The Examiner: Rutgers Pre-Health Journal Issue 15

SPRING 2016 ISSUE #15

62 Daily life of an

epileptic

cloud storage of 64 patient data

creativity can 10 save a life

Insights into 56 Schizophrenia

INTRODUCTION Dear Readers, As the Spring 2016 semester comes to an end with huge anticipation of the grandiose commencement and Rutgers Revolutionary 250th year, I present to you Issue 15 of The Examiner – Rutgers Pre-Health Journal.

The Examiner is the result of ten years in the making. From changes in concepts, themes, columns, logos, managing styles, and other innovations, we’ve managed to keep one thing consistent: our purpose of building a strong scientific platform and informing our Rutgers community of public health, medicine, science, and research relevant to Rutgers.

As my undergraduate years at Rutgers come to an end, during these past four years in the Examiner, I have learned a lot and had an opportunity to work with many skilled and talented individuals. I am confident it will remain in good hands and the legacy will move forward. On that note, I would like to extend my best wishes to those graduating and hearty congratulations!

I would like to thank my executive board, journalists, RUSA allocations, faculty advisors and administrative staff for contributing to this issue.

On behalf of myself and the entire Examiner executive board and journalists, I hope that you, the readers, will enjoy reading this latest issue. We will sincerely appreciate your feedback or inquiries on our Facebook page or email at ruexaminer@gmail.com.

Happy Reading!

Thanks and regards,

Pujitha Talasila Editor-in-Chief

Editor in Chief Pujitha Talasila

managing editors Aayush Visaria Sabrina Mohsin Aimee Parado Santhoshi Kotrike

layout editor Valerie Lim

website manager Dillon Heyck

public relations Soundarya Nattuva

treasurer Divya Mohanraj

journalists Khush Patel Monica Naropanth Hira Tassawar Pujitha Talasila Michael E. Small Kavya Aggarwal Marisa Wong Ridhima Sakhuja Harsha Gopalakrishnan Sabrina Carmant Mrudula Chakravarthy Sabrina Mohsin Aimee Parado Ridhima Sakhuja Ankita Veta David Lo Matthew M. Kim Kaylynn Shuleski Divya Mohanraj Mihika Shah Mona Rassouli

3

Table of Contents Community

6 Take a Right at Bone Marrow Drive- Khush Patel 8 A Mildew Manifestation: Mold in College Dormitories -Monica Naropanth

10 Creativity Can Save a Life- Hira Tassawar

14 Relaying Off Cancer- Pujitha Talasila

15 Rutgers University Emergency Medical Services:

Responding to the Community- Michael E. Small 22 Is Rutgers Caring Enough about Diabetes Care?- Kavia Aggarwal

24 What’s that smell?- Marisa Wong

Discusses the two gas leaks that took place last semester

Self 25 26 28 30 32 33

IUDs: Contraceptives to a T- Ridhima Sakhuja Zika Virus and You- Harsha Gopalakrishnan Take Your Brain for a Run- Sabrina Carmant Can you game too much?- Mrudula Chakravarthy Contact Lens Confessions- Sabrina Mohsin Four Years Wiser, Four Fewer Teeth- Aimee Parado Wisdom teeth and when they should be extracted

Research 35 36

38

Parasitology: The Debugging of Parasites- Ridhima Sakhuja (Microbe)-FREE Chipotle!- Ankita Veta A look at Chipotle and Rutgers Research

Squashing the Superbugs: A Newly Discovered Antibiotic and the War Against Antibiotic Resistance- David Lo

Genetics/Epigenetics 40

44

48

They are what you eat- Mathew Kim

how epigenetic changes arise and how they can affect offspring

Single But Deadly- Kaylynn Shuleski SNP research at Rutgers

The Mysterious Genetic and Epigenetic Connection Between Obesity and Type 2 Diabetes Development- Divya Mohanraj

Neurology/Mental Health 56 60

62

Insight into Schizophrenia- Mihika Shah Infidelity: The Neurochemical Weakness That Stems from Within- Mona Rassouli The Daily Life of an Epileptic- Shyam Ladani

Healthcare 64 Cloud Storage ofPatient Data- Chris Kim 66 A New Health Care Paradigm- Hill Chang

Take a Right at Bone Marrow Drive

by Khush Patel

On campus, regular blood drives are hosted

by New York Blood Center and various student organizations.

However, on February 24, 2016, Rutgers held something that many students didn’t have the opportunity to participate in before – a bone marrow drive. The drive was hosted with the help of Be The Match, a registry specialized in bone marrow transplantation. The event intended to raise awareness for bone marrow donation and to register interested donors with Be The Match’s extensive database. Patients with compromised immune systems, such as leukemia victims, require life-saving bone marrow transplants to revitalize their bodies’ defenses.

One of the largest challenges facing patients who require transplants is the difficulty of finding a match.

Over 70% of patients that need bone marrow transplants do not have a match in their families.1 According to Betty Kelly, a community engagement representative from Be The Match, it is very hard to find bone marrow donors because “matching key genetic factors can be very difficult, even between parent and child”.2 The chances of finding a match within one’s family is roughly 30%.3 Furthermore, there are many components that contribute to the suitability of a marrow donation. For example, race holds a major factor in bone marrow transplants.3 Many genetic markers that pertain to bone marrow transplants differentiate depending on heritage and ethnicity. Scientists can even link particular sequences in the human genome to an individual ethnic makeup. These specific sequences have a strong influence in the body’s ability to discern foreign objects, or in other words, reject or accept a transplant.

A dilemma that organizations, like Be The Match, face is a shortage of minorities registered as donors.

The chances of finding a donor are even slimmer for multiracial patients because their genetic requirements are very rare.3 These stringent requirements are not present for other types of donations because 6

bone marrow transplants require even more genetic similarities between donors and recipients as compared to other procedures, such as organ transplants and blood transfusions.3 This is due to the fact that bone marrow produces white blood cells, the backbone of the immune system. If less than ideal bone marrow is transplanted into a patient, the new white blood cells will recognize the rest of the body as foreign or invasive and begin to attack it. The body’s rejection to a transplant is especially dangerous for cancer patients, who are already physically weak.

At this point, you may be convinced of the dire need for donors, yet are still hesitant.

It is likely that you are concerned about how painful the procedure will be. Well, contrary to what you see in House M.D. and Grey’s Anatomy, bone marrow transplants are generally painless. The majority of donations are done by collecting blood from one arm, extracting the needed cells, and returning the remaining blood to the other arm. This process is called peripheral blood stem cell donation (PBSC); it consists of taking the drug filgrastim and is basically an extended blood donation.4 In some instances, liquid marrow may need to be extracted from the pelvic bone; however, this procedure is performed under general anesthesia.4 Residual pain after the donation is usually just minor aches and pains that subside within a few days, a small price for a life-saving contribution.

For many, finding a match is the difference between living in a hospital bed for the rest of their lives and pursuing their dreams with vibrant health.

A small swab of your saliva is all that is needed to test your compatibility and register as a donor. So be on the lookout for upcoming bone marrow drives and take those few extra minutes out of your schedule. Who knows? Maybe you could be someone’s saving grace.

Over 70% of patients that need bone marrow transplants do not have a match in their families.1

Contrary to what you see in House M.D. and Grey’s Anatomy, bone marrow transplants are generally painless.

If less than ideal bone marrow is transplanted into a patient, the new white blood cells will recognize the rest of the body as foreign or invasive and begin to attack it.

The majority of donations are done by collecting blood from one arm, extracting the needed cells, and returning the remaining blood to the other arm.

7

A Mildew Manifes

Mold in College Dormito

by Monica Naropanth

8

“Ew, what’s that smell inside of your room?”

mold can cause aggravating symptoms. Symptoms

The odor inside of your dormitory may be more

of a mold infestation include: increased cough, skin

than just an accumulation of smelly clothes. One

itch, voice hoarseness, and/or fatigue. Mold can also

very possible cause of this odor could be mold.

inflict upper respiratory problems, aggravate asthma

According to an international study, approximately

symptoms, and irritate allergies.3 Before you mistake

12.2% of dorm rooms contained visible mold

your common cold for mold symptoms, you should

spots after the year 2000.1 Before you freak out and

thoroughly investigate your room for mold. The

abandon your dorm, take a moment to learn about

most common mold, A. Alternata, grows in damp,

these important characteristics of mold. Firstly, it

moist places and could very well be the source of

is important to know that most mold growing in

your symptoms. A. Alternata mainly exists within

college dorms causes little to no harm. However,

indoor areas such as showers, ventilators, and in

mold begins to raise concern when it exists in large

between dorm walls.3 This is frightening because

amounts (a.k.a. mold infestation!)

there is possibly mold living right next to you!

Mold gives off a distinct “diffuse mildewy

Luckily, there are certain preventative

smell”.2 If students suspect this smell, then it is best

measures that you can implement to reduce the

that they leave their dorms immediately because the

amount of mold growth in your dorm.

station:

tories

Whenever you spill a drink, it is extremely important to

For more information on this, visit

clean it up right away or else mold can possibly infiltrate

http://rehs.rutgers.edu/student_safety_mold.html

the cup. As college students, we sometimes overlook a little bit of mold growing in our dorms. However, we are only setting ourselves up for a possible nightmare.

Rutgers Environmental Health & Safety, or REHS, is highly aware of the mold concern within college dormitories. As a result, REHS has constructed a set of guidelines to adhere to when it comes to the issue of mold.

To eliminate mold in dorms, REHS sends out trained individuals to locate the source of mold and then expel it. The methods of expelling the mold include using a wet vacuum, damp wipe with water/detergent, or a high efficiency particulate absolute (HEPA) vacuum. Overall, practicing good hygiene and maintaining dryness in your dorm can help prevent the growth of mold.

“

Symptoms of a mold infestation include: increased cough, skin itch, voice hoarseness, and/or fatigue. Mold can also inflict upper respiratory problems, aggravate asthma symptoms, and irritate allergies.3

�

9

Hira Tassawar

CREATIVITY CAN SAVE A LIFE

10

Creativity has a good reputation

writing poetry, playing video games that

for being an impressive and innate ability

involve puzzles and challenges, drawing and

held by rare people. The average person

even cooking. This form of “art therapy”

also views it as an unachievable talent, as

is now a common treatment method for

if being creative is wizardry. For some,

mental and chronic diseases.2 Expression is

to achieve the creative mind is a tedious

vital for a healing process, and when people

task but it is certainly worth the time.

draw or write about traumatic experiences

Creativity is meditation for the soul, and

it better aids them in coping with the

medicine for the body. In the last decade,

problem.2

chronic diseases have been a focus of

medical research, especially because they

surely an enchanting talent, but it is not

are associated with depression and chronic

impossible to achieve. A blank paper

stress,1 but “engagement with creative

and a sharpie is all you need to create

activities has the potential to contribute

beautiful works of sharpie art while sitting

towards reducing stress and depression”.1

in your dorm. Nonetheless, there are

When performing or viewing a creative

many opportunities to enhance a creative

task, the mind loses conscience of its

mind in an environment as creative as

surroundings and wanders off to a happy

Rutgers University. At Rutgers, there is a

and focused place. There is indeed evidence

unique new organization called Rutgers

that “engagement with artistic activities,

Art in Medicine Society or RAMS for

either as an observer of the creative efforts

short. RAMS was initiated by current Co-

of others or as an initiator of one’s own

Presidents Puneet Dhillon and Agratta

creative efforts, can enhance one’s moods,

Sharma last summer and began accepting

emotions, and other psychological states”.1

members in fall of 2015. When questioned

Some simple examples of creative activities

about the original purpose of RAMS and

are notebook doodling, arts and crafts,

whether that purpose has evolved, Puneet

As one can see, creativity is

11

replied, “The original purpose was to find the

Fundamentals, Visual Thinking, Figure Drawing,

intersection between art and medicine, or art in

and Ceramic Sculpture. Also, the School of Arts

science, because for us, we still love art even though

and Sciences offers many Art History courses.

we are pursuing careers in the medical field. We

Likewise, the Zimmerli Art Museum is free for

have stuck to that purpose but now also focus on

Rutgers students, giving the opportunity to ignite a

the effects of art in several areas such as mental

creative mind through visualization of great works

illness and its use in a hospital setting.”3 To further

of art. Art is readily available at Rutgers, and there

explain the health benefits of art, Puneet added, “Art

are numerous opportunities for students to utilize all

has somewhat of a stigma in the realm of STEM…

the artistic facilities offered. With its mental healing

Though medicine can heal your physical illness, art

powers, physical health benefits, and ability to turn a

can help you define, accept, and understand it.” It is

frown upside down, creativity is surely magical.

tough to ignite creativity in a large group of people because it means for each individual to stand out in his or her own way , and when asked how RAMS motivates people to be creative, they responded saying, “We start each meeting with a craft to sort of help our members keep their creativity flowing…

When we went to volunteer at St. Peter’s Hospital, for example, we helped children in the pediatric ward tie-dye their pillowcases,” allowing their individual creativity to shine. When questioned about personally experiencing the health benefits of art, Puneet expressed her own appreciation for art: “For me, personally, painting, drawing and collage had helped me through many incidences of anxiety that normally accompanies a pre-med, or really any education.”

The resources do not end there: amazing classes are offered at Mason Gross such as Drawing

12

“Art has somewhat of a stigma in the realm of STEM… Though medicine can heal your physical illness, art can help you define, accept, and understand it.”

13

Below: decorated luminaria bags

14

by Pujitha Talasila

“Each lap gets us closer to a world with more birthdays”

is the theme for this year’s event for American Cancer Society’s Relay for Life – Rutgers Chapter. First, let’s backtrack a little. What is cancer? That can be answered with a simple definition or can encompass a wide range of scientific terms. To keep it simple, cancer is a cluster of diseases characterized by uncontrollable growth of abnormal cells in the body, forming tumors.1 For example, lung cancer occurs due to abnormal growth and spread of tumor cells in the lungs. In 2016, 1,685,210 new cases of cancer are expected to emerge and 595,690 deaths due to cancer are predicted to occur which accounts to almost 1,630 people per day dying from this unpleasant disease.1 A disease as widespread and lethal as cancer is important and prevalent on a global scale, thus one can expect widespread support, even at the college level.

15

Speaking of the global scale, the American Cancer Society (ACS) is a voluntary organization with over 2.5 million people devoted to “create a world with less cancer” through the awareness of screenings and current research. Additionally, fundraisers, events, services and programs, and quality health care are promoted

by ACS. The tremendous efforts of ACS are vast and influential as seen by the 22% decline in cancer death rates in the United States just within the past two decades as well as a 50% reduction in smoking rates.2 Recently in December 2015, ACS awarded the Rutgers Cancer Institute of New Jersey a $360,000 institutional twoyear research grant, which brings an inclusive total of $29 million in grants to Rutgers University, since 1989.2 The goal of this research money is to train the next generation of cancer researchers. Rutgers Cancer Institute Director Robert S. DiPaola, MD says, “Our multidisciplinary approach provides an ideal environment to foster synergy with the American Cancer Society”.2 Furthermore, Professor

16

Stavroula Sofou of the Biomedical Engineering Department at Rutgers University received a 4-year, $720,000 Research Scholar Grant from ACS to help implement and conduct a targeted liposomal anti-vascular alpha-particle therapeutic method for cancer treatment.3 The American Cancer Society works relentlessly for their mission of “eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and service”.4

Colleges Against Cancer (CAC) – Rutgers Chapter is the voice of ACS at Rutgers University. CAC is a national association of college students, faculty, and staff committed to promote ACS’s mission of fighting cancer and refining college communities by supporting and promoting ACS’s programs and events.5 CAC’s Rutgers Chapter Treasurer, Shriya Puri says, “The volunteers of CAC do what they do because cancer has a way of impacting everyone and we want to see the day that a cure is found.”

Below- Last year’s E-board (left to right): Shriya, Sarah, Lauren, Dara, Gina, Gianna, MJ, Siobhan, Hope, Natalie

They do so through educating, advocating, promoting awareness, and hosting events for the student body.

Some of the many events they promote include Relay for Life, Making Strides against Breast Cancer, and Great American Smokeout in addition to their fundraising events such as bake sales, bar nights, and Dine to Donates.

Relay for Life is an event where teams of people come together and camp out all night in the idea that “Cancer never sleeps”.5 A range of people participate in such events including cancer survivors, teenagers, adults, and a potpourri of individuals from different backgrounds and stories coming together to “celebrate, remember, and fight back” cancer. CAC-Rutgers Chapter fundraises and hosts a Relay

for Life event on our campus every spring to bring both Rutgers and the surrounding community together at the Rutgers Athletic Center (RAC) on the Livingston campus. The night is filled with entertainment, activities and awareness programs such as the Lumanaria Ceremony where lumanaria bags and candles are lit to honor loved ones who lost their lives to cancer or are fighting it.

Events like Relay for Life and others are hosted by CAC to promote better lifestyles such as campaigns to quit smoking and encouraging screenings for early detection of cancers as well as fundraising to fight cancer. What better way to bring an entire college community together!

17

18

Pictures from left to right, top to bottom: 1) Friends hanging out during down time at a relay event. 2) Miss Relay Pageant: A drag show to raise money 3) Survivor dinner 4) The Survivor Lap: The first lap of the night of the survivor’s walk after cutting the ribbon

19

Rutgers University Emergency Medical Services: Responding to the Community

by Michael e. small

In a community as big as Rutgers University, with over 48,000 students across the main New Brunswick campus, when a medical emergency happens, who do you call?1 If you thought 9-1-1, you are right, but you might be surprised by who shows up. The people responding may be your very own classmates transporting patients in a Rutgers University ambulance.

20

Since 1998, Rutgers University has had its own Emergency Medical Service that responds to calls on the New Brunswick Campus 365 days a year, 7 days a week, 24 hours a day.2 These dedicated EMTs (Emergency Medical Technicians) are certified by the New Jersey Department of Health and Senior Services in providing Basic Life Support services, which include CPR, first aid/trauma life support, monitoring vital signs, administering emergency oxygen and recognizing life threatening emergencies. In addition, Rutgers’ EMTs are trained in the use of the pre-dosed auto-injecting epinephrine devices, commonly known as “Epi-Pens” for the treatment of anaphylaxis (a severe allergic reaction). Additionally, due to new legislation, Narcan administration is used to help curb opioid related deaths in NJ. Although it is optional for EMS agencies in NJ to carry Epi-Pens and Narcan kits, Rutgers stocks both on their ambulances.

Rutgers University EMS works with Robert Wood Johnson University Medical Center Mobile Health Services to ensure that no matter what emergencies come in, they will be handled by the most skilled people for the job. Since Rutgers University provides Basic Life Support by Emergency Medical Technicians, they count on RWJ to provide the highest branch of pre-hospital care known as Advanced Life Support (ALS) which is provided by EMTs that have advanced training in fields such as EKG interpretation, administration of cardiac resuscitation drugs, various methods of intubation (insertion of a tube into the compromised or unstable airway), and I.V. drug administration.3 These advanced EMTs are more commonly known as paramedics.

All of the training in the world means nothing if you can not access your patient. That is why RUEMS boasts a well-equipped and large fleet of vehicles designed to respond to any location in the community. E.J. Miranda, Director of University News and Media Relations for Rutgers EMS states that “a fleet of six BLS (Basic Life Support) ambulances, two rescue trucks, two Explorers, one Alternative Support Apparatus (ASAP), two UTVs, six bicycles equipped with EMS equipment, one Medical Ambulance Bus (MAB), two eight passenger golf carts, one Incident Command Trailer, and one Mass Casualty Incident Trailer” are used by Rutgers EMS for various event stand-bys and to respond to approximately 2,900 calls for service every year across the five Rutgers New Brunswick campuses.

Looking to get involved and become certified to help in an emergency? Rutgers University EMS operates their own Training Bureau that provides training in CPR, first aid and defensive driving for faculty, staff and students (at a reduced price) as well as members of the public. Courses are regularly posted on their website: http://rues.rutgers.edu under the Training Section.2 Courses are also available upon request either at their training center or an off-site location.

21

Is Rutgers Caring Enough about Diabetes Care?

by Kavya Aggarwal

A growing issue throughout college campuses, including Rutgers University is the lack of initiative to provide routine care of Type I Diabetes. Oftentimes, staff members may be unwilling to inject glucagon into students suffering from hypoglycemia if they are unconscious.1 Additionally, students may be unable to access efficient therapy, as traditional insulin therapy may sometimes be inconvenient.

It is necessary that the correct measures be taken for treating those with diabetes in order to avoid life threatening accidents. Currently, federal regulations exist allowing students the right to receive care for diabetes that they require to stay safe, and to participate in daily activities. Staff members sometimes offer regular insulin therapy, but despite regulations, these students are sometimes discriminated against or not provided with care in emergencies.

Discriminations and lack of proper care occur either because staff members are unwilling or unprepared to help due to effort, or because schools do not properly enforce or offer treatment.1

One treatment that has been created, which would allow for students to stay focused on schoolwork and daily activities rather than their disease is N-lithocolyl insulin, a prolonged acting insulin.2 In periods of sleep or in hours when students do not eat, insulin’s rapidly

22

acting effects are far from beneficial. Insulin breaks down from a hexameric to monomeric form, causing it to act fast and causing students to require more insulin, even during periods of inactivity. However, this designer insulin involves lithocolyl, a cholesterol and fatty acid group, which keeps the insulin in a state of relaxation, and causes it to become slower in binding to a receptor. This slows down the effect of insulin and would allow students to maintain a balanced basal level of glucose throughout the day regardless of whether the student eats or not.

Rather than taking insulin frequently, with this prolonged acting insulin, students do not have to constantly worry about diabetes. Currently, this form of insulin is not available to everyone as a resource, especially in schools. Schools are so far unlikely to provide this designer form of insulin due to the expensive nature of the product. However, if more diabetic students have access to this form of insulin, they would have the ability to be more successful.2

Aside from the issue of inconvenience, lack of care from staff members around students is an issue for those affected by diabetes.

According to the article Many Schools Failing on Type I Diabetes Care, by Catherine Saint Louis, “in the last five years, the Justice Department has pursued a handful of cases of discrimination against diabetic students�.1 Although non-nurses are often trained to administer insulin, they refuse to provide this care to students. Because of these complications, students and families have begun lobbying for change and trying to convince schools to provide better resources for those with diabetes, and to require staff members to provide assistance to those in need of it.

above: a blood lancet; used by Diabetes patients to get a small sample of blood to test their blood glucose level. image from www.framepool.com 23

By Marisa Wong

24

IUDs:

By Ridhima Sakhuja

T contraceptives to a

The concept behind the intrauterine device can be dated back to Ancient Greece, when Hippocrates first came up with the idea of placing a small stone in the uterus to prevent pregnancy.1 Modern day IUDs consist of a flexible T-­shaped frame and work by either blocking the sperm, consequently preventing fertilization, or by inhibiting the monthly release of an egg. Despite being one of the first FDA approved contraceptives, up to now IUDs only accounted for less than 1% of contraceptive use in the US after Dalkon Shields, a popular IUD, was removed from the market during the 1980s. This was due to the lack of proper insertion techniques and the design that caused the device to get stuck in the uterus, linking it to permanent infertility and pelvic inflammatory diseases.2 However, close to thirty years later with a more thoroughly tested and effective design, IUDs have made their way back to the contraceptive market. A 2015 CDC study indicates that the number of IUD above: an intrauterine device. implants increased by five times in the past fifteen years, deeming (hand for size comparison) it the fastest growing birth control method in the country.3 Long lasting and effective, IUDs have a user effectiveness rate of 99.2% as compared to a 91% effectiveness rate for birth control pills and an 82% effectiveness rate for male condoms.4 While it is important to note that IUDs do not prevent STDs, the procedure of inserting an IUD is relatively simple, and it can stay in the uterus for up to twelve years with little to no maintenance and minimal side effects.2 According to the American College Health Association, as of 2014, the most popular form of birth control amongst female students at Rutgers University are birth control pills.5 The studies also indicate that only 3% of Rutgers female students use IUDs, which is a slight increase from the percentage of IUD users in 2012.6 With the previous fears and preconceptions regarding IUDs fading, the devices are regaining their popularity amongst teenagers and college students, many of whom want an effective way to prevent pregnancy.

“The more you can take the user out of the equation ­­if she so desires ­­the more you’ll be able to prevent unintended pregnancy,” said Megan Kavanaugh, a senior research scientist and public health specialist at the Guttmacher Institute.4 “More and more people are jumping on the IUD and implant bandwagon because it seems like they might be potentially appropriate to cover for these long periods of a woman’s life when she needs coverage”.4 Will IUDs successfully regain its lost popularity or will another controversy plunge its user rate again? Only time will tell, but for now, they certainly seem to be on their way to potentially becoming the most popular contraceptive method amongst women today.

THE EXAMINER

25

Zika Virus and You

by Harsha Gopalakrishnan

The Zika virus has created a pandemic in the Americas, especially Brazil. It is estimated that over 1.5 million people have been infected by the Zika virus and 3,500 cases of microcephaly reported between October 2015 and January 2016.2

26

Aedes aegypti, has been found along the Gulf Coast, Florida and as far north as Washington, D.C. Despite this there have only been 258 cases of Zika virus acquired

by American citizens through travel, and zero locally acquired vector-borne cases reported.5 (image source: nbc news)

It seems like every one to two years we get another epidemic that infiltrates the media and creates paranoia in the minds of the public.

Two years ago it was the Ebola epidemic that made headlines around the world.

More recently, the Zika virus has created a pandemic in the Americas, especially Brazil. It is estimated that over 1.5 million people have been infected by the Zika virus and 3,500 cases of microcephaly reported between October 2015 and January 2016.2 Microcephaly is an ailment which causes newborn babies to have a head circumference more than two standard deviations below the mean. As the child grows older they will suffer from a dwarfed overall size, delay of motor functions, and intellectual disability.1 The degree of these symptoms may vary, but the overall impact on the child’s life will no doubt be extremely debilitating. There is approximately a 1 in 100 risk of microcephaly among pregnant women that contract Zika, but even 1% is a huge problem when the virus is so widespread.4 To prevent the further outbreak of the Zika virus, several countries have issued travel warnings, along with some South American countries going as far as advising their citizens to delay planned pregnancies until more is known about the virus.

Fortunately for those of us living in the USA, the threat of Zika virus is close to zero.

The current prevailing theory is that Zika virus is spread through a mosquito vector, which makes it unlikely for it to reach the mainland.

However, the certain type of mosquito that is most responsible for the spread of Zika, Aedes aegypti, has been found along the Gulf Coast, Florida and as far north as Washington, D.C. Despite this there have only been 258

cases of Zika virus acquired by American citizens through travel, and zero locally acquired vector-borne cases reported.5 The current main concern for American citizens in regards to the Zika virus is the upcoming 2016 Summer Olympics taking place in Rio de Janeiro, Brazil. Currently, Brazil President Dilma Rousseff has said her “entire government is working on fighting this emergency”.3 And its sports minister added that the country has no plans to cancel the Games. Some US athletes have already raised concerns about traveling to Brazil such as USWNT goalie Hope Solo who has told Sports Illustrated “If I had to make the choice today, I wouldn’t go, I would never take the risk of having an unhealthy child”.3 Only time will tell if the Zika virus will cause significant problems to the Summer Olympics and pose a greater threat to the general population of Brazil and the world.

Additionally, the Rutgers Center for Global Advancement and International Affairs issued an advisory in accordance with CDC guidelines, for students and faculty planning to travel to the Caribbean and South American countries.6 Rutgers also urges study abroad students to register at the University Risk Management websites for medical access and emergency travel assistance abroad.6 For now however, it seems like Brazilian officials have devoted an enormous amount of resources to containing the virus before the world games3, but travelers should still remain cautious when traveling to South American countries and make sure to avoid mosquito infested areas.

27

Take Your Brain for a Run

by Sabrina Carmant 28

Whether you are looking to improve area of the brain responsible for learning your general brain function or if you just and short-term memory) after a continuous want to pass your next organic chemistry controlled workout lasting several weeks. exam, look no further than your They grouped the rats based on local gym or park. It is well the workout they were going to “When known that the brain is like a endure which involved distance one exercises,” muscle; if you do not use it, running (moderately jogging), Christin Anderson, it will atrophy. This is why fitness coordinator at the high intensity interval running exercise is effective for (sprinting), and resistance University of San Francisyour muscles. Despite this training (weightlifting). co, says, “you can think logic, very few people ever After the experiment was more clearly, perform think to exercise their brain completed it was discovered better, and your mobeyond brain teasers and that the rats that were jogging rale is better. difficult crosswords. The link gained the most amount of brain between exercise and improved mass in their hippocampus. The brain function was speculation as best until sprinters gained an amount as well but not scientists started testing the theory. as much, and the weight lifters gained very

Ms. Kotelko was an acclaimed and little to none in comparison to the control successful nonagenarian (a person between group.2 Although, it is very possible that the ages of 90 and 99) track-and-field they gained brain mass in a different area of athlete who has many medals and world the brain. records to her name. Before her death in

Although, if you need more than 2014, Ms. Kotelko participated in a study the reasons above to get out and go for to compare her brain to other people a nice jog, as noted on a WebMD article, of various age groups. In the “When one exercises,” Christin Anderson, aftermath, the results showed fitness coordinator at the University of that she had increased brain San Francisco, says, “you can think As scientists mass compared to others more clearly, perform better, and have now proven, of her age and a brain your morale is better. This is pure certain types of that looked decades science -- stimulate your nervous exercises can be done younger than she actually system and function at a higher to improve brain 1 was on a scan. Before, level.” 3 It is the exercises that get function and increase scientists could not directly your heart really pumping that you total brain mass. link her workout regimen to want to aim for because anything her improved brain capacity. that is good for your heart is good for However, as scientists have now your brain.4 Now, for those of us that do not proven, certain types of exercises can be have time for a full blown workout regimen, done to improve brain function and increase a suggestion would be the Scientific 7 total brain mass.

Minute Workout. To keep you motivated, A study that was recently published in the download the free app. It may not have Journal of Physiology involving a group of been tested by the researchers, but it will researchers at the University of Jyvaskyla in definitely get your heart pumping and it is Finland. They conducted an experiment on only for seven minutes a day.5 a group of male rats to measure the amount of neurogenesis in their hippocampus (the 29

Mrudula Chakravarthy

?

30

31

Contact Lens Confessions

by Sabrina Mohsin

Contact lenses have been revolutionized over the last century.

32

At first, their sole purpose was to enhance vision and act as an alternative to eye glasses, but now contact lenses can be worn for cosmetic reasons where one can experiment with different colored lenses. With such accessibility and popularity, have the dangers of improper contact lens care diminished over time? Studies today have identified a rise in contact lens contamination and consequently, eye damage in contact lens wearers. With bacterial eye infections becoming more common in today’s society, it is time to understand why and how such issues can arise.

The Center of Disease Control (CDC) performed a national survey in 2015 to better understand the types of non-hygienic behaviors that increase the risk of bacterial eye infections.1 It was reported that most wearers used the same contact lens case longer than the recommended amount of time of three months. By doing so, contact lens wearers increase their risk of obtaining some type of contamination or infection. The second most common type of risk behavior was introducing new sanitizing solution to the contact lense case prior to rinsing out the old solution. When a new cleaning solution is added it will, ironically, reduce the disinfectant properties of the first solution and overall, the contact lenses will not be purified for safe use. However, even more alarming is the fact that about 50% of people surveyed indicated wearing contact lenses to sleep. According to Dr. Jeanine Graves, optometrist in Fairlawn, NJ, this is one of the most dangerous outcomes of non-hygienic contact usage. She states, “When we wear a contact lens we prevent the cornea from absorbing its normal amount of oxygen from the atmosphere. The cornea is the only organ to breathe independently from the air, not via oxygenated blood from the lungs. If we then close our eyes over this contact lens the oxygen supply at the cornea falls to zero. Even an eye without a contact lens that is closed has only a 12% oxygen level at the cornea so add a contact lens and even that is gone. Long term, the cornea simply starves.”

Many Rutgers students who wear contacts have experienced falling asleep in them. To understand why this is such a common phenomenon, several Rutgers students who wear contact lenses were asked about wearing contacts while sleeping. A majority of them explained that by the end of the day, indolence and laziness were the causes of their lack of care. Sarah Wolfson, Ph.D. Candidate at Rutgers University, explains how over the years she has learned to become more cautious and aware of proper contact lens care, stating, “When I was an undergraduate, there were times when I would fall asleep with my contact lenses still on which was mostly because I was lazy.”3 She continues to explain that due to improper care, she experienced pain and eye redness. This encouraged her to take better care of her eyes as she says, “I was afraid of getting pink eye and my eyes hurting the next day.

Now I’m more responsible when it comes to eye care, and I am more aware of the pain that comes with the lack of care.”3

Although eye redness is a common consequence of improper eye care, it is possible to encounter even more serious scenarios. Brian Mohsin, a freshman at Rutgers, shares his story of what at first seemed like a minor red eye but later developed into a bacterial infection that led to a corneal ulcer. Corneal ulcers are due to the habitation of bacteria in a slit of the cornea.

It can be treated with antibiotics, and in most situations will leave a scar on the cornea after treatment. Corneal ulcer transplants are recommended for most patients.4 Brian explains how more awareness about hygienic contact lens care should be promoted today, especially for young adults and adolescents stating, “My lack of hygienic care towards my contacts most likely lead to the buildup of bacteria. I wasn’t aware that improper care could lead to an ulcer. Because contact lenses are in direct contact with the eye, it is important to take precaution and care of your eye when wearing contact lenses.”5

Contact lenses have made life less of a burden for people with vision problems. However, with this privilege comes the responsibility to follow the recommended procedures of sanitizing contact lenses.

For more information about taking care of your eyes while enjoying the ease of contacts, talk to your optometrist or visit the CDC’s list of preventative care at http://www.cdc.gov/contactlenses/.

Four Years Wiser, Four Fewer Teeth When you graduate from Rutgers, you may have fewer teeth than you had when you first arrived on the Banks of the Old Raritan.

You probably did not lose all those teeth to the candy you ate while studying, and hopefully you did not lose them during some ill-advised dare one Friday night.

Instead, you lost those teeth during a procedure that left you with “chipmunk cheeks.” On the other hand, you might have been lucky and did not need to go through this procedure at all, or maybe you went through it before college.

The procedure being referred to is the extraction of wisdom teeth.

Wisdom teeth, also called third molars, are the last of a person’s permanent teeth to develop. Wisdom teeth erupt (meaning to push through the gums) usually between the ages of 17 and 21.1 The location of wisdom teeth in the back of the mouth makes wisdom teeth unnecessary for chewing and a challenge to keep clean.1 If they are not cleaned properly, bacteria might grow, leading to gum disease and oral infection.2

Wisdom teeth are considered to be a vestigial feature of humans. More and more people are lacking wisdom teeth.3 In the past, there used to be more room in the mouth for wisdom teeth due to a number of reasons.4 Previously, humans ate very coarse food, which wore down teeth, reducing their

by Aimee Parado

size. The human jaw was also larger since it had to work harder to chew food, and people lost some of their teeth at an early age. However, modern dentistry and the shift to eating processed foods have resulted in less wear on teeth and less early loss of teeth, but these changes have left humans with too many teeth and too little space in their mouths.4 This lack of space leads to problems when wisdom teeth erupt.

Wisdom teeth can be categorized three ways: erupted, partially erupted, or unerupted (impacted).4 Erupted wisdom teeth successfully push out of the gums and are aligned properly. They do not need to be removed. Partially erupted wisdom teeth are only partly visible from the gums. Impacted wisdom teeth are trapped in the jawbone. If wisdom teeth are partially erupted or impacted, they can be removed to prevent problems.1 According to the American Dental Association (ADA), wisdom teeth may need to be removed if there is pain, infection, cysts, tumors, damage to adjacent teeth, gum disease, or tooth decay.5 The decision of whether or not to remove wisdom teeth depends on the dentist, since different dentists have different beliefs. For example, dentists may choose to remove a patient’s wisdom teeth if they are growing near the nerve of the lower jaw, and many dentists choose to extract wisdom teeth even before the wisdom teeth’s roots are fully formed so that potential problems are completely avoided.2 (continued on next page)

33

Removing wisdom teeth before the roots fully form means performing the surgery while the patient is younger and therefore can recover faster.2 Even if a patient’s wisdom teeth are not removed, the wisdom teeth should still be monitored because people become vulnerable to more health problems as they age, and new problems can include issues with wisdom teeth.5

Categories of Wisdom Teeth:

Although the thought of undergoing surgery to remove wisdom teeth may sound frightening, a dentist’s recommendation to remove your wisdom teeth should not be ignored.

2) partially erupted: Partially erupted wisdom teeth are only partly visible from the gums.

Otherwise, you may face more dental problems in the future. If you find yourself in the situation where you must get your wisdom teeth removed, try to schedule the surgery during a vacation from classes. This will give you time to rest after the extraction and will give you time to hide those temporary chipmunk cheeks you may get.

34

1) erupted: successfully pushed out of the gums and are aligned properly.

These do not need to be removed.

3) unerupted (impacted): trapped in the jawbone.

If wisdom teeth are partially erupted or impacted, they can be removed to prevent problems.1

by Ridhima Sakhuja

Parasitology: The Debugging of Parasites

What are the first few things that come to mind when you think of parasites?

You may visualize pictures you often see in science textbooks or miniscule bug-like creatures that you search online. Or you may start to think of the harmful and sometimes lethal diseases that parasites have been linked to, such as malaria or ringworm infections. Overall, you probably do not harbor very pleasant images of the diseasecausing microorganisms that seem to hold very little value and interest in the eyes of many. However, as research now indicates, parasites may be a lot more prevalent in our lives and hold a lot more value in the medical field than they were previously accredited with.

Sukhdeo, a parasitology professor at Rutgers University.

“For a very long time, researchers thought that they had a good understanding of how things work in the environment and in the human body, but that was before we realized that we were underestimating the complexity that parasites add to this system.”3

Dr. Sukhdeo is currently doing research on the role of parasites in food chains. Today, most accepted models of food chains disregard the role of parasites, but Dr. reasons that parasitic conditions As humans, we are currently Sukhdeo in consumers often make them more sharing the world with three susceptible to predators, thus catalyzing the food chain process along. million species of parasites.

Even more recently, in October 2015, the Nobel Prize in medicine went to three According to the World Health Organization, scientists, Satoshi Omura, Youyou Tu, and malaria, caused by the transmission of William C. Campbell, for their work parasites through mosquitoes, is in formulating an anti-parasite among the top causes of death drug, marking the second According throughout the world.1 As college time in the last century that the World students, we are constantly a Nobel Prize was given in Health Organization, exposed to parasites in our the field of parasitology.4 malaria, caused by the daily lives, due to easily The three scientists have transmission of parasites spreading infections in used avermectin and small dorm rooms or public through mosquitoes, is ivermectin chemicals to transportation facilities. In the among the top causes create artemetin, a drug past few years, parasitology of death throughout that can fight ringworm has become a rapidly growing infections and malaria.5 the world.1 field as it is gaining more The study of recognition for its importance to parasitology is still early on the understanding of diseases and in its development, but as current biological processes.2 research indicates, it is becoming a more “Ronald Ross was one of the first promising field and a vital key to the general parasitologists to be recognized for his work understanding of biology and human with malaria in 1910, but scientists have not physiology. Perhaps in a few years of time, looked into the prevalence of parasites in we will no longer be looking at parasites in our lives until recently,” notes Dr. Michael

35

(Microbe)-FREE CHIPOTLE! In our everyday lives, how many times do we really stop to think about what is in the food we eat?

Probably never, unless a major chain like Chipotle closes down due to an outbreak of norovirus, dashing students’ hopes of a quick meal downtown. Yet, the threat of food contamination and foodborne illnesses is very real and costly. From 1990 to 2005, 22% of outbreaks were directly related to produce and the various contaminants that they harbored, including the infamous E.coli and Salmonella.1

Currently, most methods of cleaning produce involve merely washing and packing the fruits or vegetables, which has proven to be ineffective time and again, as witnessed by several outbreaks. Such outbreaks are especially common in large food corporations where fast, mass production is key, and chance for error is prominent despite taking many precautions. For instance, Chipotle alone has seen outbreaks of E.coli, Salmonella, and norovirus over the years, affecting over 300 people just since August 2015.2 While people have tried several methods for post-harvest decontamination, the procedures are either ineffective in reducing the number of pathogens, or stripping food of its nutritional value by heating.1

With this in mind, researchers have been investigating new techniques like cold plasma technology to eliminate contaminants from food,

36

by Ankita Veta

thereby reducing food-borne illnesses. Plasma is defined as “an ionized gas consisting of neutral molecules, electrons, and positive and negative ions”.1 Often called the fourth state of matter, plasma is everywhere, from TV’s to neon signs. Now, however, it is being used to revolutionize food science by helping to inactivate microbes.

Rutgers’ own Dr. Mukund Karwe, Professor and Dean of International Relations in the Department of Food Science, is working with this exact technology to find the most efficient methods of decontamination. In an interview for Rutgers Today, Dr. Karwe explains, “With plasma, we can actually decontaminate the fruits and vegetables after they are put inside the package and the package is sealed”.3 This prevents cross-contamination from one batch of produce to the other. By using non-thermal temperatures, this technique allows for decontamination of food without losing nutrients that would have otherwise been lost through the use of heat.

While cold plasma technology is still being researched, it provides hope for the public that the food they consume is safe and microbe-free.

Not only will it ensure the health of the consumers, but it will also reduce healthcare costs of treating infections or illnesses resulting from otherwise avoidable outbreaks. If cold plasma technology takes off, we may yet have hope for fresh, non-microbe ridden comfort food from our favorite chains!

Did you know?

Currently, most methods of cleaning produce involve merely washing and packing the fruits or vegetables, which has proven to be ineffective time and again, as witnessed by several outbreaks.

Chipotle alone has seen outbreaks of E.coli, Salmonella, and norovirus over the years, affecting over 300 people just since August 2015.2

37

Squashing the Superbugs A Newly Discovered Antibiotic and the War Against Antibiotic Resistance

by David Lo

38

There are many harmful bacteria out there that can cause a lot of frightening diseases. From cholera to Salmonella, new strains of bacteria are emerging all over the world. Doctors fight these bacteria with antibiotics like penicillin, the first antibiotic discovered by Alexander Fleming in 1928.1 After returning to work from the holidays, he discovered something peculiar – one of his petri dishes of gram-positive bacteria, Staphylococcus, had an unusual blue-green mold growing inside. The mold, later known as Penicillium notatum, had a clear, circular zone around it without any staph bacteria. This mold was isolated, cultured, and purified, creating what we now know as the antibiotic penicillin.2

Since then, many new antibiotics have been discovered through the same process. A bacterial sample is taken from a source, isolated onto nutrient-rich agar, and allowed to multiply to see if it kills Staph bacteria. However, only 1% of all naturally growing microbes can grow in a laboratory, which is why for nearly thirty years, no new class of antibiotics have been discovered.3 This is known as the Great Plate Count Anomaly where the remaining 99% refuse to grow in lab, many of which have the potential to kill bacteria in newer, more novel ways.4

Today, we may have to worry a little less.

Researchers Kim Lewis and Slava Epstein at Boston’s Northeastern University realized lab environments do not contain hundreds of nutrients and growth factors that could cultivate bacteria.

Thus, they invented a new method of cultivating bacteria – the isolation chip or iChip that replaced the traditional petri dish.5 “Essentially we’re tricking the bacteria,” says Lewis, therefore providing a more natural home.5 Each well on the iChip traps bacterial cells in a membrane, but allows nutrients in when buried in soil or an outside environment. After screening thousands of new bacteria, they finally found Eleftheria terrae, the species that produces Teixobactin. This antibiotic works by binding to lipid II and lipid III, key precursor molecules of bacterial cell wall synthesis which kills the bacteria early on.6

Every time antibiotics are used, the bacteria in the body have a chance of developing resistance to it which is why it is imperative to use only when necessary. According to the Center for

Disease Control (CDC), four out of five Americans are prescribed antibiotics every year in a rate the CDC describes as “excessive”.7 For instance, the cold is one of the common conditions antibiotics are prescribed for yet serves no function. Colds and flus are viral not bacterial infections. Patient noncompliance is another culprit. If patients do not complete the treatment plan and some bacteria remain, it gives them more opportunities to evolve and adapt to become superbugs, multiplying, spreading, and outsmarting antibiotics.8

Rutgers University played a critical role in antibiotic history with the discovery of streptomycin in 1943 by Albert Schatz and Selman Waksman. As opposed to Fleming’s chance observation of mold inhibiting bacterial growth, twenty-three year old Schatz tested hundreds of bacteria that could potentially stop the growth of gram-negative bacteria that were resistant to penicillin. This brave lab assistant worked in isolation in the basement of Martin Hall on Cook Campus with virulent strains of Tubercle bacillus, bacteria that causes tuberculosis. Within three and a half months, Schatz had isolated two potential strains of bacteria in the phylum Actinomycetes.

He named the derived antibiotic “streptomycin.”

Mayo Clinic then conducted toxicity, animal, and human trials while Merck conducted large clinical trials showing streptomycin’s effect in killing tuberculosis, cholera, and many more penicillin-resistant diseases.9 Despite Schatz’s work, it was Waksman who was solely awarded the Nobel Prize in Physiology or Medicine in 1952.10

The introduction of antibiotics with penicillin and streptomycin transformed the entire landscape of medicine providing cures for the most prevalent diseases of the time. Resistance, however, has the power to return humanity to the pre-antibiotic era, a time when it was common for people to die from an ordinary infection. Luckily, the invention of the iChip will hopefully uncover new antibiotics to add to the arsenal of treatments to prevent this dystopia from occurring. Most importantly, we must use antibiotics only when necessary, complete the full round of treatment, and appreciate the rich history of antibiotics and how it has the power to stop some of the world’s most deadly diseases.

39

40

They Are What You Eat

by Matthew M. Kim

In the most simplistic sense, DNA is comprised of unique sequences that code for the various proteins that comprise the vast array of complexes that embody an organism, allow for specialized function, and set limitations on what an individual is capable of.1 However, DNA constitutes only half the multifaceted study that is genetics. The burgeoning field of epigenetics expounds upon heritable changes in gene activity that do not involve changes in the DNA sequence itself.2 In other words, epigenetics provides an understanding of how phenotypic variation may arise without altering an organism’s genotype.

41

Within an organism, the genome is comprised of hundreds, thousands, and even billions of base pairs; the epigenome accounts for all the chemical modifications and alterations made to those very base pairs that govern the resultant expression of genes.

Examples of known epigenetic processes include DNA methylation, sumoylation, and phosphorylation.

The well-studied process of DNA methylation for example involves the addition of methyl groups on the C-5 position of a cytosine ring.3 Such a process results in the alteration of gene expression via transcriptional silencing.

Expectedly, epigenetic mechanisms such as DNA methylation directly and indirectly play an indelible role in regulation of protein production, cell differentiation, and DNA accessibility.1 At the same token, epigenomic modification may foster metabolic disorders, cognitive illnesses, and even cancer if mistakes occur.4 Interestingly, epigenetics is also governed by environmental factors that may induce the onset of certain chemical modifications within an organism which—much like an on or off switch— may activate or suppress particular genes.2 Platitudinous activities such as eating, exercising, sleeping, and smoking are of many environmental factors that contribute to epigenetic alteration in

42

human beings.5 Ostensibly, the ability for such modification to be passed down and inherited generationally is the more pressing concern.

In fact, what makes epigenetics so incredibly unique is its transgenerational inheritance character—often referred to as epigenetic memory. Phenotypically induced changes as well as the onset of known epimutations has been proven to be transferred transgenerationally.

Polymorphism, genetic abnormalities, and the expression of disease promoting genes in a parent, predisposes their offspring to those very illnesses.5

Thus, for college students here at Rutgers and elsewhere, it is imperative to be both intelligent and methodical of our lifestyle commitments amidst all the chaos and glory that is college. Advice on making wise eating decisions, refraining from smoking and consuming vinous inebriants, exercising on a weekly basis, and avoiding exposure to pollutants— albeit hackneyed and threadbare—is no less applicable to ensuring the lifelong well-being of the young and invincible.

Perhaps more importantly is the idea that the multifarious range of foods we consume to the very activities we engage ourselves perpetually sculpts and casts the epigenetic fate of our own progeny and future generations to come, each and every day.

Platitudinous activities such as eating, exercising, sleeping, and smoking are of many environmental factors that contribute to epigenetic alteration in human beings.5

43

44

Single But Deadly

By Kaylynn Shuleski

When you hear the words ‘genetic diseases’, the initial causations that come to mind are point mutations, such as deletions, insertions, and substitutions. Each genetic alteration induces its own detrimental effects on the organism the mutation acts upon. Let us consider substitutions, which are ranked the least harmful and most common of all three. Although initially not thought as sufficiently harmful, recent data has shown that substitution mutations are linked to the progression of addiction and alcoholism.

45

A gene substitution is a variation of just one nucleotide in a genetic sequence, also known as single nucleotide polymorphisms (SNPs).1 SNPs can either be synonymous, meaning the change of a nucleotide does not affect the protein sequence or nonsynonymous, meaning the substitution of a nucleotide does alter the final protein. Nonsynonymous SNPs are classified even further into nonsense and missense mutations. A nonsense mutation means that the replaced nucleotide codes for an early stop codon, preventing the complete sequencing of a protein. Missense mutations on the other hand, code for alternate amino acids in a protein, which can cause the protein to function improperly. Protein malfunctioning may ultimately contribute to the development of diseases such as cancer, as well as influence physiological responses to drugs.2

Rutgers University has numerous research projects investigating single nucleotide polymorphisms. Distinguished Professor Lei Yu, from the Department of Genetics, is currently researching the genetics of ‘pleasure and pain’ including predisposition to alcoholism and drug addiction in Rutgers’ NeuroPharmacoGenetics Laboratory.3 One project in his lab focuses on a missense SNP in the OPRM1 gene that codes for the muopioid receptor, an important regulator for the brain’s reward system.4 The substitution of one amino acid in the protein’s gene sequence causes the receptor to malfunction by altering its binding affinity with the β-endorphins that are present in opioids.

46

The mutated mu-opioid receptor “binds β-endorphin approximately three times more tightly” than the common form of the receptor, increasing the potency of opioids almost three-fold.4 The increased binding affinity between the receptor and endorphin is what intensifies the drug’s effects and raises a person’s vulnerability to drug addiction.

Although the location of the SNP and functionality of the mutated protein is known, the precise mechanism behind SNP protein alteration is yet to be discovered.

To further his research, Professor Yu, along with Rutgers undergraduate students, have created a mouse model that contains the exact same genetic variation in the muopioid receptor as humans. Through this research model, Yu and colleagues hope to discover what exactly takes place on the molecular and cellular level that triggers the disease in the first place.3 The ultimate goal is to gain information that will aid pharmaceutical companies in developing a drug that targets the malfunctioning molecule, which can then be used for clinical purposes.3 If successful, Professor Yu’s research will aid in the advancement of medical treatment for those predisposed to alcoholism and drug addiction.

The substitution of one amino acid in the protein’s gene sequence causes the receptor to malfunction by altering its binding affinity with the mu-endorphins that are present in opioids.

Types of SNPs synonymous: change of a nucleotide does not affect the protein nonsynonymous: a) nonsense: the replaced nucleotide codes for an early stop codon b) missense: codes for alternate amino acids in a protein

Although the location of the SNP and functionality of the mutated protein is known, the precise mechanism behind SNP protein alteration is yet to be discovered.

47

The Mysterious Genetic and Epigenetic Connection Between

Obesity is a chronic, multifactorial disease

spontaneously developed obesity. Obesity is also influenced by the environment due to changes in diet, weight, exercise activity, stress and cortisol levels, and high that results from an excessive amount caloric intake or lipid overload. Obesity of body fat, which can be quantitatively remains a huge epidemic in the United screened through a person’s body States and its prevalence has quadrupled mass index (BMI) (BMI ≼ 30.0 kg/m2 from 1994 to 2010 with respect to both is significant for obesity). This numerical age-specific obesity and diabetes in measure provides a reliable estimation of the U.S. (Fig. 2) (Centers for Disease a person body fat content based on his/ Control and Prevention [CDC], 2010). her height and weight. Obesity may be This increased prevalence may be due derived from the interaction of multiple to the obesogenic environment that we genes (genetic predisposition to excessive live in and the widespread availability of weight gain or body fat) and the preserved foods and artificial ingredients environment and involves both epigenetic that are loaded into the many foods that and xenobiotic factors, which can mediate we consume today. the phenotypic expression in individuals genetically predisposed to or who

By Divya Mohanraj The onset of obesity can also be triggered by environmental toxins and endocrine disrupting chemicals (e.g. bisphenol A) that induce the xenobiotic response. Bisphenol A (BPA) is an industrial chemical found in a variety of different plastic containers used for storing perishables and it is also found in the resin linings of metal cans to prevent corrosion and food/ beverage spoilage (Mirmira & EvansMolina, 2014). BPA is linked to having estrogenic activity with estrogen receptor-mediated effects and previous data from epidemiologic studies have shown positive correlations between urinary BPA levels and obesity and diabetes (Mirmira & Evans-Molina, 2014). Most people with obesity are also at higher risk for other diseases, including coronary heart disease, type 2 diabetes, hypertension, and sleep apnea

(Drong, Lindgren, & McCarthy, 2012).

On the other hand, type 2 diabetes was previously known as non-insulin dependent or adult onset diabetes mellitus

and it is a non-hereditary (but, prone to genetic predisposition) and non autoimmune metabolic disorder that has a relatively late onset and long course of development. It is primarily caused by insulin resistance or beta cell dysregulation due to the lack of insulin production in the pancreatic beta cells or improper uptake of insulin by the body’s cells (specifically, muscle and liver cells) and environmental factors (includes epigenetic and xenobiotic influences) including aging and lifestyle changes, such as, significant changes in diet,

weight, and exercise, as well as, a history of smoking and/or a sedentary lifestyle. Obesity is also a potent risk factor for type 2 diabetes, as studies have shown the increased prevalence of obesity and type 2 diabetes in the U.S. from 1994 to 2010 (CDC, 2010). According to the Centers for Disease Control and Prevention National Diabetes Statistics Report (2014), “29.1 million people or 9.3% of the U.S. population have diabetes with 8.1 million people undiagnosed for the disease,” (CDC, 2014) and this translates to approximately 1 in 11 people who may have either type 1 or type 2 diabetes (“A Snapshot of Diabetes in the United States,” 2014). Also, “In adults, type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes,” (CDC, 2014) and it begins with the body not being able to produce enough insulin to maintain normal blood glucose levels and then progresses to insulin resistance due to the improper functioning of the pancreatic beta cells (either can’t make enough insulin, can’t properly use insulin, or in some cases, can’t secrete any insulin at all) (CDC, 2014). However, it is the less detrimental of the two forms of diabetes mellitus (type 1 and type 2) and can easily be prevented or remedied with proper diet and exercise to promote a healthy weight.

50

Both obesity and type 2 diabetes are complex, related diseases with polygenic susceptibility and previous genome-wide association (GWA)

studies have suggested that DNA haplotype-specific methylation at the FTO (fat mass and obesity associated) gene susceptibility locus could explain a novel epigenetic connection between obesity and type 2 diabetes development in humans (Bell et al., 2010). In reference to the study conducted by Bell and his colleagues (2010), a specific region within the FTO susceptibility gene locus was identified in a type 2 diabetes (GWA) study, in which, the same haplotype across intron 1, exon 2, and intron 2 controlled vulnerability for the disease through obesity (Bell et al., 2010) and this demonstrates that there is an epigenetic connection between the two diseases involving DNA methylation at the CpG islands. According to previous studies targeted towards understanding the role of FTO in obesity and type 2 diabetes, rodent studies have shown that the FTO regulates BMI but, human studies don’t necessarily prove this link with respect to FTO mutations (McCarthy, 2010).

Also, the FTO risk allele has been

51

eating disorders, and the neurobiology cause childhood obesity and promote behind diet selection and obesity. type 2 diabetes as it has been found Dr. Bello believes that the potential that the hypermethylated CpG site at epigenetic connection between obesity the border of intron 2 and exon 3 and type 2 diabetes stems from the FTO of POMC in human peripheral blood gene and he stated, “The FTO (fat leukocytes is correlated with mass and obesity associated) obesity due to changes in “The gene is an indirect variant its binding with the histone FTO (fat of type 2 diabetes, which acetyltransferase (HAT) mass and obesity has been associated P300 complex (Drong, associated) gene is an with obesity,” (Bello) and Lindgren, & McCarthy, indirect variant of type according to previous 2012). This complex 2 diabetes, which has genome wide association is related to histone been associated with (GWA) studies, this variant acetylation and promoting obesity,” is strongly correlated POMC gene expression via with changes in BMI, hip a relaxed, open chromatin circumference, and weight conformational state. Although which implies it relationship to human blood leukocytes are not obesity and the reason why some explicitly involved in promoting obesity individuals may be comorbid for both or weight gain, the study suggests childhood or adult obesity and type 2 that analogous results may be found diabetes (Scuteri et al., 2007). Dr. Bello in the POMC neurons of the arcuate also stated, “Since obesity is a risk factor nucleus (Drong, Lindgren, & McCarthy, for developing metabolic disorders, 2012). Considering that obesity and the obese and overweight children are a obesogenic environment are the greatest higher risk for type 2 diabetes mellitus” risk factors of type 2 diabetes, epigenetic (Bello). However, he assures us that regulation of POMC is crucial to both obesity and type 2 diabetes can be maintaining this balance and preventing remedied by proper nutrition, exercise, early onset of the disease. In relation to rest, and maintaining a healthy weight, the Rutgers University community, it is as long as family history or genetic important for all students and faculty to predisposition is not involved. be aware of the implications of obesity and type 2 diabetes as these are two of the most common and preventable Another underlying epigenetic diseases in the United States today link between obesity and type 2 with increasing prevalence rates since diabetes is related to the role of 1994 (CDC, 2010). As per Lovejoy proopiomelanocortin (POMC), and Sainsbury’s Sex differences in obesity and the regulation of energy which is a leptin-responsive gene that homeostasis study (2008), obesity is codes for various hormones and plays more prevalent in women compared an important role in weight regulation to men in most countries around the in the hypothalamus (Drong, Lindgren, world due to differences in body fat & McCarthy, 2012). In particular, distribution, mutations in the POMC gene may 52

energy balance and hormonal changes, and appetite and satiety differences (Lovejoy & Sainsbury, 2008).

It also reflects on the importance of routine exercise and proper nutrition and diet. Specifically, obesity is linked to an increased risk of cardiovascular disease (CVD), hypertension, stroke and cancer (Van Gaal et al., 2006 and Guh et al., 2009) and we can help to dispel this statistic by promoting nutritious diet options for students living in both on and off-campus residential communities, providing various fitness and intramural sports opportunities all year around, and ensuring that students annually visit their primary care physicians for their physical examinations to maintain a healthy weight. We can also do our part by replacing high lipid content foods on-campus with low calorie options and providing more access to fresh local produce and unprocessed foods.

Overall, obesity and type 2 diabetes can affect people between the ages of 18-22 years (especially, those with strong genetic predisposition) and it is important to visit your primary care physician if you have any symptoms or are unsure of your chances of developing either of the diseases due to family history.

53

Figure 2: Centers for Disease Control and Prevention

54

Overall, obesity and type 2 diabetes can affect people between the ages of 18-22 years (especially, those with strong genetic predisposition) 55

Insights into

Schizophrenia

by Mihika Shah

Schizophrenia, a neurological disorder, is the altering of natural thought processes; it is the development of symptoms such as: hallucinations, delusions, thought disorders, movement disorders, and reduction in speaking among various others.1

Concisely, it is a deviation in behavior and emotions. Schizophrenia has had severe implications on persons aged 16 to 30.1 The exact means through which the psychosis associated with schizophrenia is triggered is hidden within the chemistry of the brain. Regardless, several propositions have been set forth including: genetic factors, environmental factors, and aberrant chemical structuring of the brain.2 Additionally, those troubled by the disorder are inclined to suffer through stigmatization as well. Stigmatization not only hinders progress of treatments for schizophrenia, but it also hinders social progress. History is witness to the lack of growth in all aspects of humanity due to segregation and discrimination. Thus, it is our duty as Rutgers students and as humans to set aside differences and assimilate people of all different walks of life including those who suffering through schizophrenia.

In terms of sociology, selfstigmatization is incepted due to the segregation of persons with schizophrenia by the general society.

Those diagnosed with the disorder

see themselves reflected in the general society as “outsiders” and deviants which they then adopt as their own identity.3 The inability to feel comfortable while confronting a disorder as serious as schizophrenia results in further anxiety which worsens the condition and could lead to a decrease in the effectiveness of the treatments. Research at Rutgers attempts to integrate people suffering through the affliction that is schizophrenia. One such example is the study “Randomized Controlled Trial of Treatment for Internalized Stigma in Schizophrenia”, managed

by Dr. Philip Yanos, professor at John Jay College of Criminal Justice, and Dr. Steven Silverstein, professor at Robert Wood Johnson Medical School. The purpose of the study is to develop therapies which prevent the self-stigmatization and reduction in self-esteem due to the onset of schizophrenia.3

More than that, the New Jersey Medical School and Robert Wood Johnson Medical School have contributed much to the unraveling of schizophrenia. While no definitive medical (continued on next page)

cures are available, the ongoing research process demonstrates the importance of specialized research in discovering medical treatments and cures. An illustrative study which demonstrates a Rutgers contribution to deciphering schizophrenia is one conducted by Dr. Brian Keane, assistant professor at Robert Wood Johnson Medical School. In his “Neural Mechanisms of Perceptual Organization Deficits in Psychotic Disorders� he attempts to study the differences in control over visual pathways in the brain of healthy patients, schizophrenics, and persons with bipolar disorder. This would allow the isolation of brain sections which are involved in the initiation and/or development of the disorder.2 Currently, the only treatments available for schizophrenia are antipsychotic medications that ensure neurotransmitters are present in the brain in amounts that allow dynamic equilibrium.1 Isolating specific brain sections would be a tremendous step towards a cure.

As students of a university supporting research for schizophrenia, it is crucial to spread awareness about this disorder. It is crucial to

58

be respectful and encouraging of those facing the disorder. Not only do neurological disorders require scientific research, but they also require a positive attitude towards those suffering from such diseases.

The inability to feel comfortable while confronting a disorder as serious as schizophrenia results in further anxiety which worsens the condition and could lead to a decrease in the effectiveness of the treatments.

59

Infidelity: The Neurochemical Weakness That Stems from Within

by Mona Rassouli

The person whom you’ve placed all your trust in has just stabbed you in the back. A silent evil, one that they cannot acknowledge, that they won’t acknowledge, even though you know the truth. The blood pools and spills over the memories. Happy memories, happy lies, they are now a grey glimmer of the deceit your loved one reeks of. You feel played, sold short and taken advantage of. As your mind floods with feelings of hatred, disgust, and heartache, you begin to blame yourself. How could you let this happen to you? You feel pitiable, weak. You always compared your relationship to others, promising yourself that it would never turn out like them. You were wrong; an impossible nightmare has become your inevitable reality.

You are not to be pitied. You were not weak. Your partner was the weak one, the one who is truly pitiable.

The one who can’t admit their wrong, since the gravity of their wrong would pull them into a black hole of despair.

Now, what are you to do?

The number of individuals who undergo affairs and partake in infidelity in our modern day society is abhorrently excessive. Infidelity has existed within the human race throughout history, yet it has become so commonplace that it is beginning to become the social norm. From scandalous celebrity affairs to the Ashley Madison website, it appears that promiscuity is devouring monogamous relationships.

The root of this explanation has always been conveyed to individuals in our society through psychological and cognitive studies; however, there is a more profound extraction to be found in brain chemistry. The behavioral and cognitive explanations of a cheating mentality will be briefly explored before delving into the chemical aspect of infidelity.

Dissonance theory is an intriguing aspect of promiscuity. The theory abides by the notion that cheaters tend to disassociate, or cut themselves out of scenarios via emotional detachment from the action.

This theory conveys that as a coping mechanism, cheaters minimize the wrongness of the act, or simply outright defend themselves by incessantly insisting that their actions lied outside the realm of their character.1 A technique referred to as “cognitive gymnastics” is utilized to lessen or in certain scenarios to completely eradicate the negative consequences or interplaying sentimentalities.1 This results in a disability of the cheater to not only refute their mistakes but to also commit them again in the future.

Dissonance theory and cognitive gymnastics are further supplemented by the psychological environment the individual was exposed to during childhood. The emotional attachments we form with others stem directly from the parenting manner we received as minors.2 The same lack of affection and attention that molds the innocent into modern serial killers, is conveyed through infidelity. It can be further extrapolated that if complete detachment from other humans and value for life fabricates manslaughter, that infidelity could be the milder extension.2 While extensive research has thus far proved these studies to be true, they cannot possibly account for the entire scope of the truth of infidelity.

The ultimate source of infidelity is found in the mind and the levels of the chemicals that comprise it.

Dopamine is the most renowned neurochemical. It directly affects the reward center of the brain, which is situated in the ventral tegmental area (VTA) of the mind. The VTA is the direct link between addiction and the resulting satisfaction. Therefore, infidelity is actually classified as an addiction due to the chemical

rush it delivers to the brain. Additionally, individuals who are embedded with the long allele gene of the dopamine receptor are roughly 30% more likely to cheat and to fall prey to addictions.3 Individuals who continuously cheat are, therefore, entwined in their addiction.

Vasopressin is quintessentially the hormone that induces “cuddling.”

It functions akin to oxytocin, resulting in feelings of trust, empathy, and social bonding during high levels of vasopressin. When vasopressin exists at inefficient quantities, individuals are more likely to commit infidelity. Additionally, low vasopressin readings are reflected in individuals with autism, in the sense that their minds do not register social cues.3

At the stage of infatuation, chemicals are either discharged or eradicated in potent quantities to amplify feelings of attraction towards the new lover.4 The first chemical is norepinephrine which is responsible for shortness of breath, or in a more literal sense, the person takes one’s breath away. The second chemical is serotonin, a chemical that triggers the bulk of the effect of antidepressants.4 One would logically deduce that this chemical would increase, yet that is simply not the case. In actuality, as serotonin rapidly diminishes, individuals feel hollow. Their emotions are void, leading them to be susceptible to needs of fulfillment. These needs of fulfillment and longing cause the individual to garner an obsession towards another person.4

As we continue to form bonds and long lasting relationships, it’s our human duty to educate ourselves on the chemical and behavioral aspects of our loved ones. Infidelity can conclusively be classified as a mental illness, and just like any other malady, it requires patience, understanding, and a remedy.

Sometimes a cheater needs help, and if one was truly in love, to the point where they still cherish the individual, then help is necessary. Every relationship has its rough patches. Although, if the individual has caused too much pain and suffering to you, then it would be better for both your sakes to terminate the relationship. After all some people need to truly lose what matters in order to fully learn from their mistakes.

61

by Shyam Ladani

The space around you is steaming up.

You’re awaiting the pleasures of a warm shower after a long day of classes. You’re ready to scrub away the day’s sweat and give yourself a freshening reward.

You open the shower curtain and raise your foot to step in when all of a sudden, you feel a strange sensation through your

62

body. An electrical storm has begun. Large groups of neurons fire simultaneously. Millions of electrical signals are sent by axons and millions are received by dendrites. You start to lose feeling in your legs, lose your vision, and worst of all you start to tremor. This is not just a normal type of shiver.

Your whole body is vigorously shaking and trembling as you lay on the floor.

Epilepsy may be caused by anything that disrupts natural activity including brain trauma, oxygen deprivation, stroke, or infection.2

This sort of brain activity followed by its effects describes a disorder known as Epilepsy 1 . As you step on the bus or walk into class, take a look around. Many people around you who look just like you suffer from this disorder and you may have no idea. The day to day fight against this disorder is not one of ease; it takes many great precautions and sacrifices.

People with epilepsy must make sure their home includes no hard flooring, just in case they were to fall. Even something as simple as taking a shower is dangerous. Many epileptic people have someone stand outside to listen for any uncommon sounds. They are also advised to use a microwave rather than a stove to cook any meals because of the immediate danger that stove brings. Severe epilepsy may also hold people back from being able to drive.

You may be wondering what causes this disorder? Epilepsy may be caused by anything that disrupts natural activity including brain trauma, oxygen deprivation, stroke, or infection 2 . It affects people of all ages, although more common in young children or older people.

Considering the danger of epilepsy, it is important to raise awareness on this disorder.

The proper care needed for loved ones with epilepsy is a special skill that takes great patience. It is one in which sacrifices must be made by the individual and the people involved in his/her life. Tomorrow may be the day when you meet a lifetime friend with this disorder 2.

You may need to step in and help at the time of a seizure. Tomorrow may be the day when you face a seizure. It is important to be proactive and gain the knowledge you need to better your safety. Remember in case of an emergency, pick up the phone and dial 9-1-1.

63

Cloud Storage of P a t i e n t D a t a

by Christopher Kim

The 21st century has brought about a myriad of technological innovations and improvements that have revolutionized almost every field. One such innovation gaining increasing prominence in health care is the usage of cloud computing to store electronic medical records (EMR). The general concept is to store a patient’s medical records and information electronically in a cloud system: a remote database controlled by a third party that can be accessed on a computer via the Internet. Through cloud storage, information can readily be shared between hospitals and healthcare providers. To understand the growing shift towards the cloud, consider the following number: 34,878,887.

64

In 2005, one study placed estimates that hospitals save up to $81 billion by switching to electronic records.2

of Patient Data

In 2014, according to the American Hospital Association, that was the total number of patients admitted to hospitals in the United States.1 It is important to note that hospitals nationwide request patients to complete forms pertaining to but not limited to medical history, consent, family or emergency contacts, and insurance information. Robert Wood Johnson University Hospital’s pre-admissions form alone has over 100 individual items to fill out, which when printed is approximately 10 pages. To delineate the issue of paperwork, simply perform the math. An 8.5x11 inch sheet of paper weighs 0.10 pounds. Even if every patient filled out only one-page worth of paperwork during every hospital visit, hospitals across the United States would be dealing with sheer voluminous paperwork weighing at onehundred and seven tons.

The gravitation towards cloud storage of EMR becomes clear. The question is raised: why waste hospital resources printing forms and storing physical copies every instance a patient is admitted?

The information asked is typically not different from hospital to hospital. In 2005, one study placed estimates that hospitals save up to $81 billion by switching to electronic records.2 And in this modern era of data analysis and statistics, digital records stand to provide new avenues for analyzing health trends and treatments. Hospitals like St. Peter’s University Hospital have led the change in health care information technology, founding the New Jersey Health Connect Health Exchange and investing heavily in advanced EMR systems.3 However, there exists a caveat. Patient privacy of medical records is federally protected under the Health Insurance Portability and Accountability Act. Yet the federal law does more to prevent malignant and improper uses of data by hospital staff than it does to prevent individuals from hacking cloud servers for medical data. Between August 2014 and March 2015, a timeframe of less than one year, approximately 96 million medical records were stolen from 3 major vendors (Community Health Systems, Anthem, and Premera).4 The reality of identity theft is that an EMR is worth significantly more than a credit

card; an EMR contains a person’s social security number, birth date, medical history, address, and phone numbers. Unless vendors can demonstrate adequate cybersecurity and physical security of the actual servers, security risks present a formidable obstacle towards completely embracing the cloud.

Compounding the issues associated with cloud storage are legal considerations. How does the concept of consent fit in? When a patient Between August 2014 and March is required to fill 2015, a timeframe of less than one paperwork, he or she year, approximately 96 million is conscious to fill it medical records were stolen from 3 out; but what about major vendors (Community Health when the patient Systems, Anthem, and Premera).4 is admitted to the hospital unconscious?

Who makes the decision on how and when to access needed private patient records stored in the cloud? Furthermore, who exactly owns the data and records stored in a cloud system? Different vendors have different fine print and legal terms, and depending on where the physical server resides, different local and national laws regulating data can be in effect.

Cloud storage of EMR is not simply a cloud on the horizon; it is a topic that is gaining increasing relevance as more healthcare providers rely on the cloud, or at least consider doing so. Cloud storage has been frequently cited as the solution to the question of how hospitals can improve their efficiencies in storing and transferring patient data. The shift to the cloud would save both money and time – both of which are vital in the healthcare industry. But the technology presents a new question that asks where the line must be drawn between convenience and cybersecurity, performance and privacy. Patients and healthcare providers alike should be aware of the risks and benefits before deciding to rely on cloud services for electronic medical records.

Because ultimately, data is what should be in the clouds, not our heads.

65

A New Healthcare Paradigm

By Hill Chang

66

Once President Obama signed the Affordable Care Act into law in 2010, healthcare became one of the most divisive issues in the country. Even today, despite its remarkable track record in lowering the rate of uninsured Americans by 35%, many Americans remain skeptical.1 As of September 2015, over 60% of Americans still did not approve of the law.1 But after three years, three open enrollment periods, and dozens of Congressional hearings, the Affordable Care Act has shown that it is here to stay. Without getting into legality or ethics, it is about time to evaluate how effective Obamacare has really been.

The first and most impressive statistic about the ACA is its significant decrease in the number of Americans uninsured. At the end of last year’s enrollment period, 11.7 million signed up for health insurance, and the most recent data show that Obamacare has covered

around 20 million people since its inception.2 The group in which the ACA has made its largest strides is the youth demographic, specifically college students. Since open enrollment began in October 2013, the majority of people who signed up for health insurance through healthcare.gov have been 19-25 year olds, which is welcome news considering they have historically been the group with the highest uninsured rates.3 Even more people have automatically been covered because of the ACA’s provision extending parental health insurance to cover family members until the age of 26.4 That is right – the semiannual Rutgers “health insurance waiver form” is the product of Obamacare, too. This significant improvement to America’s uninsured rates is also beneficial for the law because social welfare programs need young, healthy people in the insurance risk pool in order to make them actually affordable.

The most recent data show that Obamacare has covered around 20 million people since its inception.2

However, changes have been more muted outside of the young adult age group. As of September last year, the general population only experienced small changes in several key statistics, such as the number of people who were unable to afford the necessary medical care and the number of people with reliable access to a primary care facility.3 And though one of the largest selling points of the ACA has been the “affordable� part of it, many plans with the lowest premiums actually have deductibles in the thousands of dollars.3 The fact that federal law still does not address the difference between innetwork and out-of-network medical facilities also means that consumers frequently find themselves saddled with a surprisingly high bill that they were not properly informed about.3 Research has also shown that in anticipation of health insurance becoming less lucrative, insurance providers are shifting the burden of costs onto their workers, resulting in layoffs and wage cuts.2 In addition, the Congressional Budget Office still estimates that about 30 million people will remain uninsured even after several more

However the Congressional Budget Office still estimates that about 30 million people will remain uninsured even after several more years, mostly due to state resistance against Medicaid expansion and the fact that illegal immigrants are ineligible.1 years, mostly due to state resistance against Medicaid expansion and the fact that illegal immigrants are ineligible.1 Even in New Jersey in 2016, over 350,000 people remain uninsured.5 A large portion of the blame for this can be placed on technical issues relating to healthcare.gov, the online sign-up platform. Each open enrollment period brought with it a new slew of glitches, and states had to spend millions patching up their systems. As a result, the federal government has had to push the deadline back multiple times just to meet enrollment goals.2 To be fair, though, many of the key problems that Obamacare faces have been the result of its scuttling by a Republican-dominated Congress. Since 2010, there have been over 50 attempts to repeal parts or all of the Affordable Care Act, with one reaching Obama’s desk (only to be vetoed, of course) in January of this year.1 This is not just at the federal level, either. For example, New Jersey lawmakers have repeatedly stalled attempts to increase the transparency of healthcare billing practices.6 Maybe if the college-age demographic showed as much 67

WORKS CITED A New Health Care Paradigm 1Hamblin, J. (2015, March 16). The Precarious Success of Obamacare. Retrieved March 05, 2016, from http:// www.theatlantic.com/health/archive/2015/03/for-those-that-hate-obamacare-do-you-know-why/387913/ 2Leonard, K., & Cook, L. (2016, February 4). Obamacare: What Went Right And What Went Wrong? Retrieved March 5, 2016, from http://www.usnews.com/news/blogs/data-mine/2016/02/04/as-the-3rd-open-enrollment-ends-a-look-at-how-obamacare-is-doing 3Griggs, T., Park, H., Parlapiano, A., Patel, S., Russell, K., & Smith, R. (2014, October 26). Is the Affordable Care Act Working? Retrieved March 05, 2016, from http://www.nytimes.com/interactive/2014/10/27/us/is-theaffordable-care-act-working.html?_r=1#/ 4 Health Insurance Coverage For Children and Young Adults Under 26. (n.d.). Retrieved March 05, 2016, from https://www.healthcare.gov/young-adults/children-under-26/ 5Shah, A. (2016). Be Jersey Strong. Retrieved March 05, 2016, from https://bejerseystrong.org/ 6Livio, S. K. (2015, December 11). ‘Greed’ helped stall N.J. bill to curb surprise out-of-network medical costs: Lawmaker. Retrieved March 05, 2016, from http://www.nj.com/politics/index.ssf/2015/12/greed_sidelines_nj_ out-of-network_insurance_legisl.html Relaying off Cancer 1 Cancer Statistics. (n.d.). Retrieved March 15, 2016, from http://www.cancer.gov/about-cancer/what-is-cancer/statistics 2 Research. (n.d.). Retrieved March 15, 2016, from http://cinj.org/american-cancer-society-awards-new-research-and-training-grant 3 Sofou Receives Research Scholar Grant from the American Cancer Society. (n.d.). Retrieved March 15, 2016, from http://bme.rutgers.edu/news/sofou-receives-research-scholar-grant-american-cancer-society 4 American Cancer Society | Information and Resources for Cancer: Breast, Colon, Lung, Prostate, Skin. (n.d.).

Retrieved March 15, 2016, from http://www.cancer.org/ 5 RU Colleges Against Cancer. (n.d.). Retrieved March 15, 2016, from http://www.eden.rutgers.edu/~rucac/ Squashing the Superbugs 1. Fleming, A. (1929). On the antibacterial action of cultures of a penicillium, with special reference to their use in the isolation of B. influenzae. Br. J. Exp. Pathol. 10,226–236. Retrieved March 20, 2016.

2. Kardos, N. & Demain, A. L. (2011). Penicillin: the medicine with the greatest impact on therapeutic outcomes. Appl. Microbiol. Biotechnol. 92, 677–687. Retrieved March 20, 2016.

3. Lewis, K. (2013). Platforms for antibiotic discovery. Nature Rev. Drug Discov. 12,371–387. Retrieved March 20, 2016.

4. Kim, L., Epstein S., D’Onofrio A., Ling LL. (2010). Uncultured microorganisms as a source of secondary metabolites. The Journal of Antibiotics 63, 468–476. Retrieved March 20, 2016.

5. Nichols, D. et al. (2010). Use of ichip for high-throughput in situ cultivation of “uncultivable” microbial species. Appl. Environ. Microbiol. 76, 2445–2450. Retrieved March 20, 2016.

6. Ling LL, Schneider T, Peoples AJ, Spoering AL, Engels I, Conlon BP, Mueller A, Schäberle TF, Hughes DE, Epstein S, Jones M, Lazarides L, Steadman VA, Cohen DR, Felix CR, Fetterman KA, Millett WP, Nitti AG, Zullo AM, Chen C, Lewis K. (2015). A new antibiotic kills pathogens without detectable resistance. Nature 517: 455–9. Retrieved March 20, 2016.

7. Kollef, M. H. (2007). Limitations of vancomycin in the management of resistant staphylococcal infections.

Clin. Infect. Dis. 45 (Suppl 3). S191–S195. Retrieved March 20, 2016.

8. Centers for Disease Control and Prevention, Office of Infectious Disease. (2013). Antibiotic resistance threats in the United States. Retrieved March 20, 2016 at http://www.cdc.gov/drugresistance/threat-report-2013.

9. Schatz, A., Bugie, E. & Waksman, S. A. (1944). Streptomycin, a substance exhibiting antibiotic activity against gram-positive and gram-negative bacteria. Proc. Soc. Exp. Biol. Med. 55, 66–69. Retrieved March 20, 2016.

10. American Chemical Society, Office of Communications National Historic Chemical Landmarks Program.

(2005). Selma Waksman and Antibiotics. Retrieved March 20, 2016 at http://www.acs.org/content/dam/acsorg/ education/whatischemistry/landmarks/selmanwaksman/selman-waksman-and-antibiotics-historical-resource. pdf.

Cloud Storage of Patient Data 1Fast Facts on US Hospitals. (n.d.). Retrieved March 01, 2016, from http://www.aha.org/research/rc/stat-studies/ fast-facts.shtml 2Japsen, B. (2013, January 7). Despite Huge Investments in Electronic Health Records, Cost Savings Still Elusive. Retrieved March 01, 2016, from http://www.forbes.com/sites/brucejapsen/2013/01/07/despite-huge-investments-in-electronic-health-records-cost-savings-still-elusive/#594bf39c69f3 3Saint Peter’s named a Most Wired hospital. (n.d.). Retrieved March 03, 2016, from http://www.saintpetershcs. com/News-and-Events/Press-Releases/2012/Saint-Peters-named-a-Most-Wired-hospital/ 4Munro, D. (2015, July 6). Healthcare Moves To The Cloud But Is The Cloud Ready For Healthcare? Retrieved March 04, 2016, from http://www.forbes.com/sites/danmunro/2015/07/06/healthcare-moves-to-the-cloud-but-isthe-cloud-ready-for-healthcare/#5bab151865a0 (microbe)-FREE CHIPOTLE 1 Niemera, B. (2011). Cold Plasma Decontamination of Foods. Annual Reviews. http://www.annualreviews.org/ doi/abs/10.1146/annurev-food-022811-101132.

2 Smith, A., & Garcia, A. (2016). Chipotle to close all restaurants on Feb. 8 for food safety meeting. CNN Money. http://money.cnn.com/2016/01/15/news/companies/chipotle-food-safety-meeting/.

3 [Rutgers Today]. (2015, January 30). How To Get Rid of Food Poisoning. [Video File]. Retrieved from https:// www.youtube.com/watch?v=f8kewtc5HBI. Creativity Can Save a Life 1Stuckey, H. L., & Nobel, J. (2010). The Connection Between Art, Healing, and Public Health: A Review of Current Literature. American Journal of Public Health, 100(2), 254–263. http://doi.org/10.2105/AJPH.2008.156497 2How the Arts Affect Your Health. (2008, June). News in Health. https://newsinhealth.nih.gov/2008/June/docs/ 01features_01.htm 3[Personal interview, March 4, 2016] Rutgers University EMS 1Facts & Figures. (2015). Rutgers University. Retrieved from http://www.rutgers.edu/about/facts­figures 2Rutgers Emergency Medical Services (EMS). (24, October 2015) Administration & Public Safety. Rutgers University. Retreived from http://rues.rutgers.edu/ 3Gulli, Benjamin. (2011). Emergency care and transportation of the sick and injured (10th ed.). Sudbury, MA: Jones and Bartlett.

The Mysterious Genetic and Epigenetic Gonnection Between Obesity and Type 2 Diabetes A Snapshot of Diabetes in the United States. (2014). Retrieved March 22, 2016, from http://www.cdc.gov/diabetes/pubs/images/diabetes-infographic.jpg Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among U.S. Adults Aged 18 years or older. (2010). Retrieved March 6, 2016, from http://www.cdc.gov/diabetes/statistics (Originally photographed 2010) Drong, A. W., Lindgren, C. M., & McCarthy, M. I. (2012). The genetic and epigenetic basis of type 2 diabetes and obesity. Clinical Pharmacology & Therapeutics, 92(6), 707-715.

Guh, D. P., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C. L., & Anis, A. H. (2009). The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC public health, 9(1), 1.

Lovejoy, J. C., & Sainsbury, A. (2009). Sex differences in obesity and the regulation of energy homeostasis. Obesity Reviews, 10(2), 154-167.

McCarthy, M. I. (2010). Genomics, type 2 diabetes, and obesity. New England Journal of Medicine, 363(24), 2339-2350.

Mirmira, P., & Evans-Molina, C. (2014). Bisphenol A, obesity, and type 2 diabetes mellitus: genuine concern or unnecessary preoccupation?. Translational research, 164(1), 1321.

National Diabetes Statistics Report, 2014. (2014). Retrieved March 22, 2016, from http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf Scuteri, A., Sanna, S., Chen, W. M., Uda, M., Albai, G., Strait, J., ... & Dei, M. (2007). Genomewide association scan shows genetic variants in the FTO gene are associated with obesity-related traits. PLoS Genet, 3(7), e115.

Van Gaal, L. F., Mertens, I. L., & Christophe, E. (2006). Mechanisms linking obesity with cardiovascular disease. Nature, 444(7121), 875-880.

Zika Virus and You 1 Zika and Pregnancy. (2016). Retrieved March 18, 2016, from http://www.cdc.gov/zika/pregnancy/question-answers.html 2 Mcneil, D. G., Louis, C. S., & St, N. (2016). Short Answers to Hard Questions About Zika Virus. Retrieved March 18, 2016, from http://www.nytimes.com/interactive/2016/health/what-is-zika-virus.html 3 Olympic Athletes Concerned About Zika Virus. (n.d.). Retrieved March 18, 2016, from http://learningenglish. voanews.com/content/zika-virus-olympic-concerns/3187238.html 4 Zika virus associated with 1 in 100 risk of microcephaly, says study. (2016). Retrieved March 18, 2016, from http://www.theverge.com/2016/3/17/11252840/zika-virus-risk-microcephaly-lancet 5 Zika virus disease in the United States, 2015–2016. (2016). Retrieved March 24, 2016, from http://www.cdc.gov/ zika/geo/united-states.html 6 Rutgers Centers for Global Advancement and International Affairs. (n.d.). Retrieved March 24, 2016, from http://global.rutgers.edu/health-travel/special-advisories Infidelity: The Neurochemical Weakness that Stems from within 1Le, B. (2013, November 23). Cheaters Use Cognitive Tricks to Rationalize Infidelity. Retrieved March 13, 2016 2Nelson, T. (2015, March 10). Are we meant to be monogamous? Why people cheat, and the appeal of open relationships. Retrieved March 13, 2016 3Moffit, M. (2015, October 29). The Science of Cheating. Retrieved March 13, 2016 4Le, B. (2013, November 20). Cheaters Use Cognitive Tricks to Rationalize Infidelity. Retrieved March 26, 2016

Is Rutgers Caring Enough About Diabetes Care?

1 Louis, C. S. (2015, October 26). Many Schools Failing on Type 1 Diabetes Care. Retrieved March 04, 2016, from http://www.nytimes.com/2015/10/27/health/many-schools-failing-on-diabetes-care.html?_r=0 2 Whittingham, J. L., Jonassen, I., & Havelund, S. (2004). Crystallographic and Solution Studies of N-Lithocholyl Insulin: A New Generation of Prolonged-Acting Human Insulins†. Retrieved March 04, 2016, from http://pubs.acs. org/doi/pdf/10.1021/bi036163s Take a Right Down Bone Marrow Drive 1 Be The Match. (2016). Donation FAQs. Retrieved March 04, 2016, from https://bethematch.org/Support-the-Cause/ Donate-bone-marrow/Donation-FAQs/ 2[Personal Interview with Betty Kelly, February 22, 2016] 3 Shay, Christopher. (2010, June 03). Bone Marrow Transplants: When Race Is an Issue. TIME. Retrieved March 2, 2015, from http://content.time.com/time/health/article/0,8599,1993074,00.html 4 Hudson, William. (2012, December 26). Why I donated my bone marrow. CNN. Retrieved March 2, 2015, from http://www.cnn.com/2012/12/25/health/bone-marrow-donation/ What’s That Smell?

1Alvarez, M. (2007, Jan 9). Gas Leaks: What You Don’t Smell Will Harm You. Fox News.

Retrieved from http://www.foxnews.com/story/2007/01/09/gas-leaks-what-dont-smell- will-harm.htm 2 Carbon Monoxide Detector Requirements, Laws, and Regulations.

(2015, September 3). Retrieved from http://www.ncsl.org/research/environment-and-natural-resources/carbon-monoxide-detectors-state-statutes.aspx They Are What You Eat 1Weinhold, B. (2006). Epigenetics: The Science of Change. Environmental Health Perspectives, 114(3), A160–A167.

2Ling, C., & Groop, L. (2009). Epigenetics: A Molecular Link Between Environmental Factors and Type 2 Diabetes. Diabetes, 58(12), 2718–2725. http://doi.org/10.2337/db09-1003 3Jin, B., Li, Y., & Robertson, K. D. (2011). DNA Methylation: Superior or Subordinate in the Epigenetic Hierarchy? Genes & Cancer, 2(6), 607–617. http://doi.org/10.1177/1947601910393957 4Blakey, C. A., Litt, M. D., & Huang, S. (2015). Epigenetic Gene Expression and Regulation.

London, UK: Academic Press.

5Skinner, M. K., Manikkam, M., & Guerrero-Bosagna, C. (2010). EPIGENETIC TRANSGENERATIONAL ACTIONS OF ENVIRONMENTAL FACTORS IN DISEASE ETIOLOGY. Trends in Endocrinology and Metabolism: TEM, 21(4), 214–222. http://doi.org/10.1016/j.tem.2009.12.007 Insight Into Schizophrenia 1National Institutes of Health. (n.d.). Schizophrenia. Retrieved from http://www.nimh.nih.gov/health/publications/ schizophrenia-booklet-12-2015/index.shtml#pub2.

2Rutgers University. (n.d.). Division of Schizophrenia Research Studies. Retrieved from http://ubhc.rutgers.edu/dsr/ research/index.html.

3Diapha, P. (2016). Formal Control. Retrieved from Rutgers University Sociology 101.

A Mildew Manifestation: Mold in College Dormitories 1 Sun, Y., Zhang, Y., Sundell, J., Fan, Z., & Bao, L. (2009). Dampness in dorm rooms and its associations with allergy and airways infections among college students in China: A cross-sectional study. Indoor Air, 19(4), 348-356. Retrieved March 23, 2016.

2 Mayer, Heather. FOX News Network (26 July 2011). 2011”9 Health Hazards Hidden in College Dorms | Fox News.”Fox News. Web. 02 Mar. 2016.

3 Gabriel, M. F., Postigo, I., Tomaz, C. T., & Martínez, J. (2016). Alternaria alternata allergens: Markers of exposure, phylogeny and risk of fungi-induced respiratory allergy. Environment International, 89-90, 71-80.

Can You Game Too Much?

1First U.S. inpatient treatment center for Internet addiction opening. (2013, September 7). Retrieved November 23, 2015, from http://kdvr.com/2013/09/07/first-u-s-inpatient-treatment-center-for-internet-addiction-opening/ 2Wolchover, N. (2012, October 4). What Is Internet Use Disorder? Retrieved November 23, 2015, from http:// www.livescience.com/34264-internet-use-disorder-addiction.html 3Neal, M. (n.d.). Addiction? Video Games Crowded Out Man’s Real Life. Retrieved November 23, 2015, from http://www.huffingtonpost.com/2011/08/28/addiction-video-games-cro_n_939892.html 4Quigley, R. (2013, May 3). ‘I killed my mom with my .22. I don’t know why I did it’: Chilling 911 call reveals 13-year-old boy admitting he tried to rape and then shot dead his mom ‘for taking away his Call of Duty video game’ . Retrieved November 23, 2015, from http://www.dailymail.co.uk/news/article-2319064/Noah-CrooksChilling-911-reveals-13-year-old-boy-admitting-tried-rape-shot-dead-mom-taking-away-video-game.html IUDS: The New Black of Contraceptives 1Tarico, V. (2013, October 15). A Brief History of the IUD: The Strange Ways We’ve Tried to Stop Pregnancy.

Retrieved October 28, 2015, from http://www.alternet.org/personal-health/brief-history-iud-strange-ways-wevetried-stop-pregnancy 2Cheng, S., & Leuven, K. (2015). Intrauterine Contraception and the Facts for College Health. The Journal for Nurse Practitioners,​417­423. Retrieved October 28, 2015, from http://www.sciencedirect.com/science/article/pii/ S1555415514007570 3Sifferlin, A. (2014, June 30). The Best Form of Birth Control is the One No One is Using. Retrieved October 28, 2015, from http://time.com/the-best-form-of-birth-control-is-the-one-no-one-is-using/ 4Young, J. (2015, February 24). The IUD Is Getting More Popular In America. Here’s Why. Retrieved October 28, 2015, from http://www.huffingtonpost.com/2015/02/24/iud­birth­control_n_6736218.html 5American College Health Association. (2014). American College Health Association­-National College Health Assessment (ACHA-­NCHA) Institutional Data Report ­Fall 2014 Rutgers University New Brunswick [PDF File]. ​ Hanover, MD: Author.

6American College Health Association. (2012). American College Health Association-National College Health Assessment (ACHA-­NCHA-­II) Institutional Data Report­Fall 2012 Rutgers University [PDF File]. Hanover, MD: Author.

Parasitology: The Debugging of Parasites Works Cited Malaria. (n.d.). Retrieved March 04, 2016, from http://www.who.int/mediacentre/factsheets/fs094/en/ Callaway, E., & Cyranoski, D. (2015, October 5). Anti-parasite drugs sweep Nobel prize in medicine 2015. Retrieved March 04, 2016, from http://www.nature.com/news/anti-parasite-drugs-sweep-nobel-prize-in-medicine-2015-1.18507 3. Sukhdeo, M., Dr. (2016, March 4). Parasitology [Personal interview].

4. Parasitologist | Bioscience Careers | About Bioscience. (n.d.). Retrieved March 04, 2016, from http://www. aboutbioscience.org/careers/parasitologist 5. Johnson, S., & Hirschler, B. (2015, October 05). Beating parasites wins three scientists Nobel prize for medicine. Retrieved March 04, 2016, from http://www.reuters.com/article/us-nobel-prize-medicine-idUSKCN0RZ0U020151005

Take Your Brain for a Run Malaria. (n.d.). Retrieved March 04, 2016, from http://www.who.int/mediacentre/factsheets/fs094/en/ Callaway, E., & Cyranoski, D. (2015, October 5). Anti-parasite drugs sweep Nobel prize in medicine 2015. Retrieved March 04, 2016, from http://www.nature.com/news/anti-parasite-drugs-sweep-nobel-prize-in-medicine-2015-1.18507 3. Sukhdeo, M., Dr. (2016, March 4). Parasitology [Personal interview].

4. Parasitologist | Bioscience Careers | About Bioscience. (n.d.). Retrieved March 04, 2016, from http://www. aboutbioscience.org/careers/parasitologist 5. Johnson, S., & Hirschler, B. (2015, October 05). Beating parasites wins three scientists Nobel prize for medicine. Retrieved March 04, 2016, from http://www.reuters.com/article/us-nobel-prize-medicine-idUSKCN0RZ0U020151005 Contact Lens Confessions 1 Nearly All Contact Lens Wearers in National Survey Report Risky Eye Care Behaviors That Can Lead to Eye Infections. (2015, August 20). Retreived from http://www.cdc.gov/media/releases/2015/p0820contact-lens.html 2[Personal interview, March 17, 2016] 3[Personal interview, March 8, 2016] 4 Garg, P., & Rao, G. N. (1999). Corneal Ulcer: Diagnosis and Management.Community Eye Health, 12(30), 21–23.

5[Personal interview, March 3, 2016] The Daily Life of An Epileptic 1Fisher, R. S., Boas, W. v. E., Blume, W., Elger, C., Genton, P., Lee, P. and Engel, J. (2005), Epileptic Seizures and Epilepsy: Definitions Proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 46: 470–472. doi: 10.1111/j.0013-9580.2005.66104.x 2Schachter, S. C. (2014, March). Who Gets Epilepsy? Retrieved March 04, 2016, from http://www.epilepsy.com/learn/epilepsy-101/who-gets-epilepsy Single But Deadly 1Fisher, R. S., Boas, W. v. E., Blume, W., Elger, C., Genton, P., Lee, P. and Engel, J. (2005), Epileptic Seizures and Epilepsy: Definitions Proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 46: 470–472. doi: 10.1111/j.0013-9580.2005.66104.x 2Schachter, S. C. (2014, March). Who Gets Epilepsy? Retrieved March 04, 2016, from http://www.epilepsy.com/learn/epilepsy-101/who-gets-epilepsy Four Years Wiser, Four Fewer Teeth 1Tooth Eruption: The Permanent Teeth. (2006, January 1). Retrieved March 28, 2015, from http://www.ada.org/~/ media/ADA/Publications/Files/patient_58.ashx 2Carr, A. (2014, February 27). Impacted wisdom teeth. Retrieved March 28, 2015, from http://www.mayoclinic. org/diseases-conditions/wisdom-teeth/expert-answers/wisdom-teeth-removal/faq-20058558 3Rogers, K. (n.d.). 7 Vestigial Features of the Human Body. Retrieved March 28, 2015, from http://www.britannica.com/list/136/7-vestigial-features-of-the-human-body 4Who put the “Wisdom” in Wisdom Teeth? (2007, August 1). Retrieved March 28, 2015, from http://www.altusdental.com/pdfs/altustips_wisdomteeth.pdf 5Wisdom Teeth. (n.d.). Retrieved March 28, 2015, from http://www.ada.org/en/Home-MouthHealthy/az-topics/w/wisdom-teeth

Image References Zika Virus Images.nbcnews.com Take A Turn Down Bone Marrow Lane footage.framepool.com greysanatomy.wikia.com Wikipedia.com Fanpop.com Newhealthadvisor.com Diabetes Care usnews.com

“Let the world b Throw the prism light —Ray Bra

d burn through you. ght, white hot, on paper.� radbury, WD

Thanks for Reading!

- The Examiner Team