Before Edward Chu entered his fourth year at Icahn School of Medicine at Mount Sinai in New York, he took a 12-month sabbatical to launch his first clinical trial. He wanted to evaluate whether patients using an anti-blood-clotting drug, usually to prevent heart attacks, should stop before general surgery. He thought that if he dedicated himself to the project for 12 months, he could wrap up any loose ends before he graduated in 2013. That was optimistic, to say the least. Check out the rest of my piece at Naturejobs.
I've written about Rett Syndrome for a few years now (a few examples here, here and here). Rett is a rare neurological disorder that primarily affects girls, and shares some features of autism. Although symptoms vary in type and severity, the disorder is marked by a progressive loss of speech and motor skills. Girls with Rett may also have seizures and trouble breathing. In 1999, scientists found that mutations in a single gene, MECP2, cause Rett. You might think that a single-gene disorder would be easier to understand and eventually cure compared with more genetically complex disorders like autism. Maybe that's true. But researchers are still trying to find out what the MeCP2 protein does. In the early 90s, Adrian Bird’s group purified MeCP2—which stands for methyl-CpG binding protein 2—and named the protein for its ability to bind parts of the DNA with a chemical tag called a methyl. Methyls tend to dampen the expression of genes, suggesting that MeCP2’s function is to silence genes. Studies published since then suggest MeCP2 activates or represses the expression of many genes. Other results suggest that the protein binds throughout the genome, influencing the way DNA packs into a cell. New evidence, published today (December 21) in Cell, shows that MeCP2 binds to spots throughout the genome that are tagged with the chemical, 5-hydroxymethylcytosine (5hmC) in mice, and that this interaction may be important for understanding Rett Syndrome. See the rest of my story at the Rett Syndrome Research Trust blog, as well as a podcast by RSRT director Monica Coenraads.
Nicole zur Nieden is expecting her first baby any day. But this is not what keeps her awake at night. It's funding, or the lack thereof, for her research that keeps her tossing and turning. As an assistant professor of cell biology and neuroscience at the University of California, Riverside (UCR), zur Nieden has two more years before going up for her tenure review. Demonstrating that she can pull in funds is the requirement of tenure she feels she has the least control over. See the rest of my story at New Scientist's career column, The Insider. (Since the story ran, I found out that Nicole had a healthy baby boy.)
Researchers have constructed a new synthetic bacterium that detects Pseudomonas aeruginosa, a common microbe and a leading cause of hospital-acquired infections, and explodes, releasing antimicrobials that kill the invaders. The results, published today (August 16) in Molecular Systems Biology, suggest that the engineered bacteria might eventually be used to prevent or treat infection with P. aeruginosa in humans. Get the full story at The Scientist.
Some participants in the Amgen Scholars Program (that I write for) posted this awesome musical story about their summer science research at Caltech. To the tune of Michael Bublé's "Haven't Met You Yet," it's "Just Haven't Made You Yet":
Last week, I gave a talk to a group of about 20 local engineers and engineering students at NC State about project management, based on what I learned for my feature in Naturejobs about the career path. My piece was about management in the life sciences, but engineering projects face many of the same common pitfalls. It's easy for timelines and budgets to get out of control, for clients to have unreasonable expectations about the end results, for the people you're managing to lose interest and 'buy-in.' It felt strange and somewhat scary to get up in front of experienced project managers and talk about these issues as an outsider, but the audience was super friendly and interactive. Afterwards, people shared their 'war stories' in management, namely about how easily things can get out of control. Being a good project manager means being able to motivate and inspire the right people from the very beginning of the project, the audience told me. A student asked whether it means you need to be a "people pleaser," and the veterans responded that's not quite it: you're not going to make everyone happy, but you need to respect them and keep them involved. Some students asked questions about how they can get into management, and we talked about the variety of ways you can build your knowledge in this area, by for example, getting an MBA or a MEM (Master of Engineering Management) or Project Management Professional certification. It doesn't seem like there's a single right answer for how much or what sort of training you should get -- rather, it'll depend on the company you work for and how much technical knowledge your job requires. Many people learn on the job, and that's okay too (though it can be stressful). It seems like aspects of project management come naturally to some people. (Kind of like how good bedside manners might come more easily to some doctors than others.) In management, I think that the ability to motivate others may be one of those skills that's hard to teach. The students in the audience seemed eager to pick up these soft skills, though. Many students I've interacted with are focused on having their careers planned out. I think that's great, but I would just say that it's all too common for people to take unexpected paths, for the better. As one audience member said, if you find a person whose job you hope to have one day, ask her how she got to that position. More often than not, you'll find that she took the scenic route.
I've been holed up in my home office in the past few months, willing the winter to disappear but also getting massive cabin fever. All this isolation makes me an awkward human being. (See The Oatmeal on what it's like to work at home.) The good news is that I'm getting stuff done. In February, I had a piece in Nature Medicine (subscription required) on experimental vaccines to help treat addiction. These vaccines work by triggering your immune system to detect and sequester drugs -- nicotine or cocaine, for example -- before they reach the brain and tap into its reward circuits. Nicotine vaccines are in late-stage clinical trials, and will probably be the first to get approved. Cancer vaccines are also hot right now, and I wrote about the career opportunities in this area for NatureJobs. The first cancer treatment vaccine, called Provenge and manufactured by Seattle-based biotech Dendreon, is marketed for the treatment of late-stage prostate cancer. The treatment is expensive ($93,000), but it looks like Medicare plans to cover it. Perhaps for Dendreon, and the many scientists plugging away on their own cancer vaccines, the jobs are here to stay. For this month's issue of The Scientist, I talked to researchers who are finding new--and sometimes unconventional-- biological indicators of disease. Like analyzing the breath of children to see whether it's possible to pick up early signs of asthma. Or scanning the brains of former athletes for metabolites that signal damaged tissue. Check it out. At Medscape Medical Students, I have been recruiting physicians and medical students to write and have been doing some writing of my own. In particular, I'm writing for a new series called "Students Are Talking About" which allows me to lurk in the Medscape student discussion forums. (I'm not creepy, I promise!) The latest result of my lurkery is a piece on depression in medical school. (You have to have a subscription to access the article, but signing up is free and easy.) It's not big news that many medical students are depressed or burnt out, as I mention in one of my previous posts, but researchers have really started getting a grasp on how having poor emotional health can affect the education of future doctors. Addiction, cancer, depression. I just realized that I've been working on some super heavy stuff. Perhaps I need to take on a lighter topic?
I recently signed on as a freelance clinical editor with Medscape Medical Students and have been busy learning the ropes. As part of the adjustment process in my exciting new role, I have been learning more about what medical school is like. Rifling through studies, blogs and tweets has allowed me to get inside the heads of medical students. (And as a result, I may never go see a doctor again.) During my immersion into the world of medical education, I have been assaulted by acronyms such as OSCEs, MSREs and USMLE. What the heck are shelf exams? When do rotations happen, and what's the residency match process like? These are the basics that I need to absorb, pronto. I was digging around on PubMed the other day when I noticed the plethora of data on medical students, on everything from their mental health to study habits. As an outsider, the fact that there's so much data is somewhat surprising. Medical training seems so steeped in tradition. How has studying it helped bring about change for the better? Maybe it is changing. At least there seems to be open dialog about medical education's unfortunate side effects -- however difficult those are to remedy. Here's what I've found so far: There's a lot of talk about burnout and depression. About 53 percent of med students have burnout -- which includes emotional exhaustion and feelings of professional inadequacy -- according to a survey of about 2500 students from 7 US medical schools. Perhaps not surprisingly, the burnt bunch was more likely to report having done something dishonest, like cheat. Another recent study from JAMA found that 14 percent of medical students (at the University of Michigan) report symptoms of moderate to severe depression. What's more, roughly 5 percent of the 505 students surveyed reveal that they've had suicidal thoughts at some point during training. Although these reports acknowledge the stigma attached to depression, it's easy enough to find future doctors having an honest conversation about it, in blog posts like this one. Medical educators seem to be increasingly concerned with teaching empathy -- or could it be that I'm new to this topic? Studies show that empathy erodes during medical training (although some researchers say that finding is exaggerated). Still, it's hard not to notice anecdotes coming straight from the exhausted trainee. In a poignant blog post on Medscape, for example, psychiatry resident Kendra Campbell explains how not getting her basic needs met -- namely, sleep and food -- made her resent her patients during an 18-hour shift. Her essay appears to have brought all sorts of medical-trainee-internet-lurkers out of the woodwork, many saying that they can relate. Some schools are making empathy part of their curricula. Robert Wood Johnson Medical School in New Jersey has a " Humanism and Professionalism" component to third-year rotations that includes blogging about clerkship experiences and debriefing after significant events, among other things. The University of Massachusetts Medical School tested a "human factors" day-long course that includes efforts to improve empathic communication in medical students, with some positive results. In any case, it seems there is still room for improvement at the bedside. Physicians tend to miss most opportunities to respond to their patients' emotions with empathic statements. Perhaps just being reminded of this problem will help student doctors fight it.
 Mice with many sexual partners produce more fertile sons than do monogamous mice, providing a biological benefit of promiscuity, according to research published online today (January 20) in BMC Evolutionary Biology. When a female mates with multiple partners -- a scenario called polyandry, which is common in mice -- sperm from rivals must face off to fertilize her eggs. This so-called "sperm competition" has been linked to the evolution of testes size, as well as sperm form and function, and promiscuity is believed to have evolved partly as a way for females to select genes for the highest quality sperm to pass onto her sons. But this is the first experimental evidence in mammals showing that promiscuity can affect the offspring's fertility. Read more at The Scientist. Image by Cheryl Himmelstein.
The neurons of people with Rett syndrome contain an overabundance of retrotransposons — DNA sequences that copy and insert themselves into new spots throughout the genome — during early development, according to a study published 18 November in Nature. Retrotransposons, also known as 'jumping genes,' make up nearly half of the mammalian genome. Long labeled as 'junk DNA,' these genes may have a biological function and influence disease, say researchers. Get the full story on SFARI. Image courtesy of Alysson Muotri.
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