Volume 2, Issue 1: The Science of Being Sick

January 2016

Volume II, Issue I

The University of Miami’s FIRST Undergraduate Scientific Magazine

The Rebirth of Drugs, 8 Be My Eyes, 18 3D Printing: Adding To Our Future, 20 Artificial Intelligence, 22 “Water” You Researching?, 26 Angiogenesis, 38 What to Expect in Medical School, 40

The Science of Being Sick

Microbiology and Immunology Program Research Interests 1. Regulation of B lymphopoiesis during aging 2. Generation of immune tolerance to human allogeneic kidney transplants 3. Malaria, Leishmania 4. Quality of the immune system in breast cancer patients in response to psychosocial intervention 5. Neonatal immunity 6. T Helper cell function in neonatal life 7. Intestinal pathogens in neonatal life 8. Autoimmune and inflammatory mechanisms in diabetes and cancer 9. Defects in B cells, T cells and antigen-presenting cells 10. Murine tumor models to develop multi-pronged approaches to potentiate vaccine- and naturally-induced antitumor immunity 11. Personalized enzyme- based therapy for cancer of the pancreas, lungs, brain, colon, rectum, breast, head and neck 12. Molecular genetics of hematopoietic stem cell differentiation 13. Molecular genetics of stem cell self-renewal and maintenance 14. Developmental biology and plasticity of hematopoietic stem cells 15. Lupus and Type 1 diabetes but also to immunodeficiencies and B cell malignancies 16. Graft vs. Host Disease (GVHD) in models of allogeneic bone marrow transplantation (BMT) 17. Rejection of the marrow graft: The ‘barrier’ against stem cell and progenitor cell engraftment post-BMT 18. Immunotherapy for Leukemia 19. The ability to fix functions when killer lymphocytes are forced out of tune and overwhelmed by a continuously growing tumor or 20. chronic infections such as HIV or Hepatitis B and C 21. A unique mucin immunoenhancing peptide with antitumor properties 22. Mammary tumor effects on thymic development and functions 23. Impaired functions of macrophages from tumor bearing mice 24. Role of tumor associated factors in the upregulation of matrix metalloproteinase-9 (MMP-9) in T cells from tumor bearers 25. Cytokine receptor regulation of T lymphocyte development, activation, and memory; T regulatory cells in suppression of autoimmunity 26. Immunobiology of T regulatory cells 27. The IL-2 receptor in T regulatory cell development 28. T cell immunity and cytokine receptor signaling 29. Memory T cells in tumor immunity 30. Molecular mechanisms of viral carcinogenesis and angiogenesis activation by the Kaposi’s sarcoma Herpesvirus (KSHV) 31. Identification of the viral G protein-coupled receptor as an angiogenic oncogene of KSHV 32. Identification of Cyclooxygenase-2 as a mediator of vGPCR angiogenesis and tumorigenesis 33. A cell and animal model of KSHV-mediated carcinogenesis 34. Microbial pathogenesis, Transcriptional regulation 35. Vaccine-induced memory CD4T cells and HIV reservoirs 36. Antibody responses in HIV and aging 37. Immune activation in virologically suppressed Indian HIV-Infected patients 38. Molecular pathogenesis of Yersinia pestis 39. Antigen cross presentation by chaperone gp96 to generate Cytotoxic T cells 40. Regulating T Regulatory Cells with TNFRSF25 41. Membrane tethered Perforin-2 and control of intracellular killing 42. Regulation of B Lymphocyte development and function in senescence 43. Cellular microbiology 44. Negative regulation of NF-κB and inflammation 45. Mechanism of HTLV-1 Tax mediated NF-κB activation 46. Negative regulation of JAK/STAT signaling pathway by HTLV-1 Tax 47. Studies of TNF superfamily ligands as vaccine adjuvants for HIV, malaria, and cancer 48. Construction and testing of molecular adjuvants that enhance replication-defective HIV or SIV attenuated virus vaccines 49. Clinical study of therapeutic HIV vaccines containing antigen-loaded ex vivo derived dendritic cells 50. Role of innate immunity and especially of macrophages in the interplay between a tumor and the host’s immune system Ebola Virus Courtesy of the CDC

News UHealth - 6 Psychedelics - 8 Tye I Diabetes - 10

Did You Know?

contents

The Science of Being Sick - 11 Have You Ever Wondered Why? - 15

Capturing Science Through Photography Kasey Markel - 16

Innovations in Science Be My Eyes - 18 3D Printing - 20 Artificial Intelligence - 22

Research Nanophotonics - 24 Starving Cancer - 25 Water You Researching? - 26 RSMAS Student Profiles - 28

Journals Neural Progenitor - 29 Levitt - 30

Ethics in Science Chronic Pain - 31

Health Science Losing Weight - 34 Caloric Intake - 36 Angiogenesis - 38

Source: CDC (PHIL)/ F.A. Murphy

Featured Story: Why Do We Get Sick?

Freshman Advice

The beginning of every semester brings new things: a fresh start, new adventures and , of course, that infectious plague that seems to destroy half of the class in the first two weeks. Symptoms from runny nose to high fever

Medical School - 40 Does (S)he Bite - 42

swarm the campus, and nobody seems to know who is next. While many continue with their daily routines, students walk around campus in fear of being infected. But what actually makes us sick? And if we already got sick before, why do we get sick again? These questions, as well as some tips on how to get better and stay well, are answered by examining the infections that plague us.

From the Editor-in-Chief: Before you picked up Scientifica today you woke up from your confortable mattress, grabbed your iPhone (or android device), took a shower, selected your clothes for the day, had a warm breakfast, and rode a hurricane shuttle to your classes or work. You were able to enjoy some of the latest scientific and technological advances in modern history. That mattress you woke up from is composed of polyurethane memory foam, a type of organic material that softens the mattress when it detects body heat. Meanwhile the iPhone that you picked up to Snapchat your breakfast creation was designed and launched by Apple in 2007 after decades of research in Multi-Touch screen technology and various improvements in computer programmable software. I grew up with the notion that science applies to all of us whether we chose a career in Science Technology and Mathematics (STEM) or we find our passion in communication, architecture, and education because all of these careers are interconnected and essential to our survival as a species. To all the people that believe

science is not applicable to you or dislike science I dedicate our third issue to you. I hope that you can move past the fear that STEM only involves complicated formulas and mechanisms that very few people can understand and that you can find an article that makes you want to learn more. To the hundreds of scientists that have contributed to our success and failures in scientific advancements I also dedicate this issue to you because without your ingenuity, perseverance, and a little bit of luck we wouldn’t have any of the innovations that allow us to grow as a society everyday. Enjoy this issue and keep a lookout for the launch of our website umiamiscientifica.com!

Victoria A. Pinilla Escobar Microbiology & Immunology ‘16

From the Editorial Advisor: It has been a rollercoaster of a ride with Scientifica this past year. We have high ambitions and a drive to push the boundaries of scientific journalism. We are looking forward to an outstanding publication year and rely on our supportive faculty and student staff as well as our CORE. We are pleased of the overwhelming support we received from the student body in regard to our latest referendum that was passed. The monies generated from this endeavor will take effect in the fall of 2016 and we appreciate any support that comes our way prior. This year, we will be publishing a total of 4 instead of the two we published last year. Please follow us on our Facebook page and we will update you on our

potential achievements. Enjoy this issue!

Roger I. Williams Jr., M.S. ED Director, Student Activities Advisor, Microbiology & Immunology Undergraduate Department

BOARD OF FACULTY ADVISORS Richard J. Cote, M.D., FRCPath, FCAP Professor & Joseph R. Coutler Jr. Chair Department of Pathology Professor, Dep. of Biochemistry & Molecular Biology Chief of Pathology, Jackson Memorial Hospital Director, Dr. John T. Macdonald Foundation Biomedical Nanotechnology Institute University of Miami Miller School of Medicine

Mathias G. Lichtenheld, M.D. Associate Professor of Microbiology & Immunology FBS 3 Coordinator University of Miami Miller School of Medicine

*Eckhard R. Podack, M.D., Ph.D. Professor & Chair Department of Microbiology & Immunology University of Miami Miller School of Medicine

Michael S. Gaines, Ph.D.

Assistant Provost Undergraduate Research and Community Outreach Professor of Biology

Thomas Goodman, Ph.D. Associate Professor of English

Leticia Oropesa, D.A. Coordinator Department of Mathematics Professor of Mathematics

Geoff Sutcliffe, PhD Chair Department of Computer Science Associate Professor of Computer Science

Yunqiu (Daniel) Wang, PhD Senior Lecturer Department of Biology

Barbara Colonna, Ph.D. Senior Lecturer Organic Chemistry Department of Chemistry

Charles Mallery, Ph.D.

Associate Professor Biology & Cellular and Molecular Biology Associate Dean

Geoffrey Stone, Ph.D. Professor & Joseph R. Coutler Jr. Chair Department of Pathology Professor, Dep. of Biochemistry & Molecular Biology Chief of Pathology, Jackson Memorial Hospital Director, Dr. John T. Macdonald Foundation Biomedical Nanotechnology Institute University of Miami Miller School of Medicine

Onur Tigli, Ph.D. Electrical and Computer Engineering Dr. John T. Macdonald Biomedical Nanotechnology Institute (BioNium) Department of Pathology Miller School of Medicine University of Miami

Meryl Blau, M.A. Lecturer Portfolio Development AAF Competition

Sarai Nunez, M.A. Lecturer Graphic Design

*UMiami Scientifica’s staff is currently mourning the loss of one of our most distinguished professors and board members, Dr. Eckhard Podack. We extend our deepest condolences to his family, friends and colleagues. Our magazine will be paying homage to Dr. Podack’s life and scientific accomplishments in our next issue, but for now, we would like to pass on the sentiments that Dean Pascal J. Goldschmidt expressed in his statement to the medical campus. Thank you for all of your support and help, Dr. Podack. Our biggest hope is that this issue and all of our issues to come will always make you proud. You will remain in our thoughts and hearts always.

It is with great sadness that I let you know that our dear friend, colleague and mentor Eckhard Podack passed away today at the Mayo Clinic in Rochester after an extraordinary fight for his life.

Our loss is substantial, not only of a friend who we adored and shared wonderful memories with, but also of a colleague whose talent is akin to those who have received the Nobel Prize. The work on immune therapies for cancer and the killing of microorganisms with the Perforin family of proteins that he discovered will have a long-lasting impact on our fellow humans. His work will continue to advance through dear colleagues in his Department of Microbiology and Immunology and at Sylvester Comprehensive Cancer Center, and beyond.

Eckhard’s impact on education has also been invaluable for our undergraduate and graduate students and our post-graduate trainees.

We want to extend our sincerest condolences to his beloved wife Kristin and the entire Podack family. When the time is right we will gather to celebrate the life of our friend and scientific giant, Eckhard Podack.

Pascal J. Goldschmidt, M.D. Senior Vice President for Medical Affairs and Dean University of Miami Miller School of Medicine CEO, University of Miami Health System Scientifica is the first undergraduate scientific magazine at the University of Miami. The purpose of Scientifica is to serve the University of Miami community – by presenting medical, engineering, and scientific ideas through the ideals of scientific journalism. As a premier undergraduate scientific magazine, we aim to spark the curiosity, innovation, and passion in the students pursuing the science, technology, engineering, and mathematics (STEM) fields.

The University of Miami’s FIRST Undergraduate Scientific Magazine

Staff Victoria A. Pinilla Escobar, Editor-in-Chief Jennifer V. Chavez, Managing Editor Michaela E. Larson, Design Director Henry Mancao, Copy Chief Andrew Rubio, Copy Assistant Sara Friedfertig, Copy Assistant Natalia Beadle, Photo Editor Sumanth Potluri, Business Director Pierrah Hilaire, Marketing Director Yukthi Kodali, Marketing Associate Roger Williams, M.S. Ed., Editorial Advisor Zil Patel, Editor, Innovations in Science David Lin, Writer, Innovations in Science Daniel Brzostowicki, Writer, Innovations in Science Veronica Andresini, Editor, Did You Know?

Natalie Massiah, Writer, Did You Know?

Rick Lin, Editor, News Catherine Mulloor, Writer, News Valentina Suarez, Writer, News Madiha Ahmed, Editor, Ethics in Science Gabrielle Eisenberg, Writer, Ethics in Science Barbara Puodzius, Writer, Ethics in Science Rohan Badlani, Editor, Journals Anum Hoodbhoy, Writer, Journals Jude Jakari, Writer, Journals Renuka Ramchandran, Editor, Health Science Anthony Pumilla, Writer, Health Science Joseph Bonner, Writer, Health Science Kriti Sood, Editor, Freshman Advice Michelle Xiong, Writer, Freshman Advice Shivani Hanchate, Writer, Freshman Advice Ethan Freire, Writer, Freshman Advice Peyton Brown, Editor, Research Mirza Baig, Writer, Research Aalekyha Reddam, RSMAS Correspondent

Since we were founded in the spring of 2014 our magazine has been recognized as the best new student organization by the Committee of Student Organizations (COSO) and is approved for distribution throughout the Coral Gables, Medical, and RSMAS campuses by the Board of Publications. Our magazine is produced four times a year, twice a semester. Print Farm printed 2,015 copies of the magazine on 8.5 x 11 inch, 80lb coated text paper. Text used in the magazine is Agency, Calisto and Segoe. Our designers used Adobe Creative Suite CC software InDesign, Photoshop, and Illustrator to design all pages. For additional information, please visit umiamiscientifica.com.

Srividya Kannan, Photography Connor Verheyen, Graphic Design Yumi Suh, Graphic Design Savannah Geary, Graphic Design Manuel Pozas, Graphic Design Kelsey Vonk, Web Design

All of our articles, photographs, and illustrations are copyrighted by the University of Miami.

Scientifica is identified by ISSN 2381-6552.

John Wiltshire, Radio Show Host Lydia Livas, Radio Show Host

“We’re Putting Coral Gables Back on the Map!” - Natalie Massiah

If one of your peaceful mornings was interrupted by the loud clanking, banging and ringing of machines, congratulations! You have witnessed one of the many construction projects that are on campus. One of the more prominent of these projects is the University of Miami Health System, with its latest project being built next to the Ponce de Leon parking garage. With the slogan “We’re Putting Coral Gables Back on the Map,” the anticipated health center is expected to open its doors in the fall of 2016 and will hope to better serve the people of Coral Gables, South Miami and Kendall.

Mr. Benjamin Riestra, chief administrative officer of the Lennar Foundation Medical Center, states that its purpose is to “provide an environment of care that provides patient dignity and compassion for patients and their families.”

The Lennar Foundation Medical Center officially began when the university was granted 50 million dollars from the Lennar Corporation to create a health care service that would provide education on health care, patient care and extensive research. The building hopes to be an academic outpatient health care center, which basically means that services will not require hospitalization. This is done not to minimize patient-

doctor interaction, but to allow the patient to return to a place where they would be more comfortable.

As Riestra put it: “We are here for the patients. The patients and their families don’t want to come here. It’s not their choice in the morning to wake up and come to any healthcare facility. They are trusting us in their care and it’s incumbent upon us to deliver that care with dignity and compassion. If we forget that, we fail as healthcare providers.”

Pre-meds, as you may (or may not) know: the future of healthcare is constantly changing, and the way that we deliver healthcare will follow suit. In Riestra’s words: “We’re planning this building for 30 years. If there is one thing I am certain, it’s for uncertainty of what healthcare is going to look like in the future. If we don’t plan strategies to make ourselves future proof, we’re not doing a good job. We’re not benchmarking ourselves to other healthcare institutions.

We’re benchmarking ourselves from a consumerism perspective to other industries — for example, the restaurant industry. Why is it OK for us to think a patient can wait one to two hours for an appointment, when as consumers we have no regard for a restaurant that seats us an hour late if we have a reservation? What

happens at the 20 minute, 30 minute mark? Well, you leave or complain until they see you. Healthcare is not like that. Why do people think its OK to wait one to two hours? It’s not! We all live our everyday lives with certain expectations and demands on other industries, and we need to put those demands in ourselves.”

That being said, this building will also provide lots of volunteer opportunities for resume builders: Riestra plans on incorporating programs with different departments of our academic mission to provide internships in healthcare management, nursing and engineering for a better prepared and successful future.

“They are literally at my back door, and we’re all part of the same family, so why not help them?” he recounted. “When I got my first job, I was finishing up my MBA and I was fortunate enough to meet former CEO of Jackson-Memorial Hospital Ira Clark. I walked into his office and he asked me, ‘What do you want to do?’ and I said, ‘I want to be a hospital administrator like you.’ He then replied, ‘What do you know about hospitals?’ and I said, ‘What do you mean? I studied the books and my classes,’ and he said ‘You don’t know anything.’ — and he was 100 percent right. ‘I’m going to tailor an academic residency program in all the different areas of the hospital within the next year, and that’s how you’re gonna learn.’ And that is exactly how I learned. The books had zero life experience compared to the real thing.”

The foundation sets itself apart from others because it is an academic health system; research and teaching are part of their mission of delivering healthcare. Academic medicine is unique because it is a research-based, precise branch of medicine that contains more intense protocols and clinical trials.

Experiments are evaluated, results are challenged, and innovative procedures are developed in order to further enlighten the community. “We are at the forefront of innovation and research, and we are able to translate ‘from the bench to the bedside,’” Riestra explained, “a huge benefit for patient care and earlier exposure to new practices and improvements in outcomes compared to nonacademic medical centers.”

The man behind the plan is Dr. Pascal J. Goldschmidt-Clermont, who also happens to be the dean of the University of Miami Miller School of Medicine. Dean Goldschmidt is a renowned cardiologist who has had remarkable leadership positions (namely, chief of the cardiology department at Duke University) and involvements with medical relief efforts in the 2010 earthquake in Haiti. On being asked how one man could do so many things at once, he replied, “You know, the key to a successful career is to bring value to your fellow humans. As a physician, you see patients ... There’s a sentence in the play “Wicked,”

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that I always found fascinating: ‘I’ve changed for the better, because I knew you.’ If you manage to transform the life of the individual and they are able to catch the feeling of it because they knew you, they know they would want people to have the same experience.”

Goldschmidt hopes that the Health System thrives within the next ten years. By providing ambulatory care, implementing cost effectiveness, and creating a consistently excellent patient care experience, UHealth aspires to be a one-stop healthcare center for the people of Coral Gables. “We are the safety net; we are the people to come to when nothing else works, and we have to create solutions ... We have to make sure we provide two things: hope and opportunity.”

Goldschmidt reiterated: “It’s a job, and if we fail to provide those two things, we fail as health care providers.”

On behalf of UMiami Scientifica, we wish the best of luck to Mr. Riestra and Dean Goldschmidt to their next adventure, and we look forward to the grand opening in Fall 2016!

The term I had the pleasure “lysergic acid of interviewing Dr. diethylamide” Juan Sanchez-Ramos, sounds like professor of neurology, something you would pharmacology and come across on an psychiatry at the organic chemistry test University of South — if LSD did show up Florida. He serves as on your test, you would the medical director of hopefully know the reaction the Parkinson’s Research - Valentina Suarez mechanism between lysergic Foundation. A few years ago, he acid and diethylamide. That it conducted research regarding the has the chemical composition of therapeutic effects of banisterine — a C20H25N3O. That the (R)-stereoisomer psychoactive drug derived from a vine plant is more potent than the (S). That its chemical — on Parkinson’s disease at the University of Miami’s structure is similar to that of the ergot alkaloids.

Miller School of Medicine.

You would also know that LSD’s key ability to bind to After graduating from the University of Chicago, Sanchezserotonin receptors results in a bewildering reaction within the Ramos moved to Europe with aspirations of becoming an mind — the alteration of consciousness. artist. It was there that he became exposed to the world Perhaps you’d be relieved to know that lysergic acid of hallucinogens. Interested in how artwork becomes diethylamide won’t be on next week’s test — and that’s because more “fragmented, symmetrical, and mystical” when an this molecule has been banned for almost 50 years. artist consumes LSD, Sanchez-Ramos began studying the First synthesized in 1938 by Alfred Hofmann, LSD “mechanisms of hallucination.” His curiosity eventually led him became widely distributed by psychiatrists throughout the to pursue the study of psychopharmacology.

1940s, 50s and early 60s. Then, in 1967, LSD was banned in “At that time, I had really wanted to work on how LSD the United States; as a result, all research on the drug’s effects works on the central nervous system to alter consciousness. was discontinued. LSD was placed in “Schedule I” under the But, in 1970 all research on LSD was banned. It was Controlled Substance Act for its high potential for abuse and impossible,” Sanchez-Ramos recalls. Despite this hurdle, no apparent medical use.

Sanchez-Ramos has conducted promising research on other Although born in the laboratory psychoactive substances — namely psilocybin, banisterine and and intended for research and ibogaine.

The use of the psychotherapy, LSD has weaved its Banisterine is a psychoactive compound that is prepared psilocybin mushroom way into popular culture. Commonly from the South American vine Banisteria caapi. It was hailed is documented as far known as “acid,” LSD has lived in in the 1920s as a “magic drug” due to its ability to alleviate back as 7,000-9,000 the underground ever since. Now, years. certain symptoms of Parkinson’s disease. Today, a remnant of with more countries moving towards banisterine’s therapeutic effects remains — we would not have the decriminalization of many discovered the benefit of administering levodopa to patients psychoactive drugs, the possibility of conducting research on with Parkinson’s disease had it not been for studies conducted drugs such as LSD is resurging. on this psychoactive drug. Recent studies have shown that, in But, what does this mean for modern medicine? low dosages, banisterine significantly improves motor function To many, the name LSD brings to mind vivid images and rigidity in patients with Parkinson’s. of the 1960s “hippie” era. Many have forgotten that it was Ibogaine, an indole alkaloid found in the root bark of not meant to be consumed for leisure — it was meant to be shrub called Tabernathe iboga, has been found to be to be taken in the psychiatrist’s office. We have also forgotten that, potentially useful in promoting long-term abstinence from although drugs like LSD are banned, they have been important addictive substances such as cocaine. Claimed by addict selfin the road to discovering novel treatments for conditions such help groups as beneficial in overcoming drug craving, as Parkinson’s disease.

Ibogaine may help reestablish homeostasis in neural systems that have been impaired in their capacity to experience pleasure, as shown by recent studies.

“There are more and more applications of psychedelic drugs to medical purposes that are not being allowed to be studied,” Sanchez-Ramos explained. “For example, psilocybin, derived from the magic mushroom, might be a good way treat PTSD, based on what we found while conducting animal studies. And, psilocybin has shown to be very helpful in people who are dealing with end-of-life issues, because it makes them aware of the transcendental, it makes one see the unity of all, and so it can be very, very helpful in dealing with one’s mortality.”

There is a clear benefit associated with psychoactive drugs. Why then, are these drugs deemed as having no medical use?

The answer is decidedly complicated.

First distributed among psychiatrists, drugs like LSD sparked interest in governmental agencies like the CIA. Used for experiments in mind-control before finding its way into the hands of the general public, psychedelics began to develop a negative stigma: “They were banned for social and political reasons,” noted SanchezRamos. “It actually leaked out Francis Crick, from CIA activity and became Nobel Prize-winner and distributed widely and so father of modern genetics, many people were taking it in was under the influence of a time where there was huge LSD when he discovered unrest. It made you see an the double-helix strucalternate reality; it made you ture of DNA. question things such as ‘Why do things have to be this way?’

And, that is considered to be somewhat of a threat. It’s kind of a political view. Since it got way out of hand, and there were too many people using it that didn’t know how to use it, the drug completely got discredited.”

Looking back on the history of psychedelics, ancient cultures worldwide used them under ritualistic and guided settings. Likewise, these drugs are meant to be employed under professional supervision. “All pharmacotherapy, and even psychotropic agents that alter consciousness, perception and feeling, should always be dealt in conjunction with

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psychotherapy. These drugs can be very scary, frightening, and even dangerous because of your altered perception. These agents should never be selfadministered, they have to be given under guidance,” advised Sanchez-Ramos. “For example, this is not a true hallucinogen but it is very therapeutic agent: MDMA. It can be very useful in marriage counseling. But you don’t just give a couple MDMA and send them to the woods; you sit down with a psychotherapist that is supervising the MDMA session.”

There is big benefit to be uncovered — or, perhaps, recovered — in psychedelic research. With legalization and decriminalization of formerly illicit substances becoming increasingly common, we may soon see a surge to conduct research on psychedelics. SanchezRamos contended, “Pharmaceutical companies would be very glad to work with these substances. There are novel therapeutic agents that they could develop. There are a lot of variations on these structures that could be made.”

We may soon find ourselves in the midst of the rebirth of psychedelics in modern medicine. “I’m amazed because I’m part of the generation that thought it would always be underground,” he remarked. Truly, the shift in ideology regarding psychedelics is as revolutionary as their newfound applications. In the near future, we can hope to see such formerly stigmatized substances finding widespread acceptance in the medical field — until then, such hallucinogens have a lot of ground to cover in order to change minds, not alter them.

In the 1950s, the United States government launched a secret program called MK Ultra where heavy dosages of LSD were administered to CIA employees, doctors, and to the general public, without their knowledge, in an attempt to study mind control and chemical warfare.

Is a Cure for Type I Diabetes Almost Here?

According to the Juvenile Diabetes Research Foundation, approximately three million Americans have Type I diabetes. This is a condition where the body does not or cannot produce the insulin necessary to maintain a constant blood sugar level. For diabetics, the constant insulin injections can be a burden, but perhaps a new research project can offer a cure. The Diabetes Research Institute at the University of Miami Miller School of Medicine has shown that islet cell transplantation can restore natural insulin production in those with Type 1 diabetes. The results of the research show that almost all patients are able to discontinue their insulin shots after the procedure and still maintain a normal blood glucose concentration. However, the new islet cells run have a low survival rate after transplantation. Researchers have many theories as to why this may happen, including a temporary lack of adequate oxygen immediately after transplant within the infusion site, harmful inflammation at the transplant site and the use of harsh anti-rejection drugs. However, researchers are presently developing cutting-edge techniques — namely the utilization of aptamers and cell encapsulation methods — to combat such aforementioned problems.

Researchers are developing aptamers specifically to aid in the process of islet cell transplantation. Aptamers are small, naturally-occurring DNA or RNA molecules that, as discovered recently, can be artificially created to “flag” the insulin-producing beta cells. This allows researchers to record their levels of function; provide targets for cell imaging procedures; and potentially deliver immunosuppressants to the target cell, which could aid in solving the problems associated with the islet cell transplant rejection. This would ultimately allow the transplanted cells to function properly, alleviating the

- Catherine Mulloor

problems associated with Type 1 diabetes. Although aptamers are not a novel invention, this is groundbreaking research — prior to this development, there is no way to locate or quantify the insulin-producing cells in the body. Additionally, aptamers are cheap and easy to make.

If this research proves successful, the applications of these aptamers could be used to prevent problems with transplant rejection.

Another method scientists are working on that may prevent islet cell rejection is the use of cell encapsulation methods. Through collaboration with the Diabetes Research Institute at the University of Miami and the École Polytechnique Fédérale de Lausanne in Switzerland, researchers have developed a new cell encapsulation method in an effort to protect the transplanted insulin-producing cells from destruction by the immune system. In their recently published journal article, they demonstrate that their encapsulation method allows efficient protection to the islets without compromising function of the cells. This new process overcomes previous challenges with the encapsulation of islets, such as large capsule size (which only protects the large islets) and the inability to get encapsulated islets into sites with oxygen and nutrients that support the transplanted cells. These researchers were able to transplant encapsulated cells that had an extra layer of protection, while also maintaining the cells’ function.

Although the transplant of islet cells has met some challenges, new research has led to the use of aptamers and cell encapsulation methods to prevent transplant rejection. These various research projects taking place at the University of Miami are providing hope for many Type 1 diabetics that a cure may soon be found.

The Science of Being Sick

- Natalie Massiah

The beginning of every semester brings new things: a fresh start, new adventures and , of course, that infectious plague that seems to destroy half of the class in the first two weeks. Symptoms from runny nose to high fever swarm the campus, and nobody seems to know who is next. While many continue with their daily routines, students walk around campus in fear of being infected. But what actually makes us sick? And if we already got sick before, why do we get sick again? These questions, as well as some tips on how to get better and stay well, are answered by examining the infections that plague us.

So... What’s Getting Me Sick?

Over the course of your lifetime, you will encounter a great deal of viruses, bacteria and other microorganisms; some can be harmless and some can be nearly lethal. It would be preferable, of course, for our study, work and sleep patterns to not be thrown off track by getting sick. However we may wish for this to be the case, the hope of never getting sick is highly unrealistic. There is no need to panic when you actually do end up with a fever and a pounding headache. In case your trip to WebMD isn’t enough for you, we’re going to give you a rundown of common diseases you might encounter at college, as well as symptoms, what to do when you feel sick, and tips on preventing another bout of sickness.

The Common Cold The common cold is a Picornavirus — specifically, a Rhinovirus — and is most likely the most “common” sickness you will encounter during your undergraduate career.

According to the Mayo Clinic, symptoms range from a runny nose, sore throat and fatigue, to a low grade fever. It can be contracted through infected body fluids such as sneezes, which produce droplet nuclei that become airborne and are easily taken in by our respiratory system. Fomites such as utensils, surfaces and hands can harbor various microorganisms. If you were to touch a contaminated fomite and then touch your eyes, nose or mouth, you would be infecting yourself unknowingly.

Upon contact with any of the aforementioned orifices, the microorganism is able to enter your body. Once inside, the foreign body binds to the epithelial cells that are meant to protect you providing it with a moist environment. In an attempt to kill the “invader,” your body releases distress signals that cause the body to heat up — heat denatures proteins and therefore can break down the virus’s outer casing (capsid), killing it. The virus prefers to be in a cooler environment and resides mainly in your nasal cavity — a region constantly receiving cold fresh air every time you breathe. The virus is

able to survive here and cause sneezing, which leads to a runny nose and fatigue. Microorganisms are opportunistic and, in cases when your immune system is compromised (as in extreme stress), you are much more susceptible to infection. Since the RNA of the virion behaves as mRNA, it has the ability to replicate quickly using the components within the host cell to manufacture additional viruses. There is no way to predict which strain, out of more than 115, will run rampant next; this makes developing a vaccine for the common cold nearly impossible to accomplish. There is, however, hope for us all: We can take precautions to avoid spreading disease, such as not coughing or sneezing in our hands but rather in our shoulder or a tissue. Simply washing your hands after exposure can often mean the difference between getting sick and not.

The Flu The flu virus is an Orthomyxovirus, and is a contagious disease that spreads like the common cold. It is known to have a short period of illness, and will generally run its course in seven to 10 days. Symptoms include severe aches in joints and muscles, weakness or fatigue, a high fever (which can be a key factor in differentiating the cold and the flu) and a dry cough that produces no mucus. Much like the common cold, the flu can also spread through contact with infected body fluids, but is mostly spread through coughs and sneezes. Due to the thousands of droplets expelled with a single sneeze or cough, the flu can spread rapidly among individuals.

The flu virus contains its own unique set of RNA that is designed to make us sick. Due to mutations in several different subtypes of the virus, each strain presents with a different pathogenic profile. Since heat can denature the proteins and kill the virus, the presence of a low fever is actually a good sign! In fact, many of the symptoms present during the flu are not the virus’s doing, but our body’s natural defense mechanism. Think of it as having your own army fighting the virus inside of you in order to keep it under control.

Unsure on whether you have the flu or not?

Take our quiz, and find out!* Was your onset of symptoms sudden or gradual?

A. Completely sudden. I feel like a mack truck ran me over.

B. Gradual. Honestly, I’ve been feeling this way for a while now.

How do you feel in general?

A. I feel horrible. I don’t even

know why I’m taking this quiz.

B. I don’t feel well, but I don’t feel like death.

Have you had a fever of above 100 degrees?

A. YES!

B. No.

* This is not a substitute for medical advice, diagnosis, or treatment. If you think you may have the flu please seek medic

Bacterial Infections Although bacterial and viral infections appear very similar, the causative agents are very different. Bacteria are complex, single-celled microorganisms that can reproduce on their own. They have the ability to survive in different environments, even in extreme temperatures. Bacteria that reside in or on our body (called natural flora) help with digesting food and nutrients as well as fighting off other illnesses alongside our immune system. Microbial infections are spread through contact of infected hosts (including kissing or sexual contact), contaminated surfaces that are commonly used by multiple people (also including food and water), and contact with infected animals (such as pets, livestock, fleas and ticks). Some notable bacterial infections that you might see on campus (and hopefully don’t get infected with!) are strep throat, staph infections and E. coli. Symptoms of bacterial infection include sneezing, fever, vomiting and diarrhea (depending of the pathogenesis of the bug), all of which are a result of our natural body’s defense system. Unlike viruses, bacterial infections can usually be treated with antibiotics; however it is important to keep notice of the illness in case it persists. Prolonged infection of streptococcal pharyngitis (strep throat), for example, can lead to other severe diseases such as scarlet and rheumatic fever, even if you are being treated with antibiotics.

How Did I (Scientifically) Get Sick?

Now that we’ve explained what viruses and bacteria are and what they do to you, it’s time to get down to the scientific stuff: How did I actually get sick? When a particle from a sneeze or cough reaches another human, it usually attaches to the cell wall with the help of specific proteins. Upon attachment, the virus then injects genetic material into the host cell. Once inside, the viral DNA or RNA goes through a process of uncoating, replication and assembly. When the new viral DNA or RNA is made, the host cell releases it either by breaking apart, dying, or allowing the new viruses to bleb out

through the plasma membrane. These new viruses then go on to attack more cells, creating a cascade of events that makes you sick.

The most common transmission of infectious bacteria is via the fecal-oral route. It is important to note that less than 1 percent of bacteria actually cause disease in a person, but with a suppressed immune system this number can be larger.

Once a bacteria has entered a suitable environment, it is able to reproduce on its own through a quick process called fission, where one bacterium becomes two. Unlike viruses, most bacteria replicate outside of a host cell. If the host becomes overwhelmed or the bacteria has started to invade tissue or organs, disease symptoms will begin to appear. If you suspect that you have a bacterial infection, you can usually be treated with an antibiotic that will kill the bacteria completely, or stop it from reproducing — unlike with a viral infection.

Because your body has trillions (yes, TRILLIONS!) of cells that are constantly being renewed, as well as an immune system to combat disease, the chance of getting sick is minimal as long as you maintain a healthy lifestyle.

The Best Way to Get Better Despite better judgement and advice, many students continue to go to classes even if they are ill. However, the Student Health Center on campus advises students NOT to go to classes if they feel a bug coming. Health is important to survival, and going to class can put your health, as well as other students’ health, at risk! In addition to checking in with the Student Health Center, there are a ton of remedies you can use at home. Drinking lots of fluids and getting rest are the most recommended, as well as taking proper medication to address the illness when available. The Student Health Center is open on weekdays from 8:30 AM to 5:00 PM and Sundays from 11:00 AM to 4:00 PM. Appointments are made at mystudenthealth.miami.edu, and walk-ins are welcomed. Be sure to get plenty of rest, or watch plenty of Netflix, however you choose!

Mostly A’s: Do you have a cough? If so, what type is it?

A. Dry and non-productive. I feel like I’m coughing up a lung over here.

B. Definitely productive, tissues galore!

edical attention.

Do you have a sore throat?

A. No, that’s basically the only

thing that isn’t bothering me.

B. Yes, I can barely speak!

You probably have the flu! According to the CDC, you may have the flu if you have all or some of these symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headaches, extreme fatigue and chills. If you think you have the flu, try to stay home and avoid contact with other people. Drink plenty of fluids and feel better!

Mostly B’s: You probably have the common cold! The CDC states that you too should stay home while you’re sick, and avoid close contact with others to avoid spreading.

You should see a doctor if you get a temperature higher than 100.4, your symptoms last more than 10 days, or if they are severe or unsual. The #1 way to avoid catching a cold is washing your hands often with soap and water.

Join the Colombian Students association Everyone is welcome!

Email for meeting dates: Colsaum@gmail.com Facebook Group: UM COLSA

Get Smart radio show is now hiring show writers and social media personnel. Tune into WVUM 90.5 every Monday at 7pm!

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o r p e l e s o H t w o R ( d r o r

D W

Did You Know?

Did YOU know?

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Have you ever wondered how many calories we burn while we sleep, or why we snore? Have you ever wondered why rainbows exist, or why it’s difficult to remember dreams? Our newest section, “Did You Know?” explores the simplest answers to life’s toughest questions. Is there anything in particular you’d like to know? Comment on our facebook page, instagram or even snapchat, and your question may be answered in our next issue!

- Veronica Andresini

Did you know?....

How the human eye is able to see the rainbow?

The rainbow is a meteorological and optical phenomenon that occurs when light from the sun shines through the millions of minuscule rain droplets that form a barely visible mist, or even when the sunlight peeks through the clouds during a drizzle. The sun emits a number of electromagnetic waves, three forms of which are released: ultraviolet light, visible light, and infrared light. Ultraviolet and infrared wavelengths, expectedly, are not visible to the human eye. Visible light, or visible spectrum, is itself comprised of seven different-colored wavelengths: red, orange, yellow, green, blue, indigo and violet — the colors of the rainbow.

However, the human eye perceives them all at once as white light. In order to see the different colors, the wavelengths must be separated — exactly what happens when sunlight shines through water droplets. The separation of the wavelengths is made possible by the phenomenon of refraction.

Refraction is the passing of a wave of light from a fast traveling medium (in our case, air) to a slower one (water). As a wave of light enters a water droplet, this shift causes it to bend. As the wave leaves the water droplet, refraction occurs at a specific angle — this allows the seven wavelengths of light to separate into individual bands and materialize into a colorful rainbow.

Did you know?....

Why we only see one side of the moon?

The reason that only one side of the moon ever faces the Earth is easily understood by examining their movement within the solar system. Both the Earth and the moon fulfill a period of rotation and a period of revolution. The rotation movement involves the spinning of an astronomical body on itself around an imaginary axis. For example, Earth rotates around an axis that passes through the North and South Poles. As Earth performs its rotation movement, it simultaneously carries out a period of revolution. This means that it follows an elliptical path (an orbit) around the sun. The Earth rotates from west to east in 24 hours, and it takes approximately 364 days to complete one orbit around the sun.

Concurrently, the moon rotates on itself and follows an orbit around the Earth, thus following it around the sun. The moon takes approximately 28 days to complete its orbit — the exact timespan needed for its rotation. This is what is so peculiar about the moon’s dynamics compared to Earth: The moon’s rotation and revolution period have the same time span. This phenomenon is called synchronous rotation. It is a result of gravitational forces that cause the rotation of a smaller body to gradually slow down until it is synchronized with its revolution around the larger body. In fact, the moon spun much faster millions of years ago, but slowed down because of Earth’s gravitational influence. If the moon did not rotate, its far side would eventually face the Earth. However, because of its orbital and rotational synchrony, we only ever see one side.

Miniature Marvels Have you ever wondered how many things you interact with on a daily basis, but never actually get to see? Kasey Markel, a junior at the University of Miami stopped wondering and started seeing.

A

fter completing his electron microscopy class last fall, Kasey was inspired by the beautiful images he got to capture, and decided to make it part of his daily life. Kasey is an undergraduate researcher and microscopy technician at the Miller School of Medicine, where he is currently involved in transplants involving Schwann cells. He is also a teaching assistant for this year’s scanning electron microscopy class. The most interesting part of his job? “Peering into the unseen worlds that exist all around us, discovering nature’s hidden minutiae.”

(Right): Sarcomeres are the fundamental unit of muscle in nearly all animals, and are composed primarily of actin and myosin, as well as titin to prevent overstretching. The strong dark lines within the wide light section are Z bands, composed of actin and titin, which separate adjacent structural components along the major axis of the muscle fiber. The broader dark bands are the sections of overlap between actin and myosin, and the faint lighter region in the middle is the H zone, where only myosin filaments are present.

When muscle is contracted, myosin pulls on actin, drawing adjacent Z bands closer together, resulting in shortening of the tissue.

(Bottom Right): Antheridia are the male reproductive structures of flowers, and will release pollen at maturity. This specimen was obtained from the red hibiscus in the Gifford Arboretum, and was imaged through extended depth of field reflected light microscopy, in which many images at different focal planes are correlated and combined into a resultant image. There were 20 separate focal planes in this image, amounting to over a gigabyte of raw data.

Of particular interest are the surface details of the pollen, which are widely used in identifying pollen from both living and plant fossils. Pollen has even found use as evidence in criminal cases, allowing for the tracking of items to specific locations of origin, often within a tolerance of only several hundred square kilometers.

(Above): Foot of a common honey bee under SEM. The distal segment of the foreleg is shown in purple, the tarsal in green. The claw, shown in blue, is a remarkably common structure in insect anatomy, allowing for standing and hanging on nearly any surface; however, it is less convenient for walking on flat ground. As such, when walking on smooth flat surfaces, the claw will retract and the bee’s weight will fall on the empodium, shown in yellow.

(Left): In even the most everyday objects, there are wondrous worlds hidden out of the reach of our senses.

Rendered here barely visible is the logo of a popular website as shown within a folder on a 577 pixel per square inch phone screen. Under the microscope, the coherence of the image disappears and the individual Organic Light Emitting Diodes (the OLED part of AMOLED screens, common in android smartphones) are visible.

Be My Eyes: Lend Your Eyes To The Blind

- Zil Patel

Imagine how difficult life might be for those who are blind or visually impaired. Even the smallest and most mundane tasks, such as checking the expiration date on a gallon of milk or finding something to eat in the pantry, could pose a challenge to those with limited or complete lack of eyesight. Thankfully, there is now an easilyaccessible way that smartphone technology can help these people with such frustrating yet essential daily tasks.

Be My Eyes is a free iPhone application that allows people who are blind to get in contact with a network of sighted volunteers who can assist them with tasks that require a pair of functional eyes. It is a nonprofit startup based in Copenhagen, Denmark and backed by the Danish Blind Society, the Velux Foundations and the software development studio Robocat. The goal of the app is to create a community that contributes and benefits from small acts of kindness. Be My Eyes has slowly transformed the way of living for the visually impaired since its development and debut in 2012. Although it has only recently gained momentum in the United States, this app has already successfully aided over 75,000 people worldwide. Be My Eyes currently has a network of more than 218,000 sighted helpers, and only continues to grow and revolutionize the world of medical assistance technology.

UMiami Scientifica recently spoke to the Denmarkbased team behind Be My Eyes, and here is what they had to say.

The idea behind Be My Eyes originates from a 50 year-old Danish furniture craftsman, Hans Jørgen Wiberg, who started losing his vision when he was 25.

Through his work at the “Danish Blind Society,” Wiberg recognized that blind people often need assistance with smaller, everyday tasks and that a “pair of eyes” could make a significant difference. In April of 2012, he presented the idea for an application at a startup event in Denmark. At this event, he met the rest of the Be My Eyes team and together they won the prize for “most innovative idea.” Since 2012, the team has worked diligently to make the app a reality. His wish is that the app will make both the everyday life of blind people easier and provide a new, flexible opportunity to volunteer. “It

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is flexible, takes only a few minutes to help and the app is therefore a good opportunity for the busy, modern individual with the energy to help others,” said Wiberg.

Through a direct video call, the app gives the blind user the opportunity to ask a sighted volunteer for help with tasks that require normal vision. The sighted helper “lends” his or her eyes to the blind user via smartphone.

The sighted helper is able to see and describe what the blind person is trying to show by filming with the smartphone’s built-in camera. That way, by working together, they are able to solve the problem that the blind person is facing.

The app is free and can be downloaded in the app store. It is currently only available for iPhone users, but an Android version is in the works. Anyone over the age of 13 is able to download it and become a helper!

Be My Eyes is unique because it is the only app that connects the visually impaired with sighted helpers via the camera in the phone. “The app makes it possible to get help at times where it might be inconvenient to get help from neighbors or friends, and you don’t have to go apologetically and ask for help,” says John Heilbrunn, vice chairman of The Danish Association of the Blind, who is also blind himself.

Future milestones include: Outreach: We wish to reach out to blind associations — even more blind people should benefit from our app!

Android App: We are working on an Android version.

Many blind users don’t have an iPhone, therefore we also wish to make the app available for Android. More than 10,000 additional users have already signed up for the Android version at http://bemyeyes.org/android.

Improvement of success rate: Right now only 9/10 calls are successful; we wish to make every call a success!

Better user experience: We wish to improve the system’s speed and accuracy so that a blind person does not have to wait long for a match.

There you have it. In just two easy steps of downloading the app and creating an account, you, too, can lend your eyes to the blind.

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the cutting edge:

r. Raymond Burke had a unique challenge ahead of him. Back in January, he was tasked with performing an operation on a young girl suffering from total anomalous pulmonary venous connection (TAPVC), a complex defect in the veins leading from the lungs to the heart. She needed an unusual surgical procedure to repair the deformed veins in order to survive. Cardiologists and a biomedical engineer at the Nicklaus Children’s Hospital, formerly the Miami Children’s Hospital, took MRI and CT scans of the girl’s heart and reformatted them to be rendered readable by a 3-D printer. A 3-D model of her heart was generated by a company in Atlanta and sent over to the hospital.

Elaborating on the benefits of such a model, Burke said, “I thought that holding and manipulating a flexible 3-D replica of this child’s heart might allow me to plan an operation that hadn’t been done before, configuring the necessary patches to create the exact shapes and dimensions to match her deformed pulmonary veins.” The surgery was a resounding success. The medical field is just one area that can be impacted by 3-D printing, a complex process that is not quite as easy as some people might believe.

According to Walter Puls — CEO of 3-D Chimera,

a local 3-D printing company in Coral Gables — the first thing to understand about “3-D printing” is that it is largely a colloquialism that laypeople use. A more accurate term for the process is “additive manufacturing.” The basic principle behind it is essentially the opposite of traditional forms of manufacturing, which often utilize a subtractive process — one starts with a chunk of raw material and gradually removes pieces of it in order to obtain the desired shape. Conversely, with additive manufacturing, one gradually adds layers of material in order to produce the desired model.

The most commonly referenced 3-D printing method is fused deposition modeling (FDM), which was the first process to have its major patents expire. After that, there was a gold rush of sorts to utilize the technology. FDM starts with raw material that comes in a thin filament, typically measuring either 1.75 millimeters or 3 millimeters thick (as per industry standards).

This filament is, more specifically, a strand of thermal plastic that is fed into an extruder which hangs above an even, solid surface where the material is eventually deposited to make the model.

The extruder has a thermistor and a nozzle: the thermistor heats the plastic to temperatures over 200 degrees Celsius, causing it to melt, and the nozzle deposits it below, where it dries and binds

edited; with PDFs, however, one typically can only view it or add text to the existing content. In the same spirit, the shape of the model in the STL file cannot be changed. It can be scaled up or down and different sections can be cut and printed separately but the overall shape and geometry cannot be manipulated.

There are some misconceptions surrounding 3-D printing technology which are no doubt rooted in sciencefiction. Puls likened people’s expectations to Star Trek’s replicator, a tool with which people imagine some sort of object and then watch as it gets made for them. Futuristic as it is, 3-D printing is not quite so refined as its fictional counterpart. One limitation of the printing process is that the machines are not fully autonomous — they still require human monitoring. Also, the products that materialize as a result of these 3-D printing processes aren’t usually complete when they emerge; human hands are often left to add the finishing touches. The most surprising truth is that the entire process is not as fast and easy as people sometimes imagine it to be.

With regard to medical application, Puls gave two general uses of this technology. The first involves using the technology to generate specialized, nonstandard surgical tools. Maybe a doctor needs a part that has a particular rigidity or perhaps he or she wants a nonstandard bend in a certain place along the instrument. Although this application of 3-D printing is undeniably useful, it is very competitive and has already been thoroughly explored.

Puls is interested in printing exact copies of internal organs from MRI or CAT scans of the diseased area of the patient, as in the case of Burke and his patient. A driving philosophy of modern medicine is the idea of minimally

three-dimensional printing to the layer that was deposited before it. The model is built this way, layer by layer. One of the limitations of this kind of process is that materials fewer than two millimeters thick cannot be made easily. For example if an architect is trying to make a model of an building, difficulties could arise if some of the thinner support features end up being too small to be printed via the same method as the model’s other components.

Additionally, the FDM process only supports unicolor printing. This characteristic poses no issue for functional models, but does impose limitations on artistic models or models that measure responses to finite elements such as heat or wind flow distribution. For these cases, broader spectrums of color might be desired and a method other than FDM would have to be used. Two such processes are the paper- and powder-based methods. The powder-based method can more easily make products with complex geometry, but the paperbased printers are relatively cheaper to use considering the fact that the main material is paper.

STL files are used to generate the models to be printed.

Puls likened this file type to PDFs for text documents. With documents saved as DOC files, the text within can be easily

- Daniel Brzostowicki

invasive procedures, in which physicians avoid making large incisions during operations. With this newfound technology, a doctor can have the diseased region printed to act as a model for surgical practice and preparation while being as unobtrusive on the actual patient as possible. The technology is especially useful in rare or unusual cases that may require some sort of novel, untested surgical approach in order to treat the patient. The main challenge involves informing — and, in some cases, convincing — insurers, doctors, hospitals and patients of the value of utilizing the technology. One would need a printer that costs about $350,000, material that costs about $10 per cubic centimeter, software that costs $25,000 and a 3-D printing specialist who would receive a salary of about $150,000 a year. Considering these costs, the hospital would need to charge about $2,000 or $3,000 for the product and process.

Although it may not be as glamorous as its portrayal in popular media, 3-D printing is an incredibly useful and, in some cases, vital process with the potential to revolutionize not just the medical field, but many other disciplines as well.

ar·ti·fi·cial in·tel·li·gence

noun the theory and development of computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.

H

- Jude Jaraki

ave you ever wondered how the face detecting feature on Facebook knew the right person to tag? Or how Siri knows what you’re saying and is able to talk back to you? Let’s not even get started with the self driving cars. To say technology has come far would be an egregious understatement. In our modern-day society, technology has integrated itself so deeply that it is unimaginable to even think of going without. How did technology reach this degree of invasiveness in society without us even realizing it? Perhaps it is because the prospect of automation is so enticing. But computer technology is not just replacing redundant and mechanical processes — it is also starting to replace procedures that require thought. Therein lies the premise of artificial intelligence, or AI. AI is a broad field of study which focuses on the creation and understanding of software that exhibits intelligent behavior. Philosophical issues do arise when trying to define intelligence and knowledge, but for the sake of computers, the Turing Test is used to determine intelligence. To pass the Turing Test, a computer has to have human-level ability in all areas of cognitive knowledge.

Essentially, the computer must be indistinguishable from a human. For this to occur, a computer must be able to store and access knowledge, use reason to draw conclusions from that knowledge, and learn by applying this knowledge in new abstract ways — all while communicating information effectively, usually through a human language. However, generalizing these three characteristics gives rise to

the notion that they are attributes and consequences of rational thought. The goal of constructing an AI can then fall into either one of two definitions of intelligence: to act and think like a human or to act and think rationally.

There is only a subtle difference, but profound societal consequences.

For a computer to act and think like a human gives it the ability to replace redundant human procedures. These include customer service phone lines, telemarketers and factory manufacturers. In today’s developed society and economy, much more of the population perform services that require abstract thought, inventive thinking, and the ability to add onto existing knowledge. These people work in academia, industry research and development, and the like. They are society’s creators and innovators — this explains why they have not yet been replaced. As of now, computers are replacing jobs consisting of manual tasks as a result of their ability to think and act humanly, albeit on a basic level. However, computers have not quite made the leap to rational thought or abstract learning, though they are starting to. This is the point at which the most profound criticisms arise — even surfacing in literature more than half a century old. Eerily clairvoyant, Kurt Vonnegut’s first novel Player Piano is a dystopian story exploring the consequences of a society that had most of its working class (in this case, factory workers) replaced by machines because it was cheaper to have machines perform such menial tasks. Vonnegut described the society as having gone through a second Industrial Revolution, where the first was a revolution that devalued “muscle work” while the second devalued “routine mental work.” But it is Vonnegut’s prophecy of a third Industrial Revolution that is truly foreboding: “devaluing human thinking.” That is the theoretical point at which machines will completely replace the human workforce — a truly catastrophic event. Thankfully, research and AI technology is far away from that point. However, that does not stop Elon Musk, CEO of Tesla, and Stephen Hawking, renowned theoretical physicist, from cautioning against the possible threats AI poses, and promoting AI safety. Despite this farsighted concern, AI development continues to push computer technology past the boundaries of what we only considered science fiction.

One of the subfields on the forefront of AI development is machine learning — getting a computer to do an action without explicitly programming it to do that action. This is the idea behind the self-driving car, facial detection, speech recognition and so much more. Machine learning incorporates both supervised learning and unsupervised learning. Supervised learning consists of processes that give the machine example inputs and outputs then leaves it on its own to learn the rest (exemplified by support vector machines and neural networks). Support vector machines are given a set of data which they must classify according to its algorithm, categorizing it according to the given data along with

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further extrapolation. Neural networks are an attempt at modeling the AI after a biological neural network, the most pertinent of which being our brains. Given a set of inputs and outputs and a complex relation between the two, neural networks will find patterns in the data to connect the inputs and outputs.

Unsupervised learning gives the machine no directive in its pre-programmed algorithm, forcing the machine to figure out the desired outputs from the given input — exemplified by deep learning. Essentially, the machine is supposed to decipher a pattern within the data in order to derive the algorithm. Deep learning does not rely on a set of examples for its logic extrapolation. Instead, it uses its set of algorithms to model abstract objects into data using sample architectures. For example, a picture might be viewed as a vector of intensity per pixel or as its edges and regions. Using either of these methods, depending on the algorithm given, a computer can understand and see the picture manifest in manipulable data.

This is the basis for facial detection and recognition software. AI researchers are pushing for more reliance on unsupervised learning over supervised learning because unsupervised learning will ultimately drive technology to develop a human-level AI. Once a machine reaches human level AI and after it passes the Turing Test, two ethical issues have to be considered, human safety from AI being a primary concern. First is machine ethics, the moral behavior of these AI machines. Undoubtedly, these machines will be held to the same moral standard as humans would; however, since they are designed by humans, they may come programmed with ethical constraints that would eliminate the issues surrounding their morality.

The algorithms set for the machine determine its ethical outcomes. There is a central decision tree, which dictates the flow of information through these pre-programmed algorithms. Second is roboethics, the moral behavior of the humans designing these machines. This focuses more on humans than does its counterpart; it entails moral behavior with components such as dignity, human rights, equality and respect for cultural diversity. As AIs continue to develop, the humans who program them must be more and more cognizant of the societal impact this technology holds. As AI becomes more pervasive in the economy, AI safety should focus on the environmental effect these technologies have, their consequences on the socioeconomic gap and, particularly, the resultant dehumanization of humans. These are all extremely profound issues that may arise with abuse of this technology, and it is humanity’s ethical responsibility to design them such that proper safety standards are in place.

- Rohan Badlani

nanophotonics: When the conventional laws of physics are bent, the possibilities are endless — as are the challenges. Combine that with a playing field that is essentially invisible to us, and we are looking at an entirely new ballgame.

Nanophotonics is one such area wherein up and coming research at the University of Miami is leading to breakthroughs that can change the way our world functions.

Nanophotonics falls under the umbrella of nanotechnology, which as a whole involves extensive interdisciplinary research between scientists of all backgrounds, from medicine to engineering. Nanophotonics focuses on the interaction between light and matter on a nanoscopic scale. This field is the primary focus of the laboratory of Dr. Sung Jin Kim at the University of Miami College of Engineering.

While the interactions between light and matter are well understood in physics, working on such a small scale results in phenomena that differ completely from what is expected. Specifically, Kim explores the applications of nanomaterials, nanostructures and nanodevices. Using nanophotonics, he develops energy devices, such as, specifically solar cells, and improves the functionality of currently available sensor devices. Using tiny semiconductors that range from 2 to 10 nanometers in size, Kim hopes to make a solar cell that can be specially tailored to exhibit certain optical and electrical properties that would optimize energy efficiency. Due to properties unique to nanoscale devices, the same semiconductor can be modified to have a variety of absorption spectra. This allows for the cell to be modified so it can target specific frequencies of light that allow it to absorb as much of the sun’s rays as possible.

Through the study of plasmonics (an area of nanophotonics concerned with the use of metals), Kim is able to utilize the strong absorption qualities of nanoscale particles

It’s the next [small]

thing.

of metals to create sensors. For example, a small particle of gold would absorb green light and give off a pink coloration. However, this can be manipulated by coating the outside of the metal with other materials. As a result, the metal would be able to absorb different colors of light. But, it does not stop there.

Kim actually works outside of the visible light spectrum to tune a sensor to other frequencies on the electromagnetic spectrum, such as infrared waves. He is able to do this by changing the size and nanostructure of the sensor. These infrared sensors even have military applications — they can be used as a form of night vision that can detect artificial structures.

The endless possibilities in store and the appeal of exploring the unknown fuel Kim’s drive to study this relatively (and quite literally) obscure field of applied physics. Many of his experiments involve creating ideas without any visual capabilities and then realizing their efficacy through the results. Assumptions are thrown out the window; the results of his experiments are often wildly different from initial hypotheses. The recent proliferation of nanoscale technology is encouraging growth in interdisciplinary studies. However, with this surge in interest comes the requirement of a more holistic curriculum for those entering the field.

This emerging area of research is truly unique and offers opportunities like no other to students who possess the motivation and patience to work in a field that is only recently taking flight. Kim recommends for all those wishing to enter the nanoworld to develop a strong background during their undergraduate education by taking classes related to the subject. The novelty of nanophotonics lends itself to an exciting research experience that can inspire and captivate the minds of not only undergraduate and Ph.D students, but also that of the world as a whole.

Growing Without Oxygen: The Next Cure for Cancer?

- Anum Hoodbhoy

The process of protein synthesis — the ability of cells to generate proteins via transcription and translation — is a topic which has been very well studied in the fields of microbiology and molecular biology for years. Our understanding of how a cell has the ability to translate ribonucleic information to generate proteins (otherwise known as the “building blocks of life) is a discovery which has not only been fundamental to our understanding of how basic cell processes work, but has also continued to be a hot topic for ongoing scientific research and studies. From the department of biochemistry and molecular biology at the University of Miami Miller School of Medicine, Dr. Stephen Lee has taken this topic of study to another level. With his ongoing cancer research at the Sylvester Cancer Center, Lee analyzes the biochemical mechanisms of cancer cells and discovered that cancer cells have the ability to activate an alternative protein synthesis machinery which allows them to generate proteins in low oxygen tensions (otherwise known as hypoxia). This new discovery allows scientists to investigate a novel process which is different from our current understanding of protein synthesis in adult epithelial cells: dependence on oxygen for protein synthesis and lethal intolerance to hypoxic conditions.

To further explain the process, Lee described how a cancer cell grows. He explained that a cancer cell has different layers; initially, the cell is small enough for all of its layers to be fully oxygenated.

However, as the cancer cell begins growing larger, it starts to lose its oxygen content and slowly becomes more hypoxic.

Lee also explained that even though these cancer cells start becoming deficient in oxygen as they grow, they are still able to make proteins and wreak havoc inside the body.

From this discovery, Lee’s laboratory investigated and soon demonstrated that “cells have evolved a program by which oxygen tension switches the basic translation initiation machinery” and therefore have the ability to “evade hypoxiainduced repression of protein synthesis.”

Lee elaborated on the future of his research by giving an example of antibiotics. He explained that most antibiotics work by inhibiting the protein translation of prokaryotic cells specifically, leaving untouched the eukaryotic cells that compose our body. Once the antibiotics stop the protein synthesis of the prokaryotic cell, they kill the bacteria and restore our health. By following a similar process, Lee aims to go after cancer cells. Because cancer cells become increasingly hypoxic as they grow and switch to a different method of protein synthesis independent of oxygen, Lee intends to use this research to develop an antibiotic that will inhibit this alternative method of protein synthesis that hypoxic cancer cells have successfully mastered. By developing an antibiotic that is able to inhibit this hypoxic process of protein synthesis, the drug will only kill cells that thrive in hypoxic conditions.

This will then allow the antibiotic to target and ultimately destroy tumor cells. Lee also explained that using this method will work for all types of cancer cells, as every cancer cell uses this alternative protein synthesis process.

Lee explained that this concept of hypoxic cancer cells developing another way of making proteins is a fundamental property that dates back millions of years ago. He reasoned that the first cells were able to survive anaerobically; by understanding this, we are able to accept that cancer cells also have similar properties that allow them to perform certain biochemical processes without the presence of oxygen.

According to Lee, this discovery took a long time to publish not because of the time spent performing the proper experiments, but because it took a long time to conceptualize what was happening and to propose an idea that no one had thought of before. “It takes time for the concept to develop and evolve,” said Lee. “We were not intellectually or emotionally ready to accept what was going on and we could not think that it was possible that there could be another life” — one without oxygen. Though tumor cells pose their own set of challenges, it was ultimately the intellectual growth and acceptance of the idea that allowed this idea to manifest into a full-blown discovery.

“Water” You Researching About?

-Mirza Baig

Stemming from a simple interest of Dr. Bowman Ashe, then dean of the University of Miami, to develop an institution pursued for tropical marine research here in South Florida, the Rosenstiel School of Marine and Atmosphere Science (RSMAS) has evolved into one of the leading academic oceanographic and atmospheric research establishments in the world.

With the main campus harboring marine research and educational parks that extend to more than 65 acres, it has provided students with essential hands-on experience, granting opportunities to work on projects aiming to solve environmental issues faced today.

Ranging from investigations of the Deepwater Horizon oil spill in 2010 to RJ Dunlap shark tagging programs, RSMAS has been committed to administering to its students a unique yet exceptional learning experience that prepares them for the challenges they may face after graduating.

Involvement in research at the campus can begin as early as freshman year of one’s undergraduate career; however, some students may not know where to begin or what fields of study they are interested in. Professor Sharon L. Smith of the Department of Marine Biology and Ecology addressed several questions regarding the path taken by the very students so eager to tackle today’s ecological crises. Her expertise is highly

regarded to be one of the most profound in the spheres of ecology, population dynamics, spatial distribution and community structure of zooplankton and copepods in environments such as the East Greenland and Arabian Sea. She has also convinced many students to partake in her research, making her insight quite valuable.

Q: What are the different departments that students can get involved with at RSMAS? While there were originally six departments, the faculty have been rearranged to encompass five departments: Marine Geosciences, Marine Biology and Ecology, Marine Ecosystems and Society, Ocean Sciences and Atmospheric Sciences. These individual departments handle tasks incorporating subjects such as chemistry and physics and applying them towards the physical and biological environments of coral reefs, oceans and fisheries. There are also fields that deal with environmental policies, if there are any students that want to get behind the diplomatic aspects of what we do at the campus. There are even some projects that relate to biomedicine, as there is a toxicologist using algae as a model organism and another researcher investigating the physiological and behavioral effects of our use of antidepressants on marine and coastal life.

Q: How can undergraduates get involved with research at RSMAS? Any faculty member with a research grant has the ability to accept students that are motivated and passionate about learning. Contacting Dr. Gary Hitchcock is one way to get started, as he can match students into projects they have an interest in, whether it be for credit, volunteer or even pay. Usually, students are matched according to their field of study. If they study physics, they will be advised to work in a research facility exploring the physical facets of oceanography, atmospheric sciences, etc. Dr. Hitchcock also occasionally brings a number of the faculty members to speak to the freshman class about potential interests they may have.

However, the most effective way is by taking initiative and approaching faculty members, asking if they would like any help in their research lab. Search potential projects that interest you, shoot the researchers an email, and meet with them to talk about what you’re curious about.

Q: Is there anything undergraduates should be prepared for before starting?

Science is composed of the entire process, beginning from the brainstorming of ideas to receiving the award.

Therefore, there are a lot of bumps in the road and a lot of work that has to be done to reach the objective.

Students shouldn’t be discouraged if they are given a monotonous task at first because they have to realize that this is all part of the development of the findings.

I’ve had undergraduates in my own lab that have had to sort out data, throw out toxic materials which have to be dealt with in a certain way, etc. This is not exactly what I would want them to be doing during their time; however, it has to be done. But, researchers pay attention to the way undergraduates respond to the monotonous work to see who has the drive and assurance to understand that scientific inquiry consists of many different aspects. My advice is to work diligently in any assignment given, for it could be the way you perform it that will show these researchers just how passionate you are.

Research

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Q: What kinds of projects can students get involved with under Marine Biology?

There are projects consisting of scuba surveys of fisheries in the Florida Keys National Marine Sanctuary, working closely with the staff to develop mathematical projections of whether or not a certain species of fish should be allowed to be caught. In terms of reefs, we have numerous researchers with labs and facilities centered on mangroves, benthic fauna (organisms found on the seabed) and coral reefs. There is also work on — believe it or not — neurophysiology using sea slugs as the animal model for reflex aging. Mathematics are also used in research dealing with the connectivity of how one larvae from an island in the Caribbean can reach other surrounding islands. There is another physicist that is trying to determine how the red tides of the west Florida shelf develop. We have also been humbled to have one of the first people in the world working on a controlled experiment showing that CO2 acidifying the oceans has resulted in corals becoming unable to calcify — consequently compromising their structural integrity.

Q: In what ways do field programs such as the research vessels beneficial for students during their work?

If you are working in a lab with someone who is going to sea, and if you can work out your schedule as an undergrad, I say it is very beneficial for you to partake in that expedition. These voyages are on average about 30 days so it is critical to make sure you don’t have any conflicts with any upcoming events. The students then wake up, eat meals quickly, complete their tasks, and upon the completion of their shifts (some of which can be up to 12 hours), they have the rest of their day to themselves.

What is most imperative is that you should be sure that you want partake on the research vessel voyage. Agitation and irritability is common so it is strongly advised to know what you’re getting yourself into. Monetary complications will not allow the vessel to turn around for just one person. That ship has sailed. Literally!

RSMAS Student Profiles - Aalekhya Reddam

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hen it comes to science, research and education go hand in hand. So it is no surprise that undergraduate research is one of the main focuses in the Rosenstiel School of Marine and Atmospheric Science (RSMAS). Undergraduates pursuing degrees in Marine Science often take advantage of the numerous research opportunities offered and work closely with professors to gain experience in their fields of interest. A few of these people are outlined below:

Ben From: Titusville, New Jersey Year: Junior Majors: Marine Science and Chemistry What lab are you working in and who is the professor?

I work in the Hansell Laboratory for Dr. Dennis Hansell. I work directly under one of his graduate students, Meredith Jennings.

What project are you working on in the lab?

I am working on two projects at the moment. We are attempting to measure the organic carbon produced by diatoms throughout their lifecycle. We are also attempting to measure the amount of organic carbon diatoms that siliceous phytoplankton expel during their two growth phases and to characterize the types of carbon that are produced. My second project is the construction of a nanomolar TOC (Total Organic Carbon) analyzer that should, in theory, be able to measure TOC with 100–1000x that resolution.

Why are you doing research?

I am involved in research because it is what I want to do after I graduate college I currently plan on attending graduate school, and the experience and knowledge I gain from undergraduate research will be invaluable to me later in life as I begin the application process. Additionally, I am involved in research because I really like learning new things about oceanic chemical properties. I like the excitement of getting the results of an experiment and analyzing the data to find new trends and to create new hypotheses.

What are some of the challenges you face when doing research?

Research takes serious commitment. Since we are a primarily undergraduate research institution, professors are looking for students who can really assist in and eventually take on projects. So endeavoring in research is a serious time commitment. While I love research, it does add extensively to my work load and can sometimes lead to some late nights finishing classwork.

Madison From: Winter Park, Florida Year: Junior Majors: Marine Science and Chemistry What lab are you working in and who is the professor?

I work in the Hansell Lab directly with Cristina Romera-Castillo, a postdoctoral associate under Dr. Dennis Hansell.

What project are you working on in the lab?

Dr. Romera-Castillo’s project is to find out the amount of organic carbon produced by different planktonic species.

A certain amount of the organic carbon will be partially made up of antioxidants, whose physical property is to act as a free radical scavenger. These free radicals exist most notably from the photodissociation of the ozone by CFC’s.

If the amount of antioxidants produced by phytoplankton is known, the information can be put to good use in reducing the amount of free radicals in the environment.

Why are you doing research?

After taking two semesters of a reading course titled Marine Biogeochemistry with Dr. Dennis Hansell, I knew that I wanted to get involved with something that had more to do with my major (marine chemistry) I had previously worked in two different labs in the marine biology sector and liked them but didn’t feel as passionate about them as I do with marine chemistry.

Do you have any suggestions for anyone looking to get into research in RSMAS? If you are looking to do research at RSMAS, find out which professors perform research in a field you’re passionate about. Once you know who the professor is, take a class with them so you get to know them and feel more comfortable with them. An alternative is to just email them. Professors and researchers are extremely approachable — and don’t be afraid to ask if you can do research with them!

Neural Progenitor Cells Dr. Meghan Blaya is a postdoctoral associate currently doing research for the Miami Project to Cure Paralysis at the University of Miami Miller School of Medicine. Recently, her team investigated the effects of transplantation of neural progenitor cells (NPCs) on rats with induced traumatic brain injury (TBI). NPCs are special precursor cells that can differentiate into the various types of cells that make up the central nervous system. In order to initiate the intracellular signaling necessary for the development and survival of neural cells, molecules called neurotrophins must be secreted by other cells; these must then interact with receptors on the surfaces of the cells that are to survive and develop. Three prominent receptor types are Trk receptors A, B and C, each normally responding to its own specific neurotrophin. Blaya’s team wanted to investigate the effects that NPCs that express multineurotrophins — neurotrophins that can interact with more than one type of Trk receptor — might have on disease outcomes. Because of their nonspecificity, multineurotrophins act more broadly than do regular neurotrophins.

Blaya and her colleagues prepared their own specially-designed multineurotrophin, which they designated MNTS1. They hypothesized that transplantation of NPCs that secrete MNTS1 would lead to better outcomes in injured rats relative to regular NPCs and controls. The results of the experiments indicate that the NPCs in and of themselves promote neurorestorative events — even without expressing multineurotrophins — and that the cognitive outcomes were similar in injured rats receiving either type of NPC, which was unexpected.

The MNTS1 multineurotrophin was constructed from the backbone of NT-3, a human neurotrophin which binds to Trk C receptors; its first six amino acids on the N terminus were replaced by seven amino acids from the N terminus of NGF, a neurotrophin which binds to Trk A receptors. The introduction of the NGF amino acid sequence conferred to the NT-3 the ability to bind to Trk A receptors in addition to the Trk C receptors to which it would normally bind. After this step, an aspartic acid at position 15 of the NT-3 backbone was changed to an alanine, granting NT-3 the ability to bind to Trk B receptors in addition to Trk A and C receptors.

Thus, MNTS1 was born. Lentiviruses were then used to transport this DNA construct to regular NPCs in order to turn them into MNTS1-secreting cells.

The experiment involved two groups of rats: the first group had traumatic brain injury (TBI) induced by fluid percussion treatment while the second group underwent sham surgery — faked surgical intervention — which allowed the group to serve as a control. Both groups were further divided into three conditions. The first group had multineurotrophin-secreting NPCs transplanted into them; the second had regular NPCs expressing green fluorescent protein (GFP) transplanted into them; and the third didn’t have any NPCs transplanted into them — they were merely injected with a sterile saline solution. The six conditions were then as follows: sham/ vehicle, sham/GFP-NPCs, sham/MNTS1-NPCs, TBI/vehicle, TBI/GFP-NPCs and TBI/MNTS1-NPCs. The injections of NPCs and saline vehicles took place one week after the sham surgery or induced TBI, depending on the group. Cognitive outcomes were evaluated five weeks later using the Morris water maze to test spatial memory. The researchers had originally hypothesized that the rats that received MNTS1-secreting NPCs would experience better cognitive outcomes after injury than would those that received either the saline vehicle or the regular NPCs because the rats with MNTS1secreting cells have increased survival, neuronal differentiation and

- Daniel Brzostowicki

neurite extension relative to those in the other groups. Indeed, these results were observed in the experiments; not expected, however, were the similar improvements in cognitive outcomes experienced by the injured rats, regardless of the type of NPC they had received — the regular, unmodified NPCs or the NPCs that secreted MNTS1. Blaya and her colleagues believed that there were two important reasons behind this observation: the NPCs have intrinsic neurorestorative activities, accounting for the therapeutic effect of the regular NPCs; and the time frame they used for these experiments was relatively small. Blaya speculated that if the time between brain injury and administration of NPCs had been longer, then perhaps the MNTS1-secreting NPCs would have had more positive outcomes than did the regular NPCs. The next steps in her team’s research would involve examining more chronic time windows in order to verify whether the MNTS1 will have a greater salutary effect. Blaya also wanted to examine the optimal number of neural progenitor cells with which to treat injured animals. She thought that perhaps they could have used fewer cells in the experiment. She elaborated, “Although we didn’t see any seizures or any kind of behavioral problems with the animals … you still need to make sure you have the most efficacy with the least amount of manipulation into the brain.”

In 2012, The Miami Project to Cure Paralysis gained approval from the FDA to start performing clinical trials for the transplantation of Schwann cells (which play a role in sending electrical signals through the peripheral nervous system) to patients with spinal cord injuries. Thus far, this setup was the only one of its kind the FDA had approved. Although clinical trials for transplantation procedures such as the ones studied by Blaya and her colleagues have not yet been approved for the treatment of human brain injuries, Blaya is hopeful that the eventual approval of such procedures will lead to exciting new avenues in patient care.

A Look Into the Field of Anesthesia Research and Development - David Lin Many of us know someone who has had surgery before or have been under the knife ourselves. When people think of a surgery, they tend to overlook one of the most important physicians in the operating room — the anesthesiologist. The anesthesiologist is usually sitting in a chair hidden behind the curtain, monitoring the patient’s vitals and making sure the patient does not wake up in the middle of the surgery. When we think of an anesthesiologist, we may not consider the innovative research being conducted in the field. Instead, we usually just think about what they do in the operating room, not in the lab.

I had the opportunity to sit down with Dr. Roy Levitt, a professor in the department of anesthesiology at the University of Miami Miller School of Medicine. Levitt conducts research at the University of Miami’s Pain Management Center, one of the leading pain management facilities in America. He mentioned that the center was created to cater to the treatment of certain diseases that are not quite as prevalent as are issues such as cardiovascular disease and cancer: spinal degeneration, which causes low back and neck pain, as well as joint degeneration, which causes pain in the shoulder, hips and knee — all important issues in their own right. His own research focuses on chronic pain, specifically the transition from acute injury to chronic pain, and why certain patients are more susceptible to chronic pain.

One of the biggest challenges in the field of anesthesiology is how to best treat chronic pain as a result of an operation. Levitt mentioned that, as the field develops, they must begin to use a multidisciplinary approach; the physicians and researchers need to think about how they are able to treat patients holistically and take a full-body approach. The physicians treat the source of pain with local anesthesia. Meanwhile, they must consider the psychological complications of chronic pain, such as sleep deprivation, depression and post-traumatic stress disorder. They also

combine Western and Eastern medicine, utilizing acupuncture, physical therapy and electrocutaneous stimulation. Other treatments include administration of medicine that prevents the nerves from signaling neuropathic pain.

Although treatment is the central issue most researchers are trying to tackle, Levitt believes the environmental and genetic causes of pain present an equally (if not more) important issue. One key to understanding these components of chronic pain is to understand the genetic differences in animals.

Levitt and his collaborators are looking at both animal and human populations in order to dissect the genetic contributors to chronic pain.

Just as important as treatment is taking preventative measures. Levitt mentioned that there is not much research in this area of pain management; however, he did say that 50 to 60 percent of patients have pain due to environmental factors, such as the type of surgery and the kind of nerve injury. He also mentions that patients can take medicine during the perioperative period (immediately before and after the operation) as preventative measures for neuropathic injuries.

These medications include tricyclic antidepressants and gabapentinoids, which dampen the intensity of pain generation.

In addition to these medications, anesthesiologists can use serotonin and norepinephrine inhibitors to treat high-risk patients in the preoperative period when practical.

According to Levitt, patients who are more susceptible to preoperative pain will also be more susceptible to postoperative pain. He also explained that age is inversely related to chronic pain, and that chronic pain seems to be more prevalent in females (although the reason for this is unclear). Another group of patients who may be more susceptible to chronic pain are individuals who have preoperative anxiety. These are patients who have previous expectations and are worried about the surgery. If they are not educated on the nature of the operation and do not know what to expect, they are more at risk.

Levitt’s lab analyzes the factors that lead to chronic pain after acute pain and injury. His research can potentially transform how anesthesiologists treat high-risk patients.

They are trying to find out which kinds of patients are more susceptible to pain and attempting to understand the mechanism behind the sensation of pain. After that, they can use biological intervention to simulate a resistant individual within a susceptible individual.

In addition to the groundbreaking research happening in the Levitt lab, there are exciting innovations in the pharmaceutical field. There are advancements in therapy of nerve growth factors, which would enhance the treatment of chronic osteoarthritis. The University of Miami is also collaborating with the University of Pittsburgh and University of Michigan in pioneering pre-clinical studies on using herpes simplex virus (HSV) mechanisms to target sensory nerves, using these viral molecules to alter the pain response.

All these exciting developments will take several generations to be realized, and it is vital to train the next generation of researchers to propel the field forward. Levitt explained that, for up and coming students, the most important part of this goal is finding devoted mentors and getting early exposure to the research field. Ultimately, the student must be persistent. With so much innovative research happening in the field, it is essential we instill the next generation of researchers not just with skill, but also with curiosity.

Living with Two Evils: The Perils of Chronic Pain & Addiction - Gabrielle Eisenberg

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veryone has experienced pain. As little kids, we tumble off of our bikes and scrape our knees, and some of us may even fall off of the jungle gym and end up with stitches or a cast. When these accidents occur, we know what to do: for a scrape, we apply an antibacterial ointment and maybe an adhesive bandage featuring our favorite cartoon; for the more serious injuries, we seek care from medical professionals who can sew us up or give us a neon cast, perfect for collecting signatures from compassionate friends and family. Most importantly, when these accidents occur, we know that eventually, the pain will stop. Unfortunately, some people are not as fortunate.

The pain we experience from a scrape or a broken bone is classified as acute. Dr. William C. Shiel Jr., chief editor for MedicineNet and coeditor-in-chief of the Webster’s New World Medical Dictionary, describes acute pain as of “sudden onset and is usually the result of a clearly defined cause, such as an injury.” In other words, when someone is experiencing acute pain, he or she should be able to determine the underlying cause and, once that cause has been treated, the pain should dissipate. Chronic pain, however, does not fade away — instead, it causes its victims to suffer for an extended period of time.

According to the National Institute of Neurological Disorders and Stroke (NINDS), in these cases, “pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap — sprained back, serious infection, or there may be an ongoing cause of pain — arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage.” Experts at the institute explain that “common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), and/or psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).”

There are many disorders that result in chronic pain — among them is fibromyalgia, a condition that researchers believe to be caused by overactive nerves, manifesting as pain and extreme pressure sensitivity all over the body. Almost one in 60 Americans suffer from fibromyalgia; one such individual currently attends the University of Miami and volunteered to share her experience (for privacy purposes, she will be referred to as Jane Doe). Jane was only thirteen years old when she first realized something was wrong — and finding the ultimate diagnosis was no small task. “I was 13 when I first noticed symptoms such as really big pains and brain fog,” Jane reminisced. “I saw about six

doctors before actually being diagnosed because everyone called me crazy or said that they were growing pains. I saw my pediatrician, an adolescent medicine doctor, a gastroenterologist, a neurologist, a pain specialist and a rheumatologist. The rheumatologist was the one who was finally able to diagnose me,” Jane mused. “It was the best day of my life, to be honest.”

Unfortunately, fibromyalgia is not an easy disease to diagnose because not much is known about it, and, due to its effect on so many organ systems, it is essentially a disease of exclusion. Jane had to undergo a rigorous series of testing before her rheumatologist finally solved the case.

“Every doctor ran different tests, all of which basically culminated in blood tests, MRIs, CT-scans, an endoscopy, nerve reaction tests and, finally, a pressure point test. The pressure point test is basically the closest thing we have to a definitive test in the fibro community,” she explained.

“If you have 11/18 painful pressure points and meet all of the other criteria, you can be diagnosed with fibromyalgia by the Board of American Rheumatology. My rheumatologist relied mostly on past medical history, the pressure point test, and elevated inflammatory molecules in my blood.” To manage her condition, Jane relies on an assortment of prescription pain pills.

Unfortunately, painkillers can be very addictive, and this stigma poses significant obstacles to the chronic pain community — one of which is the constant suspicion that patients are forming drug-seeking behavior. Because prescription drugs have such potential for addiction, those who truly need them find it difficult to obtain them.

When Jane had her appendix removed close to a year ago, she experienced this dilemma firsthand. Jane recounted, “The surgery went well. I had a great surgeon; he was always concerned about my pain level because he knew my previous history, as were the nurses. As soon as they woke me up from surgery, I felt the pain associated with them removing an organ and cutting me, obviously, and I told them I was in pain.” She continued, “They were in a hallway, wheeling me back to my room, and I told them that I had a headache, and that I was in really bad pain. I always have headaches after general anesthesia, and they knew this. One of the nurses responded and said ‘Okay, we’ll get you comfortable soon.’ She reached for something by the nurse’s station, something I’d assume was Tylenol or morphine to put in my IV once we got to the room.” Unfortunately, Jane’s story took a turn. “Then, the other nurse slapped her hand away from my IV and said, ‘No, she has fibromyalgia, they have drug-seeking behavior.’ Luckily, my mom was there and knew that I would not complain about pain if I didn’t have it and that I am not addicted to drugs, so she demanded that I get pain medication after the surgery.”

Jane’s story is not a rare occurrence, as healthcare professionals are instructed to be on a strict lookout for drug-seeking behavior. The Office of Diversion Control recently published a brochure outlining some of the telling actions and characteristics that indicate addiction.

Ethics in Science

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Addict patients who are trying to secure prescription medication will often demand to be seen immediately and will attempt to manipulate conversation with their doctor so that the doctor gives the patient what they want.

This includes, but is not limited to, describing classic and common symptoms of various ailments; pretending to feel symptoms that can only be treated with narcotics, stimulants or antidepressants; or claiming that they are allergic to non-narcotic medications.

Unfortunately, even taking prescription painkillers for a truly serious medical condition has the possibility of contributing to the lifestyle described above. Dr. Elizabeth Hartley, an addictions expert, explains some of the many reasons why painkillers, specifically opioids, can be so habit-forming: “Painkillers numb physical pain very effectively, and nondrug pain management services can be inaccessible. Painkillers can also distance you from emotional pain and can be pleasurable and induce relaxation.” As people developing addictions take more painkillers, their tolerance can increase very quickly, causing them to require even more pills to produce the same physical and psychological effects. Additionally, as they increase their intake of such medications, these patients lose sensation as a result of remaining in uncomfortable positions and will often overuse the part of their body that required them to initially take the pills. This leads to more pain, which leads to more pills.

As their addictions develop further, patients may also use the painkillers to treat their withdrawal symptoms, strengthening their dependence on the medications.

Painkillers are legal and are usually the first course of treatment, but they are chemically similar to drugs like heroin. As a result, they are incredibly addictive and readily accessible. By the time physicians detect an addiction, it is often too late — and although doctors may discontinue painkiller therapy, patients are still left with a threatening addiction. Patients must then resort to using illicit substances to experience the same sensations, which, as we all know, leads to a whole other host of problems.

These addictions often develop unintentionally, as the patients are simply trying to treat a medical condition but are instead left with an arguably much worse disease.

Frequently (and unfortunately), those who experience chronic pain often feel stigmatized when they receive their prescriptions or take their medicine; in addition to enduring intense pain every day of their lives, they must also battle the healthcare system to get the help they need. Less addictive substances are in great demand and ought to be produced, and a greater emphasis should be placed on alternative forms of pain management that can supplement or even replace medicinal therapies. Only then can chronic pain sufferers live their lives without battling one evil and living in fear of another.

If you or a loved one is experiencing an addiction, please visit the American Addiction Centers for help at: www.americanaddictioncenters.org

Losing Weight the Right Way

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Courtesy of the CDC

- Joseph Bonner

t seems like everyone is trying to lose weight nowadays.

Even a modest exposure to this diet craze can be incredibly confusing. Some proponents argue that carbs and sugar are the primary reason for obesity’s prevalence — essentially the root of all dietary evil. Others believe that high-carb diets are beneficial for health and longevity.

The Atkins diet promotes eating fat-containing foods over carbs, while Carb Backloading suggests that eating high amounts of carbs at specific times is optimal. Paleo eliminates entire food groups from its regimen: dairy and processed grains. Some people simply incorporate any food into their diet as long as it fits within their caloric intake. Some individuals only eat within a four to eight hour period and fast the rest of the day, while others eat every two to three hours. You can see where the confusion and contradiction comes into play when comparing these diets against one another.

Interestingly enough, people can and have lost weight on nearly all of these diets. You might be asking yourself, “How is that possible? Isn’t there a correct way to diet? It just doesn’t seem to make sense.” The answer to these questions is a little more complex than “yes” or “no.” It requires an exploration of how nutrition and physical activity physiologically influence weight changes, as well as the underlying principles of why most diets at least somewhat work. The interplay between caloric intake, food choices, physical activity and social behaviors is integral to a successful long-term diet. Let’s explore some of these ideas to better understand how to diet healthily.

One question worth addressing is: How does someone lose we rght? Most people know that it involves burning calories, eating less food and being active. For our purposes, we’ll go a few steps beyond that. One of the most important fundamental aspects of weight loss is a caloric energy deficit. This is mainly achieved by two means — consuming fewer calories or being more physically active. Most people use a combination of the two.

Total Daily Energy Expenditure (TDEE) is a measurement used to determine how many calories daily someone needs based on their age, body composition, metabolism and activity level.

Within this overall figure is the basal metabolic rate (BMR) — how many calories an individual needs to sustain his or her body’s needs while at rest. In general, it has been shown that a prolonged caloric deficit lowers BMR and, by default, TDEE. This occurs because losing muscle mass and other metabolic tissue reduces the body’s caloric requirements.

Health Science So far, everything presented seems pretty straightforward. Taking in fewer calories than you need should result in weight loss. Unfortunately, it’s not as simple as a math equation. Most recommendations suggest a caloric deficit of 500 calories a day or so to net a loss of one pound per week. It might be tempting to increase the deficit to 1000 calories, since, theoretically, you should be able to lose weight at twice the rate, right? Not quite. Dramatic caloric deficits have been shown to worsen some of the physiological responses to weight loss at a faster rate. Think of metabolism as a thermostat in a house. If the internal temperature of the house becomes too hot, then the thermostat will cool to bring down the temperature. If the temperature becomes too cool, then the opposite will happen. The same is true with metabolism. Significant changes in caloric intake will encourage the body to use several mechanisms to reach a caloric balance and stop changing weight.

Some of these mechanisms include hormonal changes, loss of muscle mass and a shift toward energy storage. Two important hormones involved in weight loss are leptin and insulin. Leptin is known as the satiety hormone. It usually tells your brain when your energy demands are being met.

Insulin, on the other hand, helps the uptake of glucose in the blood. Glucose is a monosaccharide (simple carbohydrate) involved in a variety of energy storage processes in the body.

It has been shown that both insulin and leptin levels decrease when someone loses weight. This is important because a reduction in leptin, the satiety hormone, means that it will be harder to feel full from eating a meal. Feeling hungry during a diet is actually a physiological phenomena to combat losing weight. A reduction in insulin makes adipocytes (fat cells) more insulin-sensitive in order to compensate for the lack of its availability. Adipocytes then decrease in size (but never in number). After a prolonged caloric deficit, it becomes easier to store energy in fat cells. This is one reason why many people find it relatively easy to regain any weight they had lost .

Many other mechanisms that prime the body to store energy and regain weight occur during hypocaloric dieting.

The takeaway is that being in a deficit induces a response to stop weight loss. That response can be further intensified by the severity of that deficit. Losing weight on the smallest deficit possible for appreciable and consistent weight loss can mitigate decreases in metabolic and hormonal efficiency — in other words, you lose weight best when your caloric deficit is high enough to lose weight, but not so high that it hinders the process.

I had the pleasure of interviewing Dr. Kevin Jacobs, a professor in the exercise physiology department who specializes in research concerning metabolism and various factors that impact substrate usage at rest and during exercise.

He graciously answered questions I had regarding weight loss, typical dieting mistakes and practical suggestions for losing weight in an efficient and safe manner.

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In our conversation, Jacobs first spoke about how a lot of people make the mistake of making unfeasible changes to their diet or exercise. They either cut calories too quickly, are too restrictive with their food choices, or set themselves up for injury by exercising too intensely.

He suggests that anyone interested in losing weight instead make manageable yet meaningful changes over time. Jacobs also mentioned that most “fad” diets are too restrictive because they totally eliminate certain food groups or macronutrients. Practically speaking, it is very difficult, psychologically taxing and not always necessary to lose weight. Consuming a mixed amount of protein, carbohydrates and fat from micronutrient-dense whole food sources is beneficial for satiety and health. Jacob made two other noteworthy points: exercise alone can make our bodies more efficient at partitioning calories toward muscle repair as opposed to fat storage, and hiring a nutritionist might be a worthwhile investment to avoid some of the pitfalls of over-dieting.

While it seems that a caloric deficit is the main driver of weight loss, there are other critical factors to consider when attempting to lose weight. The rate at which weight loss occurs can impact the severity of muscle loss, hormonal disruption and metabolic reduction over time.

Heavily restrictive dieting is socially and psychologically debilitating, and not entirely necessary for weight loss.

Being physically active and reaching a modest deficit by eating mostly unprocessed whole foods of each macronutrient is ultimately key in preserving health and muscle, while still losing weight.

Dr. Kevin Jacobs Associate Professor Department of Kinesiology & Sports Sciences School of Education & Human Development

Calories, Macronutrients, and Estimating Caloric Intake − Joseph Bonner

Calorie is a term we see every day — from nutrition labels to health fad infomercials, it is plastered all over the food we eat. It seems that many people have a very rudimentary understanding of what calories are and how they tie into food and diet. Most individuals realize that consuming too many calories can lead to gaining weight, and eating too few calories can lead to weight loss. But there are several other important things to consider in regards to caloric intake — essential knowledge for anyone trying to be more health-conscious. Even a basic appreciation of the main points of this article will arm you with powerful tools that you can use to improve your body composition in order to become healthier.

First, what exactly is a calorie? Scientifically speaking, a “calorie” refers to the amount of energy it takes to raise the temperature of 1 kilogram of water by 1 degree Celsius. While not everyone needs to know the chemistry behind an individual calorie or how it plays a role in energy metabolism, it is important to understand some of the underlying concepts of simple nutritional science. For instance, the caloric energy we derive from food essentially comes from our bodies breaking down various molecules. These molecules fall into larger categories, called macronutrients. These macronutrients can be further divided into proteins, carbohydrates and fats. Each of these categories can be divided even further, but for now it’s good enough to know that proteins, carbohydrates and fats are subunits of calories that we break down from energy and nutrients.

Since calories inherently come from different “sources” within different kinds of food, at the end of the day, is a calorie just a calorie? The answer to that question is a little more complex than a simple yes or no.

Macronutrients do in fact yield caloric energy by being broken down, but there might be differences in overall fat oxidation (breaking down of adipose tissue) when reducing different macronutrients in one’s diet. A study was conducted on fat oxidation differences between a restricted carbohydrate group and a restricted fat group.

It was found that after 6 days of consuming about 800 calories less of each macronutrient per the given group, the low fat group experienced 67% more body fat loss than the low carb group. It is important to note that the study only lasted 6 inpatient days, and that the authors noted more long-term data was needed. They also acknowledged that both groups would eventually experience decreased fat loss as their individual

metabolisms adjusted to the reduced caloric intake.

What about changing the main source of a certain macronutrient? Another study was held in which participants consumed a diet that was matched for macronutrient profiles and caloric intake. The only variable altered was sucrose (sugar) consumption — 43% vs 4%. The results of the study demonstrated that the high sucrose content did not adversely impact weight loss between the groups. In another experiment,subjects supplemented either with rice or whey protein for 8 weeks and did not observe any noticeable differences in their body composition or performance.

These studies point toward the notion that varying intakes of specific macronutrients may bring about different thermic effects on fat loss. However, the sources of those macronutrients do not seem to significantly alter overall weight loss as long as there is an adequate caloric deficit. With that being said, this does not mean that food sources do not matter as long as macronutrient intake is accounted for. While caloric intake via macronutrient consumption is an influential factor in weight management, it is certainly not the only thing to consider.

Micronutrient and vitamin consumption is equally, if not more, important for overall health and longevity. Foods like fruits, vegetables, lean cuts of organic meats, fatty fish and whole grains are great sources of essential nutrients for health — such as vitamins, minerals, omega-3 fatty acids and fiber.

Hopefully it is clear that caloric intake, macronutrient intake and regular consumption of vitamins and minerals are all critical aspects of achieving healthy weight-related goals. Of course, this assumes that you know roughly how many calories and approximate amounts of protein, carbs and fats you should eat on a regular basis. It is essential to understand that caloric intake depends on many factors, such as metabolism, physical activity, body composition and fitness goals. Below is the SterlingPasmore Equation, which accounts for body composition and gives a good estimate of one’s daily caloric needs. It is also relatively easy to use, and only requires a little bit of math. The equation first calculates how many calories a person needs per day to support their basic physiological functions — a measurement called the basal metabolic rate (BMR). Then, it factors in physical activity. I would suggest that after calculating an estimate of your caloric needs, you keep track of how your weight is impacted by it and adjust from there.

Health Science

Sterling-Pasmore equation:

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This equation is based on your body composition. You need 13.8 calories to support 1 pound of lean muscle mass

BMR = Lean body mass (lbs) x 13.8 calories You can obtain your lean body mass from body fat measurements (you can measure these yourself using a relatively inexpensive tool called a body fat caliper).

Calculate lean muscle mass vs. fat mass: Body fat % x scale weight = fat mass Scale weight – fat mass = lean body mass

Factor in activity and calories burned during exercise: Low Intensity

Light Exercise

Moderate Exercise

Active Individuals

Extremely Active

mostly leisure activities, primarily sedentary

walking for 30-50 min 3-4 days/week, golfing, chores

60-70% maximum heart ratefor 3060 min, 3-5 days/week

70-85% MHR for 45-60 min/ session 6-7 days/ week

intense exercise, heavy manual labor, competitive athletes

BMR x 1.2

BMR x 1.375

BMR x 1.55

BMR x 1.725

BMR x 1.9

= calories needed per day

Anti-Angiogenesis:

The Future of Cancer Therapy?

- Renuka Ramchandran

Angiogenesis in a breast cancer cell. Courtesy of the National Cancer Institute

C

ancer. The multi-faceted disease that was once an enigma still demands unwavering scrutiny from researchers around the world. Cancer is not just one disease — it is several. However, the latest advancements in genetics, molecular and cellular biology, and immunology are paving a way to the newest treatments and maybe even a few cures. Many now involve angiogenesis, the process our body uses to grow blood vessels. Dr. William Li, president and medical director of the Angiogenesis Foundation, has recently sparked a conversation regarding the treatment of cancer and other diseases with a revolutionary method: antiangiogenesis — preventing the growth of new blood vessels that would support a tumor.

Why is angiogenesis so instrumental in the approach to combating disease? There are approximately 60,000 miles worth of blood vessels in the human body of a typical adult.

These integral pathways have the amazing ability to adapt to any environment within our body. They are everywhere — from forming detoxifying channels in the liver and traveling along nerves to lining the air sacs in the lung for gas exchange.

However, blood vessels do not normally grow spontaneously (except in specific circumstances). Therefore, the body must be able to control angiogenesis through a system of stimulatory and inhibitory factors. When blood vessel growth is needed, the body releases stimulators, or angiogenic factors, which cause new blood vessels to develop. When there is an excess of blood vessels, the body returns to homeostasis by releasing natural inhibitors of angiogenesis.

What happens when this balance is compromised?

We know now that a number of serious health conditions, including cancer, arise due to the effects of too much or too little angiogenesis. Excessive angiogenesis leads to many diseases, namely cancer, blindness, arthritis and obesity. Li explained that “there are more than 70 major diseases affecting more than a billion people worldwide, that all look on the surface to be different from one another, but all actually share abnormal angiogenesis as their common denominator.” This led to a shocking realization: Control angiogenesis, control cancer.

Angiogenesis is a characteristic of every type of cancer.

However, cancers do not start out as tumors with a blood supply. They start out as microscopic cells that form a mass smaller than the tip of a ballpoint pen. Without a blood supply providing nutrients and oxygen, this little nest of cells will not grow any larger. Regardless of our health, we probably all have these minute, harmless cancers forming in our body at all times.

Dr. Judah Folkman, pioneer of the field of angiogenesis, called this phenomenon “cancer without disease.” The human body’s ability to control angiogenesis is, therefore, one of our most vital defense mechanisms, as it prevents the blood vessels from feeding the cancers. If angiogenesis is blocked and blood vessels never reach the cancer cells, the tumors will never grow. However, if angiogenesis occurs, the cancer begins to metastasize and release more angiogenic factors at an alarming rate. With this knowledge in mind, researchers have begun to study angiogenesis more carefully, hoping to distinguish the fine line between benign and deadly.

Anti-angiogenic therapy is a new approach that aims to treat cancer by cutting off its blood supply. Unlike chemotherapy, it focuses only on the blood vessels feeding the cancers. Tumor blood vessels are not like normal blood vessels; they are weak in their structure, which makes them susceptible to various treatments. Experiments have been conducted in other species;

when a nine-year old dog named Milo with a malignant neurofibroma in his shoulder that invaded his lungs was treated with a mixture of anti-angiogenic drugs, the cancer’s growth was slowed down to a rate that extended his survival to six times more than his veterinarian had predicted. With this information, the scientists of the Angiogenesis Foundation treated more than 600 dogs in similar conditions, yielding a 60 percent response rate and improved survival. In one interesting example, they treated a 20-year-old dolphin in Florida that had deadly squamous cell carcinomas in her mouth. After a newly created anti-angiogenic paste was applied on top of the lesions, the cancer completely disappeared in seven months. As a result, the scientists realized that this therapy could be used for a wide range of cancers.

Patient survival data showed that there has been a 70 to 100 percent improvement in survival for people with kidney cancer, multiple myeloma and gastrointestinal stromal tumors. For other cancers, however, only slight improvements were seen because such patients were being treated after the cancer had spread. The researchers went back to investigate the causes of cancer and saw that diet accounts for 30 to 35 percent of many of them, suggesting that preventive measures should be taken through our daily food intake.

This then brings us to the question: What can be added to our diet that is naturally anti-angiogenic? As the folks at the Angiogenesis Foundation put it: “Can we eat to starve cancer?”

We very well can. There are a number of foods, herbs and drinks that are laced with naturally-occurring inhibitors of angiogenesis.

Here a few of the best: Red Grapes/Red Wine: These foods contain the anti-angiogenic ingredient resveratrol that has been shown to inhibit angiogenesis by 60 percent.

Strawberries and Soybeans: Extracts have been shown to potentially inhibit angiogenesis.

Kale/Collard Greens: These have among the highest concentration of lutein and zeaxanthin carotenoids in carotenoidrich green leafy vegetables, and are thus associated with risk reduction for certain angiogenesis-related forms of disease.

Tomatoes: This fruit contains the anti-angiogenic ingredient lycopene and showed a 50 percent reduction in the risk of developing prostate cancer in men who cooked them into their meals two to three times per week (in men who did have prostate cancer, those who had more servings of tomato sauce had fewer abnormal blood vessels).

In several studies, soy, parsley, garlic, grapes and berries all proved to be more successful at inhibiting angiogenesis than common drugs used to reduce the risk of cancer in people.

Many herbs and spices — including turmeric, garlic, cinnamon and ginger — have also been found to possess anti-angiogenic properties. Using this information, the Angiogenesis Foundation is currently creating the world’s first rating system that scores foods by their anti-angiogenic, cancer-preventive properties. Antiangiogenesis can also help with the world’s obesity problems; adipose tissue, or fat, is dependent on angiogenesis. If fat grows when blood vessels grow, then starving the fat of its blood supply could have far-reaching implications, some of which have already been proven in mice studies.

Anti-angiogenic therapy has opened our eyes to a whole new world of possibility. While the medical field still has a laundry list of problems, anti-angiogenesis seems to be a step toward checking off one more item.

To learn about more natural cancer-fighting foods you can add to your diet, check out eattobeat.org.

A Look into Medical School Life - Michelle Xiong

An outstanding GPA, shadowing experience, MCAT scores, research opportunities, community service and extracurricular activities fill every pre-med student’s mind. But what happens after those applications are sent and that acceptance letter arrives? What actually fills day-to-day life in medical school, the holy grail that pre-meds have fought so hard to attain? For all those new undergraduate pre-meds or those still sending in their applications, this information should shed light on the four years you’ve been somewhat fearing but mostly dreaming of.

The first two years are comprised of basic science courses. Some medical schools offer classes such as microbiology, immunology, biochemistry and genetics in a stand-alone manner. The majority of medical schools, however, have recently begun to weave subjects together to create more integrated courses.

Generally, the first six months focus on the core principles of biomedical science that are intertwined in units called modules. For example, the human structure module — the first of which being taught at the University of Miami Miller School of Medicine — combines gross anatomy, histology, embryology and cellular biology.

Most schools have begun to incorporate organ system modules as well, which begin in the latter part of the first year and continue through the second year at the Miller School of Medicine. Students take organ system modules such as rheumatology, oncology, hematology, infectious diseases,

renal science and respiratory science. All the modules are sequential and lockstep and so, as medical student Paige Finkelstein explained, “everyone’s doing it together and so we get to know each other very well throughout the first and second years.” In the past, the material was structured such that the information on one system, such as the cardiovascular system, was solely based on the underlying science; concrete pathology and abnormalities were left to be covered in the second year. Now, scientists and clinicians work together to create integrated modules that teach both the science and pathology of a system starting the very first year.

Concurrent with the modules are the doctoring courses that run through the first and second years — or, as Dr. Mechaber put it, “learning the art of being a doctor that goes with the science.” In these courses, medical students learn how to take medical history, carry out various physical

exams, generate a hypothesis, think through problems and learn the components of the clinical skill set essential for any prospective doctor.

The third and fourth years at the Miller School of Medicine are relatively similar to those at other medical schools: during these two years, medical students go through various rotations in blocks. Rotations encompass inpatient and outpatient medicine and can include surgery, pediatrics, OBGYN, primary care and internal medicine. The order of these rotations varies based on student preference, as long as each is completed (unlike the lockstep modules). For the rotations, a complex, computerized system matches students.

Sometimes, students may even request a specific hospital in which to be placed. During the third year, six weeks are set aside for electives, during which students may choose to partake in research, experiment with specializations or even go on vacation. Additionally, during the fourth year — though rotations are still in progress — students are given the chance to complete an internship. For one month, the student is given a pager and virtually every privilege — as well as every responsibility — that an intern who has already graduated medical school would have.

Exams in the modules for the first and second years usually consist of a midterm and a final, both in a multiplechoice format. Courses such as anatomy typically have practical exams and some other courses may have shortanswer examinations (although this is a bit of a rarity).

These exams are structured to resemble those written by the National Board of Medical Examiners.

For the doctoring courses, competency assessments are

Paige Finklestein, Second Year Medical Student, MD/MPH program

Advice Tidbits

The amount of material covered in a brief period of time can be more difficult to handle than the difficulty of the material itself.

Don’t be a gunner — a really high achieving student who succeeds at the expense of others.

Invest in a Keurig machine.

Learn to cook well enough to pack lunch everyday and, thus, minimize spending.

Get involved with shadowing while in medical school, too.

Freshman Advice

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held at the end of the first, second and third years. For the first year, the assessment is relatively systematic; students are deemed competent if they can take a patient’s medical history and execute all of the essential components of a physical exam. The second-year assessment is similar, though a greater application of knowledge is expected from students the second time around. When given standardized patients, students must only perform physical exams that are relevant to the case. After completing all the clerkships in year three, one entire weekend is dedicated to the Objective Structured Clinical Exams (OSCEs). Students go through a whole spectrum of different scenarios. One scenario might, for example, involve an unexpected phone call from a patient, and a faculty member may listen in on the call.

After all that, students have to take the three-step United States Medical Licensing Exam (USMLE); this is the test that prospective physicians must take in order to earn their licenses. Step 1 is usually taken after the conclusion of year two, but some schools may have students take it after their third year. This step primarily tests students’ knowledge of basic science in a clinical context. Step 2 consists of two parts: a clinical knowledge aspect (Step 2 CK) and a clinical skills aspect (Step 2 CS). This part is generally completed any time during the fourth year. Step 2 CS requires students to travel to one of five centers nationwide to complete 12 stations similar to the OSCEs. Passing Step 2 is required in order to gain admission into residency programs. Lastly, Step 3 is taken after graduating medical school — a mix of multiple-choice questions and case simulations serve as the final obstacle to becoming a fully licensed doctor.

Medical school may seem overwhelming, but do not be discouraged. There are many who have come before you and many that will follow. What matters is that you keep your head high — you’ll be wearing that M.D. white coat before you know it!

Interesting Fact Shadowing while in medical school is on another level compared to undergraduate shadowing — even a first-year medical student can be thrown in to do CPR on a patient.

Dr. Alex Mechaber Senior Associate Dean for Undergraduate Medical Education Professor of Medicine, effective June 2015 Alumnus of the University of Miami, undergraduate and medical school

Freshman Advice: Does (S)he Bite?

- Shivani Hanchate

Most students will readily agree that approaching professors is a bit of a challenge.

Although most are open and willing to talk to their students, many of the students are intimidated by the prospect of engaging their professors in conversation. However, these exchanges can prove to be beneficial in a number of ways. Relationships built in college will follow you for the rest of your life; thus, it is essential that you begin fostering strong bonds with your professors early on in your undergraduate career.

You never know when you are going to need help in a class, a word of advice or even a recommendation letter. Here are some tips to help you start working toward developing a bond with that professor you’ve been meaning to talk to: “Hey is for Horses” If the professor is unavailable after class or does not have convenient office hours, don’t let your question go unaddressed — you should try communicating via email.

This is often the best means of reaching professors! Be sure to maintain a semblance of professionalism; remember to include a concise and relevant subject line, be specific about your inquiries, and avoid — under any circumstances — using slang.

Also, start off your e-mail on the right foot; formalities like “hello” or “dear” should be used in place of “hey.” Remember: “Hey is for horses” (not professors).

Just Say Hi The University of Miami is a pretty small school; it’s not uncommon to catch your professors heading towards you on campus walkways or standing in front of you at Starbucks. Instead of walking the other way or ignoring them, you might as well just say hi. If your professor is having a great day, a simple hello could even lead to a meaningful conversation. Now, the professor should recognize your face and — as long as you remember to introduce yourself — your name. You never know what a small greeting might lead to!

Ask Questions If your professor is available after class or has convenient office hours, go and ask questions (even if you don’t think you have any). Asking questions demonstrates your dedication to their class as well as your desire to learn. Don’t hesitate to verbalize your curiosity. Asking a question about class could give way to some fascinating semester-long discussions! Even if you do not end up building that strong student-mentor relationship you had hoped to achieve, you will (at the very least) receive answers to your questions and learn how to interact with different types of professors so that perhaps you’ll successfully be able to network with the next one you encounter.

Take the Road Less Traveled By It is so easy to justify missing class in college when you can just read the textbook or even watch videos and skim through presentations of the lectures you missed. Although this may provide you with an easier, alternate route to that grade you want, you will miss out on a great opportunity along the way — not to mention all the tuition money you’d be letting go to waste! If you go to class (and try to participate), your professors are much more likely to acknowledge your presence and remember your face. Then, when you ask for that recommendation letter or that 0.01-point curve, there is a better chance that your professor will recall your engagement and commitment to his or her class and reward your effort. That one hour out of your day will help you more than you think. Simply put: Just go to class.

Roger on the Edge: Don’t be “fooled” by Anti-Vaxxers!!!

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There is a movement around the WORLD that is called the Anti-Vaccination (AntiVaxxers) movement. A group of individuals that are growing and posing a serious threat to public health. Due to their unfounded data, they encourage you to not give vaccinations to your children when they should get them. Their reasons are based on unfounded data that links vaccines to Autism and other genetic diseases, which are all FALSE!!! As a result of this movement, diseases that have been eliminated are back and in some cases killing innocent youngsters. Just imagine young Bobby, he’s an innocent little tike and just because of his parent’s views little Bobby will not grow up to be Bigger Bobby. A future lost when it all could be prevented. There is a reason vaccines were created and it’s for diseases that pose us an immediate threat to life and well-being. End this madness before it ends us. Comment on Facebook!!!

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