DiveRCSIty – March 2019 (Vol. 4 Issue No. 3)

#DIVERCSITY RCSI Student run Newspaper and Publications

| March | |Publication Year 2019, Vol. 4, Issue No. 3|

e n i c i d e M n o i t a v o n & In *SEE MEGAN MURNANE’S UNALTERED ARTWORK IN FULL ON PG33

Women on Walls: new portraits commissioned for RCSI’s historic board room

pg 22-25

Exclusive Sneak Peak at RCSI’s new Heritage Collections

Printed at

Anatomy Interfaith Ceremony Reflection by ANUSHKA JAYAKRISHNAN

A Publication by

pg 12-13 pg 34

// Meet the team

Editors’ Notes

DIRECTOR AND EDITOR-IN-CHIEF

DIRECTOR AND EDITOR-IN-CHIEF

QASIM ALI BARI »

« ALIYA ESMAIL

FEATURE ARTICLES

EDUCATION

DEENA SHAH »

« NYI TUN SAN

CULTURE AND LEISURE

NEWS AND RCSI EVENTS

DAVID JOYCE »

« SARAH CULLEN

SOCIAL MEDIA OFFICER

NEWS AND RCSI EVENTS

KATHY LIU »

« DERMOT FARRELL

COVER ART DESIGNER

ILLUSTRATOR

MEGAN MURNANE »

« MERNA BAWYAN

STAFF ASSOCIATES CORRIENA BRIEN & TANYA CHAPPLE - CONTENT REVIEW, STAFF CO-ORDINATORS PROF CLIVE LEE- WRITER: ANATOMY

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Editors’ Notes

D

ear Reader,

Welcome to our third issue of the year! The theme this month is ‘Medicine & Innovation’, and I must say the response we’ve had has been astounding with so many wonderful and well researched articles submitted.

I’d like to give a special shout-out to everyone on the DiveRCSIty team (all those lovely faces on the opposite page) for helping make this paper run more and more like a well-oiled machine with every issue. And as always, the biggest thanks to all of our contributors - without you, there is no paper!

Editors’ Notes.

// At a glance...

A TASTE OF THIS ISSUE Our ‘Medicine & Innovation’ section kicks off on page 12 with a look at a selection of historical medical instruments held in RCSI’s newly launched Heritage Collections. Lori Israelian and Ashka Shah explore some of the ingenious new apps being developed to help diagnose HIV and rare genetic diseases. RCSI’s Dermatology society make their DiveRCSIty debut, putting a spotlight on cutting-edge technological innovations within the specialty. Phebe Zaytoun and Harleen Jhinger make a case for the introduction of therapeutic music relaxation rooms on campus, and Dylan Walsh highlights the as-yet-untapped potential of video games as epidemiological models.

I’m delighted to announce we have a feature article on the vital Women on Walls campaign at RCSI, written by our own Aliya Esmail. The portraits now hanging in RCSI’s Board Room recognise the pioneering achievements of eight extraordinary women and mark a significant stride towards enhancing the visibility of historical female leaders in healthcare. Aliya and I, alongside friends and families of the subjects of these paintings, were in attendance at their unveiling this month as part of RCSI’s International Women’s Day celebrations - a

truly momentous day for RCSI, which also saw the college achieve university status following an announcement from Minister of State for Higher Education Mary Mitchell O’Connor. You can read all about these trailblazing women on pages 22-25.

The talents of Megan Murnane once again grace our cover. Her stunning painting “Corpus Collosum: a love story” can be seen, unobstructed and in full, on page 33. And the college’s budding community of poets are back to showcase their work, accompanied by the artistic stylings of DiveRCSIty illustrator extraordinaire Merna Bawyan.

This issue also features RCSI’s Sports Union’s regular column, where you can read the unbelievable story of RCSI student Tommy Browne who rowed the Atlantic! Anthony Javed Machikan tells of his experience volunteering with the Christina Noble Children’s Foundation in Vietnam. The good folk at ‘Reel Talk’ return with their themed film reviews. And while I wait for rhubarb to come back in season (watch this space) you can find my recipe for tangy lemon tart alongside some more savoury dishes in the back half of this issue.

SPECIAL MENTIONS: The winner of November’s Anatomy with Clive Lee contest was Muhammad Faizul Nazri, securing that One4all voucher mere minutes ahead of an influx of correct answers!

JOIN THE COMMITTEE: If you’re feeling inspired or simply have an itch to get involved, please drop an e-mail to divercsity@rcsi.com.

We’d be more than happy to meet with you and are always prepared to answer any and all questions!

To join our mailing list, or for societies or general enquiries, email divercsity@rcsi.com Read anything you love? Did we print something you hate? Have a great idea or suggestion for the paper?

Let us know how we are doing! editor.divercsity@rcsi.ie Share the excitement online, Like us on facebook.com/DIVERCSITY Join the Facebook Society Group Page for the latest updates facebook.com/groups/divercsitysignup Share and view this issue online from issuu.com/rcsidivercsity

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DIVE INTO

YOUR UR U AT

PASSIONS

UNIVERSITY

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//Cultural Diversity Month

« HUSSAIN SAJWANI (SU Cultural Officer)

Cultural diversity is an integral part of RCSI’s identity as a medical college. RCSI prides itself on the number of nationalities that study in its hallowed halls, but this is so much more than a mere side note for a student prospectus. Every day, we are surrounded by a unique student populace. We sit with Europeans, Americans, Asians, Arabs, Africans, and everyone in between.

I am often at times reminded of a funny comment made by a previous SU member, “If you do RCSI right you’ll never pay for a hotel room again”. Truly, this is the case. I have met people from nearly every background and corner of the world in my time at RCSI, and for this I am eternally grateful. It is not only long-lasting friendships I have formed, but by getting to know such a diverse group of people, I have seen their cultures as well.

Within the massive cultural melting pot of RCSI I have learnt more in the past 3 years than any book could teach me. I have heard languages from distant places, eaten exotic foods I could never have dreamed of, seen beautiful cultural displays of art and dance, that have left me awestruck. Indeed, these cultural experiences have molded me and made me a more enlightened and well-rounded individual.

This brings me to the big CDM “Cultural Diversity Month”. During this month, we celebrate all RCSI has to offer. It is a time for one to see all faiths, clothes, foods, art, poetry, dance and beliefs that embody every single unique and amazing culture we are fortunate to have here. I would encourage all students to participate in CDM. Not only is it a great way to showcase your culture to the student body, but it also lets you encounter other cultures first hand. As an added bonus, there are several competitions during CDM which spices up the action.

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These competitions include, a Soccer World Cup, International Food Night and the big one International Night.

First off, on the 1st of March students kitted up to play in RCSI’s Five a Side Soccer World Cup. This was a mixed team event where students got to represent their desired country in the sports hall.

Next, we had International Food Night. This event called to all food lovers out there. Students showed off their cooking skills to all their friends and peers. Don’t forget that the better the dish the more impressed the judges were. Lest we forget that you got to taste foods from every corner of the globe.

Thus, we reach the climax of this month. A night of immense fun, companionship and competitive spirit … International Night. Here, the cultural societies compete to win the hearts of the audience and judges. More importantly, this night gives all a chance to showcase their culture, through song, dance and any other artistic expression.

In conclusion, from the 4th to the 15th of March cultural societies and students booked the Expo Stage to showcase their culture, faith and ethnicity to all via a cultural booth display.

As you can see, CDM is a month of fun, learning and community building. We hope you enjoyed all that was on offer. For anyone who wishes to participate in any of the above events, do not hesitate to contact me via my email: su.culture@rcsi.com.

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//Brazilian Jiu Jitsu, the world’s fastest growing martial art and RCSI’s New Club of the Year – What’s the Hype?

1) Self-Defence

At its core Brazilian Jiu Jitsu is a grappling and ground fighting system aimed at using leverage to gain an advantage in unarmed self-defence situations. This lends itself most notably to circumstances in which you are confronted by a larger or more athletic opponent. BJJ originated in the mean streets of 1920’s Rio De Janeiro where self-defence was a daily concern, and it now features prominently under the bright lights of the Ultimate Fighting Championship – a true testament to the fact BJJ is one of the most important components of unarmed combat. Using chokeholds, joint locks and positional dominance, BJJ is aimed at incapacitating your opponent while keeping you safe! This allows you to overcome attackers using strategy and leverage rather than brute force and athleticism – it’s a truly cerebral martial art. Not to mention that most physical altercations end up on the ground at some point…

2) Self-discovery

While the general principles and techniques taught in academies remain the same for everyone, each BJJ practitioner has their own style and unique form of expression on the mats. What works for some body types may not work for others – but there is a style for all. Further, learning how to problem solve under pressure – such as when someone is trying to use their BJJ to choke you – lends itself to all aspects of your life and teaches you how to deal with stress in real-time. This is a skill some of you may find desirable throughout your medical careers (hint, hint).

3) Friendship

Great friendships are forged in the heat of battle! Sparring and grappling with someone is a fantastic – albeit unorthodox – icebreaker and many BJJ practitioners will vouch that some of their dearest friendships were made on the mats.

4) Get In Shape!

Surprisingly (or not) sparring at almost 100% intensity will get you in great shape and allow you to exercise for a long time without getting bored!

5) Join Ireland’s first competitive collegiate team!

To our knowledge RCSIBJJ is the first team among the post-secondary institutions in Ireland! Did we mention that we medalled at the Cork Open – a reflection of the incredible teaching we receive from Chris Bowe, Ireland’s most accomplished BJJ competitor.

Come and see what all the hype is about on Tuesday nights at 8:20 in the Sports Hall at 26 York Street!

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Lifestyle

// Sports Section

Brought to you by

Dublin Marathon Coverage: A word from our fastest male and female from RCSI Niamh Clifford Q: How do you manage sport and school?

A: Managing sports and college can sometimes be hard but I think it’s really important to keep up sports, even when busy with exams and to not feel guilty about going exercising for an hour even if there is loads of study - study is always never ending but an hour exercise is definitely worth the break. Training most days is a great to help clear your head. I found going for a quick 5-8K run or to a gym class in the morning before college and sometimes getting out for a jog in the evening was a nice break from the library.

Q: Have you ever dealt with injury or hardship in sport?

A: Yeah, I had issues with my achilles (from increasing mileage)- I had to start going to the gym which I never really did and realised doing stretches and core is pretty much as important as getting in mileage. I always try to run on grass now which is good to do if possible.

Hardship isn’t too common in running I think- if you put in work you generally get results.

Q: What has been the most rewarding part of your sport or can you touch on a particularly rewarding experience?

A: Definitely being able to run the marathons. The Boston Marathon was one of the most rewarding experiences. There is a lot of relief when you finish a marathon since there are so many things that can go wrong. But if you’re training for your 1st 5k or 10k you’ll get a similar sense of achievement so I would definitely recommend eventually working the distance up to a marathon.

Q: How do you deal with disappointment in sport? Do you think practicing resilience in sport will make you a better health care professional?

A: There are loads of bad days in sport, but it can teach you valuable lessons and help you when other things go wrong in life. Just being able to get out in the fresh air and run is great, and it’s important to remember that. Definitely the resilience from sport can enable you to cope with issues from work as a healthcare professional. It helps alleviate stress but also makes you realise you can get through things if you persevere.

Barry McHale Q: Why did you decide to run a marathon?

A: I wanted the opportunity to go to Boston.

Q: What is the hardest part about training for a marathon?

A: Getting out the door is the hardest part, everything after that is easy.

Q: How does it feel when you cross the finish line?

A: I felt relieved, but also drained and like I couldn’t move… no euphoria unfortunately…

Q: What advice can you give first time marathon runners?

A: Run slow in the first half of the marathon, otherwise you might feel like you’re going to die in those last 6 miles.

Q: What are you most excited about for the Boston Marathon?

A: My sister coming to cheer me on.

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Athletic Feature of the Month: Tommy Browne did the impossible and rowed the Atlantic Give us a brief description of what you did?

Last year, three friends and I completed the challenge of rowing, unaided, across the Atlantic Ocean in a small boat we called ‘Saoirse’. On 14 December 2017, we left a small island called La Gomera which lies just off the coast of Africa.

After 32 days, 22 hours and 4 mins of non-stop rowing, we made it to Antigua, a Caribbean island, on the other side of the Atlantic (the biggest relief of my life!)

Who’s idea and why?

We all had our own reasons for seeking an adventure: I had heard about a man rowing across the Atlantic, and thought it sounded like the toughest thing in the world to do. Years later, I had my own challenge of working through pretty bad depression. I thought if I could get through that, then I could certainly give a shot at rowing the ocean!

How long did you train for and what courses did you take?

About two years. I had to learn to row first. River rowing is highly technical and precise, but luckily ocean rowing is less so. Rowing in big seas doesn’t demand the same sort of precision, it's more about trying to stay in the boat.

Training: • Recorded our VO2 max before and after the row • Gained a lot of weight – to lose very quickly on the row • Sea conditioning – learning to live on the boat • Recorded our VO2 max before and after the row We took a number of specialised courses including: • Sea survival course – National Maritime College of Ireland • First Aid at Sea • Seamanship and navigation • A radio license course What supplies and tools did you have with you on the boat?

We had in excess of 3,000 pieces of equipment, each with its specific location on the boat, for which we all had to learn and remember, for example: • • • •

A year’s worth of freeze dried food (astronaut food) 4 cans of coke - our luxury items for Christmas Day An inflatable life-raft Flares and EPIRB (a distress radio beacon in the event we capsized or got lost at sea) • A grab bag - of emergency items if a disaster hit • Desalinator (to convert salt water to drinking water) solar powered (good on cloudless days, less so in bad weather!)

• Scrubbers and goggles (to clean and descale the underbelly of the boat)

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What was the scariest moment?

Nine days in, we hit a very severe weather front which was fairly intense. The swell threw up 50-foot waves. We had to row up the high wall of each wave, reach the top and brace for the rapid descent. This was tough during the day when we could see the waves coming, but more terrifying at night when it was impossible to see them.

On the night of 23rd of December, around 2 am, we were hit by a freak wave on the bow side. We capsized, Pat and myself were thrown out of the boat; fortunately, we were harnessed in. Rolling the boat back over and trying to scramble on board in high waves and the pitch black was a massive challenge - we were petrified! We lost oars, broke the rudder and worst of all one of the toilet buckets went overboard!

When did you know you were safe and what did it feel like?

The first time we saw the lights of Antigua at about 50 miles out from shore – a feeling hard to put into words!

How long did it take to recover from it?

Getting off the boat was wobbly, we had claw hands, blisters, harness welts, shredded bottoms, 10kg weight loss, poor eyesight and we were quite mentally shaken. It didn’t take long to gain the weight back (thanks to Domino’s discount codes and the likes).

What’s next on your bucket list?

I would love to swim across the English Channel and pass FUN2!

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Male Elite Athlete of the Month: Angus Lloyd Professional Rugby and Peripheral Placements, how to do it all!

When did you start playing rugby? (who got you involved also) I first started playing rugby when I was 6. I remember I had already started playing hockey and my Dad asked me if I wanted to play rugby instead. The answer must have been yes because the next week my Dad brought me down to Blackrock College RFC and I haven’t looked back since. That was 20 years ago.

Who was your rugby role model growing up?

It’s hard to pick out one to be honest. Peter Stringer was definitely one. He showed that you didn’t have to be massive to play professional rugby (I was always small).

What 90’s kid wasn’t a Brian O’Driscoll fan? Right now though I’m a massive fan of how Aaron Smith of New Zealand plays.

When did you play your first professional game, and what was it like?

My first pro game was for Ulster in September 2016. I came off the bench with 15 minutes to go against Scarlets, who went on to win the league that year. I feel pretty ill before games with nerves but this was a new level. We won that night and I played ok. Since I have gotten a good few more games under my belt so am more used to the occasions and just treat it as a normal game of rugby now.

Have you had many injuries? How did you cope with them?

I’ve had a few. Not as many as others involved in the sport but the most serious was a completely ruptured ACL when I was 21. It happened just off the back of a broken scaphoid so between the two injuries I was out of action for the bones of 15 months.

It was a very tough period. But when I look back it was the making of me. I trained really hard after the ACL reconstruction surgery to get back to full fitness. It took 7 months and even to this day it was the best condition I’ve ever been in. I played really good rugby off the back of it which eventually rewarded me with a pro contract. It also made me realise that my rugby career could end at any moment, so I really put the head down in college.

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When did you decide you wanted to study medicine?

I have always wanted to study medicine, luckily though I didn’t do well enough in my leaving cert. This allowed me to do a degree in Biochemistry which I absolutely loved. After my biochem degree I started straight into medicine in RCSI. How do you find time for both study and interprovincial rugby?

It’s definitely not easy and can be quite overwhelming at times, but with the right people around you it’s possible. I have to be efficient with my time. Whatever you are doing you have to be 100% switched on to get the most out of it, be it training or study. I’m very lucky to have very supportive family and friends who are forever helping me in any way they can. RCSI have also been extremely supportive which has been a huge help.

What advice do you have for people struggling with the workload in RCSI? When I am struggling (which is a lot), I always make a list of what I need to do and put it in order of importance at that moment in time. And I just work through it. Sometimes you feel like you’ll never reach the end but if you just keep working consistently you ll get there. Also surround yourself with positive people, no one has time for negativity.

Where is your favourite study spot?

I mix it up between 2 and 3. Never the collaborative room on 2 though If you get any free time, what’s the first thing you want to do?

Grab a coffee with friends. Just chill out.

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//RCSI Rugby I was recently asked to reflect on Rugby at RCSI, particularly for those who may not be familiar with the sport (no, it’s not football). I hope this will encourage some of you to come play!

“So, what even is rugby?”

Ever see that sport on the TV where they’re doing the hakka, or that looks just like American football but they aren’t wearning any protective gear? Yeah, that’s rugby… but wait, there’s so much more to it than that!!!

So forgetting the Rambo antics momentarily, let’s get down to basics: Rugby is an outdoor field sport, with 15 players on the pitch from each team at any one time (unless someone has been sent off for foul play). The basic rules are simple. Pass the ball backwards, run forwards and tackle with arms or shoulders below your opposition’s shoulders. The aim, as with many sports, is to score points, ideally more than the opposition team can – shocking, I know. 5 points are awarded for a try (touching the ball off the ground in the oppositions side of the field, like an American touchdown), after which there is a kick at the goal posts worth a further 2 points; 3 points are rewarded for any other kick over the posts during the game – known as a conversion.

There are a few more complicated rules pertaining to offside but those can easily be picked up at one of our beginner sessions or by watching a few games with the team. Aside from that, almost anything goes and players of all shapes, sizes and skillsets are needed for the various different positions on each team. This is a sport that by its nature encourages a diverse set of players, just one more reason you should come try it out!

“When would I get to play rugby then?”

RCSI RFC is involved in the Leinster League Division 3. We are an open club so we have players who are not in the college who play with us too; this allows us to be competitive and encourages a more inclusive environment in the club, and hey, sometimes it’s nice not to have a conversation about school, school and more school.

We play games every Sunday, these can be home or away, with transport organised by the college. Training is on Wednesday and Friday nights in Railway Union Rugby Football Club in Sandymount, Dublin 2 which is easily accessible by bus, DART or with a lift from one of the other players. Training is usually an hour long and starts at 7pm so there is always time for a bit of team bonding afterwards.

Aside from this, we also play in the Hospitals Cup. This is an exclusive and prestigious league between all the major Dublin medical schools that runs between October and December next year. RCSI players studying medicine are eligible to play for Beaumont Hospital.

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« LUKE TRENCH (HOSPITALS CUP CAPTAIN)

The last competition we play in is the annual match against our French counterparts from St. Antoine (UPMC) in Paris – an expense-paid trip every other year.

This is a longstanding tradition of over 30 years that is much anticipated by both teams and a real highlight of the year for everyone involved.

“So do I just show up with a rugby ball then?”

You will need Rugby boots, much like soccer boots, or “cleats” to the North Americans, however, they must have metal studs at the bottom. You will also need socks, shorts and a jersey (capable of being pulled, dragged and manhandled).

For the more formal occasion, the team wears “Ones”, which is an outfit consisting of brown shoes, cream chinos, a blue shirt, college tie and navy blazer. (We hope this clears up some of the confusion as to why we often show up to events all dressed the same).

“Will I feel like I’m in ‘Mean Girls’ and nobody wants to talk to me?”

We get it - coming down to play a new sport with a group of players who already know each other is an intimidating experience, however, we would love to take this opportunity to encourage anyone who is interested to come on down and see what we are about.

Every year we have new players join the team from all nationalities, some who have never touched a rugby ball before, others have played in different clubs. Most stay, but all remark how friendly and encouraging all the players are. At the end of the day we all want the club to grow and do as well as possible. The only way for this to happen is with steady recruitment and good training.

Of course, there is a huge social aspect to the rugby club too and some of my most memorable nights have started off with the rugby club, not to mention the trips to Paris.

“Do I have to be into surgery to play rugby?”

I think it would be unfair to say that every player in the rugby club wishes to persue a career in surgery. No matter which specialty you are passionate about, the rugby club is one invaluable tool used to meet and develop relationships with a wide range of consultants in the local hospitals. They often attend the games and love to see a few friendly faces around the wards.

I hope this piece was informative and that some of you may consider joining us at some point in the future.

If you want to get involved, contact RCSI RFC Captain Thomas Moore!

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Clubs & Societies

//Humans of RCSI

« ALEXANDRA NIEUWESTEEG

« BETH CHIAM

“We all doubt ourselves in everything we do and those short moments of hesitation is what stops us from doing things we could’ve done. This leads to us missing out on experiences and opportunities for us to grow and to learn from as individuals. So I guess my message is to believe in yourself and that some opportunities arise for a reason and that we shouldn’t let self-doubt determine our fate.

PS. I wish the Dispensary still gave out free pastries”

“Life’s like a paper plane, just throw it and see where it lands.

Often we feel terrified in coming out of our comfort zone. But life is too short to actually miss these opportunities, especially when they’re a once in a life time experience.

Take a shot and see what the outcome is.

As once Drake said, “Long as the outcome is income.” ”

“In moments of doubt, trust your gut, hug your pet and eat a donut. ”

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“Speed up when life is slow, and slow down when things get too fast. Know how to pick things up, and when to put them down. RCSI has its ups and downs, but finding balance is key. Having life perspective usually helps with that.”

“Gratitude turns what we have into enough, and more. It turns denial into acceptance, chaos into order, confusion into clarity. It makes sense of our past, brings peace for today, and creates a vision for tomorrow.

PS: Am I the first cover for 2019? I mean wow?”

“Work hard, play harder”

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Clubs & Societies

//Instruments & Innovations from RCSI’s Heritage Collections

« SARAH CULLEN

« DERMOT FARRELL

All of us know that RCSI is an historic college with a legacy spanning over 200 years. In its past, the college and its members have contributed hugely to the progression of medicine. As such; RCSI is now the custodian of a treasure trove of material relating to the history, practice and teaching of medicine and surgery in Ireland. The remit of the Library’s Heritage Collections is to curate, preserve and promote this diverse material - which includes archives, artefacts, manuscripts, antiquarian books, paintings and pamphlets.

They also hold a rich selection of historical medical instruments, ten of which will be highlighted in a new RCSI Heritage Collections Instruments & Innovations booklet, launching at this years Research Day. Here we’re going to have an exclusive sneak peek at some of the more noteworthy innovations included within:

A Hole In The Head Don’t suppose any of you would like to guess what this invention was used for?

Well, you could be forgiven for not knowing as thankfully, modern day surgical techniques have blessedly advanced; but, in the 18th century, using this device was the safest and best way to correct a haematoma. This piece was commissioned by a Dublin cutler, and combined two devices used previously to created a safer and easier to use device.

Invented in 1791 by the founding president of our college, Samuel Croker King’s new device was better for both surgeons and patients - in that the operator was less prone to fatigue and the device was less likely to slip mid procedure.

‘The expeditious working of the trepan with the safety of the trephine’

The Body’s Voice The stethoscope is perhaps the most universally recognised instrument of medical practice.

The invention of the stethoscope is credited to René Laënnec, who in 1816 was inspired by the sight of two children sending acoustic signals to each other with a length of wood. He found that using a rolled-up sheet of paper to listen to a patient’s internal organs produced louder and clearer sounds than the previous practice of immediate auscultation (placing one’s ear directly on the patient). Latterly, Laënnec refined his rolled-up paper to a simple wooden tube – essentially, the first stethoscope.

The stethoscope as we know it dates from 1851, when Arthur Leared presented his improvement at the Great Exhibition in London. Using flexible gutta-percha tubes, Leared’s device was binaural – meaning it had two earpieces – as opposed to Laënnec’s monaural version. Without pursuing the commercial potential of his invention, Leared left Britain to serve in the Crimean War. When he returned he found that a Dr Cammann of New York was manufacturing and selling binaural stethoscopes. Leared wrote to The Lancet to set the record straight, noting that ‘it is not only possible, but highly probable’ that his idea had been ‘pirated’. Nowadays Leared is generally given credit for the invention, but it is Cammann’s version that set the industry standard that we all use today.

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The Visionary In 1765 Sylvester O’Halloran published a treatise on gangrene, including a list of proposals to advance surgery at the time; in 1765, Irish surgery was unregulated and inconsistent. Influenced by the Académie Royale de Chirurgie, O’Halloran’s Proposals advocated the creation of a list of competent surgeons, the appointment of professors and the establishment of suitable premises in Dublin. The document is considered a blueprint for what would become RCSI. O’Halloran had many medical interests, but his reputation was founded on early research in ophthalmology. At twenty-two he published A new treatise on the glaucoma, or cataract (1750), followed by A critical analysis of the new operation for a cataract (1755). His findings were based on patients he treated as well as experiments on freshly-killed calves and live dogs. RCSI Heritage Collections holds a variety of sets of cataract knives similar to those O’Halloran would have used.

To The Point In 1844, Francis Rynd attended to a middle-aged woman with severe facial pain. His treatment involved the injection of morphine beneath the skin, for which he invented a new instrument, the forerunner of the modern hypodermic syringe. Rynd’s instrument had a hollow needle but not a plunger and so relied on gravity. He noted “all pain .. had ceased..” within minutes of injection.

In 1853, a French surgeon, Charles Pravaz, added a plunger to Rynd’s instrument. Subsequent modifications were made in Edinburgh by Alexander Wood (who used the word ‘subcutaneous’) and Charles Hunter in London (who preferred ‘hypodermic’), giving rise to a long, fractious, public debate between the two. Rynd did not comment until 1861, when he published in the Dublin Quarterly Journal of Medical Science a fuller account of his earlier innovation.

As seen in the photo, syringe barrels were initially made of metal, but by 1866 they were made from glass.

“The forerunner of the modern hypodermic syringe”

The Instruments & Innovations booklet is a Library initiative, but in many respects, it involved the whole RCSI community: it officially began as an undergraduate project for the 2017 RCSI Research Summer School, RCSI academic staff provided clinical insight, and the instruments themselves are largely gifts from alumni and their families.

This was released on March 7th and is available from the library if you are interested in learning more!

Every summer the Library takes part in the Research Summer School program, taking in undergraduate students to complete historical/humanities-based research within the sphere of Medical History. Offers have been made for 2019, but if this is something that is of interest to you in the future, please contact archivist@rcsi.ie for more details.

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//Trouble diagnosing a rare genetic disease?

There’s an app for that!

American scientists from a Boston, Massachusetts’ based start-up have developed an app that uses a form of machine learning to assist clinicians with the diagnosis of rare genetic diseases. By using multilevel, complex algorithms known as artificial neural networks, the app can assign the most likely genetic syndrome to a patient simply by analysing their facial features that are often highly associated with a particular disease. Patient outcomes depend on early diagnosis, suggesting that this technology may play an invaluable role in the field of rare diseases diagnosis.

The app, Face2Gene, can analyse facial landmarks like the eyebrows, nose and mouth of the patient from an image, reference its database, and generate a ranked list of likely genetic diseases [1]. According to the published study, this app has been outperforming medical geneticists in the differentiation and identification of genetic syndromes [1]. An example provided by the study is in the identification of Angelman syndrome amongst other genetic diseases [1]. The scientists who developed the app trained Face2gene with 766 images of Angelman syndrome, and nearly 3000 negative cases of Angelman syndrome. A survey conducted by Bird et al. later found that dysmorphologists had averaged an accuracy of 71%, whereas the artificial intelligence system of Face2Gene achieved an accuracy of 92% [3]. Face2Gene is powered by a deep learning system called “Deep Gestalt”.

The algorithms designed in deep learning systems try to mimic the large array of neurons in the neocortex of the brain to form an artificial “neural network”, providing enhanced capabilities in identification and classification of complex images. The scientists trained the artificial neural network by analysing over 17,000 patient images representing more than 200 syndromes. In a clinical setting, Deep Gestalt achieved a 90% accuracy by listing the correct syndrome in the top 10 suggestions across 500 different images. Healthcare professionals who use the app have the ability to add to the database, making Deep Gestalt a growing, community-based platform. Having been trained on tens of thousands of images, it has a greater accuracy than past facial recognition studies. Similarly to the vast majority of machine learning systems, Deep Gestalt’s performance will depend on increasing its database of patient images to train the neural networks and improve accuracy.

« LORI ISRAELIAN

Aside from assisting clinicians, molecular biologists may also benefit from face-scanning apps. For instance, Face2Gene could be used to supplement data from high-throughput genome sequencing to confirm that certain variants in a gene are causative of a syndrome. Since roughly 80% of rare disease are genetic in nature, any tools that appease the diagnostic challenges of experts or validate disease-causing variants will be extremely valuable to clinicians and scientists [2].

Though Face2Gene has the ability to enhance healthcare systems, it does also have several limitations. Face2Gene harbours major concerns surrounding data accumulation and sharing. While widespread usage of the app would ensure the continuous training and evolution of the Deep Gestalt framework, it may also compromise patients’ confidentiality. Robust mechanisms to protect the patient database and preserve the app’s integrity are crucial for promoting the integration of apps like Face2Gene into medical practice. The eventual usage of Face2Gene by clinical geneticists, paediatricians, and rare disease experts will not only lead to faster diagnosis and better care for patients, but also contribute to the advent of genetic testing for the delivery of precision medicine.

1. Gurovich, Y, et al. Nature Med. https://doi.org/10.1038/s41591-018-0279-0 (2019) 2. de Vrueh R, Baekelandt ERF, de Haan JMH. Priority medicines for Europe and the world: a public health approach to innovation. WHO Background Paper 6.19. Rare Diseases. 2013http://www.who.int/medicines/areas/priority_medicines/BP6_19Rare.pdf. Accessed 20 January 2019.

3. Bird, L. M., Tan, W. H. & Wolf, L. The role of computer-aided facial recognition technology in accelerating the identification of Angelman syndrome. In 35th Annual David W Smith Workshop (2014).

An input image is first preprocessed to achieve face detection and facial landmark detection. The Deep Gestalt platform can then analyze the features and extract the phenotype, which is followed by a list of output syndromes sorted by a similarity score.

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//HIVSmart!

A New Self-testing App for HIV diagnosis

« ASHKA SHAH

20 years ago, if a person was diagnosed with Human Immunodeficiency Virus (HIV), they would be predicted to live, on average, no more than 12 years. In today’s world, a person diagnosed with HIV can be expected to live a near-normal lifespan with access to life-long treatment and management by available pharmaceuticals. With incredible medical advances and innovative technological developments, all individuals with HIV should be diagnosed and set up with a medical regime. However, stigma, discrimination, social visibility and fear of non-confidentiality between doctors and patients often prevent people from getting tested in health care facilities.

In 2014, the Joint United Nations Programme, established an ambitious target for HIV treatment, the 90-90-90 goal. This called for countries to have 90% of those living with HIV to be tested, 90% of those tested positive to be on treatment, and 90% of those on treatment to be virologically suppressed by 2020. To reach the first 90%, the World Health Organization (WHO) recommended the use of HIV self-testing as an alternative strategy to conventional HIV testing services.

Recently, Dr.Nitika Pant Pai and her team from the Research Institute of the McGill University Health Centre developed an open-access mobile health application, called HIVSmart!. It guides an individual to do their own HIV screening test by obtaining a saliva sample from the gum lining of their mouth. This non-invasive technique can detect HIV antibodies just within 20 minutes. It also provides a 24-hour helpline and confidential linkages to health care facilities and counsellors if tested positive.

The researchers tested the usage of HIVSmart! and published their findings in the Journal of Medical Internet Research. Firstly, an in-home HIV test kit and tablet was given to 450 homosexual participants in a private health clinic, mimicking an unsupervised home. Instructional videos and directions in the smart application were used to demonstrate the procedure of saliva collection and subsequent processing to participants. Then the ability to perform the test, interpret the results and connect to health care professionals, when needed, was measured.

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The results showed that, 99.3% of participants that self-tested negative, also had their self – test results confirmed by laboratory testing. Furthermore, 0.7% of participants that tested positive were all confirmed positive using standard laboratory testing.

The study results strongly support the use of self-testing technology like HIVSmart! to achieve the 90-90-90 goal and enhance screening and diagnosis of HIV in vulnerable populations. In this manner, “HIV invisible” populations can gain more access to care and this can ultimately save lives.

Reference: Pant Pai N, Smallwood M, Desjardins L, Goyette A, Birkas KG, Vassal AF, Joseph L, Thomas R. An Unsupervised Smart App-Optimized HIV Self-Testing Program in Montreal, Canada: Cross-Sectional Study, J Med Internet Res, 2018

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//The Use of Video Games as Epidemiological Models Since their conception, video games have not been very highly regarded in the field of academia. However, this could change with the emergence of new pandemics.

The responses of video game players to virtual outbreaks offer us an opportunity to conduct studies on how to prevent the spread of epidemic diseases in the real world. The recent Ebola- and Zika virus outbreaks, while not an immediate threat to us here in Ireland, do not bode well for the future, as even the slightest mention of an infected person making his/her way across an ocean seems to lead us to write “The End is Nigh” on every newspaper. While it may be hard to directly emulate the random and chaotic nature of The Corrupted Blood Incident, it would not be too difficult to design a video game with a modus operandi that would enable us to study the way players would act together in response to scripted events, such as an infectious disease outbreak. By designing virtual diseases that spread and affect players in a similar nature to a known, potentially pandemic-causing disease, it may be feasible to develop more successful pre-emptive protocols to minimise the damage and panic that is caused by the emergence of epidemic strains of various pathogens.

In-game screenshot taken by Richard Smith during the Convergence of the Real and the Virtual, the first scientific conference ever held within World of Warcraft, which took place from the 9th to the 11th of May 2008, and which had a total of 120 participants. A book has been written about the event.

Back in September of 2005, upon the release of a new update for the massively multiplayer online role-playing game (MMORPG) World of Warcraft, something happened which had little to no impact on the fate of the world, but a major impact on the millions of players that were playing the game at the time. The incident would come to be known as The Corrupted Blood Incident, and began when a plague that had been designed to remain in one area of the virtual world, was spread to the general population through a glitch which enabled in-game pets and non-playable characters (NPCs) to act as carriers of the disease. Because the virtual infection involved the slow, gradual draining of health, higher-level players were not greatly affected, as many had the ability to repeatedly heal themselves. In this way, higher-level players also became carriers, and although these players found the plague to be somewhat debilitating, as it required constant healing; among lower-level players, the infection was often fatal.

When news of the plague reached the game’s general population, something extraordinary happened. Rather than simply logging off and waiting for a so-called ‘hotfix’, players instead started to migrate from the cities to the countryside in their thousands. Not only this, but some players who were adept healers began setting up makeshift healing-camps to help affected players (some charging for their services); other infected players set about actively infecting others. As the corpses in the cities grew higher and quarantines were introduced by the game’s developers, comparisons began to be drawn between the responses of the game’s community to the virtual outbreak, and the responses of people to real-world epidemics.

There are many advantages to the use of video games as epidemiological models.

Firstly, there is no doubt that the available sample population in an average online multiplayer video game far exceeds the population that could reasonably be used in a real-world study with human participants – for example, World of Warcraft, in its peak, had over 10 million active players. Secondly, despite the virtual nature of video games, players enjoy the ‘total immersion’ aspect of the experience to the point that it seems likely that their in-game responses to a virtual event might mirror their responses to a similar real-world event.

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This is not an entirely new idea. Games such as Plague Inc., which was released over four years ago, enable the player to direct a virtual pathogen in a simulated pandemic, and may give us a more global-scale view of the spread of pandemic diseases. Perhaps most worryingly, in the case of Plague Inc., is that even if the player designs an asymptomatic pathogen, the disease will – over an admittedly long period of time – eventually spread through most of the population and evolve traits that can make it potentially fatal. (If you are not curious enough to spend €10 on Plague Inc., there is a free, online alternative called Pandemic 2 which you might want to check out.) While these pre-existing simulators may exaggerate both the transmission of diseases and the associated government responses – for example, in Pandemic 2, if a man in Japan is seen to have a light head-cold, Madagascar will often close its borders and cut off all ties with the rest of the world – with some tweaking and input from academics, these games may present a good global-scale model for the realistic spread of known diseases, should they begin to spread over a wide geographical area.

There is an abundance of literature on The Corrupted Blood Incident available online. As such, I would direct interested readers to the 2011 blog-post written by Alex Ziebert for engadget.com, as I feel it presents a more thorough discussion of the incident than is often found elsewhere – as well as a more flattering view of the players involved.

To conclude, while video game simulations may not be the most intellectual method by which to predict the spreading patterns of infectious diseases, it would be a shame to dismiss the potential of video games in the study of epidemics and pandemics. This is because although the world of video games may be virtual, the responses of player-controlled characters may often provide a good approximation of the person controlling them, and can teach us how they might react in a similar, real-world scenario – within reason of course.

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Screenshots from Plague Inc. (by Ndemic Creations)

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//Technological Innovations in Dermatology

« SARAH COLBERT-KAIP

Biotechnology refers to a vast number of applications that use living systems, like bacteria and yeast, in manufacturing, medicine, technology, and more.

The earliest exploitations of biology for human need go back thousands of years, for the production of alcoholic beverages and food. It wasn’t until the mid 1800s that Louis Pasteur discovered that microbes were the cause of fermentation. Now, biotechnology is a multi-billion dollar industry and leads the way in medical innovations. Breakthroughs in cancer and gene therapies frequent headlines, but there is another area of biotech that can’t be ignored: Dermatology.

The skin is the largest organ in the body with a laundry list of pathologies ranging from mildly irritating to life threatening. Fortunately, the skin’s unique properties (absorption, regulation, protection, excretion, secretion, and sensation) make it an excellent target for new technologies. The main categories emerging from the field are: disease detection, treatment delivery, and biological sensors.

Disease Detection: In 2017, a hand held device called sKan was developed by a group of Canadian students which detects melanoma using thermally-sensitive resistors. In Singapore, scientists created NanoFlares, tiny programmable gold balls encased in nucleic acid which fluoresce in the presence of disease biomarkers.

Treatment Delivery: Advancements in microscopic nanoneedles have been made by South Korean scientists which improves the comfort and appearance of drug delivery patches using a new design for silicon wafers. Luma Therapeutics, an American company, released a hand held device which treats psoriasis using LEDs.

Biological Sensors:

Researches at Northwestern University created tiny UV sensors which work with your smart phone to tell you how much UV radiation you have been exposed to. The technology is now being sold by La-Roche-Posay (owned by L’Oreal). Even tattoos are being made with the hopes of sensing heat and radiation.

Only time will tell which products prove useful, but we are sure to see more fascinating innovations coming from dermatology-inspired biotechnology.

To see more on this topic, go to http://www.medgadget.com/ and follow @Dermsocrcsi on Instagram

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//Music Relaxation Rooms at RCSI Introduction Being in a third level educational institution may be challenging at times. This can be due to the heavy and demanding workload. Therefore, students feel pressured to complete their assignments and exams to their full potential, in order to achieve greatness.

The need for perfection can foster the development of stress in their daily lives. Some may choose to deal with increased levels of stress through a variety of ways such as exercise, music, cooking, and more. However, given that universities can be a large contributor to the stress some students experience, they should have an active role to help alleviate the aforementioned stress. Some educational institutions have implemented music therapy rooms in their school and have seen, first hand, the benefits of music relaxation rooms.1 Students experience stress in their daily lives Firstly, a student according to the Oxford dictionary is “a person who is studying at a university or other place of higher education.”2 This definition doesn’t take into account the entire life of a student. A student is a human, friend, sibling, parent… They have, just like anyone else, a personal life with its difficulties and its joys. But do universities really take that into consideration as they create the student’s workload? Being a student in today’s day and age requires an immense skill for time management, as well as balance in all aspects of their personal life. This can be even more challenging for students who are studying abroad. This brings upon the question, how can universities assist students to manage a heavy workload and personal matters?

Given that students have a lot to manage, they are bound to get stressed from time to time. But what is the definition of stress, and why is it even worth exploring if it is simply a feeling that can’t be quantified or measured? Referring back to the Oxford dictionary, stress is “a state of mental or emotional strain or tension resulting from adverse or demanding circumstances.” 3 How can this mental or emotional strain physically affect the individual? Research has been proven that prolonged periods of stress can cause allostatic wear and tear to the body. 4 It is suggested that a lifelong pattern of stress can alter the brain’s development and how it ages.4 Research also suggests that a combination of pharmaceutical and physical therapy can help reduce chronic stress and its effects on the body.4 This is due to the fact that stress releases hormones from the brain in order to allow the body to cope with the stressful stimuli. The emotional and mental aspects of the body are as important as the physical aspects (although not as easily quantifiable), and should not be neglected as it is an essential component of an individual’s health.

As aforementioned, it is evident that students struggle with stress all throughout their third level education.5 According to Mayo Clinic research, “Studies suggest that mental health worsens after students begin medical school and remain poor throughout training. On a personal level, this distress can contribute to substance abuse, broken relationships, suicide, and attrition from the profession.”6 It is evident that there is a need for universities to provide healthy alternatives for students to reduce stress, as it can be a large part of a student’s life and have a negative impact on their health and wellbeing.

Impact of music on stress Given the need for outlets (provided by schools), music relaxation rooms could be an option due to research displaying the positive effect of such rooms.1,7,8 This would be the first method to suggest as it is a non-invasive and natural technique to aid in the reduction of stress. A music relaxation room could be a location on the college campus that is designed for relaxation though listening to therapeutic music. As well as this, the room could have a landscape scenery to promote calmness.

Furthermore, the effect of music (as a relaxation method) after a psychologically stressful task (also known as a stress test) was measured by quantifying cortisol levels in saliva during a research experiment. Cortisol is a stress hormone that is released when

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« PHEBE ZAYTOUN

« HARLEEN JHINGER

the body is faced with a stressful stimulus. The salivary cortisol levels were monitored in the participating students over 24 hours before, during, and after the stress test. The results indicated that the salivary cortisol levels stop increasing when the stressor is switched off when individuals listen to music (the experimental group). However, for individuals in the control group (who didn’t listen to music), cortisol levels continued to rise for half an hour.7 The advantage of music to alleviate stress is clearly demonstrated by this research as it compared rising, quantifiable, stress levels in silence as well as in musical periods.

By the same token, research conducted in the Journal of Music Therapy evaluated 50 undergraduate students who were taking a stressful mental test. These students listened to different types of music as they were doing the test. They were asked to rate their relaxation level throughout the musical periods. The result of this research suggested that music has a positive effect on the cognitive component and stress response of the students involved.8 In light of this research, it is clear that music is a healthy way for students to reduce their stress levels which would, in turn, have a positive effect on their physical wellbeing as previously mentioned. Given this, music relaxation rooms should be implemented in universities.

The idea of using music as a form of therapy in order to alleviate students stress is modern but not unprecedented. A primary school in New Jersey has implemented music therapy as part of their program, in order to help their students who suffer from learning disabilities to sharpen skills such as memory, focus, attention and more.1 They have different music sessions that the children may choose from (group, individual, specific) to help them further develop their skills.1 This is an example a school taking the initiative to help students achieve their full potential in the academic aspect of their life. It is quite evident that music, although may appear as futile to some, is actually very important and helps tremendously in the mental capacity of these children, who are still cognitively developing. It begs the question, how much more of an impact can music relaxation rooms have on the reduction of stress levels of university students?

Conclusion It is evident that the benefits of incorporating music relaxation rooms on the university campus can help students study better without jeopardizing their mental health. There have been numerous studies that have measured the effects of music on students’ mental and emotional wellbeing. As well as this, schools who have decided to incorporate music therapy in their institutions have been successful. Universities should ensure that their students are in good health. According to the Oxford dictionary, health is “a person’s mental or physical condition.”9 This alludes to the cruciality of a person’s mental condition to be well, in order to be a healthy individual. Seeing as music is beneficial in reducing students’ high levels of stress, it would, therefore, be beneficial to implement music relaxation rooms in third level institutions, such as RCSI, to alleviate stress and academic pressure that students are placed under.

References 1) Music Therapy - The Pilot School [Internet]. Pilotschool.org. 2018 [cited 28 October 2018]. Available from: https://www.pilotschool.org/ integrated-support/music-therapy 2) Student | Definition of student in English by Oxford Dictionaries [Internet]. Oxford Dictionaries | English. 2018 [cited 23 October 2018].

Available from: https://en.oxforddictionaries.com/definition/student 3) Stress | Definition of stress in English by Oxford Dictionaries [Internet]. Oxford Dictionaries | English. 2018 [cited 24 October 2018].

Available from: https://en.oxforddictionaries.com/definition/stress 4) McEwen B. Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain. Physiological Reviews. 2007;87(3):873-904.

5) Ribeiro et al J. Stress and Quality of Life Among University Students: A Systemic Literature Review. Elsevier. 2017.

6) Dyrbye L, Thomas M, Shanafelt T. Medical Student Distress: Causes, Consequences, and Proposed Solutions. Mayo Clinic Proceedings.

2005;80(12):1613-1622.

7) KHALFA S, BELLA S, ROY M, PERETZ I, LUPIEN S. Effects of Relaxing Music on Salivary Cortisol Level after Psychological Stress.

Annals of the New York Academy of Sciences. 2003;999(1):374-376.

8) Burns J, Labbe E, Arke B, Capeless K, Cooksey B, Steadman A et al. The Effects of Different Types of Music on Perceived and Physiological Measures of Stress. Journal of Music Therapy. 2002;39(2):101-116.

9) Health | Definition of health in English by Oxford Dictionaries [Internet]. Oxford Dictionaries | English. 2018 [cited 25 October 2018].

Available from: https://en.oxforddictionaries.com/definition/health

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//A Workout a Day Keeps the Chemicals at Bay Introduction Nearly everyone has felt depressed at some point in their lives; [1] however, what happens when it evolves into a major depressive disorder that doesn’t necessarily go away?

Depression is a very prevalent topic and it is important to look at the treatment of depression from a holistic perspective; including both medicinal and alternative methods of therapy. Recently, the relationship between exercise and mental health has been further explored. Does exercise really improve our mental wellbeing, and if so, how?

Exercise as treatment Generally, exercise is associated with an improvement in physical health. However, studies have shown that exercise can also refine the quality of mental health. [2,3,4] Interestingly, the effect exercise has on mental health can be comparable to some firstline pharmacotherapies for mild to moderate depression [2]. Exercise promotes the release of the happy chemicals in the brain, endorphins and serotonin, thus increasing your overall mood [3]. As well as this, it has been found that exercise produces more PGC (Peroxisome proliferator-activated receptor gamma coactivator), which is a factor that encourages the breakdown of kynurenine, a metabolite released during stressful events [4]. Increased kynurenine breakdown would result in a weakened bodily response to stress. This is important because often times long term stress can be translated into depression [4,5].

Students and stress The World Health Organization estimates that 300 million people worldwide suffer from depression [6]. Furthermore, studies show that students have a higher likelihood to suffer from depression [7,8]. Such studies have made it clear that mental health discussions need to become prioritized in educational institutions. Physiologically, this high stress can eventually result in students having poorer mental health than when they initially started school [9].

Issues with drugs and treatment To effectively treat depression pharmacologically the drug must be able to pass the very selective blood brain barrier; therefore the special medications that have this ability often have adverse effects on the body, as well as combatting the depressive symptoms [4]. Those side effects include; nausea, insomnia, and dry mouth [10]. Exercise could potentially be a useful technique to treat depression, as it allows the body to use its own natural pathways to combat depression. It has been determined that exercising forty minutes a day, for three days a week is considered an adequate amount, particularly for production of PGC [4]. Furthermore, exercise can be considered a more accessible and affordable method of treatment in comparison to drugs, especially in certain parts of the world where health coverage and access to hospitals are a big factor in the quality of healthcare. Research has also shown that the health benefits of exercise on mental health appear to be long-lasting [11].

« PHEBE ZAYTOUN

« HARLEEN JHINGER

students and staff and offer a variety of classes ranging from yoga to core strengthening. Emails are sent out to all students detailing gym classes that are available during the week, allowing students to see what they may be interested in and to plan their week in advance, in order to attend gym classes. They also offer free personal training sessions to all RCSI students. Additionally, a woman’s only gym is available on site.

To encourage students to get to the gym, they host a variety of events, including one where participants received a free Bluetooth speaker after completing various tasks at the gym. RCSI also offers personal consultations with students regarding the topic of nutrition. They help students create easy and affordable nutrition plans and weekly grocery lists. This aids students significantly throughout their heavy workloads and effectively reduces stress.

Variables It is important to remember that depression is a subjective illness, and like many aspects of medicine, one treatment may not be universally effectively. The link between exercise and mental health is currently in the research phase [11], and has yet to be clinically proven. Although more research is needed on the antidepressant effects of exercise, research has made it clear that exercise can help decrease the symptoms of depression [10, 11].

Conclusion To sum, exercise is a natural method to increase PGC levels and reduce stress, which in turn has a positive impact on mental health [4]. Exercise is accessible through the gym at RCSI, as well as being free of cost for students who study at RCSI. They also have the opportunity to get involved in the many initiatives the school gym has to offer. Mental health is clearly important to the overall well-being of a student; yet, the negative stigma around mental health continues to prevail. This is why education of primary and secondary students is crucial to reduce and potentially eradicate the stigma associated with mental health.

References 1. What is Depression? – The College of Psychiatrists of Ireland [Internet]. Irishpsychiatry.ie. 2018 [cited 30 October 2018]. Available from: https://www.irishpsychiatry.ie 2. Carek PJ, Laibstain SE, Carek SM. Exercise for the Treatment of Depression and Anxiety. 2011;41(1):15-28.

3. Health Direct. Exercise and Mental Health. Australia: Australian Government Department of Health, 2017.

4. Karolinska Institutet. Physical Activity and Depression. Sweden: Kommunikationsavdelningen, 2016 5. Van Praag H. Can stress cause depression?. The World Journal of Biological Psychiatry. 2005;6(sup2):5-22.

6. Depression. World Health Organization. 2018 [cited 28 October 2018]. Available from: http://www.who.int/news-room/fact-sheets/ detail/depression 7. Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Medical Education.

2005;39(6):594-604.

8. Moir F, Yielder J, Sanson J, Chen Y. Depression in medical students: current insights. Advances in Medical Education and Practice.

2018;Volume 9:323-333.

9. Abdulghani, Hamza M et al. “Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia” Journal of health, population, and nutrition vol. 29,5 (2011): 516-22.

10. Side effects [Internet]. nhs.uk. 2018 [cited 29 October 2018]. Available from: https://www.nhs.uk/conditions/antidepressants/side-effects/ 11. Craft, Lynette L. and Frank M. Perna. “The Benefits of Exercise for the Clinically Depressed” Primary care companion to the Journal of clinical psychiatry vol. 6,3 (2004): 104-

Mental health education in primary years Once the relationship between exercise and mental health is understood and established, education with respect to the positive impacts exercise can have on our mental health should be provided. Starting mental health discussions at a young age could help the new generation overcome the negative stigma revolving around mental health. By the same token, mental health should be taught in primary and secondary school curriculums as a core subject, as youth should not feel negatively stigmatized and hesitant to reach out for help if mental health issues arise. With so much emphasis placed on physical health during the primary and secondary school years, mental health can be lost in the mix- or even worse, non-existent.

RCSI and exercise The Royal College of Surgeons in Ireland (RCSI) has worked on encouraging students to get to the gym whenever possible. RCSI has provided free gym sessions for

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2019

« OLA MICHALEC

…At a Glance

The International Conference of Healthcare and Medical Students (ICHAMS) is held annually at the Royal College of Surgeons in Ireland (RCSI) to allow undergraduate healthcare and medical students to present their research to peers and professionals in the field. Our mission is to create a platform for students across the globe to interact with one another in order to challenge conventional methodology and encourage innovation in medicine.

The conference includes workshops offered on a variety of topics as well as keynote speakers representing incredibly impactful realms of medicine. Centered in the vibrant city of Dublin, Ireland, we also encourage our participants to embrache the rich culture via city walking tours and traditional Irish music.

The first conference was held in 2011 and in 2013 the conference received the Irish Healthcare Award for student project of the year. As we continue to grow as an international conference, we are continuing to follow our mission of creating a global platform for innovation and medical research. The eighth edition of the ICHAMs conference took place from February 21-23, 2019. For more information visit our website www. ICHAMS.org or contact us at ichams@rcsi.ie Here are some highlights from this year’s conference! With Clare Lambert and Biance deBenedictis as next year’s Co-Chairs we expect nothing more than another amazing conference next year… stay tuned for ICHAMS 2020!!

DAY 1: Thursday, February 21st Keynote Session

Social Programme Dr. Blánaid Hayes, Specialist Consultant (Occupa2onal Medicine) and Lead Inves2gator of the Na2onal Study of Wellbeing of Hospital Doctors in Ireland. As former Dean of the Faculty of Occupa2onal Medicine of the Royal College of Physicians of Ireland (RCPI), her research interests include doctor’s wellbeing, needle-s2ck injury and influenza immuniza2on of healthcare workers. Her research into personal and workplace wellbeing in hospital doctors has helped to inform curricular developments and supports in RCPI and other postgraduate medical training bodies in Ireland. This year, Dr. Blánaid Hayes discussed…..

PUB QUIZ We kicked off the start of the conference at our trivia night at Against the Grain!

It was good craic and a great opportunity to meet students from Ireland and beyond!

DAY 2: Friday, February 22nd Keynote Session

Social Programme Professor Karen Redmond, Consultant Cardiothoracic and Lung Transplant Surgeon, was the first female lung transplant surgeon to be appointed in the UK and Ireland. With a special interest in minimally invasive keyhole surgery for lung cancer and mesothelioma, Professor Redmond has won many presEgious awards both for her research and medals in surgery. In 2013 alone, she performed 33 lung transplants. She also has an internaEonal experEse in ex-vivo lung perfusion, allowing lungs to be recondiEoned outside the body prior to implantaEon. This year, Professor Redmond discussed clinical innovaEons in thoracic surgery and lung transplantaEon.

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PUB CRAWL In a city that is world-famous for its pub scene (there are 751 pubs in Dublin). Dublin's nightlife had to be part of the experience and after all... we all know the Guinness tastes better in Ireland!

Attendees got the opportunity to explore Dublin at night!

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Societies

Workshops A: Obstetrics Simulation with “Lucina”- Ireland’s Only Birthing Mannequin In this workshop, students had the unique opportunity to bridge what they learn in lecture to the clinical setting in the state-of-the-art Obstetrics Simulation Lab at RCSI. They gained hands on experience in the labour and delivery process on Lucina, who models the physiology of a real patient, responds to clinical interventions as they are performed and has vitals monitored in real time!

B: LGBTQ in Healthcare People that identify as LGBTQ+ often experience unjust discrimination and stigma in their societal and healthcare experiences. This workshop explored the importance of creating a safe space to properly address healthcare needs and how we can embark on reaching this goal with understanding and awareness. A final year medical student at RCSI, Cameron Chalker, discussed his personal healthcare experiences, and the nuances of caring for people with diverse sexual and gender identities.

C: Innovative Research Discussion: New Blood Test to Detect Alzheimer’s Disease Dr. Tobias Engel and Mr. Aidan Kenny, who collaborated in a multi-centre study with colleagues in Spain to identify a small molecule in the blood that can be used to detect early stages of Alzheimer’s disease, led this workshop. They took us through their research process, from the early stages of this novel hypothesis to where their research is today. This workshop was an insightful and inspiring opportunity to learn how to navigate the often unexpected, but rewarding challenges that research studies pose.

D: Suturing Workshop Under the direction of final year medical students, this suturing course gave students the ability at hands-on teaching in basic suturing and wound closure techniques, a vital skill for any doctor.

E: RCSI Historic Tour Granted a charter in 1784, RCSI is entrenched in histroy. For over 200 years, the college has prided itself on education and innovation in health sciences, and our facilities are a reflection of the college’s history. Students joined renowned RCSI porter Frank Donegan, on a walk through time on one of the college’s longest standing buildings and heard first hand the story of the college and some of the great minds that have passed through the halls of RCSI.

DAY 3: Saturday, February 23rd Workshops F: Plastering/Casting The ability to assess and manage fractures is an important practical skill for aspiring medical professionals. This workshop, led by Dr. Nafisah Borhan and Dr. Fareeda Borhan, offered students the chance to get hands on experience in fracture management.

J: Ultrasound Skills Led by Dr. Nicholas Lim, resuscitation fellow at the Mater Misericordiae University Hospital, this workshop offered students the chance to learn the basics of how US works. Also, students got the opportunity to use the US probe to identify organ structures within the abdomen.

K: Intubation & Chest Drain Practical Skills Tracheal intubation allows for the maintenance of an open airway and chest drains are effective in removing air and fluid from the pleural space. Led by Dr. Jennifer Clarke and Dr. Rachel Wu, in RCSI’s state-of-the-art Surgical Suite, this workshop gave students the opportunity to learn & practice both techniques!

L: Introduction to Laparoscopy Skills Laparoscopic procedures have revolutionized surgical practice, dramatically reducing post-operative infection rates and the duration of hospital stay and they have become the mainstay of many surgical specialties. During this workshop, students got the rare opportunity to gain experience in what will undoubtedly be a significant component of any surgical specialty.

M: General Practice Skills Session The General Practice faculty at RCSI conducted a hands-on workshop which included clinical vignette interpretation and instruction on skills including: ECGs, fundoscopy, otoscopy, venipuncture, blood pressure and more!

Interactive Patient Session In this engaging learning session, Professor Arnold Hill and Dr. Deirdre Duke, discussed their unique perspectives to managing their patients as they took us through a number of cases of patients they were currently treating.

Professor Arnold Hill is Professor and Chair of Surgery at RCSI and Consultant General & Breast Surgeon. His clinical interests are in the area of breast cancer and melanoma. His laboratory research interest is in the transcriptional control of breast cancer, in particular the role of coregulatory proteins.

Dr. Deirdre Duke is a Consultant radiologist with a special interest in Breast and Lymphoma Radiology. She is the Lead Clinician of symptomatic breast services at the Beaumont Breast Cancer Centre. Her research focus is in breast cancer and lymphoma.

G: Suturing Workshop – Saturday Masterclass Under the direction of Mr. Gary Bass, Chief General Surgery SpR at Tallaght Hospital, this suturing masterclass gave students of all abilities hands on teaching in basic suturing and wound closure techniques under the experience of experienced surgeons.

H: Rapid Interpretation of Electrocardiograms (ECG) Attendees joined Dr. Sebastian Gracias as he demonstrated how ECGs can not only be easy to read, but enjoyable as well! Over the course of this workshop, Dr. Gracias highlighted key features of common ECGs and also assisted in placing ECG leads on a surface model.

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//Women on Walls

« ALIYA ESMAIL

Introduction This year, I visited the Boardroom in RCSI’s historic building on St. Stephen’s Green on a few occasions. Once, for the annual Awards Ceremony to celebrate student achievement, and also to celebrate Canadian Thanksgiving with friends by bonding over our shared love of food. What both of these occasions had in common is the diversity of students and faculty they drew together. The few times I have been in this room, I have always been struck by the contrast of past and present – the walls adorned with portraits of older male physicians, and the room today filled with healthcare providers and students of all ages, races and ethnicities, backgrounds, and talents. This contrast is none too common across medical and academic institutions. Standing in the boardroom can feel uncomfortable; I have felt boxed in by walls that represent a history that is not reflective of me or my experiences, or even who I aspire to. Coming up very soon, we can celebrate the ways in which representation is changing and it starts with the portraits in the Boardroom!

Spearheaded by the Equality, Diversity and Inclusion Unit (EDI) Unit, in partnership with Accenture, the campaign, Women on Walls, seeks to make women leaders visible through a collection of commissioned portraits that will create a lasting cultural legacy for Ireland. These portraits will recognise the pioneering achievements of eight extraordinary women and enhance the visibility of historical female leaders in healthcare.

In March 2018, RCSI announced an Open Call to artists to commission this collection of new portraits. More than 55 proposals were submitted and then carefully considered by a selection committee who ultimately selected the eight successful proposals by six artists. The portraits were unveiled this month as part of RCSI’s International Women’s Day celebrations.

The portraits grace the walls of the historical Boardroom, which was formerly known as the “College meeting room” at the time of its early use in 1810. Examinations and ceremonies alike were held in this room, along with significant meetings to discuss changes across the College. While reading through an old document on the history of the Boardroom, there was one meeting in particular that resonated with me. In 1885, a special meeting was held in the Board Room during which RCSI decided to begin accepting women, a decision that was controversial at the time. Knowing that this decision was made in the Board Room amplifies the significance of the extraordinary female portraits displayed around the room. These new portraits show me that the college has a rich history, and that we, as students from all backgrounds and identities, are part of it.

This campaign is one of the many ways the EDI Unit continues to support the embedding of an organisational culture that celebrates diversity and inclusion at RCSI. The portraits help to better reflect the diverse student population at RCSI and highlight women who serve as role models for us all, as we sit our exams in the Boardroom, looking to them for inspiration.

Meet the Extraordinary Women The campaign features eight extraordinary women who have, at some point in their lives, crossed paths with RCSI, and who have done work both nationally and globally. Here are the inspiring biographies of each woman (in alphabetical order), compiled and written by the RCSI Library Heritage Collections.

Dr. Victoria Coffey (1911 – 1999) Dr. Victoria Coffey was one of the first female paediatricians in Ireland. After qualifying at RCSI, Coffey worked at the Meath and Coombe Hospitals before being appointed in 1943 as medical officer in charge of children at St. Kevin’s Hospital. During this period, she developed her interest in the neglected field of congenital birth defects and began a distinguished publishing career.

Appointed lecturer in teratology at Trinity College, Coffey went on to conduct pioneering research on a range of subjects including metabolic disorders in the newborn and Sudden Infant Death Syndrome (SIDS). In 1979, she was elected a Fellow of the Royal College of Physicians Ireland and was also a founding member of their Faculty of Paediatrics. She was the first female recipient of RCSI’s Distinguished Graduate Medal, first woman President of both the Irish Paediatric Association and the RCSI Postgraduates’ Association, and President and founding member of the Irish and American Paediatric Society.

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Dean Mary Frances Crowley (1906-1990) Born in Wexford, Mary Frances Crowley undertook her professional training in Britain, earning her Registered Nurse Certificate in 1935. She returned to Ireland in 1941 to take up a senior position in Sir Patrick Dun’s Hospital. In 1944, she was appointed Assistant Matron of the Royal Victoria Eye and Ear Hospital. Immediately after the war, Crowley travelled to northern France as Matron of the Irish Red Cross Hospital at Saint-Lô (the hospital’s storekeeper, interpreter and driver was Samuel Beckett, the future Nobel Laureate). For their work at Saint-Lô, Crowley and her staff were awarded the Medaille de la Reconnaisance Française. Crowley founded the Nursing Training School at the Eye and Ear and became Director of Nursing Studies. In 1974, her ambition of many years was realised with the establishment of a Faculty of Nursing at RCSI, the first of its kind in Ireland or Britain.

Dr. (Emily) Winifred Dickson (1866-1944) Dr. Emily Winifred Dickson was the first female fellow of RCSI. Born in Dungannon, Co. Tyrone, she began her studies at RCSI in 1887, two years after the College first admitted female students. Dickson enjoyed a distinguished academic career, winning a number of student medals and receiving her licence in 1891. She obtained her MB (Bachelor of Medicine, first class honours, with an exhibition prize) from the RUI in 1893, the year she also earned her fellowship of RCSI, a first for a woman in any college of surgeons in Ireland or Britain. She studied on a scholarship in Vienna and Berlin, and in 1894 on the opening of the Extern Department for Diseases of Women at the Richmond Hospital, Dublin, was appointed as its first gynaecologist; she also served as supernumerary assistant at the Coombe. In 1896 Dickson was appointed examiner at the RCSI; another first for women in Ireland or Britain. In later life, she worked in Britain as a medical health officer and general practitioner.

Dr. Margaret (Pearl) Dunlevy (1909-2002) Dr. Margaret (Pearl) Dunlevy was an epidemiologist whose championing of immunisation served to eradicate tuberculosis in Ireland. Born in Donegal, Dunlevy received her licence from RCSI in 1932, coming first in her class. After several years training in Britain, including a period as a TB physician in Cardiff, Dunlevy earned a diploma in public health from UCD, again coming first in her class. She continued her research into TB as assistant medical officer in Dublin, at Crooksling Sanatorium and at St. Ultan’s Hospital for Infants, where she was member of the BCG committee (Bacillus Calmette– Guérin: a vaccine primarily used against tuberculosis). The success of Dunlevy’s BCG pilot programme in Dublin led to its nationwide expansion, with further success. In later years, Dunlevy published extensively and was a columnist for the Irish Medical Times. She was President of the RCSI Biological Society, President of the Irish Society for Medical Officers of Health and a member and fellow of the Royal College of Physicians Ireland.

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Dr. Mary Josephine Hannan (1865-1935) Dr. Mary Josephine Hannah was the first woman both to train and to qualify at RCSI. Born in Dublin, she enrolled in 1886 (a year after women were first admitted) and received her licence in 1890. A short time later she travelled to India to work in several of Lady Dufferin’s hospitals dedicated to female healthcare. In 1896, she established herself as Cardiff ’s first practising female doctor. Subsequently, Hannan relocated to South Africa where she became a member of the General Committee of the South African Medical Congress. For many years she worked as a medical officer to native women and lectured in midwifery at the Victoria Maternity Hospital, Johannesburg. A champion of women’s rights, Hannan was a member of the Women’s Enfranchisement League; on occasion she refused to pay taxes which applied to unmarried women but not unmarried men. She also founded the Girl Guide movement in Pretoria.

Sr. Dr. Maura Lynch (1938-2017) Sr. Dr. Maura Lynch was a surgeon who revolutionised obstetric fistula care in Uganda. Born in Youghal, Co Cork in 1938, Lynch joined the Medical Missionaries of Mary aged seventeen before studying medicine at UCD. She earned a diploma in obstetrics and gynaecology at the Royal College of Obstetricians and Gynaecologists, and then studied tropical medicine and Portuguese in Lisbon so that her order could send her to Angola. After nearly twenty years of clinical work in Angola, Lynch saw that the need for a specialist surgeon in the country was not being met. She therefore at the age of forty-seven undertook further study in Ireland and obtained the Fellowship of the Royal College of Surgeons in Ireland in 1985.

After another two years in Angola, Lynch was reassigned to Uganda, where she would remain for the next thirty years. Lynch is credited with more than 1,000 repairs of vesicovaginal fistula, all the while raising funds and awareness of this disease of poverty.

Dr. Barbara Maive Stokes (1922-2009) Dr. Barbara Maive Stokes was a paediatrician and pioneering disability campaigner. Born in London, Stokes studied medicine at Trinity College, Dublin, after which she trained as house physician at the Meath Hospital. She earned a certificate in public health from UCD in 1947 and hoped to become an epidemiologist, but the marriage bar prevented this as positions in that field were all within the public service. Turning to paediatrics, Stokes was appointed assistant physician at St Ultan’s Hospital; she also worked at the Royal City of Dublin Hospital, and in the 1950s was senior demonstrator in pharmacy and physiology at RCSI. Stokes first involvement with the association that would become St Michael’s House, a community-based service for people with an intellectual disability, was as a part-time volunteer; later she managed the entire organisation. A tireless advocate, Stokes served on many boards, notably the National Rehabilitation Board and Inclusion Ireland.

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Dr. Mary Somerville Parker Strangman (1872-1943) Dr. Mary Somerville Parker Strangman was a doctor, suffragist and elected councillor. Born in Waterford, Strangman and her sister Lucia enrolled at RCSI in 1891, receiving their licences in 1896. After training and lecturing in Britain, Mary Strangman became the second woman to earn the fellowship of RCSI in 1902. Establishing a practice in Waterford, Strangman also volunteered at various local women’s charities and published a number of research articles on alcoholism and morphine addiction. She was an active suffragist and served on the executive committee of the Irishwomen’s Suffrage Federation (1911 – 1917).

As co-founder of the local branch of the Woman’s National Health Association, Strangman worked to combat tuberculosis, the country’s principal killer disease. Seeing the authorities’ poor investment in sanitation, Strangman stood for election on a public health platform and was elected Waterford’s first female councillor in 1912. Retiring from office in 1920, Strangman continued in general practice and as physician at Waterford County and City Infirmary.

Meet the Artists!

Catherine Creaney • Subject: Dr. Barbara Maive Stokes

Enda Griffin • Subject: Sr. Dr. Maura Lynch

Molly Judd • Subjects: Dr. Victoria Coffey and Dr. Mary Josephine Hannan

William Nathans • Subject: Mary Frances Crowley

Mick O’Dea • Subjects: Dr. Emily Winifred Dickson and Dr. Mary Somerville Parker Strangman

Benita Stoney • Subject: Dr. Margaret (Pearl) Dunlevy

Time to celebrate The official unveiling was held on Tuesday, March 5th followed by a special viewing for all staff and students on Friday, March 8th in conjunction with International Women’s Day celebrations. For more information on the featured women and comissioned artists, you can visit women.rcsi.com. There will also be a Podcast series with 9 episodes; one episode for each woman and a bonus behind the scenes episode. Details coming soon!

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//and now for the Pharmers...

« SARAH CULLEN

On introduction of the new MPharm degree in 2015, it was decided that the 12 months of placement that the students were sent out on between 4th and 5th year would now be unpaid, and the fees would treble in price. Suffice to say, this made pharmacy students very unhappy. It was a long time coming (and we have to acknowledge all the work that went into the outcome in these last four years!). On the blustery morning of January 24th, over 500 students from RCSI, UCC and TCD took to the streets to protest these changes, and to try and enact real change. Happily for us, we came away with the result we wanted, but we must fight to ensure our right to a fair and non-exploitative education.

A note from the PharmSoc on the events of the strike: RCSI Pharmacy Society want to extend a massive thank you to all the students who attended the Launch and Rally at the Dáil and PSI. We want to thank all of the people who have put their time and efforts into this campaign Union of Students in Ireland, IPSA - Irish Pharmaceutical Students Association, APPEL reps, Class Reps, Student Unions and Pharmacy Society committees and members of all the Schools of Pharmacy in Ireland. I think we have all made our voice heard, and a step in the right direction has been made.

PharmSoc have run a number of events over the course of the academic year and here are the highlights…

Freshers Backyard BBQ @ Diceys

PharmBall It is always one of the highlights of the year, and 2019 certainly did not disappoint. The theme was Gatsby, the wine was flowing, and the music was pumping. A great night had by all, and with great timing off the back of the result from the protest we celebrated like only the pharmers know how to do.

Career Clues Night

This event is run every two years by the PharmSoc in the college to help educate students on the ways they can, and should, use their pharmacy degree. We had speakers from all aspects of pharmacy – community, industry, hospital and even had a pharmacy student give a speech! It was a great night run by the society and really helped pharmacy students see what their degree can do for them.

Keep an eye out for future PharmSoc events, they’re always sure to be a good dose of craic!

March 2019

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//RCSI Vietnam Volunteer Experience (CNCF) My experience “Why do you want to do this?”

That’s what I was asked by the three interviewers as I sat across from them, their eyes fixed on me, and it felt as though they were analyzing my every breath.

I replied with the sincerest words I’ve ever spoken: “I want perspective. I want to experience something that fills me with passion, compassion and gratitude.”

I was lucky enough to be chosen to volunteer with the CNCF and the resulting trip to Vietnam gave me all I’d hoped for and so, so much more.

To give a spot of background, the Christina Noble Children’s Foundation (CNCF) is a charity organization with a multitude of projects taking place in many different countries. Every year they partner with RCSI to send three student volunteers to help take care of the kids they house in Vietnam. It is here that they house and care for underprivileged children in the affectionately named “Sunshine Centre”.

The children in the centre come from poverty, abuse and abandonment - many of them suffering from a host of mental and/or physical growth abnormalities. These kids, however, were by far the best part of the trip. The children there show so much resilience and strength to be able to smile, laugh, play and learn every single day.

There was one boy about four years old living there who was unable to walk. Every day I would see the physiotherapist put his legs in splints and encourage him to walk; he would struggle and cry from the pain it caused him, but day in and day out, through the pain, he walked. And when he was done with the ordeal, he would have the biggest smile on his face.

Every day in the Sunshine Centre, I had experiences just like this one. In my time there, I experienced the free education that the CNCF provides to the dirt-poor children of Vietnam. I saw them provide free healthcare to the poor public community who needed it. I saw the opportunities that they gave children who will actually graduate from school, and perhaps even college, as opposed to experiencing a far less fortunate outcome. Many children grow up selling cigarettes to tourists on the street, and the CNCF are playing a part in preventing this. It was realizing the harsh realities of this life that I felt so privileged and grateful to be attending a college like RCSI. We visited a home for the blind and experienced what life was like for those kids.

Later that day, I remember staring at a tree in a park and appreciating the diverse shades of green in each of the leaves, as the haze of the setting sun bathed them in gold.

March 2019

« ANTHONY JAVED MACHIKAN

Any time I think about those times I’ve mentioned previously, I remember how lucky I am in every aspect of my life. Even to have the ability to use all my limbs! I am certainly more grateful now for the seemingly normal and inconsequential things – the things the children I worked with would love to experience. If you truly want to experience something real and genuine or need some perspective in your life, then volunteering with CNCF is a great way to do it.

The culture of Vietnam is surreal – so much so, there are times when you actually feel like you’re in another world. The city is loud and bustling, with more scooters on the street than there are neurons in the brain. Some people sing on the pavements, while others cheer as if they’re at a Beyonce concert. Everyone is always trying to sell you something and what they lack in persuasion, they make up for in persistence.

They’re mostly all friendly, polite and they love talking to foreigners to improve their English. It is definitely a culture shock, but a magnificent culture shock.

The food is unique, to put it lightly. It’s incredibly cheap and there’s so much variety that you’re bound to find something you love and something you hate. Be sure to try it all - I was surprised to find out what I actually liked. I have to say that a huge part of the culture is not just learning about Vietnam, but learning about yourself as well.

I can’t write a piece about volunteering in Vietnam without mentioning the beauty of the country itself. Vietnam is gorgeous. After the time we spent working with CNCF, my RCSI friends (Sinead and Aoife) and I travelled from one city to the next via “sleeper buses” (look it up, it’s a million-dollar idea for getting to Beaumont).

Each city had a new experience; from sleeping in loud, wild hostels, to kayaking through an oyster farm. Exploring a cave in an island in the middle of the ocean, bathing in a waterfall to hiking more than 20km up a mountain to spend the night with a Chinese-Vietnamese family with barely any electricity. My absolute favorite though, was riding a motorcycle for the first time 120 km through the Hai Van Pass (Google it).

These are just bits and pieces of my experience, but there were so many more things that made an emphatic impact on me. I went there looking for some direction and perspective; and I came back feeling fulfilled. If you’re interested in immersing yourself in something new, positive and exciting, then I strongly urge you to apply, or to volunteer with another organisation. I did and it turned out to be the best two months of my life.

An extra note from the writer: I just want to say thanks to DiveRCSIty for letting me talk about this experience (God knows my friends have had enough). Thanks to Aoife Howard, Sinead Kinsella, Lance McGrath and James Tsoale for volunteering (under RCSI) as well, they were amazing craic and made the experience all the more enjoyable.

Thanks to RCSI for the opportunity and I need to say thank you very much to the CNCF and Christina Noble herself. The work she does is inspirational and I hope that my life makes a positive impact on the world just as I believe the students and staff of RCSI do and will continue to do in the future.

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Clubs & Societies

RCSI Centre for Mastery: Personal, Professional & Academic Success is a multi-disciplinary team of specialists working collaboratively to facilitate and empower RCSI students to achieve their personal, academic and professional goals. We seek to promote and facilitate continuous growth and skills development for future healthcare leaders at all stages of their training. Make an appointment to meet us today. Office locations in both 123 St Stephen’s Green and Beaumont Hospital, Student Centre.

Meet the Team Ronan B. Tobin Head of Student Engagement & Development and Head of Unit.

Aoife Gilligan Quinn Student Welfare Officer

Tel: 01-4028565 Email: comppas@rcsi.ie

Tel: 01- 4022504

Career Development

Communications & Language (CAL)

Fionnuala Rahilly Career Development Manager

Helen Kelly Lecturer in Communications & CAL Programme Co-ordinator

Tel: 01-4022565 Email: Careerhub2@rcsi.ie

Tel: 01-4022252 Email: helenkelly@rcsi.ie

Dr. Ebun Joseph Career Development Consultant

John Baird Teaching Fellow, CAL

Tel: 01-4025046 Email: Careerhub2@rcsi.ie

Tel: 01-4028505 Email: johnbaird@rcsi.ie

Academic Development

CoMPPAS Administration

Learning Access & Facilitation

Margie Morgan CoMPPAS Faculty Co-ordinator

Pro-active and integrated career readiness services enabling a 3-stage RCSI Student Career development Journey: Career Discovery, Career Choice, Career Ready

Email swo@rcsi.ie

Embedded and aligned academic programmes enhancing professional communication and language competency in academic and clinical learning environments.

Enhancing academic and digital skills through one to one coaching, workshops and peer-led tutoring.

Empowerment and direct facilitation of students with disabilities, ongoing medical conditions and specific learning difficulties.

CoMPPAS Administrative support, planning and project management

Tel: 01-4028565 Email: comppas@rcsi.ie

Jacinta Burke Academic Development Officer & Learning Access

Jessica Doherty CoMPPAS Co-ordinator

Tel: 01-4028663 Academic Development Email: academicdevelopment@rcsi.ie Learning Support learningsupport@rcsi.ie

Tel: 01-4022222 Email: comppas@rcsi.ie

Student Welfare

Confidential practical and emotional support. Promoting positive growth, resilience and student wellness. Assistance with RCSI regulatory processes.

Sinead O’Kelly Student Welfare Officer

Follow CoMPPAS on Twitter @RCSI_CoMPPAS Find us online at http://www.rcsi.ie/comppas Instagram Follow #RCSIWelfareBear on Instagram at welfarebearrcsi

Tel: 01-4028537 Email: swo@rcsi.ie

SEPTEMBER March 20192015

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Niteline listens ARTICLE WRITTEN BY NITELINE.

I

haven’t studied hard enough. I’m finding it hard to fit in. I miss home. I feel lonely. I’m not having fun. I wish I didn’t get drunk last night. I’m scared of coming out. Is this course for me?

Everyone experiences college differently, there is never a ‘right’ way.

A lot of the time people say that college has to be the best years of your life, and you feel like you have to make it so. No one tells you how hard it can be and no one tells you that it’s ok to have these feelings. It sometimes feels difficult when things get on top of you. You deny yourself the right to feel sad because you think you shouldn’t. If everyone around you is coping with the same things as you then why is it that it is more difficult for you? When things get too much it can sometimes be hard to open up and talk about it. You’ll say you don’t want to bother anyone. Opening up isn’t easy but by sharing how you feel with someone else they might also be more at ease with sharing with you. No one feels fantastic all the time, it’s important to know that. The simple act of asking someone if they are okay could be more beneficial than you know. Giving someone your listening ear to let them talk about their day can make a huge difference.

We don’t have to worry about things on our own. If you ever need to talk about your day you can call Niteline any night of term from 9pm to 2.30am. We provide a non-judgemental, non-directive completely anonymous and confidential listening ear. No problem is too big or too small. We listen.

The Wellness Wheel take a moment to reflect...

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//The Poet’s Page

« ANUJ RASTOGI

When I was 13, I checked out a book from my school library entitled “The Art and Craft of Poetry” by Michael J. Bugeja – an inspiring collection of poems from Walt Whitman to Robert Pinsky. After 3 months, the school filed a missing book slip and sought an exorbitant fee for the “lost” item. At the time, I was mendacious enough to play innocent, so I claimed I never checked it out in the first place. Of course, I never returned it (next level trolling). I still look at it – as a source of inspiration and technical guidance.

For those of us who have a penchant for it, reading and writing poetry is a profoundly transformative experience. I can be lost in words and poetic syntax for hours on end, transported to a place where time passes without notice (Note: I do not suffer from absence seizures). But one need not go through years of careful lucubration by candlelight to be a good poet. Anyone can write poetry, and more importantly, anyone can love reading it.

In this column, I intend to be your guide. Get reading, get writing, and submit. I believe reading and writing poetry ranks among the highest of pleasures humans can sense – akin to listening to a spine-tingling piece of music, gazing up at a night sky ablaze with starlight, smelling a ripe guava, or even eating chocolate. Come with me on this mental jaunt, as we dive neck deep into a world of words with wit and wonder. Enjoy.

“Deconstruction” No, all charms do not fly, thank you.

There are no awful rainbows.

So what puzzles shouldn’t be dismantled for fear?

The choices I make about love are as free, As the first autumn leaf that falls from its wistful tree.

And with what precedent should we set the charms of consciousness?

This rainbow through a microscope deserves reverence still.

Much better, it seems to me, To thank yourself for the sojourn in sensibility, Than to force your eyes on the splendour of fables.

-Anuj Rastogi

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Ana-tho-me (anatomy) Patiently, my teacher lies there, waiting to impart a body of knowledge which took a life to learn.

He does not notice or share my apprehension; yet, ours are decisions taken to better others.

Breathlessly; he presents the mysteries of our ancestors; no words could reveal the depth of wisdom contained within.

For his great legacy bestows to those who dare to learn; the bones of human enlightenment. –John Taaffe

My First Patient, My Teacher You are dead, And your name I do not know.

The avenues you walked down in life, I do not know, but I have touched the tired muscle fibres that carried you there.

The dreams you had for your life, I do not know, but I have chased the nerves to your brain that keep them secure.

The love you had in your heart, I do not know, but I have pictured the coursing blood that your heart pumped to your body.

The hands you warmly held in yours, I do not know, but I have flexed the strong fingers that went through 103 winters.

The burdens you carried on your shoulders, I do not know, but I have lacerated through the tension that you held there.

The beauty and ugliness you witnessed in your life, I do not know, but I have touched the shell of your eyes that played a million scenes.

The children you brought into this life, I do not know, but I have cradled the womb that provided warmth and life.

The moments you suspired in despair or relief, I do not know, but I have grasped the lungs that contained your breath.

The many times your heart has been broken, I do not know, but I have gazed into the depths of the glands that housed your tears.

You are dead, And your name I still do not know, but I received your permission to uncover the miracle of the human body, through you, and for that I am forever grateful.

Sincerely, Shazia Dinath

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The Many Phases of RCSI September starts, everyone departs On an adventure as of yet unforeseen, Make new friends fast; and pray that they last, Or so says our beloved Dean.

Studies are a pain; awake I must remain, That’s what coffee was invented for, Prof Kearney had me in stitches; his rapping is hilarious, Could one ask for any more?

Winter is cold, so I’ve been told, And studies are getting harder, Anatomy is fun, but not for everyone, And card signing is a disaster.

Summer break’s a relief, see what we’ve achieved With research summer school in full swing, Dr O’Neill is unbelievable, her passion inimitable, As she makes ICHAMS the in-thing!

Friends, companions, rivals, and peers I’ve saved you for last, as you are most dear, In my heart you’ll forever be, Memories we’ve made, I’ll cherish for eternity.

Spring, summer, autumn, winter, It seems the time to depart is near, But wherever we may go, I hope the future may show, For all that are willing to see, That for 2.5 years, RCSI was synonymous with me.

Farewell beloved alma mater, We will hold you in our hearts forever, When we grow old, so I’ve been told, Who knows what the future may hold?

I’ll remember the motto that showed us the way, Consilio Manuque, Consilio Manuque, Consilio Manuque.

–Kevin Chan

It’s now been a year, and we’re all still here, JC3 is all about the head and neck, 26 York St is done, and so begins the fun, Till the staff keeps us all in check (although it’s still great craic) Spring arrives, everything thrives, Except the IC1 students who complain Anatomy replaced with pathology, HBPS with microbiology, It’s enough to drive us all insane!

Prof Hill’s a thrill, he’s got the skill, His lectures leave me in wonder, Surgery is his specialty, his knowledge may reach infinity, But Carbimazole’s all that I can remember.

I’d offer an apology, to Prof Leader and her pathology, If I couldn’t remember her 6I’s Infection inflammation, what’s the other four I didn’t mention, It’s okay, I’m not winning the Sheppard’s Prize.

Dr. Fitzpatrick is unsurpassed; her lectures are a blast, I’ll remember her advice for micro; When clostridium’s your enemy, and you need a treatment therapy, Metronidazole is the way to go.

Prof. McConkey lectured on malaria, endemic in South East Asia, Then got infected by not taking mefloquine, But after many a session, I have but one question, Is MacConkey agar really named after him?

March 2019

Illustrations by Merna Bawyan

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//Corpus Collosum: a love story

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« MEGAN MURNANE

DIVERCSITY.COM

Lifestyle

//Anatomy Interfaith Ceremony Reflection

« ANUSHKA JAYAKRISHNAN

Recently, I attended my very first Anatomy Interfaith Ceremony at RCSI and it was a truly emotional and humbling experience. The following is an essay I had written to the families of the selfless donors, thanking them for their sacrifice and sharing with them my experiences in the anatomy lab. Although I didn’t end up speaking at the event, writing this essay made me dwell on my first experiences in the lab, and reflect on the deep impact of being able to learn through cadavers as early on as my first month in medical school.

Good evening, My name is Anushka and I am a first year medical student. When thinking about how to express my strong feelings of gratitude towards our self-sacrificing donors, as well as all of you, in words, this quote by Henri Nouwen came to my mind.

“Our humanity comes to its fullest bloom in giving. We become beautiful people when we give whatever we can give: a smile, a handshake, a kiss, an embrace, a word of love, a present, a part of our life...all of our life.”

Your loved ones have given to us, the greatest gift one could ever receive. It holds great value in my eyes and this selfless donation will forever be in my memory as I strive to be the best doctor I can be. I remember how the night before my very first anatomy practical, I was in a state of multiple emotions - excitement, fear, and anxiousness.

However, entering the lab and reading through the list of ages and conditions of each donor, translated to me how they weren’t merely bodies; but real people who have lived and will continue to live as they allow us to learn more about anatomy than any textbook could ever have taught us.

As all first year medical students are, I too was very excited. Yet during my first two hours with her, I felt enveloped in a state of calm and respect. I surely was eager to begin learning but with added understanding of how grateful I was for her, and her family’s kind donation.

The greatest accomplishment is one of selfless-giving, something that gives meaning and purpose to our lives like nothing else. Your loved ones gave of themselves to the very end, gave their very bodies, and will continue to impact others beyond their last heartbeat.

I have grown a bond with my donor, looking at her hands, that have held those of her loved-ones, her feet and leg muscles, supporting her throughout her life, the intricacies of her heart, that once held her love and compassion, her brain, which used to carry her beautiful memories and emotions. Leave here today knowing that your loved-ones are beautiful both on the inside and out. I am awed everyday studying the intricacies of their bodies, and I know the parts of their personality that I am unable to see, that you all have experienced were beautiful as well. Leave here also knowing that we are truly and immensely grateful for your sacrifice as well. I know it was not easy for you to give up your loved ones to such scrutiny; to allow things so very private to go public. We treated them with utmost respect and will strive to use what they taught us to be the best doctors we can. Your open-heartedness and compassion have allowed us to study the complex nature of the human body in a way that has taught me not only about physical anatomy, but more so about the value of kindness, a giving heart and gratitude.

Finally, my experience with your loved ones taught me that life is fragile, some things are not made to endure.

However, the learning and knowledge my peers and I will gain, through this humbling gift, will endure and we will strive to treasure this sacrifice lifelong. Thank you.

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//RCSI Book Club

« MANVIR TANUK (RCSI BOOK CLUB PRESIDENT)

“What an astonishing thing a book is. It’s a flat object made from a tree with flexible parts on which are imprinted lots of funny dark squiggles. But one glance at it and you’re inside the mind of another person, maybe somebody dead for thousands of years. Across the millennia, an author is speaking clearly and silently inside your head, directly to you. Writing is perhaps the greatest of human inventions, binding together people who never knew each other, citizens of distant epochs. Books break the shackles of time. A book is proof that humans are capable of working magic.”

-Carl Sagan The RCSI Book Club has started up again this year and we’re so excited to read something other than lecture slides with you! Literature, like music, is the great unifier. We can all read the same novel and be instantly transported to the same world. Yet, viewed through our own lenses, each of our experiences can be wholly different. It is this ipseity which encourages us to learn from one another. The club’s diversity allows us to cultivate an inclusive environment in which students from different programs can share their unique perspectives, which only contributes to our understanding of literature and each other. Through books, we provide a platform to share your thoughts and opinions, practice public speaking, and encourage personal and social development. And for those who still aren’t 100% sold, there’s always great food at each meeting to nourish your stomachs while you nourish your mind!

The current book club pick is “Cutting for Stone” by Abraham Verghese. We will be meeting at the beginning of April to discuss this epic novel spanning five decades and three continents. Follow us on our Facebook page (RCSI Book Club), where you can also contact us if you have any questions. We look forward to reading with you!

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Clubs & Societies

//Reel Talk The Proposal While February may have come and gone, there’s never a wrong time to sit down to some romantic comedies while stuffing your face with popcorn and candy. But with a never ending list of options, which should you choose? My personal favorite rom-com (and honestly one of my favorite movies in general) is The Proposal with Ryan Reynolds and Sandra Bullock.

« ANDI

At the beginning of the movie, Margaret (Bullock), a Canadian book editor, manipulates Andrew (Reynolds), her assistant, into marrying her so she doesn’t get deported. After an interview with US immigration, Margaret is forced to travel with Andrew to his hometown in Alaska for his grandmothers birthday. Upon arrival in Alaska, we find out that Gammy is none other than the great Betty White! Hilarity ensues over the course of the weekend and were left with a happy ending.

« SHAREEF

Reasons you should watch the Proposal this March: 1. Ryan Reynolds. This is really the only reason you should need.

2. Betty White. She’s hilarious and I really want to be her when I grow up!

3. Kevin the adorably floofy Samoyed puppy.

4. Ryan Reynolds.

Tucker and Dale vs. Evil

Friends With Benefits It was Monday evening and I’d been up since 5 am on a general surgery placement. All I wanted was to watch a movie with my girlfriend over Skype. Neither of us are really into romcoms, but after she vetoed the first 10 I suggested due to the lack of cute guys, we settled on “Friends with Benefits”.

« DYLAN

This (somewhat) romcom follows the story of a small town boy named Dale (Tyler Labine) and his journey to overcome his inferiority complex to pursue the woman of his dreams (Katrina Bowden) with the help of his loveable sidekick (Alan Tudyk) despite the disapproval of her friends. This is a love story that defies stereotypes and shows the audience that a kind soul and caring nature can be much more powerful than looks and social status.

The film follows Dylan Harper ( Justin Timberlake), an art director from LA, and Jaime Rellis (Mila Kunis), a head hunter (not one of the exciting ones) for a men’s magazine in New York. From here on out, you know the drill. Boy meets girl, boy and girl attempt to keep feelings out of their relationship, (warning, major spoilers ahead), boy and girl fall in love, boy screws it up, boy wins back girl through grand romantic gesture. Add some mischievous shenanigans, a couple of flash mobs, some gorgeous shots of New York city and LA and that’s pretty much the entire movie.

I’ll be honest guys, my girlfriend quit halfway and watching the rest of it alone made me wish I could go through junior cycle again instead. I know, harsh, and I might have enjoyed it a bit more if I could stop picturing Meg from Family Guy in every scene, but honestly, that might’ve made the movie a bit better. “Friends with Benefits” is a good movie if you want to relax with someone special and zone out, but if you want an actual romantic comedy, with a bit more romance and comedy, pick something else!

The movie follows two well meaning “Hillbillies” as they set out to renovate a new dilapidated holiday cabin. Enter stage left a stereotypical group of college students who due to a series of unfortunate and somewhat absurd events, perceive our two protagonists as deranged killers and an epic and confusing battle ensues.

This movie is perfect for groups who cannot reach a consensus on what genre of film they want to watch. There is a bit of everything mashed into a 90 minute package.

In summary, imagine if the “Hills Have Eyes” had a baby with “The Notebook” and they were both working professionals, so they hired “Final Destination” as a live-in nanny, what you have imagined is “Tucker and Dale vs Evil”.

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// Food Diaries

« SIMRANPAL DHANJU

Welcome back everyone!

Today I figured it’s time we took a look at breakfast. Yes, no one has time to make it during the week but come Saturday/Sunday morning we’re all obviously sleeping in (and definitely not questioning our decisions the night before…) so there’s no excuse not to treat yourself !

For now we’ll tackle how to make a breakfast staple, pancakes! The beauty with this recipe is that you can make the “dry mix” ahead of time and keep it forever. When the time comes, you can simply add the wet ingredients and get cooking right away. It’s like having your own instant pancake mix but a million times better! Feel free to add whatever mix-ins you like, this batter works great with fruits, nuts, chocolate and anything else you can think of !

If you’re whipping up a lot of these at one time then one tip I have for you is to set your oven to warm and put in a tray. As each pancake is done add them to the tray and cover with a clean towel. That way you can make a dozen of these and each one will still be nice and warm for serving.

Pancakes Ingredients Dry Mix • 6 cups all-purpose flour • 2 tablespoons sugar • 1 tablespoon baking powder • 1.5 teaspoons baking soda • 2 teaspoons salt Wet mix (for 1 cup of dry mix) • 1 cup buttermilk • 1 egg • 2 tablespoons melted butter

Recipe 1.

2.

3.

4.

5.

6.

Mix all dry ingredients together and store until needed.

Whisk melted butter and eggs together before adding buttermilk.

Whisk together wet mix and dry mix until just combined; don’t overmix. Let stand for 5 minutes.

Preheat a pan over medium heat and add in a little butter or oil, swirl to coat the pan.

Using a measuring cup or a ladle, pour some batter in the pan and let it spread out.

You’ll notice that the top of batter will start to bubble as it cooks and these bubbles will eventually pop.

Once you see the middle of the batter start to bubble and pop your pancake is ready to flip.

7. Cook on the second side for an additional minute and repeat with the remaining batter.

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// Lemon Garlic Butter Shrimp

« SANAT RASHINKAR

Hi folks !

I have brought you a very easy recipe that I am sure will bring you joy and satisfy your yearning for seafood. I think it is the best option for a starter.

This recipe will be good to serve in just 15 minutes !

Remember friends that the right amount of garlic and lemon will balance the spiciness and sweetness and create fireworks in your mouth.

You can save time by using ready to cook shrimps which are available in Dunnes stores.

Serves: 2 People

Ingredients • 2 tsp of butter • 2 tsp of minced garlic (3-4 cloves) • 200 grams of shrimp (or prawns) • 2 tsp of lemon juice • 3 tsp water • Half tsp corn flour • Some salt and pepper

Recipe 1. Prepare your shrimp for cooking by deveining and peeling them. You could keep the tails intact if you want. I suggest buying ready to cook shrimp from Dunnes which will save your time.

2. Mince all the Garlic cloves properly.

3. Take a small bowl and add to it half tsp of corn flour and to it 1 tsp of water and mix it with a spoon to form a corn flour slurry. This will give our lemon garlic sauce a creamy and thick consistency. We will use this slurry later on in the steps.

4. Heat your large skillet over medium-high heat and wait till it becomes hot.

5. Add 2 tsp of butter to the pan and let it melt completely.

6. Add the minced garlic to the butter and cook it till the garlic becomes fragrant. DON’T let the garlic become brown!!

7. Fry the shrimps and add salt and pepper according to your taste. Make sure you cook the shrimp (ready to cook shrimp or uncooked shrimp) for 2 minutes on each side and stir occasionally. Do this till the shrimp become pinkish.

8. Add in the remaining half tsp of butter, lemon juice and water and cook by stirring until the butter melts till the uncooked shrimp are cooked completely (don’t overcook them).

9. If you have used ready to cook shrimp you can cook them till the prawns have become hot from inside.

10. Finally add the corn flour slurry and mix properly.

11. Stir the shrimp with its sauce till the sauce becomes thick or reduced!

12. You can add more water if you want the sauce to become more runny.

13. Take off the heat and taste it. You may add more salt and pepper or lemon juice if you want.

14. Give it a final stir and then serve it on a dish. You may garnish it with some finely chopped parsley.

15. You could have this with rice if you wish too!

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// Q’s Counter

Societies

« QASIM ALI BARI

Tangy Lemon Tart Ingredients

PASTRY • 250g plain flour • 70g icing sugar • 125g unsalted butter cubed • 2 egg yolks

(alternatively you could pick up a ready-made tart shell at your local supermarket - I won’t tell if you don’t) FILLING • 3 eggs • 135g caster sugar • zest and juice from 2 lemons • 150ml double cream

LEMON

TART

Instructions 1. To make the pastry, mix the flour and icing sugar in a bowl. Rub the butter into the flour with your fingers until crumbly. Mix in the egg yolks. If the pastry is still too dry, add 1-2 tbsp water until it comes together. Flatten out the pastry with your hands, wrap the dough in cling film, then chill for at least 30 mins. While the pastry is chilling, make the filling. Beat all the ingredients, except for the zest, together. Sieve the mixture, then stir in the zest.

2. Roll out the pastry on a lightly floured surface to about the thickness of a €1 coin, then lift into a 23cm tart tin. Press down gently on the bottom and sides, then trim off any excess pastry. Stab a few holes in the bottom with a fork and put back in the fridge for 30 mins.

3. Heat oven to 160C/140C fan/gas 3. Line the tart with foil and fill with rice or dried beans. Bake for 10 mins, then remove the tart tin from the oven, discard the foil, and bake for another 20 mins until biscuity. When the pastry is ready, remove it from the oven, pour in your lemon mixture and bake again for 30-35 mins until just set. Leave to cool, then remove the tart from the tin and serve at room temperature or chilled.

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Education

Anatomy WITH Clive Lee //

Clubs & Societies

« PROF. CLIVE LEE HEAD OF ANATOMY RCSI

MCBURNEY’S POINT Charles McBurney (1845–1913) was born in Massachusetts and studied at Harvard and at the College of Physicians and Surgeons of Columbia University in New York. After graduating MD in 1870, he spent two years training in Europe. In 1889, he wrote a paper in the New York Medical Journal in which he described pain in acute appendicitis: The seat of greatest pain, determined by the pressure of one finger, has been very exactly between an inch and a half and two inches from the anterior spinous process of the ilium on a straight line drawn from that process to the umbilicus.

We now describe this as McBurney’s Point, one third of the way from the ASIS to the umbilicus.

In an open appendicectomy, the incision is made at McBurney’s point, but like any procedure, it can have complications. Medical innovation has changed the way appendicitis is treated and a laparoscopic approach is now commonly used to remove the appendix.

Twenty years after having his appendix removed via an incision at Mc Burney’s point, a man presents to the clinic with a right sided, direct inguinal hernia. Which nerve injured at his operation might have predisposed him to this hernia?

A. B. C. D. E.

Femoral Genitofemoral Iliohypogastric Ilioinguinal Pudendal

BE IN WITH A CHANCE TO WIN OUR MONTHLY GIVEAWAY! Winner will be announced and contacted in the next month’s issue.

Illustrations courtesy of freepik

Enter by emailing A, B, C, D or E with the subject Anatomy Quiz! to divercsity@rcsi.ie

SEPTEMBER March 2019 2015

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Education

//Innovations in Imaging In keeping to the theme of innovation, RCSI Rad Soc would like to present some new innovations in the world of medical imaging.

New Advances in Breast Cancer Detection in Mammography

Mammography has proven to be effective in detecting breast cancer early during treatable stages, and thereby reducing death caused by breast cancer. However, it is often the case that images are suspicious but inconclusive. Thus, women are called back for additional mammograms or biopsies. Many of those called back find that their abnormal findings turn out to be actually benign. This “callback rate” has been estimated to be about 10% in the US, which is higher than ideal. There are associated costs and unnecessary anxiety with the high rate of callbacks.

A new technique called three-compartment breast imaging (3CB) may be the answer. This technique uses dual-energy mammography to measure the protein, lipid, and water composition of tissue and identify when a mass has a tumour’s unique water-lipid-protein ratio. A study from the University of Chicago, found that this technique, coupled with artificial intelligence algorithms, improved the ability to predict cancer. Moreover, this technique does not require extensive modifications of existing equipment. A drawback to this technique would be that the patient would receive 10% more radiation dose than a regular mammogram. However, it can be argued that the current state of affairs would have women take multiple mammograms when images are inconclusive. This technique is still experimental and not clinically practiced anywhere at the moment, but it does seem promising.

Machine Learning in Brain MRI Research

With the copious amounts of data being generated each day from neuroimaging, especially from concerted initiatives worldwide and independent labs, machine learning is becoming increasingly important to organize this data in a clinically meaningful way. Machine learning algorithms have most recently been used in structural brain MRI Alzheimer’s dementia (AD) research and schizophrenia research. For instance, whole-brain atrophy patterns have been shown to automatically identify patients with AD, track treatment responses, and even predict the progression of mild cognitive impairment to AD (Hampel et al., 2018). Functional MRI (fMRI) machine learning algorithms applied to schizophrenia is especially interesting. In a recent study published in the Nature subsidiary Schizophrenia, Kalmady and colleagues (2019) developed a machine learning algorithm called EMPaSchiz (pronounced “Emphasis”; which stands for “Ensemble Algorithm with Multiple Parcellations for Schizophrenia Prediction”). This enabled the authors to diagnose schizophrenia by identifying unique fMRI patterns of global brain network activation. The diagnoses matched clinical DSM criteria and outperformed previous algorithms. While clinical application of fMRI is not ready for primetime, the authors argue that the use of this algorithm in psychiatry may eventually help diagnose schizophrenia at the individual and population level.

References: Kalmady SV, Greiner R, Agrawal R, Shivakumar V, Narayanaswamy JC, Brown MRG, Greenshaw AJ, Dursun SM, Venkatasubramanian G. (2019). Towards artificial intelligence in mental health by improving schizophrenia prediction with multiple brain parcellation ensemble-learning. Nature Publishing Group: Schizophrenia. 5(1): Article 2 (in press). https://doi.org/10.1038/s41537-018-0070-8 Hampel H, & the Alzheimer Precision Medicine Initiative (APMI). (2018). Revolution of Alzheimer Precision Neurology: Passageway of Systems Biology and Neurophysiology.

Journal of Alzheimer’s disease. 64(1): 47–105. doi: 10.3233/JAD-179932 Drukker, K., Giger, M., Joe, B., Kerlikowske, K., Greenwood, H., & Drukteinis, J. et al.

(2018). Combined Benefit of Quantitative Three-Compartment Breast Image Analysis and Mammography Radiomics in the Classification of Breast Masses in a Clinical Data Set. Radiology, 180608. doi: 10.1148/radiol.2018180608

Pathological changes in schizophrenia suggested by the EMPaSchiz algorithm.

A. Increased activation in the right caudate and right superior temporal pole.

B. Increased activation in the lateral aspect of left superior temporal gyrus and horizontal ramus of the right lateral sulcus, lower activation in the left posterior cingulate gyrus.

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RCSI LIBRARY WWW.RCSI.IE/LIBRARY | 26 YORK STREET | BEAUMONT HOSPITAL NEW E-JOURNAL PLATFORM

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