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This article was migrated. The article was marked as recommended. Although medical students involved in research training express greater interest in academic medicine, a paucity of clinician-scientists remains. Herein, we describe a feasible project, titled 'The Miniproject,' which introduces first-semester medical students to basic concepts in scientific research. The Miniproject was introduced in 2007 as part of a major curriculum reform to provide a structured, systematic approach to scientific training to Karolinska Institute's study programme in Medicine. The Miniproject itself was developed in recognition that emphasis is increasingly placed on student-centred study, which involves greater assumption of responsibility by the student for his or her own learning. Over the course of five days during the first weeks of medical school, students participate in a variety of activities designed to align with five intended learning outcomes. These intended learning outcomes include: formulating a scientific hypothesis; discussing, in broad terms, at least one method used to answer a scientific question; giving and receiving feedback from peers and teachers; demonstrating the ability to search, interpret, present and discuss written and oral scientific medical information; and actively engaging in a small group discussion. Teachers facilitate small group discussions, but encourage students to lead these discussions. Via electronic, anonymous evaluations, most students (65.1%) evaluated the Miniproject as good or very good. In conclusion, the Miniproject is a feasible project led by researchers, and which is designed to introduce first-semester medical students to scientific literature and the research process, as initial steps in the scientific development thread.

BIRC5 (Survivin), an inhibitor of apoptosis protein (IAP), is over-expressed in several human cancers and increased expression is associated with poor prognosis. The goal of the current study was to evaluate the role of BIRC5 in Ewing sarcoma (ES), the second most common pediatric bone sarcoma.BIRC5 protein expression was determined in ES cell lines using Western Blot analysis. Functional role of survivin on growth and viability of ES cells was assessed by siRNA knockdown of BIRC5 and by using a small molecule inhibitor YM155. Immunohistochemical analysis for BIRC5 protein was performed on patient tumor samples using an anti-survivin antibody. The degree of BIRC5 protein expression was correlated with clinical parameters and patient outcome.BIRC5 is over-expressed in a panel of ES cell lines. Gene silencing of BIRC5 in the ES cell line TC-71 decreases cell growth by more than 50% for each BIRC5 siRNA construct compared to non-silencing siRNA control constructs. YM155 also reduces ES cell growth and viability with an EC(50) ranging from 2.8 to 6.2 nM. BIRC5 protein is expressed in majority of the ES tumor samples with minimal expression in normal tissue (P0.005). Tumors with more than 50% expression are associated with worse overall survival than tumors with less than 50% expression (Hazard Ratio: 6.05; CI: 1.7-21.4; P = 0.04).BIRC5 is over-expressed in ES cell lines and tumor samples. Further, it plays an important role in cell growth and viability in vitro. Higher degree of expression in patients is an independent poor prognostic factor.

BackgroundSeveral reports have shown that less aggressive patterns of diagnostic activity and care are provided to elderly breast carcinoma patients. We sought to investigate whether differences in the management of older women with breast cancer are associated with survival.Methods and findingsIn an observational study using a population-based clinical breast cancer register of one health-care region in Sweden, we identified 9,059 women aged 50-84 y diagnosed with primary breast cancer between 1992 and 2002. The 5-y relative survival ratio was estimated for patients classified by age group, diagnostic activity, tumor characteristics, and treatment. The 5-y relative survival for breast cancer patients was lower (up to 13%) in women 70-84 y of age compared to women aged 50-69 y, and the difference was most pronounced in stage IIB-III and in the unstaged. Significant differences in disease management were found, as older women had larger tumors, had fewer nodes examined, and did not receive treatment by radiotherapy or by chemotherapy as often as the younger women. Adjustment for diagnostic activity, tumor characteristics, and treatment diminished the relative excess mortality in stages III and in the unstaged, whereas the excess mortality was only marginally affected in stage IIB.ConclusionsLess diagnostic activity, less aggressive treatment, and later diagnosis in older women are associated with poorer survival. The large differences in treatment of older women are difficult to explain by co-morbidity alone.