Nursing science

The new paradigm: from ‘bench to bedside’ to the translational research ‘valleys of death’

What's in this Issue

What's this got to do with nursing? The intersection between nursing and basic science.

The “Sixth International Symposium on Interventional Elec-trophysiology in the Management of Cardiac Arrhythmias”was held in Newport, Rhode Island on September 24–26,2010. This symposium commemorated a special landmark inclinical cardiac electrophysiology. Twenty years had elapsedsince the first in this series of symposia recognized interven-tional electrophysiology as a distinct scientific discipline. In1990,thissymposiumwastheveryfirst internationalmeetingdevoted exclusively to the fundamentals of science andclinical practice of interventional electrophysiology. Theumbrella of “interventional electrophysiology” gathered suchdiverse but fundamentally linked sciences of experimentalelectrophysiology, epidemiology, pharmacotherapy, cardiacpacing, defibrillation, catheter and surgical ablation, imaging,and clinical trials as applied to the management of cardiacarrhythmias. The crystallization of this discipline and thebreadthanddepthofscienceinthisfieldledtotheevolutionofa committed scientific journal devoted to it, the Journal ofInterventional Cardiac Electrophysiology. The meeting con-tinues a longstanding tradition of providing a scientificforum for experts from Europe and North America to presentfrontiers in research as well as critically evaluate develop-ments in interventional cardiac electrophysiology in ascientific forum. The presentations at this meeting are thebasisforaseriesofreviewarticlesthathavebeencriticallyacclaimed in past years and memorialized in print, initially intextbook form and more recently as special issues of theJournal of Interventional Cardiac Electrophysiology.This symposium’s scientific program was restructured tofocus on translational science, new technology, and therestructuring of clinical practice based on clinical trials inour field. Regenerative medicine, genomics, and molecularbiologic research into inherited or acquired heart rhythmdisorders assumed center stage in basic science presentations.Innovations in technology bought imaging methods in clinicalelectrophysiology into focus. New catheter navigation tech-nology, computed tomographic and magnetic resonanceimaging methods, intracardiac and three-dimensional echocar-diography, and essentials of clinical interpretation of theseimagingdatafortheinterventionalistboughtanewfrontierintoview, the “integrated” electrophysiologic laboratory. Newdevelopments in device and ablation therapy were reviewedin the context of evidence-based practice. The rise ofperformance standards and metrics for arrhythmia programs,impact of clinical trials, and registries on interventionalelectrophysiologic practice and outcomes research in clinicalelectrophysiologyfocusedthediscussionsonthepathaheadforthe interventional electrophysiologist.TheNewportsymposiumhasnowbeenmemorializedwiththe authors preparing state-of-the-art review articles for twospecial issues of the journal. The first issue encompassesadvances in basic and translation science, imaging, newtechnology and developing standards for patient follow-upand management, catheter and surgical ablation, and clinicaltrials in drug, device, and ablation therapies. Special issueslikethisonearenot possiblewithout the enormoussupport ofour authors and our editorial staff. We are grateful to theauthors for this serious effort to critically assess our current

This article discusses the basic science associated with a chemical eye injury caused by an alkaline substance. It uses the case of Mr P who presented to an ophthalmic emergency department having sustained an injury caused by wet plaster having fallen into his eye, to link the basic science to the care and treatment of a patient. Having a knowledge of the basic science underpinning ophthalmic injury and disease enables practitioners to understand the mechanisms involved and, therefore, enables them to choose the most appropriate, evidence-based care and treatment.

The new companion volume to Surgery: Scientific Principles and Practice, 2nd edition, represents a collaborative effort by 183 contributors under the guidance of Editor-in-Chief Lazar J. Greenfield, MD. This distilled version contains 835 pages in 109 chapters and could easily stand alone as a reference for the intended audience of medical students, house officers, and medical practitioners. Indeed, if all the information contained within its pages were absorbed by a student, he or she would have a tremendous advantage at the beginning of a surgical internship. The preface by Dr. Greenfield explains, “…students need a portable source of information to understand the rationale for the diagnostic and therapeutic efforts they observe.” This text clearly accomplishes that goal. The first major subdivision, Scientific Principles, prepares the reader for today’s examinations, which are weighted heavily towards the basic sciences. Material is presented logically with excellent diagrams that solidify and explain the understanding of subjects without redundancy. In the second section, Surgical Practice, general surgical problems are clearly organized by system beginning with the digestive organs. After reviewing the abdomen, the text returns to the thorax, surgical endocrinology, vascular system, and finally, the surgical subspecialties. Most sections begin with a thorough discussion of anatomy and physiology, echoing the basic-science tone of the work. Current surgical management is comprehensively but concisely presented, partitioned by disease etiology, presentation, diagnosis, and treatment. References are limited to approximately 10 per chapter and include both journal articles and book sections. The book has one shortcoming—although the index is 30 pages long, it unfortunately often fails to guide the reader in the correct direction. Despite this, Essentials of Surgery: Scientific Principles and Practice is very well-written and constitutes an excellent educational tool, whether it is used for review, or alone as a primary text.

Several years ago, I spent a sabbatical at University of Modena, Italy, living nearby in the famous university town of Bologna. While there, firm roots were established to search for anticancer molecules and new wave antibiotics (1,2). Far from my radar screen was another adventure, now unfolding in Bologna and even for eCAM. Little did I realize that another visit was simmering and taking shape-long before the birth of eCAM and the appointment of a strong group of editorial board members focused around that region of Italy, all professors and or practitioners in nearby universities: Andrea Cossarizza, Modena, Claudio Franceschi, Carlo Ventura, Paulo Roberti di Sarsina, Carla Maria Giovanardi, Bologna, Paulo Bellavite, Verona, Francesco Marotta, Emilio Minelli, Milan. All are contributing forcefully to uncovering the basic science and clinical practice of CAM. In a sense the seeds for this new plant were nurtured even earlier when Claudio Franceschi and I first met as immunologists on leave at the Karolinska Institute, Stockholm, I on my first sabbatical as a Guggenheim Fellow from UCLA and Claudio, a younger post doc. Both of us are immunologists. I worked in the laboratory of Goran and Erna Moller and Claudio with George and Eva Klein. This was in 1970–71 and we remained in sporadic contact by my requesting some of Claudio's previously published histopathology of spleens from an exotic animal for my first book, Comparative Immunology published by Prentice Hall, in 1976 one of several books in the Immunobiology Series. We met on other occasions mostly through strong mutual interests in the blooming subject of neuoroendocrine immunology and there luck struck again where at one symposium, I became immediate friends with Andrea Cossarizza MD then a PhD student working with Claudio. Move now from 1990 to 1993 and we witness my decision to come to University of Modena for my fourth sabbatical in Claudio's lab. Originally wanting to work on immunorecognition in snails (sharing some work also with another collaborator, Enzo Ottaviani), as luck would have it I decided almost impulsively to work on the earthworm with Andrea. Why? Snails were in hibernation and could not be collected during the fall of 1993. Besides, I had just finished supervising another PhD student Michael Suzuki at UCLA on the natural cytotoxicity of earthworm coelomocytes, so all I needed was to convince (and this was not at all difficult) Andrea to do some “quick and dirty experiments” and confirm Suzuki's thesis, co-culturing earthworm leukocytes with K562, a common tumor cell line useful for assaying natural cytotoxicity. I wanted especially to search for the evolutionary precursors of NK cells. This turned out to be an outstanding adventure, demonstrating for the first time the distinct separation of phagocytosis from NK cell killing of foreign tissue antigens. Our work supported Burnet's view of immunologic surveillance and brought back into focus once again since Metchnikoff, the crucial position of invertebrates and animal models in understanding the basic science underlying immune responses, i.e. the prominent role of innate immunity as essential for survival of species (3). During that period in Italy I also spent some time with Prof Nicolo Parrinello, University of Palermo working on the neuroendocrine consequences of stress induced by crowding on the immune system of fish. It was also of special interest to look at the antimicrobial peptides of tunicates (actually some of these are useful as anticancer therapeutics (4). In the meantime eCAM was born and I turned internationally for experts to serve as Editorial Board members and once again found myself seriously considering this region of Italy (5–8). Claudio Franceschi brings to the board his expertise in senescence, having coined the word centenarians; at the moment he is exploring the possible role of curcumin in apoptosis (9). Clearly aging populations could be real targets for CAM approaches. Andrea Cossarizza and I are once again collaborating closely on quercetin, a flavonoid and differential apoptotic activity on leukemic cells and peripheral blood lymphocytes (10,11). Stem cells reach a high level of relevance to CAM (12) through the work of Carlo Ventura (13) in which he proposes cell models with receptors that may be vulnerable to outside influences. This captures the basic science approaches to CAM with the ultimate promise of evidence based, not all clinical but highly relevant. More recently the importance of acupuncture is evident in the influence of Carlo Maria Giovarnardi. He is in charge of the Fondazione Mateo Ricci, an institution dedicated to the diffusion of acupuncture and traditional Chinese medicine. Moving somewhat eastward toward Venice, Paulo Bellavite is exploring all aspects of basic science in relation to homeopathy (14). And then there are the efforts of Emilio Minelli and Francesco Marotta in Milan. Turning to more clinical aspects, we are ever mindful of the importance of networking throughout Italy and internationally by the efforts of Paulo Roberti di Sarsina that are particularly important here (15). Let me state at the outset that by briefly focusing on this region, there is neither particular bias toward CAM in Italy nor any other country. UCLA where I am based has a Collaborative Centers of Integrative Medicine (CCIM) and there are certain other similar consortia. There is a large focus in parts of Asia where our travels have been rather extensive, thanks to generous invitations. It is only fortuitous that I have been able to combine my own research interests somewhat independent of CAM coupled with this current sabbatical (Senior Visiting Scientist, Institute for Advanced Studies, University of Bologna;hosted by Claudio Francheschi) with efforts to stimulate and integrate more CAM activities. It is this spirit of inquiry, my own, some of which overlap with CAM that makes this position of Editor in Chief so very rewarding!

Introduction. Since the early 20th century, medical education has evolved, notably with the Flexner report emphasizing the fusion of foundational sciences and clinical reasoning. As the field grew, educators adeptly incorporated new sciences and technologies, ensuring curriculum balance and depth. Aim. This research aimed to explore the role of basic sciences in contemporary medical education, focusing on their integration with clinical practice. Methods. An institutional-based cross-sectional study design was implemented at Umm Al Qura University, College of Medicine, Makkah, Saudi Arabia, from March to June 2023. This study involved surveying 470 medical students, from a total campus population of 1,360 students (excluding preparatory year), using a pre-tested and structured self-administered questionnaire. All questions in the survey were formatted to elicit dichotomous responses, namely “yes” or “no”, and the collected data were analyzed using SPSS version 20. Results. The study discovered that while a high percentage of medical students (96.6% in earlier years to 94% in senior years) recognized the importance of basic sciences in the MBBS curriculum, there was a noticeable decline in this belief as students advanced through their clinical years. Similarly, the perception of the utility of foundational knowledge of basic sciences for understanding clinical subjects decreased slightly from 93% in earlier years to 85% in senior years. About 92.7% of students across all years believed a strong understanding of basic sciences was crucial for clinical proficiency. However, the perceived benefit of suggested readings/textbooks declined from 82% in earlier years to 77% in senior years. Feedback on curriculum enhancements showed robust support for more engaging teaching methods, with over 90% favoring the incorporation of multimedia tools and group-based sessions. Conclusions. Our findings underscore the foundational role of basic sciences in medical education for clinical competency, highlighting a gradual shift in student perceptions as they progress through their training. This shift signals the necessity for adaptive teaching strategies that effectively integrate basic sciences with clinical practice to maintain relevance and efficacy in medical curricula.

Nutrition for the Hospitalized Patient: Basic Science and Principles of Practice

Aconference held at the North Sea resort town of Noordwijk in the Netherlands was orga-nized on September 29, 2000 by SEIN, the Special Centre for Epilepsy in the Netherlands, under the title “Crosslinks in Neurophysiology and Epilepsy.” This supplement consists of a number of articles based on the lectures delivered at that conference. The conference itself was ostensibly held to mark the retirement of Fernando H. Lopes da Silva, M.D., Ph.D., who had held the position of Director of Scientific Research at SEIN for a number of years. This was the second of two conferences held within a short period of time; the previous one commemorated his retirement as Professor of Neurobiology at the University of Amsterdam. The Noordwijk conference managed to bring together some of the most sought-after speakers in the basic sciences, as well as in the clinical practice of epileptology. The mix of basic science and clinical practice, drawing on the best from each discipline, had long been Fernando's approach to neuroscience. Indeed, clinical epileptology has greatly benefited from advances in all fields of neurobiology, most notably from neurophysiology. In its turn, epileptology has provided the basic scientists with the practical knowledge necessary to further advance the various models of epileptogenesis based on the lessons derived from the epilepsy clinic. The Noordwijk conference achieved another distinction, affording us the chance to wit-ness the marvels of present-day communication capabilities. Jerome Engel, M.D., Ph.D., who was recuperating from an illness at the time and unable to travel, delivered his lecture via a satellite link from Los Angeles, California, and took and answered questions from the audience. We have since then missed the presence of another speaker, the late Francisco Varela, who fortunately for us was able to attend and whose contribution to this supplement has been kindly submitted by his close colleagues in Paris, France. The Editorial Board and the Assistant Editor wish to express their thanks to the speakers of the conference for their contribution to this supplement, as well as for their fortitude in maintaining faith that the Noordwijk conference's proceedings would ever be published. Perhaps we have all been a bit presumptuous in thinking we were the last to celebrate Fernando's lifetime professional achievement. Neither we nor the speakers and participants of the Noordwijk meeting had a way of knowing that one could perhaps pension Fernando off from his work but not from his hobby, as many of our readers have witnessed by following the scientific literature since then. As a result of Fernando's work since his retirement, a follow-up meeting might have to be arranged a few years from now.

Postgraduate medical education has developed rapidly since World War II due to physicians' demands for refresher courses and graduate training in the specialties.Postgraduate training at The University of Michigan Medical Center operates under academic direction as a department of the undergraduate medical school, and it is sufficiently decentralized to be within the reach of every practitioner in the state.The current postgraduate medical program in Michigan includes extramural and intramural courses, affiliated hospital and visiting programs, and training in basic science and general practice.

This scoping review will be conducted according to the JBI methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) extension. It aims not only to map the existing molecular evidence but also to provide a translational framework linking biological mechanisms to clinical management. By integrating findings across experimental and human studies, this work seeks to bridge the gap between basic science and clinical practice, highlighting how hormonal therapies may influence key molecular pathways in endometriosis. Furthermore, this synthesis is expected to identify gaps in the current literature and to inform future translational and mechanistic research, supporting the development of more targeted and biologically grounded therapeutic strategies.

Dealing With the Problem of Bridging the Gap Between the Basic Sciences and Clinical Practice: Teaching, Research and Service

Medical science is going through a transformative period where innovations are happening at a very high rate, interdisciplinary integration is being promoted, and there is a greater opportunity to enhance health outcomes in the world than ever before1. With the demarcation between basic science and clinical practice increasingly becoming unclear, clinical and translational medicine has been at the center stage of this transformation- as the gateway through which laboratory findings are transformed into a significant intervention to patients and communities across the globe. The past 20 years have seen a revolution in the understanding and treatment of diseases as a result of improved genomics, molecular biology, and bioinformatics studies. Such advances have now brought the era of personalized medicine, where the decision to be taken in treatment more and more depends on the specific genetic and molecular profile of a person instead of the universal clinical trends2. This method does not only improve the effectiveness of treatment, but reduces the negativity and leads to a new model of personal care. Nevertheless, the actualization of the full potential of these developments cannot be achieved without a strong system of translations, that is, a system that has a mechanism that makes laboratory discoveries validated, well-tested ethically, and well-implemented in clinical practices3.

The transplantation of organs, cells, and tissues has burgeoned during the last quarter century, with the development of multiple new specialty fields. However, the basic principles that made this possible were established over a three-decade period, beginning during World War II and ending in 1974. At the historical consensus conference held at UCLA in March 1999, 11 early workers in the basic science or clinical practice of transplantation (or both) reached agreement on the most significant contributions of this era that ultimately made transplantation the robust clinical discipline it is today. These discoveries and achievements are summarized here in six tables and annotated with references.