History of Medicine Schedule and Abstracts 2009-2010

From Genes to Genome: An historical perspective (David Wheeler) Ignaz Semmelweis: Medical Prophet Without Honor (Ronald L. Young) Why Lewis Thomas, MD is Not a Bore: The Life of a Biology Watcher (Steven Greenberg) Doctors from Hell: The Horrific Account of Nazi Experiments on Humans (Vivien Spitz) Illuminating Autism: Passing the Torch from the Twentieth Century (Student Essay Contest Winners) (Lynn Yudofsky) Healing Beyond Hippocrates: The Temples of Asclepius and Public Health Care in Ancient Greece (Andrew Baldwin) Iron Wills and Iron Lungs: The Polio Years in Texas (Heather Green Wooten) William Osler and the Inspirational Uses of History (Michael Bliss) Working Too Hard and Achieving Too Much: The Cost of Being Harvey Cushing (Michael Bliss) Medicine in Ancient Egypt (Gene Boisaubin) The History of Diabetes (Jeff Unger)

State of the Antarctic and Southern Ocean Climate System

This paper reviews developments in our understanding of the state of the Antarctic and Southern Ocean climate and its relation to the global climate system over the last few millennia. Climate over this and earlier periods has not been stable, as evidenced by the occurrence of abrupt changes in atmospheric circulation and temperature recorded in Antarctic ice core proxies for past climate. Two of the most prominent abrupt climate change events are characterized by intensification of the circumpolar westerlies (also known as the Southern Annular Mode) between similar to 6000 and 5000 years ago and since 1200-1000 years ago. Following the last of these is a period of major trans-Antarctic reorganization of atmospheric circulation and temperature between A. D. 1700 and 1850. The two earlier Antarctic abrupt climate change events appear linked to but predate by several centuries even more abrupt climate change in the North Atlantic, and the end of the more recent event is coincident with reorganization of atmospheric circulation in the North Pacific. Improved understanding of such events and of the associations between abrupt climate change events recorded in both hemispheres is critical to predicting the impact and timing of future abrupt climate change events potentially forced by anthropogenic changes in greenhouse gases and aerosols. Special attention is given to the climate of the past 200 years, which was recorded by a network of recently available shallow firn cores, and to that of the past 50 years, which was monitored by the continuous instrumental record. Significant regional climate changes have taken place in the Antarctic during the past 50 years. Atmospheric temperatures have increased markedly over the Antarctic Peninsula, linked to nearby ocean warming and intensification of the circumpolar westerlies. Glaciers are retreating on the peninsula, in Patagonia, on the sub-Antarctic islands, and in West Antarctica adjacent to the peninsula. The penetration of marine air masses has become more pronounced over parts of West Antarctica. Above the surface, the Antarctic troposphere has warmed during winter while the stratosphere has cooled year-round. The upper kilometer of the circumpolar Southern Ocean has warmed, Antarctic Bottom Water across a wide sector off East Antarctica has freshened, and the densest bottom water in the Weddell Sea has warmed. In contrast to these regional climate changes, over most of Antarctica, near-surface temperature and snowfall have not increased significantly during at least the past 50 years, and proxy data suggest that the atmospheric circulation over the interior has remained in a similar state for at least the past 200 years. Furthermore, the total sea ice cover around Antarctica has exhibited no significant overall change since reliable satellite monitoring began in the late 1970s, despite large but compensating regional changes. The inhomogeneity of Antarctic climate in space and time implies that recent Antarctic climate changes are due on the one hand to a combination of strong multidecadal variability and anthropogenic effects and, as demonstrated by the paleoclimate record, on the other hand to multidecadal to millennial scale and longer natural variability forced through changes in orbital insolation, greenhouse gases, solar variability, ice dynamics, and aerosols. Model projections suggest that over the 21st century the Antarctic interior will warm by 3.4 degrees +/- 1 degrees C, and sea ice extent will decrease by similar to 30%. Ice sheet models are not yet adequate enough to answer pressing questins about the effect of projected warming on mass balance and sea level. Considering the potentially major impacts of a warming climate on Antarctica, vigorous efforts are needed to better understand all aspects of the highly coupled Antarctic climate system as well as its influence on the Earth's climate and oceans.

An arranged marriage for precision medicine: hypoxia and genomic assays in localized prostate cancer radiotherapy

Prostate cancer (CaP) is the most commonly diagnosed malignancy in males in the Western world with one in six males diagnosed in their lifetime. Current clinical prognostication groupings use pathologic Gleason score, pre-treatment prostatic-specific antigen and Union for International Cancer Control-TNM staging to place patients with localized CaP into low-, intermediate- and high-risk categories. These categories represent an increasing risk of biochemical failure and CaP-specific mortality rates, they also reflect the need for increasing treatment intensity and justification for increased side effects. In this article, we point out that 30-50% of patients will still fail image-guided radiotherapy or surgery despite the judicious use of clinical risk categories owing to interpatient heterogeneity in treatment response. To improve treatment individualization, better predictors of prognosis and radiotherapy treatment response are needed to triage patients to bespoke and intensified CaP treatment protocols. These should include the use of pre-treatment genomic tests based on DNA or RNA indices and/or assays that reflect cancer metabolism, such as hypoxia assays, to define patient-specific CaP progression and aggression. More importantly, it is argued that these novel prognostic assays could be even more useful if combined together to drive forward precision cancer medicine for localized CaP.

WOCAT - World Overview of Conservation Approaches and Technologies - Preliminary results from Eastern and Southern Africa

The World Overview of Conservation Approaches and Technologies (WOCAT) is a program of the World Association of Soil and Water Conservation (WASWC), organized as a consortium of several international institutions. The overall goal of WOCAT is to contribute to sustainable utilization of soil and water. WOCAT collects and analyzes information on soil and water conservation (SWC) technologies and approaches world-wide, and presents the collected information in computer databases and decision support systems, and in the form of handbooks, reports and maps readily accessible to SWC specialists and policy-makers world-wide. WOCAT has prepared a framework for the evaluation of soil and water conservation and has started data collection. The paper presents preliminary results with promising SWC technologies and approaches used in Eastern and Southern Africa. The first finding is that hardly any promising SWC activities could be found on common grazing lands. Analysis of the cropland shows some of the bio-physical and socioeconomic conditions under which certain SWC technologies and approaches are used, including land use types, climatic zones and land tenure, and looks at issues such as participation and costs. Furthermore, classification criteria for SWC technologies and approaches are discussed.

Rapid divergence in physiological and life-history traits between northern and southern populations of the British introduced neo-species, Senecio squalidus

Alien plants provide a unique opportunity to study evolution in novel environments, but relatively little is known about the extent to which they become locally adapted to different environments across their new range. Here, we compare northern and southern populations of the introduced species Senecio squalidus in Britain; S. squalidus has been in southern Britain for approximately 200 years and reached Scotland only about 50 years ago. We conducted common garden experiments at sites in the north and south of the species’ range in Britain. We also conducted glasshouse and growth chamber experiments to test the hypothesis that southern genotypes flower later, are more drought-tolerant, germinate and establish better at warmer temperatures, and are less sensitive to cold stress than their more northern counterparts. Results from the common garden experiments are largely consistent with the hypothesis of rapid adaptive divergence of populations of the species within the introduced range, with genotypes typically showing a home-site advantage. Results from the glasshouse and growth chamber experiments demonstrate adaptive divergence in ability to tolerate drought stress and high temperatures, as well as in phenology. In particular, southern genotypes were more tolerant of dry conditions and high temperatures and they flowered later than northern genotypes. Our results show that rapid local adaptation can occur in alien species, and they have implications for our understanding of the ecological genetics of range expansion of introduced weeds.