Patricia Silveyra - Trailblazing Scientist

And I feel like if we remain silent or if we don't acknowledge them, we contribute to the promise.

We are honored to feature Dr. Patricia Silveira today. Patricia, Associate Professor, Director of the BBL and Beerstretcher Blackwell Distinguished Term Scholar at UNC Chapel Hill, where she conducts research on sex -specific mechanisms of lung inflammation and inflammatory lung disease. Her laboratory uses a combination of molecular biology, immunology and endocrinology approaches to study hormonal regulation of gene expression networks in response to environmental insults.

Patricia, we are so excited to hear about your professional work and your personal journey today. Thank you for taking the time to be here.

Yeah, so my journey is no different than the one that other scientists, I say, you know, was a very curious person since, you know, since I was a kid. However, I didn't have anybody that I knew that was a scientist up until I was almost finishing high school. It was actually something I had to do for high school that I had to interview a bunch of scientists and doctors that opened that field for me. So up until then, I didn't even know that there were people whose job was to go to the lab and do what I actually do. And part of that motivates me to talk about my work with young kids and with high school kids, because you know each of those kids could be me. So I studied biology in Argentina. In Argentina we don't have bachelor's degrees like here and it's different. We do something called a licenciatura which takes about seven years total. You have like the first year where you have to take courses to get into school. All you have to do is just to pass the exams and then you enroll. It's not like here in the US where you have to get accepted to the school. It's different there, you sign up and you go as long as you complete the exams. But overall, it takes about seven years to get a licenciatura, five to seven years in different disciplines. The one in biology takes that much. And when you look at the equivalence between the US and Argentina for

what that degree means, here that is the equivalent of a bachelor's and a master's degree, because we also do a thesis at the end to become licenciados. So once I was doing my licenciatura, I was kind of in between the different types of biologies. I really liked the botany, but I also really like anything that had to do with genes and regulation of how genes were being expressed. So as soon as I finished my degree, I enrolled in a PhD program, which, again, is the same. You go to a lab, you volunteer, and then with your professor, you sign up for grad school. It's totally different than here.

And I started studying processes that control appetite, actually, in the brain. So I used a rat model, and what we found, like just a brief description of what my thesis was about, is that males of females had different pathways, you know, that regulated this appetite cues. And also that the females, those cues were the genes that were involved in those pathways. Their expression depended on the hormonal levels that were in their bloodstream. So in a way we found this connection between appetite and endocrinology. And so, that was very interesting. And I started trying to look at diseases that, in which, you know, these processes were affected. So, I became more interested in diabetes initially. But studying it in animal models was something that I wasn't 100 % happy. I wanted to do something that was more translational, where I could actually work with the models, but also work with human cells or actually get information from human patients. And that wasn't a possibility in Argentina. So as soon as I finished my PhD, I, it's a very long story that I will tell you once we talk about my scholarship, but I found a scholarship after applying to a million scholarships that allowed me to go do a postdoc abroad. And I ended up coming to the US. That was, you know, I wanted to go to Europe, but I ended up coming to the US. It was, you equally good for what I wanted to do because the resources I needed to start doing this translation journey were here. So I came here

and I joined a diabetes lab. And I started working with this patient samples. And I had a terrible, terribly bad experience working in that lab. So it was just bad leadership, the science wasn't what I would call rigorous and I wasn't happy being in that lab. However, I was three months working in that lab and I had a scholarship for a year. So I had to make decision. I was going to go back home, or I was going to stay and find a different lab to finish. And it was actually one of the best things that happened in my career, because I switched to a lab where they were doing pulmonary physiology. And I only learned about the lungs, like in grad school, taking courses, but I never actually worked with lungs before. So I spent the rest of that year, working in that pulmonary lab, and I fell in love with it. So for the next, I would say 10 years, I studied how the endocrine system regulates processes in the lung, and I became the person who does that. That has given me the option to open my own lab and to conduct research on that. We can discuss more later, but it was a journey of transforming perhaps bad experiences into something that ended up being beneficial. At the time I thought my career was over, obviously, but how wrong I was. Thank

you very much for that answer, Patricia.

You've sort of started already to cover what I wanted to ask you next, but I was going to ask, and if you don't mind adding a little bit to it, if you could describe your experience coming to U .S. as an ambassador, I'm going to say this wrong, ambassadorial scholar, and for those who aren't familiar with it, could you explain the ambassadorial scholarship program?

Yes, so when, you know, people find different ways to fund their travels, you either to come here to do PhD, there are several scholarships, there are several organizations, but after you graduated, You kind of have to find like a mini grant or a scholarship that is like a short term. So the things that were available for me, meaning that I was eligible to apply, were usually international agreements that have funding to do exchanges of professionals or or to, for example, bring professionals from Latin American countries to the US with the promise that they will come back and apply what they learned here. So I look for several options. There was the L 'Oreal for Women in Science. There was the Pew Research Center. And all of those, in a lot of those,

I had trouble because you kind of have to write a grant in English. And my English was like okay to publish papers, but not to the level to write a grant. Like I know that now because I teach a grant writing course and I know that when I was writing those grants, I had very, very little training on how to do it. So speaking with the person that was actually working in diabetes here in the US,

she mentioned that when she came to the US from Italy, she had came through a Rotary International grant. So I went online and I looked at Rotary because all I knew about Rotary at that time was that it had that wheel and that it was in every town, but I really didn't know what they did. And so I looked online and I couldn't really find that much information. So I started asking around and turned out that my mom, My mom's a school teacher, so the principal of her school was a Rotarian, so he took me to their meeting. I met with them and they explained to me that there were some grants that I could look for. They connected me with a person that was doing that. So long story short, the Ambassadorial Scholarship is a program that's been around for several years. Unfortunately, they stopped calling it that way about five years ago. It's now called a global grant. But basically, it's a one -year scholarship that at the time I got it will give you about $23 ,000 to $25 ,000 for a year. And you have to go to another country and either take a course,

or you could do a research experience. And in return, what you have to do is to go to the Rotary Club and talk about your country. I got at least 20 times during that year. So that's how you serve as an unofficial ambassador of your country because you go and you promote international understanding and collaboration. So it's been a wonderful experience. It was very hard to combine with how demanding it is to work in a lab. So sometimes I will run an experiment and then I had to go drive an hour to go give a talk about Argentina in a Rotary Club and then come back and then work very late. But it actually, what brought me to the US and yeah, I'm very grateful. So yeah, so the program continues to exist. Right now, the way it works is that you have to find a Rotary Club to sponsor you and then the Rotary Club in the country where you're going to sponsor you. And they both have to fundraise a portion of the scholarship and then Rotary International matches it.

I know that that was pretty time consuming for you. I appreciate you kind of explaining the ins and outs

of that, I mean, that's a lot to handle at once. So just to kind of hop around in your journey a little bit, what prompted you to apply for bootcamp and what expectations did you have for the experience?

Yeah, so, you know, academia is such an interesting place. There's, if I were to classify people that are in academia, they are the people who've all been doing the same thing, and they continue to do that, and it's been 30, 40, 50 years. And they're still advising young people. And then you have the people kind of in the middle that are trying to struggle, to juggle the different demands of today's world. So we have our students that joined grad school and they are not going to become professors. If you look at the numbers, less than 10 % will. However, the school is structured in a way to prepare them to be professors. So that is unrealistic. So a lot of what we do is we try to offer students training or skills that are going to serve them when they're graduating. And one of the things that I saw was not covered is this route to entrepreneurship. You would ask the students, you know, they have ideas, they want to change the world, and then they enter grad school, and they're told, no, you have to follow this path, you have to fit in this box.

And I wasn't happy with that. I really wanted to help them explore other venues, but I also realized that I had zero experience doing entrepreneurship, and I had like maybe one friend that did it. So the major motivation for me was to network, actually with people who were starting companies and were successful doing companies that were related to healthcare, and also to learn the process so that I could actually, in my own words, try to explain it to them. However, in the process of applying and describing myself and what I do and, you know, doing the MOOCs and like the exercises, I realized that a lot of what I do in my own research could be applied in, you know, starting a new venture eventually, right?

Part of what we study as a, you know, you've mentioned, you sex specific mechanisms, like perhaps you guys don't know what that means. Just to give you a brief and a very, very vague description. If you find a male and a female that have a disease called asthma, which makes your lungs inflamed and you can't breathe properly, the treatment is the same for men and women. We give them the same inhaler, we attack the same receptors, and we try to mitigate these symptoms the same way. But if I look at a lung of a asthmatic male, female, but if I actually look at the animals where we mimic this asthma, the genes that are being expressed and the mechanisms that are happening, the remodeling of the lung, they're different. So we're basically treating women as small men in many diseases, but also in lung disease. And the fact that I had all this information

that I had learned from my models about how, for example, if you have mice and you put them to, do you expose them to an air pollutant that is going to cause them what is called airway resistance, which is something that happens during asthma? What happens is that depending on the phase of the estrous cycle, which is the menstrual cycle of the mice, the response is different. Depending on the levels of estradiol that are circulating, the response is different. And experimentally, we have removed these hormones and we have put them back again, and we've shown that these hormones are modulating these processes. So what if we can help women match their hormonal fluctuations with the way that we treat their symptoms for asthma? So I looked around, is there any medicine, is there any treatment

that is considering this, I couldn't find anything. So if anybody's going to do that, I will, I want to be part of that team. Right. And the same with exercise, Nancy was mentioning, you know, what she does, you know, you know, that women, their performance is different throughout their month. However, they get training, the same type of training for every day of the month, you know, we have to start considering the sex differences and the fluctuations in hormones, in everything we do. And for that, we need basic science. So instead of quitting my basic science job and starting a venture, I want to continue to generate this information, but also provide this information

to perhaps a team that starts a new venture. So if anybody wants to do that with me, I'm gonna be your partner. Did I answer your question?

Yes, yes, you completely did. And I'm muting myself, so you can't hear me laughing, but I really appreciate that you, I mean, you basically applied to Bootcamp to help others. So this ties in, I to the next question Spencer's going to throw at you. Thank

you very much for that answer to Nancy's question. I was, as Nancy just said, I was going to ask how you feel that the Bootcamp experience shaped the way you approach your work?

Well it's definitely yeah I think I already answered that question but yeah but it has opened my you know my understanding it has expanded my understanding of the whole process it has made me less reluctant to try it you know because initially I was like well you have to be an entrepreneur like you have to have a career in business you have to have an MBA I mean that those were the type of people that I saw doing this type of thing and then in bootcamp I met people with different backgrounds that were actually being really successful and the tools that we were provided with just to go through the process and learn the ins and outs was extremely helpful. But I think the number one benefit that I gained from participating in Bootcamp was to have the access to this network, to network with people, like anytime I need something or I have a question about something, I am sure somebody in this network has dealt with it and they can help me troubleshoot it or figure it out. And the same way with the other way around. I have had calls with people that were in my cohort about, you know, they were trying to do some biomarker measurements, you know, in human samples.

I had all the protocols in my lab. I told them what worked, what didn't, you know, we just had a phone call and I was able to orient them. with another boot camper. We actually wrote a grant for NSF and he's gonna be using my laboratory, but I also coach him how to write the grant. So it's great to have access to this group of people that otherwise I would have never, being a professor in a university, I would have never even crossed paths with.

Now that makes a lot of sense. I really appreciate you kind of elaborating on that answer. You had posted, you know, in the chat group that we're in, and how I became acquainted with you, on that wonderful piece on intersectionality. And you have such a unique and valuable perspective, and I really appreciate how you verbalized that. So for those that haven't had a chance to read that. Can you explain what intersectionality is and how it affected the way you approach your career and maybe your life?

Sure. So we all heard about the term underrepresented minority in a way or another. And if you haven't, for example, here in the US, if you look at the people who conduct research or there are professors, or that obtain grants, and you compare the proportion of each of the different races, genders, and what are other dimension you want to look ethnicity, immigration status. If you look at the breakdown, and you compare it with the breakdown of the general population, there are groups where, you know, there's enough people that could be doing something, but there are not that many people doing science. And typically you see a skewed to male and white professor, you know, and it even becomes in a way an unconscious bias that we acquire as kids. Like if you ask five -year -olds to draw a scientist, usually they draw a guy. So there's been a lot of efforts to change that. Like anybody could be a scientist. However, it's hard to think that you can be something if you don't see yourself represent.

So, with that in mind, the different, you know, the breakdown of race, gender, ethnicity, et cetera, sometimes we have studied that a particular gender has these issues to navigate the academy or whatever field. I'm sure in entrepreneurship it also happens. But the combination of these different dimensions of who you are is what we call that intersectionality. So it's not the same to be a woman than to be a black woman in medicine or in science or to being a black queer woman. And as you add these layers, you grow your intersectionality. Everybody has their own intersectionality. And the key now is how can you take

those dimensions of yourself and use them to your advantage or to benefit, you know, whatever goal you have or whatever thing you want to do in the world. So, that is in a way what it is and rarely we think about it. So, I have been doing a lot of work trying to understand how these layers in myself can make me a better scientist or a better mentor because part of what we see the problem in academia is, is that we take students and we try to make them mini versions of ourselves. And that is one of the top problems that the students experience. And in particular for students that are from these underrepresented groups, a lot of times what happens is that they feel that they need to be somebody different than who they are. Like they have to live like themselves at home and then in the lab, they have to act or behave in a particular way. So trying to combat that, I started exploring the intersectionality and I was invited by an organization called SACNAS where I actually serve as a mentor and a support member

to write a piece about it. So it was really hard to write, but basically what I did is I took my career journey and I saw how the intersectionality I already had being a scientist in Argentina changed when I moved to this country because in this country I became an immigrant, in this country I became a minority, right? In my country most people kind of looked like me but maybe there were some differences but not as striking as it is here, if I compare myself to the typical scientist here. So I also became a person, you know, that speaks a different language. The person that has an accent.

So all these layers starting adding struggles to myself, you know, and in a way, if you let those things affect you, you can be severely affected. You know, it can affect the way you perform. It can affect the way you be yourself. It can affect the way that you encourage others. So, I wanted to understand that first, so that I could actually see how I can use it to my advantage. So, in that piece, if you read it, basically it says what I just told you, like how I acquired all these layers of intersectionality, but then how I realized that having them made me a better communicator, because the fact that I had to pay extra attention to understand the English, I was able to pick on things that others were not. the fact that I was asking probing questions made me connect better with people. So even though I thought that was a disadvantage,

in the end, a lot of my students appreciate that I take time to actually understand what they're saying. They appreciate that I understand what it is to live in a very low salary, or to move very far away from your parents, or to come from a family where nobody's a scientist, and then you have to actually explain, I actually need to work this weekend. I actually need to stay late.

My cells are gonna die if I don't change the media. You know, there are things that no matter how many times you explain to your family, if they're not in science, they're not gonna get it. So it was very, I think it was very powerful for me to like actually be able to put that into words. And I didn't think it was gonna have that impact. Like people contacted me after reading it. they felt in a way connected to me. And they, they appreciate that sometimes, you know, sometimes you just need to see something, you know, in paper to actually process it. And for some people, I was able to just put it in words. So they appreciated that. And I'm glad.

Thank you so much for that answer, Patricia. I also read through your article and I greatly enjoyed it personally.

I was hoping to ask, well, okay. So, to me, it seems like medical research is a field where any exclusionary thinking is particularly harmful and dangerous for people's lives. I was hoping, firstly, do you agree, and I suppose if you do, what do you think could be done better to allow for greater diversity in research within your field, at least?

Well, I think I already alluded to some of it when I talk about the male -female problem. Yeah, absolutely agree with you. It's not just that, if you actually dig deeper in most of, for example, the genomic studies, when you look at which individuals are recruited to do something called a GWAS study where they actually look at mutations throughout the genome and see if they're associated with different traits or diseases, they're like 99 .1 % white. And so, we're basing all the medicine that we are deriving from this research on a particular group. So in a way, even though we may be all very similar, there's a lot that we don't know.

And in doing so, we are not personalizing medicine, but we are favoring certain groups. The same way, there are diseases that overwhelmingly get more funding than others. And if you actually look at the breakdown of who gets affected by those diseases, you will see that it is also a disparity. If you even compare, for example, cystic fibrosis versus sickle cell anemia, both primarily affect more white people versus black people. And you see the striking differences in how many people are doing the research, which is closely tied to how many people get funded, how many dollars are there to conduct this research. So it is a very complex system in which every little bit contributes to these

health disparities. Health disparities research in itself is actually very underfunded. And people who do that are usually very discouraged, like they get less funding, so they end up leaving the academy, and that research is not being conducted. So what can we do? We have to continue the conversation, and we have to continue to encourage these type of research to happen. We have to bring it into light. A lot of people don't know this. A lot of people don't know that 75 % plus of the models we use to study disease are male models, are male cells, are male animals. So, basically, we've been doing this for one sex only, and now we're encouraging and not only encouraging.

NIH is actually asking researchers to justify, if they're not going to use both sexes, why? Well, there may be reasons, you know, there may be diseases that they don't, like, for example, prostate cancer, you can't study females, right? This is just the extreme example, but there are other examples in which it would make it makes more sense to just study one sex or another. But in general, you just have to incorporate that variable and actually analyze it very well. And the same will happen when you do population studies that you have to account for differences in the way people live, in the type of air they breathe, in their culture, in the type of food they eat. So we're very far away from understanding how the human body responds to different traits or diseases or environmental exposures because we have been looking with a very narrow vision. So I think if we continue to bring it up to light and discuss it, things are gonna start changing.

Well, and I appreciate you talking about the variation in environmental exposure

as well as the sex specific research. I honestly didn't realize that that much research was dedicated, you know, to male -specific studies too. So this next question kind of builds off of that a little bit. Entrepreneurship and research are closely tied aspects of the professional world. So what do you feel is misunderstood by entrepreneurs about research? and how can the two fields interconnect better than they do now?

I'm just going to speak from my experience. You so I think there's the major difference that we have is the time variable, you know, you guys in the entrepreneur world, like, everything has to happen really fast. And there's a lot of decisions to be made. And you know, you have stakeholders that are like, waiting on return. And in research, and the other difference before I continue, and you have an idea and you start, like you get to go, right? In research it's different because the way the system is structured, at least for most academic institutions, is that you have an idea and then you need to like get preliminary data and then you need to write a grant and then that grant takes like a year to get funded it and then you finally get the money and you deal with all this administrative stuff that delays you so much. So by the time you actually publish a paper, you started like six years ago. It's crazy, like crazy slow. So I feel like just that will be like a struggle,

you know, because a company that you're starting, you can say, Oh, yeah, okay, in six years, I'll give you some data, you know, that will be ridiculous. I don't know if you guys agree. I'm not an entrepreneur, but I don't think that it's going to be a very well -received if you go to your pitch and you say that, right? So on the other hand, universities have started to do this, you what's it called, like innovation. It has a special name, it's a technology transfer, okay? So they have these specific offices where they bring people that are not bootcampers, but they are people who have MBAs or they have training in how to conduct businesses. And then they put us together with us and they say, okay, you guys meet and talk about how what you're doing now can be transformed into a business. And by the way, sign all these papers saying that all your ideas are going to belong to university. And you know, it's just very overwhelming. So the PIs and the professors in general, they try to stay away from that. I mean, this is what I see. Unless they are like late in their careers where they already have tenure and they have already, you know, established their labs and they have funding that the research is happening. And then they go for like, okay, now I'm going to start a company. So it's my observation. I've seen very few young investigators that actually start companies. And if they do, they're like partnering with senior people.

And I think there's a little bit of misconception on, you know, how this works and what are the timelines. And, yeah, that creates a lot of, yeah, I would say that that creates a lot of misconception, but also people just refrain from starting. I don't know if you guys agree, because I, again, I only see what I see as an academic and the patterns that I have observing people starting companies.

So I was really intrigued by what you said about the gender differences and I know we've discussed this before. I think you know I work on Alzheimer's and I get terribly frustrated when the data I see is all on the male brain and I personally have raised the issue of imaging female stroke. So when there is a stroke, okay fine, we understand to a degree how the brain is affected, but could it be that the female brain responds differently and that the recovery from the stroke is different than the female? I personally come up against a lot of resistance. The worst is probably that people, and these are academics by the way, so this isn't lay people, these are the people in academia who should be more critical of these studies. And what I come across is the kind of dismissal where people will say, oh yeah but it's the brain, how different can a male and female brain be? and how different can the male and female response be? And this gets me really frustrated

and I come back really disappointed. And I wanted to ask you, how do you deal with it? Because on one level you have to keep going, right? But on the other level, there is, to me, it's basic. It's based on the male and female brain, maybe different, but I find people don't even want to entertain the idea. So how do you deal with it and keep going?

Yeah, so if you talk to any senior professor who is in a big shot on sex differences, they will tell you that they've been fighting all their lives, just not being taken seriously. I think part of the thing that happens is that people don't want to be told that they've been doing things wrong, right? And they just get very defensive. Like if you've been for 50 years using male models, here's this junior person telling me that I'm doing only one sex. Of course, the reaction is typically that way. And then it's, yeah, in a lot of

times it is expressed as dismissal. There are a lot of people that understand what you're doing and in the long term they're going to appreciate what you're doing. What I do is I hang out with more people that understand it. There are organizations, there's one organization called OSSD, Organization for the Study of Sex Differences, which most of them are neuroscientists actually. And, you know, we host workshops and we just, you know, we put things on websites and we have the annual meeting where we highlight all this research. But for the people that are not part of that community, it is very hard. And actually, they got really mad when the NIH started requiring this. Luckily, the Office for Research on Women's Health at the NIH is putting a lot of effort into requiring this and they're giving specific grants for people to look at that. And just yesterday, I emailed a person in my own institution who asked me to teach a guest lecture for him. And I said that I saw on his website that he was doing sex differences, cystic fibrosis, that it'd be great to collaborate. And his answer was, yeah, we were, but we could never get it funded, so we gave up. I was like, okay, this is the typical response, right? like, so you're going to give up on helping 50 % of the population, because you don't get funding, you know, and that's another problem academia has, you know, it really, and similar to what I just said, with the, you know, with the diseases that have more money or less money, it really shapes what kind of research we do. So the way we fight that is to continue to do it, you know, and to, you know, just show them the data, you know, they are going to be reluctant, they are going to be, you know, they're going to doubt it because they're so used to looking one dimension, but you have data to show that you're actually right, that you have a hypothesis that is valid. Yeah, and to me, it's been harder to convince academics than the general public.

I talk to women who have asthma and they're all like, yeah, I get symptoms very different throughout the month. And I'm like, you tell your doctor. And they're like, no, they don't listen to me. They don't think it's a big deal. But I have way, a lot of people that read my work, they contact me and they're like, what can I do to fix my asthma? And I am not an asthma doctor, so I can't give them medical advice. I talk to your doctor, ask them.

You know, ask them to consider that variable. But it's hard, you know, we have a long way to go. But yeah, I don't, I hope you don't get discouraged. You keep going.

I have to be honest, it's hard. So along the same lines, I wanted to put in a grant, look at dementia in females. And I couldn't get funding for it because it's just a brain, right? We've already done it in the male, why do we need to do it in the female?

And that was really disheartening. But it's also very difficult when you get senior people come to give a talk on dementia. And I remember one occasion I was so disappointed I walked out. It was either walking out or taking the microphone and saying something that I might regret later, but just to give you an idea. He's a very senior person and he had given this talk on dementia and how females are more affected than men. And so in his last slide one of his conclusions was like so he was speculating why women might be affected more by dementia. Okay fine there's the classic hormonal thing that they will bring up. And then, you know, I've heard this so many times before, I was a little bit immune to that. What really got me annoyed is when he said, and you know, the women of this generation, this particular age group that are getting dementia, when they were young, they were not educated. They did not go to college and university because the social structure was such that it was men that went to university and had high -level education and because the men have had high -level education and training, their brains are more active and and they don't get Alzheimer's.

So I thought, okay, do I take the microphone now or do I just leave? This is the level of ignorance that you're constantly fighting and I know we have to, otherwise nothing changes. But also there is this issue that there isn't much solidarity amongst the scientists themselves to raise a collective voice together, right?

Well, luckily there are organizations, as I said, you know, and yeah, I mean, we know that that's, you know, changing the status quo is hard, no matter, you know, in this field and in many other fields, but no major breakthrough has happened by following the same thing that everybody else was doing. You know, like, you know that as entrepreneurs, you know, you guys have to see what's being done, see a need or an issue, and then act. And in that process, you're going to encounter resistance. That's gonna happen. So yeah, I don't know if I have specific advice to you, like to say, you you have your data, you trust your data. Whatever they are saying, you know, it's their interpretation, that's fine for discussion. But that dismissal like that, you shouldn't let it get to yourself.

Thank you very much, Patricia. I had sort of a more general abstract question, which I understand might be a little bit difficult to answer, just because no one quite knows the future, but I was hoping I could get your perspective on sort of any predictions you have about the fields of medicine and medical research, and how you think those fields are of going to change in the coming years?

Yeah, I see. I mean, there are some trends that, you know, as we just said, you know, that there's the consideration for sex as a biological variable. It's only been required in the past, I would say, five years, three to five years, so we're starting to see some of the results of the research. So we're going to expand the variables. There's a lot of pressure to acknowledge this one -dimensional type of research we've been doing and act upon. What I see in the academia is that it's just the typical profession as you go and you get a grant and then you get a professor position and then you keep going. It's just no longer happening. Looks like tenure is something that may or may not be with us in the next 15, 20 years. And I think schools are starting to respond to these demands from students. Like I mentioned earlier, you know, there are not many professors. So they start to do other experiences combining grad school. And I think once those schools become very holistic and integrating all these different aspects that a PhD gets you to do, the way we do science or who gets to do science, or how we do science is going to change. I don't know, as Nancy said, I'm a very positive person. I think that shows in what I'm saying. But I do think that, you know, as long as there are people who are challenging the status quo and that are keeping in mind, you know, what the world needs and responding to it, science is going to be improving. So yeah, this is a difficult time in our country and in the world, but especially in our country with science, you know, with all these, all these attacks on immigration and immigrant scientists and, you know, immigrant students. So it is difficult to predict what's going to happen. But overall in the world, we see that there's more interdisciplinary science being done. And as long as we continue to encourage that and doing it, it's going to help us help more patients.

Thanks so much.

I know that we're throwing questions at you from every angle. So I really do appreciate your optimism and your enthusiasm. And I'm sure you have to keep feeding that, in your industry. But I think the fact that you seem to have that naturally in the fiber of your being, makes you the great scientist that you are. And when we talked personally, you had so many great stories. It's really clear to me that like, you really see the greater life lesson and find some element of wisdom and everything. And you told me a great story from your experience at the Rotary Club when you were in the ambassadorial scholarship program. So I know I'm kind of leading you on, but I was wondering if

you could give us a little bit of your life wisdom and talk about the best lesson from your journey.

Yeah, so it's very funny that like almost 90 % of my interactions with people, they reach the conclusion you just did. But when I, I don't think I am a positive person myself, because I'm very critical of my work, you know, and what I do. So part of being very self -determining and being, in a way, successful comes from how hard you are on yourself too. I feel like when I'm doing things, I am maybe too hard on myself. I revise everything to, I can find an extra space in a document. This is how much I proofread everything, which in a way makes me very slow. See how I'm seeing the negative everywhere, right? So I feel like continuously I'm trying to combat that. And the way I do that, and I learn, is that you can be critical of yourself all the time, but you have to stop and look back and see, okay, what did I learn from this? What happened? What was good? And try to extract the good moments and see that, did I know this was going to turn out so well? No, that's the answer, 100 % of the time. Like I never know where anything's going. I used to be the grant, like Ramon just mentioned. You don't know what's gonna happen, but you're always thinking that they're not going to find it, to fund it.

And then when they find it, you're like, oh my God. You know, and it's just like great. It's like, it's a roller coaster of emotions. So having to cope with that, I just understand that the ups and downs are normal, but that there's always something that you can learn and apply in the future has been very beneficial. And I read a book that was called the Entrepreneurial Rollercoaster, and it was for entrepreneurs. And I remember, you know, mentioning that. And I actually learned a lot from, you know, something totally unrelated to me because this was way before I did bootcamp. I'm sure you guys read it. But there are tools out there to help, you know, try to find the positive. I don't think I'm a motivational speaker like you said because there are way too many people that do this better than me. But my advice to any of you who are struggling and that, you know, is finding hard to do things or finding hard to like show things is that look back, you know. When I was a postdoc and I had trouble, you know, thinking if I was ever going to become a professor, I would back to my CV and I would see like the different things that I did. Or then I would talk to people that I helped and then I see them, you know, progress or graduate or get places and that would just give me, energy. So I learned to absorb that energy and use it for the future. And then the story that I told you is from a different aspect, the aspect of randomness. When we network, every conversation has so much potential. So we interact and we don't know each other. I don't know anything about you. You don't know anything about me and anything can happen. It can happen that we never meet again, or it can happen that we end up doing

this wonderful thing together. So the story that I told Nancy, if now you want to hear it, is that I was in my ambassadorial scholarship. So this was during the time that I was in the lab, very busy, and I was actually doing the lab work. And I had all these genes to measure with a technique that was basically just putting a tube and taking it back from a machine like a million times because we didn't have an automatic thing to do it. So I had to spend like six, seven hours just doing this movement. So I was kind of halfway done and my goal was to help in an auction that was happening at the Rotary Club by going, buying some nice things, put them in a basket and then just provide just an item for them to auction on. Well, there were way too many tools. By the time I was done, there was no time for me to prepare that. So I was like, how can I help? So I said, okay, well, I speak Spanish. I speak English now. I can just offer Spanish lessons, like conversations with a Spanish native. If you wanna polish your Spanish, you're learning Spanish, whatever. So I literally went in the lab computer and I printed a flyer with a Spanish flag offering that. So the auction happened the following day and somebody bid on my auction and turned out that person was a gynecologist and he was on the board of an organization that had grants. So we started meeting I gave him the Spanish lessons and in one of the conversations I mentioned one of the projects that I was doing with premature babies and you know lung development. He said that be great for our foundation. Why don't you apply to this grant? I had never heard of that foundation before. It was a local foundation that had money. I put in the grant, I got the grant, and then I funded a study that was published a year later. So, you know, like, should I have been less busy in the lab? That would have never happened. So stories like that are the ones that, you know, you do never diminish the power of anything that you do, whether it is a conversation with someone or just an action to help your local Rotary Club. So was that the story, Nancy? Because

I feel like I told you so many.

Yes, that was the story. Okay.

Thank you so much, Patricia. Krish has just asked a question in the questions and discussion channel. He says, brilliant information Dr. Patricia. My question is about the current epidemiological models. There are multiple models which are actually trying to predict the infection intensity. Being into pandemic modeling I see a lot of problems in the existing models, be it from any forum, educational, data science, or scientific orgs, a mixed model approach apart from agent SIER. there is a point to integrate genetic mutation mapping with the country COVID index, open bracket, built on epidemiological, there we go, demographic stratification data based on that is actually getting in place. What do you think of the progress on this kind of research?

Yeah I mean I'm not an epidemiologist. I'm following the COVID research as close as I can, mostly from the mechanistic point of view. There's like thousands and thousands of papers that are published continuously. Like the amount of information is so overwhelming that it's hard to process. So people are working in teams. And also, there's a lot of information that's being done to rushed, you know, I briefly alluded to the fact that research is slow. Because when you do research fast, sometimes you make mistakes. So a lot of what we see now is this, okay, there's funding, let's do it, oh, publishing, and then you just see all this information that in a lot of cases is being retracted, right, because people have taken a second look, have reanalyzed the data, and have realized that their conclusions were too fast, or that they were missing information to interpret those results. And now in different contexts, they don't mean that anymore. So with regards to the question that

Krish is asking, you know, I think that the answer is, you know, that we need interdisciplinary teams because this is a virus that has way too many components so we need to understand how it affects people but we also need to understand what else like that that word that was hard to pronounce comorbidity means when you have more than one thing in your body like if you have diabetes and now you get COVID for example that would be a comorbidity so we need people who are population scientists we need people who are epidemiologists we need people who know about the virus we need people who know about social scientists you know like, how are people interacting? What are people doing? How do we put response to public health measures? You know, you see here in the US, people don't want to wear masks. I mean, just, we never predicted that that was going to happen. We're in other cultures, people are wearing masks all the time. So it's such a complex system, with so many variables that requires expertise from so many disciplines. This is a great test for us to show that interdisciplinary science is what we need to be doing from now on. So I don't know if I can answer your question about how accurate or good this is, but I think incorporating as many variables as possible helps you get to the root of the problem. And yeah, the way COVID is happening in one country versus another is going to depend on their culture, on the way that they respond

to the guidelines, on the mutations that are happening in the virus because the climate if it is different or like the first virus that arrived suffer a certain mutation. And there's just so much that we need to learn, not from this virus, but from this virus it's important that we do it fast because this is affect, we're in the middle of the pandemic right now. Okay, I hope I answered your question.

I know some of the questions are a little tricky to give a concise answer to. I really appreciate you doing that. We do have another question.

Yes, Trista, sorry if I missed it already, but I caught you when you were talking about

the red tape around universities when it comes to scientists or academics collaborating in an entrepreneurial venture. I just wondered whether you, since the boot camp, you had decided to try that or not necessarily with an academic institution or otherwise. I wondered if you had gone on in that direction in any way.

Yes, I have started conversations with some people that are already doing it And then with some of the people that work in my institution, they're nurse scientists. What we feel that is the pressure, we're considered early career scientists, still.

And you as an associate professor, you're considered an early career scientist?

Yeah, but I am still within the 10 years of graduating, so I am kind of early to mid, yeah. but a lot of the people that I work with are early career scientists. So we get a lot of reluctance from the senior leadership. They say, well, wait until you have at least this much money to support your funding and your salary, and then you can go and do that. So I feel like this, they're not telling us no, but they're like, yeah, wait. And it's not the first time I encounter that kind of a system. I feel like even though I am transitioning to be mid -career, I'm still, yeah, there's still people who think I shouldn't be doing things and I shouldn't be listening to them. But yeah, I'm fighting, I only did bootcamp like a year ago so I still have a

way to go.

Do you think that's more to do with universities wanting to be sure with money rather than how much time has passed in terms of experience?

I think it depends on the institution. There are institutions that have learned how to thrive from this and get the benefit it, and there are others that are still kind of stuck, you know, in some way. So if you find the right environment, and the right, you know, like, just collective power, right, like what we were discussing with Ramat, like, if you have a group of people who are going to push with you to that, and you're not going to be the sole person doing it, yeah, the change is coming. I mean, certainly, when you talk to early to mid -career scientists, and even the grad students. Everybody wants to do something different. Like we all acknowledge that what's in place is no longer working. So the change is coming. We just need to be smart in how we implement it.

Great, thank you.

Thank you so much.

And I know we are a couple minutes past the hour and we've let this be a little free form, but I really wanna be respectful of your time, Patricia. Do you have time for a couple more questions or, okay.

I think the next question is Carlos, right? Okay, so Carlos says that he's from Venezuela and he's asking, how do I see the medical research in Latin America according to my experience and what are the changes that should be done? So one of the lessons I learned from, you know, observing what's happening in my own country, just as an example, my country is Argentina. Argentina has these ups and downs in economy that if you have never followed Argentinian economy, it's very interesting. We adapt very fast to it. We are used to the, okay, any day you could lose everything and then any day you can get everything back.

I think that's part of who I am as a person too. But what we see is that when there are governments in place that favor research, meaning that they create a ministry of research or that they provide scholarships for students to get PhDs or that they provide positions for professors to stay in the country so that they don't have to leave. There's so much innovation that happens. I Argentina created their own COVID test. Argentina is participating in vaccine trials. And right now this is all happening because the government that is right now has invested in science. Whether the other things that they do are right or wrong, when they invest in science, we see the results like years later. And the other thing is that in Latin America and some in some countries, the majority of them, you know, it's education is a little bit more accessible than it is maybe in countries that are more developed because of how much it costs study. So, and, you know, it's not for everyone, because not everyone knows that they can do it. So I feel like as long as we continue to celebrate the research advances, and like, for example, everything that happened with COVID, like you see it on TV, and then you see the scientists talking and with social media, you see like the labs, you know, people showing and what they've done and where they started and how they compare internationally, that encourages more people to join science, because the problem is having enough scientists, but also keeping them employed and giving them the resources so that they can thrive. I think each Latin American country shares these, roller coasters of economical situations, but I think there should be something that is long -term that invest the money and that money can stay in science. Because as you know, you can't start something and then in three years, four years, you get a new government and then everything you started has to disappear and then start it again.

So I think the solution is to have something that it doesn't depend on who's in charge, that is continuously providing resources because we see that when there are resources, we

All right, yeah, Redmond, go ahead and ask your question if you're in a position to do so. Sure.

So hi, Patricia. Thank you so much for sharing your story and also to the other person who shared her frustrations. I think those are really, really, you know, real concerns. So I wrote this out, you know, in a question channel, so I'm just going to read it so it's more structured that way. So I think, yeah, I think there are some ways to help and in my opinion, that's entrepreneurship exactly. So I've worked with some startup from Latin and to your point about the differences differences between male and female. And there's like companies out there that are trying to do quote, unquote, like precision medicine for LATAM folks. So their claim is like the current genomic database is comprised of exactly kind of what you said, maybe dominantly white.

So those treatments may not be as effective to people who are not represented in that database. So the way they do it is that the concept is to be able to monetize these, you know, these smaller groups per se, so that they could get funding elsewhere other than from like, you know, like, you know, academia way, like you have to get grants and stuff like that. But, you know, and then you can now, you get funding from private investors. So driving innovation from like a bottom up level, like everything is trying to democratize and you know, everything can go in parallel and you as like an expert in the medicine field, maybe you could be an advisor. that's like one way to help and I guess the other one is of course like spin -offs from universities so maybe establishing like a close relationship with like the IP patent office to kind of work on that maybe there's something that that could be done because I've seen some uni spin -offs you know become incredibly successful. So another point that I wanted to make is that you know I think the other person sorry I lost connection there so I didn't catch your name but I think

the other mentioned the issue of Alzheimer's, like, you know, in women, from what I understand, it's like really difficult to jump to that right away for like a complete treatment, right? Right now, I think the overall overarching understanding is that it could be delayed, you know, maybe like lessens some of the symptoms and whatnot, but it's really difficult to treat it at the root. And I think that has to do with like the difficulty of achieving to, of arriving to this kind of solution. And I think someone brought up, you know, from the past discussions with people that brought up the issues of like the rat model or something like that. I don't know like the full details, like just a disclaimer, I'm not an expert in this field in any sense. But I've had seen, I've seen people like focus on, you know, treating Parkinson's first because that's like an easier way to monetize. And then, you know, with that funding and whatever, they create like a roadmap basically around the end goal of treating Alzheimer's. But, you know, they have like a bunch of milestones in between. And it's showing that to investors really build confidence and also attractiveness in their business case, and in which sense they're getting funding from profit investors. But I guess one underlying problem is that with these really big NBCs, there are a lot of big companies out there doing the same thing, and sometimes they fail. And when they fail, investors get really basically bummed out, even the big companies are failing. What makes you so much better?

In which case, I think is an advantage for you guys, actually, because you guys have worked in academia and you guys have a lot of, you know, database, you know, to your point, like you said, build those databases and whatnot. And these are the opportunities that I think is really a way for you to present these databases in like a convincing way when other people are not able to do so. So these are some things that I think, you know, could help move, you know, the progress forward. Like, you know, with all like, you know, taking the consideration of, you know, the gender issues, you the race issues, and also, you know, pushing medicine forward, I think these are the ways, some of the ways that are more entrepreneurial that could potentially help. And I think you could start just by, you know, being an advisor in the beginning, and eventually, you know, propel from there. Because that's just, you know, kind of what I wanted to

Thank you so much. Yeah, I absolutely agree. I see a lot of senior people, you know, acting as advisors. I haven't seen that many junior, but I think you're exactly right. We have

to start, you know, trying doing it. And then we have to start sharing that is something else that we can do to help. So as I think a lot of people don't know someone who does And, you know, this is just from conclusions from my own conversations with colleagues, that as soon as this becomes more and more popular, in a way, there will be more people jumping in. So we just need to keep it, keep doing it. Keep at it. Yeah.

Awesome. Hey, Spencer, can I say something? Go ahead, Was. Hey, Patricia.

It was lovely listening to you. first of all very very inspirational the fact that you are at it and I think research is almost like entrepreneurship nobody believes you at first and till you are actually able to pull it off in a way entrepreneurship and research are very similar I think I could talk to you for an entire day about sex differences It's funny because I am trained in alternative medicine and a lot of alternative medical streams like Ayurveda and traditional Chinese medicine they have always pointed out differences in the way men and women are being treated. But I think as modern medicine came in, they started looking at that as a bane and saying that oh no it was done because women were suppressed and that is why they were treated differently. Probably are we completing the cycle now to say that hey no, they probably have the wisdom to know that they probably reacted differently. So, like I said, I could talk to you an entire day about this because from a clinical side and the research side, but I would like to hear your thoughts on whether you have noticed that a lot of ancient sciences did treat them differently. Maybe they had some, knew something that we just brushed off as, hey, they were just being patriarchy or something like that.

Well, so there's data. There are people who are collecting information from their patients. You there are publications even in lung disease, and I don't know that much about diabetes, but I know that it's recognized in more than one domain. So yeah, we know, for example, what you see the fluctuations throughout the cycle. I mean, if you measure hormone levels, you you measure, for estradiol, progesterone, and they fluctuate, right? And then even testosterone in males, you know, throughout the day, but not like in the way that, you the cycling changes that happen throughout the month in a woman. But like, when you think about that, okay, so there's more estrogen circulating, right? What does estrogen do? When you think about the mechanism, and this may be too much for some of the people

that are not in biology, but estrogen is a lipid. it's like a fat, it gets into your cell and inside of the cell, there's this protein that binds to it, this is one of the ways it acts. And when it binds to that protein, it goes to the nucleus of the cell and it triggers expression of genes. This is like what is called like transcription factor. So the more estrogen typically means more expression, right? So when you think about that and you see that that's happening every month and it's the same moment, what if any of those genes is related to that response that you're studying? I mean, you can't ignore that. So it flirts me to just think that for years we didn't consider it.

It may be that the body has another mechanism to control that, or it may be that the genes that are being expressed do not have anything to do with the disease that you're studying. Yeah, but we still need to investigate it because these hormones are coming into the body, you know, in the bloodstream, whether we inject them or not, right? Like the person is fluctuating these levels every month. when they're in reproductive age. And then, you know, when they're kids, they're not. And when they're after menopause, they're not either. There are other things that change. So part of this personalized medicine, you know, encompasses studying all of this. When we look at data from medicine, just, you know, medicine, Western medicine, eight of every 10 adverse reactions to medicine are reported in women. And you know, I can give you more and more numbers

that show like, okay, we can't just treat them the same way. We can't just calculate by weight. There's like the study on, there's one drug that now comes in the male version, the female version, because it was making women so sleepy that the next day they were like crashing their cars. They were taking the same dose based on weight. And then they realized that, you know, the mechanism was different in women than men. and they had to modify. So I feel like, you know, we don't have much information because historically we were trying to protect women, right? You know, for things that happened in the past, for a while, women were not allowed to be part of trials. But that only justifies the part where we don't include them when, you know, when we didn't include them in studies. But the fact that we only use male mice or male rats or male cells, I mean, you have to find a cell line that is female for lung epithelium. It's not available, right? So, that is unjustified. That when you ask people why they only use males, they say, well, females give me too much variability. Like, I don't want to deal with that. It's going to mess up my statistics. And I'm like, well, then you're helping less, you're helping only half of the population with your research. That is unacceptable. So, yeah, it requires a change in, you know, your mindset? Why are you doing what you're doing? Which sometimes is hard, you know, in academia, just to think that what you're doing is going to help a patient, you 20, 30 years from now, it's not immediate. But it also requires educating yourself, like thinking outside of the box. Like there's even studies on, you know, for medical books that only have male images,

you know, that's just, I keep talking, like you just said, we can keep talking about this problem. But as long as we keep this conversation, things will start changing. And I feel like if we remain silent, or if we don't acknowledge them, we contribute to the problem.

And so much, Patricia. I'm so glad you were able to rejoin us, Waseem, too. And I know sometimes we do have connection issues, but it's so wonderful to be able to connect from so many different parts of the world. I really appreciate you taking so much time to answer so many of our questions today and I could ask you a million more but um I'm I'm gonna wrap us up to give you an opportunity to move on with your day. I personally learned a lot and I really appreciate you sharing you know both from an educated standpoint

and from a personal standpoint, from your life lessons and your amazing journey. And this is such a diverse community. It's an honor to be able to bring people together this way. So thank you so much everyone for taking an hour and a half of your day today with us.

Thank you. I everybody's discussion and comments and yeah, looking forward to connecting more.

Thank you so much, Patricia. Have a lovely day, everyone.

You too. All right. Take care.

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