Straight talk with...Victor Dzau

NAS: speaking the truth to power for 150 years

On July 1, 2014, Victor Dzau, the current chancellor of health affairs at Duke University, will relinquish his position at the university to begin the first day of his six-year term as President of the Institute of Medicine (IOM) of the United States National Academies. Dzau is a prominent figure in the international world of health affairs whose penchant for innovation and policymaking led to an array of leadership roles in academic and corporate settings. Before coming to Duke, where he has led projects in translational research, health policy, and community health, Dzau held influential posts at Harvard Medical School, Brigham and Women’s Hospital, and Stanford University. A physician by training, Dzau rose to prominence in the early 1980s through his work on the renin-angiotensin-aldosterone system, a biochemical mechanism implicated in hypertension and congestive heart failure. His findings ultimately led to the development of a class of drugs called angiotensin-converting enzyme-inhibitors, which continue to be widely used as standard-of-care drugs for cardiovascular disease. Dzau spoke to PNAS about his background in health affairs and plans for his new role. Victor Dzau. Image courtesy of The Chronicle Newspaper, Duke University, Durham, NC. > PNAS:You were born in Shanghai, raised in Hong Kong, moved to Canada for medical school, and began your career in biomedical science in the United States. Did your childhood exposure to health disparities influence your decision to pursue health affairs later in life? > Dzau:As a boy, I moved with my family from Shanghai to Hong Kong under difficult circumstances. Around the 1950s, postwar China was rife with poverty …

Allocating Scarce Resources in Disasters: Emergency Department Principles

A right royal spat

Working Together to Address Challenges to the Teaching of Evolution

For many years, the National Academy of Sciences (NAS)1 has been at the forefront in responding to challenges to the teaching of evolution, working with other national and state organizations with similar objectives (summarized in Alberts and Labov, 2004 ; Labov, 2005 ). The NAS has established a website2 that makes freely available its three current publications on evolution education (NAS, 1998 , 1999 , 2004 ; National Research Council, 1996 ). Other publications about evolution (e.g., Hazen, 2005 ; Ayala, 2007 ), a variety of position papers, and links to evolution resources from other organizations comprise the balance of the site. One of these publications, Science and Creationism: A View from the National Academy of Sciences, 2nd ed. (NAS, 1999 ), has been widely used by people in many communities and especially by legal scholars and practitioners. It has been a prominent resource for major court cases, including Selman v. Cobb County Board of Education and Kitzmiller v. Dover Board of Education. The first edition (NAS, 1984 ) was originally prepared as an amicus brief for the United States Supreme Court.3 These booklets were important because they provided courts, educators, policy makers, and the public with a clear synopsis of the kinds of evidence that support both the fact and the theory of evolution, and they offered succinct explanations of the processes and nature of science (Ayala, 2008 ). The second edition of Science and Creationism was released just before the ascent of the intelligent design creationism movement as a prominent voice in the “controversies” about evolution, and this publication devotes only two paragraphs to that challenge. Thus, the leaders of the NAS decided that an update to this booklet that addresses these more recent challenges was both timely and necessary. The new edition has been renamed Science, Evolution, and Creationism (SE&C) (Figure 1). Given the increasing importance of an understanding of evolution for prevention and treatment of disease, this new booklet has been developed jointly by the National Academy of Sciences and the Institute of Medicine (IOM).4 As with the two earlier editions, SE&C (NAS and IOM, 2008 ) was authored by a committee of prominent scientists, many of whom are members of the NAS or IOM. And, this committee includes two teacher leaders, both of whom have served as president of the National Association of Biology Teachers. Figure 1. Cover of Science, Evolution, and Creationism. However, unlike its predecessors, this new edition was shaped to a large extent by a careful program of audience research. This research was initiated to bring about a better understanding of the frame of reference that the intended audiences bring to this issue. The committee decided early in the revision process that its goal was to successfully inform opinion leaders and influentials who could then use this information to help reframe5 discussions about the evolution “controversy.” By presenting authoritative scientific information in ways that address the questions and concerns of those who are unsure about teaching evolution in science classrooms, the authoring committee would provide opinion leaders and influentials (scientists, business leaders, clergy, teachers, members of school boards, policy makers, judges, lawyers, and others) with the tools needed to change the understanding and decisions of other people who comprise the “wobbly middle.” They defined the wobbly middle as the large percentage of citizens that various national polls have shown to be undecided about whether or not evolution, creationism, or some combination should be taught in public school science classrooms.

Trust is essential to the doctor/patient relationship, but trust in physicians' fiduciary ethic has become less plausible as a protector of patients' interests. The rise of managed care often is seen as undermining the fiduciary ethic and lessening the trustworthiness of care. But can managed care enhance that trustworthiness? Four possible sources of trustworthiness in managed care are discussed: ethical standards in the managed care industry, nonprofit organizations, physician control, and performance monitoring by purchasers. Limitations on all of these fronts suggest the continuing importance of a strong fiduciary ethic on the part of physicians who make patient care decisions.

US Institute of Medicine studies military burn pits

CBE is pleased to launch a new feature called Points of View (POV).POVs address issues faced by many people within the life sciences education realm.We will present two or more opposing POVs back-to-back on a particular topic to promote

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

When assessing the risks and benefits of medical drugs, the approach may be precautionary or permissive. If these different approaches actually influence the analysis and interpretation of technical medical data, then they are not merely a matter for discussion among philosophers, but should be debated by those concerned about medical risks and public health. To examine the interaction between expert risk-benefit assessments of drugs, on the one hand, and permissive/precautionary approaches, on the other, the triazolam (Halcion) case is scrutinised. Specifically, the assessments of triazolam by the FDA's 1992 Psychopharmacological Drugs Advisory Committee (PDAC) and the National Academy of Sciences' 1997 Institute of Medicine (IoM) are analysed. Both the PDAC and the IoM exhibited permissiveness towards triazolam. The PDAC gave priority to anecdotal evidence about triazolam in use, when assessing efficacy, but to controlled clinical trial data, when assessing safety. In each instance the types of data which favoured triazolam were given priority. While a lack of compelling evidence of efficacy from clinical trials was regarded as insufficient to negate the drug's benefits, compelling evidence from clinical trials was required to confirm signals of lack of safety. The IoM and the PDAC avoided the problem of patient safety in 'the real world' by limiting their conclusions to the safety of the drug under the conditions of use recommended on the label. Whether or not a society adopts a precautionary or permissive approach to the risk assessments of new technologies is not merely a matter for technical experts and science, it is also a social and political matter. A precautionary approach to drug safety could yield different expert assessments. It might require compelling evidence of drug efficacy where good alternative therapies exist; integrate how a drug can be used safely into evaluation of controlled clinical trial data; and put more emphasis on the correlation between disaggregated clinical trial data and spontaneous reports of adverse drug reactions.

The Institute of Medicine, part of the US National Academy of Sciences, recommended last week that the country needs an independent programme to evaluate “which diagnostic, treatment, and prevention services...

This article is made for the special issue of Cellular and Molecular Bioengineering—“Mechanobiology: A Tribute to Shu Chien’s Scientific Achievement” for his 80th Anniversary. Shu Chien is well known as a founder and pioneer of bioengineering. He is the only one in the world who simultaneously holds six academicians: US National Academy of Sciences, US National Academy of Engineering, US Institute of Medicine, and American Academy of Arts and Sciences, as well as Chinese Academy of Sciences and Academia Sinica Taiwan. As one of Shu Chien’s PhD students at Columbia University, the author emphasizes in this article the significant contribution of Professor Shu Chien in creating and defining chemotherapeutic engineering as an emerging and prospective multidisciplinary area, which is defined as application and further development of engineering especially chemical engineering principles to solve the problems in chemotherapy of cancer and other fatal diseases such as cardiovascular disease and AIDS. Proof-of-concepts experimental results obtained so far are summarized. Safety issue is addressed. Prospect and outlook are described. In the author’s point of view, chemotherapeutic engineering may change the way we make drugs and the way we take drugs, and will thus make significant contribution to the twentieth century medicine.

Event Abstract Back to Event AAAS at the Forefront of Cultivating the Next Generation of STEM Professionals Iris Wagstaff1* 1 American Association For The Advancement of Science, United States It has been well documented that the U.S. is not producing enough STEM majors and professionals to fill the job demands of the current and future workforce (Carnevale, Smith & Melton, 2011; National Academies of Sciences, Engineering, & Medicine, 2007). This problem is heightened with respect to women and racial minorities who continue to be underrepresented (National Academies of Sciences, Engineering, & Medicine, 2011; National Science Foundation, 2017). To maintain competitiveness in a global economy, the U. S. must leverage ALL of its human capital. This requires creating educational and career pathways to develop the talent needed to advance areas of health, energy, and national security. To this end, the American Association for the Advancement of Science (AAAS) – the oldest and largest multi-discipline scientific association in the world - develops and supports STEM education initiatives through its Education and Human Resources Division (EHR). The three-pronged foci of the EHR division is scientific literacy, broadening participation in STEM, and developing the STEM workforce. This presentation will highlight some of these efforts that include: 1) the Emerging Researchers National (ERN) Conference in STEM for undergraduate and graduate STEM majors to present their research and participate in skills development, 2) Science NetLInks, which provides online K-12 lessons, tools, and resources for students, parents, and teachers, 3) Science in the Classroom – a collection of freely available annotated research papers from the Science family of journals, 4) GSK in the Summer – A hands-on science program for elementary school children offered in community-based organizations in the DC metro area and in 20 other cities across the U.S., and 5) the STEM Volunteers Program – an organization of STEM professionals who volunteer in K-12 classrooms in the Washington DC metro area. Outcomes and impact of the ERN Conference and support of chemistry students will be highlighted in detail. Acknowledgements I would like to acknowledge NSF for funding the Emerging Researchers National Conference in STEM - Grant No. 1645036, Shirley Malcom - Director of the Education and Human Resources (EHR) Unit of AAAS, and Yolanda George - Deputy Director of EHR. References Carnevale, A., Smith, N., & Melton, M. (2011). Georgetown University Center on Education and the Workforce. Science Technology Engineering Mathematics (STEM). Retrieved from https://1gyhoq479ufd3yna29x7ubjn-wpengine.netdna-ssl.com/wp-content/uploads/2014/11/stem-complete.pdf National Academy of Sciences, National Academy of Engineering, and Institute of Medicine. 2007. Rising Above the Gathering Storm: Energizing and Employing America for a Brighter Economic Future. Washington, DC: The National Academies Press. https://doi.org/10.17226/11463. National Academy of Sciences, National Academy of Engineering, and Institute of Medicine. 2011. Expanding Underrepresented Minority Participation: America's Science and Technology Talent at the Crossroads. Washington, DC: The National Academies Press. https://doi.org/10.17226/12984. National Science Foundation, National Center for Science and Engineering Statistics. 2017. Women, Minorities, and Persons with Disabilities in Science and Engineering: 2017. Special Report NSF 17-310. Arlington, VA. Retrieved from www.nsf.gov/statistics/wmpd/. Keywords: stem, Education, NSF, ERN, Broadening participation in STEM, diversity Conference: National Organization for the Professional Advancement of Black Chemists and Chemical Engineers (NOBCChE) 45th Annual Conference , Orlando, Florida, United States, 17 Sep - 20 Sep, 2018. Presentation Type: Oral Presentation Topic: STEM Citation: Wagstaff I (2019). AAAS at the Forefront of Cultivating the Next Generation of STEM Professionals. Front. Chem. Conference Abstract: National Organization for the Professional Advancement of Black Chemists and Chemical Engineers (NOBCChE) 45th Annual Conference . doi: 10.3389/conf.fchem.2018.01.00060 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 19 Oct 2018; Published Online: 17 Jan 2019. * Correspondence: Dr. Iris Wagstaff, American Association For The Advancement of Science, Washington D.C., United States, irisrwag@yahoo.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Iris Wagstaff Google Iris Wagstaff Google Scholar Iris Wagstaff PubMed Iris Wagstaff Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Celebrating Mayo Clinic Proceedings' 90th Anniversary: A Story of Longevity and Progression of Mission