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medicinska fOreningen’s

medicor student magazine

THE FUTURE OF OUR GENOME

WHEN SCIENCE TURNS DREADFUL p.10

FALLING THROUGH THE DARKNESS p.34

ALONG CAME THE AI p. 31

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Prelude When I started my studies at KI, the student magazine was a golden opportunity to reconcile everything I held dear. Trying to solve mysteries in the hidden parts of the world as a journalist was among my daydreams as a child. I have always been fascinated by a good story and loved the allusive atmosphere attractive visual compositions can create. Although the daring lives of journalists and their commitment to truth inspired me in many ways, the joy of uncovering mysteries in science got me swamped. Chasing the unknown, however, has become a vital part of the path I followed as I dived headfirst into the world of science. I was given a voice when I thought a girl from a hidden corner of the world would not matter, so what better way to use that voice to give the same chance to others? I appreciated many unique opportunities and experiences Medicor offered to me. From planning to delivery, it is such a pleasure to take part in all stages of its making. We aspired to inspire students to explore beyond the curriculum, to seek and tell the stories they find interesting and to dare. To try. Along the way, I have learned and improved a great deal, but I was not alone in this path. I have been very lucky to work with people who share the same passion and their help has been a crucial part of bringing this magazine into your hands. Medicor team involves many talented people but I would like to give special thanks to some of them. First to Joanne Bakker, whose dedication and valiant effort carried us further each and every time. Her endless support, keen eyes, and sharp mind were vital for the magazine and for me. To everyone at MF, who have always been available to help. Finally, to all the people who dared to get out of their comfort zone in order to develop new skills and contribute to Medicor. Keep up the spirit! Each issue of Medicor is a product of teamwork and therefore very precious, but this one in your hands is special to me for another reason. It is my last one as editorin-chief and I am proud to present you the last issue of Medicor in 2017. Time flies. While the present is our choice, the future is an institution, a dream at best. We produce long-term forecasts and open fortune cards, yet the future remains, more often than not, as a surprise and catches us ill-prepared. In this issue, we adopted a futuristic theme to prepare better for what might come, while drawing lessons from what already happened. We also adopted a futuristic look for once. Our cover story takes us on a journey to envision the future of our genome and probes our fears and desires in the light of recent advances as well as regulations in genetics. Sten Linnarsson, Niklas Juth and Gemma Marfany spared their valuable time and enlightened us with their expertise while we explored the borders of the relationship between our DNA and our “human” identity. This journey is one of the best Medicor has offered so far. In line with the theme, we venture into the technology that lays the foundation for organ printing, inform you about the futuristic innovations, and inquire what awaits us when the artificial intelligence takes a more prominent role in our society. We also offer you a fiction story for the first time in Medicor. Among other interesting articles, don’t miss the last words of the current president and vice president of MF summarizing their productive year and welcoming the new administration and lend an ear to the call for attention to the global surgery conditions in underdeveloped countries. The Medicor team has been lucky to get an exclusive interview with the 2017 Nobel laureates of Physiology or Medicine and we are grateful to Ann-Marie Dumanski for this invaluable opportunity.

Photo by Matthijs Dorst for Medicor

Medicor Magasin Grundad 2006. Trettonde årgången. Utges av Medincinska Föreningen i Stockholm ISSN: 1653-9796 Ansvarig utgivare: Yildiz Kelahmetoglu Tryck och reproduktion: Elanders Sverige AB Adress: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Utgivningsplan 2017: nr 1: mars, nr 2: maj, nr 3: oktober, nr 4: december. Kontakta Medicor: chefredaktor@medicor.nu www.medicinskaforeningen.se http://medicor.nu Frilansmaterial: Medicor förbehåller sig rätten att redigera inkommet material och ansvarar inte för icke beställda texter eller bilder, samt tryckfel. Upphovsman svarar för, genom Medicor publicerat, signerat frilansmaterial; denna(e)s åsikter representerar nödvändigtvis inte Medicors eller Medicinska Föreningens. Freelance material: Medicor retains the right to edit incoming material and does not take responsibility for unsolicited texts or pictures, and printing mistakes. The contributor agrees that, through published and signed Medicor material, their opinions do not necessarily represent those of Medicor or Medicinska Föreningen.

Finally, the revelations about the workplace harassment in Swedish society spanning from the film industry to academia served as a wake-up call for the most people. As #metoo alliance keeps growing and exposing the patriarchal structure in many parts of the society, we see more and more women bravely raising their voices to make a change. If you experienced any type of harassment or abuse, whether you choose to come forward or not, remember that you are not alone and it is not your fault. You can find information about what to do in such case on MF website. There are many ways to tell a story. I told mine, come and tell yours.

Yildiz Kelahmetoglu Editor-in-Chief 2

Cover Photo: Jill Heyer


Overture SCIENCE WHEN SCIENCE TURNS DREADFUL

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Matthijst Dorst tells a story about the designer drugs and emphasizes how science amends itself with evergrowing new data.

4D BIOPRINTING Find out more about the cutting edge technology that holds great promise for organ printing.

SCIENCE SNIPPETS Catch up with the latest findings in the research community with our selected stories.

CAMPUS

COVER STORY

THE FUTURE OF OUR GENOME

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Join us for a journey into a world where we investigate the borders between our humanity and genetics.

Gustaf Drevin and Anna Petterson lay down the facts and needs to achieve humanitarian surgical conditions in low and middle income countries.

THE ERA OF BIG BRAIN PROJECTS

PRESIDENT’S WORD Pontus Dannberg and Max Kynning conclude a productive year and hand over MF administration to the new president and vice president.

BEYOND ACADEMIA Lend an ear to Theresa Mader for the seminar series from people who followed an “alternative” career. The future starts now.

CULTURE

GLOBAL FOCUS GLOBAL SURGERY

iGEM STOCKHOLM ROCKS BOSTON

20117 stockholm iGEM team brings gold medal and a best entrepreneurship nomination from the Giant Jamboree. Hear the story behind their success.

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SMÖRGÅSBORD

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ALONG CAME THE AI

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SCIENCE IN ART

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FALLING THROUGH THE DARKNESS

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FUTURISTIC INNOVATIONS A glimpse of the innovations taking us closer to future step by step.

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What do the large scale brain projects aim for and how likely are they to achieve those?

As artificial intelligence become an integral part our lives, Sunjay Fernandes looks for an aswer to “Where do we go from here?”

Or art in science? Rikard Forlin looks into the intricate relationship between the two.

A fiction story

medicor Yildiz Kelahmetoglu • Editor-in-Chief Joanne Bakker • Associate Editor, Cover story Editor Varsha Prakash • Editor of Science | Isabelle Wemar • Editor of Campus Zach Chia • Editor of Global Focus | Diana Čekatauskaitė • Editor of Culture Yildiz Kelahmetoglu, Joanne Bakker • Layout Design | Jakob Dahlström, Johanna Jangland, Matthijs Dorst, Jutta Roth, Jill Heyer, Justin Knight, Hamid Ershad Sarabi, Magnus Endal • Photographers| Alexandra Jurczak, Giovanni Cioffi, Adele Kastensson, Yildiz Kelahmetoglu, Larsen Vornholz, Pontus Dannberg, Max Kynnig, Theresa Mader, Matthijs Dorst, Anastasios Mastroanastasiou, Gustaf Drevin, Anna Petterson, Lina Abdel Halim, David Unger, Sunjay Jude Fernandes, Rikard Forlin, Ronan McCabe, Patrik Bjärterot, Tatiana Álvarez Giovannucci, Anna Boytsova, Julia Svensson • Writers | Alexandra Edwards Henriksson, Martin Axegård, Britanny Carson, Roksana Khalid, Zach Chia, Mauricio Barrientos, Johanna Frost-Nylen, Tobias Goodden, Nigel Kee • Proofreaders | Pixabay, Flickr, Freepik • Illustrations

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Aperture Merry Christmas and a happy new year from Medicor! God Jul och Gott Nytt Ă…r!

Want to showcase your photography skills? Email us at chefredaktor@medicor.nu and get a chance to see your photo here in the next issue of Medicor. 4


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SAVE THE DATE

EVENT CALENDAR FOR JANUARY - MARCH 2018

GRADUATION AFTERPARTY AT MF

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ICE-SKATING IN KUNGSTRÄDGÅRDEN Let´s strap on some skates and glide around the ice-skating rink in the middle of the city with a magical atmosphere of lights and joy. You can rent your skates on sight and it is opened every day.

JAN JAN / MAR 4

The Amphioxgames are something you do not want to miss out on! Gather a team and prepare for a day filled with games, competitions and dares all around the town. The day will end with your first KIsittning, the Amhpioxgasque and a long night of fun. Find more info at the MF website.

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Aula Medica, karolinska institutet A whole day filled with interesting lectures given by several professors, followed by a poster session, interactive activities and round table discussions with KI Career service and KI Grants Office. Refreshments will be served for registered participants and registration is for FREE.

30 JAN

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CHASE 2018: CAREERS IN HEALTH AND SCIENCE

Aula Medıca, Karolinska Institutet

What kind of jobs does the health sector offer? Should I stay in academia or enter the industry? Come find out the answers to these questions and many more. The event is for free and the registration opens in February.

Info and registration: http://chasesthlm.se

Hammarbybacken, Stockholm

Do you want to see some of the world’s best alpine skiers in a city event? Then you should go to the Audi FIS Ski World Cup in Hammarbybacken, Stockholm. It has, for the past years, become an annual highlight.

Info and tickets:

http://worldcupstockholm.com

FEB NOV

PLANET EARTH II

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Info: http://conference.ki.se/byrs/

It is time to welcome the new students on their first day of a new chapter in thir life. A day filled with information and friendly faces and do not forget to attend the infopub in the evening to get inspired by the different committees and get an insight in the student life of KI. FREE attendance. Welcome to KI and MF!

AUDI FIS SKI WORLD CUP STOCKHOLM

JAN

BIOMEDICUM YOUNG RESEARCHERS SYMPOSIUM

FEB

ericsson globe, stockholm

80 musicians in a symphony orchestra playing live, while a unique movie featuring wonderful pictures of animals and nature. Plus it is shown on a big screen. Could it get any better?

Info and tickets:

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https://www.stockholmlive.com/events/ detail/planet-earth-ll/

MAR

HJÄRNFESTIVALEN

10-14 MAR

Hjärnfestivalen is organized for the second time and it is open for everyone. Take the opportunity to find out more about your own brain. Go to exhibitions, workshops and participate in interactive activities. And it is completely FREE.

Info: By Julia Svensson and Anita Birovecz 6

we the all the

Nobels Väg 10

JAN

Nobels Väg 10

Graduation is at our doorstep and celebrate it with a big party. Take chance and share this day with the newly graduated students at graduation afterparty.

WELCOMING DAY AT KI AND INFOPUB AT MF

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AMPHIOXGAMES AND AMHPIOXGASQUE

Nobels Väg 10

http://v-i-s.se/english-2/hjärnfestivalen. html


Photo by @cikstefan

The best use of curiosity is research

Clinical Scientist Training Programme (CSTP) Do you want to explore your imagination, test your ideas and discipline your creativity? Consider a doctoral education at Karolinska Institutet. CSTP offers research funding for medical, dental, psychology and speechlanguage pathology students* interested in pursuing a Ph.D. The next call for funding opens in February 2018.

For more information: http://ki.se/cstp *Note that you have to have completed at least 6 semesters but still be a student when applying.

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Smörgåsbord

It bleeds! - Artificial cadaver HUMAN CADAVERS HAVE LONG BEEN USED TO TRAIN MEDICAL STUdents, a hallmark of medical education dating back hundred years. However, before synthetic life forms appear, entrepreneurs from SynDaver, a company in Tampa, Florida, USA came up with a synthetic human model as an alternative to working with preserved corpses. One model, aimed at surgeons and first responders, even mimics what happens in the body during surgery or trauma, with the biological functions in a living person in distress, such as fluctuating respiration, blood pressure and heartbeat, according to the SynDaver website.

Deep learn your genome GOOGLE RELEASED A TOOL CALLED DEEPVARIANT THAT USES DEEP learning to construct full human genomes. AI technologies are dominated by deep learning which is a kind of machine learning technique based largely on the networks of the human brain. These mathematical models are the ones that learned to identify your face on Facebook photos or recognize your instructions to Siri. Now engineers in Google and Verily taught one to take raw sequencıng data and build your genome with all your base pairs from scratch. DeepVariant already took first place in a contest that promotes improvements in genetic sequencing. As of today, you can get your whole genome sequenced from a teaspoon of spit for just $1,000 but current machines can only give you a snapshot of your genome with an incomplete, patchy outcome. But from now on you can go deep in learning about your genome variant!

Superspeed transportation HUMANITY ADJUSTS GEARS FOR THE SUPER-FAST MASS AUTOMATED TRANSport via trains. A new technology called Hyperloop One will revolutionize the transportation by loading passengers into a pod and accelerating gradually via electric propulsion through a low-pressure tube. The pod uses magnetic levitation to accelerate and lift above the track. Thanks to ultra-low aerodynamic drag, it can conveniently glide at airline speeds for long distances. If you are thinking this is too good to be true, hear this first: According to Virgin Group, a British company behind the innovation, Hyperloop One will be fully electric powered and sustainable. The system is in the early stages of the commercialisation and passed a test in the world’s first full-scale hyperloop system at the DevLoop site near Las Vegas. In fact, it showed great promise as it reached the top speed of 310km per hour (86m/s) during phase two of testing. Including security check, ticketing, refuel, and waiting for departure, this amount of speed reduces the travel time from Stockholm to Istanbul in half for example. Imagine sipping some tea near Bosphorus, or cruising in French riviera for a weekend. Now we are talking. (Time estimate is from www.hyperloop-one.com)

By Yildiz Kelahmetoglu 8


Futuristic innovations

Digital currency (aka bitcoin) AT THE END OF 2017, IF YOU STILL HAVEN’T HEARD OF BITCOIN, COME CLOSER. Bitcoin is a form of digital currency, also referred as cryptocurrency. One might even call it gold for the digital era. There are other cryptocurrencies but bitcoin is the Zlatan of them. They are not controlled by any government or centrally processed by any bank. Like gold, the supply is limited in part by the effort required to produce it. Being free of banknotes allows for instantaneous transactions and borderless transfer-of-ownership. To prevent the double spending, which is the biggest issue in the absence of a bank or credit card as an intermediary, Bitcoin uses a public digital ledger that records every transaction, also known as blockchain. Computers with specific softwares compute complex mathematical problems all around the world to incorporate information from a bitcoin transaction. Once solved, other computers in the network verify the math. This way the collective confirmation and the public record of the transaction overcome the lack of centralized clearing. Goodbye bank fees!

Biochip enhanced memory YES, THE FUTURE IS HERE, GET A PROSTHETIC MEMORY JUST LIKE YOUR computers. A brain implant developed by the researchers from the University of Southern California was demonstrated to improve the human memory for the first time. The device was implanted in volunteers who were having brain electrodes for epilepsy treatment. The device collected brain activity data during tests designed to stimulate either short-term memory or working memory. Then, the device electrodes were programmed to stimulate the brain with the pattern associated with optimal memory performance. Shortterm memory was improved by roughly 15 % and working memory by ~25 %. (Dong Song, University of Southern California, data from Society for Neuroscience)

Semi-synthetic life COULD LIFE HAVE EVOLVED IN DIFFERENT WAYS THAN THE “A”S, “T”S, “G”s, and “C”s? The bacteria with an expanded genetic code would argue yes. These bacteria with an “unnatural” base pair that scientists call X and Y, were successfully grown in culture. Floyd Romesberg, a scientist at the Scripps Research Institute was the first to show that a living organism can incorporate the unnatural DNA and also copy it as it divided in 2014. Now, his team reports that the bacteria are using their expanded code to synthesize proteins with equally unusual components. Even though this sounds like the door to different life forms, there was no change in the rest of the bacterial cell. We are only beginning to learn how far life can be redesigned. Hello synthetic biology, hello future! (Nature, November 2017)

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SCIENCE

When science turns dreadful By Matthijs Dorst The best way to understand a system is to poke it. If you can poke a system in a systematic way, and carefully write down what happens, you are doing science. This is the basic premise behind some of the new techniques used by scientists these days. The trouble with brains of course, is that they are rather difficult to poke, at least not without their owners objecting. While drugs exist that work on the entire brain, what scientists really needed was a way to control specific brain cells. Enter chemogenetics: using genetically modified animals, or through viruses that genetically alter cells, new receptors and channels are created only in the brain region or cell population where they are wanted. Soon the cells start making new channels and pumps that are activated only when they encounter a specific molecule. These are called Designer Receptors Exclusively Activated by Designer Drugs or DREADDs for short. When these receptors are activated, they can cause the cell to be more active, or instead quiet down depending on which variant is used. They offer a way to poke the brains of living and behaving animals. However, it is no trivial task to pick the correct drug. This drug must able to activate the new receptor without activating anything else, and it cannot be too similar to existing neurotransmitters so your new receptors are not accidentally activated when they should be quiet. The most popular designer drug used so far is Clozapine-N-Oxide. This drug had its moment in the spotlight not to long ago.

Chemogenetics: Return of Clozapine It was a warm, lazy day in early August when a newly established lab published its first paper. Despite never being particularly eager to take time off, most scientists were away from their institutions 10

enjoying holidays. As is often the case with newly published papers, in a few weeks, people would start reading it, and perhaps share it within the small niche of scientists working on the same topic. A few months down the line it would start being cited here and there. For any other paper, the story would end here. But this is not so for the paper published in Science, by Gomez JL et al in August 2017. Soon after it came out, rumors started appearing on Twitter, “There is a problem with DREADDs.” In response, someone would tweet, “Are our results still valid?” As the news spread, more and more people read what the young scientist had reported, specifically that Clozapine-N-Oxide (CNO) converts into Clozapine. The theory behind DREADDs, otherwise inert compounds that activate these receptors, no longer appeared to be supported. If this was true, hundreds of published studies and studies in progress could turn out to be invalid, unless they included the right controls. Soon, Twitter was abuzz with worried scientists; some scientists confirming that they had indeed observed unwanted side effects.

It took a few days for the excitement to calm down. Soon, researchers realized that while the results did change our understanding of DREADDs, they did not necessarily mean that previous data were incorrect. Rather, it highlighted the importance of performing the necessary controls when designing a study. It served as a strong reminder that the tech-

nique you are using is not perfect and is not without caveats. The study highlighted that CNO was good, but not perfect. Sure, by itself CNO is inert and capable of activating the desired receptors, but CNO can be converted into Clozapine inside the body, and clozapine does have a direct effect on the brain. Moreover, ancient studies already highlighted the ability of Clozapine to cross the blood-brain barrier and cause side effects.

How problematic are these side effects? At low doses, they are practically undetectable and harmless for most studies. At higher doses, the effects may not necessarily interfere with what is being studied. By comparing the results to those obtained in animals without the DREADD receptor, the nature of these effects is easily validated. Since most studies already included such controls, their results remained valid. Much of the feelings of dread that initially spread through the scientific community now seemed unwarranted. In a way, this episode illustrated just how science works: with new data comes new understanding. With better understanding, we can do better science. A perpetual cycle of improvement.


SCIENCE Science and Fame Half a year has passed since DREADDgate. With the turmoil settled it is now time for reflection. And so, Medicor sought out the scientist behind the study, Dr. Michaelides, who is a Principal Investigator at the NIDA Intramural Research Program. Below is our interview with him.

Did you expect these results to cause such commotion? “Not to the extent that they did. The whole experience was surreal. While I did expect a notable response from the community, what followed was surprising. The paper caused a lot of reactions and we received numerous (and continue to do so) emails from students, postdocs, junior and even senior scientists asking about their specific experiments. Many people were curious as to how we came to the discovery. Therefore, we tried to write about the technology in a clear and positive light.”

What are your thoughts on some comments, calling it “DREADDgate” for example? “In retrospect it is not surprising people used such terms to try and rationalize the situation. Our findings questioned an established, pre-fixed model and I guess it was difficult to believe how something like that could have been missed. The simple explanation is that, the necessary experiments for validating CNO were never performed and we all assumed, incorrectly, certain qualities about the ligand that it does not possess.”

Was it difficult to publish this work, where many controls etc. were required to convince the reviewers? “We sent the manuscript to two journals prior to Science. The editors decided to not send to peer-review, rejecting it on editorial grounds and citing lack of sufficiently broad interest. Ironically, one of these journals featured our paper in their “highlights” section. Naturally, my colleagues and I found the editorial rejection puzzling given the popularity of DREADDs and the broader meaning of our findings in relevance to the current pace of methods and tool development in the field. Nevertheless, I guess the editors were skeptical given that it was our lab’s first paper and that we were challenging an established model.

In contrast, the experience with Science, which has a discrete editorial review process, was rapid and smooth. The reviewers were for the most part convinced and did not request many additional controls. I believe this is because we used the appropriate methods/tools and our experiments were quite thorough, implementing many different convergent approaches to illustrate our point. What also helped, were a couple of papers from other labs that had already been published by that time and which supported our findings.”

Photo: Neurons with DREADDs, by Matthijs Dorst

Do you expect other to try and disprove or replicate your findings? “I hope so. That is how science should work. Notably, colleagues at our institute had already replicated part of our findings prior to the publication of the paper, and since its publication, numerous other labs have contacted us saying that they have also replicated our findings and/or obtained results that agree with our interpretation. Based on this, I expect several papers will be published soon that support our findings.”

As a relatively new lab, do you expect this attention to be beneficial for future work?

that might be controversial and this is what he has to say, “Repeat your experiments, once, twice, three times. If you are 100% confident that your results are solid, share this with senior colleagues that you trust as you will likely need their support to advance your message. I was fortunate to have very strong support from my senior colleagues at NIDA, whose help was critical for moving our work forward and getting it exposed. Furthermore, be transparent about your findings to the leaders in the field and to those whose work you are challenging and most importantly, persevere, and never give up.” •

“Absolutely. Both my lab members and I have noticed a positive change in how other scientists approach us. The paper and the resulting publicity have opened many new doors and collaborative opportunities and have significantly facilitated our ongoing work. It has also forced us to work harder and faster and has increased productivity and enthusiasm in the lab. Ultimately I think that this has helped the technology as it has increased our knowledge of how the DREADD system works and has exposed a potential pitfall that should be addressed early on in the development of novel actuators.” As a conclusion to the discussion and as we come to the end of this interview about DDREADS, we asked Mike about what advice he has for other young researchers when they discover something

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SCIENCE

4D Bioprinting The Future of Regenerative Medicine

The infinite scientific possibilities of an unknown future fuel creativity, inspiring a plethora of young scientists to merge biology and technology to accomplish revolutionary research. The outcome of this research could potentially produce remarkable solutions to major healthcare issues plaguing humanity. One of these revolutionary developments is the next generation technology of biobuilding to create viable tissues and organs. These bioprinted tissues and organs could transform transplantation medicine by reducing and possibly resolving waiting lists of patients for donor organs. By Anastasios Mastroanastasiou The beginnings of bioprinting Over the past years, 3D bioprinting technology set its own dot on the discovery map, raising excitement regarding its application in organ transplant procedures and what consequences this technology could hold. Multiple international research groups have worked on applying 3D bioprinting towards treatment. For example, a research team at Cornell University has successfully created a functional ear that gives hope to children born with a congenital deformity known as microtia, where the external ear is underdeveloped. In 2003, Thomas Boland of Clemson University patented the use of “bioink”. Bioink is composed of biocompatible materials or living cells which are loaded into a cartridge to print tissues. Unfortunately, the first limitations for 3D bioprinting 12

appeared shortly afterwards, with issues regarding the vascularization of the tissue, natural signaling, and the quality and composition of the bioink. These problems generated big doubts regarding how 3D bioprinted structures and materials would perform in vivo, in an actual living human being. The next generation of bioprinting, 4D bioprinting, is trying to overcome these issues.

Photo: Frank Wojciechowski (flickr)

4D bioprinting: the times they are a changin’ While 3D bioprinting turned out to be limited in producing physiologically functioning organs, 4D bioprinting could present a solution to this lingering issue. When someone reads “4D”, they might wonder what the “4” stands for. The fourth dimension that 4D bioprinting is referring to is ‘time’: the printed objects can change their shape over time in response to an external stimulus. In the human body, a normal, native tissue undergoes dynamic changes in its environment. The heart and brain both produce and respond to electrical signaling, the esophagus is subjected to peristaltic movements, and blood vessels respond with vasodilation to high levels of carbon dioxide or nitric oxide. Therefore, a


SCIENCE native tissue is not static, but it has to be responsive to changes in its environment. The same holds true for bioprinted tissues or organs. For these reasons, a fourth dimension, that is the ability to react to external or intrinsic stimuli, was added to the already existing 3D bioprinting system. For instance, the pumping of the heart is a consequence of the intrinsic stimulus of the pacemaker cells that generate the electrical signals. In 4D bioprinting, stimuli-responsive biomaterials are added to the bioink to generate biologically active constructs that can alter the shape of the printed object. Stimuli-responsive materials can be mainly divided into two groups, those responding to temperature or water.

“Stimuli-responsive biomaterials are added to the bioink to generate biologically active constructs that can alter the shape of the printed object.”

as we all know, vital as it delivers nutrients and oxygen via the blood that are essential for the survival of any organ, be it the native or the transplanted organ. While 3D bioprinting could not ensure sufficient vascularization, 4D bioprinting could provide a solution to that problem. One answer is to bioprint the cells layer-by-layer in a hydrogel contained in cylinder-shaped structures resembling the vasculature. This should be combined with the activation of the vascular cells by maturation factors, for example the Cyclin-CDK complex that promotes cell proliferation. Different cell types can be used for the creation of a vascular system, such as fibroblasts, mesenchymal stem cells (MSCs) and embryonic carcinoma cells (ECs). The formation of a functional vascular system is a complicated process, requiring adequate cell migration and aggregation in combination with growth factors, the proper interaction of MSCEC cells, and extracellular matrix components. Another solution is cell traction force, which enables self-folding through tension generated by cells on the extracellular matrix. Agarose rods made up by bioprinting could be used as the filling material to fabricate vascular tubes. All in all, the use of thermosensitive and

The first group of thermoresponsive materials respond to temperature changes by shrinking, swelling or folding. Certain polymers can transition into another shape close to the physiological temperature. A representative material is poly(N-isopropy-lacrylamide), PNIPAAm in short. When using this kind of material, a mixture of the thermosensitive polymer, the bioink and nutrients or growth factors is injected in the body. The polymer undergoes a phase transition as the temperature increases and forms a gel, releasing its contents from the structure. The other class of humidity responsive materials are abundant in nature. Researchers around the world are fabricating humidity responsive materials based on polyethylene glycol (PEG) and agarose (AG). The great asset of agarose is that it is chemically and electrically neutral. What’s more, its gelatin-like properties are depending on a temperature that does not denature proteins. Both characteristics are essential for use in the human body - we would not want our 4D bioprinted liver to destroy the proteins of our own cells... Vascularization: the lifeblood of engineered tissues The major problem to manufacturing artificial organs is providing a sufficient vascular system. The vascular system is,

Ethical responsibility of the new era It is undeniable that 4D bioprinting appears to be the future of regenerative medicine and it has great potential. Up to now, it is only the beginning into accomplishing zero mortality organ transplants or tissue regeneration. The living quality and health conditions of people would increase significantly if 4D bioprinting becomes successful and available to everyone. Most importantly, it could lead to a different era of human health revolution that cannot be perceived at the moment. It might even give rise to the next evolutionary step of the human species, the ‘transhuman’: a homo sapiens with enhanced physical and intellectual capabilities.

“There are still many issues to address regarding the safety and functionality of 4D bioprinted tissues and organs before they could become available in the clinic.” These developments give rise to important ethical questions. How much of our physical body makes us ‘human’? Living in a tissue-engineered society sounds exciting but at the same time daunting. The word ‘human’ in the dictionary could be given a different definition in the future. Will this tissue-engineered society lead to categorization of people according to the level of biofabricated organs they possess and exclude the ‘normal’ people? In the end, will this technology be available to everyone or only to a few? Only future will tell.

Photo: Pixabay

humidity sensitive materials in the bioink could be the solution to fabricate tissues that can react to the dynamic changes that occur in the tissue’s environment. A functional vascular system can be fabricated with the use of smart biomaterials that will supply the tissues with nutrients and oxygen to secure their survival and proper function. However, there are still many issues to address regarding the safety and functionality of 4D bioprinted tissues and organs before they could become available in the clinic.

It is of high importance that scientists reach out and inform the public of the great future possibilities of medical discoveries to avoid confusion and fear. The discovery of something as exciting and revolutionary as 4D bioprinting results in confusion at first and fear of how this discovery is going to be used in the hands of scientists, governments and private corporations. As the scientific world is a major driver of social change and a significant number of people feel threatened by change, it is of high importance that scientists inform the public about the benefits as well as the disadvantages of new scientific technologies. •

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SCIENCE

Science Snippets By Alexandra Jurczak ALZHEIMER DRUG THAT TREATS YOUR TEETH

SCIENTISTS TEST PSYCHEDELICS ON HUMAN MINI-BRAINS

Researchers at King’s College London have found a natural way of repairing tooth cavities without the need for cement filling. A drug developed to treat Alzheimer’s disease also happened to regenerate dentine, a mineralized material that protects the tooth, by stimulating stem cells contained in the tooth pulp. Cavities were repaired within six weeks when small collagen sponges soaked in the drug were inserted into them. Since the drug has already passed the safety tests for other purposes, scientists hope that it would be quickly approved as dental treatment. (Scientific Reports, January 2017)

Humans have used psychedelic substances for centuries without really knowing their actions on our brains. However, it’s difficult to learn more without getting anyone high. Fortunately, Brazilian scientists have found a way. They exposed cerebral organoids - 3D cultures of neural cells that resemble a developing human brain- to single doses of hallucinogenic compound known as 5-MeO-DMT. The drug was found to alter the proteome of mini-brains by upregulating proteins crucial for memory and learning and silencing factors involved in inflammation and degeneration. The study suggests a hidden, neuroprotective effect of restricted substances that could be of interest for medical and scientific communities. (Scientific Reports, October 2017)

NOVEL NANOCHIP HEALS WITH A SINGLE TOUCH

Photo: Paul Rigg, Flickr

ORGANS

Researchers at Ohio State University have developed a new technology to inject genetic material into living skin cells, in order to change their function. Tissue Nanotransfection (TNT) can generate any type of cell within the patient’s own body and can be used to repair injured tissue by growing elements of any compromised organ. The procedure is short and non-invasive, requiring only a small electrical charge that immediately induces cell reprogramming. Despite the concept being simple, TNT needs to be further explored in order to improve the technology. (Nature Nanotechnology, August 2017)

FIRST DIGITAL MEDICINE APPROVED BY FDA

Photo: f2486122, Flickr

A novel digital medicine system (DMS) has been developed to objectively report ingestion of an anti-psychotic drug in patients with schizophrenia. The FDA-approved sensor is activated by gastric juices in the stomach and sends signal to a wearable patch that logs the date and time of intake. Health experts believe that DMS will improve patient outcome by helping them to stick to their medicines, and may even help track participants of clinical trials that test experimental drugs. (Neuropsychiatric Disease and Treatment, October 2016)

A PEN THAT DIAGNOSES CANCER

ANTI-AGING MUTATION DISCOVERED

MasSpec Pen is a real-time diagnostic tool, which brings a new approach to cancer diagnosis. Developed by researchers at University of Texas, this handheld device uses tiny droplets of water that extract molecules from patient’s cells to detect cancerous tissue in about 10 seconds. MasSpec Pen can speed up surgery and lower the risk of infection and cancer recurrence. However, the size of the mass spectrometer that it is connected to is still a limiting factor in the transition phase to the clinic. (Science Translational Medicine, September 2017)

Northwestern University researchers have found a small Amish community that carries a mutation in SERPINE1 gene to live 10 percent longer than others. Individuals with a single copy mutation are protected from age-related changes, observed by low blood pressure, low fasting insulin levels and more flexible blood vessels. Given this discovery, researchers have developed a drug that is currently in phase 2 clinical trials, which could potentially slow the effects of aging in humans. (Science Advances, November 2017)

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Photo: Mike Allee, Flickr


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iGEM Stockholm rocks Boston A gold medal, a nomination and countless memories

The 15 students of iGEM Stockholm have spent most of 2017 researching bacteria, raising money, talking to biotech companies, designing logos, collaborating, organising seminars and much more. After 10 months of hard (but fun!) work, they finally got to reap the reward at the final conference in Boston where they were awarded a gold medal for an excellent research project and were nominated for Best Entrepreneurship. By Adele Kastensson and Larsen Vornholz What is the iGEM competition? The international Genetically Engineered Machines (iGEM) competition is the world’s biggest competition in synthetic biology, initiated at Massachusetts Institute of Technology (MIT) in 2003. This year, over 300 teams from across the globe tried to solve a real-world issue using synthetic biology and hopefully win a gold medal.

It contains the results, achievements and information about the team and the project. On the basis of the wiki, the judges evaluate the projects based on criteria such as innovation, creativity, feasibility and impact.

“At the end of our iGEM journey, we would find our designers pipetting in the lab and our scientists designing presentations in a nonacademic fashion.” The competition is divided into tracks including therapeutics, diagnostics, software, hardware, art and the environment. In November, the iGEM teams flew to Boston to showcase their projects at the final conference, known as the Giant Jamboree. Two weeks prior to the Jamboree, each team had to finalise their project’s documentation on a “Wiki” page, a standardised template given by iGEM. 16

and promote their project through a 20 minute oral presentation and a scientific poster. The last day was reserved for the highly anticipated final awards ceremony. When we arrived to register for the Giant Jamboree and saw the 5,400 other participants, we were able to truly appreciate the magnitude of iGEM. Gathering students from all over the world in one place, the Giant Jamboree was a place where inspiration was both given and taken. It was wonderful to finally get to see what everyone else had been up to, both inside and outside of the lab.

“(...)as many as 250 people found their way to our presentation and that our live-stream reached 2,700 viewers.” Photo: Jutta Roth

The Giant Jamboree in Boston The Giant Jamboree is a four-day conference in which the teams showcase

Our project – to engineer a lung probiotic to degrade thick mucus in the airways – stood out in its futuristic approach. But no two ideas were alike, with projects ranging from improved synthetic biology techniques to speaking with plants.

Photo: The iGEM Foundation and Justin Knight

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The Giant Jamboree was a place to inspire and to be inspired in. It was wonderful to finally get to see what everyone else had been up to both inside and outside of the lab.

Trying to decide which of the 313 project presentations to attend at the Jamboree proved to be a challenging task, so we were extremely happy to see that as many as 250 people found their way to our presentation and that our live-stream reached 2,700 viewers. We also enjoyed high traffic at our poster where we had not only the opportunity to present our project in more detail, but also very rewarding and lively discussions with fellow iGEM presenters, supervisors, judges and business representatives. Many acknowledged that they had been following our project for quite a while and came to our presentation because they were eager to see what we had accomplished.

iGEM in numbers Nearly 5,400 participants from 310 teams representing 44 countries across the globe. 43% of teams from Asia 28% of teams from North America 25% of teams from Europe Gender: 47% women and 53% men.

egory. We could not have accomplished what we did without our wonderful supporters. We are grateful for our sponsors, supervisors, advisors, instructors, volunteers and, of course, our friends and families who have been so supportive. Although receiving awards and medals is certainly inspiring and a fun aspect of the competition, we brought something back from Boston which is of more worth than any prize. As one of our team members put it, “iGEM builds character – but more importantly, it brings people together.”

Our project was well-received by both judges and other iGEM presenters, and we were pleased to earn a gold medal for a well-executed project. The medals are used to rate the quality of the teams’ research, collaboration, public engagement and documentation. With higher medal value, the requirements became more difficult and more comprehensive.

In addition to receiving the gold medal, we were also ecstatic to obtain a nomination for “Best Entrepreneurship”, which put us in the top three teams for this cat-

succeed in targeting many different social groups by organizing seminars and debates about synthetic biology and participating as exhibitors in different public events. While running our “Democratic Biology” campaign for the public, we realised that we were simultaneously running a democratic campaign within our own team, in which we shared our collective knowledge and expertise. At the end of our iGEM journey, we would, for example, find our designers pipetting in the lab and our scientists designing presentations in a non-academic fashion. We all share the view that one of the best things about iGEM Stockholm is its diversity. In representing 11 different nationalities and 7 different study fields, we learned so much from each other, both inside and outside of the lab, obtaining knowledge we otherwise would have never acquired.

What did iGEM Stockholm accomplish?

To earn bronze, teams needed to register and meet the basic requirements, while for silver, teams had to collaborate and demonstrate that the newly designed BioBrick (genetic element) of their project worked. The gold medal was awarded to teams who had met the requirements for bronze and silver, but were also able to model parts of their project, incorporate its social impact and most importantly that the project worked as expected.

Source: The iGEM foundation

iGEM Stockholm 2018

2017 iGEM Stockholm Team Photo: Jakob Dahlström

Democratic Biology: science for everyone As mentioned in the last Medicor issue (#3 2017) iGEM Stockholm ran a campaign called “Democratic Biology” with the goal of making biology available not just to scientists, but to everyone. We

With iGEM Stockholm 2017 being the 3rd iGEM Stockholm generation in the competition, we celebrate the continuation of a golden success story. To sustain the unique opportunity for highly motivated students to compete with top-ranked universities across the globe, the iGEM Stockholm alumni association (SGEM) organises the recruitment of the next iGEM Stockholm team. We will be excited to see the iGEM Stockholm team of 2018 start off the next season this coming January. •

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MF President’s word

All good things come to an end. It seems like only yesterday that we were elected to head Medicinska Föreningen (MF), but when this reaches you, our final month in office will have begun, and the end of the year approaches faster than normal. At least that’s how it feels. That’s why we think this is the perfect time to reflect upon the year that was.

Photo: Johanna Jangland

When elected to president and vice president, we had a clear ambition – to make MF and its activities more accessible and open to all, and to further make all students feel at home with the union. Together with our board, we have done our utmost to achieve this. We updated MF’s communications; renewing our website and increasing our presence on KI’s social media, and have strived to inform all students of how they can engage themselves in the activities they are interested in. We hope that an increased amount of qualitative information gives all students a better awareness of what MF is and can do for each and everyone.

“(...) we had a clear ambition – to make MF and its activities more accessible and open to all, and to further make all students feel at home with the union” Our board recently held the first Open-House event at MF, a complementary event to the reception activities in the beginning of the year, to further enlighten curious students. We have long considered it a weakness at MF, that the informational events, or stepping stones to learn more, are all concentrated in the beginning of the semester and exclusively target the first-semester students. With our Open-House event, we sought to reach students of all levels, as well as further create networks within MF’s bodies. During the event, the union house was full of energy and joy, as over 100 students participated and learned more about how they can get involved in MF’s committees and societies, and what we have to offer. The week after the Open-House event, the first gathering of the newly elected MF Council was held. At this meeting, the elections for MF’s positions of trust are held annually.

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To our great joy, the Council elected a new president and vice president of MF to take up where we leave off at the end of the year. Both Iris Peña Arriaran and Laura Andersson ran for the positions with an ambition to further increase MF’s visibility and attraction.

We hope that the foundation we have laid this year, by further strengthening MF’s general activities, and the projects we have started, such as the new website and info events, will help Iris and Laura fulfill their vision for MF during the next year.

“a year of change and optimism at MF” This, together with the fact that the “Future Union House” project is picking up speed, will without a doubt lead to a year of change and optimism at MF in 2018. With hope for the future, and a wonderful year behind us, we would like to give our thanks and hand over to the next president and vice president of Medicinska Föreningen. • Photo: Pontus Dannberg

They are highly qualified, with Iris having a background in the female skit-group Flix and the central organisation for student unions, SSCO, and Laura being the current chairperson of the Reception Committee, in addition to previous experiences as a project leader at a sports media group. With their complementing merits and skills, we have high hopes that, under their guidance, MF will soar to new heights.

Max Kynning & Pontus Dannberg President & Vice President Medicinska Föreningen ordf@medicinskaforeningen.se vordf@medicinskaforeningen.se


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Medicor had an exclusive interview with the 2017 Nobel Laureate Michael Rosbash. Tune in to our website (www.medicor.nu) to hear about it! Photo: Theresa Mader (Medicor writer and LinkedIn Manager), Michael Rosbash (2017 Nobel Laureate in Physiology or Medicine), Isabelle Wemar (Medicor Campus Editor), Marianna Tampere (Medicor writer)

Beyond Academia By Theresa Mader As a PhD or MD/PhD student, have you ever felt lost or even desperate when thinking about the time after your thesis? Or do you feel excited but a bit crunched between all the possible career choices you have? Perhaps you have already thought about a specific job position and would like to know if it really fits you? Regardless of how you feel about your future, we at the PhD Careers Beyond Academia Club at Karolinska Institutet (KI) are here to help. It may seem like the most obvious way to go after obtaining your PhD is to get a Postdoc, and continue within research, but there are a number of reasons why you should also consider a position outside academia. Firstly, it is difficult to get to a higher academic position, given how few there are in proportion to the number of PhD graduates. Secondly, the work environment in academia may not suit everyone. Lastly, constantly having to gather funding for your research can be tiring. Central to the PhD Beyond Academia Club are our seminars that are held in small groups with a casual atmosphere, leaving plenty of room for discussions and questions. In addition to covering a wide range of careers, from science journalist to medical science liaison, the seminar series tries to reveal the everyday job behind the fancy titles.

Entering the Swedish Life Science industry is not always simple, so let us give you some advice. First tip, being able to speak Swedish is a huge advantage in the industry, so why not try out KI’s free courses in Swedish – Language@KI? Second tip, let your colleagues know you are looking for a job in the pharma or biotech industry and go to the company mingle events organized by KI Career Service. Third tip, try not to think of yourself as merely a “lab person” – your work also includes organizing, planning, coordinating and collaborating. Why not look for a job where you can utilize those skills as well? And finally, try talking to people in the industry and asking them about their current job and how they got there. Just as important as finding out about positions you are interested in, is looking into those you would never otherwise consider you might change your mind, and if not, at least you have done some networking. One of our previous seminar speakers, Milica Uhde, a consultant at IQVIA, told

us that during her PhD she realized that she enjoyed discussing science and brainstorming ideas a lot more than the actual experiments. With that in mind, she began looking for a job where she could do the things she liked the most and settled for her current position. She advises those who intend to transition from academia to read up on the pharma and biotech news. Some important newsletters are Fierce Pharma, Fierce Biotech and Bio Smart Brief. “But you should not lose the focus of your PhD work”, Hovsep Mahdessian says, another of our speakers and a medical science liaison at Bayer. The quality of of your work and your dedication will be assessed in your coming occupation, and is important to all your future endeavors. While it is important to think about and plan for your career, the future depends on the now. So why not follow our Facebook and LinkedIn pages to find out about our next seminar, today? • 19


COVER STORY

Story and interviews Tatiana Ă lvarez Giovannucci and Ronan McCabe Photo: Jill Heyer 20


The future of our genome Diary Entry: 17/11/2085 As the days seep their light, and we are drawn from the swell of summer, I often come to think of things. Like walking across sand, the ground beneath us feels at times so uncertain. We shift. In our careers, in our social relations, in the places we call home. Yet we place certainty in the knowledge that our lives have never been so prosperous. The steps that we took to get here – agriculture, the scientific method, industry, and now genetic modification – have resulted in profound change and have assigned many of our ailments to the past. You could say that we have become a gene based society, with our DNA the defining currency upon which we live. It is everywhere: in the holographic adverts presenting further ideals for which we should all strive, in the waving of our genetic data as the flag of our personhood, and the decisions our parents took to eliminate future health risks. It is amazing - so many lives have been saved that otherwise would have not. But uncertainty still remains. Are we really ultimately defined by our DNA as the world around would suggest or is there more...to being human?_

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COVER STORY

G

enetics holds such pre-eminence that its reach has surpassed the realms of science and entered into our cultural references by featuring in science fiction productions, futuristic novels and being part of the current philosophical and ethical discourse. The focus is on the genetic modification of humans and the uses of our genetic information. Like the diary entry above, through such avenues as science-fiction, we explore our fears and aspirations for the future. It may be the dystopian world envisaged in the film GATTACA or the more egalitarian-anarchistic-utopian world of an Iain M. Banks novel. But while these often strike us as over the top and unrealistic, are there any important truths to behold in science fiction regarding DNA issues?

Health benefits Humans have shaped their environment to their wants and needs through the use of genetics since early history, most obviously in the selective breeding of plants. The natural laws behind this were obscure until the nineteenth century, when Gregor Mendel discovered the concept of inheritance, giving birth to the study of genetics. The field has developed greatly since then, and modern advancements hold the promise that we can treat and even eliminate genetic disease. One of the most exciting research tools at present is the CRISPR/Cas technology. Derived from a cellular mechanism found in prokaryotic organisms, it allows researchers to study the implication of any gene of interest in any particular biological system through ‘knock-out’, or deletion of the gene.

It is hoped that this will eventually be used in a clinical setting. The idea would be to address monogenic diseases (e.g. Huntington’s and cystic fibrosis) through deleting/replacing the single causal gene in the human embryo. However, this hope has yet to be realised and has been hindered by, among others, the presence of off-target effects. In addition, some researchers question whether CRISPR is really the solution for monogenic diseases. “The simpler solution would be to do in vitro fertilisation and then select [a healthy embryo]. It is done already. It does not completely eradicate disease, but neither would editing: only a few people will be able to afford it, or would like to do it,” says Sten Linnarsson, professor of Molecular Systems Biology at KI. He is referring to preimplantation genetic diagnosis (PGD), a technique established in the 90s to help couples with a high risk of conceiving a child with a severe genetic disease. They require an oocyte biopsy, followed by in vitro fertilization (IVF) and embryo screening. With our current knowledge it is hard to envisage such genetic technology being extended to clinically treat more complex diseases – which may involve gene-gene and gene-environment interactions – in the immediate future. The use of genetically-modified human embryos in research also raises serious ethical considerations. This is highlighted by the restriction in place here in Sweden with the Genetic Integrity Act (see BOX 1), which states that human embryos can only be used for a fourteen day period after which they must be destroyed. Perhaps not capturing the imagination to the same extent, the use of genetic data confers the most immediate clinical benefit. Biobanks are a noticeable example. These banks hold biological samples, with individual samples numbering in the 100’000s. Such a huge sample size has massively amplified the capacity and power of research into the genetic components of certain diseases and allows for the identification of biomarkers for disease.

Beyond health ‘Suppose we have the power to choose people’s genetic characteristics. Once we have eliminated genetic defects, what, if anything, should we do with this power?’ - Jonathan Glover (What sort of people should there be?, 1984) Sten Linnarsson Photo by Matthijs Dorst

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cal. However, the possibility that the use of genetics exceeds the domains of science raises some chilling prospects. These are exemplified in movies like GATTACA (1997), taking place in a dystopian future in which natural conception is replaced by IVF and PGD for embryo selection. Consequently, the correction of genetic imperfections has become routine, and genetics rather than moral excellence determines a person’s worth. Niklas Juth, an ethics researcher at KI, tells us that it is not far-fetched that a ‘class society’ may form where our genetic constitution is known and used by employers, spouses etc. But rather than this being driven through state policy, as has previously been the case and how it is described in most sci-fi scenarios, Juth states that “it is more plausible to imagine that it will be, so to speak, on the market arena” leading to the worrying scenario of ‘back-door eugenics’ (see BOX 2).

If safe enough, not using tools that would avoid suffering would be unethi-

Niklas Juth, Photo by Matthijs Dorst

Thankfully, there are protections against the misuse of genetic data beyond the clinical setting. Juth explains that the previously mentioned Swedish Genetic Integrity Act “states that genetic information may not be used to the detriment of individuals.” And while there are some exemptions made for insurance companies who stand to make significant economic losses, they only “are allowed to ask for genetic information that you already have, they are not allowed to force you to get new genetic information.” Fredrik Lanner, assistant professor at KI studying human embryonic development, believes that society will be able to successfully regulate new genetic technologies. In an interview in the magazine Medicinsk Vetenskap, he points out that embryo screening by IVF and PGD are nowadays established techniques in


COVER STORY

1: The Genetic Integrity Act (2006:351)

A compilation of several laws restricting the use of certain technologies in order to safeguard the integrity of the individual. The Act regulates the use for medical purposes only of prenatal and preimplantation genetic diagnosis, puts in place measures for research or treatments using human eggs. It also includes measures to safeguard the privacy of the individual, regarding the use of genetic investigations and genetic information. Lastly, the Act also contains provisions on criminal liability for trade in human biological material.

2: Eugenics Eugenics as a political concept reached its height in the beginning of the 20th century. Many states adopted policies to ‘improve’ their population’s genetics and were characterised by unsavoury acts of discrimination and even forced sterilisation. Needless to say, today we would understand this to be in complete breach of human rights.

3: Reform of data protection rules in the EU

The objective of this new set of rules is to give citizens back control over their personal data. The reform entered into force in 2016, and from the 6th May of 2018 it should enter into the national laws of all EU Member States. By these rules, the individual should give consent for any information collected, and have access to it at any time. The data should be stored with special security measures. The information should be at all times trackable, and the individual should be able to withdraw consent and retrieve the information at any time.

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COVER STORY

In the future, we might be able to overcome some of our ‘flaws’: low physical endurance, aging, even mortality. use only to avoid serious diseases, not for selecting embryos by any other genetic trait. “I think that society will be able to deal with the issue of how CRISPR should be used just as well,” he remarks. “I think the UK is a good role model,” says Niklas Juth, referring to the public discussions and governmental investigations that led to the legalisation of mitochondrial DNA transfer in 2015.

What is it that scares us about genetic modification? In the context of biotechnology, the generation and use of genetically modified organisms (GMOs) has expanded. Most of the concerns regarding GMOs tackle health-related consequences of their consumption, or the interference with environmental processes. However, GMOs do not seem to challenge the identity of the organism in question: wheat modified to resist better plagues or droughts, continues being wheat, right? But when the same line of thought is applied to humans, it creates some feeling of uncertainty. Are we perhaps afraid that genetic modification challenges our own identity? This concern is not universal, though. The transhumanist movement believes that the advances in genetics can be employed, together with other technical developments, to enhance human capabilities. In the future, we might be able to 24

overcome some of our ‘flaws’: low physical endurance, aging, even mortality. Niklas Juth believes that currently, the use of gene editing for enhancing human capabilities should not be performed. “We don’t know enough. So the potential benefits - which are very uncertain - would not yet at least outpace the potential risks.” However, he argues that the alarm that human enhancement generates is unfounded. “Who really is in principle against enhancement? And why? We try to enhance the capabilities of our children by different means: by practising and education, etc. So why shouldn’t we do it by genetic means if we can?”

Gemma Marfany Photo by Sternalia Productions

Gemma Marfany, geneticist and member of the Observatory of Bioethics and Law at the University of Barcelona, thinks that genetic modification should not be considered as dehumanizing, but puts into question the usefulness of the transhumanist goal. “I do not foresee that lengthening our lives, being stronger or thinking faster will make us in any way happier. And certainly, there is no way that we could be immortals. As a biologist, I believe this is an oxymoron type of issue: we live therefore we die.”

Misunderstanding genetic data ‘All he’d wanted were the same answers the rest of us want. Where did I come from? Where am I going? How long have I got?’ (Blade Runner, 1982) DNA provides some answers to these questions. Follow your mitochondrial DNA and you will get an unbroken lineage going back to the first women migrating out of Africa. DNA certainly cannot tell you how your career prospects look like, but it can give you some probabilities about your future health status, which generally creates more angst: will I develop cancer? Or diabetes? Intimidating questions to which the answer, we are told, lies in our DNA. This idea has boosted the success of direct-to-consumer genetic testing companies, like 23andMe or AncestryDNA. As easy as spitting into a tube, you can get all sorts of information


COVER STORY

about your ancestry, health markers, or even find out about unknown relatives.

which genome sequencing is performed in this movie.

There are discordant opinions on the value, or even morality, of these tests. On one side, worried voices claim that these tests have the potential to do more harm than good. You may argue that by knowing your risk for, for example, diabetes you might be able to adjust your lifestyle to prevent it. But would we? “You might as well react the other way around,” Niklas Juth points out. “If it [the test] says I got this huge risk of diabetes I might as well have as much fun as I can and eat more cake.”

If a systems biologist could not extract much out of his genome… Can we? There are basically two kinds of genetic information. There is the monogenic kind of data - you have a mutation that will unambiguously result in a disease, but most of these diseases are actually very rare. Our big worries - cancer, diabetes, mental illness - are of the multifactorial kind, with many genes involved and, importantly but often forgotten in the media, environmental factors. The field of epigenetics tries to address these complex interactions by studying how external cues influence gene expression and inheritance without modifying the DNA sequence (e.g. through DNA methylation). So the problem with the multifactorial data is that we tend to overestimate the genetic contribution. “Because the translation from DNA to disease, or to happiness or to fitness or whatever… we just don’t know how to do this translation,” remarks Sten Linnarsson.

On the other side, there is enthusiasm about the empowerment of society. “People should have the power to collect this information and use it, and I think they will be able to handle it,” says Sten Linnarsson. He believes that we tend to exaggerate how useful DNA data actually is. And that’s said from experience. “Most of the information was useless,” he concludes from his own genetic data (part of it publicly available on his lab website). Nevertheless, genetic data is of great use in science and healthcare. Sten predicts that as the costs plummet, DNA sequencing will fully integrate in the medical practice: not as a way to diagnose, but to be performed ubiquitously. This means that the amount of sensitive data handled by the healthcare system could eventually become a burden, a problem that Sten believes will not occur: “As the cost plummets, it also means that it would actually be more convenient and cheaper to just do it again next time. You then not even need to store it… we might get closer to a GATTACA type of scenario, right?”, alluding to the ease and speed at

Niklas Juth identifies the same tendency to overemphasize the value of genetic data, and describes what he calls ‘genetic exceptionalism’: the idea that, opposed to other medical data, there is something special about DNA. He stresses that the characteristics that might make genetic information special - that it is transmittable, that it is shared to a large extent between relatives, and that it is sensitive - are shared with other non-genetic information, as exemplified by the case of a child with congenital syphilis: a disease that is not genetic but transmittable to offspring, tells about the mother and the child, and is certainly sensitive.

Perhaps scientists should focus on bringing awareness of what the limits of DNA information are and how to interpret the data. Because what we don’t understand we cannot control - a vulnerability that could be exploited for commercial purposes.

The rise of a genetic social network? Although DNA may not be as special as we might think, it is still sensitive data. And as such, its unauthorized use could affect the person’s wellbeing or violate his/her privacy. Despite of being carefully safeguarded by law, the way big data companies use our non-genetic sensitive data is already an ongoing issue. “The issue here is when, how, why for and who will be interested in analyzing our genetic information,” says Gemma Marfany. Niklas Juth also shows some concerns about the commercialization of genetic testing, as it challenges the needs-first basis of the healthcare system: when healthcare products require out of pocket payments, the more money you have, as opposed to need, the greater your access. Sten Linnarsson, on the contrary, believes commercialization itself is not a problem, but that we should perhaps adopt a protectionist approach in the regulation of these companies to avoid the generation of big monopolies. “If 23andMe and any other company has the DNA [sequence] of everybody and can cross reference this, that would be dangerous.” New regulations like the EU Data Protection Reform (see BOX 3) aim to give more control to people over their sensitive data, also covering genetic data. Will these regulations be enough? We will have to see. •

Diary Entry 3/12/2107

The story we draw from our DNA has been constantly shifting and changing in its hues. While stirring the palette of nature and nurture, we first looked for answers inside ourselves. We then looked outside. And though it appears we have come now to see a balance of colour, in our curious minds we always wonder... where will our story take us next?_ 25


GLOBAL FOCUS

Global surgery: moving from the neglected stepchild to a central aspect of global health

By Anna Petterson and Gustaf Drevin

Hans Rosling rightly spread the message that the world is rapidly improving. The Millennium Development Goals successfully highlighted fundamental health problems and resulted in increased access to basic healthcare in low- and middle-income countries (LMIC). But the recent global health discourse has missed out on conditions affecting billions. Anna Petterson and Gustaf Drevin call for an urgent paradigm shift and enlightenment of an overlooked topic in global health - surgery. The surgical disease burden is a public health issue Surgical conditions relate to all health sectors, from maternal health to trauma. Provision of surgical care is fundamental to strong health systems. Still, 5 billion people lack access to safe, affordable, and timely surgical care. Conditions that in high-income countries are treatable can be fatal in LMIC. 95% of the unmet need for surgical care is found in LMIC. An estimated 17 million people died from conditions amenable by surgical intervention in 2010, compared to 3.8 million people dying from HIV/AIDS, tuberculosis, and malaria - combined. If you thought that was worrisome, consider that the epidemiological transition towards non-communicable diseases such as cancer, diabetes, and cardiovascular disease will add to the backlog of conditions requiring surgical attention. Still, we bet that you have read much more about the burden of infectious diseases than surgery in your global health reading. You might even perceive surgery as complex, expensive, and not practically feasible in LMIC – even professionals thought so. Indeed, the head of the World Bank, Jim Yong Kim, and the global health legend, Paul Farmer, aptly named surgery “the neglected stepchild of global health” in 2008.

The state of global surgery But things are changing dramatically. 26

Today, global surgery has a larger presence in the global health discourse. A report written by the Lancet Global Surgery Commission in 2015 effectively addressed critical knowledge gaps in this field. Modelling projects combined with empirical data produced a rough but mind-blowing report of the state of surgical care in LMIC.

“Untreated surgical disease will cost up to

$13 trillion by 2030

just in lost economic productivity - but scaling up surgical platforms to prevent this would cost just $300 billion.” One third of the global disease burden can be addressed with surgical care - a steep increase from the previous estimation of 11%. The commission further estimated that 1.5 million, or 7% of deaths in LMIC, can be directly averted with effective surgical intervention. But patients cannot access the surgery that is offered, or do not receive timely surgical care, mostly because of financial barriers. Up to 48 million people face catastrophic economic loss to pay for the direct and indirect medical costs connected to accessing surgery in LMIC. Unsurprisingly, the countries accounting for the poorest 37% of the world’s population perform only 6% of surgeries. And, an additional 143 million

surgical procedures are needed annually in LMIC, a 50% increase compared to the current 313 million operations annually. The unmet need is tremendous and the resources are missing – medical staff as well as equipment. Surgeons, obstetricians, and anaesthesiologists are required to maximise health outcomes. Deficits are seen in basic equipment including anaesthesia machines, pulse oximeters, and even sutures. In addition, it is not uncommon for hospitals to lack fundamental requirements such as reliable electricity and running water. Covering for the millions of procedures is mainly an issue of human and material resources - quite the challenge for already burdened health systems.

The compelling case for investing in surgery The avenues for change are numerous. Surgery is surprisingly cost-effective, even comparable to public health interventions such as mosquito nets, hypertension treatment, and vaccinations. It prevents disease such as HIV through circumcision, cures cancers and injuries, and palliates chronic diseases. Untreated surgical disease will cost up to $13 trillion by 2030 just in lost economic productivity - but scaling up surgical platforms to prevent this would cost just $300 billion. Surgery is a treatment modality that addresses a significant proportion of the global disease burden and shares common building blocks with the broader health system. This means that scaling up of surgery improves provision and outcomes of care in many health sectors. Basically, surgery


GLOBAL FOCUS

Photo: Magnus Endal magnus.endal@capacare.org

has to be incorporated into national health plans in LMIC and be offered free of charge. The return of this investment is great – in economics and in human health.

Increased recognition on the global scene So, global surgery has evolved into a field of research, advocacy, and policymaking. There was only scant empirical knowledge but the Lancet Global Surgery Commission acted in synergy with other milestones in 2015, such as a World Bank report called Disease Control Priorities and a World Health Assembly resolution calling for increased attention to global surgery. Soon after the Lancet report, the World Health Assembly published a resolution calling for increased focus on global surgery and anaesthesia. This important acknowledgement put surgery right up on the global health agenda. The World Bank subsequently added five surgical metrics to its guiding document, the World Development Indicators. Zambia then became the world’s first country to adopt a National Surgical, Obstetric, and Anaesthesia Plan (NSOAP). Surgery is no longer a “neglected stepchild”, but has made its way to the political negotiating tables and research foci of global health actors worldwide.

The momentum of global surgery So where does that leave us? Despite gains made to have surgery added to policymakers’ to-do lists, we are nowhere near fulfilling these promises (do not misinterpret us: millions of people are still dying from the lack of basic surgery). But, recent research has started defining country-specific challenges to surgical care provision, barriers to accessing surgical care, and it investigates the role of surgery in universal health coverage. The academic space and potential of global surgery is huge. The authors have worked with and can attest to the allure of global surgery. Anna has investigated the gender differences pertaining to access to and quality of general surgery in Uganda and Gustaf is currently enrolled in The Paul Farmer Program in Global Surgery and Social Change in Boston and has clinical and research experience from half a dozen African countries. We argue that global surgery despite its increased recognition is just an emerging public health issue and needs involvement of the next generations of academics and clinicians.

nurses, midwives, anaesthesia officers, and public health specialists. We suggest that you contact academic actors in these professions at your university, hospital, or similar institutions. You can have a rewarding and instructive experience in joining the global surgery community. If you are a medical student at Karolinska, you might want to apply for the elective “Global Surgery” (2016) in your clinical years. To conclude, we urge interested students to explore what role you can have. The global surgery community has far to go in achieving our promises to the populations we serve, and this will indeed be a fight for you to undertake, tomorrow, the day after, and possibly as a long-term commitment to populations that still die from conditions that are amenable with basic surgical care. • Anna is currently in her 9th semester in medicine at the Karolinska Institutet. Gustaf is a medical student at Karolinska Institutet currently on sabbatical, working as a Research Associate at the Paul Farmer Program in Global Surgery and Social Change at Harvard Medical School.

The scarcity and questionable quality of surgical data are a great challenge to the global surgery community and colleagues in LMIC. There is a huge need for more research and involvement of surgeons, 27


GLOBAL FOCUS

The era of big brain projects

By Lina Abdel-Halim and David Unger

In recent years, the EU, US, China, Japan and Korea have all launched large scale brain mapping projects. What are they all about and are they useful? Lina Abdel-Halim & David Unger investigate. Alzheimers. Stroke. Depression. Three examples of neurological disorders amongst a myriad of others. Most of us have heard about them, and since a whopping 1 in 6 people suffer from a neurological disorder, ranging from minor trauma to debilitating diseases such as ALS, we can also assume that there is a fair chance that many of us have at least been in contact with someone suffering from one disease form or the other. Patients with these disease are plagued with several impairments, which the World Health Organisation measures in DALYs - “Diseaseadjusted Life Years”, i.e the number of healthy years lost to a disease including death. Using this measure, it is estimated that the global rate of mortality from neurological diseases amounts to 6.8 million deaths annually. So what shall we do to prevent these diseases? We are bombarded by advice through the media to “maintain” our brain health. We wear helmets, exercise regularly, develop safer ways to drive a car and stimulate brain cells by solving sudoku. Some of us go vegan. But in the end all of this can only take us so far, which is perhaps why scientists recently have been trying to tackle these issues alternatively using large-scale projects, “big brain projects”. So what are these “big brain projects”? And why are the scientists putting so much stock in them?

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As of 2017, there are currently five notable big brain projects, and more are surely to come. The European Human Brain Project, The American BRAINS Initiative, The Japanese Brain/MINDS Project, The China Brain Project and The Korea Brain Initiative. And there is honestly not much to say about them, mainly because their objectives are all very straightforward and similar. Each of these five projects is undergoing the arduous and, one might even argue, Sisyphean task of trying to map the human brain as a means not only to solve all problems regarding neurological diseases, but to also understand cognition and human behaviour. No small task by any measure.

“Each of these five projects is undergoing the (...) Sisyphean task of trying to map the human brain.” In April 2005, Henry Markram of the Brain and Mind Project in Switzerland, started the Blue Brain Project. He was motivated to start this initiative not only by scientific aspects but also due to a personal reason being that his son Kai had been diagnosed with autism, and he wanted “to be able to step inside a simulation of my son’s brain and see the world as he sees it.” According to Markram, that could only be done by mapping the

entire brain’s circuitry. The Blue Brain Project was the basis for a $1.3 billion EU grant to Markram and his colleagues to expand this effort; the European Human Brains Project saw daylight in October that same year. In April 2013, three months after this EU grant, the then US President Barack Obama made a speech announcing the start of the American “BRAINS initiative”. In announcing this initiative, Obama stated, “As humans, we can identify galaxies light years away, we can study particles smaller than an atom. But we still haven’t unlocked the mystery of the three pounds of matter that sits between our ears.” The era of big brain projects had begun. These massive enterprises consists of researchers and scientists from all possible relevant disciplines; neurology, psychology, psychiatry, neurophysiology, molecular biology and pharmacology and IT to name a few. All generated data from the various fields of study is equally valued and shared across all disciplines, something that was difficult to achieve before but is now possible by gathering all involved specialties under one and the same roof. The projects in their entirety are organised according to the bottom-up and top-down design with accumulation of data on molecular and cellular neuroscience in the bottom, followed by integration of the data in increasing levels of complexity starting first with different


GLOBAL FOCUS brain regions and then finally the entire brain. Besides seeing a need to map the brain in order to figure out mechanisms behind neurological disorders, scientists also see the need to better understand memory, cognition and behaviour. This, in all likelihood, will prove to be just as gruesome to understand as understanding the etiopathology of neurological diseases. These brain projects require a highly sophisticated and advanced computing capacity and thus, rely heavily on neuroinformatics, neurorobotics, high performance computing, and, most importantly, simulations.

“Perhaps the irony in all of this is that we have to completely understand as much as we possibly can about the brain in order to really figure out how much we do not know.” While the European and the American projects are more focused on the technological aspects, the Asian projects in contrast are generally smaller in scale and more focused on the biological aspects of the question by developing and using specific animal models for studying brain physiology and pathology. Hence, the Japanese project “brain/ MINDS” is using its tried and tested transgenic marmoset monkey model. The project’s 10 year primary end-goal is to have a complete atlas of the marmoset brain with the integrated data to reveal how neural action affects behaviour, motor control, and the building of neural networks. The project will also provide the potential to use the genetically

modified marmosets in research and preclinical studies along with more systematically compiled databases to develop novel diagnostic capabilities and treatments for brain diseases. In 2016 the Korean government announced the start of the “Korean Brain Initiative” with the intention of building a strong foundation for future neuroscience research, as well as tying the research to applications in industry. This focus on industrial development of the generated data is what differentiates the Korean from the Japanese effort. 2016 also saw the announcement of the Chinese Brain Project. The goal is to better understand cognition on a neuronal level through the development of brain-inspired technology, improved diagnostics and interventions. With their large population and rising life expectancy, the Chinese health services understand that brain related diseases will only become an ever-increasing problem. Prevention is the cure. The project will foster novel ways of diagnosing diseases as well as their treatment. The Project also focuses on brain inspired computation, however unlike the European project they are more focused on developing technology for industry.

Money, money, money... Sten Grillner is a professor of neuroscience at Karolinska Institute and Sweden’s representative at The Human Brain Project. Professor Grillner’s field of interest is locomotion, or how the brain decides and performs goaloriented motion from ion channels to actual behaviour. He graciously spent the night before our interview making the following calculation: it would take a person 33 years to read every single article on PubMed about neuroscience assuming

that we spend an hour on each article and read ten a day for six days a week. Now if it takes this much time to just read the articles, imagine actually performing the experiments, compiling all the data, understanding it and writing the articles. The projects are all in all time-consuming beyond comparable measures, and if something is time-consuming, then it is bound to be expensive. It is no surprise that these big brain projects have astronomical costs. The European Human Brain Project have been given the mindblowing sum of 1 billion euros by the EU. And here is the kicker. It is nowhere near enough. In comparison, we have the Human Genome Project, which had the single objective of sequencing the whole human genome. This took 13 years at a cost of $5.1 billion.

The point of it all Just like in Plato’s chariot allegory in Phaedrus, the world brain projects seem to be heading in different directions. Some are prioritising the goal of brain-inspired computing whereas others are focusing on more conventional ways of study (animal models, basic research). While both options are not mutually exclusive, it seems important to note that in the future a lot of neuroscience research will rely more heavily on computer simulation and the development of new technologies. All projects try to link the natural intelligence of the brain with artificial intelligence. This is perhaps the most interesting outcome of these projects. The EU project in particular is dedicating massive amounts of money in developing systems that simulate the brain instead of studying it directly. Is it futile to try to map the entire brain with all its neurons, synapses, connections, channels, receptors and transmitters when they, in the end, might still not be enough to understand any individual brain? Meaning, it might not really matter which function we ascribe to a neuron when this same neuron under different conditions could exert another function if it’s required to. A normal person with intact vision uses specific neurons to see. These same neurons in the visual cortex have been demonstrated to respond to Braille reading and hearing words in a person with impaired vision. Perhaps the irony in all of this is that we have to completely understand as much as we possibly can about the brain in order to figure out how much we do not know. Socrates would have been proud. As the wise Yogi Berra once said: “It’s hard to make predictions, especially about the future.” One cannot but agree specially in this case. • 29


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*: Free pass does not include the opening concert. Conditions for the give away will be announced on the Medicor MF and Frames - Portuguese Film Festival website and Facebook pages.

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CULTURE

Along came the AI By Sunjay Jude Fernandes

Bender, David, Marvin, Cylons, Chappie, Major, KITT. All these are characters that can elicit a sense of joy, hope, comfort but also caution. They also are all artificially intelligent. As we move into an era of machines capable of learning from their surroundings, the assistance we receive makes us more accepting of their intelligence. But as they become an integral part our lives, mere acceptance is not enough. So where do we go from here? One way is hope. Hope that with the development of AI, our lives become easier, more comfortable. The other is caution, and possibly fear of becoming too dependent, or just not intelligent enough to stay relevant in the future.

Let’s try hope. Imagine a day where you are woken up, served breakfast, driven to work, comfortably seated at a mostly automated workstation, fed lunch and brought back home. You arrive to a warm meal, get pampered and put to bed. Then, you wake up the next day and the next, to the same. What did you do? Well, mostly nothing, because you don’t know how to cook or drive. You are also probably irrelevant at work, so now you need to find purpose somewhere else. Let’s say you learn how to paint. But, who are you painting for? Do people even paint anymore? Maybe you can learn to play an instrument. Let’s try the guitar. But how do you even know what a guitar is if you’ve never seen one, at least not in

person? You’ve only heard that once upon a time we lived on the blue planet where people painted, made music and even used three-ply tissues themselves. While all of the above doesn’t sound too bad comfort-wise, it does question how we perceive human purpose and meaning. I did say hope. Due to its infinite computational power, AI could add, say, 25 more ways how to use the Kamasutra, which sounds incredible for an AI lover. But this goes far beyond the book itself. This is a mere symbol of the possibilities for the future AI could create. Being enhanced for instance, not genetically but technologically, would give one the ability to plug into an ever-expanding universe of data where we no longer have a need to have AI separately but within us. We could be in a world where we are the AI.

But, does this mean we lose our humanity? Not if we ask ourselves what it means to be human, what it mean to be yourself? How to be happier, smarter, more creative or even love better -- you teach yourself all of this already. And what makes us all different is still in us. We all use that same brand of phone in different ways.

How about co-existence with technology with a free will to embrace? Technological advances have governed our lives throughout, in the food we eat, vegan or carnivore, in the clothes we wear, hand or machine spun, in our accommodation, mansion or tent. Weighing hope vs fear of AI is a complex issue. Not because it doesn’t exist, but because we don’t and never will fully understand what it means. With the smartphone we all own, we can’t deny that it’s enriched our lives. But, we also can’t deny it’s had unexpected outcomes, like the invention of selfie sticks.

Developing, learning, adapting. That’s what we do as humans and that’s what we expect the AI to do eventually. Not all of us wake up with plans of world domination. Similarly, no AI is the same. All this being said, we still have time to think about it, to choose to develop and embrace. It’s not a dark world, there will be light even when we have fully developed AI. Light for the selfie stick wielding robot on vacation with its handy guide to the galaxy! •

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Scientific Art:

a different way to look at science, and art? By Rikard Forlin

Viruses invading our cells, bacteria drifting around, cancer cells spreading in our body there is an entire world invisible to the human eye. However, scientists are now collaborating with artists, trying to capture these beautiful - yet sometimes horrible - wonders of nature, not only to study them, but also for us all to admire. So how did it all start? A Complicated Relationship First of all, it is important to note that the cultural divide between art and science has not always been there; for much of human history, these two fields did not oppose but rather complemented each other. The relationship culminated in the Renaissance era, with the great work of Leonardo da Vinci, both a scientist and an artist. In the Victorian era, however, the two began to grow apart; as art was influenced by the idea to paint idealised scenes and portraits, ignoring the ugliness and perplexity of reality, science was pulled in another direction by publishing important scientific works (e.g. Darwins “On the origin of species”). Up to this day, the gap between science and art is still substantial. However, certain projects are now aiming to bridge this gap. In 1966, Barbara Steveni and her husband John Latham started the Artist 32

Placement Group. They produced ten short films about industrial waste heaps (called “bings”), that were broadcasted on Scottish Television. A year later, Gyorgy Kepes and Robert Rauschenberg co-founded E.A.T. (Experiment in Art and Technology) to initiate and support collaborations between artists and scientists. They were to create groundbreaking visual pieces of art that incorporated new technology, such as video projection, wireless sound transmission and Doppler sonar, things which had never before been seen in art. Although these movements eventually faded away, there has been a renaissance of ideas in recent years trying to reconcile science and art. Two years ago, a famous art collector Dasha Zhukova donated a million dollars to M.I.T. to create an artist residency, and in 2011, CERN, the home to the famous Large Hadron Collider, initiated “Collide”, a major art residency pro-

gram, that has held several exhibitions inspired by science, nature and technology.

But more than being appreciated for its beauty, can it also help us in a more practical way? ‘‘Science is too important to leave to the scientists,’’ says Mike Stubbs, director of FACT, to The New York Times. ‘‘Science has kind of become a new church, but it is clear now that technology has not been applied to everyone in society to their benefit. We need voices from the arts and socio-cultural disciplines to provoke important debates.” Bram van den Broek, the winner of Nikon’s Small World Photography Competition of 2017 with his image of a human skin cell expressing fluorescently tagged keratin (a protein found widely expressed in the human body), believes so: “The ex-

Photo: Hamid Ershad Sarabi

CULTURE


CULTURE pression patterns of keratin are often abnormal in skin tumor cells, and it is thus widely used as tumor marker in cancer diagnostics. By studying the ways different proteins like keratin dynamically change within a cell, we can better understand the progression of cancers and other diseases.”

artists whose work defines this lack of boundary between science and art. They combine mathematical integration of moving architecture into representations of fading memories in, for example, Alzheimer’s disease or use microetching to reflect brain connectivity in the utmost detail.

For research institutions like CERN or even Karolinska, these exhibitions work not only as a way to translate their findings to a larger audience but also as a means to engage with people, provoking discussions and raising awareness.

In the art world all production has a story to tell. The images we have exhibited here are also not just images, they mean something, they have a story to tell. They reveal the beauty of design within us all.”

Is there an interest in these kind of In Stockholm, the Sven-Harry’s Art collaborations on either side?

Museum has opened The Invisible Body (Den osynliga kroppen) exhibition in collaboration with the Ragnar Söderberg Foundation. It tells the story of ongoing medical research and technical development, in the words of medical images taken at laboratories for scientific purposes. It is a unique exhibition with a different perspective; visual - yet not.

“There is a growing interest on both sides. Artists or even scientists themselves have been illustrating scientific data artfully, whereas artists are using the scientific knowledge to build representations of, for example, anatomical structures or picture diseases. After having a discussion with several artists and showing them our photos, many were eager to organize Saida Hadjab is the co-founder and workshops with scientists to understand scientific coordinator of The Invis- the way we, scientists, think and what we

ible Body, speaks about the weight of these new influences:

What do you believe is the most useful purpose of the collaboration between art and science?

see, what are the principles of life behind the images in order to inspire themselves and retranslate their new knowledge into artful pieces. During her speech at the vernissage of The Invisible Body exhibition, Jessika Gedin said: “People who research this, move through both body and soul, beauty and brutality, the visible and the invisible. People who see the image, but look for the whole picture - causal context, consequences, explanations, and perhaps also cure. Life again. It is not just great science, it is also great art.”

If you speculate, what do you believe is the “next step” for art in science? “The next step for art and science is for the society to become knowledgeable about the design within us to its highest possible extent. The concept we have developed is quite new and very much appreciated, so we are aiming at spreading it. The next step will be to meet the public but not only to share the beauty of art in science but also spread scientific knowledge, possibly around the world.” •

The Invisible Body exhibition is open until January 7th, 2018 at Sven-Harry’s Art Museum in Stockholm.

“Both science and art aim to reflect the truth honestly, be it an emotion or a biological principle both are expressions of Life. The greatest thing about this collaboration is the artful representation of biology that gives an emotional aspect to the knowledge observed. It is a major step in spreading the knowledge through the broader society. Visualizing the subject of discussion, for example, in the clinic is very useful to help the patient to understand the mechanism and the complexity of a tissue or disease. This makes discussing the state of art and future perspectives easier. The art’s role is to make the patient relate to what he is seeing and ultimately help develop ownership towards one’s own structure in health and disease. The art inspires a positive attitude in the patient towards a possible future intervention. The boundary between art and science has always been blurry. Many scientists are artists (musicians, painters, poets, etc.) who have creative minds, a trait which is essential for excelling at their passion. Refil Anadol and Greg Dunn, although a mathematician and a neuroscientist by training, are two contemporary

Photo: Hamid Ershad Sarabi

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CULTURE

CULTURE

Falling through the darkness Fiction story by Anna Boytsova Charlie woke up feeling the sweat drip down his forehead. “Heavens, what a strange dream!” he thought. “Pale figures, an old fortune teller and a fall through the darkness. It doesn’t make any sense.” He looked around his room. The moon spread its light through the jalousies, creating large stripes on the floor. Everything was so calm and still. Suddenly his stomach started to rumble and Charlie decided to pay the kitchen a visit.

Surprised at the fact that she knew him, Charlie walked in. There was a table in the middle of the room set for three with a pot of steaming mushroom soup. On the walls hung amulets and dreamcatchers. On top of the drawer opposite to the door stood a big glass jar occupied by a spider. The woman drew aside her silver hair from her lined face, poured some soup into one of the bowls and asked Charlie to sit down.

He snuck down the steps quietly so that his housemates would not hear him. When he had almost reached the kitchen, he saw something that brought him to a halt. There was a door opposite the kitchen archway that he had never seen before. White, weathered, with a rusty knob. “I’m probably fast asleep,” Charlie thought. He pinched himself in the arm but the door was still there. His stomach rumbled again, this time even stronger, and Charlie looked towards the kitchen. Should he just make a sandwich and go back to bed? No, not this time. The curiosity trumped hunger and Charlie approached the door.

After Charlie had finished she took his bowl and looked at him. “Why do you waste your time and life coming back to this place? You gain naught by doing so. If you want to continue with your life, you must not be distracted, and stay focused. There is no other way around it.” She saw he was confused and shook her head: “That’s enough for today. Go now, I’m having an old friend over for dinner.” Charlie thanked her for her hospitality and went back to the hall. Before he closed the door, he looked back at the woman. She laid some tarot cards on the table and mumbled a mantra in a foreign language.

The handle felt unpleasantly cold in his sweaty hand. Charlie felt the raw, damp air gushing through a narrow crack. He hesitated. Was there really a reason to walk in here? Behind the door, he found a long, dark hall with a faintly shining lightbulb, hanging from the ceiling. Charlie took some tentative steps inside and let go of the knob. Grey doors, the same colour of the walls, were lined up along the room.

With some hot food in the stomach, the corridor did not feel as frightening and cold as earlier. What did worry Charlie was that all doors except one had disappeared. “Well, then the choice is already made for me,” he thought and smiled to himself. The sound of his bare feet on the floor was like light taps on a drum. He opened the door and walked through it.

SLAM! Charlie turned around quickly and saw that the door he had just entered through was shut. He pulled the handle, but could not open it. Panic spread through his body like an explosion and his heart beat as if trying to break his ribcage. Feeling the cold sweat trickle down his spine, he began running around, trying to open other doors in the corridor, to no avail.

This time he was on a balcony, probably sometime during autumn. The fresh air made him feel a little more at ease. At his left sat an old hunchbacked man laying a puzzle on a little table. “Would you like to help me?” he asked with a peculiar smile. Charlie sat beside him and began searching for fitting pieces. It proved difficult because every piece had the same grey colour. “You’ve got to pick them up to see if they fit together,” said the old man as if he could read Charlie’s thoughts.

Finally, one of the doors gave way and the raw air of the hallway clashed with the much warmer one of the new room, which smelled strongly of thyme. Through a heavy wooden screen, small glimpses of light from the centre of the room cut through. The screen was pulled aside and a tall woman appeared behind it. “Oh, is it you?” she sighed and looked sorrowfully at Charlie. “Please come in. You must be hungry!” 34

After some hours, the puzzle was finally complete. It looked like one of the doors in the hall Charlie had come from. “What a meaningless picture,” Charlie thought. ”Isn’t it nice to have done something that you can appreciate later in your life?” the old man asked. “Thank you for your help, young man, but now I have to leave you. A very nice lady is waiting for me today.” Having said those words, the old man

dissolved into the air together with the puzzle, to Charlie’s shock. A little feeble, Charlie had to breathe for some seconds before returning to the hall. It was pitch-black in the corridor. He could hear heavy steps as the door closed behind him – or was it his heart beating again? Charlie stood with his back against the bare wall and waited for what would come next. Is this ever going to end? The light bulb was turned on again. Only Charlie and the door on the opposite end was in the hall. He walked rapidly to it, afraid that it would disappear like everything else in this place did. He gripped the metal knob and swung the door open. The darkness behind it made him feel vertiginous. He heard the steps again and looked behind him. In the gloomy light from the bulb he saw pale figures, suddenly filling up the hall and waving to him with white handkerchiefs. Did they say goodbye? Charlie shrugged, waved back at them and looked to the darkness in front of him again. It drew him in and soon he could not resist it anymore. Charlie took a great step into the blackness and discovered there was no floor. He fell and fell and fell. It felt as if hours had passed, but he still had not reached the bottom. His heart was racing and he wondered if there perhaps was no bottom to reach. Charlie woke up feeling the sweat dripping down his forehead. “Heavens, what a strange dream I had!” he thought to himself. “Pale figures, an old fortune teller and a fall through the darkness. It doesn’t make any sense.” He looked around his room. The moon spread its light through the jalousies, creating large stripes on the floor. Everything was so calm and still. Suddenly his stomach started to rumble and Charlie decided to pay the kitchen a visit. He snuck down the steps quietly so that his housemates would not hear him. When he had almost reached the kitchen, he saw something that brought him to a halt. There was a door opposite the kitchen archway that he had never seen before. White, weathered, with a rusty knob. “I’m probably fast asleep,” Charlie thought. He pinched himself in the arm but the door was still there. His stomach rumbled again, this time even stronger, and Charlie looked towards the kitchen. •


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Medicor MF 2017 December issue  

Medicor adopts a futuristic theme for the last issue of the year. Medicor is the quarterly student magazine of Medicinska Föreningen.

Medicor MF 2017 December issue  

Medicor adopts a futuristic theme for the last issue of the year. Medicor is the quarterly student magazine of Medicinska Föreningen.

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