1. HB12 BMT2 UNIT A Obj.1.00 Exploring Bioethics Module 1

2. 1.01 Bioethics concepts What is Bioethics you ask?
Well, Ethics seeks to determine what a person should do or the best course of action, and provides reasons why. It helps people know how to behave, treat other people and the type of communities to live in. (Similar to _______?)
Bioethics is a subfield that explores ethical questions related to the life sciences. Bioethical analysis helps us to make decisions about policies and how to use new biomedical knowledge and innovations.

3. Bioethical VS Scientific questions
Scientists seek to describe and understand phenomena in the world. They want to describe what “is”.
Ethicists seek to determine what people “should” do or the best course of action.
What are the physical risks of using steroids? s/e
Should athletes be allowed to use steroids? s/e
How can we modify a mouse for……… ? s/e
Should we modify a mouse for………? s/e

4. Why learn about Bioethics? Or, why is it important?
Is it ok to take steroids to enhance sports performance? How are they different from a high protein diet or vitamins? How should I decide on ways to enhance my natural abilities that are permissible? (Carl’s case)
Should I take a genetic test to determine if I carry a gene for an illness I can do nothing about or prevent? If I find out I carry it, should I tell my siblings or my spouse? What do I do with the results?

5. STEROIDS 2 Major types: Anabolic- builds up muscle mass (Testosterone)
Catabolic- breaks down muscle & reduces inflammation (Cortisone & Prednisone). Used widely in medicine for asthma, arthritis & skin conditions.
Synthetic substances- similar to male sex hormone Testosterone. Anabolic Androgenic Steroids are what body builders use. “Androgenic” increase “male characteristics” such as muscles.

6. STEROIDS CONT’D.
Anabolic steroids may be prescribed by a doctor for someone who does not make enough Testosterone on their own.
However, Anabolic Steroids (without an Rx), is ILLEGAL in the US. (Well know athlete?)
Anabolic steroids on the street cost about $10 each pill, or a liquid (10ml) for $150.

7. STEROIDS CONT’D.
Side effects can be very serious. It stunts (reduces) growth in adolescents.
Men can grow breasts, women can grow excessive hair all over their bodies/deepen voice,
Men can have shrunken testicles and decreased sperm counts.
Can increase acne and cause baldness.
Weakens Immune system
Affects mood- can be extremely happy/depressed/delusions and “Roid Rages”, violent & angry outbursts. Suicidal ideation.

8. Advances in the life sciences are giving humans new capacities, such as new medicines, procedures, ability to manipulate or alter plants and animal DNA (and human DNA) that bring many benefits to millions of people.
However, what are the potential effects or harm that can be inflicted? How will we know?
Should vaccines be mandatory even if the parent objects? Why/why not?
What is the fairest way to distribute organs to the thousands of people they could help? What could alleviate this problem? What is being done?
This is known as “public decision” policies.

9. So, why teach about Bioethics?
Advances the understanding of science
Prepares us to make informed, thoughtful choices
Promote respectful dialogue among people with diverse views
Emphasize critical thinking skills
Learn ethical reasoning skills

10. Concepts and skills in Bioethics
Four key questions to ask when faced with an ethical choice: (LEARN THESE!!)
1. What is the ethical question?
2. What are the relevant facts?
3. Who or what could be affected by the way the question gets resolved?
4. What are the relevant ethical considerations?
Three considerations to confront in the decision: (LEARN THESE!!)
1. Respect for persons/people
2. Minimize harm/maximize benefits
3. Fairness

11. Other ethical considerations??
Weighing ethical considerations…..
What would be some things to consider and weigh in on?
Any Current issues come to mind??
Building and assessing strong/weak justifications:
Why? Why do you hold that view? Why do you feel this way?
Is there ever a right or wrong answer? Why?
Grandmother with failing sight but still drives
STRONG:Relevance, reference to facts, description of potential effects, applying and identifying, analysis, logical reasoning/conclusions.
WEAK: errors in facts, errors in understanding or applying, errors in logic

12. Euthanasia VS Physician Assisted Suicide What’s the difference?
Physician-assisted suicide entails making lethal means available to the patient to be used at a time of the patient's own choosing.
By contrast, voluntary active euthanasia entails the physician taking an active role in carrying out the patient's request, and usually involves intravenous delivery of a lethal substance.

13. Grief (ɡrēf/) noun
deep sorrow, especially that caused by someone's death.
"she was overcome with grief"
synonyms: sorrow, misery, sadness, anguish, pain, distress, heartache, heartbreak, agony,  torment, affliction, suffering, woe, desolation, dejection, despair; mourning,  mournfulness, bereavement, lamentation; 
literarydolor, dole
"he was overcome with grief"
informal
trouble or annoyance.
"we were too tired to cause any grief"
synonyms: trouble, annoyance, bother, irritation, vexation, harassment; informalaggravation, hassle
"the police gave me a lot of grief"

14. “How To Die In Oregon”
This documentary explores real life responses to Oregon's "Death with Dignity Act“, the first law in the U.S. to allow physicians to prescribe lethal doses of drugs to the terminally ill.
A middle-aged woman with terminal liver cancer, prepares to take her own life, while another cancer patient decides to suffer through his illness even though death is just as certain for him. Others grapple with choosing their own course of action, and one man decides to hold a "death party.“
*Assignment

15. How many states have death with dignity?
As of February 20, 2017, California, Colorado, District of Columbia, Oregon, Vermont, and Washington have Death with Dignity statutes.
In Montana, physician-assisted dying is legal by State Supreme Court ruling.

16. Identifying types of questions
Ethical, Scientific, Legal, Personal Preferences
Why is it important to know the difference in the type of questions?
Would each type affect what the outcome would be?
How?

17. 1.02 Module 2 Balancing Individual and Community Claims Establishing State Vaccination Policies

18. What are the four key questions to always ask yourself?
What are relevant ethical considerations?

19. Exploring Vaccines Setting vaccine policies
Under what circumstances, if any, should a state grant exemptions to its school vaccination policy?
What would be some reasons for an exemption?
What’s the difference between exemption and opting out?
Should the state be able to threaten legal action and/or fines to get parents to comply with the state’s vaccination policy?
Gathering relevant facts…………… read article 2.2

20. Master 2.1 Get kids vaccinated, or else…………..(ARTICLE)
The Washington Post, Nov. 14, 2007
Get Kids Vaccinated or Else, Parents Told
Should Public Health over ride a parent or an individual person to refuse vaccines?
What about health care workers being forced to get Hepatitis vaccines and Flu/Pneumonia vaccines?
Employer not paying sick days if they are out due to illness and did not receive vaccines…………

21. Community Immunity What is it? How can the community be affected?
Site some recent examples.
RISK vs BENEFIT
Do you know anyone that has ever had a childhood disease, such as;
Smallpox, Measles, Mumps, Polio, Pertussis
Rubella (German Measles), Diptheria, Varicella
Have you ever even heard of these diseases?

22. Exemptions, Opting out, Non Immune Status
Some reasons for:
Exception?
Opting out?
Non-Immune status?

23. Community Immunity cont’d.
Master
Activity from
“Re-emerging Infectious Diseases” BMT1
Community Immunity Simulation
Class or Home: Copy of Master 2.10
Refer to data Master 2.8

24. Vaccines, Ethics, Social Policy (Fairness and Respect)
Master 2.7, 2.8, 2.10
Master 2.11 Read Scenarios
Master 2.12
How much of a Role of state to enforce vaccines?
Coercive of forceful implementation?
Master 2.13 Letter for state policy

25. 1.03 Allocating Scarce Resources The case of Organ Transplantation Module 3

27. Pre-Module Homework (Required)
Master Historical cases
Fairness?
Possible criteria?
Relevance?
Pros and Cons?

28. Organs- scarce organs
Bone Marrow- function and location of stem cells, diseases treated with stem cell transplant, significance of matching tissue types, donors from different ethnic backgrounds.
Blood transfusions- blood groups, matching donor/recipients
Tissues- corneas, skin, bone, tendons, cartilage, heart valves, blood

29. Organs that can be transplanted
Kidney Pancreas Liver
Heart Intestine Lungs
Tissues that can be transplanted
Skin Corneas Heart Valves
Bone Marrow Blood
Connective tissues:
Bone, tendons, cartilage and ligaments

30. Factors that affect waiting times
Blood type
Tissue Type
Height and Weight
Size of donated organ
Medical urgency
Geographical location
Number of donors in the local area

31. Organs after death
One person can help as many as 8 people, and many more by donating tissue.
Organs can only be donated by people that die in the hospital. WHY?
Most Tissues need to be donated within 24 hours of death, but person does not have to die in the hospital.

32. Myths about donation Medical treatment of the pt will be affected.
Family must pay additional expenses
Unable to have “open casket” after donation
Religious groups disapprove of organ/tissue
Donation
Rich and/or famous people receive donations more quickly
Having a “heart” on my Driver’s License means I am an organ donor and I don’t have to tell anyone, even if not 18 yrs old

33. What is Brain Death?
“The total and irreversible destruction of the brain and brain stem”
An established medical and legal diagnosis of death
SOME CAUSES:
TRAUMA TO THE BRAIN, CVA, ANOXIA, TUMOR
BRAIN DEATH is not a coma or persistive vegetative state!

34. Brain Death vs Coma Brain Death: All brain tissue is dead
No blood flow to the brain
No electrical activity present in the brain
Coma:
A portion of the brain is injured
Brain still receiving blood flow
Electrical activity still present in the brain

35. Blood/Organ Donation Virtual blood donation
Facts about organ donation:

36. FAIR ALLOCATION / CRITERIA
SO, how are organs allocated (allocation)?
allotment, assignment, distribution, apportionment, sharing out, handing out, dealing out,doling out, giving out, dishing out, parceling out, rationing out, dividing up/out;informaldivvying up
What are some of the criteria?
Who decides?
What are the current UNOS policies?
How are the “new” policies different from previous policies?
Which policy is “fairer”, and why?
Movie: “John Q” Ethical vs Insurance

37. What are YOUR wishes?
Could or would you consider being an organ donor? Why or why not?
Have you ever had this discussion with your family?
Have your views/opinions changed since starting this lesson?

38. What is your recommendation?
Based on the criterion in previous module, do you think it’s a “fair system” for allocating organs?
What do you think is the MOST important criterion? Why?
What criterion do you think is the LEAST important? Why?
Should one criterion be MORE important depending on the patient’s situation? Why?

39. What is the answer to shortages on organs for transplantation?
Tissue engineering is the use of a combination of cells, engineering and materials methods, and suitablebiochemical and physicochemical factors to improve or replace biological tissues.

40. What is tissue engineering???
Youtube

41. What does this mean to the future of organ transplantation?
Youtube- Tissues and 3D Printing
<iframe width="560" height="315" src=" frameborder="0" allowfullscreen></iframe>

42. Why “GROW” organs?

43. How is it done?
PBS NOVA: Replacing body parts

44. 1.04 Weighing Benefits and Harms Ethical Issues in Genetic Testing Module 4

45. Geneticists are scientists who study genes and their variations, how information is used and controlled by cells and transmission from one generation to the next.

46. Knowledge of Genetics is fundamental to understanding Biology and essential
for understanding many of
the most important
public issues that we face.
Genes are bits of biochemical information, and the information they carry is transmitted from generation to generation by coiled molecules called DNA
The DNA that carries genetic information in cells is usually packaged in the form of one or more large molecules called Chromosones

47. whose genes are exactly the same. Or, are they?
Our genes are our “Blueprints” that direct the synthesis of proteins--- the molecular laborers that carry out all life-supporting activities in the cell. ALL humans share the same set of genes, but individuals can inherit forms of a given gene from their parents, making each person genetically unique, EXCEPT FOR………..
Identical twins,
whose genes are exactly the same.
Or, are they?
The causes of monozygotic twinning are generally unknown and unidentified. No one really knows why an egg splits; technically it's a malfunction of the normal development process.

48. What is DNA?
Because the individuals originate from a single combination of egg and sperm, they share the same DNA. According to the  Biology Expert, DNA is "a type of macromolecule known as a nucleic acid. It is organized into structures called chromosomes and housed within the nucleus of our cells. DNA contains the genetic information necessary for the production of other cell components and for the reproduction of life." The DNA, shaped like a double helix, are organized into chromosomes.

49. Every cell contains forty-six chromosomes
Every cell contains forty-six chromosomes. The father's sperm contributes half of their chromosomes (23) while the mother's ova, or egg, contributes the other half (23). Since monozygotic twins originate from the same egg/sperm combination, they have the same DNA.
However, although they share the same genetic characteristics, identical twins are not necessarily exactly alike.

50. Modern genetics involves Genetic Engineering, or Gene Manipulation.
This has produced many advances in medicine and industry, but the potential for abuse with the techniques has raised many ethical and legal questions.
Genetics influences us daily by the foods we eat, identifying criminals and treating diseases.
Current issues are cloning, treating diseases with stem cell & gene therapy, genetic testing for diseases, gender identity and recent privacy laws requiring personal medical information.

51. Environmental mutagens & carcinogens:
Ultraviolet radiation, radioactive wastes, food additives, agricultural chemicals & industrial solvents all produce changes at the gene level and are the basis of many Risk-VS-Health controversies.
Biotechnology, based on Molecular Genetics, is offering solutions to many problems that have the potential for creating new problems.
Such as: GMO’s, new diagnostic tests
medications and treatments,

52. The Human Genome Project
An international collaboration of scientists, governments and drug companies from around the world. It was completed in 2003.
Produced detailed “maps” that identify chromosomal locations of human genes.

53. Mendel’s Rules
Gregor Mendel began the study of inheritance by focusing on the seven different traits of the pea plant. He could readily identify the seed color, they were either green or yellow. The colors did not blend, or crossover. When he blended a yellow & green seed together, he found the green color disappeared. He concluded that the yellow seed was dominant over the green seed. Now known as ALLELE

54. GENOTYPE refers to the combination of genes that code for a trait.
PHENOTYPE describes the physical manifestation of that trait.
In the pea plant, two copies exist of each of its chromosomes, therefore, two ALLELES make up its GENOTYPE.

55. Should you have GENETIC testing?
Inherited vs Somatic Genetic mutations, what are the differences?
Are Genetic tests 100% CERTAINTY that a person will get a disease, or just indicate a CHANCE of developing it?
Should individuals under the age of 18 yrs be forced to have Genetic testing? Why?
Who gets the results?
What to do with the results?
How will it, or can it change a person’s life?

56. Biological gender in humans is determined by one chromosomal pair– Xx or Xy
It is now clear that genes are vastly more influential than virtually any other force in shaping sex identity and gender identity…[T]he growing consensus in medicine is that…children should be assigned to their chromosomal (i.e., genetic) sex regardless of anatomical variations and differences—with the “option”, by choice, of switching, if desired, later in life.
geneticliteracyproject.org

57.
Inherited Genetic Mutation- (Germ cells); sex cells or Gametes. Transmission of DNA from 1 parent. Present in ALL cells. Passed on, but not necessarily developed.
Examples:
Sickle Cell Anemia, Cystic Fibrosis, Some Cancers

58. Somatic Gene Mutation, in ALL body cells, EXACT copies of a particular cell (stem cells). Only affects new cells created from the mutated cell. Does not affect Gamets, so can not be passed on.
Examples:
Neurodevelopmental Disorders, Intellectual Disabilities, Epilepsy, Autism, Alzheimer’s, Schizophrenia

59. Questions????????
Which disruption of cell function leads to mutations that result in cancer?
A. Protein Synthesis C. RNA translation
B. RNA transcription D. DNA replication
Which one is NOT an inherited trait in humans?
A. height C. skin color
B. hair color D. Intelligence
Whales have a pelvis. Which type of evolutionary process is this?
A. fossil C. biochemical
B. anatomical D. geographical
Which health issue is directly caused by a mutation causing continuously growing and dividing cell?
A. COPD C. Muscular Dystrophy
B. Cancer D. Hypertension

60. Genetics Mutation
STEM cells BRCA gene
Immunotherapy
Can become cell/organ specific _____________
Stimulates “T” cells to fight disease
_______________________________________
Change in a gene _________________________
Study of genes ___________________________
Mutation found in breast cancer _____________

61. DNA Discovery Documentary
June 5, 2017
DNA - THE HUMAN RACE - PBS - Discovery Science History (documentary)

62. Research Paper Genetic Disorders
Autism
Crohn's Disease
Cystic fibrosis
Dercum Disease
Down Syndrome
Duane Syndrome
Duchenne Muscular Dystrophy
Fragile X Syndrome
Gaucher Disease
Hemochromatosis

63. Hemophilia
Huntington's disease
Marfan syndrome
Myotonic Dystrophy
Neurofibromatosis
Osteogenesis Imperfecta
Parkinson's disease

64. Phenylketonuria
Poland Anomaly
Porphyria
Progeria
Prostate Cancer
Retinitis Pigmentosa
Schizophrenia
Severe Combined Immunodeficiency (SCID)
Sickle cell disease
Skin Cancer

65. Spinal Muscular Atrophy
Tay-Sachs
Thalassemia
Trimethylaminuria
Turner Syndrome
Intellectual Property and Genomics:
Who owns the genes and any “products” produced from those genes? (example-fertilized eggs that have been cryopreserved, both parents are killed. What happens to the eggs? Who owns them?

66. Ethical Issue Intellectual Property and Genomics:
Who owns the genes and any “products” produced from those genes? (example-fertilized eggs that have been cryopreserved,
(The preservation of cells and tissue by freezing)
Both parents are killed.
What happens to the eggs?
Who owns them?

67. SO 4 KEY QUESTIONS , AGAIN:
What is the Ethical question? (Respect for persons)
What are the relevant facts?
Who or what could be affected by the way the question gets resolved?
What are the Benefits vs Harms?
(Ensuring that benefits, risks(harms) resources, and costs are distributed equally)
What are the relevant ethical considerations?

68. Research Paper #3, Genetic Disorders
1. Minimum of 6 pages in length
2. Typed, 12 font, double spaced, PROPER GRAMMER & SPELLING
3. Cover page (1)
4. Introduction/background, Mode of inheritance, Clinical description of the disorder, detection/treatment (4 pages or more)
5. Works cited/reference page with at least 5 references, only 3 from internet (1 page)

69. 1. Introduction/cover page: What is the name of the disorder
1. Introduction/cover page: What is the name of the disorder? Are there any other names by which it is commonly known?
2. Mode of inheritance. All genetic disorders are inherited. There are several different ways in which they can be inherited. Determine whether your disorder is an autosomal dominant trait, an autosomal recessive trait, an X-linked recessive trait, a chromosomal error or a multifactorial trait (polygenic disorder). Chromosomal errors may take several types: a particular missing chromosome (e.g. a missing X chromosome), an extra chromosome

70. 2. cont’d(e. g. an extra chromosome 21), or a damaged chromosome (e. g
2. cont’d(e.g. an extra chromosome 21), or a damaged chromosome (e.g. part of a chromosome deleted). A multifactorial disorder is one which is caused by several genes or by a combination of genetic and environmental factors.
3. Clinical description of the disorder What are the features of the disorder? How does it affect the victim? What is it like to have the disorder?
How would you describe the disorder to someone else? What is the disorder like externally, internally, biochemically, psychologically, etc.?

71. 3. cont’d. What problems are associated with the disorder
3. cont’d.What problems are associated with the disorder? Is the disorder physically limiting? Is it life-threatening? Is it invariably fatal? Is it found more commonly in certain groups of people, such as a particular ethnic or religious group or particular sex?
4. Treatment: Can anything be done for the disorder? Can the basic defect be treated?
Can the symptoms or results of the disorder be treated? Is there a cure for the disorder? Is there any gene therapy for the disorder?

72. 5. Detection: Can the disorder be detected before its symptoms appear
5. Detection: Can the disorder be detected before its symptoms appear? If so, how? Can it be detected prenatally? If so, how? Is there any way to detect a carrier of the disorder? If so, how? 6. Discuss the role of a Genetic Counselor when a genetic disorder is diagnosed either prenatally or after birth. Identify some psychological factors associated with genetic disorder diagnosis.

73. 1.05 Research Ethics: The Power and Peril of Human Experimentation Module 5

74. Biomedical Research has greatly contributed to human health, providing cures and treatments for a wide range of conditions and diseases, and improving quality of life. We benefit on a daily basis from this research, but generally have no clue how it all comes about.
Guidelines (policies) are in place to protect humans from inappropriate conduct/practices that could cause them harm.
Humans must “volunteer” and have “informed consent” to participate in clinical trials/studies.

75. How are participants recruited?
What are some ways you think participants are recruited?
Do you think these are ethical? Why?
Do you think any of these could skew the results?

76. How important are control groups?
What are some elements of a good experiment?
What is the purpose of experiments?
What is a variable?
Should you know if you are in an experimental or control group? Why?
Do you think that could influence the outcome?
RCT-(Randomized controlled trial) randomly sorted into experimental and control groups
Blinding- not knowing which group you are in
Double Blind-researcher/participant do know which group is “control”/”treatment” group

77. Control group- comparison grp using a placebo or standard of care.
Standard of care- the most widely accepted current treatment.
Outcomes- what is being measured in the end, the dependent variables.
Side effects- secondary effects from drugs or treatment that are usually undesired.
Coercion- threatening a person
Undue Inducement- swaying a person to do something risky by offering incentives that distort a person’s judgement.

78. Exploitation- unequal benefits to individuals; a group of people benefits at the expense of others.
(3rd world countries selling organs)
Informed consent- participant’s must understand what they are agreeing to, potential risks and benefits (if any) of participating, the purpose and goals of the research, and the alternatives they have to participating. They should know they are voluntary and can quit at any time.

79. Decision Time
Would you be willing to participate in a clinical trial, even if it probably wouldn’t benefit you?
But, it might benefit someone else in the future.
Clinicaltrials.gov
Identify Clinical Trial’s
What are the incentives (if any)?
What phase is it in?
What is the duration?
Participant criteria?

80. Zoe Diana Draelos, MD Dermatology Consulting Services
Home
Learn About Studies
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Meet Dr. Draelos
Research Clinics
Articles
Investigator
Welcome!
We are glad you visited our website. I am Zoe Diana Draelos, MD, a clinical and research dermatologist, with a special interest in problems associated with the skin, hair, and nails. I am trained to perform medical, surgical, and cosmetic dermatology and routinely share my expertise with others through lectures, demonstrations, and the many textbooks I have authored. I enjoy developing treatment plans to insure the resolution of medical skin problems and also offer a variety of cosmetic procedures, including filler injections, botulinum toxin injections, face peels, and liposuction. This is the artistic side of dermatology.
I enjoy treating patients of all ages with dermatologic problems, but I also like cutting edge technology, which is best evaluated through clinical research. I have 30 years of dermatology research experience and have contributed to the understanding of the majority of topical prescription drugs used for disease treatment and also have studied the safety and efficacy of many over-the-counter drugs and cosmetics. I specialize in designing unique protocols and can complete research projects in-house from start to finish or participate in any part of the research process.
I have personally written this website to provide information regarding both our medical and cosmetic clinical practice and Dermatology Consulting Services, our research arm. Please use this website to find out more about my interests and skills in dermatology and dermatologic research.

82. Guidelines for Ethical Research
Groups----
Develop rules for ethical considerations:
Respect for persons
Harms and Benefit
Movie: Miss Evers’ Boys 

83. The film tells the story of the Tuskegee experiment, a U. S
The film tells the story of the Tuskegee experiment, a U.S. Federal Government secret medical experiment on poor African Americans in Macon County, Alabama during the years , designed to study the effects of untreated syphilis. The story is told from the perspective of the small town nurse Eunice Evers (Alfre Woodard) who is well aware of the lack of treatment, but feels her role is to console the involved men, many of whom are her direct friends.
Worksheet

84. Using Technology to Study Cellular and Molecular Biology
HB12 Biomedical Technology 2
Unit A
Objective 2.00
Using Technology to Study Cellular and Molecular Biology

85. How do you define Technology?
What does technology do for us?
How have you been impacted by technology?
Do you think technology is always a good thing? Why?

86. 2.01 What is Technology ?
Technology is a body of knowledge used to create tools, develop skills, and extract or collect materials.
It is also an application to meet an objective or solve a problem.
What type of courses are required, and built on?
What are resolution and scale?
What is the relationship of structure/function?

87. What is Information Technology and Computer Technology?
In general, what does technology do for us?
List some technologies you use on a daily basis. How does this technology solve problems and make your life easier?
OK, you live in the stone age. You have ripped your clothes and needs to be repaired.
So, what’s the problem?
How would you do it? What kind of tools (or technology) would be available to do this?

88. How has technology evolved through the years?
What disciplines have been involved in the process?
A problem may remain basically the same over time, but advances in technology have changed how the problem is solved.
Write the words “Problem” and “Technology”. Draw arrows to draw a graphic that represents the relationship between a problem and technology.

89. Searching for scale What is scale?
Biological molecules are small, but how small is small?
1. How do Biological structures, ie: cells, organelles, bacteria and viruses compare in size with one another? (SCALE)
2. How do Molecules compare in size with Biological structures cells, organelles, bacteria and viruses? (RESOLUTION)

90. Scale
Scale is a way to represent the relationship between the actual size of an object (ie: length & mass) and how that size is characterized either numerically or visually.
A scale is a series of ascending & descending steps to assess either some relative or absolute property of an object. (Where have you heard about this before?)

91. Seeing the scale of things
Eye-
Light Microscope-
Electron Microscope- 1st one in 1933, Ernst Ruska, was awarded the 1986 Nobel Prize in Physics. Can magnify 1,000x-300,000x
X-Ray Techniques-
What would make one technology more useful than another in any given situation?
So, having the right tool for the task will be addressed……………..

93. 2.02 Resolving Issues (Resolution)
What is “Resolution”?

94. Doing research in cellular and molecular biology requires scientists to identify the right technology (tool) for the job.
( Just as you use either a flathead or phillips head screwdriver)
Detailed structural knowledge about biological objects requires information obtained in three dimensions. RESOLUTION

101. 2.03 Putting Technology to Work
So, what’s the problem?
Applying technology- how does it work?
What can we do about it?
This is what science is all about

102. In today's western world, you no longer have to grow your own food, or wash your own clothes by hand. And you don't have to worry as much about the prospect of getting sick and dying.
Agricultural technologies like fertilizers (discovered by chemists), combine harvesters (built by engineers), and selective breeding (worked on by biologists) have allowed us to produce incredible amounts of highly nutritious (??) (GMO’s) food on relatively little land. This has led to a huge boom in the population.

103. One human problem is our susceptibility to disease
One human problem is our susceptibility to disease. But thanks to science and medical technology, our life expectancies have increased at a dramatic rate. We now have antibiotics and other drugs to cure diseases (thanks to chemists), MRI scanners to take images of the inside of the body (developed by physicists), ventilators to breathe for you, and pacemakers to beat your heart for you. All these things are only possible because of what scientists have learned over the last two centuries.
EVOLUTION

104. Science and technology has also given us the gift of time. 
We have far more time than we used to. We used to have to manually clean our own clothes and dishes, sweep floors with a brush, collect water from a well, and work only by daylight.
Human productivity has increased so much thanks to dishwashers, washing machines, vacuum cleaners, piped water, and artificial lights. It's just that we've found “new ways” to fill our time. (cell phones, games, computers, etc.)
MEDICAL INNOVATIONS

105. In 2011, people playing Foldit, an online puzzle game about protein folding, resolved the structure of an enzyme that causes an Aids-like disease in monkeys. Researchers had been working on the problem for 13 years. The gamers solved it in three weeks. (TECH Nerds)
A year later, people playing an astronomy game called Planet Hunters found a curious planet with four stars in its system, and to date, they've discovered 40 planets that could potentially support life, all of which had been previously missed by professional astronomers.

106. On paper, gamers and scientists make a bizarre union
On paper, gamers and scientists make a bizarre union. But in reality, their two worlds aren't leagues apart: both involve solving problems within a given set of rules. Genetic analysis, for instance, is about finding sequences and patterns among seemingly random clusters of data. Frame the analysis as a pattern-spotting game that looks like Candy Crush, and, while aligning patterns and scoring points, players can also be hunting for mutations that cause cancer, Alzheimer's disease or diabetes.
Our brains are “programmed” to recognize patterns.

107. Popular Research Games
 *Phylo: Make patterns and research diseases
*Foldit: Make a shape and understand proteins
Forgotten Island: Study organisms to assess man's impact (similar to Monkey Island)
Fraxinus: Align patterns to save ash trees
*EteRNA: Make shapes to understand genes
Ora: Protect a forest… to help protect forests
*Eyewire: Untangle puzzle and unearth new neurons
Cropland Capture: Identify arable land to feed the world

108. 2.04 Technology: How Much is Enough?

109. ENOUGH ALREADY ???
A year ago, an IBM computer won a Jeopordy game. From Fb to Angry Birds, technology is turning its attention to keep people healthy.
Venture capitalists have invested $955 MILLION into healthcare IT, triple from just 3 years ago.
The Federal gov’t. is also planning to spend up to $29 BILLION in incentives (??) to encourage hospitals and doctor offices to digitize health records.

110. How are “Tech Nerds” getting involved in Healthcare?
1. Crunching data to offer better diagnosis and treatment.
Keeping track of patient history, stay up to date on medical research and analyze treatment options
2. Helping doctors communicate with patients.
Translation apps
3. Linking doctors with other doctors.
Doximity, a social network exclusive to doctors for collaboration on difficult cases. It’s received $27 MILLION from the cofounder of LinkedIn.

111. 4. Connecting doctors and patients.
Medical consultations online and over the phone. Pt’s able to schedule appointments online.
5. Helping patients stay healthy.
Mobile Apps and gadgets to help people stay active, sleep better and eat healthier
Fitbit-tracks daily activity and sleep
Lark- a silent alarm clock and sleep monitor that tracks and analyzes a person’s quality of sleep over a period of time.
Dozens of calorie counting, food-monitoring and menu tracking Apps to help the diet conscious.

112. Help or Henderence?

114. How much technology is enough?

115. Is Technological Change in Medicine Worth It?
When costs and benefits are weighed together, technological advances have proved to be worth far more than their costs.
It’s only bad when the costs increases are greater than the benefits.

116. Two benefits of medical Innovations:
1. The value of better health- longer life as well as improved quality of life.
EX: LVAD vs Heart Transplant
2. Effect of financial effect on others- results from the increased production that results from people to work and earn more.
Worker’s comp. vs “Light Duty”

117. Treatment Expansion
Example 1- Heart Attack
1960’s ByPass surgery, major open heart surgical procedure.
1970’s Angioplasty, use of a balloon catheter to break up the blockage
1990’s Angioplasty with Stent placement to hold arteries open.
Cardiac Catheterization- a diagnostic procedure to measure the location and extent of arterial blockage.
INOVATION

118. 1984- $3 BILLION (Medicare) was spent on heart attack patients.
1998- nearly $5 BILLION (3.4% increase)
The number of heart attacks declined by 1%/year
But why was more $$$$$ spent when the number of heart attacks decreased?
As a result of better Risk Management, such as reduced smoking, better control of BP and cholesterol levels.
So, Benefit vs Costs???

119. Example 2- Low birth weight
1950 very little could be done for low birth weight infants
By 1990, there were substantial medical technologies available to treat these infants.
However, Medical and Developmental Complications- Cerebral Palsy, Blindness, Mental Disabilities were/are high risk for these infants.
Associated costs of Special Education, Disability payments, Ongoing Care, Medical Equipment (W/C), etc.

120. Example 3- Depression
Researchers are working on new approaches to treatment-resistant depression. They offer hope to people who haven't been able to control their depression with traditional methods. (Medications)
Currently, some of these approaches are available for people with depression only through research studies (clinical trials).

121. The high prevalence of depression in the general population has an adverse impact on the community and depression affects the patients well being and their productivity in life. It is reported as the third leading cause of disability as measured by disability adjusted life years (DALYs) and is projected to became the second leading cause in 2020 (WHO 2012). Furthermore, the life time risk of suicide in patients diagnosed with depression is as high as 6% (Inskip et al., 1998).Therefore effective treatment of depression is very important to prevent disability

122. fluoxetine – Prozac (1st in this class of drugs, 1988)
 SSRI’s (Selective Serotonin Reuptake Inhibitors) came about in the 1990’s. They have been considered as first line treatment for depression. They block a receptor in the brain cells that reabsorbs serotonin, (a mood enhancing chemical), making it more available to send messages.
There are six drugs available in this group,namely: 1st line tx’s
 fluoxetine – Prozac (1st in this class of drugs, 1988)
paroxetine - Paxil
sertraline - Zoloft
citalopram - Celexa
Escitalopram – Lexapro
fluvoxamine - Luvox (social anxiety, OCD)

123. Here are some of the newest advances for tackling treatment-resistant depression:
Transcranial Magnetic Stimulation (TMS, or rTMS) sends bursts of energy -- from electromagnets -- to specific areas of the brain. This treatment is thought to affect nerve cell communication in the brain that may play a role in depression.
The procedure is fairly simple and can be done in a doctor's office. It was approved by the FDA as a standard (nonexperimental) treatment for depression in October, 2008

124. During the procedure, the doctor or a technician will place the "paddle" against your scalp. The specific area of your scalp depends on what part of the brain your doctor is trying to affect. When switched on, the wire coil creates a magnetic field that can painlessly penetrate your brain. This magnetic field excites (stimulates) the targeted brain areas. Sessions often last about 30 minutes. You might be treated 5 days a week for 4 to 6 weeks.
TMS seems to have few risks and side effects, and it doesn't require hospitalization.

125. Magnetic Seizure Therapy (MST) is an experimental procedure that uses strong magnetic fields to trigger a controlled seizure in the brain. The effects are similar to those of ECT. For reasons that doctors don't entirely understand, these seizures can relieve thesymptoms of depression rapidly. MST requires a stay in the hospital. During the procedure, you would need to be under general anesthesia.
 According to a 2005 article in Primary Psychiatry, only 40 people worldwide have ever received this treatment. 

126. Deep Brain Stimulation is an invasive surgical procedure in which electrodes implanted in specific brain areas deliver a targeted electric current to relieve the symptoms of depression. It is already used as a treatment for Parkinson's disease. The electrodes that are surgically implanted in certain regions of the brain are powered by a battery pack implanted in the chest or abdomen.
While these new treatments are exciting, most are still experimental. Doctors aren't sure yet how well they work long term or what the effects will be.

127. Using the rain forest to fight viruses?