Educating young people on tuberculosis

To mark World TB Day 2020, Professor Sanjib Bhakta, Professor of Molecular Microbiology and Biochemistry, discusses his new collaborative project which aims to educate children on tuberculosis (TB).

JoiHok

 Birkbeck’s Mycobacteria Research Laboratory is currently working on a charity project, called ‘JoiHok’ (translated to ‘Let victory be yours!” in English), that is looking at educational intervention as a means of spreading awareness and effective control of disease. The project concentrates on students in greater Kolkata, India from low socioeconomic backgrounds, whose families are disproportionately affected by tuberculosis (TB) due to factors like malnutrition and poor living conditions.

TB has progressively worsened with the advent of antibiotic resistance, hence there is urgent need to review and deal with the disease not only as a medical concern or even public health problem alone, but also as a social problem. The project is using creative tools like local folk-art and music to encourage children to engage, learn and discuss the issue of antibiotic resistance in the context of TB. It is hoped the children’s knowledge will be transferred to household members which in turn could encourage patients to adhere to prescribed anti-TB medication.

Global infectious diseases are rarely out of the news, as new communicable diseases such as COVID-19, Ebola, Zika, bird flu as well as older, familiar diseases such TB, cholera and malaria, raise concerns about outbreaks and global pandemics. In our ever-changing, rapidly globalising world, the free movement of people and goods, social change, urbanisation and environmental degradation, mean that microorganisms can move quickly between and across populations, crossing natural and human-made borders with ease. On top of this, microorganisms are constantly adapting and developing resistance to existing antibiotic and other treatments, leading to the resurgence of old diseases and the evolution of new ones.

Birkbeck’s research-intensive MRes Global Infectious Diseases course is designed for developing the research aptitude and skills that one needs to develop an academic or professional career as a researcher into global infectious diseases.

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Cool views of molecular machines

Carolyn Moores, Professor of Structural Biology, writes about how academics in the Institute of Structural and Molecular Biology (ISMB) are using their new cryo-electron microscope to address big questions about antibiotic resistance, disease and life itself.

The state-of-the-art cryo-electron microscope at Birkbeck

Tucked discreetly in a corner of the Malet Street Extension building, a new state-of-the-art microscope is generating Terabytes of high-resolution imaging data. This £4M cryo-electron microscope (cryo-EM) is using Nobel Prize-winning technology to address a wide range of biologically and biomedically important questions. Researchers in the Institute of Structural and Molecular Biology (ISMB) are using it to study the molecular machines that are found within all living cells and that are essential for life. The ISMB – a joint research institute between Birkbeck and UCL – is internationally recognised as a centre of excellence for cryo-EM and for our research focused on diverse molecular machines.

In 2016, we were thrilled to be awarded a grant by Wellcome which, together with contributions from Birkbeck and UCL, funded the purchase of our Titan Krios microscope. Delivery day, earlier this year, was a big moment for the whole team. Prior to its arrival, we had been working hard with colleagues from Estates and external contractors to prepare a high-spec room for its arrival. Our microscope travelled in its own juggernaut from the Thermo Fisher factory in The Netherlands, with its ~3,300 parts carefully catalogued and packed in 21 crates. With nerves jangling, we all held our breath as the largest and heaviest part of the microscope was squeezed into the lift, travelled one floor to the basement without mishap, and edged its way out again. Constructed by dedicated engineers over the course of 8 weeks like a very big ship in a bottle, this 4.5 tonne, 4m tall monolith is now steadily producing up to 4TB of data a day.

Christmas came early – delivery of the cyro-electron microscope

Since its invention in the 1930s, electron microscopy has steadily improved in power and sophistication, and recent advances have moved this method to the forefront of structural biology. In particular, rapid freezing of samples to liquid nitrogen temperatures (~-195°C) allows sample preservation to be maintained inside the microscope, and provides some cryo-protection from the otherwise damaging effects of the electrons that are used for sample imaging. The cryo-EM field has undergone a technological revolution in the last ~5 years such that the application of this methodology has expanded enormously. The 2017 Nobel Prize in Chemistry was awarded to three pioneers in the field.

Our new microscope brings many benefits. First, it is very stable: since the ultimate goal of our experiments is to visualize the position and organization of all the atoms from which molecular machinery is built, microscope stability is vital. Coupled to this, the Titan Krios is designed to allow automated data collection such that, after a few hours of set up, data collection experiments can be left to run for several days without user intervention. Previous generation equipment required trained microscopists to sit at the microscope for as many hours as they could manage. Since our structural experiments require many thousands of sample images to be computationally combined to reveal their 3D structure, this is gruelling. Implementation of sophisticated data collection software is much more efficient and strongly preferred by the microscopists! In addition, although still requiring expertise and training, the Titan Krios is user-friendly while not compromising on its high-end capabilities. Around a dozen ISMB researchers have already received training and are busy collecting data for studies on topics as diverse as cancer, dementia, antibiotic resistance and malaria. Understanding the structures of biological molecules and assemblies reveals how they work and makes it possible to design drugs or treatments for diseases.

Installation in Birkbeck’s Malet Street building

With new opportunities come fresh challenges. Because the new microscope produces high-quality data – and a lot of it – so efficiently, our focus has now shifted to the problem of producing high-quality samples that can be fed into the Titan Krios imaging pipeline. This now represents a major bottleneck for many projects, both because of the time intrinsic to sample optimisation and because researchers need to learn the skills in order to undertake this optimisation. We are now focusing on ways to allow more projects and more researchers at UCL and Birkbeck to benefit from the cryo-EM “resolution revolution”.

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Shining a light on brain development

Since recording the first brain images of babies in Africa, Professor Clare Elwell, part of the Brain Imaging for Global HealTH (BRIGHT) network, of which Birkbeck is a member, has been leading a pioneering study to increase our understanding of early brain development. Clare discusses bringing a new imaging technology to a remote Gambian village, and how it could help babies suffering from malnutrition to reach their full potential.

Image credit Bill and Melinda Gates Foundation

Before they reach five years of age, one in four children across the globe are malnourished. There’s a lot of research showing the detrimental impact this has on their development. But we know very little about what’s going on inside their brains.

Conventional brain imaging techniques, like magnetic resonance imaging (MRI), require large, bulky and expensive scanners. Unfortunately, this technology is not available in resource-poor settings, often where malnutrition is most prevalent, and is not always suitable for very young babies.

Clare Elwell with an infant taking part in the BRIGHT study: Image credit Bill and Melinda Gates Foundation

The BRIGHT families

We’re recruiting the mothers before the babies are born, because some of our measures start within the first few days of the infants’ lives. It’s a huge commitment. We’re extremely grateful to all the families in our study, both in the UK and in The Gambia.

For some mothers this is their first baby; they have no idea what’s ahead of them, and yet they’ve agreed to enrol into a study where we’re going to be part of their lives for at least two years. It’s really thrilling to see how motivated and how dedicated they are to this project.

Hopes for the future

I think the BRIGHT study is a good example of where a solution had existed for a long time, but we just didn’t know about the problem. Once I realised that understanding infant brain development in Africa was a challenge, it’s been incredibly rewarding to bring in existing technology to help.

Infant with fNIRS imaging headset in Keneba: Image credit Ian Farrell

We’d like to continue to follow our cohort and to study them in the pre-school years, so that we have a continuous measure of their brain function. I’d also really like to see the MRC field station at Keneba become a centre of excellence for infant brain development studies. Capacity building has been a large part of our project and we have been training many local field staff to conduct a whole range of infant brain development assessments. This will help us use all the skills and the talent that’s already in Africa to learn how we can optimise the methods we are using; to better understand brain development in this population; and ultimately, to ensure that all infants reach their potential in leading happy and healthy lives.

The BRIGHT study is a collaborative project, made up of a team of researchers from UCL, Birkbeck University of London, the Medical Research Council Units in Cambridge and The Gambia at London School of Hygiene and Tropical Medicine, Cambridge University and Cambridge University Hospitals.

The project is part of the Global fNIRS initiative for the use of fNIRS in global health projects. This blog was first published by the Medical Research Council, and is reposted with their permission.

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Using historical evidence to improve conservation science

In a new paper, Dr Simon Pooley from the Department of Geography argues that moving beyond historical ecology to draw on methods from environmental history is crucial for the field and allied sub-disciplines of ecology like restoration ecology and invasion biology.

As researchers turn increasingly to history as a resource for understanding the trajectory of a planet under unprecedented human pressure, we need to be clear about the methodological challenges of finding and using historical data.

Mainstream ecology recognises the importance of recovering long-term ecological records by applying rigorous methods to the study of charcoal, ice cores, pollen and tree rings. The uses of historical textual and graphic sources are seldom accorded analogous rigour.

Ecologists use scientific methods to learn from the past, drawing on resources developed by historical ecologists to source data and assemble it into time series, predicting fluctuations and trends in variables over time.

Recently, interest in the impacts of human actions on earth systems has led scientists to aggregate data on generalised human perturbations like greenhouse gas emissions or the industrial manufacture of fertilizers. They then compare these with variables tracking impacts on related earth systems like earth surface temperatures and ocean acidification.

For environmental historians, the resulting framings of relationships between human agency and earth systems are often too linear and generalised. Further, historians urge analysts to pay closer attention to the contextual factors shaping data production, rather than dip uncritically into ‘the past’ as a ‘goody bag’ of useful facts.

This paper is aimed at ecologists rather than historians; it aims to communicate some of the major considerations they should be aware of when collecting and interpreting historical data. These can be handily divided into four themes, summarised as questions:

  • Why, how, and by whom were the data collected?
  • How were the data measured (relating to time periods and spatial units in particular)?
  • What conceptual filters shaped data collection and interpretation?
  • What anomalies, exceptional events and human influences shaped data collection?

The paper notes that the purposes for which data were initially collected, and by whom they were collected, using which methods and tools, all importantly shape what is (and is not) collected and in what form. Long time-series often combine datasets shaped in different ways in accordance with all these factors. A simple example is that, beginning in the late sixteenth century, the Gregorian calendar was adopted sporadically across Europe over several centuries, and then in parts of Asia and elsewhere in the late 1800s and early 1900s. In each instance, days were won or lost as regional or national calendars were adjusted accordingly.

The reporting periods used by institutions vary (and change) and researchers compiling time series must take these changes, and ‘longer’ and ‘shorter’ years used to adjust to new reporting cycles, into account when incorporating their data.

And of course datasets should never be taken at face value: whale catch data published by Russia and Japan in the postwar period, for instance, should be treated with due scepticism.

In the 1970s, mathematical models were devised to estimate historical (baseline) saltwater crocodile populations in northern Australia, as a means for judging when conservation measures introduced early in that decade had resulted in an adequate recovery to pre-exploitation levels. However, when a series of attacks followed an unexpectedly quick population recovery, public opinion demanded a rethink of models which calculated that these populations were will still at only 2% of their historical size.

Northern Territory researchers consulted historical records and interviewed former hunters, discovering that pre-exploitation crocodile population densities had varied significantly from river system to river system. According to their revised estimates, populations were at 30-50% of pre-exploitation levels, sufficient to allow controlled sustainable use of crocodiles. This resulted in a policy shift which has proven to be a successful long-term management approach in the region.

The ways in which underlying theories and conceptual frameworks shape data collection are challenging to work out. Examples include powerful narratives about desertification and deforestation which shaped how colonial foresters and agricultural experts interpreted landscape change and management in the colonies in which they worked. Ideas about fire, forests and rainfall long shaped expert thinking about landscape change in India, Madagascar and many parts of Africa, and arguably still influence management interventions aimed at changing or preventing traditional practices by local peoples. In India, ideas about degradation through burning still guide management of savannas, which are arguably misclassified as degraded woodlands.

The four themes identified in my paper are discussed in the text in relation to a schematic figure. Of course, any such visualisation conceals considerable complexity, but it provides a useful framework for exploring some of the challenges. The paper gestures to some of these further complexities through examples from my monograph Burning Table Mountain: an environmental history of fire on the Cape Peninsula (Palgrave 2014; UCT Press 2015) and a recent paper on fire and expertise in South Africa (Environmental History 23:1, 2018). These examples show some ways in which published theories don’t always match the authors’ recommendations for management in the field, or the results of experimental science are ignored in the face of powerful narratives about ecological phenomena like fire, soil erosion and drought. Finally, they demonstrate how complex factors – social, economic, cultural – combine in diverse ways to shape whether and how scientifically informed policies are implemented.

The paper concludes by arguing that the use of historical approaches as summarised in its accompanying figure can help improve the accuracy of the data we draw on to do important conservation work like estimate the conservation status of ecosystems or species, or prioritise conservation action. At a deeper level, historical methods allow us to tease apart the many interacting factors which shape policy and management and influence their interrelations with other narratives, knowledge systems and priorities in particular contexts, over time.

The paper is available (open access) with supporting figure and references in Conservation Letters.

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