What you missed, Part 1: Titled.

There are some statements that could be considered exaggerations.

That was the best cheesecake EVER.

Maybe the whole thing with the fire ants was a bad idea.

I have been in school FOREVER.

In my case, I think that last one was technically true. 

I went from undergraduate right into a Ph.D. program, something I think I would never have done had I known better. At times it was fun, and now that it is over I am finding it easier to remember that. Frequently it was horrible. 

I stuck it out for a few reasons. First of all, I am stubborn. Second, the idea of quitting was scary. But I like to think the most important reason I stayed is because, every so often, it was AWESOME. I loved the moments - few and far between as they were - when I got something to work (repeatedly) and realized I was looking at something new. Something where I could go to the world "I know something you don't know" and actually be kind of almost sure it was true.

Mostly, it was probably the second thing though. I used to think that it is hard to be something that you're not.

In any case this happened last spring. May 17th, to be precise.

"So listen carefully.... SCIENCE!"

"This is what I can do with powerpoint."

"Look, some more things I can do with powerpoint."

It took me about eight weeks to recover normal sleeping habits after the defense... which was actually fine, because I did a lot of great TV show watching and reading in the unmentionable hours of the day.

The defense, like my research career, wasn't all that pretty. It wasn't really enjoyable. Fortunately I had the support of a loving and wonderful family, especially on the sprint through the end. 

And, two days after my thesis defense, I got to go to a really fantastic party.

More on that soon...

Fund me... but not Rick Perry.

Let's be honest, I'm not often impressed by the Republican Right. Or even the Republican "middle" - which is really just less-right.


But Rick Perry is on my radar with his stance on Global Warming. Not because I Love Al Gore, but because of Perry's line of reasoning.


From the Huffington Post:

Texas Gov. Rick Perry took his skepticism about climate change one step further on Wednesday, telling a New Hampshire business crowd that scientists have cooked up the data on global warming for the cash.

In his stump speech, Perry referenced "a substantial number of scientists who have manipulated data so that they will have dollars rolling in to their projects."

"We're seeing weekly, or even daily, scientists who are coming forward and questioning the original idea that man-made global warming is what's causing the climate to change," Perry said. "Yes, our climates change. They've been changing ever since the earth was formed."

That's right. According to Rick Perry, Scientists cook the data.



But wait, that's not all!


The WaPo goes on to report the next day:

“They have seen the headlines in the past year about doctored data related to global warming,” Perry writes. “They know that we have been experiencing a cooling trend, that the complexities of the global atmosphere have often eluded the most sophisticated scientists, and that draconian policies with dire economic effects based on so-called science may not stand the test of time. Quite frankly, when science gets hijacked by the political Left, we should all be concerned.”

Good thing science is never manipulated or hijacked by the Right. Never. Never ever.


Now, I'm not saying scientists should never be questioned, or that science is always right, or that science knows everything about a given topic (let alone global warming) right now. There are too-frequent reports of people who have falsified data and lost their positions, issue retractions, damage other careers, etc. This is very, very bad. Even one report is too-frequent, given the nature of scientific research to build upon the findings of others.


But this is discovered through the process of competition, further experimentation, and peer review.


Not by politicians.


Just because a poll says a majority of people don't believe a theory (Global Warming, for example) is not true, doesn't mean that their theory is any more correct. Popular opinion does not a truth make. Ask Copernicus. 


It's the collection and evaluation of evidence - which can be a long, gradual process - that should influence our interactions with (and actions on) the world.


Perry uses general terms when he talks about these Scientists Gone Wild, if you watch the clip (at the end of the post). "Substantial number." Which then becomes "some cases". He points to the emergence of scientists that question the working hypothesis as evidence that the theory is false - thereby furthering the implication that the data is false and politicized. 


No, it's science. 

Science.

Scientific development comes from trying to prove or disprove a working hypothesis. Perry is merely taking the flip side of what he's accusing liberals of doing - that is, politicizing global warming - only he's doing it at the expense of science's credibility in the eyes of the public.


And I didn't hear any disclosures, Governor Perry. Come on, even "scientists" do that.


I'm not sure if it's willful ignorance, or a belief that the public is not interested in specifics behind his accusations, or the desire to capitalize on a popular idea about science.


And in a way, that's what's most alarming about Perry. His comments reflect a fundamental problem in the perception of science - which, in turn, leads me to believe this is an attitude he's likely to carry into the White House. 


The prejudice that scientists would fabricate data to funnel in research dollars doesn't bode well for the future of research in America. Clearly, Perry has never tried to apply for an NIH grant.


It's not about global warming, Perry. Sorry.


Here's a video of his answer so you can judge for yourself. The question takes a while and is hard to understand, but Perry is loud and clear.

Bad Moon on the Rise

You've probably heard by now that Saturday evening we'll have a perigean full moon.


Also known as "Super Moon."

(That cover was pretty different - kind of why I like it.)


When the moon is at its "perigee," it's at its closest point to the planet. The opposite, when the moon is at its furthest point, is called "apogee." This is the first time perigee has coincided with a full moon in about twenty years. 


There was an almost "Super Moon" in 2008, according to an article in USA Today. The Super Moon of 2011 will be about 2% closer than that event. Or, this much.


Moonrise is scheduled for 7:37pm.


So what's the point? Well, the consensus seems... not much. Tides might be a bit high, but there's no need to fear swarms of natural disasters.


To seque "neatly" from natural disasters... there's information abound on the internets that talk about moon:menstruation links and lunar fertility cycles; however, a study that looked at lunar cycles and IVF suggested any connection was borderline and oversimplification at best. 


A different study suggests a possible link between the moon cycle and attacks of "pseudogout." Tides, which are of course the result of the gravitational forces between the earth and moon, may also play a role in controlling global temperature when the tides are "extreme."


Yeah, you didn't see all that science coming, did you?


It should be a nice weekend, weather-wise, so enjoy some time outside with a warm beverage and take a look at the sky. That's my plan, anway.


Although I'll be keeping an eye out for were-wolves. (Silver bullets might be a good idea, too.)

Science Education: the glass half-broken?

Science education is a topic that I'm very much interested in. 


In fact, I attended a fascinating discussion at the 2011 Biophysics Meeting yesterday on "The Future of Science Education in America." Since then, a couple of things have come to my attention in the news - coincidence? No. I think that it's part of an ongoing, massive realization that we are failing children with the current system.


The discussion I attended featured talks by four people: Bruce Alberts, Editor of Science Magazine, Shirley Malcolm from American Association for the Advancement of Sciences (AAAS), and David Asai and Tuajuanda Jordan from the Howard Hughes Medical Institute (HHMI).


Each person brought something unique to the table. Alberts has long championed changing the educational system when it comes to STEM (Science, Tech, Engineering, and Math) programs. Malcolm did an excellent job of summing up what works and what doesn't for education at all levels - K-12, university, and post-graduate. And Asai and Jordan are both involved in some remarkable new programs designed to engage and retain students in the sciences.


Rather than break down my notes, I'll just hit some of the major themes. And because it's a summary of my notes, I'm probably not going to have time to track down and link all sources independently - just contact me or comment if something's unclear.


1. Proper science education is requisite for producing a science-literate populace.
I don't mean this sentence to sound snobby, but that's the way it is. I sincerely believe that the nonsense with Creationism would not have roots if more of the population understood science. (Yes, I can call it nonsense, because this is my blog. And because it is.)
Many people will not take science again after whatever introductory classes they choose to fulfill requirements. Creating a set of intro courses that teaches people how to think like sciences will help them understand science later in life - even if they end up in an entirely different field. Thus, people will know the right questions to ask when they read a story about a scientific breakthrough. Parents will know how to be involved in their kids' science education. Politicians will - maybe - better appreciate the need to fund many of the problems that are highly underfunded - in favor of 'sexier' fields - and understand the challenges that we face moving forward.


2. Introductory science courses are a major failure in the system.
Too many Universities adopt a rubber-stamp approach with 600-student lectures, or an attitude that 'weeds out' students trying for a science-related major. Rather than teaching students how to think, the panelists pointed out, they burden students with irrelevant facts. Examples weren't limited to universities. Grade school kids are often required to memorize sections of the periodic table (I was). But what does that give them for the future? Why spend time on that? Interesting thought.


3. S, T, and E, which were weak to begin with, have largely been pushed aside in favor of M.
This is not to say that math is not important, but this imbalance is a huge problem if we hope to produce students that are competitive with the rest of the world (and we need to do so). According to Alberts, part of this is due to standard testing, which requires emphasis on language and math, and part of this is due to No Child. In addition, failure of the states to adopt the national standards for science education proposed in 1996 led to a massive problem: publishers trying to write books to satisfy each state, reduction of test standards to cover everyone's requirements, curricula that don't match across state lines, etc. Interestingly, panelists cited efforts that are underway to create a new set of national recommendations.


4. At all levels (even K), science classes need to shift from memorizing facts (think, parts of a flower) to emphasizing the scientific process. 
Examining a problem, generating and testing hypotheses, collecting data, and analyzing results. These are the skills useful to science that assist with problem solving and analysis. These are also far more engaging activities. Plus, think about how much more applicable this problem-solving technique is than knowing what a stamen is.


5. Pilot programs such as the SEA run by HHMI move away from large lecture format and to small groups, interactive lessons, and critical thinking. 
These programs, since their institution, have been shown to retain higher numbers of students (ie, they minimize the number of kids who switch majors) and produce higher grades when compared to the standard university lecture model. Programs at the HHMI also extend resources to schools that may be less competitive for resources or other educational grants.




I will say that I wholly support the things discussed by the panel. I was fortunate enough to take two physics classes in college that adopted this interactive teaching approach (the professor's research was physics education research). They were far more engaging than most other courses I had in four years, and in some ways more difficult. We were given a box of items at the start of each lab, told the problem, and then told to find a way to make it work. It was by far the closest experience to graduate school I had - before I hit the lab bench, anyway. And they were 100 level classes.


There is no reason why students of all ages could not benefit from this approach. Consider the inquisitive nature of a five year old. Those kids can be very observant. What a waste not to let them use it to ask and answer questions about the world around them.




So, out of this discussion, I will just give you the things that caught my attention in the news. They seemed relevant to one or more of the points mentioned above.


1. An analysis of Science education in Maryland via the Baltimore Sun.


2. A story via NPR about a future "Noah's Ark" Park in KY that features creationist themes - oh, and to which the state's governor has proposed giving tax breaks.




Finally... I don't have children and I'm not a teacher, so I'm not closely in tune with what's going on in HCPSs. But I have participated in the past as a judge in the HoCo STEM Fair*, and I was impressed by much of what I saw - particularly in the mentorship programs that paired students with research faculty in the state.  I see this as a really excellent feature of our local system, and hope that other aspects of HoCo's STEM programs are as strong (or getting there). (hocoblogs@@@)


Oh.. one more thing... I went searching for news releases about the latest STEM fair, and failed to find one after a few minutes of googling and searching both Explore Howard and Columbia Patch - just the same announcement that it was happening. This is an extreme disservice to the program, and I'm pretty disappointed in that, Local News Outlets! Bigtime Fail.  Still, if you're willing to believe me that there were equally cool projects the last year I judged, here's a story from... 2001. >.>


Edit: Here are mentions of MS and HS science fair winners on Columbia Patch (link with search term "science fair").




What do you think of overhauling the STEM educational programs in HoCo? Maryland? Nationwide?  How would you change it?

Brief Intermission...

It was a crazy weekend - crazy busy, not crazy Weekend At Bernies. The next few days will be just as busy. So while I have no shortage of things to blog about... I'll probably be off the radar for a few more days.


Until then... some stuff.


NaNoEdMo has gotten off to a slow start. Here's my progress as of Day 6. See the dark blue line? The sad looking one? Yeah... that's me. The few hours I have logged have not been focused on a single work. I feel like I should have gotten more today, but I feel weird about logging work stuff.

This might be, in part, due to some misspent time....


Pawn Stars is a great show - seriously, I know it must be somewhat staged but it's amazing what these guys know.

Still, I have questions...

• These people go in there and take a hit because the pawn shop has to be able to find a niche market for many of the items. In this day and age of the internet... WHY?
• How does one not notice the Made In USA stamp on the "original" French art?
• How much of that money actually leaves Vegas?
• Does anyone ever mess with Antoine?

Speaking of distractions...

Bucket List Blogfest is coming up - sign up today!


What else...

I made this for dinner last night. It also makes an excellent breakfast.

Pizza with fennel, pancetta, mozz, cheddar, and 1/2 with red onion.
Yes, breakfast. Don't judge.

I'll be at the Biophysical Society's annual meeting this week. I saw someone there today with something very much like this. I still am not quite sure what to say about that. I wish I had stopped and asked her about it.

Happy Monday folks. See you in a few days.

Happy Tuesday

Happy Tuesday. 


Last night, I submitted a short story to a literary journal for the first time ever.


This was a big step for me. For a while I thought I would send the story to The New Yorker. Rejection letters are part of the process, and I thought it would be totally fine if my first one was from a magazine like that. ;)


In the end, I picked a more appropriate review. I should hear something in April. Unless I wrote my cover letter wrong and they bin it. I feel like I read the directions about 43 times.


I can't thank my last-minute eyes, Susan, Meghan, and Erinn, enough. Ladies... you rock awesome socks.


Now to wait. 




What are YOU waiting for (besides your pair of Awesome Socks)?  Tell me in the comments below!

Food Physics and Freakonomics

The Freakonomics Podcast has a two-part series in the making called "Waiter, there's a physicist in my soup." The first half is on the Freakonomics blog on the NYT now and covers the topic of Molecular Gastronomy.

Physicist Nathan Myhrvold is releasing a self-published reference work called "Modernist Cuisine: the Art and Science of Cooking."  I call it a "work" because Amazon clocks it at 2400 pages.  It's gotten a strong endorsement from Harold McGee, and sounds absolutely fantastic.

Intrigued? It lists for $625, but you can score it on Amazon for $467.62. AND it's Prime-eligible.

I will stick to On Food And Cooking.

The discussion in the podcast is pretty interesting, but when they interjected Alice Waters as a counterpoint, I thought the whole "face off" on each side felt forced.

Waters points out that she doesn't personally think the Molecular Gastronomy movement is the way she wants to eat.  She says: 

"In my view it’s to, you know, make it into something you can’t imagine. You know, surprise you.  That’s not to say that I haven’t been delightfully surprised.  It’s not that.  It’s that I am so hungry for the taste of the real that I’m just not able to get into that which doesn’t feel real to me. It’s a kind of scientific experiment, and I think that there are good scientists and crazy old scientists that can be very amazing. But it’s more like a museum to me. It’s not a kind of way of eating that we need to really live on this planet together."

As the counterpoint (offered by Dubner), Myhrvold says he loves Waters' restaurant, but then he goes off on this point:

"Well like it or not, physics happens, OK? So it turns out when you heat a piece of meat there’s a set of physical principles that are at work. Wishing doesn’t make the food hot, it’s the way molecules bump into each other that makes it hot. And if you are going to understand that in a reasonable way, I think it informs how you do cooking.  Now is it possible to cook without understanding? Of course it is.  For people that want to just, in a rote way, to repeat exactly what they were told to do without understanding why it works, hey go for it!  You don’t need me.  If all you want to do is repeat the recipes of the past and you have no curiosity about how or why it works, then you don’t need to have this physical understanding. On the other hand, why does it ruin the experience to understand how and why it works? You drive over a bridge, don’t you hope the civil engineer knows why bridges stand up? Or you go up to the ninth floor of a building here, don’t you hope that all those floors below us were designed by a guy who knows how buildings stand up? I think that informing people, whether it’s chefs, or foodies, or the average person, informing them on some of the ways that stuff actually works, I don’t see how that is a problematic notion."

He sounds as if he's answering/defending against a different point.


I'm assuming that this is the result of two separate interviews, spliced together to make a neat piece.  But I don't think it addresses Waters' comment - is this how we should be eating?

Does Molecular Gastronomy offer a more healthful or sustainable cuisine? Does it promote appreciation of resources or the whole animal?

Does it add to our food identity, the lack of which is in part driving morbid obesity, foodborne pathogens, and a drop in food IQ?

Something I take more issue with... you don't have to be an advocate of Molecular Gastronomy to appreciate that cooking is science, and to know the science behind cooking. 

With a little work, you can learn the science in your favorite recipes, whether they're handed down or cut from a magazine. Following a traditional recipe doesn't necessarily mean a surrender to ignorance, particularly when you have learned the techniques and skills that allow execution of that dish.


I'm sure Myhrvold's 6 volume work goes layer-by-layer through those basic techniques of cooking. It's probably phenomenal (even if it exceeds the price range or storage ability of many home cooks).

But I'm not convinced - from this interview at least - that learning how to make watermelon chips or baked potato foam or deep fried carrot juice will help me to appreciate how food works. It might be that I'm just inexperienced or lack the appreciation or palate. 

For something as visceral and personal and compelling as food can and should be.... should that matter?

A list, and the snow day that isn't

In case you missed it... there's snow on the ground. Quite a lot more than I was led to believe earlier, for all the forecasts that said most of it would come this evening. There were 2+ inches on my car, and that was an hour before the winter storm warning officially began.


The drive to the lab was not fun. That's not even considering the fact that I was here late last night trying to fix a problem - roughly ten hours passed between when I locked the door and when I came back.


So, to put myself in a better mood and to start the day off right better, here's a list of 10 things that are awesome about the Snow Day That Isn't so far.

1. The snow was really easy to brush off my car.
2. I was able to stop for a hot cup of Dunkin coffee to go - and it was made the way I asked for it.
3. When I walked from the garage to the lab, the precipitation was mostly snow. It's really nice to walk in the snow.
4. There are a few people here. I had a spontaneous conversation with one dude by the elevator, he was pretty entertaining.
5. The department ice maker is running really low for some reason, but because I'm in so early, I didn't have to fight for my ice.
6. Since I'm the only one in the lab, I can listen to We're Alive while I work and not have to worry about the zombie sounds and screams disrupting my coworkers' concentration.
7. I am wearing one of my favorite tee-shirts. If I'd stayed at home, I'd probably still be in my pajamas.
8. At least one thing I left last night worked. I might be 3/3 by the end of the day.
9. I have plenty of time to organize my desk. (I thought about posting a picture of the mess, but I don't want photo documentation...)
10. Since I'll already be on the road, I can swing by the store and pick up some essentials on the way home.

Enjoy your snow day, and if you have to be out on the road, drive safely!

"Mr. Watson, come here...

...I want you," said Alexander Graham Bell on January 25, 1915.


To which Watson replied, "Do you have any idea what time it is here?!?!"


Alright, I may have taken some artistic liberty in the re-enactment of the conversation. Today marks the anniversary of the first transcontinental telephone call. Amazing to think about now, in an age where calling around the globe or videoconferencing over the internet is more or less routine.


I wonder where we'll be in another hundred years*.


Somewhat ironically, I left my phone at home today. It's thrown me off a little, but at the same time, has been somewhat liberating.


We may get snow tonight and tomorrow - stop by the store for milk, bread, and TP. Then bring them all by my house, 'cause seriously, I'm almost out.


Happy Tuesday, everyone. 






*Barring destruction via global warming, Zombie Apocalypse, or the election of Sarah Palin to the presidency.

My day in the lab...

...is kind of like this, only with slightly less Cookie Monster.


Just in case you were wondering.

Thanks to Jeff for sharing this awesome video!

Hey Woman, No Cry

Work has just been taking it out of me the last couple of days, but I didn't want to leave you with nothing until the next Food versus Food (coming this Friday!).  So I thought I'd share an interesting article in Scientific American this week.


Basically the article looks at a study, accepted for publication a few weeks ago in Science, demonstrates that female tears contain a "chemosignal."  When men are exposed to that signal, they reported a loss of sexual arousal.  


And this wasn't just an "OMG crying!" response - subjects simply sniffed a sample of female tears.  Beyond self-reporting, physiological tests showed decreased arousal, reduced levels of testosterone, and changes in brain activity that were consistent with decreased arousal.

This isn't really unusual - pherimones have been talked up a lot in pop culture over the last few years, and the term is decades old.  Cells - even normal cells in your own body - move following chemical signals in a process called Chemotaxis.  Pherimones have also been shown to influence animal behavior.

What Jason Castro, the author of the SciAm article points out, is that this study is unique because it shows that the signal contained in tears taken from one human has a measurable response on another.

"Examples like these reinforce the idea that we might converse via molecules in a way that’s qualitatively different from our more familiar interactions. Whereas spoken conversations are abstract and nuanced, chemical conversations are physical and largely hard coded. This opens the door for some of the more imaginative hypotheticals surrounding the field of pheromone research. Could pheromones override out better judgment? Be distilled and weaponized to evoke mass panic? Crafted into a perfume with will-bending allure? Perhaps all of these things are already happening naturally, and we don’t even know it?

Probably not. Yet the newfinding by Dr. Sobel’s group is almost as exciting as scientists (and perfume makers) could have imagined. It turns out that we do indeed send a chemical message that others can’t resist. But that message is “hold off.”"   

--Castro, J. "Her Tears Will Control Your Mind." Scientific American. 11 Jan 2011.(emphasis mine)

It's fascinating to speculate how many other ways we signal each other as we go about our daily lives.  Studies like this show the intricate link that's evolved between behavior, hormones, and the senses.  


Moreover, what do studies like this mean in a world that's becoming increasingly electronic - where communication, be it business or personal, is carried out over long distances (leaving us with only visual or aural clues)?  Will (Does?) this subtly change the way we communicate in the modern age?


You can read the full text of the article, which details the methods and findings of the study, and Castro's analysis on the Scientific American website.

Good Morning, Science.

Today is looking like a busy day - lots to do, plus I don't really want to stay late and spend my evening commute dodging people who can't drive in the snow.  On the plus side, I got into the lab early.


Also, maybe I need more sleep.  At several points this morning I realized that I was rockin' a throwback style from the '90s.  It may be a message from my subconscious.


Hmm.


On to science.  Enjoy the day, everyone.

Abstruse Goose Comics - Creative Commons License
Thanks to Six for the AM laugh!

Happy birthday to you...

CPR!  Yup, that's right, CPR turns 50 years old today.


Whoops.  I mean 38.  Again.


Seriously, though, on this day in 1960, the official guidelines for CPR were adopted by the American Heart Association.  I thought this was kind of cool, seeing as I've been teaching it for roughly ten years now and have seen the protocol change even in that short window of time.


CPR, or cardiopulmonary resuscitation, is an emergency intervention used to maintain the flow of oxygenated blood in a person (or patient, victim, etc) when the person's heart stops working effectively.  Typically this would be used when someone goes into cardiac arrest or encounters some other life-threatening situation that stops the heart. 


I was surprised to learn that the use of artificial breaths (ie, mouth-to-mouth) and chest compressions has been around for several hundred years.  As early as 1760, artificial breathing was touted by the Parisian Academy of Sciences as part of a protocol to revive drowning victims.  Successful use of the practice was seen years earlier, when Dr. William Tossach used mouth-to-mouth resuscitation to revive a miner.  Depending on the sources I found, dates for this varied wildly between 1732 and 1771, though the most commonly cited appears to be 1743.  Dr. Friedrich Maass utilized chest compressions to revive a teenager in 1892 (again, some variation in date based on source).  There is also evidence that different forms of resuscitation may have been used earlier in history.  Check out some of the earliest methods here and here.


So what did CPR in 1960 look like?  The major development in 1960 was the establishment of a protocol that used "closed-chest cardiac massage."  Basically, the protocol focused on pressing on the chest to circulate blood, which was oxygenated by the delivery of artifical breaths.  This use of chest compressions and breaths differed from the then-commonly-used Holger-Nielsen Technique that was utilized from 1911 through the 1950s.  


In recent times, the AHA has changed its CPR protocol, such as the ratio of compressions to breaths delivered in a minute.  In 2005, the AHA recommended the use of 'Hands-Only CPR' for bystander-intervention in an emergency.  Three years later, following the publication of its recommendation panel in a peer reviewed journal, the guideline was expanded. 


Basically, this revision eliminated the use of artificial breaths for the lay person, or bystander.  The change was thought to focus on three advantages (in no significant order):
1) Eliminating bystander hesitation to intervene (by removing a step that requires a barrier like a mask to be performed safely)
2) Focusing on the delivery of high-quality, rapid compressions at a rate of 100 per minute (think about the beat to 'Staying Alive') is used as a temporary intervention until EMS arrives
and
3) Making the protocol easier to learn, thus increasing the chances a person will receive CPR care. 


Subsequent studies have shown that Hands-Only CPR requires more effort on the part of the rescuer, but quality of CPR has improved.  Studies also showed that removing the artificial breaths did not change the outcome of survival or the flow of oxygenated blood in the subjects.  At present, no studies in human patients or animal models support the claim that reducing or eliminating breaths is harmful.


Although this idea seems counter-intuitive, it actually makes sense from a biology standpoint.  You may remember from basic biology that oxygen is carried by hemoglobin on red blood cells.  To describe a simplified loop, the red blood cells squeeze their way through capillaries in the lungs and pick up fresh oxygen.  They then tumble through the bloodstream via arteries until they reach a new capillary bed, this one in tissues. A second exchange happens, and the oxygen is delivered to the rest of the body.  The red blood cells then return through veins to the lungs, where they pick up more oxygen.  Check out a handy diagram here.  Venous blood doesn't have 'zero' oxygen, it just has oxygen present at a lower pressure than that of arterial blood.


Interestingly, delivery of 100% oxygen doesn't actually increase the amount of oxygen in a person's blood or tissues.  The advantage of 100% oxygen delivery is that it increases the amount of oxygen in the lungs.  When a person becomes unconscious and is unable to breathe, the amount of oxygen available to them is largely a function of the amount of oxygen in their lungs (ie, lung volume, and the amount of oxygen in small sacs called alveoli that help mediate gas exchange).  The air we breath is typically about 20% oxygen.  Increasing this percentage facilitates the exchange of oxygen to hemoglobin as the blood pumps through the lungs, but it doesn't significantly increase the amount of oxygen in the blood itself.  There are even situations when delivery of 100% oxygen (or hyperoxia) can be detrimental - email me if you want to discuss that and we can chat. It's a fascinating field of research.


So, intuitively, if the blood is pumping through the lungs as a result of hands-only CPR, it will pick up some oxygen as it passes through the alveoli and circulate it during the intervention (lungs have a residual volume unless they're collapsed).


Likely the biggest advantage of hands-only CPR is that it dramatically improves the odds that a person in cardiac arrest will receive CPR intervention.  The technique is easy to learn and reduces the need for a mask to mediate safe contact between rescuer and victim.  CPR alone actually has a low rate of success in reviving adults, and is meant to be a primary, temporary intervention until expert care is available.  The introduction of defibrillation confers significantly higher survival advantage than CPR alone, even when the shocks are delivered by non-healthcare professionals.


Current AHA CPR guidelines are summarized neatly here (or here in full, if you want to read a lot of journal articles).  Italics not mine.

"When an adult suddenly collapses, trained or untrained bystanders should—at a minimum—activate their community emergency medical response system (eg, call 911) and provide high-quality chest compressions by pushing hard and fast in the center of the chest, minimizing interruptions (Class I).

• If a bystander is not trained in CPR, then the bystander should provide hands-only CPR (Class IIa). The rescuer should continue hands-only CPR until an automated external defibrillator arrives and is ready for use or EMS providers take over care of the victim. 
• If a bystander was previously trained in CPR and is confident in his or her ability to provide rescue breaths with minimal interruptions in chest compressions, then the bystander should provide either conventional CPR using a 30:2 compression-to-ventilation ratio (Class IIa) or hands-only CPR (Class IIa). The rescuer should continue CPR until an automated external defibrillator arrives and is ready for use or EMS providers take over care of the victim. 
• If the bystander was previously trained in CPR but is not confident in his or her ability to provide conventional CPR including high-quality chest compressions (ie, compressions of adequate rate and depth with minimal interruptions) with rescue breaths, then the bystander should give hands-only CPR (Class IIa). The rescuer should continue hands-only CPR until an automated external defibrillator arrives and is ready for use or EMS providers take over the care of the victim.^"

--directly quoted from Sayre, MR. et al. 

"Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest" Circulation. 2008;117:2162-2167 

Check out an instructional video here.  There's also a video of the American Red Cross Science advisor's lukewarm assessment of hands-only CPR here.  (One specification he mentions is that full CPR is more effective in children.  In the interests of keeping this post to a reasonable length, I've chosen to focus on adults.)

I am interested to see if the recommendations will change for primary responders such as lifeguards or even EMS, to further accommodate Hands-Only CPR.  In my effort to look at primary sources, I noticed that many of the studies I read used animal models instead of humans.  This is necessary for controlled conditions and physiology, but the differences between real human patients (huge amount of variables) and identical animals (minimized variables) does leave some questions as to the benefits of ventilation in cardiac arrest.  

However, at the most basic level the take away of the AHA's recent change is that early intervention can increase a person's chance of survival in case of emergency.  

So, awesome readers, to celebrate CPR's birthday, get out there and find a class in your community.  Help ensure this skill continues to save lives!

Have a comment about the history of CPR, current guidelines, or any of the science I've mentioned above?  Leave one!

Canine Epilepsy...

...really sucks.


Don't get me wrong, I'm not saying epilepsy is all fun and games for people.  However, canine epilepsy presents some serious challenges.  It is impossible to explain to a dog what is going on; similarly, the dog can't tell you how it's feeling, so it can be hard to recognize the signs pre-seizure.


A number of years ago, MeatHead, the bulldog, was diagnosed with hypothyroid, and then seizures.  

Most beautiful bully ever...

When Meathead was diagnosed, I learned that epilepsy is somewhat common.  The estimate is 4-5%, but anecdotally, many dog owners I know either had or knew someone who had a dog with grand-mal seizures.  There may be breeds predisposed to the disease, but that doesn't yet seem clear.


Epilepsy may be inherited (primary or idiopathic) or acquired (secondary or symptomatic). Seizures resulting from tumor, stroke, metabolic imbalance (think blood sugar, electrolytes) and hypothyroidism would all be considered secondary, because the seizures are the symptom of an underlying disease.  Inherited epilepsy has its own origin, probably genetic, and research is ongoing to try and tease apart the mechanisms of the disease.


What is a seizure, besides scary?  Basically, a seizure is a neurological event.  Think of a normal brain (human or dog) as a net - it's composed of many nerves (segments of rope) that respond to a stimulus (like... a tennis ball hitting the net).  The stimulus is transmitted through the neural network, and is translated into information.  


"Ow, that was hot." or.. "Hey look, a wall."


In a seizure, many different portions of the brain respond improperly to a stimulus.  So instead of a single tennis ball hitting the net, imagine a dozen rapid-fire volleying machines firing at will.  The result is a seizure, either of the grand-mal variety (stiffness, loss of body function, drooling, disorientation, etc) or the focal variety (this may or may not be noticeable, as it involves a smaller portion of the brain).  One seizure event pre-disposes the organism to subsequent seizures.  


Seizures of both types can be preceded by a 'prodrome' stage, and by a 'post-ictal' stage in which the dog lies still or may have trouble getting his bearings.


For a more thorough description of types and stages, go here.  


At the moment, treatment of epilepsy is all about controlling the seizures.  


Because Meatie also has hypothyroid, and hypothyroidism can cause seizures, both conditions must be carefully managed.  The thyroid medication has not resolved the symptoms alone, so he's also been on Potassium Bromide (KBr) for some time.  In the last day, we began supplementing his medication with phenobarbitol (PB).  Both of these drugs decrease the excitability of neurons in the brain.  


Interestingly, PB is not commonly prescribed for humans in developed countries.  Instead, benzodiazepime derivatives like Valium are preferred.  As a barbiturate, dependence, depression, and behavioral changes can result from PB use; however, in developing countries it is still given to humans.  


For dogs, KBr and PB are often given in combination with Diazepam (aka, Valium), one such benzodiazepime derivative.  Diazepam binds to a unique site in a receptor called a GABA receptor, which controls a Chloride 'ion pump' and normally inhibits nerve activity.  This binding makes the GABA receptor more likely to activate (increases the frequency), decreasing excitability.  


Barbiturates like PB bind the GABA receptor as well, but it acts in a different way: binding of PB increases the amount of time the receptor is active (increases efficacy).  PB also binds a receptor called AMPA which typically excites nerves, as well as other receptors in a non-specific manner.  


Side effects of both these drugs include confusion and sedation, which we've seen in our mutt.  PB can cause liver damage over time and requires regular blood testing.


Potassium bromide is a salt, like table salt, but with different elements.  KBr is the only one of these three drugs not approved for use in humans in the USA, because it's difficult to establish an effective dose without causing toxicity (called Bromism).  Bromism can cause changes in appetite, sensory perception, and behavior, aggressiveness, psychoses, and even more seizures.  


Determining a balance of each of these drugs is often necessary to manage canine epilepsy.


What else is a concerned owner to do?  First, we log each of MeatHead's seizures, and talk to the vet when we have concerns.  Like recommendations for people, we keep the area clear.  If he's on the couch or the bed, we move him to the floor.  When he's finished the seizure, we block off the area so he won't tumble down the steps and hurt himself.


There are several alternative therapies out there, but alternative drugs are very expensive because they're typically used in humans (who have insurance).  Administering supplements could make things worse if they cause side effects that haven't been documented by studies.  One thing we do is apply an ice pack to his back when he does have the seizures.  I'm not sure this helps, but at least keeping him cool won't hurt.


Our dog has been on KBr for years, with Diazepam as needed.  Recently, we decided to had PB, since the frequency of seizures has not really decreased to an acceptable level.  Since he's started the PB, Meathead has been disoriented.  The vet said it would take a few days for things to normalize, and I hope it does soon.  It's very hard to watch a loved one (and yes, dogs count) suffer, and it's even harder to be unable to explain it to them.

Mo and MeatHead

For more information, check out the links above.  If you have a story about dogs, canine epilepsy, or anything else, please share in the comments.