I'm still here
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?
The study of medical students
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.
Frisky mice produce fertile sons
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.
A controversial new approach that quiets the activity of certain neurons in the brain alleviates breathing difficulties in a mouse model of Rett syndrome, according to a study published 4 October in the Proceedings of the National Academy of Sciences.
Rett syndrome, a rare neurodevelopmental disorder diagnosed almost exclusively in girls, shares some features of autism.
Besides loss of speech and motor skills, children with Rett syndrome often have irregular breathing: they often hold their breath, hyperventilate or swallow air.
Get the full story on SFARI.
I don't know of anyone in the science journalism community who doesn't know Bora Zivkovic. Prolific blogger extraordinaire known to many of us as Bora, he and Anton Zuiker started the first of what's now known as ScienceOnline, an annual conference in which prominent journalists and bloggers and scientists gather to eat delicious food (eg, LocoPops) and discuss how they can do their jobs better.
I met Bora at the first of these gatherings, the 2007 Triangle Science Blogging Conference. In a blogging 101 session, he taught us beginners how to set up our first blogs on WordPress and encouraged us to be brave and write our first posts.
That's why I'm honored that he interviewed me about my work and my impressions of ScienceOnline 2010. Read it here and here.
In the interview, I gave special props to Penny, my first blog commenter and super supportive running friend, and my mom (also super supportive) who left me a voicemail telling me that I needed to correct a few typos on my new website. Thanks to Bora for the interview and to the people who support me by keeping it real.
I'm smarter than you.
I've learned quite a bit from my pets. From my feline housemates, for example, I've gleaned a lesson from the 'fight-and-nap,' when a prolonged face-off between two cats turns into a doze by both parties. Which I take to mean that rather than letting trivial disagreements bother us, we humans should just let them go.
But it turns out that this lesson is the tip of the iceberg. My pets are, it seems, a collective of miniature physicists covered in fur, as evidenced by two recent experiments that use high-speed video footage.
The way a cat drinks, for instance, depends on its innate ability to balance the inertia of upward-moving water with the gravity pulling down on that liquid, according to a study done by a small team of engineers at Massachusetts Institute of Technology. The work is published in last Thursday's issue of Science.
Cats lightly touch the tips of their tongues to water to drink -- that much is obvious. What you don't see in real time is that the tongue tap draws a column of liquid upward. Just when the water column nears its highest point, the mouth of the cat quickly shuts around it, the researchers found. You can read more about it in the New York Times, R&D Magazine and Time (the latter includes a sweet slow-mo video). Ed Yong has a nice discussion of this going on his blog, Not Exactly Rocket Science. I was surprised to learn that the scratchy hairs on a cat's tongue have nothing to do with the way it laps water.
In another new study, which will be presented at a fluid dynamics meeting next week, scientists from the Georgia Institute of Technology worked out how quickly dogs and other furry animals have to shake to dry themselves.
The shake is an oscillation that begins at the head and moves throughout the body, and must be frequent enough to overcome the forces that hold water to the body. So, the smaller the animal, the faster it must shake, the group found.
Discovery News reports that companies such as Whirlpool are interested in incorporating these drying principles into washing machine designs.
Whether these new findings inspire any life lessons for me remains to be seen, but they do confirm my sneaking suspicion that cats and dogs are somewhat brilliant.
Check out this awesome video of various animals dry themselves (courtesy of David Hu's group):
Researchers have developed the first stem cell system that makes it possible to study the early development of neurons from people with Rett syndrome, a rare disorder on the autism spectrum.
With the approach, reported 12 November in Cell, the scientists show that stem cells derived from the skin of people with Rett syndrome generate fewer functional neurons than do those from healthy individuals.
Get the full story on SFARI.
Image courtesy of Carol Marchetto and Alysson Muotri.
H.M.'s gift to science
About a year ago, scientists at the University of California, San Diego finished slicing the entire postmortem brain of one of the most famous neurological patients of all time: Henry Molaison or H.M.
The story of H.M. is probably familiar to anyone who has taken an intro neuroscience or psychology course. At 27 years of age, after suffering from increasingly severe and debilitating seizures, H.M. agreed to an experimental operation that involved the removal of large chunks of his brain's temporal lobes.
Although the surgery abated H.M.'s seizures, it left him unable to form new memories. Taking more than 50 years of behavioral and brain imaging data from H.M., scientists pieced together a basic understanding of human memory. Memory is regulated by discrete areas of the brain, rather than cells spread throughout, researchers learned. In addition, the hippocampus area, a region which was removed in H.M.'s surgery, is necessary for forming long-term memories.
In 2008, H.M. passed away, leaving his last gift to science -- his brain, which was sectioned, stained and digitized for any scientist to study. Check out video footage of the slicing and an interview with lead scientist Jacopo Annese, director of the UCSD Brain Observatory on the The San Diego Union-Tribune website.
I checked in periodically (okay, obsessively) on a live webcast of the sectioning, which has lasted more than 48 hours and included some sleep and breaks. Having cut my fair share of frozen rat and mouse brains, I can only imagine the technical challenge of cutting a human brain, and a famous one at that.
Of course, the researchers were extra careful with H.M.'s brain. They discussed whether to cut the whole brain, or to first divide it into smaller chunks that would be easier to cut. In the end, they decided to the brain whole, figuring that it would minimize tissue loss.
The scientists also expressed some concern, in an entry of the Project H.M. blog (which seems to have disappeared from the Observatory's site) that it would be challenging to slice tissue in the area of the lesion because of the extensive scarring in the temporal lobes.
Luckily, the scientists made it through the scarred area. The hardest part of sectioning is over, but the real challenges (and excitement) — of analyzing H.M.'s cells and making new conclusions about human memory — have just begun.
In which I blog about tweets
I spend entirely too much time on Twitter, especially on Fridays, when my attention span has waned to nearly nil. Here's some interesting stuff on my radar this week:
Via @brainpicker, building thick skin with Rejection Therapy.
Freelancers and rejection are fast friends. So naturally, I perked up when I heard about the challenge to get rejected for 30 days in a row. Like, legitimately rejected. It's all about thinking to ask for what you want.
Via @RebeccaSkloot and many others, The Immortal Life of Henrietta Lacks was named Amazon Best Book of the Year. Not only that, but it made @LibraryJournal's and @PublishersWeekly's top 10s as well.
Via @stevesilberman, @edyong209 and too many to name, the story of how an editor from Cook's Source took content from a writer, published it without her permission, and then wrote an unbelievably snarky and not-well-thought-out reply when the writer complained. Facebook users gathered other duplicate content published in the magazine, although it's unclear whether the editor had permissions for these articles. LA Times, Poynter Online covered this, and How Publishing Really Works gave an especially thorough account.