Recently on Facebook, I saw a post from my friend about her sadness in reaction to two of her friends committing suicide. The situation was even more devastating because both of them were only in their late 20s.

Suicide has become a prominent issue, especially for young adults in our society. Surprisingly, according to statistics from the Centers for Disease Control and Prevention, one American dies by suicide every 12.95 minutes. With that, over 40,000 Americans die by suicide each year, making it the 10th leading cause of death in the United States and the second leading cause of death for young people ages 10 to 241.Photo of hand with "stop suicide" written on it.

Facing this, the first question on everyone’s mind is why. Why did their friend, child, parent or spouse take their own life? Based on the research, the top 10 reasons for this phenomenon include depression, loss of hope, frustration, fear, psychosis, drug and alcohol problems, past regrets, societal problems, relationship-caused heart break and unemployment.

The reasons listed above aren’t foreign to young adults like us. We are experiencing similar pressures every day like classes, academic work, jobs, relationships, etc. Often, it is even a combination of these pressures.

So how to make ourselves feel more comfortable when pressures are big? There are several suggested ways to release burdens:

  1. Know that there is always more than one option to solve the problem. Be more patient, and you will figure it out sooner or later.
  2. You can always turn to your family and friends for help. Whenever you are unhappy, think about the people you love and who love you. Tell them what you feel. Maybe they cannot solve the problem, but they definitely can make the situation better for you.
  3. Never think you’re the only one facing similar problems. Many people have gone through the same situation before. People have different types of pressures in different stage of their lives. Just give yourself more confidence and trust you can conquer it.
  4. Attend more social events and meet new friends there. Johns Hopkins has lots of attractive events happening on both the Homewood and medical campuses.
  5. Though you may feel tempted, do not use alcohol or drugs to cover your pain. Drinking or using drugs cannot solve our problems but can make a situation even worse.

The pace of everyday life is so fast for most of us that we normally don’t have time to care about ourselves, let alone other people. I firmly believe that if we could pay just a bit more attention to our families, friends and classmates, we can make a huge different for those going through difficult times.

At the end, to everyone reading this article in a difficult point of life: Do not feel like you’re alone, and do not give up. Life can sometimes be bitter and is not always perfect, but it can be sweet if we keep trying and never quit.

If you need someone to share your burden with, please take me as your new friend and feel free to contact me at xliu47@jhmi.edu.

1. Data obtained from CDC’s Web-Based Injury Statistics Query and Reporting System (WISQARS)

About the Author

Xin Liu

Xin Liu is a postdoctoral fellow in biological chemistry. She loves her research, writing, singing and is really happy to make new friends here.

Go to any laboratory, talk to any scientist, ask any graduate student about a technique called polymerase chain reaction (PCR), and just about everyone will have heard it and used it before. In a few years’ time — if not already — the CRISPR-Cas9 system will likely achieve the same level of pervasiveness.

CRISPR-Cas9 (clustered regularly interspaced short palindromic repeats/ CRISPR-associated nuclease 9) is a novel genome-editing tool that has taken the science community by storm.

DNA Strand

The system, naturally occurring in bacteria as a mechanism for self-defense against invading viruses, is elegant in its simplicity. At its core, the system requires recognition of two palindromic sequences that then enables the cutting of those DNA sequences by a protein (cas9), thereby protecting the bacteria.

Because it is highly specific and efficient at cutting DNA, scientists soon retooled the bacterial CRISPR-Cas9 for use in genome editing with the premise that if specific sequences can be cut out, genes can be knocked out. Furthermore, sequences that are cut can be replaced with DNA of interest, allowing the study of specific mutations. The simplicity, along with great efficiency and accuracy, lent itself to be adapted as a powerful tool to modify virtually any genome. This has particularly significant implications for the field of gene therapy, whereby genomes are manipulated for disease treatment or prevention.

Additional Resources:

Here are some ways that CRISPR is currently affecting gene therapy for some disorders for which limited treatment is available.

About the Author

Xuan Pham

Xuan Pham is a human geneticist graduate student who enjoys telling stories about genetics with a creative twist.

According to the Centers for Disease Control and Prevention, childhood obesity has more than doubled in children and quadrupled in adolescents over the last 30 years. In 2012, alone more than one-third of all children and adolescents were considered overweight or obese.

As health professionals, we are aware that patterns of daily behavior begin in early childhood and affect short and long-term health. Healthy nutritional choices and daily exercise are particularly important for long-term well-being and obesity prevention.

preteen boy working out

In Baltimore City, there is a federally funded program called B’More Fit through the program B’More Healthy Babies, which helps low-income postpartum moms lose weight by participating in a weight loss program and weekly exercise classes. The program includes daycare services for the parents while they are taking classes. At the forefront of this massive collaborative effort is Carolyn Bramante, a med/peds resident.

Through a citywide collaborative effort of the pediatric residency programs throughout Baltimore City, the Maryland chapter of the American Academy of Pediatrics and the Baltimore City Health Department, the children of parents involved with the program receive their own nutritional education and exercise program.

The pediatric residents have stepped in to fill the initial programming gap by teaching age-appropriate curriculum on healthy eating and exercise to children while they are in the custodial childcare. The curriculum is taught by combined internal medicine and pediatrics, or med-peds, and pediatric residents, and it covers similar topics to those in the mothers’ classes. Each session ends with a content summary for the mothers so that they can reinforce the topics at home. These classes currently take place at the Druid Hill YMCA every Monday evening.

Along with the classes, children also get to participate in fun activities, such as tasting different types of vegetables and fruits, reading age-appropriate books related to healthy eating, and of course lots of playtime at the end to allow them to exercise.

It is wonderful to know that even with extremely busy schedules, these residents have taken the time outside of their medical responsibilities to make a difference and help fight an epidemic that needs all of our involvement.

About the Author

Sylvia Owusu-Ansah

Sylvia Owusu-Ansah is a pediatrician who emergently takes care of pediatric patients and would like to be a philanthropist when she grows up.

This past week, the first ever “JHU Forum on Race in America” took place with speaker Ta-Nehisi Coates at the forefront. Ta-Nehisi, a prominent writer for The Atlantic, is an active advocate for contemporary issues.

Though scheduled months in advance, the talk could not have come at a more appropriate time in Baltimore, with recent unrest in the city forcing many to consider racial issues more critically in their own lives.

The talk was structured in three major parts. After a brief introduction by Nathan Connolly, an assistant professor of history at the Krieger School of Arts and Sciences, Ta-Nehisi took the stage and delivered an impassioned speech highlighting what he believes to be the critical issues underlying the racial problems in America. Specifically, he focused his attention on the underlying, and sometimes unobvious, society-wide practices that promote racist policies within this country.Ta-Nehisi Coates

Drawing the attention of the audience toward these ideas, Ta-Nehisi elegantly pointed out the underlying mechanisms that fuel the type of behavior we see. When given the proper context, it becomes obvious that these responses are not the cause, they are a reaction. And understanding why they occur is paramount to beginning to solve these problems.

When talking about the recent violence in Baltimore, he derided general condemnation of the actions. Instead he reasoned, “the lives of black people in this city – the lives of black people in this country – have been violent for a long time.” Why, then, would it be so surprising that they reacted violently now?

With these ideas in mind, Ta-Nehisi ended his speech and joined Nathan Connolly, and Dr. Debra Furr-Holden, associate professor at the Bloomberg School of Public Health, for a conversation. During this dialogue, the three panelists touched on similar ideas, and expounded upon concepts from some of Mr. Coates’ books. All along, the same themes were echoed: These problems originate much higher than the visible reactions we see. To make real change, we must address the issues on a systemic level.

The event wrapped up with a Q&A session where audience members were invited to interact with the panel with their own comments and questions. One viewer in particular asked a question about how to deal with the sense of defeatism one can feel when faced with such a daunting task as trying to change hundreds of years of racial inequality.

Ta-Nehisi scoffed at the idea, saying young people, “have no right to feel defeated...,” reminding everyone that people have been struggling against these and far worse issues for years and that hadn’t stopped them.

As the event drew to a close, Ta-Nehisi left his audience with a lasting and profound remark, echoed by his fellow panel members. He called upon us all to, “…not hide behind our own guilt.” But rather, be “thinkers” and force ourselves to struggle with the issues even, and perhaps especially, when they’re uncomfortable.

About the Author

Bree Yanagisawa

Bree Yanagisawa is an aspiring scientist who is passionate about the unique opportunity represented in engaging science through the use of mass media sources.

Here on campus, Project Bridge is a student organization that aims to bridge the gap between biomedical science and the general public. On April 16th, Project Bridge sponsored a Science Café event about multiple sclerosis (MS). MS is a disease that involves the central nervous system and results in damage to the myelin sheaths that cover nerves. This damage results in common early disease symptoms, such as numbness, weakness, tingling and problems with vision. However, the disease course is variable, with some who are more severely affected than others.

This event was held at Red Emma’s and featured a talk by Nicoline Schiess, M.D., M.P.H., an assistant professor of neurology at Johns Hopkins. Currently, Schiess spends part of the year in the United Arab Emirates (UAE), where her research focuses on the prevalence of MS in the Middle East. MS affects more than 2.3 million people worldwide. Previous studies had shown that it was more prevalent in northern latitudes and less prevalent in the Middle East and Africa. However, such statistics could be confounded by a bias in diagnosis.
MS is diagnosed by a combination of the patient’s clinical history, a neurological exam and an MRI. Yet because MRIs are not as readily available in the Middle East as they are in the U.S., the number of people affected by MS in the Middle East could be underestimated. To address this, Schiess began an MS clinic in Dubai, and preliminary work has found a higher-than-expected number of patients with MS.

Beyond the difficulties with diagnosis, UAE patients have another hurdle they must overcome: a lack of resources that promote “patient empowerment.” According to Schiess, though there are similarities between her UAE patients and their U.S. counterparts—including MRI findings, disease symptoms and challenges associated with living their daily lives—a key difference is that “patients in the U.S. are empowered with knowledge.” They tend to be well-educated about their disease and proactively seek resources to manage the disease effects.

This empowerment is partially a product of patient-initiated foundations, such as the National Multiple Sclerosis Society, as well as many other smaller local and national groups. These groups provide educational resources for patients and their families, organize support networks, and fund both basic science and clinical research. In contrast, patients in the UAE have a harder time because of a lack of these resources and a continuing stigma associated with disability. However, the situation is improving.

As the event concluded, I felt I had learned more about MS, particularly outside of the U.S., and had an increased appreciation for how patient-centered groups can help empower patients with MS and their families.

About the Author

Alisa Mo

Alisa Mo is an M.D./Ph.D. student who's passionate about the intersection of neuroscience, genomic medicine and society. She’s also a pianist and enjoys cooking.

When attempting to elucidate the function of biological macromolecules, visual representations can be extremely useful tools. Often, these tools can help pinpoint the structural origin of a particular function and are invaluable for understanding how complex systems work.

a dna double helix transitions into a human figureSometimes it’s just easier to grasp something when you can see it.

That said, obtaining these structures can be far more difficult than you might think. A basic rule of thumb: The more complex the molecule, the harder it is to obtain its structure. This inherent difficulty makes a recent feat by Johns Hopkins scientists even more impressive.

The 3-D structure of the intricate protein system known as the origin recognition complex (ORC) was published in Nature on March 11. Lead author on the paper, Franziska Bleichert, Ph.D., a postdoctoral fellow in the lab of James Berger, Ph.D., determined the structure of ORC using a technique known as X-ray crystallography. Upon purifying and subsequently crystallizing the protein, Bleichert used high-energy X-rays at the Argonne National Laboratory’s Advanced Photon Source to obtain data that allowed her to construct an atomic-level image of the complex.

The ORC system is an elaborate six-piece protein machine (ORC1-ORC6) essential for DNA replication, a process that must be carried out in order for multicellular organisms to continue to grow and thrive. This process is accomplished by a large complex known as the replisome. The ORC is a key component of this process, as it is responsible for the recruitment of other replisome components and the loading of specific proteins, called MCM2-7 complexes, onto DNA. These complexes unwind the DNA, exposing the genetic information buried within the helical, double-stranded structure for replication.

The crystal structure reveals that ORC3, one of five subunits that compose the open, ring-shaped main body of ORC, makes contact with the “tail” subunit ORC6. Mutations in this tail have been shown to inhibit assembly of ORC and are implicated in the development of the dwarfism disorder known as Meier-Gorlin syndrome.

“The crystal structure explains why a mutation in ORC6 that is linked to Meier-Gorlin syndrome in a subset of patients results in defective binding of this subunit to ORC3,” says Bleichert. “The structure also makes specific predictions on how the different ORC protein subunits might interact with DNA in the central channel of ORC and with other replication initiation factors.”1

Further investigation of the structure unveiled that an expected interaction between ORC1 and ORC4, proven to exist through biochemical assays, was nowhere to be found. The crystal structure indicates a snapshot of ORC1 positioned in such a way that it blocks the channel formed by the other subunits and prevents DNA binding. Though unexpected, this finding indicates that ORC is capable of adopting an inactivate mode and is not continuously active as once thought. It is likely that this new structural feature represents a potential regulatory mechanism that requires further study to elucidate.

Importantly, this work shows in a rather astounding way how a structure from a single crystal can reveal biological functions that were previously invisible and provide a visual map for understanding the mechanistic origins of disease.

 

1. The cited quotation is based on material provided by DOE/Argonne National Laboratory.

About the Author

Shannen Cravens

Shannen Cravens is a Ph.D. student in molecular biophysics with a passion for teaching who enjoys weaving art into her lab life.

How many times have you tried to explain your research to a friend, only to get a blank stare back? Such was the case with Daniel Pham, a graduate student in the Department of Neuroscience working in the Meffert lab. Daniel first realized his problem while trying to explain his research to his boyfriend and found himself “mumbling about how brain cells are like a series of interconnected roads, with trucks delivering cargo from one set of roads to another, then unloading when they reached a state border.”

a women is showing off a container to a group of children

Image courtesy Project Bridge

This analogy not only failed but also confused both participants. After realizing how difficult it was to explain his research, Daniel reached out to his classmates, Wendy Xin and Joe Bedont, and realized that many other scientists face a similar difficulty. In November 2012, along with two other graduate students, Naoko Kozuki from the school of public health and Molly Needelman from the Maryland Institute College of Art/Carey Business School, they founded Project Bridge, a group designed to connect scientists with the community at large.

The initial goal was to have two types of events: one to train scientists to discuss their work with the public, and the other to foster science-public interactions. Currently, the group hosts an annual Casual Night of Science, a TED-inspired set of lectures from experts; a monthly Baltimore Science Café, a discussion of a broad topic by a Johns Hopkins researcher at Red Emma’s; and a monthly table at the 32nd Street Farmers Market, an interactive event with entertaining experiments and presentations.

These events provide an important and unique way for Johns Hopkins trainees to communicate with the public — an immensely important yet remarkably difficult skill for any scientist. Most importantly, the group is constantly growing in both membership and projects. And, according to Daniel, group members are able to initiate projects as they see fit and can rely on Project Bridge for financial and volunteer support.

When asked about the most important thing a scientist needs to know when interacting with the public, Daniel advised to keep the level of detail to a minimum so that people will still see the big picture. “Once they see the big picture, there needs to be some type of connection to their life — why does this matter? Why should I care? How does it affect me? Getting the public involved in the discussion only helps to better our own understanding and streamline our science.”

As with anything, practice makes perfect, and a natural starting place is with friends and family. Daniel suggests to “try explaining your science research with them, and see if they can explain it back to you. It’s always fun, and even if you make mistakes, you can keep trying. After all, it is how Project Bridge was formed!”

If you want to become involved with Project Bridge, email projbridge@jhu.edu to be added to the listserv.

Like the group on Facebook or follow them on Twitter @projbridge.

 

 

About the Author

Kevin Monk

Kevin Monk is a neuroscience graduate student who enjoys sharing scientific discoveries with anyone interested in reading about them.

On April 28, Johns Hopkins Medicine will put on its inaugural Dancing with the Hopkins Stars, the most recent — and perhaps the most glamorous — iteration of the annual United Way campaign.

arielle medford dancing

Ten couples will raise funds for their respective causes within United Way, a charity organization that works to empower communities through multiple avenues, from education to nutrition to organized efforts to fight homelessness. At the end of the night, awards will be given to both the couple with the favorite dance and the couple that raises the most money. Competitors range from administrators to nurses to doctors to departments chairs.  And, full disclosure, there’s also a medical student: That would be me.

Dances that evening will include the hustle, Viennese waltz, tango, jitterbug, a traditional Greek dance, hip-hop, freestyle, foxtrot, salsa and Lindy Hop. Advertisements for the event are proving to be just as glitzy as the dances themselves promise to be.

Most recently, posters of each partnering set have been put up around the hospital. That was a surprise! I have to say that when I came to medical school, I did not imagine to one day see posters of myself in full développé with a shooting star wrapped around my leg.

The school doesn't just embrace academics pull quote_Arielle Medford

And though unexpected, it’s an exciting development. I have been dancing since I was 4 and, upon moving to Baltimore for medical school, I had to come to terms with the fact that the dancing chapter of my life may be ending. It was not an easy decision, but I was willing to make the sacrifice to come to Johns Hopkins.

Since coming here, however, much of my experience outside of the hospital wards has been defined by dancing. The medical school is divided into four colleges. Every year, we compete in College Olympics, and every year, the dance-off has been a personal highlight for me. In addition, for our white coat ceremony the first year, I danced a ballet solo to live instrumental music performed by my peers, and we later performed a dance medley consisting of salsa, African dance, hip-hop, Bollywood and a ’90s boy band dance.

arielle medford dancing Experiences like these embody the Johns Hopkins experience. The school doesn’t just embrace academics; it celebrates everything that makes its students and workforce unique.

I look at the broad swath of Johns Hopkins reflected in my competitors, and I am incredibly proud to be among them. Regardless of our backgrounds, we are all coming together for a common cause.

On the night of the competition, expect dips, flips and at least one faculty member to be doing the A-Town Stomp. It will be a night 0to remember, and I couldn’t be more excited to be a part of it.

About the Author

Arielle Medford

Arielle Medford is a fourth-year medical student who spent this past year doing cancer research. She is also a dancer and a writer, and she loves everything science.

As our appointment came to an end, I took a few minutes to give final instructions to my patient. Though she had many medical issues, she had unfortunately been absent from my clinic for almost six months, making this appointment particularly important and valuable.

I observed as she leaned in and struggled to understand the problems that I attempted to address. As I did, it became apparent to me that not everything was being accurately translated. I paused and asked if she understood. She nodded, though I suspected this was not the entire truth.

woman shows a medical prescription bottle to a manStill determined to get through, I grabbed a sheet of paper and wrote the simplest information that I could to explain her health concerns. Again, I probed to see if she could understand with the words now in writing. She regarded the paper with a quizzical look but glanced back to me and said, “I’ll try, but if not, I’ll get someone to help me.”

And then, things became clearer to me.

Health literacy is certainly not a new issue. The Institute of Medicine and the U.S. Department of Health and Human Services define health literacy as the “degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” It is estimated that about 15 percent of American adults have poor health literacy, and this proportion is higher among the elderly.[1] This problem is perhaps even more acute in urban clinics like my primary care clinic in East Baltimore.

Katie Shaw, M.D., a fourth-year internal medicine and pediatrics resident at Johns Hopkins, sees the impact of poor health literacy regularly and has identified ways to bridge the literacy gap in her clinic.

“There are simple things, like using the teach-back method or simply asking the patient what they understand about their medical condition, that provide a lot of insight for me as a provider,” said Dr. Shaw, who did health literacy research as a medical student at Vanderbilt. The teach-back method allows the patient to explain their understanding of the medical plan to the provider, who can make sure that both parties are on the same page. Dr. Shaw also recommends utilizing nurse case managers, home care nurses and pharmacists to reach out to patients with low health literacy.

“Taking a small amount of time to work to make sure patients understand and are engaged in their health plans goes a long way,” said Dr. Shaw.

Lucky for me, I got another try at explaining such topics to my patient who was admitted to the hospital just a few days after our previous meeting. Visiting her, I thought back to our challenging conversation in that small clinic room. Now there was more to share and more to explain.

I sat down next to her with a smile and asked her how she felt. Success would not come overnight. However, with a new approach to talking through issues with this patient and others with low health literacy, I am confident that together we can help her achieve better health.

 

[1] Kutner M, Greenberg E, Jin Y, et al. The health literacy of America’s adults — Results for the 2003 national assessment of adult literacy. Washington, DC: US. Department of Education; 2006:i–60. Available at http://nces.ed.gov/pubs2006/2006483.pdf. Accessed April 7, 2015.

 



 

About the Author

Ryan Lang

Ryan Lang is a physician and writer with a passion for the underserved and a desire to bring the medical issues of this population to light.

Graduate school is a lot of work.

video game joystick surrounded by charts, graphs and lightbulbs

While the type of work varied throughout my first three years here, expectations remained high. These expectations are what drives us to do great research and hopefully make significant changes in the lives of patients who need new treatments. But the stressful atmosphere can be overwhelming.

Like many of my fellow students, I developed a few coping mechanisms. During graduate school, it was playing the video game “Mass Effect.”

For those who are unfamiliar, the “Mass Effect” series is a science fiction-based game set in a world just beyond the recognition of the one we live in today. Space travel is common and alien races abound, as does conflict. While some may see the game as a mindless mashing of buttons, I found it both entertaining and enlightening.

Mass-Effect-pull-quote_Bree-YanagisawaVideo games constantly get a bad rap. Critics claim they increase violent acts or encourage an inactive lifestyle. But I see them as a remarkably underutilized resource. Playing through the “Mass Effect” universe, I interacted with real scientific concepts that encouraged me, an advanced level scientist, to get excited about scientific learning in a completely different way than I had before — an idea I found highly intriguing.

In a world where the scientific community is becoming more specialized, the scientific literacy of the general population is only decreasing. And, unfortunately, it is becoming harder and harder to attract young people to science, a field generally considered more intellectually challenging than other required courses. But if we could use an outlet that already attracts so many youth as a catalyst for encouraging interest in science, we could not only inspire scientific literacy at a young age, but also potentially lead children to seek out this knowledge on their own.

To that end, many companies have been creating stimulating educational games that can be incorporated into classrooms. In fact, NASA just recently launched an alternate reality game called “DUST” to encourage science engagement in high school-age children. Another company, GlassLab Games, partnered with “SimCity” developer EA Games to create a modified version of “SimCity” to teach children how the effects of pollution can affect town infrastructure and vice versa.

Though these examples are encouraging, the concept of using video games to promote science literacy is still in its infancy. But the potential to promote science as a fun learning experience for younger generations is an exciting one. I’m anxious to see what we can do with it.

About the Author

Bree Yanagisawa

Bree Yanagisawa is an aspiring scientist who is passionate about the unique opportunity represented in engaging science through the use of mass media sources.