find better ways to have some cross-talk, whether that''s internships for graduate students to get some experience in industry or other ways to get the students really exposed to the industrial side of drug development. Obviously, all the trained scientists on the industry side have been through academia because they had to go through it to get their PhDs, and thus they understand the academic side of the house pretty well. I really think the challenge is getting to people who have spent their whole career in academia to have a better understanding of what the drivers are on the industry side.

“One of the opportunities for academia is to find better ways to have some cross-talk, whether that''s internships for graduate students to get some experience in industry or other ways to get the students really exposed to the industrial side of drug development”

Between target identification and clinical trials of course there is another piece. At what point does the researcher in academia put down his pipette, walk out and start a biotech company? Should that happen?That''s a fraught question because I think it is an enormous undertaking to start a biotechnology company. Fundraising, intellectual property, regulatory affairs, company management – there are a whole number of disciplines that biotech companies have to take on. It is very rare that an academic scientist is going to have the training, the time and the motivation to do all of those things while also continuing to pursue their academic career in a very challenging funding environment. I think it comes back to this point that we were talking about with teams. I think it is really important for a scientist who is excited about their work and thinks it may be the basis of a company to go out and begin to form a team that is going to increase the likelihood of success. They have to accept the fact that science is a critical component, but it is just a component, and many different disciplines along with many different people are needed to make a successful company. If a scientist can bring that sort of collaborative view point and is open to working closely with an intellectual property attorney, with a business development person and with whomever their funding source is, that will increase their likelihood of success. They have to do it with a certain amount of humility, which is to say that it isn''t just going to be the science that drives the success: all the given pieces have to come together to be successful.You''ve watched a lot of technology coming through, including at your new position at Mars. Which technology excites you?We all have to pay a lot of attention to CRISPR and the gene-editing technologies. There is certainly a number of intellectual property issues that have to get sorted out but that''s clearly an area that will have a huge impact not just on human health but on animal health and plant health as well.The other area I''ve been thinking a lot about lately is the microbiome. As sequencing technology has altered in cost and time, we have begun to be able to explore the microbiome in a way that historically was not possible. And it feels like we are moving towards a tipping point where the explosion of understanding is going to open up a lot of interesting opportunities for us to intervene. Whether that''s through traditional drug modalities or through altered nutrition or through changing the microbial community in soil to produce crops that have higher nutrient value or other approaches, I think that''s another broad area that seems poised to begin to offer really interesting results.Were you surprised that a company like Mars, which has not been a basic research company at all, is now giving you an opportunity to build something that is much more research-orientated?The reality of Mars is that they have actually had a very deep fundamental research program for a number of years. They got involved in the sequencing of the cacao genome and contributed it to the public domain, and they are now also involved in the sequencing of the genomes of a large number of orphan crops in Africa. So they have been very active in their research both in the company and in collaboration with academic scientists around the world. The nature of the company has meant that the work is perhaps not as obvious as others, but it is a remarkably science-driven company in much of what it does.You have done a myriad of things. What are the one or two things that you are most proud of?I am most proud of my efforts to keep a hand in both the commercial and the academic world. It certainly has not been easy but I have received enormous satisfaction from the opportunity to work with bright students at each of the schools I have had the opportunity to teach at. I am not sure there is anything more satisfying than the opportunity to work with students and feel you have helped them towards their goals.At the same time, I think I''ve been effective in doing that because I have managed to keep an active role in the applied world. In some ways, my greatest achievement has been finding a way to balance those two interests in a way that seems to have worked for the various organizations I''ve been affiliated with.How do you relax away from work? Do you have a family?I am married. My wife is a securities litigator so has a very active career of her own. We have two children, one in high school and one in middle school. I''ve had the privilege to coach both of them on their various soccer teams since they were each about 4 years old so that''s been a lot of fun.The other thing that many people will not find relaxing – but for some reason my family does – has been taking backcountry ski trips annually for a number of years. Worrying about navigating through the snow and finding shelter before darkness falls has a way of clearing the mind.     

On Cloning: Advocating History of Biology in the Public Interest

Cloning – the process of creating a cell, tissue line or even a complete organism from a single cell – or the strands that led to the cloning of a mammal, Dolly, are not new. Yet the media coverage of Dolly's inception raised a range of reactions from fear or moral repulsion, to cautious optimism. The implications for controlling human reproduction were clearly in the forefront, though many issues about animals emerged as well. On topics of public interest such as cloning, historians of biology have the opportunity to make a unique contribution. Such debates are often aired as if they have no precedents, either in biology or in the ethical, moral, and social concerns arising in the public arena. The technology leading to Dolly draws on strands of research going back to the 1890s, and the cycle of public response has been repeated often in the past century. What can we learn from examining these events historically, and how can we – or should we even try – to inform public opinion? I think we should try and will outline briefly some of the ways that can work.     

Gene patents and capital investment

Will the US Supreme Court''s ruling that genes can no longer be patented in the USA boost venture capital investment into biotech and medical startup companies?Three years ago, Noubar Afeyan, managing partner and CEO of Flagship Ventures, an early-stage venture capital firm in Cambridge, Massachusetts, USA, was working with a biotech start-up company developing techniques for BRCA gene testing for breast cancer risk that avoided the patents held by Myriad Genetics, a molecular diagnostics company in Salt Lake City (Utah, USA) and the only operator in the field. However, despite the promise of the start-up''s techniques, investors were put off by Myriad''s extensive patent portfolio and fiercely defensive tactics: “A lot of investors were simply not willing to take that chance, even though our technology was superior in many ways and patentably different,” Afeyan said. The effort to launch the start-up ultimately failed.…it is also not clear how the Supreme Court''s ruling will affect the […] industry at large, now that one of the most contested patents for a human gene has been ruled invalidAfeyan believes the prospects for such start-ups improved on the morning of 13 June 2013 when the US Supreme Court ruled in an unanimous vote that Myriad''s fundamental patents on the BRCA1 and BRCA2 genes themselves are invalid, opening up the field to new competitors. The court''s ruling, however, validated Myriad''s patents for BRCA cDNA and methods-of-use.The court''s decision comes at a time when venture capital investment into the life sciences is projected to decline in the years ahead. Some believe that the court''s decision sets a precedent and could provide a boost for products, diagnostics and other tests under development that would have been legally difficult in the light of existing patents on human and other DNA sequences.The US Patent Office issued the original patents for the BRCA 1 and BRCA2 genes in 1997 and 1998 for the US National Institute of Environmental Health Services, the University of Utah and Myriad Genetics. One year earlier, Myriad had launched its first diagnostic test for breast cancer risk based on the two genes and has since aggressively defended it against both private and public competitors in court. Many universities and hospitals were originally offering the test for a lower cost, but Myriad forced them to stop and eventually monopolized BRCA-based diagnostics for breast cancer risk in the USA and several other countries.“Myriad did not create anything,” Justice Clarence Thomas wrote in the Supreme Court''s decision. “To be sure, it found an important and useful gene, but separating that gene from its surrounding genetic material is not an act of invention.” Even so, the court did uphold Myriad''s patents on the methodology of its test. Ron Rogers, a spokesman for the biotech firm, said the Supreme Court had “affirmed the patent eligibility of synthetic DNA and underscored the importance and applicability of method-of-use patents for gene-based diagnostic tests. Before the Supreme Court case we had 24 patents and 520 claims. After the Supreme Court decision, we still have 24 patents. […] [T]he number of our patent claims was reduced to 515. In the Supreme Court case itself, only nine of our 520 patent claims were at issue. Of the nine, the Supreme Court ruled that five were not patent-eligible and they ruled that four were patent-eligible. We still have strong intellectual property protection surrounding our BRCA test and the Supreme Court''s decision doesn''t change that.”Within hours of the ruling, capitalism kicked into high gear. Two companies, Ambry Genetics in Alieso Viejo, California, and Gene by Gene Ltd in Houston, Texas, USA, announced that they were launching tests for the BRCA1 and BRCA2 genes for less than the US$3,100 Myriad has been charging privately insured patients and US$2,795 for patients covered by Medicare—the government health plan for the elderly and disabled. Several other companies and universities also announced they would be offering BRCA testing.Entrepreneur Bennett Greenspan, a managing partner of Gene by Gene, explained that his company had been poised to offer BRCA testing if the Supreme Court ruled against Myriad. He said, “We had written a press release with our PR firm a month before the release of the Supreme Court with the intention that if the Supreme Court overruled the patent or invalidated the patent that we would launch right away and if they didn''t, we would just tear up the press release.” His company had previously offered BRCA gene testing in Israel based on guidelines from the European Union.Myriad Genetics has not given up defending its patents, however. On 9 and 10 July 2013, it slapped Ambry and Gene by Gene with lawsuits in the US District Court in Salt Lake City for allegedly infringing on patents covering synthetic DNA and methods-of-use related to the BRCA1 and BRCA2 genes. Rogers commented that the testing processes used by the firms “infringes 10 patents covering synthetic primers, probes and arrays, as well as methods of testing, related to the BRCA1 and BRCA2 genes.”On 6 August 2013, Ambry countersued Myriad, arguing that the company “continues a practice of using overreaching practices to wrongfully monopolize the diagnostic testing of humans'' BRCA1 and BRCA2 genes in the United States and to attempt to injure any competitor […] Due to Myriad''s anticompetitive conduct, customers must pay significantly higher prices for Myriad''s products in the relevant market, often nearly twice as high as the price of Ambry''s products and those of other competitors” [1].Just as the courts will have to clarify whether the competitors in this case infringe on Myriad''s patents, it is also not clear how the Supreme Court''s ruling will affect the biotech and diagnostics industry at large, now that one of the most contested patents for a human gene has been ruled invalid. In recent years, venture capital investment into the life sciences has been in decline. The National Venture Capital Association and the Medical Innovation & Competitiveness Coalition reported from a survey that, “An estimated funding loss of half a billion dollars over the next three years will cost America jobs at a time when we desperately need employment growth” [2]. The survey of 156 venture capital firms found that 39% of respondents said they had reduced investment in the life sciences during the previous three years, and the same proportion intended to do so in the next three years. “[US Food and Drug Administration] FDA regulatory challenges were identified as having the highest impact on these investment decisions,” the report states, adding that many investors intended to shift their focus from the US towards Europe and the Asia/Pacific region.Another report from the same groups explains how public policy involving the FDA and other players in “the medical innovation ecosystem”—including the US patent system, public agencies, tax policy, securities regulation, immigration laws and private groups such as insurers—affect the decisions of investors to commit to funding medical innovation [3].Some investors think that the court decision about the patentability of human DNA will increase confidence and help to attract investors back to the life sciencesSome investors think that the court decision about the patentability of human DNA will increase confidence and help to attract investors back to the life sciences. “The clarity is helpful because for the longest time people didn''t do things because of ambiguity about whether those patents would be enforceable,” Afeyan said. “It''s one thing to not do something because of a patent, it''s another to not do something because you know that they have patents but you''re not sure what it''s going to stop you from doing because it hasn''t been really fully fleshed out. Now I think it is reasonably well fleshed out and I think you will see more innovation in the space.”Others also appreciate the clarification from the Supreme Court about what is a patentable invention in regard to human genes and DNA. “The Myriad decision was a very solid reading of the underlying purpose of our patent law, which is to reward novel invention,” commented Patrick Chung, a partner with New Enterprise Associates, a venture capital firm in Menlo Park, California, which invested in 23andMe, a personal genomics company based in Mountain View (California, USA), and who serves on the 23andMe board.But not everyone agrees that the Supreme Court''s decision has provided clarity. “You could spin it and say that it was beneficial to create some certainty, but at the end of the day, what the Court did was reduce the scope of what you''re allowed to get patent claims on,” said Michael Schuster, a patent lawyer and Intellectual Property Partner and Co-Chair of the Life Sciences Group at Fenwick & West LLP in San Francisco, California, USA. “It''s going to be a continuing dance between companies, smart patent lawyers, and the courts to try to minimize the impact of this decision.”Kevin Noonan, a molecular biologist and patent lawyer with McDonnell Boehnen Hulbert & Berghoff LLP in Chicago, Illinois, USA, commented that he does not expect the Supreme Court decision will have much of an impact on venture investments or anything else. “This case comes at a time fortunately when biotechnology is mature enough so that the more pernicious effects of the decision are not going to be quite as harmful as they would if this had happened ten, 15 or 20 years ago,” he said. “We''re now in the ‘post-genomic'' era; since the late ‘90s and turn of the century, the genomic and genetic data from the Human Genome Project have been on publicly available databases. As a consequence, if a company didn''t apply for a patent before the gene was disclosed publicly, it certainly is not able to apply for a patent now. The days of obtaining these sequences and trying to patent them are behind us.”Noonan also noted that the Myriad Genetics patents were due to expire in 2014–2015 anyway. “Patents are meaningless if you can''t enforce them. And when they expire, you can no longer enforce them. So it really isn''t an impediment to genetic testing now,” he explained. “What the case illustrates is a disconnect between scientists and lawyers. That''s an old battle.”George Church, professor of genetics at Harvard Medical School (Boston, Massachusetts, USA) and Director of the Personal Genome Project, maintains that the Supreme Court decision will have minimal influence on the involvement of venture capitalists in biotech. “I think it''s a non-issue. It''s basically addressing something that was already dead. That particular method of patenting or trying to patent components of nature without modification was never really a viable strategy and in a particular case of genes, most of the patents in the realm of bio-technology have added value to genes and that''s what they depend on to protect their patent portfolio—not the concept of the gene itself,” he said. “I don''t know of any investor who is freaked out by this at all. Presumably there are some, because the stock oscillates. But you can get stock to oscillate with all kinds of nonsense. But I think the sober, long-term investors who create companies that keep innovating are not impacted.”Church suggests that the biggest concern for Myriad now is whole-gene sequencing, rather than the Supreme Court''s decision. “Myriad should be worrying about the new technology, and I''m sure they''ve already considered this. The new technology allows you to sequence hundreds of genes or the whole genome for basically the price they''ve been charging all along for two genes. And from what I understand, they are expanding their collection to many genes, taking advantage of next generation sequencing as other companies have already,” he said.Whatever its consequences in the US, the Supreme Court''s decision will have little impact on other parts of the world, notably Europe, where Myriad also holds patents on the BRCA genes in several countries. Gert Matthijs, Head of the Laboratory for Molecular Diagnostics at the Centre for Human Genetics in Leuven, Belgium, says that even though the US Supreme Court has invalidated the principle of patenting genes in America, the concept remains in Europe and is supported by the European Parliament and the European Patent Convention. “Legally, nothing has changed in Europe,” he commented. “But there is some authority from the US Supreme Court even if it''s not legal authority in Europe. Much of what has been used as arguments in the Supreme Court discussions has been written down by the genetics community in Europe back in 2008 in the recommendations on behalf of the European Society for Human Genetics. The Supreme Court decision is something that most of us in Europe would agree upon only because people have been pushing towards protecting the biotech industry that the pendulum was so way out in Europe.”Benjamin Jackson, Senior Director of legal affairs at Myriad Genetics, commented that Myriad holds several patents in Europe that are not likely to be affected by the Supreme Court''s ruling. “The patent situation both generally and for Myriad is a lot clearer in Europe. The European Union Biotech Directive very clearly says that isolated DNA is patentable even if it shares the same sequence as natural DNA,” he said. “Right now, it''s pretty uncontroversial, or at least it''s well settled law basically in Europe that isolated DNA is patentable.” However, while the Directive states that “biological material which is isolated from its natural environment or produced by means of a technical process” might be patentable “even if it previously occurred in nature”, the European Patent Office (EPO) in Munich, Germany, requires that the subject matter is an inventive step and not just an obvious development of existing technology and that the industrial application and usefulness must be disclosed in the application.Myriad has opened a headquarters in Zurich and a lab in Munich during the past year, hoping to make inroads in Europe. In some EU countries, Myriad offers its BRCA test as part of cancer diagnosis. In other countries, BRCA testing is conducted at a fraction of what Myriad charges in the USA, either because institutions ignore the patents that are not enforced in their jurisdictions, or because these countries, such as Belgium, were not included in the patent granted by the European Patent Office. Moreover, in various countries BRCA testing is only available through the healthcare system and only as part of a more extensive diagnosis of cancer risk. In addition, as Matthijs commented, “[t]he healthcare system in Europe is very heterogeneous and that''s also of course a big impediment for a big laboratory to try and conquer Europe because you have to go through different reimbursement policies in different countries and that''s not easy.”Ultimately, it seems the Supreme Court''s decision might turn out to have little impact on biotech firms in either the USA or Europe. Technological advances, in particular new sequencing technologies, might render the issue of patenting individual genes increasingly irrelevant.     

Evolutionary psychiatry: foundations,progress and challenges

Evolutionary biology provides a crucial foundation for medicine and behavioral science that has been missing from psychiatry. Its absence helps to explain slow progress; its advent promises major advances. Instead of offering a new kind of treatment, evolutionary psychiatry provides a scientific foundation useful for all kinds of treatment. It expands the search for causes from mechanistic explanations for disease in some individuals to evolutionary explanations for traits that make all members of a species vulnerable to disease. For instance, capacities for symptoms such as pain, cough, anxiety and low mood are universal because they are useful in certain situations. Failing to recognize the utility of anxiety and low mood is at the root of many problems in psychiatry. Determining if an emotion is normal and if it is useful requires understanding an individual's life situation. Conducting a review of social systems, parallel to the review of systems in the rest of medicine, can help achieve that understanding. Coping with substance abuse is advanced by acknowledging how substances available in modern environments hijack chemically mediated learning mechanisms. Understanding why eating spirals out of control in modern environments is aided by recognizing the motivations for caloric restriction and how it arouses famine protection mechanisms that induce binge eating. Finally, explaining the persistence of alleles that cause serious mental disorders requires evolutionary explanations of why some systems are intrinsically vulnerable to failure. The thrill of finding functions for apparent diseases is evolutionary psychiatry's greatest strength and weakness. Recognizing bad feelings as evolved adaptations corrects psychiatry's pervasive mistake of viewing all symptoms as if they were disease manifestations. However, viewing diseases such as panic disorder, melancholia and schizophrenia as if they are adaptations is an equally serious mistake in evolutionary psychiatry. Progress will come from framing and testing specific hypotheses about why natural selection left us vulnerable to mental disorders. The efforts of many people over many years will be needed before we will know if evolutionary biology can provide a new paradigm for understanding and treating mental disorders.     

Restoration ecology: the study of applied optimism

As a young trainee in the field of restoration ecology in the modern age, it is difficult to feel optimistic about our future. As many environmental protections are de‐regulated and the climate crisis heightens, I turned to restoration to find hope in a changing world. Restoration ecologists are the optimists of biology. We work every day to make the world a better place and our passion and forward thinking spurred the United Nation's “decade of restoration.” Learning about the successes of the hardworking members of this field gives me hope. As the earth moves toward an unimaginable future, we should continue to try to make the world a better place and encourage those around us to act and restore the environments they value, whether it be large‐scale restoration or preserving garden pollinator habitat. I am forever thankful to restoration ecology and the optimism the field provides.     

The Structure of an Image

It is a special joy to get one's hands on a good instrument, and it is particularly pleasant to show it to people who will be good judges of it. I should like to present to my colleagues' attention a theoretical model I have found to be a very convenient intellectual tool useful in both psychodiagnostics and for psychotherapy.     

Diagnosing Suicides of Resolve: Psychiatric Practice in Contemporary Japan

In Japan, suicide has long been depicted as an act of free will, even aestheticized in the cultural notion suicide of resolve. Amid the record-high Japanese suicide rates since the 1990s, however, Japanese psychiatrists have been working to medicalize suicide and, in the process, confronting this deeply ingrained cultural notion. Drawing on two years of fieldwork at psychiatric institutions around Tokyo, I examine how psychiatrists try to persuade patients of the pathological nature of their suicidal intentions and how patients respond to such medicalization. I also explore psychiatrists' ambivalent attitudes toward pathologizing suicide and how they limit their biomedical jurisdiction by treating only what they regard as biological anomaly, while carefully avoiding the psychological realm. One ironic consequence of this medicalization may be that psychiatrists are reinforcing the dichotomy between normal and pathological, "pure" and "trivial," suicides, despite their clinical knowledge of the tenuousness of such distinctions and the ephemerality of human intentionality. Thus, while the medicalization of suicide is cultivating a conceptual space for Japanese to debate how to bring the suicidal back onto the side of life, it scarcely seems poised to supplant the cultural discourse on suicide that has elevated suicide to a moral act of self-determination.     

Can doctors place limits on their medical practices?

PHYSICIANS SHOULD EXERCISE GREAT CAUTION and probably seek legal counsel if they decide to place specific limits on the work they will do or patients they will see, lawyer Karen Capen warns. The BC Human Rights Council recently ruled that a physician had violated the province''s Human Rights Act when he declined to provide artificial insemination for a lesbian couple. The physician argued unsuccessfully that increased risks of litigation constituted a bona fide and reasonable justification for denying the service.     

Rattlesnakes Create a Context for Localizing Their Search for Potential Prey

This paper presents systematically collected field data on what transpires between free-living rattlesnakes (Crotalus viridis oreganus) and individuals of an important prey species, California ground squirrels (Spermophilus beecheyi). In the course of two field seasons we discovered that rattlesnakes and California ground squirrels can engage in at least six different episode classes: snake watching, snake following, inspecting/probing coiled snakes, interaction, rattlesnake approaching squirrel and envenomation. If a rattlesnake is moving directly toward a squirrel and is within 3 m of its burrow an interaction may develop, but more commonly it does not. Instead of engaging the snake, the squirrels seemed to try to remain stationary in the face of the snake's advance, as if to minimize affording the snake information about the nursery burrow location. The rattlesnakes in turn behaved as though they were using the location of the squirrels that resisted moving away from their advance as the hub of a radial search pattern. We argue that if the squirrel engages the snake before it discovers the burrow, the location of the nursery burrow may be revealed and the pups' vulnerability actually increased.     

The control of food flow in a society of the ant Myrmica rubra L

The control of prey, thin syrup and water flow, through a society of Myrmica was studied. Larval intake increases if they are deprived of prey, but not if they are deprived of water or sugar. Deprivation causes them to take prey juices from workers and they get more if the workers themselves have also been deprived; this is because such workers over-collect and readily pass on their surplus. Even well-fed larvae will take prey juices from these surfeited workers; they will also take sugary fluids but not water. The head of a larva elicits some food collection by workers even if it is immobile, but the real cause of food flow towards larvae is their ability to absorb and assimilate the prey juices which they can obtain from workers. Starved nurse workers can obtain prey and water from foragers but a reverse flow does not occur; only thin syrup is exchanged freely between workers.     

Long-term social bonds promote cooperation in the iterated Prisoner's Dilemma

Reciprocal altruism, one of the most probable explanations for cooperation among non-kin, has been modelled as a Prisoner''s Dilemma. According to this game, cooperation could evolve when individuals, who expect to play again, use conditional strategies like tit-for-tat or Pavlov. There is evidence that humans use such strategies to achieve mutual cooperation, but most controlled experiments with non-human animals have failed to find cooperation. One reason for this could be that subjects fail to cooperate because they behave as if they were to play only once. To assess this hypothesis, we conducted an experiment with monogamous zebra finches (Taeniopygia guttata) that were tested in a two-choice apparatus, with either their social partner or an experimental opponent of the opposite sex. We found that zebra finches maintained high levels of cooperation in an iterated Prisoner''s Dilemma game only when interacting with their social partner. Although other mechanisms may have contributed to the observed difference between the two treatments, our results support the hypothesis that animals do not systematically give in to the short-term temptation of cheating when long-term benefits exist. Thus, our findings contradict the commonly accepted idea that reciprocal altruism will be rare in non-human animals.     

Red Imported Fire Ants: A threat to eastern Australia's wildlife?

The discovery of the Red Imported Fire ants (Solenopsis invicta) in Brisbane on 22 February 2001 sent shock waves through urban and rural communities alike. This article is an attempt to address the often repeated question ‘What will become of Australia's unique fauna if they spread along Australia's eastern seaboard?     

Work life balance?

There is no perfect recipe to balance work and life in academic research. Everyone has to find their own optimal balance to derive fulfilment from life and work. Subject Categories: S&S: Careers & Training

A few years ago, a colleague came into my office, looking a little irate, and said, “I just interviewed a prospective student, and the first question was, ‘how is work‐life balance here?’”. Said colleague then explained how this question was one of his triggers. Actually, this sentiment isn''t unusual among many PIs. And, yet, asking about one''s expected workload is a fair question. While some applicants are actually coached to ask it at interviews, I think that many younger scientists have genuine concerns about whether or not they will have enough time away from the bench in order to have a life outside of work.In a nutshell, I believe there is no one‐size‐fits‐all definition of work–life balance (WLB). I also think WLB takes different forms depending on one''s career stage. As a new graduate student, I didn''t exactly burn the midnight oil; it took me a couple of years to get my bench groove on, but once I did, I worked a lot and hard. I also worked on weekends and holidays, because I wanted answers to the questions I had, whether it was the outcome of a bacterial transformation or the result from a big animal experiment. As a post‐doc, I worked similarly hard although I may have actually spent fewer hours at the bench because I just got more efficient and because I read a lot at home and on the six train. But I also knew that I had to do as much as I could to get a job in NYC where my husband was already a faculty member. The pressure was high, and the stress was intense. If you ask people who knew me at the time, they can confirm I was also about 30 pounds lighter than I am now (for what it''s worth, I was far from emaciated!).As an assistant professor, I still worked a lot at the bench in addition to training students and writing grant applications (it took me three‐plus years and many tears to get my first grant). As science started to progress, work got even busier, but in a good way. By no means did I necessarily work harder than those around me—in fact, I know I could have worked even more. And I’m not going to lie, there can be a lot of guilt associated with not working as much as your neighbor.My example is only one of millions, and there is no general manual on how to handle WLB. Everyone has their own optimal balance they have to figure out. People with children or other dependents are particularly challenged; as someone without kids, I cannot even fathom how tough it must be. Even with some institutions providing child care or for those lucky enough to have family take care of children, juggling home life with “lab life” can create exceptional levels of stress. What I have observed over the years is that trainees and colleagues with children become ridiculously efficient; they are truly remarkable. One of my most accomplished trainees had two children, while she was a post‐doc and she is a force to be reckoned with—although no longer in my laboratory, she still is a tour de force at work, no less with child number three just delivered! I think recruiters should view candidates with families as well—if not better—equipped to multi‐task and get the job done.There are so many paths one can take in life, and there is no single, “correct” choice. If I had to define WLB, I would say it is whatever one needs to do in order to get the work done to one''s satisfaction. For some people, putting in long days and nights might be what is needed. Does someone who puts in more hours necessarily do better than one who doesn''t, or does a childless scientist produce more results than one with kids? Absolutely not. People also have different goals in life: Some are literally “wedded” to their work, while others put much more emphasis on spending time with their families and see their children grow up. Importantly, these goals are not set in stone and can fluctuate throughout one''s life. Someone recently said to me that there can be periods of intense vertical growth where “balance” is not called for, and other times in life where it is important and needed. I believe this sentiment eloquently sums up most of our lives.Now that I''m a graying, privileged professor, I have started to prioritize other areas of life, in particular, my health. I go running regularly (well, maybe jog very slowly), which takes a lot of time but it is important for me to stay healthy. Pre‐pandemic, I made plans to visit more people in person as life is too short not to see family and friends. In many ways, having acquired the skills to work more efficiently after many years in the laboratory and office, along with giving myself more time for my health, has freed up my mind to think of science differently, perhaps more creatively. It seems no matter how much I think I’m tipping the balance toward life, work still creeps in, and that’s perfectly OK. At the end of the day, my work is my life, gladly, so I no longer worry about how much I work, nor do I worry about how much time I spend away from it. If you, too, accomplish your goals and derive fulfillment from your work and your life, neither should you.     

Paying Our Way: Private and Public Meanings of Migration

The typical Dutchman came to Australia and became 'invisible'. It was as if he were a man without and out of history. Yet this same Dutchman's arrival was largely assisted and 'organised' by the Dutch and Australian governments. Drawing on public and life history materials this paper considers the complex meanings around assisted Dutch migration to Australia, and how they have affected Dutch identity and assimilation. Of particular interest are the conflicting meanings associated with being an assisted migrant, the question of acceptance or denial of responsibility for migration, and Dutch as surrogate British.     

Genetic relationships in the olive (Olea europaea L.) reflect multilocal selection of cultivars

One hundred and two olive RAPD profiles were sampled from all around the Mediterranean Basin. Twenty four clusters of RAPD profiles were shown in the dendrogram based on the Ward’s minimum variance algorithm using chi-square distances. Factorial discriminant analyses showed that RAPD profiles were correlated with the use of the fruits and the country or region of origin of the cultivars. This suggests that cultivar selection has occurred in different genetic pools and in different areas. Mitochondrial DNA RFLP analyses were also performed. These mitotypes supported the conclusion also that multilocal olive selection has occurred. This prediction for the use of cultivars will help olive growers to choose new foreign cultivars for testing them before an eventual introduction if they are well adapted to local conditions. Received: 10 April 2000 / Accepted: 15 May 2000