10 describe how the principles of signal detection

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Unformatted text preview: o be more virulent than those spread by respiratory secretions.  Bacteria from deep soil samples show resistance to many antibiotics. Explain. 10. Describe how the principles of signal detection theory explain how selection shapes mechanisms that regulate defenses such as fever and pain and how these principles can guide research about when it is safe to use drugs to block such defenses.  Costs of fever include tissue damage, the risk of seizures, and metabolic costs. Describe how high you would expect these costs to be in comparison with the bene ts if fever is controlled by a regulatory mechanism that is near optimal. Nesse et al.  If natural selection shaped optimal regulatory mechanisms, why do not more problems arise from using drugs that block normal defense responses such as cough and vomiting? 11. Understand somatic selection.  Describe how selection among immune cells results in adaptive responses to infection.  Describe the importance of somatic selection in explaining cancer and planning chemotherapy strategies. 12. Understand the evolutionary origins of senescence.  Explain some of the evidence that aging rates are life history traits shaped by selection.  The physiological reserve declines with age at remarkably similar rates in multiple organ systems. Explain why.  A colleague says that nothing can be in uenced by natural selection after reproduction ends. Why is this incorrect? 13. Explain the origins and signi cance of genetic variations that in uence responses to pharmaceutical drugs.  What do drug metabolizing enzymes do, and what are the medical consequences of variation in their activity among individuals?  What was the role of drug metabolizing enzymes in our evolutionary past and why might this have generated the variation we see today? 14. Demonstrate understanding of the aspects of microbial genetics that affect medical outcomes.  What is the evolutionary signi cance to an RNA virus of a mutation rate 1,000 times greater than that of a DNA virus? What implications does this have for the design of vaccines against HIV and in uenza?  How can DNA be exchanged among bacteria? What is the functional signi cance for the bacteria? What are the implications for the development of antibiotic resistance? Once again, we emphasize that the above learning objectives and examples are only suggestions. We hope they will encourage more systematic investigations of optimal policies about evolution education in medicine. We know we have omitted important items, and a sophisticated committee would edit many items to a more suitable format. While we await such more comprehensive assessment, some will ask what speci c topics should be covered in the medical curriculum. Remarkably few suggestions have appeared (46, 55). Ours appear in the next section. Topics That Should Be Covered in a Medical School Course on Evolutionary Biology 1. A review of core principles of evolutionary biology. 2. Common misunderstandings about evolution: how to recognize and avoid them. 3. Evolutionary explanations: importance, formulation, testing. 4. Cooperation, kin selection, levels of selection. 5. Evolutionary genetics, signals of selection, drift, pleiotropy, demography, etc. 6. Evolutionary considerations in epidemiology, and genomewide association studies. 7. Life history theory applied to humans. 8. Senescence and late-onset diseases. 9. Reproduction, sexual selection, and related medical problems. 10. Antibiotic resistance and virulence evolution. 11. Coevolution, arms races, and related aspects of infectious diseases. 12. The ecology and evolution of emerging diseases. 13. Somatic evolution in cancer, and immunology. Nesse et al. 14. Diseases of modern environments and the epidemiological transition. 15. Defenses, their regulation, and their costs. 16. Tradeoffs, at levels from genes, to physiology, to behavior. 17. Development as a product of and contributor to evolutionary change. 18. Facultative adaptations (phenotype plasticity) and related diseases. 19. Human evolution and ancestral environments. 20. Genetic differences among human populations and rates of evolutionary change. 21. Heritability and an understanding of how genes interact with environments. 22. Behavioral ecology, behavior, and the origins and functions of emotions. The Integrative Power of Evolutionary Understanding for Medicine Two things about medical education are widely acknowledged; there is more to learn than anyone can learn, and much of what we teach students now will be obsolete soon. The usual conclusion is that we need to teach students general principles, and we need to teach them how to nd speci c information when they need it (43). An evolutionary framework offers a valuable contribution that stretches beyond any speci c discipline. It does not address one level, such as biochemistry, or one system, such as the immune system. Rather, it offers principles that apply to every biological system at every level. As a recent overview of another Sackler Colloquium on Darwin noted, “Most scientists agree that...
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This document was uploaded on 01/31/2014.

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