The Crisis: an open letter to fellow scientists

by Arthur P. Ruiz, Ph.D.

 

“These are the times that try men’s souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but he that stands by it now, deserves the love and thanks of man and woman. Tyranny, like hell, is not easily conquered; yet we have this consolation with us, that the harder the conflict, the more glorious the triumph. What we obtain too cheap, we esteem too lightly: it is dearness only that gives everything its value.”

The Crisis, Thomas Paine, 1776

 

Trump’s election has unleashed a catastrophe in the adjoining arenas of American politics, society, science and culture, the true repercussions of which will not truly be known for years or decades to come. Whatever the legitimate problems with vested interests and professional sycophants in the halls of government, the elevation of the utter embodiment of the worst elements in human nature – avarice, hubris, deception, fraud, abusiveness, vanity – to the highest office should shame the ethical sensibilities of every citizen in this country. Ignoring any worthy debates about ideas or policies or the legislative directions that mark every election, Trump has loudly and enthusiastically announced an unprecedented attack on the fundamental democratic institutions of our country – governmental checks and balances, transparency, accountability, rule of law, a free and critical press, and, most importantly, the very existence of facts themselves. Trumpism is an assault on the foundations of empirical Western thought that originated with Aristotle and were refined during the Enlightenment, the Scientific Revolution, and the Age of Reason –reality, however imperfectly, can be captured, assessed and described by human faculties. Logic, rationality and experimental testing can allow us to determine degrees of confidence in ideas. While we are all entitled to our own opinions, we all share a basic set of facts. As practitioners and defenders of science, the emergence of this toxic new paradigm, where up is down, oppression is compassion, arrogance is humility, incompetence is capacity, scapegoating is accountability and hatred of others is love of country, should shake us to our very cores.

Our Duty to Patients or Our Duty to Society?

How a Patient-Centered Model Can Reconcile the Two

by Ramy Sedhom MD and Daniel Sedhom MD

Healthcare in the United States is expensive, with one of the highest rates of per capita spending worldwide, and the cost continues to increase every year. There is a continuing national dialogue regarding fiscal responsibility, efficient spending, and ethical debates about resource allocation. Medical providers are asked to examine their own personal practice patterns and contributions to the overall burden of health care costs. As physicians, we find ethically worrisome the pressure to make some of these decisions at the bedside in an ad hoc manner, especially when cost concerns seem to deprioritize our duties to our patients. Shared decision making, with the patient selecting the health outcome of highest priority to them, is an important guideline and should be considered in future payment models.

Stress and Step 1: One Medical Student’s Perspective

http://www.health.harvard.edu/heart-health/7-ways-to-keep-stress-and-blood-pressure-down

by Sukhjot Sandher

During the basic science instruction of our first and second years of medical school, we are rigorously tested on whether we are prepared to complete our third and fourth year clinical rotations. The USMLE Step 1 examination, taken by most medical students at the end of their second year, is one of the most significant assessment metrics. Your “Step 1” results largely determine your options in both the residency program and specialty choices. The performance pressures surrounding the Step 1 lead many students to undertake a grueling study regime filled with sleepless nights to cram in every last bit of knowledge. However, this may actually end up doing more harm than good. Research has shown that intense amounts of stress may be counterproductive in learning and academic performance, suggesting that an essential part of performing well is to develop a healthy mindset leading up to the test.

Real Time Science

by Arthur Ruiz

pngimg.com/download/6628

One of the most important aspects of being a successful scientist is the ability to effectively communicate one’s work to peers and the lay public. Research papers typically take a structured narrative form, similar to the “keyhole” model most of us learned in high school writing classes: start with a broad description of the state of a field and its outstanding issues, narrow it down to one’s own research topic, describe the experiments and results, and then broaden back out to how one’s results add to the field and advance the boundaries of future research. Within this framework, scientists carefully craft a structured flow of experiments, where one finding leads to a logical next step, and eventually a story of discovery and insight unfolds. Fitting certain findings into a narrative can have important consequences on the overall impact of the report and its reception by the field, and researchers can spend months or years building up a critical mass of data that eventually gets molded into a satisfying scientific story.

However, recent work coming out of the University of Wisconsin-Madison is challenging this way of doing things. The Zika experimental science team (ZEST), led by David O’Connor, is studying the progression of Zika infection in macaque monkeys. The goal is to examine the proposed link between Zika infection and microencephalitic birth defects, but as an emerging disease, relatively little is known about Zika’s life cycle, pathogenesis and interaction with the host immune system. Establishing a similar viral infectivity pattern between humans and macaques could allow further work in determining how the virus is able to infect a fetus and interfere with normal brain development. But rather than waiting to complete the course of the experiments, compiling the data and looking for significant results, then finally rolling everything into a paper, the group can publish their raw data as daily updates to a publically accessible website. Anyone with a web browser can follow updates of viral load levels in the saliva, urine and blood of these monkeys. And, importantly, scientists planning their own work involving Zika virus can access critical information about the progression of infection which could help them to design more effective experiments.

Pass the cheese, please.

by Anne Kessler

source: etsy.com

True to my roots, I am a cheese enthusiast. Born and raised in Wisconsin, the leader in US cheese production (sorry not sorry California), I grew up thinking that eating cheese and only cheese in a room full of people donning green and gold jerseys and bright yellow ‘cheeseheads’ was just another Packer Sunday. True to what our license plates say – America’s Dairyland – Wisconsin produces over 25% of all our nation’s cheese each year. Quantitatively speaking, this means that in one state alone in a single calendar year, over one million cows from more than 10,000 dairy farms produce nearly three billion pounds of cheese.

Despite declining milk consumption in America (all varieties, including cream and ice cream products), dairy utilization has continued to rise nationwide – largely due to a steady increase in cheese consumption over the last 40 years. Currently, US cheese consumption is roughly 34 lbs per capita with data trends predicting a rise to nearly 40 lbs per capita by the early 2020s. Just last year, researchers from the University of Michigan published a cross-sectional study that provides some insight into why – other than the obvious ‘it’s delicious’ – the average American consumes such a large quantity of cheese per annum: Cheese may be an ‘addictive’ food.

Marathon Running: The macroevolution and continued adaptation of a ‘uniquely human trait’

by Anne Kessler

source: spiritedthoughts.wordpress.com/2011/06/23/nature-can-take-care-of-itself/

According to the fossil record, endurance running capabilities first evolved roughly two million years ago, approximately four million years after the initial evolution of bipedal walking – a divergent moment in evolutionary history leading up to the human species. Fast forward to present time. In America alone, over 500,000 people complete at least one marathon in a given year. Because many people run races of distances that exceed 26.2 miles (ultra-marathon) and many runners never register for official races, the actual number of endurance runners in America likely exceeds one million people. Despite the fact that the majority of human beings find endurance running an abnormal and entirely painful behavior, it has only continued to rise in popularity across people of all ages and abilities since the initial “running boom” of the 1970’s.

So, why do so many people participate in endurance/marathon running?  Perhaps one reason is because we are the only species that can.

My Daughter the Doctor

by Walter G. Wasser, MD

The world of medicine has now been open to women for decades. As parents, especially those in the medical field, recognize their daughters’ interests in medicine, they should encourage and support them as they pursue the long and difficult path toward their careers. Since the long years of medical school and clinical training typically coincide with a woman’s reproductive years, it is critical to foster a supportive environment where women can fulfill their academic aspirations without having to sacrifice the desire to start a family.

Here is the story of our daughter, Laurie. I hope that it can serve as an example of what a young woman can accomplish if nurtured and encouraged to achieve both goals – family and medicine – simultaneously.

What’s in a p-value: science or magic?

by Anne Kessler

http://www.r-bloggers.com

Upon completing my first year of graduate coursework, I found myself where no student wants to be – in a summer class. Per the stipulations of my training grant, I was enrolled in the Clinical Research Training Program’s summer intensive with a single goal in mind (pass) and very little appreciation for all that I would learn in the subsequent three months.

On the first day of introductory biostatistics, Einstein’s own Dr. Hillel Cohen discussed the use, misuse, and abuse of p-values in the scientific community.  He asked our class, which was composed of both students and clinicians, to provide a good definition for the term ‘p-value.’ He was not at all surprised when the best response we could provide was what he coined “a popular but entirely incorrect” definition of what a p-value actually is. For me, this raised feelings of concern and terror – How was it possible that a diverse room of researchers, all of whom use statistical methods to confirm that their research findings are relevant and significant, is incapable of collectively defining what a p-value is? At the end of the first lesson, Dr. Cohen wrote the definition of a p-value on the board: “A p-value is the calculated, estimated probability of observing the test statistic (or results more extreme) given that (1) the null hypothesis is true, (2) the assumptions of the test are not meaningfully violated, and (3) there is no systematic or differential random error.”

 

Cogito, ergo sum homo? – (I think, therefore I am human?)

© Sergei Gladyshev /Hotspot Media

by Arthur Ruiz

What makes a person deserving of human rights? Is it something intrinsic in our nature, “endowed by [our] Creator with certain unalienable Rights”, as Thomas Jefferson wrote? Or is it simply the result of mutually-agreed-upon social conventions? Early humans defined “themselves” by their small tribal communities, and any outsiders were usually seen with a mix of suspicion and distrust. As societies began to develop and expand, the “in-group” of people consisted of villages, city-states, ethnic identities, and then nations. Even vaunted legal landmarks recognizing a certain baseline level of rights, like the Magna Carta or the Bill of Rights, still applied to a select group of “rights holders” (English nobles and property-holding white males, respectively). An important social achievement of the 20^th and early 21^st centuries has been the entrenchment of the idea that all human beings, regardless of their origins, beliefs or identities, are entitled to certain “inalienable” rights by virtue of their humanity.

The scope of this concept took an interesting turn this past April, when New York Supreme Court Justice Barbara Jaffe granted a writ of habeas corpus to two research chimpanzees, Hercules and Leo, who were being used for experiments in human cognition at Stony Brook University. This decision resulted from lawsuits filed by the Nonhuman Rights Project (NhRP), on behalf of four chimpanzees (the two Stony Brook ones, as well as two others held on private property), which made the argument that the chimpanzees should be considered “legal persons”, based on their advanced emotional and cognitive capabilities. The writ of habeas corpus granted to the chimpanzees did not by itself confer legal personhood (and Jaffe quickly amended her decision to remove the specific term “writ of habeas corpus”), but it was an important step towards the possible recognition as such. In practical terms, it legally obligated Stony Brook University to answer charges that Hercules and Leo had been “unlawfully detained”.

From genome to transcriptome: new layers of gene expression

by Dulguun Amgalan

The field of molecular biology, as its name implies, is the study of life at the molecular scale. Living things are made of cells, and each one of these basic units of living matter is a complex molecular machine, in which macromolecules such as nucleic acids, polysaccharides and proteins interact together to generate a metabolic process we know as “life”. Although organisms are overwhelmingly diverse when observed from the outside, the fundamental molecular processes are essentially uniform, and it is this constancy that provides molecular biologists with the tools to understand how living things function.