After five days of non-stop science, technology, and policy, I’m taking a break. No post today, I’ll be busy filling out government paperwork so that I’m reimbursed for my travel expenses.

New medicines are tested on adults, but frequently prescribed to children suffering from the ‘adult’ disorder. How do physicians know the proper dose for sick children? How do they know if the drug will be effective? The prevailing wisdom treated children as small adults. Physicians now believe that this assumption may harm children, resulting in overmedication, undermedication or adverse effects.

At a presentation at the AAAS annual meeting in Chicago, I learned that physicians in the U.S. and the European Union are studying the effects of adult medication on children, but have come up against the issue of informed consent.

Human subjects that agree to participate in a clinical study must “be given the opportunity to choose what shall or shall not happen to them,” according to the U.S. Department of Health and Human Services. Parents may give consent on behalf of their children.

Studies of treatments for life-threatening situations, however, may not provide time for informed consent. A child having a seizure, potentially life-threatening, requires immediate treatment. The traditional drug is diazepam; a newer drug of the same class is lorazepam, even though it’s never been tested in a clinical trial on children.

A new NIH study is comparing which seizure medication is more effective in children, using the principle of exception from informed consent (EFIC).

Under EFIC, clinicians can treat a child with seizures using either medication (randomized, as per the design of the study) without first receiving consent from the parents. After the child is stabilized, the parents can choose to opt out — the child has still received treatment, but no further data will be recorded as part of the study. Moreover, parents may stipulate that in future seizure situations, their child not participate in the study but receive conventional treatment.

The guidlines for EFIC are strict: close supervision from the institution where the study is performed, public disclosure, community consultation, and the physicians must attempt to get informed consent as soon as possible

The AAAS annual meeting in Chicago covers some weighty issues: climate change, shrinking arctic ice, safety of the world’s drug supply. It can get depressing, so one afternoon I decide to attend a more whimsical symposium: the mathematics of origami, the art of paper sculpture. A single sheet of paper, no glue, no cutting, only folding.

In most of the sessions attendees and speakers dress formally, in business attire; talks are polished and professional, often lacking animation and spontaneity.

The origami session was a refreshing exception. The speakers were unpolished, casually dressed nerds, but in the most positive sense — creative, dynamic mathematicians whose passion for paper folding was infectious.

Tamara Veenstra demonstrated how she uses origami to teach students about number theory. Tom Hull discussed the many types of math used in origami: geometry, matrix algebra, statistical mechanics, and more. For example, analyzing folding using matrix algebra is being applied to the design of microscopic identification tags that can be monitored over a wide area. One day soldiers might wear such tags so that their location and health can be monitored remotely. “The math involved in paper folding is far-reaching and deep,” said Hull. Applications occur in “unexpected places.”

What a wonderful rationale for basic science! Robert Lang took off on this theme, showing how an origami pattern was used on the solar array panels of a satellite, and for telescope parts — objects that need to be collapsed during transport. Small for the journey, large for the destination. Also cardiac stents, inserted into arteries and then expanded to prop them open. Flattening automobile airbags, an algorithm with roots in a problem that crops up when trying to design origami insects. Problems solved for “aesthetic value” have practical applications, according to Lang. “They could even save a life.”

The science of origami is so advanced that there are now computer programs that create crease patterns instructing you to fold anything, houses, birds, a hermit crab peeking out of its shell, fish with detailed scales. Origami on demand.

Erik Demaine, a 27-year-old whiz kid from MIT, is pushing boundaries with curved origami — you have to see it to believe it. Luckily, Erik brought examples that I was able to play with. The idea of curved creases, as opposed to the straight creases of conventional origami, is that a symmetrically folded object pops into a 3-dimensional unsymmetrical shape. He is working at the intersection between science and art, some of his work in on display at MOMA in New York. He’s also researching reconfigurable robots, one object, multiple folds, different shapes, much like the cartoon Transformer robots.

Once you branch out into different material — folding metal, polyurethane, even glass — the possibilities become astounding.

Image by Jonathan Fildes

Former Vice President Al Gore speaks at the AAAS annual meeting

First, he warmed up the crowd with some jokes, describing himself as a “recovering politician.”
Gore then outlined three major crises: economic (credit and global recession), security (instability in oil rich regions), and environmental, and declared that the common link was our “absurd” over-dependence on carbon-based fuels. We need a global stimulus, he said, which the United States must lead.

Gore’s audience, a group of scientists, many of whom specialize in earth sciences and oceanography, didn’t need much convincing on this topic. He talked about the scientific data and compared the public’s current misperceptions about the science behind global warming to the public’s misperceptions centuries ago about the theories of Copernicus and Galileo, that the earth orbits the sun.

And then the lights dimmed and the PowerPoint presentation began, an updated version of the presentation immortalized in the documentary film “An Inconvenient Truth.” In his introduction, Gore thanked AAAS President James McCarthy for his scientific tutelage over the years — many of Gore’s slides were more graphically pleasing versions of the data McCarthy showed in his lecture Thursday night.

Image by Jonathan Fildes

We need to go far, quickly.

“We have a full blown political struggle to communicate the truth about our situation,” Gore said. Scientists should use their clout and authority to speak out and educate the public about climate change. Invoking an African proverb, “if you want to go quickly, go alone, if you want to go far, go together,” Gore told the crowd that we need to go far, quickly.

Gore ended his talk by telling us to “start getting involved in politics…but keep your day job.”

He left the ballroom as he entered, to a thundering standing ovation. For security reasons, we had to wait to leave the ballroom, and when we were allowed to depart, it took some time to funnel the tightly packed crowd up a single escalator. This unexpected inconvenience meant that I missed the ‘Dance Your Ph.D.‘ performance.

Animals, plants and microorganisms produce a wide variety of chemicals, ranging from analgesics, such as opiates produced by opium plants, to cancer treatments, such as taxol produced by Pacific yew trees. Some types of wormwood make artemisinin, a treatment for malaria. Extracting chemicals from nature is often costly and damaging to the environment. Artemisinin, which is in short supply, is expensive and time consuming to synthesize in the laboratory.

One solution to this production problem comes from the burgeoning field of synthetic biology.  As I learned this morning at the AAAS annual meeting in Chicago, researchers are using genetic tricks to turn microorganisms, such as bacteria and yeast, into factories that produce artemisinin, which can then be easily purified.

It takes many chemical reactions for wormwood cells to make artmesinin. To boost production, scientists need to be able to purify chemicals from fast growing, fast producing microorganisms such as cultured yeast and bacteria. So University of California Berkeley professor Jay Keasling and his colleagues genetically engineered yeast to produce the proteins required for the myriad metabolic pathways required to manufacture artemisinin. (Keasling also heads the Joint BioEnergy Institute.)

The problem is that yeast do not normally produce artemisinin, so adding these “unnatural” metabolic pathways often damaged the cell. According to Keasling, troubleshooting such genetically modified microorganisms is the biggest bottleneck — his laboratory spent years trying to boost production efficiency.

A big problem was low yield. The proteins produced intermediates in the artemisinin pathway, but these intermediate chemicals would often accumulate and harm the cell. Keasling likens this to a leaky pipe. If you have several pieces of pipe, but no way of connecting them, whatever is flowing between them will leak. Researchers need a way to connect the pipes — the proteins — to minimize the leaks, but there are no standard “protein connectors.” The solution was a scaffold, a physical method to link the proteins to keep them in close proximity to each other. That way, when the first protein produced an intermediate, that intermediate would be picked up by the second protein, waiting nearby, and converted into the second intermediate, and so forth, until artemisinin was produced.

When Keasling and his team placed three key enzymes on a scaffold, they boosted their artemsinin yield to over 25 g/ml, the level needed to make synthetic production economically viable.

Keasling has now partnered with the French pharmaceutical company Sanofi-Aventis to scale up and optimize production for use in treating malaria. The microbially produced artemisinin will be on the shelves in a year or two, sold at a reduced price in Africa, according to Keasling.

I just arrived in Chicago for the annual meeting of the 161-year-old American Association for the Advancement of Science (AAAS).

Together with approximately 10,000 other participants, I will try my best to attend all 175 symposia, plenary lectures, poster presentations and exhibits during the next four days.

AAAS bills itself as the “world’s largest general scientific society.” They also publish the prestigious journal Science (whose articles I regularly profile for America.gov). Membership is open to all. The AAAS mission is to “advance science and serve society.” I can to attest that. Thanks to AAAS I am contributing to the policymaking process by spending this year away from the lab, working in the State Department.

Tomorrow, former vice president of the United States and Nobel laureate Al Gore is giving a keynote lecture, plus there’s an award ceremony for the winners of the ‘dance your Ph.D. contest,’ as well as lectures on synthetic biology, antibiotic resistance, and ocean conservation success stories.