Overview
In 2019, at the iGEM conference in Chongqing, through academic exchanges, we deeply understand the topic and extend HP content which has a deeper impact on society. Our focus is on how to make the community recognize the feasibility of viral treatment of diabetes, so as to provide a new perspective and method for future diabetes treatment work. To this end, we have also specially developed a family GI manual, with the support of the Southern Medical University Popular Science Association, jointly completed the broad masses of outdoor knowledge popularization activities on synthetic gene and virus therapy.
In terms of outreach, our focus is on research in hospitals, communities and the Internet. We interviewed clinicians, specialists and nurses in hospitals or interviewed them with questionnaires. We consulted them about the difficulties encountered in the current diabetes treatment process and the measures taken by doctors to promote the optimization of our project. At the same time, we have actively contacted Changsha Welfare Home to tell the elderly about the causes of diabetes and to obtain their recognition of our treatment. We have successfully built a bridge between society and Research - the Red Cross Public Welfare Propaganda Team.
From the very beginning, our strategy has been to focus on the degree of recognition of viral treatment. We considered the issue of social acceptance of this approach and how to successfully establish an impact that lasts longer than the iGEM contest. We begin our journey by moving into the lives of health care and patients. We try to make society understand how viral treatment works and how we should carry out our projects from the perspective of human practice. We started our journey with the firm belief that a successful project comes from its impact and contribution to society.
Part I Collaboration with Hospital & Health Center
Because the ultimate goal of our project is to come up with a solution for diabetes treatment, It can promote the optimization of our project to understand more specifically the difficulties patients face in the process of diabetes treatment and what measures the doctors take. So, we make a nurse interview and visit and a clinical interview questionnaire to solve these problem.
Nurse Interview and Visit
Realizing that treatments of T2D are carried out directly by nurses, we contacted Guoxiu Li, head nurse of the Department of General Medicine (former Gerontology) of the Second Affiliated Hospital of Chongqing Medical University. With Ms. Li's consent, we conducted a nurse interview and hospital visit.
Ms. Li showed us the nursing work of diabetic patients and answered our questions about specific problems arising from current treatments. The Second Affiliated Hospital of CMU also agreed to provide our team with more treatment data of the patients for further analysis.
When we asked the nurses, who are in long-term first-hand contact with T2D patients, how they hope the treatment of diabetes could be improved, they said that it would be nice if there were a convenient way of treatment that doesn't require frequent medication. As a chronic disease, diabetes requires lifelong treatment, and the treatment process is tedious, which brings physical and psychological burden to patients, many diabetics want simpler treatments that ameliorate pain. If patients could be freed from the pain of frequent insulin injections and cumbersome treatment procedures, they would cooperate with clinical treatments more actively.
Currently, insulin together with some other insulin sensitivity improving medicines are the most widely applied approach for the glycemia control of diabetic patients. However, constant and frequent insulin injection would bring too much pain the patients. They are eager for a new way to treat diabetes.
Clinical Interview Questionnaire
The specific content of the questionnaire
To delve deeper into the issue, we would need to know what are some methods of treatment and how are the treatments evaluated from an expert point of view. We were also interested in what existing ways to control blood sugar in diabetics does the hospitals in our community offer. Therefore, in July and August, we conducted diabetes-related interviews with relevant professional doctors both online and offline to improve our subject.
We produced a survey that was filled out by 14 clinicians from different regions and different levels of hospitals, including the associate chief physician of endocrinology, the chief physician of geriatrics, and the chief physician of internal medicine. Below is a more detailed breakdown of the questions we asked.After collecting the questionnaire responses, we sorted out these key takeaways:
1. Current characteristics and tendencies of diabetes
• Middle-aged, female, obesity
2. Evaluation of clinical approaches
• Oral medication/Insulin injections/GBP
• DPP-4 inhibitor (decreases glucagon levels)
• SLT2 (increases urine sugar excretion); rosiglitazone (increases insulin sensitivity)
3. Comparison of regional differences
• Treatments offered by township hospitals are simpler than those of city hospitals.
Part II Raising Awareness
Synthetic biology is fascinating, offering viable cures to certain diseases. While we are using such an advanced technique to develop a solution to diabetes that may ultimately be applied to patients, we do not tend to limit our iGEM project within isolated labs, but make it an intensely social activity. We realize that it is our responsibility to grasp every opportunity to present our project, clear up any possible misunderstandings, and engage the public in the discussion of synthetic biology. From 2019 up to now, we have conducted regular activities, including surveying the public understanding of diabetes, educating the public through brochures and lectures, and contacting clinical experts. In these activities, we visited different communities, been involved in people's daily lives, and had open communications. Our team spared no effort in developing Human Practices that truly integrates iGEM and synthetic biology into the lives of common people. During our mutual communication with the public, we gathered valuable feedback, which, in return, allowed our team to understand the concerns of the public and inspired us to take further actions on our project.
Public Questionnaires
I. Questionnaire on Measuring the General Public's Knowledge of Diabetes
Our objective is to evaluate how much the general public is familiar with the causes and cures of diabetes and find out which group(s) lack such knowledge the most. Participants were asked to complete 7 True-or-False questions regarding the most fundamental knowledge about diabetes. 524 people were investigated by random sampling on the Internet. We categorized their ages into 4 distinctive groups: Juvenile, Young, Middle-Aged, and Aged. Among the 524 people surveyed, 47.3% are middle-aged, 16.4% are Juvenile, and 36.3% are over the age of 40. The gender ratio is roughly half-to-half.
After collecting and analyzing statistics, we found that only 65 people answered every question correctly, 43 of them were from the youth group, and 18 were from the middle-aged group. The results show that middle-aged people and the young are most capable of distinguishing effective and ineffective methods in the treatment of diabetes. The aged and Juveniles groups, in contrast, are less familiar with the knowledge. This phenomenon may be caused by the lack of general diabetic education among juveniles and the misleading social superstition that is popular among the old. Take the statement in question 6, for example: "Eating bitter melon can lower blood sugar levels." The correct answer is "False." However, only half of the juvenile group and low to 36.4% of the Aged group choose the correct answer. The theory that by merely eating bitter melons, one can reduce blood sugar levels currently exists only in folk remedies with no scientific research to prove. Some aged patients, who especially believe in those remedies, decide to eat bitter melon all day instead of taking medicine - This is not advisable.
Regarding the results and the prevalence of diabetes among people in China, it seems surprising to us that 87.6% of the surveyed have misunderstandings on this significant public health problem. Therefore, we think it necessary to give lectures to popularize the appropriate way of curing diabetes and decided to make the old our major target audience since they lack such knowledge the most.
II. Questionnaire on Public Acceptance of Adenoviruses for Diabetes Treatment
To know the general public's acceptance of Adenovirus based gene therapy for diabetes treatment.We conducted a survey in the form of online questionnaire to evaluate to what extent adenovirus use in diabetes treatment is accepted by the public. We investigated 537 people by random sampling on the Internet. The sample proportion is also based on the age distribution in China and the transfection mechanism has been given in the form of a sketch on the first page of the questionnaire.
Our survey results show that virus therapy is poorly accepted by the public – despite more than half of our subjects support our idea, those who accept it themselves have not yet make up 30% of the population. The negative impression of the virus likely causes people to hesitate in exposing themselves to an unfamiliar therapy like virus therapy. Based on its public impression that is not optimistic enough, we believe that follow-up science popularization is indispensable.
Our team would later address these issues by launching public engagement program trying to make them feel less concerned about trying new treatments through by providing fundamental knowledge on virus and gene therapy. We have achieved initial success by forming a collaboration with Southern Medical University Science Education Association who would actively support us in realizing further goals.
Based on that ,we realized that virus based gene therapy seems poorly accepted by the public in our society, which we believe, due to the negative impression generated by the name ‘virus’ and people’s unfamiliarity on gene therapies. AndWe addressed these issues later by educating the public and trying to make them feel less concerned.
Diabetes Knowledge Popularization Activities with the Red Cross
The previous online survey shows various degrees of misunderstanding on diabetes both in the elderly and the young, especially the elderly. Among the 524 valid questionnaires received by our team, only 12.4% of the respondents (65 persons) answered all questions correctly.
Considering our project aims to create a novel clinical application of type II diabetes mellitus (T2D), specifically by degrading GCGR to help decrease the blood glucose level, we believe it’s indispensable to conduct a popularization of diabetes in communities.
One member of our team, Yuhang Ye, is a member of the Red Cross. The Red Cross is one of the many local non-profit organizations that promote healthy lifestyles to the general public to prevent diabetes and other dietary diseases. Sharing the same goals, we collaborated with the local Red Cross. Through Ye's contact, our group and the Red Cross jointly held the Diabetes Knowledge Popularization Lecture in the old people's home of Changsha No.1 Social Welfare Institute on June 23rd.
Our team members handed out self-made brochures to the old, explained the mechanisms of diabetes and its treatment, and introduced our project, including an FAQ section at the end of the lecture.
Both young volunteers and the elderly at the Welfare Institute were interested in these topics that relate closely to everyday life. After the lecture, they eagerly asked questions about the lifestyle of diabetics, and we were more than happy to answer. Before leaving, the caretaker asked our contact information hoping for long-term communication on diabetic diets, believing our lectures would be more accessible to the elderly than those of clinicians.
The Red Cross in Changsha also decided that they would hold regular health knowledge popularization activities with NUDT_CHINA. We firmly believe that our project is beneficial to the community. We have future plans to set up a two-way communication platform, on which not only we could guide the treatment and prevention of diabetes, but also diabetic patients can help us understand what particular challenges they face in real life.
After receiving overwhelming responses in follow-up visits in Changsha, we expanded our outreach and organized diabetes knowledge talks in Chongqing and Guangzhou.
Outdoor Popular Science Activities for Adenovirus
To further enhance the public's understanding and acceptance of gene editing and viral therapy, 45 science popularization volunteers of the Southern Medical Science Education Association and HP team members carried out related educational groups in Guangzhou Yuexiu Park. In order to increase the proportion of citizens who are willing to participate in popular science education activities, we selected Yuexiu Park as a place for our popular science activities, where there is a large influx of people on the weekend, mainly consisting of the elderly and families with children. 
Based on its public impression that is not optimistic enough, we believe that follow-up science popularization is indispensable. 
To further enhance the public's understanding and acceptance of gene editing and viral therapy, especially the adenoviruses transfection mechanism in our project, 45 science popularization volunteers of the Southern Medical Science Education Association and HP team members carried out related educational groups in Guangzhou. Aiming to increase the proportion of citizens who are willing to participate in public science education activities, we selected Yuexiu Park as a place for our popular science activities, where there is a large influx of people on the weekend, mainly consisting of old people and families with children. 
We provided them with the Synthetic Biology brochure of the Ocean University of China and our cartoon cards, expecting to introduce the mechanism of synthetic biology and virus therapy vividly. We also designed interesting games to introduce the process of adenoviruses transfection, and thus unravel the public's misunderstanding of gene editing and virus therapy, and further enhance their interest in synthetic biology. We exchanged contacts with children and parents who showed interest in synthetic biology so that we could invite them to follow-up activities.
Household GI Reference Manual
We designed posters about the GI (Glycemic index), aiming to let more people know about GI and make better meal plans to maintain healthy blood sugar levels. We gathered and selected data from the Internet to make a GI table of common foods. Since many people don't have a comprehensive understanding of the prevention of diabetes or cautions while dealing with it, the posters also incorporated some suggestions. For example, it mentions that GI can be influenced by cooking methods and suggests that meat for diabetics be boiled or stewed instead of fried or barbecued (doctors do not always mention this to diabetic patients). We also designed the poster to be relatively small so that it can be easily pasted at home, say, on the refrigerator.
Link of the GI Reference Manual
You can stick the manual in the right place
Tao qianqian's family is looking through the manual
