Your Textbook is a Mitten, Not a Glove

How well does the textbook you use in your course fit?  What I mean by that is:

• Have you looked at whether the reading style is geared toward the students you typically encounter? Is the text written for beginners or experts?


• Have you compared your actual expectations (objectives & expected outcomes) to the content available in the textbook?


• Is the textbook organized in way that facilitates learning by both reading and raiding?

Of course, no textbook is going to fit you, your students, and your course like a glove.  Even if you create your own, or edit a custom version of existing text material, the fit will change as you and your course evolves as you gain teaching skills, adjust your techniques, and your students' needs change.

Textbooks fit like a mitten, not a glove. Because the best they can do is approximately fit course objectives and content, student learning needs, and your teaching approach.

But mittens are great.  They cover your hand and give you some wiggle room.

As a "mitten" your course textbook should cover what you need it to cover.  It's okay if it covers a bit more than you need.  That extra coverage will be used later for reference and future learning in professional and clinical courses.  Extra content also helps fill in prior learning gaps, which allows students to "get it" on their own as they read or raid.  And extra content may help students better see the context and importance of the required content.  Satisfying natural curiosity is not a bad thing, either.

Although well-fitting mittens cover a bit more than they need to, a mitten should not be too big.  So having so much content in a textbook that it's hard to stay focused mainly on the required content is not good for learning. Conversely, a mitten should not be so small that you can't get it around your big hand or wiggle your fingers a bit.

Some mittens have special features like a slit through which you can extend your fingers when you need more precise movements than your mitten will allow—as when opening your flask of hot tea.  If your students would benefit from a supplemental atlas, an audio glossary, a list of word parts for each term, or other special learning features of textbooks, then consider those carefully, too.

The key is to think of a textbook as an off-the-shelf item that will never fit precisely.  It's up to you to make sure it fits well enough.  And the only way to get that fit is to try on all the mittens.  Don't just glance at them, really put your hand in and see what they're like.

Plaid mittens are the best.  That has nothing to do with the analogy I'm making here—I just like plaid mittens.

Photo credits: Mélanie, Bin im Garten

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

Why bother with protein folding?

For those of you who use (or refer to) my textbooks, you may notice that I've been gradually adding more and more coverage of protein folding to most of them. My newest text (due out in March) adds a bit more to the story. Why bother?  Isn't that way more than beginning students need to know for an A&P course preparing students for health careers?

I submit that beginning A&P students should know a bit about protein folding.

Knowing the very basic principles of protein folding help students visualize the complex shape of proteins.  That, in turn, helps them understand that "it's all about shape" when trying to understand how proteins like enzymes, receptors, and most other proteins work—proteins that they'll encounter many times throughout their A&P course and beyond. 

Besides that, protein folding has become a key concept in understanding not only how the body functions, but how to intervene therapeutically in important diseases.  If a class of therapy based on protein folding is now being developed, a class of therapy that many of our students will likely encounter in their professions, don't we owe it to them to cover the basic ideas of protein folding? 

This latest idea was brought up at a recent meeting of the American Society of Cell Biology (ASCB).  You may want to read the article below, which briefly summarizes some current work being done in developing drugs that affect protein folding systems.  None of the specific  information in the article would be appropriate for A&P students to learn.  But reading it will give the A&P professor better insights about why the concept of protein folding is important for students to learn.  And it gives you a chance to say, "I was just reading about how scientists are now developing drugs based on protein folding . . . " to get their attention in class!

Want to know more?

Protein Folding and Disease: The Path from Bench to Bedside
V. Glaser
Genetic Engineering & Biotechnology News 15 Jan 2012. Vol. 32, No. 2
[Brief, illustrated article that clearly summarizes some recent work in applying principles of protein folding to drug therapies.]
my-ap.us/wFh6F2

Protein folding animation
[Interesting Quicktime animation that shows a protein folding]
my-ap.us/xzWnW4

GCSF Protein Folding Illustration Movie
[Another animation, a bit more complex than the previous one.  Clearly shows different types of models used in most A&P textbooks.]
my-ap.us/xpSisS


The Three-Dimensional Structure of Proteins
[Narrated animation showing four levels of protein structure, including visualization of protein folding.]
my-ap.us/yAS2fr

Free book on heart function!

Besides free advice, The A&P Professor is also a big fan of free resources and references.  And here's a set of free resources that will help give you a new perspective on cardiovascular function, particularly the factors that affect cardiac output.

I was recently contacted by Doug Anderson, a relative of the late cardiac surgeon, educator, and inventor Robert M. Anderson.  Doug told me about their family's efforts to make Dr. Anderson's contributions to understanding cardiovascular function widely available to the educational community.

Besides a FREE downloadable textbook outlining an approach to understanding cardiovascular function that is different than what you might be used to, there is also a FREE video that summarizes Anderson's concepts.

The video features Anderson himself walking the viewer through the operation of an elegant pump that he designed and built for teaching purposes. For a deeper understanding of the fluid dynamics behind cardiac function, you should consider watching the video.

By the way, this textbook has a  Creative Commons license that allows you to use all or part of it FREE in your course!

Anderson with his circulation model 

If you are looking for a FREE "medical school lesson" on the factors that influence blood flow, then check out these resources:

Want to know more?



Free textbook

Gross Physiology of the Cardiovascular System
Robert M. Anderson
PDF (printable) my-ap.us/zGtqOa 
Kindle and ePub formats coming soon!

Free video

The Determinants of Cardiac Output
University of Arizona Health Sciences Center with Robert M. Anderson et. al.
Video my-ap.us/xT5dx9
Illustrated transcript my-ap.us/ywWcgL

Free website

Gross Physiology of the Cardiovascular System
Includes additional resources
cardiac-output.info

Anderson's approach is a bit different than what many of us are used to.  Tell me what you think!

Dendritic cell pioneers win Nobel Prize

The Nobel Assembly at Karolinska Institutet has today decided that

The Nobel Prize in Physiology or Medicine 2011

shall be divided, with one half jointly to

Bruce A. Beutler and Jules A. Hoffmann

for their discoveries concerning the activation of innate immunity

and the other half to

Ralph M. Steinman

for his discovery of the dendritic cell and its role in adaptive immunity

 

Summary

This year's Nobel Laureates have revolutionized our understanding of the immune system by discovering key principles for its activation.
Scientists have long been searching for the gatekeepers of the immune response by which man and other animals defend themselves against attack by bacteria and other microorganisms. Bruce Beutler and Jules Hoffmann discovered receptor proteins that can recognize such microorganisms and activate innate immunity, the first step in the body's immune response. Ralph Steinman discovered the dendritic cells of the immune system and their unique capacity to activate and regulate adaptive immunity, the later stage of the immune response during which microorganisms are cleared from the body.
The discoveries of the three Nobel Laureates have revealed how the innate and adaptive phases of the immune response are activated and thereby provided novel insights into disease mechanisms. Their work has opened up new avenues for the development of prevention and therapy against infections, cancer, and inflammatory diseases.

Two lines of defense in the immune system

We live in a dangerous world. Pathogenic microorganisms (bacteria, virus, fungi, and parasites) threaten us continuously but we are equipped with powerful defense mechanisms (please see image below). The first line of defense, innate immunity, can destroy invading microorganisms and trigger inflammation that contributes to blocking their assault. If microorganisms break through this defense line, adaptive immunity is called into action. With its T and B cells, it produces antibodies and killer cells that destroy infected cells. After successfully combating the infectious assault, our adaptive immune system maintains an immunologic memory that allows a more rapid and powerful mobilization of defense forces next time the same microorganism attacks. These two defense lines of the immune system provide good protection against infections but they also pose a risk. If the activation threshold is too low, or if endogenous molecules can activate the system, inflammatory disease may follow.
The components of the immune system have been identified step by step during the 20^th century. Thanks to a series of discoveries awarded the Nobel Prize, we know, for instance, how antibodies are constructed and how T cells recognize foreign substances. However, until the work of Beutler, Hoffmann and Steinman, the mechanisms triggering the activation of innate immunity and mediating the communication between innate and adaptive immunity remained enigmatic.

Discovering the sensors of innate immunity

Jules Hoffmann made his pioneering discovery in 1996, when he and his co-workers investigated how fruit flies combat infections. They had access to flies with mutations in several different genes including Toll, a gene previously found to be involved in embryonal development by Christiane Nüsslein-Volhard (Nobel Prize 1995). When Hoffmann infected his fruit flies with bacteria or fungi, he discovered that Toll mutants died because they could not mount an effective defense. He was also able to conclude that the product of the Toll gene was involved in sensing pathogenic microorganisms and Toll activation was needed for successful defense against them.
Bruce Beutler was searching for a receptor that could bind the bacterial product, lipopolysaccharide (LPS), which can cause septic shock, a life threatening condition that involves overstimulation of the immune system. In 1998, Beutler and his colleagues discovered that mice resistant to LPS had a mutation in a gene that was quite similar to the Toll gene of the fruit fly. This Toll-like receptor (TLR) turned out to be the elusive LPS receptor. When it binds LPS, signals are activated that cause inflammation and, when LPS doses are excessive, septic shock. These findings showed that mammals and fruit flies use similar molecules to activate innate immunity when encountering pathogenic microorganisms. The sensors of innate immunity had finally been discovered.
The discoveries of Hoffmann and Beutler triggered an explosion of research in innate immunity. Around a dozen different TLRs have now been identified in humans and mice. Each one of them recognizes certain types of molecules common in microorganisms. Individuals with certain mutations in these receptors carry an increased risk of infections while other genetic variants of TLR are associated with an increased risk for chronic inflammatory diseases.

A new cell type that controls adaptive immunity

Ralph Steinman discovered, in 1973, a new cell type that he called the dendritic cell. He speculated that it could be important in the immune system and went on to test whether dendritic cells could activate T cells, a cell type that has a key role in adaptive immunity and develops an immunologic memory against many different substances. In cell culture experiments, he showed that the presence of dendritic cells resulted in vivid responses of T cells to such substances. These findings were initially met with skepticism but subsequent work by Steinman demonstrated that dendritic cells have a unique capacity to activate T cells.
Further studies by Steinman and other scientists went on to address the question of how the adaptive immune system decides whether or not it should be activated when encountering various substances. Signals arising from the innate immune response and sensed by dendritic cells were shown to control T cell activation. This makes it possible for the immune system to react towards pathogenic microorganisms while avoiding an attack on the body's own endogenous molecules.

From fundamental research to medical use

The discoveries that are awarded the 2011 Nobel Prize have provided novel insights into the activation and regulation of our immune system. They have made possible the development of new methods for preventing and treating disease, for instance with improved vaccines against infections and in attempts to stimulate the immune system to attack tumors. These discoveries also help us understand why the immune system can attack our own tissues, thus providing clues for novel treatment of inflammatory diseases.

 

Bruce A. Beutler was born in 1957 in Chicago, USA. He received his MD from the University of Chicago in 1981 and worked as a scientist at Rockefeller University in New York and the University of Texas in Dallas, where he discovered the LPS receptor. Since 2000 he has been professor of genetics and immunology at The Scripps Research Institute, La Jolla, USA.
Jules A. Hoffmann was born in Echternach, Luxembourg in 1941. He studied at the University of Strasbourg in France, where he obtained his PhD in 1969. After postdoctoral training at the University of Marburg, Germany, he returned to Strasbourg, where he headed a research laboratory from 1974 to 2009. He has also served as director of the Institute for Molecular Cell Biology in Strasbourg and during 2007-2008 as President of the French National Academy of Sciences.
Ralph M. Steinman was born in 1943 in Montreal, Canada, where he studied biology and chemistry at McGill University. After studying medicine at Harvard Medical School in Boston, MA, USA, he received his MD in 1968. He has been affiliated with Rockefeller University in New York since 1970, has been professor of immunology at this institution since 1988, and is also director of its Center for Immunology and Immune Diseases.

Key publications:

Poltorak A, He X, Smirnova I, Liu MY, Van Huffel C, Du X, Birdwell D, Alejos E, Silva M, Galanos C, Freudenberg M, Ricciardi-Castagnoli P, Layton B, Beutler B. Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: Mutations in Tlr4 gene. Science 1998;282:2085-2088.

Lemaitre B, Nicolas E, Michaut L, Reichhart JM, Hoffmann JA. The dorsoventral regulatory gene cassette spätzle/Toll/cactus controls the potent antifungal response in drosophila adults. Cell 1996;86:973-983.

Steinman RM, Cohn ZA. Identification of a novel cell type in peripheral lymphoid organs of mice. J Exp Med 1973;137:1142-1162.

Steinman RM, Witmer MD. Lymphoid dendritic cells are potent stimulators of the primary mixed leukocyte reaction in mice. Proc Natl Acad Sci USA 1978;75:5132-5136.

Schuler G, Steinman RM. Murine epidermal Langerhans cells mature into potent immunostimulatory dendritic cells in vitro. J Exp Med 1985;161:526-546.

High resolution image (pdf 3,6 Mb) 

The Nobel Assembly, consisting of 50 professors at Karolinska Institutet, awards the Nobel Prize in Physiology or Medicine. Its Nobel Committee evaluates the nominations. Since 1901 the Nobel Prize has been awarded to scientists who have made the most important discoveries for the benefit of mankind.

Nobel Prize® is the registered trademark of the Nobel Foundation 

The information above is taken directly from 

The 2011 Nobel Prize in Physiology or Medicine - Press Release
Nobelprize.org. 3 Oct 2011 my-ap.us/pE7zzC

Want to know more?

Immune Responses

[An animated activity from the Nobel Prize folks.] 

my-ap.us/o9s6Zt 

Find a brief explanation of dendritic cells in these textbooks:

• Anatomy & Physiology (Chapter 21) Patton & Thibodeau
• Essentials of Anatomy and Physiology (Chapter 19) Patton, Thibodeau, & Douglas

Find FREE images and videos you can use in your course

Dendritic cells
http://my-ap.us/pkQycM

Watch a brief video on dendritic cells.

Looking for a new one-semester A&P textbook?

I'm excited about the recent publication of my latest textbook for A&P students!  Essentials of Anatomy & Physiology is designed for use in one-semester A&P courses. 

Coauthors Gary Thibodeau and Matt Douglas worked closely with me and a very talented team of creative editors and scientific illustrators to produce a textbook that students will love to use.

What?  A text book that students will actually use?!  How can that be?

Let me summarize just two of the many reasons:

• This book is the most visually oriented textbook in its niche.
  
• There are more illustrations than in most other one-semester books, providing students with additional visual help in mastering concepts.
  
  
• Each illustration is carefully designed for maximum learning effectiveness.
  
  
• Most figures include a detailed "walk through" that explains the meaning of image, rather than merely providing a perfunctory title.
  
  
• It includes the Clear View of the Human Body, a bound-in set of transparency overlays that provide a virtual dissection experience for readers as they peel away (or add) layers of the body from either an anterior view or a posterior view.  This experience allows readers to develop a sense of anatomical relationships among body structures.
  
  
• Numerous summary  tables act as graphic organizers to help students see relationships among concepts.
  
  
• We worked hard to get the images and tables close to related text.  This kind of visual integration not as easy at is sounds, requiring several passes at the layout to "get it right" and creatively fit everything together.
  
  
• This text is carefully constructed to be easy to read and easy to raid.  Polls conducted with my students show that most students who use a textbook use some combination of reading chapter sections straight through and simply raiding parts of chapter sections when they need to find something.
  
  
• Even strong readers have some difficulty reading highly technical scientific texts.  We use straightforward, conversational language to communicate difficult terminology and difficult concepts.
  
  
• This text breaks the material down into smaller chapters so that readers do not get overwhelmed and get so discouraged they won't read the book.
  
   
• Our page design uses many levels of bold headings to help students understand the organization of concepts as they read and to find specific concepts when they raid.
  
  
• I worked with reading specialists and ESL teachers to find ways to make the book more accessible to all readers.  For example:
  
  
• We include a significantly larger glossary than most texts in this market. 
  
  
• In-chapter pronunciation guides for all boldface terms used in each chapter.help students master the language of A&P.
  
  
• We provide the meanings of word parts for all boldface terms so that students can start building their skills in understanding scientific terminology
  
  
• A comprehensive outline summary at the end of each chapter visually organizes concepts so that readers can solidify their comprehension of the chapter.
  
  
•  Downloadable audio chapter summaries (included in the included online resources) can be used along with the printed chapter summaries to strengthen understanding even more.

And that's just a small sample of the many unique features of our new Essentials of Anatomy & Physiology. You really do need to see it for yourself!


Want to know more?

If you go to the electronic brochure, you can view a sample chapter, get a list of available ancillaries, learn about the complete online course available with the textbook,  and request a FREE examination copy.

Click the link:  http://my-ap.us/gcH7Jr

What do tuft cells do?

We've known for a half-century that the lining of the small intestine has a scattering of weird little cells called tuft cells.  They are called that because they have distinctive tufts of microvilli facing into the intestinal lumen.  But what do they do?  We're finally getting to the answer!

A recent article in Journal of Cell Biology outlines confirms some recent discoveries about tuft cell function and extends our knowledge a bit further.

Apparently, tuft cells are secretory cells that produce opioids in the gut.  They are also the only epithelial cells that produce the COX (cyclooxygenase) enzymes needed to produce prostaglandins involved in inflammation and tumor formation.

Some physiologists had previously proposed a sensory role for tuft cells.  Could they be involved in tasting foods in the gut and be part of the signaling mechanism that regulates exocrine and endocrine secretion that controls digestive and metabolic processes?

As we learn more about tuft cells, we are sure to discover a role for them in normal regulation of intestinal function as well as in important pathological processes. 

Want to know more?

A fifth amendment to the intestine's constitution
Ben ShortJournal of Cell Biology 2011 192:706. Published March 7, 2011, doi:10.1083/jcb.1925iti2
[Brief synopsis of the discovery and its importance]
http://my-ap.us/ezeS9J

Distinct ATOH1 and Neurog3 requirements define tuft cells as a new secretory cell type in the intestinal epithelium.
Gerbe, F., et al.
Journal of Cell Biology 2011 Mar 7;192(5):767-80. doi:10.1083/jcb.201010127.
[Original research article.  Includes many illustrations, supplements, helps and cross references. FREE full text]
my-ap.us/eCNITF

Here's a really nice teaching image from the Gerbe et al. article, which complements Figure 25-18 in the Anatomy & Physiology 7/E textbook:  my-ap.us/hmdFub (includes downloadable PowerPoint slide)

Here are all the PowerPoints available with the Gerbe et al. article: my-ap.us/gKY7ZG

Chemosensory Perception in the Gut 
Hofer, D., et al.
Physiology February 1999 vol. 14 no. 1 18-23  
[Article proposing sensory function of tuft cells; FREE access to full text/PDF; nice images]
http://my-ap.us/g2HCxw

 

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.]

Nobel Prize: Test Tube Babies

This morning, we heard the news . . . the 2010 Nobel Prize in Medicine or Physiology is awarded to Robert G. Edwards "for the development of in vitro fertilization."


Professors and students using my Anatomy & Physiology (7th ed.) textbook can access an article on in vitro fertilization (IVF) at A&P Connect online at evolve.elsevier.com

If you are thinking of mentioning this award in your classes this week, which I am planning to do myself, you are welcome to use the following information from the Nobel Committee, as well as the images linked to the thumbnails presented here (scroll down to the bottom for more).

Of course, be aware that the use of IVF is condemned by some religious groups (for example, see Dignitas Personae) and thus classroom discussions may become heated.

There is also advanced information available at the Nobel website.  This is a nice publication that summarizes the science.

If you want a short set of slides that you can use today in your class, then use this link:

theAPprofessor.org/slides/2010-Nobel-IVF.pptx

 

Summary

Robert Edwards is awarded the 2010 Nobel Prize for the development of human in vitro fertilization (IVF) therapy. His achievements have made it possible to treat infertility, a medical condition afflicting a large proportion of humanity including more than 10% of all couples worldwide.

As early as the 1950s, Edwards had the vision that IVF could be useful as a treatment for infertility. He worked systematically to realize his goal, discovered important principles for human fertilization, and succeeded in accomplishing fertilization of human egg cells in test tubes (or more precisely, cell culture dishes). His efforts were finally crowned by success on 25 July, 1978, when the world's first "test tube baby" was born. During the following years, Edwards and his co-workers refined IVF technology and shared it with colleagues around the world.

Approximately four million individuals have so far been born following IVF. Many of them are now adult and some have already become parents. A new field of medicine has emerged, with Robert Edwards leading the process all the way from the fundamental discoveries to the current, successful IVF therapy. His contributions represent a milestone in the development of modern medicine.

Infertility – a medical and psychological problem

More than 10% of all couples worldwide are infertile. For many of them, this is a great disappointment and for some causes lifelong psychological trauma. Medicine has had limited opportunities to help these individuals in the past. Today, the situation is entirely different. In vitro fertilization (IVF) is an established therapy when sperm and egg cannot meet inside the body.

Basic research bears fruit

The British scientist Robert Edwards began his fundamental research on the biology of fertilization in the 1950s. He soon realized that fertilization outside the body could represent a possible treatment of infertility. Other scientists had shown that egg cells from rabbits could be fertilized in test tubes when sperm was added, giving rise to offspring. Edwards decided to investigate if similar methods could be used to fertilize human egg cells.
It turned out that human eggs have an entirely different life cycle than those of rabbits.  In a series of experimental studies conducted together with several different co-workers, Edwards made a number of fundamental discoveries. He clarified how human eggs mature, how different hormones regulate their maturation, and at which time point the eggs are susceptible to the fertilizing sperm. He also determined the conditions under which sperm is activated and has the capacity to fertilize the egg. In 1969, his efforts met with success when, for the first time, a human egg was fertilized in a test tube.
In spite of this success, a major problem remained. The fertilized egg did not develop beyond a single cell division. Edwards suspected that eggs that had matured in the ovaries before they were removed for IVF would function better, and looked for possible ways to obtain such eggs in a safe way.

From experiment to clinical medicine

Edwards contacted the gynecologist Patrick Steptoe. He became the clinician who, together with Edwards, developed IVF from experiment to practical medicine. Steptoe was one of the pioneers in laparoscopy, a technique that was new and controversial at the time. It allows inspection of the ovaries through an optical instrument. Steptoe used the laparoscope to remove eggs from the ovaries and Edwards put the eggs in cell culture and added sperm. The fertilized egg cells now divided several times and formed early embryos, 8 cells in size (see figure).
These early studies were promising but the Medical Research Council decided not to fund a continuation of the project. However, a private donation allowed the work to continue. The research also became the topic of a lively ethical debate that was initiated by Edwards himself. Several religious leaders, ethicists, and scientists demanded that the project be stopped, while others gave it their support.

The birth of Louise Brown - an historic event

Edwards and Steptoe could continue their research thanks to the new donation. By analyzing the patients' hormone levels, they could determine the best time point for fertilization and maximize the chances for success. In 1978, Lesley and John Brown came to the clinic after nine years of failed attempts to have a child. IVF treatment was carried out, and when the fertilized egg had developed into an embryo with 8 cells, it was returned to Mrs. Brown. A healthy baby, Louise Brown, was born through Caesarian section after a full-term pregnancy, on 25 July, 1978. IVF had moved from vision to reality and a new era in medicine had begun.

IVF is refined and spreads around the world

Edwards and Steptoe established the Bourn Hall Clinic in Cambridge, the world's first centre for IVF therapy. Steptoe was its medical director until his death in 1988, and Edwards was its head of research until his retirement. Gynecologists and cell biologists from all around the world trained at Bourn Hall, where the methods of IVF were continuously refined. By 1986, 1,000 children had already been born following IVF at Bourn Hall, representing approximately half of all children born after IVF in the world at that time.

Today, IVF is an established therapy throughout the world. It has undergone several important improvements. For example, single sperm can be microinjected directly into the egg cell in the culture dish. This method has improved the treatment of male infertility by IVF. Furthermore, mature eggs suitable for IVF can be identified by ultrasound and removed with a fine syringe rather than through the laparoscope.
IVF is a safe and effective therapy. 20-30% of fertilized eggs lead to the birth of a child. Complications include premature births but are very rare, particularly when one egg only is inserted into the mother. Long-term follow-up studies have shown that IVF children are as healthy as other children.
Approximately four million individuals have been born thanks to IVF. Louise Brown and several other IVF children have given birth to children themselves; this is probably the best evidence for the safety and success of IVF therapy. Today, Robert Edwards' vision is a reality and brings joy to infertile people all over the world.

Robert G. Edwards was born in 1925 in Manchester, England. After military service in the Second World War, he studied biology at the University of Wales in Bangor and at Edinburgh University in Scotland, where he received his PhD in 1955 with a Thesis on embryonal development in mice. He became a staff scientist at the National Institute for Medical Research in London in 1958 and initiated his research on the human fertilization process. From 1963, Edwards worked in Cambridge, first at its university and later at Bourn Hall Clinic, the world's first IVF centre, which he founded together with Patrick Steptoe. Edwards was its research director for many years and he was also the editor of several leading scientific journals in the area of fertilization. Robert Edwards is currently professor emeritus at the University of Cambridge.

References:

Edwards RG. Maturation in vitro of human ovarian oocytes. Lancet 1965; 2:926-929.

Edwards RG, Bavister BD, Steptoe PC. Early stages of fertilization in vitro of human oocytes matured in vitro. Nature 1969; 221:632-635.

Edwards RG, Steptoe PC, Purdy JM. Fertilization and cleavage in vitro of human oocytes matured in vivo. Nature 1970; 227:1307-1309.

Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet 1978; 2:366.

Edwards RG. The bumpy road to human in vitro fertilization. Nature Med 2001; 7:1091-4.

The preceding information is from "The 2010 Nobel Prize in Physiology or Medicine - Press Release". Nobelprize.org. 4 Oct 2010 http://nobelprize.org/nobel_prizes/medicine/laureates/2010/press.html


Some images you may find useful (click each thumbnail)

Sperm injection into oocyte

Human embryos developing in vitro

Robert G. Edwards

PDF from the Nobel website

Nobel medal

Looking at cilia

 

In a recent article in The Scientist, Peter Satir points out that the cilium was the very first distinct organelle ever directly observed by scientists--van Leeuwenhoek noted their existence in the 1660s.  But we are only now starting to fully understand these amazing and vital structures.

Until only the last decade or so, we thought that cilia were organs of cell motility--period.  But as I've noted in recent editions of my textbooks (e.g. Anatomy & Physiology, p.82-83), we now know that cilia play a critical role in a cell's ability to sense its surroundings.

Not only is this sensory function useful for, well, er, mediating senses such as hearing and equilibrium, it's also critical for cells to figure where to go (and when) during embryonic development.  In fact, it's been shown that situs inversus (the condition in which internal organs are flipped in their left-right orientation) is caused by a mutation affecting the structure of the primary cilium of developing cells in the embryo.

Cilia, it turns out, are centrally involved in a lot of different cell functions.

If you want a quick and interesting review of the history of cilia from one of the pioneers in cilia research, including answers to "why do we have to learn this stuff if I'm going to be a [insert health profession here]?," then check out this article:

Eyelashes Up Close
Peter Satir
The Scientist Volume 24 | Issue 7 | Page 30 2010-07-01
[Brief, well-illustrated review of what we know about cilia so far.  Includes great graphics and useful references.]

For more FREE images of cilia you can use in your course, see The A&P Professor website's FREE Image Library of Cell Structures.
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Encouraging students to start their library

Today, I posted an entry at The A&P Student blog encouraging students to begin a personal library of professional books.  I encouraged them to start with their A&P textbook.

Many students sell their textbooks back to the bookstore as a regular thing . . . without stopping to realize that SOME textbooks should be going into their individual professional library.

 

A professional library is the set of references that a student can begin to build NOW and continually add to throughout their professional career. Such individual libraries serve as indispensable tools to help professionals survive and excel in a health-related career.

For health professionals, the A&P textbook will be needed for  upcoming health professions courses and clinicals/practicums. It will also serve well later, when students finally begin their careers.

You may want to post one or more of these links to share with your students:

Selling your textbook?

[Recent blog post from The A&P Student]

Do NOT sell your textbook!

[Blog post from The A&P Student from May 2009]

Your Professional Library

[Brief article from my Lion Den collection of Study Tips and Tools]

FREE respiratory images

You already know that I'm slowly adding to the Free Image Library at The A&P Professor website.  I've recently added a few images related to the Respiratory System to the collection.

All the images are either copyright-free or provide a free license to re-use them with permission.  So you can use them to . . .

• Add them to your PowerPoint slides.
  
  
• Use them in handouts or outlines.
  
  
• Use them in tests or worksheets. Many of them have numbered and/or unlabeled versions that make this easy for you.
  
  
• Provide them to students to use for their reports, projects, or concept maps.
  
  
• Use them as icons for your website or learning management system.
  
  
• Illustrate case studies with medical images or clinical procedures.
  
  
• Use pathology images to hammer home concepts of normal anatomy and physiology.
  
  
• Make your own anatomy T-shirts using iron-on transfer paper to print the images.
  
  
• Receive inspiration to become a scientific illustrator.  (Then call me, I can use your help!)

Why not just use the images provided by the publisher of your textbook?

• No textbook contains all the variations of how to draw a structure or concept.  Use alternate images to help drive home a particular point.
  
  
• Students aren't really learning their anatomy and physiology if they memorize a particular diagram.  Using alternate diagrams on worksheets and tests pushes them to learn where things really are in the body. . . not where they happen to be labeled in the book.
  
  
• Textbooks must conserve space to remain a practical tool.  There are many images that would be great to show students . . . such as medical images, portraits of A&P heroes or sources of eponyms, or amazing micrographs . . . that are simply not appropriate for a beginning-level textbook.
  

This image of an iron lung is not appropriate for a textbook, perhaps, but it might help you explain the concept of how pressure affects the mechanics of breathing.

Please send me your ideas for images that you need (maybe I can find them for you).

I'll be updating you when I add more topics to the Free Image Library.

If you have any suggestions for additional subjects for images, let me know and I'll try to find them for you.

Lipid rafts

Having lived most of my life near the river banks at the confluence of the Mississippi and Missouri Rivers, I guess I have a special place in my heart for rafts. A few years ago, when scientists discovered organized domains within cell membranes and named them rafts, I guess it all felt pretty obvious to me . . . and comfortable.

I was thinking about rafts today when I received this month's issue of  The Scientist, which features a cover story on the evolution of the lipid raft concept.

My Life on a Raft
Kai Simmons
The Scientist Volume 24 Issue 2  Page 24 February 2010
[Brief article by a pioneer in the discovery and study of lipid rafts]

In my textbook Anatomy & Physiology I define a membrane raft as . . .

"a structure made up of groupings of molecules (cholesterol, certain phospholipids, proteins) within a cell membrane that travel together on the surface of the cell, something like a log raft on a lake; also called lipid raft"

 When I first added the concept of lipid rafts to our introductory chapter on cellular structure a number of years ago, some of my colleagues were a bit put off by this addition.  Some reviewers suggested that I drop it because it wasn't, well, standard in the texts with which they were familiar.

First, I think that when we form our own cohesive idea of what a cell is, it's hard to break that apart easily to accommodate changes and (especially) radical new concepts.  It's even harder to imagine that any new concepts of cell structure and function have any place in an introductory conversation about cells. 

Second, it isn't always immediately clear that a beginning student is really going to encounter significant applications of such a new concept in their studies . . . or in their practice.

With lipid rafts, the concept was used several times in other parts of the book to understand such central ideas as endocytosis.  As a science, we continue to learn about significant medical application opportunities, such as a possible effective therapy for HIV infection and other viral conditions (for example, see New non-drug fix for HIV).

Similarly, come colleagues question my textbook's coverage of the cytoskeleton and motor molecules, when this dynamic system seems to play a basic, central (and increasingly well understood) role in many mechanisms typically covered in a beginning A&P course . . . not to mention applications in clinical science.

So updating a textbook can be quite challenging when it comes to deciding how to handle new ideas that come along. 

When, if ever, is a new biological concept ready to be put into an introductory textbook?  If one puts it in early, then some users are alienated by the unfamiliar.  Some may even be suspect of something different than the orthodox and time-tested A&P curriculum. If one waits until everyone has already become familiar with the new idea, then isn't it a bit late to be first introducing into a textbook?

For me, the central question is, "Do textbook authors have any responsibility to introduce new concepts into the curriculum?"   I think the answer is yes.  Of course, curriculum issues are guided by more than just textbook content.  Many agents interacting on many levels help guide the evolution of curriculum in anatomy and physiology (and any other discipline).  I think textbook authors are in an unusual . . . and sometimes scary . . . position of offering some of the latest ideas available.

Of course, introducing additional concepts has to be balanced with the concern that too much information, no matter how up-to-date or relevant, may make it hard for the beginning learner to establish a meaningful foundation upon which to build later, fuller understanding of human structure and function.  Another difficult and scary task, then, is to determine what is essential at the beginning level and what can be held off for a later time when the additional information will be more easily incorporated into a student's understanding.


I'd love to hear your comments!   What is the role of the textbook author when in comes to incorporating new or changed concepts in the A&P curriculum?  How can one determine which concepts are better left for later learning?

NOTE: Get some FREE images of lipid rafts to use for your class at The A&P Professor FREE Image Library.

A light touch

There's a recent piece in Science News about the sensation of light touch in the skin. It includes some nifty sound files that allow a person to hear the signals for light touch sent by tactile disc complex of the skin.

As you may recall from my textbook Anatomy & Physiology, the sensory structure for light touch is comprised of two pieces: a tactile epithelial cell and a (tactile disc) sensory nerve ending. The former is often also called a Merkel cell and the latter a Merkel disc. These two pieces working together can be called a epithelial tactile complex or a Merkel disc complex.

The Merkel name comes from the German anatomist Friedrich Merkel, who in 1872 was the first to describe what we now know as Merkel cells. But these days, the international list of anatomical terms (Terminologia histologica) avoids the eponym and instead uses descriptive names.

The Science News article summarizes some recent research that helps to further clarify the mechanisms of how the sensory complex for light touch actually works. Specifically, it outlines how the tactile epithelial cells release glutamate, a neurotransmitter, that may communicate with the sensory neuron to send the signals needes to transmit the sensation of light touch.

The article further describes some gene-knockout experiments that help to prove that light touch cannot be perceived without the tactile epithelial cells to work along with the sensory neurons.

As the article points out, there is still much to learn about the mechanisms of light touch and the specific and detailed roles of the cells involved in sensation.

Want to know more? Check these out:

A Role for Merkels
Tina Hesman Saey
Science News, published online 18 June 2009
[Article summarizing recent research into the role of tactile epithelial cells.]

To listen to samples of tactile epithelial (Merkel) cells and the signals they generate, please click here.

Merkel Cells Are Essential for Light-Touch Responses
Stephen M. Maricich et al.
Science 19 June 2009:Vol. 324. no. 5934, pp. 1580 - 1582
DOI: 10.1126/science.1172890
[The original research report; also includes a link to a podcast.]

There's a great FREE animation of the light touch mechanism at YouTube but the narration is in German. In an English-only classroom, using the video with the narration muted might work well. Click here for the video.

If you missed my recent article Fingerprint functions about the role of epidermal ridges in sensation (lamellar corpuscle function) click here to read it.

If you're like me and a fan of A&P history or eponyms, or both, then click on the portrait of Merkel (click here if you can't see it in your news feed) for a FREE image you can use in your classroom presentation or course website.

My textbook Anatomy & Physiology includes nice diagrams of the light touch structures in Chapters 6 and 15 (the digital file is in the FREE Instructor's Resource CD).

Getting a Clear View

If you are using any of my textbooks in your A&P course, you have probably already seen the nifty Clear View of the Human Body . . . a set of opaque and transparent overlays that allow you to peel away layers of the body in a sort of virtual dissection.

I recently posted this tip to my blog for students The A&P Student . . .

DO NOT FORGET that the CLEAR VIEW is there!

A lot of students look at it when they first get the book and are thumbing through the pages marveling at all the interesting artwork and photos (and trying to size up how interesting or difficult the course may be). But as they get involved in the learning process, many students forget that the Clear View is there . . . and miss out on using this valuable tool.

Why use the Clear View? It's a great way for students to develop their concept of the spatial relationships of the body . . . that is, how all the organs "fit together."

To see my tip for students go to Using the Clear View of the Human Body.

To provide a link to my YouTube video that walks through the Clear View use this URL:

http://www.youtube.com/watch?v=h-MRH9r73I8

Preview it here yourself first:


[The video player embedded here may not appear in your news feed or emailed newsletter. Go to The A&P Professor blog to access the video viewer. Go to The A&P Professor website to learn how to embed the video in your PowerPoint or webpage . . . or simply link to it from your own email or webpage.]

Photo by mnadi at flickr.com

It's here!

The new seventh edition of my textbook Anatomy & Physiology is hot off the presses!

I'm really exciting about this edition . . . for a number of reasons.

For example:

• It features a new type of creative paging that puts all the illustrations and tables near the portions of the text that refer to them . . . or at least as close as is possible.
  
  
• The art program has been completely revised. The art is more attractive, easier to use, and more useful for learning.
  
  
• It features many new features, such as chapter summary podcasts, online A&P Connect articles related to text content, and more.
  
  
• This narrative text has been revised to improve reading efficiency for all readers . . . expert readers as well as those who struggle with reading.

And that's just the tip of the iceberg!

Want to learn more? I'll be sharing more over the next few weeks in The A&P Professor blog. In the mean time, check out the online brochure and talk to your Elsevier/Mosby sales rep!