When to give up on a MOOC course

For the first time, I am considering dropping a course more than halfway through completing it. The course is Chemicals and Health – Johns Hopkins University | Coursera, and it has turned out to be quite a disappointment. I was looking forward to learning more about toxicology and how to interpret research to determine the effects of novel chemicals on human health.

Unfortunately, that’s not what I got. There was one excellent unit on toxicology, but the rest of the course really didn’t offer much that interested me. It gave cursory overviews of biomonitoring and the methods  and nomenclature that researchers use when measuring the health effects of chemicals (e.g. acute versus chronic effects,  blood sampling versus urine sampling),  but didn’t ask students to apply any of this knowledge by interpreting research.

The thing that really disappointed me, though, was one of the first homework assignments, which required students to watch “The Story of Cosmetics” on YouTube and then post responses. (I’m not linking the video here because I don’t want to drive any more traffic to it than already exists, but if you are curious about it you can Google it I’m sure you’ll find it.) The video is propaganda against the use of novel chemicals in cosmetics. Now, I actually agree  with the video’s creator that there are chemicals being used in cosmetics that should not be there because they aren’t good for human health and/or cause problems when they enter the sewage system. But I don’t like the videos hand-sweepingly broad classification of sodium lauryl sulfate (a detergent derived from coconut oil that some people are allergic* to but most people handle just fine) along with lead (which is poisonous to every human), or that it doesn’t distinguish between ethyl mercury and methyl mercury (neither of which should be in cosmetics, but one of which is a very useful preservative in medicine that does not linger in the body or cause any of the effects that panickers claim it does.) Continue reading


Genetic testing conundrums: sickle cell trait

In my Genomic and Precision Medicine course on Coursera, we were asked:

In the US, the National Collegiate Athletic Association (NCAA) requires screening of all college student athletes for mutations in the gene that causes sickle cell anemia, an autosomal recessive disease that manifests early in life. Name one pro and one con of this policy.

Here’s my answer. It will not win any prizes for eloquence, but it got the job done of summarizing the issues in a few sentences or less. (I cheated and included more than one con):

Pro: Individuals who are carriers for sickle cell anemia (that is, they carry only one copy of the mutated sickle cell gene) do not have sickle cell anemia. However, they are at greater risk of hypoxia (inadequate oxygen supply to a region of the body) and rhabdomyolysis (sudden death of muscle tissue) during intense exercise than non-carriers. These conditions can be life-threatening. By knowing who carries the gene, coaches can alter training programs to reduce risks — for example, by making sure that carriers get rest breaks and don’t get dehydrated.

Con: The sickle cell trait is far more common in African-Americans and Africans than in other groups. In the past, the higher prevalence of sickle cell trait in blacks was used as an excuse to refuse healthy blacks entry into competitive sports and the military. Coaches may offer less rigorous training and playing opportunities to NCAA athletes who are identified as carrying the sickle cell trait, even when these athletes are perfectly healthy. (Although carriers in general are at higher risk for exercise-related complications, risk varies by individual, with some individuals being very affected, and others seeming not to be affected at all.) Professional sports teams may avoid recruiting players with sickle cell trait for fear that they will not perform as well as their non-carrier counterparts. In addition, focusing on sickle cell may distract trainers from preventing other, more common causes of sudden death in athletes, such as undetected heart problems.


  • Lecture notes from Nussbaum RL and Norton M. Genomic and Precision Medicine, Week 2: Applying Genomics to Medicine. 2015. Coursera.org.
  • Lecture notes from Noor M. Introduction to Genetics and Evolution. 2015. Coursera.org.
  • Stein R. Colleges mandate sickle cell testing. The Washington Post. 20 Sept. 2010.

I wanted to add that making sure that all athletes get reasonably frequent rest breaks and are taught to avoid dehydration would dramatically reduce rhabdomyolosis risk, plus many other health risks, without requiring testing. But that’s not the question that was asked, so I didn’t. In a world where colleges are okay with putting students at regular risk of concussion and other serious injuries, expecting them to suddenly embrace good preventive health practices might be overly optimisitic.


Brain Anatomy: Internal and Ventral Structures | Cerego


Brain surface gross anatomy: gyri and sulci | Cerego

screenshot 1

I’ve created my first online flashcard set for Foundational Neuroscience using Cerego. Although the course materials include about a bazillion links to various brain atlases and other resources, there are no flashcards among them. So someone had to do it.

I first encountered Cerego when taking Introduction to Anatomy: Musculoskeletal Cases on edX, which integrated flashcards into  the curriculum. I’ve tried other flashcard systems before (for example, Memrise), but definitely prefer Cerego. (I’d like it even more if it had an Android app.)

So enjoy, brainiacs: Brain surface gross anatomy: gyri and sulci.

Screenshot 2


Autism Awareness Day


Pnemonic devices for remembering anatomical directions

Recently I finished Introduction to Clinical Neurology from University of California – San Francisco on Coursera, and discovered to my surprise that I actually enjoy neurology. Who’da thunk?

Naturally, I went on a binge of signing up for other neurology courses. This week was the start of Foundational Neuroscience for Perception and Action from Duke University on Coursera. I wasn’t worried about it until I got a welcome email last week from course professors warning us that the material was difficult and we should be prepared to work our asses off.  So of course I decided to procrastinate on watching any of the lectures.

Today I’ve watched three lectures, and it turns out not to be as terrifying as the original email made it out to be. So far the concepts are things that anyone with a successful high school biology background, Google, and motivation should be able to master.  I suppose it could get worse, but if I don’t run away screaming in the first week of a course, I tend to finish it.

I want to share some awesome pnemonic devices given in the class notes for remembering anatomical directions and that I wish had been shared in AnatomyX – Musculoskeletal Cases, an introductory human anatomy course from Harvard on EdX that was otherwise absolutely awesome. Also some of my own ones mixed in:

  • rostral/caudal: Rostral comes from the Latin word “nose” and means “toward the nose“; caudal means “toward the tail.” Their reference is the long axis of the central nervous system, which is angled.
  • coronal (frontal) plane: Its reference is to the long axis of the body, which is straight (i.e. perpendicular to flat ground when a person is standing up straight). Divides the body into front and back. You can remember it by thinking of a tiara-syle crown (corona), which is heavily decorated on the front and bare in the back.
  • sagittal plane: Its reference is to the long axis of the body. Divides body into left and right (the sagittal view is the side view of the body). Think of Sagittarius, an archer, and how the archer holds a bow in the sagittal plane.
  • axial (horizontal) plane: Perpendicular to the long axis of the body, and parallel to the ground or horizon in a person standing up straight. 
  • ventral/dorsal: Their reference is the long axis of the central nervous system. Dorsum is Latin for “back.” Ventral is from the Latin for “belly.” So ventral is toward the belly, and dorsal is toward the back. (Well, usually. Because humans stand on hind legs, dorsal also refers to the top of the head. Think of cats instead of humans to make remembering this one easier. The top of a cat’s head is on the same side of its spine as its back is, so the “top” in that case can be thought of as “back.”)
  • anterior/posterior: Their reference is to the long axis of the body. “ante-” as in “antenatal” and “antebellum” means “before” -> before the center of the body -> “toward the front side.” Posterior is even easier to remember, because we already use that term to  mean “backside.”
  • superior/inferior: Superior is the tops, inferior is at the bottom. So superior means toward the top of the body, and inferior means toward the bottom.

Public Health and the Free Market (Pandemic Influenza Preparedness Framework)

Here’s an excerpt from a discussion I had on the discussion boards of Epidemics, Pandemics and Outbreaks on Coursera. We were discussing the role of the free market in public health during epidemics. Other people said more interesting things, but alas I don’t have permission to copy what they said, so you’re stuck with my boring comment:

The market works for many things, but it does not necessarily result in better public health. This was illustrated in the development and patenting of antiretroviral medicines for HIV. Although they were based in part on publicly gathered/funded information and research, they were priced out of range for uninsured people in the United States and pretty much anyone in the developing world. It took the work of activists, governments and other “non-market” players to make antiretrovirals more widely available.

I don’t view pharma as holding treatments or vaccines for “ransom,” but rather trying to return as much profit as they can to their shareholders. The Framework seeks to balance that factor out by encouraging pharmaceutical companies that benefit from shared information to return some of that benefit (in the form of vaccines that aren’t priced out of accessibility) to the public. The Pandemic Influenza Preparedness Framework from the World Health Organization says:

6.10Access to vaccines in the inter-pandemic period for developing countries

6.10.1 Separately from measures to support the WHO PIP vaccine stockpile set out in section 6.9 above:

(i) Member States should urge influenza vaccine manufacturers to set aside a portion of each production cycle of vaccines for H5N1 and other influenza viruses with human pandemic potential for stockpiling and/or use, as appropriate, by developing countries; and

(ii) Member States should continue to work with each other, with the Director-General and with influenza vaccine manufacturers, with the 20 aim of ensuring that adequate quantities of vaccines for H5N1 and other influenza viruses with human pandemic potential are made available to developing countries at the same time as to developed countries, on the basis of public health risk and needs and at tiered prices (see 6.12 below).

6.11Access to pandemic influenza vaccines

6.11.1 Member States should urge vaccine manufacturers to set aside a portion of each production cycle of pandemic influenza vaccine for use by developing countries; and

6.11.2 The Director-General, consulting Member States and the Advisory Group, will convene an expert group to continue to develop international mechanisms, including existing ones, for the production and distribution of influenza vaccines on the basis of public health risk and needs during a pandemic, for consideration by the World Health Assembly in 2010.

6.12 Tiered pricing

As a measure to improve the affordability for developing countries of pandemic influenza vaccines and vaccines for H5N1 and other influenza viruses with human pandemic potential, and antivirals, Member States should urge influenza vaccine and antiviral manufacturers individually to implement tiered pricing for these vaccines and antivirals. As part of this approach, influenza vaccine and antiviral manufacturers individually should be urged to consider the income level of the country, and negotiate with the national authorities of the recipient country, in arriving at the price to be applied in the private and public markets of each country. In this context the vulnerability of the least developed countries should be taken into account.

By the way, Epidemics, Pandemics and Outbreaks is a decent course overall, though I got a little bored in week 3 and would have preferred a stronger medical focus. Although it’s already started, none of the deadlines for quizzes have come around yet, so it’s not too late to sign up. It’s a fairly light workload and could easily be completed in a week with an hour or two of commitment each day, though of course you’d get more out of it by spending more time and doing the optional assignments in addition to the required ones.