Abstract

A new era on medicine are expected to happen in the coming years. Due to the

advances in the field of nanotechnology, nanodevice manufacturing has been

growing gradually. From such achievements in nanotechnology, and recent results

in biotechnology and genetics, the first operating biological nanorobots are

expected to appear in the coming 5 years, and more complex diamondoid based

nanorobots will become available in about 10 years. In terms of time it means a

very near better future with significant improvements in medicine. In this work

we present a practical approach taken on developing nanorobots for medicine in

the sense of using computational nanomechatronics techniques as ancillary tools

for investigating manufacturing design, nanosystems integration, sensing and

actuation for medicine applications. Thus the work describes pathways that could

enable design testability, but also help scientists and profit corporations in

providing the helpful information needed to test and design integrated devises

and solutions towards manufacturing biomedical nanorobots.

2. Introduction

The use of robots in surgery has provided additional tools for surgeons enabling

minimally invasive intervention or even long distance tele-operated surgeries [1].

Indeed we may trust on human creativeness and technical capabilities that can

ever be improved in terms of technical achievements [2], [3], [6]. In recent years

the medicine has enabled significant wellness for the life quality and longevity of

the world population [11]. And for the coming years, we may be prepared to

experiment even more benefits, as results from advances that are being pursued

step by step in new fields of science, such as nanobiotechnlogy [9], [13]. With

the expected miniaturization of devices provided by several works on nanoelectromechanical systems (NEMS), nanomanufacturing has actually become

a reality [12], [14].

Hence, with the NEMS recent advances on building nanodevices, and the

development of interdisciplinary works, altogether may be translated in few years

through the development of integrated nanomachines, also known as nanorobots.

With the use of techniques that are advancing rapidly, such as nano-transducers

[22], [5], and biomolecular computing [2], [13], nanorobots are expected to be

able to operate in a well defined set of behaviors performing pre-programmed

tasks [7], [4]. Thus in the coming few years, nanorobots being tele-operated to

perform surgery, or even nanorobots continually supervising the human body in

order to assist organs that may require some kind of repair, is one of the most

expected revolutionary tools for biomedical engineering problems.

The development of nanorobots is an emerging field with many aspects under

investigation. Simulation is an essential tool for exploring alternatives in the

organization, configuration, motion planning, and control of nanomachines

exploring the human body. The work we have been done concentrates its main

focus on developing nanorobot control and design applied to nanomedicine.

Nanorobot applications could be focused mainly on two major areas, as follows:

nanorobots for surgical interventions, as well as their utilization for patients that

need constant monitoring. The nanorobots require specific controls, sensors and

actuators, basically in accordance with each kind of biomedical problem.

Advanced simulations can include various levels of detail, giving a trade-off

between physical accuracy and the ability to control large numbers of nanorobots

over relevant time scales with reasonable computational effort. Another

advantage is that simulation can be done in advance of direct experimentation. It

is most efficient to develop the control technology in tandem with the fabrication

technologies, so that when we are able to build these devices, we will already

have a good background in how to control them.

We propose computational mechatronics approaches as suitable way to enable nanoelectromechanical systems (NEMS), nanomanufacturing has actually become

a reality [12], [14].

Hence, with the NEMS recent advances on building nanodevices, and the

development of interdisciplinary works, altogether may be translated in few years

through the development of integrated nanomachines, also known as nanorobots.

With the use of techniques that are advancing rapidly, such as nano-transducers

[22], [5], and biomolecular computing [2], [13], nanorobots are expected to be

able to operate in a well defined set of behaviors performing pre-programmed

tasks [7], [4]. Thus in the coming few years, nanorobots being tele-operated to

perform surgery, or even nanorobots continually supervising the human body in

order to assist organs that may require some kind of repair, is one of the most

expected revolutionary tools for biomedical engineering problems.

The development of nanorobots is an emerging field with many aspects under

investigation. Simulation is an essential tool for exploring alternatives in the

organization, configuration, motion planning, and control of nanomachines

exploring the human body. The work we have been done concentrates its main

focus on developing nanorobot control and design applied to nanomedicine.

Nanorobot applications could be focused mainly on two major areas, as follows:

nanorobots for surgical interventions, as well as their utilization for patients that

need constant monitoring. The nanorobots require specific controls, sensors and

actuators, basically in accordance with each kind of biomedical problem.

Advanced simulations can include various levels of detail, giving a trade-off

between physical accuracy and the ability to control large numbers of nanorobots

over relevant time scales with reasonable computational effort. Another

advantage is that simulation can be done in advance of direct experimentation. It

is most efficient to develop the control technology in tandem with the fabrication

technologies, so that when we are able to build these devices, we will already

have a good background in how to control them.

We propose computational mechatronics approaches as suitable way to enable the fast development of nanorobots operating in a fluid environment relevant for

medical applications. Unlike the case of larger robots, the dominant forces in this

environment arise from viscosity of low Reynolds number fluid flow and Brownian

motion and such parameters are been implemented throughout a set of different

investigations. We have been developing practical and innovative paradigms

based on the Nanorobot Control Design (NCD) simulator that allows fast design

testability comparing various control algorithms for nanorobots and their

application for different tasks. Also such information generated by the NCD can be

useful as parameters for building nanodevices, such as transducers and actuators.

Robots in Surgery

Topics Covered
1 . A bstract
2 . I ntroduction
3 . N anorobots for Medicine
4 . M otivation
5 . D eveloped Simulations
6 . C onclusions
7 . A cknowledgements
8 . R eferences
9 . C ontact Details

It is a pleasure to introduce you to St. Vincent’s Medical Center:

General Internal Medicine
This clerkship is designed to provide maximum clinical experience in the hospital setting, with emphasis on acute care medicine patients. The student is given the opportunity to apply the basic sciences and methods taught in medical school to the clinical setting. The student is involved directly in the day-to-day work of the medical teaching team and in the care of his/her own patients in conjunction with careful and continuing supervision by the resident and the attending internist. The student will join the House staff in all departmental teaching activities. You will be on call every fourth night with the team.
Ambulatory Care
The Ambulatory care elective at St. Vincent’s Medical Center provides the fourth year medical student with a one-month block rotation in primary care medicine. History taking and physical examination techniques as they apply to ambulatory patients will be reviewed. Problem identification and problem solving, as well as health maintenance and screening will be emphasized. Medical students will see patients in both the private practice office setting an in the medical clinic setting. Continuity of care and appropriate timely follow-up are the mainstays of the experience and of good ambulatory medicine. A series of case presentations and informal lectures on selected topics in ambulatory care are provided. The student will be given a weekly self-study packet that includes a case presentation with problems to solve, as well as handouts on current medical literature and reading material.
Geriatrics
The clinical clerkship at the Jewish Home for the Elderly of Fairfield is a highly structured, comprehensive on-month rotation in Geriatric Medicine. This rotation includes direct patient care under the supervision of 11 internists with special interest and expertise in geriatric medicine. Insight is gained by working with physical therapists, occupational therapists, recreational therapists, podiatrists, and a nursing staff with unique skills in Geriatric Medicine. Included are two half-day experiences of home care in an affiliated outreach program. Patient rounds occur daily with an attending physician, as well as bi-weekly Neurology rounds and monthly Dermatology, Psychiatry and OT/PT rounds.
Pulmonary/Critical Care Medicine
Over the course of this elective, the medical student will be exposed to varied aspects in the clinical field of pulmonary/critical care medicine. Areas of clinical pulmonary such as respiratory failure, infectious lung disease, malignant disease of the lung, obstructive airway disease and pulmonary vascular disease will be covered during the course of the month. Rounds will occur daily under the supervision of an attending pulmonologist. A pulmonary fellow will work with the student on the pulmonary consultative service, and cases will be presented and discussed with the attending on daily teaching rounds. The student is also encouraged to attend MICU teaching rounds. Pulmonary function tests and their interpretation will be reviewed with the student, and the techniques of pulmonary procedures (such as bronchoscopy, thoracentesis and pleural biopsy) will be demonstrated. Attendance at outpatient pulmonary clinic, as well as weekly chest radiography conference is highly encouraged.
Gastroenterology
A written curriculum with references and pertinent articles is provided for the student, as well as access to the AGA slide series, and pictorial guide to gastroenterology. The student will make consult rounds daily, in addition to teaching rounds with the gastroenterology attending. The student will be able to attend the weekly GI conference, which will expose the student to topics in GI radiology, pathology and endoscopy. The student will also observe endoscopies and other procedures throughout the rotation.
Cardiology
During the course of this elective, the student will acquire a better knowledge of clinical cardiology, allowing improved management of common cardiovascular problems encountered in the practice of internal medicine. Exposure to clinical cases and the various diagnostic and therapeutic modalities used in the practice of cardiology, will aid in the student’s patient management abilities. The student will attend rounds in the CVU as well as be a member oft eh cardiology consultative service. EKG interpretation will be performed on a daily basis and be supervised by an attending cardiologist. One week “mini-rotations” in invasive and non-invasive cardiac services will allow for an increased understanding of diagnostic and therapeutic cardiology. Attendance at didactic cardiology conferences, as well as at interactive conferences (such as murmur rounds), is encouraged.
Infectious Diseases
During the course of this rotation, students will team to integrate their knowledge of microbiology and pharmacology into clinical situations for optimal Therapeutic decision-making. As a part of the infectious disease consultative service, the student will actively be involved in obtaining comprehensive infectious disease medical histories and will gain increased proficiency in treating infectious diseases. An attending physician will supervise the student along with a resident. The student will participate in infectious disease consultations in both the inpatient and outpatient settings, join ID rounds, team to interpret pertinent laboratory data (x-rays, culture results, microbiologic slides) and attend infectious disease clinics at St. Vincent’s Medical Center under the supervision of the ID attending.
General Surgery
This clerkship is designed to provide a diagnostic approach to patients pre-selected for surgical remedy of the disease process. Emphasis is placed on pre-operative assessment and pos-operative care. Opportunity is provided to participate in Emergency Room care of trauma patients and to conduct surgical pre-admissions evaluation. The student works closely with the Senior Surgical Resident and teaching Attending Surgeon.
Radiology
This rotation is designed to integrate the student’s basic science knowledge of anatomy and physiology into the diagnostic imaging procedures. There is emphasis on problem-solving techniques using imaging and integrating these radiological studies into the patient’s care. The student experiences one-on-one teaching with a staff radiologist to learn the art of interpreting biopsies, drainages, and arteriograms are part of the rotation. There is a reading list and materials provided by the Department of Radiology for the student. Further rotations in Nuclear Medicine and Radiation Oncology are also available.

Animal research

Medical research improves the understanding and treatment of disease. Despite
advances in other methodologies, the Academy believes that research using
animals is sometimes essential.5 The Academy supports the ‘3Rs’ that seek to:
replace the use of animals where possible, reduce the number of animals used
and refine procedures in order to minimise suffering. 6 In discussing animal
research, particularly that which involves primates, the Academy acknowledges
that the Home Office is principally concerned with the regulation of this work
rather than carrying it out.
Research using animals in the UK is regulated by the Home Office, which is
advised by the Animal Procedures Committee (APC). The current system seeks
to ensure the highest possible standards of welfare for animals in scientific
procedures. The Academy endorses the verdict of the Davidson Review, which
concluded that UK legislation governing the use of animals in scientific
procedures goes beyond the requirements of European Directive 86/609/EEC,
and recommended that statistical returns process, personal and project
licenses, should be simplified.7 8
In the case of non-human primates, the Academy wishes to draw the OSI’s
attention to the Weatherall report that concluded that there is a strong
scientific case for the carefully regulated use of non-human primates in
research where there are no other means to address clearly defined questions
of particular biological or medical importance. 9 Of particular relevance to the
use of science in the Home Office are recommendations to:
· introduce retrospective reporting on the severity of procedures for nonhuman
primates;
· accelerate work towards improving and applying current best-practice
regarding housing of non-human primates;
· further efforts to improve interactions between regulatory bodies at
national and international levels and between regulatory bodies and the
scientific community;
· act on the recommendations of the forthcoming National Centres for the
3Rs and Association of the British Pharmaceutical Industry study on
regulatory toxicology and re-examine responses to the 2002 APC report;
· urgently examine concerns that the costs and harassment by activists
are forcing scientists and research companies to purse non-human
primates work overseas; and
· give careful consideration of the creation of UK centres of excellence for
non-human primate research.
Health and criminal justice are hugely important services that are encountered
by almost everyone and rightly receive substantial resources from government.
The quality of these services is, in part, dependent upon the knowledge and
information that underpins them. Research that is relevant to the Home Office’s
mission of ‘building a safe, just and tolerant society’ is organised and integrated
with its services in a fundamentally different way from the organisation of
medical science and its subsequent integration with health services. 10 These
differences not only relate to the quality, management and use of science, but
also apply more widely in university departments and in public services relevant
to Home Office functions.
Similarly, the production of evidence fundamental to the roles of the Home
Office is organised very differently from evidence production in the medical
sciences. Research can be thought of as a continuum from basic to applied. In
the health services these categories of research have a similar status, but in
the Home Office there is much more emphasis on the theoretical, which
considers matters such as the causes of crime, rather than on applied research,
which considers matters such as interventions to prevent crime.11 A continuum
between fundamental and applied research in the Home, as is the case the
medical sciences, is important.
A principal symptom of this imbalance – and lack of emphasis on applied
science - is the absence of university police or offender management schools
and a lack of recognition of police science or offender management science in
research-intensive universities. 12 13 This model contrasts sharply with the
situation in the medical sciences where clinical academics at medical schools,
within or closely associated with hospitals and universities, integrate research,
training and service delivery. The success and widespread support for this
approach in the medical sciences perhaps indicates that it would be appropriate
for other fields such as criminal justice that would benefit from the translation
of basic research into applications.14 15The Home Office should lead the
recognition and development of police and offender management science in the
Home Office, the higher education sector and in police and offender
management services.

Response to the Office of Science and Innovation’s Review of Science in the Home Office

Summary
1. The Academy of Medical Sciences welcomes the opportunity to contribute to the
Office of Science and Innovation’s ‘Review of Science in the Home Office’ and
would be happy to expand on the points made in this submission or provide
further assistance if required. This response has been informed by the
Academy’s recent meeting on ‘The Science of Violence’, the recent report of the
working group chaired by Sir David Weatherall on the use of non-human
primates in research, the continuing deliberations of the Academy’s committees
on Brain Sciences, Drugs and Addiction, the work of its Non-Experimental
methods committee and the Academy’s report ‘Calling Time’. 1 2 3 Copies of the
‘Science of Violence’ meeting report and the Weatherall report are enclosed
with this response.
2. The Academy’s response comes from the perspective of the medical sciences
and it recognises that some of the topics encompassed by this consultation are
beyond its remit. With regard to the terms of reference of the Review, this
response is principally concerned with: science strategy, horizon scanning, the
extent to which the Home Office reviews and harnesses existing research,
commissioning and management of new science, the quality and relevance of
Home Office research, the use of science to formulate policy, the management
of relevant evidence and Home Office research capacity and capacity building.
3. In summary, the Academy supports the strategic aim of the Home Offices’
Science and Innovation Strategy to provide high quality science that is fit for
clearly defined purposes and to positively encourage the external science and
technology community to help drive innovation.4 While much of the Home
Office’s strategy focuses on the social and physical sciences, medical science
has much to offer. The Academy particularly wishes to emphasise the need to:
· Implement the recommendations of the Davidson Review in order to
reduce the regulatory burden associated with the use of animals in
scientific procedures while maintaining the highest standards of animal
welfare.
· Implement relevant recommendations from the Weatherall report.
· Improve the quality and quantity of applied research conducted by the
Home Office by establishing a dedicated fund for research into services,
increasing the use of randomised and other controlled types of research
methodology and establishing a field trials unit.

Behavioral Science

University of Kentucky 2008-2009 Undergraduate Bulletin 1
BSC 331 BEHAVIORAL FACTORS IN HEALTH AND DISEASE.
The study of human behavior relating to health and disease and the organization of health care as a social system. Selected concepts
from the psychological and social sciences are presented in a biobehavioral frame of reference and applied to the consideration of specific
problems.
BSC 607 FOOD RELATED BEHAVIORS.
This team-taught course will provide background in topics and methods in food related behaviors to students in Nutritional Sciences
and other interested students. The course will follow a problem-based learning approach, and will consist of 3 out of 4 modules in any
given year. The four modules will be Social and Cultural Perspectives on Food, Psychological Perspectives on Food and Food Behaviors,
Challenges to Community Food Security, and International Issues in Nutrition. (Same as ANT 607, NFS 607, NS 607.)
BSC 620 ORIENTATION TO MEDICAL BEHAVIORAL SCIENCE.
This course offers a structural exposure of students to the varieties of basic and clinical science research and current issues in health
care policy under discussion at the University Medical Center. Following weekly attendance at research seminars and clinical rounds,
students will present their observations in follow-up discussion groups. May be repeated to a maximum of three credits.
BSC 626 SURVEY OF HEALTH PSYCHOLOGY.
A survey of the field of health psychology. It will explore the ways in which social and psychological research contribute to an
understanding of health and illness behavior. Prereq: Graduate or professional standing and consent of instructor. (Same as PSY 626.)
BSC 645 ANTHROPOLOGY AND EPIDEMIOLOGY.
This course will introduce students to the fundamentals of epidemiology, as the methodological approach, which underlies biomedical
research, and will examine the ways that the methodologies of anthropology and epidemiology complement each other in the study
of health and disease. The course will examine the points of similarity between anthropology and epidemiology particularly as regards
the importance of examining sociocultural phenomena in order to better understand the origins of disease. The course will explore the
tensions between anthropology and epidemiology in matters of methodology, exemplified by the debate over quantitative vs. qualitative
This overview course is designed to introduce the student to the major methods and technologies of clinical and translational science.
The course will consist of 14 presentations followed by open discussion of the presentation and assigned readings by class members.
The location of classes may change based on the content of the lecture. Homework assignments will provide experiential opportunities
to work with the various methods and technologies. Active participation by all members is expected. Each weekly presentation is
designed to provide a general overview of a method or technology commonly used in clinical and translational science. Discussions are
intended to integrate the information across traditional disciplinary boundaries. Homework assignments are designed to provide practical
experience with the discussion topic. Prereq: Graduate standing.
#BSC 732 INTERDISCIPLINARY PROTOCOL DEVELOPMENT.
This course is designed to orient students to leadership and teamwork processes involved in clinical and translational research and to
train students to function effectively in team settings. Students will be assigned to multidisciplinary teams with a designated principal
investigator. Each team will be assigned to develop an integrated multidisciplinary grant application to address an assigned clinical
research topic. Students are expected to apply their knowledge of effective scientific communication, responsible conduct of research,
and methods and technologies of clinical and translational science to the grant application. The course will consist of four class periods.

The first three classes will consist of an orientation to communication and the role of leadership and teamwork in multidisciplinary
clinical and translational research. The final class period will be reserved for a teams organizational meeting. Supplemental team meetings
are optional. Each team member will be required to complete an individual five-page research methods report that is integrated into
a multidisciplinary research application addressing a clinical research topic assigned to the team under the direction of an assigned
principal investigator. Prereq: Graduate standing.

DNA

CHARLES NESSON:
First, I'd like to introduce Fredrick Bieber. He served on the Harvard
Medical School faculty for two decades where he directs and teaches courses in genetics, pathology and
forensic science. He has a long-standing interest in science, law and public policy. He served on the Social
Issues Committee of the American Society of Human Genetics, and is a member of the DNA Advisory
Board of the Federal Bureau of Investigation. He recently was appointed by the Solicitor General of
Canada to the legislatively mandated National DNA Advisory Committee of Canada to oversee certain
activities of the Royal Canadian Mounted Police. Dr. Bieber.
FRED BIEBER
HARVARD MEDICAL SCHOOL
MR. BIEBER: Good morning. I was asked by Ira and David and Chris, who I thank very much
for inviting me, to try to form a bridge between some of the basic biology and medicine that applies to
human-identity testing and the work that you are concerned with in the courtrooms across the nation.
And in keeping with the theme that was started last night, I'd like to show this first slide and
really hopefully remind you that those of us, including myself, in medical genetics are not as the New York
magazine would imply, trying to create perfect people in our work in genetics and the hospitals and clinics.
In fact, if I were involved in such a project, I would have certainly worked on the ambiguous genitalia that
would certainly doom this particular new species to one generation. Some of you may have Ursula
LaGwynn's (ph) novel, A Path of Darkness where there are people who can morph to one or the other
depending on the circumstance.
But this is not really what genetics is all about, and I think from hearing the presentations last
night you understand that the media often takes one idea or concept and moves farther in the public line
than certainly the scientists or clinicians have in mind.
I'd like to start with a story after this slide, reminding that besides the work in forensics and
paternity that you're familiar with, there's a huge body of data and a large practice in genetics in all
modern countries that involves heart-wrenching and life decisions every day in the clinic and the hospitals
using the same technology for the diagnosis and treatment of disease, for the selection of the recipients of
bone marrow or organ transplants, and the identification of work casualties and the studying or rare and
endangered species.
All of these methods and concepts are similar, if not identical to what are used in the identity
testing that you use in the courtroom. And this fact I think often escapes interested persons in the public
who have the idea, because of so many of the challenges, that there's something apparently different about
the biology and the science and the practice of forensic genetics when, in fact, a new case almost a carbon
copy of that which we use in the clinics every day.
I want to tell you a story that unfortunately recurs and gives you some example of the kind of
work that got me interested in science and law and public policy. At one point, we saw a two-month-old
male with fractures, hernia, large liver, presenting at fifteen months with a third fracture, healing well later
on.
Now in accordance with the laws in most states, when nurses or clinicians or educators or police
officers suspect child abuse of any kind, they must report this, and in a Massachusetts it falls under Chapter
51A. And these children are often removed from their parents' custody and placed in foster care. Here's a
photographic image for you of the radiograph showing the fractures of the long bones which would
certainly be startling to any nurse or clinician who saw such a patient.
There's a photograph on the right of the boy and his additional fracture. There's a problem here
however. As we would teach our medical students or nursing students in both medical centers. There's a
real laundry list in the so-called differential diagnosis of skeletal trauma that includes innocent trauma
normal variance, and a whole category of disorders that we call skeletal dysplasia. And as a medical
geneticist this is an area that we pay a lot of attention to, especially in infants who have skeletal changes
like those you saw on the x-ray.
It turns out that this child and many like him who have been taken from their parents across the
country and in other countries actually had a genetic disorder called osteogenesis imperfecta that is due to a
molecular defect in the production of collagen that forms the matrix of cartilage in bones and in fact was
not the victim of abuse. This particular child was put back in his parents custody after this diagnosis was
finally made.
Many times we use biochemical and molecular and DNA-based methods to perform diagnostic
tests on children like this in the hope of further injustice in that individual instant case. So I think you can
see that in the clinic we are not only concerned with the diagnosis and treatment of disease but also in the
justice system, and genetics plays a cardinal role every day of my work.
But we're here for this session for the next two days to talk about forensics, and I don't need to
remind you of the data in this slide of all of the methods that you've been involved in-- sex offender
tracking, the exculpation of wrongly accused and wrongly convicted or incarcerated suspects or individuals,
the identification of human remains, the identification of the possibility of serial offense, et cetera.
As you know DNA, that forms the basis for this identity testing, is derived from our parents in
the sperm and egg and can be found in most tissues in the body. And where nuclear DNA is not present,
mitochondrial DNA often is, and Bruce will have a word to say about that.
David wanted me to show you at least one photograph of the human chariotype, and I run a lab
that performs its testing at the Harvard Teaching Hospital where we actually look at the chromosome
patterns of patients or tumors in bone marrow from those patients to determine whether there's an extra
chromosome or missing chromosome, a deleted chromosome or a rearranged chromosome.
And all of our DNA, for those of you who aren't scientists, is packaged in these compartments
that we call chromosomes. We line them up in pairs and these chariotypes. And as you know, we get one
from each parent-- one from mom, one from dad. And we're actually in the forensics setting analyzing the
DNA, the double helix that is tightly wound around protein, pistones (ph), and packaged into these
chromosomes. So we're actually looking right at the molecular structure of the DNA.
And there are a number of methods to do this. I won't spend much time on this, but I think
historically you should be aware that there are several methods to type B and A in the identity testing
situation.
One is to cut the DNA at various points separated in a gel-based system and produce bands on
an RFLP-based system which behave in accordance to Mendelian's first and second laws so that we can
actually do paternity testings and include or exclude individuals in pedigrees like this. So all this work has
to be done just like it is in any genetic system.
These profiles, or these bands can be used to compare known samples, the so-called K-samples in
FBI lingo to the so-called Q samples, the question samples derived from crime scenes. And individuals or
their samples can be included or excluded with relative ease using these highly efficient separation
methods.
This work began in England actually in the 1980s when Alec Jeffries now knighted at Sir Alec
Jeffries first used this powerful method to actually exclude a false confessor to one or two brutal crimes
involving young teenage victims. And this work led to the conviction of Colin Pitchfork for the slaying
and sexual assault of both these girls. And this story is in The Blooding for those of you who aren't
familiar with that.
Nowadays a different separation method is used based on the fact that there are four-based pair
tandem repeats called STRs that exist throughout the human genome, and these size differences can also be
used in systems to produce patterns like the electrotherograms you see on this slide. There are typically 13
loci that are used worldwide--some countries use more, some use less-- that produce peaks and valleys like
this that can allow you to distinguish one sample of DNA from another.
This is a moving target, however. That is the technology, and there are new methods that may
automate or reduce the amount of lab wet bench work that's required, and watch the stock. This is not a
stock pit, but watch the stock of Nanogen, Apimetrics, Intel and Motorola because biochips or gene chips
as they're called will be taking off, I would predict, in the next few years because of the biological
applications of these micro-array systems that allow one to categorize literally hundreds of samples on a
single chip, a computer-sized chip.
And the chip readers are being made by Hewlett Packard which will allow us, as shown here in
some data from our lab looking at DNA from tumors and normal tissues from the endometrium to look at
what genes are expressed or not expressed in different human tissues at different times of the season,
different times of development.
We shouldn't forget our friends in the animal kingdom and the plant kingdom. There's a lab in
Ashland, Oregon that does this kind of testing on plant and animal DNA where it's relevant in the
investigation of crimes, sometimes involving humans. And I want to say just a couple of words before I
close about the courtroom issues that remain as I go to court to testify in evidentiary hearings-- these issues
shown here; they're in your handout-- are still coming up from time to time.
Much of this is technology as it moves has to pass through evidentiary hearings. Many of you
know the Frye decision by Hart. It's a two-page decision in 1923-- and this and other federal standards,
including Daubert, Kumo Tire and others, determine whether or not new evidence comes into the courts.
And for every article you could show like this where a court has admitted DNA evidence, this is
from the Boston Globe where the Supreme Court allowed it to come in. There are other cases where the
courts may rule otherwise in individual cases.
So the DNA wars have been fought throughout the country, including in Massachusetts. There
are staggering numbers that can be derived from a mathematical calculation of how rare or how frequent a
particular profile across many genetic loci would be. And these calculations make use of standard
population genetic theory and practice.
The numbers are quite imposing, and many individuals feel that mathematics could be a sorcerer
in our computerized society. And while it should assist the trier of fact, it shouldn't cast a spell over the
jury.
Larry Tribe at our law school wrote an article you should read as some point, called Trial by
Mathematics. It doesn't deal with DNA forensics at all, but the theme and ideology there is quite
interesting, and he argues in this review against these, of some forms of statistics in the Court. Other legal
scholars however have felt that the jury must be best informed, and that can only happen with proper data.
Some courts have ruled that experts can offer an opinion saying that a profile is unique. And this
court decision in the state of Washington dealt specifically with DNA population genetics. So this is a
changing platform as well.
I want to finish by inviting you to this about caveats in the interpretation of DNA evidence. We
hear from our friends all the time at work, did he do it; if the DNA matched, he must have done it. As I
would remind all of my own students, at the beginning and at the end of a lecture on forensic DNA,
finding someone's DNA at a crime scene doesn't tell us how it got there and when, no more than not
finding it doesn't mean that I wasn't there, okay.
So I don't think we can put all our eggs in the DNA basket. You know many stories, I'm sure,
about DNA from twins that would not be distinguishable even though their digital fingerprints would be,
is an exclusion, really an exclusion.
There are DNA mixtures that can be problematic to interpret. There are the missing third
parties. There are even odd cases where patients have had bone marrow transplants so that later on when
they're tested, the DNA from their peripheral blood lymphocytes actually reflects the DNA profile of the
donor of their bone marrow, rather than their own genomic DNA.
So there are enough instances like this that should require all of us to remember Louie Pasteur's
quote that Achance favors the prepared mind, and we really need to be thinking probably about these
matters. Thank you for your attention.

Aderans and HairDX Introduce Genetic Hair Loss Test To Japan

HairDX Enters Into Exclusive Distribution Agreement With Aderans

Pharmacogenomics research and development innovator
PharmaGenoma, Inc. and its subsidiary HairDX, LLC (www.hairdx.com), pioneers genetic tests for
predicting the risk of male and female hair loss, today announced an exclusive agreement with
Aderans Company Limited of Tokyo to introduce the breakthrough tests in Japan starting on
March 1, 2009. The HairDX test collection kit is listed with Japan's Pharmaceuticals and Medical
Devices Agency (PMDA) as a Class I medical device.
The agreement makes Aderans the sole Japanese distributor of HairDX’s revolutionary genetic
tests, and further expands Aderans’ leadership in the hair care and medical fields. Aderans and its
group of companies span over 17 countries worldwide, and in 2001 Aderans purchased Bosley,
Inc., one of the world’s largest brands in hair transplant, to further solidify its global position as a
leading company in the hair care industry.
“PharmaGenoma is a leader in molecular dermatology and is excited to bring the latest in genetic
science to Japan. We believe our partnership with Aderans will benefit millions of Japanese men
and women concerned about hair loss,” says Andy Goren, President & CEO of PharmaGenoma,
Inc.
HairDX’s simple genetic test provides an accurate and understandable genetic analysis of a man’s
or woman’s likelihood of developing Androgenetic Alopecia, the most common type of hair loss.
”Aderans partnership with HairDX will allow people in Japan to learn their risk for hair loss early, so
they can choose the best treatment to preserve their hair,” says Katsuji Tokumaru, President of
Aderans Co. Ltd.
About HairDX, LLC
HairDX, LLC (www.hairdx.com) is a subsidiary of PharmaGenoma, Inc. Based in Irvine, CA, USA.
HairDX is a molecular dermatology research and development company. HairDX markets the first
genetic test for male and female hair loss. The company is dedicated to the research and
development of new prescription based therapies tailored to an individual's genetic make up.
HairDX uses only CLIA certified laboratories (Clinical Laboratory Improvement Amendments) to
perform the genetic analysis. The HairDX test collection kit is listed with Japan's Pharmaceuticals
and Medical Devices Agency (PMDA) and the United States Food and Drug Administration (FDA)
as a Class I medical device.
Among HairDX leaders is William V. Murray former Division President of the Molecular Biology
Division of Applied BioSystems, Inc., who formerly served in various executive leadership
positions within Medtronic, Inc., Andy Goren former CEO of MobileWise, Inc. and GeePS, Inc.,
Professor Doron Lancet, PhD, Head of the Crown Human Genome Center at the Department of
Molecular Genetics, Weizmann Institute of Science, Dr. Elon Pras, Director of the Institute of
Human Genetics, Sheba Medical Center in Tel-Hashomer, Israel, Sharon Keene, MD and
President and Medical Director of Physician's Hair Institute, in Tucson, Arizona and nationally
recognized for her pioneering work in the hair transplant field, and Elliott J. Stein, an intellectual
property attorney and co-founder of GeePS, Inc.
About Aderans Co. Ltd.
Headquartered in Tokyo, Japan, The Aderans Group offers a comprehensive lineup of products
and services to successfully address whatever concerns people may have about their hair. The
Group operates a variety of hair-related businesses targeting men and women in Japan and
overseas. In addition to manufacturing and selling custom-made and ready-made wigs and
hairpieces, the Group assists with healthy hair growth, hair-transplant and other hair-related
services. It also undertakes research and development into hair-regeneration technology. The
Group’s global presence includes bases in 15 nations, mainly spanning North America, Europe
and Asia. To drive further growth, the Group is marshalling all its resources to establish itself as a
total hair solution company

Assessment

The examination for each subject of MVST 1A and 1B is divided into three sections. Sections I and II are assessed for both the Tripos and the 2nd MB/2nd Vet MB. Section III is assessed for the Tripos only.
• Section I is a theory paper, and is assessed either by MCQ or short notes.
• Section II is a practical or data handling paper, and is usually assessed by MCQ or short notes.
• Section III is an essay paper.

The Third Year
An enormous range of courses is available in year three. Students may take in-depth courses in many of the subjects studied in their first two years; these are offered in the NST Part II courses. Students who wish to maintain breadth of study can combine courses from different departments in NST Part II BBS. Alternatively, they may choose to take courses in something rather different, such as Anthropology, Law, Management Studies or Philosophy.

Outline of the Part I Medical and Veterinary Sciences Tripos
Individual courses will focus on the “core” scientific knowledge, which doctors need to have in order to cope with clinical practice

First Year Courses
Second MB and Tripos
1) the overall layout of the structures of the body is covered in Functional Architecture of the Body (Medics) and Veterinary Anatomy and Physiology (Vets)
2) the chemical and molecular mechanisms underlying the functions of the body and the mechanisms that govern inheritance in Molecules in Medical Science (Medics and Vets)
3) the mechanisms that underlie communication within the body, and the maintenance of the stability of the internal environment in Homeostasis and Histology (Medics and Vets)
Second MB (Medics)
1) patients and societal context are introduced in Medical Sociology
2) basic concepts of epidemiology and biostatistics as tools for critical assessment of the quality of scientific evidence and appropriate inference are introduced in and epidemiology and basic statistics in the Introduction to the Scientific Basis of Medicine
3) students begin encountering patients in the community in Preparing for Patients A (PfPA). Subsequent parts of this course take place in the second year (PfPB and PfPC) and in the third year (PfP D), and satisfactory completion of all four parts is required for Second MB qualification.

Second Vet MB (Vets)
1) basic animal husbandry and nutrition is introduced in Farm Animal Husbandry
2) basic concepts of epidemiology and biostatistics as tools for critical assessment of the quality of scientific evidence and appropriate inference are introduced in and epidemiology and basic statistics in the Introduction to the Scientific Basis of Medicine
3) the nature of the veterinary vocation as well as some practical training in animal handling and restraint is covered in Preparing for the Veterinary Profession
Students who do not have A level Biology also take a short preparatory course in Cell Biology.

Teaching and Learning Methods

Teaching and Learning Methods
Each subject within Part I of the course employs a variety of teaching and learning methods, including lectures, small-group teaching sessions (supervisions), computer work, practical classes, and problem based learning. In addition, medical students undertake a programme of patient contact (PfP), and vets engage in practical animal handling as part of Farm Animal Husbandry. Vets also undertake farm practice through the Extra Mural Studies programme.
At Part II, in addition to lectures, students undertake a dissertation, based on literature review or laboratory project work.

Support for Students and their Learning

There is an extensive provision of student support and guidance, involving among other things
1) Introductory sessions at the beginning of their first year.
2) Individual course handbooks and websites.
3) University, Departmental and College libraries and computing facilities.
4) Students are assigned a Director of Studies and a personal Tutor by their College.
5) Small group tutorials (supervisions) provided by Colleges with collaboration of Departments.
6) Extensive staff contact in practical classes.

Criteria for Admission
Because students will be simultaneously gaining academic and professional qualifications, selection for admission in medicine is rather more complex than for most subjects, and involves four separate hurdles:
1) students have to satisfy the "pre-medical requirements”, which are:
a. GCSE Physics, Biology and Mathematics at Grade C or above
b. AS level Chemistry and AS level in two of Physics, Biology or Mathematics
c. A level in at least one of Chemistry, Mathematics, Physics or Biology
2) students must also meet the criteria that have been formulated by the Council of the Heads of Medical Schools as being necessary in order to start as a medical student
3) the Cambridge course is scientifically demanding and nearly all successful candidates gain at least three A grades at A-level
4) students must also undergo a check for any criminal record through the Criminal Records Bureau (or similar if from overseas).

For admission in veterinary medicine, the requirements are broadly similar:
1) students have to satisfy the "pre-medical requirements”, which are:
a. GCSE Physics, Biology and Mathematics at Grade C or above
b. AS level Chemistry and AS level in two of Physics, Biology or Mathematics
c. A level in at least one of Chemistry, Mathematics, Physics or Biology
2) the Cambridge course is scientifically demanding and nearly all successful candidates gain at least three A grades at A-level
3) students must also undergo a check for any criminal record through the Criminal Records Bureau (or similar if from overseas).
Mechanisms for evaluating and improving the quality of student learning support
Students have termly meetings with their College Tutor and Director of Studies to monitor and review their progress. This is facilitated by reports submitted to the Colleges by the student’s supervisors on each course.
Each course in the MVST has a course management (or teaching) committee, which regularly reviews the content of that course, student feedback and comments from examiners. Students are represented on these committees.
All courses have External Examiners, who are required to submit a report on the examination to the University. This is normally responded to by the DOMVE with appropriate input from the Head of Department, or an appointed deputy. The report and response is scrutinised by the General Board’s Education Committee.
The first two years of the course are managed by the MVST I Committee. This reports to the Faculty Boards of Biology and Medicine and to the Medical Education Committee which takes an overview of the whole course, pre-clinical and clinical, and advises on changes necessary to meet changing demands of the professional bodies.
All Departments who teach in the Tripos are reviewed by the General Board once every six years.

Programme Aims of Medical and Veterinary Sciences

In the first two years, medics and vets study for both the Tripos and for the professional qualification of 2nd MB/2nd Vet MB. Some courses are assessed for both qualifications; some are for professional purposes only.
The programme aims to:
1) to provide high quality education in medical biosciences leading to intellectually self-reliant graduates of the calibre sought by the profession.
2) to provide a stimulating and challenging learning environment where teaching is informed and enhanced by research to international standards of excellence.
3) to provide training and experience in the scientific principles and practice of research and its evaluation.
4) to continue to attract outstanding students from a variety of backgrounds, and to develop their potential to enable them to contribute fully to the cultural and intellectual base of society.
5) to contribute to the national and international needs for practitioners and leaders in the medical profession.


By the end of the first two years (MVST Part IA and IB) preclinical students should have:
1) knowledge and understanding of the basic principles and processes of human biomedical science;
2) been introduced to common forms of disease and the contribution made by biomedical science to understanding their basis;
3) begun to develop observational and deductive skills in associating molecular and cellular events with the outcomes of disease;
4) acquired basic laboratory manipulative skills and begun to develop skills in analysis and interpretation of experimental data;
5) acquired basic information technology skills in searching for and retrieving information;
6) begun to develop skills in oral and written communication and in learning through curiosity ;
7) begun to develop skills in listening to and dealing with patients;
8) become aware of the standards of competence, care, conduct and responsibilities expected of a member of the medical profession;
9) become enabled to progress to clinical training.

MEDICAL AND VETERINARY SCIENCE TRIPOS

MEDICAL AND VETERINARY SCIENCE TRIPOS

1. Awarding Institution University of Cambridge
2. Teaching Institution University of Cambridge
3. Programmes accredited by General Medical Council
Royal College of Veterinary Surgeons
4. Final Award B.A. (Hons) (for all students)
2nd MB/2nd Vet MB
5. Programme Title Medical and Veterinary Sciences
6. UCAS Code A100MB/BChir
D100MB/VetMB
7. Relevant Benchmark Statements Medicine; Veterinary Medicine
8. Qualification Framework Level H
9. Date of Programme Specification October 2006

Re-thinking on medical admission for science and healthcare

India’s population now exceeds 100 crores and the big challenge before the Government is to provide basic healthcareto all segments of the society. In spite of the economic and technological developments and the huge investments made in the medical education sector, the doctor patient ratio is extremely low in our country, compared to that in developed countries. We need professionally qualified and competent doctors to fill gap. Therefore, it is the need of thehour to develop a comprehensive medical education policy binding to the whole country, and more investment is to be pumped into the medical education sector. But the current realities are quite dismal.

Many students who pass out from the medical colleges are ill-equipped to treat patients. This scenario has emerged with the introduction of capitation fee for medical admission, which is now a deeprooted malaise in medical admission all over the country. Students with no calibre, aptitude or interest get into the medical profession either due to the funds they command or due to parental compulsion.

Only a few with merit, talent and aptitude for the medical profession get a chance to enter the portals of the medical colleges. It is quite unfortunate that in some states, the minimum marks for the qualifying examination have been lowered, in spite of the IMC directives otherwise.
Students who get into the medical profession in the merit category through the medical entrance examination are, no doubt, competent enough to get into the system and will come out as qualified professionals. Due to their interest in the profession, they take the risk of even undergoing rigorous coaching for one more year to fulfil their dreams.

Another fact is that we cannot do away with the reservation quota due to our complex socioeconomic realities. However, it is time to have a rethink on the procedure for admission into our medical colleges. There are two pertinent reasons for this. Now we mourn the declining
quality of students who opt for conventional degree courses, and, as already mentioned, many opt for medical education because of parental pressure or due to some other reasons. In order to get around these situations, we need to think of revising the mode of admission to the medical course. In many developed countries, students opt for medical education after their pre-med or
graduation, and the age of entry is usually 21 years. Here, immediately after their +2, at the age of 17 or 18 years, students choose the course without understanding the responsibilities and
commitments that are needed for the profession.


If we decide to fix any degree in science, with biology as one of the subjects in +2, as the minimum qualification for admission to the medical course, it will serve two purposes. First, many good students will come for basic degree.