The StethoSCOOP
Cornell University Pre-Medical Society Fall 2015
The StethoSCOOP Editor-in-Chief:
Zachary Kassir
Managing Editor:
Courtney Stevens
Content Editors:
Alex Gordon, Henry Kanengiser, Akila Venkataramany
Writers:
Nathan Barr, Greg Bielat, Rachel Chuang, Uche Ezeh, Alex Gordon, Daniel Jablansky, Henry Kanengiser, Jeremy Pustilnik, Akila Venkataramany
Table of Contents A Hard Pill to Swallow: Increasing Drug Prices in the United States
4
You vs. Medical School: Maintaining Your Mental Health
6
Buying Babies: An Ethical Analysis of the Free Market Sex Cell System
8
Ayurvedic Medicine: A Longstanding Traditional Healing Method
10
Addy Goes to College
12
Bio-Piracy and the Need for Increased Protection of Traditional Remedies
14
Hudson River Exploitation and Recovery
16
Preventing Cancer Through Food
18
The Problem with Medical School Admissions
21
References
24
A Hard Pill to Swallow: Increasing Drug Prices in the United States By Alex Gordon
This past Sept ember, a lit t le known drug company named Turing Pharmaceut icals made nat ional headlines when it raised t he price of Daraprim, a t reat ment for a parasit ic infect ion known as t oxoplasmosis. The parasit e is ext remely common and rarely causes sympt oms, however it poses a significant risk to HI V/AI DS pat ient s and ot her immunocompromised individuals. Though increases in drug prices are a fairly common occurrence in t he Unit ed St at es, t his was a unique case - t he price of Daraprim rose by over 5000%, from about $13.50 t o $750 per pill. The result ing social media campaign against Turing?s CEO M art in Shkreli made t he
unpopularit y of t his decision quit e clear. Small increases in drug prices due t o inflat ion and ot her market forces are underst andable, but changes of t his magnit ude are hard t o just ify, calling int o quest ion t he reasons for t hese price increases. Though t he revenues of pharmaceut ical are necessary t o develop fut ure medicines, it is difficult t o rat ionalize increases in drug prices t hat occur wit hout changes in t he qualit y of t hese drugs. Turing?s alleged rat ionale for t heir price increase is t hat increased revenues will allow t hem t o research new t oxoplasmosis t reat ment s. I n response t o t he immediat e crit icism Turing received, Shkreli
claimed t he company is ?t arget ing ? i nvest ment s t hat bot h improve on t he current formulat ion and seek t o develop new t herapeut ics wit h bet t er clinical profiles t hat we hope will help eradicat e t he disease.? Short ly aft er Shkreli?s response, t he opinions of several expert s undermined his st at ement : Dr. Wendy Armst rong, an infect ious diseases professor at Emory Universit y, comment ed, ?I cert ainly don?t t hink t his is one of t hose diseases where we have been clamoring for bet t er t herapies.? I n light of t hese opinions, it seems Turing?s int ent ions may not have been as alt ruist ic as Shkreli suggest ed. Shkreli?s st at ement s might have been more just ifiable if he had said t hat Turing want ed t o develop t reat ment s for ? ot her? diseases. Nevert heless, it is unlikely t he public would feel t his just ified a 5000% increase. Though perhaps not applicable in t his part icular case, t he core idea of Shkreli?s rebut t al ? t hat revenue from t he sale of drugs allows pharmaceut ical companies t o develop new medicines ? holds some t rut h. Despit e t heir predominant ly negat ive port rayal as cold and profit - driven, drug companies creat e medicines t hat save count less lives. Addit ionally, t he mass product ion of t hese drugs helps ensure t hat disease t reat ment s are widely available and in many cases cost - effect ive. Aspirin, one of t he most commonly used medicines for pain and inflammat ion, was developed by Bayer AG, a leading pharmaceut ical
company. Undoubt edly, many of t he medical development s t hat improve t he qualit y of our lives were made possible by pharmaceut ical revenues. Research and development aside, drug price changes are st ill confusing part ially because t hey oft en occur independent ly of medical advancement s. I n many cases, t he drugs pat ient s receive are exact ly t he same despit e t hese increases. Bet ween Oct ober of 2013 and April of 2014, t he price of Doxycycline, an ant ibiot ic t hat has been used for decades, rose from $20 t o $1849 per bot t le. At t he same t ime, t he price of Pravast at in, a cholest erol- lowering drug, grew from $27 t o $196 per bot t le. As wit h Daraprim, t hese increases in price did not coincide wit h any improvement wit h t he qualit y of t he drugs leading us t o quest ion t he t rue mot ives of pharmaceut ical companies. W hile t he rising cost s of drugs may lead t o new t reat ment s in t he fut ure, t hey creat e problems for t he people current ly dependent on t hese drugs. For pat ient s t aking Daraprim, a mont hly supply of pills now cost s t ens of t housands of dollars. Underst andably, someone paying t hat much for t he medicine t hey need t o survive might not feel t hat t he development of new t reat ment s warrant s such a drast ic price hike. Regardless of what is necessarily fair, it seems t he drug companies have t he final say in t hese prices for bet t er or worse.
5
You vs. Medical School: Maintaining Your Mental Health By Rachel Chuang
For many medical st udent s, or st udent s considering medical school, it 's oft en easier t o t ake care of ot hers rat her t han t hemselves. As Cornell Universit y implement s several init iat ives t o fight against t he ever- present st igma of ment al illness, it is also import ant t o remember t hat maint aining ment al healt h is not just necessary t hroughout our undergraduat e educat ion, but also t he rest of one's life.
Bet ween 20 t o 30 percent of medical st udent s in t he Unit ed St at es st ruggle wit h depression.
St udies have shown t hat during a st udent ?s four years of medical school, t hey begin t o exhibit higher levels of ment al dist ress, including anxiet y, depression, and subst ance abuse, compared t o t heir peers t hat are not enrolled in medical school. A compilat ion of research regarding burnout during residency revealed t hat 75 percent of resident s report ed experiencing burnout , which affect ed t heir abilit y t o int eract wit h pat ient s and ot her st aff. These resident s had a great er likelihood of making errors and failing t o out line all t reat ment opt ions while working wit h pat ient s.
Oft en t hose t hat st ruggle wit h depression find it difficult t o reach out t o ot hers and admit t hat t hey have a ment al illness. For t his reason, it is crit ical t o reduce st igma surrounding ment al healt h on college and medical school campuses.
M ent al problems t hat arise during medical school can affect you for t he rest of your life.
The New England Journal of M edicine report s t hat a higher percent age of doct ors commit suicide compared t o t he rest of t he general public. Addit ionally, ot her report s suggest t hat pre- med st udent s, or people t hat choose t he medicine career pat h, exhibit t rait s t hat make t hem more prone t o ment al dist ress. Such t rait s include perfect ionism, compet it iveness, and at t ent ion t o det ail, all of which make t he possibilit y of failure seem even more daunt ing and st ressful.
M edical schools are making changes t o increase awareness about ment al healt h.
Though t he st at ist ics regarding ment al healt h and medical school appear t o be discouraging, t here are numerous posit ive changes t hat are being implement ed across t he count ry in medical schools. I n 2014, Saint L ouis Universit y (SLU) modified t heir curriculum "t o prevent depression, st ress and anxiet y." Following t he design of around 40 ot her U.S. medical schools, SLU implement ed all pass/fail grades for pre- clinical courses in t he first t wo years of t he curriculum, eliminat ing unnecessary st ress. The cont ent and order of cert ain classes were also changed t o bet t er support t he ment al healt h of st udent s.
To direct ly combat t he possibilit y of t he development of lifelong ment al healt h issues, SLU creat ed a course for st udent s t o develop st rat egies t o effect ively deal wit h st ress and preserve ment al healt h. I ncredibly, following t he execut ion of t hese alt erat ions t o t he SLU curriculum, t he depression rat es of first year st udent s dropped from 27 percent t o 11 percent , while St ep 1 board scores (licensing exam) significant ly increased.
The act ions of Saint L ouis Universit y exemplify a crit ical piece of informat ion t hat is oft en overlooked by universit ies: reducing st ress does not just mean offering addit ional ment al healt h resources for st udent s, but also addressing t he root issues and causes behind st udent st ress.
There is always somewhere or someone t o t urn t o.
Though t he conversat ion about ment al healt h is growing and shift ing, t here is st ill much work t o be done, not only in medical schools but also at Cornell Universit y. I n order t o bet t er address t hese issues, we as a collect ive st udent body at Cornell should engage in conversat ions regarding ment al healt h (our own or of t hose around us), and int ent ionally creat e a support ive communit y and environment on campus. I f you are st ruggling wit h st ress, anxiet y, depression, or any ot her ment al healt h issues, t here are so many people and resources here t hat are ready t o help you. Cont act Counseling & Psychological Services (CAPS) at 607 255- 5155 or visit caringcommunit y.cornell.edu for more informat ion.
7
Buying Babies: An Ethical Analysis of the Free Market Sex Cell System By Henry Kanengiser
Sperm and egg donat ion are a prominent part of our societ y. As of 2013, t he number of donat ed eggs used in in vit ro fert ilizat ion (I VF) was more t han 18,000. The most popular sperm and egg banks receive hundreds of applicat ions t o donat e each mont h. I t is est imat ed t hat 30,000 t o 60,000 children are born via art ificial inseminat ion annually. Thus, families can be made for people who had no ot her way t o conceive a child, a feat t hought impossible 75 years ago. However, t here are syst emic issues present in
t his free market syst em of sex cell donat ion t hat make t he process highly problemat ic. The free market commodificat ion of human cells allows cust omers t o choose cells based on sexist and largely unscient ific charact erist ics. I t also creat es a flow of resources from t he poor t o t he rich, raising an et hical quest ion about t he moralit y of selling cells. A more et hical process may be a bet t er way t o ensure t hat people are able t o have t he children t hey desire while maint aining et hical values and respect for t he value of every human body.
I ssues begin wit h t he process by which sex cells are donat ed. Alt hough t hey are called donat ions, people who give t heir cells t o a sex cell company receive financial compensat ion. M en can receive up t o $12,000 for one year of donat ions, and women can receive $8,000 for a donat ion process t hat t akes about six mont hs t o perform. Young women and men are a good populat ion t o solicit for donat ions, making college campuses a nat ural and popular locat ion for advert isement s. However, ext remely high pricing, especially common among collegiat e egg donat ions, begs t he quest ion of whet her t hese donors donat e due t o t he size of t he payment . The issue wit h payment for cells can be seen on t he nat ional scale. As t he Great Recession began t o hit t he count ry as a whole in 2008, t he rat e of sex cell donat ion across t he count ry increased by bet ween 25 and 100 percent by 2009. The et hical quest ion of payment for body part s, be it sperm, a kidney, or blood, is not a new one in t he Unit ed St at es. Yet if t he Unit ed St at es has chosen t o ban t he sale of blood and t he sale of non- vit al organs as it did in 1984, why t hen is t he sale of non- vit al cells condoned and left t o t he market t o regulat e? The unique nat ional allowance given t o t he sex cell donat ion syst em in t he Unit ed St at es is concerning. Furt her syst emic issues exist wit hin t he advert ising and select ion processes of t hese sex cells. First ly, t he sex cell companies det ermine viable donors based on sexist expect at ion about childcare. Rachel Almeling writ es about t his in her book ? Selling Genes, Selling Gender? . I n it , she point s out t hat egg agencies will look for a donor who is int erest ed in keeping cont act wit h t he person or people who purchase her egg, following mat riarchal expect at ions beyond t he family st ruct ure. She also det ermines t hat a male donor is not expect ed t o have an at t achment t o his sperm or t o whomever purchases it , furt hering t he idea t hat men carry no int erest in t heir genet ic offspring. These
expect at ions reveal an indust ry built on sexist beliefs and est ablishes furt her reasoning t hat t he free market syst em may be problemat ic. Secondly, t he way t hat companies advert ise for t heir sex cells demonst rat es social biases t hat result in public response t inged wit h eugenics. W hen people look t hrough t he cat alogues of cells from count less people, t hey are oft en met wit h descript ions of t he ?cells? and t he person t hey came from. These descript ions may include bot h relevant informat ion ? height , hair color, medical hist ory ? and irrelevant informat ion ? hobbies, G.P.A, religion ? which combine t o give a pict ure t hat isn?t exact ly represent at ive of cells. Classifying bot h genet ic and social t rait s as int rinsic t o sex cells creat es a syst em of gendered eugenics, where people purchase cells based on t he social charact erist ics ascribed t o t hem and favor t hose t hat mat ch West ern images of masculinit y and femininit y. These t rends hurt American societ y as a whole by encouraging damaging biases and make t he capit alist market ing of sex cells highly quest ionable. The capit alist market for sex cells in t he Unit ed St at es has clear flaws. Several solut ions have been proposed t hat provide a syst em more focused on t he wellbeing of t he offspring as well as on t he cell purchasing populat ion as a whole. One such proposal encourages a change from market - based t o gift - based reproduct ive relat ions. This requires st rict regulat ion of t he amount of payment offered for sex cells, improvement s in t he st andards of informed consent for donors, and limit ing t he informat ion used t o market cells t o purely genet ic fact ors. Similar st eps have been largely successful in t he Unit ed K ingdom. Combining t hese reforms should help t o encourage caut ion regarding t he aut onomy of donors and t o shape t he syst em of sex cell purchasing t o be more based in medicine, working t o address t he t wo main issues wit h t he syst em as it current ly st ands.
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Ayurvedic Medicine: A Longstanding Traditional Healing Method By Akila Venkataramany
I n modern t imes, medicine has evolved t o encompass several approaches of bot h physical and ment al t reat ment . Wit h t he compet it ion for admission t o medical school cont inuously increasing, prospect ive st udent s have t o become more aware of t he variet y of professions available wit hin t he umbrella t erm ?medicine.? I n ot her count ries such as China and I ndia, t he pract ice of t radit ional medicine is popular and well- accept ed, and t his t rend is spreading around t he world due t o cult ural globalizat ion. Ayurvedic medicine is a t elling example of t he spread of t hese kinds of medicine. The modernizat ion of medical care and accept ance of ot her t ypes of clinical pract ice have made such knowledge of ot her nat ions? healt h care relevant t o societ y t oday. Though not primarily st udied in t he Unit ed St at es, Ayurvedic medicine is becoming more influent ial in t he I ndian medical communit y and in West ern medicine. bbbbbbbbbbbbbbbbbbb Ayurvedic medicine originat ed in I ndia around 3,000 t o 5,000 years ago. The word ?Ayurveda? it self
comes from Sanskrit , and t he t wo halves of t he word t ranslat e t o ?life? and ?science or knowledge? respect ively. The ? Veda? s, a set of t he world?s oldest t ext s t hat are essent ial t o t he Hindu religion, first det ail Ayurveda in t hree books: ? Caraka Samhit a, Sushrut a Sambhit a, ? and ? A st anga Hridaya. The Caraka Samhit a i s t he int roduct ion t o Ayurvedic medicine, and it ? proposes general medical t heory. The ? Sushrut a Sambhit a? discusses surgical pract ices, such as reconst ruct ive surgery and skin graft ing. Finally, t he A st anga Hridaya? ? , in combinat ion wit h it s companion t ext ? A st anga Sangraha? , describes more specific Ayurvedic ideas and t heir connect ion t o everyday life. M uch of Ayurvedic philosophy branches from Hindu principles, which focus on how people int eract wit h t he rest of t he int erconnect ed universe. Basic energies called doshas are divided int o t hree specific t ypes: ? vat a? , t he energy t hat cont rols involunt ary bodily funct ions such as breat hing and blinking;? ? pit t a? , t he energy t hat cont rols met abolism; and ? k apha? , t he
energy t hat cont rols growt h. I n t heory, t he doshas must be balanced in order t o be funct ioning properly. I n a balanced st at e, t he individual experiences posit ive emot ions and effect s such as creat ivit y and forgiveness, but differences in t hese doshas causes more negat ivit y, anger, and insecurit y. I n addit ion, t he ? Prakrut i? , which encompasses all physical, ment al, and funct ional at t ribut es of an individual, comes from maint aining an equilibrium among t he self- consciousness, cosmic int elligence, and ego. Ayurvedic medicine init ially surrounded t he promot ion of healt h, but most people current ly ident ify it as a met hod of t reat ment for t hese imbalances, wit h t he goal of event ually curing t he result ing diseases. bbbbbbbbbbb Ayurvedic t reat ment s are highly individualized as each person has varying imbalances and may not be experiencing t he same sympt oms. Because Ayurvedic medicine focuses less on cures and more on purificat ion, t reat ment s can be bot h palliat ive and purifying. Typical t reat ment s will include changes t o personal exercise regimes, diet s, and habit s. Herbal supplement s designed t o specifically t arget medical issues are common, and changes in food can focus on ensuring t hat a person receives adequat e quant it ies of each basic t ast e, such as bit t er, sweet , salt y, and sour, t o achieve a healt hy and balanced diet . Exercise may be relat ed t o cont rolled breat hing t echniques and Yoga, which is based on t he same t ext s as Ayurveda. Research on t he validit y of Ayurvedic t reat ment s is limit ed but st eadily growing wit h t he increased accept ance of t radit ional remedies. According t o a clinical st udy conduct ed in 2011, t urmeric, a common Ayurvedic t reat ment , and it s act ive ingredient curcumin are ?effect ive for rheumat oid art hrit is and ot her inflammat ory condit ions.? Curcurmin use led t o improvement for t hose who suffered from inflammat ory bowel disease, psoriasis, polyposis, and ot her condit ions. The st udy not ed, however, t hat t he dat a are few, and more t rials need t o be conduct ed in order t o gain st ronger support in t he scient ific communit y. I n t he Unit ed St at es, Ayurvedic medicine cont inues t o gain a st eady following. Educat ional opport unit ies are limit ed because few inst it ut ions have commit t ed t o providing necessary t raining, but t he Nat ional Ayurvedic M edical Associat ion st andardized t he curriculum for t hose who wish t o be cert ified as a pract it ioner by requiring a minimum of 500 hours of educat ion. Current ly, t he California College of Ayurveda and t he Ayurvedic I nst it ut e are t he only t wo
schools in t he Unit ed St at es t hat provide full- t ime t raining programs. Ot her cent ers hold short er t raining programs, seminars, and int ernships t o increase awareness and Ayurvedic educat ion. Originally est ablished as a hist orically prevalent met hod of healing, Ayurveda is now popular among suggest ed home remedies on t he int ernet t hat range from t reat ment s for acne t o emot ional and ment al issues. Global communicat ion and educat ion has allowed Ayurveda t o permeat e West ern cult ure and medicine, and furt her accept ance of t his pract ice will likely increase as ot hers begin t o learn more about it s philosophical background and principles for healing.
11
Addy Goes to College By Uche Ezeh
The st ory has become all t oo familiar: a college st udent is t aking several courses while juggling a job, sport s, volunt eer work and an out side social life. The st udent has recent ly been feeling unfocused and sleepy and is fret t ing about t heir chance of doing well. An exam is approaching soon, so t he st udent inevit ably resort s t o non- medical prescript ion drugs, such as Adderall (commonly referred t o as ?Addy?) and Rit alin, in hopes of enhancing his or her t est performance. According t o expert s, prescript ion medicines like Adderall and Rit alin are commonly used t o t reat individuals who suffer from at t ent ion deficit hyperact ivit y disorder (ADHD). ? D r. Edward Hallowell, a psychiat rist and ADHD expert , report s t hat ADHD st imulant s "st rengt hen t he brain's brakes, it s inhibit ory capacit ies, so it can cont rol it s power more effect ively".1 And ? according t o a recent ly published art icle in Neuroxia? , ?Do Smart Drugs Act ually M ake You Smart er??, drugs such as Rit alin and Adderall increase t he concent rat ion of a family of key brain neurot ransmit t ers called monoamines- - dopamine, serot onin and norepinephrine.2 A DHD brains commonly lack sufficient levels of specifically ? dopamine and norepinephrine in t he prefront al cort ex and basal ganglia, which are responsible for mot ivat ion, at t ent ion and alert ness. But for t he past t en years, college st udent s have begun abusing t hese prescript ion st imulant s for nonmedical purposes, prompt ing public healt h concern due t he addict ive pot ent ial of t hese drugs. Nat alie Rich, coordinat or for Prevent ion I nit iat ives at Universit y of Nort h Carolina at Chapel Hill, report ed in t he ? H uffingt on Post ?how ?st udent s t hink t hese drugs are safer t han?st reet drugs, but in realit y, t heir effect s are very similar, and t hey can be highly addict ive.? ?3 W hile subst ances like marijuana, L SD, heroin and ecst asy, which are also commonly found on college campuses, are classified as Schedule 1 subst ances by t he US Drug Enforcement Agency
(DEA), subst ances like Adderall and Rit alin are just one level down making t hem Schedule 2 drugs, t he same cat egory as cocaine, met hamphet amine and oxycodone. The DEA classifies t hese drugs as Schedule 2 given t heir medical value but dangerous addict ive pot ent ial, which may lead t o severe psychological or physical dependence. The biggest issue in dealing wit h abuse of pills like Adderall is t hat t heir efficacy has perpet uat ed t his myt h t hat t hese ?st u? dy drugs? can enhance a st udent ?s school performance. Dat a from t he Part nership for Drug- Free K ids in 2014 found t hat 1 in 5 college st udent s, ages 18- 25, report ed using non- medical prescript ion drugs once during t heir lifet ime. Furt her breakdown of t he st udy also revealed t hat t he main mot ivat ing reasons st udent s report edly abuse prescript ion st imulat ions were t o improve t heir performance at school, t o improve performance at work, and t o simply st ay awake (31%)? .4 The exploit at ion of ADHD drugs among college st udent s is alarming for it s prevalence, but is an issue for ot her reasons as well. W hat makes t his prescript ion misuse even more alarming is t he pot ent ial combinat ion of t hese drugs wit h ot her illicit drugs. K elly and colleagues from Vanderbilt Universit y report ed t hat among t he t ot al number of subject s who used prescript ion drugs, 65.9% also report ed using at least one anot her subst ance, t he most common being alcohol and marijuana.5? Ot her st udies demonst rat e anot her concern surrounding t his misuse by measuring t he magnit ude of correlat ion t hat exist s bet ween prescript ion abuse and ment al healt h issues. M isuse of prescript ion? st imulant s has been associat ed wit h
psychosis, seizures, and cardiovascular event s.6 According t o Columbia Universit y, snort ing Adderall has even more det riment al consequences since it ent ers t he bloodst ream quicker, wit h side effect s such as short ness of breat h, increased heart pressure, st roke and somet imes deat h? .7 The analyses clearly suggest t hat young adult s do misuse or abuse prescript ion drugs. Furt hermore, college campuses have become hot beds for t he abuse of prescript ion st imulant s such as Adderall. Adderall has for many college st udent s become a way t o cope wit h t he high demands of school work and t he st ress incurred as a result of t he compet it ive nat ure of college. Healt h surveys are revealing t hat Adderall abuse is not only common among college st udent s, but is becoming even more popular wit h high school, and even middle school st udent s. Since t here is no diagnost ic crit eria for diagnosing ADHD, it leaves t he quest ion as t o whet her cert ain individuals are suffering from ADHD or abusing manipulat ing t he diagnost ic t est ing. One obvious way t o combat t he problem wit h Adderall abuse is t o change prot ocol and add more regulat ion. I n an int erview wit h Dr. Eric Houchin of Bronson Hospit al in M ichigan, he discusses t heir new prot ocol which involves t he signing of a cont ract before t he prescript ion is prescribed. This cont ract would be an agreement bet ween t he doct or and t he pat ient agreeing t o follow t he doct or?s order and may also include agreement s t o prescript ion pill count s, counseling and drug t est ing? .8 I t is quest ionable whet her t hese effort s t oward regulat ing Adderall abuse will be effect ive, however, it is a st ep in t he right direct ion.
13
Bio-Piracy and the Need for Increased Protection of Traditional Remedies By Nathan Barr
Tradit ional medicine is t he culminat ion of count less cycles of t rial and error t he allowed ancient societ ies t o ext ract useful remedies from t heir environment . M odern medicine has oft en made significant advances by observing t hese t ime t est ed procedures, and t he largely unt apped pot ent ial of t radit ional medicine is just now being realized. Unfort unat ely, t he modern world?s int erest in t radit ional remedies has lead t o exploit at ion of t he very people t hat discovered t hem. Syst emic regulat ion is needed t o prot ect ancient societ ies from t he modern act of Bio- piracy.
Bio- piracy is defined as ?t he misappropriat ion of t radit ional knowledge of indigenous communit ies for t he purpose of seeking exclusive pat ent ownership over t he knowledge?1? . Pharmaceut ical companies oft en harness t he t housands of years of medicinal development by ancient societ ies t o quickly creat e new cures for disease. I n 2015 Tu Youyou won t he Nobel Prize in Physiology for her discovery t hat Art emisia Annua, an Asian wormwood t radit ionally used as a Chinese remedy for fever, had ant i- malarial propert ies t hat could be used t o t reat humans.2?,3?Unfort unat ely, gaps in copyright laws have allowed companies t o profit
off of t radit ional knowledge wit hout giving money and recognit ion t o t he ancient cult ures t hat spent cent uries developing t hese t reat ment s. A not able and infamous case of Bio- Piracy occurred in t he lat e 90s 4?and cent ered on an ot herwise unremarkable flowering cact us known as Hoodia.5? Originat ing in t he desert s around Sout h Africa, t he San people have spent cent uries hunt ing in t he dry and largely uninhabit ed desert t errain. I n t he face of long days of hunt ing, t his t ribe was forced t o develop coping mechanisms for st arvat ion.6? One of t hese was consumpt ion of Hoodia Pilifer, a species of Hoodia plant s made famous for it s appet it e suppressing qualit ies. I n 1932, a young German biologist living among t he San described t he effect s of Hoodia Pilifer as having ?removed t he pangs of hunger so efficient ly t hat [ he] could not eat anyt hing for a day?.5? This powerful effect did not escape not ice from t he out side world. I n 1999 t he US government grant ed The Sout h Africa Council of Science and I ndust rial Research (CSI R) a pat ent for p57, a hunger- suppressing molecule derived from Hoodia Gordonii.7 A legal bat t le erupt ed when it came t o light t hat CSI R had not given t he San people any credit in 2?This became one of t he first examples of a t he pat ent .? bio- piracy case being t ried in court and demonst rat ed t he import ance of recognizing t radit ional medicine. The lack of regard for t he people who originally discovered p57 was an ext remely significant oversight by bot h t he US government and t he CSI R. Tradit ional
remedies are developed over many decades of ext ensive research and development . By grant ing ownership of t his pat ent t o t he CSI R, t he US ignored t he significant t ime and effort t hat t he San people invest ed int o discovering t his t reat ment . The San successfully won t heir court case against CSI R in 2002 and were grant ed an undisclosed amount of money as well as given official recognit ion on t he pat ent .2? The case of Hoodia demonst rat es a gap in t he US and int ernat ional pat ent laws when it comes t o t radit ional medicine. Bot h law codes include a loophole t hat leaves t radit ional medicine unprot ect ed. One common requirement for pursuing a pat ent is t o demonst rat e t hat it is a novel product . I n t he phrasing of US law, which is similar t o t he int ernat ional code, a novel product is somet hing t hat has not been ?pat ent ed or depict ed in a publicat ion in t he Unit ed St at es or a foreign count ry?.1?Tradit ional knowledge, however, is by definit ion oft en undocument ed and t herefore usually not included in t he dat abases consult ed by pat ent researchers t o det ermine novelt y. This leaves t radit ional knowledge vulnerable t o ?exploit at ion in t he Unit ed St at es? and t hroughout t he world.1? Tradit ional knowledge offers many incredibly powerful insight s int o t he healing propert ies of t he life forms around us. Act ive research int o developing modern medicine from t hese ancient t radit ions should be encouraged. At t he same t ime pat ent laws need t o be modified t o bet t er prot ect t he cult ures t hat discovered t hese propert ies.
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Hudson River Exploitation and Recovery By Daniel Jablansky
I t is not a coincidence t hat t he first civilizat ions were founded along rivers. Rivers were crucial t o societ y because t hey gave people wat er for drinking, cleaning, and agricult ure. They allowed people t o t ransport goods, people, and ideas far away. They were also places for recreat ion and where wast e could be dumped and sent away. Over
t ime, rivers cert ainly have not lost t heir value, and one of part icular int erest t oday is t he Hudson River. The Hudson River is not only locat ed 5 minut es from my house in Briarcliff M anor, West chest er Count y, NY, but it also flows past millions of people and down int o New York Cit y, t he Unit ed St at es? most populous cit y. New York Cit y
grew as a result of it s locat ion on t he Hudson River because t he cit y was able t o receive goods from t he once indust rial upst at e New York and ship t hem overseas. Unfort unat ely, t hough, especially since t he I ndust rial Revolut ion, t he river has been abused. I t has been exploit ed as a wast e sit e, and cont aminat ion of t he Hudson has had negat ive impact s on t he humans t hat live near t he river as well as t he organisms in it . The general reason t hat t he Hudson is pollut ed so much is simply because, over t ime, more people living on it s coast has meant more ways t o pollut e and abuse t he river. As civilizat ions developed along t he river, more people demanded goods and wast e out put s. Consequent ly, sewage discharges went int o t he Hudson and led t o high bact eria count s and low oxygen levels. Valuable wet lands were filled in, scenic vist as were desecrat ed by quarrying, millions of fish were killed in cooling wat er int akes, and food webs were cont aminat ed by t oxic chemicals. Out of all of t he negat ive impact s humans have had on t he Hudson River, t he most known one and arguably most dest ruct ive one was General Elect ric?s disposal of t he insulat ion mat erial, polychlorinat ed biphenyls, or PCBs, int o t he wat er. PCBs are of part icular concern because of t heir harmful effect s on humans. St udies of t hese t oxic chemicals? effect s on humans show t hat exposure t o PCBs is associat ed wit h a wide range of t oxic development al, reproduct ive, endocrine, and carcinogenic effect s. Plus, t heir propert ies t hat make t hem excellent insulat ors is what keeps t hem in t he environment . As a result of PCBs abilit y t o persist in t he environment , t hey are known t o accumulat e in t he t issues of organisms, which in t urn brings PCBs int o t he food chain. Once t hese chemicals ent er t he food chain, t heir harm is maximized. PCBs cont inue past t he life- cycle of any one organism, so are able t o move t hroughout t he food chain (Simon, 2012). I n a process known as bioaccumulat ion, PCBs are originally consumed by bot t om feeders and plankt on, and as organisms, usually fish, eat what is smaller t han t hem, t he PCBs become more concent rat ed in t hose organisms. Event ually, birds and humans consume large fish result ing in a
poisonous concent rat ion of PCBs in t heir t issues (Brown et . al., 1985). Ot her cont aminant s of t he Hudson River include heavy met als. Paper mills, fact ories, and bat t ery fact ories as well as sewage wast e have pollut ed cadmium, chromium, copper, lead, mercury nickel manganese, and zinc int o t he Hudson, which can accumulat e in fish and shellfish, making t hem unsafe t o eat . About 10 years ago, a st udy on t he wat er qualit y of t he Hudson found t hat heavy met als were highest near urban sit es. These sit es cont ained met al levels higher t han t he regulat ions t hat t he New York St at e Depart ment of Environment al Conservat ion (NY SDEC) allows. W hile met al concent rat ions could have decreased a lit t le by now, t his process t o nat urally remove t he met als could t ake decades or even a cent ury. Nonet heless, in t he fut ure, heavy met als will event ually be buried or carried t o t he sea, and if climat e change cont inues t o cause sea level rise, t his would expedit e t he process due t o t he increased mixing of wat er and sediment s. On a more posit ive not e, PCBs in t he Hudson have been decreasing over t ime. The main cause for decline was General Elect ric ceasing t o release PCBs int o t he wat er. This caused a dramat ic decrease in t he amount of PCBs in t he Hudson. Overall, t he Hudson River is not complet ely clean. I t may never be, but it is improving. Today, t here are a number of nonprofit s t hat are act ive in upholding t he ecosyst em of t he Hudson. The t hree most popular ones are Clearwat er, Riverkeeper, and Scenic Hudson (St rayer, 2012). Clearwat er was founded by Pet e Seeger in 1966 wit h an effort t o recreat e a beaut iful Hudson for people and sloops. Current ly, Clearwat er is working on a project t o make General Elect ric dredge more t han t hey current ly have t o and more informat ion can be found on t heir websit e. As t he Hudson cont inues t o become cleaner, we need t o cont inue looking at our nat ural resources and t heir relat ionships wit h humans. We need t o ask ourselves why our resources are import ant t o us and how we benefit from pollut ing and harming t hem. Though t he Hudson flows t wo ways, t he fut ure only flows one.
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Preventing Cancer Through Food By Greg Bielat
Cancer is a prevalent disease, especially in t he Unit ed St at es. There is a lot of informat ion available, but it can be overwhelming t o sort t hrough it and figure out how t o apply it t o your life. I n t his art icle, I will highlight foods t hat are t he most efficacious in prevent ing and promot ing cancer, and discuss t heir corresponding mechanisms. To underst and how t he beneficial compounds in t hese foods work, it is essent ial t o know a few key t erms. Angiogenesis is a process in which t umors obt ain a blood supply, apopt osis is programmed cell deat h, and inflammat ion is an immune syst em response t hat t arget s t he root cause of cellular damage. Chronic inflammat ion, such as t hat induced by foods rich in fat and refined sugar, can gradually det eriorat e body t issues, which increases t he risk of developing various diseases such as heart disease, st roke, cancer, and diabet es.
Cruciferous veget ables (especially dark green veget ables)? . W hen cell walls of cruciferous veget ables are broken (chopping, chewing, blending), a react ion convert s molecules called glucosinolat es t o isot hiocyanat es (I TCs). I TCs increase t he speed at which t he body removes carcinogens, inhibit t he abilit y of carcinogens t o cause cancer, reduce inflammat ion and oxidat ive st ress, inhibit angiogenesis, and induce apopt osis in cancer cells.1? Beans? . Beans are rich sources of fiber and resist ant st arch. W hen bact eria in t he int est ines ferment fiber and resist ant st arch, t he fat t y acid but yrat e is produced. Scient ist s have found t hat but yrat e quells inflammat ion in t he colon and inhibit s angiogenesis. Also, it can down- regulat e t he gene expression of endot helial growt h fact or (which may prevent t he promot ion of cancer by reducing t umor- growt h- promot ing effect s).2?,3 Onions and garlic? . These foods cont ain organosulfur compounds, which help det oxify t he body from carcinogens, st op t he growt h of cancer cells, and inhibit angiogenesis.4?They are also significant sources of flavonoid ant ioxidant s such as quercet in, which help prevent cancer by lowing t umor growt h, inducing apopt osis in cancer cells, and fight ing inflammat ion.5?-9 M ushrooms? . One st udy showed t hat mushrooms exhibit ant i- inflammat ory propert ies, st imulat e immune syst em funct ion, prevent DNA damage, reduce t he rat e of cancer cell growt h, induce apopt osis in cancer cells, and inhibit angiogenesis when consumed. They also have aromat ase inhibit ors, which block est rogen product ion.1?0- 12?Excess est rogen in t he body has been shown t o increase t he risk of breast cancer. 19
Berries? . All berries cont ain ext remely high concent rat ions of ant ioxidant s, which help count eract cancer by prevent ing DNA damage and inhibit ing angiogenesis.1?3, 14? Seeds? . All seeds possess healt h- promot ing benefit s, but flax seeds are current ly considered t he most effect ive at fight ing cancer. They are t he largest sources of omega- 3 fat s and lignans, which have been shown t o induce apopt osis in cancer cells, diminish t umor growt h, and lower est rogen levels t hat cont ribut e t o breast cancer.1?5, 16 Tea? . Green t ea cont ains high amount s of several pot ent polyphenols: EGCG, EGC, ECG, and EC, which act as st rong ant ioxidant s. Thus, t hey help prot ect cells from DNA damage caused by react ive oxygen species.1?7 ? A lso, t hey can inhibit proliferat ion of and induce apopt osis in t umor cells.1?8?Furt hermore,t hey have been found t o prot ect against UVB cellular damage.1?9 Vit amin D? . Vit amin D in high levels in t he blood has been found t o promot e cellular different iat ion, reduce t he rat e of cancer cell growt h, induce apopt osis of cancer cells, and inhibit angiogenesis.2?0- 23? Unless you get significant sun exposure every day t hat allows your body t o synt hesize vit amin D, supplement at ion is necessary because foods do not nat urally cont ain large amount s of vit amin D. M eat and Dairy? . High consumpt ion of animal- based prot ein increases levels of insulin- like growt h fact or 1 (I GF- 1) in t he blood. I GF- 1 is associat ed wit h cancer, part icularly breast cancer, by allowing cancerous cells t hat already exist in t he body t o grow and proliferat e fast er.2?4- 32 ? I nt erest ingly, children nat urally produce high levels of I GF- 1 in order for t hem t o grow, and bodybuilders eat a lot of prot ein t o increase I GF- 1 levels t o pack on muscle mass. This is not usually a concern for children because most kids do not have cancer cells in t heir bodies. However, it is unfavorable t o have high I GF- 1 levels as an adult because adult s are no longer growing. Adult s have also lived for more years, so t hey have been exposed t o carcinogens t hat may have caused cancer cells t o form in t he body. Addit ionally, cooking meat at high t emperat ures produces het erocyclic amines, which are carcinogens.3?3
I n general, a plant - based, most ly unprocessed diet seems t o be best for prot ect ing yourself against cancer. There is not much we can do t o limit our exposure t o carcinogens t hat creat e cancer cells in t he first place. However, choosing what we consume is a powerful way t o influence whet her or not t hese cancer cells grow and mult iply.
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The Problem with Medical School Admissions By Jeremy Pustilnik
I f you t hought it was hard get t ing int o Cornell for your bachelor?s degree, t hink of what it is like get t ing int o medical school. According t o t he American Associat ion of M edical Colleges (AAM C), Weill- Cornell M edical College accept ed lit t le under 2% of it s over 6,000 applicant s in 2014. So for all t he pre- meds out t here, keep loading your 16 t ons of number- 9 coal, because hopefully it will pay off for us in t he end. The requirement s for medical school generally ent ail t aking t wo semest ers of biology, t wo semest ers of
general chemist ry, t wo semest ers of physics, and one semest er each of organic chemist ry and biochemist ry, most of which are encapsulat ed wit hin t he biology major across most universit ies. But what is t he purpose of having t hese hard sciences as requirement s for a profession t hat deals largely wit h human int eract ion? Sure, it may be import ant t o know about how t he sodium/pot assium ion channel and how ot her processes in t he body work in order t o maint ain int ernal homeost asis, but doct ors deal largely wit h people, not wit h chemist ry. Doct ors need t o know about sympt oms,
disease, anat omy, and t reat ment , not t hermodynamics and ionic bonding bet ween element s, so how are physical science courses good indicat ors of how good a doct or someone will become? M y own parent s, who are physicians, along wit h t he ot her doct ors in my family can t est ify t hat t hey use almost none of what t hey learned from t hese undergraduat e science courses in t heir profession. Perhaps t hey are requirement s because t hey are rigorous and oft en difficult courses meant t o prepare you for t aking t hose in medical school, but t hen why not make t he requirement s ones wit h a medical focus, and make t hem difficult (if t hat is t he goal)? Pursuing an undergraduat e degree in biology (or a similar field like biochemist ry, et c.) is t he most t ypical t rack for someone int erest ed in pursuing medical school aft er college, and as such it is t he largest major in t he applicant pool. However, only approximat ely 50% of bio major applicant s ult imat ely get accept ed t o medical school. The fact t hat anyone can t ake t he required pre- med courses and graduat e wit h any major, when t he biology major is t he most demonst rat ive for t hose int erest ed in medicine, begs t he quest ion, ?W hat exact ly are medical schools looking for?? Apparent ly, it isn?t someone who presumably st udies life it self. Even wit h t he same amount of relevant experience shadowing doct ors, volunt eering, and conduct ing research, t here seems t o be a discriminat ion against biology majors. So you might ask yourself (ancient Russian and feline behavior majors aside) t hen, ?well, perhaps t heir int erest in life is t oo unspecialized in t heir st udies, and t hey should t ake more healt h- relat ed courses?. I ndeed, t his would make more sense, especially in t erms of rest ruct uring t he biology major, but t he AAM C also provides st at ist ical dat a on ?specialized healt h sciences? majors, and even less of t hem (~34%) get accept ed t han biology majors! But why is t his? I s it t hat medical schools hold t hem to a higher st andard t han t he mid- air- t ie- dye- making majors because t hey are already in a somewhat similar academic environment as medical school? Even if t hat is t he case, shouldn?t t heir demonst rat ed passion and perseverance t o st udy medicine out weigh perhaps a lower GPA? M edical schools can be assured t hat t he people who just spent t he past four years of t heir lives confirming t heir love for medicine will not drop out . A higher percent age of humanit ies majors (~46%) are accept ed t o medical school t han bot h biological sciences majors (~40%) and specialized
healt h science majors (again, ~34%). Therefore, it would seem one?s chances of get t ing int o medical school would be maximized by majoring in t he philosophy, religion, and art of squirrel wat ching t han biology. I n essence, you should major in somet hing t hat demonst rat es you have no int erest in medicine t han in somet hing t hat demonst rat es t hat you do. M edical school isn?t like college: you don?t get t o swit ch your major or have t he freedom explore all t he different disciplines in life. You know what you want t o do, and you are t here t o do t hat and t hat only. Highly select ive undergraduat e schools like Cornell look for people who are bot h smart and int erest ing ? t hey have a passion for making met al sculpt ures of dead chickens, or t hey have founded a charit y t o save t he microorganisms t hat have yet t o be found on M ars, or t hey have won t he nat ional compet it ion in purple crayon making. They want people wit h high GPAs/t est scores (t hat demonst rat es t hey can handle t he rigor of t he courses) and have a passion for t hings t hat are oft en quirky and weird (t o diversit y and enrich t he st udent body). This explains why valedict orians get reject ed from many select ive schools if t he only t hing t hey have going for t hem is good grades, and why undergraduat e admissions always t out t heir ?holist ic, non- formulaic? process. But medical school isn?t college. They shouldn?t be looking for fashion design majors. They should be looking for someone who is passionat e about t his one t hing and has demonst rat ed it t hrough relat ed ext racurricular act ivit ies and good grades, because medical school isn?t a t ime when you have free t ime t o explore every act ivit y in which you have even a moderat e int erest ? you will be swamped wit h work all t he t ime. But sadly, t his is not even t he case for grades. Even t he highest science GPA earners in t he medical school applicant pool (mat h and st at ist ics majors- 3.54 average) have about t he same accept ance rat e as humanit ies majors (3.43 average). I am a biological sciences major because I am fascinat ed by life and living creat ures and I have a passion for medicine. I would hope t hat medical schools could recognize me as a good candidat e for cont inued t raining in medicine, but t he fact is, t o t hem I am just anot her plain biology major t hat t hey roll t heir eyes at as t hey t uck my applicat ion underneat h t he underwat er basket weaving major?s applicat ion. M edical schools will pay no not ice t o what I would suggest t o change about t he syst em because t his has been an ongoing cont roversy for decades. They cont inue t o ignore any ment ion of reform, but t here
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needs t o be a more obvious t rack t o medical school. W het her t his means rest ruct uring t he biology major by removing all of it s useless physical science requirement s and replacing t hem wit h healt h, anat omy, and physiology courses or by making healt h science t he dominant accept ed major (because people do t he biology major for ot her reasons, for example, ecology and evolut ionary biology, anot her passion of mine), it doesn?t mat t er. W hat mat t ers is t hat t his syst em is broken and t hat biological science majors like me should have a bet t er shot at mat riculat ion t han ot hers because we have demonst rat ed int erest bot h out side of t he classroom and wit hin for medicine. We do not have t o cut out t he opt ion of accept ance for t hose who do not realize t heir passion for medicine unt il or aft er t he end of t heir undergraduat e years (one of my parent s was a
French major aft er all, and is a hugely successful doct or), but it is ridiculous t hat a higher percent age of humanit ies majors get accept ed t han biology majors. Biology majors have t he ambit ion and t he drive t o succeed just as much, if not more, t han anyone else in any ot her major. And if I can?t get int o medical school, t hen when we colonize M ars, I will st art my own medical school where we pract ice fair admissions. And t hat will be a good day.
All st at ist ics were t aken direct ly or calculat ed from t he American Associat ion of M edical Colleges?st at ist ical dat a and fact sheet s available publicly on t heir websit e at aamc.org
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Ayurvedic M edicine: A L ongst anding Tradit ional Healing M et hod Ayurvedic M edicine | Taking Charge of Your Healt h & Wellbeing. (n.d.). Ret rieved from ht t p://www.t akingcharge. csh.umn.edu/explore- healing- pract ices/ayurvedic- medicine Ayurvedic M edicine: An I nt roduct ion | NCCI H. (n.d.). Ret rieved from ht t ps://nccih.nih.gov/healt h/ayurveda/int ro duct ion.ht m#hed4 Chopra, A., & Doiphode, V. V. (2002). Ayurvedic medicine: core concept , t herapeut ic principles,??and current relevance. M edical Clinics of Nort h America? ? , ? 86? ( 1), 75- 89. doi:10.1016/s0025- 7125(03)00073- 7 St at us & Development of Ayurveda in t he Unit ed St at es (USA) | CA College of Ayurveda. (n.d.).? ? Ret rieved from ht t ps://www.ayurvedacollege.com/art icles/drhalpern/St at us_ Development _Ayurveda_ USA Universit y of M aryland M edical Cent er. (2013). Ayurveda. Ret rieved from ht t ps://umm.edu/healt h/medical/alt med/t re at ment /ayurveda W hat Happens in a Visit t o an Ayurvedic Pract it ioner? | Taking Charge of Your Healt h & Wellbeing.? ? ( n.d.). Ret rieved from h? t t p://www.t akingcharge.csh.umn.edu/explo re- healing- pract ices/ayurvedic- medicine/what - happens- visit - ayurvedic- pract it ioner PHOTO: ht t p://www.freeimages.com/phot o/healt hy- lunch- 1322367 ht t p://www.freeimages.com/phot o/yoga- 1159968
Addy Goes t o College 1CNN.
(2014, April 18). Just say yes? The rise of 'st udy drugs' in college. Ret rieved from ht t p://www.cnn.com/ 2014/04/17/healt h/adderall- college- st udent s/ 2Fan, S. X . (2013, April 18). Do smart drugs ACTUAL L Y make you smart er?- Neuroxia. Ret rieved from ht t p://www. neurorexia.com/2013/04/18/do- smart - drugs- act ually- makeyou- smart er/ 3Huffpost College. (2013, April 9). Using St udy Drugs t o Get Bet t er Grades: W hy You Should Think Twice | Her Campus. Ret rieved from ht t p://www.huffingt onpost .com/ her- campus/dangers- of- st udy- drugs_b_2978867.ht ml 4Feliz,J.(2014,November13).NewSurvey:M isuseandAbuseofP rescript ionSt imulant sBecomingNormalizedBehaviorAmong College St udent s, Young Adult s - Part nership for Drug- Free K ids. Ret rieved from ht t p://www.drugfree.org/newsroom/ adhd- survey- 2014
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K elly, B. C., Wells, B. E., L eClair, A., Tracy, D., Parsons, J. T., & Golub, S. A. (2013). Prevalence and correlat es of prescript ion drug misuse among socially act ive young adult s. I nt ernat ional Journal of Drug Policy? ? , ? 24? ( 4), 297- 303. 6L akhan, S. E., & K irchgessner, A. (2012). Prescript ion st imulant s in individuals wit h and wit hout at t ent ion deficit hyperact ivit y disorder: misuse, cognit ive impact , and adverse effect s. ? B rain and behavior? , ? 2? ( 5), 661- 677. 7Rose,G. (2011, M arch 29). W hat Are t he Dangers of Snort ing Adderall? | L I VESTRONG.COM . Ret rieved from ht t p://www.livest rong.com/art icle/239688- what - are- t he- dan gers- of- snort ing- adderall/ 8Erspamer, E. (2013, December 2). New Obst acles for Adderall Pat ient s t o Crack Down on I llegal Use. Ret rieved December 1, 2015, from ht t p://fox17online.com/2013/ 12/02/new- obst acles- for- adderall- pat ient s- t o- crack- down- o n- illegal- use PHOTO: ht t p://www.freeimages.com/phot o/loadsa- books- 1568319
Bio- Piracy and t he Need for I ncreased Prot ect ion of Tradit ional Remedies 1Garcia,
Javier. ?Fight ing Biopiracy: The L egislat ive Prot ect ion of Tradit ional K nowledge.? ? B erkeley L a Raza Journal ? 18 (2007): 4- 28. Web. 25 Oct . 2015. 2 ? Youyou Tu - Fact s". ? N obelprize.org.?Nobel M edia AB 2014. Web. 27 Oct 2015. <ht t p://www.nobelprize.org/ nobel_prizes/medicine/laureat es/2015/t u? - fact s.ht ml> 3Hunt , K at ie, and L u, Shen. ?Nobel Prize Winner Scoured Ancient Text s for M alaria Cure ? CNN.com.? CNN. ? Cable News Net work, 6 Oct . 2015. Web. 27 Oct . 2015 4?Bio- Piracy of Tradit ional K nowledge.? ? B io- piracy of Tradit ional K nowledge. ? CSI R and AY USH, n.d. Web. 25 Oct . 2015. 5Heerden, F.r. Van. ?Hoodia Gordonii: A Nat ural Appet it e Suppressant .? ? J ournal of Et hnopharmacology 119.3 (2008): 434- 437. ? H t t p://www.sciencedirect .com/? .? W eb. 26 Oct . 2015 6Tellez, Viviana M unoz. ?Recognizing t he Tradit ional K nowledge of t he San People: The Hoodia Case of Benefi- sharing.? ? I pngos. ? W eb. 25 Oct . 2015. 7?L everaging Economic Growt h t hrough Benefit Sharing.? World I nt ellect ual Propert y Organizat ion, Web. 27 Oct . 2015 Heerden, F.r. Van. ?Hoodia Gordonii: A Nat ural Appet it e Suppressant .? Journal of Et hnopharmacology ? 119.3 (2008): 434- 437. Ht t p://www.sciencedirect .com/? .? W eb. 26 Oct . 2015 ?Bio- Piracy of Tradit ional K nowledge.? ? Bio- piracy of Tradit ional K nowledge. ? CSI R and AY USH, n.d. Web. 25 Oct . 2015. Tellez, Viviana M unoz. ?Recognizing t he Tradit ional K nowledge of t he San People: The Hoodia Case of Benefi- sharing.? I pngos. ? W eb. ? 25 Oct . 2015. ?L everaging Economic Growt h t hrough Benefit Sharing.?
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World I nt ellect ual Propert y Organizat ion, Web. 27 Oct . 2015 Garcia, Javier. ?Fight ing Biopiracy: The L egislat ive Prot ect ion of Tradit ional K nowledge.? ? B erkeley L a Raza Journal ? 18 (2007): 4- 28. Web. 25 Oct . 2015. Hunt , K at ie, and L u, Shen. ?Nobel Prize Winner Scoured Ancient Text s for M alaria Cure ? CNN.com.? ? CNN. ? Cable News Net work, 6 Oct . 2015. Web. 27 Oct . 2015 "Youyou Tu - Fact s". ? N obelprize.org.?Nobel M edia AB 2014. Web. 27 Oct 2015. <ht t p://www.nobelprize.org/nobel_ prizes/medicine/laureat es/ 2015/t u? - fac t s.ht ml> PHOTO: ht t p://www.freeimages.com/phot o/gavel- 1238036
Hudson River Exploit at ion and Recovery Area. (2013, February 19). Ret rieved from ht t p://msa.maryland.gov/msa/mdmanual/01glance/ht ml/area .ht ml#area Brown, M ., Werner, M ., Sloan, R., & Simpson, K . (1985). Polychlorinat ed biphenyls in t he Hudson River. Environment al Science & Technology, 19(8), 656- 661. Claudio, L . (2002). The Hudson: A River Runs t hrough an Environment al Cont roversy. Environment al Healt h Perspect ives, 110(4), A184- A187. De Avila, J. (2014, July 21). Temporary Closing of I ndian Point Power Plant I s Considered. The Wall St reet Journal. EPA. (2015, April 30). Hudson River Cleanup. Ret rieved from ht t p://www.epa.gov/hudson/cleanup.ht ml bbbbbbbbbbb K linkhammer, G., & Bender, M . (1981). Trace met al dist ribut ions in t he Hudson River est uary. Est uarine, Coast al and Shelf Science, 12(6), 629- 643. L ibrary of Congress. (n.d.). Henry Hudson and His Crew Sailed int o t he River t hat Would Bear His Name. Ret rieved from ht t p://www.americaslibrary.gov/jb/colonial/jb_colonial_ hudson_1.ht ml NY SDH. (2015, M arch 1). Hudson River Tribut aries Region Fish Advisories. Ret rieved from ht t p://www.healt h.ny.gov/ environment al/out doors/fish/healt h_advisories/regional/huds on _river_and_t ribut aries.ht m New York St at e Canals. (n.d.). Ret rieved from ht t p://www.canals.ny.gov/hist ory/hist ory.ht ml New York St at e Depart ment of Environment al Conservat ion. (2015). The Hudson Est uary: A River That Flows Two Ways. Ret rieved from ht t p://www.dec.ny.gov/ lands/4923.ht ml NRDC. (2007, M arch 23). Hist oric Hudson River Cleanup t o Begin Aft er Years of Delay, But Will GE Finish t he Job? Ret rieved from ht t p://www.nrdc.org/wat er/pollut ion/hhud son.asp St rayer, D. (2012). The Hudson primer t he ecology of an iconic river. Berkeley, CA: Universit y of California Press. Simon, M . (2012, July 2). Remediat ing t he Hudson River. Ret rieved from ht t p://www.eart ht imes.org/pollut ion/remedi at ing- hudson- river/2066/
Sloan, R., K ane, M ., & Skinner, L . (2005). Of Time, PCBs, and t he Fish of t he Hudson River. NY SDEC: Depart ment of Fish, Wildlife and M arine Resources. Swaney, D., L imburg, K ., & St ainbrook, K . (2006). Some Hist orical Changes in t he Pat t erns of Populat ion and L and Use in t he Hudson River Wat ershed. American Fisheries Societ y Symposium, 12, 75- 112. The Cit y of New York. (2015). Celebrat ing New York Cit y's Clean Drinking Wat er. Ret rieved from ht t p://www.nyc.gov/ ht ml/dep/ht ml/environment al_educat ion/celebrat e.sht ml Wall, G., Riva- M urray, K ., & Phillips, P. (1998). Wat er Qualit y in t he Hudson River Basin, New York and Adjacent St at es,1992?95. U.S. Geological Survey Circular. Young, L . (2011, August 12). Bans On Hudson Swimming And Boat ing M ay L ast Through Weekend Aft er Ossining Sewer M ain Break. Ret rieved from ht t p://newyork. cbslocal.com/2011/08/12/healt h- officials- warn- against - swi mming- boat ing- in- hudson- aft er- sewer- main- break- in- ossin ing/ PHOTO: ht t p://www.freeimages.com/phot o/hudson- river- upst at e- 139 7741
Prevent ing Cancer Through Food bbbbbbbbbbbbbbbbbbbbbb 1Higdon
J, Delage B, Williams D, et al. Cruciferousv eget ables and human cancer risk: epidemiologic evidence and mechanist ic basis. Pharmacol Res 2007;55:224- 236. 2M ary A. Zimmerman, Nagendra Singh, Pamela M . M art in, M ut husamy Thangaraju, Vadivel Ganapat hy, Jennifer L . Waller, Huidong Shi, K eit h D. Robert son, David H. M unn, and K ebin L iu. 2012. But yrat e suppresses colonic inflammat ion t hrough HDAC1- dependent Fas Upregulat ion and Fas- mediat ed apopt osis of T cells. Am J Physiol Gast roint est L iver Physiol 302: G1405- G1415. bbbbbb 3PrasannaK umarS,ThippeswamyG,SheelaM L ,PrabhakarBT, Salimat hBP. But yrat e- induced phosphat ase regulat es VEGF and angiogenesis via Sp1. Arch Biochem Biophys. 2008 Oct 1;?478(1):85- 95. 4Powolny A, Singh S. M ult it arget ed prevent ion and t herapy of cancer by diallyl t risulfide and relat ed Allium veget able- derived organosulfur compounds. Cancer L et t 2008;?269:305- 314. 5Pierini R, Gee J M , Belshaw N J, et al. Flavonoids and int est inal cancers.BrJ Nut r 2008;?99 E Suppl 1:ES53- 59. 6M iyamot o S, Yasui Y, Ohigashi H, et al. Diet ary flavonoids suppress azoxymet hane- induced colonic preneoplast ic lesions in male C57BL /K sJ- db/db mice. Chem Biol I nt eract 2010;?183:276- 283. 7Shan B E, Wang M X , L i R Q. Quercet in inhibit human SW 480 colon cancer growt h in associat ion wit h inhibit ion of cyclin D1 and survivin expression t hrough Wnt /bet a- cat enin signaling pat hway. Cancer I nvest 2009;?27:604- 612. 2009;?281:162- 170.
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8X avier
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The Problem wit h M edical School Admissions PHOTO: ht t p://www.freeimages.com/phot o/st ack- of- books- 1531138 ht t p://www.freeimages.com/phot o/cap- diploma- 1315412
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