Treatment of lupus nephritis: art or science? [Editorial]

No Abstract

In situ hybridization to mRNA: from black art to guiding light

In situ hybridization to mRNA in embryo sections or wholemount embryos is one of the most powerful analytical tools available to the molecular developmental biologist. For many workers, this procedure provides the first insights into the function of newly isolated genes, allowing the formulation of hypotheses and setting the course for further research. This paper presents a personal historical perspective of the development of in situ hybridization, looks at the theory and practice of the technique, summarizes the current state of the art, and speculates on possible directions for the future as a tool in functional genomics.

Segmentation of spoken words into syllables by English-speaking children as compared to adults

Given the importance of syllables in the development of reading, spelling, and phonological awareness, information is needed about how children syllabify spoken words. To what extent is syllabification affected by knowledge of spelling, to what extent by phonology, and which phonological factors are influential? In Experiment 1, six- and seven-year-old children did not show effects of spelling on oral syllabification, performing similarly on words such as habit and rabbit. Spelling influenced the syllabification of older children and adults, with the results suggesting that knowledge of spelling must be well entrenched before it begins to affect oral syllabification. Experiment 2 revealed influences of phonological factors on syllabification that were similar across age groups. Young children, like older children and adults, showed differences between words with short and long vowels (e.g., lemon vs. demon) and words with sonorant and obstruent intervocalic consonants (e.g., melon vs. wagon). (C) 2002 Elsevier Science (USA). All rights reserved.

Whither our Art? Clinical Wisdom & Evidence-based Medicine

The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute. For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other, human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why particular beliefs are held, and the epistemological status of claims based in wisdom or experience. The paper critically appraises a number of claims and distinctions, and attempts to clarify the connections between EBM, clinical experience and judgement, and the objective and evaluative categories of medicine. I conclude that to demystify clinical wisdom is not to devalue it. EBM ought not be conceived as needing to be limited or balanced by clinical wisdom, since if its language is translatable into terms comprehensible and applicable to individuals, it helps constitute clinical wisdom. Failure to appreciate this constitutive relation will help perpetuate medical paternalism and delay the adoption of properly evidence-based practice, which would be both unethical and unwise.