2024 Edition
"You may not control all the events that happen to you, but you can decide not to be reduced by them."
Maya Angelou
The Editor's Take
Welcome AMWA to the March edition of the Newsletter! This month we have articles on Burnout, Health Crisis: Unmasking the Humanitarian Emergency in Gaza, and Navigating the Health of Your Mind and Body in the Media Maze. We also have our paired articles: Spotlight - Dr. Mary Putnam Jacobi and What’s Poppin’ - MINOCA. Additionally, we have a submission article by Shannon-Renee Odoi on AI for early disease detection. As always, here is our Study Playlist as you all finish up midterms this week.
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
Spotlight: Dr. Mary Putnam Jacobi
By: Sahaana Anand and Gauri Guruprasad
Mary Putnam Jacobi, M.D., was a revolutionary trailblazer in the late 1800s who fought for women's rights to study and practice medicine. In addition to changing the course of medicine forever, she made significant strides in comprehending gynecological health. At 17, she decided she wanted to become a doctor, to her father's disapproval but eventual support. Since medical schools were not accepting women, she studied under Dr. Elizabeth Blackwell, the first American woman to earn a medical degree. Eventually, she earned an M.D. from the Female Medical College of Pennsylvania in Philadelphia. At 31, she married Dr. Abraham Jacobi, who is known as the father of pediatrics. Together, they fought their way through hardships as a couple, revolutionizing the world of medicine.
Dr. Jacobi's gynecological advancements progressed due to a refutation essay she published known as "The Question of Rest for Women during Menstruation" (1876) in response to Dr. Edward H. Clarke's "Sex in Education or A Fair Chance for the Girls" (1873). Dr. Clarke argued that girls and boys should not be educated in the same way because while overworking the brain in both sexes could result in "monstrous brains [...] and constipated bowels", girls were at special risk due to their more complex reproductive organization (Speaker). Dr. Jacobi was not the sole retaliator of his essay, as plenty of other women's rights advocates published a hefty volume of essays. For her fiery retort against the misinformed misogynist, Dr. Jacobi won the Boylston Prize at Harvard University. Dr. Jacobi's prize-winning essay described her thorough research into the effects of menstruation on women in terms of their activity levels and whether a lack of rest deteriorated their health. She surveyed 268 women on the topic and even charted pulse pressure variations during menses, using the data to perform elaborate statistical analysis. Her astute observations led her to the conclusion that there was "nothing in the nature of menstruation to imply the necessity, or even the desirability, of rest for women whose nutrition is really normal" (Speaker). She raised the bar for women physicians by conducting research herself and displaying her own medical prowess, countering the self-righteous attitudes of male physicians.
Dr. Jacobi has also been a pivotal pioneer in advocating for combatting the prejudice that women were unfit for medical practice. She argued for equal educational and training opportunities for women in medical schools, and she also did this by co-founding the American Women's Medical Association in 1876 (so fitting for our chapter!). This organization was established in hopes of providing women with extra support and opportunities to network with other female scientists and physicians who would not have gotten the means to do so otherwise. All of her perseverance and hard work led her to even be recognized internationally as a doctor that shaped discussions for gender equality. Of course, with all of this, there was a prevalence of critics and people who simply claimed that women were incapable of excelling or even pursuing scientific works. However, Dr. Jacobi excelled by displaying her expertise and openly holding men to higher standards. She argued that women were capable of the sciences and medicine not due to their maternalism or femininity but their capacity to master the physiology and critical thinking that is crucial to medicine. She exhibited her knowledge to such an extent and re-defined what it meant to be a woman in the sciences.
Dr. Jacobi's quick-witted and cutthroat approach to defending her fellow women made her one of the most influential women in medicine, especially in the newfound realm of research, in which women were not present before. Through her lectures, advocacy, and large-scale organization, Dr. Jacobi upheld a prolonged impact on the progression of women in medicine. She paved the way for future generations of female physicians and broke gender barriers.
Burnout
By: Zoe Du
Pre-health students have a lot on their plates between classes, MCAT, clinical hours, research, and more; we’re no strangers to stress. Stress can have its benefits in the short term. However, chronic stress places you at risk for burnout, a syndrome characterized by three dimensions: emotional exhaustion, high depersonalization (cynicism), and a low sense of personal accomplishment. While burnout has predominantly been studied in the context of the workplace, it has been gaining traction within the last decade in the medical field with increasing recognition of the significant prevalence of burnout among health professionals and medical students. Surveys estimate that 50% of medical students will, at some point, exhibit signs of burnout, which is associated with symptoms like depression, substance abuse, anxiety, and gastrointestinal issues. To reduce medical student and physician burnout, we need to look at where the risk for burnout begins, and studies have shown that it may start in undergraduate school.
The first study by Fang et al. on burnout in premedical students determined that despite exhibiting more personal efficacy, they have greater depression severity and emotional exhaustion compared to non-premedical students. In particular, women and Hispanic students had especially elevated levels of burnout. Another study found that junior premedical students report feeling more overwhelmed than non-premedical students, and female juniors, in particular, feel more overwhelmed than their male peers. This is further supported by a 2018 paper that determined that the negative association between depressive symptoms and medical career interest is stronger for premed women than men. So, how do we recognize signs of burnout, and how do we prevent it?
Common signs of burnout
Fatigue: Feeling chronic exhaustion or a lack of energy is a major sign of burnout
Apathy: feeling a loss of purpose or a lack of satisfaction
Headaches
Significant changes in diet or sleep patterns
Ways to reduce the risks of burnout
Taking breaks and exploring hobbies: A common contributor to burnout is poor work-life or school-life balance. Build regular breaks into your schedule and take advantage of breaks like Spring break to relax and explore things you enjoy.
Taking care of your mental health: UTD has several mental health services, and therapy can help you manage stress healthily.
Exercise: among the many health benefits of exercise is better mental health and emotional wellbeing
Reaching out for help from family, friends, and people you trust.
To leave you with one final thought, enjoy Spring break and be gracious with yourself.
Health Crisis: Unmasking the Humanitarian Emergency in Gaza
By: Gauri Guruprasad
The humanitarian crisis in Gaza, intensified by the Israel-Palestine war, has provoked a dire health emergency for countless individuals. Israel’s blockade of the Gaza Strip began in 2007 under the guise of preventing weapon smuggling. On October 9th, 2023, Israel ordered a comprehensive blockade of the Gaza Strip, leaving residents without food, water, fuel, electricity, and medicine. The situation reached a critical point on October 11th when the only power plant in the Gaza Strip ran out of fuel, plunging the region into darkness and halting the supply of running water. While Gaza has grappled with humanitarian challenges for years, the events of 2023 have significantly intensified the health crises, marking a devastating escalation in both immediate and long-term health impacts.
Beyond the tragic loss of countless lives on both sides, the relentless bombing in Gaza has unleashed a myriad of devastating health consequences. The Integrated Food Security Phase Classification (IPC) has classified over 90% of the population to be in Phase 3 or above in terms of Current Acute Food Insecurity in Gaza, which means that 90% of Gazans are in a health crisis (IPC Global Initiative). According to the Projected Food Insecurity Statistics, this statistic is expected to grow more grim, as 100% of the population is projected to face a health crisis, raising the risk of famine and chronic malnutrition. Furthermore, as mentioned previously, the blockade exacerbates the lack of clean water and sanitation, leading to a skyrocketing risk of infections, gastrointestinal issues, and dehydration. Over time, this can lead to chronic dehydration, increased cholesterol in the blood, premature aging, kidney issues, and even brain tissue shrinkage.
Moreover, cases of diarrhea in children under five “jumped 66 percent to 59,895, and increased by 55 percent for the rest of the population”, according to the WHO. These figures are likely understated, as the health systems in Gaza are nearing collapse, with some cases of extreme dehydration even causing kidney failure in mere children. Additionally, the environment is being tormented by the effects of the bombing, with the aerosolized concrete and debris causing mass pollution in all three elements of life: sea, air, and land. The United Nations estimates that 1 in 5 structures in Gaza have either been damaged or destroyed, indicating that people are living without proper shelter and breathing in carcinogens (Scientific American). In addition, breathing in these toxic fumes, consisting of concrete, asbestos, and silica, can lead to respiratory disease, cell necrosis, and cancer, as per systematic research after the 9/11 attack in New York (Scientific American).
Additionally, as mentioned in the December newsletter in the article titled “Attacks on Hospitals - A Modern Humanitarian Crisis,” deliberately planned bombings have destroyed hospitals, leading to reduced access to healthcare systems. Consequently, due to the lack of contact with the outside world, economic systems have collapsed as a result of the blockade. The economic turmoil resulting from the crisis not only aggravates the immediate mental health struggles of families but also sets the stage for a looming mental health epidemic. As economic instability deepens, so does the prevalence of mental illness, particularly in war-torn areas where children exposed to violence and bloodshed are likely to carry the trauma into adulthood, struggling to overcome their haunting past. Thus, the immediate effects of the humanitarian crisis pale in comparison to the profound effects that will perpetuate over the Gaza Strip for years to come.
This relentless crisis, stretching over decades, has mercilessly touched every aspect of human survival. Across the globe, voices have risen in protest, calling for an end to a conflict that has disproportionately claimed the lives of innocent women and children. Yet, for the survivors, the ordeal is far from over. The innocent civilians spared by death are left to confront severe, long-lasting, and merciless health repercussions that will follow them for the rest of their lives. Beyond the realm of political affiliations, the sanctity of human health emerges as the cardinal concern that unites us all.
What's Poppin': MINOCA
By: Zoe Du and Tanya Baiju
Myocardial infarction (MI), i.e., a heart attack, is characterized by cardiac muscle death resulting from decreased or absent blood flow to the myocardium. While the pathophysiology most of us are likely familiar with involves occlusion and blockage of arteries that can be detected by angiograms, about 6-8% of MI cases are non-obstructive. Termed myocardial infarction with non-obstructive coronary arteries (MINOCA), this presentation originally led some physicians to label patients with symptoms of acute MI as false positives that did not require further investigation or therapy—coining the diagnosis as MINOCA was the first step to improving the treatment of these patients.
The signs and symptoms of MINOCA are essentially the same as those of obstructive MI. Chest discomfort, including pain, pressure, and tightness, is common, as are shortness of breath, nausea, and lightheadedness. As MINOCA has been found to affect women disproportionately, it is essential to note that heart attacks commonly present less dramatically in women compared to men, which contributes to underdiagnosis. Diagnosis is further complicated because angiograms are often the only imaging method used to diagnose MIs. Another primary challenge that MINOCA poses is determining the underlying cause of acute MI symptoms or presentation. Literature indicates several potential causes of MINOCA, including but not limited to the erosion of atherosclerosis plaques (plaque disruption), coronary spasms, spontaneous coronary thrombosis/emboli, coronary dissection, myocarditis, and pulmonary embolism. Because the causes of MINOCA are diverse, researchers are still investigating what contributes to MINOCA. However, it is known that there are common risk factors with obstructive MIs, such as high blood pressure, high cholesterol, diabetes, and smoking, albeit to a lesser degree. MINOCA patients also tend to be more common in younger women of color.
MINOCA patients have often been disregarded because previous research showed that “they didn’t have a higher risk of dying or recurrent heart attacks” and weren’t studied (American Heart Association 2018). Among those patients, women were five times more likely to have it than men. Additionally, these heart attacks were also twice as common in non-white patients than in white ones, with a higher prevalence reported in African-American, Hispanic-American, and Pacific Islander populations. MINOCA patients are less likely to smoke or have any other traditional risk factors for heart disease. With all these factors in mind, a lot goes into diagnosing MINOCA and treating it.
MINOCA treatment occurs similarly to other heart attacks. It includes antiplatelet therapy, statins, ACE inhibitors, and beta blockers. However, to better approach MINOCA treatment, further research is needed to understand the cause of MINOCA and why it occurs. Currently, there are trials to understand treatment options better. The Women’s Heart Center at Cedars-Sinai is leading the WARRIOR clinical trial, which tests whether “standard therapy used for obstructive coronary artery disease is effective for women with chest pain and no obstructions” (Cedars-Sinai, 2023). There have also been studies on the effects of renin-angiotensin-aldosterone-system (RAAS) inhibitors and statins lowering mortality in MINOCA patients (Sykes et al., 2021). Nevertheless, individualized treatment for MINOCA is heavily dependent on the research behind its presentation as well as incorporating better systems in patient assessment for those who are more vulnerable, especially young women of color.
Navigating the Health of Your Mind and Body in the Media Maze
By: Sahaana Anand
How often do you find yourself wanting to be productive, such as studying or working, but you retreat to scrolling on your phone or putting on a show to binge? If you are anything like most other people our age, your answer is probably every day. Social media and technology are tools that everyone uses almost every day and all the time, making them our new normal. To sit and think about what we do and why we do it all the time can be almost uncomfortable. However, doing so can yield many realizations, and positive change can also result from that. Social media and media addiction can have detrimental effects on both the mental and physical health of college students. Excessively using it can cause high levels of stress, anxiety, and depression, as well as hinder you from being proactive with your health.
Since technology is relatively novel in the grand scale of time, we still need to learn its factual long-term effects. However, with research studies and correlated causes, we can try to be mindful of our uses. Combating media addiction can be done with mindful boundaries, routines, and taking up hobbies.
Before delving into how to combat the issue, let's take a look at the research being done in this realm. According to a research article published by Dr. Cardoso-Leite in the National Library of Medicine, a set of analyses revealed that media multitasking and total time on media were associated with adverse psychological outcomes and that media should be considered more intensively as a societal concern. The complexity of media consumption and the quickly fluctuating landscape of digital media would be best taken up as a practice of mindfulness. A quote that I live by and has been proven time and time again by every experience is one that says, "Too much of anything is good for nothing." On a day-to-day basis, media can put us in a loophole of wasted time, guilt, and repetition. It can lower the attention span and even memory strength of many, especially for the younger population who are still developing their brains.
Next, for actually facing the issue. Just like any form of addiction, refraining from something that we use every day can be difficult. Going from constantly consuming our thoughts with external media can be an easy distraction, but not sitting with your emotions and thoughts can be detrimental. Keeping up with how you feel and understanding what to do about them is crucial to maintaining a stable mind. Some ways to help with this are to set clear boundaries with media usage, such as time limits and designated periods of focus on other work. Creating a structure or routine with your daily life can be the only thing between you and a healthy lifestyle. Turning off notifications for apps that do not require immediate attention, engaging in mindful practices, and having open communication with your friends are all ways to strategize for healthier media consumption. With the whole world at our fingertips, balancing consumption with self-care practices can be very difficult. Sitting and thinking about how you want to maintain that well-being during these college years can be all you need to find a balance!
In conclusion, the negative effects of social media and media addiction on the mental and physical health of college students cannot be overstated. The consequences of excessive screen time can significantly impact students' overall well-being, from heightened stress levels to disrupted sleep patterns and sedentary lifestyles. Recognizing the signs of such a thing and taking proactive steps to establish healthy boundaries and habits are essential. It's crucial for college students to prioritize self-care and find a balance between their digital and real-world interactions. By being mindful of our media consumption and making intentional choices, we can safeguard our mental and physical health, ultimately enhancing our academic performance and overall quality of life.
AMWA Member Submission:
Revolutionizing Healthcare - The Role of Artificial Intelligence in Early Disease Detection
By: Shannon-Renee Odoi
In recent years, artificial intelligence (A.I.) has emerged as a game changer in various industries, and healthcare is no exception. With its ability to process large amounts of data quickly and efficiently, A.I. has shown great promise in revolutionizing disease detection and diagnosis. Early disease diagnosis is one of the most critical areas where AI will have the most significant impact. Early detection improves patient outcomes, reduces healthcare costs, and saves lives. This article explores the role of A.I. in the early detection of diseases and its implications for the future of healthcare.
Medical imaging such as X-rays, MRIs, and C.T. scans are essential in diagnosing. However, accurate interpretation of these images can be difficult and time-consuming for healthcare professionals. AI-powered algorithms can analyze medical images with incredible speed and accuracy and help identify abnormalities human vision misses. Also, AI can assist radiologists by highlighting areas of concern and reducing risk to monitor it to facilitate early diagnosis.
A.I. algorithms can analyze large data sets, including electronic health records, genetic profiles, and lifestyle factors, to identify patterns and predict the likelihood of a person developing certain diseases. Given this predictive power use, healthcare providers can intervene and implement preventive measures to reduce the risk of disease onset. Based on their medical history and lifestyle choices, for example, AI could identify individuals at high risk for diabetes or cardiovascular disease, enabling targeted interventions such as lifestyle early intervention or medical intervention.
Wearable devices with sensors capable of monitoring vital signs, activity levels, and other health data have generated a wealth of real-time health data. A.I. algorithms can continuously analyze this data and detect changes; it is not a subtle indication of underlying health issues. By providing early warnings of potential health problems, AI-enabled remote monitoring systems enable individuals to take the initiative to manage their health and seek treatment in time appropriately when necessary.
AI-enabled screening programs can transform population health policy by identifying individuals at risk for specific diseases. By analyzing demographic data, medical history, and biomarkers, A.I. algorithms can prioritize individuals for targeted research, maximize the efficiency of healthcare resources, and improve health outcomes in people on a quantitative scale, for example, A.I. age, family history, and genetics. It can help identify individuals eligible for cancer screening based on risk factors such as carcinogenesis, thereby improving early detection and survival rates.
Although the role of A.I. in early diagnosis is promising, several challenges and considerations need to be addressed. These include ensuring the privacy and security of patient data, addressing algorithm bias and transparency issues, integrating A.I. technologies into existing healthcare workflows, and fostering collaboration among A.I. developers, health professionals, and regulatory agencies to ensure safe and effective AI-powered deployment. Solutions are available.
Artificial intelligence has tremendous potential to transform healthcare, especially in the early detection of diseases. Using A.I. systems for advanced image interpretation, predictive analytics, remote monitoring, and population health management, healthcare professionals can detect diseases at earlier stages, delivering better outcomes to patients and optimizing the safe, ethical, and accurate use of healthcare products that are cereals A variety of challenges and considerations that need to be addressed to ensure deployment such as how A.I.
Sources
https://cfmedicine.nlm.nih.gov/physicians/biography_163.html
https://www.womenhistoryblog.com/2015/06/mary-putnam-jacobi.html
https://circulatingnow.nlm.nih.gov/2014/07/29/the-question-of-rest-for-women/
https://www.cedars-sinai.org/newsroom/what-is-minoca-a-type-of-heart-attack-mostly-affecting-women/
Esteva, Andre, et al. "Dermatologist-level classification of skin cancer with deep neural networks." Nature, vol. 542, no. 7639, 2017, pp. 115-118. Liu, Xiaolei, et al. "Application of artificial intelligence in early diagnosis of cardiovascular diseases." Frontiers in Cardiovascular Medicine, vol. 7, 2020, p. 578574. Rajkomar, Alvin, et al. "Scalable and accurate deep learning with electronic health records." NPJ Digital Medicine, vol. 1, no. 1, 2018, p. 18. Topol, Eric J. "High-performance medicine: the convergence of human and artificial intelligence." Nature Medicine, vol. 25, no. 1, 2019, pp. 44-56. Zhang, Yan, et al. "Artificial intelligence and medical imaging 2020: advances, perspectives, and challenges." The Lancet Digital Health, vol. 2, no. 6, 2020, pp. E295-E309.
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