Linking a country's HDI with its COVID-19 mortality rate Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Correlation between wealthy countries and COVID-19 mortality rate 09/03/26, 08:30 Last updated: Published: 24/08/23, 17:20 Linking a country's HDI with its COVID-19 mortality rate Investigation title: Could there have been a correlation between very rich countries and COVID-19 mortality rate? Investigation period: December 2019- November 2020 (Approx. 1 year) Background The World Health Organisation (WHO) were first alerted about coronavirus on the 31st December 2019, by a lot of pneumonia cases in Wuhan, China that has a population of 11 million. Furthermore, by 15th January 2020 there were precisely 289 cases recorded in countries such as: Thailand, Japan, S.Korea, and other places in China. And of the original cases there were 6 deaths, 51 severe cases - 12 of which were in critical condition. Meanwhile, the virus responsible for the cases was isolated and had its genome mapped, and was shared on 12th January. HDI represents the measurement of development. This is a composite of Gross National Income (GNI) per capita, mean years of education and life expectancy at birth, to measure the development of a country. It is calculated between a scale of 0 (least developed) to 1 (most developed) and all its values are to 3 significant figures. HDI values of 2019 and countries of HDI greater than 0.800 were used, as these are all regarded as very high HDI-countries so were in the scope of this investigation. Therefore, this research aimed to determine the impact of human development on the number of mortalities caused by SARS-CoV-2; where human development is measured by HDI, and the number of mortalities per hundred thousand from December 2019 to November 2020. Method Stratified sampling produced 12 countries, in descending order of HDI value: - Australia, Netherlands, UK, Austria, Spain, Estonia, UAE, Portugal, Bahrain, Kazakhstan, Romania, Malaysia See Table 4 . Results See Chart 2 . r= 0.321 (3 s.f.) – Pearson’s test ∴ There is a moderate positive linear correlation between HDI and mortality rate due to SARS-CoV-2 per 100,000. Further stats testing- Spearman’s Rank ∑D^2 = 216 n = 12 Rs = 1 - (6 ∑D^2 )/ n(n^2 – n) = 1 - (6 x 216) 1584 = 0.182 (3 d.p.) Rs = 0.245 ＜ Critical Value (0.0.587591) ∴ There is no correlation between HDI and mortality rate due to coronavirus per 100,000. Conclusion The null hypothesis was accepted: there is no correlation between a country’s HDI and its mortality rate due to SARS-CoV-2. A biogeographical reason for this is that the more developed countries (such as those in my investigation- for example, the UK) have a higher level of immigration from latitudes closer to the equator, therefore there is a section of their society with increased susceptibility to SARS-CoV-2 due to vitamin D deficiency. It is known that low vitamin D levels have a negative impact on immune function and that low vitamin D levels are common in the immigrant population. Therefore, it is likely that there is a link between vitamin D deficiency and mortality rate per 100,000, however this could be overstated due to confounding factors such as socioeconomic status, residence and employment. This would explain why countries at higher latitudes like the Netherlands have higher mortality rates per 100,000 (41.80) which is the third highest HDI-country in this investigation. Another explanation for this non-correlation could be that the less developed countries could be more used to dealing with a pandemic, or stress on a healthcare system, due to previous experience. For example, after the SARS outbreak, many countries decided to prepare in case of a pandemic, however some large HDI-countries such as the UK chose not to and even ignored other warnings on the effects of a pandemic (like the exercise signs simulation). Moreover, studies have shown that as a very high HDI-country becomes more developed, its healthcare system continues to develop until it reaches a peak where its effectiveness is undermined by economic benefit or interest. This would explain why the UK had a death rate of 342 per 100,000 and a total death count of around 232,422 (as of early 2026), and as of 2024/25, the UK recorded higher-than-expected death rates compared to other countries. Implications Since there is no correlation between a country’s HDI index and its mortality rate of COVID-19, this may apply to other diseases that became pandemics such as 1918’s Spanish Flu, or more recent ones like the SARS outbreak in the early 21st century. As for tropical diseases (malaria, dengue, chikungunya and others) and other illnesses such as the common cold and the flu, these diseases present in only certain geographies. This means that the countries with these ailments will be of a similar HDI and economical status; therefore there would be a correlation between a country’s HDI index and its mortality rate of these diseases, to a certain extent. Investigation conducted and written by Roshan Gill Tables, charts, stats and calculations by Roshan Gill Summary by Manisha Halkhoree ‘Implications’ section by Manisha Halkhoree Related articles: Causality vs correlation / Impacts of global warming on dengue fever / Global Health Injustices (series) Project Gallery

Non-cell-autonomous cancer progression from chromosomal instability Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Immune signals initiated by chromosomal instability lead to metastasis 09/07/25, 15:23 Last updated: Published: 14/09/24, 22:17 Non-cell-autonomous cancer progression from chromosomal instability Unravelling the intricate relationship between immune cells and cancer cells through STING pathway rewiring. Introduction Chromosomal instability ( CIN ) has long been recognised as a prominent feature of advanced cancers. However, recent research has shed light on the intricate connection between CIN and the STING (Stimulator of Interferon Genes) pathway. Researchers at Memorial Sloan Kettering Cancer Center (MSK) and Weill Cornell Medicine conducted this ground-breaking study, which has provided fascinating insights into the function of the immune system and its interactions with cancer cells. In this article, we will delve into the findings of this study and explore the implications for future cancer treatments. STING pathway The STING pathway plays a crucial role in the response to cellular stress and the innate immunity response to DNA damage and chromosomal instability. Chromosomal instability refers to the increased rate of chromosomal aberrations, such as mutations, rearrangements, and aneuploidy, within a cell population. This instability can lead to genomic alterations that contribute to the initiation and evolution of cancer. This pathway is activated when the presence of cytosolic DNA is detected, which can be indicative of cellular damage or infection, triggering a cascade of signalling events leading to the production of type I interferons and other inflammatory cytokines. Many recent studies have revealed an intriguing relationship between chromosomal instability and the STING pathway, including the STING pathway’s ability to be activated by the accumulation of micronuclei resulting from chromosomal instability in cancer cells. This activation can lead to the promotion of anti-tumour immunity and the suppression of tumourigenesis. The Promise and Limitations of STING Agonist Drugs STING-agonist drugs have shown great potential in preclinical studies, arousing optimism for their use in cancer therapy. However, clinical trials have yielded disappointing results, with low response rates observed in patients. Dr. Samuel Bakhoum, an assistant member at MSK, highlights the discrepancy between lab findings and clinical outcomes. Only a small fraction of patients demonstrated a partial response, leading researchers to question the underlying reasons for this disparity. The Sinister Cooperation: CIN and Immune Cells Chromosomal instability acts as a driver for cancer metastasis, enabling cancer cells to spread throughout the body. The STING pathway, specifically, is where Dr. Bakhoum's team discovered that the immune system has a significant impact on this process. The cooperation between cancer cells with CIN and immune cells is orchestrated by STING, resulting in a pro-metastatic tumour microenvironment. This finding provides a crucial understanding of why STING-agonist drugs have not been effective in clinical trials. Introducing Contact Tracing: Unravelling Cell-to-Cell Interactions Researchers utilised a newly developed tool called ContactTracing to examine cell-to-cell interactions and cellular responses within growing tumours. By analysing single-cell transcriptomic data, they gained valuable insights into the effects of CIN and STING activation. The tool's capabilities allowed them to identify patients who could still mount a robust response to STING activation, enabling the selection of better candidates for STING agonist therapy. STING Inhibition: A Potential Solution Interestingly, the study suggests that patients with high levels of CIN may actually benefit from STING inhibition rather than activation. Treatment of study mice with STING inhibitors successfully reduced metastasis in models of melanoma, breast, and colorectal cancer. These findings open up new possibilities for personalised medicine, where patients can be stratified based on their tumour's response. By identifying the subset of patients whose tumours can still mount a strong response to STING activation, doctors could select better candidates for STING agonists. This biomarker-based approach could help figure out which patients would benefit from turning on STING and which would benefit from turning it off. This could lead to more targeted and effective treatments for people with advanced cancer that is caused by chromosomal instability. Conclusion Based on the research findings, it can be concluded that chronic activation of the STING pathway, induced by CIN, promotes changes in cellular signalling that hinder anti-tumour immunity and facilitate cancer metastasis. This rewiring of downstream signalling ultimately renders STING-agonist drugs ineffective in advanced cancer patients. However, the study also suggests that STING inhibitors may benefit these patients by reducing chromosomal instability-driven metastasis. The research highlights the importance of identifying biomarkers to determine which patients would benefit from STING activation or inhibition. Overall, these findings provide valuable insights into the underlying mechanisms of cancer progression and offer potential opportunities for improved treatment strategies for patients with advanced cancer. The study shown in figure 1, analysed 39,234 single cells within the tumour microenvironment (TME), categorised by cell subtype assignment. It showed that tumour cell rates of CIN were genetically dialled-up or dialled-down. The study also showed CIN-dependent effects on differential abundance at the neighbourhood level, grouped by cell subtype and ranked by mean log2 (FC) within each cell subtype. Node opacity was scaled by the p-value. Written by Sara Maria Majernikova Related articles: Cancer immunologist Polly Matzinger / The Hippo signalling pathway / Cancer metastasis / Arginine and tumour growth Reference: Li, J., Hubisz, M.J., Earlie, E.M. et al. Non-cell-autonomous cancer progression from chromosomal instability. Nature 620 , 1080–1088 (2023). https://doi.org/10.1038/s41586-023-06464-z Project Gallery

The 14-day rule and stem cell-based embryo models Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Regulation and policy of stem cell research Last updated: 20/10/25, 15:40 Published: 23/10/25, 08:00 The 14-day rule and stem cell-based embryo models This is the last article (article no. 3) in a three-part series on stem cells. Previous article: The role of mesenchymal stem cells in regenerative medicine. Welcome to the final article in this series of three articles about stem cells. Article 1 was an overview of stem cells, and Article 2 focused on mesenchymal stem cells. In Article 3, I will look at the regulation and policy of stem cell research, which is important given the rapidly changing landscape of stem cell research. Introduction If used effectively, stem cells can be used in treating diseases, understanding human development, and more. For example, a recent paper published in September 2025 explains how scientists created embryos from human skin DNA, in an experimental process they named “mitomeiosis”. Here, the scientists attempted to force the egg cell to divide to remove half of its chromosomes so it could be fertilised like a normal egg cell. While mitomeiosis was unsuccessful in creating viable egg cells, new advancements like this raise ethical questions about the use of stem cells, especially those derived from embryos. As a result, policies and regulations must be created and followed to ensure stem cells are used ethically and appropriately. Two major topics in this policy landscape are the 14-day rule for using human embryos and the creation of Stem Cell-Based Embryo Model (SCBEM) frameworks. The 14-day rule One of the most widely known restrictions in the field of stem cells is the 14-day rule. The 14-day rule prohibits scientists from culturing human embryos in vitro (in the laboratory) beyond 14 days or the appearance of the primitive streak. The primitive streak is a developmental marker signalling the point at which an embryo is biologically individualised. The appearance of this streak also marks the beginning of gastrulation, which is when embryonic cells start differentiating into the three primary germ layers: endoderm, mesoderm, and ectoderm. A timeline of human embryo development from day 0 to day 14 is shown in Figure 1 to help visualise the different stages. In the UK, the 14-day rule is a law under the Human Fertilisation and Embryology (HFE) Act 1990 (as amended 2008) . These human embryos are either donated with consent for research purposes due to no longer being needed, are unsuitable for fertility treatments, or are embryos created explicitly from donated sperm and eggs for research purposes. However, scientific advances have meant that human embryo cultures have now become advanced, resulting in embryos being destroyed at the 14-day deadline due to the law. For example, in 2016, researchers developed new in vitro culture systems that allowed human embryos to be maintained in the lab up to the 12th and 13th day of development. This had previously not been possible. Unfortunately, the experiments had to be stopped because they were approaching the 14-day legal limit. Therefore, scientists have questioned whether the 14-day rule is still fit-for-purpose, and if not, how it could be amended in a way that still ensures ethical and appropriate use of these cells. A specific area of development that scientists do not have a lot of information on is the “black box” period, which includes the moment of gastrulation, happening around day 14-15. Having further knowledge of gastrulation could be used to improve the success rate of In Vitro Fertilisation (IVF), by helping scientists to understand possible causes of early miscarriage and implantation failure, and working to mitigate those. Because of this debate, the Nuffield Council on Bioethics has launched a project to better understand the arguments for and against extensions to the 14-day limit on human embryo research. The Council aims to use this project to provide decision-makers, such as policymakers, with the evidence they need to decide whether to extend the time limit. Regulating Stem Cell-Based Embryo Models (SCBEMs) There is also the development of SCBEMs to consider, as seen in Figure 2 . SCBEMs are also called embryoids or embryo models. They are complex, organised three-dimensional structures derived from pluripotent stem cells, which are cells that can differentiate into all cells in the human body. SCBEMs replicate certain features and processes of embryonic development, meaning they can provide new insights into stages of early human development that have been normally inaccessible to scientists. However, SCBEMs are not defined as embryos under existing laws, like the HFE Act 1990, meaning there is a policy and regulation gap covering these structures. To fill this gap, researchers recently created the first-ever UK guidelines for generating and using SCBEMs in research. The new SCBEM Code of Practice was published in July 2024 and has clear guidance and standards, increasing the transparency of research that will be conducted using SCBEMs. The Code requires that research have well-justified scientific objectives and adhere to an approved culture period, the minimum duration needed to achieve the scientific objective. For example, the Code prohibits the transfer of human SCBEMs into a human or animal womb. Furthermore, adherence to the Code requires that a dedicated SCBEM Oversight Committee be created to review and approve proposed work. An SCBEM Register is also needed to record information about successful applications. Both of these increase the transparency and openness of research using SCBEMs. Future of regulation and policy of stem cell research Given the rapid pace of development in stem cell research, policies and regulations must be created and followed to ensure ethical and appropriate use of these cells. The review by the Nuffield Council on Bioethics regarding the 14-day rule will be important in determining if the rule should be extended. The extension could allow scientists to study developmental stages such as gastrulation, currently part of the “black box” period of development occurring after 14 days. The creation of the UK's first-ever SCBEM Code of Practice in July 2024 has introduced guidelines to fill the existing policy gap, requiring research using these models to have well-justified scientific objectives, follow approved culture periods, and be reviewed by an Oversight Committee to ensure transparency and ethical use. However, there is a need for stronger regulations, as opposed to guidelines, for using SCBEMs, and it is an important example of where policy needs to continue to be developed. Written by Naoshin Haque Related articles: Animal testing ethics / How colonialism, geopolitics and health are interwoven Project Gallery

How it's used Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link AI in medicinal chemistry 08/07/25, 17:18 Last updated: Published: 07/07/23, 21:47 How it's used We are always surrounded by medicine, whether this be through, for example, the cabinet in your house containing prescription drugs or walking by a pharmacy during the day. It is no secret that medical drugs are essential - they both mitigate the symptoms of disease and even prevent further future illness. However, whilst ingesting a tablet is easy for most, it seems to be that we can sometimes forget the vigorous amount of scientific research that goes into successfully synthesising a new drug, i.e. the core of medicinal chemistry. This process typically takes up to an astounding 10 years or more, but with new artificial intelligence (AI) emerging it is thought to be that this number will lower. What exactly is artificial intelligence? It can broadly be defined as the ability to produce human intelligence through the use of machinery such as computers or software. Based on this, one may question why AI is needed if we can just simply communicate ideas through writing, speaking and so on. The answer is increased efficiency – one example of man made neurones is discussed on the website Interesting Engineering, which are able to produce impulses up to one billion times per second. Fascinatingly, this is quicker than humans, so it could also be argued that AI is actually better than us! There are many phases of the drug development process, from early pre-clinical research to post-market surveillance. When a drug is administered, the body uses enzymes such as mainly those from the CYP family to break the compound down into smaller structures, through a process known as metabolism. Drug metabolism can create toxic molecules that are able to covalently bind to proteins in the body causing serious illness, but also molecules that can be harmlessly excreted through faeces or urine. Of course, chemists can look for sites of metabolism by studying the angles and positions of atoms, however AI is able to do this much quicker and with higher accuracy. SuperCYPsPred is an example of a free online web application that can predict if a drug may be a CYP enzyme inhibitor in pre-clinical drug discovery, as the software is able to identify five of such inhibitors. Through this, we can understand how a drug’s metabolic pathway may differ and investigate further early on, allowing scientists to make structural changes before proceeding onto the next phase of development. Through this, millions of pounds can be saved from marketing an unsuccessful drug as well as decrease the chances of causing injury to the public. AI is also able to use machine learning (ML) to carry out tasks. ML is when machinery processes a large data set and identifies complex patterns to problem solve. From this then comes deep learning (DL), which allows this ML to be applied in different fields. For example, DeepCE is a “novel deep learning computer model” that helps predict changes in gene expression with certain drugs. It is able to do this by using the following two sources: DrugBank which contains data for 11,000 safely approved drugs and the L1000 dataset that has information on over 1 million perturbed organ tissue gene expressions. From this, researchers were able to obtain 10 drug candidates for the treatment of COVID-19 infection, in which 2 have been successfully marketed. Based on the above, it is clear that AI holds a lot of power in speeding up the drug discovery and development process. With the technology sector advancing in general as well, we are looking at a future where AI will become even more dominant in the pharmaceutical research industry. Whilst AI can predict several drug properties, it is also important to remember that we physically cannot predict every single thing out there – we can only try our best, which AI is aiding. Written by Harsimran Kaur Related articles: AI in drug discovery / A breakthrough procedure in efficient drug discovery / Role of chemistry in medicine Project Gallery

Getting treatment can prevent things from getting worse Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Depression in Children 10/07/25, 11:17 Last updated: Published: 17/06/23, 13:46 Getting treatment can prevent things from getting worse It's normal for kids to feel sad, act grouchy, or be in a bad mood at times. But when a sad or bad mood lasts for weeks or longer, and when there are other changes in a child's behavior, it might be depression. Therapy can help children who are going through sadness or depression. And there are things parents can do, too. Getting the right care can prevent things from getting worse and help a child feel better. Symptoms of depression Sad or bad mood. A child may seem sad, lonely, unhappy, or grouchy. It can last weeks or months. A child may cry more easily. They may have more tantrums than before. Being self-critical. Kids going through depression may complain a lot. They may say self-critical things like, "I can't do anything right." "I don't have any friends." "I can't do this." "It's too hard for me." Lack of energy and effort. Depression can drain a child's energy. They might put less effort into school than before. Even doing little tasks can feel like too much effort. Kids may seem tired, give up easily, or not try. Not enjoying things. Kids don't have as much fun with friends or enjoy playing like before. They may not feel like doing things they used to enjoy. Sleep and eating changes. Kids may not sleep well or seem tired even if they get enough sleep. Some may not feel like eating. Others may overeat. Aches and pains. Some children may have stomach aches or other pains. Some miss school days because of not feeling well, even though they aren't sick. Causes of depression Some common reasons include: - life events like someone dying - moving schools or other big changes - physical health problems - experiencing physical, sexual or psychological abuse or neglect - witnessing violence or a traumatic event - if you have an unstable family environment Intervention Three of the more common methods used in depression treatment include: - cognitive behavioral therapy - interpersonal therapy - psychodynamic therapy Written by Chhaya Dhedi Related articles: Childhood stunting in developing nations / What does depression do to your brain? / Brain of a bully / Anxiety / Postpartum depression in adolescent mothers Project Gallery

The tireless challenge Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Childhood stunting in developing countries 09/03/26, 15:17 Last updated: Published: 09/03/24, 17:53 The tireless challenge Introduction Certain countries worldwide face numerous challenges that decrease their populations' quality of life; some include hunger, poverty and rising harmful emissions, which are complicated to resolve. This is because international cooperation is needed to tackle them effectively. Another significant challenge faced is stunting, defined as diminished growth and development that children experience, because of undernutrition or lack of sufficient nutrients, frequent infections and deficient psychosocial interventions, according to the World Health Organisation (WHO). As of 2025, the latest findings reveal that an estimated 127 million children in the globe are affected by stunting. WHO's target of stunting reduction by 2030 has not yet been met (the target was originally for 2025, but was forced to be pushed back due to slow progress). With this definition in mind, this article will delve into stunting and malnutrition before discussing how stunting is linked to infectious diseases and harmful emissions, and steps forward to reduce this condition in developing countries, as shown in Figure 2 . Undernutrition and stunting Stunting is one of the consequences of undernutrition, possibly due to reduced synthesis of insulin-like growth factor 1 (IGF-1) in the body, leading to amplified growth hormone (6). As for the determinants of undernutrition, a paper from Brazil found socioeconomic characteristics like family income and biological ones such as age notably linked to undernutrition. Another result of undernutrition is being underweight. A systematic review from Ethiopia focusing on nutrition in 5-year-old children amalgamated 18 studies. It estimated that stunting and being underweight had 42% and 33% prevalence, respectively; it could be inferred that undernutrition is linked to stunting. Additionally, a paper that used data from 32 Sub-Saharan African countries discovered that providing maternal health insurance (MHI) reduces stunting and being underweight, which explains that boys are more likely to be affected by stunting than girls in all UN regions and sub-regions. In turn, MHI is necessary for supporting children’s health. Non-nutritional factors and stunting As for infections and stunting, an article highlighted that children with stunted growth are vulnerable to diarrhoeal and respiratory diseases besides malaria. Moreover, conditions worsen undernutrition, causing a vicious cycle between them, manifesting into growth defects. Furthermore, a systematic review of 80 studies found a connection between helminth infections and stunting, but insufficient evidence supported this hypothesis. With this said, there may need to be additional studies to investigate this further. With undernutrition’s impact on the immune system, newborns and small children with extreme protein deficiency have smaller thymuses and underdeveloped peripheral lymphoid organs, leading to immunological cell defects such as reduced T-cell count. Before concluding this article, exposure to harmful emissions is a recurring problem that affects everyone, including children. Different observational studies proposed that inhaling nitrogen oxide and particulate matter in utero could modify DNA methylation, possibly influencing foetal growth. Conclusion Reflecting on all the evidence in this article, stunting in developing countries is heading in a direction where it could become problematic. However, according to findings from UNICEF, stunting has gradually reduced between 2000 and 2020 in children under 5 years old. Nevertheless, awareness of stunting in developing countries is critical because it is the first step to tackling this health issue, and ultimately meet the WHO target by 2030. Written by Sam Jarada Related articles: Childhood obesity / Depression in children / Postpartum depression in adolescent mothers REFERENCES Jamali D, Leigh J, Samara G, Barkemeyer R. Grand challenges in developing countries: Context, relationships, and logics. Business Ethics, the Environment & Responsibility. 2021 Sep;30(S1):1–4. Maleta K. Undernutrition. Malawi medical journal: the journal of Medical Association of Malawi. 2006 Dec;18(4):189–205. World Health Organization. Stunting in a nutshell. www.who.int . 2015 Nov;19. Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Maternal & Child Nutrition. 2018 May 17;14(4):e12617. Vaivada T, Akseer N, Akseer S, Somaskandan A, Stefopulos M, Bhutta ZA. Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. The American Journal of Clinical Nutrition. 2020 Aug 29;112. Soliman A, De Sanctis V, Alaaraj N, Ahmed S, Alyafei F, Hamed N, et al. Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta Bio Medica : Atenei Parmensis. 2021;92(1) Correia LL, Silva AC e, Campos JS, Andrade FM de O, Machado MMT, Lindsay AC, et al. Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil. Revista de Saúde Pública. 2014 Feb 1;48:19–28. Abdulahi A, Shab-Bidar S, Rezaei S, Djafarian K. Nutritional status of under five children in Ethiopia: a systematic review and meta-analysis. Ethiopian Journal of Health Sciences. 2017 Mar 15;27(2):175. Kofinti RE, Koomson I, Paintsil JA, Ameyaw EK. Reducing children’s malnutrition by increasing mothers’ health insurance coverage: A focus on stunting and underweight across 32 sub-Saharan African countries. Economic Modelling. 2022 Dec 1;117:106049. Vonaesch P, Tondeur L, Breurec S, Bata P, Nguyen LBL, Frank T, et al. Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA). Wieringa F, editor. PLOS ONE. 2017 Aug 10;12(8):e0182363. Raj E, Calvo-Urbano B, Heffernan C, Halder J, Webster JP. Systematic review to evaluate a potential association between helminth infection and physical stunting in children. Parasites & Vectors. 2022 Apr 20;15(1). Schaible UE, Kaufmann SHE. Malnutrition and Infection: Complex Mechanisms and Global Impacts. PLoS Medicine. 2007 May 1;4(5):e115. Sinharoy SS, Clasen T, Martorell R. Air pollution and stunting: a missing link? The Lancet Global Health. 2020 Apr;8(4):e472–5. UNICEF. Malnutrition in Children. UNICEF DATA. 2023. Project Gallery

Using Surface Guided Radiation Therapy (SGRT) Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Revolutionising patient setup in cancer treatment 11/07/25, 10:50 Last updated: Published: 18/10/23, 11:50 Using Surface Guided Radiation Therapy (SGRT) Cancer treatment can be a painstaking and difficult procedure to undergo given the complexity in the treatment process. The weight of a cancer diagnosis carries a huge mental and physical burden on the patient. It is therefore important to place emphasis on delivering an efficient and streamlined process whilst at the same time not cutting any corners. Manual methods of delivering care can and should be automated by AI and technology where possible. This is especially applicable in the preparation of delivering a dose of radiotherapy treatment where traditionally, breast cancer patients will undergo a tattoo setup which provides physical guidance on area at which the dose should be delivered. Patients suffer not only by the knowledge of the disease, but they are also marked with reminders of the experience by an increasingly outdated positioning technique. Innovation in radiotherapy treatment allows for a more ethical and streamlined solution. Surface Guided Radiation Therapy (SGRT) treatments provide a means for tracking a patient's position before and during radiation therapy, to help ensure a streamlined workflow for accurate treatment delivery. This type of treatment not only eliminates the need for an invasive tattoo setup but also provides a faster and more accurate way to deliver radiation doses to the patient. For example, precise measurements made by the software will ensure that radiation is delivered specifically to the targeted area and not the surrounding tissue. With a regular tattoo setup, this can be a common issue as patient movement, often triggered by respiration, can alter the accuracy of the tattoo markup, thereby reducing the effectiveness of the radiation treatment. The way in which many SGRTs work is through a system of cameras, mounted to the ceiling, which feed data into a software program. Each camera unit uses a projector and image sensors to create a 3D surface model of the area by projecting a red light onto the patient’s skin. (See Figure 2) This 3D surface model serves as a real-time map of the patient's position and surface contours. By constantly comparing the captured data with the pre-defined treatment plan, any deviations or movements can be detected instantly. If the patient moves beyond a predetermined threshold, the treatment can be paused to ensure accuracy and safety. The use of this cutting-edge technology is an important step in being able to provide some level of comfort for patients in a challenging environment. The integration of such systems represents a significant advancement in patient-centric care in the field of radiation therapy. Written by Jaspreet Mann Related article: Nuclear medicine Project Gallery

For some species, the rock-paper-scissors theory determines survival or reproductive success. Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Rock, paper, survival? Last updated: 02/04/26, 18:23 Published: 02/04/26, 08:00 For some species, the rock-paper-scissors theory determines survival or reproductive success. Rock-paper-scissors: a classic way of resolving petty disputes or making small decisions. That is, if you’re a human. For some species, the rock-paper-scissors theory determines survival or reproductive success. It occurs when three equally strong variants coexist in a population. The three variants interact “non-transitively”, meaning there is not one clear best variant; each variant has an advantage in a different environment. Variants of a species are controlled by genetics, so they are called “genotypes”. This article describes two cases of rock-paper-scissors competition between three genotypes of the same species, and one case between different species. Alternative mating strategies in side-blotched lizards The first scientific article to describe a real-life rock-paper-scissors system was published by Sinervo and Lively in 1996. They studied male side-blotched lizards that come in three different throat colours: yellow, orange, and blue. The lizards fight each other for territory and female mates, and the more females a male has on his territory, the more offspring he can have, so the more successful he is. Orange-throated male lizards are the most aggressive and have the most testosterone. Blue-throated males are less aggressive, so they lose fights against the orange-throats and therefore lose their females. Yellow-throated male lizards do not fight for mates, so they lose their females to the fighting blue-throated males. Instead, yellow-throated males pretend to be sexually active females, deceiving another male lizard and mating with his females. Since orange males are more aggressive in finding females, they are more prone to yellow-throated deception, and lose many females to the yellow-throats. So yellow beats orange, orange beats blue, and blue beats yellow: a rock-paper-scissors dynamic. Sinervo and Lively found that blue-throated males dominated the side-blotched lizard population in 1991, but they were wiped out by the more aggressive orange-throated males in 1992, who themselves were wiped out by the deceiving yellow-throated males in 1993-4. A population dominated by yellow-throats was the ideal environment for blue-throated males to come back in 1995 ( Figure 1 ). Therefore, rock-paper-scissors competition causes a population to cycle between three equally strong genotypes over time. Colicin dynamics in E. coli While rock-paper-scissors theory determines reproductive success in side-blotched lizards, the stakes are higher in E. coli bacteria, where the three genotypes fight each other to survive. In this system, there are three strains (i.e. types) of E. coli called colicin-producing (C), colicin-susceptible (S), and colicin-resistant (R). Strain C makes a toxin called colicin, which kills strain S. Strain R outcompetes strain C because not only is it resistant to strain C’s colicin, but it also saves the energy needed to produce it. However, by gaining colicin resistance, strain R loses nutrient uptake abilities. This means strain S, which is better at nutrient uptake, outcompetes strain R. So C kills S, S outcompetes R, and R outcompetes C: a rock-paper-scissors dynamic ( Figure 2 ). Kerr et al. found that when the three E. coli strains were grown on a solid agar surface, they stayed at equal, constant biomass for one week. If one strain grew too much, another strain in a system would outcompete it and bring the biomass back down. Therefore, rock-paper-scissors competition maintained strain diversity and stability in a genetically heterogeneous E. coli population. Rock-paper-scissors-lizard-Spock in coral reefs Expanding rock-paper-scissors theory to between species, rather than within species, creates a complex and diverse ecosystem. ‘The Big Bang Theory’ TV show popularised a five-object version of rock-paper-scissors called rock-paper-scissors-lizard-Spock, which expanded the number of possible scenarios in the game and reduced the chance of a draw. Similarly, a 1979 paper describes dozens of possible interactions between seven species of marine animals off the coast of Jamaica, keeping the marine ecosystem diverse. There were five sponges (S-2 Toxemna sp. , S-3 Tenaciella sp ., and three previously undescribed sponges S-4, S-5, and S-6), one coral species (C-1 Madracis sp. ), and one ascidian (A-1 Didemnum sp. ). These species all grow as colonies, in which hundreds of individual animals function as one cohesive unit. However, coral reefs have limited space, so colonies of different species fight over a solid surface to grow on. Scientists noted the outcomes of dozens of interactions where the colony of one species grew over the colony of another, to determine whether the ecosystem is linear/transitive or not. They found many examples of non-transitive interactions; for example, one rock-paper-scissors three-species system, and one system where six species beat each other in a cyclical pattern ( Figure 3 ). Even though species S-4 can outcompete five other species, there is always the risk of species S-2 outcompeting it, so S-4 cannot dominate the ecosystem. Depending on the spatial and temporal organisation of the Jamaican coral reef, any of the seven species can dominate. Conclusion Non-transitive interactions lead to high diversity and cyclical patterns over time. Scientists have observed these interactions between and within species, and across ecological scales from small laboratory bacteria to complex coral reef ecosystems. If one variant begins to dominate, that makes another variant perform better, keeping the system balanced. While the three variants co-exist in some situations, like the E. coli colicin dynamics, they take turns being dominant in other situations, like the side-blotched lizards. So next time you’re thinking of using rock-paper-scissors to decide something, maybe try C-S-R E. coli or orange-yellow-blue lizards instead! Written by Simran Patel REFERENCES Sinervo, B. and Lively, C.M. (1996) The rock–paper–scissors game and the evolution of alternative male strategies. Nature , 380(6571), 240–243. Buss, L.W. and Jackson, J.B.C. (1979) Competitive Networks: Nontransitive Competitive Relationships in Cryptic Coral Reef Environments. The American Naturalist , 113(2), 223–234. Kerr, B., Riley, M.A., Feldman, M.W. and Bohannan, B.J.M. (2002) Local dispersal promotes biodiversity in a real-life game of rock–paper–scissors. Nature , 418(6894), 171–174. Project Gallery

Heteroelements, defined as elements other than C or H, frequently include the p-block elements. Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Chemistry beyond carbon: the heteroelements Last updated: 04/05/26, 18:41 Published: 07/05/26, 08:00 Heteroelements, defined as elements other than C or H, frequently include the p-block elements. Introduction Organic chemistry is often teased as ‘elementally boring’, a joke among inorganic chemists, because of its reliance on C, H, O and N. While organic chemistry is broadly defined as the study of carbon containing compounds, this overlooks the role of heteroelements in synthetic chemistry. Heteroelements, defined as elements other than C or H, frequently include the p-block elements. Their diversity in chemical properties often enables exotic functional group transformations; inaccessible with ‘traditional elements’. Therefore, this article will explore the roles of selenium, phosphorus and sulphur in organic synthesis, highlighting how their unique reactivity expands the synthetic toolbox. Selenium Selenium’s unique position within Group 16 underpins all of its reactive behaviour. Selenium’s polarisability means it can act as both a nucleophile and electrophile depending on the context. Its larger atomic size stabilises lower oxidation states making Se (IV) compounds readily accessible, while the orbital mismatch between selenium and oxygen explains why selenoxides are prone to decomposition. Selenium anions readily undergo nucleophilic substitution (S N 2) with halogenoalkanes to form alkyl selenides (Se-C). Upon oxidation (i.e. H 2 O 2 ), selenium is oxidised to form a selenoxide which undergoes syn elimination to form alkenes. This provides a useful alternative to E 1 and E 2 eliminations, as no leaving group is required. See Figure 1 . Selenium dioxide (SeO 2 ), a direct analogue of CO 2, enables allylic oxidation of C-H bonds. This reaction has been used widely across industry and academia as a method of functionalising otherwise inert positions. Sulphur Just above Selenium in the periodic table, sulphur chemistry parallels many of the chemical properties of selenium. Thiols (C-S) can readily participate in S N 2 reactions to generate thioethers. Under oxidising conditions, these species can form disulfides, an important feature of the tertiary protein structure. The nucleophilic character of sulphur can also be exploited to functionalise ketones without reducing the carbonyl group. The ketone can undergo a reaction with 1,3 - propanedithiol to generate a dithiane. This dithiane intermediate can then perform further S N 2 reactions under basic conditions before addition of HgCl 2 to remove the dithiane and unmask the ketone. Additionally, sulphur can also react to form sulfonium ylides. An ylide is a neutral molecule in which adjacent atoms carry a positive and negative charge. These compounds are formed from nucleophilic attack followed by base deprotonation of one of the adjacent C H bonds. These species are ideal reactants for forming strained rings. Phosphorus The chemistry of phosphorus is largely dominated by its ability to form stable compounds in the +3 and +5 oxidation states. Again, phosphorus largely acts as a nucleophile and, like sulphur, is able to form ylides. This is central to one of the most important alkene forming reactions; the Wittig Olefination. The Wittig reaction selectively forms both E and Z alkenes from a phosphonium ylide and either a ketone or an aldehyde. To synthesise the ylides, the same procedure is used as described with sulphur, with the nucleophilic species typically triphenylphosphine (PPh 3 ). The adjacent positive and negative charges form a polarised bond which matches the dipole of the carbonyl. The carbonyl species then aligns with its respective opposite charge on the ylide to form an oxaphosphetane intermediate after a [2+2] cycloaddition. The ring strain of this intermediate means it decomposes to form an alkene and a strong P=O bond. Phosphonium ylides are also key intermediates in the Corey-Fuchs reaction. The ylide is crucial to the formation of a dibromoalkene intermediate from a starting aldehyde. Under basic conditions and slow heating, the alkene decomposes to form an alkyne from an aldehyde in a single step. Conclusion Heteroelement chemistry plays a vital role in expanding the scope of organic synthesis, enabling transformations that would otherwise be difficult. The importance of this field is reflected industrially where sulfonamide formation and the Wittig reaction rank among the 20 most commonly used reactions in drug discovery. While this article has focused on the roles of Se, S and P in ionic mechanisms, both silicon and boron are also central to modern organic synthesis, especially catalysis and cross coupling mechanisms. Written by Antony Lee REFERENCES E. Vedejs, J. Org. Chem., 2004, 69, 5159-5167 C. G. Rodriguez, J.B. Rodriguez, ChemMedChem , 2024, 19, e202400063 Nobel Prize – https://www.nobelprize.org/prizes/chemistry/1979/press-release/ (Accessed March 2026) D.G. Brown, J. Bostrom, J. Med. Chem ., 2016, 59, 4443-4458 Project Gallery

A scientific reflection on the humanitarian, physical, and psychological cost of war Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Maveerar Naal: health, trauma, and resilience amid decades of war Last updated: 05/03/26, 14:49 Published: 27/11/25, 08:00 A scientific reflection on the humanitarian, physical, and psychological cost of war Every year on the 27th of November — and throughout the month of remembrance — Eelam Tamils worldwide observe Maveerar Naal, honouring those who lost their lives during Sri Lanka’s war (1983–2009). While traditionally centred on fallen fighters, this period also serves as a vital opportunity to reflect on the epidemiology of trauma, the collapse of public health systems, and the long-term physical and psychological consequences carried by Eelam Tamil communities after more than two decades of conflict. This article reframes Maveerar Naal not only as a commemoration, but also as a scientific reflection on the humanitarian, physical, and psychological cost of war — and the resilience of those who survived it. A health system under siege From the mid-1980s onward, northern and eastern Sri Lanka experienced a chronic, escalating humanitarian emergency. Repeated mass displacement, food scarcity, blocked medical supply routes, and intermittent bombardment steadily eroded the region’s healthcare infrastructure. Clinics became inaccessible due to shelling or military restrictions, and maternal and child health services deteriorated sharply. Early epidemiological observations from the 1990s documented widespread anxiety, depression, and trauma symptoms among civilians, demonstrating that mental-health consequences were emerging long before the war’s final years. By the late 2000s, the public health crisis intensified dramatically. As the conflict entered its final phase — from late 2008 to May 2009 — more than 2.5 million people were trapped in active conflict zones, while approximately 800,000 civilians were internally displaced. Entire districts lost functional hospitals; others were forced to convert schools, churches, and tarpaulin shelters into emergency medical centres. Human resource shortages reflected the near-total systemic collapse: in some northern districts, only 34 of 108 midwife posts and 6 of 27 doctor posts remained filled. Pregnant women delivered in makeshift bunkers, neonatal mortality spiked, and infectious diseases spread rapidly through overcrowded displacement camps. For many, survival came at the cost of long-term disability, untreated injuries, and profound psychological trauma. Physical health consequences across populations The physical scars of the war persist across generations. Civilians experienced blast injuries, shrapnel wounds, burns, and amputations, often without access to timely surgical care. Emergency operations were performed in unsterile environments; in some cases, anaesthesia was unavailable, forcing staff to improvise with inadequate substitutes. Conditions in displacement camps — overcrowding, poor sanitation, contaminated water — led to outbreaks of diarrhoea, hepatitis A and E, and vector-borne diseases. For combatants, chronic health burdens are well-documented. Peer-reviewed studies, including research published in journals such as the International Journal of Social Psychiatry and the Journal of Rehabilitation Medicine , report the following long-term conditions among injured veterans: Back pain: 69.4% Knee osteoarthritis: 18.8% Hypertension: 22.4% Diabetes: 34.2% Phantom-limb pain among amputees: over 77% PTSD among amputees: ~41.7% These outcomes reflect years of untreated injuries, limited rehabilitation access, chronic stress, and long-term nutritional deficiencies. Psychological trauma and intergenerational consequences The psychological impact of the war has been profound. Medical workers described witnessing mass casualties with inadequate supplies — a situation that produced significant moral injury, compassion fatigue, and long-lasting mental-health consequences. Among severely injured fighters, mental-health assessments published in trauma and rehabilitation journals report: PTSD: 41.7% Adjustment disorder: 16.4% Depressive disorder: 15.6% Somatoform/dissociative disorders: significant prevalence Civilians exposed to high-intensity conflict show similarly alarming patterns. Studies from humanitarian organisations and academic institutions report that approximately: 64% of civilians exhibited long-term trauma-related effects 27% experienced PTSD 26% had anxiety disorders 25% had depression 18% experienced functional disability due to psychological distress Notably, emerging research has identified intergenerational transmission of trauma, with children of survivors — even those born after 2009 — displaying elevated rates of anxiety, behavioural challenges, and trauma-related symptoms. This represents a critical area for continued scientific study and intervention. Health workers on the frontline: the hidden scientific story The war’s final months produced some of the most extreme medical working conditions documented in modern conflict settings. For ethical, political, and safety reasons, this article does not name frontline medical staff; however, their experiences are well-recorded in reports by Physicians for Human Rights (PHR), Human Rights Watch (HRW), and eyewitness testimonies. One regional physician coordinated makeshift hospitals inside schools and religious buildings. With no supplies, he sterilised instruments over open flames, used sarongs as dressings, and suspended IV fluids from tree branches. He performed dozens of emergency surgeries daily, sometimes operating while artillery fire struck nearby. A field-hospital superintendent described conducting amputations without anaesthesia, supported only by volunteer nurses. When their facility was shelled — an incident documented by multiple international observers — dozens died instantly. Survivors were treated in trenches illuminated by mobile phone torches. Another medical coordinator reported overseeing triage for thousands of displaced civilians, many severely dehydrated or malnourished. He described having to prioritise patients based solely on survivability, an ethically devastating but necessary decision in conditions of extreme scarcity. PHR and HRW documented at least 30 direct attacks on hospitals between December 2008 and May 2009. These incidents — some among the most thoroughly investigated attacks on medical facilities globally — illustrate the catastrophic collapse of health infrastructure and the extraordinary resilience of those who continued to provide care. Reflection, healing, and the path ahead Maveerar Naal is, at its core, a day of remembrance. Yet for many Eelam Tamils, it is also a day of scientific reflection — a moment to acknowledge the measurable, long-term consequences of conflict on physical health, mental well-being, and community resilience. Healing requires investment in: Long-term mental-health services rooted in trauma-informed care Rehabilitation programmes for amputees and individuals with chronic injuries Public health research into intergenerational trauma Accessible healthcare for survivors living in diaspora communities Preservation of evidence and health data for historical and scientific record By understanding the epidemiology of suffering, communities can better design strategies for recovery. By recognising the extraordinary resilience of civilians, fighters, and health workers, they honour all forms of courage. And by grounding remembrance in scientific truth, Maveerar Naal becomes not only a memorial, but a commitment to protecting health, dignity, and humanity for future generations. In remembering the past, we build the foundation for a more compassionate, prepared, and resilient future. Written by Jeevana Thavarajah Related articles: Impact of war on health (series) / South Asian Mental Health / Ethnic Health Inequalities REFERENCES Amnesty International (2009) Sri Lanka: Twenty Years of Make-Believe. Available at: https://www.amnesty.org/en/documents/asa37/005/2009/en/ BBC News (2009) Sri Lanka shells no-fire zone. Available at: http://news.bbc.co.uk/2/hi/south_asia/8046136.stm Catani, C. et al. (2008) ‘War trauma, child abuse and PTSD in Sri Lankan children’, Journal of Child Psychology and Psychiatry . Available at: https://pubmed.ncbi.nlm.nih.gov/18673497/ Channel 4 News (2011) Sri Lanka’s Killing Fields. Available at: https://www.channel4.com/news/sri-lankas-killing-fields Fernando, G. and Ferrari, M. (2013) ‘Short- and long-term psychological effects of war in Sri Lankan populations’, Asian Journal of Psychiatry . Available at: https://pubmed.ncbi.nlm.nih.gov/23885541/ Human Rights Watch (2009) Sri Lanka: Repeated Shelling of Hospitals. Available at: https://www.hrw.org/news/2009/05/08/sri-lanka-repeated-shelling-hospitals International Committee of the Red Cross (ICRC) (2014) War injury rehabilitation and prosthetics – Sri Lanka. Available at: https://www.icrc.org/en/document/sri-lanka-prosthetics-rehabilitation International Crisis Group (2010) War Crimes in Sri Lanka. Available at: https://www.crisisgroup.org/asia/south-asia/sri-lanka/war-crimes-sri-lanka Office of the High Commissioner for Human Rights (OHCHR) (2015) OISL Report: Sri Lanka. Available at: https://www.ohchr.org/en/hr-bodies/hrc/oisl-sri-lanka Physicians for Human Rights (PHR) (2009) PHR calls for inquiry into detention of doctors and war crimes in Sri Lanka. Available at: https://phr.org/news/phr-calls-for-inquiry-into-detention-of-doctors-and-war-crimes-in-sri-lanka/ Project Gallery