Written by: Muskaan Kaur Dhaliwal ------------------------------------------------------- In today's day and age the role of telemedicine plays such a huge role in healthcare. But what exactly is telemedicine?, why does it hold such significance? It is quite important to have ourselves explore its limitations and the numerous benefits it offers to patients and providers alike. Telemedicine is a fundamental that facilitates the provision of medical care on a global scale through its remote telecommunications. A significant advantage of this approach is its ability to monitor patients' health data, like your levels of glucose, without requiring them to visit a healthcare facility but instead do it at their home. This remote monitoring is conducted via personal devices, allowing patients to communicate with their healthcare providers through video calls, for instance. The advent of telemedicine proved invaluable, mosly in contemporary society where technological advancements have introduced numerous tools that are beneficial. This very model of healthcare delivery was helped with developing to assist individuals residing in rural areas, thereby enhancing access to medical services with greater ease. Consequently, many patients can now conduct routine check-ups from the comfort of their homes, a process that previously necessitated in-person visits. However, there are also many limitations inherent in telemedicine. Certain medical examinations that require physical presence cannot be performed remotely, as accurate diagnoses often depend on in-person assessments. Additionally, privacy concerns arise from the technological frameworks employed in telemedicine, necessitating robust measures to safeguard sensitive health information from potential breaches. Acknowledge the very importance of telemedicine is essential, as it highlights the remarkable progress we have achieved in recent years. The capability to perform virtual consultations has significantly improved access to healthcare services for countless individuals.

Written By: Roan Aly ------------------------------------------------------------------------------------- We all have loved ones; it’s the essence of human nature – socializing, connecting, forming bonds. But what if, on a completely ordinary day, amidst the confusion and stress of your daily life, a doppelganger replaces your loved one and aims to spy on you. And what if, then, as you report this newfound information to everybody you know, with quite not enough evidence to prove it, you are labelled insane? What if, despite your persistence in the veracity of your sanity, the brume of madness has truly infected the recesses of your mind? This brume, the Delusion of Doubles, is the most prevalent delusional misidentification syndrome, and has caused violence, injuries, and death. Capgras Syndrome, going by a number of differing names such as the Delusion of Doubles, Imposter Syndrome, and Capgras Delusion, encompasses the main notion of the psychiatric disease, in which an individual persistently believes that a loved one, either a person or a group of people, has been replaced by an imposter. Those with this disease typically possess the delusional conviction that the “imposter” who has suddenly entered their life harbors ill, persecutory intent towards them or another loved one. This syndrome is sometimes mistaken for the Fregoli delusion, in which an individual holds the delusional belief that different people are all a single person who changes their appearance and is in disguise. Capgras syndrome is the most prevalent disease in the vast array of delusional misidentification syndromes (DMS).  The most common loved one that the afflicted patient would accuse is their own spouse, in which they delusionally believe that an imposter of the same sex has replaced their spouse, and ergo is attempting to spy on or harm them or somebody close to them. The accused imposter can range from a parent or spouse to even one’s own child or siblings. In rare cases, however, one may even accuse themself of being the imposter, known as “reverse Capgras syndrome”. A concomitant symptom that many afflicted with Capgras delusion experience is the increased threat of violent behaviours due to paranoia, often a result of the persecutory intent which it is believed that the accused harbors. The risk of violence and homicide is much higher in male patients compared to female patients with the Capgras delusion, despite the condition being more common in the latter. Moreover, patients often demonstrated social withdrawal and self-isolation prior to violent acts. Oftentimes, the victims were found to be family members or coresidents of the patient, which is consistent with the evidence that those most familiar to patients are more likely to be misidentified.  Eight cases of Capgras delusion were examined in a 1989 case series, and the following violent behaviors were found: shot and killed father, pointed knife at mother, held knife to mother’s throat, punched parents, threatened to stab husband with scissors, non-specifically threatened physical harm to family, injured mother with axe, and threatened to stab son with knife and burn him. Seven of the 8 patients were coresidents with the misidentified persons, and 5 of the 8 patients were averse to treatment attempts. The study suggested that the chronicity and content of the delusion seemed to increase the risk of violent behaviours. The case posited that the patient would try to keep their agitation hidden, careful lest any trace should be left exposed. Despite the appearance of stability, patients were likely to react violently to minute changes. The provenance of this condition is rather well known, despite very little being known about the disease itself. A French psychiatrist, Joseph Capgras, is the first known man to have described this delusion. He and Jean Reboul-Lachauxx coauthored a paper on a paranoid 53-year-old woman who, according to the paper, “transformed everyone in her entourage, even those closest to her, such as her husband and daughter, into various and numerous doubles.” She held the delusion of being famous, wealthy, and of royal lineage. Despite the fact that 3 of her 4 children had passed away, she was firm on her belief that they were abducted, and that her only surviving child was replaced by an imposter who donned a similar appearance.  Capgras delusion, while de trop, is not extremely pervasive, as studies have found that the morbidity rates of this delusion affect 0.12% of the population in general, and 1.3% as a comorbidity for primary diagnoses of other diseases, such as schizophrenia. Other primary diagnoses that can entail Capgras syndrome include schizoaffective disorder, Alzheimer disease (AD), Lewy body dementia, epilepsy, cerebrovascular accident (CVA), pituitary tumours, and advanced Parkinson disease (PD). It was also found that women experience Capgras delusion more often than men, with three women having the syndrome for every two men. There are several theories on the causes of Capgras syndrome. It may occur after structural changes in the brain, such as atrophy, lesions, dysfunction, or injury. Capgras syndrome has been linked to brain damage in the bifrontal, right limbic, and temporal regions of the mind. Very little else is known about the disease – medical professionals struggle identify how it develops, but they believe that both the dysfunction of facial processing neural networks as well as hypothesis-appraisal networks result in the skewed facial recognition of the misidentified loved one. This belief, however, makes way for a concerning possibility: there may be genetic factors that influence both the occurrence and content of these delusions. This cause is not set in stone, however, as another scientific review of 255 published cases of Capgras syndrome shows that researchers find it challenging to pinpoint the exact cause, which varies among cases. Furthermore, no cure has been discovered for this delusion. A 2014 study showed that 73% of Capgras syndrome cases had comorbid diagnosis of schizophrenia, 26.4% had dementia and 16.7% had mood disorders. It has been found that treating this condition’s comorbidities, if any are present or identified, can ease its symptoms.  Of the numerous cases of Capgras syndrome, an example includes a 24-year-old male who had received many mental health diagnoses in the past, but no history of any brain trauma. The patient was admitted into a hospital after confessing to self-harm attempts and criminal activity. He stated: “I feel everything is unreal. I feel suicidal and guilt”, and plotted to either walk onto an active road or shoot himself in the head due to disturbing thoughts and memories. The main piece of evidence that allowed the medical professionals to diagnose him with Capgras syndrome was due to his belief that his mother was not real. He claimed: “Last year my sister told me it was not 2016, but it was 2022. She told me that I have hurt my mother with a padlock—that you could no longer identify her face. I don’t remember having done this. I have lived with her since that time, so I don’t think it’s really [my mother].” He firmly held onto the belief that his mother was replaced by government officials who were sent to spy on him and elicit confessions for his inappropriate behaviour while in the military. Younger patients with the Capgras delusion have been found more likely to have purely psychiatric comorbidities—such as schizophrenia, substance-induced psychosis, or schizoaffective disorder—as opposed to underlying medical conditions. In the case of the 24-year-old male, the Capgras delusion was thought to be due to a disorder in the schizophrenia spectrum, specifically schizophreniform disorder. Capgras syndrome, a delusional misidentification syndrome initially discovered by French psychiatrist Joseph Capgras, describes the delusion in which an afflicted patient believes that a loved one is an imposter who harbors ill intent towards them. The psychological condition is most common in patients with previous mental health diagnoses, and is more likely to occur in women. The exact cause is unknown however, due to the belief that the misidentified person aims to harm them, the patient is likely to display violent behaviours towards them, despite appearing mentally stable. There is no cure for the condition, however therapy and targeting comorbidities may assist in lessening the symptoms. The cause of the illness is not known, and while many theories have been made, the development of the delusion seems to differ between patients. The delusion of doubles has the potential to turn your loved ones into a lie, or turn you into a lie in the reality of a loved one. Mysterious and seemingly incurable, the delusion only spreads. References : Gotter, A. (2017, May). What Is Capgras Syndrome? Healthline; Healthline Media. https://www.healthline.com/health/capgras-syndrome Lovering, C. (2016, May 17). What Is Capgras Syndrome? Psych Central; Psych Central. https://psychcentral.com/conditions/capgras-syndrome#:~:text=Capgras%20syndrome%20isn't%20a,as%20schizophrenia%20or%20schizoaffective%20disorder . Chhaya, T. (2017). She’s Not My Mother: A 24-Year-Old Man With Capgras Delusion. Federal Practitioner : For the Health Care Professionals of the VA, DoD, and PHS, 34(12), 38–41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370465/ Shah, K. P., Jain, S. B., & Wadhwa, R. (2023, May 29). Capgras Syndrome. Nih.gov ; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK570557/ Capgras Syndrome. (2023). Psychology Today. https://www.psychologytoday.com/us/basics/capgras-syndrome#:~:text=Capgras%20syndrome%20is%20rare.,syndrome%20for%20every%20two%20men . Very Well Mind. (2023). What Is Capgras Syndrome?  https://www.verywellmind.com/capgras-syndrome-7100791#:~:text=Unfortunately%2C%20there's%20currently%20no%20cure,ease%20symptoms%20of%20Capgras%20syndrome . Ellis, H. D., & Lewis, M. B. (2001). Capgras delusion: a window on face recognition. Trends in Cognitive Sciences, 5(4), 149–156. https://doi.org/10.1016/s1364-6613(00)01620-x

Written by: Aya Ahmed Abdel Tawwab ------------------------------------------------ Doesn’t it seem peculiar saying about loss of perception of the surrounding half of the world? If it does, how can you then imagine the unusual reality of those who develop Hemispatial neglect? This unusual reality comes from the inability of patients with neglect syndrome to respond to events occurring in exactly one half of their world, resulting in their weird behaviors that reflect their deficit in processing and interaction with data from this half as if it is “neglected” by them. Nature and Symptoms of the Syndrome: Hemispatial neglect is a neurological condition follows a damage in definite parts of the brain hemispheres. Patients with neglect shows symptoms of lateralized inattention and failing to report information about scenes from one side of their center of gaze. The manifestations of neglect syndrome can be so bizarre that they are hard to believe if not directly observed. Milder cases are less observable. However, symptoms can develop in sever cases to reach complete ignorance -not just inattention- for one side, and acting as if half the universe no longer exists. This may be more understandable if you know that patients with neglect may shave only one side of their face, brush the teeth on only one side of their mouse, eat from only one side of the plate and initiate movement to just one side. If patients are asked to point to the midline of their body, they point too far to only one side. Knowing that the left and right brain hemispheres recognize inputs from contralateral(opposite)parts of the environment-the right hemisphere recognize inputs from left side and vice versa-; it is reasonable that the neglected side to the neglect patients is the side contralateral to the side of the damaged brain region. Although damage can happen to either side of the brain, it is usually the left side of world that disappears in the neglect syndrome! The reason of that is not fully understood yet, but one hypothesis explaining that is that brain regions related to neglect syndrome are mostly lie in the right brain hemisphere, so that damage of any of them causes the left side to be unrecognized. In addition to neglecting objects on their left side, some patients show symptoms of(anosognosia), a condition by which they deny their neurological deficit. For example, they may deny the fact that they don’t use their left hand or that they only eat from the right side of the plate! Causes and anatomy: Neglect syndrome results from lesion of definite brain regions accompanied to a disorder in the middle cerebral artery territory due to a stroke or other causes as neurodegenerative disease. Often the resulting lesion centers on the inferior parietal cortex but damage to the brain involves a number of brain regions involved in attention, perception and memory. Research has identified nine brain regions which are commonly associated with neglect syndrome including: right posterior middle temporal gyrus, right inferior parietal lobule, etc. You needn’t focus on these such disturbing concepts, instead, you should understand that the position of these nine brain regions relative to the right hemisphere reinforces the fact that neglect is relatively common following right hemispheric damage. The severity of neglect syndrome increases as more as the brain damage spreads to affect brain regions of major processing functions. In case of neglect syndrome, the brain acts as a computer system that receives inputs without processing them. For instance, patients can see everything but they aren’t perceiving everything; because brain regions involved in perception of visual information are damaged. This may be better understood if we compared ‘neglect syndrome’ to ‘Hemianopia’. Both disorders lead patients to miss information on the left. Patients with hemianopia miss information on the left; because they cannot see it; due to a cut in the visual field so that visual information doesn’t transfer from the retina to the occipital lope. While patients with neglect miss information due to an attentional deficit; they see, but they don’t perceive the visual information. Appearance of neglect syndrome can be an indicator on the presence of a range of comorbid conditions. That is why neglect is important in providing early detection for such diseases. In other words, if you don’t care a lot about the disappearance of your left side, you certainly would care about the more dangerous diseases associated with this disappearance caused by neglect. Assessments: Diagnosis of neglect is relatively simple. Two main tests are carried in order to asses not only the presence but the severity of the syndrome. The first test is the behavioral inattention test (BIT), contains six pen-and-paper and nine behavioral assessments aim at discovering the view of the world as seen by a neglect patient. The less clearer the seen view is the severer the neglect is. One of the pen-and-paper assessments is the ‘line cancellation test’. In such assessment, patients are given a paper with lines scattered across it and a pen and asked to mark each of the lines. Patients with neglect ignore all lines on the left side of the paper. The second test is Catherin Bergo Scale (CBS), that provides more detailed image of how neglect affects the daily living. It consists of ten items related to everyday functioning including grooming, dressing, navigation, moving and eating. Treatments: There are a number of potential treatments for neglect ranging from compensatory and training strategies to those targeting the underlying deficit. The compensatory strategies are less effective and are said to treat the piece not the whole. It depends on finding ways to bring the patients attention to the left. Prism adaption is one of the most common applied compensatory strategies that aim at initiating leftwards movement and trying to increase cognition for the left side. In this strategy, patients are asked to point to visual targets while wearing special lenses that shift their vision to the right. However, recent treatments target the affected brain regions. For example, some studies are carried to test whether dopaminergic drugs can treat neglect by reducing inattention. Although many treatments for neglect hold promise, at present they are experimental and not widely available. For decreasing the possibility of developing neglect, it is essential to immediately monitor and control the presence of any other neurological conditions that would simulate the appearance of neglect. To sum up: Neglect syndrome is a serious condition that requires increased awareness among health practitioners and needs more understand for causes and symptoms. Not only the prevalence and debilitating nature of neglect are what create the need for awareness, but also the fact that neglect syndrome is associated with a range of comorbid conditions including some neurodegenerative disease, strokes and hemiplegia. This enhances the role of hemispatial neglect in alerting clinical staff to likely presence of other serious diseases; for which early detection is a good way to avoid long term risks for such diseases. Neglect syndrome arises due different causes, all centric about partial or complete damage to some of main brain regions involved in processing sensory information-information received from sensory organs as mouth, nose and eyes-. This damage results in improper functioning brain regions that provide incomplete image for the surrounding world, so that patients affected by neglect will behave strangely because there is a missed part of the world, they are neither feeling nor interacting with.

Written By: Roan Aly -------------------------------------------------------------------------------- When you look in the mirror, what do you see? A living, breathing body? Or a rotting, bloodless corpse? Individuals with Cotard’s Syndrome see the latter – a horrifying delusion of death. Walking Corpse syndrome, also known as Cotard's delusion, is an extremely rare mental disorder in which the affected person holds the delusional belief that they are dead, do not exist, are putrefying, or have lost their blood or internal organs. It is a broad term for very differing symptoms: some may believe that they are dead, that parts of their body are missing, that they are dying, dead, or do not exist. Some even firmly believe that nothing exists – hence, this interconnectedness between death and existence is demonstrated by the eerie Walking Corpse Syndrome. Cotard's Syndrome, named after the French neurologist Jules Cotard who first described the condition in 1880, remains one of the most confounding mental disorders in medical literature. Known clinically as nihilistic delusion, Cotard’s Syndrome can lead to severe existential distortions that manifest in complex and terrifying ways. Individuals afflicted with this disorder may feel as though their flesh is rotting, their organs have ceased to function, or their blood has drained from their body. At its extreme, patients may assert that they are no longer alive, despite possessing biological signs of life. This detachment from reality creates an odd sense of isolation, as they cannot connect with the world around them; occasionally leading to the denial of existence. When experiencing this disorder, an afflicted individual is likely to attempt self-harm, become entirely speechless, possess odd delusions of immortality, be completely insensitivity to pain, suffer from melancholia, or even have voices in their mind perpetuating the false idea of their death. Researchers have found that Cotard's Syndrome often arises from other psychiatric or neurological conditions, such as depression, schizophrenia, epilepsy, or traumatic brain injury. The syndrome is also sometimes observed in cases of dementia or as a side effect of certain drugs. Brain imaging of those with Cotard's Syndrome often reveals abnormalities in the parietal and frontal lobes, which are regions responsible for awareness, identity, and body perception. This neuroanatomical basis suggests that Cotard’s Syndrome may result from disrupted signals within these brain regions, leading to a complete breakdown of one's self- perception. The symptoms of Cotard's Syndrome can vary in intensity and complexity. Some individuals experience relatively mild symptoms, such as feeling disconnected from parts of their body, while others may believe they are entirely dead or decomposing. The symptoms of Walking Corpse syndrome include nihilistic delusions, which is the belief that one is dead, no longer exists, or has lost all bodily functions. Those suffering from Cotard’s delusion may also face hypochondriacal concerns, and obsessively believe that their organs have stopped working or that they lack vital body parts. Another concomitant byproduct of this syndrome is a deep, unshakable depression, which further fuels the afflicted individual’s delusions of non- existence. Due to their belief in their non-existence, affected individuals may stop eating, drinking, or attending to basic hygiene, viewing these activities as meaningless. The patient typically isolates themselves, avoiding social interaction entirely due to their delusional belief. Throughout history, there have been around 200 documented cases of Cotard's Syndrome, all of them illustrating the horror and fatality of this disorder. One well-known case involved a middle-aged woman referred to in psychiatric literature as “Mademoiselle X,” who believed that she had no brain, nerves, chest, or entrails and was unable to die a natural death. This belief became so severe that she ultimately starved herself to death, convinced that nourishment was pointless. In another case, a man in his 50s began to experience Cotard’s Syndrome following a traumatic brain injury. He believed his organs were rotting inside him and claimed he could smell his own decaying flesh. His distress led him to abandon his job and isolate himself completely from friends and family. Treatment eventually helped him improve, but only after years of intense therapy and medication. This case, in particular, highlights how the disorder is indeed treatable, though difficult. Treating Cotard's Syndrome is challenging due to the complexity and rarity of the disorder. The best known treatment is a combination of therapies tailored to their specific symptoms and underlying conditions. Some other methods of treatment include antidepressant and antipsychotic medications, which can help alleviate the depressive and delusional aspects of Cotard's Syndrome, electroconvulsive Therapy (ECT) which, by electrically stimulating the brain, can alleviate symptoms of both depression and delusional beliefs, Cognitive Behavioral Therapy (CBT), which can aid individuals in managing symptoms by challenging their delusions, and hospitalization and Supportive Care, which is typically applied in severe cases of self-neglect to ensure the patient receives basic nutrition and hygiene. Cotard’s Syndrome, while rare, highlights the intricate relationship between mind and body and the blurred line between existence and death, determined only by the reality that one’s state of mind depicts – as seen in those affected exist in a state where life and death blur, rendering their experiences unfathomable to the outside world. While treatment can be difficult, successful intervention is entirely possible, and has worked in previous cases. Most of the time, however, a patient will die of self-neglect due to their firm belief in their death before receiving proper treatment. To look in the mirror and see a rotting, putrefying shell of the unfamiliar body you once dwelled in is a rare experience that not many can speak of. The belief of decease, despite the persistence of life, is the reality that paints the blurred line between existence and death. References:  Sahoo, A., & Josephs, K. A. (2017). A Neuropsychiatric Analysis of the Cotard Delusion. Journal of Neuropsychiatry, 30(1), 58–65. https://doi.org/10.1176/appi.neuropsych.17010018  Rath, L. (2020, January 23). What Is Cotard’s Syndrome (Walking Corpse Syndrome)? WebMD. https://www.webmd.com/schizophrenia/cotards-syndrome  The. (2018, January 2). Cotard Delusion and Walking Corpse Syndrome. Healthline; Healthline Media. https://www.healthline.com/health/cotard-delusion  Grover, S., Aneja, J., Mahajan, S., & Varma, S. (2014). Cotard’s syndrome: Two case reports and a brief review of literature. Journal of Neurosciences in Rural Practice, 05(S 01), S059–S062. https://doi.org/10.4103/0976-3147.145206  Ruminjo, A., & Mekinulov, B. (2008). A Case Report of Cotard’s Syndrome. Psychiatry (Edgmont), 5(6), 28. https://pmc.ncbi.nlm.nih.gov/articles/PMC2695744/  dev-site. (2021, November 17). 12 Weird & Mysterious Diseases You Never Heard Of | Makati Med. Makati Medical Center. https://www.makatimed.net.ph/blogs/12-weird- mysterious-diseases-you-probably-never-heard-of/

Written By: Karla Uriostegui --------------------------------------------------- Schizophrenia is one of the most serious chronic mental illnesses that affects 1% of the population worldwide. Some of the main symptoms are delusions, hallucinations, disorganized speech, trouble with thinking and lack of motivation. Schizophrenia generally starts between 15 and 25 for men and between 25 to 35 for women. Unfortunately, there isn't a cure for schizophrenia, but researchers are working to produce better treatments. Currently, we don’t know exactly what produces schizophrenia however we are getting some ideas by studying genetics, conducting behavioral research and using advanced imaging to look at the brain’s structure and function.   Neuroinflammation     Neuroinflammation takes an important role in the pathogenesis of schizophrenia cases. As we already know, inflammation activates our immune system. In the context of schizophrenia, there is evidence for a chronic, low-grade activation of inflammation and the immune system. Measurement of inflammation and immune activation requires the use of makers such as cytokines (proteins that modulate inflammation and the immune response). These proteins have been studied as possible molecular markers of schizophrenia. Also, meta-analyses have demonstrated increased pro-inflammatory cytokines in patients with established schizophrenia. In addition, these findings suggest that the increase in inflammatory tone does occur at an early phase, preceding the onset of overt psychotic symptoms.         We can state that increased inflammation occurs early in the course of the disorder and is not only a result of medication use. Fortunately, such findings help patients who do not respond properly to traditional treatments, but may benefit from therapies that choose other biological routes such as anti- inflammatory or immunomodulatory agents.   Oxidative stress     Oxidative stress occurs when there is a disparity between production of free radicals such as reactive oxygen species (ROS), and antioxidant defense mechanisms which can develop in cell and molecular injury. Reactive oxygen species may be released from damaged tissue, serving as catalysts of inflammation and immune processes. Immune cells produce and use reactive oxygen species to kill pathogens. We consider that oxidative stress may be an inducer as well as a product of inflammation   Conclusion      To conclude, there is an evident connection between neuroinflammation and oxidative stress which is crucial to understand schizophrenia. Inflammation in the brain may trigger the disease, even before symptoms manifest. Previous research suggests new treatment options, beyond the usual medications, such as anti-inflammatory drugs. Fortunately, there is hope for better outcomes for people who suffer from schizophrenia and don’t respond to standard treatments.

Written by: Harmehar Kaur --------------------------------------------------------------------------- Phage therapy is an old medical concept experiencing a renewed interest in healthcare due to the rise of antibiotic-resistant bacteria. It is the use of bacteriophages to treat bacterial infections. Bacteriophages, or phages, are viruses that specifically infect bacteria. Recent research suggests that these viruses might be the key to addressing a growing crisis in antibiotic resistance. Can phage therapy offer a viable alternative to traditional antibiotics? A recent review of phage therapeutic potential has shown phages to be highly specific to their bacterial targets, which means they can attack harmful bacteria without disturbing beneficial microbiota. This ability is not characteristic of broad-spectrum antibiotics, which can disrupt the balance of the microbiome and lead to further health issues. Phages work by attaching to their bacterial host, injecting their genetic material, and replicating until the bacterial cell bursts, releasing new phages to continue the cycle. Clinical research also provides promising evidence. A study published in Clinical Infectious Diseases examined the use of phage therapy in treating a patient with a multidrug-resistant infection. The patient received a customized phage cocktail that successfully eliminated the infection when antibiotics had failed. This case underlines the potential of personalized phage therapy to treat antibiotic-resistant infections.  Phage therapy has also proven effective in animal models. A study in the Journal of Antimicrobial Chemotherapy tested phage therapy on mice infected with antibiotic-resistant bacteria. The results showed that phage-treated mice had a significantly higher survival rate than those treated with traditional antibiotics.  Despite favorable research results, phage therapy faces hurdles regarding immune responses. The body's immune system can neutralize phages before they reach their target, limiting the therapy's efficacy. Regulatory frameworks for phage therapy are still underdeveloped, which poses challenges for widespread clinical adoption. Ethical concerns, such as the potential for phage resistance, need also be addressed.  Phage therapy undeniably offers a promising alternative to combat antibiotic-resistant infections. As research progresses, personalized phage treatments could develop in ways that will revolutionize our approach to treating infectious diseases. The potential of phage therapy emphasizes a need for further research and robust regulatory frameworks to ensure its safe and effective use in clinical settings.

Written by: Sabrina Xu ------------------------------------------------------------------------------------- The use of Deep Brain Stimulation (DBS) to modify personality traits in criminal rehabilitation presents a unique intersection of neuroscientific intervention and ethics. Originally developed for treating neurological disorders, DBS offers a potentially transformative method for reducing recidivism rates among criminal offenders by targeting brain regions associated with aggression and impulsivity. Below, We focus on the positive and negative effects of DBS (especially of the prefrontal cortex) on patients affected with antisocial personality disorder (ASPD) and psychopathy. This essay explores the ethical implications of deploying DBS within the criminal justice system, aiming to balance the therapeutic benefits of DBS against ethical concerns such as consent, patient benefit, and personal identity. The Emergence of DBS and How It Works In the last 50 years, there has been rapid development in the safety and efficacy of Deep Brain Stimulation (DBS), an invasive and reversible technique that has emerged as a viable option for the treatment of neurological and psychiatric disorders. During the procedure, electrodes are inserted deep into the brain at targeted regions, connected via wire extensions to a small electrical generator under the collarbone, which continuously passes electric pulses into the brain. Stimulation parameters such as frequency, pulse width, and voltage need to be altered to achieve maximum efficacy. Despite the growing awareness in neuroscience to explain and predict antisocial and illegal conducts, the extent to which such knowledge is used to advance research in criminology remains limited. The most prevalent mental disorders across offenders are antisocial personality disorder(ASPD), borderline personality disorder (BPD), and major depressive disorder (MDD). Currently, criminal rehabilitation techniques in the UK involve educational, psychological and vocational therapies to help them learn skills for use outside prison. In terms of its effectiveness, the reoffending rate in the UK is 56% (after <1 year of rehabilitation), which could conceivably be reduced by the use of DBS and other neurointerventions. According to a number of influential views in penal theory, one of the primary goals of the criminal justice system is to rehabilitate offenders. Whilst DBS could potentially provide powerful new means of facilitating criminal rehabilitation, it also raises several ethical problems (although more traditional criminal justice interventions do not), and it is these problems that provide the impetus for this essay, which explores the hypothesis that using DBS could rehabilitate criminals more efficiently. Need for DBS vs Ethical Concerns A link between frontal lobe and criminal behavior is supported by the research on empathy, moral decision-making and reasoning . A prototypical example of contempt for social rules and legality with a strong neurobiological characterization is offered by ASPD, a clinical condition characterized by behaviour potentially harmful to themselves or others . An estimated 1% of males meet the criteria for psychopathy, which roughly equals 1,150,000 adult psychopathic males in the United States. Almost 93% of that population, are in prison, jail or on probation . It has been shown through studies that reduced connections in the prefrontal cortex holds accountability for the severity of ASPD. Currently, there is no pharmacological treatment for ASPD. Regardless of past efforts, therapies proved to be ineffective and those who underwent treatment were often more aggressive and showed higher rates of recidivism following their incarceration. So this is where DBS steps in, and what makes it so compelling is its reversibility and minimization of infection. The electric impulses to be sent into targeted brain areas, stimulating and inhibiting neural activity to regulate emotions, aggression, and impulsivity. One of the main problems is that DBS constitutes a form of medical intervention, and it is a standard tenet of medical ethics that it is permissible to perform a medical intervention on a competent individual only if that individual has given his/her informed consent to that intervention. However, it is not clear whether the consent obtained from an incarcerated individual, is valid. In terms of the extent of consent, offenders should be given the choice to either undergo DBS treatment and serve less time in prison, or serve their full sentence without treatment. In the UK, individuals have a legal right to refuse medical interventions, this highlights the view that moral reasons to respect individual autonomy prevail over reasons to protect the offenders’ interests. Another consideration is patient benefit: in these cases where “the doctor is happy, the patient less so,” some have hypothesized that it is a difficulty in self-perception after surgery that dampens patients’ estimates of the success of the procedure. For example, patients may struggle to reconcile their pre-surgery identity with the changes induced by the procedure, leading to a sense of disconnection and dissatisfaction. Additionally, the emotional toll of undergoing a such a significant medical procedure should not be underestimated. It is essential for doctors to consider these factors when evaluating rehabilitation success and to offer care and compassion for their patients. Conclusion Although the use of DBS (and other neuro-correctives) is currently rare, there are good reasons to trust the possibility of them becoming more prevalent in the future. However, the revolutionary technology that makes effective rehabilitation possible, also poses several ethical problems that requires ongoing collaboration between researchers, neuroscientists, and psychologists. I believe that with the correct efforts made, it is plausible to ethically implement DBS not only in criminal rehabilitation but also in various other areas of medicine and therapy.

Written By: Krrish Ladha ------------------------------------------------------------------------ Abstract Neurodegenerative diseases (NDs) encompass a group of chronic conditions characterized by progressive dysfunction and a gradual decline in cognitive, motor, and behavioral functions. This article discusses various aspects of NDs, represented by Alzheimer’s disease (AD), Parkinson’s disease (PD), and Huntington’s disease (HD). The primary aim of this article is to increase awareness and understanding of these conditions. With no cure, the trajectory of NDs tends to worsen over time. Some fundamental molecular mechanisms contributing to nerve degeneration include protein aggregations, neuroinflammation, and viruses. These factors significantly impact human health in various ways. While there is no cure for NDs, there are temporary solutions that can ensure a slower and easier life. Some current treatments include temporary relief through pharmaceutical interventions, therapy, and more. The most common pharmaceutical intervention is Donepezil HCL, which can help treat dementia and improve memory and awareness (Alzheimer's Association, 2023). Introduction Neurodegenerative diseases take a heavy toll on individuals and families. Alzheimer’s disease (AD), Parkinson’s disease (PD), and Huntington’s disease (HD) are the most common examples of NDs characterized by different clinical features. Despite different underlying molecular mechanisms, research methods have yet to find a way to fully address these neurological disorders. These conditions are typically incurable and worsen over time. Key factors caused by neuron degeneration include viral infections and the unprecedented nature of ND pathogenesis (National Institute on Aging, 2021). This article explores these factors' intricacies in shaping the course of NDs by underscoring the immediate need for unique approaches through diagnosis and treatments. Literature Review Neurodegenerative diseases are characterized by the loss of neurons. Alzheimer’s disease (AD), Parkinson’s disease (PD), and Huntington’s disease (HD) are the most common NDs. The loss of connection between neurons characterizes AD, Parkinson’s disease causes a loss of reflexes, and HD is the cause of neuron death and represents distinct pathological features. Overall, each neurodegenerative disease depicts different symptoms, both pathologically and clinically (ScienceDaily, 2024). Alzheimer’s Disease Alzheimer’s disease (AD) is one of the most common NDs. It primarily affects older adults ages 65+ because of changes in their lifestyle and environment, posing great dangers. Changes in the brain primarily classify and characterize Alzheimer’s disease. These changes occur due to genetics, age, and other factors (Yale Medicine, 2023). A recent study by Yale Medicine shows that “in January, the FDA gave the medication an accelerated approval based on amyloid plaque clearance,” referring to the drug Lecanemab. This drug has been shown to remove plaque in the brain. “Lecanemab works by removing a sticky protein from the brain that is believed to cause Alzheimer’s disease to advance” (Yale Medicine, 2023). It has also been demonstrated to slow functional decline in the early stages of AD. Parkinson’s Disease Parkinson’s disease (PD) is the second most common ND, causing a loss in motor reflexes. It is distinguished by its compounded neurodegenerative nature, characterized by rigid and slow (bradykinesia) motor movements. Along with AD, Parkinson’s disease usually first develops after age 60. It occurs when a chemical in the brain called dopamine is not released. When the cells in the brain’s center (basal ganglia) die or become impaired, they limit or prevent the movement of muscles and motor control (Mayo Clinic, 2024). Current research and treatments for PD suggest that the best way to help is by increasing the dopamine levels in the brain through sleep, exercise, exposure to sunlight, and more. This can help control muscles and improve motor reflexes. Another way to help is through therapy, using a drug called Levodopa to help increase dopamine levels. Huntington’s Disease Huntington’s Disease (HD) is a genetically inherited neurodegenerative disease passed from parent to child through a mutation. If one parent has HD, there is a 50% chance that the offspring will inherit it. HD has been linked to “repeat expansion” (National Institute on Aging, 2021). According to the National Institute on Aging, repeat expansion is “a type of mutation that results in abnormal repetition of certain DNA building blocks.” This mutation occurs when sets of three DNA blocks repeat multiple times, producing a protein called Huntington. This neurodegenerative disease impacts individuals by damaging nerve cells, leading to malfunction and brain damage. While NDs remain incurable, current treatments for HD include drugs like haloperidol, tetrabenazine, and amantadine. Although HD isn’t curable, these drugs aim to treat and control specific symptoms and unusual movements (National Institute of Neurological Disorders and Stroke, 2024). Conclusion In conclusion, neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease, pose significant challenges to human health. These conditions are characterized by progressive dysfunction and a gradual decline in cognitive, motor, and behavioral functions. While current treatments provide temporary relief, there is an urgent need for more effective therapies. Increased awareness and understanding of these diseases are crucial for developing better diagnostic methods and treatments in the future. References Ladha, K. (2024). Insights into neurodegenerative diseases: Understanding impact, symptoms, treatments. Alzheimer's Association. (2023). 2023 Alzheimer’s disease facts and figures. Retrieved from https://www.alz.org/alzheimers-dementia/facts-figures Mayo Clinic. (2024). Parkinson’s disease: Symptoms & causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-2037 6055 National Institute on Aging. (2021). Neurodegenerative diseases. Retrieved from https://www.nia.nih.gov/health/neurodegenerative-diseases National Institute of Neurological Disorders and Stroke. (2024). Huntington's disease fact sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Huntingtons-Dise ase-Fact-Sheet ScienceDaily. (2024). Neurodegenerative diseases. Retrieved from https://www.sciencedaily.com/news/health_medicine/neurodegenerative_diseases/ Yale Medicine. (2023). Alzheimer’s disease. Retrieved from https://www.yalemedicine.org/conditions/alzheimers-disease

Written By: Gabriela Slom ------------------------------------------------------------------------ Diabetes these days is one of the major chronic diseases diagnosed in people globally, especially type 2 diabetes which may normally develop in the later years of a persons life depending on various lifestyle factors such as excessive weight and inactivity. Due to these, fat can build up in and around the pancreas which is responsible for the production of insulin, and so its effective ability to control blood sugar levels is negatively impacted. However, it has been found that losing weight can reverse the whole process. In the UK there is an increase in cases of obesity, thousands of people were invited and hundreds completed a year-long programme,fully funded by NHS (National Health Service), where individuals had to stick to a strict 900-calorie-a-day liquid diet for many months before they were allowed to comsume solid food. The participants agreed it was difficult to adhere to it but many completed it successfully and described it as “truly life-changing”. Massive improvements were seen in their lifestyles and health, health complications due to obesity and risk of diabetes was minimized greatly. It is important to note that we do not know how long the remission will last or how remission can affect the development of diabetes in the future, hence it is essential to discuss this with a medical professional before attempting this low-calorie diet as it may be dangerous for certain individuals.

Written By: Harmehar Kaur --------------------------------------------------------------------- The human microbiome has been a highly-researched frontier for many years. It is a crucial aspect of human health and its relationship with various diseases. However, the mycobiome, the fungal component of the microbiome, remains noticeably underexplored in comparison. The mycobiome is a collection of fungi, including Candida, Aspergillus, and Malassezia, that reside in regions like the gut, skin, and oral cavity. Emerging evidence emphasizes the impacts that the mycobiome could have on human health, influencing everything from our immune function to our mental well-being.  The mycobiome has the potential to modulate the mechanisms of our immune complex. Fungi can interact with immune cells, which trigger responses that may either protect against or contribute to autoimmune diseases and allergies. Research published in Frontiers in Immunology demonstrated that specific fungal species could modulate immune responses, potentially affecting conditions such as asthma and rheumatoid arthritis​. The mycobiome's role in the gut is especially intriguing to researchers. Fungal organisms can influence digestion, nutrient absorption, and the overall health of the gastrointestinal tract. Dysbiosis is an imbalance in the microbial community, which includes fungi. This imbalance relates to conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). A study in Gut Microbes showed that patients with IBD had a distinct fungal profile compared to healthy individuals, suggesting that targeting the mycobiome could be an unexplored approach to treating IBD​.  The skin mycobiome is also a critical facet of our health. Conditions such as atopic dermatitis and psoriasis are associated with an imbalance in skin fungi. For example, Malassezia, a common skin fungus, has been implicated in seborrheic dermatitis and dandruff. Research in The Journal of Investigative Dermatology found that individuals with atopic dermatitis had significantly different fungal communities on their skin than those without the condition, indicating that the mycobiome could be a relevant contributor to skin health.  Some of the most exciting mycobiome research surrounds its relationship to our mental health. The gut-brain axis, a complex communication network between the gut and the brain, is influenced by both bacteria and fungi. Some fungi produce neurotransmitter-like compounds that affect mood and cognitive function. Although this area of research is still in its infancy, its initial findings seem promising.  Treatments engineered to target the mycobiome are emerging as an approach to managing various health conditions. Preclinical studies of antifungal probiotics and dietary interventions have shown favorable results. A study in Cell Host & Microbe revealed specific dietary fibers could modulate the gut mycobiome, improving gut health and reducing inflammation.  The more we understand the specific roles of fungi within the microbiome, the higher the likelihood that we develop innovative and effective treatments. The mycobiome could be the key to unlocking new insights into human health and disease, offering us the chance to harness the power of this often-overlooked component of our microbiome.