Examiner 2018 spring

Features Dynamic Interpersonal Relations with Geriatrics Anisha Singh Debunking Myths about Coffee Shea Patel Anosognosia: A Break from Reality Nikhita Nambiar

pre-health journal for the students, by the students

“wherever

the art of medicine is loved,

there is also a love of

humanity�

-

hippocrates

staff editor in chief Soundarya Nattuva Matthew M. Kim senior Managing Editor Jennifer Fang Managing Editors Hill Chang Kaylynn Shuleski Diljeet Kaur Priyanka Tiwari Chandni Khawaja Pooja Deshpande senior layout editor Yasasvi Talagadadeevi layout editor Aliyah Khatri webmaster Dilon Heyck public relations Ummia Zaman Benjamin Feng treasurer Mihika Shah events Khush Patel

journalists Anisha Singh Faraz Khan Dhruthi Patel Daniel Peltyszyn Nicholas Page Soundarya Nattuva Katelyn Sudak Jeremy Mahr Nikki Kurian Jasmine Cheung Shea Patel Minna Kim Amy Fakhri Anusha Patil Rushabh Mehta Soham Shah Taylor Good Ben Estabillo Nikhita Nambiar Prateeksha Rout Troy Karanfilian Hira Tassawar Rachael Ogbonna Gabby Dedvukaj Sam Friedman Elizabeth James Rohan Shah David Natanov Shreya Saranathan

Table of Contents Anisha Singh Dynamic Interpersonal Relations with Geriatrics Faraz Khan Pimp Your Ride, Not Your Mouth Dhruthi Patel Man Made Medicine and Women’s Health Daniel Peltyszyn The War on GMOs: A Brief Overview Nicholas Page Defying Aging: The Biology of Naked Mole Rats Soundarya Nattuva Chimeras: A Solution to Organ Transplants Katelyn Sudak Hippocratic Hypocrite Jeremy Mahr Meditation Workshops Offer Fresh Perspective on Mental Health Relief Nikki Kurian Hey, Who Needs Medicine?

Jasmine Cheung What’s the Flu to You? Shea Patel Debunking Myths about Coffee Minna Kim What Ought We to Do?: Exploring a Deficiency of Undergraduate Ethics Education Ben Estabillo Of Mice and Mental Illness: How Affective

Biases in Mice Offer Insight on Depression Nikhita Nambiar Anosognosia: A Break from Reality Prateeksha Rout Turning a new page in research techniques: The in vivo revolution Amy Fakhri Healing Medicine: Dangerous Side Effects for Women Anusha Patil Search the Soil: The Newest Antibiotic for Drug Resistance Rushabh Mehta A Single Breakthrough, a Single Genome, and Two Macaques Taylor Good Don’t Flakka Do Drugs Soham Shah Fighting the Unknown: Researching Rare Diseases Troy Karanfilian Swallowing Change Hira Tassawar The Healing Power of Music Gabby Dedvukaj E-Cigarettes Sam Friedman A Turning Point in Psychiatric Symptomatology Elizabeth James Is it All in Your Head? Scientific Theories About Trypophobia Rohan Shah A Charge for Change in an Addiction Crisis David Natanov The Search for a Stress Vaccine Shreya Saranathan Progeria: A Rare, Fatal and Incurable Disease Rachael Ogbonna Skin Graft Essentials

Aging is a process of accumulating colorful experiences, varying mindsets, ample precautions from past mistakes, noteworthy accomplishments followed by greater successes, and long lengths of wisdom that lead to last a lifetime inside the head and the heart of each individual. Unfortunately, aging also comes with its side effects, from cognitive impairments to physical restraints by the body’s organs. In fact, the Family Caregiver Alliance stated that there is a 68% chance of a person 65 years of age or older becoming physically disabled in at least two activities of daily life or becoming mentally impaired.1 As a result, the field of geriatrics is constantly growing. Geriatrics specializes to aid the aging population in their health and mental needs in order to minimize the effects their conditions have on their standard of living. There is evidence that the number of elders over the age of 64 in paid longterm care services will double by the year 2050 due to the increasing growth of the need for the field.1 During my time shadowing a geriatric internal medicine physician, I was able to step in and take a walk into the field and interact with each of its patients to build a better understanding and appreciation of geriatrics.

Every day that I come into the healthcare center, I learn something new about medicine and the uniqueness of the field. An average day at the particular healthcare center consists of first making rounds to the long-term patients who arrived from the hospital for rehabilitation and care and making sure they are on the right path for recovery. Afterwards, we head to the physical therapy department to assess the current regimes that some of the patients are going through and make changes as needed. Then, we head to the medical clinic, which runs like a normal doctor’s office but caters to the elderly population that lives in the Independent Living apartments of the nursing home. Standing alongside Dr Nanavati, I can see how careful he is with each patient, see how his actions and knowledge

of geriatrics reflect in his relations with the patients, and learn how to interact with the different types of older patients. For example, especially for those patients with dementia--a mental condition common among this population--the physician would sit at eye level with them rather than standing, talk to them in a calm manner and about only one thing at a time, avoid distractions in the environment, and have patience and be ready to repeat the information a couple of times.

The study of geriatrics extends beyond the doctor’s office. At Rutgers University’s Department of Health, Health Care Policy, and Aging, there is a wide variety of ongoing research projects immersed in the field. Some studies address how the differences in one’s healthcare and access to healthcare affect access to proper care and eventual treatment.2 Another study

by Tobias Gerhard, D. P. Devanand, and Cecilia Huang observes the effect of lithium therapy on the risk for dementia on a population participants diagnosed with bipolar disorder. The study has published an article in 2015 concluding that the lithium therapy has indeed reduced the risk for dementia, and thus providing one of the few ever found therapy treatments for dementia.3

From my time shadowing at the center, I learned about how hearing loss works in elders and effective communication techniques, about the differences between congestive heart failure and chronic vena stasis, about the prevalence of dementia and Parkinson’s disease in elders. Every time I shadow, I continue to overflow my notebook with inscribed notes on the richness of knowledge that can be accumulated from geriatrics. Not only does the growing field provide a teeming amount of information, but also a collection of wisdom and perspectives picked up from the incoming patients, job satisfaction in giving back to where a lot of need is in high demand, and growing personal relations with each patient that cannot have been collected from simply reading a textbook.

Pimp Yo ur Ride, Not Yo ur Mo uth.

Faraz Khan

In an increasing digitalized world, facial and body appearances are becoming more of a concern for young adults. However, irreversible modifications to the human body have been performed for a millennium by ancient and modern civilizations for various reasons. Surface tattooing, tribal imprinting, and body piercings that were used by ancient civilizations are also commonly seen today. Specifically, the phenomenon of a piercing within the oral cavity has been practiced throughout history by diversified groups of people.2 Whether for a desired aesthetic on Instagram, some teenagers are getting piercings located in their oral cavity which can have a detrimental impact in regards to one’s dental health.3 Intraoral piercings can cause certain mutilations of the tongue, cheek, frenulum, and uvula, which can then lead to a myriad of dental complications.4

Piercings located in the oral cavity can have inimical effects which range from damage to hard and soft tissue to the development of caries, or cavities.4 About one in ten young adults in Britain have an oral piercing with the tongue being the most prevalent location.1 A metal stud implanted in the tongue or lip can hinder cleaning and result in damaging repercussions on one’s oral health.5 Dental health is critical during one’s adolescent years since almost all permanent

adult teeth emerge during this time.8 Dental plaque or tartar, from infection, can engender demineralization of the enamel surface resulting in tooth decay.6 One of the most common complications that arises from a tongue piercing is a tongue fissure, which are benign, wrinkled grooves that form on the surface of the tongue.4 In serious cases, the metal stud located in one’s oral cavity may affect their periodontal structure and in turn, cause gum recession and bone loss.6

A metal stud in the lower lip is usually related to gum recession, whereas a tongue piercing is associated with tooth decay.7 The prolonged implanted presence of metal in the mouth can affect organs throughout the entire human body. Systemic complications such as dermatitis (skin eczema) and endocarditis (inflammation of heart valve) can result from severe infections from a metal stud situated within the oral cavity.7

If you have an oral piercing it is recommended to remove the jewelry daily, and clean it with detergent and alcohol. It is also critical to clean the piercing area as well, with a brush and antiseptic mouthwash.3

For whatever reasons one may want to modify their oral cavity whether it be for fashion, recalcitrance, or individuation, the health risks involved can be deleterious.4 And let’s be honest, posting a picture of your piercing on Instagram won’t even hit triple-digit likes.

Man Made Medicine & Dhruti Patel Women’s Health

Every cell in our bodies has a sex. This means that men and women are different at the cellular level.

More notably, the genetic and biochemical differences between the two sexes can greatly affect one’s health.

In fact, there is growing evidence of sex differences in the development, symptoms, prognosis and severity of diseases such as obesity, HIV/AIDS, tuberculosis, autoimmune problems and coronary heart disease, to name a few. In addition to different patterns of illness, “differences in the physiology of the sexes [such as in energy storage and metabolism] translate into differences in [the] pharmacokinetics and/or pharmacodynamics [of] specific drugs”.³ Simply, men and women metabolize some types of drugs differently. The understanding of these sex-based differences are crucial in developing new approaches to the prevention, diagnosis and treatment of diseases. Therefore, being male or female is a fundamental variable in designing and analyzing clinical research.

In the past, clinical trials have not always adequately enrolled women or analyzed sex-specific differences in the data. However, in the recent decades, there have been numerous initiatives in the United States by the NIH and FDA to remedy this underrepresentation of women and inadequate attention to sex differences in medical research. In 2015, “a comprehensive review of the roles of the NIH and FDA in increasing the quantity and quality of research involving women [...] found that including women in research and [the] use of improved data analysis approaches have had a positive impact on the treatment of breast and cervical cancer and cardiovascular disease”.² The integration of

sex considerations in clinical research “strengthens the overall health evidence base, helps facilitate specificity in health policies and planning, allows clinicians to better tailor care to individuals, and [...] contributes to the attainment of health equity goals globally”.¹

Not nearly enough progress has been made, however. There is a lack of research focused on maternal morbidity and mortality, alcohol and drug addiction, lung cancer, malignant and nonmalignant gynecologic disorders and cancers, and Alzheimer’s disease. “Women [also] remain underrepresented in clinical trials in cardiovascular disease, the primary killer of both women and men in the United States, and cancer, the nation’s second leading cause of death for both women and men”.⁴

Fortunately, more steps are being taken in order to include women and minorities in scientific research. In 2016, the FDA Office of Women’s Health and the NIH Office of Research on Women’s Health launched an initiative called “Diverse Women in Clinical Trials” in order to increase the number of female and minority participants in medical research.

“Biennial reports to Congress are [now being] required on [the] progress made in women’s health research and the professional status of women physicians and scientists. Most importantly, provisions for the appropriation of federal funding through the NIH to support the enactment of the law are included”.²

As future clinicians, nurses, doctors or researchers, patient advocacy is the cornerstone of our professions. Initiatives as such are opportunities to make medical treatments safer and more effective for all women.

The The War War on on GMOs: GMOs: aa Brief Brief Overview Overview A genetically modified organism, or GMO, is an organism whose genetic material has been manipulated through genetic engineering. 1 Such manipulations result in changes in the organism’s DNA nucleotide sequence, which ultimately affects the proteins that arise through transcription and translation and go on to define the organism’s phenotypic properties. GMOs can be anything from bacteria to plants to animals, and play roles in biotechnology, biomedical research, and ecology. 2 Despite their various applications, such organisms are most commonly discussed with respect to their role in human food and agriculture, which has grown to be a highly contested subject.

The subject of GMOs in agriculture splits the aisle in two, dividing scientists and nonscientists on their usefulness, safety, and potential environmental consequences. The debate is complicated further by strong public opinion in addition to companies, advocacy groups, and special interests that have taken firm stances on both sides. One of the frontrunners in GMO awareness is the Non-GMO Project, which is “dedicated to building and protecting a non-GMO food supply” and offers its characteristic blue label to products that meet its standards. 3 Similarly, Whole Foods has called for clear labeling of products that include GMOs, while Chipotle and Ben & Jerry’s have stopped using GMO ingredients. 4, 5, 6 These actions are likely a reflection of public opinion, as a 2013 New York Times poll found that 93% of respondents called for clear labeling of products that contain GMO ingredients, while 26% said that such foods are toxic.

7 Critics of GMOs, such as the Non-GMO Project, assert that the research claiming that GMOs are safe is biased, as such research is conducted by biotechnology companies that produce them. 12 One of the organization’s central claims is that GMOs negatively impact the environment; given that most GMOs are engineered for resistance to herbicides and production

Daniel Peltyszyn

of pesticides, they have allegedly contributed to the emergence of superweeds and superbugs that require stronger compounds to kill. The group also maintains that GMOs and the patents that biotechnology companies hold over them negatively impact farmers, who can be sued for even accidental growth in their fields. 13 Still, others question the long-term health effects of GMO consumption and argue that even after intentional manipulation of the genome, accidental changes could spontaneously occur, potentially giving rise to new toxic proteins or allergens. 8 Meanwhile, proponents of plant or plantbased GMOs argue that they are safe to consume, and that GMOs lower the price of food, increase farmer safety by allowing them to apply fewer pesticides, produce higher yields, grow in less-than- favorable soils, endure extreme temperatures, tolerate insects, and withstand disease and herbicides. 8 Given that more than 80% of corn and 90% of soybeans and cotton grown in the United States are genetically modified without evidence of any significant risk, scientists argue that GMOs might be the golden ticket in the face of an ever-growing population. 9, 10 It is estimated that malnutrition contributes to half of all deaths in children under five; GMOs serve as a potential solution, the most prominent example being golden rice. 11 This genetically-modified rice variety is so called because of its distinctive yellow hue, caused by the insertion of a gene from corn and another from a bacterium that allows for beta-carotene production, a source of vitamin A. 14 If golden rice were to become a staple food in certain parts of the world, vitamin A deficiency could be reduced, lessening the pervasiveness of blindness and weakened immune systems that it causes.

Regardless of what any corporation, organization, or scientist claims, the power to choose ultimately lies with the consumer. Before picking up that bag of potato chips or tub of oatmeal, or putting down that cotton t-shirt, consider the evidence presented by both parties and make an educated decision.

Humans have long been fascinated with the idea of living forever. The idea of eternal life is entrenched in human mythology, stretching back to antiquity in the form of stories such as the fountain of youth and the sorcerer’s stone. Despite our hopes and dreams, humans have yet to overcome the inevitable tide of aging. One animal, however, may have already cracked the antiaging code: the naked mole rat. While they do not quite live forever, naked mole rats are unique amongst mammals because they defy Gompertzian mortality laws. In simplistic terms, they do not age. This surprising feature was discovered by scientists at Calico labs, the Google funded startup that hopes to understand the biological causes of aging. By drawing from a catalog of nearly 4,000 naked mole rats that they kept in their colony for 35 years, researchers were able to perform detailed analysis of naked mole rate death rates 1 . By showing that naked mole rats do not undergo aging, scientists have discovered a mammalian model organism for studying the molecular mechanisms that may underlie longevity.

While many of us perceive aging as a sum of its symptoms, wrinkly skin, loss of muscle mass, dementia, and increased risk for cancer, the scientific definition of aging is much more specific. Aging is defined as the increased probability of dying as an organism grows older 2 . By this definition, humans clearly undergo significant aging as the chance of dying doubles every eight years after the age of 30 3 . This relationship is defined in the Gompertzian mortality laws which state that aging increases exponentially in humans after 30 years of age. This law also applies to all mammals once they reach adulthood. In the current research by Calico, it has been shown that naked mole rats defy Gompertzian mortality laws, in other words, the chance of a naked mole rate dying stays approximately constant as they grow older which is equivalent to proving that they do not age.

Naked mole rats have long been of interest to scientists because of their biological peculiarities. Notably, they have a lifespan that is quadruple that of a similarly sized mouse and they are known to be resistant to developing cancer 4 . Additionally, naked mole rats are also

Defying Aging:

The Biology of Naked Mole Rats Nicholas Page known to possess upregulated levels of proteins involved in DNA repair and proper protein folding 5, 6 . On top of all of this, their ribosomes contain three rRNA subunits in contrast to the two subunit ribosomes typical to other mammals a modification which helps to decrease the error rate during mRNA translation 7 . All of these findings demonstrate that naked mole rats are quite unique in comparison to other mammals. These past discoveries are what inspired researchers at Calico labs to invest in a long study of naked mole rat lifespan to determine once and for all if naked mole rats aged.

This finding opens the door for exciting possibilities in the future of aging research.

Calico Life Sciences, which discovered the lack of aging in naked mole rats has over $1.5 billion in the bank due to its connections to Google and thus has plenty of money to ask questions about the biological mechanisms of aging. Now that naked mole rats have been demonstrated to be the first mammal to lack aging, they can be used as a model system to study differences in cellular biology between mammals that age and do not age. This will eventually pave the way to developing drugs that may be able to mitigate the side effects of aging or possibly reduce the rate at which we age. Due to its position as a private company, Calico has been very secretive about their research up to this point so the scientific community is unaware of what other exciting projects they may be working on. Either way, using this first discovery as a stepping stone, there is certainly hope that scientists are getting closer to understanding the root causes of aging.

Chimeras:

A Solution to Organ Transplants

In the United States, roughly twenty people die every day waiting for an organ transplant.

With only 12,211 donors and 116,592 people in need of an organ, the need for donated organs is greater than the supply 1 . To combat this problem, scientists are looking for alternative ways to obtain organs. Currently, scientists are perfecting the creation of functional organs from stem cells in vitro, meaning the procedure was performed outside of an organism. Recently a group of researchers at University of Minnesota have come up with less conventional method to creating organs: chimeras, or human-animal hybrids. This procedure involves injecting adult human stem cells into the early stage embryo of an animal, and later harvesting the fully transplantable human organs at adult stage. In the past twelve months, plenty of progress towards implantation of human stem cells into animal embryos has been made. This progress is a result of combining gene editing, stem cell biology and several frontline technologies. Professor Daniel Garry, a cardiologist and the leading head for a variety of chimera projects at the University of Minnesota, with his team of researchers, have created the first successful human-pig chimera.

The research team aims to “[incubate] human organs, genetically matched to a patient, for use in transplants or for testing new medicines more safely and effectively” 2 . The process first involves “knocking out” key genes of a specific organ, using CRISPR, to stop its development. Then, induced pluripotent human stem cells (iPS) are injected into a pig embryo so that the tissue of interest can develop inside the pig embryo. As a result, Daniel Garry allowed for the incubation of a human organ of

interest through stem cell biology. Of the 2,000 hybrids that were transferred to surrogate sows, more than 150 of the embryos developed into chimeras that were mostly pig, but with a tiny human contribution; this means that for every 1 human cell, there were 10,000 pig cells. The researchers and their teams are aware of the ethical concerns that might arise from this milestone so they only allowed the pig fetus to develop for one trimester, or 28 days; the development was terminated 3 . Daniel Garry suggests that with this innovation, an interspecific chimera has an organ well suited to the patient in need of them.

Despite achieving a huge milestone in chimera research, it has reignited ethical concerns; a few of which include the possibility of creating “intelligent animals with humanized brains”, the “potential for bizarre hybrid creatures to be accidentally released into the wild”, the possibility of “the progeny would look more human or more pig” and, most importantly, whether it was ethical or not to take the lives of animals in order to improve the lifestyle and salvage the lives of the individuals 2. Though this option could potentially save many lives and alleviate the lifestyles of those effected by a weary or lack of an organ, would result in the deaths of a large number of animals. While several cases addressed the ethical concerns regarding the of killing animals for the benefit of humans, others discussed and tried to justify the rationale and importance of saving human lives over that of animals.

Regardless of what ethical lens one chooses to look through, the development of chimera organs is a rapidly emerging medical reality with great rewards as well as objectionable costs.

Soundarya Nattuva

Hippocratic Hypocrite Katelyn Sudak

In a time of powerful campaigns such as Tarana Burke’s #MeToo Movement or the Time’s Up Legal Defense Fund, more women are becoming vocal about their experiences with sexual assault. While the #MeToo Movement strives to support survivors and end sexual violence, 1 the Time’s Up Legal Defense Fund’s goal is to “end sexual assault, harassment and inequality in the workplace.” 2 Although these two movements have slightly varying goals and target different audiences, they recognize the same problem: women of all backgrounds-- from the everyday woman to celebrities in Hollywood-- are experiencing sexual violence and something must be done to stop it. Victims are now beginning to speak out and directly address their perpetrators in an effort to stop sexual assault.

However, victims never expect their perpetrators to be their doctors. Most recently and publicly, Larry Nassar, the doctor to the US Olympic women’s gymnastics teams, athletes at Michigan State University and girls at Michigan’s Twistars gymnastics club, pleaded guilty to sexually abusing girls under the guise of medical treatment. 3 Nassar admitted to these actions after more than 100 accusers filed civil lawsuits against him. As Olympic Gold Medalist McKayla Maroney read in her statement, Nassar “abused my trust, he abused my body and he left scars on my psyche that may never go away.”

4 The countless other statements from other victims shared the same general message. Many of the women involved put their trust in Nassar, as he told them that he was providing medical treatment, and he abused it.

Unfortunately, Nassar’s abuse of power is not isolated; it is just one of the many instances of doctors exploiting the trust of their patients.

These actions go against the fundamental medical code of conduct for medical professionals: the Hippocratic Oath. The Oath states that physicians

must “abstain from every voluntary act of Mischief and Corruption and further from the seduction of females or males, of freemen and slaves.” 5 Through the actions of numerous doctors, including Nassar, the core principles of the Hippocratic Oath are being disregarded, making these individuals hypocrites for repeating the Oath without following it.

Medical codes of conduct are put in place to protect both the patient and the doctor.

Through providing these ethical guidelines, physicians are able to define a clear relationship between patient and doctor, safeguarding all involved individuals. When these codes are broken, there will be a significant impact on both the doctor and the patient. While the doctor may face jail time and lose his or her license, the patient will be impacted much more severely.

As McKayla Maroney stated, Nassar’s actions had, and continue to have, an impact on her mental wellbeing. Other abused patients report “serious levels of depression, anxiety, suicidal thoughts or attempts, and dissociation.” 5 Additionally, victims find it hard to trust others, as well as themselves. After not being able to trust their own physicians, victims often find it hard to trust their loved ones. Some victims even find it hard to trust themselves, often blaming themselves for these horrific acts. Victims may believe that “their lack of clear judgment and inability to protect themselves” led to the abuse. 5

The atrocities that Larry Nassar made his victims endure is unacceptable and unethical.

Fortunately, sexual abuse victims are beginning to address the perpetrators directly, allowing them to receive the justice they deserve.

Through examining Larry Nassar’s actions, the importance of adhering to ethical conduct codes is revealed, as well as the consequences that result if these codes are not followed.

Meditation Workshops Offer Fresh Perspective on Mental Health ReLief Jeremy Mahr

Meditation, the process wherein an individual focuses their attention on a particular thought, object, or activity for the purpose of achieving a more relaxed emotional and mental state, has long been a part of diverse religious traditions such as Buddhism, Hinduism, and Taoism. More recently, meditative practices have been exported to the West for secular purposes of stress reduction, relaxation, and self-improvement, including at Rutgers University. As part of its wider arsenal to combat mental illness in the university, the Rutgers Counseling, ADAP, and Psychiatric Services (CAPS) offers free Mindfulness Meditation Noon Workshops for students and personnel alike, under the instruction of Dr. Siobhan Gibbons.

A staff psychologist affiliated with Rutgers CAPS, Dr. Gibbons is also a certified instructor in Mindfulness Based Stress Reduction. She is involved in instructing noon meditation workshops three times per week across the University. After introducing herself to the Tuesday group at the Busch Campus Center, she organizes the session, as usual, into three parts.

First, she begins with a sitting meditation exercise. As the meditation group is told to close their eyes and sit still in their chairs with backs straight, Dr. Gibbons encourages each individual to let go of everyday thoughts and instead concentrate on the rates of his or her own breathing. Next, she proceeds with the standing meditation. While standing with their eyes closed, the students are once again urged by Dr. Gibbons to shield themselves from distracting thoughts while focusing attention onto their body positioning. The last portion of the session is the wildcard, in which Dr. Gibbons introduces a new meditation technique unique to each session. For this Tuesday workshop, she decides to lead with a short walking exercise, with emphasis placed on each individual forward, rolling, and pivoting motions of the foot.

She then allows the students to experiment around different forward, backward, and sideways motions.

Despite the versatility of the tasks, these exercises collectively used the concept of meditation to assist practitioners in separating themselves from the anxieties of everyday life.

The well-substantiated body of research demonstrating the link between meditation and improved well-being can be credited towards the modern popularity of meditation as a self-care tool. A study carried out by Yale University found that meditation reduced behaviors associated with unhappiness, rumination, and worrying by decreasing activity in the Default Mode Network, a region of the brain that has been linked to mind-wandering and self-related thinking [1]. Researchers at Harvard have also discovered that an eight-week Mindfulness-Based Stress Reduction program can change brain structure by increasing cortical thickness in the hippocampus, which controls learning and memory, as well as decreasing volume in the amygdala, associated with fear, anxiety, and stress. These observed physiological changes by the team were linked to an improved sense of psychological well-being among study subjects, indicating that meditation affects not only the brain, but also responses to stress and anxiety [1].

As she wraps up the meeting, Dr. Gibbons emphasizes the self-care aspects of meditation by discussing how meditation can be integrated into everyday life: while cooking, reviewing lecture notes, or even waiting for the campus bus. As the students leave the confines of the Busch Campus Center meeting room back to work or classes, they bring with them the wisdom of a unique but rather esoteric self-help method offered by Rutgers University. By expanding beyond traditional counseling and psychiatric services offered by most schools, RU CAPS showcases its commitment to more holistic and unconventional forms of mental health support.

Hey, Who Needs Medicine?

In a place like a college campus, it is inevitable you will contract at least the common cold from your peers. Although we all get sick, this article will discuss the alternative approaches to medicine that college students take. Resulting from a poll of 307 Rutgers University student, 47% picked medicine when asked to pick one of the option listed, medicine, sleep, hydrate, vitamin C, exercise, or visit the health center. This illustrates the fact that more than half of voters used alternative approaches to medicine. Although these approaches are common for students, are the three most popular: sleep, hydrate, and vitamin C, actually effective in any way?

The first common held idea that we will look into is that in taking a large amount of vitamin C after getting sick is effective. Many people are guilty of this approach, but “When vitamin C was tested for treatment of colds in 7 separate studies, it was found to be no more effective than the placebo at shortening the duration of cold symptoms.” 2 After taking large doses there is almost a plateau in the body, causing little to no effect. Through research, it is evident to researchers that high doses of vitamin C has more effect on preventing colds rather than stopping them once they have been contracted. One study found that, “For the average child who suffers about 28 days of cold illness a year, taking daily high-dose vitamin C would still likely mean about 24 days of cold illness” 2 shortening them by about 8% in adults and 14% in children. It seems that for colds you would be better off not downing orange juice.

Another approach students often taken, since we all hear it from our doctors, is to stay hydrated.

Nikki Kurian

bodies to fight off infections, and during sickness this is easy when we produce waste and vomit, which releases mass amounts of water. A study done at Michigan State University says that, “drinking enough water aids with digestion, which helps keep the intestines healthy…helps the body absorb nutrients… helps the kidneys do their job of balancing electrolytes and filtering waste from the body… lessening congestion and allowing mucus to be coughed out of the body.” 1 Staying hydrated seems to be a beneficial tool when sick, because it gives the body what it needs to fight off the infection. It is a popular, quick, and simple step students can take besides taking medicine.

Lastly, sleep is a popular approach students take, along with a natural response to heal the body when sick.

“During sleep, you make more white blood cells that attack viruses and bacteria, says Sunita Kumar, MD. Kumar co-directs the Center for Sleep Disorders at Loyola University Medical Center.” 3 So by sleeping you are basically helping your body build the necessary “army” to fight off the sickness you are facing. It is important not only when sick, but also when trying to prevent sickness because your body needs white blood cells at all times.

It is important to keep in mind that college students do not just focus on one method, but use a combination of many, nor are sleep, hydration, and vitamin C the only cures. Other responses I received from the poll were exercise, prayers, and herbal tea, along with the comedic responses of ‘calling mom’ and ‘denial.’ Although it may be helpful to use alternative medicineafter a person becomes sick, the more effective approach seems to be to use these methods to prevent becoming sick.

You have probably already heard about how serious the flu is this year, whether it was from a news article, the cautionary email sent out by the university, or a friend who has already been infected with the virus. Taking into account how contagious the flu is, it seems more likely to be surrounded by people with a bad cough and nasal congestion than it is to run into someone who is enviably symptom-free, especially in colleges where students are living in close quarters with their peers. Dubbed by some media outlets as one of the worst in years, there is no doubt this flu season is particularly more intense. But what is it about this year’s flu that makes it more dangerous? And how does this flu season actually compare to those of years past?

First, it is important to put into context just how deadly influenza infection can be - and has been this winter. As relatively healthy young adults, college students tend to view the flu as more of a nuisance than a deadly disease. However, the flu is responsible for the hospitalization of hundreds of thousands of people every year, some cases of which even result in death, particularly among young children and those over 65 years of age1. As of early February, the number of hospitalizations this winter have already exceeded that of the entire 2014-2015 flu season, which was also considered worse than usual with approximately 710,000 Americans being hospitalized for flu-like symptoms and at least 56,000 deaths2.

Besides the record-breaking numbers, there is nothing really new or unique about this year’s flu, which is predominantly caused by the H3N2 virus that was discovered 50 years ago, but is associated with more severe illness, less receptive to vaccination, and usually the most lethal3. This is because H3N2 can evolve very rapidly to evade the body’s immune system. Every year, the World Health Organization (WHO) reviews labs and clinical studies in order to predict the most common influenza strains for theupcoming season. Based on their research, they will make recommendations on the compositions of the year’s vaccine, which will ultimately tackle three or four of these strains4. While the WHO did successfully predict the prevalence of H3N2, the vac-

What’s the Flu to You? Jasmine Cheung

cine was estimated to be only 25% effective against this strain, and only about 36% effective overall5.

Still, experts say it is still worth getting the flu shot. Not only do some flu seasons last until May, but getting vaccinated can prevent this year’s statistics from getting worse. While vaccination will not guarantee your complete escape from sickness, it can save you - and perhaps those more vulnerable to the disease around you - from getting more seriously inflicted by it.

Debunking Myths About

Coffee Shea Patel

Whether it be Starbucks or Dunkin Donuts, a cup of coffee is bound to be spotted in the hands of the typical college student. Coffee is the fuel that every college student requires to function. While some need only one cup to kick start their day, others have an insatiable need for coffee. Often used to complete through class, or to stay up late to study for exams, it is prevalent in everyone’s lives. People are often told that coffee is bad for the body, however, they are unable to exclude it from their diets. However, there are many myths in regards to the effects that coffee has, but what is the truth?

Coffee is known to be a stimulant, a substance that increases the activity of the nervous system, and as with all stimulants, it is the target to the creation of many myths. One of the myths regarding coffee is that it aids in the development of kidney stones, which are insoluble calcium deposits present in the kidneys.

These stones can form in a variety of sizes, and are incredibly painful to pass and the formation of kidney stones often leads to scar tissue in the ureters if too many are formed. With this in mind, people are hesitant to drink coffee, but with it being their only source of energy, they are left with no other option. Luckily, this myth is debunked by Dr. Ephrem Olweny1, who states that coffee, in fact, “has been shown in large epidemiological studies to decrease the risk of stone formation”.

Coffee is a diuretic, meaning it “[inhibits] the effects

of antidiuretic hormone (ADH) and thus increasing urine flow - the greater the rate of urine flow the less likely stone crystals are to form”2. So if anything, coffee should be consumed to avoid kidney stones.

This comes to the next myth – that decaffeinated coffee is supposedly better than caffeinated coffee. According to The American Journal of Clinical Nutrition3, “higher intakes of caffeine were associated with a lower risk of developing a stone” when patients with a greater caffeine intake had a 26% lower risk in developing kidney stones. “In the subgroup of participants with a low or no intake of caffeinated coffee, the inverse association between caffeine intake and kidney stones remained consistent” the study states. The same results were present with decaffeinated coffee, which proves that while caffeine does play a large role in the prevention of the formation of kidney stone, it is not the sole component. To some, caffeine stimulates headaches, so decaffeinated coffee is the better solution. For others, there is no harm with caffeine present.

So the next time it is said that coffee has harmful effects, just bring up how it will prevent the creation of kidney stones due to increased urination, and make sure to mention that caffeine is not at all bad as it is portrayed for the same reason. Go enjoy a cup of coffee, regular or decaffeinated, but remember everything in moderation.

Minna Kim

“I swear to fulfill, to the best of my ability and judgment, this covenant…” Each year, almost 20,000 graduates of medical school and many more graduates of other healthcare professional schools recite some form of the Hippocratic Oath1, one of the earliest document of ethics in medicine in the Western world2 .

Countless medical advancements and ethical conversations have taken place today, centuries since the time of the ‘Father of Medicine’ himself. A superb understanding of ethical principles is more necessary than ever because the technology available today allows for changes which have wider implications, affecting families, generations, and even humanity. While ethics education are heralded as an essential part in healthcare professional schools’ curriculums, there is a lack of such a pronounced emphasis on undergraduate college campuses3. While the required courses for professional schools admissions include elective courses such as English and Psychology, there is no mention of courses in ethics4; in addition, such a course requirement cannot be found in the curriculums of science majors at most US colleges, even at Rutgers University.

According to British philosopher R.M. Hare, ethics is the “language of morals” 5; a tool to express

and discuss human values and morals using logic by asking the question: “What ought we to do?” Some of today’s most debated topics, including gene editing, euthanasia, consent, and the right to healthcare require extensive tools to be discussed in a proactive manner6. Without the correct tools, a discussion between two people with different values will circle and circle, never reaching a conclusion. For physicians and other healthcare professionals, it is important to be equipped with tools, because “patients are suffering and vulnerable, and medical treatments are not merely technical, they often invade patients’ bodies and engage their consciences, ” according to research conducted by Du Bois et al7. Earlier exposures to topics in ethics and classical, historical cases of controversies and debates prepares students to be ethics advocates.

There is an immediate need for more courses designed for undergraduates working towards professions in healthcare. At Rutgers, where we have only a handful of courses designed covering medical ethics and biomedical ethics, we can begin an initia’ ‘tive in order to build student interest in ethical courses, and can begin implementing major-requirements or offer more courses in ethics.

When you think of a harmful disease, you may gravitate toward the flu, or cancer, or any number of sicknesses that ravage the body. However, diseases which target the mind can be just as damaging, if not more so, due to the fact that the biological causes for many are still unclear.

Major depressive disorders, informally known as depression, are difficult to treat despite being one of the most common mental illnesses. Complications in developing methods to treat depression stem in part from the limitations of animal models; a recent review article written in the United Kingdom, however, has noted an improvement to existing models.1

A shortcoming with using mice to test the efficacy of antidepressants is relating a behavioral change in an animal to the complex emotional state that arises due to depression.

Commonly used tests are the forced swim test (FST) and the tail suspension test (TST).2,3 The FST involves measuring the amount of time it takes for a mouse to give up on escaping a waterfilled tank (i.e. only moving to keep the head above water rather than trying to leave the tank).2 Similarly, the TST measures how long mice struggle to free themselves while they are suspended by their tails.3 An antidepressant’s efficacy is then measured by how it affects the amount of time mice spend struggling during these tests.

In the field of neuropsychology, a type of test known as an affective bias test (ABT) is utilized. An affective bias describes how emotions influence cognitive processes ranging from attention to learning and decision-making.1 More recently, a variant of the ABT known as the judgement bias task (JBT) has been used. In the ABT, a mouse is conditioned to associate digging through two specific substrates, or materials, with a sugar pellet reward. Afterwards, the mouse is presented with both substrates, with only one type containing a reward, for a total of 30 trials.1 Mice treated with antidepressants pickthe correct substrate more often than the control group.1 Similarly, the JBT teaches mice to associate one frequency with pressing a lever to receive a reward and another frequency with pressing a different lever to avoid punishment.1 The response of the mice to frequencies that are between the reward and punishment frequencies is then recorded.

Mice treated with antidepres

sants are more likely to press the reward lever compared to the control group.1 While the FST and TST have resulted in false positives (i.e. antidepressants taking immediate effect in the test when they have a delayed onset effect in clinical trials), the ABT and JBT show promise as relevant animal models in the testing of antidepressants.1

It is worth noting that despite the improvements in modelling depression in animals, the biological source of depression is still unclear.

An observed effect in the brain is atrophy of the hippocampus, but this atrophy is more likely a symptom of long-term depression than its cause.1 Research has also been conducted to determine if changes in the amygdala are a biological source of depression, as a symptom is an inability to derive pleasure from previously rewarding activities. In regards to this, Dr. Anthony Uzwiak of Rutgers University notes, “When you ablate the amygdala, it [a conditioned response to stimuli] goes away. Now, does that mean that it is requisite but not sufficient or is it the thing?

We can implicate it at some level, but we can’t directly state that it’s a cause of depression.”4

While the inner mechanisms that give rise to depression remain an enigma, the usage of the ABT and the JBT provides researchers a way to test antidepressants safely and reliably.

Despite their brains being a fraction as complex as that of a human’s, mice remain integral to the development of our understanding of depression and, hopefully, the creation of a definitive cure.

Of Mice and Mental Illness: How Affective Biases in Mice Help Develop Antidepressants Ben Estabillo

Agnosognosia: A Break From Reality Nikhita Nambiar

Three women come into the room in wheelchairs.

They had all suffered strokes in the right hemisphere of their brain and have been rendered hemiplegic, fully paralyzed on the left sides of their bodies. Each patient is questioned separately, while sitting in front of a mirror so they can observe their movements.

Doctor: Can you walk?

Patient A: Yes! Doctor: Can you use both hands? Your right hand and your left hand?

Patient A: Of course!

Doctor: Are both your hands of equal strength?

Patient A: Certainly.

Anosognosia is the lack of insight about one’s own disability or disease, which can include motor, visual, or cognitive deficits.

The term was initially coined by neurologist Joseph Babinski in 1914 in reference to lack of insight in hemiplegic stroke patients, but it is now used to describe the unawareness of numerous conditions, including cortical blindness, Alzheimer’s disease, Huntington’s disease, Traumatic Brain Injury, Schizophrenia, Bipolar Disorder, and eating disorders. Anosognosia stems from physical lesions or abnormalities in the brain and extends beyond the limits of regular denial, as 5 seen with the patients above.

These patients were part of a study published by V.S. Ramachandran and Diane Rogers-Ramachandran in 1996 to understand the extents of anosognosia in hemiplegic patients.

The study continued by introducing the women to another hemiplegic patient in a wheelchair and asking him to move his left arm, which he was clearly unable to do. When the women were asked if his arm was actually moving, two out of three believed that it 3 was.

This demonstrated, quite surprisingly, that one’s lack of insight about their own disability was capable of extending to another person’s disability.

Numerous comprehensive studies have been done to understand the manifestation of anosognosia in the brains of people with hemiplegia and schizophrenia.

The overall conclusion of these studies is that no one region of the brain is responsible for causing anosognosia, but rather an intricate network in volving numerous regions. Damage to these regions could impede the white matter circuits connecting parietal, frontal, and subcortical parts of the brain.

In hemiplegia, specific regions identified with anosognosia include the insula and basal ganglia, premotor and cingulate cortex, temporoparietal cortex, and the amygdala and hippocampus.

The amygdala and hippocampus are known to play a role in memory and emotional response, particularly fear, which brings up the possibility that damage to these areas could prevent one from reacting normally to the alarming feedback of a paralyzed limb, and even cause the patient to forget it. 5 Many of the components found to affect anosognosia in hemiplegia were also noted in studies of anosognosia in schizophrenia. Using MRIs, it was found that

those with schizophrenia and anosognosia had a thinner right insular cortex, and fMRIs illustrated a drop in brain activity in the insula, medial prefrontal cortex, and inferior parietal lobe when patients were asked to perform self-reflective tasks. The insula, a small and once neglected region of the brain, has recently been linked to interoception and sense of self, both of which could drastically affect one’s ability to recognize their own condition.

Furthermore, patients were found to have lower volumes of both gray and white matter, damaged white matter, poor cerebral blood flow to the superior parietal lobe, 4 and degeneration of the frontal lobes.

In cases of hemiplegia and cortical blindness, one can almost call anosognosia benign; it allows the patient to get on with their lives without feeling affected by their disorders.

However, in patients where anosognosia is comorbid with schizophrenia or bipolar disorder, a more serious outcome could ensue.

50% of patients with schizophrenia and 40% of those with bipolar disorder also have anosognosia, which is the foremost reason why people with these disorders might refuse treatment or medication. 4 Living with untreated bipolar disorder or schizophrenia in some situations equates to homelessness; with family unable to care for them, and the inability to hold a job and make rational decisions, there is nowhere to turn but the streets.

In people with psychosis involving paranoia or command hallucinations, not getting treatment could lead to uncontrolled violent behavior, which in America, is more likely to lead to incarceration than commitment to an inpatient facility. In the state of New Jersey, involuntary commitment laws specify that the patient must be a danger to oneself or to others. 2 Not only does being “a danger to oneself or others” have many possibilities for interpretation, but it also excludes numerous patients with nonviolent symptoms who are still in dire need of help, and whose families may be trying desperately to get them that help. 1 Considering the widespread impact of anosognosia in everything from hemiplegia to schizophrenia and bipolar disorder, better understanding this condition and updating healthcare policies regarding the disorder could save millions who are living in an altered reality.

Turning a new page in research techniques: The in vivo revolution Prateeksha Rout

Debates over the ethics of both in vitro and in vivo methods have been hard pressed over time, experience, and evolution of new technology. Both methods are used extensively in a variety of fields, including but not limited to: cosmetics, drugs/pharmaceuticals, cancer growth and development, immunotherapy, developmental neurotoxicity, antibody production and toxicology (Saeidnia, n.d.).

In vitro methods reduce the need of using animals while testing therapies and products, eliminating the need for animal protocols, or experience required for animal handling. In cases where the animal in question is at risk of contamination, in vitro methods ensure the system is free of such contaminations (“Summary of Advantages and Disadvantages of In Vitro”, 1999).

In vitro is usually used when the system being studied is well understood, meaning that the “normal” functioning of the system is being tested with variability in certain factors, or chemicals (Coecke 2007). In vitro methods fall short in trying to mimic complex systems or endpoints, as it is still an artificial statement. They also are not able to exactly replicate the inner cellular conditions of organisms, particularly microbes. So, results can be quite different to what would be expected in an “actual, living breathing system” (Coecke 2007).

In contrast, vivo methods consume a large number of animals, constitute intensive labor, are experimentally complex, and are often not sensitive enough (Coecke 2007). Especially when used to detect DNT, in vivo methods do not provide a comprehensive understanding of the detailed mechanisms behind the toxicity. They are also unsuitable for screening large amounts of chemicals, and their capacity for truly representing the human systems are largely unclear (Hartung 2009).

Toxicity is hard to compare, especially when comparing human responses and animal responses. In vivo models also incur high contamination rates, due to cellcell interactions within the test animal (Hartung 2009).

An alternative research strategy could be using non-mammalian models (like C. Elegans, Zebrafish), along with human cell lines. Unfortunately, neither system is fully compatible with the absorption, distribution, metabolism, and excretion (ADME) phenomena, which predicts the disposition of a pharmaceutical compound within an organism. Therefore, when testing for drug passage and effects on the human body, caution needs to be taken when using either of these models. Overall, in vitro methods offer more advantages in most industrial applications and areas where production depends on bioreactors being used, like antibody production (“In Vitro And In Vivo Antibodies Production”, 2016). In vivo methods are useful in recreating cellular connections within human systems in other animal test subjects, and if used in lieu with in vitro assays, such as mechanical based in vitro assays working together with in vivo ones, can provide for better and more ethical approaches to research.

Healing Medicine: Dangerous Side Effects for Women Amy Fakhri

What if I told you that the medical science that has been discovered over the past century has been primarily based on half of the population?

Eighty percent of the drugs that are withdrawn from the market are withdrawn due to dangerous and potentially deadly side effects on women. 1 It takes a long time to transform a drug from an idea to a readily prescribable medication, so the fact that we are discovering adverse side effects on women after medications have been released is unacceptable. Most animals used in the lab are male animals, and most clinical trials have been performed exclusively on males. The male model has become the ideal model for medical research. 1

An example of this is the sleep aid Ambien, which has been frequently prescribed to people with sleep disorders. However, due to the lack of women in the clinical trials, the fact that women metabolize the drug at a slower rate than men went unnoticed. Therefore, female users were waking up with traces of the drug in their systems- which caused them to get behind the wheel drowsily. In 2016, the FDA officially recommended cutting the dosage in half for women only, but they could not take back the damage that had been done. 1 The intention behind this phenomenon can be considered somewhat righteous. It stemmed from World War II, in which new rules were put into place to prevent unfair testing of medication.

These rules included preventing women of childbearing age from participating in said studies.

It was also easier to eliminate confounding variables in these studies, as the male anatomy is more homogenous than the female anatomy. 1 The commonly held belief that males and females are alike in every way except for reproductive organs couldn’t be further from the truth.

If we take a look at the anatomical differences, the blood vessels that surround the heart are smaller in women, and the way that these blood vessels develop disease is also different. One of the first steps when a physician suspects a heart attack is to perform an angiogram, whose role is to check for blocked arteries. But this test could possibly miss a type of heart disease that is more common in women, called coronary microvascular disease, which damages the smaller arteries previously mentioned. 2 Moreover, men and women experience heart attacks very differently. Males experience a sensation analogous to an elephant sitting on their chests, while 3 women experience discomfort.

So how can we treat these dangerous side effects for women? Advances have been made in medicine regarding groups that are anatomically very different than that of male adults- the study of pediatrics arose for a specific reason.

Children aren’t merely little adults; therefore, research is now conducted on children for their own betterment. In a similar fashion, research must also be performed on women in order to ensure the effectiveness and proper dosage of medications and ultimately better healthcare.

Search the Soil: The Newest Antibiotic for Drug Resistance Anusha Patil

What do Fashion Week and the newest antibiotic that has been proven effective against drug-resistant bacteria have in common? They both hail from Milan, Italy. Beyond the racks of haute couture and floor-to- ceiling prestigious paintings, deep within the earth, lies the solution to the epidemic of antibiotic-restant bacteria that’s sweeping the nation.

This is where Pseudouridimycin comes into play. Teams of scientists from Milan, drugdiscovery company Naicons, and even some of Rutgers’ staff including Richard H. Ebright, collaborated on the hunt for new antibiotics.

Though nearly all of today’s antibiotics have been found searching the soil, scientists haven’t done this in decades because the soil was believed to have been over-mined. The teams from Milan, Rutgers, and Naicons decided to resort to this method in one last ditch effort (no pun intended). Here, they found a microbe that produces a substance known as Pseudouridimycin. Pseudouridimycin (PUM) is a nucleoside-analog inhibitor for bacterial RNA polymerase, meaning that it appears similar to the NTPs (nuclear triphosphates) that bacterial RNA polymerase uses to build RNA but cannot actually be used.

When PUM is bound by bacterial RNA polymerase instead of actual NPTs, the polymerase can no longer synthesize RNA which explains why there are fewer cases of resistance involving PUM compared to other antibiotics.

If bacteria mutated so that the binding site of NTPs for RNA polymerase was altered in such a way that nucleoside-analog inhibitors like PUM could not occupy that space, even regular NTPs could not be bound by RNA Polymerase and RNA would not be synthesized.

A loss of function in RNA Polymerase would mean a lack of success in transcription and translation, and would ultimately lead to the eventual death of these mutated bacteria. What really makes PUM stand out is that it’s the first nucleoside-analog inhibitor that inhibits bacterial RNA Polymerase but not human RNA polymerase. Although both bacterial and human RNA polymerases are structurally and sequentially similar, human RNA polymerase lacks a site for PUM’s chemical side chain to link to, making PUM bind more tightly in the case of bacterial RNA Polymerase compared to human RNA Polymerase. Though PUM works like a currently-used antibiotic called Rifampin in that it inhibits bacterial RNA Polymerase, PUM inhibits the enzyme through a different mechanism and binding site which allows it to be used in treatment courses along with Rifampin and without exhibiting cross-resistance 3 .

The widespread use of antibiotics in agriculture and medicine has cultivated bacteria that are now resistant to many of the miracle medications we once touted. According to the World Health Organization, with antibiotic resistance comes “longer hospital stays, higher medical costs, and increased mortality” 1 . Research predicts that “If nothing is done, 10 million people are estimated to die each year from antibiotic resistance infections by 2050” 2 . This explains the race to create new antibiotic treatments effective against drug-resistant bacteria.

Though there is still more work to be done—Dr. Ebright estimates that he and his research team “will take 1-3 more years to make this drug more effective” 3 —if this new drug is passed, it will be one of the first new antibiotics created in more than a decade. Keep your eyes peeled… Pseudouridimycin could soon be coming to the shelves of a store near you.

aasingle singlebreakbreakthrough, through, aasingle genome single genome, and and two Two macaques macaques Rusabh Mehta

rusabh mehta

Two newborn macaques jump around in their incubator, their seemingly erratic crawling and cooing a sharp contrast to the fact that their genomes are one and the same. The video released by the Institute of Neuroscience (ION) shows Zhong Zhong and Hua Hua, two identical sisters cloned from the method that created Dolly the sheep in late nineties, a technique known as somatic cell nuclear transfer, or SCNT. Dolly represented the first breakthrough in genetic cloning, demonstrating how genes previously inactivated could be reprogrammed back to a state similar to those of stem cells, or what is known as totipotency.2 Zhong Zhong and Hua Hua, however, represent the overcoming of a major hurdle, too: cloning primates through somatic cell nuclear transfer.

Mu-Ming Poo, the director of ION in Shanghai, spearheaded this project, where previous attempts at cloning did not result in any live offspring.

The success of this particular attempt can be attributed mainly to the use of two specific molecules, H3K9me3 demethylase Kdm4d mRNA and histone deacetylase inhibitor trichostatin A. Both of these molecules were important to further reprogramming the nucleus, ultimately resulting in improved pregnancy rate and fetal development. Specifically, they function to remove specific markers located on the genome, ultimately creating cells similar to stem cells.1

On one hand, this milestone in primate cloning represents a step closer to more accurately studying genes and gene imprinting as well as their role in complex diseases like Alzheimer’s and autism.3 Identical animals are especially useful because of their shared genome as differences in their behavior or traits can be pinpointed to certain environmental factors rather than genetic variability. Other uses for research include gene function itself as well as regulation of development and gene therapy, too. On the other hand, however, this is just the first step towards truly successful genetic research. For one, the efficiency of nuclear transfer is still less than 1%, where it has been since the cloning of Dolly, and the improvement of this rate is Dr. Poo’s next project.2 Furthermore, the creation of knockout or knockin monkeys, arguably the most useful tool in studying individual genes, requires the use of the CRISPR/Cas9 system. Seeing as this system has its own drawbacks, including off-target effects, applying this development in primate cloning may be delayed.1

Despite the limited scope for application, the breakthrough is nonetheless a step in the right direction. Going forward, as the transfer efficiency increases, this breakthrough will continue to provide several advancements towards understanding complex diseases like never before.

Don’t Flakka Do Drugs Taylor Good

“She began yelling and screaming ““go away!”” while she was alone in her bedroom.”

Her parents, struck by the sudden paranoia and altered mental state of their daughter, sent the 17year-old girl to a psychiatric hospital for 72hour treatment for her psychotic behavior and auditory hallucinations. The patient, who has had no history of mental health issues was coherent enough to explain that her friends drugged her with flakka, after several days of treatment with Olanzapine and Lorazepam. 1 This patient is not the only recent case in the US. In fact, flakka use has become an epidemic in the past few years in south Florida. Flakka, or Alpha-PVP, is a highly addictive synthetic drug similar to baths salts and falls under the cathinone class of drugs. Cathinones are dopamine stimulants and reuptake inhibitors.

They prevent the reuptake of epinephrine, norepinephrine, and serotonin which in conjunction with increased dopamine causes lasting euphoria to be felt by the user. These neurotransmitters are important for the regulation of all human emotions. Furthermore, flakka is a hydrophobic molecule, making it extremely easy to pass through the hydrophobic cell membrane causing it to be metabolized quickly by the body. 1 What makes this drug so dangerous, though, is the thin line between euphoria and delirium- and other horrible side effects. Flakka induces agitated delirium which is characterized by anxiety, confusion, and violent bizarre behaviors. In more severe cases the user can experience fast heartbeat, high blood pressure, high body temperatures, excessive sweating, and possibly seizures. 1

When all these symptoms add up, there are cases of users that “have attacked authorities, run through the streets naked claiming they’d lost their possessions, and in one case, even impaled themselves on a spiked 2 fence”, explained by Carmen Chai.

This recent interest or spike in flakka use is due to its low cost and high profit margin.

Flakka is sold for $5 a hit- about 0.10 grams, which is significantly cheaper than cocaine which is sold for about $62-$80. Considering that flakka can be bought for $1,000 to $2,000 overseas then sold for $4,000 to $6,000 to a U.S. wholesaler, drug dealers can make approximately $40,000 to $50,000 on the streets for a single kilogram. Both aspects of this consumer/producer exchange appeal to college students and low-income citizens. Both groups are taking advantage of the low cost of the drug, while some college student begin dealing in order to bring in some extra cash. Additionally, flakka can be vaped using an e-cigarette which not only appeals to college students because of its discreet nature but also because the drug is sent directly into the bloodstream making the absorption even faster. 4 This separates flakka from other well-known drugs and according to Dr. Nabil El Sanadi, chief executive of Broward Health and an ER doctor, makes flakka more dangerous than cocaine, amphetamines, heroin, and oxycontin. 3 Ultimately, Flakka is a highly dangerous and addictive drug that cannot be taken lightly. Cheap thrills are not worth the medical tragedies that they beget.

fighting the unknown Researching Rare Diseases

Soham Shah

“Rare diseases” are defined as affecting no more than 200,000 people in the US.1 However, just over the past two decades, the recognition of rare diseases has received major attention from clinical researchers and the pharmaceutical industry.3 So, why are they regarded as such an important issue? While a relatively few number of individuals may be affected by a rare disease, there are countless disorders that fit into the definition, and as a result, a very large number of patients may collectively be affected by these “rare diseases”. But because of the large array of lesser-known disorders, effective treatments are often limited or even non-existent, largely due to our incomplete understanding of the disease physiologies.

Even though they are considered a significant public health issue today, rare diseases were once generally ignored by scientific research. Since they were largely neglected in the past, these rare disorders are often labelled “orphan diseases.” 3 It was not until 1983, however, that the United States passed the Orphan Drug Act, which incentivized the development of orphan drugs.3 As a result, pharmaceutical industries started to focus more on the production and advancement of treatments for these rare diseases.3 Awareness and progress for treatments of rare diseases grew, and soon, people began to become more informed of the severely debilitating characteristics of these diseases.

Today, there are many public-research programs, such as those at colleges, that are dedicated to rare diseases that are growing at a fast rate, in the hopes of discovering a potential treatment.1 Here at Rutgers, a school often defined as a research university, investigations can cover a vast array of diseases. Take for example cystinuria, a rare genetic disorder that Dr. Amrik Sahota of the Rutgers Division of Life Sciences studies. This fairly uncommon disorder causes the buildup of cystine stones in the bladder and kidneys, and affects approximately 1 in 7,000 to 1 in 10,000 people in the US.2 However, while regarded as a rare disease in regards to its prevalence in the entire US population, cystinuria is actually the most common inherited stone disease in children.2

Despite this, for the past 30 years, there have been no advances in the treatment options, and the treatments that do exist tend to be unreasonable or ineffective.2 With further investigations, however, Dr. Sahota hopes to be able to finally discover a safe, potent treatment for cystinuria patients.

Another example of a rare disease is giant congenital melanocytic nevus (CMN). This rare skin condition may cause numerous neurological complications, malignancies, and tumorous growths.1 In 1999, when Heather Etchevers’s newborn daughter was diagnosed with CMN, she was dismayed by the lack of information about her daughter’s condition. Etchevers, who then was using genomics to study embryonic neural crest cells, spent ten years trying to expand her research and get a project on CMN off the ground.1 Now, she is now fully engaged in her project and is a prominent advocate for the rare disease community.

There are, however, still many major obstacles involved in trying to study rare diseases. These include problems receiving funding for the research, dealing with minimal background information to work from, and challenges finding study participants to gain human data from.1 While better-known conditions like cancers or diabetes receive national attention and financing, less common disorders may have difficulty starting off their research, as funds are scarce for conditions with a small market.1 Researchers for the rare diseases may also be faced with minimal background material, and even after they obtain data, due to their small sample size, it may be hard to get sufficient statistical confidence in the results.

However, with most rare diseases being genetic disorders, the rapid growth in genomics has allowed for advancement in the discovery and investigation of thousands of rare diseases.1 Over even just the next few years, major ground-breaking findings will likely be made about these lesser known disorders.

swallowing

change Troy Karanfilian

As you step through the sliding glass doors of the dining hall, you are immediately faced with a slew of important decisions: grilled chicken or nuggets, whole-grain or white bread, Coca-Cola or water, etc. As it turns out, the decisions that you make are predetermined before you even set foot in the building. Restaurants strategically use a wide range of factors, from the arrangements of the tables to the wording on the menus, to get customers to buy what the management wants them to buy. Customers usually have no idea that they are being manipulated. However, thanks to a new program that Rutgers has recently adopted, these strategies are being used for good, by helping consumers make smarter, healthier choices.

Last spring, the Rutgers administration began participating in the “Menus of Change” program. Rutgers is implementing this program in order to move towards a healthier future. They aim to get rid of processed, unhealthy foods in the dining halls and replace them with natural, whole foods. This will limit students’ exposure to sodium, refined sugars, and preservatives.1

The Menus of Change University Research Collaborative (MCURC) is jointly run by the Culinary Institute of America (CIA) and Stanford University. It is a network consisting of 178 institutions and universities (including Rutgers.) Its purpose is to support evidence-based culinary innovation and research. Having such a large network is highly beneficial because it allows institutions to share findings, increases chances for grant funding, and makes the studies being conducted stronger due to much larger sample sizes. All of this research can be used to help students make better food choices. Since these students will soon become the parents of the next generation, this program will have a lasting impact for years to come.3

Oftentimes, the studies conducted in the field of food science are not comprehensive enough. Even when they are, the findings are rarely applied to actual restaurants and cafeterias. Thanks to MCURC, invaluable research is being conducted on all of the different factors that play a key role in the choices that consumers make. Such factors include labeling of food, cafeteria layout, and menu strategies. For example, one study showed that the number of customers who chose to eat vegetables increased 41% when said vegetables were paired with an indulgent description (as opposed to being labeled as “healthy.”)3

One of the earliest examples of research that MCURC has conducted was a sensory study to reduce the amount of meat and sodium consumed. The CIA concluded that blending meat with umami-rich mushrooms can improve the nutritional quality of certain meals without compromising flavor. They ran taste tests at Rutgers and 5 other universities across the country to determine the exact mix of mushroom and beef that would be most appealing to students. Based on the data, students prefer a 50-50 blend.3 This research is the basis for what is now the “Sizzling Scarlet Knight Burger,” a burger patty made with a mushroom-beef mixture that can be found at the Livingston Dining Hall’s brand new burger bar. Based on the success of the Scarlet Knight Burger, Rutgers is also trying to incorporate mushrooms into other meat dishes.2

Although the main intention of Menus of Change is to help students, some still seem to be nervous that these new options mean the end of fried foods in the dining hall.

However, this notion could not be further from the truth. A nutritionist at Rutgers who was instrumental in implementing this program here, Peggy Policastro, PhD, RD states, “The main goal of dining is to satisfy students’ needs.”

She goes on to say that taking away all unhealthy foods has never been the objective, because it would make the consumers unhappy. The point of Menus of Change is to provide more options and guide students toward healthy choices, rather than forcing them to eat healthy by removing fatty foods. As Dr. Policastro explains, “Chicken nuggets and french fries aren’t going away, but you may see a mixture of sweet potato fries and regular fries, you may see a baked chicken wing in addition to a fried one” (personal communication, February 26, 2018).

The fact that Rutgers has chosen to be a part of this truly groundbreaking research collaborative provides students a very unique opportunity. It allows us to participate in studies that may one day help to solve the obesity epidemic. All we have to do to is give the new options a chance. By trying a new burger recipe, you are not only helping yourself, but people all across America as well.

It is very well known that music mends the soul. As Hans Christian Andersen once said, “Where words fail, music speaks.”4 Music has a positive reputation for allowing people to experience “feel good” vibes, but can this enchanting healing power of music go beyond simply making you smile?

In other words, can music cure a patient with PTSD?

Post Traumatic Stress Disorder (PTSD) impacts 7.7 million adults.3 PTSD is a mental health condition triggered by a traumatic event, such as war combat, illness, an accident, the sudden death of a loved one, or abuse and assault.1 Symptoms of PTSD include flashbacks, nightmares, anxiety, and hypervigilance.5 General treatment for PTSD patients includes cognitive behavioral therapy and eye movement desensitization and reprocessing, alongside medications to manage its symptoms. However, another effective treatment method that’s gaining popularity is the use of music therapy for PTSD patients.

Similar to language, music is a concept specific to humans. However, its impact surpasses that of verbal communication, in that “music goes beyond the kinds of conceptual meaning that could be captured in words, but which may underlie words. Music has a unique quality that enables direct access to an affective and tangible aspect of the human psyche.”5 In the brain, PTSD is observed to impact the hippocampus and the amygdala.When listening to music, these same areas of the brain are stimulated, demonstrating a clear connection.

Evidence also shows that music “can be used as a tool to stimulate these areas to activate neurogenesis and/or neuroplasticity, thereby reconditioning the brain back to healthy functioning.”3

A vast majority of the research on PTSD patients focuses on soldiers with the disorder. One such study explored the use of music therapy with soldiers who suffer from combat-induced PTSD. It examined spontaneous drumming as a way to facilitate a sense of “belonging, intimacy, togetherness, and connectedness; to achieve a non-intimidating access to traumatic memories; to allow an outlet for rage; and to regain a sense of control.”2 Drumming has been receiving considerable attention in music therapy due to its physicality. The action of drumming itself can be an outlet for anger or other bottled-up emotions, and the rhythmic sound generated can act as a reward.

The use of music therapy to treat PTSD patients is becoming more and more popular, as it has proved to be effective in reducing the occurrence of PTSD symptoms like social avoidance and the startle response.3 Music helps PTSD patients regain a sense of belongingness despite the isolation they may feel when reliving their memories. Hence, it is safe to say that music has more implications in healthcare than one might think. Music can mend both the soul and the mind.

The Healing Power of Music Hira Tassawar

E- cigarettes Gabby Dedvukaj

Vaping, hookah, and E-cigarettes, oh my!

Well, “oh, my!” is right. These alternatives to cigarettes are sweeping the nation, and have been doing so for the past few years. These ENDS, or electronic nicotine delivery systems, are supposed to be utilized as a way to help a cigarette smoker quit.1 It is a less dangerous way of getting the nicotine fix many of these smokers depend on. However, there are many myths about these devices which are very important to debunk. It is important to be informed that these devices are not as magical as one may believe them to be.

First, it is critical that one understands what these devices are composed of. These devices are battery-operated and contain a refillable cartridge and a heating element which heats up a liquid mixture.2 This liquid mixture usually contains nicotine and other gels for flavoring and color. ENDS allow a higher concentration of nicotine to enter the body, in a quicker amount of time than cigarettes. Nicotine has detrimental effects on multiple parts of the body, as its target organs are the peripheral and central nervous system. Nicotine also causes nausea, abdominal pain, and a plethora of more results that will have a severely negative impact on one’s health. It is also one of the most addicting agents, deemed just as addictive as heroin and cocaine by the US Surgeon General.3 Nicotine is only one of forty-two chemicals that make up this liquid mixture- twenty of which are highly harmful to health.

Today, many people use these alternatives to cigarettes believing they are doing their body well. As mentioned before, twenty of these forty-six chemicals were deemed as threats to health. For example, formaldehyde, which is one of the most dangerous chemicals within this liquid and is also emitted in secondhand smoke is used to preserve dead bodies. It is classified as a human carcinogen found in cancers such as nasopharyngeal cancer.

Another harmful chemical found in ENDS is benzene, which is present in pesticides and gasoline. By inhaling large sums of benzene, detrimental reproductive effects would be a result, an increased chance of leukemia would not be surprising, and many different blood disorders would occur. 4 The list goes on and on and on.

Recently, NYU Medical School has conducted a study on mice which debunked this myth that E-Cigs are a generally healthy option.

While it is true that cigarettes cause more harm to an individual’s health than E-Cigarettes, as tobacco nitrosamines found in body fluids of E-Cig smokers are 97% lower than in regular cigarette smokes, it has been found that ECS (E-Cigarette smoke) causes a great amount of damage. ECS cause DNA damage to the lung, bladder, and heart because E-cigarette smoke induces O6-Methyl-Deoxyguanosine in these specific organs. This causes the nicotine to be metabolized into MDOH, which methylates DNA, which is what ultimately makes ECS carcinogenic. Additionally, the ECS also reduces the DNA repairing function and proteins in the lung since aldehydes present in ECS impair DNA function. This was proven in this experiment by testing the effect of ECS on two major DNArepair mechanisms- NER (nucleotide excision repair) and BER (base excision repair). Once these two mechanisms were exposed to ECS, it was found that their level of activity was significantly lower than in the lung tissue of filter air exposed mice. 5

College campuses all over the country are filled with student believing they are not harming their bodies with these ENDS. The nicotine and other chemicals within these electronic versions of cigarettes undergo the same pathway as cigarette smokers, causing damage to vital organs. Think twice before picking up the vape pen. A person’s health is of larger value than the taste of cotton candy flavored smoke.

A turning point in psychiatric symptomology Sam Friedman

Modern techniques and technological advancements are known to have propelled genetic research forward significantly over the past few decades. In recent years, one of the greatest advancements in the field of Genetics has been the newfound ability to collaborate through cohorts, consortiums and online databases and to aggregate significant amounts of data into a single, centralized location. This is especially pertinent in research areas, such as psychiatric symptomatology, which, at base, require a plethora of samples and data sets in order for researchers to be able to find patterns and draw conclusions.

Linda Brzustowicz, M.D. is a Distinguished Professor in the Department of Genetics at Rutgers University. Dr. Brzustowicz also serves as Chair of the Department of Genetics and is the principal investigator of a lab that deconstructs genetic phenotypes of psychiatric disorders such as autism, schizophrenia and specific language impairment. One of the goals of Dr. Brzustowicz’s lab is to link these conditions back to specific parts of the human genome.

Using statistical methods––through collaboration with Dr. Steve Buyske of the Rutgers Statistics department––and python coded algorithms that package and collate the more than two hundred thousand samples of accessible clinical data, Dr. Brzustowicz’s lab is able to link behavioral patterns to specific genes.

According to Rampp et al.1,“reported exposure to a traumatic event is relatively common within the general population (40-90%)” and this type of exposure is said to lead to a range of psychological disorders. However, if this is the case, then why do “only a fraction of the individuals” affected by such traumatic events end up with PTSD? This can be explained by genetic predispositions; in an interview, Dr. Brzustowicz shared that, despite our tendency to believe that psychological disorders are triggered mainly by environmental factors, “we have known for about one hundred years that many psychological disorders are actually linked back to genetic factors.” This does not, however, mean that it is easy to find links between genetics and the physiological manifestations of psychological disorders. Dr. Brzustowicz explained: “it is increasingly apparent that there is not a one-to-one relationship between disorders and the genetic faults that may cause them.” In most instances, there is an overlap in genetic expression, and it takes a group of compromised genes––in different locations and combinations––for problems to take effect. “No one gene interacts by itself to cause an end result, but rather issues arise as a group of interactions,” shared Dr. Brzustowicz.2

It is also important to keep in mind that such genes have shown to differ in their expression in different people based on familial predispositions––two very similar people can have very different reactions based on their families’ differing predispositions. This is the case, for example, for patients with psychosis––no one gene determines the physical expression of the condition. Rather, the condition is manifested through the grouped interactions and predispositions of the whole genome. This much is known. However, the genes themselves, we have yet to discover. This is where Dr. Brzustowicz’s research steps in.

The National Institute of Mental Health (NIMH)’s Repository and Genomics Resource (NRGR) receives and processes blood samples and subsequently aligns it to corresponding clinical data––all of which is stored on a secure web-server and can later be analyzed by qualified researchers. In March of 2018, under the direction of Dr. Brzustowicz, the clinical data catalogued by the NRGR––the diagnostic assessments that pair with the genetic samples––was transferred to Rutgers University, where it is now curated, from Washington University St. Louis along with a $50 Million grant from the NIMH to Rutgers. Hopefully, this grant and the improved access to the centralized pool of data that it will provide will help Dr. Brzustowicz and her fellow researchers identify specific genes that interact to trigger psychological disorders.

This would enable doctors to more confidently and objectively diagnose their patients and provide them with the proper treatment. Eventually, it may even enable research to develop preventative measures for psychological disorders.

We are constantly learning more about our genome. Incredibly, the number of genes in each human body resembles the number of genes contained in a fruit fly. 2This similarity, however, belies the complicated, intricate reality that distinguishes the human genome from that of flies and other more primitive organisms. Humans offer an incredibly powerful and robust collection of regulatory regions and sequences that interact in ways that make the human genome extremely difficult to decrypt. Being able to link psychiatric disorders back to the human genome is no small feat. Luckily, thanks to the hard work being done at Rutgers and around the world––through much collaboration––a breakthrough is more likely now than ever before.

Scientific Theories About Trypophobia Elizabeth James

Popularized in part by the most recent season of American Horror Story, images testing the concept of trypophobia— the fear of groups of small holes or bumps—have become popular on social media sites, such as Instagram and Facebook. While not yet officially recognized as a phobia by psychiatrists, anxiety caused by these small holes is believed to affect thousands of people all over the world.

The term ‘trypophobia’ was first coined by a Reddit user in 2005, who simply combined the Greek words for ‘hole’ and ‘fear’ in attempts to describe his and others’ discomfort with small clustered holes. According to the American Psychiatric Association, people who look at images of small holes can feel “discomfort, disgust or fear... [they] may get goosebumps, feel distressed, feel itchy or feel like their skin is crawling.” Despite this, however, trypophobia has not yet been included as an official phobia in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). There are multiple reasons for this, but the main reason is that psychologists argue that most people with trypophobia are not really afraid of the holes, but rather disgusted by them. This difference is crucial, because the DSM defines a phobia as an “irrational and persistent fears of certain objects or situations.” This means that in order to be classified as a phobia, the fear must be greatly exaggerated compared to the actual potential danger of the object, and that the fear must be long-lasting as well as anxiety-inducing. In essence, as the American Psychiatric Association defines it, most (although not all) people who suffer from a phobia have a fear that prevents them from living out their normal life. However, unlike other phobias that have been recognized and listed in the official DSM, trypophobia mainly causes disgust -it usually doesn’t cause a person to have to cancel work, school, etc

Still, it is important to note that these feelings of discomfort are universal. A 2013 study by Geoff Cole and Arnold Wilkins found that 16% out of the 286 participants “reported discomfort...when presented with an image of a lotus seed pod,” one of the most popular trypophobic images. Even at Rutgers, many students express the same disgust and anxiety when looking at these pictures. “It feels like ants crawling all over my skin,” said sophomore Ananya Nethikunta. “I just get so anxious and want to escape.”.

Is it all in your head?

This then raises raises the question - why does so much of the general population experience discomfort when exposed to images of clustered holes? The researchers the 2013 study tried to determine what the underlying cause of this discomfort might be, and found that the clustered holes present in trypophobic images are reminiscent of features of dangerous animals, like snakes and certain types of octopuses. Dr. Cole suggests that upon seeing a trypophobic image, even if it’s a picture of a plant on Instagram, the brain alerts us that we might be looking at a poisonous animal, and that we need to run away.

This contributes to the argument that trypophobia should, in fact, be recognized as a legitimate phobia by the American Psychiatric Association. Certain psychologists, however, argue that perhaps trypophobia is simply made up in our heads, as a defense mechanism against what the brain perceives to be a dangerous signal. If this were the case, then trypophobia would not be a real phobia, but rather merely a warning signal from our brains. Therefore, this explains why the American Psychiatric Association does not consider trypophobia to be a real phobia, and why many psychiatrists and psychologists haven’t even heard of it.

While anxiety should not be taken lightly, the next time you look at an image of a lotus seed pod and start feeling scared, try to remember, or at least convince yourself, that what you’re feeling is little more than than an evolutionary response to what the brain thinks might be a dangerous animal. That being said, if you’re really looking to overcome your aversion to clustered holes, Drs. Cole and Wilkins both highly suggest exposure therapy. Both reported that they themselves had trypophobia that readily went away when they kept looking at different pictures over an extended period of time..

With that said, Rutgers students have many options available to them if they are experiencing extreme or debilitating trypophobia or any other kind of anxiety problem. Rutgers CAPS is open year-round every weekday from 8:30 to 4:30 on both College Ave and Cook-Douglass campuses and have resources for all students who may be undergoing any kind of problem.

Rohan Shah

A Charge for Change in an Addiction Crisis

Gone are the days when teens wait for their parents to leave their wallets or purses unattended to “borrow” a Lincoln, Jackson, or Franklin. A new era has arrived, one that has Little Johnny and Billy stealing Fentanyl, Oxycodone, and Hydrocodone from the family medicine cabinet due to an incessant addiction that has affected individuals of all ages, color, and gender. It seems that there is always a fad, a hot item amongst the general populace that is laughed off as quickly as it once rose to popularity. However, this drug addiction is no laughing matter, and it has become quickly apparent that if no action is taken, little Johnnies and Billies will no longer be around to witness the full-blown unraveling of the opioid crisis.

Opioids are a class of drugs that bind to receptors in the brain and spinal cord to alleviate pain signals, thereby activating reward centers in the brain via dopamine release. This chemical cascade results in the feeling of euphoria or a “high.” These pain relievers are usually safe when taken for a short duration as prescribed by the physician, but due to their ability for pain relief, they are often misused, leading to dependence and ultimately, overdose. The numbers are astonishing. In 2016 alone, the opioid crisis took 59,000 American lives with added estimates of 2.6 million prescription opioid addicts and 5.0 million heroin users. To date, nearly 77 million American have fallen victim to the crisis in some way. As of 2017, the percentage increase of drug overdose deaths among adults aged 55-64 rose from 4.2 per 100,000 to 21.8 per 100,000, with the 45-54 year old age group representing the largest total population of opioid overdoses.

To place more salt on the wound, the future looks all the more bleak. With past epidemics, there always seemed to be a potential solution, one that could be implemented at a moment’s notice, simply waiting for unanimous approval for legislature or the populace. In regards to the opioid crisis, however, not only is there no current solution in the works, but it is clear that there won’t be one anytime soon due to a multitude of factors, ranging from insufficient funding in legislature to the medical dichotomy between pain management and addiction. President Trump declared the opioid crisis a national emergency and has set a spending budget of 1 billion dollars to tackle the issue. Medical providers and public health experts, however, have scoffed at the budget, mainly because the estimated price to tackle the opioid epidemic has been raised to a whopping 10 billion dollars. Health providers add that legislature is doing very little in its power to make changes for medication access and subsequent treatment.

It is more than obvious that the opioid crisis comprises a series of downfalls, so why are these drugs continually prescribed? The simple answer is because they work. Pain management has been shown to be reduced much quicker and more effectively in all types of procedures compared to potential alternatives. In addition, many patients have proclaimed that their health insurance covers such medications rather than their non-addictive alternatives, making it cheaper for consumers in the short-term. Still, the looming dangers of addiction have worried many patients for any sort of procedure due to a lack of trust within themselves to remain physically independent.

Such a complicated matter brings up the question: What is being done to combat the epidemic?

Although there have been a myriad of attempts to mitigate access and prescription, no success has been evident. However, American hospitals have lead the charge for change with new research for alternatives, along with a stricter prescription policy. Dr. Shaul Cohen, an Anesthesiologist at RWJUH claims, “We [healthcare providers] are to be blamed for providing easy access to our consumers. By over-prescribing opioids for better pain management, we have opened the gate for more abuse.” When asked about his current research, Dr. Cohen added “healthcare teams should make physicians more aware of this crisis and inform them to refrain from unnecessary prescription of narcotics. Additionally, we should enforce for non-opioid pain treatments as our research suggests that NSAIDs (Non-Steroidal Inflammatory Drugs) not only treat pain management effectively, but also expedite same-day discharges with reduced nausea.” Dr. Cohen has made it clear that he hopes to take a step in the right direction by determining the efficacy of alternative treatments, such as an NSAID combination with local anesthesia, so that patients receive the same level of pain management, along with reduced levels of nausea and physical dependence.

As parents, teachers, children, and general members of society, we need to make the concerted effort for change in the right direction because we can all watch a loved one steal a pack of gum from our purses or a 5 dollar bill from our wallets, but we can no longer shield ourselves with a veil of ignorance from the truth. A truth that has 12 year olds stealing opioids due to addiction. Let us not have loved ones just become a part of another statistic. Rather, let us all fight to provide help to those who need and deserve it.

the search for a stress vaccine David Natanov

Stress: it is the ceaseless complaint of Rutgers students, workers, and parents around the globe. Stress, however, is also a vital part of being human; without a stress response, humans would be unable to properly cope with danger by initiating the “fight or flight” response. Some scientific research even suggests that brief bursts of mental pressure during exercise of meaningful work may actually be neuroprotective.1 However, when a person’s stress response cannot be turned off, increasing levels of hormones known as glucocorticoids seep into the brain and cause a slew of neural, immunological, and cardiovascular insults.1 The negative effects of this “chronic stress” can make it harder to cope with the circumstances that brought about the condition, triggering a nasty feedback loop that continually worsens a person’s health. Recent research suggests that chronic stress increases the risk of over numerous human illnesses and plays a leading role in diseases like Post Traumatic Stress Disorder (PTSD) and depression. Increasing knowledge of the biological dangers of stress has lead researchers to wonder whether the scientific community could prevent certain diseases by creating a “vaccine for stress.”2 By preemptively limiting the extent to which stress can harm the body, scientists hope to improve the condition of millions of people and to revolutionize the treatment of mental illness

Robert Sapolsky, one of the minds behind the movement to reframe stress as a medical condition rather than a social ill, is also one of the earliest investigators involved in studying the viability of a stress vaccine. Sapolsky has spent decades studying baboons in West Africa and realized that low-rank baboons, who had greater levels of stress hormones, also experienced shorter life expectancies.2 In 2003, Sapolsky announced his intentions to try to decrease the detrimental effects of stress by neutralizing these excess glucocorticoids with an experimental technique known as gene therapy. His approach entailed the use a modified herpes simplex virus to express an artificially created chimeric receptor that contained both a glucocorticoid receptor binding domain and an estrogen DNA binding domain.3 Therefore, with the use of this treatment, high levels of glucocorticoids in the bloodstream would activate the neuroprotective estrogen signalling pathway. This would stave off the worst effects of stress without completely eliminating it.3 Rats treated with this gene therapy virus displayed a greater resilience against stressors like forced-swimming and electrical shock.3 .

Although gene therapy is still a highly experimental treatment, Sapolsky is hopeful that this technology can one day be applied to humans and is working on developing a similar treatment for use in human tissue.

However, Sapolsky is not the only scientist that is researching a way to stem the effects of stress. One of the most promising approaches for dealing with chronic stress comes from an unlikely source: ketamine. Ketamine is popularly known as a recreational drug sold under the name “Special K,” but it also is believed to be involved with the process of neurogenesis, or the creation of new neurons. The stress response is a known inhibitor of neural growth, which in turn is linked with depression.1 Although this connection between neuron growth and depression is likely quite complicated, mice who exhibit a positive response to serotonin-based antidepressants frequently display neurogenesis within the hippocampus.1 By canceling out the degradation of neurons due to stress with small doses of ketamine, scientists like Rebecca Brachman hope to develop better treatments to depression, particularly in cases that resist treatment.4 Brachman’s approach to the treatment of stress is particularly interesting because it combines experimental ketamine therapy with the transplantation of immune cells from mice that had previously been exposed to extreme stressors.5 The latter therapy was envisioned after Brachman discovered that mice that received these stress-exposed cells displayed a greater sociability and an overall resilience against trauma.5 Though the mechanisms for Brachman’s treatments are unknown, she and other scientists are working to refine this hypothetical vaccine against stress.

Though stress is widely considered a vital part of the human experience, the scientific community’s push to recognize it as a medical risk may one day lead to preventative treatments for mental illness. People who suffer from mood disorders and those who are chronically exposed to stress may benefit immensely from treatments against stress, but only if the therapies are relatively inexpensive and unobtrusive. With so much attention being given to stress and its relation to mental health, only time will tell if there really can be a vaccine for stress.

progeria: a rare, fatal, and incurabale disease shreya saranathan

Kaylee Halko seemed like a typical newborn child. She slept often, cried when hungry, and occasionally smiled at various individuals.

However, unlike other newborns, Kaylee was not growing. At five months of age, she weighed nine pounds, half of the recommended size. Her parents were alarmed - how could their seemingly healthy baby not be growing? Doctors were appalled as well, unsure of her medical condition. After visiting several doctors, there was a confirmed medical diagnosis: Kaylee was suffering from Progeria, a rare and fatal medical condition that causes children to experience accelerated aging.

Hutchinson-Gilford Progeria Syndrome (Progeria or HGPS) is a rare genetic condition that causes children to resemble symptoms of premature aging. It affects one in every four million children, impacting males and females equally. Progeria is caused by a mutation in LMNA, a gene that produces Lamin A protein. Lamin A protein is structurally vital, as it holds the nucleus of a cell together.1 This mutation causes cellular instability, which jumpstarts the aging process. In early infancy, children with Progeria have a normal appearance. However, starting from nine months of age, children experience growth delays such as short stature and low weight.2 They also begin to develop distinctive facial features. These features include an enlarged head, highpitched voice, underdeveloped jaw, loss of hair, delayed tooth development and loss of muscle mass.1

Along with distinctive facial features, children with Progeria develop atherosclerosis, cardiovascular disease, strokes, and hip dislocations.

Atherosclerosis in particular causes very threatening complications during childhood, as most children die of heart disease at fourteen years of age. The lifespan of a child suffering from Progeria is typically between 8 to 21 years of age.2 That being said, although these children have several medical issues and conditions, their brains develop normally. Therefore, the majority of children with Progeria receive an education and partake in normal extracurricular activities.

However, currently, there is no definitive cure for those affected by Progeria. Several of those affected attend occupational and physical therapy two to three times a week to ensure maximum range of motion and flexibility. Doctors may prescribe statins, nitroglycerin for angina and routine therapy for congestive heart failure.1 In 2012, the first clinical drug trial used Lonafarnib, a farnesyltransferase inhibitor (FTI) that was initially developed to treat cancer. Although it is not FDA approved, every child has shown improvement such as gaining weight, better hearing, improvement in bone structure and/or increased flexibility in blood vessels.2

Because Progeria is a rare disease, it is vital to spread awareness and educate others. To learn more about this fatal disease and ways to get involved, visit the Progeria Research Foundation. Hopefully in the future, there will be treatment to cure Progeria and allow affected children to live a prolonged and healthy life.

Rachael Ogbonna

skin graft essentials

Skin grafting is defined to be a surgical operation in which a piece of healthy skin is transplanted to an injected or new site of the body. The vast majorityof skin grafting has been performed in the last century, however the earliest record originates in ancient India (Ameer et al. 2013). Specifically, tilemaker caste in India utilized free grafts of skin, for example subcutaneous fat, for “healing power”. (Ameer et al. 2013). In 1804, Giuseppe Baronio, a physiologist, introduced skin grafting to the New world. He transferred various thicknesses of skin varying in size at variable time intervals from theside root of the tail of sheep(Ameer et al. 2013). Allthe grafts he performed were successful. Baronio sparked the interest and developed of the skin grafts seen today.

Artificial skin is defined as a “collagen scaffold” that promotes the regeneration of skin in mammals. This graft is made of synthetic material that imitates the dermis and is combined with the cells from one’s own bone marrow (Yannas et al. 1989). Biomaterials are also used to support the replacement of both the epidermis and the dermis (Yannas et al. 1989). In order for this tissue engineered graft to be successful, it must meet the basic requirements.

Firstly, the skin must be able to provide a barrier layer of renewable keratinocytes, or cells from the upper barrier of human skin (MacNeil 2008). It must be well vascularized and provide elastic structural support as an outer layer of the body (MacNeil 2008). The overall development of the graft also depends on the skin physiology of the patient, specifically their stem cells and sensory transduction (MacNeil 2008). Two types of skin graftsaresplit level and full thickness grafts, whichare also based on the patient’s skin thickness (Scherer-Pietramaggiori SS et al.). Each type of graft involvesdifferent procedures.

There are also three other types of grafts based on the source of the new skin, the autograft, allograft, and xenograft. (Scherer-Pietramaggiori SS et al.)

There arevast amountsof key biomaterials used for engineering skin tissue. An epidermal cover delivers keratinocytes, which take on the wound bed and form a new epidermal layer (MacNeil 2008). A dermal replacement provides a dermal alternative to enhance wound healing or is utilized in a two-stage skin replacement protocol (MacNeil 2008).

These listed biomaterials can only provide certain benefits, but cannot replace the overall function of the skin. Further research is being conducted in order to achieve the most efficient skin graft for patients, particularly severe burn victims or those in need of transplants (MacNeil 2008).

Skin grafts serve to be most beneficial for its medical uses, specifically in the treatment of those with diabetic ulcers and infected wounds, severe burns, skin cancers, and open fractures of the legs (Scherer-Pietramaggiori SS et al.). The graft is expected to improve the health of a wounded site and impede any potential long-term implications that are often linked to complicated skin injuries. Other benefits include donor site morbidity, and refined overall split thickness of the skin (Scherer-Pietramaggiori SS et al.). Overall, skin grafts are continuously being modified for the benefit for who is to use it in the coming future.

works cited Dynamic Interpersonal relations with geriatrics Photography: Cristian Newman 1 Family Caregiver Alliance. (2015, January 31). Selected Long-Term Care Statistics.

Retrieved from: https://www.caregiver.org/selected-long- term-care- statistics 2 Rutgers Insitute of Health, Health Care Policy, and Aging Research. (n.d.). Division on Aging. Retrieved from http://www.ihhcpar.rutgers.edu/divisions/default.asp?v=2&o=1 3 Tobias Gerhard, D. P. Devanand, Cecilia Huang, Stephen Crystal and Mark Olfson. (2015). "Lithium Treatment and Risk for Dementia in Adults with Bipolar Disorder: PopulationBased Cohort Study." The British Journal of Psychiatry.

PImp your ride, not your mouth Photography: Jon Tyson 1 Bone, A., Ncube, F., Nichols, T., & Noah, N. D. (2008). Body piercing in England: a survey of piercing at sites other than earlobe. BMJ : British Medical Journal, 336(7658), 1426–1428.

2 Ferguson, H. (1999). Body piercing. BMJ : British Medical Journal, 319(7225), 1627–1629.

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ISRN Dentistry, 2014, 1-6. doi:10.1155/2014/876510 6 Stockman, J. (2013). Tongue Piercing: The Effect of Material on Microbiological Findings. Yearbook of Pediatrics, 2013, 119-121. doi:10.1016/j.yped.2011.10.045 7 Vilchez-Perez, M. A., Angeles Fuster-Torres, M., Figueiredo, R., Valmaseda-Castellón, E., & Gay-Escoda, C. (2009). Periodontal health and lateral lower lip piercings: a split-mouth cross-sectional study. Journal of Clinical Periodontology, 36(7), 558-563. doi:10.1111/j.1600-051x.2009.01431 8 Wong, H. M., Peng, S., Wen, Y. F., & McGrath, C. P. (2016). A population survey of early factors associated with permanent tooth emergence: findings from a prospective cohort study. Community Dentistry & Oral Epidemiology, 44(5), 467-475. doi:10.1111/cdoe.12236 man made medicine and women’s health Photography: Vlad Tchompalov ¹Gahagan, J., Gray, K., & Whynacht, A. (2015). Sex and Gender Matter in Health Research: Addressing Health Inequities in Health Research Reporting. International Journal for Equity in Health,14(1), 12. doi:10.1186/s12939-015-0144-4 ²Link, D. G. (2017). Women in Clinical Trials—Sex Matters. The Journal for Nurse Practitioners,13(4), 311-312. doi:10.1016/j.nurpra.2017.01.014 ³Liu, K. A., & Mager, N. A. (2016). Women’s Involvement in Clinical Trials: Historical Perspective and Future Implications. Pharmacy Practice,14(1), 708-708. doi:10.18549/pharmpract.2016.01.708 ⁴Mazure, C. M., & Jones, D. P. (2015). Twenty Years and Still Counting: Including Women As Participants and Studying Sex and Gender in Biomedical Research. BMC Womens Health,15(1). doi:10.1186/s12905-015-0251-9

The War on GMOs: A Brief Overview 1. Powell, C. (2015, August 9). How to Make a GMO. Retrieved from Harvard University, The Graduate School of Arts and Sciences: http://sitn.hms.harvard.edu/flash/2015/how-to-make-a-gmo/ 2. Diaz, J. M., & Fridovich-Keil, J. L. (2009). Genetically modified organism. (EncyclopÌdia Britannica, Inc.) Retrieved from Encyclopaedia Britannica: https://www.britannica.com/science/genetically-modified-organism 3. The Non-GMO Project. (n.d.). About. Retrieved from Non-GMO Project: https://www.nongmoproject.org/about/ 4. Whole Foods Market. (n.d.). What Are GMOs? Retrieved from Whole Foods Market: https://www.wholefoodsmarket. com/gmo-your-right-know 5. Chipotle Mexican Grill. (n.d.). G-M-Over It. Retrieved from Chipotle Mexican Grill: https://www.chipotle.com/gmo 6. Hallenbeck, T. (2014, June 15). Ben and Jerry’s says goodbye to GMOs. Retrieved from USA Today: https://www. usatoday.com/story/money/business/2014/06/15/ben-and-jerrys-says-goodbye-to-gmos/10542275/ 7. Kopicki, A. (2013, July 27). Strong Support for Labeling Modified Foods. Retrieved from The New York Times: http:// www.nytimes.com/2013/07/28/science/strong-support-for-labeling-modified-foods.html 8. Freedman, D. H. (2013, September 1). The Truth about Genetically Modified Food. (Nature America, Inc.) Retrieved from Scientific American: https://www.scientificamerican.com/article/the-truth-about-genetically-modified-food/ 9. Recent Trends in GE Adoption. (n.d.). (United States Department of Agriculture) Retrieved from Economic Research Service: https://www.ers.usda.gov/data-products/adoption-of-genetically-engineered-crops-in-the-us/recent-trends-in-geadoption/ 10. Restrictions on Genetically Modified Organisms: United States. (n.d.). (United States Library of Congress) Retrieved from Library of Congress: https://www.loc.gov/law/help/restrictions-on-gmos/usa.php 11. UNICEF. (n.d.). Malnutrition. Retrieved from UNICEF: https://data.unicef.org/topic/nutrition/malnutrition/ 12. The Non-GMO Project. (n.d.). GMO Science. Retrieved from Non-GMO Project: https://www.nongmoproject.org/ gmo-facts/science/ 13. The Non-GMO Project. (n.d.). GMO Facts. Retrieved from Non-GMO Project: https://www.nongmoproject.org/gmofacts/ 14. Harmon, A. (2013, August 24). Golden Rice: Lifesaver? Retrieved from The New York Times: http://www.nytimes. com/2013/08/25/sunday-review/golden-rice-lifesaver.html

Photography: Dominik Martin Defying Aging: The Biology of Naked Mole Rats

Ruby, J., Smith, M., & Buffenstein, R. (2018). Naked mole-rat mortality rates defy Gompertzian laws by not increasing with age. Elife, 7. http://dx.doi.org/10.7554/elife.31157 Gavrilov, L., & Gavrilova, N. (2014). New Developments in the Biodemography of Aging and Longevity. Gerontology, 61(4), 364-371. http://dx.doi.org/10.1159/000369011 Finch, C., Pike, M., & Witten, M. (1990). Slow mortality rate accelerations during aging in some animals approximate that of humans. Science, 249(4971), 902-905. http://dx.doi.org/10.1126/science.2392680 Edrey, Y., Hanes, M., Pinto, M., Mele, J., & Buffenstein, R. (2011). Successful Aging and Sustained Good Health in the Naked Mole Rat: A Long-Lived Mammalian Model for Biogerontology and Biomedical Research.

ILAR Journal, 52(1), 41-53. http://dx.doi.org/10.1093/ilar.52.1.41 Perez, V., Buffenstein, R., Masamsetti, V., Leonard, S., Salmon, A., & Mele, J. et al. (2009). Protein stability and resistance to oxidative stress are determinants of longevity in the longest-living rodent, the naked mole-rat. Proceedings Of The National Academy Of Sciences, 106(9), 3059-3064. http://dx.doi.org/10.1073/ pnas.0809620106 Kim, E., Fang, X., Fushan, A., Huang, Z., Lobanov, A., & Han, L. et al. (2011). Genome sequencing reveals insights into physiology and longevity of the naked mole rat. Nature, 479(7372), 223-227. http://dx.doi. org/10.1038/nature10533 Azpurua, J., Ke, Z., Chen, I., Zhang, Q., Ermolenko, D., & Zhang, Z. et al. (2013). Naked mole-rat has increased translational fidelity compared with the mouse, as well as a unique 28S ribosomal RNA cleavage.

Proceedings Of The National Academy Of Sciences, 110(43), 17350-17355. http://dx.doi.org/10.1073/ pnas.1313473110 Photography: David Clode

chimeras: a solution to organ transplants 1Unos.org. (2018). Data | UNOS. [online] Available at: https://unos.org/data/ [Accessed 23 Mar. 2018].

2Devlin, H. (2017, January 26). First human-pig ‘chimera’ created in milestone study. Retrieved March 23, 2018, from http://www.theguardian.com/science/2017/jan/26/first-human-pig-chimera-created-in-milestonestudy 3Regalado, A. (2016, December 31). Pig-human chimeras are being gestated in the U.S. Retrieved March 23, 2018, from http://www.technologyreview.com/s/545106/human-animal-chimeras-are-gestating-on-us-research-farms/ Hippocratic Hypocrite 1 Me Too. (n.d.). Retrieved February 19, 2018, from https://metoomvmt.org/ 2 Time’s Up Now. (2017). Retrieved February 19, 2018, from https://www.timesupnow.com/ 3 Hanna, J. (2018, February 01). The fallout from Larry Nassar’s sexual abuse is just beginning.

Retrieved February 20, 2018, from https://www.cnn.com/2018/01/26/us/larry-nassar-investigation-fallout-march/index.html 4 Lutz, T. (2018, January 24). Victim impact statements against Larry Nassar: I thought I was going to die. Retrieved February 20, 2018, from https://www.theguardian.com/sport/2018/jan/24/victim-impactstatements-against-larry-nassar-i-thought-i-was-going-to-die 5 Lundgren, K. S., Needleman, W. S., & Wohlberg, J. W. (2004). Above All, Do No Harm: Abuse of Power by Health Care Professionals. Retrieved February 20, 2018, from http://www.therapyabuse.org/p2-abuse-of-power.htm Photography: Marcelo Leal Meditation Workshops Offer Fresh Perspective on Mental Health Relief [1] Walton, A. (2015, Feb 9). 7 Ways Meditation Can Actually Change the Brain. Retrieved from http://forbes. com.

Photography: Sam Austin Hey, Who Needs Medicine?

1. How Staying Hydrated will help with Sickness and Injuries. (2015, May 05). Retrieved February 18, 2018, https://www.lurongliving.com/healthy-living/blog/fitness/staying-hydrated-helps 2.Sorry, Your Vitamin C Megadose Is Basically Useless. (2015, September 16). February 17, 2018, https://www. huffingtonpost.com/entry/emergen-c-airborne-does-it-work_us_55f3709ee4b063ecbfa486c8 3.The Healing Power of Sleep. (2016, October 06). February 18, 2018, https://www.webmd.com/a-to-z-guides/ discomfort-15/better-sleep/healing-power-sleep Photography: Freestocks

what’s the flu to you?

Photography: Kelly Sikkema 1.Centers for Disease Control and Prevention. Key Facts About Influenza (Flu). Retrieved from https://www. cdc.gov/flu/keyfacts.htm 2.McNeil, D.G. (2018, January 18). This Flu Season Is Now the Worst in Years: Here’s Why. Retrieved from https://www.nytimes.com/2018/01/18/health/flu-season-facts.html 3.Scutti, S. (2018, February 15). Flu vaccine just 36% effective this season, CDC reports. Retrieved from https://www.cnn.com/2018/02/15/health/flu-vaccine-effectiveness-cdc-feb-15/index.html 4.World Health Organization. (2017, March 2). Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season. Retrieved from http://www.who.int/influenza/vaccines/ virus/recommendations/2017_18_north/en/ 5.Centers for Disease Control and Prevention. (2018, February 16). Interim Estimates of 2017-18 Seasonal Influenza Vaccine Effectiveness. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a2.htm?s_ cid=mm6706a2_e debunking myths about coffee 1. Olweny, E. (2018, February 14). [E-mail interview].

2. Dr.Olweny is an Urologist at Robert Wood Johnson University Hospital 3. Ferraro, P. M., Taylor, E. N., Gambaro, G., & Curhan, G. C. (2014). Caffeine intake and the risk of kidney stones. American Journal Of Clinical Nutrition, 100(6), 1596. doi:10.394 Photography: Mike Kenneally What Ought We to Do?: Exploring a Deficiency of Undergraduate Ethics Education 1. Table B-2: Total graduates by U.S. medical school, sex, and year. (2017, December 1). Retrieved February 17, 2018, from https://www.aamc.org/data/facts/enrollmentgraduate/148670/total-grads-by-school-gender.html 2. Smith, W. D. (2018, February 09). Hippocrates. Retrieved February 17, 2018, from https://www.britannica. com/biography/Hippocrates 3.Glicksman, E. (2016, April). “What Do I Do?” Teaching tomorrow’s doctors how to navigate the tough ethical questions ahead. AAMC Reporter. Retrieved February 17, 2018, from https://news.aamc.org/medical-education/ article/teaching-doctors-ethical-questions/ 4.Admission Requirements for Medical School. (2015, October 06). Retrieved February 17, 2018, from https:// students-residents.aamc.org/choosing-medical-career/article/admission-requirements-medical-school/ 5.Hare, R. M. (1963). The language of morals. New York: Oxford University Press.

6.Hill, T. (2017, December 12). The language of morals. Lecture presented at Medical Ethics.

7.Dubois, J. M., & Burkemper, J. (2002). Ethics education in U.S. medical schools. Academic Medicine,77(5), 432-437. doi:10.1097/00001888-200205000-00019 Photography: Janko Ferlic Healing Medicine: Dangerous Side Effects for Women 1 McGregor, A. (n.d.). Why medicine often has dangerous side effects for women. Speech presented at TEDx, Providence, Rhode Island. Retrieved February 05, 2018.

2 Levine, H. (n.d.). Women’s Health, Men’s Health: Why Gender Matters. Retrieved February 27, 2018, from https://www.consumerreports.org/health/how-womens-health-and-mens-health-differ/ 3 Merz, N. B. (n.d.). The single biggest health threat women face. Speech presented at TEDxWomen 2011. Retrieved February 09, 2018.

Photography by: Verne Ho

Search the Soil: The Newest Antibiotic for Drug Resistance 1. Antibiotic resistance. (2017, November). Retrieved February 23, 2018, from http://www.who.int/mediacentre/factsheets/antibiotic-resistance/en/ 2. Senthilingam, M. (2016, May 23). Protecting the world from deadly superbugs. Retrieved February 24, 2018, from https://www.cnn.com/2016/05/23/health/stoppingsuperbugs/index.html 3. Borman, S. (2017). Antibacterial molecule may discourage resistance. C&EN Global Enterprise, 95(25), 9-9. doi:10.1021/cen-09525- notw7 Photography: Kyle Ellefson A Single Breakthrough, a Single Genome, and Two Macaques 1. Liu, Z., Cai, Y., Wang, Y., Nie, Y., Zhang, C., & Xu, Y. et al. (2018). Cloning of Macaque Monkeys by Somatic Cell Nuclear Transfer. Cell, 172(4), 881-887.e7. http://dx.doi.org/10.1016/j.cell.2018.01.020 2. Tian, C., Kubota, C., Enright, B., & Yang, X. (2003). Cloning animals by somatic cell nuclear transfer - biological factors. Reproductive Biology And Endocrinology, 1.

3. Zhang, S. (2018). Chinese Scientists Have Successfully Cloned Monkeys. The Atlantic. Retrieved 20 February 2018, from https://www.theatlantic.com/science/archive/2018/01/china-monkey-clones-zhongzhong-huahua/551318/ Fighting the Unknown: Researching Rare Diseases 1Madhusoodanan, Jyoti. LabX Media Group. (2016). The Challenges of Rare-Disease Research.

TheScientist. Retrieved from: https://www.the-scientist.com/ 2Sahota et al. (2014). Novel Cystine Ester Mimics for the Treatment of Cystinuria-induced Urolithiasis in a Knockout Mouse Model. Urology, 84(5). doi:10.1016/j.urology.2014.

07.043 3Schieppati et al. (2008). Why Rare Diseases Are an Important Medical and Social Issue. The Lancelet, 371. doi:10.1016/S0140-6736(08)60872-7.

Photography: Jamie Davies Don’t Flakka Do Drugs 1. Crespi, C. (2016). Flakka-Induced Prolonged Psychosis. Case Reports in Psychiatry, 2016, 1-2. doi:10.1155/2016/3460849 2. C. Chai, (2015). “What you need to know about flakka, the latest drug causing erratic behaviour,” Global News. Retrieved from https://globalnews.ca/news/1942263/what-youneed-to- know-about- flakka-the- latest-drug- causing-erratic- behaviour/ 3. Connor, T., McFadden, C., & Nadi, A. (2015, December 21). 'Devil's Drug': Flakka Is Driving Florida Insane. Retrieved from https://www.nbcnews.com/news/us-news/devilsdrug-flakka- driving-florida- insane-n471531 4. J. Firger, (2015). “What Is Flakka? Florida’s Dangerous New Drug Trend”, CBSNews, CBS Interactive, San Francisco, Calif, USA. Retrieved from https://www.cbsnews.com/news/flakka-floridas- dangerous-new- drug-trend/ Photography: Mitchel Lensink

Of Mice and Mental Illness: How Affective Biases in Mice Offer Insight on Depression 1. Robinson, E. S. (2018, January 19). Translational new approaches for investigating mood disorders in rodents and what they may reveal about the underlying neurobiology of major depressive disorder.

Retrieved February 18, 2018, from http://rstb.royalsocietypublishing.org/content/373/1742/20170036 2. Can, A., Dao, D. T., Arad, M., Terrillion, C. E., Piantadosi, S. C., & Gould, T. D. (2012). The Mouse Forced Swim Test. Retrieved February 18, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353513/ 3. Can, A., Dao, D. T., Terrillion, C. E., Piantadosi, S. C., Bhat, S., & Gould, T. D. (2012). The Tail Suspension Test. Retrieved February 18, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3353516/ 4. [Personal interview with Dr. Anthony Uzwiak, February 14, 2018] Photography: Freestocks Anosognosia: A Break from Reality 1. Jaffe, D. J. (n.d.). Legal Basis for Involuntary Commitment and Involuntary Treatment.

Retrieved February 10, 2018, from https://mentalillnesspolicy.org/ivc/involuntary-commitment- concepts.html 2. New Jersey. (2018). Retrieved February 10, 2018, from http://www.treatmentadvocacycenter.org/browse-by- state/new-jersey 3. Ramachandran, V. S., & Rogers-Ramachandran, D. (1996). Denial of disabilities in anosognosia. Nature,382(6591), 501-501. doi:10.1038/382501a0 4. Serious Mental Illness and Anosognosia. (2016, June). Retrieved February 10, 2018, from http://www.treatmentadvocacycenter.org/storage/documents/backgrounders/smi-and-anosognosia.pdf 5. Vocat, R., Staub, F., Stroppini, T., & Vuilleumier, P. (2010). Anosognosia for hemiplegia: a clinical-anatomical prospective study. Brain,133(12), 3578-3597. doi:10.1093/brain/awq297 Photography: Pierre Acobas Turning a new page in research techniques: The in vivo revolution Saeidnia, S., Manayi, A., & Abdollahi, M. (n.d.). From in vitro Experiments to in vivo and Clinical Studies; Pros and Cons. Retrieved February 18, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/26778084 Hartung, T., & Daston, G. (2009, July 17). Are In Vitro Tests Suitable for Regulatory Use? | Toxicological Sciences | Oxford Academic. Retrieved February 18, 2018, from https://academic.oup.com/toxsci/article/111/2/233/1641269 National Research Council (US) Committee on Methods of Producing Monoclonal Antibodies.

(1999, January 01). Summary of Advantages and Disadvantages of In Vitro and In Vivo Methods. Retrieved February 18, 2018, from https://www.ncbi.nlm.nih.gov/books/NBK100200/ Coecke, S., Goldberg, A. M., Allen, S., Buzanska, L., Calamandrei, G., Crofton, K., . . . BalPrice, A. (2007, June). Workgroup Report: Incorporating In Vitro Alternative Methods for Developmental Neurotoxicity into International Hazard and Risk Assessment Strategies.

Retrieved February 18, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892131/ A. (2016, January 18). In Vitro And In Vivo Antibodies Production | Antibody Production.

Retrieved February 19, 2018, from http://neobiolab.com/research/in-vitro- and-in- vivoproduction-of- antibodies Photography: Drew Hays

Swallowing Change 1Alexander, A. (2017, March 30). Menus of Change Come to Rutgers. Retrieved February 19, 2018, from https://news.rutgers.edu/feature/menus-change-come-rutgers/20170327#.Woz1kKinE2w 2Alexander, A. (2017, December 7). Sizzling Scarlet Knight Burger Could Put Rutgers on the Culinary Map. Retrieved February 20, 2018, from https://news.rutgers.edu/sizzling-scarlet-knight-burger-could-put-rutgers-culinary-map/20 171204#.Wo0o1KinE2w 3The Culinary Institute of America, & Stanford University. (n.d.). Overview of the Menus of Change University Research Collaborative. Retrieved February 20, 2018, from http://www.moccollaborative.org/images/uploads/pdf/MCURC_Overview_(10-31-17)4.p df The Healing Power of Music 1 Breslau, N., Davis, G. C., Andreski, P. (1991). Traumatic Events and Posttraumatic Stress Disorder in an Urban Population of Young Adults. Arch Gen Psychiatry, 48(3), 216-222.

2 Moshe, B., Dorit, A., Yuval, W. (2008). Drumming through trauma: Music therapy with post-traumatic soldiers. The Arts in Psychotherapy, 35(1), 34-48.

3 Sorensen, M. (2015). The Neurology of Music for Post-Traumatic-Stress Disorder Treatment: A Theoretical Approach for Social Work Implications. Retrieved on February 20, 2018 from: https://sophia. stkate.edu/cgi/viewcontent.cgi?article=1526&context=msw_papers 4 Spencer, M. (2016). Hans Christian Andersen. Retrieved on February 27, 2018 from: http://www.classicfm.com/discover-music/latest/quotes-about-classical-music/andersen/ 5 Sutton, J., Backer, J. D. (2009). Music, trauma, and silence: The state of the art. The Arts in Psychology, 36(2), 75-83.

Photography by: Johannes Plenio Skin Graft Essentials Ameer, F., Singh, A. K., & Kumar, S. (2013). Evolution of Instruments for Harvest of the Skin Grafts. Indian J Plastic Surgery,46, 28-35.

MacNeil, S. (2008). Biomaterials for Tissue Engineering of Skin. Materials Today,11(5), 26-35.

Scherer-Pietramaggiori SS, Pietramaggiori G, Orgill DP. Skin graft. In: Neligan PC, ed. Plastic Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 17.

Yannas, I., Lee, E., & Orgill, D. (1989). Synthesis and Characterization of a Model Extracellular Matrix that Induces Partial Regeneration of Adult Mammalian Skin. Proc Natl Acad Sci U S A,933-937.

Photography by: Toa Heftiba A Turning Point in Psychiatric Symptomatology 1Rampp, C, et al. “Epigenetics in Post-Traumatic Stress Disorder.” Progress in Molecular Biology and Translational Science., U.S. National Library of Medicine, 15 Nov. 2014, www.ncbi.nlm.nih.gov/pubmed/25410540.

2 “Background on Comparative Genomic Analysis.” National Human Genome Research Institute (NHGRI), Dec. 2002, www.genome.gov/10005835/.

Photography by: Joe Roberts

E-Cigarettes 1. A. (2016, December 8). E-cigarettes and Lung Health. Retrieved February 27, 2018, from http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html 2. FDA . (2018, January 26). Vaporizers, E-Cigarettes, and other Electronic Nicotine Delivery Systems (ENDS). Retrieved February 27, 2018, from https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm45 6610.htm 3. Mishra, A., Chaturvedi, P., Datta, S., Sinukumar, S., Joshi, P., & Garg, A. (2015, March). Harmful effects of nicotine. Retrieved February 27, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/ 4. Harmful Chemicals in Electronic Cigarettes. (n.d.). Retrieved February 27, 2018, from http://www.gaspforair.org/gasp/gedc/pdf/E-CigSmoke.pdf 5. Lee, H., Park, S., Weng, M., Wang, H., Huang, W. C., Lepor, H.,. . .Tang, M. (2018, January 29). E-cigarette smoke damages DNA and reduces repair activity in mouse lung, heart, and bladder as well as in human lung and bladder cells. Retrieved from http://www.pnas.org/content/early/2018/01/25/1718185115 Photography by: Daoudi Aissa Is it All in Your Head? Scientific Theories About Trypophobia 1.Cole, G. C. (2013, August 27). Fear of Holes. Retrieved February 18, 2018, from http://journals.sagepub.com/ doi/abs/10.1177/0956797613484937 2.A. (Ed.). (2017, October 27). Trypophobia: Fear or Disgust at the Sight of Clusters of Holes. Retrieved February 20, 2018, from Trypophobia: Fear or Disgust at the Sight of Clusters of Holes 3.Milosevic, I., & McCabe, R. E. (2015). Phobias: the psychology of irrational fear. Santa Barbara, CA: Greenwood, an imprint of ABC-CLIO, LLC. 4.Cawley, L. (2013, December 30). Deadly animal markings offer clue to fear of holes. Retrieved February 27, 2018, from http://www.bbc.com/news/uk-england-essex-25321318 Photography by: Toia Montes A Charge for Change in an Addiction Crisis Drugabuse.gov. (2018). Opioid Overdose Crisis. https://www.drugabuse.gov/drugsabuse/opioids/opioid-overdose-crisis. 17 Feb. 2018.

Ehley, B. and Haberkorn, J. (2018). Trump Declared an Opioids Emergency. Then nothing changed‌ POLITICO. https://www.politico.com/story/2018/01/11/opioids-epidemic-trump-addiction-emergency-order-335848.

17 Feb. 2018 Brodwin, E. (2018) Deaths from Opioid Overdoses Have Jumped- and one age group is being affected at stark rates. Business Insider. www.businessinsider.com/opiod-overdose-death-statistics-2017-2016. 17 Feb. 2018.

Photography by: Pina Messina

The Search for a Stress Vaccine 1. McEwen, B. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. European Journal Of Pharmacology, 583(2-3), 174-185. doi:10.1016/j.ejphar.2007.11.071 2. Sapolsky, R. (2017). Behave. New York, NY: Penguin Press.

3. Cheng, M., Jin, M., Sapolsky, R., Sun, G., Zhao, H., & Steinberg, G. (2009). Blocking glucocorticoid and enhancing estrogenic genomic signaling protects against cerebral ischemia. Journal Of Cerebral Blood Flow And Metabolism, 29(1), 130-136. doi:10.1038/jcbfm.2008.105 4. Brachman, R. A., McGowan, J. C., Perusini, J. N., Lim, S. C., Pham, T. H., Faye, C., & ... Denny, C. A. (2016). Archival Report: Ketamine as a Prophylactic Against Stress-Induced Depressive-like Behavior. Biological Psychiatry, 79(N-Methyl-D-Aspartate Receptors: Mood, Psychosis, and Cognition), 776-786. doi:10.1016/j. biopsych.2015.04.022 5. Brachman, R., Lehmann, X., Herkenham, X., & Maric, D. (2015). Lymphocytes from Chronically Stressed Mice Confer Antidepressant-Like Effects to Naive Mice. Journal Of Neuroscience, 35(4), 1530-1538. doi:10.1523/JNEUROSCI.2278-14.2015 Photography by: John Sekutowski Progeria: A Rare, Fatal and Incurable Disease 1 Hutchinson-Gilford Progeria- NORD (National Organizations for Rare Disorders). (n.d).

Retrieved February 20, 2018, from www.rarediseases.org/rarediseases 2 Nordqvist. C. (2017, December 19). Progeria: Causes, symptoms, and treatment.

Retrieved February 20, 2018, from https://www.medicalnewstoday.com/articles Photography by: Annie Spratt Cover Photography: Meta Zahren Staff Page Filip Bunkens

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