Connecting Ethical Reasoning to Global Challenges through Analysis of Argumentation.

Scientific literacy is built on critical thinking. The postbaccalaureate workforce enhances our economies and societies by contributing a wealth of knowledge and skill sets to local communities, respective industries, and beyond as our world becomes increasingly interconnected. Education in scientific literacy should teach students how to learn about science and how to cultivate and communicate a positive attitude about science. Learners in a 200-level nonmajors biotechnology course engaged with a series of ethical dilemmas after mastering the basic elements of argument structure and advanced tools in argument evaluation. To introduce collaboration as a constructive process in undergraduate education, student interactions with peers require guidance, flexibility, and compassion to learn from each other. Students gain critical thinking mastery from two modules addressing how we argue and evaluate claims. Students apply these critical thinking skills to various ethical arguments involving responsible conduct of research training. Using our structured and interdisciplinary approach, new scholars learn through practice how to read, analyze, and evaluate research scenarios and respond to potential ethical situations. This strategy allows students to develop important scholarly skills, including a systematic approach to evaluating credibility and applying generosity to theirs and others' understanding of their circumstances.

Cardiac uses of phosphodiesterase-5 inhibitors.

Phosphodiesterase-5 inhibitors (PDE5Is) improve erectile function by enhancing nitric oxide availability in the penis and its supplying vasculature, resulting in vasodilation and increased blood flow. PDE5Is might benefit cardiovascular diseases because phosphodiesterase-5 is also located elsewhere in the body, including the pulmonary and systemic vasculature and in hypertrophied myocardium. PDE5Is are approved for pulmonary arterial hypertension, given that they improved several hemodynamic and clinical parameters in large randomized trials. Initial evidence suggests that PDE5Is benefit patients with congestive heart failure and secondary pulmonary hypertension. PDE5Is seem to improve hemodynamic and clinical parameters in patients with high-altitude pulmonary edema (HAPE) and high-altitude pulmonary hypertension. In climbers with prior episodes of HAPE, PDE5Is prevented HAPE in 2 small randomized trials. In small randomized trials of PDE5Is, patients with Raynaud's phenomenon demonstrated improved blood flow, fewer symptoms and frequency of attacks, and resolution of digital ulcers. In addition to enhancing vasodilation, PDE5Is seem to protect the myocardium through complex pathways that involve nitric oxide, cyclic guanosine monophosphate, protein kinase G, extracellular-signal-regulated kinase, B-cell lymphoma protein-2, and Rho kinase inhibition. In animal models of acute myocardial infarction, PDE5Is consistently reduced infarct size indicating cardioprotection and PDE5Is also promote reverse remodeling and reduce myocardial apoptosis, fibrosis, and hypertrophy. PDE5Is might also benefit patients with treatment-resistant hypertension, preeclampsia, or peripheral arterial disease. This review presents the pathophysiology and trial data with regard to the use of PDE5Is for cardiac diseases.

Investigational noncardiovascular uses of phosphodiesterase-5 inhibitors.

INTRODUCTION: At the present time, inhibitors of phosphodiesterase type 5 (PDE5) have Food and Drug Administration approval only for the treatment of erectile dysfunction and pulmonary artery hypertension, for which their mechanism of action is vasodilation and augmentation of blood flow by impeding PDE5-mediated breakdown of cyclic guanosine monophosphate. However, these agents are also being investigated in a wide range of other potential medical and surgical applications for which current treatment options are limited and in which their mechanism of action may be the same as or different from their effects in the two approved indications. Even if only some of these potential applications prove useful, the effect on clinical practice could be far reaching. AREAS COVERED: This literature review summarizes potential noncardiovascular uses of PDE5 inhibitors, with emphasis on clinical research. Topics include a variety of male genitourinary disorders other than erectile dysfunction: cutaneous ulcerations, tissue protection, neurological conditions, diabetes, cancer, transplant and reconstructive surgery, female sexual dysfunction and disorders of pregnancy. EXPERT OPINION: The exceptionally wide range of research taking place with PDE5 inhibitors holds promise not only for improved therapeutic options but also for an improved understanding of the basic biological mechanisms that underlie scientific medicine.