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Beaks, Bills and Climate
By SINDYA N. BHANOO, The New York Times, June 28, 2010
In the 1800s, an American zoologist named Joel Allen posited that animals in cold climates evolved to have shorter appendages (limbs, ears, and tails) than those in hot climates, in order to minimize surface area and thereby minimize heat loss. The theory, known as Allen’s rule, has long appeared in biology books, but scientific evidence for it has remained weak.
Now a study comparing bird bills provides the most substantial evidence yet in support of Allen’s rule.
Researchers looked at more than 200 bird species and found that there is a significant relationship between bill length and climate. Birds that live in hot environments, like the toucan, tend to have large bills. Those in colder environments, like the turkey, have smaller ones.
In the case of the toucan, about 30 to 60 percent of body heat can be lost through the beak. In a hot, tropical environment, this is extremely useful.
On average, birds living in cooler climates, like the turkey and the partridge, have beaks one-third to one-fourth the size of birds in warmer climates, said Glenn Tattersall, a biologist at Brock University in Ontario, Canada, and one of the study’s authors. This helps them retain body heat, Dr. Tattersall said.
For the study, he gathered data on birds that live in Canada’s cooler climate, while his co-author, Matthew Symonds of Melbourne University, focused on Australian birds that live in warmer climates.
Their study will appear in a future issue of The American Naturalist.
Effort Uses Dogs’ DNA to Track Their Abusers
By MALCOLM GAY, The New York Times, June 25, 2010
ST. LOUIS — Scientists and animal rights advocates have enlisted DNA evidence to do for man’s best friend what the judicial system has long done for human crime victims. They have created the country’s first dog-fighting DNA database, which they say will help criminal investigators piece together an abused animal’s history by establishing ties among breeders, owners, pit operators and the animals themselves.
Called the Canine Codis, or Combined DNA Index System, the database is similar to the Federal Bureau of Investigation’s digital archive containing the DNA profiles of criminal offenders. Scientists say that by swabbing the inner cheek of a dog, they will be able to determine whether the animal comes from one of several known dog-fighting bloodlines.
“People are not generally going to the pound and buying pit bulls to fight — these dogs are from established bloodlines,” said Tim Rickey, senior director of field investigations and response for the American Society for the Prevention of Cruelty to Animals. “And if a suspected dog fighter’s animal matches one of those bloodlines, that would be a key piece of evidence.”
The database, a joint effort by the A.S.P.C.A., the Louisiana S.P.C.A., the Humane Society of Missouri and researchers at the Veterinary Genetics Laboratory at the University of California, Davis, was developed during an investigation last July that resulted in 26 arrests and the seizure of more than 400 dogs. The investigation, which stretched across seven states, from Iowa to Texas, resulted in the largest dog-fighting raid in United States history, the authorities said.
“We ran the DNA to see if we could connect the different crime scenes and 400 different dogs, which we were able to do,” said Dr. Melinda Merck, a forensic veterinarian for the A.S.P.C.A. “A lot of times defendants will claim not only that they are not dog fighting, but also that they’re just breeding and they don’t know each other.”
The DNA showed otherwise, indicating that many of the dogs were related. The July raids have yielded at least 17 guilty pleas, and while the DNA evidence did not conclusively prove a relationship among defendants, it certainly suggested one. Investigators caution, however, that DNA evidence alone will rarely make a case, though many juries have come to expect it.
“There is definitely a C.S.I. effect,” Dr. Merck said. “Juries want to know that if you have evidence you’ve run every possible test. The DNA is just one more tool in our kit that can bolster our cases.” She added, “I do think it’s something that is going to make the dog-fighting world very nervous.”
Illegal in all 50 states, dog fighting gained national attention in 2007 when Michael Vick, then the star quarterback for the Atlanta Falcons, pleaded guilty to federal dog-fighting conspiracy charges and went on to serve 21 months in prison.
Investigators say the multimillion-dollar industry is often associated with other illicit activities like drug trafficking and gambling. But the real money, they say, comes from breeding the animals, which can fetch up to $50,000 for a champion fighter.
“There’s a lot of money that’s made on the fight purses and the side wagering, but the goal for these dog fighters is to breed a champion or a grand champion,” Mr. Rickey said. “It’s not uncommon to get $5,000 for a puppy. Over a dog’s lifespan, that can be in the tens of thousands if not hundreds of thousands of dollars.”
Researchers say the database, which contains the genetic profiles of nearly 400 of the dogs recovered in the raid, will become more useful as it grows.
Beth Wictum, who directs the forensic unit at the University of California, Davis, where the database is stored, hopes to “identify other lineages that are in the West.”
Investigators add that the database may also prove useful in forensic investigations of blood samples found at a dog-fighting site, allowing them to establish the presence of a particular dog.
“One of the challenges in a lot of these fighting pits is that the losing dogs are often executed and dumped along the side of the road somewhere,” Mr. Rickey said. “This database may provide a useful tool for tracking down where the animal was bred, and maybe the owner.”
Nearly 250 of the animals recovered during the July 2009 raid have been rehabilitated and are now pets or service and therapy dogs.
“These animals were horribly mutilated — missing ears, missing eyes, missing parts of their legs,” said Jeane Jae, a spokeswoman for the Humane Society of Missouri, which housed the animals that contributed to the database. “But when given a choice, many will choose not to fight — that’s an animal that’s capable of rehabilitation.”
One such animal, a brown and white pit bull that now goes by the name Reggie, still bears a web of fight scars across his face. The dog cowers at the sound of cheering crowds, which his owner, Gale Frey, believes he associates with the roar of the fight pit.
Nevertheless, Ms. Frey says, Reggie has made great strides and is being trained to work as a therapy dog in St. Louis-area hospitals.
“We’re moving forward,” said Ms. Frey, who runs Phoenix Pack, a nonprofit dog rescue service in St. Louis. “The pit’s in the past.”
Antibiotics in Animals Need Limits, F.D.A. Says
By GARDINER HARRIS, The New York Times, June 28, 2010
WASHINGTON — Federal food regulators took a tentative step Monday toward banning a common use of penicillin and tetracycline in the water and feed given cattle, chickens and pigs in hopes of slowing the growing scourge of killer bacteria.
But the Food and Drug Administration has tried without success for more than three decades to ban such uses. In the past, Congress has stepped in at the urging of agricultural interests and stopped the agency from acting.
In the battle between public health and agriculture, the guys with the cowboy hats generally win.
The F.D.A. released a policy document stating that agricultural uses of antibiotics should be limited to assuring animal health, and that veterinarians should be involved in the drugs’ uses.
While doing nothing to change the present oversight of antibiotics, the document is the first signal in years that the agency intends to rejoin the battle to crack down on agricultural uses of antibiotics that many infectious disease experts oppose.
Dr. Joshua M. Sharfstein, the agency’s principal deputy commissioner, refused at a news conference to give details about when the agency would take more concrete steps.
“We believe this is a public health issue of some urgency,” Dr. Sharfstein said. “We’re looking to see some progress soon.”
About 100,000 people die every year from hospital-acquired infections caused by bacteria that, because of overuse of antibiotics, have developed resistance to the usual remedies and cannot be killed with them. Many others die from superbugs contracted outside hospitals.
How many deaths can be attributed to agricultural uses of antibiotics?
“I don’t think anyone knows that number,” said Dr. James Johnson, a professor of medicine at the University of Minnesota, “but I think it’s substantial.”
Antibiotics are used in agriculture for three reasons: to promote animal growth, prevent illness and treat sickness. How antibiotics in feed and water help to fatten animals is not entirely clear.
The industrialization of animal husbandry has increased processors’ dependence on antibiotics because factory farm animals tend to be sicker and feed-lot diets can encourage bacterial infections.
The Union of Concerned Scientists estimated in 2001 that 84 percent of all antibiotics were used in agriculture and that 70 percent were used simply to promote animal growth, not to treat or prevent illness. The Animal Health Institute, a trade association, estimated that 13 percent of agricultural antibiotics were used to promote growth.
Dave Warner, a spokesman for the National Pork Producers Council, said most agricultural antibiotics were given to healthy animals not to promote growth but to prevent illness.
The distinction is important because F.D.A. officials said they were mostly concerned with the use of antibiotics to promote growth — not to prevent or treat illnesses. If the agency some day bans growth promotion as a use, there is a chance producers would simply relabel such uses as preventative.
Mr. Warner said his organization opposed the F.D.A.’s guidance. “We think this guidance could lead to the elimination or costly review of previously approved animal health products,” he said.
The Animal Health Institute said in a statement that it welcomed the guidance and had “long supported efforts to promote judicious use of antibiotics.”
Representative Louise M. Slaughter, Democrat of New York and chairwoman of the House Rules Committee, said the F.D.A. had “not gone far enough or moved fast enough.” Ms. Slaughter has proposed legislation banning nontherapeutic uses of some classes of antibiotics.
Exercise: Bicycling to Keep Off Extra Pounds
By RONI CARYN RABIN, The New York Times, June 28, 2010
Bicycling for exercise may help women control their weight during their 30s and 40s, a new study says.
Brisk walking has the same effect for slim, overweight and obese women, researchers found, but slow walking does not.
The findings are based on the second Harvard Nurses’ Health Study, which is tracking 116,608 female nurses who periodically fill out questionnaires about their health, weight, diet and behavior. The new analysis, published in the June 28 issue of Archives of Internal Medicine, looked at weight change and behavior from 1989 (when the nurses were 25 to 42 years old) to 2005; to isolate the effects of exercise, the researchers controlled for other obesity risk factors.
They found that women who increased physical activities like brisk walking and bicycling by 30 minutes a day during the 16-year period maintained their weight and even lost a few pounds, but those whose exercise was slow walking did not lose any weight.
Women who decreased their bicycling time from more than 15 minutes a day to less than 15 minutes gained about four-and-a-half pounds on average.
“This is not suggesting that if you bicycle for five minutes you will immediately go back to the weight you were when you were 18,” said Anne C. Lusk, a research fellow at the Harvard School of Public Health who was an author of the paper. “If that were true, bicycle sales would go through the roof.
“But it’s highly suggestive that bicycling is highly beneficial in women.”
Childhood: Combination Vaccine and Seizure Risk
By RONI CARYN RABIN, The New York Times, June 28, 2010
Toddlers who get a vaccine that combines the measles-mumps-rubella and chickenpox immunizations are at twice the usual risk for fevers that lead to convulsions, a new study reports.
The risk for a so-called febrile seizure after any measles vaccination is less than 1 seizure per 1,000 vaccinations; but among children who received the combined vaccine, there is 1 additional seizure for every 2,300 vaccinated, said Dr. Nicola Klein, the study’s lead investigator and director of the Kaiser Permanente Vaccine Study Center.
The reactions, which occur a week to 10 days after vaccination, are not life-threatening and usually resolve on their own. The fever-related convulsions can be frightening, but they are brief and not linked to any long-term complications or seizure disorders.
To do the analysis, published this week in the journal Pediatrics, Kaiser Permanente researchers used the government’s Vaccine Safety Datalink, a safety surveillance system that compiles data on nine million members of eight managed-care organizations.
They compared seizure and fever reactions among 83,107 1-year-olds who had combined M.M.R. and chickenpox vaccinations with reactions of 376,354 toddlers who received separate vaccines.
“Unless parents have a strong preference for the combination vaccine, providers should use a separate vaccine,” Dr. Klein said.
Rethinking the Way We Rank Medical Schools
By PAULINE W. CHEN, M.D., The New York Times, June 17, 2010
During my internship, the first year after graduating from medical school, I took care of a middle-aged woman who began our first conversation with a question that patients still ask me today.
“So doctor,” she said as I pulled my stethoscope out to listen to her heart, “where did you go to medical school?”
In a social context, I might have considered her question to be polite chatter, a filler during an awkward quiet moment. But on that particular afternoon her words felt more like a dart lobbed at what I had presumed to be a budding and promising patient-doctor relationship.
Trust from this patient, I remember thinking, is not going to depend on my bedside manner or clinical judgment but my medical school.
But even before I had placed my stethoscope bell against my patient’s chest, I realized that I, too, had been culpable of submitting doctors to the same line of questioning. Although I might have satisfied my curiosity more surreptitiously — searching on the Internet, scanning hospital directories, inconspicuously craning my neck to discern Latinized school names on diplomas — I was just as eager as my patient to learn about the medical schools my doctors had attended.
Once I had the information, I would do what my patient did that afternoon: I would mentally find its place within the medical school hierarchy in my mind. Like some existential fast forward button, the right answer to this question could raise the trust in any patient-doctor relationship to a whole new level without a second thought, because by virtue of having graduated from a “good” school, that doctor had the ability to address the most pressing needs of all of his or her patients.
The thought process was easy — good school, good doctor; bad school, bad doctor.
Maybe.
Shaped by magazine lists, friends’ and strangers’ confirmations and professional hearsay, the notion that a medical school’s quality can be ranked and then passed on directly to their graduates has become an integral part of American culture. But most of these popular rankings reflect a school’s highly specialized research funding and capabilities, not the general quality of its medical school graduates. Criteria like research funding and cutting edge investigations are of course significant, but they more accurately reflect the social needs of the previous century when medicine, backed by scientific investigation, was just starting to make a difference in the health care outcomes of patients.
Thanks to many of those advances, the population as a whole has successfully aged. But the drive to elucidate, for example, the molecular basis of high blood pressure has in turn become less urgent. Instead, other, more social, health care issues have reached critical points: the shortage of primary care physicians; the lack of accessible health care and providers in certain areas of the country; and the yawning disparity between racial and economic backgrounds of those who become doctors and those who are their patients.
Despite the changes in patient needs, many patients, and their doctors, continue to fall back on old rankings, assuming that institutions that succeeded in addressing the needs of the 20th century can still do so in the 21st. But according to a report published this week in The Annals of Internal Medicine, it is time to reexamine that assumption.
Researchers from the George Washington University School of Medicine looked at the more than 60,000 graduates of America’s 141 medical schools — both allopathic and osteopathic — from 1999 to 2001. Putting the issues of primary care shortage, underserved communities and workforce diversity under the banner of “social mission,” the researchers found that many of the schools that were traditionally ranked highly were also among those least focused and least successful in addressing the most pressing issues facing the country right now.
“The absolute irreducible mission of medical schools is the education and graduation of doctors to care for the country as a whole,” said Dr. Fitzhugh Mullan, lead author of the study and a professor of health policy and pediatrics at the university. “U.S. medical education has drifted over to this highly rarified and specialized focus that has resulted in some major shortfalls.”
The funding system has encouraged this drift toward specialization and hi-tech research. The investigators also found that institutions that received more federally funded grants, in the form of research grants from the National Institutes of Health, also tended to devote fewer efforts to a school’s social mission. Grant money and the security it affords individuals and institutions drive institutions to emphasize research, sometimes at the expense of other urgent but less lucrative endeavors.
The opportunity to learn from and be mentored by faculty members involved with the latest research can be stimulating for medical students, but the pressure to bring grant money into an institution can draw even the most enthusiastic educator away from students and back to the laboratory bench. “Research is not the same as medical education,” Dr. Mullan observed. “Research is important, but it can overwhelm.”
And when medical schools “are already heavily invested in a mission that is traditional and research oriented,” noted Dr. Mullan, broadening their focus can be slow and difficult, even if they are aware of the growing crises in primary care and the health care work force.
In recent years, some visionary medical educators have left older institutions in an effort to jump-start such changes in new medical schools. Most of these new schools, sometimes referred to as “millennial medical schools,” embrace missions that unabashedly attempt to address some of the ills of the current health care system. The A.T. Still University of Health Sciences School of Osteopathic Medicine in Mesa, Ariz., and the Herbert Wertheim College of Medicine at Florida International University in Miami, for example, “embed” students in underserved areas from as early as the first year of medical school. Other institutions, like the Hofstra-North Shore -LIJ School of Medicine, which is due to begin classes in August 2011, have made it a priority to educate students from diverse, nontraditional backgrounds.
Naysayers warn that this redirection of focus, whether in established medical schools or new ones, will decrease the selectivity of students and produce less competitive and less competent future physicians. But educators like Dr. Mullan counter that traditional selection criteria based on cognitive exams and premedical course grades do not necessarily translate into clinical ability.
“Doctors who have done very well on everything from kindergarten to residency training in terms of getting into prestige places are assumed to have sharp intellects,” Dr. Mullan said. “But none of that correlates in any scientific way with their performance as physicians.” The more relevant measure of high level competency, Dr. Mullan asserts, is the multiple certification evaluations that take place during medical school, training and licensure. “They have to pass these, otherwise they cannot practice.”
Moreover, Dr. Mullan noted, “If there’s not even a doctor near where you live who can offer services, then the quality a priori is bad.”
“The mission and function of all schools won’t be and shouldn’t be the same,” Dr. Mullan added. “But we all might think about how we could be a little more responsive to the ongoing needs of patients and of our country. If we continue to produce more doctors in the system we have now, we won’t be able to address the needs, the health outcomes and certainly the populations that are underserved, dying and suffering as a result of it.”
