Competencies in premedical and medical education: the AAMC-HHMI report

One hundred years ago, Flexner emphasized the importance of science in medicine and medical education. Over the subsequent years, science education in the premedical and medical curricula has changed little, in spite of the vast changes in the biomedical sciences. The National Research Council, in their report Bio 2010, noted that the premedical curriculum caused many students to lose interest in medicine and in the biological sciences in general. Many medical students and physicians have come to view the premedical curriculum as of limited relevance to medicine and designed more as a screening mechanism for medical school admission. To address this, the Association of American Medical Colleges and the Howard Hughes Medical Institute formed a committee to evaluate the premedical and medical school science curricula. The committee made a number of recommendations that are summarized in this essay. Most important were that competencies replace course requirements and that the physical sciences and mathematics be better integrated with the biological sciences and medicine. The goal is that all physicians possess a strong scientific knowledge base and come to appreciate the importance of this to the practice of medicine. While science education needs to evolve, Flexner's vision is as relevant today as it was 100 years ago.     

Using "spinal shrinkage" as a trigger for motivating students to learn about obesity and adopt a healthy lifestyle

Obesity is a global problem; however, relatively little attention is directed toward preparing and inspiring students of medicine and allied medical sciences to address this serious matter. Students are not routinely exposed to the assessment methods for obesity, its overall prevalence, causative factors, short- and long-term consequences, and its management by lifestyle modification. This physiology laboratory exercise involving students of medicine (n = 106) was developed to 1) introduce medical students to methods of obesity assessment and to differentiate between general and abdominal obesity, 2) generate an interest and sensitivity about obesity, and 3) stimulate thinking about modification of their lifestyle in relation to eating habits, weight control, and physical activity. Spinal shrinkage (the difference between the standing height of a person and his/her recumbent length) was used as an immediate observable parameter to demonstrate the effect of adiposity. Spinal shrinkage is recognized as an index of the compressive forces acting on the spine and is related to body mass index. A positive correlation (r = 0.365, P < 0.05) was observed between body mass index and spinal shrinkage. A questionnaire was used to assess student responses to this exercise. Students were motivated to engage in more physical activity (74%), adopt healthier eating (63%), and enhance their knowledge about obesity (67%). They expressed keen interest in the laboratory exercise and found the sessions enjoyable (91%). The laboratory exercise proved to be a success in motivating the students to actively learn and inquire about obesity and to adopt a healthier lifestyle.     

Robert Chambers and Thomas Henry Huxley, Science Correspondents: The Popularization and Dissemination of Nineteenth Century Natural Science

Robert Chambers and Thomas Henry Huxley helped popularize science by writing for general interest publications when science was becoming increasingly professionalized. A non-professional, Chambers used his family-owned Chambers' Edinburgh Journal to report on scientific discoveries, giving his audience access to ideas that were only available to scientists who regularly attended professional meetings or read published transactions of such forums. He had no formal training in the sciences and little interest in advancing the professional status of scientists; his course of action was determined by his disability and interest in scientific phenomena. His skillful reporting enabled readers to learn how the ideas that flowed from scientific innovation affected their lives, and his series of article in the Journal presenting his rudimentary ideas on evolution, served as a prelude to his important popular work, Vestiges of the Natural History of Creation. Huxley, an example of the new professional class of scientists, defended science and evolution from attacks by religious spokesmen and other opponents of evolution, informing the British public about science through his lectures and articles in such publications as Nineteenth Century. He understood that by popularizing scientific information, he could effectively challenge the old Tory establishment -- with its orthodox religious and political views -- and promote the ideas of the new class of professional scientists. In attempting to transform British society, he frequently came in conflict with theologians and others on issues in which science and religion seemed to contradict each other but refused to discuss matters of science with non-professionals like Chambers, whose popular writing struck a more resonant chord with working class readers. This revised version was published online in July 2006 with corrections to the Cover Date.     

On the character of hygienic science

In its nature, ends and purposes, hygiene is a medical science. Consequently, it can be axiomatically accepted that the character of medicine is also the character of hygiene. Traditionally, medicine ranks among biological sciences. The author deliberates on the need to regard the current complex of medical sciences, hygiene included, as socio-biological sciences.     

Amylin decreases food intake in mice.

The isolation of amylin from pancreatic islets has stimulated interest in its potential role in the pathogenesis of type II diabetes mellitus and in its possible physiological roles. Amylin administered intraperitoneally decreased food intake in non-food-deprived and food-deprived diabetic and nondiabetic mice. Amylin also decreased feeding induced by insulin administration without significantly affecting blood glucose levels. Amylin also decreased food intake following intracerebroventricular administration. It is possible that amylin plays a physiological role in appetite regulation and may play a pathophysiological role in the altered appetites seen in some persons with type II diabetes mellitus.     

General principles regarding the use of adult stem cells

Abstract.  With only a few, almost inevitable exceptions, biomedical research has developed within the last 50 years under the tutelage of ethical standards of notable precision. In the vast world of scientific investigation, few disciplines can boast of having realized documents of such ethical rigour, and respect for the integrity and intrinsic value of the human person has been one of the cardinal principles of the researcher. Research is intrinsic to the medical profession; the reward of research is knowledge and its techniques are ordered towards maintenance of human health. Since this end concerns human beings, it demands an extremely rigorous ethical approach. Ethical aspects are present from the first moments of the experimental project and occur on three levels: choice of the objectives, selection and use of the appropriate means for the study, and application of resultant new discoveries. Today, our moral attention cannot be reduced to a cost–benefit analysis. Biomedical sciences and medicine have overlapping areas of interest that can be sources of tension: the good of the subject versus scientific utility; profit versus complexity of research; liberty versus ethical and juridical bonds; the public versus the private; and the individual versus the community. Here, I attempt to formulate some essential principles that should guarantee humane measures for research on humans.     

Laser-induced breakdown spectroscopy (LIBS): a novel technology for identifying microbes causing infectious diseases

With the advent of improved experimental techniques and enhanced precision, laser-induced breakdown spectroscopy (LIBS) offers a robust tool for probing the chemical constituents of samples of interest in biological sciences. As the interest continues to grow rapidly, the domain of study encompasses a variety of applications vis-à-vis biological species and microbes. LIBS is basically an atomic emission spectroscopy of plasma produced by the high-power pulsed laser which is tightly focused on the surface of any kinds of target materials in any phase. Due to its experimental simplicity, and versatility, LIBS has achieved its high degree of interest particularly in the fields of agricultural science, environmental science, medical science, forensic sciences, and biology. It has become a strong and sensitive elemental analysis tool as compared to the traditional gold standard techniques. As such, it offers a handy, rapid, and flexible elemental measurement of the sample compositions, together with the added benefits of less cumbersome sample preparation requirements. This technique has extensively been used to detect various microorganisms, extending the horizon from bacteria, molds, to yeasts, and spores on surfaces, while also being successful in sensing disease-causing viruses. LIBS-based probe has also enabled successful detection of bacteria in agriculture as well. In order for good quality processing of food, LIBS is also being used to detect and identify bacteria such as Salmonella enteric serovar typhimurium that causes food contamination. Differences in soil bacteria isolated from different mining sites are a very good indicator of relative environmental soil quality. In this connection, LIBS has effectively been employed to discriminate both the inter- and intra-site differences of the soil quality across varying mining sites. Therefore, this article summarizes the basic theory and use of LIBS for identifying microbes causing serious agricultural and environmental infectious diseases.     

Validating concepts of mental disorder: precedents from the history of science

A fundamental issue in any branch of the natural sciences is validating the basic concepts for use in that branch. In psychiatry, this issue has not yet been resolved, and indeed, the proper nature of the problem has scarcely been recognised. As a result, psychiatry (or at least those parts of the discipline which aspire to scientific status) still cannot claim to be a part of scientific medicine, or to be incorporated within the common language of the natural sciences. While this creates difficulties within the discipline, and its standing in relation to other branches of medicine, it makes it an exciting place for “frontiersmen” (and women). This is one of the key growing points in the natural science tradition. In this essay, which moves from the early history of that tradition to today’s debates in scientific psychiatry, I give my views about how these fundamental issues can move towards resolution.     

Worthy heir or treacherous patricide? Konrad Lorenz and Jakob v. Uexküll.

The biologist Jakob v. Uexküll is often seen as the preceptor of modern behavioral theory, who lastingly influenced Konrad Lorenz in particular. Nevertheless, Uexküll has been highly inadequately received by the school Lorenz founded. This neglect of Uexküll's works resulted because Lorenz and Uexküll came into contact at a time when the biological sciences were sundered by a deep ideological division. On the one side stood the Darwin-rejecting Neo-Vitalists (for example Uexküll), on the other side were the Neo-Darwinists (for example Lorenz). After Vitalism was overcome as a consequence of the Evolutionary Synthesis, Darwinists who had taken an intermittent interest in Vitalists and their theories could now only distance themselves completely from earlier ideas. This went not only for biologists and behavioral researchers, but also for medical scientists. The emancipation from the starting points of their own science was so complete that, even decades later, when the earlier debates about Mechanism and Vitalism were long since historically outdated, behavioral research never investigated its own history.     

Biology in the secondary science curriculum

The search for a model of balanced science has not so far been based on a detailed analysis of the nature and effects of the science curriculum. The present paper attempts to begin to fill the gap, from the perspective of biology, using data from the Assessment of Perform-ance Unit (APU). It is shown that, in England, the uptake of the subject as an option outstrips that of the other sciences, with pupils quoting its intrinsic interest as their motivation. Biology serves to attract to science pupils of all abilities and girls in particular. The other sciences are not so successful in this sphere. However, performance data show that the study of biology is not as effective in enhancing science performance as are the physical sciences.     

Physiology, biomedicine, medicine

The physiology throughout centuries was considered as the basic fundamental science in medicine. Rapid development of molecular biology, genetics and of some other natural sciences in 2nd half XX demanded century not only the answer to a question on the sciences defining the base of development of medicine, but also key problems of its progress. The biomedicine is formed, its methods are discussed, is frequent in system of natural sciences, parities with physiology. The special attention is given unconditional necessity of finding-out of molecular mechanisms of functions, targets of action of physiologically active substances and obligatory correlation of data of modeling with the same processes in conditions in vivo in whole body. The role of various sciences in the decision of fundamental problems of medicine, a place and role of physiology in modern medicine is shown.     

The need for standardization in wildlife science: home range estimators as an example

Individual studies in wildlife science are indicative rather than conclusive. Although multiple studies can be meta-analyzed in such a way that scientific hypotheses can be tested, robust meta-analyses are often difficult or impossible if variables of interest are not measured in a uniform manner. We hypothesized that measurements, even of basic and unequivocal variables, are rarely standardized in wildlife sciences. We tested this assumption by reviewing randomly selected papers that describe the home range of mammals (n?=?25) and birds (n?=?25). In these papers, home ranges were calculated using 11 methods and 8 computer programs. The number of radiolocations used to calculate home ranges varied from 9 to >2,000. By estimating home ranges for two radiotelemetry data sets, we demonstrate that home ranges are not comparable if different methods are used and that estimates of home range are not standardized. We assume that measurements of other biological variables are even less consistent across studies. In order to advance wildlife sciences, we believe that standardization initiatives are required at an international level.     

China's struggle for practical regulations in medical ethics

The introduction of ethical regulations in medicine in China might seem at odds with the country's social and moral reality. Chinese bioethicists find themselves torn between the necessity to re-create a fully-fledged modern health-care system and aspirations to become global players in the biomedical sciences. The result is a top-down approach in medical ethics, created on behalf of the people. Despite its introduction, there are concerns about whether China is prepared to embrace the standards it claims to have adopted.     

Misprescription and misuse of one‐tailed tests

One‐tailed statistical tests are often used in ecology, animal behaviour and in most other fields in the biological and social sciences. Here we review the frequency of their use in the 1989 and 2005 volumes of two journals (Animal Behaviour and Oecologia), their advantages and disadvantages, the extensive erroneous advice on them in both older and modern statistics texts and their utility in certain narrow areas of applied research. Of those articles with data sets susceptible to one‐tailed tests, at least 24% in Animal Behaviour and at least 13% in Oecologia used one‐tailed tests at least once. They were used 35% more frequently with nonparametric methods than with parametric ones and about twice as often in 1989 as in 2005. Debate in the psychological literature of the 1950s established the logical criterion that one‐tailed tests should be restricted to situations where there is interest only in results in one direction. ‘Interest’ should be defined; however, in terms of collective or societal interest and not by the individual investigator. By this ‘collective interest’ criterion, all uses of one‐tailed tests in the journals surveyed seem invalid. In his book Nonparametric Statistics, S. Siegel unrelentingly suggested the use of one‐tailed tests whenever the investigator predicts the direction of a result. That work has been a major proximate source of confusion on this issue, but so are most recent statistics textbooks. The utility of one‐tailed tests in research aimed at obtaining regulatory approval of new drugs and new pesticides is briefly described, to exemplify the narrow range of research situations where such tests can be appropriate. These situations are characterized by null hypotheses stating that the difference or effect size does not exceed, or is at least as great as, some ‘amount of practical interest’. One‐tailed tests rarely should be used for basic or applied research in ecology, animal behaviour or any other science.     

Ecology after 100 years: Progress and pseudo-progress

Has the science of ecology fulfilled the promises made by the originators of ecological science at the start of the last century? What should ecology achieve? Have good policies for environmental management flowed out of ecological science? These important questions are rarely discussed by ecologists working on detailed studies of individual systems. Until we decide what we wish to achieve as ecologists we cannot define progress toward those goals. Ecologists desire to achieve an understanding of how the natural world operates, how humans have modified the natural world, and how to alleviate problems arising from human actions. Ecologists have made impressive gains over the past century in achieving these goals, but this progress has been uneven. Some sub-disciplines of ecology are well developed empirically and theoretically, while others languish for reasons that are not always clear. Fundamental problems can be lost to view as ecologists fiddle with unimportant pseudo-problems. Bandwagons develop and disappear with limited success in addressing problems. The public demands progress from all the sciences, and as time moves along and problems get worse, more rapid progress is demanded. The result for ecology has too often been poor, short-term science and poor management decisions. But since the science is rarely repeated and the management results may be a generation or two down the line, it is difficult for the public or for scientists to decide how good or bad the scientific advice has been. In ecology over the past 100 years we have made solid achievements in behavioural ecology, population dynamics, and ecological methods, we have made some progress in understanding community and ecosystem dynamics, but we have made less useful progress in developing theoretical ecology, landscape ecology, and natural resource management. The key to increasing progress is to adopt a systems approach with explicit hypotheses, theoretical models, and field experiments on a scale defined by the problem. With continuous feedback between problems, possible solutions, relevant theory and experimental data we can achieve our scientific goals.     

The doctor and the "delta factor": Walker Percy and the dilemma of modern medicine

As medical science progresses, a tension has developed between the art of medicine, which deals with patients as individual persons, and the science itself, which focuses on the objective pathology.This tension is furthered as medicine identifies itself increasingly with science. To explore the consequences of this unbalanced identification, and the strain it places on the physician-patient relationship, this article examines the thought of Walker Percy, and in particular his novel The Second Coming. In this novel, Percy, a physician by training, presents a case of a patient suffering at the hands of medicine-turned-reductionist. The novel highlights the breakdown of communication between physician and patient within modern medicine, and raises important questions about how to best understand, and thereby preserve, medicine's true art.     

Regenerative pharmacology: the future is now

Regenerative medicine technologies cross the boundaries of numerous scientific fields, including cell and molecular biology, chemical and material sciences (i.e., nanotechnology), engineering, molecular genetics, physiology and pharmacology. As such, regenerative medicine truly represents an integrative and logical (r)evolution of medical science. This groundbreaking field of research has the potential to radically alter the treatment of diseases or disorders characterized by the lack of viable cells or tissues. The goal of this report is to review the current challenges and opportunities in the emerging field of regenerative medicine and to describe the role of the pharmacological sciences in the acceleration, optimization, and evaluation of engineered tissue function in the service of regenerative medicine technologies.     

The general practitioner as sports physician.

General practitioners must become more knowledgeable about sports medicine in order both to treat the injured athlete and to provide better rehabilitative treatment and advice on fitness and exercise to other patients. Close involvement with young amateur athletes also helps to keep the older physician "in tune" with the younger generation. Finances remain a major problem for amateur sporting events and sports medicine groups, as well as for the individual physician volunteering his time.     

Know thy mouse

In science it is imperative that the basic reagents and materials are defined and uniform. Unlike chemical reagents, which are uniform over time, mice, like all living creatures, have an intrinsic genetic drive to change, with mutations accumulating over time leading to increasing genetic variation and phenotypic change. Such changes compromise the reproducibility of experimental data over time and place. The use of the mouse has expanded rapidly in recent years and many scientists who have turned to the mouse as a research model might be unaware of the profound impact of changes in genetic background. Here we discuss the sources of genetic change and strategies to reduce them with the idea of strengthening international genetic standards for inbred mice.