2024 Edition
"I've been absolutely terrified every minute of my life - and I've never let it keep me from doing a single thing I wanted to do."
Georgia O’Keefe
The Editor's Take
Welcome back, AMWA, to the first edition of the 2024 Newsletter! This edition has articles on the path to becoming an MD/Ph.D., gluten-free diets, college students' common struggles, and heart health awareness. We also have our two paired articles: The Sex Talk You Never Had - Birth Control and Hot Button: The Controversies of Paolo Macchiarini. Here is our Spotify playlist for this month!
As always, if you would like to submit an article piece of your own, have ideas you would like to see incorporated into the newsletter, or have any questions, email me at Tanya.Baiju@utdallas.edu.
-Tanya
The Sex Talk You Never Had -
Birth Control: Contraceptive and More
By: Zoe Du and Riya Ramani
Colloquially known as birth control pills or simply “the pill,” oral contraceptives were designed to prevent pregnancy. Containing either a combination of estrogen and progesterone or just progesterone, the pill works by preventing follicular development and ovulation. When taken perfectly, the pill is 99% effective; in practice, the effectiveness is closer to 93% due to factors like missing a day. Due to its high effectiveness, safety, and relative accessibility, birth control pills are the most common type of contraceptives, with approximately a quarter of women aged 15-44 on contraceptives choosing the pill.
While primarily used as a contraceptive, birth control pills have a plethora of non-contraceptive functions. A study by the Guttmacher Institute found that while 86% of women use oral contraceptives to prevent pregnancy (i.e., 14% of women take the pill exclusively for non-contraceptive purposes), 58% of women use the pill to some degree for reasons other than to prevent pregnancy including the following.
Reducing Cramps and Menstrual Pain (31%) For some women, menstrual pain or dysmenorrhea can be debilitating and significantly impact their quality of life. While there may be side effects, oral contraceptives are effective at reducing the level of pain women with dysmenorrhea experience.
Menstrual Regulation (28%) While we learn in biology that the menstrual cycle is 28 days long, the reality is far from it for many women, with estimates of between 14-25% of women experiencing irregular menstrual cycles. Irregularities include amenorrhea (absent), oligomenorrhea (infrequent), menorrhagia (heavy), and polymenorrhea (cycle less than 21 days). By regulating hormones, oral contraceptives can help make menstrual cycles more regular. That being said, you may experience irregular cycles in the first few months of taking or stopping the use of oral contraceptives.
Treatment of Acne (14%) Oral contraceptives are generally accepted to be effective at treating androgenization, including acne, by suppressing androgen secretion and reducing the amount of free androgens.
Beyond the three functions above, oral contraceptives have also been indicated in helping to treat or prevent ovarian cysts, endometriosis, pelvic inflammatory disease, rheumatoid arthritis, and more.
As reproductive rights are continuously being challenged across the United States, birth control may be reduced to and misrepresented as only a contraceptive. Still, it is essential to remember that birth control is so much more than just a contraceptive. It helps women improve their quality of life in several ways that should not be politicized or banned.
Why Consider an MD/PhD?
By: Alyssa Chiev
The field of physician-scientist might seem daunting to most. The idea of completing eight years of medical and graduate school, not including residency, is enough to make this dual degree unattractive to most students, not to mention the low acceptance rate into these programs. However, if time is not a concern and you want to spend most of your time conducting medical research, consider applying to M.D./Ph.D. programs!
How to get into an M.D./PhD Program
The admission process is similar to the M.D. admission process. First, indicate that you are applying to M.D./Ph.D. programs instead of M.D. programs when submitting an AMCAS application. Then, you must write extra essays detailing why you want to pursue a dual degree. You will meet with faculty from Ph.D., M.D., and M.D./Ph.D. programs at the interview stage. However, there are some cases where, if you are rejected, the school will direct your application to their M.D.-only programs. Overall, the application processes between these two programs are similar. Although M.D./Ph.D. programs are regarded as selective, it is essential to remember that only a few students are interested in them. In 2016, there were 1,936 program applicants, and 649 were matriculated.
Career Prospect
The career of a physician-scientist is a unique one. According to AAMC, about 75% of U.S. M.D./Ph.D. graduates are in academic medicine or pharmaceutical company positions to use their interest in patient care and research. They are typically faculty members at an academic medical center and spend most of their time conducting research (although this can vary with their specialty). They spend their remaining time teaching, doing administrative tasks, or performing clinical services.
"Do I need an M.D./Ph.D. to be a physician-scientist?"
No, however, an M.D. applying for research funding and academic positions will most likely be overshadowed by M.D./Ph.D.s as they have more research experience than their M.D. counterparts.
"How is the salary?"
Unfortunately, physician-scientists salary is not too high, averaging around $80,000-$110,000, considering the intensive schooling compared to regular physicians.
Benefits
Despite the low salaries and years of intense schooling, there are several benefits in this field to make up for it:
Most programs grant tuition-free training; in addition, most students receive stipends. According to AAMC, it can be as high as $38,000 annually.
You will be a top expert in your field.
Not only will you be able to treat patients, but you will also be able to pursue research that may translate into a clinical cure for a particular disease.
Pursuing a career as a physician-scientist is worth it if you enjoy research and want a career practicing medicine as well. If the time commitment and difficulty seem okay, this dual degree is worth considering. While there are setbacks to this dual degree, this degree offers unique and rewarding benefits.
Gluten-Free - Fad or not?
By: Zoe Du
Imagine you are at the store to restock your fridge and pantry. As you turn down the bread aisle, you see an overwhelming number of options. White, whole wheat, whole grain and seeds, gluten-free… wait, gluten-free. You’ve seen fitness and health influencers recommend a gluten-free diet for weight loss and reduced inflammation and bloating; it sounds healthy enough. You check the price, and it’s twice as expensive as your standard loaf of bread - that often means something is higher quality and/or healthier. You cannot help but wonder, is gluten-free worth that price tag, and is there truth to the health claims?
Well, the answer is it depends. For about 6-7% of the U.S. population, around 20 million Americans, a gluten-free diet is crucial because of gluten intolerance. Perhaps the most widely known condition is celiac disease, in which gluten triggers an immune response. While gluten consumption causes symptoms like diarrhea, bloating, and nausea to be felt acutely, over time, inflammation and damage to the small intestine leads to malabsorption of nutrients like calcium, vitamin D, folate, and vitamin B12. In children especially, this can deleteriously impact growth and development. For those with gluten intolerance, a gluten-free diet often helps manage these symptoms.
Ironically, gluten-free foods can contribute to micronutrient deficiencies for non-gluten intolerant consumers. Wheat products are commonly fortified with essential vitamins and minerals like B vitamins, folate, and iron; gluten-free products often are not. Additionally, gluten-free does not equate to low-carb or low-fat. In fact, in many cases, gluten-free products contain more sugar and fat than their gluten-containing counterparts. Subsequently, studies have indicated increased fat and calorie consumption with a gluten-free diet. Obesity, weight gain, and insulin resistance have also been observed.
Beyond the health impacts of a gluten-free diet, it is also simply less accessible to the average consumer. Gluten-free foods are, on average, about twice as expensive as wheat-based products, making the gluten-free diet much more costly to maintain. The increasing popularity of gluten-free diets may be a double-edged sword. At the same time, the increased demand contributes to a greater number of gluten-free foods, which may also contribute to increased prices.
While necessary for individuals with gluten intolerance, gluten-free diets start to cross into the territory of fad diets. While some gluten-free diet adherents have anecdotal evidence of positive health benefits, the current literature does not provide strong evidence to generally support these claims. It can, in fact, have negative health effects if not diverse.
Hot Button: The Controversies of Paolo Macchiarini
By: Sahaana Anand and Alyssa Chiev
Paolo Macchiarini is a world-renowned thoracic surgeon famous for his plastic windpipes infused with stem cells. These stem cell-infused windpipes took the world by storm because they solved two significant problems in the medical world: lack of organ donations and organ rejection. His new creation led to widespread media attention to his place of work, the Karolinska Institute, one of Europe's best hospitals at the time. However, there is a problem: all of his patients are dying.
From 2011 to 2012, Paulo performed an experimental procedure with patients needing a trachea transplant. The idea was that he would spread the patient's stem cells over the synthetic trachea, and once inserted, the stem cells would grow and provide the replacement. Usually, when trying out novel surgeries like these, they would need to be studied and experimented with in a lab setting. The problem with this procedure was that it never made its way out of the lab. It has never been in the lab, to begin with. As a result, all of the patients but one who received this synthetic trachea passed tragically.
After these procedures, Dr. Macciarini suddenly disappears and is not present for post-operative complications. Dr. Sandhu, a coworker of Paolo, stated: "Macchiarini's pattern was to carry out these high-profile surgeries then not be available for follow-up. He would disappear and ignore phone calls. He blamed the doctors who picked up his cases for the poor outcomes." Most of these complications result from infection from the trachea being exposed to air rapidly after the procedure. Not only that, but as it turns out, stem cells were not regenerating the trachea at all.
Some of these particular patients who underwent surgery by Dr. Macciarini were Hannah Warren and Andemariam Beyene. Hannah was an American child, and she was born without a trachea. She got a synthetic windpipe and stem cell implantation, but she unfortunately died a few months after this surgery. Andemariam, on the other hand, was from Eritrea and also received a synthetic trachea in 2011. Though it was initially considered a success, complications later arose, leading to severe health issues and ultimately leading to his death in 2014.
These cases garnered significant media attention and raised ethical questions about experimental treatments, informed consent adequacy, and proper medical research regulation. Much talk and frustration was expressed over how such a high-stakes situation could be allowed legally without much repercussion. This led to the eventual in-depth investigation of Dr. Macciarini's work.
Only when a Belgian researcher submitted a report to the Karolinska Institute accusing Paolo of scientific misconduct did questions emerge about his work. Further investigations into Macchiarini's work revealed discrepancies in his research publications and allegations of scientific misconduct. This led to his dismissal from his position at the Karolinska Institute in Sweden and a tarnished reputation in the scientific community.
Eventually, Vanity Fair wrote a piece exposing his outlandish lies within his personal and professional life. Since then, Paolo has had 11 of his research papers retracted and others corrected. However, as of right now, he is still able to practice medicine, and in 2023, he was sentenced to 2.5 years for gross assault on 3 of his patients.
The controversies surrounding Dr. Paolo Macchiarini's stem cell research emphasize the critical need for unwavering ethical standards, rigorous scientific scrutiny, and vigilant patient safety measures in the realm of regenerative medicine. The cases involving synthetic trachea transplants, fueled by allegations of research misconduct, inadequately informed consent, and horrible patient outcomes, undermine the accountability that must go in experimental medical procedures. The gaps in the ethics of Macchiarini's work serve as a clear reminder of the potential pitfalls when cutting-edge medical innovations outpace careful consideration of ethical implications, regulatory oversight, and the safeguarding of patients. This also has a larger impact on the scientific community, emphasizing the importance of maintaining the highest standards of integrity, transparency, and patient protection in pursuing groundbreaking medical advancements.
CSCS: College Student Common Struggles
By: Sahaana Anand
As college students in the pivotal era where academics and internships take center stage, it is easy to get caught up in the hustle of it all. These four years of our lives are full of new experiences, turbulence, personal growth, and transition, to say the least. It marks a significant transition from adolescence to adulthood for most of us, and the complexities that come with these crucial years are extensive. The college experience encompasses various challenges, opportunities, and experiences that shape everyone profoundly, setting the stage for future academic, professional, and personal endeavors. From academic rigor to social exploration, the college years serve as a pivotal chapter in the journey of self-discovery and preparation for the realities of the adult world. By addressing some of the most common struggles that college students go through, I hope that you gain new perspectives or ideas to look after yourself and each other.
One of the most common situations that all college students find themselves in is learning how to balance all aspects of their lives during these years: academics, extracurriculars, work, socializing, and self-care. From having everything written in print on how you should live your days to having this new concept of freedom and time to do things on your own time, it is quite challenging to find a balance on how to use your time wisely. With all these new opportunities in the palm of our hands, we tend to overuse our time in any one area and not enough in others. The best way to combat this issue is to be easy on yourself and learn time management skills.
We see hundreds of tactics online to manage your time, but how do you truly keep up with it? Some of us need more alone time, and others need more socializing time with friends. Learning what format you like best and setting aside a 'guilt-free fun time' is the best way to approach it. Even when you relax, remind yourself that you are supposed to have downtime and that it is for your well-being. Balancing coursework, exams, and assignments can be overwhelming, especially when multiple deadlines coincide. Being busy 24/7 and doing work all the time can be great, but having some downtime aside—time you can enjoy however you please without feeling guilty about not being productive at that time—is so important.
This also plays into the burnout that comes with running without any stops. Without time management and lots of procrastinating, stress levels increase and can also lead to mental health pressures. Finding a community by putting ourselves out there and having a support system can make or break for so many. Treat yourself with compassion just like you would others. It goes such a long way.
A video essay comparing cultures emphasized that modern times play into a 'live to work' rather than a 'work to live' mindset. In such a sense, the grind culture can be detrimental to people's mental well-being. Recognizing students' unique challenges during this pivotal period, colleges must create environments that foster mental, emotional, and physical health. Focusing on well-being empowers us to build resilience, navigate challenges, and develop the skills necessary for a fulfilling and balanced future. So, before all else, remember that you are human, find what makes you happy, and treat yourself like you would a best friend!
Heart Health Awareness for College Students
By: Riya Ramani
In the hustle and bustle of college life, amidst late-night study sessions, fast food runs, and packed schedules, it's easy for students to overlook their heart health. However, caring for your heart is essential for maintaining overall well-being and ensuring a healthy future. As February marks American Heart Month, let's delve into some practical tips and strategies for nurturing heart health tailored explicitly to college students.
Understanding Heart Health
The heart is not just a vital organ pumping blood throughout the body; it's the cornerstone of our existence. Maintaining a healthy heart is crucial for sustaining energy levels, improving cognitive function, and enhancing overall quality of life. Unfortunately, heart disease remains a leading cause of mortality globally, emphasizing the importance of prioritizing heart health from a young age.
Challenges Faced by College Students
College life often presents unique challenges that can negatively impact heart health. From irregular sleep patterns and stress to unhealthy dietary habits and sedentary lifestyles, students face various risk factors that can predispose them to heart disease later in life. Additionally, the newfound freedom and social pressures of college may lead to unhealthy behaviors such as excessive drinking and smoking, further exacerbating the risk.
Practical Tips for Heart Health
Prioritize Physical Activity: Incorporate regular exercise into your routine, aiming for at least 150 minutes of moderate-intensity aerobic activity per week. Explore campus fitness facilities, join sports clubs, or simply take brisk walks between classes to stay active.
Make Healthy Food Choices: Opt for nutrient-dense foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit your intake of processed foods, sugary snacks, and high-sodium meals often found in college cafeterias and fast-food joints.
Manage stress Effectively: Practice stress-relief techniques such as deep breathing exercises, mindfulness meditation, yoga, or journaling to alleviate academic and personal stressors. Establishing a balance between academics, social life, and self-care is essential for optimal heart health.
Get Sufficient Sleep: Aim for 7-9 hours of quality sleep each night to support heart health and overall well-being. Establish a consistent sleep schedule, create a relaxing bedtime routine, and minimize screen time before bed to improve sleep quality.
Avoid Smoking and Limit Alcohol Intake: Steer clear of smoking and vaping, as they pose significant risks to heart health. Additionally, consume alcohol in moderation, adhering to recommended guidelines to minimize the adverse effects on cardiovascular health.
Stay Informed and Proactive: Educate yourself about heart health and proactively manage your risk factors. Schedule regular check-ups with a healthcare provider, monitor your blood pressure and cholesterol levels, and maintain a healthy weight.
As college students, investing in your heart health today lays the foundation for a vibrant, fulfilling future. By adopting healthy lifestyle habits, managing stress effectively, and staying informed about heart health, you can safeguard your well-being and thrive academically, socially, and personally.
Sources
https://www.vanityfair.com/news/2016/01/celebrity-surgeon-nbc-news-producer-scam
https://news.ki.se/the-macchiarini-case-timeline
https://counseling.utdallas.edu/
Aljada, B., Zohni, A., & El-Matary, W. (2021). The Gluten-Free Diet for Celiac Disease and Beyond. Nutrients, 13(11), 3993. https://doi.org/10.3390/nu13113993
Pavliv, D. (2017, March 9). The gluten-free craze: Is it just a fad or is it necessary?. National Center for Health Research. https://www.center4research.org/gluten-free-craze-just-fad-necessary/
Reilly, N. R. (2016). The gluten-free diet: Recognizing fact, fiction, and fad. The Journal of Pediatrics, 175, 206–210. https://doi.org/10.1016/j.jpeds.2016.04.014
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693657/
https://www.plannedparenthood.org/learn/birth-control/birth-control-pill
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