As a child, my mother would take my siblings and me to the local public library. I would check out so many books that the librarians would often ask if I was sure I could read them all. I met their challenge, however, to the point where I would sometimes get in trouble at school for reading under the desk. In high school, my friends and I would spend hours in the library reviewing calculus problems and laughing at comic books during our study breaks. In college, we had 24/7 access to our school library, and almost half my time as an undergraduate was spent amongst the books.

kids learning in a library with their teacherOne of the facilities that I have most missed in medical school is easy access to a library. The Johns Hopkins campus has no shortage of libraries, but all of them have either limited hours or facilities, making them fairly inaccessible to students who wish to spend extended amounts of time studying there. This week was the first time in years that I had set foot in a library. The quiet feel and smell of paper brought back so many memories that I spent almost an hour there perusing the stacks, which led to the discovery of many treasures, such as an encyclopedia from the 1860s and a book donated by a highly controversial former patient.

quote: For me though, the hushed whispers of students and librarians browsing the stacks, the smell of pages in the air, and the idea that I was surrounded by thousands of objects of learning motivated me to keep going in my studies. Libraries have always held a special meaning in our society. They are a place where for millennia, the most sacred texts and the most important secrets of societies were stored. They are a place where people can gather with friends to increase knowledge. They are one of the few public places where one can spend hours alone getting lost in thought or in the thoughts of others. Libraries are vital to the development of an interest in school and learning in children, as they allow children space to explore their creativity. Programs in libraries serve as havens of safety and fountains of knowledge for children after school hours. I know that if my mother had not taken us to the library at a young age, then I would not have developed an early interest in school. Finally, libraries are a place for the community, where children, adults, students and the elderly can all gather to empower their own learning.

quote: They are magnets that draw in a community, that help spawn ideas and invention, and ultimately, are an investment for future generations. Since I have started medical school, the usage of libraries had been shrinking, and study spaces now consist mainly of large rooms with desks and a few computers. E-books are the new trend, and almost everything is now in either PDF form or available online. For me though, the hushed whispers of students and librarians browsing the stacks, the smell of pages in the air, and the idea that I was surrounded by thousands of objects of learning motivated me to keep going in my studies. It is just not the same studying in an empty room. Libraries are communal spaces, and it is important to remember that books in libraries are far more than mere objects that can be replaced by virtual copies. They are magnets that draw in a community, that help spawn ideas and invention, and ultimately, are an investment for future generations. The trend of shrinking libraries should be reversed, and these community centers should be brought back to the forefront of scholarly life.


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Rabia Karani

Rabia Karani just completed her M.P.H., and is now finishing up her last year of medical school. She is passionate about any topic regarding patient care and public health. An anthropologist at heart, she is an avid reader, a Harry Potter enthusiast, and she hopes to use her love for writing to inspire understanding between different groups of people.

We’re all familiar with the flu. Most consider it a pesky inconvenience or perhaps a good reason to miss work to stay home and watch Netflix. Among the list of viruses frequently mentioned in the news — Ebola, HIV, Zika — the “scare factor” associated with the flu is relatively low. But to an epidemiologist, the influenza virus is both frightening and a very real, impending threat. Indeed, scientists have been saying for the past decade that the “next big one,” (i.e. the next highly pathogenic, pandemic flu strain) could emerge at any time, and when it does, it’s going to be bad.

Determining the Most Deadly Flu Strains

The virulence of flu strains waxes and wanes over time. Influenza viruses accumulate mutations that alter their infectivity, and new strains emerge periodically, often in seasonal patterns or waves. The flu that infects many people each winter tends to be a virus that is just different enough from the previous year’s predominant strain to establish infection and typically causes minor symptoms. Occasionally, however, a new strain will emerge, either from recombination between two human strains, or from an event called “spillover,” in which an animal virus mutates in such a way that it becomes able to infect humans. These are the strains that epidemiologists are most worried about, for several reasons.

First, a recently crossed-over virus tends to be more virulent to humans because it is sufficiently different from previously-encountered strains that most hosts don’t have an adaptive immune response already mounted against it. Second, if a recently crossed-over virus is spread by an animal that travels long distances (e.g. birds), or has frequent contact with humans (e.g. pigs), this increases the potential for the virus to spread rapidly, not just via human-to-human transmission but also animal-to-human. Indeed, scientists believe that the most virulent influenza strain in recorded history — the Spanish flu — resulted from a crossover event from an avian virus, with the result being a pandemic that killed more people than were killed throughout the entirety of World War I.

Did you know: A flu virus strain that originates in animals can turn deadly because most people don't have an immune response already mounted against viruses that come from animals. Also, if a virus passes to humans from an animal that either travels long distances or has frequent contact with humans, it's much more likely to spread rapidly.

It’s safe to say that most people alive today don’t remember the last “big one.” The worst pandemic in recorded history took place between September 1918 and April 1919, during which the virus killed an estimated 675,000 people in the United States and as many as 50 million people worldwide. In more recent flu outbreaks, most deaths are people from at-risk populations — children, the elderly, and people with compromised immune systems — whereas healthy adults are typically considered to be less at risk. For reasons that are still not well understood, the virus that caused the Spanish influenza pandemic specifically killed young, healthy adults at a much higher rate than has been seen before, or since, such that 50 percent of deaths were people between the ages of 20 and 40, and 99 percent were under the age of 65.

The virus ultimately infected 25 percent of the U.S. population and as much as 40 percent of people worldwide, making it the most infectious flu strain in recorded history. Although in the U.S. only 2.5 percent of infected people died, which admittedly doesn’t sound like much, this value is several-fold higher than the case fatality rates of other flu strains. This seemingly low fatality rate (for comparison, the recent epidemic strain of Ebola had a case fatality rate of approximately 50 percent) lowered the average life expectancy in the U.S. by 12 years.

The Only Certainty is the Uncertain

With past pandemics in mind, epidemiological experts pay close attention to each year’s flu strains and broad trends across time to try to predict when the next big one will hit. Increasing population densities, advances in air travel and the globalization of business in the last century make it extremely likely that when it does hit, it will impact the world more greatly than the Spanish influenza pandemic. Indeed, it has been estimated that if a strain infected and killed the same percentage of people as in 1918, today, somewhere between 74 and 370 million people would die.

Unfortunately, the inherent unpredictability of viral mutation and crossover events means that it is unlikely that researchers will be able to head off such an event with prospective vaccine development, and predictive modeling based on past flu pandemics has failed to identify any concrete patterns. In the meantime, epidemiologists are stuck waiting, with the unsatisfying reality that, as the philosopher Pliny the Elder said, “the only certainty is that nothing is certain.”


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Emily Fray

Emily is a second-year Ph.D. student in the Biochemistry, Cellular and Molecular Biology Graduate Program. She is passionate about reading and writing about science, learning about infectious diseases, consuming large quantities of caffeine, and studying her personal role model, Louis Pasteur. She hopes to someday combine her loves of English and science to work as an editor for a major journal or textbook company.

It’s funny to note that many medical conditions are described using food analogies. For example, boxers are often diagnosed with “cauliflower ear”, a condition where the swollen ear resembles the folds of cauliflower; and birthmarks with a characteristic red color are referred to as “port wine stain.” Another example, cellulite, is often described as “orange peel skin” or “cottage cheese-like.” Cellulite affects 80 percent to 90 percent of women, most of whom consider it unsightly, inconvenient or unattractive. But why do women get cellulite and not men?

quote by Sarah Robbins: differences in sex hormones between males and females have also been suggested as the cause for female cellulite, specifically those related to the feminine hormone cycle. There are several possible reasons, all of which are attributed to unique aspects of female physiology. Subcutaneous tissue is organized differently in males and females. In females, the connective fibers that hold adjacent cells together are organized perpendicularly, which allows fat cells to expand in a rectangular pattern; whereas in males, these fibers are zig-zagged, which constricts the fat cells into a diagonal arrangement. These patterns are not unique to overweight or obese people, but are completely determined by sex.

Gaining weight can exacerbate the appearance of cellulite, however, because it causes fat cells to expand, similar to overfilling a mattress. Differences in sex hormones between males and females have also been suggested as the cause of female cellulite, specifically those related to the feminine hormone cycle. Researchers have pointed to increases in estrogen that occur during the menstrual cycle as a possible cause of chronic inflammation that could lead to the destruction of subcutaneous connective tissue.

Damage to connective tissue could cause or exacerbate the appearance of cellulite by affecting the shape and integrity of the elastic fibers that are responsible for holding tissues in a specific organization, making the skin more prone to the indentations and rippling which are characteristic of cellulite. Despite the high prevalence of cellulite, however, there is currently only a small body of published research regarding the cellular mechanisms leading to cellulite, and the precise cause remains unknown.

diagram of cellulite cells shows that cellulite forms when there is an excess of fat cells in the skin
Even though cellulite isn’t a health issue, but rather a female trait, many women may still want to change the appearance of their “orange peel skin.” Currently, the simplest way to reduce cellulite is to lose weight. However, for reasons that aren’t clear, weight loss doesn’t always help for some women. There are many other treatments available, including topical treatments, laser therapy, shockwave therapy, dermabrasion and manual massage. A recent review looked at over 70 clinical studies and concluded that laser therapy seems to be the most effective.  Laser therapy is a relatively expensive but minorly invasive option. The procedure requires that patients visit a physician, who numbs the affected area and makes several small incisions through which a laser is threaded. Once inserted, the laser thread can target and ablate enlarged pockets of fat and stubborn subcutaneous fibers that may be causing the skin’s dimpled appearance. Due to the cost of this treatment, some may opt for other treatments or diet and exercise plans instead. Ultimately, women should consult a physician when considering which option is best for them.

The prevalence of smooth, photoshopped thighs on today’s billboards and magazine covers simply does not represent actual female physiology. It’s important to remember that having cellulite isn’t a symptom of a larger medical problem, and it certainly isn’t something that requires treatment if it isn’t an aesthetic concern. For women who are bothered by the appearance of their cellulite, however, current treatments may help, and more innovative treatment options may be just around the corner.


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Sarah Robbins

Sarah Robbins is a human genetics Ph.D. student. Her skill at reading recipes has made her able to translate her talents from pies to PCR.

Have you ever been working in the lab and developed a technique or an assay that you think could be marketable? Would you know what to do to bring it to market? Many scientists don’t have much business experience, making it difficult to take an idea and turn it into a product. Thankfully, this is where Johns Hopkins Technology Ventures (JHTV) comes into play.

light bulbs symbolizing ideasJHTV was established at Johns Hopkins in 2008 to serve “as the licensing, patent, and technology commercialization office for Johns Hopkins researchers and inventors.” It is responsible for completing material transfer agreements, filing invention disclosures and aiding in the patent application process. The activities of JHTV have grown significantly since its inception. From just 2015 to 2016, licensing revenue increased from $17.9 million to $58 million. In 2016 alone, JHTV helped achieve 153 new patents for Johns Hopkins investigators and form 22 new startups.

The process starts when an investigator discloses an invention to JHTV. The JHTV team then evaluates the technology to determine a commercialization strategy. This will often involve filing a patent and protecting the intellectual property before moving forward. After patents are established, the technology can advance to marketing and outreach; the technology may be licensed to another company or result in the formation of a startup.

process of filing a patent

There can be a lot to gain from working with JHTV. For some, going through the invention process with JHTV can open new research opportunities. The startup Pharos Biologicals was formed by a collaboration between two Johns Hopkins faculty members, Drs. J. Thomas August and Hai-Quan Mao. Their company combines the bioengineering expertise of Dr. Mao and the RNA virus knowledge of Dr. August, with a focus on designing novel vaccines for viruses like Zika. Drs. August and Mao use viral DNA to stimulate an immune response against a specific pathogen and administer the viral DNA using a nanosphere vaccine-delivery system. Their company builds on two patents, filed previously by Dr. August with Johns Hopkins, and their vaccine has progressed to clinical trials. The development of Pharos Biologicals has allowed these Hopkins investigators to take their collaboration to the next level, branching out from their NIH-funded Zika research to apply their vaccine technology to related viruses using resources from venture capitalists and revenue from their technology.

For one Ph.D. student, an internship at JHTV gave him a leg up to become a patent agent. Kyle Bruner, a graduate of the Cellular and Molecular Medicine Program, was a member of the Commercialization Academy, a JHTV program that teaches students about science from the intellectual property and marketing side. Kyle appreciated that this gave him the “opportunity to gain a perspective that a graduate student wouldn’t normally get.” He focused on intellectual property and patent law during his internship, which gave him the experience he needed to take the next step in his career.

For inventors and those interested in learning more about topics related to entrepreneurship, JHTV also offers a whole host of other resources, including a Mentors-in-Residence program that pairs faculty and startups at Johns Hopkins with experienced entrepreneurs, industry leaders and venture capitalists. These relationships help move startups along the path to success. JHTV has sponsored a Bootcamp for Technology Entrepreneurs program that provides skills and knowledge for participants, who have ranged from undergraduates to principal investigators, to bring ideas out of the lab and into the marketplace. JHTV also hosts guest speakers throughout the year to cover keys to success in commercialization, marketing and startups. No matter what your skill level or interest in being an entrepreneurial scientist, JHTV has a way to help you out.


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Rebecca Tweedell

Rebecca Tweedell is a fifth-year Ph.D. student in the Cellular and Molecular Medicine program with a strong passion for infectious disease research. In addition to loving anything and everything nerdy and generally uncool, she is an avid runner, rower and random sport participant. Her dream job is to be a Disney princess, singing and performing by day, while writing scientific manuscripts by night.

Retro girl applying perfume (All clothes and other accessories are original, from the first part of the xx. century!) Toned image, real film grain added for vintage feeling.Pheromones are chemicals secreted by animals that influence the behavior of recipient animals of the same species, often to attract mates. That some form of chemical communication occurs between animals was first recognized as far back as ancient Greece, when the Greeks noted that male dogs were attracted to secretions from female dogs in heat. Bombykol, a pheromone released by female silkworm moths, was the first pheromone to be chemically characterized by Nobel Prize–winning German chemist Adolf Butenandt in 1959.

Since then, pheromones have been identified in a plethora of animal species, including flies, fish, ants and mice. However, human pheromones have famously eluded scientists. This is because there are several sources of pheromone-like compounds in humans: axillary (armpit) glands, salivary glands, seminal and urine secretions, all of which are composed of hundreds if not thousands of chemicals. Moreover, the often-accepted primary source of potential pheromones, axillary gland, also breeds bacteria, which change the chemical composition of the secretions. In addition, the difference in composition between males and females, changes due to age, emotional state and menstrual cycle all add to the complexity of identifying human pheromones.

The difference in composition of pheromones between males and females, changes due to age, emotional state and menstrual cycle all add to the complexity of identifying human pheromones.Although the existence of human pheromones, specifically human sex pheromones, is highly controversial, scientists agree that natural human scents can modulate the behavior of other humans. Several studies have shown a correlation between the perceived attractiveness of members of the opposite sex and an appealing smell associated with their sweat. A paper published in 1991 and follow-up studies conducted in the early 2000s indicated that the steroid hormones androstadienone (AND), found in male sweat, urine and saliva; and estratetraenol (EST), found in female urine, might be putative human sex pheromones. Perfume companies immediately started selling products containing these chemicals, or their derivatives, and marketing them as “love potions”.

However, there was no consensus in the scientific community about the validity of this claim. Recently, a study published in the Royal Society Open Science journal has called into question these claims, by reporting that the pheromones AND and EST have no effect on "mate perception." In this study, the scientists tested 94 heterosexual women and men on two tasks. The first task involved perceptions of gender; the second task involved perceptions of attractiveness and unfaithfulness. Each participant was evaluated on the same task twice, on consecutive days. They either received clove oil as a control on one day and one of the two putative pheromones (AND or EST) on another day.

The order of control odor and pheromone odor was randomized. They were first asked to identify the sex of a "gender-neutral" face generated by combining many photos of men and women. Participants were then asked to rate the attractiveness of the faces and whether they thought that person was likely to commit adultery, a factor often considered when choosing a mate. The scientists worked under the hypothesis that if AND and EST truly were gender-specific pheromones, then they should affect behaviors such as mate perception, which are reproductively relevant.

The double-blind study showed that exposure to these chemicals had no effect on gender, attractiveness or unfaithfulness ratings by the participants. Therefore, the researchers concluded that the most plausible explanation for their results is that these two chemicals are not sex pheromones. This study does not rule out the possibility of the existence of human sex pheromones but strongly suggests that they might not be AND or EST.

References

  1. Putative sex-specific human pheromones do not affect gender perception, attractiveness ratings or unfaithfulness judgements of opposite sex faces
  2. Emergence of AND and EST as putative pheromones

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Monika Deshpande

Monika Deshpande is passionate about science communication. When she was a postdoc at the National Institutes of Health, she was involved in several publications, such as The NIH Catalyst and NIH Research Matters. She is adept at interviewing scientists and showcasing their achievements, and is able to write for scientific and nonscientific audience.

We live in a tumultuous time for politics across the country. Although our country may remain divided on key issues, we can all agree that with rapid legislative changes and dynamic dialogue about an uncertain future, it is ever more important for people to engage with legislators and lawmakers to shape the future they want to live in.

american flag and stethoscope

Even in medicine, at all levels, physicians continue to step into the role of policy makers and leaders; currently, the 115th United States Congress has three physicians in the Senate and 12 physicians in the House of Representatives. As a medical student, I feel compelled to stay informed and engaged on issues within and beyond the realm of health care, and I am beginning to reach out and discover new opportunities to learn about the world of policy. One of those opportunities has been through MedChi.

The Medical and Chirurgical Faculty of the State of Maryland, or MedChi for short, is officially known as the Maryland State Medical Society, which dates back to its origins in 1799. The mission of MedChi is to “serve as Maryland's foremost advocate and resource for physicians, their patients, and the public health.” MedChi serves as an advocacy body and resource center for over 22,000 licensed physicians, 24 sub-medical societies , and is a component of the American Medical Association.

As a medical student, I feel compelled to stay informed and engaged on issues within and beyond the realm of health care, and I am beginning to reach out and discover new opportunities to learn about the world of policy. I first became involved in MedChi simply by responding to an email invitation sent out to our medical school to sit in on a General Assembly meeting of the Maryland state government, a body that MedChi advises regarding medically-related legislation. As I quickly learned, MedChi, although primarily for practicing physicians, is extremely receptive to students in training. Beyond being offered free and full membership into the society, we were personally welcomed into the meeting by the CEO of MedChi, Gene Ransom III, who educated us about MedChi, set up meetings for us to meet legislators and even gave us his personal contact information.

As a first-year medical student, I traveled to Annapolis, Md., and met with a few delegates in the General Assembly who were physicians by training. I spoke with them about their role as physician legislators, and also sat in on a House of Delegates and Senate meeting as they voted on key statewide legislation. I then had the opportunity to attend the MedChi House of Delegates meeting, a MedChi Presidential Gala and a recap of legislation meeting, where I learned about current legislation being passed internally to MedChi, as well as the future of MedChi.

This has been an incredible learning experience. I’ve already begun to form a network of politicians and physicians who understand the physician’s role in tomorrow’s policy-making, and I’ve experienced legislation in action, firsthand. Furthermore, I’m planning on attending the American Medical Association annual conference next month to submit a resolution, a piece of legislation that could impact the policies of the AMA’s Medical Student Senate and, eventually, perhaps influence AMA and even national policy.

Although I’m still unclear about what my future holds, this experience has given me an insight into the career path of being a physician-politician. Whether this manifests as an elected position or simply being engaged in leadership and governance, I know that this exposure in my training will lead to lifelong skills and lessons.


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Pranjal Gupta

Pranjal Bodh Gupta is a second-year medical student who arrived at Johns Hopkins from Vanderbilt University where, over the course of four years, he danced in numerous cultural showcases. Throughout these shows, he learned various routines, including a Japanese fisherman dance (“Soran Bushi”), Indian Bollywood dance, Korean pop, Japanese drumming dance (taiko) and Indian Bhangra. As a side hobby, Pranjal made short films and majored in chemical engineering. His latest adventure includes learning medicine and trying to gain social media fame.

The competitive drive is a double-edged sword: Fighting for success or superiority sharpens our mental acuity and increases motivation, while concurrently inducing anxiety and decreasing inhibitions. Success in fast-paced. Intensive careers such as business, law, science and medicine require using this competitive spirit to drive higher performance and production. Yet this drive to succeed can prove costly and may also lead to burnout, career changes, and—more worrisome—dishonesty.

business people running on a trackAs the new generation of trainees, we’re growing in an environment that fosters collaboration, but the post-training hunt for jobs has never been more cutthroat. Therefore, it’s imperative that we understand how to stimulate our competitive drive to excel without crashing down on the other side.

Competition in the workplace and education systems is still a hotly contested issue. On the one hand, many managers and educators argue that competition brings out the best in their employees and students, and the competitive drive can be exploited beyond what’s expected. These leaders often employ tactics that openly compare production, such as workplace contests, class-rankings, and grading, on a curve. Other leaders believe that direct competition adversely affects employee and student performance. So, instead, they might keep bonuses and rankings secret, while rewarding broad collaboration. Unsurprisingly, data supporting one tactic over the other have been mixed.

drive to succeed can be troubling.Perspective May Impact Success

Recently, sociologists have begun to examine how the framing of competition in both the workplace and the classroom impacts success. In one study, employees were given a hypothetical challenge in which they were told their sales numbers would be compared with their colleagues at the end of a trial month. The workers were divided into two groups: Half were told their success during that month would determine how high above average their bonuses would be, while the other half were informed that if they scored lower than average, they would risk performance reviews and termination.

After completing the study, the researchers reported an interesting and relevant phenomenon. The positively motivated first group significantly increased their output during the experiment and engaged in a variety of creative behaviors to achieve their numbers. The other group—those threatened with negative ramifications—reported higher levels of anxiety and stress, and primarily focused on working longer, harder hours, rather than exploring creative solutions. Of course, in our own lives, competition is nearly always framed in both the positive (career success!) and the negative (failing) simultaneously. Therefore, whether we are aided or hindered by competition largely depends on our interpretation of each challenge.

The Dark Side of Academic Competition

In the experiment described above, the researchers reported one additional significant difference between the two groups: Those threatened with failure were more likely to engage in unethical behaviors. This aspect of human nature poses a serious risk in high-level, fast-paced career fields such as science and medicine. Research moves quickly, and the “publish or perish” motto has never been more true. Medical jobs are hard to come by, and without superb grades, it may be hard to access your ideal career. In fact, with the current aggressively competitive funding environment, and the consequences of losing so serious, many journals are reporting significantly increased levels of fraud and paper retractions.

A number of researchers are investigating this dark side of academic competition and have made a number of recommendations. Most involve identifying ways to reduce the cutthroat pressure trainees constantly face, such as getting rid of class rankings and de-emphasizing the number of published papers needed, as well as fostering a stronger spirit of collaboration throughout the scientific and medical communities. Realistically, however, high-stakes competition will likely never vanish from our culture. So it behooves us to learn how to harness this innate drive to improve our chances for success.


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Benjamin Bell

Benjamin Bell studies sleep and circadian rhythms in mice and flies, and is fortunate the mice understand his semi-nocturnal work schedule. When not actively in the lab, you can find him thinking about research and science-writing on his motorcycle, on the hiking trails, or at any local concert venue.

A sizeable crowd of over two hundred attendees gathered in Turner Auditorium on April 18, 2017, to hear discussions on mood disorders at the 31st Annual Mood Disorders Research/Education Symposium, sponsored by the Johns Hopkins Mood Disorders Center.

 Mood disorders, which encompass major depression, anxiety disorder, and bipolar disorder, as well as a spectrum of mood dysregulation conditions, affect up to 20.8% of Americans at any given point in their lifetimes.Mood disorders, which encompass major depression, anxiety disorder and bipolar disorder, as well as a spectrum of mood dysregulation conditions, affect up to 20.8 percent of Americans at any given point in their lifetimes (1). According to the World Health Organization, mood disorders as a group are also the leading cause of disability and decreased quality of life among Americans ages 15-44 (2). While the staple of treatment involves talk therapy and pharmacological agents, the field of mood disorders has undergone big changes in recent years, with renewed research in the electrical-circuit-based biology underlying these mental illnesses as well as more options for treatment, such as mindfulness and meditation.

The recent Mood Disorders Research/Education Symposium consisted of dynamic expert speakers from the psychiatry departments of Johns Hopkins and other highly acclaimed research institutions, including the University of Oxford and Georgetown University School of Medicine. Likewise, the topics of the mini lectures were equally diverse, ranging from expositions on ongoing research studies to patient and family spotlights that were reminiscent of the multi-dimensional and patient-oriented interviews, historically an integral part of the way psychiatry is practiced at Johns Hopkins, conducted within the units in the Meyer building.

With discipline and practice, transcendental meditation may be a potent tool to combat the anxiety-laden and reactionary aspects of major depression with which some patients may struggle.I arrived from work just in time to listen to Dr. Norman Rosenthal, known for describing seasonal affective disorder, discussed the value of transcendental meditation. With discipline and practice, transcendental meditation may be a potent tool to combat the anxiety-laden and reactionary aspects of major depression with which some patients may struggle. Dr. Guy Goodwin delivered a presentation on how smartphones could tap into a new aspect of monitoring and potentially treating psychiatric disorders, such as tracking the mood lability experienced by borderline patients. Technology, such as text messaging to monitor mood and apps for stress management, is becoming an increasingly appealing avenue to transform care for patients with mood disorders.

As a neuroscience and English literature double major from college, I paid particular attention to the talk on female poets and mania by Dr. Kay Jamison, professor of psychiatry at Johns Hopkins and author of several well-known books on her personal experience as well as profiles on artists and thinkers who have struggled with mental illness. I had read and included excerpts from her autobiography, An Unquiet Mind, in my undergraduate thesis on illness narratives, drawn to her earnest descriptions of living and thriving with bipolar disorder. Writing appeared to be a particularly effective and eloquent avenue to communicate her experience with a wide audience. On that spring afternoon at Hopkins, Dr. Jamison’s presentation also tied writing and art into a broader discussion about mental health, highlighting quotations by women writers, such as Sylvia Plath and Virginia Woolf, and showcasing the rich and varied lives and talents sufferers from mental illness held. Her lecture encapsulated an underlying theme of the symposium—that patients are more than their psychiatric disorders.

Hopefully soon, and with the aid of symposiums such as the one the Hopkins Mood Disorders Center organizes yearly, patients, family members and doctors will all benefit from strides in understanding mood disorders and their impact on patients. As Dr. Hope Jahren, author of the bestselling memoir Lab Girl, admits during her frank keynote interview at the conclusion of the symposium, “I’m not like this. This [bipolar disorder] isn’t me. … [and] empathy makes the wall between me and the world … a lot more permeable.”


References:

  1. National Institute of Mental Health. Any Mood Disorder Among Adults
  2. National Institute of Health Research Portfolio Online Reporting Tools. Mood Disorders.

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Adela Wu

Adela Wu is passionate about making connections between ideas and people, and seeing how her interests in literature, creative writing and medicine play out in that theme. In addition, she also enjoys river and sea kayaking, having recently whitewater kayaked the Shenandoah River rapids.

Each Tuesday, I read the New York Times science section over a cup of coffee and a protein bar. Last week’s article, “Hunched over his microscope, he sketched the secrets of how the brain worked,” exhibits the father of neuroscience, Ramon y Cajal’s, 19th century drawings and elucidations of the neuronal interconnectivity that wires our brain. He understood and predicted fundamental aspects of neuroscience prior to the advent of confocal and two-photon microscopy and complex genetic tools.

Thinking young monkey.Now, in 2017, the latest edition of Neuron features “Long-term two-photon imaging in Awake Macaque Monkey” by Ming Li and colleagues from Peking University in Beijing, China. The authors detail their solutions to technical challenges that have prevented successful, long-term, single cell live imaging in awake macaque monkeys. The new techniques featured in the article allow for visualizing individual neurons and dendrites in awake monkeys for months. This advance is revolutionary to the fields of cellular and behavioral neuroscience and enables live access to macaque circuitry, allowing researchers to study higher cognitive function through imaging and recording neuronal circuits in vivo.

Currently, in two-photon in vivo imaging, a cranial window providing imaging access to the brain area of interest is surgically implanted. High quality, long-term imaging in macaques has been limited by the fast membrane regeneration following cranial window implantation. Further, sizeable brain movements in awake behaving monkeys, as a result of physical or respiratory activity, have impeded successful live imaging. Finally, poor labeling of genetically encoded indicators has prevented adequate activity and individual neuron detection.

The authors combatted these challenges and detailed their surgical and imaging methods in this groundbreaking paper. Their long-term macaque imaging strategy involved two surgical procedures that utilize genetically modified adeno-associated viruses (AAVs) that encode a visual marker, often a fluorescent protein, to visualize a specific protein or molecule. With this methodology, they were able to record activity and perform live imaging in the intact macaque brain. Specifically, they used AAVs to report calcium activity as a read out for neuronal activity while the monkeys performed visualization tasks. They carried out these experiments over extraordinarily long periods of time and published results from experiments conducted for up to four to six months!

This is an incredible advance within the field of neuroscience. Researchers can now, in real time, visualize a synapse firing and detect a physiological response during completion of a specific task. Beyond visualizing neuronal activity, the authors were able to resolve individual dendrites using single-cell electroporation to deliver a mixture of inducible AAVs to express fluorescent calcium indicators. This is an incredible advance within the field of neuroscience. Researchers can now, in real time, visualize a synapse firing and detect a physiological response during completion of a specific task.

Hunched over their microscopes, Li and colleagues are beginning to detail how the macaque brain works. Instead of looking at fixed and stained brain sections, we can look inside the awake monkey brain and understand the firing patterns that underlie task completion. Their work begins to bridge the longstanding gap between genetics and cognition. Where will these technologies take us next?


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Joelle Dorskind

Joelle Dorskind is a Ph.D. candidate in the Cellular and Molecular Medicine program at Johns Hopkins. When she isn't in lab running experiments, she enjoys reading, playing soccer, running and traveling.

Children who experience traumatic experiences are known to have long-term negative health effects, including mental, behavioral and physical issues. Mindfulness interventions have proven successful in adults and those dealing with trauma to negate some of the effects of distress. It is suggested that mindfulness could be utilized in children with adverse childhood experiences to also curb negative health effects.

Adverse Childhood Experiences

Did you know: Studies conducted in schools practicing mindfulness have shown reduced classroom behavior problems and stress.There are many categories of adverse childhood experiences (ACEs) which a child may experience personally, or observe through a loved one. These include, but are not limited to: neglect, abuse (physical, emotional, sexual), violence, mental illness, incarceration, drug problems and low socioeconomic status. Prolonged stress can be psychologically and physically problematic, and can manifest as increased inflammation, neurological changes, and dysfunction of the endocrine system. ACEs are common: A CDC study found 69 percent of those examined in five states reported at least one incidence. ACEs tend to occur together, and more ACEs decrease overall health and well-being. ACEs have also been linked to an increased risk for migraines, insomnia, some cancers, learning and behavior problems, and suicide, as well as predispositions to behaviors leading to obesity or smoking.

Mindfulness and Traumatic Experiences

In a recent review by Robin Ortiz and Erica Sibinga of The Johns Hopkins Hospital, the authors determined that mindfulness intervention could prevent the negative side effects of ACEs. Mindfulness is found to be beneficial by redirecting the negative response to trauma as well as destressing the individual to hinder long-term effects of trauma. Mindfulness has proven a successful coping mechanism in women survivors of sexual abuse, incarcerated women, veterans with PTSD, and the general population by increasing resiliency. The practice has been shown to reduce inflammation, alter immunity, and decrease biological aging.

adding just 10-15 minutes of mindfulness to your day can make a significant impact on your stress levels. Try strategies like starting your day with a basic yoga sun salutation, taking a break to check in with your breathing. Doing a body scan paying attention to any tension or stress and relaxing at the end of the day with a guided meditation.

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Practicing Mindfulness

Derived from Buddhist tradition, mindfulness is the practice of being fully aware of the present moment in a non-judgmental manner. Mindfulness can be intentionally practiced in structured training programs. Outside of structured practice, mindfulness can be achieved through art therapy, yoga, group therapy, and other focuses on mind and body. Practicing mindfulness has been shown to increase resiliency. Resilience lies in the ability to effectively cope with a traumatic experience. After many traumatic experiences, the survivor may try to dissociate from the trauma, which prevents helpful processing of the event. Mindfulness brings attention and awareness to the traumatic event, which can help with coping and increase resilience.

Utilizing Mindfulness for ACEs

Employing mindfulness techniques in everyday life can help survivors of traumatic experiences, as well as benefit the general public to reduce stress. Focusing on introducing mindfulness into your busy day, or encouraging others who are struggling to bring awareness, can help everyone to negate the long-term negative side effects of stress.

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About the Author

Brittany Avin

Brittany Avin is a Ph.D. candidate in molecular biology and genetics. She is a cancer survivor, cancer researcher, and cancer advocate who’s passionate about closing the communication gap between patients, clinicians and researchers.