Policy & Practices

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Monday

Today started off with a talk discussing Science and Religion. We are a small, private, Christian institution, and as such feel that we have a unique opportunity to talk about synthetic biology and bioengineering with those who may at first think that it is not Science and Religion, but Science versus Religion. Mr. Nickels, who has a background in Christian education and public education was able to share a unique perspective of how we, as scientists, can still be both strong in faith and in science. This was the perfect way to set the tone for the rest of our summer camp as we deal with basic biology but also some controversial topics.

We then delved into science, first with the Central Dogma of Biology. This was no ordinary lecture... there was candy! Students were able to learn about the structure of DNA and how it becomes RNA with licorice and marshmallows. Next, we used our Oreo “tRNA’s” to transform RNA into amino acids, coding for proteins. It was a great and tasty time had by all!

After lunch was lab time. We gloved up to learn how to pipette and put those new skills to use by making a liquid culture and mini prep. Students were able to culture their own bacteria and learned the important conditions necessary for doing so. We then took bacteria and isolated their DNA by performing a “mini prep”.

Lastly, we discussed what iGEM is all about: teamwork and excitement for science. We introduced the project for the week: review a past iGEM project and make a presentation to present to the rest of the camp students so they can understand it too! We mapped out all of the components of a tip top iGEM project: a website, consideration of policy and practices, and of course, the science! Groups decided their interests right away and selected a past team’s work to review for the week.

Tuesday

Today was a busy day! We began with some review of proteins and chemical bonding. Then it was off to the Milwaukee School of Engineering Biomolecular Modeling lab. Gina first shared the principles of water with magnetic models so the students could feel the difference between hydrogen, ionic, and covalent bonding. We then progressed to building a peptide bond and understanding what composes the "NCC" backbone. Before we knew it, we built a long polypeptide chain! Once we understood the primary structure, we worked on forming the correct side chain interactions: hydrophobic in, hydrophilic out! Then it was story time. We got to see the large 3-D printers that they use to model and hold a GFP model. It helped us to understand RFP, which we used in the lab yesterday with our glowing red bacteria! The small scale science that we are performing in the lab this week really came to life.

Back at Wisconsin Lutheran College, Dr. Werner walked us through the basics of genetic engineering before we delved into the lab once again. It was the student's turn to make bacteria glow red, and we used the plasmids they had isolated on Monday in the mini prep to do so. We will see how this fared tomorrow! Lastly, students were hard at work on their group projects to make a presentation to share past iGEM projects with each other.

Wednesday

We made it to the middle of the week. Now that we had our feet on the ground, we began the day discussing viruses and medical microbes. Students learned the difference between viruses, bacteria, and how these organisms can wreak havoc on our bodies. We reviewed articles found on the internet and discussed their strengths and weaknesses. Being knowledgeable about reading scientific literature is important!

In lab, we saw that our transformations from yesterday to make bacteria red were successful! Then Dr. Henkel lead us on an investigation as we learned how we detect these organisms with differential media. Students sampled various places: the bathroom floor, their armpits, and anything else that they wished to swab to determine what type of bacteria was growing. Tomorrow, we will see what types of organisms are lurking in places that we touch every day. Students continued working on their group projects and began to craft their presentations.

Thursday

The week is flying by! Now that we knew about viruses, bacteria, and their medical implications, we were ready to learn about biosafety and biowarfare. Dr. Henkel shared his experiences and expertise in dangerous organisms. We then discussed how we can fight these organisms with antibiotics. However, camp instructors did not miss a beat to discuss antibiotic resistance and the implications of this.

After lunch, we learned how to make thousands of copies of DNA using the polymerase chain reaction, or PCR. Then we learned how to specifically cut DNA with a restriction digest reaction. Plus, the results from yesterday were in! We saw beautiful bacteria on our plates and were able to identify what we grew! Looks like railings make a great home for bacteria! As it was the last day to work on presentations, students were then able to practice with the projectors to prepare for tomorrow. Tomorrow is show time!

Friday

Today was the busiest of our days yet! The morning was spent polishing presentations and playing a game of jeopardy reviewing the week’s topics. We enjoyed lots of laughs and learning some things that we may have forgotten! In lab, Matt showed us how to run a “gel electrophoresis” in which we were able to separate DNA and confirm that our previous week’s experiments were successful. Next, we took some strains of bacteria and stained microscope slides in order to visualize the tiny buggers. It was exciting to see our tiny friends that we had been working with all week!

After this, Sierra spoke to the students about how we are able to genetically engineer organisms like yeast, rats, and even our own cells. Students got to view HeLa cells, the immortal cell line that originated from the cervical cancer cells of Henrietta Lacks. It was incredible to see human cells! Summer campers had some free time to explore different human tissue samples with the light microscope as well as learn how we make slides to see the incredible structures of these tissues.

It was then finally time for presentations! Instructors were impressed as students spoke about past iGEM projects and explained their results. They shared their own creative ideas about how to spread the awesome knowledge of bioengineering. We finished up the camp with a grill out and said our last goodbyes. It was truly an awesome week, filled with learning, fun, and biology.

Biotechnology Curriculum for High School Teachers

• Its purpose being to inform and educate WELS high school teachers concerning Biotechnology and its subfields such as synthetic biology and genetically modified organisms (GMOs), as well as discuss biotechnology implications given our faith in Christ.
• Biotechnology is defined as the application of science and technology to living organisms, as well as parts, products and models thereof, to alter living or non-living materials for the production of knowledge, goods and services.

The Future of Biotechnology

• The fields of Biotechnology will continue to be a driving force for innovation and production for years to come and as such it is essential that it be a part of high school curriculums in order for students to obtain a general knowledge of the subject and be able to articulate their own views on the controversial topic.

Topics for Discussion and General Outline

• Brief review of central dogma of biology, transcription, translation, etc.
• Explore general concepts and knowledge concerning biotechnology.
• Synthetic biology
• Genetic engineering
• Cloning
• Biofuels
• Bacteriophage Therapy

Discuss Biotechnology and Christianity

• What applications are not aligned with our faith.
• At what point should we stop pursuing research or investigation from an ethical standpoint?
• Is genetic engineering and manipulation in and of itself against our faith?

Mode of Communication

• First gauge interest in an in-person meeting/seminar versus an online platform. (Winter)
• Determine date and location. (Late winter)
• Gain awareness via email, Synod connections, collaborate with Martin Luther College.
• Travel to Martin Luther College and speak with college students aiming to become science teachers.

Coffee Lid Campaign

Prior to, and during the first week of the 2015 fall semester, the WLC iGEM team designed a sticker to be placed on the top of coffee lids from the WLC coffee shop. These stickers were printed with details about a biotechnology informational night that the iGEM team hosted on WLC’s campus to educate WLC students about biotechnology, and GMOs.

Later this semester (approximately the first week in October), we hope to utilize the coffee cup lid design to disseminate information about the first iGEM meeting for new or potential iGEM team members. We are also planning on using the coffee cup lid stickers during the 2016 spring semester to provide details about special iGEM events, educational opportunities, outreach programs, and general Biotechnology/GMO information. We also hope to use this in businesses around our school, so that they may gain greater awareness in biotechnology, like linking them to a website with more information.

Biotechnology Information Night

As we found with our surveys of students on our campus, there is some work to be done with biotechnology awareness at WLC. To do this, we initiated Biotech Info Night, as an informational session where we introduced iGEM, GMOs, and the great variety of applications in biotechnology. We had 17 students in attendance and had a great time learning and having open discussion about what GMOs means to our faith and to the world.

Anna speaking about GMOs at Biotech Info Night.

Christa speaking about biotech applications at Biotech Info Night.

As an iGEM team, we started the work behind writing a mission statement for our Biology Department at Wisconsin Lutheran College. As an institution of Christian faith and background, some people are opposed to genetic engineering and manipulation. As a team that is based on these principles, but also of Christian faith, we wanted to explore and verify why it is acceptable for us to be a part of both. A statement is not yet approved by our Biology department, but the work will be finished this year as we sparked the interest in having such a statement.

For the widespread implications of our project, we turned to physicians to give us answers on how to best combat antibiotic resistance. We learned from the physicians that antibiotic resistance is a growing problem that is here to stay. They were open to new alternatives to antibiotics as long as they were clinically proven to be effective. Both were trained to use antibiotics when appropriate, but that often time the risk of the infection outweighs the risk of developing resistance. The choice to use antibiotics is a complicated one. They must consider the patient’s individual social history, health, their access to care, as well as the patient’s opinion. By this analysis, it is usually favored to use antibiotics when the risk of infection is present. They did, however, note that research for alternatives is imperative as some day we will encounter a bacterial strain that is completely resistant to antibiotics. This is the importance of our project.

Our team wanted to better understand the perspective of the physician who prescribe antibiotics. They work with patients that face antibiotic resistance on a daily basis. We turned to Dr. Roessler, who has been an emergency room physician for the past 11 years, and Dr. Sobeck, an anesthesiology resident recently graduated from medical school, to help us understands their needs as physicians to help fight antibiotic resistance.

Questions

1. About how many patients do you see that are affected by some sort of antibiotic resistance?
• Dr. Roessler: I see about 2500 patients per year, 14-15 patients per shift. Of those, about 1/3 are here for infection. Of those, antibiotic resistance must be considered in all of them. 10-15% of patients still have resistance to the initial antibiotic selection and need their medication changed.
• Dr. Sobeck: At least 1-3 patients per day come through our operating room with some form of MDR/XDR organism (e.g., MSRA, VRE, etc.) so this amounts to maybe 1% of my patient population.

2. Would you prescribe an alternative to antibiotics treatment if one existed?
• Dr. Roessler: It is certainly possible that infectious diseases could be treated without antibiotics, but there would have to be a lot of research supporting alternative treatments before this could happen. Treating infections with antibiotics has become dogma, and medical dogma takes years, maybe decades, to change. Therapies such as phage therapy would likely be supplements to treatment.
• Dr. Sobeck: Yes, but only if there is evidence that this alternative therapy is at least non-inferior to traditional antibiotics.

3. In your training, were you taught to avoid antibiotic use if possible?
• Dr. Roessler: We are trained to use antibiotics when appropriate. There is really not a bias for or against. Given that the public usually wants antibiotics, and given that most people's natural inclination is to do "more" rather than to do "less" we do often focus on ways to avoid antibiotic use - when appropriate.
• Dr. Sobeck: Yes, we are taught to only prescribe antibiotics when there is a good indication, to limit the duration of antibiotic therapy, and to rotate antibiotic types.

4. What specific strains of bacteria do you feel are important to develop alternatives to antibiotics for?
• Dr. Roessler: There are many strains of bacteria that are developing resistance and are in need of additional therapies. MRSA would be a good place to start.

5. When confronted with a patient that has a possible, but not confirmed, bacterial infection, how do you decide on using antibiotics or not? When does the risk of infection outweigh the risk of antibiotic resistance?
• Dr. Roessler: For any one person, the risk of a serious bacterial infection always outweighs the risk of developing resistance. At the individual level, the key is to determine how likely there is to be a bacterial infection and then how likely it is that a serious bacterial infection could develop if not treated with antibiotics. Some of these factors include age, comorbidities, access to follow up care, reliability, understanding of their condition, and a patient's willingness to accept some risk.
• Dr. Sobeck: You need to first evaluate the clinical setting of the patient: if the patient is critically ill or immunocompromised or other risk factors for poor outcome from infection, you have a lower threshold for starting an antibiotic immediately vs waiting for confirmatory results; failing to start timely antibiotic therapy in this clinical setting could lead to disastrous or life-threatening results so the risk of antibiotic resistance is therefore lower than the risk of patient harm.

6. Are you concerned of contracting an antibiotic resistant strain of bacteria yourself, while working in a medical facility?
• Dr. Roessler: There are many risks working in healthcare. I assume that I am already colonized with resistant bacteria. Everyone assumes risks with their career choice.
• Dr. Sobeck: Not necessarily, since I have no risk factors for development of an overt infection from the resistant organism and I don't believe there is any evidence to suggest future harm to healthcare workers who are exposed to resistant organisms (this is a separate issue from exposure to known harmful organisms like TB, HIV, Hep C, etc).

7. What would you like the public to understand about antibiotic resistance?
• Dr. Roessler: Antibiotic resistance is real, and giving antibiotics, even when indicated, always comes with a price. It is rarely 100% clear that antibiotics are indicated when someone is ill. To treat with antibiotics "just in case" is careless if physicians and their patients do not consider the risks and costs of antibiotics. These include the financial cost, risk of anaphylaxis, other adverse effects, interaction with other medications, and perhaps the most important, the development of resistance. Most people don't care about antibiotic resistance because they believe it is theoretical, won't happen to them, and may not happen to anyone for many years. Right now, drug companies are keeping up with resistance, and they are likely profiting quite nicely from new medications, but eventually, nature has a way of always winning. At some point, there will be a strain of bacteria we can't cure with antibiotics alone, and there will be widespread morbidity and mortality if supplemental or alternative treatments are not developed.
• Dr. Sobeck: Resistant organisms should NOT be called "super bugs" because there are still several antibiotics and treatments that still work but they are more expensive and have the potential for serious side-effects.