univer-city of zurich: an “evolutionary-medical” perspective · • it also addresses future...

Institute of Evolutionary Medicine

P. Cézanne, Young Man with a Skull, 1896-98

Frank Rühli

Univer-City of Zurich: An “evolutionary-medical” perspective

Disclaimer This presentation represent my personal view only and not the official view by the UZH. For internal use only.


Aim

The aim of this presentation is to highlight the unique history alongside the current and future challenges of the UZH, with a particular focus on the medical disciplines and especially the Institute of Evolutionary Medicine.

Nature Medicine, 2010


Zurich as an academic / medical hub

-  the capital of Switzerland, in terms of economic power and population size

-  education and health care as ♯2 and ♯3 economically important branches of industry (after finance)

-  hosts the Swiss Institute of Technology (ETHZ), the University Hospital Zurich (the largest Swiss hospital, oldest records dating back to 1204) and the largest Swiss University, the University of Zurich (UZH)

-  “typical local cultural principles”: Protestantism (historically), modest, neutral, sustainable, innovative


Brief history of the UZH

-  founded in 1833 (building upon institutions dating back to 1525) -  full university (seven faculties, ca. 25k students)

-  the very first European university created through a democratic process, not by the church or heads of states, subsequently under constant public control (budget, legal frameworks)

-  12 Nobel Prize winners -  member of “League of European Research Universities”


Medicine at UZH

-  Medical Faculty was one of the original four founding faculties -  UZH largest Swiss Medical Faculty (ca. 3k students)

-  medicine counts for roughly a third of the UZH budget (ca. 300 Mio USD).

-  human / veterinary medicine, dentistry, chiropractic medicine, MD-PhD program, Life Science Zurich Graduate School

-  University Research Priority programs, Clinical Research Priority Programs

-  ranks ♯5 within continental Europe, ♯33 worldwide (Academic Ranking of World Universities 2016)


What is Evolutionary Medicine?

•  Evolutionary medicine or Darwinian medicine investigates human disease vulnerability and disease aetiologies (genetics, behaviour, environment, pathogens, etc.) from an evolutionary perspective.

•  It also addresses future developments in human health as a result of present-day medical and socio-economic practices.

•  Biomedical scientific concept since the 1990s •  “Medicine without evolution is like engineering

without physics” (R. Nesse, ASU)

Alcock 2012

Journal of Evolutionary Medicine 5

Table 3: Concepts and definitions of selected Medical Subject Headings that relate to evolution, as provided by the NationalLibrary of Medicine. ∗In the MeSH tree structure, terms exist in a hierarchy (or hierarchies). Certain terms (e.g., Evolution,Molecular) are indexed under other terms (e.g., Biological Evolution). Thus a PubMed search for Biological Evolutionmay also return citations identified by Evolution, Molecular, depending on the specification of the search.

MeSH term Concepts included Definition (from MeSH Descriptor Data) Indexed under∗

Biological Evolution Biological evolution The process of cumulative change over successivegenerations through which organisms acquire theirdistinguishing morphological and physiologicalcharacteristics.

Genetic Processes

Evolution, Molecular Directed molecular evolutionGenetic evolution

The process of cumulative change at the level ofDNA, RNA and proteins, over successivegenerations.

Biological Evolution

Selection, Genetic Genetic selectionNatural selection

Differential and non-random reproduction ofdifferent genotypes, operating to alter the genefrequencies within a population.

Genetic Processes

Adaptation, Physiological Physiological adaptation The non-genetic biological changes of anorganism in response to challenges in itsenvironment

Adaptation, BiologicalPhysiological Processes

Adaptation, Biological Biological adaptation Changes in biological features that help anorganism cope with its environment. Thesechanges include physiological

Biological Processes

Phylogeny Phylogenetics The relationships of groups of organisms asreflected by their genetic makeup

Biological EvolutionGenetic Phenomena

Genetic Drift Genetic DriftNeutral Evolution

The fluctuation of the allele frequency from onegeneration to the next.

Biological EvolutionGenetic Phenomena

Figure 4: ISI Web of Knowledge citations with terms “Dar-winian medicine” or “evolutionary medicine” publishedbetween 1991 and 2010.

3.3 Changes in terminology in digitized books

A digitized book database provided another measureof scientific and cultural trends in the use “Darwinianmedicine” and “evolutionary medicine.” Google books is adatabase of millions of digitized books comprising about4% of the corpus of all published books. This database ofdigitized books suggests that these terms were first used inbooks around 1990 (Figure 6). During the last two decades,“Darwinian medicine” occurred more frequently than

Figure 5: Google scholar citations with keywords “evo-lutionary medicine.” Citations from 1991 to 2011 areincluded; the continued climb in 2011 suggests that theapparent decline in citations related to evolution in 2010 inFigures 2 and 4 may not reflect long-term trends.

“evolutionary medicine” in digitized books, although recentusage suggests that the use of “evolutionary medicine”will overtake the alternative phrase (Figure 6). Additionalkeyword searches show that both of these terms (“Darwinianmedicine” and “evolutionary medicine”) have been usedmore frequently than the related phrases “evolutionarypsychiatry, evolutionary epidemiology,” and “evolutionaryimmunology” (Figure 6).


Rühli et al. 2015


The Institute of Evolutionary Medicine (IEM) - vision „Learning from the past for the present and the future.“

We are a leading international and globally connected research, teaching and service institute which is part of the medical faculty at the University of Zurich. We analyse ancient biological material and associated data to better understand modern human health issues and diseases. Due to specialist scientific expertise, excellent infrastructure and state-of-the-art methodologies, we are able to work on various interdisciplinary research questions in the context of the field of Evolutionary Medicine.

Our core competencies include: -  In the area of morphology: Clinical Anatomy; Variability and adaptation of body morphology as a

function of time (Microevolution), sex, robustness, socio-economic factors etc.; Macroevolution of joint morphology and –pathologies.

-  In the area of imaging: application of modern imaging techniques (MRI, terahertz) on historical tissues; Radiological diagnosis of pathologies.

-  In the area of ancient DNA: Co-evolution of diseases and the human genome (evolution of human pathogens, microbiome analyses etc.); Service for Archaeology/Historical Anthropology (paternity testing, sex determination).

-  Maintain a novel medical museum for the public and a medical history object collection for the scientific community (from 2016).

-  Ethical considerations for the research on historical human tissues.

Rühli et al.

Institute of Evolutionary Medicine (IEM)

The IEM - summary

•  unique Evolutionary Medicine institute worldwide (2014ff.)

•  a top down supported field at UZH: part of a University Research Priority Program

•  interdisciplinary, e.g. bridges Medical and Science Faculty

•  four groups (ancient biomolecular, evolutionary morphology and adaptation, paleopathology and mummy studies, museum of medicine and medical history collection), ca. 50 members

•  roughly two third of the institutes budget from third-party funding


The Medical Museum (planned) and the Medical History Collection


Impact of Evolutionary Medicine

Science, 2010

•  excellent example of interdisciplinary research and teaching •  increasingly incorporated into the curricula of Anglo-Saxon

universities

•  encourages critical thinking, especially for medical students

•  crucial for shaping effective future health policy strategies


The future of UZH Medicine

An ongoing process of multiple governance / research initiatives, with some having already been launched: -  Hochschulmedizin Zurich:

•  to promote interdisciplinary research and education at the interface of basic research and clinical medicine

-  Dachstrategie Universitäre Medizin Zürich: •  adjusted governance, more clusters and space-wise connected

research to be planned •  Vision 2026: e.g. promotion of innovative clinical research in

collaboration with the University Hospital Zurich to boost innovation in translational medicine, Zurich as a major health care provider with new supply concepts / information technology, innovative medical curricula


Univer-City: Hochschulmasterplan Zürich

Heritage-protected

© by

Another major challenge is the future expansion of the UZH within central Zurich, highlighting the problematic interdependence of urban planning and academic needs

Green areas

1900 vs. 2016


General challenges -  increase in number of students / curricula -  budget and space restrictions

-  global competition vs. local constraints (speed of decisions / political requirements)

-  unique selling point of Universities fades away (newly established “Universities of Applied Sciences”)

Number of UZH students red: foreigners, grey: women, blue: total


Similarities: IEM - UZH Medicine - Univer-City Zurich

-  issue on how to promote emerging interdisciplinary research and teaching fields

-  challenge of new unit(s) to be established within existing structures

-  lack of space as a major limitation

-  major part of the budget via third-party funding

-  top-down decisions vs. academic freedom

-  uniqueness / innovation as a strength

-  public as a major driver

Science, 2009


Take home message The Univer-City of Zurich serves as an excellent example of a tradition

steeped academic hub - particularly in the medical field - facing key opportunities and challenges, both in a local setting and in a globalised market.

Funding: Mäxi Foundation; University of Zurich

www.iem.uzh.ch

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C'est l‘équilibre de l'évidence et du lyrisme qui peut seul nous permettre d'accéder en même

temps à l'émotion et à la clarté. (A. Camus, 1942)

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