Volume III, Issue II
The University of Miamiâ&#x20AC;&#x2122;s FIRST Undergraduate Scientific Magazine
the science of addiction
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contents News Hooked: The Science of Addiction, 6 How to (Scientifically) Study Better for Exams, 10
Innovations in Science Plants as Communication Devices, 12 Artificial Pancreas, 14 Jetlagged, 16 Mind Over Matter, 17 Electric Car, 18 Planet Nine, 19
Superbugs, Global Health, and Tasmanian Devils, 22 Botany and Quantum Mechanics, 24 Immunotherapy, 26
Ethics in Science Womenâ&#x20AC;&#x2122;s Health, 28 Imaging, 33 Spanish Speaking Health Providers, 34
Health Science Birth Control & Depression, 38 To Sleep Perchance To Dream, 40 Mental Health and Nutrition, 42
Photo by: Gregor Fischer
Featured Story: Hooked: The Science of Addiction Drug and alcohol addiction remains one of the most neglected and highly stigmatized public health issues in America, despite the fact that it is now affecting record numbers of Americans from all walks of life. Incarceration and other strategies by the Criminal Justice system remain the principal approach to dealing with addicts, despite evidence that it is ineffective and may in fact exacerbate the targeted behavior. The perennial misconception that addiction is a moral failure or a flaw in an individualâ&#x20AC;&#x2122;s character, instead of a chronic brain disease, is in part responsible for the persistence of draconian policies toward the management of drug addiction.
HOOKED - Steven Lang
“THE PERENNIAL MISCONCEPTION THAT ADDICTION IS A MORAL FAILURE OR A FLAW IN AN INDIVIDUAL’S CHARACTER INSTEAD OF A CHRONIC BRAIN DISEASE, IS IN PART RESPONSIBLE FOR THE PERSISTENCE OF DRACONIAN POLICIES TOWARDS THE MANAGEMENT OF DRUG ADDICTION.”
Drug and alcohol addiction remains one of the most neglected and highly stigmatized public health issues in America, despite the fact that it is now affecting record numbers of Americans from all walks of life. Incarceration and other strategies by the Criminal Justice system remain the principal approach to dealing with addicts, despite evidence that it is ineffective and may in fact exacerbate the targeted behavior. The perennial misconception that addiction is a moral failure or a flaw in an individual’s character, instead of a chronic brain disease, is in part responsible for the persistence of draconian policies toward the management of drug addiction. I sat down with Dr. Steven Strumwasser, a licensed clinical psychologist and master certified addiction specialist at Mt. Sinai Medical Center, to learn more about drug culture in America and the effects of prolonged drug use on the human brain. Strumwasser and I began by discussing the Surgeon General’s recent landmark report on substance abuse in America. Contained within the report are figures which reveal the true magnitude of America’s drug problem. “The numbers are staggering,” said Strumwasser, referring to the estimated 21 million Americans suffering from drug and alcohol addiction, a number which has quadrupled since 1998. Deaths from opioid misuse have in many states replaced automobile accidents as the leading cause of preventable death. Alcohol abuse and dependence last year caused approximately 100,000 deaths, which is equivalent to an airline crash with 274 passengers aboard every day. The punitive model for managing substance abuse has only compounded the problem, often times creating criminals out of people who could have otherwise been helped through evidence based treatment. While one in seven americans will face drug or alcohol addiction in their lifetimes, only about 10 percent of people with addiction will receive evidence based treatment; the rest are shuttled through the criminal justice system or remain undetected. Just last year, 700,000 individuals were arrested for marijuana related offenses, 80 percent of those were for possession. According to Strumwasser, the criminalization of drug use and the “lock em’ up” mentality “can literally destroy any opportunity of advancement in life.” Young people are especially vulnerable to the zero-tolerance policies of many universities and the criminal justice system. Strumwasser recalled several examples of patients who were caught with drugs as college students and whose prospects for a productive future had been senselessly derailed through the stigma and scarlet letter style branding that comes with a criminal record. Even minor infractions involving drugs along with felony convictions (common amongst drug users) limit the opportunities of young people and limit the work they can pursue. Why then do we continue to manage drug addiction in this ineffective and costly manner? The answer lies in the fact that Americans have historically regarded drug addiction as a consequence of poor character rather than a chronic brain disease. Television and film often depict people with drug addiction as dangerous criminals and degenerates. Indeed, we have even come refer to victims of substance abuse through the use pejorative epithets such as “meth heads,” “freaks,” “junkies,” and “losers.”
If addiction isn’t a moral failure, what is it? The American Society of Addiction Medicine defines addiction as “a primary chronic disease of brain reward, motivation, memory and related circuitry.” Before we tackle this complex definition let’s first take a step back and consider another, more fundamental question, namely: why would someone first begin to abuse drugs or alcohol? According to Strumwasser, for most college students, drugs and alcohol are used primarily to relieve anxiety, cope with feelings of being overwhelmed, and succumb to the influences to peer-pressure. Drug use causes the release of dopamine (the body’s “feel good” chemical) in the brain’s reward center, which leads the user to experience a sense of euphoria. Drug activity in the brain is strongly associated with memory formation. Subsequently, the brain remembers the link between taking a drug and feeling good. The shorter the amount of time between taking the drug and experiencing drug effects, the stronger the association. This is called learning! Once the brain has learned the association between the substance and the good feeling, and because we humans are wired to repeat activities which make us “feel good” (eating, sex, socializing), we seek out the substance again; this is called craving. However, what a user will notice is that with repeated drug use, it begins to take increasingly larger doses of the drug to achieve the same magnitude of euphoric effect. This is called tolerance and it is a consequence of the profound changes in brain chemistry and physiology that occur with drug misuse. Our brain’s reward circuitry doesn’t like to be overstimulated. You can think of the massive release of of dopamine upon drug use as similar to a deafeningly loud song blasting on the radio. What do you do in response? You turn down the volume so the song isn’t as loud. Similarly, the brain “turns down the volume” by reducing its ability to respond to dopamine. Therein lies the problem; when the next song plays on the radio you no longer experience the same pleasure because the brain has reduced its ability to respond to dopamine (desensitization), meaning the only song that can bring you pleasure is the one that plays whenever you do take drugs. This is drug dependence, a maladaptive change in the brain which occurs as a result of prolonged drug use, such that the drug is actually required for perceived normal brain function. This dependence can become apparent upon the sudden discontinuation of drug use through presentation of withdrawal syndrome, a physiological response where a user will experience the opposite effect of the drug he or she uses. For example, stimulants such as cocaine are often abused for their euphoric effect. The drug functions in the brain by preventing the normal fall in dopamine levels after excitement; subsequently the brain is kept in a hyper-excited state. In response to prolonged use, the brain undergoes a series of adaptive changes to reduce its sensitivity to dopamine in an attempt to maintain a normal level of excitement. When the drug is removed, the effects of these changes are “unmasked” and an addicted person will experience fatigue, irritability and depression. Not all people who use drugs will develop an addiction. What accounts for individual differences in one’s potential to become an addict? A mounting line of empirical evidence is supporting the idea of an interaction between biological, psychological and social factors in determining an individual’s liability to become addicted to drugs. With respect to biology, studies of families with addiction (twin and adoption studies in particular) have
provided strong evidence for the existence of heritable factors which increase one’s likelihood to use and become addicted to drugs (though the presence of these factors may not alone be sufficient to cause addiction). Social and psychological factors underpinning addiction may include the family background, the effects of poverty and a past history of trauma, which has been shown to affect one’s likelihood to react to drug effects. According to Strumwasser, for individuals that do become addicted, the potential for relapse is always present. This is because “the association made between the environment of drug use and the pleasurable response is incredibly strong. More powerful than science can presently reveal and certainly more powerful than individuals can contemplate.” This explains why someone who hasn’t used alcohol in 20 years may walk into a party and relapse. Upon seeing and smelling the alcohol, the brain remembers how good it felt, and the brain’s reward circuit causes the person to disregard the negative consequences and experience a relapse. “This is not because they are weak individuals, or pessimistic, or flawed, or don’t care. It is that the brain circuitry is that powerful!” Strumwasser says. Indeed, it seems that exposure to drug related cues can appear to hijack our brain against our knowledge of the consequences. This impaired ability to stop has to do with issues of the prefrontal cortex and executive functioning which are affected by drug use. Strumwasser laments the fact that increased drug availability and acceptability of use have made college campuses fertile breeding grounds for addiction to take root in the highly neuroplastic brains of 18-22 year olds. He claims that students are “not only graduating with an academic degree, but are also graduating with life long problems related to drug and alcohol abuse and dependence.” He is also concerned that the legalization of marijuana, which is poised to soon replace alcohol as the most abused drug on college campuses, is taking place before sufficient research on the long term effects of its use. Strumwasser worries that the acceptability of drug and alcohol abuse on college campuses leaves many students desensitized to the comorbid effects of drug use, including impaired driving and unprotected sex. Substance abuse represents a significant public health crisis with substantial economic and human costs. The economic cost is estimated to be as high as 500 billion dollars annually spent on incarceration and related expenses. However, the human cost of lives lost, wasted potential and broken families is truly incalculable. Although public policy shifts such as the elimination of mandatory minimum sentences by some states represent progress, evidence-based treatment remains significantly underutilized despite the fact that it saves both lives and money (every dollar spent on substance use disorder treatment saves 4 dollars in health care costs and 7 dollars in criminal justice costs). Fortunately, however, the outlook for the 21 million Americans suffering from drug and alcohol addiction is not entirely bleak. New expansion of legislation, such as the Mental Health Parity Act, requires health insurance providers to provide the same coverage for substance-abuserelated disorders as for other medical illnesses. Perhaps most promising to Strumwasser is the hope that advances in brain science will shed light on the biology of addiction and offer greater inroads for the development of novel treatments.
How to (Scientifically) Study Better for Exams - Natalie Massiah College is all about building up knowledge in your field of study while also discovering new interests, getting good at networking, and last but not least, embarking on a journey of personal growth. On the flip side, college also entails stress — a lot of it — most of which revolves around one word: exams! In order to aid your brain during those long days of studying (do not pull an all nighter — more on that later), the best thing to do is to eat healthy. Yes, it might not be an easy task as a college student, but here are some healthy options that are easily available to everyone.
Studying? Eat this!
Face it, we’ve all had those nights at Club Richter where the go-to power source is composed of Outtakes and Starbucks. But don’t reach for the sugary stuff to keep you awake! These smart foods will help you retain more information, become more alert, and stay more focused. It’s a piece of cake — not literally, though. Fish contains omega-3 fatty acids which are excellent for neural function. Eating omega-3 jam-packed foods like salmon, flounder, trout and tuna can boost the efficiency of studying since most of our brain is made up of fatty tissue; two birds of a feather flock together! Considering that Miami has a variety of fish and other seafoods, you will be sure to find a perfect fit for your palate. Don’t go nuts over your exams, eat them! Pistachios, cashews, almonds and walnuts all contain omega-3 fatty acids, which are also great for cognitive performance. In addition to providing some brain power, nuts also contain iron and oxygen which allow your brain to retain more information. And the unsaturated fats in nuts (these are the good fats) are high in energy; they are the perfect pick-me-up! Fruits and vegetables contain antioxidants, which are nutrients that strengthen your body and protect it from toxins. Antioxidant-rich foods like berries, leafy greens and citrus fruits are highly recommended. The recommended servings are two servings of fruit with 4 servings of any vegetables. For a bonus study snack, you can throw some fruit in some yogurt or make a delicious, nutrient-packed smoothie. In addition to incorporating these superfoods into your college diet, it is super important to eat wisely. Eating breakfast every morning (a meal we often forget
to include in our daily routines) improves cognitive behavior and mood throughout our day. A study performed in 2011 at Loughborough University in Britain further supported this claim by conducting a study on adolescent children and teens. The children and teens who did not have breakfast showed less cognitive function than those who did. It is also important to eat at regular times (no late-night meals!) to avoid calorie binging and to avoid overeating, as they can slow you down. And of course, hydrate! Caffeinated beverages like coffee and tea will be talked about later, but it is important to not overdose on caffeine since it can make you jittery and unable to focus. Drinking cold ice water will give your body a quick pick up to keep studying if you want an alternative.
Caffeine - What is it? Why is it good for you? How can you find your perfect dosage?
The first thing that probably comes to your mind is a Starbucks venti iced coffee. And yes, while coffee may seem like the solution to all of our problems, it is certainly more complex than just the bean it comes from. Caffeine is a stimulant to the central nervous system and is considered the most heavily-abused drug in our time. However, don’t be misguided by the labeling of it as a drug. Ninety percent of Americans drink caffeine daily, and it has been shown in studies that the drug has made some medical advancements, including preventing the risk of Alzheimer’s disease. Whether you decide to spend your wild nights at Club Richter, in the stacks, or on a hammock on campus, it seems like every college student juggles a large coffee in one hand and a laptop, cellphone, or schoolwork in the other. Some go for multiple coffee trips throughout the day, chugging the bitter drink like there is no tomorrow. There’s no doubt that it is a helpful tool for staying awake, but many do not know how to drink coffee effectively. No worries, we’ll be sure to add some helpful tips to follow when drinking java; leave the milk and sugar aside. Ever wondered why Starbucks is so expensive? The answer is that higher amount of caffeine levels correlate to higher prices. For example, a McDonald’s small coffee (a 10 fluid oz drink) costs about $1, while its competitors Dunkin’ Donuts and Starbucks go for $1.78 and $1.96 of the same fluid oz volume. In the same 10 fluid oz drink, Starbucks contains about 20.6 mg of caffeine, followed by Dunkin with 12.7 mg, and McDonald’s with 9.1 mg. Fancier drinks like lattes and frappucinos contain less
caffeine due to the presence of more milk than in a plain black coffee. However, if you are looking for the king of all caffeine drinks, Death Wish Coffee Company may be able to quench your thirst. It has a whopping 54.0 mg of caffeine per fluid oz. — double, even triple the amount of its competitors! Death Wish Coffee goes on sale for about 20 dollars a pound online. Although it sounds like one cup can sell your soul to the devil, there are no worries here. Studies suggest that about 400 mg of caffeine is safe to consume on a daily basis, equivalent to 5.2 shots of espresso, five 8 fl.oz. Red Bulls, and 11.7 12 fl.oz. cans of Coca Cola!
The Power of the Power Nap
As you trek onward during finals week, you might see people sleeping in the library, hogging the chairs and beanbags in the hopes that no one would disturb their precious sleep. This is because unlike 85% of mammalian creatures, humans only need to sleep once a day. Power naps are designed to give your brain a recharge and allow improvements to problem solving (if your professors ever told you to do some problems before bed to allow your brain to “work” them out, this is why). The average power nap usually lasts about 10 to 30 minutes, although they can range from super short and optimal 6 minute naps to some lasting an hour. And the science is in the sleep! A 1995 NASA study proved that those who took a nap within the 10 to 30 minute time range (about 26.5 minutes to be exact) were more vigilant and alert than those who did not rest. Be sure not to remove your daily required sleep with these power naps though. Sleep is extremely important to cognitive function, and short power naps over a period of time with no proper rest will leave your body wanting to crash.
How to Destress
Taking a break during studying is essential in avoiding overload. It’s a reward system for putting in the desired amount of study time. There are plenty of ways to destress, like exercising, catching up on Netflix, doing some yoga, cleaning up around your dorm room — the possibilities are endless! Just be sure not to add too much time to free time, as time can fly; you might feel bad that your 10 minutes of break time turned into 2 hours of getting nothing done. With these helpful tips and a whole lot of willpower to resist the urge to procrastinate, you will be able to pass your exams with flying colors!
Plants as Communication Devices
- David Lin
Have you ever wondered about the power of plants? What if in the future, the plants in your home could send statistics about your home’s temperature, humidity, oxygen concentration and air pollutants directly to your smartphone? With new research being conducted at the Massachusetts Institute of Technology (MIT), that may soon be the case. The research team is working on plant nanobionics that aim to interface plants with specifically designed nanoparticles. With this technology, plants could eventually act as substance monitors that capable of detecting various chemicals. Among these chemicals is a group known as nitroaromatics, which are a key component in several explosives. This could change the face of environmental monitoring and urban farming, as this innovative plant technology will be able to sense the explosives in real time. The researchers specifically used spinach plants that contain carbon-nanotube-based nanoparticles in their leaves. These nanoparticles would release infrared light and allow them to be sensitive to various chemicals, such as the nitroaromatics in explosives. These plants would be able to work in detecting the chemicals in groundwater, where the substances would be absorbed into the roots and sucked up into the leaves of the plant. When the plant takes up the chemical, a detector (which is similar in intricacy to a cell phone) will detect a change in infrared emissions. The nanosensor that the study used is able to detect a broad range of explosives as well as detect component chemicals as the explosives degrade. The study, which was published in Nature, used a small infrared camera attached to a minicomputer. The group, which is led by professor Michael Strano, said that a smartphone could easily replace the setup if it had its infrared filter removed. They tested the system at around one meter, although the sensor shows potential for being adaptable to a wider range. If the sensor could be adapted to a broader range, it would be able to monitor multiple plants at once. Strano also states that the sensor would also allow one to receive the infrared signal from any angle or distance with accuracy and timeliness. According to the research group at MIT, all these processes for detecting nitroaromatic picric acid were completed within ten minutes. They declared that their method is more efficient than previous genetic engineering techniques because the other methods were dependent on waiting for the plant to wilt or de-green, which could
take days. In addition, the data collected by the spinach plant can be transmitted electronically, whereas previous methods lacked this key feature. The group is assured that they will be able to replicate their nanobionics method on other plants besides spinach. Strano mentions that although genetic engineering is extremely powerful, it has its limitations in regards to the types of plants it can work with. With nanobionics, however, there is no such restraint. Why use plants in the first place? Strano and his team indicate that the fact that plants have such a vast network of roots used to draw up groundwater with minimal energy makes them extraordinary. This is due to a process called transpiration, which causes moisture to evaporate from the leaves and allows water to be sucked up the plant’s roots. Many of the chemicals cannot easily vaporize from the leaves, thus they will stay concentrated within the leaves themselves. This allows plants to be able to detect even very low concentrations of different chemicals. So where else could this be applied? Professor Bogdan Dragnea (chemistry professor at Indiana University) studies nanotechnology as well and said this new technology could be applicable to monitoring soil contamination, which would allow scientists to monitor pollution. Although the risk of complicating studies with false positives is present, these issues will be addressed in future studies. Strano’s group wishes to further develop nanobionic technology to not only work where plants traditionally flourish (in groundwater), but they also wish to have the technology be viable for detecting chemicals present in the air. The group wants to extend the traditional capabilities of the plant; they hope that someday the plant can monitor its own surroundings for pest infestations or damage, and modify the plant’s intricate network of signaling pathways. Strano and his graduate student have already created a company called Plantea to commercialize their new technology, hoping to enter the urban farming market. In order to be profitable, urban farms need to be particularly efficient in making use of their expensive real estate. This technology would benefit farmers immensely, as the plants will be easy to monitor (since they are in a confined space). Very soon, we could see stores selling plants that act as communication devices. So, do not be surprised to see sensing-plants in your future offices that monitor the room’s temperature, humidity, and other quality-of-life statistics someday.
Artificial Pancreas â&#x20AC;&#x201D; Providing A Very Real Hope - Gabrielle Eisenberg
MiniMedÂŽ 670 System Manufactured by the diabetes division of Medtronic plc
A day in the life of a type 1 diabetic is no piece of cake (and side note: T1D is not caused by it either). Take Dylan for example. Every day he wakes up, most likely groggy from a long night of sirening continuous glucose monitor (CGM) alarms and battling both high and low blood sugars. He pricks his finger with a needle to see what his body is up to now, praying to see that magic 100. If Dylan was grappling with a series of lows throughout the night, his sugar is most likely in the upper 200s; if he went to bed with a higher sugar and injected insulin to correct it, he is probably low. Starting the day with such an imbalance only leads to more work to be done and decisions to be made in the coming hours, in addition to the normal stresses life brings. He must determine how many carbohydrates are in his breakfast, give more or less insulin depending on his sugar, and wait 3 hours to see what crisis he must battle next. But wait, there’s more! While Dylan accurately bolused (or injected insulin to cover his meal) for his breakfast, his basal insulin needs changes throughout the day, and now he realizes that his breakfast has caused him to enter a hypoglycemic state. Shaking and sweating, he guzzles a juice box and waits 15 minutes, only to see that his sugar barely budged. More juice. More waiting. Somehow, Dylan is now experiencing a blood sugar rebound so intense that he feels fatigued and nauseous, and his homework that is due in an hour has to be ignored. This process repeats until it is finally time for Dylan to get some much-needed and well-deserved rest — that is if his blood sugar cooperates throughout the night. When Dylan wakes up the next morning, the process starts over again, but this time, his insulin absorption is totally different and nothing he did yesterday is the same today! If reading that paragraph seemed exhausting, imagine what it is like for diabetics who must face this every day with no respite. It is draining. It is discouraging. It is forever. Or is it? Throughout the world, countless laboratories are on the race for a cure for this condition, as well as developing ways to
make management easier in the meantime. Medtronic, in an effort partly funded by JDRF, recently received FDA approval for their closed loop 670g insulin pump + Guardian CGM system, which aims to reduce a lot of the stress and responsibility that comes with diabetes. Currently, insulin pump and CGM technologies are separate, and while both confer a degree of alleviation to diabetics, they still require manual input. Consequently, it has been a longtime goal to combine these two into one streamlined system, and Medtronic’s new closed loop pathway does just that. Hooman Hakami, Executive Vice President of Medtronic, explains, “The MiniMed 670G system features our most advanced algorithm to date – SmartGuard HCL – which simplifies and improves diabetes management through a smart algorithm that enables greater glucose control with reduced user input ... The system delivers a variable rate of insulin 24 hours a day based on the personalized needs of the individual, maximizing the time glucose levels are within the target range. It is designed to learn what an individual’s insulin needs are and to take action to minimize both high and low glucose levels.” To diabetics, a system like this is a dream finally realized, but many wonder if it is too good to be true. According to JDRF, “The 670G system kept people with T1D within their desired blood sugar range 73.4% of the time, vs. 67.8% without the system. At night, the most dangerous time for blood sugar highs and lows, the difference was even more pronounced, 76.4% in range vs. 67.8% without the system.” To the average person, that may not seem like a staggering difference; however, when you consider how many seconds there are in a day and how many of those seconds diabetics spend worrying about their blood sugars, the improvement is extraordinary. Medtronic’s closed loop system will be available to consumers in Spring 2017, and it will serve as the vanguard for similar technology as well as future improved iterations. So while Dylan and millions of other type 1 diabetics across the globe battle their own bodies every day, they can smile knowing that very soon, the struggle will be over.
Jet Lagged? A Blast of Fresh Air Might Help
Just like having a clock on a wall, all humans have plays a role in oxygen homeostasis, as low levels of an internal biological clock that controls their daily HIF1 alpha causes failure of cells to synchronize routine. During your 11 AM class you may feel alert with oxygen variations. HIF1 alpha is a helix protein and ready to tackle the day; by 5 PM, all you want to which regulates the cellular response of oxygen do is collapse into bed. This is due to fluctuations in depletion in tissues, a total depletion of which is your circadian rhythm, otherwise known as the 24known as hypoxia. The experiment was performed hour cycle of daily activity we’re all used to. Circadian modeling jet lag in humans, as mice were prone rhythm dictates the timing and pacing of everything to jet lag after a shift in their daylight hours. By you do, from bladder control to peak muscle strength. dropping oxygen levels slightly just 12 hours before It can be trained, modified, disrupted and affected the shift in daylight hours (or even 2 hours after by light-dark cycles — changes are most noticeable the shift), the mice were able to adjust back to their during daylight savings time or when traveling to regular cycles much quicker. different countries. It is thought to have evolved to Even airline companies are listening to the allow predictability and balance in anticipation of research and beginning to make changes for the environmental changes, so that an individual can better. Commercial airline planes pressurize their maximize their use of environmental resources like passenger cabins to around the same density that heat and light. Because of its efficacy in regulating is found underground, but at altitudes of 6,000 to key internal metabolic processes, circadian rhythm 8,000 feet above sea level. This is meant to reduce is believed to confer a selective advantage to those structural and mechanical damage to the plane, organisms which have evolved the mechanism. but the pressure difference causes airsickness in In humans, the main circadian clock lies in the passengers from the sudden drop in oxygen when suprachiasmatic nucleus (SCN) in the hypothalamus the plane ascends into the air. Boeing has designed of the brain. It is regulated through light activation, a new plane known as the 787 Dreamliner which as it is connected directly to the retina and its rod/ can adjust its cabin pressure lower than that of other - Jason Truong cone photoreceptors which convert visible light to commercial planes to match its passenger-cabin air neural images. Ganglion cells synchronize the SCN using pressure to the same levels of air pressure found at the photopigment melanopsin to induce signal pathways. The lower elevations. This would essentially pressurize the cabins SCN synthesizes information from the retina and passes it even more with respect to the external environment, which onto the pineal gland, which secretes melatonin to regulate the would help passengers experience a speedier recovery from jet metabolic processes of the body. There is a direct correlation lag due to a better matching of pressure differences. With the with disturbances of the circadian rhythm and a decrease in a effect of lower oxygen levels being understood more and more human’s overall health. Obesity and diabetes can result from each day, testing higher oxygen levels may soon be on the circadian disruption and, in addition, drugs can be processed horizon. Perhaps airlines may take this up to install oxygenless efficiently if the rhythm is tampered with. However, enriched air inhalers on planes to combat jet lag from lower one of the most common disruptions experienced by people oxygen levels. around the world is jet lag, which has a hugely detrimental So the million dollar question is: What can I do to prevent effect on one’s circadian maintenance. jet lag when I travel long distances? There are actually many Jet lag involves the alterations of circadian rhythm routines that can be performed before, during and after a trip resulting from air travel across different time zones in a that can ensure you feel refreshed once you arrive at your (relatively) small period of time. It can last for several destination. First, ensure you stay hydrated and drink plenty days until adjustment to the new time zone is completed, of water, as the dryness and pressurization of cabins can with a usual estimate of jet lag’s stay sitting at around a dehydrate and tire you out, compounding the fatigue from an day of recovery for each time zone crossed. The lack of already exhausting trip. Next, make sure you leave for your synchronization with the new time zone due to different cycles trip well-rested and with plenty of sleep. You can even try to of light and dark disrupts the body’s natural pattern which train your circadian rhythm by shifting your sleep schedule controls eating, sleeping, hormonal regulation and more. This back an hour or so every day for a week leading up to your can cause symptoms like insomnia, low concentration, low trip, taking care to also shift your mealtimes accordingly with coordination, headaches, irritability, changes in eating patterns your adjusted bedtime. Avoid naps which can disrupt your and bathroom usage and so on. Overall, jet lag is a health sleep cycle, but do use the time on the plane to rest and sleep. nuisance that everyone would love to do without. Avoid alcohol before and during the flight, and try to move New research performed at the Weizmann Institute of around and get some exercise to keep yourself active. For Science in Israel shows results that cycles of oxygen cycling those that are more adventurous, there are proposed jet lag can reset biological clocks in mice; these results can hopefully treatments like sleep aids and other pills, but those should not be abstracted and tested on human subjects in the future. By be taken without medical advice. All things considered, there changing the oxygen absorption rate in cells by just 3% twice a are a number of steps you can take today to prevent jet lag, but day, mouse cells were able to be synchronized to new patterns the oxygen air discovery might just be another piece in solving of light and dark. This was theorized to be associated with the the jetlag puzzle in the future. protein HIF1 alpha (hypoxia inducible factor-1 alpha) which
Computer Mind - Jarelis Cabrera
irst an artificial intelligence and now a computer that can read my mind? Have science and technology gotten to the point where we may end up like the incapable human beings from Wall-E? In the near future we may be able to have computers make decisions for us based on our own thought patterns. Virtual Reality headsets such as HTC Vive have already taken a leap into programmed systems, infiltrating the 3D world in which we live. Through these neuro-headsets and computer programs such as Open BI, we can monitor brain activity to recognize nouns with only a momentary delay. But the real question is: how is this possible? The motion capturing games and virtual reality headsets have an integrated direct neural interface (DNI) that allows us to analyze and predict what others see based on neural impulses. The DNI head piece system is able to decode the neural impulses within milliseconds from any given stimuli. It can capture the neural activity of a brain zone but is unable to grasp a single thought in a pool of information. This is like trying to fish in a lake, but the lake contains an entire ocean’s worth of fish. It just depends on the hook and bait used to catch the desired fish. The same concept can be applied to the DNI system. It is able to read a cavity of neural impulses in a concentrated neural zone but, since there is a high intake of information being processed, the DNI system has a hard time picking up on a single, desired thought. The HTC Vive is just the newest way for machines to read your thoughts; other systems such as magnetic resonance imaging (MRI) show alternative but equally promising results. They have been previously used to decipher images from the brain waves elicited by sight using a combination of magnetic fields and radio waves. Humans naturally have an electromagnetic field surrounding them due to the neural impulses that travel from the head throughout the body. If we can record neural impulses along with deciphering
images from the brain, we may be able to predict a pattern to guess next image. From our caveman days of underdeveloped speech to today’s highly sophisticated shorthand text, humans have evolved not only a more complex way of thinking but also a more complex way of analyzing our own thoughts. In the future, we might see machines reading minds and recording memories. As exciting as this may seem, let us take a moment to weigh both the dangers and advantages that may arise with the use of machines to augment our brains. Recent science fiction movies such as Chappie, Her, and Ex Machina tackle these concerns and explore the intricacies underlying the concept of artificial intelligence. An artificial intelligence is a computer construct that develops a mind of its own and can consciously make decisions. This is one step closer to having a machine think for itself, and soon we might even find them thinking for us. There’s no need to worry about deciding what to eat for dinner when it’s only breakfast time or what outfit to wear to your dreadful 8AM class. A computer soon might be able to make all those decisions for you, taking over your life like AUTO in WALL-E. These computers may not be quite as encompassing, but they may soon be capable of doing the majority of thinking for you. Humans today seem to be declining in critical thinking, opting to depend on technology for mental horsepower. This trend could signify the human race dumbing down as a society. Conversely, if we have computers handle the minutiae for us, we would have more time and mental resources available to us that we could focus on more intensive tasks Virtual reality headsets, magnetic resonance imaging, and artificial intelligence are all on their way to replicating the very neural circuitry that makes us human. It’s amazing to see how far technology has come, shaping the most abstract of concepts into a concrete form. Finally, the superpower of mind reading may soon become reality.
Combating Climate Change with Electric Cars - David Lin We have seen a dramatic increase in the number of electric vehicles out on the road in recent years, especially with the emergence of brands like Tesla Motors. Many car companies are in healthy competition with one another to come up with the next big idea in order to address the carbon crisis we are currently in. Although we cannot predict what new technologies will develop in the near future in regard to electric vehicles, we can be certain that efficient innovations are already in the works. Along with many of the world’s leading car companies, the federal government is also jumping in to encourage drivers to make the switch to electric cars. These actions are being taken to combat the persistent concerns of climate change and oil dependency while promoting the advancement of clean energy technologies. A huge concern for many drivers who may be hesitant about getting behind the wheel of an electric vehicle is the lack of charging infrastructure. For the first time, the federal government will be creating 48 national electric vehicle corridors along 25,000 miles of major U.S. highways in 35 states. These efforts are being conducted as part of the Obama administration’s goal of cutting greenhouse gas emissions by 80 percent by the year 2050. Since his administration began in 2008, there has already been a 40 percent increase in the number of electric vehicle charging stations nationwide. The White House announced that this initiative aims to both cut greenhouse gas emission and to serve as an incentive to drivers who choose to drive electric vehicles. This announcement was followed by the introduction of a $4.5 billion loan designation for companies constructing electric vehicle charging stations intended for public use. In addition to establishing the electric vehicle charging corridors on U.S. highways, a 28-member coalition of states, vehicle manufactures, change organizations and utilities groups are pledging to accelerate the construction of this new charging infrastructure. 24 state and local governments are also pledging to partner with the federal government to increase the use of electric vehicles in their city and state vehicle fleets. Lastly, 38 businesses, non-profits, utilities groups and universities are joining the Department of Energy’s Workplace Charging Challenge, a challenge designed to provide accessible charging stations to the employees of these institutions. Part of the new plan will develop the electric vehicle charging stations every 50 miles within the corridors as well as implement additional governmentapproved signage to let drivers know where the new charging locations are along the highways in the 35
states the corridor runs through. Building both the corridor and clear signage will give current electric car owners some muchwelcomed peace of mind as they know they can drive without worrying about where to recharge their cars. At the same time, this plan educates the general public about the existence of such charging infrastructure. Many vehicle manufacturers and change organizations (including BMW and General Motors) are on board to help accelerate the process. The corridor will serve as a foundation for a future network of electric vehicle infrastructure that will span from coast to coast. The benefits of the federal government’s plan are endless. As the government creates an increased demand for electric vehicles (that will be used in federal government fleets), electric vehicle manufacturers can shift their production lines to produce higher numbers of electric vehicles. In turn, as these manufacturers produce larger volumes of electric vehicles, the cost for public consumers to purchase electric vehicles of their own decreases dramatically. As the government adopts electric vehicle technology, they promote innovation and consumer adoption — hopefully, the rest of the country will ride the electric wave soon enough. With potential millions of savings in both dollars and gallons of fuel, there is little reason for the public not to embrace the electric change. The Federal Highway Administration said that the major goal of all these initiatives and partnerships is to help reduce the carbon dioxide emissions from motor vehicles; motor vehicle pollution is the second largest single source of pollution contributing to climate change in the electric power sector. “Alternative fuels and electric vehicles will play an integral part in the future of America’s transportation system,” U.S. Transportation Secretary Anthony Foxx said in a statement. “We have a duty to help drivers identify routes that will help them refuel and recharge those vehicles and designating these corridors on our highways is a first step.” Creating the national corridors is just the first step to solving the issues. To ensure the longevity of the project, the U.S. Department of Energy is studying the most efficient way the stations can be installed within the corridors and how they can be standardized across the country. The federal government will reevaluate the stations every five years and can give the order to expand the presence of the stations when needed. One of the corridors will be created along Interstates 75 and 85 through Georgia. Unfortunately, some states (including most of Florida, Arizona, New Mexico, Wyoming and Alabama) will not have access to the electric vehicle corridors. It may take time for us to notice the difference because we need to increase the number of electric vehicles on the road in order to see the environmental benefit. This initiative will make it easier to own such vehicles and eventually increase interest in the public sector. Hopefully, with the multiple partnerships among federal governments, local governments, vehicle manufacturers and change organizations, we will be able to accelerate our transition to a gasoline-less society.
MEDICAL COLLEGE ADMISSION TEST PREPARATION PROGRAM UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE
The Medical College Admission Test (MCAT) Preparation Program is designed to help pr emedical students from underrepresented and underserved backgrounds prepare for the MCAT.
TAKE THE TEST WITH CONFIDENCE The MCAT preparation program is an eight -week course beginning Monday, June 5, 2017 through Friday, July 28, 2017. It offers class lectures, taught by Kaplan Test Prep, on content found in the Physical Science, Biological Science, Psychology & Sociology, and Verbal Reasoning sections of the MCAT. Participants will also receive study tips and test -taking strategies that will help them prepare for the written portion of the exam. In addition to these lectures, students will attend seminars that offer insight into the medical school application process and shadow physicians weekly at one of the UM/JMH teaching hospitals.
ELIGIILITY The MCAT program is a tuition-free, non-residential program open to college sophomores, juniors, seniors, and recent graduates who will be applying to health profession schools, specifically medical school. The admission committee will select 25 applicants whose applications demonstrate how they will benefit from participating in this program and are likely to be competitive candidates for medical school. Applicants must have taken organic chemistry in order to handle the course material. Accepted students are required to submit a refundable $100 deposit with their enrollment packet. The deposit will be returned after satisfactory completion of the course as determined by the program executive director and proof or registration for the MCAT.
2016 MCAT Prep Program Participants An intense study - based curriculum prepared these students for the Medical College Admission Test.
The application is available online at: http://diversity.med.miami.edu/summer-programs/mcat Completed forms should be submitted along with the following documents:
Official academic transcript (s) from all college (s) attended.
Three (3) letters of recommendation from college professors.
Personal statement (specifics outlined in application).
Passport photo (2x2).
Complete applications must be received in the Office of Diversity and Inclusion (address below) by Friday, March 17, 2017. Only complete applications will be considered. Applicants will be notified of their program status via email on Friday, March 31, 2017. Each candidate will be evaluated on the following:
Sufficient academic achievement to be competitive for medical school admission.
Application demonstrates attributes desirable in medical school applicants, such as maturity, leadership, altruism, compassion, and good communications skills.
Extracurricular activities in health care field such as, community service, research, or employment.
Preference is given to applicants from underrepresented and/or disadvantage backgrounds.
Office of Diversity and Inclusion Rosenstiel Medical Science Building 1600 NW 10th Avenue, Suite 1130, Locator R11 Miami, FL 33136 Ph.: (305) 243-7156 - Fax: (305) 243-7312 Email: http://diversity.med.miami.edu
Naomi Fields Williams College, MA Class of 2016
"Participating in the MCAT Program empowered me not only through aggressive Kaplan test prep, but also through a motivating cohort, inspirational insights, and engrossing physicianship activities. It was a holistically beneficial experience that further fueled both my desire and ability to become a physician. More than that, I know that the skills and connections that I attained during the program -- not to mention the benefits of my test score -- will far outlast this past summer."
Nareka Trewick University of Miami Class of 2016
“The MCAT Prep program at the Miller School of Medicine gave me more than the opportunity to prepare for the medical school entrance exam with Kaplan. It gave me a community of peers and mentors who continue to support me on my journey into the field of medicine. My MCAT exam score improved throughout the summer and I feel more ready than ever for medical school .”
Superbugs, Global Health, and Tasmanian Devils
n 1928, biologist Alexander Fleming accidentally discovered the world’s first antibiotic (penicillin) when he noticed mold beginning to grow in a laboratory petri dish that contained a culture of staphylococci bacteria. In 1940, researchers at Oxford published a method for isolating and concentrating penicillin, making it clinically viable for the first time. At the time of the D-Day landing in 1944, enough penicillin was being manufactured to treat all wounded Allied soldiers. By the end of the 20th century, the potency of antibiotics had completely revolutionized clinical medicine by annihilating the infectivity and mortality of bacterial diseases. This story of antibiotic use is familiar and oft-repeated; it portrays progress as inevitable, and has all the trappings of a fairy-tale, with infectious disease being firmly vanquished by the knights of Vancomycin and Ampicillin. Increasingly, however, the evidence suggests that our ‘happily-ever-after’ may be cut short, and that the optimism that accompanied the golden age of antibiotics may have been premature. It was always known that bacteria would eventually develop resistance to antimicrobial compounds, as the use of antibiotics in treatment leaves the hardiest bacteria unscathed. These subsequently reproduce, travel from organism to organism, and can even transfer their resistivity to other bacteria. While the lifespan of effective antibiotics has been extended by the development of increasingly powerful drugs, it has also been undermined at an alarming rate by their irresponsible and underregulated use. The 2014 UK Review on Antimicrobial Resistance cites the widespread use of antibiotics in commercial agriculture, poor sanitation practices in hospitals and the overprescription of antibiotics to clinical patients as primary factors in the ‘superbug’ crisis currently threatening the globe. The same review estimated that 700,000 people die every year of drug resistance in illnesses such as malaria, HIV and tuberculosis. By 2050, their mathematical models predict that number will rise to 10 million deaths annually, or roughly one death every three seconds. Domestically, the Center for Disease Control estimates that over two million people fall ill from antimicrobial bacteria every year, and of these, over 23,000 will be killed. As the war on superbugs stalls in the realm of pharmaceuticals — there has not been a new class of antibiotics discovered since the 1980’s — an unlikely source of good news has emerged from Australia, as a group of researchers there appears to have made progress in expanding medicine’s arsenal of anti-pathogenic substances. The team, which comprises E. Peel, Y. Cheng, J.T. Djordjevic, T.C. Sorrell and K. Belov of the University of Sydney, and S. Fox, an Australian government researcher in Tasmania, have identified a group of peptides known as cathelicidins present in the Tasmanian Devil that are effective at combating a broad
- Grant de la Vasselais
spectrum of bacteria. Their study, Cathelicidins in the Tasmanian Devil, was recently published in the journal Scientific Reports. The Tasmanian Devil, as well as fauna endemic to Australia generally, are highly unusual and unique in their physiology due to Australia’s longstanding geographic and climatic isolation, which has led to a divergent evolutionary path for the region’s wildlife. Particularly noteworthy is the fact that the vast majority of Australian mammals can be classified as marsupials, animals who raise their young in a pouch. Tasmanian Devil joeys (babies), like those of many other marsupials, are born at a very early stage of development in which they lack developed immune systems. Despite this, they are able to survive in the pathogenladen environment of their mother’s pouch, which made these animals good candidates for scientific investigation. An analysis of the bacterial environment of the pouches in lactating and nonlactating Tasmanian devils led the team to conclude that antimicrobial resistance was conferred to young passively both through milk and through the pouch lining. Genetic analysis identified six unique cathelicidins expressed on the 2nd chromosome of the Tasmanian devil. The researchers then synthesized each peptide and tested them against 25 bacterial strains and six fungal strains to determine their efficacy in fighting infection. Two of these, Saha-CATH5 and Saha-CATH6 were determined to be capable of fighting human pathogens, such as S. aureus (known as MRSA) and E. faecalis, both of which have developed considerable antimicrobial resistance. Saha-CATH5 showed particular promise, and was identified as having been effective against a large array of germs, which include both gram-positive and gram-negative bacteria. Another cathelicidin, Saha-CATH3 was found to have been effective in combating certain fungi. The rest were not found to be effective against the microbe samples, but their presence was identified in the skin, mouths, and intestinal tracts of recently deceased animals, which suggests that those also play an important immunological role. Cathelicidins, along with defensins, are the two primary families of antimicrobial peptides that are present in mammals. Cathelicidins in particular are small, made up of a chain of between 21 and 27 amino acids in the case of the Tasmanian Devil; they are are also cationic. They work directly to kill a variety of bacteria and parasites through electrostatic interaction, as well as indirectly through the alteration of the surrounding cellular and chemical environment — this includes angiogenesis and immune cell development. These compounds have been the subject of extensive investigation in many mammals, but until recently, there was very little exploration of marsupials. The abundance of cathelicidins in marsupials is especially intriguing given that humans only possess one cathelicidin, LL-37. Ultimately, Saha-CATH5 and 6 were considered by the team to be prime potential contenders for drug development. SahaCATH 3 possesses a lack of toxicity to mammalian cells, and so shows potential as a remarkably original antifungal drug. The researchers’ success with the Tasmanian Devil has led to an interest in investigating similar Australian marsupials like the koala, in the hopes of discovering more untapped sources of antimicrobial compounds. If new treatments are in fact successfully synthesized, they will certainly be welcome in a world that urgently needs new antibiotics to combat ever-stronger strains of infectious diseases.
The Nascent Interdisciplinary Field Between Botany and Quantum Mechanics with Begonias - Chidera O. Nwosu
any are filled with both utter amusement and skepticism when seeing the terms botany and quantum mechanics in the same sentence. In this article, quantum mechanics are defined as a term underlying the behavior of matter and its interactions with energy on the scale of atoms and photons (and additional particles) on a subatomic scale. Perhaps, it is this unique cynicism addressed to the interdisciplinary field between botany and quantum mechanics that has hindered more prolific scientific research into this study. Nonetheless, there have been budding discussions emerging about the iridescent leaves of Begonia species which have triggered a robust combinatorial interest into quantum mechanics and plants. To begin with, there are about 1,500 Begonia species in the world, but only a select few have a blue sheen which many scientists attribute a functionary role of deterring predators or protecting the leaf from high capacity lights to. Begonias are the sixth largest angiosperm species in the world. A few tidbits of Begonias are as follows: •
Closely related to melons, cucumbers, and pumpkins.
Native to South and Central America, Africa, and South Asia.
Grows best in areas with diffuse light (partial shade), on well-drained, fertile soil
Can grow from 8 inches to 2 feet in height.
Cultivated because of its dense, ornamental foliage. It develops large, asymmetric leaves
Used for polishing swords in medieval times
It is interesting to note that a hallmark property of Begonias is that they are renowned for their metallic blue iridescence. In this study, this blue iridescent leaf coloration had been investigated in a single species, B. pavonina. Many might describe its color as a blue sheen or green with a tinge of royal blue. In fact, iridescence is a term that has been decreed in various forms of life from photosynthetic organisms and symbioses. Iridescence (goniochromism) is the phenomenon of certain surfaces that modify color as the angle of illumination changes. Examples of iridescence include the feathers of peacocks, the bibs of peagons, soap bubbles, sea shells, butterfly wings and even minerals. The discovery that iridescent leaves of Begonia species take advantage of quantum mechanics to thrive in the shade was made by Heather Whitney from the University of Bristol. Whitney and her team found that epidermal chloroplasts (or iridoplasts) within these Begonia species have a photonic crystal structure derived from a periodic arrangement of thylakoid tissue (which are lightabsorbing tissues). These iridoplasts are highly modified chloroplast structures; their grana (stacks of membrane) form photonic crystals that intercept captured light to
be utilized for photosynthesis. While reading this, you might ask: how does this absorbance occur? The answer is simple. These iridoplasts are spaced in a manner that adheres to the wavelength of light they are absorbing. The crests of the light’s waveforms tie with the stacked grana, thus diminishing the velocity of light resulting in efficient absorption. It is found that this trait of iridoplasts adapts continuously. Delving further into this topic, these structures enhance photosynthesis in two ways: •
by increasing light capture at the principally green wavelengths accessible in shade conditions,
and by unswervingly enhancing quantum yield by 5–10% under low-light conditions.
In an interview featured in Popular Science, Whitney stated the following: “these iridescent leaves were always found in shade plants. This seemed counterintuitive since one would expect plants growing in the shade to scavenge every available bit of light. Iridescence reflects some light away, though.” This observation is spot-on and indeed a valid one. Once again, this observation radiates the idea that iridescence exhibited by some Begonia species may be a way of enhancing photosynthesis in areas of deep shade. Ironically, these iridoplasts function well in areas of subpar lighting, but perform poorly in bright light; chloroplasts (which iridoplasts are akin to), on the other hand, function well in bright light. Moreover, after understanding the basics of how iridoplasts function, you are probably asking the following: how does this relate to quantum mechanics? Taking a look at the photonic crystal structure of iridoplasts, these crystals are nanoscale structures that result in variating ophthalmic singularities. Photonics have been explored vigorously for the capacities in which they harvest and capture light. Over the course of time, these photonic structures have been adjusted in the photosynthetic tissues of Begonia species. Last but not least, photonic structures are prevalent in nature and often allied with structural coloration. All things considered, the research conducted by Whitney and her colleagues at the University of Bristol is novel in the cohesive comprehension of photosynthetic light capture by plants in low-light conditions. It is evident that this interdisciplinary field between botany and quantum mechanics-photonics is a fairly rudimentary one at the time, but garners enough fuel to justify delving into potentially fertile research. This study not only forges a bond between photonic adaption (iridoplasts) and photosynthetic quantum yield in chloroplasts, but also opens the door for other light-capturing complexes similar in structure or function to iridoplasts that have yet to be discovered. In the end, Whitney provocatively questioned in her interview with Popular Science the following: “How many other plants might be using aspects of photonics to enhance photosynthesis?”
Clearing the Smoke: Targeting Brain Cancer’s Immune Defenses Bald heads. Fatigued bodies. Lost appetites. These are hallmarks of a cancer treatment patient. Conventional treatments consist of chemotherapy and radiation, both of which cause a multitude of side effects. While much better than leaving the cancers untreated, these therapies are rather barbaric. Radiation therapy is basically an invisible laser pointed at the body meant to damage DNA. However, this places the rest of our body’s cells in the crossfire; although cancer cells are more susceptible due to their already unstable DNA, it is extremely difficult to avoid collateral damage. Chemotherapy is more of the same. Essentially, we give doses of poison to the body that affects cancer cells more than it does normal cells. Even with the advent of new delivery systems and specific targeting techniques, the chemicals still cause side effects when they damage normal cells. And some still wonder why cancer patients get sick and lose their hair — much of the damage we see is actually due to the treatments used to get rid of the cancer. These effects are compounded in tissues that are more vulnerable to damage, like the reproductive organs. This is troublesome when deciding to treat sensitive vital areas and is especially problematic when dealing with cancer in the brain. Even worse, chemical delivery into the brain is blocked by the blood-brain barrier, the highly selective barrier meant to deny entry of disease-causing pathogens into the brain. This greatly reduces the effectiveness of chemotherapy; compared to the array of chemotherapeutic drugs available for other cancers, brain cancer has only one drug capable of combating it. Temozolomide is a DNA-methylating drug that preferentially kills tumor cells in glioblastoma, the most commonly occurring
- Henry Mancao
brain cancer. It has improved overall clinical outcomes but is still just a palliative treatment, delaying progression without getting rid of the cancer. Worse still, there is a chance that the cancer cells can mutate and develop a repair mechanism, undoing the work of the chemotherapy. The very nature of brain cancer hampers conventional treatment, necessitating forays into other avenues of treatment instead. With a spate of recent research revealing the intimate role of our immune system in the brain (long thought to be an immuneprivileged site), researchers looked to immunotherapy for a novel treatment for brain cancer. When developing any medical treatment, the first question to ask is: Why doesn’t our body just heal it like it would with any other injury? In deep wounds and widespread infections, the body has natural healing and defense processes that modern medicine supplements in order to achieve a better, faster cure. However, brain injuries are complicated by the fact that neurons do not reproduce. The source of cancer is actually the body’s own cells, which are largely indistinguishable from normal cells. Putting those characteristics together, brain cancer presents a unique problem not unlike finding a needle in a haystack, except the needle looks like hay and the hay won’t grow back. Since cancer is just a mutated version of normal cells, it is not quite as easy to identify them as it is to identify completely different foreign invaders like bacteria. So how can we expect our immune system — the body’s natural defense system — to root out these cancer cells the same way they do for infections?
This is an easy question with an incredibly complicated answer. As it stands, cancer is smart; that is, it mutates so rapidly that it is readily adaptable to any specific treatments we can think up. While there are subtle differences we can target, cancer has several defenses in place to avoid eradication. Tumors require more blood supply to keep up with their evergrowing energy demands, so they typically express more of a protein called vascular endothelial growth factor (VEGF) than do normal cells. We can make vaccines that teach our immune system to attack such proteins — just like giving a search dog a scent to track. But, again, cancer is smart. In some cases, it can end up mutating that protein so that it escapes the targeting. This is the same arms race we face with other vaccines (such as the one we use for the flu). Even worse, cancers typically employ immune evasion tactics. In addition to passing as normal human cells when checked by the immune system, tumors create an immunosuppressive environment by recruiting immune cells called T-regulatory cells (Tregs) that downregulate our normal immune responses. Between disguises and immune bodyguards, tumors create a sort of smokescreen around them that prevents our immune system from detecting them. As a result, our adaptive effectors (T cells and antibodies) have obstacles confounding their search: normal MHC (the ID carried by cells) and immune checkpoints (recruited Tregs downregulating immune response). These counter typical vaccination strategies by hiding the targeted components from view. Modern research has pushed immunotherapy (the use of the immune system to prevent or treat a disease) from experimental stages to legitimate care options. A number of immunotherapeutic drugs have received FDA approval and inserted themselves into treatment regimens for certain cancers. Immunotherapy has found use in melanoma, lymphocytic leukemia, lung and kidney cancer and stands to gain footing in many other subtypes. It can be combined with chemotherapy and radiation to better combat the cancer, as they work synergistically to reduce tumor mass and disrupt cancer growth. Research into glioblastoma, the cancer type used as the model system for brain cancer, has yet to produce the same results, but it is still in its early stages; new findings lead us to believe that advances in the field are dependent on countering the immunomodulatory mechanisms of the cancer — targeting glioblastoma’s immune defenses and letting the body do the rest. Early clinical research focused on making a vaccine that rallies the immune system to target against a certain antigen directly located on the tumor. The most developed drug, rindopepimut, teaches our T cells to target a mutated protein called epidermal growth factor receptor variant III (EGFRvIII). However, the drug has failed to pass phase III clinical trials, with many such studies unable to show improvements in survival. Another avenue of treatment involved the use of antibodies to target VEGF to selectively attack cancer cells; this drug, bevacizumab, met similar disappointment. Despite the lack of success, the growing body of research on the interactions between the tumor microenvironment and the neuroimmune system suggests that the potency of these treatments is neutered by cancer
immodulation. If vaccines are the scent (antigen) of the suspect (tumor) for search dogs (immune cells) to target, then the cancer’s immune defenses are the smokescreen that hides the suspect’s smell from the dog’s nose. Our vaccines have yet been unable to mount an effective response against glioblastoma; our dogs can’t chase what they can’t smell. As hunters trying to oust a harmful imposter from bodily property, we must think one step ahead of our prey. Our research must then focus on neutralizing these defenses in order for other immunotherapies to be effective. Current research on that front involves immune checkpoint inhibition — clearing the smoke so our immune system can see. Checkpoint inhibition is a newer form of immunotherapy that holds much promise in enhancing existing cancer treatments. It has been clinically successful, achieving FDA-approval against several types of cancer and showing encouraging results in ongoing clinical trials for glioblastoma. Its effectiveness in immunomodulation lends to synergistic effects when used in concert with the other treatments. At this point in the fight against cancer, modulation of the immune response is the bottleneck impeding the development of effective drugs. With the help of immune checkpoint inhibitors, other therapies could soon realize their full potential — a sentiment reflected in the state of ongoing clinical trials. Combinatorial approaches currently dominate the scene of immunotherapy research. The two main checkpoint inhibition drugs are nivolumab, which targets the checkpoint proteins PD-1/PD-L1, and ipilimumab, which targets Treg receptor CTLA-4. Much of glioblastoma research is evaluating the effectiveness of combining these drugs with a number of other treatments: radiation, temozolomide chemotherapy, antibody (passive) immunotherapy, surgical resection, and even laser ablation. Checkpoint inhibition is currently the most exciting and medically relevant avenue of immunotherapy that is under study, as its results have been promising in many types of cancer. Glioblastoma in particular has seen other treatments come and go, but checkpoint inhibition can be the key that unlocks the other types of immunotherapies. With enough research, it could become a viable, FDA-approved treatment for glioblastoma and other types of brain cancer. Its development allows multi-pronged treatment regimens to combine their effects, taking down the tumor defenses while attacking the aberrant cells directly. This synergistic approach is the likely solution to the cat-and-mouse game that is cancer treatment.
Womenâ&#x20AC;&#x2122;s Health - Catherine (Mai) Hunyh
E ven though Japan is considered to be the only postdevelopmental country in the world, it still lags behind when compared to developed countries with regard to healthcare for women. In 1999, Japan finally allowed the legal distribution of low-dose oral contraceptives after 35 years of controversy. There seems to be an entire sheet of do’s and don’ts that gloves the righteous hand of women’s health, but why is it even still a debate that women should afford the same health as men? The answer most absolutely lies in the touchy subjects of sex and reproduction. Despite the big debate, there are several undisputable factors that simply cannot be dismissed. A woman’s reproductive organs can be far more complicated when compared with a man’s reproductive organs. Furthermore, due to the proximity and location of the urethra, vagina, and anus, infections thrive among women. As we fixate on this problem, we must remember that the controversy does not stem from logic or pure fact. The lens of women’s health is better seen through from a sociological point of view. Consider the women’s liberation movement. There was once a time when women’s sexuality was far from slighted. A woman’s morality seemed to be the driving force behind a hushed sensibility and quieted acquisition to a virgin repertoire. And after a few grueling centuries, today’s women are able to wear pants, vote and run for public office, speak and act freely and liberally monitor our health (at least in the USA). What is the controversy then? What are us gosh-darn feminists complaining about? Sexism does not exist out of a single sex. While women were shunned for such savagery as licentiousness, men continue to be pardoned for such savagery as rape. Females are believed responsible for pregnancies, when it takes a male to fertilize her. All these thoughts and ideas trickle down to our health system, and spring upward into our politics. Due to political involvement, there has been a diminish in the number of Planned Parenthood clinics throughout our nation, therefore diminishing opportunities for women in poverty who need those services the most. Before even touching upon the loaded topic of abortion, it’s important to remember that Planned Parenthood provides far more than just abortion. Planned Parenthood has been bashed and thrown around like a swear word, when in reality Planned Parenthood provides services like STD testing and treatment, contraception plans, sexual education, information sessions, women’s advocacy and international informative sessions and health provisions. All of these services are irrefutably pertinent to maintaining women’s health; therefore, these services should be available everywhere. The big holdup stands at abortion. There is a myth that Planned Parenthood’s sole or most common service is abortion. However, looking at the numbers, it appears that only 12% of all the services provided by Planned Parenthood have been abortions (assuming all female patients involved received only one abortion). Finally, rape is very much a matter of both public health and women’s health. Rape is not only an invasion of personal space, but also an invasion of alien flora and an attack on a woman’s mental health, both of which contribute to greater health problems. Upon suffering through a rape or sexual assault incident, it is pertinent for a victim to run a rape kit, be tested for STDs and be checked for pregnancy (if the victim is female). Afterwards, there is an onslaught of emotional trauma the victim must face regarding the entire incident aside from the unnecessary commentary piled on from others about “not reporting the
incident” and “slut-shaming”. The entire process a rape victim must face extends from physical to mental health and lasts a lifetime, regardless of how brief the sexual assault was. Many resources are required to tend to all these injuries, but what resources are allowed, if not justice? What political statement does reporting a personal injury make? Lately, there has been a question as to why the University of Miami, with its plentiful resources and outstanding rank in education, sports, and beyond has yet to build a sexual assault resource center on campus when many other schools already have. This past year, UM professor Dr. Katherine Westaway, unafraid of administration, spoke out about past sexual assault cases that have occurred at the University of Miami. She openly added some thoughts against UM administration for the events that followed. After her candid remarks, she was dismissed from the university. Recently, I attended the Women’s Cancer Symposium where I met with President Frenk, and I asked him what measures he would take to increase women’s health on campus. President Frenk seemed uncomfortable answering the question, but provided the following comment: “The idea of taking care of the health of our students in a comprehensive way can be taken care of here…all of the major health issues [such as] stress, the abuse of alcohol or drugs…and what I have found very inspirational here is the amount of peer support…I have found that students organizing together for their own health and well-being [works] best…I believe that women students working together is an extremely powerful force.” In other words, the question was dodged tactfully. The answer is that the university seems stuck on how to go about providing all the necessary resources to women. Fortunately, our wonderful health center on campus provides STD and pregnancy testing, pap smears, resources for obtaining oral contraceptives and advice regarding sexual health. And according to Dr. Brian Slomovitz, the Director of the Division of Gynecologic Oncology in the Department of Obstetrics and Gynecology here at UM, the new Lennar Foundation Health Center will have doctors available for a weekly dysplasia clinic. The clinic will also provide early testing for ovarian and breast cancer. Regarding mental health, however, the counseling center is often over-booked and unhelpful in dealing with rape and sexual assault, according to many UM students who have met with such horrific incidents. Dr. Katherine Westaway had an idea for a very large and ample sexual assault resource center, and while her thinking was certainly thoughtful, it wasn’t within means of what was reasonable at the moment. The bare necessities for such a center include a location for conducting rape-kits, police officers specially trained for dealing with these cases and psychologists that will actually help students deal with the trauma weekly over the course of a few months or longer. In the end, we aren’t all asking for a Brave New World level of callousness regarding sex or pregnancy, nor are we asking for a resource center on every block. Women’s health is about safety, equality, and most importantly: HEALTH. Women want to know that no matter what happens to them, there are resources available to help them, heal them and cure them. They want to know that there is nothing to be ashamed of in falling victim to rape or sexual assault. Regardless of what your beliefs are regarding feminism, sex and rape culture, or politics, one should agree that every person should have the right to be healthy. And, yes, women ARE people.
MINORITY STUDENTS IN HEALTH CAREERS MOTIVATION PROGRAM UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE The Minority Students in Health Careers Motivation Program (MSHCMP) pr omotes diver sity in the health and allied health professions by providing students from underrepresented backgrounds with an opportunity to develop skills that will increase their competitiveness for admission to schools of medicine.
MINI MED SCHOOL EXPERIENCE Designed to be a mini first-semester medical school experience, the Motivation Program is a full-time, seven-week program that focuses on enhancing strengths and minimizing barriers that may limit participants from being competitive applicants for medical school. Students receive classroom instruction in select science courses from the medical school curriculum, shadow physicians and attend supplemental workshops that help them develop the necessary skills to compete. Upon successful completion of this program which runs from Sunday, June 4th, 2017 through Friday, July 21st, 2017, each participant will have a holistic perspective of his or her readiness for medical school.
ELIGIILITBY MSHCMP is a tuition-free program, and open to college sophomore, juniors, seniors, and recent graduates. Applicants’ should be competitive candidates for medical school and their applications should demonstrate how they will benefit from this experience. The committee considers several criteria when selecting 25 participants for the MSHCM program including being a:
Citizen or Permanent Resident of the United States
Member of one of the following racial and ethnic populations that are underrepresented in the medical profession
American Indian or Alaskan Native
Black or African American
Hispanic or Latino
2016 Minority Students in Health Careers Motivation Program Participants
Cydnie Mitchell Georgia Southern University, GA Class of 2016
Must be one of the following:
Matriculating student who has completed at least two years of undergraduate science or premed coursework (including Organic Chemistry).
Recent science or premed graduate (post baccalaureate).
Matriculating unclassified graduate student in science pre-health profession education. Minimum science and cumulative GPA of 3.0 on a 4.0 scale.
The application is available online at: http://diversity.med.miami.edu/summer-programs/motivation Complete application forms must be received in the Office of Diversity and Inclusion by Friday, March 17th, 2017 and should be accompanied by the following documents:
Official academic transcript (s) from all college (s) attended.
Three (3) letters of recommendation from college professors.
Personal statement (specifics outlined in application).
Passport photo (2x2). Only completed applications will be considered for admission and applicants will be notified of their program status via email on Friday, March 31st, 2017. Once accepted to the pr ogr am, a $100 refundable deposit is required to secur e your space. Deposits will be returned upon successful completion of the summer program as determined by the program executive director. This seven-week, residential experience is fully funded through the Miller School of Medicine. Participants will receive free coursework, books, supplies, meals, housing, and travel expenses. All students are required to reside on campus and will be provided with transportation between campuses. Round-trip airfare will also be provided for participants who live outside the South Florida area (Miami-Dade, Broward, and Palm Beach Counties).
Jason Iyobhebhe Millersville University of Pennsylvania, PA Class of 2018
Office of Diversity and Inclusion Rosenstiel Medical Science Building 1600 NW 10th Avenue, Suite 1130, Locator R11 Miami, FL 33136 Ph.: (305) 243-7156 - Fax: (305) 243-7312 Email: http://diversity.med.miami.edu
Apply to be a part of staff! Available Positions:
Writer Designer Photographer Copy Editor Business Associate Marketing/PR Associate Distribution Associate Radio Show Writer Radio Social Media Manager
Please access the application via our Facebook page. Applications will be accepted on a rolling basis. Contact us at scientificaeditor@ gmail.com or firstname.lastname@example.org for any questions you may have.
The University of Miamiâ&#x20AC;&#x2122;s FIRST Undergraduate Scientific Magazine
The Importance of Imaging Techniques - Andrew Rubio Prior to the late nineteenth century, medicine was a very palpable field. Fractures and torn ligaments were discerned by the keen senses of the physician, but many an injury lingered (quite literally) beneath the skin. With the discovery of x-rays in 1895, however, medicine experienced a transition from a very physical, observation-based science to one that could now enjoy the use of new imaging techniques. Since then, the field of radiology has grown to the point where it is now an indispensable part of healthcare. The x-ray was the first imaging technique to mark its presence in the medical field. In terms of how the image appears on film, dense structures like bone will block a majority of the x-ray particles that pass through the body and therefore appear white in the image; however, metal and other contrasting materials will also appear white, so care must be taken to prevent any interference in taking the x-ray. In contrast, any tissues containing air (along with muscle, fat, and fluid) will appear darker on the image. The physics behind the x-ray machine involve the interaction between excited electrons and the nuclei of tungsten atoms. At its core, an x-ray machine consists of two components: a cathode and a tungsten anode. When high-energy voltage is passed through the x-ray tube, a beam of excited electrons emerge from the cathode and impact the tungsten atoms at the anode, which in turn sends an x-ray beam down toward the patient. The beams pass through the patient and onto a recording cassette, which uses chemicals to capture the x-ray image. The cassette is later washed and prepared for viewing by the radiologist. It is important to remember that bone is the best tissue in the body for reflecting x-rays; therefore, x-rays are best used for diagnosing bone-related problems like fractures, osteoporosis, osteomyelitis and tooth decay. In the twentieth century, medicine saw the advent of a new imaging technique, one that would allow for advanced imaging of the softer tissues of the body. The CT scan, short for computerized tomography, emits a series of small beams instead of the larger, denser x-ray beams. The CT scanner moves in an arc around the patient, constantly firing off small, precise beams that are picked up by detectors capable of detecting many different kinds of waves. The detector then sends data to a computer, where a viewable image of the soft tissue is constructed. A major benefit of CT scans is that they greatly reduce the time the patient is exposed to
radiation — newer CT machines can obtain an image for an entire anatomical region (like the lungs, stomach, etc.) as a patient holds their breath for just a few seconds. In general, the CT scan has become the gold standard imaging method used in hospitals since it is incredibly accurate and also minimizes a patient’s exposure to radiation. Since the CT scan is used to image soft tissue, however, it has reduced functionality if an image of the joints or of bone marrow is needed. Finally, one of the most advanced imaging techniques used today is the MRI, short for magnetic resonance imaging. In an MRI, the patient is placed inside a large magnet. The magnet takes protons out of their normal “spin” orientation, and the warping of the protons allows for an image to be created. The radio frequency pulse sent by the MRI machine takes the precessing protons out of alignment and allows for an energy exchange. The protons then move in phase instead of in random directions, and some protons move from lower energy states to higher energy states. A transverse magnetization vector is produced, which in turn produces an electrical current. The current is then picked up by an antenna, which produces the MRI signal. MRIs are especially useful when imaging the brain, but any movement by the patient can distort the image. In addition, as the MRI machine is essentially a giant magnet — no metal should be allowed inside the MRI room, as it poses a very serious risk to patients. Patients have been seriously (and even fatally) injured by metal present during testing. Simply put, the bevy of imaging techniques on the market today have revolutionized the medical field in a period of just over 100 years. Physicians can accurately diagnose and treat patients without ever directly seeing the affected bones/organs. As the technology behind these imaging techniques improves, the cost and efficiency of the machines will decrease, allowing for a more cost-effective and efficient practice of medicine.
im lighting, the smell of antiseptics, crying infants and quiet shuffling all around you. The ambience of a hospital is never particularly inviting for patients, many of whom only make the visit when it becomes absolutely necessary to do so. Now imagine, after months of avoiding or being unable to go to the doctor, you finally commit and make the visit. After filling out dozens of forms and waiting for what feels like an eternity, the nurse turns the corner and calls out your name with a big grin. You anxiously walk into the pastel-colored patient room and take a seat, staring at the colorful prevention posters and syringe-filled waste baskets around you. Before long, the doctor comes in; he looks nice, but seems to be pressed for time. Within the next five minutes he rattles off a slew of words, only a few of which you can actually discern. He shakes your hand, gives you his number to call him if you have any questions, and before long the nurse comes back in and pricks you with a few needles before you are on your way out. As a patient not too familiar with a hospital environment, this experience is frightening enough. However, what you may not have gleamed from the above scenario is that the patient described does not speak any English. This is the reality for many Spanish-speaking patients in the United States. The painful truth is that there is a growing language barrier between Spanishspeaking patients and English-speaking physicians in innercity areas, Miami included. This has posed serious challenges in healthcare management, especially in addressing/treating emergent cases as the need for translation services become overwhelming. Oftentimes key details regarding treatment get lost in communication, even when translation services are used. Not only does this pose grave issues associated with ensuring the patient takes the required medications or comes to necessary follow-up visits, but it also greatly discourages the patient from staying informed and engaged in their own healthcare management. A patient who is already uneasy with the atmosphere of a bustling inner-city hospital is much less likely to return in the future, especially if they can barely communicate comfortably with their healthcare provider. Take, for example, Childrenâ&#x20AC;&#x2122;s National Medical Center (CNMC) in Washington DC, a city boasting one of the largest Hispanic populations in the mid-Atlantic/Northeast region of the United States (ranked #12 in a 2014 nationwide census study of Hispanic population and origin in select US metropolitan areas). Out of 14 residents in the pediatric cardiovascular ward at CNMC, fewer than 5 residents are fluent in Spanish. When talking to Dr. Robert Freishtat, Chief of Emergency Medicine at CNMC, he admitted that the lack of Spanish-speaking residents slows down hospital service, especially since there are a limited number of hospital translators available. This evokes a controversial question; even though it is not a requirement for hospital staff to speak Spanish, if the job of a physician is to provide the best care possible, does it become a responsibility for physicians to know Spanish in order to effectively communicate with patients in a timely fashion? Is it ethical (or even legal) for a physician with limited Spanish knowledge to try to communicate with patients in Spanish in order to be more efficient in providing service? A study performed by the University of California San Francisco (UCSF) investigates this growing problem. The study
How to Ad Growing SpanishHealthcare - Ramya Radhakrishnan
ddress the Need for Speaking e Providers
centered around the General Medicine floor of the UCSF Moffitt-Long Hospital, an urban academic medical center with an ethnically and linguistically diverse patient base surrounding it. According to the medical centerâ&#x20AC;&#x2122;s administration, approximately 18% of patients on the General Medicine floor have Limited English Proficiency (LEP), with Spanish, Chinese and Russian being the most prevalent non-English languages. Healthcare providers on the floor include staff nurses, Internal Medicine attending physicians and the resident physicians they supervise. As part of a project with the UCSF Medical Center Interpreting Services Department, a survey was conducted with physicians and nurses working on the General Medicine floor regarding their communication with all LEP patients both before and after implementation of bedside dual-handset phones (which allow for interpretation provided through phone). Generally, it was found that physicians and nurses with low Spanish proficiency worked with interpreters; however, they were as likely to work with ad-hoc interpreters (an untrained person who is called upon to interpret, usually with lower proficiency level) as they were to work with professional interpreters. There was significant variability in the use of the strategies for overcoming language barriers among physicians and nurses with medium proficiency, particularly among physicians engaged in unidirectional communication. Ethically, the bottom line is that the frequent use of adhoc interpreters by low proficiency physicians and nurses is inappropriate based on federal policies and existing research. Federal regulations do require health-care organizations to assure the competency of language services offered by bilingual staff, especially clinicians, although guidance is lacking on how this should be accomplished. The first step, however, given the abundance of Spanish-speaking US residents, it to make â&#x20AC;&#x153;Medical Spanishâ&#x20AC;? courses available to clinicians so that they can learn relevant medical vocabulary, while ensuring that there are checks in place so that their tested ability is not misused or overextended. There is a need to establish standards for clinician non-English language proficiency to ensure the quality of communication with LEP patients. The lack of consistency in reporting fluency currently impedes the development of strategies aimed at eliminating health-care disparities, which could include matching LEP patients with truly bilingual clinicians or improving access to and use of professional interpreters. While some healthcare institutions have instituted language proficiency testing for bilingual staff, few have broached the topic of testing for physicians and nurses. In addition to ensuring standardization and better Spanish education for physicians, it may be fruitful to certify fluent Spanish doctors as primary providers for niche areas (i.e. Emergency Department in a huge inner-city area hospital) and send Spanish-speaking patients to those doctors only to improve efficiency. As always, the need for interpreters is greater now than ever, and special attention should be paid toward both improving their efficiency and hiring more interpreters to meet the growing need. With these changes set in motion in the healthcare education community, we can strive for better relationships between Spanish-speaking patients and healthcare providers in the future.
Birth Control and Depression- Is there a Link? - Rachel Colletti
Historically, women who complained to doctors about mental illness, emotional changes, or menstrual pain were told that they were neurotic or hysterical. In the 1960’s, American women demanded to be taken seriously by doctors, and thus the women’s health movement was born. Thanks to these brave women, the medical community began to listen to women and recognize their unique anatomy and physiology. The hallmark of this movement was the FDA approval of the first oral contraceptive, commonly called “the pill.” Flash forward to 2016; the CDC now reports that 28% of women of reproductive age are currently using the pill. Women are prescribed this medication for several symptoms and or diseases such as dysmenorrhea, endometriosis, premenstrual syndrome, acne and more. But as with any medication, there are side effects. Notable side effects of the pill include stroke, blood clots, nausea, headaches and weight gain. The newest side effect of the hormonal birth control pill happens to be a disease that is becoming an epidemic in the modern world: depression. The CDC reported in 2011 that the use of antidepressants has increased 400 percent in the last two decades. And it has been widely documented that women experience depression at roughly twice the rate of men. Parallel to this, the use of the the pill has dramatically increased. In September, a study linking these two trends made headlines. Researchers in Denmark found that there was an increased risk for first use of an antidepressant and first diagnosis of depression among women using hormonal contraception. The study, published in 2016, was accompanied by several high profile news stories, spreading a widespread concern for women using hormonal birth control. Will the use of their contraceptives eventually lead to clinical depression? Or in the case of women already suffering from depression, was it the pill that caused their mental illness? The researchers in Denmark performed a nationwide prospective cohort study of more than 1 million women. Because Denmark operates on a public and nationwide healthcare system, the researchers were able to access the medical records of all women living in the country. Women ages 15-34 were included in the study, and their medical history was followed for 14 years, from January 2000 until December 2013. Women with a depression diagnosis or use of antidepressants prior to the study, or a psychiatric disease were excluded. The control group consisted of women who did not use hormonal contraception. The results of the study were measured in relative risk (RR), or in other words, risk of a bad outcome. If the results show a RR greater than 1, this means that the risk of a bad outcome is increased by the treatment. In this case, a RR greater than 1 would suggest
that the use of a hormonal contraceptive increases the risk of developing the need for an antidepressant. For example, a RR of 2.0 would suggest that the risk of needing an antidepressant is twice as likely to occur when using a hormonal contraceptive than without it. Unfortunately, the results of this study were significant. It was shown that compared with nonusers, users of combined oral contraceptives had an RR of first use of an antidepressant of 1.23, users of progestogen-only pills had a RR of 1.34;, users of a patch (norgestrolmin), 2.0; users of a vaginal ring (etonogestrel), 1.6; and users of a levonorgestrel intrauterine system, 1.4. It was also shown that the relative risks generally decreased with increasing age, making adolescents among the most vulnerable for depression. According to the World Health Organization, women are about twice as likely to suffer from depression than men. This high-profile Danish study is one of the first to examine the link between hormonal contraceptives and depression. It is interesting that there have been so few studies investigating this link even though there has been an increase of both contraceptive use and depression in America. Although women have made remarkable progress in terms of equality in America, the medical establishment still operates on a male model. The best example of this is the case of heart disease. Heart disease is often thought of as a “man’s disease,” however around the same number of women and men die each year of heart disease in the United States, according to the CDC. Women experience different symptoms at the onset of heart disease, but because women are underrepresented in research, physicians lack information about the way heart disease manifests in the female body. Even when it comes to basic research, there is still a gender bias. The majority of research continues to be conducted on male cells and male animal models, and then this data is extrapolated to the female body. Thankfully the medical and scientific communities are becoming more aware of their biases and are working toward change. In 2014, the National Institutes of Health ruled that all federally funded research must include female subjects. However, much of what we know about the human body was discovered using a male model, causing women’s health to suffer greatly. The authors of the Danish birth control study concluded that health care professionals should be aware that depression is a potential adverse effect of hormonal contraceptive use, especially among adolescents. While the birth control pill has provided independence for women, as well as treatment for many medical problems, it is not a panacea and should be used with caution. While significant progress has been made in the field of women’s health, we still have a ways to go. It’s disheartening that female subjects were not required to be included in research until 2014 and that female diseases are not studied as rigorously as male diseases are. The medical community needs to make women’s health a priority, especially with complex diseases such as depression.
THE MEDICAL COMMUNITY NEEDS TO MAKE WOMEN’S HEALTH A PRIORITY, ESPECIALLY WITH COMPLEX DISEASES SUCH AS DEPRESSION.
There is nothing more precious to a college student than sleep. Yet most of the students on our campus are sleep-deprived and over-caffeinated. As it turns out, getting enough sleep has countless benefits for our health. So what exactly is sleep and how can we make sure we get enough of it? While most people believe that sleep is a passive state of rest, it is actually an extremely dynamic process. While we are sleeping, our bodies undergo distinct physiological changes and our brains cycle through several stages of activity. When we are awake, the adrenal gland releases the hormone cortisol to keep us alert and active; however, at night, the pineal gland begins to release a hormone called melatonin which signals our body to relax. Our temperature and blood pressure drops due to the signals from melatonin as well as reduced physiological demand. Kidney function slows and the production of urine is decreased, and there is an increase in the release of growth hormone. Certain physiological activities associated with digestion, cell repair, and growth are often greatest during sleep, suggesting that cell repair and growth may be an important function of sleep. It’s important to note that two distinct stages of sleep have been described. The first stage is called nonREM which stands for non-rapid eye movement. This stage occurs when you are beginning to fall asleep and remains until you are in a deep slumber. Muscle activity begins to decrease and conscious awareness of the external environment wanes. The non-REM or NREM stage has three different phases, NREM 1, NREM 2, and NREM 3. These three phases are characterized by the brain waves that occur during them. NREM 1 is the period when you are in between sleep and wakefulness, and this is when you brain emits alpha waves. Then in NREM 2 the brain emits theta waves and consciousness and muscle activity disappear. NREM 3 is characterized by delta waves and deep unconsciousness. A human must transition through these three phases before the brain enters REM sleep, or rapid eye movement sleep. The REM stage is when there is an increase in the firing of our neurons, yet we are in a deep sleep. This stage is when dreaming occurs. Human sleep occurs in periods of 90 minutes, each period consists of a non-REM and REM stage and this cycle occurs usually four or five of them per night. We know that sleep is important to human health for several reasons, mainly because of how we feel when
we don’t get enough sleep. Most of us have experienced the symptoms of sleep deprivation, including fatigue, irritability and confusion. Sleep deprivation also has negative physiological effects including weight gain or loss, increased blood pressure, increased stress hormone release, headaches and more. Sleep deprivation has been shown to lead to diseases such as diabetes, depression and fibromyalgia. As college students we often think that pulling an allnighter will help us perform on exams, but sleep deprivation has been shown to decrease cognitive function and working memory. In fact, the sleep cycle contributes greatly to memory and the processing of daily information. Simply put: sleeping before an exam is imperative. Now that we know what sleep is and how detrimental the effects of sleep loss are, here are some helpful tips to ensure a good night’s rest. The best way to enhance your sleep is to maintain a regular sleep schedule. Our bodies operate on a strict circadian rhythm, a 24 hour pattern of brain wave activity, hormone production, cell regeneration and more. Disrupting this cycle by altering the times you go to sleep and wake up every day is not optimal for health. To help yourself maintain a routine, develop a nighttime ritual that you enjoy and is relaxing. This may include taking a shower, reading a book, doing light yoga or meditation, or journaling. Try to keep electronics like your phone or laptop out of your bed. The blue light from their screens has been shown to decrease production of melatonin, making it harder to fall asleep. Electronics are also extremely distracting and make you want to stay up later than your body desires. Lastly, exercising every day will greatly improve your sleep at night. Even light exercise is better than no activity. When you are first working on getting better sleep, it is helpful to keep a log of what things helped you sleep better and how you felt throughout the day. This way you will know what exactly works for you, and you make yourself aware of how much better you feel when you are well rested. Although sleep is not always the first priority when trying to improve your health, it is the foundation for how you will feel throughout the day. Especially if you are trying to lose weight, maintaining a healthy sleep routine is imperative. Scientists have not been able to uncover exactly why we sleep, however we have come a long way in understanding what sleep is. Because the scientific community has a thorough understanding of sleep, humans now know how important it is and how to help themselves when their sleep is suffering.
To sleep...perchance to dream... - Rachel Colletti
Having trouble falling asleep? Make sure youâ&#x20AC;&#x2122;re following these tips:
Something that may seem impossible for a college student... reduce stress load!
Avoid junk food right before bed-may lead you to feel sluggish when you wake up!
Make sure to incorporate physical activity.
Adjust your thermostat before going to bed.
Reduce cellphone usage before bed
Celery for your thoughts? - Jennifer Chavez For as long as I can remember, my vice has always been ice cream sandwiches.
Forgot your closed-toe shoes for chem lab and had to run back to the dorms to get them? Have an ice cream sandwich. Forgot you had a 15 page paper due at midnight and it’s 11:43? Have an ice cream sandwich. Said “you too!” to someone who wished you a happy birthday? Have an ice cream sandwich. Although I know my vice is extremely unhealthy, I don’t feel alone in having one. The American Psychological Association published that at least 28% of adults reported supersizing their fries at McDonalds after a stressful day (and/or engaged in unhealthy eating behaviors). Almost half of these adults are repeat offenders. Unfortunately for us, an unhealthy diet has been linked to a number of mental health conditions that include depression, anxiety, attention deficit disorder and even Alzheimer’s disease. So how can something that tastes so good, be so bad for us? A study done in 2008 revealed that the most common mental disorders within American and Asian populations are depression, bipolar disorder and obsessive-compulsive disorder. It comes as no surprise that the dietary intakes of these populations reflect a severe deficit in many essential vitamins, minerals and nutrients. American and Asian populations also have the highest incidence of obesity and refined sugar intake. When given supplements for their deficiencies, patients show a general increase in wellbeing, and a reduction in the effects of their mental health disorder. Although a change in diet may be beneficial to those who suffer from mental disorders, it is important to note that eating more kale will not replace medication. Many researchers are now focusing on the human gut for more answers to psychiatry’s biggest questions. Known as the second brain, the gut is responsible for profound biological phenomena including pain sensation, mood variations and regulation of immune system function. The brain and gut are crucially connected, and a proper balance between the two must be ensured so that the human body can function properly. While altering the bacteria present in a patient’s gut can modify the levels of different neurotransmitters in the brain, repeated stress can affect the number of opportunistic pathogens that are allowed to flourish in the intestines. New research shows that by treating the gut with probiotics, there is a general decrease in the frequency and intensity of the symptoms
of mood disorders and anxiety. In the same way that the gut can be treated with probiotics, prescribing serotonin reuptake inhibitors (commonly used for treating depression and anxiety) can also help improve gastrointestinal disorders. Serotonin is a hormone and neurotransmitter that is involved in autonomic regulations like sleep, appetite and mood. It makes sense that variable serotonin levels are associated with anxiety, depression and even gastrointestinal problems; 95% of it is currently in your gastrointestinal tract, after all. As part of your GI tract, serotonin is able to establish the connection between your gut and your brain, while also protecting your stomach lining from opportunistic pathogens in the process. A gastroenterologist at McMaster University, Premysl Bercik conducted a study that analyzed the relationship between gut microbiomes and behavior. In this study, Bercik and his team used two different strains of mice: one was known to be timid and shy, while the other was relatively outgoing and fearless. In order to test for differences in behavior, Bercik gave the shy mouse strain an array of antibiotics that drastically changed their original gut-bacterial makeup, then taking note of the differences in behavior and expression. The team noted that once the composition of the natural gut flora was altered, the mice that were once considered shy were described as “bold and adventurous”. Bercik says that while his experiment reflected a drastic change in the gut microbiome, the addition of a single foreign strain can be catalyst enough for causing behavioral change. Although chia seeds and Brussels sprouts may not be your first choices for comfort food, consuming leafy greens and increasing fruit intake may help with your energy and mood while also reducing the likelihood of developing schizophrenia, eating disorders and anxiety disorders. As a general rule, nutritionists say that balance is key, while physical activity is essential. Restricting yourself from all of your vices may not always be the best plan of action — after all, taking guilty pleasures like chocolate, wine and coffee off the table completely will do more harm than good. The trick, of course, lies in exercising moderation and practicing substitution. Researchers suggest attacking your cravings for unhealthy foods with healthy replacements is a major factor in improving general health and wellbeing. In the end, while my heart may be pounding for an ice cream sandwich, my brain will find a way to thank me for grabbing a celery stick instead.