Innovations in curriculum design: A multi-disciplinary approach to teaching statistics to undergraduate medical students

Background  

Statistics is relevant to students and practitioners in medicine and health sciences and is increasingly taught as part of the medical curriculum. However, it is common for students to dislike and under-perform in statistics. We sought to address these issues by redesigning the way that statistics is taught.     

Dissolution rates of carbonated hydroxyapatite in hydrochloric acid.

Osteoclasts have been shown to dissolve efficiently and effectively the mineral phase of bone by locally controlling the environment surrounding the cell. Although this mineral phase has been identified and well characterized as carbonated hydroxyapatite, there is little understanding of the factors that affect the dissolution properties of this mineral phase. Mimicking the mechanism by which osteoclasts dissolve the mineral phase of bone may provide insight into methods for the decalcification of atherosclerotic mineral deposits in the vascular system. Accordingly, a detailed characterization of the effects of various chemical and mechanical parameters on the dissolution of carbonated hydroxyapatite mineral was investigated in this study. Increases in the mineral dissolution rate (2-10 times) were associated with increases in dissolving solution [H+], osmolality, temperature, and flow rate. Mineral dissolution rate increases (5-8 times) were associated with greater surface area of the mineral and mechanical agitation of the dissolving solution.     

Affective and Behavioral Stress Outcomes in Alzheimer's Caregivers

Few investigations have looked at behavioral stress outcomes in Alzheimer's caregivers. This study documented concentration deficits to examine behavioral outcomes of stress in 33 Alzheimer's Disease (AD) caregivers and in 33 age-, sex-, and race-matched controls. As hypothesized, caregivers showed less persistence than controls in solving problems from a standard test of problem-solving ability. In addition, caregivers tended to make more errors than controls on a standard proofreading task ( p < .09). In AD caregivers, cognitive deficits (represented by lower scores on problem-solving and concentration tasks) may be representative of a broader deficit in concentration that impairs the ability of caregivers to provide for their own needs and the needs of the family member for whom they are caring.     

Effects of Stimulus Intensity on Cardiovascular Activity

A between-groups design (N = 75) was employed to investigate the effects of stimulus intensity and repetition on cardiovascular activity. It was predicted that as intensity increased, the pattern of physiological activity would change, indicating a transition from the orienting to the defense reflex. Cardiovascular activity was represented by measures of heart rate, digital pulse amplitude, and cephalic blood content. Subjects received 12 presentations of a 1000 Hz tone of 45, 60, 75, 90, or 105 dB. Stimulus risetime was 30 msec and the duration 2 sec. Analyses of variance revealed reliable effects of intensity and repetition on all cardiovascular variables. However, neither these results nor additional multivariate analyses supported the differentiation of orienting and defense reflexes as suggested by Sokolov (1963) or Graham (1979). The importance of the startle reflex in the interpretation of these findings was discussed.     

Fetoscopic photography

Fetoscopic visualization may be used for the prenatal diagnosis of external structural malformations of the fetus. Objective documentation of these fetoscopic findings would be desirable. The photographic equipment and techniques required for fetoscopic photography have been investigated, and the results of these investigations with standard fetoscopic instruments in current clinical usage are described. The factors evaluated include the light source, camera equipment, camera settings and film.     

The aniridia-Wilms tumor association: The critical role of chromosome band 11p13

The role of del (11)(p13) as a cause of aniridia, with and without Wilms tumor, is strengthened by demonstration of this chromosome aberration in 3 patients: monozygous twin girls, both of whom have aniridia and mental retardation and one of whom has a Wilms tumor; and an unrelated boy with aniridia and ambiguous genitalia. The break points defining the interstitial deletion for the twins are 11p13 and 11p15.1, while for the boy they are 11p1302 and 11p14.1. These patients and their karyotypes substantiate the critical importance of chromosome band 11p13 (or its hemizygous representation) in the development of aniridia and an associated Wilms tumor diathesis, as had been suggested previously (Riccardi VM, Sujansky E, Smith AC, Francke U, (1978): Pediatrics 61, 604-610).     

Developmentally programmed expression of AID in chicken B cells

In mice, activation induced deaminase, AID, is expressed only in germinal center B cells. It is required for the initiation of somatic hypermutation and class switch recombination. In chickens and most mammals immunoglobulin gene rearrangement generates limited diversity and the primary immunoglobulin repertoire depends on subsequent somatic hypermutation or gene conversion. Immunoglobulin gene conversion in chickens starts in the embryonic bursa, before antigen exposure. The demonstrated requirement for AID for gene conversion in the bursal lymphoma cell line, DT40, implies developmental regulation of AID expression. To test this prediction, we examined the timing and location of AID mRNA expression. An abrupt increase in AID mRNA coincided with the onset of extensive Ig gene conversion in the bursa. Expression was also detected at earlier stages, implying either that expression of AID is not the only controlling factor for gene conversion, or that gene conversion can precede the formation of bursal follicles.     

Does the myosin V neck region act as a lever?

Recent research efforts from several groups have addressed the question of whether the amplitude of myosin's unitary step size is proportional to the length of the neck region. Unconventional myosin V, which has an extended neck region with 6IQ motifs, provides a natural template by which to test the lever arm model via mutational analysis. The most stringent test requires that a series of single-headed molecules from the same myosin class be analyzed. Here we characterized the unitary mechanics of three single-headed fragments of myosin V expressed in the baculovirus/insect cell system. Each construct consisted of the motor domain (MD) and a variable number of IQ motifs (MD2IQ, MD4IQ and MD6IQ) that bind calmodulin, followed by an epitope tag so that the molecule can be attached to the nitrocellulose surface via an antibody. The results show a correlation between the unitary step size and the number of IQ motifs, confirming that the myosin neck region acts as a lever. The step size of MD2IQ is twice that observed from single-headed subfragments of class II myosins with the same neck length. Our results are discussed in relation to data obtained concurrently from other laboratories with similar constructs.     

AIDS vaccine development: the long and winding road

Development of a vaccine that provides sterilizing immunity against HIV infection remains an elusive goal, due primarily to the difficulty in generating neutralizing antibodies to primary HIV isolates. In lieu of a present solution to this problem, recent approaches to develop vaccines against HIV/AIDS have focused not on preventing infection outright, but on eliciting potent antiviral CD8+ T-cell responses to limit HIV replication in individuals who become infected after vaccination. Successful control of HIV replication in vivo, enabled by vaccine-elicited immune responses should, in turn, attenuate an individual's rate of progression to AIDS while reducing their likelihood of subsequently transmitting HIV. Recent pre-clinical evaluation of CTL-based vaccines in non-human primate models of AIDS has shown several different vaccine modalities (e.g. heterologous 'prime/boost' strategies such as DNA + recombinant viral vectors) to be capable of eliciting high-level cellular immune responses that are associated with limitation of virus replication and protection against disease following challenge with select pathogenic virus isolates. However, it is not currently known to what extent these protective effects, observed under optimal experimental conditions in select animal models, can be translated into relevant protection of humans against AIDS. In this article we discuss the promise, potential limitations, and scientific challenges that currently provide the context for efforts to develop and successfully employ a safe and effective AIDS vaccine.