Introduction

2019 ◽  
pp. 1-10
Author(s):  
Michael L. Power ◽  
Jay Schulkin
Keyword(s):  
Medical Education ◽  
Daily Activity ◽  
Evolutionary Biology ◽  
Clinical Medicine ◽  
Evolutionary Medicine ◽  
Evolutionary Perspective ◽  
Evolutionary Thought ◽  
Physician Scientist ◽  
Medicine Today ◽  
Physician Scientists

Evolutionary medicine is an integrative discipline, combining the fields of evolutionary biology, experimental research, and clinical medicine. Contributors to the field of evolutionary medicine today come from many schools of study. Anthropologists, biologists, physiologists, and ecologists work alongside historians of science and physician scientists, all of whom are represented in the present volume. A full integration of evolutionary thought into the education of medical students and seasoned physicians has been voiced by most of the field’s contributors. Incorporating an evolutionary perspective into medicine will most likely not change the daily activity of physicians, but it will help guide the thinking and types of questions a physician-scientist should ask, by adding an evolutionary dimension. Our aim for this volume is to support medical education that teaches evolutionary medicine as a seamless component of medical practice, rather than be considered a separate school of thought.

Integrating Evolutionary Biology into Medical Education

2019 ◽  
Keyword(s):  
Public Health ◽  
Medical Education ◽  
Medical Students ◽  
Evolutionary Biology ◽  
Medical Training ◽  
Medical Curriculum ◽  
Evolutionary Medicine ◽  
Evolutionary Perspective ◽  
Female Reproduction ◽  
Teaching Aids

Clinicians and scientists are increasingly recognising the importance of an evolutionary perspective in studying the aetiology, prevention, and treatment of human disease; the growing prominence of genetics in medicine is further adding to the interest in evolutionary medicine. In spite of this, too few medical students or residents study evolution. This book builds a compelling case for integrating evolutionary biology into undergraduate and postgraduate medical education, as well as its intrinsic value to medicine. Chapter by chapter, the authors – experts in anthropology, biology, ecology, physiology, public health, and various disciplines of medicine – present the rationale for clinically-relevant evolutionary thinking. They achieve this within the broader context of medicine but through the focused lens of maternal and child health, with an emphasis on female reproduction and the early-life biochemical, immunological, and microbial responses influenced by evolution. The tightly woven and accessible narrative illustrates how a medical education that considers evolved traits can deepen our understanding of the complexities of the human body, variability in health, susceptibility to disease, and ultimately help guide treatment, prevention, and public health policy. However, integrating evolutionary biology into medical education continues to face several roadblocks. The medical curriculum is already replete with complex subjects and a long period of training. The addition of an evolutionary perspective to this curriculum would certainly seem daunting, and many medical educators express concern over potential controversy if evolution is introduced into the curriculum of their schools. Medical education urgently needs strategies and teaching aids to lower the barriers to incorporating evolution into medical training. In summary, this call to arms makes a strong case for incorporating evolutionary thinking early in medical training to help guide the types of critical questions physicians ask, or should be asking. It will be of relevance and use to evolutionary biologists, physicians, medical students, and biomedical research scientists.

scholarly journals Integrating evolution into medical education for women’s health care practitioners

2020 ◽  
Vol 2020 (1) ◽  
pp. 60-67
Author(s):  
Michael L Power ◽  
Carrie Snead ◽  
Eda G Reed ◽  
Jay Schulkin
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Women’S Health ◽  
Women's Health ◽  
Health Care Providers ◽  
Evolutionary Medicine ◽  
Evolutionary Perspective ◽  
Care Providers ◽  
Female Reproduction ◽  
Women's Health Care

Abstract Evolution is a fundamental principle in biology; however, it has been neglected in medical education. We argue that an evolutionary perspective is especially important for women’s health care providers, as selection will act strongly on reproductive parameters, and the biological costs of female reproduction are generally more resource expensive than for men (e.g. due to gestation and lactation) with greater effects on health and wellbeing. An evolutionary perspective is needed to understand antibiotic resistance, disease and health risks associated with mismatches between our evolved adaptations and current conditions, the importance of the microbiome and the maternal role in how infants acquire and develop their early-life microbiome (vaginal birth, lactation), and the importance of breastmilk as a biochemical signal from mothers to their babies. We present data that obstetrician–gynecologists’ views regarding the inclusion of evolution within their training is generally positive, but many barriers are perceived. Requiring coursework in evolutionary biology with an emphasis on evolutionary medicine prior to enrollment in medical school may be a solution.

scholarly journals Re-examining physician-scientist training through the prism of the discovery-invention cycle

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 2123 ◽  
Author(s):  
Gopal P. Sarma ◽  
Allan Levey ◽  
Victor Faundez
Keyword(s):  
Data Science ◽  
Clinical Medicine ◽  
Biomedical Literature ◽  
Qualitative And Quantitative ◽  
Career Trajectories ◽  
Physician Scientist ◽  
Dual Degree ◽  
Phd Program ◽  
Physician Scientists

The training of physician-scientists lies at the heart of future medical research. In this commentary, we apply Narayanamurti and Odumosu’s framework of the “discovery-invention cycle” to analyze the structure and outcomes of the integrated MD/PhD program. We argue that the linear model of “bench-to-bedside” research, which is also reflected in the present training of MD/PhDs, merits continual re-evaluation to capitalize on the richness of opportunities arising in clinical medicine. In addition to measuring objective career outcomes, as existing research has done, we suggest that detailed characterization of researchers’ efforts using both qualitative and quantitative techniques is necessary to understand if dual-degree training is being utilized. As an example, we propose that the application of machine learning and data science to corpora of biomedical literature and anonymized clinical data might allow us to see if there are objective “signatures” of research uniquely enabled by MD/PhD training. We close by proposing several hypotheses for shaping physician-scientist training, the relative merits of which could be assessed using the techniques proposed above. Our overarching message is the importance of deeply understanding individual career trajectories as well as characterizing organizational details and cultural nuances to drive new policy which shapes the future of the physician-scientist workforce.

Methods and clinical applications in nuclear cardiology: a position statement

2002 ◽  
Vol 41 (01) ◽  
pp. 3-13 ◽  
Author(s):  
M. Schäfers
Keyword(s):  
Nuclear Cardiology ◽  
Clinical Medicine ◽  
Imaging Techniques ◽  
Cost Savings ◽  
Cost Benefit ◽  
Position Statement ◽  
Electron Beam Tomography ◽  
Partial Functions ◽  
Cost Benefit Ratio ◽  
Medicine Today

SummaryNuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e. g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio.Our current understanding shows that effective, targeted nuclear cardiology diagnosis – in particular for high-risk patients – can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures.In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging.

scholarly journals PCR-detectable Candida DNA exists a short period in the blood of systemic candidiasis murine model

2020 ◽  
Vol 15 (1) ◽  
pp. 677-682
Author(s):  
Zheng-Xin He ◽  
Hui-Hai Zhao ◽  
Fu-Kun Wang
Keyword(s):  
Heat Shock ◽  
Murine Model ◽  
Fungal Pathogens ◽  
Clinical Medicine ◽  
Diagnostic Techniques ◽  
Systemic Candidiasis ◽  
Blood Samples ◽  
Short Period ◽  
Polymerase Chain ◽  
Medicine Today

AbstractInvasive candidiasis is a major challenge to clinical medicine today. However, traditional fungal diagnostic techniques and empirical treatments have shown great limitations. Although efforts are necessarily needed in methodology standardization and multicenter validation, polymerase chain reaction (PCR) is a very promising assay in detecting fungal pathogens. Using a “heat-shock” DNA preparation method, a rapid and simple PCR protocol for quantification of the Candida albicans (C. albicans) ribosomal DNA was established. The PCR assay could detect Candida DNA as low as 10 CFU/mL in samples prepared by the heat-shock protocol, without any cross-reaction with DNA prepared from other Candida spp. and bacterial pathogens. For simulated blood samples, the PCR test sensitivity of whole blood samples was better than that of plasma and blood cells. In the systemic candidiasis murine model, detectable DNA was only observed within 24 h after C. albicans SC5314 injection, which is much shorter than that observed in the kidney.

Chekhov's Environmental Psychology: Medicine and the Early Stories

Slavic Review ◽  
2020 ◽  
Vol 79 (4) ◽  
pp. 709-730
Author(s):  
Matthew Mangold
Keyword(s):  
Medical Education ◽  
Clinical Medicine ◽  
Environmental Psychology ◽  
Medical Writing ◽  
Early Writing ◽  
Mental Life ◽  
Case Histories ◽  
Artistic Vision ◽  
Literary Writing ◽  
Core Issues

In light of the historical circumstances surrounding Anton Chekhov's early writing career and his own statements about the importance of medicine to it, there is surprisingly little scholarship on how medicine shaped his prose. What ideas was he introduced to in medical school and how did he apply them? Which of these drew his attention as he strove to articulate a new artistic vision? How did Chekhov draw on his experience with medicine to experiment with new themes and forms in his literary writing? This article addresses these questions by focusing on the aspects of medicine that had the most discernable influence on Chekhov as he developed his literary writing: hygiene, clinical medicine, and psychiatry. It argues that Chekhov engaged with core issues of medicine not only as a medical student who wrote case histories of his patients, but also as a groundbreaking writer. As he transcodes insights from the clinic into his prose, he creates a new conception of details that disclose relationships between settings and characters and an environmental psychology emerges across his medical writing and fiction. His stories envision relationships between physical and mental life with such originality that he becomes a new literary force not long after completing his medical education.

scholarly journals Further twists in gastropod shell evolution

2008 ◽  
Vol 4 (2) ◽  
pp. 179-182 ◽  
Author(s):  
Reuben Clements ◽  
Thor-Seng Liew ◽  
Jaap Jan Vermeulen ◽  
Menno Schilthuizen
Keyword(s):  
Evolutionary Biology ◽  
Logarithmic Spiral ◽  
Spiral Growth ◽  
Evolutionary Perspective ◽  
Gastropod Shell ◽  
Form And Function ◽  
Evolutionary Origins ◽  
Taxonomic Groups ◽  
And Function ◽  
Shell Coiling

The manner in which a gastropod shell coils has long intrigued laypersons and scientists alike. In evolutionary biology, gastropod shells are among the best-studied palaeontological and neontological objects. A gastropod shell generally exhibits logarithmic spiral growth, right-handedness and coils tightly around a single axis. Atypical shell-coiling patterns (e.g. sinistroid growth, uncoiled whorls and multiple coiling axes), however, continue to be uncovered in nature. Here, we report another coiling strategy that is not only puzzling from an evolutionary perspective, but also hitherto unknown among shelled gastropods. The terrestrial gastropod Opisthostoma vermiculum sp. nov. generates a shell with: (i) four discernable coiling axes, (ii) body whorls that thrice detach and twice reattach to preceding whorls without any reference support, and (iii) detached whorls that coil around three secondary axes in addition to their primary teleoconch axis. As the coiling strategies of individuals were found to be generally consistent throughout, this species appears to possess an unorthodox but rigorously defined set of developmental instructions. Although the evolutionary origins of O. vermiculum and its shell's functional significance can be elucidated only once fossil intermediates and live individuals are found, its bewildering morphology suggests that we still lack an understanding of relationships between form and function in certain taxonomic groups.

scholarly journals Evolutionary theory of bacterial quorum sensing: when is a signal not a signal?

2007 ◽  
Vol 362 (1483) ◽  
pp. 1241-1249 ◽  
Author(s):  
Stephen P Diggle ◽  
Andy Gardner ◽  
Stuart A West ◽  
Ashleigh S Griffin
Keyword(s):  
Quorum Sensing ◽  
Evolutionary Theory ◽  
Kin Selection ◽  
Evolutionary Biology ◽  
Bacterial Cells ◽  
Evolutionary Perspective ◽  
Population Response ◽  
Future Action ◽  
Bacterial Quorum Sensing ◽  
Bacterial Quorum

The term quorum sensing (QS) is used to describe the communication between bacterial cells, whereby a coordinated population response is controlled by diffusible molecules produced by individuals. QS has not only been described between cells of the same species (intraspecies), but also between species (interspecies) and between bacteria and higher organisms (inter-kingdom). The fact that QS-based communication appears to be widespread among microbes is strange, considering that explaining both cooperation and communication are two of the greatest problems in evolutionary biology. From an evolutionary perspective, intraspecies signalling can be explained using models such as kin selection, but when communication is described between species, it is more difficult to explain. It is probable that in many cases this involves QS molecules being used as ‘cues’ by other species as a guide to future action or as manipulating molecules whereby one species will ‘coerce’ a response from another. In these cases, the usage of QS molecules cannot be described as signalling. This review seeks to integrate the evolutionary literature on animal signalling with the microbiological literature on QS, and asks whether QS within bacteria is true signalling or whether these molecules are also used as cues or for the coercion of other cells.

scholarly journals The Role of the Immune System from an Evolutionary Perspective

2019 ◽  
pp. 198-209
Author(s):  
Carsten Schradin ◽  
Rainer H. Straub
Keyword(s):  
Evolutionary Medicine ◽  
Future Generations ◽  
Lifetime Reproductive Success ◽  
Life History Stage ◽  
Evolutionary Perspective ◽  
Lifetime Fitness ◽  
Fitness Consequences ◽  
Reproductive Life ◽  
Fitness Benefits

“Nothing in Biology makes sense, except in the light of evolution.” This famous citation of Theodosius Dobzhansky also underlies the integrative field of evolutionary medicine, which faces the challenge to combine (patho-)physiological mechanisms with evolutionary function. Here we introduce a concept from the study of animal behavior, which are the four questions of Tinbergen that consider: 1. the ontogeny of an individual describing its development, 2. its physiological machinery, which 3. has fitness consequences influencing 4. the evolutionary history (phylogeny) of future generations. It is shown how this concept can be applied to infectious disease and to chronic inflammatory systemic diseases. Evolutionary medicine takes lifetime reproductive success into account. The hypothesis to be tested is that mechanisms underlying a disease in old age might have higher fitness benefits in the pre-reproductive and/or reproductive life history stage, leading to an overall increased lifetime fitness.

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