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clear Science
dragging scientific communication into
the information age



erich s. huang, md/phd
director, cancer research
sage bionetworks

erich.huang@sagebase.org
@erichhuang
http://www.viahealthcaredesign.com/LMCH%20Universal%20Exam%20Rm.jpg
Betty Jones




        “I have a lump near my mastectomy scar”
Betty Jones

                                          menopause
                                          ~50 years



              “high risk” breast cancer               “normal risk” breast cancer
Betty Jones

                                          menopause
                         36 years         ~50 years



              “high risk” breast cancer               “normal risk” breast cancer
Betty Jones

              African American Population              Non-African American Population


                                                                               16%

                                     39%

                61%

                                                                   84%


                 Triple Negative Breast Cancer                 Triple Negative Breast Cancer
                 All Other Types                               All Other Types




                                                 http://jama.jamanetwork.com/article.aspx?articleid=202952
her2
                                receptor


           progesterone
               receptor




estrogen
receptor




                          breast cancer cell
                          depends on receptor-driven
                          growth signals
her2
                                receptor


           progesterone
               receptor




estrogen
receptor




                          breast cancer cell
                          depends on receptor-driven
                          growth signals
her2
                                                  receptor


           progesterone
               receptor




                                                LS
estrogen
                                             NA
receptor
                                      S   IG
                                T   H
                             OW
                          G R
                                            breast cancer cell
                                            depends on receptor-driven
                                            growth signals
breast cancer cell
growth signals become
independent of receptors
“triple negative” breast cancer




                                  breast cancer cell
                                  growth signals become
                                  independent of receptors
“triple negative” breast cancer
the receptors are no longer present on the
cell surface...




                                             breast cancer cell
                                             growth signals become
                                             independent of receptors
“triple negative” breast cancer
the receptors are no longer present on the
cell surface...
but the intracellular signals persist




                                             breast cancer cell
                                             growth signals become
                                             independent of receptors
“triple negative” breast cancer
the receptors are no longer present on the
cell surface...
but the intracellular signals persist




                                       T
                                      N S
                                     E L
                                    D A
                                   N N
                                  E IG
                                EP S
                               D H
                            IN T
                               OW
                            G R
                                             breast cancer cell
                                             growth signals become
                                             independent of receptors
http://www.cancer.gov/images/cdr/live/CDR415523-750.jpg
http://www.cancer.gov/images/cdr/live/CDR415523-750.jpg
http://www.cancer.gov/images/cdr/live/CDR415523-750.jpg
Betty Jones

                  minus             plus

                                  lymph node
                   young
                                    negative

              african-american


               triple negative


              multifocal cancer
Betty Jones

          minus             plus

                          lymph node
           young
                            negative

      african-american                 = Aggressive therapeutic strategy

       triple negative


      multifocal cancer
http://www.flickr.com/photos/kbrookes/7497906298/sizes/h/in/photostream/
radiotherapy 3d planning




                           http://radonc.ucsf.edu/patient_information/breast/images/Radiation_Oncology_breast_img_2.jpg
Betty Jones




        “I have a lump near my mastectomy scar”
Betty Jones
              Triple negative breast cancer.
              What are the options?
Betty Jones
              Triple negative breast cancer.
              What are the options?
              Standard Stuff (Old Fashioned Targets)
              Anthracyclines
              Taxanes
              Anti-Metabolites
Betty Jones
              Triple negative breast cancer.
              What are the options?
              Standard Stuff (Old Fashioned Targets)
              Anthracyclines
              Taxanes
              Anti-Metabolites


              Platinum Agents
Betty Jones
                        Triple negative breast cancer.
                        What are the options?




                    {
                        Standard Stuff (Old Fashioned Targets)
                        Anthracyclines
     conventional       Taxanes
     chemotherapy       Anti-Metabolites


                        Platinum Agents
Betty Jones
                        Triple negative breast cancer.
                        What are the options?




                    {
                        Standard Stuff (Old Fashioned Targets)
                        Anthracyclines
     conventional       Taxanes
     chemotherapy       Anti-Metabolites


                        Platinum Agents

                        Targeted Agents
                        Cetuximab + Platinum (BALI-1)
                        Bevacizumab (GeparQuinto)
                        PARP Inhibitors
                        SRC Inhibitors
                        HDAC Inhibitors (ER-alpha)
Betty Jones
                         Triple negative breast cancer.
                         What are the options?




                     {
                         Standard Stuff (Old Fashioned Targets)
                         Anthracyclines
     conventional        Taxanes
     chemotherapy        Anti-Metabolites


                         Platinum Agents




                     {
                         Targeted Agents
                         Cetuximab + Platinum (BALI-1)
                         Bevacizumab (GeparQuinto)
     new therapies       PARP Inhibitors
                         SRC Inhibitors
                         HDAC Inhibitors (ER-alpha)
Betty Jones
                         Triple negative breast cancer.
                         What are the options?




                     {
                         Standard Stuff (Old Fashioned Targets)
                         Anthracyclines
     conventional        Taxanes
     chemotherapy        Anti-Metabolites
                     CURRENT KNOWLEDGE:
                      Platinum Agents
                     ALL THESE THERAPIES

                     {
                      Targeted Agents
                     ARE A Platinum (BALI-1)
                      Cetuximab + WASH
                      Bevacizumab (GeparQuinto)
     new therapies       PARP Inhibitors
                         SRC Inhibitors
                         HDAC Inhibitors (ER-alpha)
Betty Jones
Betty Jones
http://www.viahealthcaredesign.com/LMCH%20Universal%20Exam%20Rm.jpg
molecularly-customized
~4 million datapoints
                        cancer treatment plan
E S
                 TIM
         4 6   3
    ED
C IT
E S
           TIM
       6 3
      4 CS-
    ED MI      LS
 IT
C EN   O RIA
   G ED    T
 3 ID
   GU
E S
           TIM
       6 3
      4 CS-
    ED MI      LS
 IT
C EN   O RIA
   G ED    T
 3 ID
   GU
molecularly-customized
~4 million datapoints
                        cancer treatment plan
molecularly-customized
~4 million datapoints
                        cancer treatment plan
Magic
                                molecularly-customized
~4 million datapoints
                                cancer treatment plan
Open
Open
Open
Open Source
Open
Open Data
Open
Open Access
Access
Access = Accessible?
OpenSource
OpenData
OpenAccess
             }   Clear ?
Nature 483, 509 (29 March 2012) | doi:10.1038/483509a
Nature 483, 509 (29 March 2012) | doi:10.1038/483509a
the status quo
tolerates poor
communication
of findings
the status quo                            can reproduce
tolerates poor                            partially
communication
of findings
                                          6%
            can reproduce
            from processed
            data w/            21%
            discrepancies

                                                        54%
         can reproduce w/     8%               cannot
         discrepancies                         reproduce
                                    11%

                 can reproduce in
                 principle
so what’s in
principle
reproducible, is not
practically
reproducible
so what’s in
                                         principle
                   208,294,724
                                         reproducible, is not
                   datapoints            practically
                                         reproducible
   124 pages
   supplemental material

                   ? lines
                   unobtainable source
                   code

                    ? version or
                    architecture of R


? R packages
  key R package
  “ClaNC”
  no longer
  available

                  442 citations
THE SCIENTIFIC PROCESS:
it’s not one and done...




   define a question
THE SCIENTIFIC PROCESS:
it’s not one and done...




   define a question




         gather information
THE SCIENTIFIC PROCESS:
it’s not one and done...




   define a question           form a hypothesis




         gather information
THE SCIENTIFIC PROCESS:
it’s not one and done...




   define a question           form a hypothesis




         gather information         experimentally test
                                    your hypothesis
THE SCIENTIFIC PROCESS:
it’s not one and done...




                                                          analyze
   define a question           form a hypothesis           experimental data




         gather information         experimentally test
                                    your hypothesis
THE SCIENTIFIC PROCESS:
it’s not one and done...




                                                          analyze
   define a question           form a hypothesis           experimental data




         gather information         experimentally test       draw conclusions
                                    your hypothesis
THE SCIENTIFIC PROCESS:
it’s not one and done...




                                                          analyze
   define a question           form a hypothesis           experimental data      report, i.e. “publish”




         gather information         experimentally test       draw conclusions
                                    your hypothesis
THE SCIENTIFIC PROCESS:
it’s not one and done...




                                                          analyze
   define a question           form a hypothesis           experimental data      report, i.e. “publish”




         gather information         experimentally test       draw conclusions
                                    your hypothesis




                                                           validation by the scientific community
                                                           validation by clinical trials
generate data
@ the bench or
from a clinical cohort
generate data
@ the bench or
from a clinical cohort
store on local
generate data            server
@ the bench or
from a clinical cohort
store on local
generate data            server
@ the bench or
from a clinical cohort
store on local
generate data                               server
@ the bench or
from a clinical cohort




                         analyze on local
                         machine
store on local
generate data                               server
@ the bench or
from a clinical cohort




                         analyze on local
                         machine
store on local
generate data                               server
@ the bench or
from a clinical cohort




                         analyze on local
                         machine




   write a
   document
store on local
generate data                               server
@ the bench or
from a clinical cohort




                         analyze on local
                         machine




   write a
   document
                                   al
                          to journ
                  su bmit
store on local
generate data                               server
@ the bench or
from a clinical cohort




                         analyze on local
                         machine




                                                sent to
   write a                                      reviewers
   document                                     as pdf
                                   al
                          to journ
                  su bmit
store on local
generate data                               server
@ the bench or
from a clinical cohort




                         analyze on local
                         machine




                                                sent to
   write a                                      reviewers
   document                                     as pdf
                                   al
                          to journ
                  su bmit
store on local
generate data                                  server
@ the bench or
from a clinical cohort




                                            accepted
                                            & digitally
                                            typeset


                         analyze on local
                         machine




                                                     sent to
   write a                                           reviewers
   document                                          as pdf
                                   al
                          to journ
                  su bmit
printed
                                                                 on paper




                                               store on local
generate data                                  server
@ the bench or
from a clinical cohort




                                            accepted
                                            & digitally
                                            typeset


                         analyze on local
                         machine




                                                     sent to
   write a                                           reviewers
   document                                          as pdf
                                   al
                          to journ
                  su bmit
printed
                                                                 on paper




                                               store on local
generate data                                  server
@ the bench or
from a clinical cohort                                                 static html
                                                                       representation




                                            accepted
                                            & digitally
                                            typeset


                         analyze on local
                         machine




                                                     sent to
   write a                                           reviewers
   document                                          as pdf
                                   al
                          to journ
                  su bmit
printed
                                                                 on paper




                                               store on local
generate data                                  server
@ the bench or
from a clinical cohort                                                 static html
                                                                       representation




                                            accepted
                                            & digitally
                                            typeset
                                                                            static pdf
                                                                            representation
                         analyze on local
                         machine




                                                     sent to
   write a                                           reviewers
   document                                          as pdf
                                   al
                          to journ
                  su bmit
printed
                                                                 on paper




                                               store on local
generate data                                  server
@ the bench or
from a clinical cohort                                                 static html
                                                                       representation




                                            accepted
                                            & digitally
                                            typeset
                                                                            static pdf
                                                                            representation
                         analyze on local
                         machine




                                                     sent to
   write a                                           reviewers
   document                                          as pdf
                                   al
                          to journ
                  su bmit
printed
                                                                           on paper




                                                         store on local
          generate data                                  server
          @ the bench or
          from a clinical cohort                                                 static html
                                                                                 representation




THE ACTUAL SCIENCE                                    accepted
                                                      & digitally
                                                      typeset
                                                                                      static pdf
                                                                                      representation
                                   analyze on local
                                   machine




                                                               sent to
             write a                                           reviewers
             document                                          as pdf
                                             al
                                    to journ
                            su bmit
printed
                                                                           on paper




                                                         store on local
          generate data                                  server
          @ the bench or
          from a clinical cohort                                                 static html
                                                                                 representation




THE ACTUAL SCIENCE                                    accepted
                                                      & digitally
                                                      typeset
                                                                                      static pdf
                                                                                      representation
                                   analyze on local
                                   machine

                                                         SCIENTIFIC CLAIMS
                                                               sent to
             write a                                           reviewers
             document                                          as pdf
                                             al
                                    to journ
                            su bmit
store on local
          generate data                               server
          @ the bench or
          from a clinical cohort




THE ACTUAL SCIENCE

                                   analyze on local
                                   machine
store on local
          generate data                               server
          @ the bench or
          from a clinical cohort




THE ACTUAL SCIENCE

                                   analyze on local
                                   machine
clear Science
clear Science
clear Science
clear Science
1. re-imagine scientific communication
clear Science
1. re-imagine scientific communication
2. make every component of a data-intensive project
   (e.g. genomic analysis) web accessible
clear Science
1. re-imagine scientific communication
2. make every component of a data-intensive project
   (e.g. genomic analysis) web accessible
3. allow consumption of content at a variety of levels
   of complexity and abstraction
4. leverage open, RESTful APIs
leverage open, RESTful APIs
leverage open, RESTful APIs
                              to let users reconstitute an
                              entire analytical environment
leverage open, RESTful APIs
                               to let users reconstitute an
                               entire analytical environment




                              hardware
leverage open, RESTful APIs
                               to let users reconstitute an
                               entire analytical environment




                              software

                              hardware
leverage open, RESTful APIs
                               to let users reconstitute an
                               entire analytical environment




                                data

                              software

                              hardware
leverage open, RESTful APIs
                               to let users reconstitute an
                               entire analytical environment



                                code

                                data

                              software

                              hardware
code
  data
software
hardware
code
     data
   software
   hardware



clear Science
code
      data
    software
    hardware



clear Science
   a narrative that coherently interweaves
   scientific assertions with the executable data,
   code, software & hardware that support them
“ my computer’s the cloud,
        let me hand it to you ”
“ If I have seen further it is by standing on the shoulders
  of giants. ”
Betty Jones




        “I have a lump near my mastectomy scar”
brian bot
                                                                stephen friend
                josh greenberg                                  david burdick
                                                                mike kellen


                                  external partners

myles axton                      ian mulvaney            kelly lamarco
editor                           head of technology      senior editor
nature genetics                            •
                                                         science trans. medicine
                                 mark patterson
                                 managing exec. editor
phil bourne                      eLife sciences          eric schadt
founding editor-in-chief                                 dir. inst. for genomics &
plos comp. biology                                       multiscale biology
                                                         mt. sinai school of med.
brian bot
                                                                stephen friend
                josh greenberg                                  david burdick
                                                                mike kellen




our patients
                                  external partners

myles axton                      ian mulvaney            kelly lamarco
editor                           head of technology      senior editor
nature genetics                            •
                                                         science trans. medicine
                                 mark patterson
                                 managing exec. editor
phil bourne                      eLife sciences          eric schadt
founding editor-in-chief                                 dir. inst. for genomics &
plos comp. biology                                       multiscale biology
                                                         mt. sinai school of med.
clearScienceStrataRx2012

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clearScienceStrataRx2012

  • 1. clear Science dragging scientific communication into the information age erich s. huang, md/phd director, cancer research sage bionetworks erich.huang@sagebase.org @erichhuang
  • 3. Betty Jones “I have a lump near my mastectomy scar”
  • 4. Betty Jones menopause ~50 years “high risk” breast cancer “normal risk” breast cancer
  • 5. Betty Jones menopause 36 years ~50 years “high risk” breast cancer “normal risk” breast cancer
  • 6. Betty Jones African American Population Non-African American Population 16% 39% 61% 84% Triple Negative Breast Cancer Triple Negative Breast Cancer All Other Types All Other Types http://jama.jamanetwork.com/article.aspx?articleid=202952
  • 7. her2 receptor progesterone receptor estrogen receptor breast cancer cell depends on receptor-driven growth signals
  • 8. her2 receptor progesterone receptor estrogen receptor breast cancer cell depends on receptor-driven growth signals
  • 9. her2 receptor progesterone receptor LS estrogen NA receptor S IG T H OW G R breast cancer cell depends on receptor-driven growth signals
  • 10. breast cancer cell growth signals become independent of receptors
  • 11. “triple negative” breast cancer breast cancer cell growth signals become independent of receptors
  • 12. “triple negative” breast cancer the receptors are no longer present on the cell surface... breast cancer cell growth signals become independent of receptors
  • 13. “triple negative” breast cancer the receptors are no longer present on the cell surface... but the intracellular signals persist breast cancer cell growth signals become independent of receptors
  • 14. “triple negative” breast cancer the receptors are no longer present on the cell surface... but the intracellular signals persist T N S E L D A N N E IG EP S D H IN T OW G R breast cancer cell growth signals become independent of receptors
  • 18. Betty Jones minus plus lymph node young negative african-american triple negative multifocal cancer
  • 19. Betty Jones minus plus lymph node young negative african-american = Aggressive therapeutic strategy triple negative multifocal cancer
  • 21. radiotherapy 3d planning http://radonc.ucsf.edu/patient_information/breast/images/Radiation_Oncology_breast_img_2.jpg
  • 22. Betty Jones “I have a lump near my mastectomy scar”
  • 23. Betty Jones Triple negative breast cancer. What are the options?
  • 24. Betty Jones Triple negative breast cancer. What are the options? Standard Stuff (Old Fashioned Targets) Anthracyclines Taxanes Anti-Metabolites
  • 25. Betty Jones Triple negative breast cancer. What are the options? Standard Stuff (Old Fashioned Targets) Anthracyclines Taxanes Anti-Metabolites Platinum Agents
  • 26. Betty Jones Triple negative breast cancer. What are the options? { Standard Stuff (Old Fashioned Targets) Anthracyclines conventional Taxanes chemotherapy Anti-Metabolites Platinum Agents
  • 27. Betty Jones Triple negative breast cancer. What are the options? { Standard Stuff (Old Fashioned Targets) Anthracyclines conventional Taxanes chemotherapy Anti-Metabolites Platinum Agents Targeted Agents Cetuximab + Platinum (BALI-1) Bevacizumab (GeparQuinto) PARP Inhibitors SRC Inhibitors HDAC Inhibitors (ER-alpha)
  • 28. Betty Jones Triple negative breast cancer. What are the options? { Standard Stuff (Old Fashioned Targets) Anthracyclines conventional Taxanes chemotherapy Anti-Metabolites Platinum Agents { Targeted Agents Cetuximab + Platinum (BALI-1) Bevacizumab (GeparQuinto) new therapies PARP Inhibitors SRC Inhibitors HDAC Inhibitors (ER-alpha)
  • 29. Betty Jones Triple negative breast cancer. What are the options? { Standard Stuff (Old Fashioned Targets) Anthracyclines conventional Taxanes chemotherapy Anti-Metabolites CURRENT KNOWLEDGE: Platinum Agents ALL THESE THERAPIES { Targeted Agents ARE A Platinum (BALI-1) Cetuximab + WASH Bevacizumab (GeparQuinto) new therapies PARP Inhibitors SRC Inhibitors HDAC Inhibitors (ER-alpha)
  • 33.
  • 34.
  • 36.
  • 37. E S TIM 4 6 3 ED C IT
  • 38. E S TIM 6 3 4 CS- ED MI LS IT C EN O RIA G ED T 3 ID GU
  • 39. E S TIM 6 3 4 CS- ED MI LS IT C EN O RIA G ED T 3 ID GU
  • 40.
  • 41.
  • 44. Magic molecularly-customized ~4 million datapoints cancer treatment plan
  • 45. Open
  • 46. Open
  • 47. Open
  • 49. Open
  • 51. Open
  • 56.
  • 57.
  • 58.
  • 59.
  • 60. Nature 483, 509 (29 March 2012) | doi:10.1038/483509a
  • 61. Nature 483, 509 (29 March 2012) | doi:10.1038/483509a
  • 62. the status quo tolerates poor communication of findings
  • 63. the status quo can reproduce tolerates poor partially communication of findings 6% can reproduce from processed data w/ 21% discrepancies 54% can reproduce w/ 8% cannot discrepancies reproduce 11% can reproduce in principle
  • 64. so what’s in principle reproducible, is not practically reproducible
  • 65. so what’s in principle 208,294,724 reproducible, is not datapoints practically reproducible 124 pages supplemental material ? lines unobtainable source code ? version or architecture of R ? R packages key R package “ClaNC” no longer available 442 citations
  • 66. THE SCIENTIFIC PROCESS: it’s not one and done... define a question
  • 67. THE SCIENTIFIC PROCESS: it’s not one and done... define a question gather information
  • 68. THE SCIENTIFIC PROCESS: it’s not one and done... define a question form a hypothesis gather information
  • 69. THE SCIENTIFIC PROCESS: it’s not one and done... define a question form a hypothesis gather information experimentally test your hypothesis
  • 70. THE SCIENTIFIC PROCESS: it’s not one and done... analyze define a question form a hypothesis experimental data gather information experimentally test your hypothesis
  • 71. THE SCIENTIFIC PROCESS: it’s not one and done... analyze define a question form a hypothesis experimental data gather information experimentally test draw conclusions your hypothesis
  • 72. THE SCIENTIFIC PROCESS: it’s not one and done... analyze define a question form a hypothesis experimental data report, i.e. “publish” gather information experimentally test draw conclusions your hypothesis
  • 73. THE SCIENTIFIC PROCESS: it’s not one and done... analyze define a question form a hypothesis experimental data report, i.e. “publish” gather information experimentally test draw conclusions your hypothesis validation by the scientific community validation by clinical trials
  • 74.
  • 75. generate data @ the bench or from a clinical cohort
  • 76. generate data @ the bench or from a clinical cohort
  • 77. store on local generate data server @ the bench or from a clinical cohort
  • 78. store on local generate data server @ the bench or from a clinical cohort
  • 79. store on local generate data server @ the bench or from a clinical cohort analyze on local machine
  • 80. store on local generate data server @ the bench or from a clinical cohort analyze on local machine
  • 81. store on local generate data server @ the bench or from a clinical cohort analyze on local machine write a document
  • 82. store on local generate data server @ the bench or from a clinical cohort analyze on local machine write a document al to journ su bmit
  • 83. store on local generate data server @ the bench or from a clinical cohort analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 84. store on local generate data server @ the bench or from a clinical cohort analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 85. store on local generate data server @ the bench or from a clinical cohort accepted & digitally typeset analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 86. printed on paper store on local generate data server @ the bench or from a clinical cohort accepted & digitally typeset analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 87. printed on paper store on local generate data server @ the bench or from a clinical cohort static html representation accepted & digitally typeset analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 88. printed on paper store on local generate data server @ the bench or from a clinical cohort static html representation accepted & digitally typeset static pdf representation analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 89. printed on paper store on local generate data server @ the bench or from a clinical cohort static html representation accepted & digitally typeset static pdf representation analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 90. printed on paper store on local generate data server @ the bench or from a clinical cohort static html representation THE ACTUAL SCIENCE accepted & digitally typeset static pdf representation analyze on local machine sent to write a reviewers document as pdf al to journ su bmit
  • 91. printed on paper store on local generate data server @ the bench or from a clinical cohort static html representation THE ACTUAL SCIENCE accepted & digitally typeset static pdf representation analyze on local machine SCIENTIFIC CLAIMS sent to write a reviewers document as pdf al to journ su bmit
  • 92. store on local generate data server @ the bench or from a clinical cohort THE ACTUAL SCIENCE analyze on local machine
  • 93. store on local generate data server @ the bench or from a clinical cohort THE ACTUAL SCIENCE analyze on local machine
  • 94.
  • 98. clear Science 1. re-imagine scientific communication
  • 99. clear Science 1. re-imagine scientific communication 2. make every component of a data-intensive project (e.g. genomic analysis) web accessible
  • 100. clear Science 1. re-imagine scientific communication 2. make every component of a data-intensive project (e.g. genomic analysis) web accessible 3. allow consumption of content at a variety of levels of complexity and abstraction 4. leverage open, RESTful APIs
  • 102. leverage open, RESTful APIs to let users reconstitute an entire analytical environment
  • 103. leverage open, RESTful APIs to let users reconstitute an entire analytical environment hardware
  • 104. leverage open, RESTful APIs to let users reconstitute an entire analytical environment software hardware
  • 105. leverage open, RESTful APIs to let users reconstitute an entire analytical environment data software hardware
  • 106. leverage open, RESTful APIs to let users reconstitute an entire analytical environment code data software hardware
  • 108. code data software hardware clear Science
  • 109. code data software hardware clear Science a narrative that coherently interweaves scientific assertions with the executable data, code, software & hardware that support them
  • 110. “ my computer’s the cloud, let me hand it to you ”
  • 111.
  • 112.
  • 113. “ If I have seen further it is by standing on the shoulders of giants. ”
  • 114. Betty Jones “I have a lump near my mastectomy scar”
  • 115.
  • 116. brian bot stephen friend josh greenberg david burdick mike kellen external partners myles axton ian mulvaney kelly lamarco editor head of technology senior editor nature genetics • science trans. medicine mark patterson managing exec. editor phil bourne eLife sciences eric schadt founding editor-in-chief dir. inst. for genomics & plos comp. biology multiscale biology mt. sinai school of med.
  • 117. brian bot stephen friend josh greenberg david burdick mike kellen our patients external partners myles axton ian mulvaney kelly lamarco editor head of technology senior editor nature genetics • science trans. medicine mark patterson managing exec. editor phil bourne eLife sciences eric schadt founding editor-in-chief dir. inst. for genomics & plos comp. biology multiscale biology mt. sinai school of med.