The A&P Professor: intro AP

Showing posts with label intro AP. Show all posts

Monday, October 31, 2016

Sex-Gender Differences in Medical Research

We are only very slowly recognizing the many biological and medical differences between males and females (and masculine/feminine)—besides the obvious ones related to reproduction. There are divergent patterns in the anatomy and physiology of perhaps every body system. However, in medical research male and female subjects are often grouped together in a way that obscures those divergent patterns.

Two "viewpoint" articles in the Journal of the American Medical Association (JAMA) today focus a light on this issue and point the way to improved—more clinically useful—medical research. Links to both articles are listed below.

As one of the articles points out, women have been included in medical trials for only the past few decades. So there is still a lot of work to be done to shore up the database of male-female differences. But also a lot of work to be done in sorting out male-female patterns of health and disease. Then even more work in making this new knowledge part of the everyday practice medicine.

Both articles are brief and relatively nontechnical, but when read together, they provide an important message for those of us teaching pre-clinical health professionals in A&P. That message is that we should consider introducing—then reinforcing—the notion of body-wide sex and gender differences.

Both articles give examples of such differences, but many more are to be found elsewhere, as well. Not that we should teach every possible example in the undergraduate A&P course. However, the general concept of functional variation between males and females may be an important one to emphasize as a sub-theme in our story of the human body.

What can we use from this in teaching undergraduate A&P?

Consider making sex differences a sub-theme in your A&P course.

Occasionally point out examples of structural, functional, and clinical patterns of variation that differ between males and females.

Compare and contrast sex differences with other types of pattern variations.
Discuss "patterns of variability" in contrast to a strictly "binary" view.

Consider bringing up sex-difference research that is not yet fully supported.

Discuss whether more attention to sex differences across topics in scientific research might help advance this area of knowledge.
Discuss the opposing view that there are no clinically significant biological differences between males and females other than those related to reproduction.

Look for such examples in your textbook and other teaching/learning resources and point them out to your students.
Consider having a classroom or online discussion of this topic.
Ask students to post links to articles that discuss male-female patterns of variation

Post to course discussion or course social media channel
Bring to class or email to instructor to share with class
Post on bulletin board

Bring up this issue when discussing how science is done.

Consider asking students what effects on public health a more thorough consideration of sex differences may produce.
Ask students to look at a study and ask whether sex differences were thoroughly accounted for in the methodology. Could this affect how the study is interpreted and applied in the clinic?

Want to know more?

Consideration of Sex Differences in Medicine to Improve Health Care and Patient Outcomes

Marianne J. Legato, MD; Paula A. Johnson, MD, MPH; JoAnn E. Manson, MD, DrPH.
JAMA. Published online October 31, 2016. doi:10.1001/jama.2016.13995
One of the two articles cited in the post above.
my-ap.us/2f1pwEv

Reporting Sex, Gender, or Both in Clinical Research?

Janine Austin Clayton, MD; Cara Tannenbaum, MD, MS
JAMA. Published online October 31, 2016. doi:10.1001/jama.2016.16405
One of the two articles cited in the post above.
my-ap.us/2f1jcwM

Let’s Talk About Sex…and Gender!

Amanda M. Rossi, PhD; Louise Pilote, MD, MPH, PhD
Circulation: Cardiovascular Quality and Outcomes. 2016; 9: S100-S101 doi: 10.1161/CIRCOUTCOMES.116.002660
Brief article that addresses the issue of terminology, specifically distinguishing between terms that address sex (male, female) and gender (masculine, feminine). Includes a solid list of references.
my-ap.us/2f1Y3Tr

Q-angle image: OpenStax College

Monday, September 8, 2014

Pre-A&P

A story broadcast recently on National Public Radio (NPR) highlighted the role of a Pre-A&P course in student success.

Listen to the story yourself (link below) and tell me you don't recognize the issues brought up there. Students failing A&P because they just don't know how to read a science textbook, don't know how to study, and don't have higher-order thinking skills.

You may recall my bringing up some of these issues in a recent blog post Help Your Students Get Off to a Good Start.

The story mentions a course to help students through these difficulties at West Kentucky Community and Technical College. But I know of a lot of colleges that are taking this approach to improving student success, including my own.

Some of you have already participated in one of my past seminars on how we did it. It involves a two-phase approach:

Pre-A&P Foundations in Science

An elective, developmental-level one-credit course.
Completely online, self-paced course.
Ten modules reviewing basic concepts needed for success in A&P:

Science Basics
Introductory Chemistry
Biological Chemistry
Introduction to Cells
Cell Transport
Getting Energy
Making Proteins
Introductory Genetics
Tissues
The Human Body

Each module is comprehensive, reviewing all prior modules.
Mastery-based: students proceed to the next module only if they pass the current module by 85% or better.
Passing the comprehensive final exam at mastery level earns a "Pass" grade.

A&P 1 Supplement

An elective, 200-level one-credit course.
Runs concurrently with A&P 1 lecture/lab sequence.
Addresses basic study skills, as applied to what students are studying in A&P
Specifically addresses "trouble spots" typically encountered
Provides coaching and support of students in real time

What can we use from this in teaching undergraduate A&P?

Look at what others have done and consider trying your own version of Pre-A&P and/or supplemental A&P study-skills courses!

If you are interested in our take on this, then listen to my seminar (link below). But I've helped several other colleges get their own version of this strategy off the ground, and it's working.

Want to know more?

The Toughest Class In Nursing School Is The First One

Zoe Chace. Planet Money (NPR). September 02, 2014
Radio story of one example of Pre-A&P helping students (and increasing A&P success rates).
my-ap.us/1AfRNXV

Helping Students Succeed: Using Supplemental Courses to Reinforce Concepts and Promote Learning Skills

Kevin Patton. The A&P Professor. Accessed 5 September 2014.
Narrated video seminar with handout outlining my two-phase approach to helping A&P students succeed.
my-ap.us/1rIhHCD

Pre-A&P Foundations in Science

Kevin Patton. Lion Den. Accessed 5 September 2014.
Peek at some course documents describing my course. Includes a brief video "rationale" for such a course (used to recruit students).
my-ap.us/1hZrKBm

A&P 1 Supplement

Kevin Patton. Lion Den. Accessed 5 September 2014.
Peek at some course documents describing my course.
my-ap.us/1rQkc8b

Survival Guide for Anatomy & Physiology

Kevin Patton. Lion Den. Accessed 5 September 2014.
In case you haven't seen it yet, this is a short description of my handy student-success handbook.
my-ap.us/16aa5zg

Thanks Maureen Loomer at Wayne Community College for passing along the NPR story!

Image: Otis Historical Archives of “National Museum of Health & Medicine” (OTIS Archive 1)

Monday, September 1, 2014

Help Your A&P Students Get Off to a Good Start

I recently posted an article in The A&P Student called Getting a Good Start in Your Anatomy & Physiology Course. In it, I run down a brief list of practical strategies students can employ from the start of their course to get a solid start in a rigorous course—a course that intimidates many beginners who are not fully prepared.

My suggested strategies are organized under three subheadings:

Learn to read and raid your textbook
Brush up on your study skills
Take A&P seriously

For each of these broad categories, I list several practical and proven tips for A&P students to get a handle on things early in the course. All have links to more detailed and specific advice from various resources.

What can we use from this in teaching undergraduate A&P?

Early in your course, mention the importance of getting off to a good start—not waiting until the first test looms to get organized and begin working.
Link to the article in your syllabus and/or your course web page or LMS course shell.

QR code for the Getting a Good Start article

Consider putting an unlabeled QR code (shown) in your syllabus or on your classroom wall. Many students will scan the code and find the article simply out of curiosity. Just like a snare trap!

Have a link to the article ready to give to students who contact you about being overwhelmed with the rigor of your course.
Consider suggesting to your students that they subscribe to The A&P Student newsletter (delivered by email, FB, LinkedIn or Twitter).

Consider subscribing yourself—a great way to keep up with various tips and strategies you can pass on to your students.

Even if your course has already started it's not too late to share these strategies with your students!

Want to know more?

Getting a Good Start in Your Anatomy & Physiology Course

Kevin Patton The A&P Student 26 August 2014
Outlines several practical strategies to begin the anatomy and/or physiology course on solid footing. Link to this article from your syllabus and/or course web page.
my-ap.us/1onII8I

Subscription for The A&P Student

Choice of FREE delivery by email, Facebook, Twitter, or LinkedIn
my-ap.us/1oxkJIM

A&P is the Foundation

Kevin Patton Lion Den Slide Collection
FREE animated PowerPoint slide you can use in your introductory course presentation. The link takes you to information on accessing the entire collection. Find this one in v2, Study Tips, AP-is-foundation
lionden.com/slides-form.htm

Free animated slide

Monday, August 11, 2014

Start A&P 1 with a Comprehensive Exam. Really.

A while back, I recommended starting the second semester of A&P 2 with an exam. In that article, I stated that it's a good opportunity to get everyone started on the right track—and on the same track—before jumping right back into it.

If you think about it, even the first semester of A&P is "jumping back into it." That is, if we assume that our students have had some learning in biology already. Don't we want them to already know at least a little bit about:

basic chemistry (like what an atom is)
cell biology (at least what a cell is and perhaps a few organelles)
scientific terminology (like what roots, prefixes, and suffixes are)
genetics (what a gene is, what DNA stands for, basic inheritance)
metric system (at least the basics)
main organs of the body (like what a muscle or stomach is)

Then why not start them off with an open-book online or take-home exam covering these topics? Or more topics? Or fewer?

By starting off with a low-pressure "open" exam, we accomplish several goals:

Students learn how we will be testing them.

They'll become comfortable with the formats we use for test items, how our LMS quizzes work, how to fill out an exam book (or scan sheet or test paper), our personal quirks in testing, the depth and breadth of our assessments, and more.

They review-refresh-solidify their prior learning.

The "review exam" is a learning experience in and of itself, making sure that students fill in any gaps that may have occurred since they last encountered these concepts—even if they finished their last bio course only a few weeks ago.

Solves the "we don't have a prerequisite for A&P" problem.

Well, it doesn't completely solve it. But it does put quite a dent in it.

Allows students to work at their own pace to catch up.

Some students will breeze through their review. Others will wonder how they missed (or forgot) all these concepts. Still others have challenges in learning, reading, remembering, using English, and more. This will help even out the playing field, at least at the start of the game.

You won't have to wonder what they've learned before reaching you.

The review will ensure that they know the concepts you want them to know before they begin. And which terminology you'll using.

Saves you time in your course.

By not having to stop and review basic concepts when your students stumble, you have more class time for learning activities.

Students will have less of that oppressive, overwhelming feeling of stress a few weeks into A&P.

Many students, especially returning learners, feel like they are drowning because of the pace and sheer volume of information in their A&P course. But a review exam can get a lot of that "you should already know this"— "I should perhaps, but I don't"—stress out of the way from the get-go.

Gives students confidence as they face their new challenges in your course.

This one cannot be overstated. Much of our success in learning comes from how confident we are in our preparedness and our abilities. A review exam can be a positive learning experience that establishes a good attitude for learning from the beginning. And it won't be false confidence—they really will know the foundational concepts they need for success in A&P!

Want to Know More?

Start A&P 2 with a Final Exam

Kevin Patton. The A&P Professor. 21 Jan 2013
My previous article on using the first exam in the second semester of A&P to review, refresh, and solidify concepts from A&P 1.
my-ap.us/1lKVnTh

Teaching as Testing

Kevin Patton. The Electronic Professor 27 Feb 2009
Article outlining my use of randomized online testing as a mechanism of needed practice. Includes links to a full video presentation.
my-ap.us/p3rM6B

Practice. Practice. Practice.

Kevin Patton. Lion Tamers Guide to Teaching 3 Dec 2010
Article on the role of practice in teaching and learning, using the analogy of taming lions.
my-ap.us/WjNHLn

Image credit: kelvinsong

Monday, July 28, 2014

Syllabus Resources for A&P

Fall is the traditional start of the academic year, so as we approach that mark it may be a good time to think about ways to tweak our course syllabus in ways that may promote student success. There are some "teaching moments" in a syllabus that we don't want to miss!

I have few suggestions for you to consider.

Chunking

Experts call it excessive cognitive load and I say it's just plain rude to put all your policies, procedures, advice, and explanations in one or two big lumps, then expect students to actually read it and be familiar with the contents.

Go ahead and get it all down there—then chunk it by dividing it up into short sections, each with a short, descriptive heading. Next, rearrange all your newly chunked sections into logical groupings with a short descriptive heading. Now students will more likely read through it all, comprehend it better, and be more likely to refer to the syllabus before emailing you with their questions that can easily be answered by the syllabus.

Deadlines

We often blame it on which generation's pesonality they are ruled by—X, Y, millenial, baby-boomer—but I think it's just human nature to miss deadlines when you are unaware of the effects of doing that.

A syllabus is a good place to establish deadlines in a course, of course, but it's also a great place to briefly explain why deadlines are important. You may want to get some ideas from this brief article—or simply link to the article from your syllabus:

my-ap.us/WIhjZz

Academic Integrity

The most effective deterrent against academic dishonesty—cheating—is to promote a culture of honesty in your course. The syllabus is a great way to get that on the right footing at the outset. Here's an example from one of my syllabi, in a chunked section titled Academic Integrity:

This course relies on the principle that all who participate will do so with the honesty befitting adult, professional studies. Without integrity of all students, the integrity of the course, this school, and your own credentials all suffer. This means that all students are expected to submit only their own work, whether for assignments, papers, online tests or quizzes, in-class tests or quizzes, or any other component of this course. Thus, students may not receive inappropriate help nor give inappropriate help to other students.

SCC academic integrity policies outlined in the Student Handbook and other documents stipulate a variety of possible outcomes of violation of principles of basic academic integrity.

In this course, receiving or giving inappropriate help in online tests, in-class exams, or assignments will ordinarily result in receiving "F" for the course. Inappropriate help may include having someone do all or part of the work for you, providing or receiving copies of current in-class exam items or answers to in-class exam items, and copying someone else's work and submitting it as your own.

Students who witness or have reason to suspect violations of academic integrity in this course and do not report it promptly, thus further enabling the dishonesty, will themselves also be subject to disciplinary action.

I strongly suggest that you read the brief article Why be honest?

Feel free to adapt this (perhaps shorten it a bit?) for your own syllabus. Or use this link— my-ap.us/zHHd7H —in your syllabus to simply send them directly to an article that explains it all.

Handcrafted Uniqueness

This is kind of silly—but that's the point. I always include something like this in each and every syllabus:

Minor imperfections further enhance the handcrafted uniqueness of this document.

It's a joke, right? Well, sort of. It's actually true, and so it is fair warning that there are bound to be mistakes in my syllabus. But it's also lighthearted enough to set the light, informal tone that improves student engagement and openness to a new instructor and a new course.

For more ideas like this, check out Professors are from Mars, Students are from Snickers: How to Write and Deliver Humor in the Classroom and in Professional Presentations by Ronald A. Berk (Stylus Publishing, 2003)

Terminology

Students in the anatomy and physiology course are likely to learn more new "foreign" words than they would in a beginning Spanish, French, or German course. So it's important to set that fact out there early, so that students can get a handle on that aspect of A&P from the get-go.

Besides a brief statement about the need to learn a new language in the syllabus, I've found it helpful to link to (or embed) these resources:

Terminology for A&P my-ap.us/1rny2u4
International Terminology for A&P my-ap.us/1k1oeHi
Flash Cards: Reducing Your Study Time my-ap.us/1mQnT5b
Terminology Resources for A&P @The A&P Student my-ap.us/fsboS2

Spelling is Important

Your peritoneum is not your perineum, right? And in a medical chart, that could get through all the checks and alerts even in today's "smart" electronic environment. I, for one, am not willing to put my life—or my perineum—in the hands of a medical spell-checker. So it's important that A&P students learn that an incorrectly spelled term term is an incorrect term.

I suggest spelling that out (pardon the pun) in the course syllabus. Because not all instructors "take off for spelling," it may unnecessarily shock your students when misspelled terms are not accepted at all in A&P. If they know ahead of time that correct spelling of scientific terms is part of the course, they'll be more accepting of the idea and—even better—prepared for it.

Consider adding a link to the article Is Spelling Important? to your syllabus:

my-ap.us/1usdhDk

Renting or Borrowing Books

You may have trouble buying this one, I realize, but I can't tell you how many of my former A&P students have sold back their A&P textbook, or returned their rented book, or lent it out on permanent loan to a friend or relative. And then regretted it. Why? Because they need it for their health professions courses—and even in their jobs. A good A&P textbook is not just a learning tool for use in the A&P course, it's a valuable addition to their own professional reference library.

I usually add a phrase like this to the list of required books and manuals for my courses:

Don't rent your A&P text book! Click here for the reasons.

And don't sell it back at the end of the course. Here's why.

Here are the URLs if you want to use a similar approach—and save some students a bit of heartache when they realize they've lost a valuable resource they'll need later:

Rental URL my-ap.us/1rJKmHg

Sell-back URL my-ap.us/mhYggB

You may not agree with this approach. Or perhaps your school rents or lends textbooks to all students and you can't officially go against that in your syllabus. But it's an idea worth considering if you have the latitude to advise your students in this manner—and the insight to see the value of such advice.

The A&P Student

Lastly, there are a lot of A&P-specific study tips, tools, and advice available FREE for your students at my blog for students called The A&P Student.

Use this URL to link to it from your syllabus or course site: theAPstudent.org
If your learning management system allows for an RSS feed in your course, why not add this one? my-ap.us/1otlNx2
If you want some FREE bookmarks for your students with the URL for the resource, click here.

Photo credit: Handcraft

Monday, August 19, 2013

Death spreads throughout body

C. elegans

In class discussions, we talk about what happens when the body dies. And it's always a bit tricky when the discussion gets around to the idea that not every cell dies simultaneously.

And of course, that can lead to a discussion of how tissue death occurs, even in the case of necrosis that occurs as a result of ischemia or other damage. There are certainly many mechanisms involved—quite a few of which have yet to be clarified.

Recently, researchers have brought a step closer by mapping out some of these mechanisms. In their report (cited below), they reveal that in the gut of the C. elegans worm, calcium ions flowing into cells cause the lysosomes to burst suddenly. And we know what that means! Intracellular destruction leading to cell death.

What causes the calcium ions to rush into the cells? Gap-junction ion-channel proteins called innexins (analogous to connexins in humans) open up and allow calcium ions to flow into one cell then the next, producing a wave of destruction along the gut.

In interesting phenomenon is that esters of anthranilic acid (formed from the amino acid tryptophan) in the lysosomes not only produce acidosis in the cytosol, they also fluoresce brightly with a bluish glow during this process of cell death.

The video below shows an amazing anterior-to-posterior wave of fluorescent blue in C. elegans worms as this "wave of death" travels along the gut wall.

Okay, now here's the kicker. By knocking out the innexin channels, the researchers were able to stop the wave of death! Whoa! A cure for . . . death?!

Not so fast. This worked in a WORM, which is not as complex as a vertebrate like the human. And it only worked in INJURED worms, not elderly worms dying of old age. So it won't stave off death entirely—or unusually prolong life—but it could lead to treatments for preventing or reducing necrosis that occurs as a result of ischemia and other injuries.

This information—and that dramatic video—could be an interesting addition to your class. It ties in why it's important to understand concepts such as:

ions
amino acids
ion flow into cells
gap-junction ion channels
lysosomes
cell death and organismal death
necrosis (and factors leading to necrosis)
use of animals in research
the intersection of basic science research and medical applications

Want to know more?

Anthranilate Fluorescence Marks a Calcium-Propagated Necrotic Wave That Promotes Organismal Death in C. elegans.

Coburn C, et al. PLoS Biology 11(7): e1001613. 2013. doi:10.1371/journal.pbio.1001613
The original research article. Includes FREE images and PowerPoint slides you can use in your course.
my-ap.us/19SRjOG

Glowing, Glowing, Gone: Cell Fluorescence Casts Light on How Death Spreads Throughout Body

By Christopher Crockett. Scientific American online 2 August 2013
Brief, less technical, article explaining that researchers have identified a key molecular pathway for animal death that may provide clues for better managing traumatic injury and disease in humans.
my-ap.us/13MxJjs

Monday, August 5, 2013

Spelling IS important

In A&P, correct spelling could be a life-or-death issue. Really.

The topic of correct spelling—and the consequences of incorrectly spelled terms—was brought to mind recently with the news story about a student on the TV game show Jeopardy! whose answer was disqualified because it was misspelled. A lot of folks were angry, as though the boy was cheated, but the producers calmly pointed out that it’s not an acceptable answer if it’s not spelled correctly. Like Scrabble or Words with Friends, Jeopardy! is a game with rules, after all.

But the A&P course is not “just a game.” It is the foundation for many health professions. Professions where misspellings can be the basis for life-threatening medical errors.

A few years ago, I called our attention to Doing our part to reduce medical errors by enforcing accuracy in our courses—including correct spelling of scientific and medical terms.

Here’s what I tell my own students:

“That's part of learning how to communicate accurately and professionally. For those of you going into patient care or managing patient records, accuracy can affect a person's life . . . so it's best to learn that lesson here and now—where no one's life is in danger.”

There really IS a difference between perineum and peritoneum. Just two letters, and the whole meaning of a sentence or paragraph—or medical record—is changed. It may still make sense, even in context, but is now wrong.

Some of my students counter that current software platforms used in hospitals and clinics have safety features that autocorrect or call attention to potential errors. That’s true—to some extent. But just like the autocorrect features found in word processing software, they cannot be relied upon entirely. We really must know which term is which by its correct spelling.

Now’s a good time to think about how we are preparing our students for their profession. I want my healthcare providers to get it right. So let’s make that happen!

Monday, December 31, 2012

Rita Levi-Montalcini, growth factor pioneer

Yesterday, the scientific community lost another of its great people, Rita Levi-Montalcini.

In The Human Body in Health & Disease and Structure & Function of the Body, I wrote this about Levi-Montalcini:

Rita Levi-Montalcini had just finished a medical degree in her native Italy when in 1938 the Fascist government under Mussolini barred all “non-Aryans” from working in academic and professional careers. Being Jewish, Levi-Montalcini was forced to move to Belgium to work. But when Belgium was about to be invaded by the Nazis, she decided to return home to Italy and work in secret. Her home laboratory was very crude, but in it she made some important discoveries about how the nervous system develops during embryonic development. After World War II, she was invited to Washington University in St. Louis to work. There, she discovered the existence of nerve growth factor (NGF), for which she later won the 1986 Nobel Prize. Her discovery of a chemical that regulates the growth of new nerves during early brain development has led to many different paths of investigation. For example, by learning more about growth regulators we now know more about how the nervous system develops, as well as other tissues, organs, and systems of the body.

Note that I put in a little plug for my hometown of St. Louis, where we continue to be proud of this remarkable woman and her pioneering work.

As I said in a recent post about the passing of transplant pioneer Joseph Murray, I think the occasional story of a pioneer in the history of human science adds a lot to the A&P course. Such stories give a human dimension to the pursuit of science and provide the context needed for students to understand how we know what we know. Levi-Montalcini's story gives us the further opportunities to weave into our courses the themes of global collaboration among the scientific community as the role of women in science.

Want to know more?

Nobel Scientist Rita Levi-Montalcini Dies in Rome

U.S. News & World Report online December 30, 2012
[Plain-English obituary]
http://my-ap.us/S1RKyW

Oldest Nobel winner Rita Levi-Montalcini dies at 103

Euronews at YouTube accessed 31 Dec 2012
[Very brief video announcing the death and her contributions.]
http://youtu.be/SXjt5GI5qEQ

Nobel Lecture by Rita Levi-Montalcini

Media Player at Nobelprize.org
[Full video (in English) of Nobel lecture by Rita Levi-Montalcini in which she fully credits "good luck"; 57 minutes]
http://my-ap.us/Vf6sPz

Rita Levi-Montalcini Interview

Adam Smith, Editor-in-Chief of Nobelprize.org.
Nobel Interview, November 2008
[Video interview with Rita Levi-Montalcini, who talks about her daily work, why she had to make a laboratory in her bedroom to conduct research during World War II (3:06), the benefits of working in isolation (5:03), her post-war move to the United States (6:25), her work with Stanley Cohen and the discovery of nerve growth factor (7:15), the roles of intuition and chance in biological research (15:14), her current research (16:58), her advice to young scientists (17:41), and why this period of her life has been the best so far (28:10).]
http://my-ap.us/Ug6gA5

The Nobel Prize in Physiology or Medicine 1986 Press Release

Nobelprize.org
[Detailed news release that includes some simple diagrams that help illustrate the concepts involved.]
http://my-ap.us/ZPyacv

In Praise of Imperfection: My Life and Work

Rita Levi-Montalcini
Sloan Foundation Science Series, October 1989
[Her autobiography]
http://amzn.to/Wgjk7b

Related textbook content

Anatomy & Physiology 8th ed. p. 409, 1111-1113, A&P Connect: The Nobel Legacy my-ap.us/QZTbK1

Essentials of Anatomy & Physiology p. 231-232, 241, 610-612 my-ap.us/SCfNlj

The Human Body in Health and Disease 5th ed. p. 236-237, 644-645, 658 my-ap.us/fNN00N

Structure & Function of the Body 14th ed. p. 168-169, 472-473 my-ap.us/X6QxqE

Photo: Presidenza della Repubblica Italiana

Monday, October 8, 2012

Reprogramming cells to be pluripotent

The Nobel Assembly at Karolinska Institutet has today decided to award

The Nobel Prize in Physiology or Medicine 2012
jointly to

John B. Gurdon and Shinya Yamanaka
for the discovery that mature cells can be reprogrammed to become pluripotent

Summary
The Nobel Prize recognizes two scientists who discovered that mature, specialised cells can be reprogrammed to become immature cells capable of developing into all tissues of the body. Their findings have revolutionised our understanding of how cells and organisms develop.

John B. Gurdon discovered in 1962 that the specialisation of cells is reversible. In a classic experiment, he replaced the immature cell nucleus in an egg cell of a frog with the nucleus from a mature intestinal cell. This modified egg cell developed into a normal tadpole. The DNA of the mature cell still had all the information needed to develop all cells in the frog.

Shinya Yamanaka discovered more than 40 years later, in 2006, how intact mature cells in mice could be reprogrammed to become immature stem cells. Surprisingly, by introducing only a few genes, he could reprogram mature cells to become pluripotent stem cells, i.e. immature cells that are able to develop into all types of cells in the body.

These groundbreaking discoveries have completely changed our view of the development and cellular specialisation. We now understand that the mature cell does not have to be confined forever to its specialised state. Textbooks have been rewritten and new research fields have been established. By reprogramming human cells, scientists have created new opportunities to study diseases and develop methods for diagnosis and therapy.

Life – a journey towards increasing specialisation

All of us developed from fertilized egg cells. During the first days after conception, the embryo consists of immature cells, each of which is capable of developing into all the cell types that form the adult organism. Such cells are called pluripotent stem cells. With further development of the embryo, these cells give rise to nerve cells, muscle cells, liver cells and all other cell types - each of them specialised to carry out a specific task in the adult body. This journey from immature to specialised cell was previously considered to be unidirectional. It was thought that the cell changes in such a way during maturation that it would no longer be possible for it to return to an immature, pluripotent stage.

Frogs jump backwards in development

John B. Gurdon challenged the dogma that the specialised cell is irreversibly committed to its fate. He hypothesised that its genome might still contain all the information needed to drive its development into all the different cell types of an organism. In 1962, he tested this hypothesis by replacing the cell nucleus of a frog's egg cell with a nucleus from a mature, specialised cell derived from the intestine of a tadpole. The egg developed into a fully functional, cloned tadpole and subsequent repeats of the experiment yielded adult frogs. The nucleus of the mature cell had not lost its capacity to drive development to a fully functional organism.

Gurdon's landmark discovery was initially met with scepticism but became accepted when it had been confirmed by other scientists. It initiated intense research and the technique was further developed, leading eventually to the cloning of mammals. Gurdon's research taught us that the nucleus of a mature, specialized cell can be returned to an immature, pluripotent state. But his experiment involved the removal of cell nuclei with pipettes followed by their introduction into other cells. Would it ever be possible to turn an intact cell back into a pluripotent stem cell?

A roundtrip journey – mature cells return to a stem cell state

Shinya Yamanaka was able to answer this question in a scientific breakthrough more than 40 years after Gurdon´s discovery. His research concerned embryonal stem cells, i.e. pluripotent stem cells that are isolated from the embryo and cultured in the laboratory. Such stem cells were initially isolated from mice by Martin Evans (Nobel Prize 2007) and Yamanaka tried to find the genes that kept them immature. When several of these genes had been identified, he tested whether any of them could reprogram mature cells to become pluripotent stem cells.

Yamanaka and his co-workers introduced these genes, in different combinations, into mature cells from connective tissue, fibroblasts, and examined the results under the microscope. They finally found a combination that worked, and the recipe was surprisingly simple. By introducing four genes together, they could reprogram their fibroblasts into immature stem cells!

The resulting induced pluripotent stem cells (iPS cells) could develop into mature cell types such as fibroblasts, nerve cells and gut cells. The discovery that intact, mature cells could be reprogrammed into pluripotent stem cells was published in 2006 and was immediately considered a major breakthrough.

From surprising discovery to medical use

The discoveries of Gurdon and Yamanaka have shown that specialised cells can turn back the developmental clock under certain circumstances. Although their genome undergoes modifications during development, these modifications are not irreversible. We have obtained a new view of the development of cells and organisms.

Research during recent years has shown that iPS cells can give rise to all the different cell types of the body. These discoveries have also provided new tools for scientists around the world and led to remarkable progress in many areas of medicine. iPS cells can also be prepared from human cells.

For instance, skin cells can be obtained from patients with various diseases, reprogrammed, and examined in the laboratory to determine how they differ from cells of healthy individuals. Such cells constitute invaluable tools for understanding disease mechanisms and so provide new opportunities to develop medical therapies.

Sir John B. Gurdon was born in 1933 in Dippenhall, UK. He received his Doctorate from the University of Oxford in 1960 and was a postdoctoral fellow at California Institute of Technology. He joined Cambridge University, UK, in 1972 and has served as Professor of Cell Biology and Master of Magdalene College. Gurdon is currently at the Gurdon Institute in Cambridge.

Shinya Yamanaka was born in Osaka, Japan in 1962. He obtained his MD in 1987 at Kobe University and trained as an orthopaedic surgeon before switching to basic research. Yamanaka received his PhD at Osaka City University in 1993, after which he worked at the Gladstone Institute in San Francisco and Nara Institute of Science and Technology in Japan. Yamanaka is currently Professor at Kyoto University and also affiliated with the Gladstone Institute.

Key publications:

Gurdon, J.B. (1962). The developmental capacity of nuclei taken from intestinal epithelium cells of feeding tadpoles. Journal of Embryology and Experimental Morphology 10:622-640.

Takahashi, K., Yamanaka, S. (2006). Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell 126:663-676.

Link to a FREE handout you can use in your A&P class: my-ap.us/UNtV9i

Want to know more? Try my-ap.us/TbNCWG

Adapted from my-ap.us/TlWoqC

Monday, April 25, 2011

Supplementary courses help A&P students succeed

A few years ago, we brainstormed about what else we could do as A&P professors to help our students succeed. We realized that the two most common things holding our students back from reaching their full potential were:

Lack of adequate preparation to begin A&P on a solid footing
Lack of basic learning and study skills

With the typical A&P course involving an unrelenting flood of facts, concepts, and applications, a lack of preparation and study skills can be catastrophic.

To address the lack of preparation, we have a prerequisite of "C or better in high school biology or its equivalent within the last five years." That's the best we could manage given the constraints of our institution and its programs. But even with the most stringent prerequisites, it's rare that students really walk into an A&P class ready with a comfortable foundation in biological chemistry and cell biology.

So I developed a refresher course that incoming A&P students could take just before entering their A&P 1 course. Foundations in Science for Health Careers is a developmental level, one-hour course that is offered in a completely online self-paced format. We offer it only during the short mini-mesters and half-semesters.

The Foundations course covers the basic chemistry and biology concepts students need as they begin A&P.

To address the lack of study skills, I developed a one-credit course for our A&P 1 students to take along with A&P 1. Having been given the idea of a supplemental course by my friend Mari Hopper at Southern Indiana University, we began offering A&P 1 Supplement at our institution.

This course parallels the A&P 1 course, giving students how-to tips on specific study skills useful in A&P. Students also have the opportunity to bring their sticking points to the class to get help in getting them unstuck.

The Foundations course is the refresher course and the Supplement course is the shortcut course.

Want to know more?

Check out my video . . .

Then check out the handout and helpful links at The A&P Professor website:

SEMINAR: Helping Students Succeed

Do these courses work? We're still working on the statistics, but as the above presentations tell you, student feedback from anonymous surveys show that students are happy with what they are getting from these courses. When we get some statistical analysis done, I'll let you know!

[NOTE: If your students would like to take our online pre-A&P refresher course (BIO 095 Foundations in Science for Health Careers) prior to taking your A&P course, they can enroll at St. Charles Community College during either of two 5-wk summer sessions or during either of two 1-wk pre-fall sessions . . . or beyond.]

Saturday, March 12, 2011

Friday, December 3, 2010

Father of Fractals

You may have already heard the recent news of the passing of Benoit Mandelbrot, originator of the iconic Mandelbrot Set (pictured) and founder of the field of fractal geometry. It brings to mind the deeper understanding of human structure and function that has resulted directly from applying principles of fractal geometry. An important set of principles that I believe we A&P professors could do a better job of helping our students appreciate.

Mandelbrot's pioneering efforts in understanding the roughness of nature led to the discovery of basic principles of fractal geometry. A key characteristic of fractal structures is self-similarity (the parts resemble the whole).

In human anatomy, this self-similar characteristic is observed in surfaces that have folds, which have bumps, which in turn have their own bumps, and so on . . . producing unexpectedly huge total surface areas. For example, think of the loops of the intestines, which in turn have circular folds of mucosa, which in turn have villi, which in turn have microvilli, which in turn have membranes embedded with bumpy molecules, and so on.

Fractal self-similarity can also be observed in branched structures, such as the respiratory tract and the cardiovascular vessels. These structures have branches that have branches that have branches, and so on for many levels . . . producing large numbers of pathways and huge surface areas.

A particularly interesting characteristic of such complex fractal structures is that they are produced with relatively simple mathematical formulae. Which means that very little genetic information is needed to produce highly complex structures like intestines, blood vessels, lymphatic vessels, bronchial trees, cerebral convolutions, etc.

Fractal structures are also chaotic, a mathematical concept of "constrained randomness." Put simply, chaotic structures have an element of randomness but within limits. So when our body applies fractal geometry during development we can be certain of a particular type of structure without being certain we'll know exactly where each individual bump or branch will lie. In other words, we can more or less be certain where the main arteries will be (with some individual variation) but not so much for the various arterioles and capillaries . . . at least not precisely.

Principles of chaos also play out in human physiology when we observe the aperiodic (nonrhythmic) patterns of heart rate, brain waves (as in an EEG), and certain other functions.

Mandelbrot opened up a whole new understanding of human structure and function that is only now becoming understood widely. I've been introducing the concept of chaos and fractals in my courses, and more subtly in some of my textbooks, for several years now. My experience is that introducing simplified principles of chaos and fractals at the beginning of A&P 1, then reinforcing them when encountered throughout both semesters of A&P, help student appreciate an intriguing and important concept of human structure and function. A concept that is increasingly playing a central role in science's understanding of human biology.

Want to know more?

Benoît Mandelbrot (1924–2010)
Ralph Gomory
Nature Volume: 468, Page 378, Date published: 18 November 2010, doi:10.1038/468378a, Published online: 17 November 2010
[A brief synopsis of Mandelbrot's life and contributions from the journal Nature]

Chaos in the Human Body (Mini Lesson)
Kevin Patton
Lion Den http://lionden.com/chaos.htm
[Brief outline that I use with my own students in A&P 1]

Applications of Fractals - Human Body
ThinkQuest
Oracle Education Foundation. online (accessed 2 Dec 2010)
[Brief student-produced outline of some fractal principles of the body]

Fractal Geometry in Biological Systems: An Analytical Approach
Philip M. Iannaccone, Mustafa Khokha
CRC Press 1996
[Book outlining the initial discoveries of fractals in humans.]

Chaos: Making a New Science
James Gleick
Penguin 2008
[Reprint of the classic bestseller book that outlines in simple terms the concepts of chaos and fractal geometry. Highly recommended. Includes some applications/examples in human biology.]

Monday, October 12, 2009

Virtual autopsies

Wow, this goes on my wish list for the holiday season. Take a look at the Virtual Autopsy system at visualiseringscenter.se

After scanning a body, users can manipulate the images on what my editor, Jeff Downing, calls "an iPhone on steroids." It's a big table-top, touch-screen monitor that shows high-resolution 3D images of the scanned body.

The creators tout their project as a potential solution to situations where traditional autopsies cannot be performed (for example, in areas where cultural taboos prohibit it). It can also be a complement to traditional autopsies because it can show things that may not be visible during the routine type of examination.

Besides the gee-whiz, ain't that cool factor you'll experience when you check it out, you may want to consider showing one of the FREE video clips to your students to show them what's happening out there on the cutting edge of anatomy applications. This might be a great bit to add to your "first lecture" dog-and-pony show to get your students engaged and excited about human A&P.

There are also some cool case study ideas included at the demo page.

If you get one of these things, let me know. I want to come and play with it!

Monday, July 6, 2009

Cardiac arrest teaching moment

Sadly, we have another teaching moment in the news: the "cardiac arrest" reported as a cause of death for music artist Michael Jackson.

Recently, I described how the unexpected death of Natasha Richardson from an epidural hematoma could be used as starting point for a discussion of the structure of the coverings of the brain and how things can go wrong.

Scientific American's blog 60-Second Science has a nice article that describes the different between a "heart attack" and "cardiac arrest," a distinction lost on most folks. But A&P students, especially those headed into health or athletic/fitness fields, should be aware of what these terms mean and how it illustrates the normal function of the heart in maintaining the blood flow needed for healthy survival.

I think the contents of the blog article, and its clarification of what is usually meant by the term "cardiac arrest," is a great starting point for possible discussions of:

Whether the terms "heart attack" and "cardiac arrest" are useful enough or precise enough for (a) public reporting and/or (b) medical reporting and recordkeeping.
How are these two situations similar? What do they have in common? Can one lead to the other?
What is "heart failure" and how does that relate to the above conditions?
What factors may lead to any of the above conditions?
What happens to blood flow when the heart beats too fast? too slow? too weakly?
What effects might the illicit/unsupervised use of drugs have on heart function?
Can the supervised use of drugs have harmful effects on heart function?
Can educated observers reading the public media really deduce what happened to Michael Jackson? What do we (think we) know, and is that enough to form a solid hypothesis? What information would we like to have to form a theory of the cause of death?
There are conflicting reports of the state of health of Michael Jackson immediately preceding his death . . . are any of them reliable as scientific evidence of cause of death?

As you can see, there are several different directions one could go in to use this tragic (but popular) news story to "bring home" various topics of A&P, the scientific method, and the role of science/medicine in society in your course. Perhaps you can share with us some other questions one could pose for a class discussion.

In any case, this story presents yet another opportunity to leverage the interests of students in a particular case to explore the concepts of an A&P course.

Michael Jackson and cardiac arrest
B. Borrell
Scientific American 26 June 2009
[60-Second Science blog article calling attention to the subject of "cardiac arrest"]

Heart Disease and Sudden Cardiac Death
WebMD accessed 6 July 2009
[Excellent article explaining cardiac arrest]

Here's a video with an M.D. explaining "cardiac arrest" relative to the Jackson case:
http://www.youtube.com/watch?v=WiyIczgw89Y

[The image that appears with this article is a FREE image depicting the international symbol for an AED (automatic external defibrillator]

Tuesday, June 30, 2009

Arab contributions to human biology

If you're a fan of history of the development of our understanding of human biology, then you may be interested in an essay I recently ran across in FASEB about the "golden age" of Arab science.

The 2006 article points out that developments in Islamic medicine in the span covering 750-1258 CE not only was remarkable in itself, but also laid the foundations for additional discoveries in Europe.

A few tidbits from the article:

Yuhanna ibn Massuwayh described allergy
Abu Bakr Muhummad ibn Zakariyya ar-Razi (Rhazes) distinguished smallpox from measles, described the laryngeal branch of the recurrent nerve, investigated psychosomatic reactions, and wrote the famous 30-volume medical encyclopedia Al-Hawi
Az-Zahrawi (Abulcasis) successfully carried out lithotomies and tracheotomies, described extrauterine ectopic pregnancy, cancer of the breast, and sex-linked inheritance of hemophilia
Ibn Sina (Avicenna) authored the al-Qanun fil Tibb (The Canon of Medicine) the authority in medicine for 5 centuries
Ibn-Nafis described pulmonary circulation

To read the essay . . .

Arab science in the golden age (750-1258 CE) and today
Falagas, et al.
The FASEB Journal 2006;20:1581-1586
[FREE full-text essay cited in this blog article]

Tuesday, May 19, 2009

What is life?

A video I saw on the web recently reminded me of the meaning of life. OK, that sounds a LOT more profound than I mean it to.

What I mean is . . . one of the most interesting questions in science
that I deal with is the most fundamental question, and one that comes right
at the beginning of my A&P course. The question is, what does it
mean for a human to be alive? What constitutes a living human organism?

Unbelievably, most courses set aside the core of that question and deal solely with the superficial aspects:

defining living processes such as regulation, respiration, digestion, reproduction, etc.
outlining the levels of organization with a human body: chemicals, cells, tissues, organs, systems
describing the homeostatic nature of healthy human function

OK, I know it's only an beginning undergraduate course. I know that this is science and not philosophy (although I'm not certain of the distinction, really). I know we don't have much time in the course. I know the students don't really care about that right now (and quite possibly, never).

What really got me thinking about how central this question is to understanding the human organism was the book What is Life? by Lynn Margulis. Lynn, you recall, was the agent behind the serial endosymbiosis theory (SET) . . . which got us all thinking about how we can imagine ourselves more as a cooperative symbiotic community of organelles and cells than a distinct and fully integrated unit.

If the mitochondria in my cells can be thought of as bacteria-like symbionts, then am I not a collection of organisms rather than one organism? Well, no. By definition, a useful definition, my mitochondria ARE me and not a separate species living in me.

But we now know that I cannot survive without the proper functioning of the flora living on my skin, in my gut . . . just about everywhere my body makes direct or indirect contact with the outside world. Are these creatures, which are by definition NOT me, really a part of the organism? I wonder if our definition might change someday soon.

What got me thinking about this recently was a web video from a recent TED Conference and features a talk by Bonnie Bassler in which she really hones in on our concept of human life and relates it to the ability of some bacteria to regulate each other in much the same way that our cells communicate with and regulate each other.

[If you don't see the video viewer in your newsletter or feed version of this article, please go to The A&P Professor blog site to view it. Want to learn how to embed YouTube videos in your blog, website, or PowerPoint? Check it out at The A&P Professor website.]

Considering our rapidly growing understanding of our body as a set of interrelated functioning units--perhaps even including the creatures that live on and in us--the day is upon us that we really need an understanding of what a single human organism truly is in a biological sense.

We really need such an understanding at a beginning, undergraduate level so that we can use it as a framework for building the kind of solid understanding that will inform our later studies . . . and our professional work as scientists and healers.

Tuesday, March 24, 2009

More on stem cell policy

Last week I discussed scientific controversies in the news. I forgot about this interview on Science Friday not long ago:

AAAS President Peter Agre: Science Friday host Ira Flatox talks with Peter Agre, a Nobel laureate and the incoming president of the American Association for the Advancement of Science, about the intersection of science and public policy.

The interview, which also features guest Evan Snyder (who directs a stem cell research program), was first broadcast Friday, March 13, 2009.

Adapted from the NPR website.

It's almost too late!

A while back I mentioned all the benefits of participating in HAPS Institute (HAPS-I), the Human Anatomy and Physiology Society's professional continuing education program for A&P professors that offers short, flexible graduate biology courses.

We have four courses that begin soon . . . April 15. These courses involve both online work and sessions at the upcoming 2009 Annual HAPS Conference in Baltimore MD at the end of May.

Two of those courses still have some room in them . . .

Advances in Anatomy & Physiology 2009 (2 graduate credits)

A great "first experience" in HAPS Institute
Begins online April 15, 2009
Learners engage the material presented in the conference Update Seminars more fully than just "walking in cold"
Learners have a chance to discuss the seminar presentations together to find those gems that we can "take back to our classroom."
Faculty: Ellen Arnestad and Kevin Patton

Advanced Respiratory Biology (2 graduate credits)

A reprise of last year's wildly popular course
Explore the "in and outs" of the respiratory system for a fully understanding
Begins online April 15, 2009
Features master teacher Mary Pat Wenderoth of University of Washington

The program also offers a completely online course . . . but there are only a couple of spots left!

Best Practices in Hybrid & Online Teaching of A&P (2 credits)

No conference attendance required
Begins online May 1, 2009
Taught by online A&P experts Tom Lancraft and Janice Yoder Smith
Great credential to have in your portfolio!

Want more information? Follow these links . . .

Here's the outside of the HAPS-I brochure

(use the frame buttons to ZOOM, then scroll or print)

Here's the inside of the HAPS-I brochure

(use the frame buttons to ZOOM, then scroll or print)

[The video players and other features may not be visible in a feed or newsletter item. Go to The A&P Professor blog to view these features.]