Medicor 2021 #2

medicor medicinska föreningen’s student magazine

THE NOBEL PRIZE

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THE WOMB AS A WEAPON

TRAIL OF THE KING

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PRECISELY DIABETES How personalising diabetes treatment can mean better health for 425 million people worldwide 2021 | ISSUE 2

Prelude Dear Reader, After a long hiatus, many of you on campus will have the chance to pick up a physical copy of this issue to flip through. As you do so, I hope you linger on the insightful and thought-provoking pieces the Medicor team has carefully crafted for you.

I am spoilt for choice when writing about what I like in this issue. For the sake of brevity, my personal favourites include the pieces about the use of Precision Medicine in diabetes and the MF Journal.

This issue also discusses some more sensitive topics: animal research, reproductive rights, and a recent history of Afghanistan. Ultimately, I think these are important conversations to have, and my intention with Medicor is to provide a platform for Medicinska Föreningen’s members.

If you wish to respond to or comment on any of the content in this magazine, please reach out to us! We’re here to learn and grow together.

Photo attributed to: Maria Pavlou

The layout and look of the magazine are the work of Anny Truong and Maria Pavlou, who I have to thank for their endless patience, attention to detail, and time awaiting revised articles. Dabbling in the final stages of design made my appreciation for their work double overnight.

As I wrap up my year as editor-in-chief, I want to say thank you to all of you who have helped make Medicor’s visions a reality! We hope to keep hearing from you about the things you are passionate about. I dare say it’s half the fun.

medicor

Inika Prasad Editor-in-Chief

Medicor Magazine Founded 2006. Sixteenth year.

Published by Medicinska Föreningen in Stockholm ISSN: 1653-9796 Responsible editor: Inika Prasad Print: Lenanders Grafiska AB Address: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Contact Medicor: medicor@medicinskaforeningen.se www.medicinskaforeningen.se http://medicor.nu Freelance material: Medicor retains the right to edit incoming material and does not take responsibility for unsolicited texts or pictures, and printing mistakes. The contributor agrees that, through published and signed Medicor material, their opinions do not necessarily represent those of Medicor or Medicinska Föreningen.

Cover by Minnie Olsson Strindin Illustrative elements used in magazine attributed to Canva & Microsoft PowerPoint

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medicor • 2021 | ISSUE 2

Contents CAMPUS 5 An IGEM interview 8 The Nobel Prize 10 MF Journal 12 Blending Science & BB Business

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SCIENCE

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16 Researcher’s best friend?

20 Hand, Foot, and Mouth 22 How Playing Music Can BB Change Your Brain

26 Sweet Genes - Precision BB Medicine in Diabetes

GLOBAL FOCUS

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30 The Womb as a Weapon: BB Beyond Abortions

32 The two faces of precision BB medicine

36 How the Taliban affected BB Afghan History

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CULTURE 40 The Trail of the King 42 Your winter reading list

COMPETITION - find the chilis!

44 Bite-sized media - shaped BB by and shaping us

The discovery that won the 2021 Nobel Prize in Physiology or Medicine was greatly helped by our spicy friend capsaicin, from the chili pepper. To read more about it see the article on page 8. Also, keep an eye out for all the cute hidden chilis throughout the magazine.

They can be in different colours, sizes...and maybe even opacity. Who knows? If you can manage to find them, you could win a special prize!

medicor • 2021 | ISSUE 2

For more information about the competition follow Medicor on social media!

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CAMPUS 4 Image credits to Inika Prasad

medicor • 2021 | ISSUE 2

CAMPUS • iGEM

A foray into synthetic biology An iGEM interview AUTHORS: INTISAR SALIM & NASSAI HERREN Intisar Salim and Elsa Arksand were the team leaders for the 2021 iGEM Stockholm team; Medicor had the opportunity to sit down with Intisar and ask her some questions about what iGEM is, what they do, and why you should be a part of the next iGEM Stockholm team.

What is iGEM?

Do we have a team in Stockholm?

The International Genetically Engineered Machine (iGEM) competition is the largest synthetic biology competition in the world. Teams of multidisciplinary and international students work together to explore novel solutions to global issues using synthetic biology. Simultaneously, the teams contribute to an open registry of interchangeable biological parts called BioBricks which facilitates the work for future iGEM teams. The iGEM competition started as an independent course at Massachusetts Institute of Technology (MIT) in January 2003. In 2004, it became a summer competition with 5 teams participating and has now expanded to 310 teams and over 6000 participants in 2017, with teams from more than 40 different countries. As the number of participants in the competition increased, so did the complexity. Today, teams compete in tracks ranging from environment to manufacturing to therapeutics, to narrow the focus of the project.

Yes, we do! Unlike many other iGEM teams, the Stockholm team is not associated with a single university, a specific professor, or even a particular group of students. Consequently, each iGEM Stockholm team is independent and determined solely by the individual team members of that year.

The iGEM Stockholm Team consists of (usually up to twenty) students from Karolinska Institutet (KI) and Royal Institute of Technology (KTH), and students from other universities in Stockholm. Together, you plan, finance, execute, validate and present your research project from start to finish. The project will not only consist of lab work and fundraising but also require you to engage with the public, attend conferences to meet other teams, and finally present at the Giant Jamboree!

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CAMPUS • iGEM

What was your role in your iGEM?

What other roles are there?

I had the role of the team leader, which was quite daunting when I first got chosen, but was an amazing experience.

I would say that other roles fall into 3 main categories.

The finance team is responsible for budgeting, gathering sponsors and managing expenses. Then communication is handled by the media team and human practices, which deal with social media posting, public outreach, art projects and website management. Finally, the core of the team is obviously the science subteams, the wet lab and dry lab teams, which are the people who plan the experiments, perform the experiments in the -lab, do all the data analysis and make fancy computer models of the project.

As project leader, Elsa and I were responsible for the team recruitment and leading the team by organising meetings and planning the upcoming iGEM year.

During the iGEM project we had to keep track of a variety of requirements and to assure that official iGEM deadlines are met.

Furthermore, team leaders are not only the contact between iGEM HQ, the team, and the supervisors, but also the face of the team’s values towards the universities and the community.

What was it like being in iGEM? iGEM does not only provide you with excellent skills for your future work life, but also gives you unforgettable memories and friends for life!

The students in iGEM Stockholm are free to choose which track they wish to compete in, making the iGEM experience a unique opportunity for students to explore interesting research fields.

You choose all aspects of the project yourself, which is such an amazing creative and scientific undertaking, and really helps set you up for a future in research. If research isn’t your cup of tea, being in an iGEM also offers positions in software (website and dry lab), community outreach, finance, etc. You really can do a lot in iGEM, and you definitely don’t have to be a classic science/engineering student to join!

What can you do after iGEM? If you join the Stockholm team, you can join SGEM, an alumni network which has social events and often helps the next teams. You can be a mentor for future iGEMers, or just continue hanging out with your new iGEM buddies. iGEM as an organisation also has heaps of different ways in which you can stay involved after you finish your project, if you want to. For example, you can be an ambassador, be a part of their steering groups, or be a part of their many networks, such as the mentoring network or women in STEM. The possibilities feel quite endless. iGEM is also just a really nice thing to have on your CV, and an excellent way to connect with random people who have also gone through the challenge of iGEM. So even if you don’t want to be as involved once you finish your year, I would say that iGEM is still a good thing to do.

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CAMPUS • iGEM

What has the Stockholm iGEM team done in the past?

You can read all about the previous Stockholm projects by visiting their wiki pages, or websites created based around the project.

Back in 2015, the Stockholm team came up with a project which they called ABBBA: AFFINITY-BASED BACTERIAL BIOMARKER ASSAY, which was an Affinity-Based Bacterial Biomarker Assay (as the name suggests), to try and make diagnosis of serious diseases like cancer easier, quicker, and cheaper.

They were awarded a Gold medal, and were nominated for Best Health and Medicine Project In 2016, the next project was SMITE, which stood for Spider silk Mediated Infection Treatment, a treatment for chronic wounds based on genetically engineered spider silk! Stockholm was awarded a gold medal this year as well.

PROlung was the project for 2017, and was based around a mucus degrading lung probiotic, which aimed to reduce the levels of mucus in lungs of chronic smokers, or those with COPD. For the third year in a row, we got a gold medal.

2018 was based around Biotic Blue, which aimed to fight antibiotic pollutants in the Baltic Sea through creating an enzyme called laccase. This enzyme was capable of inactivating sulfamethoxazole, and possibly other antibiotic compounds. This year was one of Stockholm’s best, winning not only another Gold medal, but also Best Environmental Project and Best Integrated Human Practices, as well as being nominated for 5 special prizes!

In 2019, we created Esther, based on Esther Lederberg, to make a new tool for improved phage therapy, which is an addition to antibiotics. We got a silver medal this year.

Despite the pandemic, we still had a thriving 2020 team, who worked on S-POP, a modular biosensor for the detection of persistent organic pollutants (POPs) in water, and received another gold medal.

What did Stockholm do in 2021?

In 2021, we created Mikroskin, which is an aptamerbased test for dysbiosis on the skin microbiome. This aims to make skincare more accessible, and reduce unnecessary antibiotics used in dermatology by trying to ascertain what exactly causes skin problems like acne, eczema, rosacea, etc, so that you can immediately treat the root cause. We joined the tradition of Stockholm by being awarded, you guessed it, a Gold medal.

How and when can you join iGEM? You can join iGEM through the SGEM website, sgem.se/join-igem. They are currently recruiting for team members for the 2022 team! The deadline is January 9th for the next year, so get your applications in ASAP. If you miss the deadlines this year, don’t worry, iGEM comes around every year so you can always apply next time. Keep an eye out for posters around campus, or emails about it. Don’t forget to follow Stockholm iGEM on our social media as well to keep up with what we decide to do for 2022.

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CAMPUS • NOBEL PRIZE

Sensational senses The Nobel Prize in Physiology or Medicine for 2021 AUTHORS: ADA TOPCU

Medicor recently had the honour of attending the press conference announcing the winners of the 2021 Nobel Prize in Physiology or Medicine. Sitting in the Nobel Forum, we were one of the first to hear that the prize had been awarded jointly to David Julius and Ardem Patapoutian for “their discoveries of receptors for temperature and touch”. Join Ada as she walks us through the journey and research of the laureates.

One of the most fascinating aspects of being human is connecting with the world around you, be it through touch, heat, or your other senses. Research over the past few decades provided a detailed understanding of how our sensory nervous system allows us to decode information from our surroundings. However, the exact molecular mechanism for how we sense temperature and touch was only discovered recently.

The 2021 Physiology or Medicine Nobel Prize laureates’ research helps answer how our bodies generate electrical impulses following heat and touch stimuli.

The receptors discovered by David Julius and Ardem Patapoutian elucidate a molecular mechanism for how external stimuli are converted into nerve impulses for temperature and touch perception.

Sensing heat David Julius’ journey on the path that would lead him to the Nobel Prize began with the initial aim to identify the receptor for capsaicin. Capsaicin is a component of chili peppers responsible for the spicy and warm sensation we get upon eating them. His research led to the identification of a gene capable of conferring capsaicin sensitivity to cultured cells by encoding for a protein that reacts to capsaicin. This protein turned out to be a heat-activated ion channel, explaining why the body gets tricked into thinking that there is an actual change in temperature when you eat chilli peppers. It was later named TRPV1, and we now know that it is responsible for the perception of heat (thermoception) and pain (nociception).

Interestingly, both David Julius and Ardem Patapoutian independently discovered another receptor protein of the same family, TRPM8, which is activated by cold temperatures. However, it was David Julius’ initial finding that allowed for the identification of additional thermoreceptive ion channels that are part of the TRP superfamily.

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Sensing touch Ardem Patapoutian’s journey started with the identification of a cell line that produced an electric signal when subjected to mechanical force. Aiming to identify a receptor responsible for this mechanosensation, he and his colleagues studied 72 candidate genes, all of which encoded potential receptors activated by mechanical force. Indeed, a gene was discovered, which, when silenced, desensitised cells to mechanical stimuli. This gene coded for an ion channel subsequently named Piezo1. Another gene coding for a mechanosensitive ion channel, Piezo2, was discovered later. Both these newly identified ion channels were found to be activated by applying pressure onto cell membranes.

However, only Piezo2 was found to be expressed in sensory tissues and knockdown of the ion channel led to the lack of mechanosensitivity in the neurons.

On the other hand, Piezo1 has a role in a number of non-sensory functions such as vascular development.

Thus, it was identified that Piezo2 was the sensor responding to mechanical stimuli.

How do these discoveries impact our lives?

The discovered channels are also involved in mediating various conditions: mainly chronic pain, but also neuropathic and visceral pain, blood pressure conditions and so on. Investigating these receptors can thus be a potential starting-point for understanding these conditions better and developing more effective treatments.

Understanding how humans sense and process touch is not just important for managing diseases. For instance, the physical and social isolation during the COVID-19 pandemic spurred research on the topic of “touch-hunger”, caused by an absence of human contact. Greater insight into the molecular mechanism of how the human body perceives and interprets the presence or lack of touch would be an intriguing field of study.

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CAMPUS • NOBEL PRIZE

What now?

Although the discoveries of the 2021 Nobel Prize in Physiology or Medicine can be summed up in a few paragraphs, the scientists’ research process was neither short nor linear. Nevertheless, their findings allow us to understand how nerve impulses are initiated by temperature and mechanical stimuli, and how the human body makes sense of these external forces and signals.

Now that we know what role TRP channels play in temperature perception and how the Piezo2 channel allows us to sense touch, the roles of these channels in health and disease can be the focus for further research.

medicor • 2021 | ISSUE 2 Image credits to Inika Prasad

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CAMPUS • MF JOURNAL

THE

MF

JOURNAL

Imaged credits to Viivi Sairanen

Being back on campus for autumn 2021 meant that Medicinska Föreningen’s on-site activities resumed with much gusto. Here are snapshots of events and initiatives from this semester!

Clothing Swap, November 2021 Students for Sustainable Development

A Stroket gig, November 2021 Stroket

The CHaSE team, November 2021 Business Committee

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medicor • 2021 | ISSUE 2

Reception and pub for psychology students, November 2021 PsyKI, Psykologsektionen at KI

CAMPUS • MF JOURNAL

Concert & 35 year jubilee, November 2021

Imaged credits to Julie Roux & Konstantina Dindini

Mental Health Day, October 2021 Equal Treatment Commission

Pizza night and Halloween sittning, Nov 2021 Biomedicinska analytikersektionen (BMA)

Imaged credits to Rosa Radmann

Imaged credits to Nassai Herren

Imaged credits to Mimmi Lindgren & Lisa Linhardt

Blåslaget and Dragplåstret

Brunnsviken hike November 2021 Global Friends Book donations, an ongoing project STRÄVA

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CAMPUS • BLENDING SCIENCE & BUSINESS

Blending Science & Business AUTHORS: PRAVEEN PILLAI & STEPHEN TOWNSEND Balancing their love for science and business, Praveen and Stephen discuss how their studies and experiences studying the Master’s in Bioentrepreneurship at Karolinska Institutet allows them to pursue both fields.

An introduction PRAVEEN & STEPHEN: Since we started our journey in Stockholm as students in the Master’s Program in Bioentrepreneuship at Karolinska Institutet, we’ve been bombarded with exciting experiences, new learning opportunities, and met some amazing peers. Today, we wanted to share our perspective on changing focus from science to business, our time so far in the program, and our future plans.

PRAVEEN: My passion for healthcare started prior to my Bachelor’s when I was back home in Singapore.

My sister has a background in biomedicine, and our conversations about healthcare and medicine influenced me to pursue a Bachelor’s in Biomedical Engineering. This program allowed me to deal with modern medical devices and the technical aspect behind their operations. However, the curriculum was geared towards a research-based career upon graduation, and I slowly came to realise that wasn’t a great fit for me.

What did you do before the program?

STEPHEN: I completed a Bachelor’s in Biological Science and Nutrition in Canada, where I studied topics like biochemistry, physiology, and nutrigenomics. Despite being a relatively flexible program, the only business course I could study was a personal finance elective. During this time, I lived with some friends who were majoring in finance, economics, and music. Our dinner conversations were an awkward mix of scientific facts, stock market trends, and the latest DJs. Yet, they helped me gain further confidence and encouraged me in pursuing business, entrepreneurial, and non-scientific interests.

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Why bioentrepreneurship?

STEPHEN: In the final year of my Bachelor’s, a course in micronutrients sparked a thesis project and the development of my current entrepreneurial venture working with enhanced postoperative nutrition for bariatric patients. As I explored this idea, I joined a bariatric surgeon’s ongoing research project while pursuing my venture in parallel. The research project quickly pivoted from academia to a healthtech startup and marked the beginning of my shift into the world of business.

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CAMPUS • BLENDING SCIENCE & BUSINESS

How has the program helped your goals?

STEPHEN: I have gained great experience in the startup landscape in Stockholm with my first work placement at H2 Health Hub. Considering y previous experience at a health-tech startup, I would like to work for some larger or more established organizations to further understand business operations on a deeper level. I believe this would play a valuable role in helping me build my own business and enable me to apply the perspectives of large and small organizations to growing a business.

Illustration by Hamza Hayat on Canva

As valuable as this startup experience was, I still wanted to refine my business skills, learn international perspectives, and pursue my own business venture. In early 2020, I decided to quit my job, launch my business, and join the Bioentrepreneurship program at Karolinska Institutet.

PRAVEEN: After getting some experience as a research assistant, I felt I was more suited for a more dynamic work environment. With that in mind, I joined a telemedicine startup and started my professional career in the field of product development. Every day brought a new learning opportunity at work, and we started strategising how to help grow this early-stage company into a large player in the telemedicine industry.

To develop my knowledge in the medical business to further my career in the healthcare industry, I decided to apply for the Bioentrepreneurship Master’s program at Karolinska Institutet. The curriculum aligned to my learning and career goals, and getting accepted was the next step in my journey from science to business.

PRAVEEN: My first year in the program allowed me to develop the business acumen that I have been striving for. Outside of our studies, we have had a lot of opportunities to explore which field I want to pursue after graduating. An interesting opportunity to take part in a healthcare case competition, organised by Pfizer, IBM, and Region Stockholm, captured my attention. Turns out, I’m really interested in strategy development and consultancy. Interning as a consultant has provided me with first-hand experience of what being a consultant entails.

What do you want to do after the program?

STEPHEN: After graduation, I would love to jump in full-time to the health-tech startup environment either with my current venture or other organizations.

Stockholm is a really vibrant city and has a great support system for entrepreneurship and business ventures, and with Karolinska Institutet and our Bioentrepreneurship class, there is no better place to be for healthcare!

PRAVEEN: Having a clear vision of what I want in my future career, I am now focused on gaining and learning as much as I can in my 2nd year in Bioentrepreneurship. Conducting my own research about the field of management consultancy made me realise that I was interested in the pace of work and the constantly changing projects that consultants are involved in.Gaining this experience through the Master’s in Bioentrepreneurship has reassured me that I’m choosing the right direction after graduation!

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ADVERTISEMENT

KI Innovations provides support and guidance so that more research-based ideas, discoveries, and knowledge from Karolinska Institutet can contribute to a healthier future for all. At Karolinska Institutet, world-leading research continually improves our understanding of the human body and its diseases.

Research results are usually presented in scientific papers, but we want to give researchers the support they need to take steps towards transforming their ideas into products and services of value to patients and society. We are here to help in all aspects of transforming an idea into an innovation.

We spoke to Patrik Blomquist, Ph.D. A Business Coach at KI Innovations.

What do you do in your job as a coach?

We support and help students and researchers from KI who have an idea to solve problems in Healthcare. When a researcher or student comes up with an idea for a company or product, they approach us, we book a meeting to see if the idea is feasible. We also suggest improvements and changes which would lead to that. We then help with consultants, lawyers and other network connections they may need. We provide advice and lead them in the right direction.

What does an average day look like?

Usually starts at the office, sometimes we work from home. We take many meetings throughout the day which range from idea pitches to more established projects. Most of my day is meetings and networking, problem-solving, coming up with solutions, and deciding on how to move forward with projects.

Is there something you wish people knew about KI Innovations?

We see that many students and researchers don’t know about KI innovations. Some are hesitant because they think their idea is not a good one. I would say “Don’t be afraid to talk about your idea” “We are here to help you”. Book the first meeting! We will discuss the idea and go from there.

Linus Kullänger, Founder and CEO, Care to Translate shared his experience with KI Innovations.

How did you find out about KI Innovations?

I was studying medicine at KI and was dedicated to several different non-profit projects focusing on reducing inequalities in society. While doing my internship as a medical student in Sweden and abroad, I realised there was a recurrent need of accessible and safe medical translations due to language barriers between staff and patients. Together with some classmates, we built and released a beta version of what was to become the Care to Translate app. My father-in-law, who is a professor at KI, told me about KI Innovations and how they could help us reach more people.

Did you have any reservations about working with KI Innovations? In hindsight, how did they work out?

If I could go back in time, I wouldn’t change anything. I’ve learned so much during the process and KI innovations and Patrik have given me invaluable advice. I was new to businesses, how they are run and how things work and they gave me tips every step of the way. If anything, I would’ve wanted to learn about them earlier than I did.

How has KI Innovations helped you?

They really liked the idea. They supported our initiative and our vision, and I felt comfortable starting the company with their help. They helped set up the company and provided amazing network opportunities.

SCIENCE Image credits to Deepak Digwal from Pexels

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SCIENCE • ANIMAL TESTING

Researcher’s best friend?

The present and future of laboratory animals AUTHOR: SOFIYA ISKRAK Animal research remains a cornerstone of scientific research while simultaneously bringing forth concerns about the rights and safety of the animals used. The classic dilemma regarding the intrinsic value of human and animal life and suffering comes quickly to mind.

The field is wrought with crude oversimplifications of the issue, and as with any ethical questions, there are no black and white answers. What do you do when ethical dilemmas stop being just abstract notions and spill over into the real world?

In my personal life, being vegan and working in a laboratory made me face difficult questions regarding my own moral compass. Even though I have not worked with laboratory animals and only used human liver cells, the logical continuation of my project would be testing on animals. So, I started asking myself ”Are there any other options?” Is the only possible answer to stick with in-vitro research? But even in that case, the majority of in-vitro research will develop into projects that require in-vivo experiments as a follow-up. So, should I never set foot in a lab again?

Luckily, maybe such radical actions are unnecessary, as it appears my peers and I are not the only ones concerned with this. On September 15th, 2021, the European Parliament voted in favour of creating an action plan to end the use of animals in research (1).

Once again, however, the hurdle is to find appropriate alternatives. Apparently, there are quite a few!

Overview of animal welfare in the field of research Before we start our search for alternatives though, it would be quite useful to get a general understanding of the present situation.

For many fields, animal testing is a core practice.

These include basic research, applied research, regulatory testing, and breeding laboratory animals (2). However, data on the extent of animal testing carried out in each field is scarce. One paper suggests a whopping more than 190 million animals used worldwide in 2015 (3). YetHowever, we need to be careful with this number, as it is an estimate largely based on data available from European countries. To determine the exact number of animals

used and kept in labs around the world, one would not only need the precise number of animals, but also a clear definition of an animal used in research, a definition which currently varies greatly between countries.

For example, the US Animal Welfare Act does not include mice, rats, birds, and fish under the definition, hence the reported number of 797,546 animals used in research in the year 2017. This includes less than 10% of research projects carried out in the US (4).

However, a 2019 study by K. Taylor and L. R. Alvarez tried to combine all of the available data and incorporate all possible uses of animals in research.

Even if they did end up with a slightly inflated figure, it is quite clear that the numbers are above 100 million.

In the European Union, one of the most recent legislative acts concerning animals in research is Directive 2010/63/EU. It includes the famous 3R’s: Reduction, Refinement, Replacement. This rule serves as a guideline for minimizing the number of animals used in research, while also promoting the improvement of procedures in order to inflict as little pain as possible. The creation of the new plan that the members of the European Parliament approved on September 15 will once again underline the importance of these provisions and hopefully include a clear plan for the funding the development of alternative testing methods.

Worldwide, however, there persists a lack of applicable or comprehensive legislation.

Is animal research “good” for humans?

At first, there seems to be an obvious answer to this: yes! Almost all drugs currently in use have been developed and tested for safety and efficacy using animal experimentation.

Additionally, a lot of our basic understanding of biology comes from the use of animals.

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SCIENCE • ANIMAL TESTING

However, as we get a better understanding of the underlying molecular mechanisms that regulate our bodily functions, it is starting to become clear that we cannot always translate animal research into comparable results in human trials. As we are developing more and more drugs, finding new methods of carrying out safe and rapid testing is becoming more pressing than ever (5).

Looking from a different perspective, some studies show that researchers who perform their experiments in-vivo are more prone to anxiety than researchers conducting in-vitro experiments (6).

Overall, while animal experimentation has undeniably been useful, it also has plenty of drawbacks that together make up a strong case for the use of alternative methods.

What are our options?

Tissue bioprinting, organoids, organ-on-a-chip, computer models – all of these pop up in almost every article on the future of animal experimentation.

Some are more intuitive to understand, others less so, and going into details of each one will take more than one article, so here is a very brief overview!

Tissue bioprinting is a cousin of 3D printing, in which the material used isn’t plastic, but our own cells, which are submerged in a hydrogel. This technology has been around the longest among the aforementioned ones and has already proved to be useful in some cases, especially in toxicity testing on skin.

An organ-on-a-chip is the next step forward from the tissue level, and also uses 3D printing to arrange the cells into complex structures. It goes beyond simple tissues and allows for the mimicking of the anatomy and physiology of human organs. The information output is obtained from the chip embedded in the system and depending on the project it can either be detected visually or chemically. Organ-on-a-chip technology was used in the creation of the first drug that was submitted for FDA approval without having undergone animal testing. Researchers from Hebrew University used three models: heart, kidney, and liver to test a drug that could potentially be used in the treatment of cancer (7).

Organoids are miniature organs grown from stem cells. They differ from organ-on-a-chip technology mainly in the growing environment, as the cultivation of organoids is less controlled and resembles the natural process more closely. However, this “almost natural” way of proliferation and maturation means

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that producing identical organoids comes with major complications, meaning their use in research with high replicability is difficult.

As everything around us gets more and more computerised, the all-powerful algorithms make their way into the labs as well. Computer models can be especially useful for the large-scale toxicity screening of various chemicals. Predicting the potential substance toxicity based on the information from the toxicity screenings of similar chemicals and their known properties has been shown to give more accurate and consistent results than animal trials (8).

Another study used a computer simulation of a human to assess the safety of a heart medication, and the results were extremely promising (9).

Why are we still using animals?

So it seems like there are options and good reasons to switch to non-animal models, however, the majority of research remains exclusively animal-based. Why is that?

To quote Donald Ingber, Founding Director of the Wyss Institute for Biologically Inspired Engineering at Harvard University in his interview for Nature Review Materials: “The first and short answer is that we use them because they are there, and because we have used them in the past and we know how to work with animal models.” (10)

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THE FIRST AND SHORT ANSWER IS THAT WE USE THEM BECAUSE THEY ARE THERE, AND BECAUSE WE HAVE USED THEM IN THE PAST AND WE KNOW HOW TO WORK WITH ANIMAL MODELS.

I am not going to pretend like that is the only reason, and neither does Donald Ingber or other researchers who raise concerns regarding the use of animals in research. It is evident that all of the alternatives have major limitations, mostly in terms of complexity as the response of the entire organism to a substance is extremely difficult to predict. However, in many ways, continuing to use the high volumes of research animals is also a matter of habit and reluctance to change. I believe that science has the power to make lives better for everyone, and that possibilities of doing things differently in a way that reduces the exploitation of living creatures should be explored moving forward.

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GLOBAL FOCUS • ANIMAL TESTING

WANT TO GET INVOLVED? Medicor is always looking to strengthen the team and improve the quality of what we produce. You can help us raise the bar!

Reach out to us if you’re interested in writing, illustrating, editing, magazine layout, web development, or finance management.

Plus, we have good fika.

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SCIENCE • HAND, FOOT, AND MOUTH

Hand, Foot, and Mouth.

AUTHOR: MENOSHA SIVA I remember being the ripe old age of six, and seeing my classmate walk through the doors of my kindergarten with a slight rash on the corner of her mouth. My naive mind thought she had leftover jam in a peculiar pattern smeared on her face - a testament to her breakfast. Au contraire - the chaos that ensued the moment my teacher laid eyes on her was unparalleled. That was the day I learned of Hand, Foot, and Mouth disease.

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What does Hand, Foot and Mouth disease feel like?

What causes Hand, Foot and Mouth disease?

Where does Hand, Foot and Mouth disease occur?

Hand, Foot and Mouth Disease (HFMD) often occurs in children, especially pre-adolescents.

Common telltale symptoms include a red rash, usually without itching, but sometimes with blistering on the palms, soles, and rarely, the buttocks.

Patients also report having a fever, sore and scratchy throat, loss of appetite and an overall unwell feeling. While most patients manage well in the long term, and do not have lasting side effects, HFMD proves to be fatal in a small percentage of cases.

Often, these young patients develop severe central nervous system disease or pulmonary oedema that then lead to death.

HFMD is most commonly caused by an interestingly-named virus, the Coxsackievirus A16, and secondarily caused by Enterovirus 71 (EV71). (The name Coxsackie comes from the town Coxsackie, New York, a small town on the Hudson River.)

These enteroviruses spread by person-to-person contact, fecal matter, and through the air. Young Children often do not have high regard for personal hygiene or personal space. Therefore, it comes as no surprise that most outbreaks begin in schools and parks – areas where young children meet and mingle.

While first described in Canada, HFMD is most prevalent in East and Southeast Asia (1, 2).

According to the World Health Organisation (WHO), China, Japan, Hong Kong, the Republic of Korea, Malaysia, Singapore, Thailand, and Vietnam are countries with the highest number of cases as of late. This highly contagious virus often leads to outbreaks in the thousands, even millions. Malaysia reported over 50,000 incidents with two deaths in 2018 in the most recent outbreak known globally, which reinforces the fact that HFMD is not a thing of the past. In another outbreak in Mainland China in 2009, there were a total of

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SCIENCE • HAND, FOOT, AND MOUTH

1,155,525 cases, 13,810 severe cases and 353 deaths (3).

However, that is not to say that Sweden is foreign to HFMD. Known as höstblåsor, there was an outbreak in the 1970s with 9 infections (3).

Currently, there are three vaccines available to combat HFMD that have been licensed in China, but this vaccine is developed for Enterovirus 71 (4).

This does not fight infections caused by the Coxsackievirus.

Therefore, the common method as of today of treatment is similar to other viral infections: allowing the virus to run its course and waiting for our immune system to fight back.

However, when a confirmed case of HFMD is identified, preventing a mass outbreak is key. One must enforce proper hygiene techniques, and disinfect contaminated surfaces. This includes washing hands often especially before eating, and after using the bathroom (or changing diapers). It is also good practice to refrain from sharing cutlery and close physical contact when one is sick. Naturally, it is hard to tell sick, young children to not hug their best friend when infected, but other hygiene practices can be taught early on as an overall precaution from getting sick.

” Photo by Viki_B on Pixabay

Photo by huunghidt on Pixabay

How can we treat Hand, Foot and Mouth disease?

This then creates a lasting immune response that protects the child from the virus.

Regardless, once an individual has recovered, said individual can develop the disease again if infected by another strain of the virus.

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THIS HIGLY CONTAGIOUS VIRUS OFTENTIMES LEADS TO OUTBREAKS IN THE THOUSANDS, EVEN MILLIONS

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SCIENCE • MUSIC & YOUR BRAIN

How Playing Music Can Change Your Brain AUTHOR: NASSAI HERREN Have you ever wondered about the benefits of actually making music yourself and how can you play music at KI?

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SCIENCE • MUSIC & YOUR BRAIN

Photo by Providence Doucet from Unsplash

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SCIENCE • MUSIC & YOUR BRAIN

You may remember that the previous edition of Medicor offered a small view into the benefits of listening to music, but have you ever wondered about the benefits of actually making music yourself?

instead. For instance, one study showed that whilst verbal memory and reasoning were found to be significantly better in musicians, non-musicians scored better on Cattell’s Culture Free Intelligence Test (3).

While the consensus is that there are certain neurological benefits to purely listening to music, there are numerous other benefits to learning and playing music that justifies our seemingly instinctive love for music.

In addition, musicians were shown to have better temporal cognition, rhythm perception, and auditory fusion, though the degree of difference depends on multiple factors such as passive or active training, short- or longterm training, among others (4).

Listening to music is linked to social and emotional benefits, such as increased selfawareness, better arousal and mood regulation, i.e. feeling awake and alert, and improved social relatedness (1). This was first explored and coined the Mozart effect, in an experiment where participants who listened to Mozart performed significantly better on spatial abilities, and mood regulation.

Conversely, when a musician plays their instrument, they obtain all the benefits of listening to music alongside experiencing changes within the brain associated with playing music.

One major boost of playing music is increased brain plasticity, which refers to the brain’s ability to adapt, grow, and prune synapses in order to adjust to the stimuli one is exposed to. This can facilitate learning in many areas of life.

Learning music is correlated with structural and functional changes within the brain, such as a greater volume of grey matter in certain regions, and thus associated with improved auditory, motor, and visual-spatial skills (2).

Some studies show that musical ability may not actually be associated to increased logical thinking, relying more on intuition

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“Musicians learn and repeatedly practice the association of motor actions with specific sound and visual patterns while receiving continuous multi-sensory feedback. This association learning can strengthen connections between auditory and motor regions while activating multimodal integration regions. ”(5) A fun fact for aspiring medical professionals is that having a musical background has been associated with being a better doctor, doing better in medical school, or is just generally a predictor of success. This is so well-established, that many medical schools recruit specifically for those with a musical background, and both medical schools and hospitals often have orchestras for their many players (6).

Outside of musical organisations, medical fields appear to attract the most musicians than any other profession (7). The reasons for this have anecdotally been attributed to pattern recognition, discipline, perfectionism, stress management, listening, collaboration, empathy, attention to detail, and aspiration towards excellence (8). These are all highly valued skills within the medical fields.

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How to cash in your musical benefits There are two major ways you can appreciate music while studying at KI: playing with an orchestra or listening to others play.

At Medicinska Föreningen, there is a string instrument ensemble called Stroket, which meets weekly to play various types of music together. The idea is to encourage students to continue playing instruments during their studies. Many students neglect to play music because they don’t have time to practice. Stroket is extremely flexible in that they modulate the difficulty of the pieces performed based on the abilities and preferences of the current players.

Stroket has traditionally been primarily for players of the four major stringed instruments – the violin, viola, cello, and double bass. Lately they have opened up to players of other instruments as well. If you play the piano, flute, or another instrument that can harmonise nicely, then you are welcome to join!

If you want to play at a higher level or in a larger symphony, then you can also audition for other orchestras in Stockholm, like the KTH orchestra.

You may be someone who appreciates classical music but don’t play an instrument. If so, I highly recommend attending some of the concerts around Stockholm. You get student discounts at most of the concert halls, so it’s a great way to spend some time with friends!

You shouldn’t need to sacrifice your love of music during your studies. By continuing to pursue it either as something you consume or create, it can improve your life in many ways.

SCIENCE • MUSIC & YOUR BRAIN

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Photo by cottonbro from Pexels

LEARNING MUSIC IS CORRELATED WITH STRUCTURAL AND FUNCTIONAL CHANGES WITHIN THE BRAIN

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SCIENCE • PRECISION MEDICINE: SWEET GENES

Sweet genes Precision Medicine in Diabetes AUTHOR: VERA FEDOSOVA

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SCIENCE • PRECISION MEDICINE: SWEET GENES

According to the International Diabetes Federation (IDF), 425 million people live with diabetes worldwide. Associated with an increased risk of premature morbidity and mortality, diabetes has a myriad of causes, phenotypes, trajectories, and consequences. Using a common uniform treatment algorithm for all patients is often associated with progressive treatment failure and complications. How can precision medicine help?

A little bit about diabetes Diabetes mellitus is a group of chronic diseases characterised by the inability to maintain normal blood glucose levels. Glucose homeostasis depends on the glucose-sensing β-cells in the pancreas which produce the hormone insulin in response to elevated blood sugar levels. Insulin facilitates the uptake of dietary glucose by all the cells in the body, thus providing them with fuel for energy production and lowering the blood glucose levels back to normal.

The role of Precision Medicine To complicate the matters further, not all adulthood diabetes is type 2 diabetes and neither is all childhood diabetes type 1 diabetes. Moreover, another type of diabetes has recently been described, known as Maturity-Onset Diabetes of the Young (MODY). It is a relatively uncommon form of monogenic diabetes and accounts for up to 2% of all diabetes cases. It is a group of autosomal dominant disorders usually characterized by non-acute presentation similar to T2D but occurring at a younger age, typically before the age of 25.

Type 1 Diabetes

Type 2 Diabetes

Occurs in young patients

Older age of onset.

Caused by the autoimmune destruction of pancreatic islet cells.

Caused by insulin resistance in the tissues and impaired pancreatic insulin secretion, overall dysregulation of glucose metabolism.

Genetic susceptibility, immunologic perturbation, environmental factors.

Hereditary polygenic disease. Environmental factors might contribute.

Misdiagnosing MODY What makes MODY so special is that it runs a high risk of being misdiagnosed. MODY presents at an early age and cannot be treated using the common oral glucose-lowering medications, making it prone to misdiagnosis as T1D. Alternatively, MODY is often mistaken for T2D due to the non-acute presentation of the disease and the relatively low risk of ketoacidosis, i.e. a rapid decrease in blood pH. Why is getting the right diagnosis so important?

Treatment of diabetes largely depends on the type of disease. For T2D, the treatment mainly includes drugs that either promote glucose uptake, or increase insulin production in the pancreas. The T1D patients usually receive insulin analogues as a substitute for endogenously produced insulin. For MODY-patients, the treatment would primarily depend on the individual genetic makeup of the person. So in this particular case setting the right diagnosis is extra difficult but also extra important. The wrong diagnosis may also potentially lead to wrong treatment which may have fatal consequences for the patient.

This is where personalised medicine comes into play.

The glimmer of hope: precision medicine Using information about the individual genetic makeup of a patient, we can establish screening strategies and therapeutic interventions for effective management of the disease and its complications.

This is especially effective for ensuring the right diagnosis, choice of pharmacotherapy, and management of complications.

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THE RIGHT TREATMENTS, TO THE RIGHT PERSON, AT THE RIGHT TIME

Diagnose it right Precision medicine has become useful for the management of rare single-gene anomalies which cause various forms of monogenic diabetes such as MODY. The correct diagnosis of this type of diabetes is especially important as it has a direct bearing on the subsequent choice of treatment. As of the time of writing, at least 14 genetic subtypes of MODY have

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SCIENCE • PRECISION MEDICINE: SWEET GENES

been identified, each with distinct characteristic genes predominantly linked to pancreatic β-cell biology. Some forms of MODY can be managed with lifestyle modification, while others may require treatment with drugs that stimulate insulin production in the β-cells, like the well-known glibenclamide or sulfonylureas.

Choose your pill: Why your enzymes matter Modern anti-diabetic drugs usually need to be metabolised by specific enzymes to get activated. The Cytochrome P450, or CYP, enzymes in the liver are important examples – gain-of-function or loss-of-function mutations in these enzymes can modulate the metabolism and thus pharmacodynamic effects of certain drugs. Drugs that stimulate insulin synthesis (also known as insulin secretagogues) are especially sensitive to this modulation, and this may explain why some of these drugs fail in the management of T2D. For example, the insulin secretagogue repaglinide is predominantly metabolised by the CYP-2C8 variant of the CYP-enzymes while other insulin secretagogues (such as glimepiride and gliclazide, the two common modern sulfonylurea drugs) are mainly metabolised by CYP-2C9. This means that a patient who does not respond to modern sulfonylurea-drugs may benefit from a therapeutic trial with repaglinide, and vice versa.

Precision medicine can facilitate the optimisation of glucose-lowering therapy by helping to choose the appropriate treatment depending on whether the patient has CYP-2C9 or CYP-2C8.

Choose your pill: Met-formin’ opinions Metformin is another medication commonly used for the treatment of T2D that mainly acts through decreasing glucose production in the liver and the intestinal absorption of dietary glucose. It also enhances insulin sensitivity by increasing peripheral glucose uptake and utilisation. The effectiveness of metformin treatment is known to depend on the aforementioned metabolism pathways as well as cellular transport proteins, such as the organic cation transporter 1 (OCT1). OCT1 is required for the transport of the drug into the cell. Thus, mutations or other changes in the function of these proteins can influence the response to metformin therapy. Precision medicine can therefore be used to evaluate whether metformin should be used as first-hand treatment, in all, or only in "genetically appropriate" T2D patients.

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Choose your pill: Responding to insulin Since patients with T1D cannot produce insulin themselves due to the autoimmune destruction of β-cells, T1D is most often treated with insulin analogues, and response to insulin between and even within. Despite the fact that modern insulin analogues are usually associated with lower rates of variability, they are still far from optimal. Precision medicine may thus also be used to offer insight into genetic factors which influence insulin action and variability in T1D patients.

Managing complications Unsurprisingly, treatment of diabetes also includes management of its complications such as neuropathic pain. Today, Oxcarbazepine is one of the most commonly used medications for the relief of neuropathy-associated painful symptoms. However, this drug is associated with an increased risk for the development of severe life-threatening skin reactions like Steven-Johnsosn syndrome and toxic epidermal necrolysis. Fortunately, it has been found that the risk of these complications is limited to individuals with the specific gene variant HLA-B*1502, which normally provides instructions for making a protein critical for the recognition of pathogens by the immune system.

Thus, precision medicine can help us identify patients at high risk of adverse events, and thus help match therapy to patients.

Looking forwards Precision medicine is a highly discussed subject in current literature, with applications in a multitude of areas, ranging from cancer treatment and diagnostics to the management of diabetic syndromes. It has a potential role in diagnosing the type of diabetes, choosing initial therapy, establishing the dosage and intensity of glycaemic monitoring, and planning treatment for various complications of diabetes based on the individual genetic makeup of the patient. Even though it is still not a reality in clinics yet, there is strong evidence to believe that precision medicine will soon become a routine feature in the diagnosis, decision making, and treatment of diabetes.

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GLOBAL medicor • 2021 | ISSUE 2 Image credits to Mike Chai from Pexels

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GLOBAL FOCUS • ANIMAL TESTING

The Womb as a Weapon: Beyond Abortions

Abortions play a central role in the current fight for gender equality. Historically, however, this medical procedure has been used to pursue and promote eugenic ideas, which oppose equality. Should current feminism re-examine the role of abortions in reproductive health?

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Photo by Anna Shvets from Pexels

AUTHOR: MANASVINI MONI

GLOBAL FOCUS • REPRODUCTIVE HEALTH

The term 'pro-choice' is firmly embedded in contemporary feminist discourse. Proponents of gender equality around the world, from Asia to the Americas, have been fighting for the right to legal and safe abortions, to varying degrees of success. But what does it mean to be 'pro-choice'?

Some hints of the term's conventional understanding are nested within its popular American counterpart, 'pro-life'. Viewing abortions under this frame of reference does two things. Firstly, it equates being pro-choice to being anti-life. Abortions become a source of violence and the feminists who fight for it become facilitators of death. Secondly, in a bid to oppose this narrative, the mainstream feminist focus shifts entirely to abortions. With all nuance lost, the 'choice' within 'pro-choice' is obscured, and so are variations in reproductive needs. Historically, abortions have been a liberating medical procedure only for a select few.

Beyond Sexism: Power and Population Control In November 2020, Marie Stopes International, a nonprofit organisation working to provide contraceptives and safe abortions worldwide, changed its name to MSI Reproductive Choices. It turns out that the titular and iconic Marie Stopes, a 20th-century British birth control advocate, was also a eugenicist .

“Eugenics refers to the use of procedures like selective breeding and forced sterilisation in an attempt to improve the genetic purity of the human race. Eugenicists believe that disease, disability, and “undesirable” human traits can be “bred out” of the human race.”

Ignited by ideas of evolution and population control, many prominent, white scholars at the turn of the 20th century believed that one could create an ideal human through selective breeding. It so happens that their 'ideal' was white, able-bodied, and upper class.

Eugenicist thinking played a key role in Stopes' establishment of the first birth control clinic in the British Empire. She espoused ideals of bodily ownership and freedom, while simultaneously working towards ‘racial health and happiness’.

Contraceptives and safe abortions became tools to liberate white women from forced births, and mechanisms to prevent 'dysgenic' women from giving birth.

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HISTORICALLY, ABORTIONS HAVE BEEN A LIBERATING MEDICAL PROCEDURE ONLY FOR A SELECT FEW

Nazism, informed by similar eugenic ideas, also focused on increasing Aryan population numbers to prevent their alleged extinction. For Aryan women, abortion was actively discouraged, and financial subsidies were provided for young people to have families earlier. The most egregious policy was of the Lebensborn society, which provided accommodation and resources for unmarried women to bear the children of Nazi or SS officials, often through persuasion or coercion.

In both cases, control of reproduction and reproductive capacity became a means of ensuring the desired population composition. Similar strategies continue today, most notably in China’s One-Child Policy, and persecution of Uyghur Muslims through forced abortions and sterilisation.

Towards Reproductive Justice The common thread here is the imposing or withholding of reproductive rights by those in power as means of exercising a racist or xenophobic political agenda. The womb becomes both a weapon and a site of war for political actors, eroding the individual's control over their own body, identity, and future. However, the way in which this weapon is wielded and its impact on an individual is defined by their positions in society and relations to power. Some are denied motherhood and others are coerced into it.

For a truly intersectional approach to health, we must move towards ‘reproductive justice’, a term coined by Black feminists in 1994. SisterSong, an organisation founded by women of colour, defines reproductive justice as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.”

With these four central tenets, the term helps interrupt the pro-choice vs pro-life dichotomy. Reproductive health is not only about an individual’s right to abortion. In fact, as we have seen, abortion in itself is not liberating for many marginalised women. To truly be ‘pro-choice’, we must instead eliminate systemic barriers that prevent unconditional access to a comprehensive collection of services and tools that allow communities to make safe and healthy reproductive choices.

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GLOBAL FOCUS • PRECISION MEDICINE: ETHICS

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GLOBAL FOCUS • PRECISION MEDICINE: ETHICS

The two faces of Precision Medicine AUTHOR: ÖZER DEMIREL Precision medicine is an emerging term that has been increasingly used in the biomedical and medical fields, but what does it actually mean?

Precision medicine, also called precision health or personalised medicine, is a holistic medical model where an individual’s genes, behaviours, environment, and lifestyle are taken into account in order to create an individualised and tailored approach for disease prevention, risk management, and treatment. This approach allows healthcare workers and researchers to come up with more personalised, precise, and accurate strategies for prevention and treatment of diseases (1).

Given that an individual’s traits, genes, and data are heavily involved in guiding a precision medicine approach, there are several ethical aspects to consider when we look at the future and where this information, and particularly misuse of this information, may lead us.

Who has access to, and can use my data?

Given a situation where one’s employers have access to their employees medical information, in the case of certain legal rights or through using the companies medical services, employees at higher risk of certain diseases might be vulnerable to discrimination and stigmatisation from their employers. This could occur in receiving a lack of opportunities within a job, as well as being offered promotions or the job itself.

Currently, many countries, including Sweden, have laws against medical discrimination, such as in cases of pregnancy or disabilities (2). However, these tend to be difficult to enforce, and often discrimination goes unreported or are unable to be proven. This is also true in Sweden, where it was found that over half of general discrimination cases were thrown out due to lack of evidence, and only about 10% of cases reached a settlement (3). This creates a worrying precedent within the work environment, as it is previously established that discrimination based on health occurs, and could occur in the future from genetic testing against people who have less than ideal genetic traits and profiles.

Furthermore, within healthcare itself, there are not currently any laws governing which medical decisions can be guided by one’s genetic information. There is thus a risk that some patients may receive unfair or inadequate medical treatment. For instance, a patient’s genetic predisposition to rejecting an organ transplant could impact their likelihood of receiving a lifesaving transplant.

It is still important to note that genetic testing is a vital aspect of healthcare, and can often help patients before they develop a particular disease, or catch a disease early in its progression.

Medical insurance companies already factor in various aspects of health and disease when calculating the price of their insurance for different individuals. If given access to more comprehensive personal medical data, these for-profit companies could increase their premiums so that currently healthy individuals would have to pay more for their insurance because they have a certain predisposition to diseases which may affect them in the future.

Insurance may also be denied based on this data, if the risk of developing an expensive condition is too high. In Sweden, this is not necessarily something to be worried about at this point in time, due to the public health insurance system, however private companies still exist and for non-residents or those without a personal number, it may still be an important risk to consider.

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MEDICAL DATA IS STRONGLY PROTECTED AND SHOULD NOT BE AVAILABLE OUTSIDE OF MEDICAL CARE

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GLOBAL FOCUS • PRECISION MEDICINE: ETHICS

Personal concerns and knowing “too much” In addition to genetic discrimination, there might be an increased risk of being stigmatised. A study by Kraft et al. was carried out in the USA, and aimed to explore the current attitudes of minority populations for research and testing needed for personalised medicine. She found that many populations had fears of misuse of data, were skeptical of research due to discrimination and unethical research previously forced upon their groups in the past. Further concerns included hacking of data, corruption over time, length of data storage, which hospitals would have access to the data (many diverse communities preferred to use smaller medical centres which reflected their communities and values, rather than larger, richer, and generally whiter hospitals). One particular participant, an African-American, discussed fear of being stigmatised and put into a certain category as a result of genetic testing (4).

Knowing one’s own risk of particular diseases can also induce hypochondria, or anxiety around one’s health. Particularly when it comes to non-curable or non-preventable diseases, the knowledge that you are likely going to develop this illness can cause hypervigilance around symptoms, and large amounts of stress. This is currently noted in ancestry genetic tests done today, where often a disclaimer is given before one looks at their medical information (if it is available). Stress itself is strongly associated with a higher risk of developing other diseases, specifically chronic stress, such as atherosclerosis and diabetes (5).

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WHEN IT COMES TO NON-CURABLE OR NON-PREVENTABLE DISEASES, THE KNOWLEDGE THAT YOU ARE LIKELY GOING TO DEVELOP THIS ILLNESS CAN CAUSE A LOT OF STRESS

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Misinterpreted medical tests might lead to such problems where the individual may face more harm than good. Some studies show that people who have been genetically tested for breast cancer risk, such as the presence of variants of unknown significants in the BRCA gene, are more likely to undergo invasive preventative surgical operations like a mastectomy, despite their physicians considering the test to be uninformative (6). These operations are often performed to help relieve the anxiety of potentially developing a serious condition, and may have never been necessary as the cancer was not guaranteed to have developed.

Another interesting factor to note is if the patient receives the information of their predisposition or early stage of a particular disease, they are likely to go home and research it themselves. However, companies such as Google and Facebook are notorious for analysing searches over the internet and using this information to personalise advertisements for other companies, which could include private medical companies using medical data (7).

How do we prevent unethical usage of precision medicine data?

Luckily, lawmakers have had foresight and accounted for this in some policies. For instance, the Genetic information Nondiscrimination act of 2008 (GINA) is a law in the United States that created to work against the genetic discrimination by prohibiting health insurers and group health plans to use the individual’s genetic predisposition to certain diseases when making decisions such as hiring, firing, promotion and job replacements (8).

There are strong laws within Sweden about medical information safety, including digital healthcare. Some of these include the Patient Data Act (SFS 2010:659), The Healthcare Act (SFS 2015:315), Socialstyrelsen regulations for personal data processing (HSLF-FS 2016:40), as well as general data protection schemes such as the Swedish Act which supplements the EU’s Data Protection Regulation (SFS 2018:218), and the General Data Protection Regulation (GDPR) (2).

These laws basically mean that medical data is strongly protected and should not be available outside of medical care. There are several regulatory authorities which help enforce these laws. In general, you shouldn’t worry too much about your data here, but it is still important to consider the different ethical considerations and issues that may arise in the future as personalised medicine becomes more and more common.

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GLOBAL FOCUS • PRECISION MEDICINE: ETHICS

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PRECISION MEDICINE MAKES YOUR MEDICAL CARE FOCUSED AROUND YOU, AND YOUR INDIVIDUAL RISKS BASED ON YOUR GENETICS, ENVIRONMENT, AND LIFESTYLE, AND THIS TAKES IN A MORE HOLISTIC PICTURE OF WHO YOU ARE

The gift of better healthcare Precision medicine in general is a fantastic way to approach healthcare, and can often optimise the prognosis for individual patients and allow them to explore the different treatment avenues which are best for them. It also can help open doors in healthcare that may have been previously closed.

For example, it can provide better treatment alternatives and treatment strategies for groups of people who have not historically been included in medical or pharmaceutical studies and trials.

This once again raises the issue of trust from diverse communities and minorities, as historically they have been mistreated. This was something which was discussed in depth in the study by Kraft et al (4).

However, with more work and outreach into these communities, personalised medicine may prove to be a good way to bridge the gap in healthcare access.

More medical data also allows us to create BioBanks, which are amazing tools for medical research. The more data available in this database allows the research to be more extensive, and more reliable, which allows for better quality research and stronger

conclusions which can lead to more advancements within the field which improves healthcare, diagnosis, and treatment of different diseases for everyone.

In conclusion, precision medicine is a broad and new medical field in which an individual's health is taken into consideration from all perspectives.

With the rise of precision medicine, it is important to consider how we can balance precision medicine’s potential to benefit and improve lives, and the conditions and circumstances in which we must think twice before implementing this approach.

However this does not mean that precision medicine is not a great step forward in the world of medicine, and that it doesn't help people. It does. Precision medicine makes your medical care focused around you, and your individual risks based on your genetics, environment, and lifestyle, and thus takes in a more holistic picture of who you are. There are still concerns to be had, and criticisms to be made, but these are just ways of ensuring that precision medicine works the best that it can and that the information you provide to your healthcare providers is used in the best way possible to help you, and possibly others, as much as possible.

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Photo by WikiImages on Pixabay

Photo by ErikaWittlieb on Pixabay

The Taliban have managed to seize Afghanistan not only once, but twice, and recent events are reminiscent of the country’s history.

How the Taliban affected Afghan history

GLOBAL FOCUS • AFGHANISTAN & THE TALIBAN

Disclaimer! Please note that this article is not meant to be a comprehensive analysis of the complicated situation in Afghanistan, but rather a summarised overview of some of the many reasons how and why things have changed over the past two decades. There are undoubtedly more motivations which lead to the situation evolving as it did, which whave not been mentioned in this article for the sake of brevity and simplicity. Feel free to use this article as a stepping point to explore the further implications, greater history, and social landscape that compose Afghanistan.

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GLOBAL FOCUS • AFGHANISTAN & THE TALIBAN

AUTHOR: AURORA HIRVONEN The Taliban captured the city of Kabul on August, 15th 2021, marking the start of a new chapter in the ongoing conflict and a sense of déjà-vu. After US troops withdrew from the country, the Taliban in two weeks rapidly re-seized major cities in Afghanistan, following 20 years of almost complete freedom from the regime.

Towers of New York’s World Trade Center. It was believed that the mastermind behind the attack was Osama bin Laden, head of the terrorist group al-Qaeda, who was under the protection of the Taliban (1). These events triggered the beginning of the attacks from the US and its allies in Afghanistan.

Tracing back Afghanistan

Who are the Taliban? ‘‘Taliban’ is the plural form of the word ‘student’ or ‘seeker’ in the Pashto language, a language thought to have originated from the southern areas of Afghanistan (1). More precisely, they identify themselves as students who seek religion and consequently, political truth, but to the world they are viewed as a group of Islamic extremists who originated from Northern Pakistan, founded in the 1990s. They slowly moved into Afghanistan, where they gained power from 1996 to 2000 (2). The Taliban rapidly expanded, ruling almost 90% of Afghanistan by 1998. To gain people’s trust, they professed three main promises that they would apply when in power: restore peace, establish better security in the country, and enforce their rigid form of Islamic law also known as the Sharia (1).

Under their regime, changes took place, which included inequalities in education and media censorship like prohibition of televisions. Public executions and abuse became a norm, along with controlling simple aspects of how the population should look: men having to grow a beard and women being obliged to wear a burka (2).

Large media attention was drawn to them after the 11/09/2001 terrorist attack on the Twin

Afghanistan’s past is very rich and intricate and even though it is marked by many conflicts the country has much more to offer, such as community and hospitality. To simply put it, the last half a century can roughly be divided up into three blocks: the years before Taliban control, the years of Taliban rule, and the modern past of the last 20 years.

The start of the modern past of Afghanistan can be said to be marked by the fall from power of the Taliban following the 2001 US-led invasion.

During the 20 years of Talibanfree rule, considerable improvements occurred in the lives of many. For instance, a large impact was made for girls and women who received back fundamental rights that had been lost under Taliban rule. These included education, being able to start and own businesses, and having the possibility of being elected for positions in the parliament. Additionally, infrastructure improved considerably , with exponential growth in mobile phone and internet use (3). These ameliorations were a result of the large international help and economic aid, leading to quick but short-standing economic growth.

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Regardless of the prominent milestones and monetary help, conflicts and tensions were still very present during these years.

Poverty amongst the population was rampant, ranking Afghanistan one of the poorest countries in the world. It was the main contributing factor to the huge increase in poppy seed cultivation and opioid production, making Afghanistan also the largest producer and exporter of heroin (3).

The Taliban re-emerged in 2004, regrouping on the border with Pakistan and surprising many who considered them history. The Taliban began a slow fight to regain control of the country.

Their tactics were largely rooted in building trust among the Afghan population and growing in persuasiveness especially through social media communication. In 2013, the Obama administration in the US initiated peace talks with the extremists, which continued for years (4). The following period was rife with violence and attacks from both sides.

The return of the Taliban Prefacing the recent event in Afghanistan, in February 2020, an official peace agreement was finally settled between the US and the Taliban, where the two sides agreed on the withdrawal of US troops from Afghanistan, and the Taliban ceasing attacks on America (3). By September 11th 2021, the last US troops were withdrawn (3). On August, 15th 2021, the Taliban captured the city of Kabul, a major achievement for the group. With only a month of absence from the US allies, political unrest had increased as if the country had jumped back in time to 20 years.

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Photo by WikiImages on Pixabay

GLOBAL FOCUS • AFGHANISTAN & THE TALIBAN

The return of the Taliban was not only a military success for them but also an important social, cultural, religious, and political triumph. The Taliban modified their tactics, not their ideology, in order to re-seize the country.

Instead of performing complex attacks on military stations, they shifted their strategy to targeted assassinations terrorising the Afghani population.

A great debate has arisen on how international forces failed to anticipate the fast progress of Taliban advancement. The goal for the past 20 years had been to enable the Afghan government and military forces to act on their own, which appear not to have been met (5). It was estimated that a collapse of the Afghan regime would take more than three months when in reality it took only two weeks. This rapid re-takeover was characterised by local soldiers who refused to fight against the Taliban, and rather abandoned their posts before the troops arrived. This stronghold of the Taliban can be partially connected back to the relationship they have with the local population and their followers, especially their impressive ability to communicate with the individual Afghans based on their needs and perception of

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the world (6). This attitude has also been, to a certain extent, connected to a lack of nationalistic or patriotic pride in Afghanistan troops, as a result of deep governmental corruption.

Bribes were rampant, for even basic tasks, which likely caused deep distrust between the public and the government.

The current situation adds to the long-suffering of Afghans, with many trying to flee their country.

Afghanistan still lacks a range of human rights, from a democratic political system to general security, functioning and equal healthcare, potable water, and basic education. The recent coronavirus pandemic has not made the handling of the situation any easier. The modern past created after US alliances overthrowing the Taliban dominance remains a surreal memory for many.

A future rooted in the past As expected, there is great uncertainty about the future. Fear lingers that Afghanistan will become a niche for terrorism, that threatens not only regional but also global security. The Taliban in themselves do not seem to have aspirations to establish Sharia as the core global belief

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(6). This suggests they may be more likely to stay local.

However, this aspect leaves space for other extreme terrorist groups, like Al-Qaeda and ISIS to grow, who share the puritanical beliefs with the Taliban but also have global ambitions (6).

The unpredictability of Taliban’s plans certainly also revolves around politics and religion. Boys have been exempted from the initial bans on education.

However, questions arise on how life will continue for children and women, and what their rights and freedoms will look like. The Taliban have promised that they would educate girls and allow women to work, but so far definite decisions have not been made.

The return of the Taliban has raised many conflicted thoughts in the Afghan population. On one hand there is great relief that the 20-year long US military occupation is finally over.

However, the country has been left fragmented and is at risk of losing much of its religious, ethical, and cultural richness. The withdrawal of the USA’s armed forces was intended to leave Afghanistan to finally flourish on its own; instead now fear lingers for what the future under the new regime holds for the country (8).

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CULTURE medicor • 2021 | ISSUE 2 Image credits to Laura Tancredi from Pexels

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CULTURE • PROJECT WISDOM

Books to read on a cozy winter night - with Project Wisdom AUTHORS: PROJECT WISDOM TEAM, AYU TAMAKI AND FRANCISCA LEONARDO

Project Wisdom is an initiative that started at Karolinska Institutet in order to bring science lovers together. This popular science book club is open to any student in the Global Bachelor's and Master's programmes at KI. Every semester, a book list is released and students sign up. Over the course of the semester, reading groups meet up to discuss the book and its main ideas and themes.

Perhaps their list from Autumn 2021 will give you some inspiration?

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CULTURE • PROJECT WISDOM

Invisible Women: Exposing Data Bias in a World Designed for Men Caroline Criado-Perez

The Poisoner's Handbook Deborah Blum

“Invisible Women” is a book about women in data and how most of the modern world was not designed for this half of the population. The book explores biases and discrimination based on gender and goes deeper into how gender inequality affects women’s lives at a systemic level. We chose this book because we are passionate about gender equality and we believe that raising awareness toward gender disparities can make female and male readers understand better the world we live in.

This book dives into the birth of toxicology and forensic science that took place in New York over a century ago. Back then the regulation of toxins and incorporation of scientific research into solving crimes were nonexistent until two scientists stepped in.

Toxicology and forensic science are often overlooked as their meticulous work takes place where the public does not or cannot see. With this book, we wanted to explore the history of these fields in order to acquire and adapt the knowledge to our future works as scientists.

Musicophilia: Tales of Music and the Brain Oliver Sacks

Silent Spring Rachel Carson

This book is about how music is interpreted by our brain and how auditory stimuli can affect our emotions and thinking. Sacks explores how several pathological conditions, like seizures or Alzheimer’s, are triggered or alleviated by music. Above all, the author makes us gain a deeper appreciation for music and its impact on our lives and the lives of his patients. We chose this book because we were interested in the intersection of music and neuroscience and all the ways that these two intertwine and connect within the wiring of our body.

We recommend this book to anyone interested in music and in learning how music affects our brain.

Silent Spring reigns as a monumental environmental science book that is much loved by the public. Rachel Carson with her meticulous research unveiled the danger of prevalently used DDT and her work evoked a public movement that led to banning of DDT and ultimately a stricter regulation with pesticides. Her alluring writing style and the sheer importance of the book’s story led us to choose this book. We hope through the discussion of this book, the participants can ponder how science is not absolute and how disruptive mankind’s relationship with nature can be: the two things that are becoming ever more significant in today’s world.

Behave: The Biology of Humans at Our Best and Worst Robert Sapolsky This book is about what actions and reactions occur inside our brain when we decide to perform a certain behaviour or task. Sapolsky decodes these behavioural processes by way of masterful storytelling, leaving the reader reflecting upon what influences their own behaviour in everyday life. We believe that this book provides great insight into why we humans behave in many varied yet predictable ways depending on the environment we find ourselves in, and it also helps us understand ourselves and others a bit better.

Contact us!

Project Wisdom is always open for new recruits and suggestions! If you would like to join the coolest book club there is, contact us on Facebook (@projectwisdomki) or by email (projectwisdomki@outlook.com).

P.S: We have fika for every event!

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TEXT • CULTURE • KUNGSLEDEN

The Trail of the King AUTHOR: PABLO TOVAR I arrived in Sweden two months before starting my studies at KI. I didn’t have a place to stay yet and the term “homeless” was a little too rough for me to easily accept. Hence, I set off to hike as many trails as possible with my 30-liter backpack and a tent. The last trail I traversed was the Kungsleden, a 440 km long path connecting the northern cities of Abisko and Hemavan. This is an excerpt of the last days from my journal.

Second to last day: Tall peaks and dead phones I climbed the hill as the sun peeped through the sharp peaks on my right. Blue and black mountains with ice fed the streams of water from which we drank. The sky was grey and the same clouds intensified the evening sunlight. I couldn’t climb all the way to the top. I had been exhausted for the last two hours, and the only reason I kept walking was that I wanted to get to Hemavan as soon as possible, to finally end the trek, and go back to civilization to call my mom for her birthday. My phone had been dead for a couple of weeks, and the only tool that I had to check the time was the red Charizard watch I had bought for my nephew in Japan which I never gave to him because I thought he was not cool enough.

The overwhelming view surrounding me took me back to the present. The mountains, with their trees, the rivers, the wind, and the smell of humid soil and pines, reminded me that this was my last sunset in the woods.

Climbing towards the arctic summer sky I managed to glimpse a clear space between the clouds on the other side of the never-ending hill. The pale-blue sky seduced me; it was a promise of tranquility, of the calm that always comes before the storm. A promise of light and armony:

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of that eternal sunset that can only be found in the arctic summer.

As I ascended, the distance seemed to remain the same; the promise, unattainable. A white reindeer appeared in the distance: an epiphany telling me to stop walking.

As the intense crimson red of the mountains’ silhouettes on the other side of the valley disappeared, I set up my tent for the last time over the wild terrain while the sound of a nearby stream remained immutable.

Last day Part I: The rain begins I woke up at four and dozed until six. It was a calm morning, and it didn’t look like it rained the night before. I collected blueberries in the fields next to my tent and ate them with hot porridge. Soon enough it started to rain. It was a light rain and I was able to pick up my tent without getting too wet. I finally went up to the top of the hill to find a cold view of a cloudy sky and misty mountains and forests. An old man passed me. He walked at a quick and steady pace. I had met him before, the rumors said that he was hiking the Green Ribbons, a 1300+ kilometers hike that covers the mountain range between Treriksröset and Grovelsjons -including the Kungsleden’s 440 kilometers-, one way and back that summer.

I had to stop to pee a couple of times, which helped me to take some time and enjoy the view of the valley surrounded by steep hills before it was completely covered in mist. The light rain and the wind only got stronger with time, to the point that my back was being pushed into the valley with such force that it seemed as if the Kungsleden itself didn’t want me there. Before I knew it, I was drenched. I found shelter in a small stuga full of Swedish hikers eating breakfast and drying their clothes. A few minutes later the rain seemed to have calmed – only to pour down on me the moment I decided to leave. I took my sweater off and kept it dry in a plastic bag, since it turned out that my waterproof raincoat was not really that waterproof -nothing really is against stubborn rain-. I could feel my cold wet shirt stick to my skin and my socks turn to sponges as they had absorbed all the water. The good thing about Merino wool socks is that they warm you even when they’re wet- or at least it seems like that when one just keeps walking.

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CULTURE • KUNGSLEDEN TEXT •

Way

to

k Vak

ota

var

e

My tent next to wood ruins in a valley on my way to Kaitum.

It doesn’t take much to break a man, you just need a little bit of rain – constant rain. I remember those three days when I walked from Kvikjokk to Jäkkvik– right in the middle point of the Kungsleden–under a veil of faint, but uninterrupted rain. By the end of the day, everything was wet: me, my clothes, my tent, my sleeping bag, and my (dead) phone. I remember the desperation I felt at that moment; knowing that I would have to walk 45 kilometers even if I decided to turn back.

Last day Part II: The final stretch In contrast to those three days back on my way to Jäkkvik, now I felt motivated to walk. It was my last day and not even the annoying rain would stop me from finishing those 24 kilometers to Hemavan. I saw it as a mental exercise to toughen up. I sped up my pace while the chorus of “I’ll make a man out of you” from Mulan played in my head non-stop as background music. If this journey somehow changed me, I would say it made me a little bit more stoic.

Around midday, I arrived at Viterskalet, the last Svenska Turistföreningen (STF) Station before the end of the trail, located right in the middle of the legendary valley of Norra Storfjället. The wind had gotten quite violent then, and the sharp edges of the cliffs cut through the air and the grey mist whilst streams of ice-cold water flowed down the dark rock surface. I was glad that the wind was blowing on my back and not against my face. Per, the man in charge of the station, and his wife welcomed me with hot

lemonade and allowed me to stay and eat my lunch free of charge. Reindeer salami, dry muesli, and dry bread with peanut butter–it didn’t matter what I had for a meal anymore. Nothing tasted the same after the day I spent with a Sami family back in Gåbddåjávrre, when we fished and ate smoked trout, with golden and crispy skin; salty meat, so tender it melted in my mouth.

It was quite the challenge to collect the courage to leave the warmness of the Station and get back on the battlefield. From the window of the dining room, I could see the rain hitting against the wooden walls of another stuga with that chaotic violence characteristic of nature in the north. According to Per, there were only 12 kilometers left to finish the trail, and since I had a tailwind, it shouldn’t take me longer than two hours to get there.

My boots felt heavy with all the water inside; my arms and back felt cold, and my glasses got covered by the steam of my breath. I had to make several stops to hide behind some sort of boulder and eat chocolate (the main source of my strength those last days). I climbed a small hill within the valley next to a sign – 4 km to Hemavan. Once at the top, I screamed with all my might against the deluge in an instant of pure fulfillment and victory. I was finally there, just a few moments away from closing this beautiful and challenging first chapter of my time in Sweden.

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CULTURE • BITE-SIZED MEDIA

Bite-sized media - shaped by and shaping us AUTHOR: AVA ASPROMONTI Today, we consume more information on a daily basis than ever before. This is largely made possible by bite-sizing - but how might this shift in information uptake and processing be affecting us and our societies?

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CULTURE • BITE-SIZED MEDIA

Photo by camilo jimenez on Unsplash

What is bite-sized media? While there is no precise definition for this term, the Cambridge dictionary defines something bite-sized as “small or short enough to be easy to understand, remember, or deal with at one time” (1).

This form of content is by no means a modern phenomenon. Take for instance, the Japanese haiku poem, or the satirical cartoons popularised in 19thcentury British newspapers. While these art forms have significant differences, they share a common poignancy in their brevity. What is modern, however, is the sheer amount of this content being produced and consumed - how everything from entertainment, to education, to journalism, is being adapted to fit the bite-sized mould. Before diving into the effects of this shift in our consumption, let’s take a look at how it may have come to be, and how it is perpetuated.

Origins and Perpetuation Our obsession with bite-sizing probably stems from the success of the modern social media format. Being free services, these media platforms have to be funded by advertisements, meaning the most successful ones have attracted companies by being fiercely competitive for our time and attention. And they are, as of January 2021, 4.2 billion people are using social media – 90% of the world’s active internet users (2).

Some of the biggest social media platforms today are distinguished by algorithms that learn to promote content from our level of engagement . Short and emotional content garners more reactions and is, in turn, prioritised. Content creators, and other professionals, trying to reach a wider audience adapt

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CULTURE • BITE-SIZED MEDIA

their content to this model, which leads to a smaller variety of successful inputs for the algorithm to learn from. As you can imagine, this makes it challenging for any in-depth or less emotionally charged content to be seen by other users.

If you have been following the news recently, you may have heard of the whistleblower Frances Haugen, who has recently presented a strong case in the U.S. Senate against her former employer, Facebook. Thousands of insider documents point to an unnecessarily divisive, aggressive, and in some cases psychologically harmful algorithm (3).

Fortunately, algorithms can be tweaked, for instance, to promote a larger variety of content. Unfortunately, the incentive for such a change is low, as it would not capture the attention of users to the same degree.

Why do we react in ways that start this vicious loop in the first place?

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Neuroscientific Basis and Psychological Effects Social media use has been linked to the mesolimbic pathway in our brains, known more commonly as our reward system (4). Our motivational behaviour (“wants”) is regulated by a dopamine-mediated feedback signal encoded by reward prediction errors (RPEs), that is, we learn whether to repeat an action if the outcome is more rewarding than expected (increasing dopamine release) or worse than expected (reducing dopamine release). Social validation, acceptance, and approval, are all highly rewarding to us (5). Moreover, we have known since the 1950s that a schedule in which the reward is given unpredictably generates the strongest motivational drive (6).

This knowledge about our biology is exactly what social media developers use to make us check their apps often, and stay on them for as long as possible.

Strategies such as withholding likes just so they can be given out in larger bursts, or frequent notifications, are used to ensure that we are always rewarded for simply opening the app (4). Furthermore, bite-sized content is great at grabbing our attention, and we may quickly feel rewarded again. The immediate positive feedback from consuming bite-sized media reinforces our behaviour much more effectively than the distant reward of reading an article or book (following the principles of operant conditioning). This can make moderate use of social media quite difficult, especially when features like “auto-play” do not allow for a chance to pause and think.

Research in the area of bite-sized media is scarce.

While no report could be found on the psychological effects of being immersed daily in bite-sized media, there are many on the topic of digital media use.

Interestingly, a causal relationship has not been established between mental health symptoms and excessive social media use (7). There are of course documented negatives associated with social media, such as links to body image issues (8,9) and fear of missing out (“FOMO”), together with a shortening of our attention-spans (10). On the other hand, positive effects have also been observed, such as improved social connection, access to platforms for discussion and creative expression, rapid dissemination of helpful info, and so on. Many studies reach the conclusion that the quality of our media use is more closely linked with mental health than the quantity (11-13).

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CULTURE • BITE-SIZED MEDIA

” Photo by Karsten Winegeart on Unsplash

SOCIAL MEDIA USE HAS BEEN LINKED TO THE MESOLIMBIC PATHWAY IN OUR BRAINS, KNOWN MORE COMMONLY AS OUR REWARD SYSTEM

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CULTURE • BITE-SIZED MEDIA

Cultural Effects The arts have been shaped by bite-sizing, especially since many increasingly appear on, or make use of social media. This evolution has garnered mixed reactions, with some embracing, and others expressing concern, over the shift in our art consumption and production. While the number of studies on this topic are slowly increasing, ultimately, the issue has yet to stand in the spotlight of public discussion.

It is primarily the use and content of bite-sized media that has been researched, but both of these are partly shaped by the format. When information cannot be presented with depth, its only qualities - the aesthetic and sensationalistic - become its most important ones. One can argue that this leads to a cultural hyperfocus on appearances, whether in regards to desirability or success, and external metrics of determining worth (i.e. likes, comments, follows).

From this, a new set of values emerges defining how we perceive ourselves and relate to one another. A set of values that, in combination with our constant exposure to judgement (being “connected” online), can make us more susceptible to mental ill-being.

On the societal scale, a rather serious repercussion of bite-sizing has been the facilitation of the spread of misinformation. As previously mentioned, the content that grabs our attention also makes the app or website owner money through ads. This content does not have to be truthful. In fact, publishing controversial content to groups which are almost certainly going to react strongly and forward the content to others can be a very profitable venture. In addition to the ongoing input of misinformation, bitesizing fosters oversimplification and sensationalism, which are two common paths to group polarisation.

Contact between groups is further decreased by tailored media feeds, causing so-called filter bubbles that lock individuals into an echo-chamber of intellectual isolation from other viewpoints. If seen at all, other viewpoints are often oversimplified themselves, as long nuanced explanations are not typically promoted. Other opinions are therefore easily dismissed. The polarising effects arising from a combination of misinformation, bite-sizing, and social media algorithms, shape people’s behaviour and language, eventually influencing our legislators as well. Finally, these issues are exacerbated by low internet-literacy, seen mostly in older populations, and a lack of critical thinking, which depends largely on education.

YOUR AD COULD BE HERE As Stockholm’s largest student magazine, and the only Swedish student magazine in English, Medicor can provide you, your product or your service with a unique platform to reach new customers and/or members. Get in touch with us!

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CULTURE • BITE-SIZED MEDIA

Where do we go from here?

Is bite-sizing all bad? Not really. Having a format that condenses information can give us a bird’s eye view of anything from politics to the environmental crisis. From this position we can choose how we want to spend our energy, learning something superficially or in-depth. Nonetheless, at the end of the day, we may not only be exhausted from work and social pressures, but also from an “information overload”14,15. It is easy to fall into the trap of thinking that we have learned plenty after spending so much time on our sifting, without really having understood anything new.

Bite-sizing is too profitable and entrenched by now to disappear anytime soon, so this article will finish off with three bite-sized tips for the future!

1 Let us put pressure on companies and media outlets to adjust their algorithms.

More varied and rational content should be promoted to weaken the culture of arguing on emotional or aesthetic levels. If they can show our commonalities more often, we may find it easier to empathize with one another and cooperate.

2 Besides legal and technological advances improving fact-checking and minimizing echo-chambers, we as consumers can do our part by being critical of the information we consume and its sources.

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3 It is important to be aware of how various media platforms we use are trying to monopolize our time. If you are guilty of using social media passively, now is a great time to detox from those little rewards, or to use those platforms actively to improve your quality of life.

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TEXT •

the AUTHORS: VINCIANE ALLICAR & SUMEDHA JASSAL 2021 has been quite the year for us, transitioning from online to on-campus exams, then lectures, then events. It’s been challenging and occasionally overwhelming, but overall enjoyable. Medicor was not spared from the changes. For “The Return of Medicor”, we worked together to gain some momentum, and came up with a new vision for the magazine.

We, the associate editors, Sumedha and Vinciane joined Medicor to enhance our organisational skills with the ability to work comfortably in a fast-paced environment. Juggling administrative work such as contacting advertisers, assigning articles, proofreading, scheduling meetings, and organising social events takes up most of our time at this magazine. Both of us are third-year students Bachelor’s in Biomedicine students who share a love for reading, writing and a cup of good coffee.

I wanted to join the Medicor team to stimulate my curiosities and passion for science and writing. I also liked that Medicor brought forth varied content revolving around science, culture, global focus and campus. This was an opportunity to get a better idea of what goes on around campus and globally. In retrospect, I realise this has not only been a learning experience, but also allowed me to have so much fun since I got to know new people at Karolinska Institutet.

On the other hand, I first wanted to join Medicor to satisfy my curiosity for the ‘behind the scenes’ aspects of producing a magazine. I wanted to touch upon many different aspects of Medicor, be it the administrative, content-related, or creative areas, and so the position of associate editor was perfect to achieve that. Signing up though, I somehow missed that this was the “come back year” of Medicor. Regardless, it has been fun!

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As you can imagine, it is no small feat to bring back to life a dormant project. Along with the responsibilities came also the liberty of creating something new and different as a team. It was important for us to create an efficient workflow so that we could organise ourselves internally and thus facilitate a smooth transition for the following Medicor crew. It was exciting and rewarding to work together towards a common vision that materialised within a few months of our hard work!

We revamped the design, thanks to seemingly endless patience from our design team, and focused on curating engaging and thought-provoking content with our editors. We have a lot more we want to do, but all good things come with time!

For our first issue of 2021, we wanted to work with an online format – you can find it, as well all our issues dating back to 2013, on our website. Essentially, we wanted to go carbon neutral whilst matching the lifestyle of our readers who had mostly been working or studying online for the past year.

Now for the second and final issue of 2021, we’re bringing back Medicor in print. Even though we still maintain the vision of minimising our carbon footprint, we also want our readers to appreciate the classic look and feel of a physical magazine. Plus, it’s much needed break from our screens!

We hope you’ve enjoyed reading this year’s editions as much as we have enjoyed putting them together!

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TEXT •

Meet the Team

INIKA PRASAD Editor-in-Chief

CHARMAYNE LOW Events Manager

VINCIANE ALLICAR Associate Editor

ADA TOPÇU Events Manager

MARIA PAVLOU Magazine Designer

PRIYANKA BOGA Web Editor

MANASVINI MONI Web Editor & Web Designer

NASSAI HERREN Magazine Editor

TOM ENRIKO KELT Magazine Editor

NADINE GELMAR Magazine Editor

SUMEDHA JASSAL Associate Editor

ANNY TRUONG Magazine Designer

CLARISSE LOOK Web Designer

CHANG WEI-TSE Magazine Editor

REBECKA KLINGBERG Magazine Editor

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