Medical Scientists

"“My philosophy is to be honest. It’s not about being the best. It’s about being better than you were before, improving yourself. Even baby steps can be the difference in improving your health.”"

"That doesn't mean [hair] still can't be fabulous. It just means it requires a different approach."

"Experiment with different types of things, whether they are fun hats or scarves or even wigs,"

"I needed more training to lead that service. It is my obligation to give back what I have been given."

"I am grateful for the partnership between Yale and the University of Rwanda and the University Teaching Hospital of Kigali and the global health program at Yale,”Through them I have been able to come here and learn. When I go back I will be able to help Rwandans and offer a standard of care in nephrology.”"

"Treatment for these diseases is expensive not just in Rwanda but across the world. You will need more than Rwf25 million for a kidney transplant, and this is a very high amount.”"

"Even when a patient is on dialysis, they don’t have a lot of options, they will need to visit a treatment centre at least three times a week. For that service alone, you need over Rwf85,000.”"

"While the treatment of kidney disease is expensive, out of reach for many patients and requires a lot of resources especially renal replacement therapy, prevention remains the major weapon we can use to fight chronic kidney disease."

"Most insurance don’t cover this, leaving health authorities with only one campaign; how do I prevent myself from kidney disease?, when is the right time to go for check-up?, this is what we are going to focus on mainly.”"

"When Yale came on board it became easier for residents to learn because we had more physicians. You need a mentor who is there day to day to help train you in clinical reasoning and see how you examine patients.”"

"I was always told that building a scientific career was about securing grants and publishing papers, not improving health care or engaging with policy-makers. And when I questioned these assumptions, saying I wanted to impact health care directly, some people questioned whether I was truly committed to being a scientist."

"It’s tough, very challenging. One of the things which makes a big difference is having successful women mentors who understand things like balancing child and family life with work."

"My goal is to become involved in health policy and advocacy, to try to make decision makers understand why they should invest in sickle cell disease."

"I think it is very important when you are working on a disease to work closely with the people who are affected by it."

"Two or three of my colleagues left science because they didn’t get the right opportunities at the right times. These are brilliant people, now stuck. It’s a big loss. This is one of my regrets. I wish there was a way of identifying talent and getting those people more into pure science."

"The process of research is learning, unlearning and re-learning. We need to have the humility and willingness to learn from others and realise you need to re-think what you know."

"But I like to look at the prevalence of sickle-cell disease as an advantage – this is an opportunity where we can learn about malaria and genetic disorders. That’s how I try to look at it. Because it can be overwhelming, when you’re dealing with all the patients, with very few resources."

"“Mothers who have lost children now know their lives mattered.""

"Don’t feel pressured if you are a young scientist or clinician in Africa. If you want to do a particular field of study – do it."

"The danger for an African scientist, because there are so few of us, is that you end up taking administrative positions, or leadership positions when you are not ready yet. You can end up being caught in a position where you can’t learn, you can’t mature, you can’t be a proper scientist – whatever that really is."

"By using gene therapy, if sickle cell disease can be cured, it would then be possible to apply the knowledge to other conditions that are more complex. However, you can’t have a gene therapy for an African disease developed outside of Africa because it is inappropriate from an equity perspective"

"The ultimate thing for me, particularly as a physician scientist, is not just discovery, but also seeing the application of knowledge…into an improvement in health."

"We are not making science for science. We are making science for the benefit of humanity."

"There is almost minimal investment in research and development in not only Africa, but many third world countries. You need the industry to invest in science, as well as governments and philanthropy."

"From researchers’ point of view, the sad reality is that there is little incentive to go into the field and this has been the case for decades. When I completed my clinical training in the late 90s and expressed a desire to work on sickle cell disease, people said: “Why would you enter a field with no funding, no opportunities and no future?”"

"Science is made to solve problems in the society, to exploit the resources we have so as to create technology and eventually wealth."

"Science is not that difficult, it’s just a myth, women are as good as men."

"Things become easy once you learn them. The monster of complex STEM problems can be tamed with experiments and trying again one more time!"

"We wanted to acknowledge the limitations of the methods that we had and give out the data that we had so that people could see how the vaccines were performing"

"We will put the pedal to the metal for as long as we can under my leadership. My hope is I will leave them in a place where everyone recognizes that this needs to move"

"The agency needs it to modernize the nation’s public health data infrastructure, for the workforce, and quite honestly, we need it for the intersection of the two. We need data analysts working in public health"

"You know, here is what I can tell you. We are in a different place. Schools are open. Businesses are open. We have a lot of population immunity out there right now. We have a lot of protection from vaccination already. Deaths are still at 350 a day, but they are way lower than they were a year ago, two years ago at this time"

"In a pandemic, you don’t have time to wait. You have to take action to help people. We haven’t been able to be as nimble as we’ve needed to be"

"We want to make sure we get the answer right, but when we know the answer, we shouldn’t wait to convey it to others, I think people within the agency recognize the need for change""

""We are committed to dismantling the barriers faced by our community based on racism, sexism, queer-antagonism, and other discriminatory factors. These barriers include recent legislation like denying trans people from using the bathroom of their gender, barring trans people from participating in sports of their gender, and banning schools from teaching about LGBTQ acceptance"

"Today, I endorsed ACIP’s vote to expand eligibility for COVID-19 vaccine booster doses. Children 5 through 11 should receive a booster dose at least 5 months after their primary series. Vaccination with a primary series among this age group has lagged behind other age groups leaving them vulnerable to serious illness. With over 18 million doses administered in this age group, we know that these vaccines are safe, and we must continue to increase the number of children who are protected. I encourage parents to keep their children up to date with CDC’s COVID-19 vaccine recommendations."

"The people themselves were responsible or whether many of the things in the structure around them didn’t allow them to operate as swiftly as possible and didn’t allow them to prioritize. I think it’s a little bit of both"

"The latest guidance is based on science and outreach with teachers, parents and the Department of Education. CDC officials conducted comprehensive reviews of literature and extensively studied what happened during school openings in the fall and in Europe"

"There is a great need to ensure that before everyone has access to these vaccines, for those who do get sick, we are able to assist them in curing the disease or preventing its progression into a more severe disease."

"We want to prevent that progression to severe disease so that we don’t overwhelm our health care facilities."

"It paints a bleak picture of when the continent will achieve herd immunity."

"We cannot compare our health capacity with that in Europe or America. What might be considered a small number of severe diseases in the global north might have devastating consequences in Africa."

"We need to strengthen our preparedness to ensure we do not overwhelm our healthcare facilities with patients with severe illness."

"We need research here in Africa that will inform policies and test-and-treat strategies, so that as clinicians we can give the best options to people with COVID19."

"The most clinically important anaerobes are the five genera of Gram-negative rods. Bacteroides, especially the B. fragilis group (made of up ten species, one of which is the species B. fragilis), is particularly important. The other Gram-negative genera are Prevotella, Porphyromonas, Fusobacterium, and Bilophila. Among the Gram-positive anaerobes, there are cocci (primarily Peptostreptococcus) and sporeforming (Clostridium) and non-sporeforming bacilli (especially Actinomyces and Propionibacterium)."

"It has been a hundred years since the role of anaerobic bacteria and, especially, non-spore-forming anaerobes in infections began to be appreciated."

"... a recent study of ours employing the powerful pyrosequencing technique on stools of subjects with regressive autism showed that Desulfovibrio was more common in autistic subjects than in controls. We subsequently confirmed this with pilot cultural and real-time PCR studies and found siblings of autistic children had counts of Desulfovibrio that were intermediate, suggesting possible spread of the organism in the family environment. Desulfovibrio is an anaerobic bacillus that does not produce spores but is nevertheless resistant to aerobic and other adverse conditions by other mechanisms and is commonly resistant to certain antimicrobial agents (such as cephalosporins) often used to treat ear and other infections that are relatively common in childhood. This bacterium also produces important virulence factors and its physiology and metabolism position it uniquely to account for much of the pathophysiology seen in autism."

"... (1) What is the clinical relevance of anaerobic bacteriology? (2) How can the microbiologist, with limited and decreasing resources, perform reliable, detailed studies of anaerobic bacteriology? (3) When and how should susceptibility testing be done with anaerobes? If the clinician knows the usual bacteriology of various types of infection and how this may be modified by pathophysiologic processes in the host or by prior therapy, he/she can use a logical empiric approach to treatment of the patient. As to the microbiologist's dilemma, it is not realistic or rational for a microbiologist in a nonteaching hospital to do detailed bacteriologic studies and routine anaerobic susceptibility testing. The resources available should be committed primarily to the patient who is seriously ill. Such allocation of resources, of course, requires repeated and effective communication between microbiologist and clinician."

"Anaerobic bacteria currently demonstrate increased resistance to antimicrobial agents, primarily by the production of beta-lactamase. A number of species of Bacteroides, most notably those in the Bacteroides fragilis group, produce these enzymes. A few species of Fusobacterium and Clostridium produce beta-lactamase as well. Fortunately, this mechanism of resistance is readily overcome by administering beta-lactamase inhibitors coupled with a beta-lactam antibiotic that would otherwise be inactivated. Other types of resistance encountered in anaerobic bacteria include inactivating enzymes such as chloramphenicol acetyltransferase, plasmid-mediated transferable multiple-drug resistance, changes in porin molecules in the outer membrane of the bacterial cell, decreased uptake of drug by other mechanisms, changes in the target organs such as penicillin-binding proteins, and decreased reduction of the antibiotic to an active intermediate product. In many institutions, certain drugs such as cefoxitin, clindamycin, and piperacillin, which were previously active against almost all strains of B. fragilis, are now effective against only 70 to 85% of this group of anaerobes."

"Much of the available data on the incidence of anaerobic infections is not reliable. Bacteriologic data without clinical correlation are not adequate, since the organisms are not necessarily significant. Similarly, clinical data with fragmentary bacteriological information are not ideal. In both types of papers, one often finds data on specimens cultured for anaerobes that clearly must have been contaminated with normal flora (for example, coughed sputum and voided urine). The exact specimen type and source is not always indicated or recognizable."