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medicor

2016 #4

medicor medicinska fÜreningen’s

student magazine

8 World Values Day

17 Emotionally intelligent technology

28 Trump’s policy on health and environment 34 Podcast and chill

snus

Is it the holy grail of tobacco consumption? 1


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Prelude

Overture 25

Dear readers,

Throughout this year, I have had the pleasure to work with a large amount of passionate students that have dedicated their time, talent and tenacity to make Medicor a magazine of great quality for the student community.

WORLD VALUES DAY STOCKHOLM RNA CLUB FLIX - STUDENT FARCE

Science 14 15 16

This experience is something that I will always remember, and will be part of me for the rest of my life. I have learned a lot from you: You have helped me to develop, to overcome challenges, to listen, to debate, to work as one, to compromise and to solve problems. You have made me feel proud to be the Editor-inChief of Medicor. Thank you for contributing and for making this magazine a reality with each quarterly issue.

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For this issue, Medicor has taken on the heated discussion of snus consumption. We review the evidence around the health risks of doing snus compared to smoking and debate if snus could be an effective harm reduction approach. I would like to thank Patrik Hildingsson, Lars Erik Rutqvist and Hans Gilljam for proving us with valuable insight and perspectives in this matter, making this cover story one of the best this magazine has ever curated. Do not miss out!

Photo by Jingcheng Zhao for Medicor

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Among other interesting articles, we touch on the health and environmental reforms that Trump wants to enact upon beginning his presidency, we review the latest and coolest scientific findings in our popular science snippets and we offer you a list of our favourite podcasts for those times when you feel like chilling out a bit. Medicor Magasin Grundad 2006. Tionde årgången. Utges av Medincinska Föreningen i Stockholm ISSN: 1653-9796 Ansvarig utgivare: Teresa Fernández Zafra Tryck och reproduktion: Åtta45, Solna Adress: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Utgivningsplan 2016: nr 1: mars, nr 2: maj, nr 3: oktober, nr 4: december. Kontakta Medicor: chefredaktor@medicor.nu www.medicinskaforeningen.se http://medicor.nu

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SCIENCE SNIPPETS

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pirate bay of science emotionally intelligent technology

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SNUS Medicor takes on the heated debate of snus consumption

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global mental health

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TRUMP’S HEALTH/SCIENCE POLICY

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global health night

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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.

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Subject: Michael Hagemann-Jensen

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PRIVATE SPACE EXPLORATION

ANTI MICROBIAL RESISTANCE

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Culture 31 32

SOCIAL MEDIA

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PODCAST and chill

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ARE SWEDes AS COLD AS their winters?

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Tedx stockholm

38 COMICS

Cover photo: by Saket Milind Nigam for Medicor

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Global Focus

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.

Sincerely, Teresa Fernández Zafra Editor-in-Chief

KI CAMPUS 8 11 12

It is with great excitement that I present the last issue of the year: Medicor #4 2016.

As my days as Editor-in-Chief come to an end, I would like to thank all Medicor contributors once again for being part of this big family. I have Told My Story. Come and Tell Yours.

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Teresa Fernández Zafra • Editor-in-Chief Yildiz Kelahmetoglu • Associate Editor | Saket Milind Nigam • Executive Director & Director of Photography | Zach Chia • Editor of Global Focus | Sibel Ilter • Editor of Campus | Veronika Kremer • Editor of Science | Joanne Bakker • Editor of Culture Joanne Bakker, Yildiz Kelahmetoglu, Isabelle Wemar, Teresa Fernández Zafra • Layout Design | Saket Milind Nigam, Katarina Stojanovic, Anna Vidina, Jingcheng Zhao, Oliver Ljong, Zach Chia, Anny Truong, Oliver Mortusewicz • Photographers | Patrick Bjärterot, Emma Wagner, Diana Cekatauskaite, Teresa Fernández Zafra, Joanna Kritikou, Saket Milind Nigam, Olivia Miossec, Sibel Ilter, Zach Chia, Ben Libberton, Teodora Petrova, Alexandra Edwards Henriksson, Ronan McCabe, Marianna Tampere • Writers | Saket Milind Nigam, Zach Chia, Ben Libberton, Martha Nicholson, Olivia Miossec, Isabelle Wemar, Mina Saleem, Daniela Kas Hanna, Alexandra Edwards Henriksson • Proofreaders | Markus Karlsson • Comics Coordinator | Pedro Velica, Eveline Shevin, Mikael Plymoth • Comic Illustrators |Teresa Fernández Zafra, Freepik.com, flaticon.com • Infographics

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14/01 GRADUATION PARTY @22-05 Medicinska Föreningen, Solna medicinskaforeningen.se

16/01 RECEPTION FOR NEW STUDENTS

medicor

20/01 INFO PUB Medicinska Föreningen, Solna medicinskaforeningen.se

25/01

Medicinska Föreningen, Solna

CULTURE AND BRAIN LECTURE

medicinskaforeningen.se

Emily S Cross Nobel Forum, Solna @ 3pm kulturellahjarnan.se

18/01 MINDFULNESS & SELF-COMPASSION Khenpo Sodargye Nobels väg 9, Solna @ 12pm

28/01

ki.se/en/news/ki-calendar

AMPHIOX DAY & AMPHIOXGASQUE Medicinska Föreningen, Solna

KI CAMPUS

medicinskaforeningen.se

EVENTS JAN.16

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Photo by Oliver Ljong for medicor5


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Smörgåsbord

Cricket protein bars Founded by two Icelandic business men, Crowbar Protein offers food products made of insects. Insects are part of a normal diet in many parts of the world. They are highly nutritious and one of the most sustainable sources of protein. So, why not introduce insects as a viable food option to the western world? That is exactly what Crowbar Protein is working on. Their first product, an insect protein bar called Jungle bar is made up of 75 crickets, blended in with some other natural ingredients that are more familiar to us such as seeds, fruit and cocoa.

medicor

Food innovation

Quorn Quorn was first produced in 1985 in Marlow, UK and it is one of the most popular meat analogues in the market. Quorn products have a similar flavour, appearance, and consistency to meat, and are perfect if you want to reduce meat consumption while keeping some of your favourite recipes. You may be wondering though; what is Quorn actually made of? Quorn is made primarily of Mycoprotein, a source of protein produced by the fungus Fusarium venenatum. Dare to try? Jöns Jacob’s canteen here at KI regularly serves vegetarian options containing Quorn.

Bistro in vitro

Cow-less cow milk

With the mission of making the world a greener place, Perfect Day (San Francisco, USA) aims to offer milk that leaves cows out of the equation. Using fermentation methods similar to craft brewing, Perfect Day’s “dairy yeast” can synthetize proteins found in cow milk. Then, by adding plant fats, sugars and minerals, they can recreate the texture, flavor and nutrition of cow milk. But; does it really taste like cow milk? We will have to wait until late 2017 to judge for ourselves!

The first in meat burger grown in a lab was produced and tasted in 2013 (for the modest price of $300,000). Despite this, are we really ready to eat meat made in the lab? How does the future of meat look like? Bistro in vitro is a Dutch fictitious restaurant that aims to explore the food culture that lab-grown (in vitro) meat could give rise to. Visit the website and create your ideal in vitro lab menu, listen to top chefs’ opinions on the matter and discover whether in vitro meat could be something for you. You can even book a table from January 2028! www.bistro-invitro.com

By Teresa Fernández Zafra 6

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KI CAMPUS

KI CAMPUS

World Values Day 2016 By Teodora Petrova Photos by Anna Vidina

Strong intrinsic motivation and holistic decision-making are required to thrive in the rapidly changing world today. Your values are the origin of the motivation, passion, and endurance you need! But where do you get tips on discovering them or crafting a life and a career which better reflect who you are? The World Values Initiative comes to your rescue! Why do you do what you do? This was the central question behind World Values Day, a full-day event which took place on November 3rd in Aula Medica. The World Values Initiative organized it for the fourth year in a row in Stockholm to inspire students and young professionals to discover and live their true selves through talks and workshops. The recurring topics on the day were sustainable self-leadership, conscious personal and career development, as well as valuedriven leadership in today’s complex and constantly changing world.

Values are at the core of who we are

Respect, integrity, cooperation, balance, health… The list is endless. Our values express what is important to us and our highest priorities. On one hand, existing in an environment (personal, professional, or cultural) which shares our values, brings us happiness and authenticity, and is a powerful motivator. On the other, values are fundamental to our decisions. They determine what our goals are and how we go about to achieve them (for example, what we are willing to sacrifice or not in the process). Yet, some of us seldom give values the consideration they deserve. One reason is that we are rarely prompted to define what is important to us. Alternatively, we do not have time to plan how to proactively stick to it. The World Values Initiative wants to change this by, in their own words, “creating those spaces and experiences, which empower people to live their true selves”.

The story behind the World Values Initiative

The idea of values has become of great interest to entrepreneurs and businesses. Organizations, which identify the values that are important to their employees, and integrate them in their culture, have high motivational potential. Four years 8

ago, two KTH students were sitting in a lecture on this topic, when they realized that values are as important for students as for businesses, but not as popular. They found values to be the answer to the challenges each one of us struggles with: “Why am I here, studying all of this?”, “What path should I take?”, “Where is my motivation?” The initiative was created in 2012 to help students and young professionals to use values, in order to self-lead towards more fulfilling and meaningful lives and careers. Since then it has also spread to Gothenburg, Lund, and Linköping. It organizes monthly workshops in all cities, but World Values Day is the key event on its calendar.

World Values Day: a day of inspiration…

Four insightful and surprising talks were on the agenda for the day. Pamela von Sabljar, a global speaker and educator, took the stage first. Her topic of choice was overcoming the gap between knowing our values and living them. For example, how come we say communication and harmony matter, but end up losing our anger? She reminded the participants that it takes high awareness of ourselves and conscious self-training to live up to what we find important. These are also the keys to sustainability and adapting to whatever challenges or opportunities we are presented with.

Kristina Närman, a possibility mindset trainer, continued with the uncomfortable truth: we spend at least 72, 320 hours at the workplace in a lifetime. Work is such a big part of our lives, it should not be out-of-sync with our priorities and passions. Today, she is the founder of The Professional Freedom Academy and helps people create their ideal professional lives. She advised the participants to stop referring to their weaknesses as the “areas of improvement”, but to their strengths, and to strive to build up on what they love. Gregg Vanourek, the author of “Life Entrepreneurs: Ordinary People Creating Extraordinary Lives” and other books, also delivered a powerful and personal talk on how to craft our lives. Lastly, Klas Westman, former HR director of Stadium, moved away from the topic of self-leadership on to how to lead others. He spoke about a new type of leadership: the value-driven one. He himself has utilized it to transform the companies he worked in. Leadership as we know it originates from the industrial world, and thus, does not appeal to the younger generations. Who are the future leaders? The ones who have deep consideration of peoples’ values and priorities, and an ability to create environments which empower and provide grounds for self-actualization and development.

… workshops, and reflection.

Now that the participants got to hear how the speakers use values in their lives, it was time to delve into their own. The workshops were led by Malin Edshage and Anja Jensen from the company Selfleaders. It helps public and private organizations to become truly value-driven, by utilizing knowledge from motivational psychology and behavioral sciences. Malin and Anja shared an important study, which confirms that our level of satisfaction at work does not correlate with how well we know the values of our organization, but strongly relates to how aware we are of our own values. With the help of Self-Leaders’ own interactive app and group discussions, the two guided the participants through defining, prioritizing, and categorizing what is important to them: values which contribute to self-fulfillment, the ones which contribute to the greater good, etc. The day closed with the participants’ own reflections, shared in groups, and plans on what actions they would take to live the values they chose. Laura Barceló, a masters student, shares with us how she found World Values Day useful: “It is very difficult to reduce the benefits from the day to just one. I experienced so many different feelings during the event. From inspiration by the speakers, to sincerity and honesty with my peers during the workshops. I also realized aspects of my own life that I would never have thought about, which

are in fact pillars of my everyday life. But if I have to pick just one benefit, it is that I feel more self-aware. I have not changed my ideas or my mind in any way. I am the same. I feel the same. But I am more aware of it. This event has helped me see my daily life from a different perspective. Until now, I had never really thought about the importance that I, as a person, give to values, or how taking them into account when I make choices can change my life.” Many participants said they will definitely recommend the event to their friends next year.

Let us summarize!

Self-leadership starts with consciously building a solid foundation out of our core values. It progresses with selfawareness of our strengths, weaknesses, and passions. It culminates with selfmanagement, i.e. the ability to act in accordance to our values, utilizing our strengths, in order to achieve the greatest degree of self-actualization possible. Easy, right? In case you missed World Values Day, do not despair! Check out the initiative’s website and Facebook page for more information on workshops, events, and online tools to help you discover and live your own values! And join next year! •

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KI CAMPUS

The Stockholm RNA Club: where researchers and students meet chasesthlm.se

Would you like to work in the healthcare or life science sector? Are you a student or postdoc with a background in the health sciences? Then chase your dream job at the:

When: 9 March 2017, 09.00–17.00 Where: Aula Medica, Karolinska Institutet Careers in Health and Science Exposition

Arranged by:

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.se lm n! h t es atio s a str h c . egi w r ww ree F

By Emma Wagner Photo by Anny Truong

Fancy trying something new on campus? Well, we are here to introduce you to the Stockholm RNA club! We are a student-run group based at KI who aim to unite the RNA scientists across Stockholm, and encourage discussions and collaborations between students and researchers. Together, we hope to spread awareness for RNA research in Stockholm. Sounds interesting? Read on! RNA has been called many things; the origin of life, the cure for cancer, the key to understanding the brain, the list is endless. In reality, the beauty of RNA research is that it opens you up to a world of possibilities. In fact, according to the student holy bible, a.k.a Wikipedia, as of 2010 there have been thirty Nobel Prizes awarded for RNA research, and not only in Physiology and Medicine but in Chemistry too. It may come as no surprise that in Stockholm we have a huge number of high-calibre RNA research labs, focusing on topics including non-coding RNAs, RNA sequencing, CRISPR-Cas9 and computational RNA research. Now you may be asking, “how can students access this fine research?” Well, that’s where the Stockholm RNA Club comes in! Throughout the academic term we hold several events where students can meet Stockholm-based researchers. For those of you on Solna campus, we recently had the inaugural lecture for our ‘Lunch SemiRNA’ series. Held in the library, we invite students to join us over a nice sandwich and refreshing drink as local lab groups share their work and discuss their experiences in RNA research. These talks are perfect for those of you who may not be familiar with RNA biology, or perhaps are looking for topics for upcoming research projects and wanting

some more information. We plan on continuing this series in the new year, so be sure to look out for posters on campus detailing the next event! On the other hand, if you are unable to make it to our lunch seminars, or perhaps more interested in a specific area of RNA research, you may prefer our upcoming evening seminar series. More researchoriented, these talks will again be given by RNA scientists, both local and from abroad, but will give a more in-depth view into the research process, and also allow students to interact with researchers over drinks & snacks in our post-talk mingles. We will be announcing our first speaker in the coming weeks; so be sure to like our Facebook page, where we post informa-

tion about all our upcoming events- just look out for the black and white logo! Fundamentally, the strength of the Stockholm RNA Club is that we have students at every level as part of our board; from bachelor to post-doc. And so, whether you have a question about further education at KI, or whether a PhD or postdoc is the right career step for you etc., there is always someone who would be happy to sit down and discuss over fika - this is Stockholm after all! Finally, we at the Stockholm RNA Club are passionate about inspiring more students to discover the wonderful world of RNA research. This tiny molecule is destined to play a big role in the future; in therapies, genetic engineering, understanding human development, and even solve the mystery of the origin of life. Furthermore, we hope you have fun while exploring all the possibilities of RNA research in Stockholm. Still have questions? Feel like taking on a more active role in a society? We are always looking for new members to help reach our goals! If you’d like to get in touch with us just head on over to our Facebook page. In the meantime, we look forward to seeing you at one of our events soon! Vi ses! •

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KI CAMPUS

Flix – The all-girl student farce

in them, but now the audience is laughing.” “Sometimes the audience can request for omstart,” Caroline Rajala explained. Omstart is the Swedish word for ‘Restart’. “Then you have to perform again. Sometimes they request for omstart so often that you run out of songs and things to do. That’s when you have to improvise, and that’s probably the best thing you could watch as one in the audience and as a performer. We’re all down on the floor laughing.” Jacob Osbeck is in his sixth term in the medical program and is one of the directors of this year’s play alongside Iris Peña Arriarán who is in her ninth term in the medical program. Jacob stated that “This is the most fun part of the day. I’ve met so many people, and these people make me happy to the core.” When asked how he felt about directing an entire play and combining it with school, he had the same answer as everyone else. “It’s a lot but you learn to dispose your time accordingly. I have an exam tomorrow but I’m sure it will be fine.” The Flix members seemed more than content with their little group. At this point into the term, everyone knew each other and seemed comfortable around one another and the way their days were constructed.

medicor

Mary Stenvall who, like Sara herself, has been active from her very first term at KI, said that the end of the annual play would feel similar to a depression. “Post-spex depression,” she called it. “It feels like a break-up. You have all the time in the world all of a sudden. It feels weird without it.” •

Meet the members of this term’s spex “Den Unge Werther’s Original”

Jacob Osbeck - Director 6th term medical student Iris Penã Arriarán - Director 9th term medical student Caroline Rajala - Plays Werther 8th term medical student Yara Ghaziri - Plays Willy Wonka 1st term BMA student Mary Stenvall - Plays Goethe 4th term medical student She has directed for Corpus Karrolina alongside Sara Ström

Sara Ström - Plays Doctor Freud 8th term medical student She has directed for Corpus Karrolina twice before Daniela Kas Hanna - Plays Detective Mobitz 5th term biomedical student Louise Axelsson - Plays Albert 9th term medical student Siri Bugge - Plays Lotte 1st term medical student

Mathilda Björkman - Plays Charlie 1st term psychology student

By Sibel Ilter Photos by Katarina Stojanovic As a part of Medicinska Föreningen (MF), Flix is a student farce, commonly known as spex, made up by an all-girl ensemble from various programs at KI. The ensemble is routinely hand-picked at the beginning of every fall term, and whilst some faces are new and yet unknown within the MF world, there are also a handful of reoccurring ones that we see throughout the years, members of Flix which stay active from the first years of their program towards their last. Although the bigger commotion takes place under the fall term, finishing off the year with an annual play at “Teater Lederman” theater, the Flix group manages to stay active during the whole year. Usually, Flix is blended into an interplay with the corresponding student male-farce, Corpus Karrolina. During spring, Flix is active in helping out the male-farce with everything from scenery, costumes and choreography to organizing parties and get-togethers. But there is a lot more than service threading the two farces; during the rest of their time the two farces come together to sing at the different sit-downs and events arranged by MF throughout the year and prepare for the next season’s theme. 12

The true spirit of Flix is publicly presented at Teater Lederman at the end of every year. The play is presented several times over the span of five days, and every year follows a new unique theme. But the road to the ultimate goal is long and hard. Throughout the fall term, the Flix-members spend three days and sometimes – nearing the end of the term – even four and five, to rehearse and prepare for the play. And keep in mind that every occasion takes several hours, usually afterschool hours. Despite their time-consuming schedule, added with the load of their heavy school-work, members of Flix remain happy and positive to the idea of meeting every so often. “It is nice to come here and meet everyone. Everyone is the same, everyone are on the same basis and have the same conditions,” Sara Ström, a long-time member of Flix explained as we met them during their rehearsals one evening. “We’re out there in the world and we’re all very serious, playing adults. And when you get here... Sometimes you don’t want to go, but when you get here, everything lets go.” It was a feeling that a lot of them had in common. “It’s stressful but it’s worth

it. You just don’t realise it until you get here,” Daniela Kas Hanna agreed. Daniela joined Flix a couple of months ago in the beginning of fall semester. When asked why, she implied a great interest in the arts. “I’ve always thought theater and singing was fun, I just didn’t think I would have time. But then my friends forced me to apply. It did me good. I’m doing something totally different so it’s nice to find something else to do in an otherwise medicine-oriented school.” Yara Ghaziri felt the same. “I wanted to do something more than studying. When I auditioned there were so many people that were so good and I was scared I wouldn’t get a spot,” she said. “Now I’m here and these people are like my family now.” What seemed to drive these young women to such dedication and commitment were the different social events organised throughout the term. “The ‘Fyllerep’ was the best part so far. We pretty much drank and performed in front of an audience for the first time.” Although it was more fun than work, Louise Axelsson believed it did give them a lot more motivation. “When you rehearse you hear the jokes a hundred times and after a while you stop seeing the humour 13


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Science

Science

Science Snippets By Joanna Kritikou

A single gene that can cause autism Autism is a complex disease but researchers have found that mutations in only one gene can recapitulate the whole spectrum of symptoms found in autism. The team was working with children with Neurofibromatosis Type 1, a disease that causes tumors to grow along nerves. This condition is caused by a mutation in a single gene, called the NF1 gene, and has been associated with autism. After assessing the quantitative autism score in these children, they found that it was 13 times higher than in the general population, suggesting that a mutation in the NF1 gene does indeed cause autism. (JAMA Psychiatry, October 2016)

A virus that could reduce your desire to drink Alcohol is known to change the way information is processed in the brain, encouraging it to crave more alcohol. There are two main types of neurons in the striatum of the brain: D1 and D2. D1 neurons control “go” actions, which encourage behavior, and D2 neurons control “no-go” actions, which inhibit behaviors. Scientists used virusmediated gene transfer to manipulate the “go” or “no-go” neurons. By either inhibiting the “go” neurons or turning on the “no-go” neurons, they could successfully reduce alcohol drinking levels and preference for alcohol in mice. (Biological Psychiatry, May 2016)

Photo credit: Qimono (Pixabay)

Why frequent dieting is bad for you People who regularly go on diets tend to lose weight initially but bounce back and even gain weight after stopping the regime. This phenomenon is dubbed yo-yo dieting. In a new study, researchers mimicked yo-yo dieters in lab mice. They found that a change in body metabolism occurred in the yo-yo dieter mice, and they managed to figure out why. The microbiome has a hundred-fold more genes and enzymes than the body’s own cells, which are capable of digesting food and regulating metabolism. It turns out that changes to the gut microbes were responsible for the differences, including a reduction in the microbe diversity. (Nature, November 2016)

Beware of the ghost pepper People not being able to handle the spiciness of a certain pepper has for long been a go-to search on Youtube for some laughs. Unfortunately, one of the latest stories involving a spicy pepper was not so fun. A man ended up tearing a hole in his esophagus after eating ghost pepper paste. The ghost pepper is one of the top five hottest chili peppers in the world. It turned out that the chilly hadn’t exactly torn a hole in his throat but rather that his esophagus raptured due to intense retching and vomiting. So beware of these tiny spicy peppers! (Journal of Emergency Medicine, October 2016) Photo credit: Eli Christman (Flickr)

A lake under the sea While that is the last place you would expect to find a lake, the remotely operated vehicle Hercules took images of what appears to be exactly that, a lake under the sea, in the Gulf of Mexico. The water in the “lake within the sea” was found to be about five times more salty than the surrounding water. It also contains highly toxic concentrations of methane and hydrogen sulfide and can thus not mix with the surrounding sea. Needless to say, it is deadly for most organisms but researchers are looking at these lakes as a model for extreme habitats like outer space. (Oceanography, March 2016) Photo credit: Luis Deliz (Flickr)

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medicor

First egg cells made from stem cells This story might point to a fertility breakthrough since scientists have for the first time produced fully mature egg cells from mouse embryonic stem cells. The key question, of course, is whether these eggs are functional. The group showed that their eggs could be fertilized, implanted into a surrogate female and go on to produce live offspring. However it is important to point out that only a very small number of embryos created in this way developed fully to term. Besides, since this study was conducted in mice it leaves many things to still be optimized before the technique can be used in humans. (Nature, November 2016)

Private space exploration

Will SpaceX take us where no one has gone before? By Patrik Bjärterot Photo credit: SpaceX (Flickr)

SpaceX (Space Exploration Technologies Corporation) is a company that develops space rockets to send payloads, containing cargo or passengers, into space. SpaceX’s ultimate vision is to give people the opportunity to live on other planets, with Mars as the first goal. The company is currently working to land a spacecraft on Mars as early as 2018. The story of SpaceX began in March of 2002, when founder and CEO Elon Musk decided to pursue his dream of multi-planetary life. The mere 30-yearold entrepreneur wanted to change our relationship with space, so that perhaps, some day, space would be open for private travel.

Rockets could be built more cost-efficiently if more parts were produced by the same company We have all benefitted from the advances in travelling made throughout history, and in particular the last 200 years. The advancement of rail transport in the early 1800s started the competition to develop the best mechanical way to travel. The growth of commercial air travel following the Second World War is the latest development in this race. Companies like SpaceX are trying to continue this race, expanding the parameters of where commercial travel is now possible. If the companies are successful, we can hopefully all benefit from interplanetary travel in our lifetime. However, this calls for serious advancements in science and technology. The advancements of SpaceX comes from an epiphany Musk had before SpaceX even existed. Musk realized that the raw materials in a rocket were only worth about 3% of the unit itself, meaning that rockets could be built more costefficiently if more parts were produced by the same company.

SpaceX quickly evolved into a critically acclaimed company. It ranks 22nd on the MIT Technology reviews list of the 50 smartest companies and it has gained appraisal for its profoundly innovative ideas, such as the research about the reusability of space rockets. Within 14 years, the company has grown with over 4000 employees spread out in nine different offices and facilities in the United States. What makes SpaceX unique is that the company has been able to achieve viable results in such a short time. Only a decade after the company had formed, SpaceX successfully sent a spacecraft to the international space station. This resulted in a $1.6 billion contract with NASA to fly several cargo supply missions to the International Space Station. The collaboration with NASA gives SpaceX the help the company needs in order to pursue the goal of flying to Mars. Founder Elon Musk admits that without partnerships with entities like NASA, the story of SpaceX would look very different. “I feel very strongly that SpaceX would not have been able to get started, nor would we have made the progress that we have, without the help of NASA”, Musk said in an interview with the National Public Radio in 2012. The challenges that still await SpaceX are many. More tests must be done in order to calibrate the spacecrafts for optimal efficiency and safety. One of the greatest challenges is to make the spacecrafts completely reusable. To

achieve this goal, SpaceX still needs to create groundbreaking new parts for the rockets. These are advancements that rivaling companies like Boeing are already working on. The success of SpaceX has not been without setbacks. As recently as September 1, 2016, one of the Falcon 9 rockets exploded on the launch pad at the Cape Canaveral Air Force Station before take-off. The investigation pointed towards a breach in the cryogenic helium system, the fuel system that helps the craft reach different orbits. This was a very critical incident for the company as the satellite was supposed to bring Facebook to Africa.

Only a decade after the company had formed, SpaceX successfully sent a spacecraft to the international space station Despite these technical difficulties, SpaceX has been able to achieve a sustainable growth in both the number of employees and funds, which has given the company the ability to continue the journey into space, the final frontier. If SpaceX continues to make progress in the science of aerospace engineering, there is a great chance that the company will someday be able to achieve its goal of sending people to other planets. •

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Science

Science

The Pirate Bay of Science By Diana Čekatauskaitė Photo by Katarina Stojanovic The work of scientists is essentially a pyramid where new findings are supported by a coherent base of previous research. Therefore, scientists read (or at least skim through) dozens of articles a day. However, access to these articles is anything but cheap: it often costs up to 300 SEK per paper. While some scientists are lucky to be affiliated with wealthy institutions that can afford subscriptions (however, even the richest ones are now announcing cuts and expressing concerns about the affordability of scientific journals), tens of thousands of students and researchers often hit a paywall. Alexandra Elbakyan was one of them. Or at least until ‘Sci-hub’ happened. 48 million articles 1 click away

Ms. Elbakyan, a Kazakh neuroscientist working in Russia, was constantly fighting the hurdles to gain access to knowledge. In 2011, as a result of frustration and dire need, she created Sci-hub - a website that provides immediate, yet illegal access to virtually any research paper ever published. The system is ingenious in its simplicity. If a copy of a paper-in-need cannot be retrieved from LibGen, a pirated library that now hosts over 48 million papers, the paywall is bypassed in real time with a little help from other academics who have donated their credentials to support the open access movement. This is how a paper from such publishers as Springer, Sage or Elsevier gets delivered straight to the user in a matter of seconds. Once the search is completed, a copy of the paper is stored in LibGen forever, granting access to anyone at any time. With the site’s ever-growing popularity (19 million visitors worldwide and counting), Elbakyan perhaps rightfully boasts to have harvested nearly the entire content of the most paywalled publishers in the world. The extent of Sci-hub’s ac-

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cess to, quite literally, the world of knowledge is difficult to grasp. The system uses a set of credentials provided by people from different institutions. Therefore, in case of failure to obtain a paper at the first attempt, it simply switches to another key. As a result, the combined access the scientific community managed to obtain so far is probably greater than any individual governmental or academic institution that pays millions in subscriptions could ever have.

Revolutions never pass quietly

Before 2011, there was no way researchers could bypass paywalls automatically, so the problem was being solved manually. The practice, still actually wide-spread in the world, would involve emailing the authors directly, spending time on various forums for researchers or tweeting them with #ICanHazPDF, and hoping for their mercy to send the manuscript. This would take hours if not days of laborious work which could otherwise be spent in the lab or writing one’s own paper. While many academics praise Elbakyan for her work, calling her the ‘Robin

Hood of science’ or drawing comparisons to WikiLeaks’ Assange, the topic of open access is still very dividing among the scientific community. In addition to being regarded as an intellectual thief by some, she is facing a lawsuit by Elsevier on the grounds of “irreparable harm”. The publishing giant estimates that it is losing $150,000 per pirated article. Whether this money rightfully belongs to the publisher is a disputable question. While neither the reviewers nor the authors of articles get paid for their work, publishers invest a lot of money to ensure the integrity, quality and transparency of journals and employ editors, proofreaders and science communicators. Elbakyan, on the other hand, is still hiding in Russia and has no plans to take Sci-Hub down anytime soon.

Is it possible to break the vicious cycle?

However, regardless of whether most researchers support Elbakyan’s way of fighting for open access or not, the vast majority agrees that the system of scientific publishing is far from flawless. Publishers such as Elsevier report billions of dollars in income. However, unlike other creators of copyrighted material (such as artists and writers), none of the profits are shared with the researchers who publish in their journals. The reason why researchers would give away the result of years of hard work is, essentially, a self-enforcing cycle where academics are evaluated according to the number of publications in high-impact journals. Supporting the open access movement by no means entails rejecting the peer-review system. However, when the results of years of hard work (usually financed by public funds) end up behind nine locks (or paywalls, in this case), secluded from the public eye, it does indeed spark the question: Who is the ultimate beneficiary of scientific progress under these circumstances? Is it the publishers or the public? •

No one gets does:

me

like Siri

The rise of emotionally intelligent technology By Olivia Miossec

Words are only the tip of the iceberg when it comes to communication. The tone of your voice and your fleeting facial expressions are essential tools when expressing your emotional state and feelings. Current technology eliminates these elements, leaving only words and a collection of emoji to get your message across. And yet, what technology takes away from us, it sometimes willingly brings back in the form of artificial intelligence. Silicon Valley has found a solution to the problem it has created: emotion-recognition technology. With this, your phone or other devices can interpret your mood based on your facial expression or your physiological data. Say hello to Siri, your new therapist. Technology: Machine-learning its way into your heart

Imagine coming back to your home. You open the door and multiple wireless signals shoot through you. They measure your heart and breathing rate. These data are fed into a ‘router’ that interprets your emotional state: excited, happy, angry or sad. This ‘router’ is the current ‘baby’ of researchers at the MIT’s Computer Science and Artificial Intelligence lab. It is known as Emotional Quotient (EQ)Radio. This technology is made possible with machine learning. Through the collection and association of physiological and emotional data sets, the software can then be trained to predict a person’s emotional state based on their physiological data only. This innovative technology, however, is limited only to four emotions. To go beyond this, technology must be able to read our biggest emotion interface: our faces. This is the realistic ambition of Affectiva, another company borne out of MIT research. Their ‘emotion-sensing and analytics’ technology can read the subtle expressions on your face and translate these into accurate emotional insights. The software uses ‘deep learning’, a more complex form of machine learning. It

mimics the layers of our cortical neurons. It breaks down faces into pixels, analysing the facial expression in each, weighing the pixels against one another, and finally merging them into a single emotion. It can recognize subtle emotions we would not even notice. In our defence, we were not exposed to 3.9 million faces from over 75 countries as part of our ‘training phase’. In fact, our situation is quite the opposite. One study found that children who had spent five days with their smartphones were much worse at identifying various facial expressions than children who did not have access to their devices. So whilst technology is becoming more ‘emotionally intelligent’ every day, we are willingly letting ourselves be robbed of our innate abilities.

Emotion recognition: A doubleedged sword?

What is the point of such technology? In the case of the EQ-Radio, its creators believe it could be of great value in the healthcare setting. It could monitor a patient’s mood alongside other physiological parameters and thereby detect feelings of depression and anxiety, known to impede a person’s recovery. As for Affectiva, they have already vowed to help the

‘emotionally blind’ with their technology. Emotionally-intelligent devices could be a breakthrough for individuals on the autism spectrum who have difficulties with ‘reading’ other people. This is the current work of the organization ‘Autism glass project’ that uses Google glasses paired with emotion recognition technology. The glasses record and analyse faces in real time, providing the wearer with information about people’s emotions, thereby improving his or her read on the social environment. Whilst the study remains in its infancy, the results so far have been promising. Of course, these devices also have much less noble applications. At home, the ‘router’ could analyse your mood in response to certain commercials, movies or songs – and sell this data to companies. Similarly, if your phone can read your facial expression, it may transmit it to your friends and family to enrich connections, but it may also transmit it to corporations. Indeed, Affectiva already works in close collaboration with CBS and Kellogg’s. Your Google searches and WhatsApp conversations may be valuable assets to advertisers. But your emotions? That’s their holy grail. • 17


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SNUS Is it the holy grail of tobacco consumption? Story by Saket Milind Nigam

Photo by Saket Milind Nigam for Medicor 18

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Cover Story

All the fun without the fear of seriously damaging your health?

moist snuff (colloquially referred to as dip or chew). Steam-pasteurization results in a product that appears to be considerably safer than its fermented American cousin. Snus enjoyed immense popularity in Sweden all the way until WWI and WWII, when it was superseded by cigarettes. Intellectuals and the wealthy flocked to cigarettes and snus was left to Sweden’s blue-collar, working class. At the time (and up until the 1960s), the state had a monopoly on tobacco. With cigarettes in vogue, sale of snus had plummeted, prompting discussion to stop production altogether. Such a decision was held off until the US Surgeon General warned the world of the perils of cigarettes in 1968. This warning along with the introduction of pouched snus in 1973 prompted a grassroots movement that helped snus gradually find its way back into the pockets of Swedish men.

Nearly 10 years later, I’m still astounded by these statements. Could it be true? Have Swedes discovered the holy grail of tobacco consumption? All the fun without the fear of seriously damaging your health? It is only now that I’ve begun my open-minded investigation into the world of Swedish snus.

Despite overall tobacco consumption in Sweden being comparable to the rest of Europe, Swedish men have some of the lowest rates of lung, oral and pancreatic cancer - illnesses intimately linked to tobacco consumption. Foreign researchers termed this peculiarity the “Swedish Experience” suggesting that the decrease in smoking and adoption of a safer, healthier snus has led to this positive public health outcome unseen elsewhere.

An 18th century invention, the oral tobacco differs from the well-known American

Indeed, it takes a remarkable amount of scrutiny to uncover harmful side-effects

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of snus. It seems to have quite a favorable risk profile compared to the vast majority of other tobacco products in terms of cancer, oral lesions, cardiovascular disease, etc. Swedish Match AB - owning approximately 70% of the Swedish snus market hopes to bring this “Swedish Experience” to the rest of the world. “Our vision is to have a world without cigarettes,” notes Patrik Hildingsson (Vice President of Communications and Media Relations at Swedish Match). Mr. Hildingsson acknowledges that this vision is atypical for a tobacco company and takes pride in how Swedish Match has navigated the industry, research and politics. In a measure of corporate responsibility, the company has gradually been reducing its smoke-related product offerings without government or regulatory instruction. This includes an elimination of cigarette/ pipe products from their portfolio, an ongoing divestment of cigar holdings and the decision to air-cure tobacco leaves (for use in snus) instead of smoke-curing as the process of smoke-curing tobacco produces several hazardous constituents.

Swedish men prefer to use snus rather than smoke Today, only about 12% of Swedish men smoke while the rate is about 15% for women. Hildingsson believes that snus

Photo credit: Peter Knutson

W

ith the music thumping and speakers well on their way to a rattling, self-destructive end, I fought my way through the crowds of a posh Östermalm club. My cousin and his friends - too cool to dance - occupied a small corner in the back conveniently next to the bar. Their slim-fit jeans had been scarred by the outline of round, cylindrical containers. Moments later, one of them wrestled with his pocket eventually pulling out a canister of snus. “Do you want one?” Unfamiliar with the tea bags of tobacco and the unique tradition around it, I politely declined. What followed was a remarkable endorsement of the product: “no second-hand smoke”, “you can do it indoors!”, “you get that awesome nicotine buzz without any harmful side-effects” and “its way cooler than smoking!”

Photo credit: Peter Knutson

The ‘Swedish Experience’ (noun): An observation that switching smokers to snus may be an effective harm reduction approach.

Patrik Hildingsson

Prof. Lars Erik Rutqvist

Vice President of Communications & Media Relations at Swedish Match AB

Senior Vice President of Scientific Affairs at Swedish Match AB

has had a role in this relatively low prevalence; snus use is at ~20% and ~4% for Swedish men and women, respectively. In part due to tradition and culture, Swedish women have been slower to adopt snus. “The fact that we have relatively low lung cancer rates among men [compared to the rest of Europe], but not in women is a great indication of the value of snus,” argues Professor Lars Erik Rutqvist (Senior Vice President of Scientific Affairs at Swedish Match).

“I was flabbergasted and began to revisit all the things that I was taught in medical school” - Lars Erik Rutqvist Professor Rutqvist, a Professor of Oncology and former Head of the Department of Oncology at Huddinge University Hospital & Karolinska Institutet joined Swedish Match 10 years ago. During his medical training, the dogma was that smoking causes lung cancer and oral tobacco causes oral cancer. When research began to come in on snus, it appeared that snus was not associated with any increased risk of oral cancer. “I was flabbergasted and began to revisit all the things that I was taught in medical school,” recalled Rutqvist. As a result of these findings, the EU allowed removal of cancer warnings from snus packages in 2001. They now

sport a much milder, general warning on health and addiction. “Yes, there is no oral cancer risk, but there can be other oral, dental issues,” notes Professor Hans Gilljam (Department of Public Health at Karolinska Institutet). Gilljam is a trained surgeon and has spent over 25 years in pulmonary medicine. Notably, he is the only physician in Sweden working full-time on tobacco prevention and has been a strong voice in public health policies regarding tobacco. When faced with a patient who is contemplating using snus to quit smoking, Gilljam has a two-fold response: “As a physician, I leave it up to [the patient], but as a public health advocate I can never recommend one poison over another.” Instead, Dr. Gilljam would advise his patients to turn to nicotine gums and patches as there are still some safety concerns with snus. Gum disease and exposed dental roots aside, Professor Gilljam points to a few reports of more serious health risks of using snus. He cites peer-reviewed studies indicating heightened risk of pancreatic cancer (though these studies have been subject to considerable scrutiny). While there is no increased risk of myocardial infarctions, the severity of heart attacks (e.g. death from heart attacks) appears to be increased. Heavy users (i.e. consuming more than 4 canisters of snus per week) have 2-3 times increased risk of develop-

ing type II diabetes and women who use snus during pregnancy may put the fetus at risk of developing malformations like cleft palate. Professor Gilljam concludes that while smoking is public enemy number one and equates burning cigarettes to creating a “chemical factory inside your body”, there is still a lot left to learn about snus before incorporating it into a public health strategy.

Although science shows snus to be safer than smoking, there ARE some concerns that we should be aware of Instead, Professor Gilljam advocates for following the WHO/SCTC framework. This 38 article document outlines a recipe through which we can beat the smoking epidemic in a decade or two. Central to this is an initiative that Gilljam is heavily involved with: ‘Smoke-Free Sweden 2025’. Importantly, this initiative does not involve snus at all, because “there is little evidence that snus is an effective harm reduction tool.” Notably, in a 2003 issue of the Journal of Addiction, Gilljam presented original research that indicates that snus use is a very minor “component of smoking cessation at the population level.”

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...as a public health advocate I can never recommend one poison over another.” - Professor Hans Gilljam

Prof. Hans Gilljam Department of Public Health at Karolinska Institutet A looming concern is the nicotine in snus. Although nicotine itself is not particularly dangerous at the concentrations found in tobacco products, it can certainly cause addiction. The absorption of nicotine into plasma from snus is slower than with cigarettes, but ultimately enters in rather large quantities. This can prove quite addictive and complicate the process of quitting tobacco. For example, of Swedish men who have used snus as a tool to quit tobacco, around 2/3 have found themselves continuing to use snus for the remainder of their lives. Moreover, the fear of attracting new tobacco users (rather than simply converting smokers to snus) is a concern that is likely fueling the EUs resistance to snus. Although Sweden (and non-EU neighbor, Norway) has no ban on snus, there is a sales ban in place across Europe throwing a serious kink in Swedish Match’s expansion plans. It appears that this ban is completely political/historical rather than evidence-based.

Why is there a sales ban across the EU? In the 1980s the US Smokeless Tobacco Company tried to set up operations in the UK to sell American snuff. Their marketing efforts were quite aggressive and appeared to target adolescents in particular. The ensuing public outcry and parliamentary debates led to a request for the com22

pany to tame their marketing strategies. When the US Smokeless Tobacco Company ignored these requests and continued to market to adolescents, the British government issued an outright ban on the oral tobacco product. Upon entry into the EU, the UK brought the ban with them and it became a part of the EU Tobacco Directive of 1992. Under vague definitions, the directive banned the use of tobacco unless smoked or chewed. When Sweden entered the EU in the mid-90s, it appeared that snus would fall into the list of banned substances. In a small, but meaningful victory for Swedes, an exemption to the snus ban was granted due to the popularity of the product in Sweden. Though Swedish Match has been fighting to lift the EU ban on snus, Professor Gilljam believes it is unlikely as there is limited consumer awareness/demand for the product: “snus has [already] seen its best days, but who knows.” Swedish Match, of course, feels otherwise and Mr. Hildingsson points to the tumultuous progress that they have made in EU courts as success and hope. This includes the 2001 decision which allowed Swedish Match to market snus without a cancer label. A 2004 appeal led to failure when the EU defended the snus ban on the basis that snus was a new product to the EU market. A subsequent directive in 2014 reinforced the ban on snus, but surprisingly allowed the sale of new products like ecigarettes.

“This ban is completely incomprehensible, inconsistent,” pipes Professor Rutqvist. Together with the 1992 directive, a number of dangerous (e.g. Asian and African oral tobacco products, which are chewed) and less-studied products (e.g. e-cigarettes) can now enter the EU market, but Swedish snus is left in the dark. Rutqvist adds that “this ban is discriminatory.” He believes that if snus was a French or German product, it would not be banned. But because Sweden is a small country and the product is niche, snus is facing unjust opposition. Mr. Hildingsson clarifies: “imagine if you love and allow alcohol, but ban only German beers.”

of American snuff would result in a great reduction in oral cancer as well as reducing cigarette smoking”. The final decision has not come through yet, but the initial responses are promising for the Swedish snus industry. Hildingsson notes that the “FDA in the US has received the science of snus in a way that Swedish authorities have never done”

“Our vision is to have a world without cigarettes” - Patrik Hildingsson

“There is little evidence that snus is an effective harm reduction tool ” - Hans Gilljam

The frustration is palpable and shared by many in Sweden. Swedish Match has filed another complaint in May of this year to get their case reviewed again in EU court. On the other side of the pond - in the US - the situation for Swedish Match’s expansion efforts seems better. Not only is there no sales ban, but the US Tobacco Control Act signed by President Obama in 2009 includes special provisions which would allow certain products to be classified as harm-reduced products. Swedish Match has applied for these provisions arguing that “using Swedish snus instead

The topic of harm reduction programs is often considered controversial. Abstinence-only advocates believe that such programs enable continued use, but proponents point to successful programs (e.g. needle exchange).

Although Professor Gilljam is in favor of some harm reduction programs, he is weary of whether snus should be used as one. He argues that when needle exchange programs were introduced, they were dealing with pressing, life-threatening conditions like HIV/AIDS. “At the time, it was life or death in a very short time.” This is quite different compared to tobacco where the effects are not as immediate. “You may have to smoke 25 years or use snus for 30 years to see the adverse outcomes.” He argues that this should

certainly factor in to the cost-benefit analysis of implementing any harm reduction program. Gilljam, who advocates for use of nicotine gums and patches, does not view these as traditional harm reduction tools. In his mind, gums and patches are more of cold-replacement products designed to get individuals to quit smoking. “Nobody becomes an addict from patches or gum use.” He acknowledges that some reputable researchers have pushed the notion to use snus as a harm reduction strategy, but this has really “disturbed the harmony among tobacco prevention advocates.” Swedish Match, meanwhile, is sticking true to their vision and plans of expansion. If they manage to get a modified risk classification in the US, they believe it will open the doors to education, research and meaningful discussions on snus - something that has been limited in the EU. Central to the discussion of snus as a harm reduction strategy is not simply whether the “Swedish Experience” is real, but whether it’s translatable. In other words, although Sweden saw a surprising drop in tobacco-related illnesses during the same time-frame as when tobacco users turned to snus, it is not clear whether other countries will see the same effect. Professor Gilljam contends that snus advocates “have never fully admitted that [Swedes] smoked less to begin with”. In-

Photo credit: Katarina Stojanovic for Medicor

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deed, Swedes generally live healthier lifestyles and may have a set of genetic and environmental factors that distinguishes them from others. Moreover, countries like the US, have been rather successful at rapidly reducing smoking prevalence without introducing a new product on the marketplace. Gilljam points out that the Swedish reduction rate is not particularly notable - trailing several countries including the US and the UK.

Swedish Match and Prof. Gilljam envision a world without cigarettes, but advocate different approaches to get there Still, Swedish Match believes snus has the potential to break through the plateau in smoking prevalence and help in the quest to create a smoke-free society. With its rather favorable risk profile and convenience to users, it is understandable why so many around the world want to see snus hit the shelves. Whether snus is the holy grail of tobacco consumption remains to be seen. To some it may be a savior while to others it represents a dangerous detour. Whichever side of the coin you fall on, perhaps we can all agree that the tea bags of tobacco belong in your mouth or the trash - not the floor of the club. • 23


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Global Mental Health

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Global Focus

Hi there! Hi there! Do you want to develop Hi there! Do you want to develop science and health care? Hi there! Do you want to develop science and health care? Do you want to develop science and health care? science and health care?

At Innovation Office we help students with ideas within medicine and health. A mobile application, a care program or a medical device – we have the competence to take your idea to innovation. All of our services are available free of charge. Visit us in Aula Medica, Campus Solna or at ki.se/innovationoffice. At Innovation Office we help students with ideas within medicine and health. A mobile application, a care program or a medical device – we have the competence to take your idea to innovation. All of our services are available free of charge. Visit us in Aula Medica, Campus Solna or at ki.se/innovationoffice. At Innovation Office we help students with ideas within medicine and health. A mobile application, a care program or a medical device – we have the competence to take your idea to innovation. All of our services are available free of charge. us in Aula Campus Solnaand or athealth. ki.se/innovationoffice. At Innovation Office we helpVisit students with Medica, ideas within medicine A mobile application, a care program or a medical device – we have the competence to take your idea to innovation. All of our services are available free of charge. Visit us in Aula Medica, Campus Solna or at ki.se/innovationoffice.

Photo: Jingcheng Zhao Photo: Jingcheng Photo: Zhao Jingcheng Photo: ZhaoJingcheng Zhao

By Ronan McCabe

The cliché of globalisation has harkened to the dawn of a new age in Global Health. Once restricted to the area of infectious, or communicable, diseases other areas of affliction have since come to the fore. One of the most recent and underrepresented is that of mental health. The field of Global Mental Health soared to the top of the Global Health initiative in 2007, where it garnered unprecedented attention and was imbued with a new sense of urgency. Behind the stir of 2007 was a series published in the Lancet journal in September of that year. The series highlighted the inequity, injustice, and suffering that prevails over mental wellbeing globally. It is thought that up to 450 million people suffer from a mental illness worldwide with nearly 1 million suicides each year. Mental disorders account for 14% of the global disease burden and constitute 4 of the 6 main causes of years lived with a disability. Along with both social and economic costs, those who suffer are often subjected to discrimination, stigmatisation, and abuse that in many cases amount to a total disregard of human rights. The most striking inequity, often referred to as the ‘treatment gap’, is that despite being home to 80% of the world’s population, only 20% of mental health resources reside in low- and middle-income countries. The focus of the field has not been on closing the treatment gap, because it has been encumbered by a more fundamental conflict – how do we understand mental health? Global Mental Health has been shaped by a historic conflict that emerged a number of decades prior.

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This conflict concerns two differing perspectives: universalism and relativism. Universalism takes the view that our common biology translates into a universal experience of disease i.e. depression has a biological mechanism and expression that is the same across differing cultures. Relativism proposes that, mental illness is both experienced and expressed relative to the surrounding culture i.e. depression has a biological mechanism that is the same across cultures, but its expression shows clear variation.

“Despite being home to 80% of the world’s population, only 20% of mental health resources reside in lowand middle income countries.” The two viewpoints manifest as opposing stances on how health issues are approached. The former focusing on a mechanistic cure, while the latter focusing on preventative environmental strategies. But the two perspectives need not be mutually exclusive; would it not make sense to draw from both views and take into account cultural setting when devising a medical intervention?

The convergence, while constructive, is not and will not be a smooth one. While a biomedical definition of disease can ‘legitimise’ a sufferer’s illness, a big question remains over how biology meshes with local culture. If a schizophrenic person is seen as cursed by spirits how do practitioners engage in treatment and post-treatment rehabilitation? It is hard to say if any other significant gains have been made since 2007. The Lancet series was immensely positive in attracting attention and funding in support of continuing projects and interventions in low- and middle-income countries. It has also bolstered research in the area. Despite this, partly due to the invisibility of such diseases, there remains persistent governmental apathy and disproportionate underfunding. More work is needed to remind both governments and their populations that significant suffering can also manifest in apparently less ‘physical’ forms, and that this has a great impact on the overall all wellbeing of a society. Hopefully as the conflict converges within the field, minds will be concentrated on improving the situation. Because, as the saying goes, ‘there is no health without mental health’. •

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Global Focus

Global Focus

Antimicrobial resistance: the neglected global crisis

Our antibiotic abuse has consequences By Alexandra Edwards Henriksson

Photo credit: Thomas Picard

Since the deadline for the Millennium Development Goals back in 2015, the United Nations (UN) has presented a new set of global goals which, much like their predecessors, ultimately seek to eradicate hunger, disease and poverty in the world. The U.N. hopes to achieve these goals - collectively known as the Sustainable Development Goals (SDGs) - through the joint effort and commitment from all the world’s nations. Needless to say, the extensive project is every public health worker’s dream, and, unsurprisingly, served as the focus for Global Health Night this year. As wonderful as it is to see nations from all corners of the world working together for a brighter, more sustainable future, one thing stands out: why did they omit antimicrobial resistance (AMR) from these goals? “The threat of antibiotic resistance is increasing day by day. If left unchecked, it has the capacity to turn the clock back on medicine by a hundred years”. With these words, the European Commissioner for Health and Food Safety, Vytenis Andriukaitis, expressed deep concerns over the development of antibiotic resistance - and rightly so. AMR is on the rise and threatens all the world’s nations. If our antimicrobial drugs fail to target pathogenic microorganisms, the significant medical progress made this past century will no longer be at our disposal. Not only could common, currently treatable infections once again be fatal for us, but we could easily contract lethal infections during simple surgeries. It will have a particularly devastating effect on immunocompromised individuals, including cancer patients undergoing treatments such as chemotherapy, radiation, transplantation or surgery.

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The sheer thought of the detrimental impact it would have on the world is nearly inconceivable to the point where we refuse to even see it is a plausible outcome. We cannot be heading back to a time where you could die from a cut, it feels absurd. But the truth is that it is fully possible. In fact, it is currently happening.

“The threat of antibiotic resistance is increasing day by day. If left unchecked, it has the capacity to turn the clock back on medicine by a hundred years.” With more and more multidrug and extensively drug resistant microbes emerging and the recent discovery of bacteria resistant to last-line antibiotics (the “last resort” antibiotics, used when all others have failed), the AMR crisis is reaching its peak. In parts of Indochina, parasites have developed multidrug re-

sistance to the last-line antimalarial treatment, Artemisinin-combined therapy. Although AMR was always an inevitable consequence of antimicrobial drugs, the misuse and overuse of the drugs are responsible for the rapidly rising number of resistant microorganisms worldwide. In some countries around the globe, antibiotics can even be obtained over the counter and, as a result, these countries express high rates of antibiotic resistance. To combat this issue, public health agencies have been working hard to inform the public about the dangers of abusing antibiotics. Still, many individuals are not aware of the crisis. This is heavily due to the furtive nature of AMR, which, unlike outbreaks, does not draw the immediate attention of politicians and the media. The World Health Organisation (WHO) recognises that AMR is a global threat that endangers the achievement

of the SDGs. In a report from a meeting at the WHO headquarters in Geneva on 23-24 November 2015, the Strategic and Technical Advisory Group on antimicrobial resistance (STAG-AMR) “reflected the importance of connecting antimicrobial resistance to the Sustainable Development Goals (SDGs) so that AMR can support the SDGs and vice versa”.

“We cannot be heading back to a time where you could die from a cut, it feels absurd. But the truth is that it is fully possible. In fact, it is currently happening.” However, AMR not only interferes with the WHO’s role in the SDGs by jeopardising good health and well-being (the third goal); it also affects economic growth (the eight goal). A research project conducted by the RAND Corporation estimated a total loss of 100.2 trillion USD by 2050 due to AMR.

since it represents a major part of circulating antibiotics in many countries. In fact, an appalling 70% of antibiotics sold in the United States are estimated to be used in agriculture. Taking this into account, it is not surprising that AMR has reached such distressing proportions. The measures that nations are willing to take to combat AMR vastly differ, making it difficult for a global health agency such as the WHO to set common rules and goals for everyone. This discrepancy might be the root to why AMR was left out of the SDGs.

At the end of the day, it is up to all national governments to cooperate with public health agencies and realise that it is worth investing in the fight against AMR. We may be left wondering: for the sake of everyone’s health and to ensure a sustainable future, should global health agencies be given the power to force certain regulations upon countries? •

While this does not imply that the WHO is not taking action against AMR, the organisation does not have the authority to regulate the use of antimicrobial drugs; it is limited to offering guidelines for the nations.

With this in mind, AMR could not possibly have been deemed not important or relevant enough to be a target for the SDGs. I can only think of two reasons for their neglect: either we have reached a point where the damage caused by AMR is irreversible (and therefore no sustainable goal can be set by 2030), or the nations could not agree on the regulation of antimicrobial drugs consumption (and therefore did not get to be part of the SDGs). The first, grim explanation entails that AMR borders on a lost cause. After all, it seems like the situation is spiralling out of control, even after all the measures taken by public health agencies to improve the situation. But even if we cannot reverse AMR levels to how they once were, we do still have the opportunity to put the brakes on it.

“The use of antibiotics in agriculture plays a decisive role in AMR since it represents a major part of circulating antibiotics in many countries” Since the beginning of the new millennium, the EU has worked on phasing out the use of antibiotics in animals by banning the addition of antibiotics used in human health to animal feed, as well as the use of antibiotics as growth promoters in animals. The use of antibiotics in agriculture plays a decisive role in AMR

Infographic credit: The Review of Antimicrobial Resistance, Chaired by Jim O’Neil, UK, 2014

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Global Focus

Global Focus

On his actions

What will Donald Trump do with Healthcare and the Environment?

By Zach Chia

On November 8th the world woke up to the news that Donald Trump had won the US Presidential Election. From January 20th 2017, the world’s lone superpower will be led by a real estate tycoon, turned one-time TV celebrity and now novice politician. American media is awash with one of two emotional narratives: shock, horror, fear followed by rebellion or relief, excitement, hope followed by expectation. Both sides hear noises instead of listening to voices. We can only hope for that to change. As price takers, we can only deal with the facts and the reality of the result. Just prior to the election, the Trump campaign released a pledge on what a President Trump would do in his first 100 days of office. Among his claims are a number of dramatic ones on healthcare and the environment. We look at the promise versus the practice, what will happen now?

On The Paris Agreement and Climate Change Trumps actions on climate change seem to be aimed at pleasing both political spectrums. In an interview with the New York Times, Trump agreed that humans may play a role in global warming, a departure from his previous pronouncements. This was followed by meetings with climate change activists Al Gore on 7th Dec and the appointment of climate change sceptic Scott Priutt as the new head of the Environment Protection Agency 8th Dec. Trump’s stand on the Paris Agreement seems clearer. “President Obama entered the United States into the Paris climate accords unilaterally, and without the permission of Congress. This agreement gives foreign bureaucrats control over how much our energy and how much we use right here in America… No way… We’re going to cancel the Paris climate agreement and stop. Unbelievable.” - 26 May 2016

medicor

International agreements go through two stages, a signing stage where the negotiators sign the agreement as being acceptable to the nation and a ratification stage where the national governing body approves this agreement. Until the agreement is ratified, the nation is not obliged to act. The Paris Agreement comes into force once economies amounting to 55 % of the world’s total greenhouse emissions have ratified the agreement. This was achieved on 4th November 2016 with 111 countries ratifying the agreement. The current tally is 75 % of world greenhouse gases. Major emitters, United Kingdom and Iran are also expected to ratify the agreement by the close of the year. Legal terms of the agreement dictate that a signatory cannot pull out within 4 years although the new administration wants to extricate the US from the agreement as soon as possible. Included among the signatories are China, India and most EU countries. As such, even if the US pulls out the Paris Agreement, the agreement will still move ahead without the US.

On payments to UN for climate change programmes (Green Climate Fund) “…cancel billions in payments to U.N. climate change programs and use the money to fix America’s water and environmental infrastructure.” - Oct 2016 The Obama administration pledged to give 3 billion US$ to the UN’s Green Climate Fund (UNGCF); 500 million US$ have already been disbursed. UNGCF is a fund within the UN Framework Convention on Climate Change set up in 2010 to help developing countries adapt and mitigate practices to counter climate change. UNGCF planned to raise 100 billion US$ per year by 2020. However, the scheme

has been plagued by the question of who is paying the money and actual enforcement on the ground. This fund has also failed to ban the use of fossil fuels. This omission opens the possibility of the money being used on fossil fuel projects. Since its introduction in 2016, constituent European nations have pledged 4.7 billion US$, while the US has pledged 3 billion US$. This accounts for most of the funding to the UNGCF. The bulk of funding was hoped to be raised by private companies, however that has not been forthcoming. With the flaws UNGCF is beleaguered with, there is little reason to believe that the money would be used appropriately even if they goal were reached.

force companies above 50 employees to provide health insurance. Arguments against Obamacare include the fear that it would lead to massive job loss and over intrusion of the government into the affairs of private businesses and individuals. Since the implementation of the act, the number of uninsured people has dropped by 5-10 % of the population. Should the bill be repealed, 22 million people will lose health protection. Obamacare is, however, flawed in implementation. The take-up rate has been lower than anticipated, leading to many insurers pulling out. Health insurance works on the basis of risk pooling - by insuring more people and assuming the risk of an illness follows expected occurrence rats, the risk of illness is spread out and the financial burden on each individual is lessened. Less people, particularly the young and healthy, signed up than expected. This means the proportion of high risk individuals increases and the risk each company bears is greater. This decrease in insurance suppliers has therefore led to an increase in premiums for those who remain on the schemes and who sign on later. Also, the ‘carrots and sticks’ are just not big enough to encourage some companies to take up the scheme, choosing instead to pay a fine. This bill will be struck down as the Republican party now controls Congress, and the Presidency. Trump suggested a U-

turn in interviews immediately after the election. Yet, on a victory tour to his supporter base Trump insisted that the whole act would be repealed. It remains to be seen what will replace the existing act and if the desire to retain the best parts of the act will remain and if so, how.

On Childcare and Eldercare “Affordable Childcare and Eldercare Act. Allows Americans to deduct childcare and elder care from their taxes, incentivizes employers to provide on-side childcare services, and creates tax-free Dependent Care Savings Accounts for both young and elderly dependents, with matching contributions for low-income families.” - Oct 2016 This is perhaps the most non-controversial of the healthcare promises Trump has made. By allowing tax deductions on childcare and eldercare, this scheme could alleviate the financial burden on workers. If the incentives given to employers are strong enough, this could better foster family-friendly work cultures in the American workplace. In simple terms, this act would allow money to be put aside by a working adult for their children or parents without the burden of taxation on the interest earned. Individuals who can pay their own medical bills would in turn depend less on the government. This would, in effect, shift

the cost of healthcare from the government to the individual. Over the long term, the healthcare toll on the economy as a whole could drop as individuals take on the financial responsibility of paying for their own medical treatment. With enough take up, this could decrease the current expenditure on healthcare. The US currently spends 17 % of its GDP on healthcare, the OECD average is 8.9 %. However, healthcare problems are more than legislative and include social, cultural and economic factors. Problems that a singular bill cannot solve. So while this bill essentially shares the health bill with the population, it might not have the intended effect of decreasing the proportion of GDP spent on healthcare. The US is the only major economy, and one of 7 countries worldwide, to not require employers to give paid maternity leave to staff (although it should be noted that many companies do give maternity leave as part of health benefits). The US government requires employers to give 12 weeks of unpaid maternity leave with guaranteed job security instead. Based on the wording of the proposal there is no reason to believe that official paid maternity leave would be introduced. Still, the Childcare act could be a scheme that would please both employees and employers in the US (who have lobbied against maternity leave). •

On Obamacare “Obamacare is a disaster, it’s a disaster. Obamacare is going to be repealed and replaced with something so much better. So much better. So much better.” - 30 Nov 2015 “Yes [we will maintain coverage for people with pre-existing conditions] because it happens to be one of the strongest assets, also with the children living with their parents for an extended period we will very much try to keep that. It adds cost, but it is very much something that we will try to keep.” - 10 Nov 2016 Obamacare is a federal act that attempts to improve the ability of an individual to purchase medical insurance. This targets 15 % of the population that cannot afford any form of health protection. It prevents discrimination against individuals due to sex, age or pre-existing medical conditions. At the same time, it provides subsidies to the poor to enable them to afford health care coverage. Some of these are done through legal requirements that

Anti-Trump Protest in San Diego, 16th Nov 2016 Photo: Zach Chia for Medicor

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Culture

Global Focus

The Global Health Night

- Of goals and challenges

By Zach Chia The United Nations came into existence on 24th October 1945. Article 1 of the UN Charter spelt out four main purposes: 1) Maintaining global peace and security. 2) Developing inter-governmental relationships on the basis of equality. 3) Enabling international cooperation in economic, social, cultural and humanitarian sectors. 4) Being the main coordinating centre for achieving all these goals as well as promoting human rights and fundamental freedoms. Among the specific ways to achieve the goals of the UN is to focus on the health situation of the world - Global Health.

TEDx talks: the #1 place we go for inspiration and fresh perspectives. But listening to the talks live is a much richer experience than seeing them online, as our Medicor team realized.

Building on the introduction of the new Sustainable Development Goals (SDGs), Global Health Night 2016 introduced 4 speakers from government, NGO, academia and frontline healthcare to share their experiences and inspire the next generation of global healthcare providers.

Global Health Night was well attended with over 1000 attendees at the Aula Medica. Moderated by executive officer at UNAIDS in New York, Dr Josefin Wiklund the session saw talks by Assoc Prof Helena Nordenstedt an former MSF volunteer and academic focusing on global infectious disease management, Dr Christopher Benn executive director of the Global Fund, Prof Anna Mia Ekström an infectious diseases prevention academic and Dr Anders Nordström former acting Director General of WHO and presently WHO country representative to Sierra Leone. All except Dr Benn were KI alumni. 30

By Teodora Petrova

Photo credit: Dia Hedvegi, TEDx

Crossroads: the beginning of every direction. Ideas, born at the intersection of views, perspectives, and approaches. This was the topic of this year’s TEDx Stockholm event, which featured nine talks and performances that all lived up to the slogan “Ideas worth spreading”.

Inspired by the date and event, the second Karolinska Institutet Global Health Night was organised on 24th October 2016.

The SDGs are a combination of the precursor Millennium Goals – eight development goals that were targeted to be completed by 2015, and the Rio+20 Conference Resolution – focusing on development that was environmental and sustainable. The SDGs were officially launched in September 2015 with 17 key items (see infographic).

TEDx Stockholm: Crossroads

Infographic: United Nations Sustainable Development

While it was easier to be politically correct the speakers, to their credit, were open and honest on the joys, challenges and pitfalls in planning and implementing global change. They touched on sensitive topics such as political considerations when making decisions and cultural or social problems affecting sometimes simple solutions. Dr Nordström brought up the example of Sierra Leone. It is easy to speak of decreasing doctor-patient ratios; the answer is straightforward - train more doctors. But when the basic training of individuals at the primary and secondary level is lacking, how does a system even find the people to be trained to be doctors? Proceeding from the talks was a robust question and answer session in which the academic, government and civil society positions on how to effect change were sometimes in conflict. An innocuous

question led to an informative exchange between Drs Benn and Nordström over the role of politicians versus public servants. The frank exchanges gave the audience a more accurate picture of the challenges in global health management. Even the SDG is not perfect (see AMR The Neglected Global Crisis). But this is an important step forward and closed the night on an empowering note - there is so much more to do as a united world to improve global health, how can we delay any longer? •

“Crossroads” was TEDxStockholm’s 25th and largest event up-to-date. The team, consisting only of volunteers, worked for ten months to create an immaculate event on every level: from the choice of venue (Münchenbryggeriet) and speakers to the production, organization, and audiencespeakers interactions during and between the talks. No wonder the tickets were sold out completely! The event was not just thought-provoking, but an emotional rollercoaster from start to finish. “Crossroads” collected the diverse expertise of authors, musicians, scientists, a choreographer, and a journalist in original talks, aided by clever use of visual and audio materials. Who better to kick off the talks than TEDxStockholm veteran David JP Phillips, the speaker behind “Death by PowerPoint”? This time, he demonstrated the power of storytelling. Storytelling evokes a cocktail of dopamine, oxytocin, and endorphins in our brains, and makes us focus, bond, and laugh. David was only the first of many to highlight how emotions connect us and help us communicate. What comes to mind when you hear “photography for the blind”? Truls Nord pre-

sented his extraordinary concept, which makes visual arts accessible for those who often feel excluded. Tactile photography makes it possible to experience colors, light, and the atmosphere of an image in a way that was never imaginable: by touch. Performance arts were a big part of the talks. The “E” in TED stands for entertainment and as choreographer Alexander Ekman explained, entertainment means “to hold your attention”. He certainly did. Alexander demonstrated how he creates magic on stage every day and deservingly received, what he calls, “a total success standing ovation”.

“Ideas can be born where different roads meet” - Anna Olin Julia Romanowska explored art-based leadership training, while Cleo, a Swedish rapper, famous for her feminist themes, had the audience sing along. Jurgis Didžiulis, no stranger to giving TEDx talks and “a fun-junkie”, used a variety of musical techniques to show how to involve spectators into any idea through fun. KI enjoyed strong representation among the speakers. Emma Frans, epidemiologist and prominent blogger, talked about using the scientific method to battle misinformation in the media. Eva-Karin

Gidlund, who works in molecular exercise physiology, put a new twist on the benefits of exercise and suggested how to trick your brain into believing exercise is fun. Finally, no one could have tackled the topic of immigration better than Milene Larsson, senior producer and reporter for Vice Media, UK. She talked frankly, but without sparking controversy, about “the deadly paradox of EU’s immigration policies”. Milene focused on the question “Are boundaries necessary to define identities?” and reminded the audience that borders are man-made and, as seen in history, not fixed. “Surprising”, “energizing”, “eye-opening”, “captivating”, “magical”, “10/10” were the one-word reviews our team got from audience members during the mingles. Props went to the venue, the moderator Anna Olin, and the Xperience Corner. The latter was a new concept, where people were able to try virtual reality, the tactile photography mentioned earlier, and more during the breaks. Keep an eye on Facebook (@TEDxStockholm) or YouTube (TEDx Talksfor the recorded talks. Get ready for an absolutely justified, highly inspirational and fun binge-watch session! •

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Culture

Social media - keeping it real? By Marianna Tampere As the use of social media has become an inseparable part of our daily life and communication, let’s take a glance at our online habits. To describe my (and perhaps your) regular wake-up routine, it starts with a pilgrimage-like scroll through the holy trinity of social media – Facebook-Instagram-Twitter, followed by an international news site. Way before my morning coffee, I see jaw-dropping beach pictures from a blogger that I follow, I see a mouth-watering avocado sandwich my friend from Munich has had for breakfast and I see how perfectly romantic the 6-month anniversary date of this girl I’m not even really friends with was. The daily amount of information we receive about other people’s lives from social media is immense, calling for the question: “How does all this affect us?”

The truth about false impressions

If one would try and characterize Instagram pictures with a common phrase, it would most likely be “Something nice is happening in the picture”. Indeed, the majority of social media posts depict a positive situation or life event. Glammedup selfies, DIY decor or the latest coffee break, a successful job interview, a happy reunion with old friends or a scenic travel photo, you name it! As long as it has a positive vibe, it is the perfect Instagram material. While the likes are adding up, we must acknowledge that people are more prone to share the positive aspects of their lives than the negative, which automatically fuels an idealized perception of the real-life world. They say there is an Instagram version of you and a real version of you. Researchers at the University of Pittsburgh School of Medicine recently studied the impact of social media habits on the mood of the users. They reported that the exposure to highly idealized representations of peers on social media elicits feelings of envy as well as the distorted belief that others lead happier, more successful lives. These imaginary impressions might potentially create the so-called FOMO, “fear of missing out” 32

(yes, it is a widely used phrase!). Seeing pictures of your peers hanging out at that cool karaoke bar having “the time of their lives”, while you are doing laundry and watching cat videos does not necessarily boost one’s self-confidence.

They say there is an Instagram version of you and a real version of you What happens if we stay realistic?

Stina Sanders, a successful UK-based model who used to post stunning images, decided to do an experiment. She got challenged by the Daily Mail to quit portraying her seemingly perfect five-star hotel lifestyle and share “honest” shots. Do you wonder how the public reacted? After ditching all the filters and posting realistic images such as her trip to her psychotherapist, toes BEFORE a pedicure or smeared make-up after a night out, she literally lost 1,000 followers out of 13,000 within a week, followed by another 4,000. Interestingly, she received more positive comments than ever from the people that were supporting her decision! One follower stated: “I hope you know that I am following you now because of

your honest Instagrams. You may have lost many vapid and shallow losers, but you gained a lot who respect you. You’re gorgeous inside and out.” Indeed, she has now more followers than ever thanks to her honesty. People were actually happy to see that it’s OK to be normal. “I regret absolutely nothing,” Stina said to the Daily Mail. “Not only was it liberating, it has highlighted important issues like mental health and body positivity. It has got people talking openly online and I guess it has made people feel less alone.” She is currently writing a book about her personal experiences to spread the word of honesty in social media even more. At Karolinska Institutet, there are a number of blogs with the purpose of connecting people within the campus and giving insight into the everyday life of working or studying at KI – precisely what the self-explanatory aim of social media is. The blogs cover a variety of topics, from research habits to campus events, and among the writers there are PhD students, undergraduates, as well as post docs. Yildiz Kelahmetoglu, a PhD student and a blogger at KI, emphasizes the freedom to write about any topic of interest, without any forbidden territory or omertà. It is entirely up to the writer to spice up the post with criticism or glorification. What makes realistic views more popular amongst KI blog readers, is the fact that people find it easier to relate and your sound becomes more like “one of them”, she believes. Hence, delivering an open and honest story might prove beneficial!

Fake news – a major problem online

Online news serves as a fast and easily accessible source to help people understand what is happening in the world. However, recently, news stories might often have accomplished the complete opposite. A lack of clear

Photo credit: Oliver Mortusewicz for Medicor

distinction between high-quality news sources and amateur fake sites on social media have lead us to a point where gossip-mongering sites can reach people as easily as professional news media, such as The New York Times and Fox News. An explosion of misleading or even fabricated stories has spread in many social media channels. In relation to the recent US election, the vast majority of fake news concerned American politicians. For instance, people on Facebook have read that the Pope endorsed Donald Trump (not true) or seen sloppy and made-up headlines like “Proof surfaces that Obama was born in Kenya”.

People were happy to see that it’s OK to be normal The significance of this issue is only going to grow over time, as more and more people are getting their news online. In 2016, 44% of US adults got their news from Facebook according to Pollster. These increasing trends are putting the leaders of social media companies under pressure to use their power wisely. Facebook CEO Mark Zuckerberg has signaled the issue, but emphasizes to act carefully in regard to further actions. Earlier this year, Facebook decided to fire the entire team of journalists responsible for the trending news feature, because it selectively suppressed conservative news articles. Nowadays, software is used to select newsworthy articles, but the algorithm is not sophisticated enough to distinguish true from false

news, according to Vox. Zuckerberg has laid out the latest steps in order to weed out the fake news problem. Facebook will apply third-party verification to factcheck the statements and also make it easier for people to report fake stories. Other measures include labelling stories with warnings that have been identified as false. “We need to be careful not to discourage sharing of opinions or mistakenly restricting accurate content. We do not want to be arbiters of truth ourselves, but instead rely on our community and trusted third parties,” Zuckerberg told CNCB.

The critical targets

When considering the potential effects of social media, teenagers are often the first and foremost affected group of people that comes to mind. While adults have found their point of self-confidence and identity, youngsters are more like a blank canvas. Adolescence is a crucial time for social learning and experimenting with identity. Online communication, often impulsive and anonymous, is especially attractive for youngsters. After all, reaching out to others on the internet does not require as much courage as in real life. Having said all that, the dark side of social media also deeply affects teenagers. Cyberbullying is an increasing issue, especially since it might be challenging to discover, might be done anonymously and might never stop unless the target turns off its phone. Still, social media mostly provides positive encounters. Moreover, it seems to be entirely effortless for a

youngster to connect with any novelty created in social media for those likeminded – new groups, trends and events. Perhaps the feeling of actually belonging to a group alongside with fellows fuels the progress of self-confidence.

Amongst the immense possibilities and temptations online, let’s find our own way to empower ourselves and other people around us Rise above

Much like everything else in this world, social media has positive and negative features. For most of us, social media is a place to escape – either from responsibilities or from boredom. As much as we claim not to give a damn about the latest sandwich snap, we still go back there. How to get the most from this highly global and dynamic phenomenon? Beyond all the discussions about impressions created in online world, simple traits like curiosity, kindness, and empathy contribute to define the person behind the screen. So feel free to exploit the power of social media to develop your voice, to connect with like-minded people, to exude your energy and to simply explore. Amongst the immense possibilities and temptations online, let’s find our own way to empower ourselves and the people around us. •

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culture

Podcast and chill The best podcasts for beginners By Olivia Miossec As a researcher, a number of hours are dedicated to reading scientific journals. There are the cuttingedge papers you need go over to stay updated, the articles you must review, and of course your own thesis which you look through over and over until your brain shuts down. If you are a student, then there is the never-ending stream of course syllabi, textbooks and lecture notes that you do not only need to decipher, but also memorize. Opening up a newspaper or diving into a book consequently becomes a rarer occurrence. I mean, who wants to read on their break from reading?! Enter podcasts. These little gems of knowledge are great companions during walks, errands, house chores or simply during moments of intense ‘chilling’. They are thus perfect replacements to novels, newspapers and magazines and, of course, ‘easy on the eyes’. I have therefore put my willingly untreated podcast addiction to good use and made a ‘beginner’s list to podcasting’ with suggestions based on what you’re looking to learn/ what you enjoy. If you simply can’t get enough of science in your life (nerd!): Radiolab (WNYC) As the name suggests, Radiolab is a scientific podcast. More importantly, it is about the profoundly human stories science has to offer – from the past and the present. Sometimes it is about the forgotten, odd or heartbreaking lives behind the facts and theories of science – such as the tragic fate of Henrietta Lacks, the rise and fall of Heimlich or the carelessness of Typhoid Mary. Other times it deals with the exciting scientific discoveries and dilemmas of today, narrated by researchers who made science their life’s passion, or the lay people saved, betrayed or changed by science. Co-hosted by Robert Krulwich and Jad Abumrad, the storytelling prowess and editing perfection of each episode will grip you from start to finish. Episode to get you started: ‘Famous tumours’ – it is pretty selfexplanatory. It includes the story of famous tumours preserved in a museum, the tragic life of Henrietta Lacks, but also the struggle of Tasmanian devils against a contagious tumour. Note – recently Radiolab has diversified into other topics outside of science. Check out the earlier episodes to get the pure scientific experience.

If you find the economy boring (but secretely wished you understood it):

If you want to keep up with the memes, the tweets and the youths of the internet:

Planet Money (NPR)

Reply All (Gimlet Media)

Planet Money does the impossible: it makes the economy fun. They take seemingly dreary topics such as the price of oil, employee salaries or offshore tax havens and turn them into lively investigative episodes. The Planet Money team won’t simply lecture you about money; they will go and set up an offshore company in a tax heaven and tell you all about it. They will get in the middle of the ruthless food truck business and interview competitors. They will go to song writing camp to find out how one manufactures the song of the summer (or how everything about Rihanna is absolutely fake). Or they will investigate the deep dark history of the Swiss cheese mafia. In between the awe, silliness and incredulousness - you may learn a thing or two about the economy as well, and then flaunt it to any friend that still tolerates you.

It is so hard to describe what Reply All is about. The short answer is that it’s about the internet and all the craziness, knowledge, humanity and evil contained within it. As a ‘generation Y’ baby with a smartphone surgically implanted in her palm, I figured I knew everything I ever had the desire to about the internet. I was wrong. The entertainingly neurotic duo hosting this podcast reveal, from one episode to the next, corners of the internet I was unaware of. If you want to know how internet is used as a tool for ISIS fighters, but also why Pepe the frog has become a symbol of right wing activism – then this is the podcast for you.

Episode to get you started: ‘We set up an offshore company in a tax haven’ – this was released right before the Panama paper scandals (coincidence? I think not) and truly helped me understand the whole story better. It takes you step by step on how exactly offshore banking works.

Episode to get you started: ‘Quit already’ – on how a single Facebook event sparked a popular uprising in Guatemala.

If you want to win next week’s pub quiz: No such thing as fish (BBC) If you are currently in a pub quiz team, or simply want to annoy your friends with random but topical facts about everything and nothing, you need this podcast in your life. You might have heard of QI, the well-loved British game show in which a panel of personalities are asked obscure questions about the news that week. The podcast ‘No such thing as fish’ is hosted by the researchers behind those questions. In this podcast, they each come up with their favourite fact dug up that week. From there starts a banter filled conversation in which random facts and a bit of knowledge are thrown back and forth between the hosts. It’s hilarious and strangely informative. Thanks to this podcast, I now know that Neanderthals wore capes, that driverless cars’ software play Grand Theft Auto to improve their driving skills (yes, I find it reassuring too) or that some chickens are both male and female (like, split down the middle!). Episode to get you started: The most recent episode. Keep your facts up-to-date.

If you are in need of a little inspiration: TED radio hour By now everyone knows the concept of TED (Technology, Entertainment, and Design) talks. These are short talks which

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transmit ideas worth spreading delivered by leading thinkers and activists on the TED conference stage across the world. Whilst you can access such talks from their website, there is a wonderful podcast known as the TED Radio hour. These are hour-long episodes containing a collection of different TED talks selected according to a single theme. They also include interviews from the speech-givers themselves, adding further insight and depth into the talks.

If you are looking for a way out of academia: How I build This is a podcast about successful companies, from Spandex to AirBnB and how their creator made it to the top (failures included). If you dream of getting out of academia and beginning a start-up then you may want to listen for some inspiration and a few lessons of humility.

Episode to get you started: ‘How we love’- I like this episode mostly due to Amy Webb’s entertaining talk on how she ‘hacked’ online dating algorithms to find her husband. Who said nerds can’t find love?!

Or, even closer to home, there is PhD career stories hosted by Tina Persson (you may have attended one of her talks organized by the career center). In each episode, a different PhD graduate tells their career story so far, and what their next step will be.

Other notable podcasts to look out for:

So where does one access these podcasts?

If you enjoy a bedtime story:

There are many options! If you have an Apple device, iTunes still remains the best (even though it kills me to say so). They have an amazing selection, you can subscribe to any podcasts you are interested in and new episodes will automatically add to your device every time you sync to iTunes. There are of course alternative apps to manage and download podcasts such as Overcast for iOS or Google Listen for Android. Even Spotify offers podcasts - look under the ‘show’ tab in your Spotify app.

The Truth is a storytelling podcast which describes itself as movies for the ears. That is spot on. Each episode features a short story re-enacted by voice actors with nicely crafted sound effects which will grip you from start to finish. If, unlike Trump, you are a sucker for facts: Science Vs is the show for you. In each episode, the host pits a phenomenon of questionable reliability such as gun safety, organic food or antidepressant efficiency against actual research data and the cold hard facts of science. Basically Trump’s worst nightmare.

Happy listening!

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Culture

Are Swedes really as cold as their winters? By Ben Libberton

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den on the “ease of settling in” section on the survey. Perhaps the World Values Survey (WVS) can help shed some light on the issue. Located in Stockholm, the WVS is a global team of social scientists who study the way changes in values affect society and politics around the globe. In a particularly striking study, they measured how countries valued individual self-expression as well as how secular they were. When the team of scientists plotted these data on a graph, they got a random array of dots. Before they could begin dig into the details and make sense of the results, one country stood out from the rest. A single country valued individual self-expression above all others, while at the same time, being the most secular and least traditional: Sweden. Swedes value individualism and don’t hold traditional

values compared to the rest of the world. In the 2015 documentary “A Swedish Theory of Love”, Erik Gandini attributes this to a 1972 political manifesto called “Familjen i framtiden”. The goal of this revolutionary political program was to break from traditional values and to create a completely independent society where nobody depended on anyone else. In the words of Gandini, the manifesto meant to “free women from men; free the elderly from their children; free teenagers from their parents.” Since the program was implemented in 1972, Swedes have been trained to be independent and value independence highly. Now the results of the InterNations survey begin to make sense. When immigrants come to Sweden, they do not settle in, feel welcome, or find friends easily. All of these are signs of codependence, not the

sacred values of independence that the Swedes have been trained to uphold. If they were to be more friendly, maybe they would be denying themselves and the immigrants of their right not to have to depend on anyone. However, in my experience Sweden has a culture that is opening up. Fika is being exported around the globe and each year immigrants are adding to the tapestry of cultures in Swedish cities. Swedish society also seems profoundly aware of its perceived coldness and is trying to change it, just like when my neighbour invited me over. As immigrants, maybe understanding that appearing unfriendly isn’t the same as being unfriendly is the best place to start. If that doesn’t work, they say that alcohol helps. •

Photo credit: www.worldvaluessurvey.org

When I first moved to Sweden, I rented a single room in the house of a Swedish lady. She took me in and helped me settle. One weekend she was away and I was left home alone. It was the middle of the summer and I stepped out into the garden. In the neighbour’s yard I heard the clattering of cutlery and the buzz of conversation. I looked over and caught the gaze of a Swedish man who smiled and waved. “We’re just having dessert,” he said in perfect English, “would you like some?” After a bowl of ice cream and a few beers the conversation was flowing and we were having a lot of fun. From out of nowhere, the guy looked me in the eye with a serious look on his face and asked, “do you think Swedes are cold?” Despite this early experience, I’d heard of the perception of the icy, emotionless Swede. Clearly, some Swedes are worried about their reputation, and with good reason. In a survey conducted by InterNations, Sweden came in the bottom 10 of the 64 countries for “ease of settling in”, “feeling welcome”, “friendliness” and “finding friends”. In many cases it was actually in the bottom five, along with its nordic neighbours Denmark, Norway and Finland. But why are Swedes perceived as being unfriendly by foreigners? In the same survey, Sweden and their Nordic counterparts also came close to the bottom in the “climate and weather” category. I don’t think anyone feels at their most friendly when it’s minus ten degrees Celsius and they’ve just slipped on the ice running for the bus. But this doesn’t explain it. Ireland is the country perceived to have the worst weather and yet performed much better than Swe-

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Tell your story Everybody has aa unique uniquestory. story. Everybody has Everybody unique story. You can share itit in in many manyways. ways. Youcan can share You in many ways. Come tell tell yours. yours. Come yours.

medicinska föreningen’s student magazine

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Become a member today!

Become a member today! Become a member today!

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don’t just think about it, join us today! contact: chefredaktor@medicor.nu

Medicor MF 2016 #4  
Medicor MF 2016 #4  

Student magazine from the Medicinska Föreningen and Karolinska Institutet

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