Faculty Bibliography

Development of novel prognostic, diagnostic, and treatment options will provide major benefits for millions of patients with acute or chronic respiratory dysfunction, cardiac-related disorders, esophageal problems, or other diseases in the thorax. Allogeneic organ transplant is currently available. However, it remains a trap because of its dependency on a very limited supply of donated organs, which may be needed for both initial and subsequent transplants. Furthermore, it requires lifelong treatment with immunosuppressants, which are associated with adverse effects. Despite early clinical applications of bioengineered organs and tissues, routine implementation is still far off. For this review, we searched the PubMed, MEDLINE, and Ovid databases for the following keywords for each tissue or organ: tissue engineering, biological and synthetic scaffold/graft, acellular and decelluar(ized), reseeding, bioreactor, tissue replacement, and transplantation. We identified the current state-of-the-art practices in tissue engineering with a focus on advances during the past 5 years. We discuss advantages and disadvantages of biological and synthetic solutions and introduce novel strategies and technologies for the field. The ethical challenges of innovation in this area are also reviewed.

A 2013 poll in The New York Times found that three-quarters of Americans have concerns about genetically modified organisms (GMOs) in their food; most are worried about health effects. Thirty-seven percent of those with worries fear that GM foods cause cancer or allergies

Clinical genomics is poised for a rapid expansion but more work must be done to build a supporting ethical infrastructure.

Caplan cites some criticisms of the newly revised Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association--DSM-5. The DSM is often described as the bible of the mental health field--and unfortunate misnomer that leaves it open to attack as a compendium of divinely inspired truths about human behavior. The most common criticism in the reviews and books is that DSM-5 proliferates diseases beyond the boundaries of common sense

Rates of nonmedical exemptions from school immunizations are increasing and have been associated with resurfacing clusters of vaccine-preventable diseases, such as measles. Historically, state-level school immunization policies successfully suppressed such diseases. We examined state immunization exemption regulations across the United States. We assessed procedures for exempting schoolchildren and whether exemption rates were associated with the complexity of the procedures. We also analyzed legal definitions of religious objections and state legislatures' recent modifications to exemption policies. We found that states with simpler immunization exemption procedures had nonmedical exemption rates that were more than twice as high as those in states with more-complex procedures. We also found that the stringency of legal definitions of religious exemptions was not associated with exemption procedure complexity. Finally, we found that although there were more attempts by state legislatures to broaden exemptions than to tighten them in 2011-13, only bills tightening exemptions passed. Policy makers seeking to control exemption rates to achieve public health goals should consider tightening nonmedical exemption procedures and should add vaccine education components to the procedures by either mandating or encouraging yearly educational sessions in schools for parents reluctant to have their children vaccinated.

Comparative effectiveness research has the potential to dramatically improve patient care while reducing costs. In the absence of good evidence about which treatment is best for particular patients, decision making too often hinges on exogenous factors such as advertising and detailing by pharmaceutical companies, what a physician first learned to do, insurance coverage, and local custom. Without good evidence about what is best among competing but generally accepted clinical options, it is often a challenge for physicians to identify the best course of care. A great deal of effort is under way to make it easier and less expensive to . . .