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This case study is used to teach undergraduate students about hydraulic fracturing (hydrofracking), a controversial method for extracting methane from shale. The controversy arises from claims that chemicals used in the fracking process and the methane itself find their way into drinking water and are also sometimes found at dangerous levels in the air. The case study begins in a college chemistry class where a student inquires about a news item he saw about residents setting their tap water on fire. The instructor uses this as an opportunity for the students to research hydrofracking and natural gas, and she then integrate these topics into their present study of isotopes. The class first examines what isotopes are by using a guided inquiry based activity. The students then learn how mass spectrometry, which uses the principles just learned about isotopes, is employed to determine the source of methane in contaminated wells. This case study is designed for freshman chemistry students and students in environmental studies.

This case study challenges students to differentiate between anecdotal evidence and science-based evidence related to human health. The case uses a "flipped" approach in which students watch two preparatory videos prior to attending class. The first video defines anecdotal evidence while the second characterizes the different categories of scientific studies that generate evidence that is not anecdotal. Students watch the videos, analyze scenarios for anecdotal evidence, and think about what types of evidence they use to make health-related decisions. When students meet in class, they work in groups to compare and contrast these different categories of scientific studies and classify actual research studies aided by a dichotomous key for distinguishing between different types of studies related to human health. Primarily designed for students in introductory general biology courses, the activity could also be useful for lower division nutrition, physiology, or non-major biology courses or any course where students need to differentiate between science and pseudoscience.

This integrative case study is based on real events that the author experienced with her ten-year-old daughter. Although the names have been changed, all of the events (symptoms, diagnoses and treatments, types of healthcare professionals) are recorded exactly as they occurred. Both asthma and pneumonia are common in the United States (and globally). Many of the drugs described in the case study are frequently prescribed for a wide variety of ailments. The four "episodes" that constitute the case cover 1) a study of asthma triggers, incidence and treatment; 2) side effects and possible medication errors associated with steroids; 3) causes, diagnosis, treatment and prevention of community-acquired bacterial pneumonia; and 4) the mechanism of action of two different antibiotics. The "epilogue" explores a few larger themes related to healthcare and public health (e.g., continuity of care, drug resistance, asthma prevention programs). The case study could be used in an undergraduate, upper-level, infectious disease, microbiology, public health or physiology course or in a graduate-level health professions program.

This interrupted case study tells the story of Michael, a Harvard law graduate with a stressful job and a seemingly heavy drinking problem. Students are provided with background information, medical history, and lab results in order to guide them towards determining what is wrong with Michael. This study highlights cirrhosis and the effects of alcohol abuse on the liver. Before beginning the case study, students should have a background in the physiological role of the liver and the breakdown of hemoglobin. Students are asked to use the information provided for them in the case study to gather more information about liver cells and their functions, alcohol, and alcoholic liver damage. Ultimately, using multiple blood tests, the Maddrey's discriminant function (DF) score, and results from a magnetic resonance elastography (MRE), they will diagnose Michael with alcoholic cirrhosis. This case was developed for use in a non-majors physiology course, but could easily be used for a majors class.

This case study explores the recent (2010 - 2016) outbreak of neural tube defects, specifically anencephaly, in a rural three-county region of Washington state, particularly Yakima, WA. The case study focuses on the biological aspects of teratogens that may cause birth defects as well as epidemiological investigations of disease outbreaks. By the end of the case, students will have explored how our environment may have severe biological consequences on the human body during pregnancy and will have evaluated governmental and scientific investigations of a rare outbreak of birth defects. This clicker case study was developed for a non-majors biology course entitled "Human Development: Conception to Birth," although it could be taught in any introductory biology course for majors or non-majors during a unit on human reproductive biology or developmental biology. The case assumes that students have no prior knowledge of developmental biology or birth defects. The case study could also be adapted for upper-division courses by getting more in-depth on the specifics of teratogen mechanisms, the developmental biology and physiology of neural tube defects, or more complex epidemiological analyses.

This case study takes place at a fictional biotechnology company developing herbicides against invasive plant species. The case study focuses on five herbicides with different effects on photosynthesis. Students play the role of lab interns and explore photosynthesis and the herbicide effects by engaging in concept mapping, experimental design, data manipulation, and data analysis. The goal is to use the experimental data to predict the steps in photosynthesis that are inhibited by each herbicide. Students should come away from the case study with a process-based understanding of photosynthesis. This case study is designed for the "flipped" classroom with suggested preparatory videos and associated assessment questions included. Videos can be supplemented with textbook readings or mini-lectures. This activity was developed for a non-majors introductory biology course but it could also be used in any general biology course, including majors' courses. It might also be used to establish foundational knowledge for more advanced discussions of photosynthesis in plant biology (botany) courses.

Genetic studies of human disease are more challenging to perform in sub-Saharan Africa because genetic diversity is greater than in other populations. This pilot will increase our understanding of African genome variation and enable the design of large-scale genetic association studies in the region. Studies into the genetic basis of disease in European populations have made major advances in the past few years, yet similar studies in sub-Saharan Africa have been slower to develop. The high level of genetic diversity that exists in populations from sub-Saharan Africa makes genetic associations with disease more difficult to identify. The African Genome Variation Project aims to collect essential information about the structure of African genomes to provide a basic framework for genetic disease studies in Africa.

This directed case study was developed in order to present genomic data to students, allow them to interpret the impact of genetic variations on phenotype, and to explore precision medicine. Students are introduced to "Josie," a college sophomore who decides to have her genome sequenced after learning about genome-wide association studies (GWAS) in class. As students work  through the case, they learn about the different technologies that can be used in GWAS studies and interpret Josie's results for a subset of genetic markers that affect a range of traits from pharmacogenetics to disease risk alleles and non-pathogenic traits. Students are confronted with ethical issues such as duty to inform, actionable results, and variants of unknown significance (VUS). Students are also asked to reflect on their feelings about getting genomic testing for themselves. An optional activity for advanced students (included in the teaching notes) involves using the Gene database at NCBI to explore variants of the CYP2C9 gene. The case study is appropriate for use in undergraduate genetics or molecular biology classrooms.

This case study follows two beginning undergraduate researchers on a quest for a summer research project related to food web ecology. While writing their research proposal, the students receive feedback indicating that they have neglected an entire group of organisms from their food web-parasites, which leads them to a scientific research paper discussing how these organisms have been overlooked by scientists studying food webs, the challenges involved with including parasites in food webs, and the contributions parasites ultimately make to food webs. An integrated activity in which students visualize the food web using images of organisms and answer questions about species interactions provides opportunities to examine key concepts such as omnivory, ontogenetic diet changes, trophic levels, complex life cycles, and taxonomic aggregation. This case study was originally written for an undergraduate general ecology course, but could easily be adapted to undergraduate general biology courses covering community ecology or specific courses in invertebrate zoology, parasitology, or disease ecology. The teaching notes also discuss how the included code for R statistical computing software can be used to extend the case study in a more quantitative direction if desired.

This clicker case study follows a dialogue between two college students, Lucy and Dan, as they discover how alternative splicing of mRNA molecules can allow a single gene to code for multiple proteins. Dan is participating in a clinical trial for a drug that may treat his migraines by inhibiting calcitonin gene-related peptide, and Lucy is working in a summer research lab that studies the protein calcitonin. They soon realize that the two proteins are both encoded by the same gene, and through their questioning and dialogue they come to understand the phenomenon of alternative splicing. They also learn about other steps of mRNA processing and about monoclonal antibodies. This case was designed to be taught in a flipped classroom, but could easily be adapted for a more traditional classroom setting if content covered in the pre-class videos is covered during the case study instead. It was designed for an introductory-level molecular biology course, but could be adapted for higher levels by including more information about the physiology and regulatory mechanisms involved.

This case study explores the controversy surrounding Yellowstone bison (Bison bison) and the relationship between wildlife management and pluralist democracy. In the late 1960s Yellowstone National Park suspended the policy of strictly managing bison by culling in favor of "natural processes" management. This led to dramatic herd growth and to bison exiting the park in winter in search of forage. Montana cattle ranchers reacted angrily for fear that the animals would infect their cattle with brucellosis. Since 2000, several government agencies have administered the Interagency Bison Management Plan, which uses culling to manage the population at around 3,000 head. The resumption of culling has upset environmental groups, while the recently approved expansion of bison habitat beyond park boundaries continues to upset ranchers.  The ongoing political battle between ranchers, environmentalists, Native American tribes and government agencies shows how difficult it can be to balance legislative mandates, ecological values, and conflicting public demands. The case study may be employed in a variety of courses, including American Government, Public Policy, Interest Groups, Environmental Studies and National Parks.

Why is the North American population of monarch butterflies declining? In 1999, a study published in the journal Nature suggested that a variety of genetically modified corn was killing these iconic butterflies. While it was later shown that the conditions in this study did not mirror those in the field, the results garnered a lot of media attention and many people today still believe that monarchs are being killed by GMOs. This case familiarizes students with the plight of the monarchs, encourages them to think about how to test the hypothesis that a toxin is responsible for their decline, and takes a critical look at several studies that investigated the role of Bt corn in the life cycle of monarchs. This interrupted case takes 60-90 min to complete, requires little to no science background, and can be used to explore the ecology and wildlife management of monarchs; risk assessment, toxicity, and exposure; experimental design, the scientific method, hypothesis, and critical thinking; or the relationship between science, the media and the public.

This case study centers on an active teaching game that simulates a cholera outbreak among five villages along a river, similar to the Haitian outbreak of 2010. By enacting the behaviors of fictional villagers, students learn how trade, travel, sanitation practices and geographic location contribute to the spread of diarrheal disease. Documenting various contamination events of village water supplies allows students to trace the progression of the disease and illustrates how adequate sanitation facilities provide protection against the bacteria Vibrio cholera. Originally designed for an undergraduate upper-division biology course focusing on the epidemiology of diseases, the simulation is also appropriate for microbiology and public health courses, as well as lower division undergraduate biology courses and high school. Biology or epidemiology components of the case study can be highlighted depending on the emphasis of the course being taught. The game can be completed within a 45- to 60-minute class period. Playing cards are available from the Supplemental Materials tab; detailed instructions are found in the teaching notes.

"I Heart Running" is a case study in which students diagnose the cause of exercise-induced tachycardia in an otherwise healthy, 27-year-old female. The patient, Sam, is a long-distance runner and realizes that her exercising heart rate reaches over 200 beats per minute. As the story of Sam's encounters with her physician develops, students are given results from multiple laboratory tests and detailed patient background information.  Students are guided through the material with a series of questions with the ultimate goal of determining the cause of the exercise-induced tachycardia that Sam experiences. The case study is based on actual laboratory results and was designed for students in an upper-level undergraduate Human Physiology course. In this activity students will learn about heart rate, cardiovascular physiology, and oxygen carrying capacity, and factors which influence these concepts, as they try to diagnose Sam.

This case study examines a variety of biological factors that may have been involved in the 2013 dolphin "unusual mortality event" (UME) on the East Coast of the United States. The story follows a news reporter and four different scientists who are preparing their notes for speaking at a public hearing about the dolphin die-off event. After reading the story, students assume the roles of these scientists and use the jigsaw method to gather, analyze, and share information.  Due to the interdisciplinary nature of environmental toxicology, this case study exposes students to four main topics: ecology of ecosystems, endocrine system/chemical messaging, immune system function, and virus biology.

For years whale evolution was characterized by speculation and limited evidence. Evolution critics even focused on whales as a means to criticize evolutionary theory. Now whale evolution represents one of the best examples of "macroevolution." This "clicker case" uses this fascinating story of historical irony as a backdrop to the study of whale evolution. First, students study an array of whale fossils to learn how evolution is properly viewed as a branching, relationship-based process, not a linear, progressive, "chain-of-being." Using this view they learn how scientists seek to reconstruct past relationships and study transitional features, not search for "missing links." Students then learn that evidence for macroevolution relies on several lines of independent evidence from fossils, comparative anatomy, embryology, genetics, and paleoecology. With a focus on macroevolution, this case makes a critical contribution to evolution education. It could work well in a lower level undergraduate biology / evolution / paleontology course (non-majors or majors), or in an upper-level evolution course, perhaps early in the semester as a primer for related topics.

This flipped clicker case study explores the fascinating relationship between the Arizona Bark Scorpion (the most venomous scorpion in North America) and the Southern Grasshopper Mouse. Initially it would seem that the grasshopper mouse is no match for the scorpion's venom; however, the grasshopper mouse is easily able to eat the scorpion and is largely immune to the scorpion's sting. By working through this case study, students learn about neuron anatomy and physiology as they explore how the grasshopper mouse is able to survive the scorpion's venom. This case study was developed for an introductory biology course for majors, but it could also be used in an introductory biology course for non-majors or in an anatomy and physiology course. The case requires that students learn basic neuron anatomy and action potential physiology prior to class by reading their textbook or by watching videos on the subjects. An optional set of guided questions tailored to Campbell Biology (10th ed.) is included in the teaching notes.

This case study teaches students about allopatric speciation through an investigation of the benthic and limnetic sticklebacks of Paxton Lake, which are among the youngest species on Earth, diverging from each other after the Pleistocene glaciers melted and the Gulf Islands formed. Researchers at the University of British Columbia have carried out a variety of fascinating studies on these hardy little fish. Results from this research (formatted as data sheets included in the teaching notes) are provided to students who design experiments and then compare actual data to investigate why benthic and limnetic sticklebacks seldom interbreed in Paxton Lake. Developed for a first-year biology course for majors organized around the general theme of evolution and the history of life on Earth, this case study is an updated version of another case in the collection, "Something's Fishy in Paxton Lake" (Sharp, 2001). The current version is especially suited for a flipped classroom in which students prepare for class ahead of time with a reading assignment that also involves the viewing of a video by the case authors that introduces the mechanisms of allopatric speciation.

This interdisciplinary case study uses the format of a progressive disclosure to explore certain advances in biotechnology and evaluate them within the framework of societal needs, concerns and pressures.  When faced with a heart valve transplant, a high school student and her mother must decide between multiple approaches, some current and others emergent. Highlighted in this case study are the topics of xenotransplantation, 3D bioprinting and the mature minor rule. The case includes a role-playing, public hearing activity that can be used to explore many aspects at the interface of technology and culture: religious rights, parental rights, public health care policy and safety, animal rights, economic issues of organ marketing, and psychological issues of body image.  This case study was originally designed for first year collegiate classes (introduction to biology, introduction to psychology) but is also applicable to AP high school. The flexible nature of the case also allows for expansion of several aspects for advanced classes across multiple disciplines.

In this interrupted case study, students will help Dr. Gupta investigate and assess complications arising in one of her long-term patients, Jorge Alvarez. Jorge was diagnosed with Type II diabetes mellitus 10 years ago as documented in "Living the Sweet Life," an optional prequel case study also in the NCCSTS collection. Jorge has been working with Dr. Gupta to manage his condition, but this year he has come under additional stress, both emotionally and financially, and his health has deteriorated. Jorge now presents with several new signs and symptoms, including numbness, tingling and burning sensations, and a foot sore that just won't heal. Students will review the nervous system and assess Jorge's symptoms, vitals, and blood tests to determine if his diabetes has worsened. Students will also learn about tests used to diagnose types of neuropathy and consider which of them would be most beneficial for Jorge. In addition to a non-majors anatomy and physiology course, this case study may be appropriate for an introductory biology, nutrition/dietetics, or a sensory and perception course.