Monday, February 6, 2023

Ketamine Therapy for Mental Health Disorders

Hi all,

I just wanted to share a case report I recently had published in Frontiers in Psychiatry, "Medical student types journals during ketamine infusions for suicidal ideation, treatment-resistant depression, post-traumatic stress disorder, and generalized anxiety disorder."

It details the powerful anti-depressant effects of ketamine in a patient with treatment-resistant depression, suicidality, PTD, and generalized anxiety disorder. Consistent with broader studies and clinical trials, ketamine therapy was effective both short- and long-term.

Unique to this case, the patient also typed real-time journals during four of the ketamine infusions, providing a unique window into what it is like to undergo a ketamine treatment. Here are a few snippets from what the patient typed:

“I feel like I’m dreaming

The stars are so beautiful at night, they cover they sky, I wish I could see them all, just as much as I love everyone. It is so good to be here. so good to be here on earth with everyone. Everyone, I love all of you. I love you all so so so so so much!!!!!

I am experiencing beauty.

In small things

In small details and places

I want everyone to be ok

I want everyone to be ok”


“I feel calm, relaxed, I can breathe

Calm, calm, peace, peace, peaceful

It’s going to be ok 

I’m going to be ok 

I’m going to be ok

I am excited to explore

Beauty, green, a ship, falling, a road, beautiful music, I feel at home, green, a smile, happiness, warmth, it is covering me I feel like a large warm blanket. A big blanket! Safe! I feel so safe. And happy. and calm. Thank you.”

Full transcripts of the journals can be read here.

If you or a loved one is struggling with depression, anxiety, PTSD, or suicidality, I highly encourage you to learn more about ketamine-assisted psychotherapy. If you have any questions, please reach out!

References

Willms, J., McCauley, B., Kerr, L., Presto, P., Arun, A., Shah, N., Irby, K., Strawn, M. and Kopel, J., 2022. Case report: Medical student types journals during ketamine infusions for suicidal ideation, treatment-resistant depression, post-traumatic stress disorder, and generalized anxiety disorder. Frontiers in Psychiatry, 13.

https://denovotherapy.com/

Monday, September 10, 2018

MD/PhD Research Experience Essay Example

Application for MD/PhD programs requires three essays:
  1. Personal Statement
  2. MD/PhD Essay (a statement of interest specifically for both MD and PhD degrees)
  3. Research Experience Essay (a detailed description of your research experiences)
I published my MD/PhD Essay as an example for students back in 2014 (link above). Hopefully my research essay will also be a helpful example.

My MD/PhD Research Essay

Prompt: Describe your significant research experiences. In your statement, specify your research supervisor's name and affiliation, the duration of the experience, the nature of the problem studied, and your contributions to the project.

1) Toxicology, Ichthyology, and Marine Ecology Lab
Dr. Sandra Diamond (Ph.D., Zoology, North Carolina State University), Assistant Professor, Texas Tech University
January 2011-Present
1a) Antibiotic Toxicology Project (January 2011-May 2012)
My research with Dr. Diamond began with the examination of an antibiotic, Triclosan, that is included in many personal care products. After use, Triclosan is carried through drains to wastewater treatment plants. While some of the Triclosan is purged from waterways, a significant amount escapes and reaches the oceans. There, it is incorporated into the fatty tissue of benthic organisms, where it interferes with calcium signaling. The widespread distribution of Triclosan is beginning to cause humans to acquire significant levels of Triclosan, especially in breast milk. This could generate antibiotic-resistant bacteria, and may even impede calcium signaling in humans. Our goal is to understand the potential dangers of Triclosan in the environment.
I contributed to this project by working closely alongside a graduate student and constructing a literature matrix on how Triclosan behaves in the ocean. I participated in laboratory experiments, collected data, maintained the laboratory, and helped proofread material for presentations.
For my work, I was acknowledged in "The Effects of Triclosan on Reflex Responses and Anti-Predator Behavior in an Estuarine Fish" (Tiffany L. Hopper-Hedrick and Sandra L. Diamond), a poster that my group presented at the Ecological Society of America.
1b) TTU Shark Team (May 2012-December 2012)
Upon completion of the toxicology project, Dr. Diamond hired me onto the TTU Shark Team, a group seeking to establish multi-national management of shark fisheries in the Gulf of Mexico through a deeper understanding of shark ecology. Historically, the oceans have been overexploited due to advances in technology and competition for resources. Because sharks have long generation times, they are particularly vulnerable. We use geographic information systems and statistical analyses to map out seasonal distributions for fourteen species of sharks.
In this group I contributed to the construction of a literature matrix containing over 800 papers to communicate large-scale trends, such as seasonal distributions. This experience has developed my critical reading skills, increased my general understanding of scientific thought, and prepared me to design an experiment of my own.
1c) TTU/Howard Hughes Medical Institute Affiliated Project (May 2012-Present)
After earning designation as a TTU/Howard Hughes Medical Institute Undergraduate Research Scholar in May of 2012, Dr. Diamond gave me the scientific freedom to design and carry out a research project.
The concentration of carbon dioxide in our atmosphere is increasing, causing the pH of the oceans to lower significantly. In addition, ocean fertilization (the mass addition of nitrogen and phosphorus) is causing algal blooms. Because algae use up oxygen, the dramatic increase in algal populations has resulted in the creation of 'dead zones' in which there is little or no oxygen. My research examines the synergistic effects of acidification and hypoxia on Atlantic Croaker.
I am responsible for designing experiments, writing protocols for acceptance by our Animal Care and Use Committee, collecting data, making decisions concerning our budget, communicating with companies to purchase scientific equipment, and writing a technical paper. Five months ago, I was given the responsibility of organizing and training five undergraduates in our lab to maintain our artificial ocean system while Dr. Diamond was in Australia for two semesters. In addition, an undergraduate researcher worked on a sub-assignment under my project.
I have presented my work in this lab at four conferences: Texas Tech University Health Sciences Center Student Research Week, TTU/Howard Hughes Medical Institute Best and the Brightest: Research Forum, The Texas Chapter of the American Fisheries Society, and Texas Tech University Undergraduate Research Conference. Abstracts for this work have been accepted at the Arkansas Chapter of the American Fisheries Society and the 2013 TTU/Howard Hughes Medical Institute Undergraduate Research Forum.
I was also part of a panel of researchers from TTU for Earth Day at North Ridge Elementary School. At this event, I delivered a presentation on Marine Biology and Environmental Sustainability with an emphasis on mantis shrimp and sharks.

2) Plant Evolution and Ecology Lab
Dr. Dylan Schwilk (Ph.D., Ecology and Evolution, Stanford University), Assistant Professor, Texas Tech University
October 2012-Present
2a) TTU/Howard Hughes Medical Institute Affiliated Project (October 2012-Present)
In Dr. Schwilk’s lab, we are pursuing an understanding of tree ecology in the mountain ranges of Texas. The water transporting vessels (xylem) of trees become clogged, much like arteries in humans, in a process known as drought-induced embolism. Although it is impossible for negative pressures to exist in gaseous systems, this is not the case with liquids. Trees rely on extreme negative tension to pull water to heights much greater than those allowed by adhesion, cohesion, or atmospheric pressure. When trees experience drought conditions, the strength of these tensions increases as the amount of water available to them decreases. This makes the pressure within the xylem so low that water starts to boil, and bubbles form within vessels. Once a certain percentage of the xylem within a branch becomes embolized, it is sacrificed by the tree. My project examines the point at which branches are sacrificed in four oak species.
My reasons for joining Dr. Schwilk’s lab are unique. Normally, TTU/HHMI Scholars work in a single lab due to the expected levels of involvement. However, in October of 2012, one of my fellow scholars, Chris, passed away in an automobile accident. Because the TTU/HHMI Scholars are a tight-knit family, I decided to inherit his project and finish it for him. I invited every TTU/HHMI Scholar to participate in completing his project to help us heal as an organization.
My responsibilities in Dr. Schwilk’s lab include writing, modifying, and developing the protocol for an experiment, training undergraduate researchers and delegating scientific tasks, participating in expeditions to the Davis, Guadalupe, and Chisos Mountains, carrying out laboratory experiments, and recruiting new laboratory members.
I led one trip to Davis Mountains with a single non-scientist assistant to gather data.
An abstract for this work has been accepted for the 2013 TTU/Howard Hughes Medical Institute Undergraduate Research Forum, where I will present our findings in honor of Chris’s memory.
For simultaneously working full-time in the Diamond and Schwilk labs, successfully lobbying for Texas Tech University to continue its support of TTU/HHMI, and organizing and training groups of scholars to participate in Chris’ project, I received the Dr. Richard L. Blanton Endowment for Undergraduate Research.

3) Honors Thesis in Physics and Biology
Dr. Micah Green (Ph.D., Chemical Engineering, Massachusetts Institute of Technology), Assistant Professor, Texas Tech University
January 2012-Present
3a) Honors Thesis as part of the TTU Honors College
I received approval in January of 2012 to conduct an Honors Thesis outside of my major on the fine-tuning of four cosmic parameters in phase space. Normally, students are encouraged to pursue topics related to their undergraduate major when conducting an Honors Thesis. However, I was allowed to proceed with a physics-based inquiry, since I had gained competency in physics and cosmology as a result of personal study.
Over the past hundred years, physicists and cosmologists have started to notice that if certain fundamental characteristics of our universe had been anything other than what they are, the evolution of life in our universe would have been impossible. An example of one of these characteristics, called “parameters”, is the gravitational constant. If the force of gravity had been stronger during the big bang, the exploding matter would have re-condensed into a black hole. Alternatively, if gravity had been weaker during the big bang, there would not have been enough attraction between particles for stars to form, resulting in a universe comprised almost entirely of hydrogen and helium. In either case, the evolution of life in our universe would have been impossible. The general consensus of the scientific community at this point is that many parameters are finely tuned, meaning that miniscule variations in their values would render the universe lifeless.
My Honors Thesis is a review of the current scholarly conversation on the fine tuning of the universe. My primary insight concerns the target of fine tuning. Historically, physicists assumed that the universe needed to be fine-tuned for our form of carbon-based life specifically. As an evolutionary biologist, I know that this is not the case. A universe only needs to maintain a stable environment, contain the essential building blocks for complex molecules, and be expansive enough for origin events to be probable. Once an origin event takes place, natural selection could cause those collections of molecules to evolve in any number of directions. Dr. Green and I conclude that our four target parameters display fine tuning, but to a much lesser degree than has traditionally been accepted.
Because this project serves as an interdisciplinary link between biology and physics, I presented my work at GK-12 Building Bridges: Integrating Math, Science and Engineering on the South Plains. I was also invited to participate in a panel on trans-disciplinary research at this conference.
For my work on this project I received the 2013 Honors College Collaborative Learning Award.

Friday, September 7, 2018

Jesus was stabbed in the stomach

Blood mixed with water flowed out of Jesus' spear wound because he was stabbed in the stomach (probably).

We have almost no detailed information on the location of Jesus' spear wound. However, we do know three things:
1. The spear head must enter the "side", which could mean anywhere on the lateral aspect of Jesus' abdomen or torso.
2. Jesus was elevated on a cross, therefore the spear thrust would have been at an upward angle.
3. Blood mixed with water exited the wound.

There are numerous complicated scenarios in which water could have exited through the wound along with blood--most notably a pleural effusion that built up from a previous injury. These scenarios are less likely because they require an additional hypothesis (that one of the previous injuries caused abnormal fluid buildup in one of Jesus' body cavities, and this was later pierced by the spear).

But there are two situations that do not require an additional hypothesis. There are two locations where "water" builds up under normal circumstances--the stomach (Figure 1) and the bladder.

A spear wound to the bladder is so unlikely that it is hardly worth mentioning*.

A spear wound to the stomach is extremely likely (Figure 1). First, a spear wound that entered Jesus' stomach definitely would have been described as a spear wound "to the side". Second, the elevation of Jesus and the upward angle of the thrust favors a stomach wound (Figure 2). Third, Jesus had fluid in his stomach (beyond the normal gastric acid that is always present):

"28After this, Jesus, knowing that all things had already been accomplished, to fulfill the Scripture, *said, “I am thirsty.” 29 A jar full of sour wine was standing there; so they put a sponge full of the sour wine upon a branch of hyssop and brought it up to His mouth. 30 Therefore when Jesus had received the sour wine, He said, “It is finished!” And He bowed His head and gave up His spirit." (John 19:28-30)

Figure 1. Spear thrust to the stomach. Modified from http://healtharchives.info.

The stomach wound scenario is so obvious that I cannot fathom how it isn't widely accepted as the leading hypothesis for Jesus' spear wound.


If Jesus had died from previous injuries, there would have been fluid in his stomach, and the spear would have caused that fluid to mix (at least partially) with blood. If Jesus were alive, the same thing would have happened.

In fact, the stomach would have been hard to miss using an upward thrust to the side of an elevated victim. Check out a horizontal cross-section of the upper abdomen (Figure 2). Because the spear was traveling at an upward angle into an elevated victim, the horizontal plane is especially helpful for illustrating what organs would have been in the way of the spear thrust. The primary target (that definitely would have produced blood mixed with water) is the stomach.

Figure 2. Stomach outlined in green. Modified from http://www.netanatomy.com.

Conversely, at an upward angle, a spear thrust would have difficulty passing directly between two ribs (the more vertical the angle, the harder it would be). This isn't to say that a spear thrust couldn't break ribs (it could), it's just less likely than a stomach wound (which wouldn't have needed to either "thread the needle" or break ribs). This is especially true if the spear had a broad head. And again, the scenarios in which "water" is mixed with blood require additional hypotheses for thorax wounds. A stomach wound scenario does not.

A spear wound to the heart would have released SO MUCH blood  that it is unlikely that observers would have been able to appreciate any "water" coming from the wound, even if fluid had built up somewhere (unless it was a very large amount of fluid--which again requires far more mental gymnastics than a simple stomach wound). Observers definitely would have noted the watery appearance of fluid emanating from a stomach wound.

In conclusion, by far the most likely scenario is that Jesus was stabbed in the stomach.


The bladder-wound scenario
*Because Jesus was elevated on the cross, a spear wound thrust upward would have needed to enter Jesus' leg and travel upward to eventually pierce his bladder, and it would have needed to pass through thick bones to do so. This did not happen.

But the stomach is only on one side!
 True. Only wounds to Jesus' left side fit with this scenario. Similar wounds to the right side of Jesus' body would have hit the liver, which would not have resulted in "water" mixed with blood exiting the wound.

What about hitting both the stomach and the heart?
A spear thrust could go all the way through the stomach and then enter the heart. This definitely would have killed Jesus. However, this scenario is less likely than a simple stomach wound.