Examiner Spring 2024, Vol. 29

SPRING 2024

In Discussion With Professor Springer: Masculinity Ideals and Health Outcomes Diya Nathan, 8-9 Intuitive Eating: Is it the Key to Healing From the Freshman Fifteen Myth?

Erin Oxnam, 12-13 Microneedling for Hair Loss: A Dermatological Innovation Prahalad Rana, 20-21

Letter from the Editor-in-Chief Spring 2024 Dear Reader, Welcome to the Spring 2024 edition of The Examiner. Over the Fall 2023 semester, our journalists, many of whom joined us for the first time, worked to write about issues they are passionate about that are relevant to our shared interests in medicine and healthcare, and to the Rutgers community as a whole. Highlights include articles on research at Rutgers, student life, and hot-topic issues such as the recent relinquishing of the TB drug patent. Our layout team, meanwhile, has worked throughout the spring to curate them into the journal you are currently reading. As students juggling assignments, work, and extracurriculars, I am incredibly proud of our members for collaborating to create another quality issue designed to inform you about the latest in clinical science and healthcare.

Along with working to create this semester’s articles, our members were able to benefit from activities designed to help them as professionals, from a fascinating talk by Dr. Martha Haviland, the Director of the Office of Undergraduate Instruction for the Division of Life Sciences, to a peer review session and a member panel on pre-medical opportunities. We continued our blog initiative on topics like National Black HIV/AIDS Awareness Day and had an incredibly successful blood drive, collecting a total of 58 pints! Overall, we strove to leave a lasting and positive impact on the Rutgers community.

As a member of this club since my first semester, it has been amazing to see how this club has grown- and to have a part in shaping that as President this year. I am incredibly grateful for our members’ hard work, and I look forward to seeing our new board’s accomplishments!

Signing off,

Sarah Adams Editor-in-Chief

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Table of Contents

Is The Cure for Cancer Hiding in Our Jungles?

The Clinical Potential of Grounding the Human Body Rural Healthcare: Hospital Closures Affecting Vulnerable Populations Cardiac Amyloidosis: Underdiagnosis and Preventable Deaths In Discussion with Professor Springer: Masculinity Ideals and Health Outcomes Medical Benefits of Coffee: Rutgers Professor Wins Award for Parkinson’s Research Bariatric Surgery: The Next Possible Cancer Prevention?

Intuitive Eating: Is it the Key to Healing From the Freshman 15 Myth?

AI’s Profound Effect on EMS YouTube Activism Triumphs; J&J Relinquishes TB Drug Patent Nanoparticles in Food Allergy Treatment Orthorexia Nervosa: Unhealthy Healthiness Stereoelectroencephalography: Reducing Seizures When Medication Fails Learning How We Forget Microneedling for Hair Loss: A Dermatological Innovation Ozempic and its Future in Drug Addiction Recovery A Recent Rise in Young Adult Cancer Rates The Importance of Humanities in Pre-Medical Education

4 5 6 7 8-9 10 11 12-13 14 15 16 17 18 19 20-21 22 23 24

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Is The Cure for Cancer Hiding in Our Jungles?

Cielo Tumbokon Medicinal plants have a history that is deeply rooted in ancient civilizations. The earliest evidence of using plants to prepare drugs dates back to 5,000 years ago. Ancient Chinese literature often mentions the utilization of dried plants with curative properties. In the works of Hippocrates, an ancient Greek physician regarded as the father of medicine, more than 300 therapeutic plants are precisely classified 1 by their physiological action. In recent history, Dr. Rong Di, an assistant professor of Rutgers University in the Department of Plant Biology, researched Momordica grosvenori, or monk fruit, and its anti-inflammatory properties caused by its ability to inhibit inflammatory genes and enhance the expression of genes that protect against inflammation.2 There is an extensive history of humankind using medicinal plants to help relieve pain and cure different illnesses.

Recent breakthroughs by Stanford researchers have uncovered a novel compound, tigilanol tiglate (EBC-46), in a plant with promising implications for cancer treatment. Limited to the rainforests of Northern Australia, the Fontainea picrosperma, known as the blushwood tree, has unique properties.

The plant contains an anti-cancer agent called EBC-46, which must be purified from the kernels of the fruit of this plant. So far, this compound has been used locally to treat a wide variety of solid tumors in both humans and pets. The success rate of this treatment, after a single intralesional injection, is about 2 75%, and about 88% after the second round.

The secret of the plant’s healing ability lies in its mechanism of action. For administration of this chemical compound, EBC-46 is injected directly into a tumor. The treatment induces vascular disruption, effectively breaking apart blood vessels in the tumor and causing its cells to begin to necrotize or die. Next, red blood cells excavate, or spill, into the surrounding area that has tumor cell 3 necrosis, causing rapid inflammation. For external tumors, this will result in scabbing until the tumor falls off. Its application for internal tumors is still being explored, although leakage has been a cause for some concern with this treatment. A current hypothesis is that the damage caused byby the tumor’s 4 vascularization prevents EBC-46 from entering the rest of the bloodstream.

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By affecting tumor vasculature, EBC-46 helps stimulate the immune system to kill cancer cells. The complex structure of EBC-46 prevents it from being synthesized in a lab, although “analogs” or chemically similar compounds are being developed to treat other diseases, such as AIDS, multiple sclerosis, and Alzheimer’s disease.2 There has been successful laboratory preparation of EBC-46 that has been approved for veterinary and healthcare purposes. Previously, EBC-46 was considered 5 synthetically inaccessible and a limited natural source, raising environmental concerns. The discovery of EBC-46 displays the invaluable resources that rainforests contain for medicinal advancements.

Preserving rainforests remains crucial for preserving biodiversity, but additionally for ensuring access to medicinal plants, such as the blushwood tree. The conservation of these ecosystems is not limited to environmental imperative; it is a vital commitment to the well-being and medical progress of humanity.

The Clinical Potential of Grounding the Human Body Amina Noorzaie For most of human evolution, the human body has been in perpetual contact with the Earth's subtle surface charge.

However, in modern times, it has increasingly insulated itself from this natural electrical interaction through the widespread use of synthetic materials that block skin contact with the ground. Wearing rubber-soled shoes, living and working above ground in buildings, driving in cars, and sitting on insulated furniture prevents the body from absorbing the Earth's stabilizing supply of free electrons. This disconnection interferes with the body's electrical 1 circuitry and can lead to a buildup of disruptive static charge in tissues. Re-establishing this lost electrical connection to the Earth through grounding or earthing may be a key component in maintaining health, although it is commonly overlooked in contemporary society.

Simple grounding techniques have been evidenced as powerful anti-inflammatories and antioxidants, with immediate and lasting physiological benefits.2 The Earth maintains a limitless reservoir of free electrons, and when grounded, these electrons can transfer into the body. Research proposes that the influx of electrons acts as natural antioxidants, neutralizing excess free radicals that cause oxidative stress.1 Free radicals are produced continuously through normal metabolism and inflammation. Uncontrolled, they can damage cellular components over time and contribute to chronic disease. Grounding permits a sustained supply of free electrons that can swiftly reach tissues through the body’s conductive systems. Unlike slow nerve impulses or diffusing chemicals, electrons appear able to transit rapidly along these conductive tissues and impact the whole body simultaneously within minutes.

More specifically, research shows grounding improves blood flow and viscosity by increasing zeta potential, the negative charge around red blood cells, which keeps them properly spaced to reduce clumping. In one study, grounding raised zeta potential in subjects by 270% in just two hours, indicating the body's natural blood thinning response was enhanced.3 This enhancement also can also lead to a reduction in cardiovascular risks. 4 In addition, in a sports medicine related study, grounded subjects with delayed onset muscle soreness exhibited decreased circulating white blood cells upon grounding. 2 This implies faster resolution of damage and controlled inflammation, suggesting this practice be a part of any athletic/fitness lifestyle.

Dr. Labros Sidossis, the Chair of the Department of Exercise Sciences and Sports Studies and Professor of Medicine at the Robert Wood Johnson Medical School at Rutgers University, has focused on the role of lifestyle factors in the prevention and treatment of various diseases over the course of his research. He notes, “Scientific studies on the benefits of grounding are quite limited. Some research suggests that grounding might influence the levels of white blood cells, cytokines, and other molecules that play a role in the human inflammatory response system. It's also believed that grounding could alleviate pain and speed up wound healing.” However, he emphasizes a crucial point that “comprehensive and well-controlled studies are necessary to substantiate these claims.” Nonetheless, he notes, “it's widely acknowledged that spending time in nature contributes positively to human health, both physiologically and psychologically.” 5 Grounding represents a straightforward yet potentially powerful intervention for utilizing the Earth’s free electrons to neutralize oxidative stress, reduce inflammation, optimize immune function, improve blood flow, and overall, promote wellness. Grounding may also provide safe, cost-free adjuvant therapy for cardiovascular disease and 2 autoimmunity. While more studies are needed, the accumulating evidence and plausible mechanisms strongly support further research of grounding the human body and exploration of its therapeutic potential.

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Rural Healthcare: Hospital Closures Affecting Vulnerable Populations Or Doni

Rural healthcare has garnered attention due to research revealing widespread disparities in care between urban and rural communities – with rural patients often experiencing significantly worse outcomes. The healthcare facilities available to Americans widely vary depending on whether they live in urban or rural areas, with rural patients facing health challenges due to difficulty accessing medical care and facilities.

Approximately fifteen percent of Americans live in “rural” areas.1 Demographically, rural communities tend to be older and sicker than urban communities – exacerbating the health detriments of the inaccessibility of care. Rural healthcare systems in recent years have faced financial challenges that have led to a nationwide trend of hospital service cuts, and closures of entire hospitals. The American Hospital Association reported “136 rural hospital closures from 2010 to 2021, and a record 19 closures in 2020.”

2 Financial challenges due to low patient volume, patient demographics, the COVID-19 pandemic and staffing were major causes. Some hospitals have shut some of their services without shutting entirely 3 during recent years, another barrier to quality accessible care. Rural characteristics complicate financially sustaining a rural hospital as compared to an urban one – low patient volume, difficulty attracting staff, lack of patient insurance, and dwindling reimbursements contribute to difficulty remaining financially solvent.

Dr. Jonathan Kirsch is an Internal Medicine Associate Professor at the University of Minnesota, who provides and researches rural medical care. He provided insights on the difference when providing rural care. “There is a calculation about whether time and money is spent getting to a health center, and whether there are the resources there that are needed. Time factor is greater in rural settings. Due to those factors, often people present later in the course of illness. Less screening of cancer, blood pressure, diabetes.” He emphasized the issue of timely care, writing “Do you refer or not? Do you go to the local health center that is less equipped or to the city for specialty and high quality primary care?” He also notes difficulties rural Americans experience in getting exercise, as they have less access to gyms and sidewalks. An effective healthcare intervention for rural communities is mobile health clinics. Dr. Kirsch describes his as a collaboration between community based organizations with health, social, and governmental services. The provision of all of these services in a group setting allows them to gain the community’s trust and provide quality care.

Rural healthcare is a crucial service for millions of Americans’ well-being and safety. Evidence-based changes to health policy across the country have the potential to improve health outcomes for rural communities that serve as backbones for various sectors of the American economy. The previously mentioned American Hospital Association report calls on state and federal governments to collaborate on helping rural hospitals keep financially viable; interventions with the potential to reduce healthcare disparities should be researched further.

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Cardiac Amyloidosis: Underdiagnosis and Preventable Deaths Vivian Glenn Cardiac Amyloidosis is an underdiagnosed disease that causes many preventable cardiac deaths.

Amyloidosis is a protein misfolding disease characterized by aggregation of amyloid fibrils leading to multisystem organ dysfunction. Since this disease can deteriorate certain organ systems more than others, it has a widespread presentation of symptoms. This fact, coupled with the lack of knowledge regarding the disease, has led to its underdiagnosis. Growing knowledge about cardiac amyloidosis is leading to increased recognition of this disease as an underestimated cause of heart failure.1 Many different phenotypes comprise the disease, causing it to have greater infiltration of the brain, heart, or other organ systems. There are three types of amyloidosis: light chain amyloidosis, which is caused by the breakdown of immunoglobulin light chains; Wild-type transthyretin (ATTRwt) amyloidosis, which has an imprecise etiology; and Hereditary (ATTRv) amyloidosis which is caused by a mutation in the transthyretin (TTR) protein.2 ATTR amyloidosis is caused by this protein changing shape and unfolding. The instability of this misfolded protein leads to complications of the disease because it can clump up, aggregate, or turn into plaque, which can be deposited into the heart or other organs, causing disruption to the system.

Cardiac amyloidosis disproportionately affects African Americans. The age-adjusted mortality rate for all races is 3.7 for women to 6.6 for men, but for African Americans the mortality rate is double that of the 2 other races, 6.5 for women and 12.4 for men. Despite this information, areas with higher percentages of African Americans by state such as Missouri, Alabama, and Georgia have lower amyloidosis mortality rates suggesting that cardiac amyloidosis is “disproportionately underdiagnosed in black individuals”.2 It is also important to note the ongoing trials to develop drugs for ATTR amyloidosis. A treatment for amyloidosis is a drug known as Tafamidis, which stabilizes the transthyretin protein so that it is unable to misfold, thus reducing the chances of disease progression. Investigations to develop drugs, such as Tafamidis, can shed light on further treatments for this specific disease, along with other protein-misfolding diseases. Currently, the cost of the drug can be upwards of $20,000 dollars, so developing a cost-effective cure is crucial. Lack of disease awareness, underdiagnosis, and high drug costs has led to minimal access to treatment for affected individuals. Bringing awareness to this disease can help doctors and scientists bring interventions to larger patient populations.

The Liu lab at Rutgers University studies the structuring and aggregation of disordered proteins in protein misfolding diseases. Much like how cardiac amyloidosis has a late onset, Dr. Liu aims to understand why “the autosomal dominant disease trait such as mHtt does not manifest below a certain age” by asking how “age-related changes affect disease pathogenesis”?4 As an individual ages, there are changes to their hydration and pH status, which may drive disease pathogenesis. This can be linked to ATTR amyloidosis because the hereditary form has a late onset as well. Looking at environmental factors, intrinsic factors, or the interplay between the two can give insights to changes in cell environment and disease onset with aging.4 Combating cardiac amyloidosis with various scientific perspectives while increasing knowledge of the disease will decrease preventable deaths.

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Diya Nathan

In Discussion with Professor Springer: Masculinity Ideals and Health Outcomes 8

In the past decade, there has been an increasing amount of information indicating worse health outcomes are more likely for men than women. As an increasingly hot topic in the public eye, we have seen numerous studies show men have higher mortality rates than others and are more likely to develop certain disorders. One statistic from 2021 shows that men are expected to live for 73.5 years while women are expected to live for 79.3 years, but what is the cause of this? This is a question Professor Kristen Springer 1 wants to find answers to.

Professor Springer, an associate professor of sociology at Rutgers University, teaches classes on family, gender, and biosociology, all of which are topics of her research. This includes health outcomes and when it comes to research on the topic, she explains how, “The biomedical field looks at biological aspects of why this is, sociology looks at societal aspects, but not many studies which look at both.”

She believes this interdisciplinary approach will provide insight on why men have worse health outcomes.

Traditional ideas of masculinity can still be found all around us. From depictions of men in film to the other men in their daily lives, it’s not surprising that young boys learn about these ideas and internalize them. At the same time, social factors do not directly lead to death or any health condition. It leaves this gap and a question: How do these ideas lead to these conditions? This is the gap Professor Springer researches in her study ‘Getting to the Heart of Masculinity Stressors: Masculinity Threats Induce Pronounced Vagal Withdrawal During a Speaking Task’.

Men are more likely to develop heart disease which happens to be the leading cause of death in American men, and Professor Springer’s study shows how masculinity ideals play a role in why this is, by looking at their effect on causing vagal withdrawal. 2 Vagal withdrawal is a condition that causes the heart rate to go up to 100 beats per minute and is often connected to 3, 4 increased risk of morbidity and mortality.

“Students who were told they were nonmasculine after the speaking task were more likely to experience vagal withdrawal”

Essentially, the study looked at how these ideas affect men’s heart rate during a speaking task. Two hundred and eighty five undergraduate male students were randomly assigned to one of four groups, which dictated what feedback they would receive after a five minute speaking task. The experimental group was composed of the masculine and non-masculine groups comprising the experimental group, while the control groups were composed of diligent and non-diligent groups. After that their heart rate was tracked to see if they experienced vagal withdrawal. Based on their heart rate, they were organized into a new feedback group: dropping, low or high. The dropping feedback group consisted of students who experienced vagal withdrawal and then had their heart rate go down. The low feedback group consisted of students who did not experience vagal withdrawal at all, while the high feedback group consisted of students who only experienced vagal withdrawal. Simply put, the students who were told they were non-masculine after the speaking task were more likely to experience vagal withdrawal. 5 Men internalize these ideals from society, which in turn makes them more sensitive to threats to their masculinity.

As Springer explains, experiencing these threats has a physiological reaction on their cardiovascular system, and if experienced enough, this will contribute to heart conditions in the future. So while we always knew that society had some effect on these increased rates of heart conditions for men, we see Springer put together the final puzzle piece that logically connects them. More importantly, her research raises concerns on these ideals.

She also hopes to see more research on the topic and similar ones. As she states. “we don’t see a lot of bio-social research, because there isn’t much collaboration between the biomedical field and sociology” and it’s something she wishes to see change in the future. By researching these connections we find more evidence in how societal factors (be in norms on gender or something else) have large effects on health. These studies will prompt awareness on these topics, which in turn will lead to discussion and systematic change that will allow us to better deal with these issues. In her own words,“health is a beautiful marker of inequality” but without looking at the intersection of health and society, we will lose the opportunity to grasp the full picture.

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Morning Brew Breakthrough: Coffee As a Therapy For Parkinson’s Zayna Bajwa Every year, a Rutgers professor is chosen for the

Still, not many studied if it was caffeine alone in

Daniel

their

coffee that was responsible for this phenomenon, or

contributions to Rutgers and the research community

if other compounds were working in conjunction

at large. The most recent awardee is Dr. M Maral

with caffeine, or even if caffeine was involved at all.

Mouradin, a distinguished professor of neurology at

Dr. Mouradin and her research team decided to

RWJMS and the Founding Director of RWJMS’s

study the effects of chemicals other than caffeine in

Institute for Neurological Therapeutics. Dr. Mouradin

coffee in mouse model systems.

Gorenstein

Memorial

award

for

has made major contributions to the research and 1

study of Parkinson’s disease. She has particularly

Eicosanoyl-5-hydroxytryptamide (EHT) is a fatty acid

elucidated the molecular pathogenesis of Parkinson’s

derivative of serotonin found in coffee beans' waxy

disease and various forms of dementia, as well as the

coating. The team’s research found that EHT

current complications of modern treatments for these

protected the brains of mice from abnormal protein

neurological diseases.

accumulation associated with Parkinson’s and Lewy 4

body dementia. They questioned if the combination Parkinson’s disease is a neurological disorder that

of EHT and caffeine would yield a greater effect.

causes difficulty with balance and coordination due to

Their studies showed that small doses of each

2

a deficiency in dopaminergic neurons. The current

separately had little to no effect. But together,

most common treatment for the disease is levodopa

caffeine and EHT boosted the activity of a catalyst in

(L-Dopa), which acts as a dopamine replacement

the brain that prevented the accumulation of

agent. While it does improve motor movements, the

harmful proteins. This research has offered immense

treatment is unfortunately not a long-term solution.

insight into a possible new treatment to slow or even

Most patients develop a resistance to it within two to

stop the progression of Parkinson’s.

five years.

3

Dr. Mouradin’s research and work in the field of One of Dr. Mouradin’s most fascinating research

Parkinson’s is motivating to aspiring researchers.

projects (and highly relevant to the average college

Her research uncovers mechanisms of neurological

student) was her study on the compounds in coffee

disorders and offers so much potential for the future

that make it a protective agent against Parkinson’s

of Parkinson’s treatments. This is an opportunity to

4

development. Colloquially, caffeine has been credited

develop an inexpensive treatment that can be

as a chemical that can reduce the development of

broadly available and serve as a preventive therapy.

neurological disorders.

The next time finals season rolls around, enjoy your coffee and appreciate its other benefits outside of pulling all-nighters.

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Bariatric Surgery: The Next Possible Cancer Prevention?

Adhya Gummadi In the United States, heart disease is the leading cause of death in men and women across all ethnic groups.

In 2021 alone, the U.S. Center for Disease Control and Prevention (CDC) reported that 695,000 people in the United States died from heart disease, and this rate continues to increase.1 It is also notable to consider heart disease’s correlation with obesity. With increased obesity contributing to hypertension and in turn a 12% increase in heart disease, understanding the risks of obesity can lead to the prevention of a multitude of conditions. Given past data of secondary conditions to obesity, studies that reflect on the relationship between cancer and obesity were launched, as there were initially no definitive results connecting the two conditions. A recently published study by Rutgers University – in collaboration with Ohio State University – intended to identify the correlation of NAFLD, or non-alcoholic fatty liver disease, to liver cancer, one of the main cancers considered to be obesity linked.2 NAFLD is often associated with an accumulation of ectopic fat, which refers to tissue cells with lower triglycerides having excessive concentrations. This increase of ectopic fats is attributed to factors also related to obesity, including an unbalanced diet and decreased physical activity. NAFLD, an advanced liver condition that involves the excessive accumulation of fats stored in liver cells, is important to the case study because of its correlation with the occurrence of cancers, including hepatocellular malignancies. Upon the conclusion of the study analyzing the relationship between the risk of cancer and obesity, specific management studies were shown to be a positive contributor to the overall health of an individual.2 As more studies are conducted, liver cancer’s correlation to NAFLD is becoming more increasingly recognized.

Done in collaboration with the JAMA network, one of the first studies studying obesity’s connection to the prevalence of cancer was conducted by the Rutgers Robert Wood Johnson Medical School.

This retrospective study was conducted by Vinod Rustgi, a distinguished Professor of Medicine at the Rutgers RWJ School of Medicine, alongside other collaborators from Ohio State University. A study population of 98,000 privately insured individuals aged 18 to 64 who were also diagnosed with severe NAFLD participated in this study, and over one-thirds of the patients had bariatric surgery following the initial start of the study.2 Post-recovery findings of the study population indicated that the subjects who underwent bariatric surgery experienced a 49% reduction in developing cardiovascular diseases.3 Furthermore, the risk for all types of cancers decreased by 18% following bariatric surgery. This includes the rate of multiple myelomas, hepatocellular tumors, and thyroid cancer. For patients with obesity related problems, the risk of cancer for gastrointestinally based cancers, including liver cancer, dropped by 25%. When the comparison of cirrhotic and non-cirrhotic patients was analyzed, the cancer risk was reduced by 38%.

The findings of this study also provide many future implications for expanding cancer prevention and management. The collaborators within the study often mention how the correlation of bariatric surgery and risk of cardiovascular disease has never been studied so closely before. Through this new analysis, researchers can expand on the results and study the possible developments for decreasing heart disease rates.

Understanding the connection between NAFLD and cancer can also help establish new treatments for liver conditions.4 The researchers affiliated with the study ultimately intended to identify why the risk of cancer actually does decline. While the external observation has been made, lead researchers across Rutgers University seek to learn more about the molecular and biological mechanisms behind this discovery.

Furthermore, Rustgi intends to expand his patient population to better understand if this reduced risk occurs for individuals who are obese with no liver based conditions.

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Intuitive Eating: Is It The Key To Healing From The Freshman Fifteen Myth?

Erin Oxnam

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Every year, millions of people start their freshman year of college, and for many, along with this comes a fear imposed by diet culture: the freshman fifteen. This idea essentially states that during one’s freshman year of college, they will lose control over their diet due to the freedom of a buffet-style dining hall and lack of parental supervision, then subsequently gain fifteen pounds. In actuality, research has shown that the freshman fifteen is nothing more than a myth, and in fact, buffet-style dining halls may be a way to encourage even healthier eating habits.

The rhetoric surrounding the freshman fifteen can also be extremely harmful. The idea of gaining weight is often anxiety-inducing and can lead to psychological distress; such internal and external body-related stressors have been linked to episodes of binge eating, restrictive eating, and 4 developing an eating disorder. In a college setting, undernourishment that may come about due to stresses about gaining weight will decrease cognitive function and could likely result in students doing worse in school. 5 Several factors, however, support the idea that the freshman fifteen is just a myth. While weight gain is common in the first few years of college, it has less to do with dining halls, and more to do with growing into adulthood, stopping sports or other physical activity, potentially increased alcohol intake, and even skipping meals. 1 Additionally, the weight gain that does often occur is usually significantly less than fifteen pounds. In fact, a study of Rutgers University freshmen by Daniel Hoffman found that, of the students who did gain weight, roughly 75% gained an average of 6.82 2 pounds over the span of a five-month period. The weight gain also likely has almost nothing to do with going to college itself; people who do not attend college after high school usually experience a similar weight gain, only a halfpound difference. 3 The college environment may actually have unique health benefits, and this is because it supports the idea of intuitive eating.

Intuitive eating is a dietician-backed idea of listening to one’s hunger and fullness cues to indicate when to eat, what to eat, and when to stop. This style of eating is exactly what buffetstyle dining halls support: easy-to-access food, with no limit on how much or little to take. The intuitive eating approach supports the idea that a person of any size or body type can be healthy; it rejects the idea that thinness equals health. But intuitive eating is much more than just a concept; it has an entire Intuitive Eating Scale with markers such as “I trust my body to tell me how 6 much to eat,” and “I stop eating when I feel full.”

When put into practice, intuitive eating has been shown to improve psychological and behavioral health and decrease disordered eating behaviors, especially binge eating. 7 However, without the eating support that students may be used to at home with their parents, students may develop eating habits that eliminate certain food groups while overdoing others, allowing for improper nutrition, which is why on-campus dietary support is a crucial component of ensuring healthy eating habits for students.

Unfortunately, the dining hall system also allows students who may be struggling with eating disorders to restrict an unhealthy amount. They may even have no way of knowing how much food is appropriate due to the lack of portion sizes at dining halls. This is why options such as Woody’s, The Atrium, and Cafe West at Rutgers are good to use in moderation so students can gauge an appropriate portion. However, if a student is struggling with an eating disorder, they must seek help from mental health services.

Overall, the college dining environment is not the hotbed for weight gain that some may claim it to be, and the idea of the freshman fifteen often supports disordered eating rather than helping students make healthy choices. The more transparent schools and media can be about the truths behind the freshman fifteen and dining halls, students can be healthier and overall be more successful in their college experience.

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AI’s Profound Effect on EMS Ashwin Bhaskar EMS, aka Emergency Medical Services, is critical to providing pre-hospital treatment to patients and transporting them to hospitals in order to receive more substantial care. 1 Annual EMS assessments show that on average more than 18,200 EMS agencies with around 1.03 million licensed EMTs and paramedics have responded to approximately 28.5 million dispatches in the US alone. 2 Given the high call volume, there are often delays in dispatching the appropriate personnel to certain calls. Rutgers currently has an EMS organization which relies on a dispatch team obtaining relevant information about the victim and subsequently dispatching the appropriate unit. This process, although standard across many EMS agencies, can impede the promptness of patient care. Seconds are precious in EMS and can potentially be the difference between life and death. Thus, in order to optimize overall EMS efficiency, AI is slowly being integrated into many EMS organizations.

AI’s primary asset to EMS is its predictive analytics. AI utilizes algorithms which compile vast amounts of historical patient and demographic data in order to identify trends and help EMS predict when and where emergencies are most likely to occur. In addition, AI can be used to access real time traffic data, identifying factors such as road closures and weather patterns which can delay ambulance response time while also potentially jeopardizing the safety of the crew on duty. 3 In fact, companies such as IBM, have used AI to develop an ambulance scheduling system known as SoTras which takes into consideration factors such as roadside conditions which could affect response times as well as patient physique, location (e.g. what floor of an apartment building), and mobility which can affect transport.4AI also allows for improved communication, an essential skill in EMS. Through the use of secure messaging platforms, AI allows EMS professionals real time access to emergency physicians and specialists. This is crucial since guidance and assistance can be received, thereby leading to superior pre-hospital care in addition to more efficient inpatient care, given that the physician already has prior knowledge of the patient’s medical history and situation. Finally, AI can also optimize resource allocation. It can be used to better analyze patient cases and rank based on severity, allowing EMS dispatchers to assign resources to those in more critical condition.5

Despite its benefits, it is important to recognize that there are limitations to using AI in EMS. The most important concern is that of privacy. Patient data is very sensitive and it might be difficult to keep it out of the wrong hands if it is spread to several EMS professionals. This can potentially lead to HIPAA violations, which are meant to ensure that patient data remains confidential and not disclosed without appropriate patient consent. In addition, inaccuracies in the inputted patient data into the AI can lead to inappropriate decisions being suggested or made. Finally, there are ethical considerations which must be taken into account before implementation. The AI might prioritize certain patients over others based on historical data which “reflects existing biases and inequities in healthcare”.6 This could lead to inadvertent discrimination as, for example, the AI could prioritize patients with medical insurance as opposed to patients with the more severe injuries.

Overall, AI does have a future in EMS if regulated appropriately.

14

In a significant yet surprising move towards improving global access to tuberculosis treatment globally, pharmaceutical giant Johnson and Johnson has decided not to renew its patent for the drug bedaquiline. Instead, the patent will be transferred to the United Nations’ Stop TB Partnership to be used at their Global Drug Facility 1 (GDF) in order to make generic versions of the treatment.

The decision, which aims to make bedaquiline more affordable in developing nations, comes after John Green and his YouTube community took to social media to pressure J&J to allow their patent to expire.

While tuberculosis might not be at the forefront of concerns for many Americans, it is a pervasive and oftentimes deadly disease in many developing nations. In 2021 alone, 10.6 million people contracted the illness, and 2 1.6 million lost their lives to TB. Of particular concern to developing nations is the rise in cases of multidrugresistant tuberculosis, which now accounts for about onethird of all TB deaths globally.

Multi-drug resistant (MDR) tuberculosis was first discovered and patented by Dr. David Allend and his researchers at Rutgers University. Their lab focuses on understanding the emergence of antibiotic resistance at both the cellular and epidemiological levels. Their research into the genetics of MDR TB takes a look at “how different mutations arise, whether some mutations predispose or occur as the consequence of other mutations, and the effect of resistance mutations on further drug resistance evolution and disease transmission”.3 Dr. Allend’s publications have been instrumental in crafting the unique treatments used against MDR tuberculosis. This type of tuberculosis poses a huge problem to developing nations, as it does not respond to the two most common and effective TB medications, Isoniazid and Rifampicin. Johnson and Johnson’s bedaquiline is able to combat multi-drug resistant TB, making it a critical medication. However, due to its patented status, bedaquiline treatments can cost as much as $400 USD for a six-month treatment plan, and this high cost has made it challenging for many patients in developing nations to afford the treatment.

Johnson and Johnson’s decision to relinquish the bedaquiline patent to the GDF is an important step towards making this life-saving drug more accessible for patients across the globe. The GDF will use the obtained licenses to produce generic versions of bedaquiline, which can be purchased for much less than the current treatment prices. This ultimately lowers overall costs and expands bedaquiline’s availability to those who need it most. Over the next sixteen months, the GDF expects 51,000 generic doses to be created for a collective savings of $8 million.4

YouTube Activism Triumphs: J&J Relinquishes TB Drug Patent Yashmita Logaraj The power of collective action has been demonstrated through an unexpected channel - the YouTube community. Internet celebrity John Green took to the VlogBrothers YouTube channel (run by him and his brother Hank Green) to call out Johnson and Johnson for their predatory decision to renew the patent. “When you attempt to evergreen a patent, [J&J], even though you know the decision will cost hundreds of thousands of human lives over the next 4 years, you’re tarnishing your corporate reputation,” he says in the video.4 Green’s video included a call to action for the Vlogbrothers community (known as Nerdfighters), urging them to take a stand against J&J’s patent renewal. After the video was posted, thousands of Nerdfighters took to social media platforms, condemning J&J for their decision and imploring them to reverse it. Within days, the decision was revoked, and J&J released a statement saying the patent would be transferred to the GDF. This successful movement highlights the potential influence that ordinary people can have in the medical sector when organized.

J&J's decision to step back from enforcing its bedaquiline patent signifies a beacon of hope for global TB treatment accessibility. The collaboration with the GDF, coupled with the impassioned advocacy of online communities led by figures like John Green, exemplifies the potential of collective action to instigate substantial change in the healthcare landscape. As the world grapples with health inequalities, initiatives like these underscore the influence of public sentiment on corporate decisions and highlight the pivotal role ordinary individuals can play in advancing the greater good.

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Nanoparticles in Food Allergy Treatment Zoya Akhtar Food allergies are currently on the rise, as more and more adults in the United States are developing allergies to foods that they were never allergic to before. 1 Medicines such as antihistamines and epinephrine (also called adrenaline) are commonly used to treat an allergic reaction.2 Developing new methods to treat and/or prevent food allergies can help many affected Americans feel more secure regarding their health.

Food allergies occur because one’s immune system perceives a protein in a certain type of food, called an allergen, as being harmful to the body.3 The body then releases an antibody called immunoglobulin E (IgE), which ultimately causes symptoms such as a rash, nausea, or difficulty breathing.2 Anaphylaxis is a serious type of allergic reaction that can be life-threatening.4 The Journal of the American Medical Association (JAMA) has estimated that roughly 100 people die each year in the United States because of anaphylaxis that is attributed to a food allergy.4 Researchers are performing experiments to determine whether nanoparticles can potentially help lower this statistic.

Nanoparticles are very small particles existing in nature on a scale of a billionth of a meter, and this physical 5 characteristic allows them to travel through the body after being administered to a patient. In addition, the physical properties of nanoparticles can be manipulated to work in treating and preventing allergic reactions. Characteristics such as the contents of a nanoparticle and its surface molecules can be changed to make it suitable for treatment purposes. 6 Immunologists at the University of California, Los Angeles (UCLA) have shown in research published in 2023 that synthetic nanoparticles can lessen symptoms of an allergic reaction toward peanuts in mice.6 These researchers modified a nanoparticle to contain mRNA coding for a specific peanut protein (referred to as an epitope) and added sugar molecules on its surface. Mice who were given this modified nanoparticle before and after being exposed to crude peanut protein displayed milder symptoms of anaphylaxis compared to those who received no nanoparticles or a nanoparticle without the sugars or mRNA. Adding sugar molecules to the nanoparticle allowed it to bind to certain types of immune cells present in the liver, called antigen-presenting cells, which then trained the immune system to produce fewer antibodies and cytokines (proteins associated with inflammation) when exposed to peanut protein.7 Dr. André Nel, a UCLA professor involved in the study, predicts that nanoparticle therapy may be in clinical trials by 2026.6 This experiment can open a new door in the field of immunology, as these nanoparticles provide a way to both prevent and treat food allergies by teaching the immune system to accept allergens that it used to attack.

The versatility of nanoparticles is a common theme in new research showing how they can be used in the immunology field, especially concerning food allergies. The Department of Chemistry and Chemical Biology at Rutgers University has also been researching nanoparticles' potential applications in medical treatment.8 Professor Tewodros Asefa and his team have performed research regarding the potential that synthetically modified nanoparticles have in medical applications. Professor Asefa states on his website that “By introducing multifunctional organic, organometallic, or biological groups into such nanostructured materials, we create new classes of nanomaterials with unprecedented and potentially useful properties for nanoelectronics, sensing, biological imaging, and targeted drug delivery”.8 Nanoparticles can therefore be thought of as a blank canvas, being able to carry certain molecules that can help to create a new piece of ‘artwork’ in the gallery that is biotechnology.

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Orthorexia Nervosa: Unhealthy Healthiness Laamima Faizal Over the last decade, eating disorders (EDs) have garnered greater attention in the sphere of public health.

Awareness has been casted on a range of conditions, from anorexia nervosa and binge-eating disorders to the more obscure pica and avoidant restrictive food intake disorder (ARFID). However, there has been one disorder that has been silently gaining traction despite these efforts to tame the ED crisis. Its name, orthorexia nervosa (ON), is largely unknown, but symptoms of it are quite common as it starts out as an inconspicuous feat of self-control that the average person tries to achieve: being healthy. It sounds surprising at first–how could trying to better one’s state of being possibly be classified at the same level as something like bulimia nervosa? However, ON is not focused on maintaining health, but rather the obsession with it. ​Someone simply cutting out sugars and eating more vegetables is normal and displays a healthy pattern of eating that does not give rise to concern. However, when this spirals into a compulsion where they refuse to go out and eat with friends, spend most of their energy thinking about and 1 planning their meals, and limit themselves to only ten food items, it is safe to say that ON is coming into play.

ON is a behavioral eating disorder that causes people to center their lives over eating healthy. It is under-studied and relatively unknown compared to other eating disorders, such as anorexia, despite having the same effects–both disorders can lead to malnutrition, a lowered immunity, cognition problems, social isolation, and emotional instability. Unfortunately, its unexplored nature complicates the path to recovery because the people affected most likely do not know that they are orthorexic. 2 Furthermore, Dr. Edward A. Selby, the director of the Emotion and Psychopathology Lab at Rutgers University, points out how unknown eating disorders (such as ON) are able to thrive “because this ‘other’ category receives much less coverage in the media, its sufferers may not even realize they have a problem”.3 Unfortunately, college-aged students are at an alarmingly higher risk for developing ON than other populations.

Researchers at the University of North Florida determined the prevalence rates of ON in college students to be over 25%, which indicates that there is something specific to universities that influences students to adopt disordered 4 eating habits. One of the main causes of ON development in university students is that they “experience greater social pressure and thus develop unrealistic expectations for themselves, leading them to adopt compensatory 4 behaviors such as disordered eating patterns and/or dieting for weight loss”. The sudden introduction to all different kinds of people can make people insecure enough to commit to “self-help” behaviors, such as dieting and working out. However, the negative inspiration behind these health habits cultivates a sense of urgency to conform to the ideal weight, thus leading to unhealthy eating habits that can rapidly escalate to orthorexic behaviors.

In order to combat the rise of orthorexia, it must be researched more thoroughly. Dr. Selby’s Psychopathology lab at Rutgers recently published the Positive Emotion Amplification (PE-AMP) model, which relates positive feedback 5 mechanisms and social persuasion (e.g. “pro-ana” blogs) to restrictive eating disorder development). This model applies directly to ON, in which behaviors are enforced by beneficial short-term results and encouragement for being “healthy.” Further advancement of PE-AMP will hopefully expedite diagnostic development, allowing people to finally get professional help for this disorder. Until then, people will have to take initiative and seek help on their own.

However, most people do not know what orthorexia is, let alone the warning signs that may signify its presence. This means that society must be educated to understand and recognize the indicators of ON and its negative impacts on the body and mind. With this knowledge, people can check themselves and the people around them to make sure that they can live their best life unhindered with disordered eating habits.

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Stereoelectroencephalography: Reducing Seizures When Medication Fails Zara Faizi Epilepsy currently ranks as the fourth most prevalent neurological illness in the world, affecting an estimated 3.4 million adults. However, according to the National Center for Biotechnology Information, a third of this population finds little relief in anti-seizure medication. 1 If an individual fails to become (and remain) seizure-free after two trials 2 of such treatment, they are diagnosed with drug-resistant epilepsy. The inability to tolerate any form of anti-seizure medicine heightens the risks of intellectual disability, as well as emotional and behavioral problems. Respective epilepsy surgery, a procedure that involves the removal of the brain regions responsible for seizures, is an often recommended alternative. For a patient to be considered for this treatment, the precise location of the brain regions that cause seizures must be determined, and those locations must allow for minimal risk removal.

The epileptogenic zone (EZ) is a theoretical concept for epilepsy surgery. It is the area of the cortex that generates seizures and has to be removed to reduce or eliminate seizure activity. To precisely localize the EZ, electrodes are surgically implanted to record electrical signals in the brain, a practice known as stereoelectroencephalography (sEEG). In contrast to conventional techniques, sEEG mapping is less intrusive, allowing for long-term monitoring 3 and minimizing the risk of impairing motor and cognitive abilities. It assists in evaluating patient response to various treatments, providing real-time data modifications, and promoting an individualized therapeutic strategy.

Upon removal, electrodes have provided valuable data regarding epileptic patterns and have promoted discussions between patients and physicians before proceeding with surgical treatment.

A study conducted by the University Hospital of Rouen in France has proved sEEG to be an effective technique in locating the EZ in those with drug-resistant epilepsy. Data was collected on 49 sEEGS from 46 patients between 2010 and 2018. Following removal, surgical resection results indicated 20 seizure-free individuals and 32 with clear 4 improvement. The insights gained from such sEEG studies contribute to advancements in surgical resection and neurostimulation techniques, refining medical approaches for better seizure control.

Surgeons often place electrodes into the brain for weeks at a time to collect seizure data. In contrast, Behnke-Fried electrodes, named after UCLA researchers who discovered them, are designed to collect research data while simultaneously localizing seizures. In a study conducted by researchers from Rutgers University and UCLA, BehnkeFried electrodes implanted in 218 patients allowed doctors to find epilepsy networks in nearly 88% of the sample group, introducing them to treatment options involving surgery. Around two-thirds of the patients who chose to undergo surgical resection found themselves without seizures after treatment. At the same time, three-fourths of 5 those who opted for neurostimulation saw seizure rates decline by 50% or more. Encouraged by these results, Yasnori Nagahama, director of pediatric epilepsy at Robert Wood Johnson Medical School, is confident that electrode performance is strong enough to support widespread usage.

Though surgical treatment has become the top treatment choice for patients with drug-resistant epilepsy, clinical data has suggested that it is often delayed and overlooked. This is likely due to patient overestimation of the dangers associated with the option. With sEEGs, neurosurgeons may tailor surgical procedures to achieve high success rates, allowing more patients to feel secure when it comes to utilizing surgery to improve their condition.

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Learning How We Forget Siddhi Patel In order to better understand forgetfulness, one must know how memories are formed. Memory comes in two forms: short-term and long-term. Short-term memory is stored in the hippocampus and is forgotten rapidly over short periods of time. Long-term memory gets consolidated in the hippocampus and is held in engram cells.1 These cells consist of groups of neurons that undergo physical and chemical changes that strengthen or weaken their connection to one another or synaptic strength, also known as synaptic plastic theory.

Forgetting long-term memory is more difficult than forgetting short-term memory because of the consolidation process. Occasionally, long-term memory can be disrupted if a person learns a new way to complete a task and practices the new method for an extended time. However, there is the study of a new process of forgetting called intrinsic forgetting, which is the theory that 3 there is a neural signaling pathway that will induce forgetting. 2 Ultimately, this is very important as many disorders, such as Huntington’s and Alzheimer's, involve memory.

Understanding the intrinsic forgetting pathway can help us better understand the progression of the disorders.

This intrinsic forgetting aims to disrupt the connections formed by the engram, destroying the memory within those neural networks via an internal signal transduction cascade. The signal transduction cascades in the engram is triggered when the “forgetting neuron” synapses with the engram and releases dopamine into the engram. At this point, the dopamine binds to the DAMB receptor (a receptor specific for dopamine), causing the cascade to activate, which ultimately activates RacI. RacI is a G protein (protein triggered by an outside stimulus) involved in changing the size and shape of synaptic spines through the actin network.2 Remodeling the actin network would mean changing the degree to which the neuron efficiently releases neurotransmitters and synapses, ultimately inducing intrinsic forgetting.

Studies of Rac1 in Drosophila displayed a circuit activating Rac1 and triggering the activation of 15 clusters, each with a unique function in triggering the termination of certain connections and domains of the engram, impacting memory. Drosophila are fruit flies, and while many of the functions may be similar or the same, there might be alterations in the cascade in humans.2 As the study on Rac1 was done on vertebrates, more data was compiled, and researchers studied more systems, along with the olfactory (smell) system. It is certain that the Rac1 weakens the memory produced.

President of the NJ Chapter of the Society for Neuroscience and Rutgers professor in Cell Biology and Neuroscience department, Dr. Firestein, is currently researching brain and spinal cord nerve brain injury. She notes: “When engram cells cannot be reactivated, forgetting occurs. When axonal growth machinery cannot be reactivated after an injury, neuronal circuits are disrupted. Although they are two disparate processes, forgetting and neuronal injury share the fact that activation or lack of activation of molecular processes determines outcome.” 4 It is clear that the process of forgetting shares many of the same patterns as other neuronal processes. Many diseases involve problems in the synaptic structure and function of the neurons. Huntington’s disease in mice showed that the level of Rac1 was highly elevated, 3 indicating an abnormality within the neuron's structure. Alzheimer's disease Drosophila was 5 noted to have decreased mRNA expression of the RAC1 gene and, ultimately, Rac1 protein.

There was a clear association that lowering Rac1 expression contributes to neurodegeneration.

Gaining a better understanding of intrinsic forgetting can help develop scientists’ understanding of these two diseases and other neuronal behaviors, as memory is such a fundamental aspect of human existence.

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Microneedling for Hair Loss: A Dermatological Innovation Prahalad Rana

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Consider this scenario: exams are stressing you out, and on top of that, you are having a horrible hair day. As you comb your hair, you can see right through to your scalp, which is the last thing you want to worry about right now. But with 50% of men worldwide experiencing balding by age 50, you are definitely not alone. 1 In fact, hair loss is not limited to just men, as over half of women will experience 2 some form of hair loss in their lives. Given the prevalence of hair loss, there are many treatments available to help combat this problem. Popular treatments include the FDA-approved Minoxidil, a 3 vasodilator, and Finasteride, a Type 2 5Alpha-Reductase. However, both of these drugs come with their own side effects; this includes cold sweats, erectile issues, decreased sex drive, and skin rashes.4 Taking all of this into consideration, a relatively reliable and established procedure known as microneedling emerges as a potential solution.

Hair loss comes in different forms, and two common types are androgenetic alopecia and alopecia areata. Androgenetic alopecia, often referred to as male or female pattern baldness, is a genetic condition where hair gradually thins and falls out in specific patterns. On the other hand, alopecia areata is an autoimmune disorder causing sudden hair loss in small, round patches on the scalp or other areas of the body. While each type has distinct features and recommended treatments, microneedling 5 has shown promise in promoting hair growth for various balding patterns. Contrary to popular belief, microneedling is not as daunting as it may sound. It delicately stimulates the scalp with tiny needles, initiating hair growth through enhanced collagen and elastin production. Microneedling involves making tiny punctures in the skin, which triggers the release of various growth factors like plateletderived growth factor (PGF), connective tissue growth factor, and many more. These 6growth factors play a role in boosting hair growth on the scalp and can also be applied to the face to help heal acne scars.

According to a study published in the Journal of Clinical and Aesthetic Dermatology, which evaluated the safety and effectiveness of microneedling, “microneedling is an uncomplicated procedure,” with the 7 side effects appearing “to be minor and easily managed compared to other invasive technologies”. Adam DiVine, the Functional Human Anatomy Lab Instructor at Rutgers University New-Brunswick, shares insights on the safety of microneedling. According to him, the procedure falls on the safe to very safe side of cosmetic treatments. “It is minimally invasive”, and the person receiving the treatment has “full control over the amount of coverage and depth of penetration.” However, caution is warranted. As indicated on the FDA's website, microneedling, especially when performed too frequently and with a higher depth (typically exceeding 1.5mm), can potentially reach deeper layers containing living cells, nerves, and blood vessels, posing a risk of damage. 8 DiVine highlights that the primary risk is likely to arise from post-treatment skin irritation and the possibility of infection. Therefore, he emphasizes the importance of post-treatment care, suggesting basic sanitary measures such as cleaning equipment with isopropyl alcohol to prevent further complications. The patient's adherence to these guidelines contributes significantly to the overall safety of the procedure. 9

In conclusion, microneedling emerges as a compelling solution for addressing hair loss. It represents a non-invasive approach with the potential to work wonders. Before considering microneedling, it is advisable to consult with a dermatologist or hair loss expert. Embark on your journey to healthier hair with microneedling, but be sure to take careful steps to prevent any further damage to your hair. Make sure to consult a professional before starting any sort of in-home or at-office treatments!

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A Recent Rise in Young Adult Cancer Rates Tyler Tran

Cancer is a dreaded diagnosis to receive, and rightly so; it is a deadly and widely prevalent disease. Over one and a half million people in the US get diagnosed with cancer each year, killing half a million, and it directly affects 40% of 1 men and women in their lifetime—not even counting those having to deal with a loved one’s diagnosis. Cancer is often seen as purely an older person’s disease, which is no surprise, seeing as how the vast majority of cancers occur at later stages in life: 66 is the median age of cancer diagnosis.2 However, rates for multiple cancer types have been increasing in the younger population, posing a cause for concern.

For adults from age 20-50, the prevalence of multiple types of cancer has been increasing with each generation since the mid-1900s. This is true even after accounting for the increased knowledge of cancer mechanisms and increased testing and screening rates. In just this past decade from 2010-2019, a large cohort study of early-onset cancer (which 3 included over 500,000 Americans) revealed that the incidence of young adult cancer increased by 0.28% each year.

Further, this study found that the driving group behind this change was adults in their 30s, which is far below the age one would expect to hear of a cancer diagnosis.

Certain types of cancer are especially on the rise among younger adults. Much of the increase stems from patients in 3 the age group from 30 to 39 years old and from urinary and breast cancers. Most notably, though, gastrointestinal tract cancers have especially increased, even for adults as young as those in their mid-20s. For example, millennials 4 are two to four times more likely than their grandparents to develop colorectal cancer. Furthermore, in the five years 5 from 2011 to 2016, there was an increase of two percent per year for people under 50.

Cancer is a difficult diagnosis at any age but can be especially difficult for younger adults, as they face a unique set of major burdens both in physical health and lifestyle impact. For example, sleep disruption can emerge as an issue lasting years after diagnosis. Dr. Lauren Daniel, a Rutgers associate psychology professor and member of the Cancer Institute of New Jersey, studies how cancer’s symptoms, treatment, and psychological impact can all contribute to severely disrupted sleep patterns. In addition, young adults have an increased likelihood of developing more symptoms and advanced cancers compared to patients of other age groups. Similarly, Dr. Katie Darabos, an instructor at RBHS and a member of the CINJ, explained how young adult cancers can increase the risk of “infertility, sexual dysfunction, cardiovascular disease, and future cancers,” which can be especially impactful as they disrupt key “developmental milestones and goals” from social to career events during the formative years of someone’s life. A cancer diagnosis and its treatment can completely derail someone’s life plans, especially at a time when young adults may be hoping to achieve the most, and poses an early psychological threat of mortality. She hopes to develop a better understanding of the factors influencing and protecting against psychological distress for young cancer patients.

But what is driving the increase in young adult cancer? While not fully clear, modern lifestyle choices have likely contributed significantly to this increase. Despite smoking—which has long been correlated with cancer—being generally less popular in younger generations, new risks have emerged to offset this decrease, such as unhealthy diet, 6 sleep, obesity, and alcohol behaviors increasing cancer incidence. Yet beyond basic lifestyle preventative measures, the lack of full knowledge behind the driving cause of the increase in young adult cancers makes it difficult to address the issue as it continues to emerge.

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Ozempic and its Future in Drug Addiction Recovery Afia Lateef Semaglutide, colloquially known as Ozempic, has experienced a sudden rise in popularity due to its ability to act as both a drug to combat type 2 diabetes as well as aid weight loss. Unfortunately, due to its association with toxic beauty standards, Ozempic has garnered quite a negative image. However, this negative stigma may be undeserved in light of recent research attributing addiction treatment to Ozempic.

To understand how Ozempic is tied to drug addiction, its relation to food must be explained. The active ingredient in Ozempic, semaglutide, induces satiety, which leads to weight loss. Semaglutide mimics the role of a natural hormone called GLP-1, which is normally produced in response to detecting nutrients when we eat. GLP-1 is part of the signaling pathway that tells your body you have eaten and prepares it to use the energy from your food. The nutrients that trigger GLP-1 secretion are macronutrients – simple sugars, peptides, amino acids, and short-chain fatty acids. GLP-1 modulates dopamine signaling as digestion continues, stimulating exocrine 1 secretions, inhibiting gut motility, and modulating sodium absorption.

How does this mechanism of suppressing hunger translate into treating addiction? The parts of the brain that help drive eating behavior, such as the nucleus accumbens, overlap extensively with the drive to use alcohol or drugs. When someone is looking for drugs, nerve cells in two areas of the brain are active: the outer layer of the nucleus accumbens, which is involved with rewards, and locus coeruleus, which is involved with withdrawal.

Semaglutide seems to reduce activity in both brain regions. GLP-1’s relationship with dopamine is also important, 2 as dysregulation of the dopamine system is thought to contribute to addiction behavior. However, this is where doubt is born in this research. Since semaglutide interacts so closely with regions of the brain, there may be unpredictable neurological effects, especially as its usage is shifted and geared towards addiction recovery.

In a recent study, semaglutide was administered to male and female rats to reduce their alcohol intake. After eight weeks of intermittent access to alcohol, the rats were deprived of alcohol for nine days. An hour before alcohol reintroduction, the rats were treated with semaglutide. Then, alcohol was reintroduced continuously for 48 hours. Their alcohol intake was then measured after 4, 24, and 48 hours after the alcohol reintroduction.

Relapse-like drinking was defined as the percent change from the alcohol intake during baseline. The results showed reduced alcohol consumption and food consumption. This has great implications for those who suffer from AUD (Alcohol Use Disorder), as the essential characteristic of recovery is the inability to refrain from relapsing. 3 Currently, Rutgers Associate Professor Zhiping Pang’s lab focuses heavily on regulating feeding, satiety, metabolism, and obesity. Specifically, they are studying the central control of GLP-1 on feeding behavior, hoping to understand the functions of neuropeptides in the brain as well as the pharmacotherapy of obesity. This study contributes to Professor Pang’s understanding of GLP-1’s regulatory role, not only in relation to obesity and satiation but also in relation to drug addiction.

Semaglutide, or Ozempic, has gained attention for its dual benefits in treating type 2 diabetes and aiding weight loss, despite facing criticism linked to unrealistic beauty standards. Recent research suggests a potential role for Ozempic in addiction treatment, as it mimics the natural hormone GLP-1, impacting brain regions associated with both eating behavior and substance abuse. While promising, the close interaction of Ozempic with critical brain areas raises concerns about potential unforeseen neurological effects, particularly as it transitions toward addiction recovery. Encouragingly, studies on rats with Alcohol Use Disorder show reduced alcohol consumption after Ozempic administration, offering hope for those struggling with addiction. Hopefully, Professor Pang and other researchers can continue to research Ozempic’s merits in addiction recovery and work to combat it.

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The Importance of Humanities in Premedical Education Shreya Bhardwaj

The Association of American Medical Colleges (AAMC) reported a marked 17% increase in applications during the 2021-22 admission cycle and projects that this figure will 1 only continue to rise in the coming years. Most of these applicants come from STEM backgrounds, with lifesciences majors being a popular choice given the overlap between their curricula and the required courses for medical admissions. As such, many students tend to mainly take STEM courses and often overlook the value that humanities classes bring in helping them to develop a well-rounded perspective on healing. According to a journal article by Anil, et al, in which sample MD curricula were analyzed from the U.S. News’ top 31 ranked medical schools, there is a definitive lack of integration of the arts and humanities into the current required undergraduate medical curricula. 2 The study of humanities in undergraduate and medical education has become increasingly relevant to the development of observational skills, analytical reasoning, and empathy while providing insight into human conditions, illnesses, and suffering across the world. The AAMC itself strongly recommends integrating arts and humanities studies with core science and math classes, asserting that it will allow “trainees and physicians… to be better observers and interpreters and build empathy, communication, and teamwork skills''. 3

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Humanities facilitates the development of a general breadth of soft skills that are necessary for becoming a competent physician. The study of subjects such as writing, media studies, and anthropology, for example, improve communication and critical thinking skills; this factors into the larger responsibility of being able to adequately articulate details about symptoms, diagnoses, and treatments to patients and fellow medical personnel.

Similarly, subjects like sociology aid students in placing healthcare and medical issues in the context of the larger societal and environmental factors that can influence one’s health. As described in a Marymount University news blog, medical sociology explores “social and behavioral determinants of health and promotes a more nuanced examination of how personal and group identities 4 influence professional development and behavior”. Being familiar with sociological principles will also help to prepare pre-medical students for the newly revamped behavioral sciences portion of the Medical College Admissions Test (MCAT) and benefit them in the long run during their future practice.

Humanities also helps to address the demand for culturally and socially aware physicians who promote health in a more holistic manner, as noted by the American College of Physicians. 5 As Administrative Director Dr. Elizabeth Vogel of the Rutgers Health Professions Office puts it, a “prehealth student’s curriculum should train them to treat humans, not just their diseases, while accounting for their unique cultural and spiritual background”. 6 This is especially important when engaging with communities that have been historically at a disadvantage in seeking proper health care, including Native American tribal reservations and areas of generally low socioeconomic makeup. Due to a long history of abuse and discrimination against them, they are often less likely to seek out medical attention when necessary and more likely to be mistrustful of medical personnel and less satisfied with their treatment.

Culturally competent medical personnel will be more able to overcome such stigmas and provide the best possible care within the scope of the patient’s wishes.

Ultimately, a solid foundation in humanities within the greater undergraduate pre-medical curriculum will be beneficial for students in further promoting the development of analytical reasoning, communication skills and a sense of empathy for suffering of the human condition.

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WORKS CITED

Cover Photo: National Cancer Institute: Letter From The Editor Photo: Jakub Kriz Table of Contents Photo: Samuel Ferrara Is The Cure For Cancer Hiding in Our Jungles?

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Photo: Mike Blank The Clinical Potential of Grounding the Human Body 1. Oschman, J. L., Chevalier, G., & Brown, R. (2015, March 24). The effects of grounding (earthing) on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. National Institutes of Health, 8, 83-96. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378297/#:~:text=Grounding%20or%20ea rthing%20refers%20to,or%20with%20various%20grounding%20systems 2. Lockett, E. (2023, March 27). Grounding: Exploring Earthing Science and the Benefits Behind It. Healthline. https://www.healthline.com/health/grounding#_noHeaderPrefixedContent 3. Menigoz, W., Latz, T. T., Ely, R. A., Kamei, C., Melvin, G., & Sinatra, D. (2019, October 10). Integrative and lifestyle medicine strategies should include Earthing (grounding): Review of research evidence and clinical observations. Elsevier Inc., 16(3), 152-160. https://www.sciencedirect.com/science/article/pii/S1550830719305476 4. Chevalier, G., Sinatra, S. T., Oschman, J. L., & Delany, R. M. (2013, February). Earthing (Grounding) the Human Body Reduces Blood Viscosity—a Major Factor in Cardiovascular Disease, 19(2), 102-110. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576907/#:~:text=Grounding%20increases %20the%20surface%20charge,cardiovascular%20risk%20and%20cardiovascular%20events 5. Sidossis, L.(2023, November 29). Personal. https://kines.rutgers.edu/faculty/faculty/faculty-profile/690-labros-sidossis-2 Photo: Clint McKoy Rural Healthcare: Hospital Closures Affecting Vulnerable Populations 1. About Rural Health (2023). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/ruralhealth/about.html 2. Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities (2022). American Hospital Association. Retrieved from https://www.aha.org/system/files/media/file/2022/09/rural-hospital-closures-threatenaccess-report.pdf 3 .Hung, P., Kozhimannil, K. B., Casey, M. M., & Moscovice, I. S. (2016). Why Are Obstetric Units in Rural Hospitals Closing Their Doors?. Health services research, 51(4), 1546–1560. https://doi.org/10.1111/1475-6773.12441 Photo: Bianca Ackermann Cardiac Amyloidosis: Underdiagnosis and Preventable Deaths 1. Papathanasiou, M. (2020, April 27). Diagnosing cardiac amyloidosis in every-day practice: A practical guide for the cardiologist. PubMed. Retrieved November 27, 2023, from https://pubmed.ncbi.nlm.nih.gov/32373710/.

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Photo: Katsiaryna Endruszkiewicz Ozempic and Its Future in Drug Addiction Recovery 1. Chuong, V. et al. JCI insight - the glucagon-like peptide-1 (GLP-1) analogue semaglutide ... (n.d.-a). https://insight.jci.org/articles/view/170671 2. Klausen, M. et al. (2022, February). The role of glucagon-like peptide 1 (GLP-1) in addictive disorders. British journal of pharmacology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820218/

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