GENERAL MEDICAL NEWS
The staff of The Reproductive Times here offers brief referenced notifications on interesting general medical and scientific news with broad relevance to reproductive medicine and biology. Some of these news items may become subjects of more detailed reporting in The Reproductive Times on later occasions. The purpose of these short notifications is to give readers the opportunity to get immediately more detailed information by looking up the reference of the notification.
What differentiates IgE from antibodies of other isotypes?
The answer is that IgE -producing plasma cells are transcriptionally and functionally distinct from other isotypes, as a recent paper in Science Immunology suggested (1). Since relatively many female infertility patients demonstrate IgE abnormalities—usually associated with allergic phenotypical expressions—this class of antibodies is of interest, yet surprisingly little studied. Indeed, while for example, complete absence of IgA is well covered in the medical literature, complete absence of IgE—which in infertile women is much more common than absence of IgA—is not covered at all; nobody, indeed, knows the meaning of complete IgE deficiency.
Reference
1. Vecchione et al., Sci Immunol 2024;9(99). DOI: 10.1126/sciimmunol.adm8964
The unpredictability of assumptions: Does free medical school boost diversity?
Medical schools thought so; indeed, it was a main argument when NYU became the first tuition-free medical school. Why did they think so? Because of the hypothesis that the cost of going to medical school—in other words the accumulation of tuition (and other) debt—represents the principal reason minorities are incapable of achieving equal opportunities.
A recent article in Medscape Hospital Medicine, however set the record straight, using the NYU experience of going tuition-free as the study subject (1): After announcing that the school had gone tuition-free, applications went up by almost 50%. Among desired previously underrepresented groups the increase was even more pronounced, fully doubling. But here come the ultimately most telling results: At 3%, the acceptance rate for underrepresented minorities remained the same as before. Moreover, the GPA on the MCAT (the test required to get into most medical schools) went up for admission to NYU’s medical school. While students from low-income backgrounds used to represent ca. 12% of every incoming class before the change in tuition policy, since the change it has been only in the 3% to 7% range.
What are the conclusions? First, of course, tuitions have been proven not to represent a principal problem, one more hypothesis (this time a social hypothesis) that seemed so obvious, and in practice failed to deliver, a finding medicine, of course, should not be surprised about, considering how often hypotheses in medicine fail in clinical practice. But the principal conclusion must be that in trying to achieve more diversity in medical schools, two important goals for society are currently clashing, the noted desire for more diversity and the desire of most societies to build on meritocracy.
So, what is the solution if greater diversity remains the goal? The article, unfortunately, offers only the usual clichés: outreach and equal opportunity from early on in life and mentorship through K-12 and college, MCAT prep, etc. These are, of course, all good ideas; but they do not consider the likely most important factor that, ultimately, makes our children succeed or fail, and that is what they are taught at home!
The home not only matters; it is essential! There is a reason why poor Asian immigrants not only have no difficulties in being accepted into our best colleges and universities but—if not discriminated against by admission committees—would by-far exceed their expected proportional representation. They to a large degree still have two-parent homes with demanding parents. This is the reason why the two sons of a Chinese biller who spoke only broken English were accepted into every single Ivy League school and within one generation will achieve full integration and economic success in the U.S. And neither one went to fancy private K-12 schooling; both went to public schools.
These are not new conclusions. Indeed, in 1965 the so-called Moynihan Report [so named after Senator Daniel Patrick Moynihan (1927-2003) from New York] in calling for national action to combat Black poverty, identified family structure as “the fundamental problem” of Black society and argued for federal interventions with the goal of establishing “a stable Black family structure (2).”
And since 1965, things have been getting progressively worse, with single-parent households steadily increasing, and heroic single mothers often simply not being able to control especially their male offspring (a principal reason why females do so much better in college admissions than males (3)). The truth of the matter, therefore, is that unless society takes significant steps to combat and reverse the break-up of the family unit and invests in family units (and that, of course, includes if possible two parents and grandparents) the value of education, throwing more and more money at a non-performing education system will not stop the steady decline in the quality of education of our children, especially in poorer inner cities. As The Washington Post noted, especially “public education is facing a crisis of epic proportions (4),” and parents, government, and society as a whole share in the blame.
References
1. Patel AS. Medscape Hospital Medicine. August 6, 2024, https://www.medscape.com/viewarticle/free-med-school-alone-wont-boost-diversity-2024a1000eb3?form=fpf
2. The Moynihan Report. 1965. https://www.blackpast.org/african-american-history/moynihan-report-1965/
3. Nietzel MT. Forbes. August 7, 2024; https://www.forbes.com/sites/michaeltnietzel/2024/08/07/women-continue-to-outpace-men-in-college-enrollment-and-graduation/
4. Meckler L. The Washington Post, January 2022. https://www.washingtonpost.com/education/2022/01/30/public-education-crisis-enrollment-violence/
Is direct-to-consumer medical testing built on fear?
The Lancet thinks so: In an unsigned editorial regarding direct-to-consumer medical testing, The Lancet did not hold back recently, demanding tighter regulation of the industry. The editorial, however, also called for “a honest conversation” with the public about benefits, risks, and potential economic value of asymptomatic screening tests. Is a pleasure to agree with The Lancet for once!1
We see little direct benefit from direct testing but have been observing considerable misunderstanding of results, false alarms, and unexpected results at times even destroying families.
Reference
1. Editorial. The Lancet.2024;404:991