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Sir Patrick Manson is often considered “the father of tropical medicine” (Centers for Disease Control and Prevention, 2012). Prior to Manson’s work, diseases such as malaria and yellow fever were mysteries to many epidemiologists. The transmission of these infectious diseases were not previously known and Manson’s work spread awareness of how to prevent potential infection.

This was largely accomplished through his “mosquito-malaria theory”. For centuries, malaria was believed to have been transmitted via polluted air or miasma. In 1877, Manson discovered that Wuchereria bancrofti, a parasitic roundworm, was transmitted via mosquito bite into the bloodstream. The theory consisted of three components: 1) malaria was caused by a protozoan parasite 2) the protozoan is transmitted by a mosquito and 3) water in which an infected mosquito has died in can become contaminated and transmit malaria to humans. Though the last component was later discredited, Mason’s hypothesis paved the way for later physicians and scientists to break ground in the field of malaria treatment and prevention.

Manson also left a lasting impact in the medical education community. In 1899, he founded the London School of Hygiene and Tropical Medicine. The school still exists today and is a leading institute in the fields of tropical epidemiology and public health. He also wrote the book Tropical Diseases in 1898, which has become a standard for public health courses.

Sir Patrick Manson has been invaluable to our understanding of not only tropical medicine, but the mechanism of viral transmission. Manson shed new light on the nature of pathogens and how daily nuisances can be deadly vectors. Thanks to his work, your next mosquito bite is simply a minor inconvenience rather a potentially fatal event.

Today in Medical History:The Birth of Sir Patrick MansonOctober 3rd, 1844

BioDOODLES

References:Biotech:• Panache. (2015, September 7). New device can revive dead hearts for transplant. The

Economic Times. Retrieved from http://economictimes.indiatimes.com/magazines/panache/new-device-can-revive-dead-hearts-for-transplant/articleshow/48857145.cms

• TransMedics, Inc. (2015). Organ Care System. Retrieved from http://www.transmedics.com/wt/page/organ_care

• U.S. Department of Health & Human Services, Health Resources and Services Administration. (2015). The Need Is Real: Data. Retrieved from http://organdonor.gov/about/data.html

Ethics:• http://guides.library.jhu.edu/c.php?g=202502&p=1335759

Nutrition:• Feast and Famine | The Economist. (2014, November 29). Retrieved September 13,

2015, from http://www.economist.com/news/international/21635046-world-has-terrible-record-improving-peoples-diets-may-be-changing-feast-and

• T, A., M, H., & Kl, S. (2013). Global burden of maternal and child undernutrition and micronutrient deficiencies. Annals of Nutrition and Metabolism, 61(1), 8-17. doi:10.1159/000345165

• Muller, O., & Krawinkel, M. (2005). Malnutrition and Health in Developing Countries. Canadian Medical Association Journal, 173(3), 279-86. Retrieved September 13, 2015, from PubMed.

Public Health: • American Heart Association. (2014). Recommendations for physical activity in adults.• Martin, A., Pantner, J., Suhrcke, M., & Ogilvie, D. (2015). Impact of changes in mode

of travel to work on changes in body mass index. Journal of Epidemiology and Community Health, 69(8), 753-761. doi:10.1136/jech-2014-205211

Today in Medical History • Sir Patrick Manson. (2015). In Encyclopædia Britannica. Retrieved from http://www.

britannica.com/biography/Patrick-Manson• Ross and the Discovery that Mosquitoes Transmit Malaria Parasites. (n.d.). Retrieved

September 13, 2015.

President: Maheen NadeemV.P. of Events: Adit GadhV.P. of Copy: Ishpaul BhamberTreasurer: Eric BaiSecretary: Katharine HenryPublicity Officer: Ashraf Patel & Carli KovelLayout Editors: Tyler Angert, Somnath Das, Lindsay Hexter, & Mary Carter MullenCopy Editors: Alec Shannon, Mansi Maini, Yash Patel, Taylor Eisenstein, & Paul YoungWriting Staff: Zachary Charif, Sharon Hsieh, Allison Derovanesian, Vikrant Nallaparaju, Swetha Rajagopalan, Sunidhi Ramesh, Ayushi Sharma, Laura Sun, & Rohan Yarlagadda

Manson, detail of an oil painting by J. Young Hunter, 1912; in the Royal Society of Tropical Medicine and Hygiene, London.

Authored By: Vikrant NallaparajuEdited By: Yash Patel

Cover Image: Jake Rosmarin Photography

Sketched by: Lindsay Hexter

Advisory Board SpotlightDr. Michael Crutcher

The key to weight loss may actually lie in your keys – your car keys that is.

Recent research has found that switching from driving to walking, biking, or public transportation is associated with a significant reduction in weight over time. A longer commute has an even stronger correlation between weight loss and mode of transportation. These new findings pose environmental, economic, and health benefits, demonstrating a strong case for interventions that support the switch over to public transportation methods.

What is a seemingly intuitive correlation has had little longitudinal data and evidence until very recently. According to the Centre for Diet and Activity Research (CEDAR), the switch from driving to walking, biking, and using public transportation reduces BMI by 0.32 (roughly 1 kg) for an average person over a period of two years (Journal of Epidemiology and Community Health, 2015).

Primary researcher Dr. Adam Martin of UEA’s Norwich Medical School stresses, “It is well-established that being overweight or obese is linked to a wide range of diseases, most notably type 2 diabetes, cancer, heart disease and stroke” (Martin et al, 2015).

The implications of this research could produce an effect all over the country if it were to be considered a national recommendation. If a large proportion of commuters were to make the switch, this would drive down the national average population BMI.

Interventions of this type are believed to be more impactful than the current national recommendation imposed by the American Heart Association. Currently, the national recommendation is 30 minutes of moderate-intensity aerobic exercise to prevent obesity, heart disease, and other chronic conditions (American Heart Association, 2015). Incorporating walking and biking into the trip to/from work has a relatively low cost versus benefit when compared to time spent being active as per the current national guidelines.

Authored by: Ayushi Sharma Edited by: Taylor Eisenstein

The (Car) Key to Weight Loss

Dr. Michael Crutcher is one of the many distinguished faculty members part of Emory’s Neuroscience and Behavioral Biology department. Having received his PhD in Physiology from Johns Hopkins University, he joined the Department of Neurology and of the Neuroscience Ph.D. program at Emory in 1991. His research is primarily focused on the neural mechanisms of visually guided reaching movements in monkeys.

“The goal of my research was to gain a better understanding of how the brain actually mediates visually guided reaching movements. I trained rhesus monkeys to do very complex visually guided reaching tasks and then recorded the activity of single neurons in their brain while they performed the tasks. By studying the activity of hundreds of neurons while the monkeys performed these tasks we were able to clarify the different roles that different parts of the motor system play in controlling those movements.” Dr. Crutcher said.

Dr. Crutcher has taught many NBB courses over the years such as: freshman seminar courses (NBB 190) on Brain Enhancement, Curiosities of Neurology and Neuroscience, and Neuroethics as well as Perspectives in Neuroscience and Behavioral Biology (NBB 401 SWR), Biology of Movement Control (NBB 370), Neuroscience Research Methods (NBB 221), Functional Neuroanatomy (NBB 470), and Topics in Neuroscience and Behavioral Biology (NBB 270).

“He’s able to explain very confusing and abstract concepts in a way that students can understand. That’s what the best professors do, right?” College sophomore and NBB 270 student Neeraj Chawla says.

“Undoubtedly, the most rewarding aspect of being a college professor is when I get feedback from students that they really learned a lot from my course or really appreciated the help and advice that I gave them.” Dr. Crutcher said.

Biotech Figure 1. The Organ Care System device utilizes an enclosed sterile chamber to contain the heart being pumped with nutrients and blood. Credit: IndiaOnRent

Biotech Figure 2. The heart sits within the heart perfusion module while being pumped with blood and monitored by the vitals control unit. Credit: TransMedic

Nutrition Figure 3. Graphic demonstrating inverse relationship between GDP and poverty over time and the lack of change in undernourishment over the last few decades.

Authored By: Vikrant NallaparajuEdited By: Yash Patel

The Hippocratic Oath—one of the oldest and revered binding documents in history that represents the epitome of medical respect, honesty, and legitimacy.

Originally written in Ionic Greek in the late Fifth Century BCE, the recitation document has since remained a common practice in medical schools around the world. It has become not only a rite of passage for the vast majority of medical students, but has also remained a symbol of the fragility of ethics in the medical field itself.

Among the many promises outlined in the oath are a couple that stand out:

• “I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

• “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being.”

• “Above all, I must not play God.”

The surprisingly modern feel to the words of the oath imply just how little change there has been in medical ethics over the dozens of centuries that have passed since the oath was written.

This begs a serious question. Are the ethical questions we face in medicine today “new”? How did doctors a century ago deal with redundant euthanasia? Older forms of abortion? Or choosing to pull patients out of vegetative states and long-standing comas?

Most importantly, what can we learn from history’s doctors? How many answers to today’s debates lie in the past?

Authored by: Sunidhi Ramesh Edited by: Paul Young

Not a Hypocrisy- But a Hippocrates

The World Health Organization (WHO), Global Nutrition Report, and countless images from third world countries have traditionally illustrated malnutrition as the a lack of sufficient caloric intake. Typically, traditional ideas of malnutrition include stunted growth, starvation, and terminal weakness. However, these ideas are archaic misrepresentations of reality. As The Economist would note, the annual global gross domestic product (GDP) rise of 3.6% has increased the ability of most world inhabitants to obtain basic caloric intake. The resulting fall in starvation has been relatively slow, but steady for several years. Simultaneously, obesity has rapidly increased, demonstrating a fascinating 10 million persons increase in minors. In fact, the highest worldwide obesity rates originate from second and third world countries that also report high malnutrition rates. This irony is what defines a 21st century definition of malnutrition.

The new frontier of the fight against malnutrition is undernourishment. Undernourishment is based on nutrient metrics, and it tends to be a silent problem, often manifesting after a long time. As a result, for the last few decades, there has been essentially no change in the numbers for undernourishment in the world. The most frequent cases are those who lack of necessary dietary amounts of zinc, Vitamin A, and iron. Half of the world, including first world countries, struggle to obtain healthy amounts of micronutrients, even in the face of rising obesity. What is more troubling is that simply avoiding a single Vitamin for a sustained period of time can have permanent damaging effects on the human body. According to Muller and Krawinkel, the lack of proper micronutrients is the global risk factor of illness and death, indirectly causing hundreds of millions of pregnant women and their respective children irreparable damage. As a result of realizing undernourishment as the modern disease, it is ranked as a priority on the new Millennium Development Goals for the world community.

Authored by: Zach Charif Edited by: Yash Patel

(Mal)Nutritional Facts

Each day about 22 patients die waiting for organ donations, and over 94,000 Americans are waiting to receive heart transplants at any given moment (TransMedics, 2015 and HRSA, 2015). These numbers are staggering, and perhaps even more surprising are the current procedures used to transplant the heart itself. The typical method of transferring the heart from the donor to the patient involves cooling the heart with a solution until it can be implanted. However with the advent of cutting edge-technology, this long used cooling process may become a method of the past. A medical technologies company called TransMedics, has designed and produced a device called the Organ Care System (OCS) which aims to stabilize the heart once it has been taken out of the donor’s body by “pumping warm, oxygenated, nutrient-rich blood” throughout the heart as it is contained in a sterile chamber (TransMedics, 2015). The OCS is also designed to work for lungs, kidneys, and livers.

In essence, this device prolongs the healthy tissue of the heart and increases the chances that it will be viable for a patient in need of a transplant. Compared to the standard cold solution method, this new technology may decrease tissue damage, and would flush the heart with oxygenated blood and nutrients, hence increasing successful heart transplant rates. The homeostatic properties of the OCS allow doctors to run tests on the heart tissue, while it is still beating via the unit. This ensures probable cause for a match for the potential heart recipient while at the same time minimizing damage to the organ itself. Like any new device in the field, OCS comes with some caveats. One system is estimated to cost about $250,000 (“Economic Times,” 2015).

The clinical and social implications of the OCS are vast; this device has the potential to revolutionize the way heart transplants and organ donations are executed. The use of the system could ultimately improve patient outcome post-transplantation, allow for an increased number of viable heart donations, and ensure that otherwise healthy organs are harvested and maintained at a working homeostatic level.

Authored by: Allison Derovanesian Edited by: Mansi Maini

At the Heart of Technology

Nutrition Ethics

Biotech Public Health