Advance directives, autonomy and unintended death

This Paper argues that Living wills are typically nebulous and confused documents that do not effectively enable you to determine your future treatment. Worse, signing a living will can end your life in ways you never intended, long before you are either incompetent or terminally ill. This danger is compounded by the fact that those who implement living wills are often themselves dangerously confused, so that, for example, they cannot be relied upon to distinguish living wills from DNR orders. In addition, the Paper argues that advance directives concerning resuscitation are often so confused that they end the lives of healthy, alert people who have not suffered cardiac or pulmonary arrest. Finally, the paper argues that advance directives establishing durable power of attorney for health care often preserve the chief dangers of living wills. Suggestions are offered as to how you can most effectively direct your future treatment without endangering your life.     

Location,location, location? No. Catalog number

Once you start to read this Editor’s Corner, you might wonder why I have devoted an entire article, albeit a short one, to this topic. Let me assure you there are reasons. First, I want to announce a new policy for the journal that will affect all research papers. Starting with all papers that are not currently in press, we will no longer be asking for geographical locations of research companies that follow the listing of a reagent. In Materials and Methods the authors typically refer to a reagent and then list the company and its location parenthetically. For example, “…p-nitrophenyl phosphate (Sigma-Aldrich, St. Louis, MO).” Instead, we will require catalog numbers. The reason is that it is now quite easy to find a company using the internet, and in fact you rarely need to know the location because it is rare that you would send a written order. On the other hand, knowing the name of the reagent is not always sufficient to narrow down the precise item. For example, if you search for “p-nitrophenyl phosphate” at the Sigma-Aldrich site, you get seven primary choices and it is not at all obvious which one to choose. When my lab uses p-nitrophenyl phosphate for the Pho8?60 assay, we use item N9389, which narrows it down to a precise reagent. Thus, we will start requiring papers to write “…p-nitrophenyl phosphate (Sigma-Aldrich, N9389).

Second, I think this is actually a useful change, and one that many journals will start to institute once they see it being done here. The old style of listing the city and state is a relic that is no longer relevant. Furthermore, it is not even clear in the current global marketplace if this is particularly helpful. For example, if I am ordering an item from Roche Applied Science, why would anyone care where it is coming from? It is highly unlikely that a researcher in Germany or Japan is going to order from Roche Applied Science that happens to be based in Indianapolis, IN when there are much closer sites in Mannheim, Germany and Tokyo, Japan. So, do not be surprised when you start to see more and more journals adopting this approach, and remember that you saw it here first. Autophagy—the cutting edge.     

Interpretation of diagnostic data: 4. How to do it with a more complex table.

A more complex table is especially useful when a diagnostic test produces a wide range of results and your patient''s levels are near one of the extremes. The following guidelines will be useful: Identify the several cut-off points that could be used. Fill in a complex table along the lines of Table I, showing the numbers of patients at each level who have and do not have the target disorder. Generate a simple table for each cut-off point, as in Table II, and determine the sensitivity (TP rate) and specificity (TN rate) at each of them. Select the cut-off point that makes the most sense for your patient''s test result and proceed as in parts 2 and 3 of our series. Alternatively, construct an ROC curve by plotting the TP and FP rates that attend each cut-off point. If you keep your tables and ROC curves close at hand, you will gradually accumulate a set of very useful guides. However, if you looked very hard at what was happening, you will probably have noticed that they are not very useful for patients whose test results fall in the middle zones, or for those with just one positive result of two tests; the post-test likelihood of disease in these patients lurches back and forth past 50%, depending on where the cut-off point is. We will show you how to tackle this problem in part 5 of our series. It involves some maths, but you will find that its very powerful clinical application can be achieved with a simple nomogram or with some simple calculations.     

Worm control and anthelmintic resistance: adventures with a model

There are three common questions asked of parasitologists about anthelmintic resistance. Does it matter? How do you prevent it? Can you help me (it's here!)? In short, the respective answers are yes, read on the read on. Elizabeth Barnes, Robert Dobson and Ian Barger examine these issues in the context of nematode parasite control in grazing sheep. With the aid of a model, they examine some important factors that influence drug resistance and how farm management decisions and worm genetics modify these factors. They also explore the likely impact of new technologies on drug resistance and how efficient they need to be to sustain good worm control.     

Welcome by the Dean Henrik Jeppesen at the 8th International Symposium on Tardigrada

Mr. Chairman. Distinguished ladies and gentlemen. As Dean of Science it is a great honour on behalf of the University of Copenhagen and the Faculty of Science to welcome all of you here to the 8th International Symposium on Tardigrada. We are especially happy to have you here at the August Krogh Institute (named after our well-known Nobel Prize winner in Physiology), because on September 1st we celebrate the establishment of the Faculty. So coming here and honouring our 150 year anniversary jubilee help us to promote the importance of science in our society. The University was founded in 1479 as a theological catholic school. It broke down in 1530 and was reestablished in 1537 after the reformation. Right from the start in 1479 there was science thought of at the university. Mathematics and Astronomy. And Zoology became a subject over the centuries together with other subjects which are today regarded as science. But only in 1850 did we become an independent Faculty thanks to the effort and progress done by the Danish Chemist H.C. Ørsted.The animals, which you study, are marvellous in the sense that they can survive under severe conditions for centuries. Under extreme dry conditions in Sahara, in extreme cold conditions (they can survive minus 273 °C, or survive in vacuum). This has practical implications for people who need to excuse their scientific interest, for medicine if we can freeze human tissue, or for space study how to survive under extreme conditions. The study of Tardigrada is an important field here at the Institute of Zoology, at the Zoological Museum, and at the University of Roskilde, 30 km west of Copenhagen. Some of our most distinguished zoologists take part in this research. That might be the reason why you have chosen to have the symposium here in Copenhagen. They are doing research on tardigrades in marine areas, and in Greenland on the ice cap. Especially interesting are the studies done in the Ikka Fjord in Greenland, where the unique Ikkaite Tufa columns made of calcium carbonate hexahydrate originating from alkaline cold springs at the bottom of the fjord create very specific environments with nearly brackish conditions in the center and sea water salinity on the outside. And this creates varied conditions for different species of Tardigrada.We also celebrate this year the 50th anniversary of the 2. Galathea expedition which went round the world and specifically looked for deep sea fauna. There are Tardigrades here. It has been interesting to look through the 54 abstracts in the programme and read the names and work places for the 65 participants listed. In English tardigrades are called water bears, in Danish “bjørnedyr” meaning bear animals. I prefer the Danish version, this sounds more like pet bears.The symposium is followed by a field trip to the faculty's research station on Disko in Greenland. In 1994 I arrived on the new research vessel “Porsild” to Disko to deliver the new boat some of you will sail in during the workshop up there. I stayed there some days, and there was this man Professor Reinhardt Møbjerg Kristensen, looking into his microscope. It was fascinating to see the joy which he expressed explaining his animals. His engagement was so impressive and his talk so marvellous. It was really his pet animals he caressed all day and night. If all of you are looking on the water bears with the same fascination and engagement, then this will be one of the most entertaining symposiums ever held. One can fear that you are so engaged that you will forget everything around you, even to listen to the contributions of the others, and to be careful that maybe a new group will be announced.I wish you some very good days here at the Faculty of Science and some very fruitful days. I should like to thank the sponsors of the meeting, The Danish Science Foundation, The Carlsberg Foundation and Dr. Bøje Benzon Foundation. I would like to express my gratitude to the organizing committee for attracting the conference here and making the programme so wide and interesting. I can promise the committee will do all their best to help you all way through. And for those going to Disko — you will have a most splendid experience.I shall ask my colleagues at my own institute, Geography, to arrange some bad weather except on Thursday where you join the excursion. This to prevent you from sneaking away and enjoy the wonders of Copenhagen.By this once again welcome and a wish for a fruitfulconference.     

Welcome by the Dean Henrik Jeppesen at the 8th International Symposium on Tardigrada

Mr. Chairman. Distinguished ladies and gentlemen. As Dean of Science it is a great honour on behalf of the University of Copenhagen and the Faculty of Science to welcome all of you here to the 8th International Symposium on Tardigrada. We are especially happy to have you here at the August Krogh Institute (named after our well-known Nobel Prize winner in Physiology), because on September 1st we celebrate the establishment of the Faculty. So coming here and honouring our 150 year anniversary jubilee help us to promote the importance of science in our society. The University was founded in 1479 as a theological catholic school. It broke down in 1530 and was reestablished in 1537 after the reformation. Right from the start in 1479 there was science thought of at the university. Mathematics and Astronomy. And Zoology became a subject over the centuries together with other subjects which are today regarded as science. But only in 1850 did we become an independent Faculty thanks to the effort and progress done by the Danish Chemist H.C. Ørsted.The animals, which you study, are marvellous in the sense that they can survive under severe conditions for centuries. Under extreme dry conditions in Sahara, in extreme cold conditions (they can survive minus 273 °C, or survive in vacuum). This has practical implications for people who need to excuse their scientific interest, for medicine if we can freeze human tissue, or for space study how to survive under extreme conditions. The study of Tardigrada is an important field here at the Institute of Zoology, at the Zoological Museum, and at the University of Roskilde, 30 km west of Copenhagen. Some of our most distinguished zoologists take part in this research. That might be the reason why you have chosen to have the symposium here in Copenhagen. They are doing research on tardigrades in marine areas, and in Greenland on the ice cap. Especially interesting are the studies done in the Ikka Fjord in Greenland, where the unique Ikkaite Tufa columns made of calcium carbonate hexahydrate originating from alkaline cold springs at the bottom of the fjord create very specific environments with nearly brackish conditions in the center and sea water salinity on the outside. And this creates varied conditions for different species of Tardigrada.We also celebrate this year the 50th anniversary of the 2. Galathea expedition which went round the world and specifically looked for deep sea fauna. There are Tardigrades here. It has been interesting to look through the 54 abstracts in the programme and read the names and work places for the 65 participants listed. In English tardigrades are called water bears, in Danish “bjørnedyr” meaning bear animals. I prefer the Danish version, this sounds more like pet bears.The symposium is followed by a field trip to the faculty's research station on Disko in Greenland. In 1994 I arrived on the new research vessel “Porsild” to Disko to deliver the new boat some of you will sail in during the workshop up there. I stayed there some days, and there was this man Professor Reinhardt Møbjerg Kristensen, looking into his microscope. It was fascinating to see the joy which he expressed explaining his animals. His engagement was so impressive and his talk so marvellous. It was really his pet animals he caressed all day and night. If all of you are looking on the water bears with the same fascination and engagement, then this will be one of the most entertaining symposiums ever held. One can fear that you are so engaged that you will forget everything around you, even to listen to the contributions of the others, and to be careful that maybe a new group will be announced.I wish you some very good days here at the Faculty of Science and some very fruitful days. I should like to thank the sponsors of the meeting, The Danish Science Foundation, The Carlsberg Foundation and Dr. Bøje Benzon Foundation. I would like to express my gratitude to the organizing committee for attracting the conference here and making the programme so wide and interesting. I can promise the committee will do all their best to help you all way through. And for those going to Disko — you will have a most splendid experience.I shall ask my colleagues at my own institute, Geography, to arrange some bad weather except on Thursday where you join the excursion. This to prevent you from sneaking away and enjoy the wonders of Copenhagen.By this once again welcome and a wish for a fruitfulconference.     

Claude Bernard Distinguished Lecture. Becoming a truly helpful teacher: considerably more challenging, and potentially more fun, than merely doing business as usual

Few medical faculty members are adequately prepared for their instructional responsibilities. Our educational traditions were established before we had research-based understandings of the teaching-learning process and before brain research began informing our understandings of how humans achieve lasting learning. Yet, there are several advantages you may have. If your expertise is at one of the frontiers of human biology, your teaching can be inherently fascinating to aspiring health professionals. If your work has implications for human health, you have another potential basis for engaging future clinicians. And, thanks to Claude Bernard's influence, you likely are "process oriented," a necessary mindset for being an effective teacher. There are also challenges you may face. Your medical students will mostly become clinicians. Unless you can help them see connections between your offerings and their future work, you may not capture and sustain their interest. To be effective, teachers, like clinicians, need to be interactive, make on-the-spot decisions, and be "emotional literate." If you aren't comfortable with these demands, you may have work to do toward becoming a truly helpful teacher. Program changes may be needed. Might your program need to change 1) from being adversarial and controlling to being supportive and trust based or 2) from mainly dispensing information to mainly asking and inviting questions? In conclusion, making changes toward becoming a truly helpful teacher can bring benefits to your students while increasing your sense of satisfaction and fulfillment as a teacher. If you choose to change, be gentle with yourself, as you should be when expecting your students to make important changes.     

Finding autophagy

To tell the truth, I find it difficult to work when flying, or even when sitting in an airport for an extended period of time. So, typically I take along a book to read. And when I truly cannot concentrate, for example when a flight is considerably delayed, I have even been known to resort to word puzzles. Depending on the type, they do not require much attention (that is, you can pick up right where you left off after you glance at the flight status screen for the twentieth or so time, even though you know nothing has changed), or effort (although you need to use a pen or pencil, not a keyboard), but nonetheless they can keep your mind somewhat occupied. I even rationalize doing them based on the assumption that they are sharpening my observational/pattern-finding skills. One type of word puzzle that is particularly mindless, but for that very reason I still enjoy in the above circumstances, is a word search; you are given a grid with letters and/or numbers, and a list of “hidden” terms, and you circle them within the grid, crossing them off the list as you go along. I do admit that the categories of terms used in the typical word searches can become rather mundane (breeds of dog, types of food, words that are followed by “stone,” words associated with a famous movie star, words from a particular television show, etc.). Therefore, on one of my last seminar trips I decided to generate my own word search, using the category of autophagy.     

A patient's guide to choosing unconventional therapies

Unconventional therapies (UTs) are therapies not usually provided by Canadian physicians or other conventionally trained health care providers. Examples of common UTs available in Canada are herbal preparations, reflexology, acupuncture and traditional Chinese medicine. UTs may be used along with conventional therapies (complementary) or instead of conventional therapies (alternative). Surveys have shown that many Canadians use UTs, usually as complementary therapies, for a wide range of diseases and conditions. Reliable information about UTs is often difficult to find. Your doctor may be unable to give you specific advice or recommendations, since UTs are often not in a physician''s area of expertise. However, he or she will usually be able to provide some general advice and help supervise your progress. For your own health and safety, it is important to keep your doctor informed of the choices you make. This document is intended to (a) provide you with questions to consider when making your treatment choices, (b) help you find information about UTs, (c) help you decide whether a specific UT is right for you, and (d) provide tips to help you evaluate the information you find.     

Forbidden fruit

Although citrus fruits prevent and cure scurvy, they may not always be as good for you as you thought.     

Bioinformatics meets user-centred design: a perspective

Designers have a saying that "the joy of an early release lasts but a short time. The bitterness of an unusable system lasts for years." It is indeed disappointing to discover that your data resources are not being used to their full potential. Not only have you invested your time, effort, and research grant on the project, but you may face costly redesigns if you want to improve the system later. This scenario would be less likely if the product was designed to provide users with exactly what they need, so that it is fit for purpose before its launch. We work at EMBL-European Bioinformatics Institute (EMBL-EBI), and we consult extensively with life science researchers to find out what they need from biological data resources. We have found that although users believe that the bioinformatics community is providing accurate and valuable data, they often find the interfaces to these resources tricky to use and navigate. We believe that if you can find out what your users want even before you create the first mock-up of a system, the final product will provide a better user experience. This would encourage more people to use the resource and they would have greater access to the data, which could ultimately lead to more scientific discoveries. In this paper, we explore the need for a user-centred design (UCD) strategy when designing bioinformatics resources and illustrate this with examples from our work at EMBL-EBI. Our aim is to introduce the reader to how selected UCD techniques may be successfully applied to software design for bioinformatics.     

A Tale of Mother and Daughter

Loving science and nature and being a scientist can be very different, yet the two are so intertwined in a scientist''s life that you will certainly experience both aspects. This essay presents my perspective on how, as one who loves science and nature, I came to fall in love with centrosome behavior in stem cells and how I came to run a lab as a scientist. When I started, there was a big gap between my love for science and my experience as a scientist. I filled this gap by learning a “laid-back confidence.”Before the beauty of cell biology (or whatever you love), who you are (i.e., your age, gender, or race) is immaterial. Yet history shows that the ease with which you can pursue science is influenced by who you are. This has certainly been my experience. The key is to find a way to fill in the gap between who you are and what you are (i.e., a scientist), a goal in which we must all support each other. It is my hope that this essay will convey something helpful to those who are at early stages of their career and might be encountering obstacles because of who they are.     

Finding autophagy: It’s a question of how you look at it

To tell the truth, I find it difficult to work when flying, or even when sitting in an airport for an extended period of time. So, typically I take along a book to read. And when I truly cannot concentrate, for example when a flight is considerably delayed, I have even been known to resort to word puzzles. Depending on the type, they do not require much attention (that is, you can pick up right where you left off after you glance at the flight status screen for the twentieth or so time, even though you know nothing has changed), or effort (although you need to use a pen or pencil, not a keyboard), but nonetheless they can keep your mind somewhat occupied. I even rationalize doing them based on the assumption that they are sharpening my observational/pattern-finding skills. One type of word puzzle that is particularly mindless, but for that very reason I still enjoy in the above circumstances, is a word search; you are given a grid with letters and/or numbers, and a list of “hidden” terms, and you circle them within the grid, crossing them off the list as you go along. I do admit that the categories of terms used in the typical word searches can become rather mundane (breeds of dog, types of food, words that are followed by “stone,” words associated with a famous movie star, words from a particular television show, etc.). Therefore, on one of my last seminar trips I decided to generate my own word search, using the category of autophagy.     

Digging the rabbit hole,COVID-19 edition: anti-vaccine themes and the discourse around COVID-19

This article draws on a broadcast popular among the anti-vaccine community to map out six themes used by the broadcast to mislead viewers about COVID-19. The themes are the claim that “they” – government and pharma – are lying to you, claims that COVID-19 is an excuse to remove civil liberties, viewing everyone as an expert, claiming that science cannot save us, skewing the science, and a claim that “they” are out to harm the viewers. The article points out that similar themes are used to mislead followers with anti-vaccine information. It highlights the concern that these themes will not only mislead people who are already anti-vaccine about the pandemic, but may draw in people who are not anti-vaccine but are seeking information about COVID-19, and suggests some options for dealing with the misinformation. Scientists benefit from understanding these claims, as we are often tasked with providing rebuttals to this misinformation.     

Self‐ownership,relational dignity,and organ sales

Material property has traditionally been conceived of as separable from its owner and thus alienable in an exchange. So it seems that you could sell your watch or even your kidney because it can be removed from your wrist or abdomen and transferred to another. However, if we are each identical to a living human animal, self‐ownership is impossible for self‐separation is impossible. We thus cannot sell our parts if we don't own the whole that they compose. It would be incoherent to own all of your body's parts but not the whole body; and it would be arbitrary to own some but not all of your removable parts. These metaphysical obstacles to organ sales do not apply to the selling of the organs of the deceased. The human being goes out of existence at death and is not identical to the body's remains. Any objections to selling the organs of the deceased must instead be due to dignity rather than metaphysical or conceptual considerations. But the remains lack the intrinsic dignity of the human being, instead possessing, at best, relational dignity. Relational dignity would not provide sufficient reason to prohibit life‐saving sales.     

Erythrocyte exit: Out, damned merozoite! Out I say!

A new study has combined video microscopy with fluorescent labeling of host and parasite membranes to follow Plasmodium falciparum merozoites as they exit their host erythrocyte. The result has yielded some arresting images, which make compelling viewing irrespective of whether or not you have an interest in cell motility in general or P. falciparum erythrocyte exit in particular. Moreover, this work injects important new insights into the long-running debate about the biological mechanisms that underpin merozoite release.     

Advice to a young scientist (by someone who doesn’t know how to give it)

While trying to extract original and general advice from the details of my career, I realized this might not be possible. My path, like those of so many others, had too many idiosyncratic twists and turns that had to work out just the way they did to be mined for generally useful strategies. So I abandon the conceit of advice and simply give you my story. There are many like it, but this one is mine. Take what you wish from it.     

Preparation of dissociated mouse cortical neuron cultures

This video will guide you through the process for generating cortical neuronal cultures from late embryo and early postnatal mouse brain. These cultures can be used for a variety of applications including immunocytochemistry, biochemistry, electrophysiology, calcium and sodium imaging, protein and/or RNA isolation. These cultures also provide a platform to study the neuronal development of transgenic animals that carry a late embryonic or postnatal lethal gene mutation. The procedure is relatively straight forward, requires some experience in tissue culture technique and should not take longer than two to three hours if you are properly prepared. Careful separation of the cortical rind from the thalamo-cortical fiber tract will reduce the number of unwanted non-neuronal cells. To increase yields of neuronal cells triturate the pieces of the cortical tissue gently after the enzyme incubation step. This is imperative as it prevents unnecessary injury to cells and premature neuronal cell death. Since these cultures are maintained in the absence of glia feeder cells, they also offer an added advantage of growing cultures enriched in neurons.     

VEGAN,a package of R functions for community ecology

Abstract. VEGAN adds vegetation analysis functions to the general‐purpose statistical program R. Both R and VEGAN can be downloaded for free. VEGAN implements several ordination methods, including Canonical Correspondence Analysis and Non‐metric Multidimensional Scaling, vector fitting of environmental variables, randomization tests, and various other analyses of vegetation data. It can be used for large data. Graphical output can be customized using the R language's extensive graphics capabilities. VEGAN is appropriate for routine and research use, if you are willing to learn some R.