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"content": "\u003cp>http://www.kqed.org/.stream/anon/radio/science/2014/09/20140929science.mp3\u003c/p>\n\u003cp>Here’s how science usually works: Come up with a question or a hypothesis. Develop an experiment to test it and create data. As any middle school student could tell you, it’s called the scientific method.\u003c/p>\n\u003cp>Now, some researchers and entrepreneurs in the Bay Area say that method is being upended, especially when it comes to medicine.\u003c/p>\n\u003cp>Consider what happened in the pediatric intensive care unit at Stanford’s Lucile Packard Children’s Hospital a few years ago.\u003c/p>\n\u003cp>In 2011, a young girl from Reno, Nevada, was flown by helicopter to the pediatric intensive care unit of the hospital.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Giving the drug was risky. Not giving the drug was also risky.'\u003ccite>— Jennifer Frankovich, Lucile Packard Children's Hospital\u003c/cite>\u003c/aside>\n\u003cp>“She was gravely ill. Her kidneys were shutting down,” recalls Jennifer Frankovich, at the time a young attending physician at the hospital.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The girl had been given morphine to dull her crushing abdominal pain. To Frankovich, the girl’s parents, who were from Mexico, looked like deer in the headlights.\u003c/p>\n\u003cp>“There were probably more doctors around her bed than they’d seen in their lives\" she says. \"I mean, the kidney doctor, the intensivist, the rheumatology team, the hematology team. There was a huge number of doctors around this poor girl’s bed.”\u003c/p>\n\u003cp>\u003cstrong>Weighing the Risks \u003c/strong>\u003c/p>\n\u003cp>Tests showed the girl had lupus, a disease in which the immune system goes rogue, attacking the body’s healthy tissues. Lupus can cause permanent kidney damage.\u003c/p>\n\u003cp>But Frankovich worried about something else, too. She’d seen kids like this before, and recalled that some of them also developed blood clots, which can travel to the heart or lungs and be deadly.\u003c/p>\n\u003cp>Blood clots can be prevented with an anti-coagulant, which keeps the blood flowing. But that, too, carries risks. A patient on blood thinners can have a stroke or bleed into an organ. Blood thinners can also complicate surgery.\u003c/p>\n\u003cp>Giving the drug was risky. Not giving the drug was also risky. Frankovich asked her colleagues: What should we do here?\u003c/p>\n\u003cp>“There wasn’t enough published literature to guide this decision,” Frankovich says. “[They said] the best route was to not do anything.”\u003c/p>\n\u003cp>Pediatric lupus is rare, which makes formal studies hard to come by. It would take years for a single institution to identify enough subjects to come up with a meaningful sample size.\u003c/p>\n\u003cp>And the question itself was fairly obscure. Whether or not pediatric lupus patients are at a high risk for developing blood clots is one of those matters that medical researchers haven’t gotten around to answering.\u003c/p>\n\u003cp>Frankovich needed data. And that is when she had her big idea.\u003c/p>\n\u003cfigure id=\"attachment_22096\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Big-data-2.jpg\">\u003cimg class=\"wp-image-22096 size-full\" src=\"http://blogs.kqed.org/science/files/2014/09/Big-data-2.jpg\" alt=\"(David Pierce/KQED)\" width=\"1024\" height=\"1391\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Pierce/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>An Unconventional Decision\u003c/strong>\u003c/p>\n\u003cp>Frankovich had been helping build a database of pediatric lupus patients who had been seen previously at the hospital. She had digitized the charts and made them searchable with key words.\u003c/p>\n\u003cp>This isn’t typical.\u003c/p>\n\u003cp>Like any chronic medical condition, lupus generates a staggering amount of paperwork. Doctors follow each patient for years, even a decade.\u003c/p>\n\u003cp>“Our pediatric lupus patients have enough records to fill boxes,” Frankovich says.\u003c/p>\n\u003cp>She says the accumulated records of every kid with lupus who has come through Packard Hospital would fill a large room.\u003c/p>\n\u003cp>But now, all that data was accessible with a keystroke.\u003c/p>\n\u003cp>By looking for patterns within those medical records, Frankovich realized, she would, in a sense, be doing the study no one else had gotten around to doing.\u003c/p>\n\u003cp>She could look at every pediatric lupus patient that had come through the hospital to see how many of them developed blood clots, and what the risk factors were.\u003c/p>\n\u003cp>Based on that, she could calculate whether the risks of a blood clot in her current patient justified the risks of prescribing an anti-coagulant.\u003c/p>\n\u003cp>So she ran the search and presented her findings to her colleagues.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The scientific method itself is growing obsolete.'\u003ccite>— Atul Butte, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>“And universally everyone said, ‘wow, based on those numbers, it seems like we should try to prevent a clot in her,’” Frankovich says.\u003c/p>\n\u003cp>The patient was given the anti-coagulant. Over time her lupus got better. As far as Frankovich knows, she’s doing well.\u003c/p>\n\u003cp>It may not seem like it, but what Frankovich did was fairly radical, noteworthy enough to warrant a \u003ca href=\"http://bmi205.stanford.edu/_media/jfrankovich-1.pdf\">paper published \u003c/a>in November 2011 in the New England Journal of Medicine.\u003c/p>\n\u003cp>Traditionally, doctors make decisions based on two factors: One, their own expertise and that of other doctors and specialists. In other words, that team of doctors who were gathered around the young lupus patient’s bed.\u003c/p>\n\u003cp>Two, doctors consult the scientific literature. They read studies and case reports that have been published in established medical journals.\u003c/p>\n\u003cp>Frankovich was taking a third route. She was using electronic medical records to search for answers that were already out there, but hadn’t been uncovered yet.\u003c/p>\n\u003cp>\u003cstrong>A Seismic Shift in Medicine\u003c/strong>\u003c/p>\n\u003cp>It’s an example, says \u003ca href=\"https://buttelab.stanford.edu/\">Atul Butte\u003c/a>, an entrepreneur and associate professor of pediatrics at the Stanford School of Medicine, of a seismic shift happening in medicine.\u003c/p>\n\u003cp>“The idea here is, the scientific method itself is growing obsolete,” Butte says.\u003c/p>\n\u003cfigure id=\"attachment_130\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Physician-ipad-1024x682.jpg\">\u003cimg class=\"size-full wp-image-130\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Physician-ipad-1024x682.jpg\" alt=\"Healthcare providers increasingly use electronic medical records and other large data sets to understand patient responses to treatment over time. (NEC Corporation of America)\" width=\"1024\" height=\"682\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-320x213.jpg 320w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Healthcare providers increasingly use electronic medical records and other large data sets to understand patient responses to treatment over time. (NEC Corporation of America)\u003c/figcaption>\u003c/figure>\n\u003cp>This concept draws from \u003ca href=\"http://archive.wired.com/science/discoveries/magazine/16-07/pb_theory\">an essay\u003c/a> published in Wired Magazine in 2008 called “The End of Theory.”\u003c/p>\n\u003cp>According to the essay, so much information will be available at our fingertips in the future that there will be almost no need for experiments. The answers are already out there.\u003c/p>\n\u003cp>“Think about it,” Butte says. “The scientific method -- we learned this in elementary school -- is: We come up with a question, a hypothesis, and go make measurements to answer it. Now we’re living in this world where we already have the measurements and the data. The struggle is to figure out: What do we want to ask of all that data?”\u003c/p>\n\u003cp>Take, for example, a question Butte’s team has focused on recently: the rise in pre-term births in the United States. One theory, says Butte, points to an increase in exposure to environmental toxins.\u003c/p>\n\u003cp>Traditionally, this would be a challenging hypothesis to study. Medical records for these births aren’t necessarily in any one place, online. The same problem exists with records on air pollution, or weather patterns.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'We’re heading to a world where we’ll have the genome sequence of everyone on planet Earth.'\u003ccite>— Atul Butte, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>But that’s changing.\u003c/p>\n\u003cp>Now, Butte says, “you can connect pre-term births from the medical records and birth census data to weather patterns, pollution monitors and EPA data to see is there a correlation there or not.”\u003c/p>\n\u003cp>Correlation does not mean causation (as any statistician will tell you) but it’s a good jumping-off point for more targeted research.\u003c/p>\n\u003cp>\u003cstrong>The Ever-Expanding Cloud of Information\u003c/strong>\u003c/p>\n\u003cp>Big data is more than medical records and environmental data, Butte says. It could (or already does) include the results of every clinical trial that’s ever been done, every lab test, Google search, tweet. The data from your Fitbit.\u003c/p>\n\u003cp>Eventually, the challenge won’t be finding the data, it’ll be figuring out how to organize it all.\u003cbr>\n“I think the computational side of this is, let’s try to connect everything to everything,” Butte says.\u003c/p>\n\u003cp>Perhaps the biggest pool of data will be the genetic instructions written in each one of our cells.\u003c/p>\n\u003cp>It took $2.7 billion and 13 years to sequence the first human genome. Today, that same project costs $1,500 and takes about a day.\u003c/p>\n\u003cp>“We’re heading to a world where we’re going to have the genome sequence of everyone on planet Earth,” Butte says.\u003c/p>\n\u003cfigure id=\"attachment_129\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Wojcicki.jpg\">\u003cimg class=\"size-full wp-image-129\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Wojcicki.jpg\" alt=\"23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2014/09/Wojcicki.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Wojcicki-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Wojcicki-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>One of the world’s largest genetics databases belongs to the Mountain View-based company 23andMe.\u003c/p>\n\u003cp>CEO Anne Wojcicki says that huge pool of data is already providing answers.\u003c/p>\n\u003cp>Take for example, she says, a family that came to the company to learn more about three family members who had developed pancreatic cancer.\u003c/p>\n\u003cp>The family members also shared a specific gene mutation. They wanted to know: Is the mutation causing the cancer?\u003c/p>\n\u003cp>23andMe consulted its database of more than 500,000 partial genetic profiles. They found 157 people with the same mutation.\u003c/p>\n\u003cp>“What we saw,” Wojcicki says, “is that of those 157 people with that mutation, the majority said they don’t have the cancer, nor does anyone in their immediate family.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We’re able to take the timeline down from years of research to a couple weeks.\"\u003ccite>— Anne Wojcicki, 23andMe\u003c/cite>\u003c/aside>\n\u003cp>\"So we were very quickly able to conclude, not with 100 percent certainty,\" she says, \"but with a high degree of certainty, that the mutation the family thought was causing pancreatic cancer was not causing the cancer.”\u003c/p>\n\u003cp>Normally, she says, this kind of question would require expensive research grants. Researchers would have to recruit subjects with and without the disease and then run genetic tests on all of them.\u003c/p>\n\u003cp>23andMe’s searchable database meant the answers were already there.\u003c/p>\n\u003cp>“We’re able to take the timeline down from years of research to a couple weeks,” Wojcicki says.\u003c/p>\n\u003cp>For 23andMe, big data is a business model. The company anonymizes its genetics information and sells it to researchers who want to study the genetic basis for Parkinson’s disease or diabetes, for example.\u003c/p>\n\u003cp>It recently \u003ca href=\"https://www.23andme.com/ibd/\">teamed up\u003c/a> with Pfizer on a project to research inflammatory bowel syndrome. In July, the company announced a $1.37 million \u003ca href=\"http://mediacenter.23andme.com/press-releases/nih_grant_2014/\">grant\u003c/a> from the National Institutes of Health to develop its database and research engine.\u003c/p>\n\u003cp>This work raises questions about privacy, and about who gets access to this data.\u003c/p>\n\u003cp>\u003cstrong>What’s Safer? Data Or a Team of Doctors?\u003c/strong>\u003c/p>\n\u003cp>And when medicine meets big data there are always questions about safety.\u003c/p>\n\u003cp>Remember Dr. Frankovich and the lupus patient?\u003c/p>\n\u003cp>Given the success of that experiment, you might think what she did is now standard at the hospital where she works. In fact, it’s the opposite.\u003c/p>\n\u003cp>“We’re actually not doing that anymore, says Frankovich.\u003c/p>\n\u003cp>In the end, hospital administrators decided -- at least in urgent cases where time is short -- that it is still safer to trust the wisdom of a team of doctors than to search medical records for data about what’s worked in the past.\u003c/p>\n\u003cp>Frankovich agrees. Analyzing data is complicated and requires specific expertise. What if the search engine has bugs, or the records are transcribed incorrectly? There’s just too much room for error, she says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“It’s going to take a system to interpret the data,” she says. “And that’s what we don’t have yet. We don’t have that system. We will, I mean for sure, the data is there, right? Now we have to develop the system to use it in a thoughtful, safe way.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here’s how science usually works: Come up with a question or a hypothesis. Develop an experiment to test it and create data. As any middle school student could tell you, it’s called the scientific method.\u003c/p>\n\u003cp>Now, some researchers and entrepreneurs in the Bay Area say that method is being upended, especially when it comes to medicine.\u003c/p>\n\u003cp>Consider what happened in the pediatric intensive care unit at Stanford’s Lucile Packard Children’s Hospital a few years ago.\u003c/p>\n\u003cp>In 2011, a young girl from Reno, Nevada, was flown by helicopter to the pediatric intensive care unit of the hospital.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'Giving the drug was risky. Not giving the drug was also risky.'\u003ccite>— Jennifer Frankovich, Lucile Packard Children's Hospital\u003c/cite>\u003c/aside>\n\u003cp>“She was gravely ill. Her kidneys were shutting down,” recalls Jennifer Frankovich, at the time a young attending physician at the hospital.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The girl had been given morphine to dull her crushing abdominal pain. To Frankovich, the girl’s parents, who were from Mexico, looked like deer in the headlights.\u003c/p>\n\u003cp>“There were probably more doctors around her bed than they’d seen in their lives\" she says. \"I mean, the kidney doctor, the intensivist, the rheumatology team, the hematology team. There was a huge number of doctors around this poor girl’s bed.”\u003c/p>\n\u003cp>\u003cstrong>Weighing the Risks \u003c/strong>\u003c/p>\n\u003cp>Tests showed the girl had lupus, a disease in which the immune system goes rogue, attacking the body’s healthy tissues. Lupus can cause permanent kidney damage.\u003c/p>\n\u003cp>But Frankovich worried about something else, too. She’d seen kids like this before, and recalled that some of them also developed blood clots, which can travel to the heart or lungs and be deadly.\u003c/p>\n\u003cp>Blood clots can be prevented with an anti-coagulant, which keeps the blood flowing. But that, too, carries risks. A patient on blood thinners can have a stroke or bleed into an organ. Blood thinners can also complicate surgery.\u003c/p>\n\u003cp>Giving the drug was risky. Not giving the drug was also risky. Frankovich asked her colleagues: What should we do here?\u003c/p>\n\u003cp>“There wasn’t enough published literature to guide this decision,” Frankovich says. “[They said] the best route was to not do anything.”\u003c/p>\n\u003cp>Pediatric lupus is rare, which makes formal studies hard to come by. It would take years for a single institution to identify enough subjects to come up with a meaningful sample size.\u003c/p>\n\u003cp>And the question itself was fairly obscure. Whether or not pediatric lupus patients are at a high risk for developing blood clots is one of those matters that medical researchers haven’t gotten around to answering.\u003c/p>\n\u003cp>Frankovich needed data. And that is when she had her big idea.\u003c/p>\n\u003cfigure id=\"attachment_22096\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Big-data-2.jpg\">\u003cimg class=\"wp-image-22096 size-full\" src=\"http://blogs.kqed.org/science/files/2014/09/Big-data-2.jpg\" alt=\"(David Pierce/KQED)\" width=\"1024\" height=\"1391\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Pierce/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>An Unconventional Decision\u003c/strong>\u003c/p>\n\u003cp>Frankovich had been helping build a database of pediatric lupus patients who had been seen previously at the hospital. She had digitized the charts and made them searchable with key words.\u003c/p>\n\u003cp>This isn’t typical.\u003c/p>\n\u003cp>Like any chronic medical condition, lupus generates a staggering amount of paperwork. Doctors follow each patient for years, even a decade.\u003c/p>\n\u003cp>“Our pediatric lupus patients have enough records to fill boxes,” Frankovich says.\u003c/p>\n\u003cp>She says the accumulated records of every kid with lupus who has come through Packard Hospital would fill a large room.\u003c/p>\n\u003cp>But now, all that data was accessible with a keystroke.\u003c/p>\n\u003cp>By looking for patterns within those medical records, Frankovich realized, she would, in a sense, be doing the study no one else had gotten around to doing.\u003c/p>\n\u003cp>She could look at every pediatric lupus patient that had come through the hospital to see how many of them developed blood clots, and what the risk factors were.\u003c/p>\n\u003cp>Based on that, she could calculate whether the risks of a blood clot in her current patient justified the risks of prescribing an anti-coagulant.\u003c/p>\n\u003cp>So she ran the search and presented her findings to her colleagues.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The scientific method itself is growing obsolete.'\u003ccite>— Atul Butte, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>“And universally everyone said, ‘wow, based on those numbers, it seems like we should try to prevent a clot in her,’” Frankovich says.\u003c/p>\n\u003cp>The patient was given the anti-coagulant. Over time her lupus got better. As far as Frankovich knows, she’s doing well.\u003c/p>\n\u003cp>It may not seem like it, but what Frankovich did was fairly radical, noteworthy enough to warrant a \u003ca href=\"http://bmi205.stanford.edu/_media/jfrankovich-1.pdf\">paper published \u003c/a>in November 2011 in the New England Journal of Medicine.\u003c/p>\n\u003cp>Traditionally, doctors make decisions based on two factors: One, their own expertise and that of other doctors and specialists. In other words, that team of doctors who were gathered around the young lupus patient’s bed.\u003c/p>\n\u003cp>Two, doctors consult the scientific literature. They read studies and case reports that have been published in established medical journals.\u003c/p>\n\u003cp>Frankovich was taking a third route. She was using electronic medical records to search for answers that were already out there, but hadn’t been uncovered yet.\u003c/p>\n\u003cp>\u003cstrong>A Seismic Shift in Medicine\u003c/strong>\u003c/p>\n\u003cp>It’s an example, says \u003ca href=\"https://buttelab.stanford.edu/\">Atul Butte\u003c/a>, an entrepreneur and associate professor of pediatrics at the Stanford School of Medicine, of a seismic shift happening in medicine.\u003c/p>\n\u003cp>“The idea here is, the scientific method itself is growing obsolete,” Butte says.\u003c/p>\n\u003cfigure id=\"attachment_130\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Physician-ipad-1024x682.jpg\">\u003cimg class=\"size-full wp-image-130\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Physician-ipad-1024x682.jpg\" alt=\"Healthcare providers increasingly use electronic medical records and other large data sets to understand patient responses to treatment over time. (NEC Corporation of America)\" width=\"1024\" height=\"682\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Physician-ipad-1024x682-320x213.jpg 320w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Healthcare providers increasingly use electronic medical records and other large data sets to understand patient responses to treatment over time. (NEC Corporation of America)\u003c/figcaption>\u003c/figure>\n\u003cp>This concept draws from \u003ca href=\"http://archive.wired.com/science/discoveries/magazine/16-07/pb_theory\">an essay\u003c/a> published in Wired Magazine in 2008 called “The End of Theory.”\u003c/p>\n\u003cp>According to the essay, so much information will be available at our fingertips in the future that there will be almost no need for experiments. The answers are already out there.\u003c/p>\n\u003cp>“Think about it,” Butte says. “The scientific method -- we learned this in elementary school -- is: We come up with a question, a hypothesis, and go make measurements to answer it. Now we’re living in this world where we already have the measurements and the data. The struggle is to figure out: What do we want to ask of all that data?”\u003c/p>\n\u003cp>Take, for example, a question Butte’s team has focused on recently: the rise in pre-term births in the United States. One theory, says Butte, points to an increase in exposure to environmental toxins.\u003c/p>\n\u003cp>Traditionally, this would be a challenging hypothesis to study. Medical records for these births aren’t necessarily in any one place, online. The same problem exists with records on air pollution, or weather patterns.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'We’re heading to a world where we’ll have the genome sequence of everyone on planet Earth.'\u003ccite>— Atul Butte, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>But that’s changing.\u003c/p>\n\u003cp>Now, Butte says, “you can connect pre-term births from the medical records and birth census data to weather patterns, pollution monitors and EPA data to see is there a correlation there or not.”\u003c/p>\n\u003cp>Correlation does not mean causation (as any statistician will tell you) but it’s a good jumping-off point for more targeted research.\u003c/p>\n\u003cp>\u003cstrong>The Ever-Expanding Cloud of Information\u003c/strong>\u003c/p>\n\u003cp>Big data is more than medical records and environmental data, Butte says. It could (or already does) include the results of every clinical trial that’s ever been done, every lab test, Google search, tweet. The data from your Fitbit.\u003c/p>\n\u003cp>Eventually, the challenge won’t be finding the data, it’ll be figuring out how to organize it all.\u003cbr>\n“I think the computational side of this is, let’s try to connect everything to everything,” Butte says.\u003c/p>\n\u003cp>Perhaps the biggest pool of data will be the genetic instructions written in each one of our cells.\u003c/p>\n\u003cp>It took $2.7 billion and 13 years to sequence the first human genome. Today, that same project costs $1,500 and takes about a day.\u003c/p>\n\u003cp>“We’re heading to a world where we’re going to have the genome sequence of everyone on planet Earth,” Butte says.\u003c/p>\n\u003cfigure id=\"attachment_129\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Wojcicki.jpg\">\u003cimg class=\"size-full wp-image-129\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2014/09/Wojcicki.jpg\" alt=\"23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2014/09/Wojcicki.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Wojcicki-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2014/09/Wojcicki-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>One of the world’s largest genetics databases belongs to the Mountain View-based company 23andMe.\u003c/p>\n\u003cp>CEO Anne Wojcicki says that huge pool of data is already providing answers.\u003c/p>\n\u003cp>Take for example, she says, a family that came to the company to learn more about three family members who had developed pancreatic cancer.\u003c/p>\n\u003cp>The family members also shared a specific gene mutation. They wanted to know: Is the mutation causing the cancer?\u003c/p>\n\u003cp>23andMe consulted its database of more than 500,000 partial genetic profiles. They found 157 people with the same mutation.\u003c/p>\n\u003cp>“What we saw,” Wojcicki says, “is that of those 157 people with that mutation, the majority said they don’t have the cancer, nor does anyone in their immediate family.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We’re able to take the timeline down from years of research to a couple weeks.\"\u003ccite>— Anne Wojcicki, 23andMe\u003c/cite>\u003c/aside>\n\u003cp>\"So we were very quickly able to conclude, not with 100 percent certainty,\" she says, \"but with a high degree of certainty, that the mutation the family thought was causing pancreatic cancer was not causing the cancer.”\u003c/p>\n\u003cp>Normally, she says, this kind of question would require expensive research grants. Researchers would have to recruit subjects with and without the disease and then run genetic tests on all of them.\u003c/p>\n\u003cp>23andMe’s searchable database meant the answers were already there.\u003c/p>\n\u003cp>“We’re able to take the timeline down from years of research to a couple weeks,” Wojcicki says.\u003c/p>\n\u003cp>For 23andMe, big data is a business model. The company anonymizes its genetics information and sells it to researchers who want to study the genetic basis for Parkinson’s disease or diabetes, for example.\u003c/p>\n\u003cp>It recently \u003ca href=\"https://www.23andme.com/ibd/\">teamed up\u003c/a> with Pfizer on a project to research inflammatory bowel syndrome. In July, the company announced a $1.37 million \u003ca href=\"http://mediacenter.23andme.com/press-releases/nih_grant_2014/\">grant\u003c/a> from the National Institutes of Health to develop its database and research engine.\u003c/p>\n\u003cp>This work raises questions about privacy, and about who gets access to this data.\u003c/p>\n\u003cp>\u003cstrong>What’s Safer? Data Or a Team of Doctors?\u003c/strong>\u003c/p>\n\u003cp>And when medicine meets big data there are always questions about safety.\u003c/p>\n\u003cp>Remember Dr. Frankovich and the lupus patient?\u003c/p>\n\u003cp>Given the success of that experiment, you might think what she did is now standard at the hospital where she works. In fact, it’s the opposite.\u003c/p>\n\u003cp>“We’re actually not doing that anymore, says Frankovich.\u003c/p>\n\u003cp>In the end, hospital administrators decided -- at least in urgent cases where time is short -- that it is still safer to trust the wisdom of a team of doctors than to search medical records for data about what’s worked in the past.\u003c/p>\n\u003cp>Frankovich agrees. Analyzing data is complicated and requires specific expertise. What if the search engine has bugs, or the records are transcribed incorrectly? There’s just too much room for error, she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s going to take a system to interpret the data,” she says. “And that’s what we don’t have yet. We don’t have that system. We will, I mean for sure, the data is there, right? Now we have to develop the system to use it in a thoughtful, safe way.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>http://www.kqed.org/.stream/anon/radio/science/2013/05/2013-05-06-science.mp3\u003c/p>\n\u003ch2>A vast and teeming crew\u003c/h2>\n\u003cp>Here's something to stop and consider: You are mostly not you.\u003c/p>\n\u003cp>Ninety percent of the cells in your body don't have your DNA. They weren't in you when you were in the womb. Instead, they belong to trillions of tiny bacteria and other microbes that live in your stomach, your mouth and on your skin, among other places. Collectively, they make up between five and ten pounds of your body weight, a vast and teeming crew known as the microbiome.\u003c/p>\n\u003cp>Scientists have known about the microbiome for some time, but the advent of relatively inexpensive DNA sequencing has transformed the research, making it possible to sequence – and therefore identify – thousands of species of bacteria and other microbes at once.\u003c/p>\n\u003cfigure id=\"attachment_173\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"http://science.kqed.org/quest/2013/05/03/the-human-microbiome-a-rogues-gallery/\">\u003cimg class=\"size-full wp-image-173\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2013/05/rogues.jpg\" alt=\"The Human Microbiome: A Rogue's Gallery - What are these creatures living inside us? Find out here.\" width=\"320\" height=\"217\">\u003cfigcaption class=\"wp-caption-text\">\u003ca>\u003c/a>The Human Microbiome: A Rogue's Gallery - What are these creatures living inside us? (\u003ca href=\"http://science.kqed.org/quest/2013/05/03/the-human-microbiome-a-rogues-gallery/\">QUEST\u003c/a>)\u003c/figcaption>\u003c/a>\u003c/figure>\n\u003cp>Among those doing the cataloging is Katie Pollard, a geneticist at the Gladstone Institutes in San Francisco.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Not long ago, Pollard was chatting with a few colleagues in a weekly meeting when one of them, a grad student named Chris Gignoux, mentioned some field work he'd been doing in a remote part of South Africa with an indigenous sheep and goat herding group called the Khoisan.\u003c/p>\n\u003cp>The Khiosan are thought to be the oldest genetic group on earth, ancestors of the rest of us. Even their language is unique, a \u003ca href=\"http://www.youtube.com/watch?v=c246fZ-7z1w\">“click” language\u003c/a> with consonants found nowhere else in the world.\u003c/p>\n\u003cp>Gignoux is part of a team trying to \u003ca href=\"http://www.nature.com/ncomms/journal/v3/n10/fig_tab/ncomms2140_F2.html\">piece together\u003c/a> the Khoisan's evolutionary history by studying their DNA, which the team extracts from saliva samples collected during field research trips to South Africa.\u003c/p>\n\u003cp>But the scientists were running into a problem. The Khoisan samples were contaminated with non-human cells: bacteria and other microbes that live in the Khoisan's mouths.\u003c/p>\n\u003cp>“The exact DNA that they were viewing as contamination was very interesting to us,” says Pollard.\u003c/p>\n\u003ch2>A garden in your gut\u003c/h2>\n\u003caside class=\"pullquote alignright\">The exact DNA that they were viewing as contamination was very interesting to us,” says Pollard.\u003c/aside>\n\u003cp>In recent years, scientists have come to see these bacteria and other microbes as a delicate ecosystem inside each of us. You can think of it as a garden in your guts, one you are constantly tending and adding to every time you eat a meal or are exposed to something in your environment.\u003c/p>\n\u003cp>And just like a garden, things can get out of whack. Invasive species take over; certain plants die off.\u003c/p>\n\u003cp>And when this happens, scientists believe, people can get sick.\u003c/p>\n\u003cp>Michael Fischbach is an assistant professor in the school of pharmacy at UCSF. He reels off a list of diseases that might – repeat, \u003cem>might\u003c/em> -- be connected to changes in our microbiome: “the inflammatory bowel diseases, including Crohn's disease. Possibly diabetes and obesity. Possibly even allergic diseases like asthma.”\u003c/p>\n\u003cp>This is new science. No one really knows. But Fischbach and others who study the microbiome are excited about the potential here, in part because of two recent discoveries.\u003c/p>\n\u003cfigure id=\"attachment_172\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-full wp-image-172\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2013/05/pollard.jpg\" alt=\"Katie Pollard, a geneticist at the Gladstone Institutes in San Francisco, is working on cataloging the human microbiome. (Courtesy photo)\" width=\"640\" height=\"485\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2013/05/pollard.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2013/05/pollard-400x303.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2013/05/pollard-320x243.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Katie Pollard, a geneticist at the Gladstone Institutes in San Francisco, is working on cataloging the human microbiome. (Courtesy photo)\u003c/figcaption>\u003c/figure>\n\u003ch2>Fecal transplants and an unlikely connection\u003c/h2>\n\u003cp>One was the announcement last year that people suffering from a stubborn bacterial infection called C.difficile were cured after receiving \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365524/\">fecal transplants\u003c/a>. They ingested fresh feces – collected from healthy donors and teeming with healthy bacteria – through a tube in their nose. It was a microbiome transplant, and it worked.\u003c/p>\n\u003cp>The second development came last month, when a researcher at the Cleveland Clinic published \u003ca href=\"http://my.clevelandclinic.org/media_relations/library/2013/2013-04-07-cleveland-clinic-researchers-discover-link-between-heart-disease-and-compound-found-in-red-meat-energy-drinks.aspx\">results\u003c/a> connecting bacteria in people's guts to heart disease.\u003c/p>\n\u003cp>“Nobody would have put heart disease on that list,” says Fischbach.\u003c/p>\n\u003cp>He says the announcement sent ripples of optimism throughout the microbiome research community. “The notion that you could come up with something that is going to surprise even those who have been working on it for some time is very much in the air.”\u003c/p>\n\u003cp>Also fueling the excitement is the recent completion of the \u003ca href=\"http://commonfund.nih.gov/hmp/\">Human Microbiome Project\u003c/a>, an effort, funded by the National Institutes of Health, to identify and catalogue the microbiota of 242 healthy American volunteers.\u003c/p>\n\u003cp>Now that scientists are starting to get a handle on what kinds of microbes live in the human body and, roughly, how those populations differ from one individual to another, a key question will be whether there is such a thing as an “ideal” microbiome.\u003c/p>\n\u003cp>In other words, if a bad, or imbalanced microbiome can make people sick, what does a good, balanced microbiome look like? What are the microbes that have evolved to keep us healthy, and how do they do it?\u003c/p>\n\u003ch2>Was there a microbial Garden of Eden?\u003c/h2>\n\u003cp>This is a hard question to answer because most of us have made huge, sweeping changes to our microbiomes at least several times in our lives by taking antibiotics.\u003c/p>\n\u003cp>David Relman, a professor of medicine at Stanford, was one of the first scientists to use DNA sequencing to study the makeup of the microbiome, using a swab from the inside of his own cheek.\u003c/p>\n\u003caside class=\"pullquote alignright\">Antibiotics are \"more like a cluster bomb,\" says Relman. \"They're indiscriminate. And there's a lot of collateral damage.”\u003c/aside>\n\u003cp>Since then, his work has explored how antibiotics affect the microbiome, and how long those \u003ca href=\"http://www.pnas.org/content/early/2010/09/14/1000087107\">changes persist\u003c/a>. He says while antibiotics have saved millions of lives, they’re a blunt instrument.\u003c/p>\n\u003cp>“In the past, we thought of antibiotics as magic bullets,” Relman says. “But – I hate using the military metaphor – they're more like a cluster bomb, or a neutron bomb. They're indiscriminate. And there's a lot of collateral damage.”\u003c/p>\n\u003cp>That collateral damage includes healthy bacteria, which may play important roles in digestion and other functions. Antibiotics can also create ideal environments for harmful bacteria to thrive.\u003c/p>\n\u003cp>Sometimes, the balance restores itself. Other times, the changes may be permanent. If a particular strain of bacteria is lost, it can't be passed on from one human generation to the next.\u003c/p>\n\u003cp>But this is hard to study. Because there’s almost no one out there who hasn't taken antibiotics. Which brings us back to the Khoisan.\u003c/p>\n\u003ch2>Learning from the Khoisan\u003c/h2>\n\u003cp>What occurred to Katie Pollard is that the Khoisan for the most part haven’t had that repeated antibiotic exposure. If researchers can find bacteria in the Khoisan that don’t show up in the saliva of industrialized groups, she says, “that would suggest that something in the modern lifestyle has potentially wiped out these bacteria.”\u003c/p>\n\u003cp>This work is just beginning. So far, Pollard's team has identified about 900 species of microbes in the Khoisan saliva. Next, they'll compare those species to samples from other populations to see whether there are any completely novel microbes in the Khoisan, microbes she and others haven't seen before.\u003c/p>\n\u003cp>Lest anyone start thinking that the Khoisan microbiome could be some sort of wholesale solution to modern ills (maybe imported through some kind of trans-Atlantic fecal transplant?) think again.\u003c/p>\n\u003cp>Among those 900 bacterial species identified, says Pollard, are several that you definitely wouldn't want, a fact that becomes clear when you look at photos of the Khoisan, many of whom are missing teeth.\u003c/p>\n\u003cp>“Many of the bacteria we've found are known pathogens,” says Pollard, “in terms of gum disease or enhancing plaque.”\u003c/p>\n\u003cp>Modern medicine has not been all bad for the microbiome.\u003c/p>\n\u003cp>Pollard and others who do DNA sequencing on gut microbes face a massive computational challenge, one that makes the human genome project look like a cakewalk.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>But the end result, say Pollard and others, could be new insights into how we could tweak, even curate the bacteria in our bodies, to make ourselves healthier.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>http://www.kqed.org/.stream/anon/radio/science/2013/05/2013-05-06-science.mp3\u003c/p>\n\u003ch2>A vast and teeming crew\u003c/h2>\n\u003cp>Here's something to stop and consider: You are mostly not you.\u003c/p>\n\u003cp>Ninety percent of the cells in your body don't have your DNA. They weren't in you when you were in the womb. Instead, they belong to trillions of tiny bacteria and other microbes that live in your stomach, your mouth and on your skin, among other places. Collectively, they make up between five and ten pounds of your body weight, a vast and teeming crew known as the microbiome.\u003c/p>\n\u003cp>Scientists have known about the microbiome for some time, but the advent of relatively inexpensive DNA sequencing has transformed the research, making it possible to sequence – and therefore identify – thousands of species of bacteria and other microbes at once.\u003c/p>\n\u003cfigure id=\"attachment_173\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"http://science.kqed.org/quest/2013/05/03/the-human-microbiome-a-rogues-gallery/\">\u003cimg class=\"size-full wp-image-173\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2013/05/rogues.jpg\" alt=\"The Human Microbiome: A Rogue's Gallery - What are these creatures living inside us? Find out here.\" width=\"320\" height=\"217\">\u003cfigcaption class=\"wp-caption-text\">\u003ca>\u003c/a>The Human Microbiome: A Rogue's Gallery - What are these creatures living inside us? (\u003ca href=\"http://science.kqed.org/quest/2013/05/03/the-human-microbiome-a-rogues-gallery/\">QUEST\u003c/a>)\u003c/figcaption>\u003c/a>\u003c/figure>\n\u003cp>Among those doing the cataloging is Katie Pollard, a geneticist at the Gladstone Institutes in San Francisco.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Not long ago, Pollard was chatting with a few colleagues in a weekly meeting when one of them, a grad student named Chris Gignoux, mentioned some field work he'd been doing in a remote part of South Africa with an indigenous sheep and goat herding group called the Khoisan.\u003c/p>\n\u003cp>The Khiosan are thought to be the oldest genetic group on earth, ancestors of the rest of us. Even their language is unique, a \u003ca href=\"http://www.youtube.com/watch?v=c246fZ-7z1w\">“click” language\u003c/a> with consonants found nowhere else in the world.\u003c/p>\n\u003cp>Gignoux is part of a team trying to \u003ca href=\"http://www.nature.com/ncomms/journal/v3/n10/fig_tab/ncomms2140_F2.html\">piece together\u003c/a> the Khoisan's evolutionary history by studying their DNA, which the team extracts from saliva samples collected during field research trips to South Africa.\u003c/p>\n\u003cp>But the scientists were running into a problem. The Khoisan samples were contaminated with non-human cells: bacteria and other microbes that live in the Khoisan's mouths.\u003c/p>\n\u003cp>“The exact DNA that they were viewing as contamination was very interesting to us,” says Pollard.\u003c/p>\n\u003ch2>A garden in your gut\u003c/h2>\n\u003caside class=\"pullquote alignright\">The exact DNA that they were viewing as contamination was very interesting to us,” says Pollard.\u003c/aside>\n\u003cp>In recent years, scientists have come to see these bacteria and other microbes as a delicate ecosystem inside each of us. You can think of it as a garden in your guts, one you are constantly tending and adding to every time you eat a meal or are exposed to something in your environment.\u003c/p>\n\u003cp>And just like a garden, things can get out of whack. Invasive species take over; certain plants die off.\u003c/p>\n\u003cp>And when this happens, scientists believe, people can get sick.\u003c/p>\n\u003cp>Michael Fischbach is an assistant professor in the school of pharmacy at UCSF. He reels off a list of diseases that might – repeat, \u003cem>might\u003c/em> -- be connected to changes in our microbiome: “the inflammatory bowel diseases, including Crohn's disease. Possibly diabetes and obesity. Possibly even allergic diseases like asthma.”\u003c/p>\n\u003cp>This is new science. No one really knows. But Fischbach and others who study the microbiome are excited about the potential here, in part because of two recent discoveries.\u003c/p>\n\u003cfigure id=\"attachment_172\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-full wp-image-172\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2013/05/pollard.jpg\" alt=\"Katie Pollard, a geneticist at the Gladstone Institutes in San Francisco, is working on cataloging the human microbiome. (Courtesy photo)\" width=\"640\" height=\"485\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2013/05/pollard.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2013/05/pollard-400x303.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2013/05/pollard-320x243.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Katie Pollard, a geneticist at the Gladstone Institutes in San Francisco, is working on cataloging the human microbiome. (Courtesy photo)\u003c/figcaption>\u003c/figure>\n\u003ch2>Fecal transplants and an unlikely connection\u003c/h2>\n\u003cp>One was the announcement last year that people suffering from a stubborn bacterial infection called C.difficile were cured after receiving \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365524/\">fecal transplants\u003c/a>. They ingested fresh feces – collected from healthy donors and teeming with healthy bacteria – through a tube in their nose. It was a microbiome transplant, and it worked.\u003c/p>\n\u003cp>The second development came last month, when a researcher at the Cleveland Clinic published \u003ca href=\"http://my.clevelandclinic.org/media_relations/library/2013/2013-04-07-cleveland-clinic-researchers-discover-link-between-heart-disease-and-compound-found-in-red-meat-energy-drinks.aspx\">results\u003c/a> connecting bacteria in people's guts to heart disease.\u003c/p>\n\u003cp>“Nobody would have put heart disease on that list,” says Fischbach.\u003c/p>\n\u003cp>He says the announcement sent ripples of optimism throughout the microbiome research community. “The notion that you could come up with something that is going to surprise even those who have been working on it for some time is very much in the air.”\u003c/p>\n\u003cp>Also fueling the excitement is the recent completion of the \u003ca href=\"http://commonfund.nih.gov/hmp/\">Human Microbiome Project\u003c/a>, an effort, funded by the National Institutes of Health, to identify and catalogue the microbiota of 242 healthy American volunteers.\u003c/p>\n\u003cp>Now that scientists are starting to get a handle on what kinds of microbes live in the human body and, roughly, how those populations differ from one individual to another, a key question will be whether there is such a thing as an “ideal” microbiome.\u003c/p>\n\u003cp>In other words, if a bad, or imbalanced microbiome can make people sick, what does a good, balanced microbiome look like? What are the microbes that have evolved to keep us healthy, and how do they do it?\u003c/p>\n\u003ch2>Was there a microbial Garden of Eden?\u003c/h2>\n\u003cp>This is a hard question to answer because most of us have made huge, sweeping changes to our microbiomes at least several times in our lives by taking antibiotics.\u003c/p>\n\u003cp>David Relman, a professor of medicine at Stanford, was one of the first scientists to use DNA sequencing to study the makeup of the microbiome, using a swab from the inside of his own cheek.\u003c/p>\n\u003caside class=\"pullquote alignright\">Antibiotics are \"more like a cluster bomb,\" says Relman. \"They're indiscriminate. And there's a lot of collateral damage.”\u003c/aside>\n\u003cp>Since then, his work has explored how antibiotics affect the microbiome, and how long those \u003ca href=\"http://www.pnas.org/content/early/2010/09/14/1000087107\">changes persist\u003c/a>. He says while antibiotics have saved millions of lives, they’re a blunt instrument.\u003c/p>\n\u003cp>“In the past, we thought of antibiotics as magic bullets,” Relman says. “But – I hate using the military metaphor – they're more like a cluster bomb, or a neutron bomb. They're indiscriminate. And there's a lot of collateral damage.”\u003c/p>\n\u003cp>That collateral damage includes healthy bacteria, which may play important roles in digestion and other functions. Antibiotics can also create ideal environments for harmful bacteria to thrive.\u003c/p>\n\u003cp>Sometimes, the balance restores itself. Other times, the changes may be permanent. If a particular strain of bacteria is lost, it can't be passed on from one human generation to the next.\u003c/p>\n\u003cp>But this is hard to study. Because there’s almost no one out there who hasn't taken antibiotics. Which brings us back to the Khoisan.\u003c/p>\n\u003ch2>Learning from the Khoisan\u003c/h2>\n\u003cp>What occurred to Katie Pollard is that the Khoisan for the most part haven’t had that repeated antibiotic exposure. If researchers can find bacteria in the Khoisan that don’t show up in the saliva of industrialized groups, she says, “that would suggest that something in the modern lifestyle has potentially wiped out these bacteria.”\u003c/p>\n\u003cp>This work is just beginning. So far, Pollard's team has identified about 900 species of microbes in the Khoisan saliva. Next, they'll compare those species to samples from other populations to see whether there are any completely novel microbes in the Khoisan, microbes she and others haven't seen before.\u003c/p>\n\u003cp>Lest anyone start thinking that the Khoisan microbiome could be some sort of wholesale solution to modern ills (maybe imported through some kind of trans-Atlantic fecal transplant?) think again.\u003c/p>\n\u003cp>Among those 900 bacterial species identified, says Pollard, are several that you definitely wouldn't want, a fact that becomes clear when you look at photos of the Khoisan, many of whom are missing teeth.\u003c/p>\n\u003cp>“Many of the bacteria we've found are known pathogens,” says Pollard, “in terms of gum disease or enhancing plaque.”\u003c/p>\n\u003cp>Modern medicine has not been all bad for the microbiome.\u003c/p>\n\u003cp>Pollard and others who do DNA sequencing on gut microbes face a massive computational challenge, one that makes the human genome project look like a cakewalk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the end result, say Pollard and others, could be new insights into how we could tweak, even curate the bacteria in our bodies, to make ourselves healthier.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>http://www.kqed.org/.stream/anon/radio/quest/2012/02/2012-02-27-quest.mp3\u003c/p>\n\u003cp>Each year, hundreds of thousands of Americans are implanted with tiny, battery-controlled devices that regulate the beating of their hearts. Those devices transmit streams of medical data directly to doctors.\u003c/p>\n\u003cp>Many of these are ICDs – implantable cardioverter-defibrillators. They’re miraculous, life saving devices.\u003c/p>\n\u003cp>Consider what happened one October afternoon to 45 year-old \u003ca href=\"http://www.mercurynews.com/health/ci_19847981\">Hugo Campos\u003c/a>, who lives in Oakland.\u003c/p>\n\u003cp>Campos was in San Francisco’s Mission District on his way to meet a friend for lunch, when suddenly he felt weak, as if about to faint.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He was on the corner of 16th and Valencia Streets, “not a pretty place to pass out,” he says.\u003c/p>\n\u003cp>“My concern was not falling where people had spit! I'm facing death and I'm worried about falling where there's spit.”\u003c/p>\n\u003cp>He felt an urgent need to call his partner, tell him where he was. But there was no time. Campos’s brain was shutting down.\u003c/p>\n\u003cp>“So I leaned against the wall and I expected to fall. And then it passed. It went away.”\u003c/p>\n\u003cp>Campos has a genetic heart disease called hypertrophic cardiomyopathy, a thickening of the heart muscle that can prevent the heart from effectively pumping blood to the brain and body.\u003c/p>\n\u003cp>Luckily for Campos, his doctors were able to diagnose the disease before it suddenly killed him, as it does in many young athletes, for example. In 2007, Campos had the ICD implanted in his chest.\u003c/p>\n\u003cfigure id=\"attachment_166\" class=\"wp-caption aligncenter\" style=\"max-width: 300px\">\u003cimg class=\"size-full wp-image-166\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2012/02/HC_Scale-300x169.jpg\" alt=\"Hugo Campos\" width=\"300\" height=\"169\">\u003cfigcaption class=\"wp-caption-text\">Hugo Campos\u003c/figcaption>\u003c/figure>\n\u003cp>On that October afternoon, the device had two options: It could deliver a powerful jolt of electricity – like those defibrillator paddles you’ve seen on TV. Instead, it acted like a pacemaker, delivering small electrical pulses that coax the heart back to its normal rhythm.\u003c/p>\n\u003cp>The ICD probably saved his life.\u003c/p>\n\u003cp>“All systems are go again,” he says, recalling that moment. “You feel the blood rushing to your head. It feels great. Life feels great. It feels outstanding.”\u003c/p>\n\u003cp>While life-saving, the ICD comes with a downside. When the device performs its defibrillator function, the shock is powerful and can be excruciating. Some ICDs have been known to defibrillate spontaneously, an experience patients describe as \u003ca href=\"http://circep.ahajournals.org/content/4/2/242.extract\">traumatic\u003c/a>.\u003c/p>\n\u003cp>The fear of a shock, along with the ever-present possibility of sudden heart failure and death, has changed Campos.\u003c/p>\n\u003cp>It’s given him a fervent desire to know, and to control as best he can, what’s happening inside his body.\u003c/p>\n\u003cp>Campos is a web designer, and you could describe his attitude as a Silicon Valley approach to heath: He’s had his genome sequenced. He sleeps with a Zeo sleep monitor, and goes nowhere without his FitBit pedometer. Last December, Campos \u003ca href=\"http://quantifiedself.com/hugo-campos/\">photographed\u003c/a> every morsel of food he ate, for a month, removing meat and dairy from his diet.\u003c/p>\n\u003cp>Campos wants the same access to what’s happening inside his ICD. He doesn’t want to have to go to his doctor for the occasional print out of his intracardiac electrogram. He wants the complete raw data, on demand.\u003c/p>\n\u003cp>In 2009, Medtronic, which makes Campos's ICD, told him that the data was only available through his doctor. Since then, he’s met with Medtronic officials and made his case widely in the media (including this recent \u003ca href=\"http://www.mercurynews.com/health/ci_19847981\">Mercury News story\u003c/a>) and online, in a widely-watched \u003ca href=\"http://www.tedxcambridge.com/thrive/hugo-campos/\">TedX talk\u003c/a>. Another inquiry to Medtronic, in 2011 generated a similar response.\u003c/p>\n\u003cp>Meanwhile, other patients, like \u003ca href=\"http://icdusergroup.blogspot.com/2011/12/karen-sandler-cyber-lawyer-running-on.html\">Karen Sandler\u003c/a>, of Massachussets, make Campos’s demands look modest in comparison. A freedom of information lawyer, Sandler wants the full source code for her ICD.\u003c/p>\n\u003cp>“We are seeing a cultural shift,” says Paul Tang, a physician in Palo Alto who has advised the White House on health information policy.\u003c/p>\n\u003cp>Tang believes this whole issue of data and access is just starting to unfold.\u003c/p>\n\u003cp>He says soon, many more of us will have devices in our lives that can monitor our health and transmit that information to our doctors. Our iPhones can tell doctors how much we're exercising. The bathroom scale can report weight gain. Credit card companies could even tell our doctor what kinds of food we're buying.\u003c/p>\n\u003cp>“In the future,” says Tang, “I think we’re going to take advantage of much more of these signals that either emanate from your body, or can be determined noninvasively, and provide feedback on how the things you do in everyday life affect your health.”\u003c/p>\n\u003cp>Tang sees this new age of medical data as a boon for patients, a way to fully engage people in their health, so that they can see the way day-to-day decisions affect their body.\u003c/p>\n\u003cp>He says the The Patient Protection and Affordable Care Act, signed by President Obama in 2010, will give patients far more access to their medical data than every before.\u003c/p>\n\u003cp>But Campos worries that the sheer volume of new data being created, as well as the ability to remotely transmit that data directly to physicians, could end up shutting patients out of their own healthcare, even replacing traditional visits to the doctor's office.\u003c/p>\n\u003cp>He says unless patients start demanding full access to their medical data now, they risk being left out of the loop.\u003c/p>\n\u003cp>“I should be in charge of it in the same way I'm in charge of my financial information,” he says. “It’s just a matter of putting the patient in the center of their own care.”\u003c/p>\n\u003cp>Meanwhile, Campos’s ICD crusade seems to be working. A spokesman for Medtronic says the company is now willing to give Campos his raw data, and is working on ways to make this happen. The spokesman added that the company is willing to do the same for other ICD patients who request to see their raw data, as well.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Campos says he’ll believe it when he sees it.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He was on the corner of 16th and Valencia Streets, “not a pretty place to pass out,” he says.\u003c/p>\n\u003cp>“My concern was not falling where people had spit! I'm facing death and I'm worried about falling where there's spit.”\u003c/p>\n\u003cp>He felt an urgent need to call his partner, tell him where he was. But there was no time. Campos’s brain was shutting down.\u003c/p>\n\u003cp>“So I leaned against the wall and I expected to fall. And then it passed. It went away.”\u003c/p>\n\u003cp>Campos has a genetic heart disease called hypertrophic cardiomyopathy, a thickening of the heart muscle that can prevent the heart from effectively pumping blood to the brain and body.\u003c/p>\n\u003cp>Luckily for Campos, his doctors were able to diagnose the disease before it suddenly killed him, as it does in many young athletes, for example. In 2007, Campos had the ICD implanted in his chest.\u003c/p>\n\u003cfigure id=\"attachment_166\" class=\"wp-caption aligncenter\" style=\"max-width: 300px\">\u003cimg class=\"size-full wp-image-166\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2012/02/HC_Scale-300x169.jpg\" alt=\"Hugo Campos\" width=\"300\" height=\"169\">\u003cfigcaption class=\"wp-caption-text\">Hugo Campos\u003c/figcaption>\u003c/figure>\n\u003cp>On that October afternoon, the device had two options: It could deliver a powerful jolt of electricity – like those defibrillator paddles you’ve seen on TV. Instead, it acted like a pacemaker, delivering small electrical pulses that coax the heart back to its normal rhythm.\u003c/p>\n\u003cp>The ICD probably saved his life.\u003c/p>\n\u003cp>“All systems are go again,” he says, recalling that moment. “You feel the blood rushing to your head. It feels great. Life feels great. It feels outstanding.”\u003c/p>\n\u003cp>While life-saving, the ICD comes with a downside. When the device performs its defibrillator function, the shock is powerful and can be excruciating. Some ICDs have been known to defibrillate spontaneously, an experience patients describe as \u003ca href=\"http://circep.ahajournals.org/content/4/2/242.extract\">traumatic\u003c/a>.\u003c/p>\n\u003cp>The fear of a shock, along with the ever-present possibility of sudden heart failure and death, has changed Campos.\u003c/p>\n\u003cp>It’s given him a fervent desire to know, and to control as best he can, what’s happening inside his body.\u003c/p>\n\u003cp>Campos is a web designer, and you could describe his attitude as a Silicon Valley approach to heath: He’s had his genome sequenced. He sleeps with a Zeo sleep monitor, and goes nowhere without his FitBit pedometer. Last December, Campos \u003ca href=\"http://quantifiedself.com/hugo-campos/\">photographed\u003c/a> every morsel of food he ate, for a month, removing meat and dairy from his diet.\u003c/p>\n\u003cp>Campos wants the same access to what’s happening inside his ICD. He doesn’t want to have to go to his doctor for the occasional print out of his intracardiac electrogram. He wants the complete raw data, on demand.\u003c/p>\n\u003cp>In 2009, Medtronic, which makes Campos's ICD, told him that the data was only available through his doctor. Since then, he’s met with Medtronic officials and made his case widely in the media (including this recent \u003ca href=\"http://www.mercurynews.com/health/ci_19847981\">Mercury News story\u003c/a>) and online, in a widely-watched \u003ca href=\"http://www.tedxcambridge.com/thrive/hugo-campos/\">TedX talk\u003c/a>. Another inquiry to Medtronic, in 2011 generated a similar response.\u003c/p>\n\u003cp>Meanwhile, other patients, like \u003ca href=\"http://icdusergroup.blogspot.com/2011/12/karen-sandler-cyber-lawyer-running-on.html\">Karen Sandler\u003c/a>, of Massachussets, make Campos’s demands look modest in comparison. A freedom of information lawyer, Sandler wants the full source code for her ICD.\u003c/p>\n\u003cp>“We are seeing a cultural shift,” says Paul Tang, a physician in Palo Alto who has advised the White House on health information policy.\u003c/p>\n\u003cp>Tang believes this whole issue of data and access is just starting to unfold.\u003c/p>\n\u003cp>He says soon, many more of us will have devices in our lives that can monitor our health and transmit that information to our doctors. Our iPhones can tell doctors how much we're exercising. The bathroom scale can report weight gain. Credit card companies could even tell our doctor what kinds of food we're buying.\u003c/p>\n\u003cp>“In the future,” says Tang, “I think we’re going to take advantage of much more of these signals that either emanate from your body, or can be determined noninvasively, and provide feedback on how the things you do in everyday life affect your health.”\u003c/p>\n\u003cp>Tang sees this new age of medical data as a boon for patients, a way to fully engage people in their health, so that they can see the way day-to-day decisions affect their body.\u003c/p>\n\u003cp>He says the The Patient Protection and Affordable Care Act, signed by President Obama in 2010, will give patients far more access to their medical data than every before.\u003c/p>\n\u003cp>But Campos worries that the sheer volume of new data being created, as well as the ability to remotely transmit that data directly to physicians, could end up shutting patients out of their own healthcare, even replacing traditional visits to the doctor's office.\u003c/p>\n\u003cp>He says unless patients start demanding full access to their medical data now, they risk being left out of the loop.\u003c/p>\n\u003cp>“I should be in charge of it in the same way I'm in charge of my financial information,” he says. “It’s just a matter of putting the patient in the center of their own care.”\u003c/p>\n\u003cp>Meanwhile, Campos’s ICD crusade seems to be working. A spokesman for Medtronic says the company is now willing to give Campos his raw data, and is working on ways to make this happen. The spokesman added that the company is willing to do the same for other ICD patients who request to see their raw data, as well.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Campos says he’ll believe it when he sees it.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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