Chronic disease begins in the womb – and earlier

Dr. Kent Thornburg of Oregon Health & Science University presented an intriguing “Update Seminar” at the HAPS meeting in Portland, OR that discussed the increased incidence of some chronic diseases in the US and their likely epigenetic origins from even before we are born.

The implications of his talk were quickly apparent when he made the point that, after over a century of steady increases in life expectancy, the predicted life expectancy in the US has actually decreased since 2015. This should get everyone’s attention. Why in this age of plenty are we dying younger? Dr. Thornburg postulated that plentiful access to calorie-rich and nutrition-poor food has led to the current epidemic of obesity and its associated chronic diseases, most notably diabetes and cardiovascular complications. Indeed, to put a dollar amount on it, we are currently paying over $500 billion per year to treat cardiovascular diseases and that number is projected to reach over one trillion dollars per year by 2035. These costs are not sustainable under any sort of healthcare plan.

While clearly obesity of the current generation is a major concern, it is the prenatal epigenetic signature of obesity that is cause for even more concern. An epigenetic signature is a set of inheritable marks on our DNA due to DNA methylation and histone modifications. As a result, the nutrition state in the womb can affect the later health of the child, for example:

  1. The correlation of birth weight and risk of heart disease, diabetes, etc.  is a U-shaped curve in which being too small (< 5 lbs at birth) and being too large (> 10 lbs. at birth) are both associated with higher chances of chronic diseases in later life. Obese mothers are prone to give birth to babies who fall on either arm of the U-curve. This suggests that our health destiny is partly established by our mother and the conditions we experienced within the womb.
  2. The Dutch hunger study has shown chronic diseases were maintained in 3 successive generations of the people who faced starvation during World War II. This can be explained by the fact that the grandmother who actually suffered starvation nourished not only her baby daughter in utero, but also nourished that baby’s developing ovaries. Hence, grandma’s nourishment state could directly affect the nourishment of her children and even her grandchildren before they are born.
  3. Finally, the impact of epigenetics on our traits is no more apparent than in identical twins. An interesting bit of trivia for mystery sleuths is that the swirls that define our fingerprints are determined by nutritional state of the fetus and even with two fetuses within the same placenta, about 70% of identical twins have different fingerprints. Not surprisingly then, about 80% also die of different diseases, supporting the potential for epigenetic factors to combine with or modify genetic determinants of our health.

In summary, Dr. Thornburg concluded that we in the US are dealing with what he called “high caloric malnutrition” leading to “smoldering inflammation” in babies and future generations. Not the inflammation we commonly think of with immune system responses, but rather an inflammation caused by the “epigenetic burden” that leads to chronic disease. However, he did end with two important notes. First, we cannot blame the mothers since they are eating the same diet we all are. And secondly, based on animal studies, there is evidence that at least some of the epigenetic burden can be changed over time. So, there is hope.

Want to hear more of the story directly from Dr. Thornburg? Check out his TED Talk here. 


Copyright property of Todd Adamson

Andrew Russo is a Professor of Molecular Physiology and Biophysics, and Neurology, at the University of Iowa. Dr. Russo received his Ph.D. in Biochemistry from the University of California, Berkeley, followed by postdoctoral training in molecular neurobiology at the University of California, San Diego. Dr. Russo’s research area is the molecular basis of migraine. His lab uses mouse genetic models to study how the neuropeptide CGRP contributes to the pain and altered sensory perception that is a hallmark of migraine. In addition to his research, Dr. Russo enjoys teaching, which led to him becoming a co-author of Seeley’s Human Anatomy and Physiology textbook. He is a member of HAPS and especially enjoys the generally excellent update seminars at the annual meetings.

 

Anatomy & Physiology students share their knowledge with the world through Wikipedia

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We all know that students use Wikipedia. But many don’t have the skills to evaluate the accuracy of the information they read there (Wineburg et al., 2016). Instead of issuing a blanket ban on the website, many professors are now having their students write Wikipedia articles as an assignment. As one put it, “Students can’t cite Wikipedia if they’re writing it.”

In a Wikipedia writing assignment, students play the role of “expert” as they summarize course content into relevant Wikipedia articles. The exercise essentially mirrors a lit-review assignment, except that millions of people have access to that student work.

It’s part of a growing movement of educators embracing Wikipedia as a learning tool, with instructors from more than 500 universities involved in the US and Canada. Most aren’t familiar with the inner-workings of Wikipedia, but still successfully guide their students in editing articles thanks to free support and student trainings offered by Wiki Education

Practicing science communication on a world stage

By bringing their work to Wikipedia, students make a difference for public knowledge while also diving deeply into course content. Last term, a student at Drew University contributed well-referenced content to Wikipedia’s article about Sheehan’s syndrome, adding sections about its causes and history. Now the almost 200 daily visitors to the page can access better information summarized from academic sources.

Another student, from Fordham University, expanded the Wikipedia article about intrinsically photosensitive retinal ganglion cells in 2017, adding new sections about structure and function. They were even inspired to create and add a new diagram (Fig.1). Since then, the page has been viewed almost 50,000 times by Wikipedia’s readers.

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Fig 1: Diagram of inputs and outputs of ipRGCs and their corresponding location in the brain, created by a Fordham University student as part of their Wikipedia writing assignment [image link]

Sometimes instructors have students create new Wikipedia biographies for women scientists instead of having them expand articles about course topics. Only 18% of Wikipedia biographies are about women, so when students participate in this endeavor, they are helping correct that gender gap in public knowledge. Having students write Wikipedia biographies for women in STEM not only demonstrates to them that diversity and inclusion belongs in STEM, it asserts that to the world. 

Student learning outcomes

Instructors have found a Wikipedia writing assignment to be an opportunity to solidify students’ research skills, critical media literacy, and ability to write for a public audience (Vetter et al, 2019). By participating in the production of knowledge on a site they use all the time, students understand where that information comes from and how to assess the accuracy of online information they encounter in the future.

Want to get involved?

If you’re interested in improving science content on Wikipedia, there are a few ways to get involved:

  • Use Wiki Education’s free assignment templates to have your students write Wikipedia articles related to your course topic: teach.wikiedu.org.
  • Learn how to edit Wikipedia yourself and expand your educational reach to the public: learn.wikiedu.org

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As Wiki Education’s Outreach and Communications Associate, Cassidy Villeneuve helps share the impact of Wikipedia editing on students, professionals, and public knowledge.

The HAPS Learning Outcome revisions are here!

The full revision of the HAPS Learning Outcomes (LOs) is now available on the HAPS website!  This is the first major revision of the HAPS A&P LOs since their release, and brings the LOs up to date in terminology and organization.  A parallel effort with the HAPS Anatomy Learning Outcomes brings both documents into direct alignment.  

This release of the HAPS A&P LOs is the result of two years of effort by the Learning Outcomes Task Force, led by Jennifer Burgoon and Valerie O’Loughlin, which included multiple video conference calls and several face-to-face meetings generously supported by Macmillan Learning.  Macmillan flew the entire team to their offices in Austin, Texas, and made sure the group was properly cared for while they did their important work for HAPS. Generous partners like Macmillan from the private sector often make efforts like these LOs possible.

Both sets of learning outcomes are now available for download to HAPS members on the HAPS website.  All are available in three formats: PDF of the full list of 20 modules, Word versions of each of the modules separately, and spreadsheet version of all modules.  We encourage HAPS members to use these in any way you find helpful – HAPS resources like these belong to the members!

In addition, there is a white paper written by the Learning Outcomes Task Force that details the motivation, methods, and decisions made by the committee during their years long effort.  This document is designed to help longtime users of the learning outcomes transition to the 2019 editions.

The HAPS Learning Outcomes have important roles within and outside of HAPS.  Most major publishers are now keying their content to the HAPS LOs, teaching programs are aligning their outcomes to the HAPS outcomes, and within HAPS both the A&P and Anatomy Exams have been linked to the outcomes.  

The HAPS Exams bring the learning outcome process full circle by adding assessment – every question on every HAPS exam has a primary (and sometimes secondary learning outcome) with which it is associated.  The HAPS A&P exams have been in existence for decades and fully online since 2014, and the HAPS Anatomy exam has been online since its beginning. Both are among the most cost-effective standardized exams available and both continue to be actively developed and improved.  We now offer flexibility in how uses choose to administer the exams. We have both an on-campus option proctored by instructors and an off-campus method that leverages our partnership with ProctorU to open the exam to online classes and anyone who wants to offer scheduling flexibility.  

The HAPS A&P and Anatomy Learning Outcomes are now finalized, uploaded, and ready for you.  And the HAPS Physiology Learning Outcomes are on their way – the Physiology task force has started work and the outcomes should be available in roughly 18 months.  

Take a look at the latest!

HAPS Diversity & Inclusion Survey

In the fall of 2018, HAPS approved a new task force; the Diversity and Inclusion Group (DIG). This was a significant step for HAPS as a professional society. In a January 2019 blog post, Kathy Burleson, the DIG chair, explained its purpose, which is “to develop best practices, resources, and professional development for inclusive education in anatomy and physiology.” Attendees of the 2019 HAPS annual conference in Portland may recall numerous workshops, speakers, and posters promoting diversity and inclusion inside and outside of our classrooms.

 Since the mission of HAPS is to promote excellence in the teaching of A&P, we as educators must continue to strive to understand the unique identities, perspectives, and experiences of our students if we are to overcome barriers to learning. However, to move forward with that mission in a united way, HAPS needs to address any barriers to inclusion within our own member base, and understand the unique needs of our members. To accomplish this goal, the DIG created the HAPS Diversity & Inclusion Membership survey. The purpose of the survey is to gather membership data that will tell us who we are as an organization and identify needs regarding diversity and inclusion.

 The expected outcomes of the survey include the development of teaching resources, professional presentations and social events at HAPS meetings, potential funding opportunities, and the development of a 5-year plan for HAPS around diversity and inclusion.

Please consider taking the Diversity & Inclusion Survey–HAPS members should check their inboxes to find the link. Participation is entirely voluntary. The IRB-approved survey should take approximately 15 minutes to complete, and those who finish the survey are eligible to win one of six $50 Amazon gift cards. Questions concerning the IRB for this survey should be directed to Theo Smith, smittheo@iu.edu. If you have any other questions about this survey or would like to get involved with DIG, please contact Kathy Burleson, kburleson@hapsconnect.org.

Cleaning Anatomical Models with Denture Tablets

TeethThe weeks leading up to the start of a new semester are busy ones filled with ordering supplies, scheduling teaching assistants, and cleaning the lab. After scheduling custodial services for the big jobs and performing the little jobs, I never seem to have time to clean the models (most of which are 30+ years old!). A couple of models were so covered in grime, grease, adhesives from practicals past, ink, etc., that it was easier to put them back on the shelf and ‘deal with it later.’ In January 2018, however, I found myself with a bit of time and was finally going to clean one of our dental models that I couldn’t, in good conscience, discard without at least trying to clean it. My original plan was to use dish soap and an old toothbrush to clean it. I gave up after 30 minutes as I wasn’t making a dent in the grime. I considered other options, but the model was too big for our ultrasonic cleaner and I didn’t want to put it through a cycle in a dishwasher for fear that the force of water jets and heat would warp the model or remove paint.

SkullsAs I considered my next step, I recalled my recent dental work — two root canals, a bone graft, failed implants, and a temporary bridge. In an example of chance favoring the prepared mind, I thought: ‘I’m holding a model of teeth. It is made of plastic, a little metal, and a bit of paint — just like the bridge I soak every night. Would denture cleaning tablets work? It’s unlikely that I would damage the model by soaking it overnight and worth a try.’

After a 30-second rinse and brushing the morning after the soak, the model was like new. The difference was so striking I felt I had performed a magic trick. I immediately set out to clean another model to convince myself that this was repeatable. I use a basic methodology of 1 denture-cleaning tablet per 250ml of water (approximate) and an overnight soak. Models are rinsed the next day and gently scrubbed with a soft sponge. Paint that is not heat-set can be rubbed off if you scrub too vigorously. An old toothbrush can be helpful for hard-to-reach places.

FeetVertebrae

Why does it work?

Denture cleaning tablets are primarily composed of sodium bicarbonate (i.e., baking soda — a mild alkali which functions as a degreaser), an oxidizer, and a scent (typically mint). I have been testing the use of baking soda and hydrogen peroxide as soaking and cleaning agents with similar results and have been considering OxiCleanTM (composed of sodium percarbonate (i.e., sodium carbonate and hydrogen peroxide), soda ash, and detergents) as a cleanser. Costs for denture cleaning tablets, baking soda and hydrogen peroxide, and OxiCleanTM are minimal and can ‘pay for themselves’ by extending the working life of your models. Limitations are the size of soaking containers and rinsing facilities.

CaveatsFootBones

  • Perform a small-model test case before working with larger models or several models at once.
  • I do not recommend using this technique on models made of plaster.
  • Examine models for any puncture holes (for screws, hooks, etc.) and position models during soaking to avoid waterlogging.

 

 

 


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Carol Britson is an Instructional Associate in the Department of Biology at the University of Mississippi where she teaches Vertebrate Histology, Human Anatomy, and Introductory Physiology for science majors and Human Anatomy and Physiology I & II for allied health students. In 2018 she received the University of Mississippi Excellence in Teaching award from the PLATO (Personalized Learning & Adaptive Teaching Opportunities) Program supported by the Association of Public and Land-Grant Universities and the Bill and Melinda Gates Foundation.

The 2019 Annual Conference App is here!

The 2019 HAPS Annual conference app is ready for download and ready for you!

DOWNLOAD FOR iOS                      DOWNLOAD FOR ANDROID

Full schedule, easy to access. All official events are listed in the app, and all you have to do is click on the star next to an event to add it to your personal schedule.

All workshop presenters are listed, so you can find workshops by presenter or by knowing when to look. Poster first presenters are listed as well, with poster abstracts in the presenter’s bio.

Want to participate in the social stream in the app? All you have to do is register within the app and start posting! Look in the exhibits hall in the first two days to see all social posts projected on the giant social wall!

Looking for members of the HAPS leadership? They would love to hear your suggestions and will be wearing bullseye buttons to make them easy to spot. But if you’d like to get a look at them before (or after) meeting them, all their names and photos are in the app.

HAPS conference participants come from all over the world to attend this conference, and we’ve got an interactive map of all participants in the app. As you zoom in you’ll see more and more detail down to the city level.

Interested in beginning your path towards HAPS leadership? The best start is by joining a committee. Use the app to let committee chairs know about your interest and they will contact you in June.

Need more information? The app has GPS-enabled maps to show you where you are and highlights the venues we’ll be using during the conference. There is also the “Lots more info” section with, you guessed it, lots more info.

Download the app today and get started planning your personal HAPS Annual Conference schedule!

DOWNLOAD FOR iOS                      DOWNLOAD FOR ANDROID

Community College Anatomy and Physiology Education Research Program

Community College Anatomy and Physiology Education Research (CAPER) Program: Promoting Change in Classroom Pedagogy to Benefit Students

Active learning is not a new concept within HAPS. Annual conference poster and workshop sessions are chock-full of ideas on how to incorporate more student-centered techniques and personal storiesof faculty experiences with various methods. Nearly all of us likely have active learning terms in our lexicon and the majority of HAPS members would agree we should use such techniques (if not, please see the meta-study by Freeman et al. [1]). Yet an awareness of active learning and its benefit by itself does not necessarily drive change in our classroom practice.  The more change is required, especially when that change is associated with significant effort, possibly even a seismic shift from our past teaching routines, the less likely we are to rush out and try it. And if an instructor is really motivated to find out what most benefits their specific population of students, the thought of developing an actual pedagogical study can seem utterly overwhelming. This is where peer-mentoring and a set timeline can really help. The Community College Anatomy and Physiology Education Research (CAPER) Program is designed to provide the needed support for participating community college instructors.

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CAPER is an NSF-funded project, with Murray Jensen (University of MN) as Principal Investigator. CAPER is aimed at supporting community college faculty who are interested in identifying how evidence-based instructional practices (EBIPs) impact the community college student population, a population that has been under-studied in the active learning literature. The current cohort of six participants kicked off the project by participating in the HAPS-I Educational Research course in fall 2018. Their culminating project for the course was an educational research proposal they are implementing this spring. A group of additional active HAPSters also participated as mentors in the HAPS-I course, providing feedback on project proposals and helping as needed.  Kerry Hull, for example, is heading up an interdisciplinary group at Bishop’s University in Ontario, Canada that provides expertise in experimental design, data analysis, and manuscript preparation.

In addition to the studies being conducted by each instructor, all instructors are working with the research team to investigate the impact of EBIPs on reducing student stress and increasing their feelings of academic self-efficacy. If you are attending the meeting in Portland, be sure to check out the CAPER posters, or attend our workshop, to learn more specific details about the project.

Principal Investigators: Murray Jenson, Kerry Hull (BU sub-contract)
Mentors: Ron Gerrits, Betsy Ott, Kyla Ross
Research Support: Heather Lawford, Suzanne Hood
Graduate Students: Laura Seithers, Rob Palmer

[1]   S. Freeman et al., “Active learning increases student performance in science, engineering, and mathematics,” Proc. Natl. Acad. Sci., vol. 111, no. 23, pp. 8410–8415, Jun. 2014.


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Submitted by Ron Gerrits on behalf of the CAPER group. Ron Gerrits is a Professor at the Milwaukee School of Engineering where he teaches health-science courses, mainly physiology. His professional interests are science and engineering education. Currently he is one of the mentors on the CAPER project, which includes several HAPSters interested in improving physiology education (which seems to be a group trait of HAPS!).