Tag Archives: The Global Search for Education

Lyme Disease In Canada And USA Has Epidemic Potential- New Microbes Discovered

Spring means fresh flowers and sunny days, but it also brings seasonal health issues as the weather gets warmer: from Rosacea to Lyme disease.

Most likely, you or someone you know has been affected by Lyme disease, the most common tick-borne illness in North America with more than 300,000 cases diagnosed each year. In a timely new book, Conquering Lyme Disease(Columbia University Press), Columbia University Medical Center physicians Brian A. Fallon and Jennifer Sotsky reveal that despite the challenges to find a cure for this complex, debilitating disease, precision medicine and biotechnology are accelerating the discovery of new tools with which doctors will be able to diagnose it and treat patients.

“Through rapid genetic sequencing, scientists can identify many different strains of Borrelia burgdorferi as well as new tick-borne microbial infections, such as Borrelia miyamotoi, Borrelia mayonii, and the Heartland virus.”  — Brian Fallon 

Could groundbreaking technologies that rapidly increase our understanding and open up new pathways mean a cure for Lyme disease one day soon? The Global Search for Education is pleased to welcome Dr. Brian Fallon to find out how tech is tackling the ticks.

“Modern technology using Next-Generation Sequencing (NGS) allows one to discover with great rapidity all microbes that may be present within a sample of fluid.” — Brian Fallon

Brian, how has technology improved the research process for tick borne diseases?

Consider the difference in price of genome sequencing between 20 years ago and today. In 2003, it had taken the Human Genome Project about 4 years and costs estimated between $500 million to 1 billion…by 2006 the cost for sequencing a single human genome had dropped to 14 million……today a whole human genome can be sequenced within days for less than $1,000.   This is a tremendous advance.

Why is genome sequencing so important?  Let’s look at human tick-borne diseases.  When two different people are infected with Borrelia burgdorferi (the microbe that causes Lyme disease), one will resolve the disease quickly after a course of antibiotics while the other may develop a chronic relapsing remitting illness.  Why?  Because one person might have gotten a more persistent strain, while the other received  a less invasive strain that stays localized to the skin.  Additionally, the genetic differences in the human determines how the immune system responds to the invading microbe. Understanding the genetics of the infection and of the human host allows scientists to unravel the mysteries of tick-borne illnesses.

Through rapid genetic sequencing, scientists can identify many different strains of Borrelia burgdorferi as well as new tick-borne microbial infections, such as Borrelia miyamotoi, Borrelia mayonii, and the Heartland virus.  When the genome of a microbe is sequenced, it provides a starting point for the study of pathogenesis, vaccine development, and treatment.  Discovery of these new microbes inside ticks has been enormously helpful.  A patient who has had typical symptoms of Lyme disease after a tick bite but has tested negative on the blood tests for Lyme disease might puzzle clinicians. They may criticize the insensitivity of the Lyme disease tests.  However, when this same patient is tested for the newly discovered tick-borne infection, Borrelia miyamotoi, the diagnosis is then clear. Yes, the patient had a Lyme-like illness, but it wasn’t Lyme disease: it was Borrelia Miyamotoi disease.

Modern technology using Next-Generation Sequencing (NGS) allows one to discover with great rapidity all microbes that may be present within a sample of fluid.   This  “discovery based” approach using “unbiased next generation sequencing” enabled a 14 year old boy to be rescued from a fatal infection within 48 hours (Wilson et al, NEJM, 2014). This boy had endured 3 hospitalizations over 4 months, had over 100 diagnostic tests, spent 44 days in an ICU for encephalitis of unknown etiology, had a brain biopsy, and had to be put into a medically induced coma to prevent damage from his ongoing seizures.

Eventually Dr. Charles Chiu at U.C.S.F. employed NGS analysis of more than 8 million sequences with a bioinformatics pipeline (SURPI) for the detection of all known pathogens. The cause of the boy’s meningoencephalitis was revealed as Leptospira santarosai. He had likely acquired it in Puerto Rico, as it is not present in the continental United States.  He received the appropriate antibiotics and was discharged 2 weeks later to rehab.  This same approach is especially useful for uncommon infections as they might not be suspected; for example, rare tick-borne viruses such as Powassan Virus or Heartland Virus can be rapidly  detected using this discovery approach.

DNA Double Helix
DNA Double Helix
How has big data impacted the way advocacy groups support research?

A patient-generated source of Big Data is LymeDisease.org.  This California based organization developed a survey called “My Lyme Data” that patients could fill out on the web about their clinical history and lab tests and treatments.  In a short period of time, they had data on 10,000 patients whom they track over time.  With this information, they provide a more comprehensive clinical view of the bulk of patients who are diagnosed with persistent symptoms despite treatment for Lyme Disease (aka Chronic Lyme Disease).

“In geographic areas where medical professionals are scarce, AI technologies will play an increasing role in improving patient care by allowing differential diagnoses to be generated and treatment options suggested through AI-based systems accessed through the internet.”  — Brian Fallon

Jobs in all professions are being automated. Do you believe AI technologies will only assist doctors or will they replace physicians in some tasks? What does this mean for doctors, nurses, and the future of medicine?
Borrelia transmission via Tick
Borrelia

While AI technologies will go a long way to assist health care providers to provide better care, its application to medical care is still just beginning.   One can anticipate, however,  that in geographic areas where medical professionals are scarce, AI technologies will play an increasing role in improving patient care by allowing differential diagnoses to be generated and treatment options suggested through AI-based systems accessed through the internet.

The general public has more access to information than ever before about Lyme disease from websites, medical organizations, articles and social media. Everyone can be their own “expert” or even their own “doctor.”  Can you speak about the pros and cons of online health data in the era of fake news?

This obviously is a huge area of concern. Individuals used to turn to their physician or to the medical information books, such as the Merck Manual. Now, they turn to the web.

In a recent survey of patients who used the web to obtain health information (Doherty-Torstrick 2016), we learned that more than half of the 730 patients reported they experienced increased distress as a result of checking the web.  We also learned from this survey that individuals who did not have a health education were more likely to spend more time on the web and were thus prone to develop more anxiety than those who were better educated from a health perspective.   While some of the information they find may be accurate, other information may be well-intentioned but ill-informed, misleading, and even harmful.

“Researchers can rapidly screen thousands of drugs to determine which agents have the strongest ability to kill Borrelia spirochetes.  This is possible because of the development of high throughput assays, which have proven more effective than the standard agents in eradicating both the stationary phase Borrelia and its more drug-tolerant persister-forms.” — Brian Fallon

Tick distribution Canada

Look into the future.  What are the technologies you are most excited about in terms of helping to find cures for Lyme disease and improve patients quality of life?

Researchers can rapidly screen thousands of drugs to determine which agents have the strongest ability to kill Borrelia spirochetes (Feng 2014).  This is possible because of the development of high throughput assays, which have identified new antibiotics that have proven more effective than the standard agents (doxycycline, amoxicillin) in eradicating both the stationary phase Borrelia and its more drug-tolerant persister-forms.  While it cannot be assumed that what is true in the lab setting will translate to efficacy in humans, biotechnology advances have enabled the identification of new therapeutic agents, offering  much hope for a wider array of treatment options for patients in the future.

Another major advance is “big data” conducted by biomedical information engineers trained in biostatistics and computer science.  Internet search engine queries are being monitored to predict outbreaks of infectious disease.  Unanticipated side effects of drugs and their interactions can be detected through analyzing millions of digital medical records from patients who have taken a particular drug.  One can examine whether patients given an antibiotic did better when treated for longer or shorter periods, or whether patients with a pre-existing autoimmune disease are more likely to develop complications from a new onset Tick-borne infection than those without a history of autoimmune problems.

Tick
2005 James Gathany; William Nicholson
The blacklegged ticks, I. pacificus, (depicted here), and I. scapularis, are known vectors for the zoonotic spirochetal bacteria Borrelia burgdorferi, which is the pathogenic bacteria responsible for causing Lyme disease. The ticks, inoculated with the bacterium when they bite infected mice, squirrels and other small animals, subsequently pass the pathogens to their human victims when they obtain a blood meal.B. burgdorferi bacteria can infect several parts of the body, producing different symptoms at different times. Not all patients with Lyme disease will have all symptoms, and many of the symptoms can occur with other diseases as well. If you believe you may have Lyme disease, it is important that you consult your health care provider for proper diagnosis.
The first sign of infection is usually a circular rash called “erythema migrans”, or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite after a delay of 3-30 days. A distinctive feature of the rash is that it gradually expands over a period of several days, reaching up to 12 inches (30 cm) across. The center of the rash may clear as it enlarges, resulting in a bull’s-eye appearance. It may be warm but is not usually painful. Some patients develop additional EM lesions in other areas of the body after several days. Patients also experience symptoms of fatigue, chills, fever, headache, and muscle and joint aches, and swollen lymph nodes. In some cases, these may be the only symptoms of infection.

Our Lyme and Tick-borne Diseases Research Center, located at the Columbia University Irving Medical Center (CUIMC) in New York City, is right next door to an international data resource.  CUIMC is the coordinating center of a public health information initiative which includes medical records from approximately 400 million people drawn from eighty health-care organizations from around the world.  This represents a unique opportunity  to ask questions, generate hypotheses and get answers about Tick-borne diseases.  When discovery is optimized, medical care is enhanced.

For the Silo, David Wine/CM RubinWorld. 

Brian Fallon, MD, MPH is the Director of the Lyme and Tick-Borne Diseases Research Center at the Columbia University Irving Medical Center and the author with Jennifer Sotsky of Conquering Lyme Disease: Science Bridges the Great Divide, published in 2018 by Columbia University Press.

Virtual Reality Use In Classroom Shows Deforestation Reality

“When the viewer looks down, they’ll see their arms are branches, their body is the trunk, and when they move, the tree moves too.” – Winslow Porter

Virtual Reality (VR) and Augmented Reality Markets are expected to reach US$162 billion by 2020.  How can schools use virtual reality to make learning more engaging?

Most of us don’t live in a rainforest but we do know that they are in great danger. Classrooms are looking for ways to help young learners better understand the deforestation crisis, for which we urgently need to find global solutions. What if it were possible to have first-hand experience on how we as humans are contributing to the extinction of trees?

Tree  is a hyper-realistic VR experience that transforms the audience into a living and breathing rainforest tree. The viewer can see and feel the tree’s growth from a seedling into its fullest form and witness its fate firsthand. In a collaboration between MIT Media Lab and filmmakers Milica Zec and Winslow Porter, a fully immersive virtual reality story about a tree was created. The film has been presented to date at over 70 conferences and film festivals (including Sundance and Tribeca).

The Global Search for Education welcomed Winslow Porter to talk about the reality of deforestation and how Treecan help.

People often develop a personal connection to the tree after viewing the experience.” – Winslow Porter

Winslow, what motivated you to tell this story? How did you come up with the idea?

Everything started with our first project, Giant, in which we depicted an innocent family trapped in a war-zone. Giant speaks about the destruction humans do to each other, and we wanted to continue in our second piece with how humans destroy nature. That is how the idea of Tree was born. We wanted to shift the perspective of the audience and place them in the position of nature, so that they can witness firsthand how we as humans contribute to deforestation.

What does the VR experience really add to our viewing experience in this story? Are we missing something if we don’t see this movie in VR?

In our piece, we use VR as a tool to transform the viewer into a living and breathing tree. When the viewer looks down, they’ll see their arms are branches, their body is the trunk, and when they move, the tree moves too. We use multi-sensory elements so the viewer feels the growth from a tiny seed underground, to the tallest tree in the rainforest. We use a Subpac – essentially a backpack with bass speakers in it – to vibrate along with the piece, simulating the feeling of growing and expanding. The viewer can also smell the soil and the rainforest, sense the change in temperature and feel the wind on their face when they reach their tallest height. As of now, we believe that VR is the only medium that allows us to closely replicate what it is like to be a tree.

How do people react during and after the Tree experience? What kind of emotional connection is evoked?

So far, we have brought Tree to over 70 festivals and conferences and witnessed thousands of people from across the globe take off the headset. Most people have a very emotional reaction to the piece, strongly identifying with the tree. There is no language in the piece, just the sounds of nature, which creates a universal story that anyone can relate to. After the experience, people have a stronger understanding of the deforestation happening all around the world. People often develop a personal connection to the tree after viewing the experience.

“At the end of the experience, we give each viewer the seed of the tree they just embodied with the message “take this seed as a reminder to keep our forests standing.” – Winslow Porter

Climate Change and the Environment are timely topics. In what ways do you believe Tree can add to our understanding of these issues? How would it be different from traditional ways we learn about The environment and climate change?

Since most of us do not live inside of a rainforest, it’s difficult to imagine what is really happening. Tree brings you into that environment and shifts a viewer’s perspective to shed light on a topic that many people haven’t really thought about before. We partnered with the Rainforest Alliance, which helped us remain scientifically accurate while creating the project, and also provided us with a lot of knowledge about deforestation. People often come out of the headset asking what they can do to help, so at the end of the experience, we give each viewer the seed of the tree they just embodied with the message “take this seed as a reminder to keep our forests standing.” We link them to our website and the Rainforest Alliance, so they can discover the many different ways they can help.

What can you tell us about your next project, Rainforest? What’s the story and what’s the inspiration?

Rainforest is a mixed reality game. In Tree, we focused on a singular rainforest tree, when in reality there are many plants and animals that inhabit those forests. We want to educate people on this entire wonderous world that is being threatened by extinction. To do that, we wanted to bring the actual scale rainforest into the player’s room. Rainforest allows people to play in the environment, and through entertainment and fun they can discover and learn about all the life within. They will also learn about the dangers that rainforests are facing and actively participate in the preservation of those ecosystems.


“With VR, the screen is no longer just across from us, but all around us, and viewers have the ability to be a part of the piece they are viewing.” – Winslow Porter

The global VR market is growing rapidly. As the technology improves in the next 5 years or so, what do you believe are the additional benefits for storytellers/creators as well as entertainment consumers? What are the challenges?

With VR, the screen is no longer just across from us, but all around us, and viewers have the ability to be a part of the piece they are viewing. We’re breaking the boundaries and making entertainment more visceral and real, no matter where people are. Instead of watching movies on a TV screen, the movie can be playing all around someone, even inside their home. The viewer is getting the opportunity to become a participant in these pieces and decide on where the story should go, and how it should progress. The biggest challenge is that although we’re developing these projects with ground-breaking technology, not everything is ready for mass consumption, however, that time is coming very soon. For the Silo, David Wine/CMRubinWorld.

C M Rubin and Winslow Porter

Dance Healing Immigrant Victims Of War Prejudice And Sexual Exploitation

Study after study has shown that arts education nurtures students’ creativity and problem-solving skills, competencies that are critical for success in a 21st Century world, but how does dance and movement facilitate healing and transform at-risk youth?

14 year old DTC dancing participants Richard Rutherford Danny Guerrero
14 year old DTC dancing participants Richard Rutherford Danny Guerrero

New York’s Battery Dance launched its Dancing to Connect programs in 2006. Since that time, the program has spread to 6 continents, 50 countries, 100 cities, and 1,000 schools. A powerful new documentary by Wilderness Films follows six dancers from the dance company from India to Eastern Europe to the Korean Peninsula to the Middle East as they support vulnerable youth helping them to express themselves through movement. The film focuses on the struggles, frustrations, resilience and ultimate transformation of the students and their dance teachers.

Producer Cornelia Ravenal says that as a trauma survivor she understood the power of art to “heal and transform.” Ravenal along with husband partner Mikael Södersten collaborated with Battery Dance Founder Jonathan Hollander to create the documentary because she believed this was a story that had to be told. As global populations continue to grow, migration and increasing social and cultural diversity are reshaping classrooms worldwide. Solutions for integrating and uniting peoples from diverse cultural backgrounds are now sought by schools and communities all over the globe. Hollander believes that “no divide has been too great for the art of dance, the primacy of movement, the common humanity, and expression, to span.”

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Battery Dance performs on the world’s stages, teaches, presents, and advocates for the field of dance. The Company is dedicated to the pursuit of artistic excellence and the availability of the Arts to everyone. Battery Dance has produced over 100 original dance works choreographed by its founder and artistic director Jonathan Hollander, in collaboration with a diverse array of composers and designers, and its cast of outstanding dancers.

CMRubinWorld launched in 2010 to explore what kind of education would prepare students to succeed in a rapidly changing globalized world. Its award-winning series, The Global Search for Education, is a celebrated trailblazer in the renaissance of the 21st century, and occupies a special place in the pulse of key issues facing every nation and the collective future of all children. It connects today’s top thought leaders with a diverse global audience of parents, students and educators. Its highly readable platform allows for discourse concerning our highest ideals and the sustainable solutions we must engineer to achieve them. C. M. Rubin has produced over 700 interviews and articles discussing an expansive array of topics under a singular vision: when it comes to the world of children, there is always more work to be done. For the Silo, David Wine.