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

A restored wildlife reserve in Mozambique Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link How Gorongosa National Park went from conflict to community Last updated: 06/11/25, 11:53 Published: 27/03/25, 08:00 A restored wildlife reserve in Mozambique This is article no. 5 in a series on animal conservation. Next article: Emperor penguins, the kings of the ice . Previous article: Pangolins: from poached to protected . Gorongosa National Park was the centre of a dark time in Mozambique’s history, which led to most mammals being hunted and entire species going locally extinct. Over the last 20 years, a public-private collaboration has restored many of these species and made Gorongosa National Park a healthy ecosystem again. In this article, I explore what nearly wiped out Gorongosa’s mammals and how they are doing today. About Gorongosa National Park Gorongosa National Park is a wildlife reserve in Mozambique containing grasslands, savannahs, woodlands, and wetlands. It lies at the East African Rift's southern end, making for a complex geological landscape centred around Lake Urema ( Figure 1 ). Lake Urema and the rivers draining into it support a high diversity of herbivorous mammals like elephants, zebras, and antelopes. Civil war and subsequent recovery Gorongosa National Park has illustrated the connections between society and ecology for decades. Civil war raged in Mozambique between 1977 and 1992. During this war, both sides hunted without restrictions in Gorongosa for meat and for valuable animal parts like ivory, which were exported to pay for ammunition. This decreased the population sizes of all animal species in the national park by at least 90%. Twelve years after the war ended, an American non-profit called the Gregory Carr Foundation partnered with the government of Mozambique to conserve and restore Gorongosa. The initiative, now called the Gorongosa Project, aims to bring back mammal species which went locally extinct in the war. In addition to providing healthcare, jobs, and education to 200,000 people living near the national park, the Gorongosa Project invests in tourism and ecological research. Ecologists are interested in how different animal species would rebound from the war and how a diverse ecosystem could be created nearly from scratch. By fostering healthy connections between local communities, scientists, and wildlife after the Mozambican Civil War, the Gorongosa Project has become something special. How different animal species recovered after the Mozambican Civil War Since mammalian herbivores were the cornerstone of pre-war Gorongosa National Park, their recovery has been prioritised. The populations of most herbivores have increased since the Civil War but at varying rates. Waterbucks, a species of antelope, have dominated Gorongosa in the years following the war ( Figure 2 ). This could be because more waterbuck survived the war in the first place and/or because they naturally reproduced faster than other mammals. Stalmans et al. found that waterbucks were found to be growing as fast as they biologically could, as though they had infinite resources and no diseases or predators. Meanwhile, the populations of larger herbivores like hippos, buffaloes, and elephants, which used to dominate Gorongosa, are recovering much slower than waterbucks ( Figure 2 ). With this change in the herbivore community came changes in vegetation. According to Daskin et al., the amount of land covered by trees in Gorongosa increased by 34% between 1977 and 2012 ( Figure 3 ). This was because there were fewer elephants or other ‘browsing’ herbivores to clear out woody vegetation. Thus, the Mozambican Civil War altered the community structure of herbivorous mammals and plants in Gorongosa National Park. After herbivores showed signs of recovery, scientists turned to restoring carnivorous mammals. Lions were the only carnivores not to go locally extinct during the war, so they recovered fastest. Between 2012 and 2016, Bouley et al. counted 104 lions in Gorongosa – about half the pre-war count. Following the success of lions, wild dogs were introduced from two different South African populations in 2018 and 2019. Over the following three breeding seasons, 82 pups were born, and dogs originally from different populations naturally formed their own packs. Wild dogs and lions prefer different prey and hunt in different habitats within Gorongosa, allowing both carnivores to coexist. This successful restoration of mammalian carnivores completed Gorongosa National Park’s post-war ecosystem. Conclusion After most mammals in Gorongosa National Park were hunted during a civil war, the Gorongosa Project restored a functioning ecosystem by diligently monitoring wildlife and working alongside local people. The park has brought attention to the often neglected non-human impacts of war. Conservationists are optimistic that if Gorongosa National Park’s ecosystem can recover from almost nothing, it is not too late to save other damaged ecosystems. Although Gorongosa’s ecosystem today is dominated by waterbucks, time will tell whether populations of carnivores and larger herbivores will return to their former glory. Written by Simran Patel Related articles: Galapagos tortoises / Vicuna conservation / Wildlife corridors REFERENCES Stalmans, M.E. et al. (2019) ‘War-induced collapse and asymmetric recovery of large-mammal populations in Gorongosa National Park, Mozambique’, PLOS ONE , 14(3), p. e0212864. Available at: https://doi.org/10.1371/journal.pone.0212864 . Daskin, J.H., Stalmans, M. and Pringle, R.M. (2016) ‘Ecological legacies of civil war: 35-year increase in savanna tree cover following wholesale large-mammal declines’, Journal of Ecology , 104(1), pp. 79–89. Available at: https://doi.org/10.1111/1365-2745.12483 . Bouley, P. et al. (2018) ‘Post-war recovery of the African lion in response to large-scale ecosystem restoration’, Biological Conservation , 227, pp. 233–242. Available at: https://doi.org/10.1016/j.biocon.2018.08.024 . Bouley, P. et al. (2021) ‘The successful reintroduction of African wild dogs (Lycaon pictus) to Gorongosa National Park, Mozambique’, PLOS ONE , 16(4), p. e0249860. Available at: https://doi.org/10.1371/journal.pone.0249860 . Gorongosa National Park (2020) Our Mission , Gorongosa National Park . Available at: https://gorongosa.org/our-mission-2/ (Accessed: 8 December 2024). Poole, J. et al. (2023) ‘A culture of aggression: the Gorongosa elephants’ enduring legacy of war’, Pachyderm , 64, pp. 37–62. Available at: https://doi.org/10.69649/pachyderm.v64i.518 . Project Gallery

Preserving trust and exposing betrayal Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Uncovering the Disturbing World of Healthcare Serial Killers 14/07/25, 16:06 Last updated: Published: 25/02/24, 15:08 Preserving trust and exposing betrayal Background We depend heavily on medical professionals during our most defenceless and vulnerable moments, trusting them with our well-being. However, what would happen if this trust was broken? What if the medical professionals were to pose harm rather than fulfil their intended function as protectors? Healthcare serial killers are one of the most disturbing subsets of serial killers - the name itself suggests that individuals within the healthcare industry exploit their position to murder patients. True crime and media often go hand in hand in the modern era. There are many web series, TV dramas, and movies that delve into real-life narratives. Accumulating over 68.31 million hours watched, Netflix's film "The Good Nurse" in 2022, depicts the story of Charles Cullen, a figure recognised as one of the most prolific serial killers in American history. The film quickly rose to prominence and became the best-performing English-language film production on the platform. This phenomenon in media underscores a broader pattern wherein the portrayal of serial killers becomes increasingly prevalent within popular culture. Motives Criminologists and true crime filmmakers engaged in extensive efforts to figure out what motivates serial killers to carry out such horrific crimes for decades. The motives behind killings are diverse, complex and sometimes unknown. Some perpetrators may attempt to justify their actions by claiming to ease the patient's suffering under the guise of “mercy killing”. Others can be driven by the desire to be praised, to exert power or control over the patient, or to gain financial benefits. For example, Dr. Harold Shipman, a British doctor killed over 200 patients, primarily driven by sadistic motives. His misdeeds were ultimately exposed when he attempted to forge the will of one of his victims. Key traits and methods Although it might be tempting to create a list of characteristics typical of healthcare serial killers, no universally applicable formula defines their personalities. However, according to research by Yardley, E., and Wilson, D. (2016), attention-seeking, strange behaviour when a patient dies, and frequent changes in hospital working locations are characteristics that healthcare serial killers frequently exhibit. Furthermore, the study conducted by Birmingham City University criminologists shows that the most popular technique employed by healthcare serial killers is poisoning, specifically through insulin overdose. Notably, insulin overdose was the principal method employed by 25% of healthcare serial killers. For instance, in the case of British nurse Lucy Letby, who was given a life sentence for killing seven infants and attempting to murder six others, the use of an insulin overdose was a notable method employed. Ethics Examining the ethical implications of healthcare serial killing is essential, as it involves the breach of trust and violation of core principles of the healthcare profession. The relationship between a medical professional and a patient is based solely on trust, which healthcare serial killers have exploited. What's worse is that medical professionals frequently target elderly, chronically ill, or vulnerable patients, highlighting significant ethical issues. Challenges Detecting healthcare serial killers is difficult, primarily because their victims are frequently elderly or suffering from chronic illnesses. Investigations typically stem from an unusually high number of deaths rather than patient or family complaints. Even if the police initiate an investigation, it may be too late to collect physical evidence, as bodies may have been cremated or significantly decomposed, leaving no trace of substances in the patients' systems. Furthermore, in rare cases where a medical professional faces charges, they may use defences such as assisted suicides or attribute deaths to unintentional medical errors, potentially resulting in reduced sentences or lesser degrees of homicide . Conclusion Healthcare serial killers are a deeply disturbing phenomenon within the medical profession. The idea that people upon whom we rely on to take care of us can occasionally exhibit malevolence is extremely unsettling. By employing research to understand the existence of serial killers in the healthcare industry, we can address the many questions that surround their behaviour. Studying the motive behind such crimes, looking at the key traits and methods, and addressing the challenges associated with identifying such perpetrators provide insights crucial for safeguarding the community of patients who are at risk and preserving the core moral principles of the medical field. Let’s conclude by saying that the way that healthcare serial killings are portrayed in popular media is a clear reminder of the moral and professional obligations inherent in the provision of healthcare. Written by Prabha Rana Related articles: Neurology of serial killers / Intern Blues References ‘The True Story Behind Netflix’s The Good Nurse’. TIME, 27 Oct. 2022, https://time.com/6225730/the-good-nurse-true-story-netflix/ . Menshawey, Rahma, and Esraa Menshawey. ‘Brave Clarice-Healthcare Serial Killers, Patterns, Motives, and Solutions’. Forensic Science, Medicine, and Pathology, vol. 19, no. 3, Sept. 2023, pp. 452–63. PubMed, https://doi.org/10.1007/s12024-022-00556-4 . Tinning, Danielle. ‘Meet The British Physician Who Killed Hundreds Of His Patients — On Purpose’. All That’s Interesting, 21 Apr. 2023, https://allthatsinteresting.com/haroldshipman . Guy, Fiona. ‘Medical Serial Killers: The So-Called Angels of Mercy’. Crime Traveller, 27 June 2018, https://www.crimetraveller.org/2018/06/healthcare-medical-serial-killers/ . Townsend, Mark. ‘Study Identifies Key Traits and Methods of Serial Killer Nurses’. The Guardian, 22 Nov. 2014. The Guardian, https://www.theguardian.com/uknews/2014/nov/22/study-identified-key-traits-serial-killer-nurses . Project Gallery

Due to systemic barriers like a lack of interpreting services, and discriminatory treatment, among other factors Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Ethnic Health Inequalities Last updated: 02/04/26, 18:24 Published: 05/03/26, 08:00 Due to systemic barriers like a lack of interpreting services, and discriminatory treatment, among other factors This is Article 3 in a series on health inequalities. Next article: Addressing health equalities . Previous article: S ocioeconomic health equalities . Welcome to the third article in a series of articles about health inequalities. This article will look more in detail at what ethnic health inequalities are. Introduction Ethnic health inequalities are persistent disparities in health outcomes, experiences of healthcare, and even employment within the healthcare sector itself, for ethnic minority groups. Individuals from minority ethnicities frequently face an increased risk of poor health compared to their White counterparts. These inequalities are often rooted in structural racism and the racialisation of socioeconomic factors, rather than biological or cultural differences, suggesting that racism itself is a primary determinant of health. They are exacerbated by differences in socioeconomic status and deprivation. These inequalities manifest in different ways for different minority groups, and can be measured by specific health outcomes in different conditions. How ethnic health inequalities manifest A joint report by the Health Foundation and Runnymede Trust explained that Bangladeshi and Pakistani individuals have higher mortality rates for circulatory diseases. They also have significantly higher rates of metabolic conditions compared to their White counterparts. This predominantly includes diabetes, which is three to five times more common in Bangladeshi and Pakistani individuals. This is a result of both genetic factors and lifestyle and diet factors, the latter of which can be influenced by socioeconomic status; the report explains that Bangladeshi and Pakistani individuals are much more likely to be in poverty or deep poverty, impacting their ability to afford health-improving goods, such as nutritious food. As they are also more likely to live in deprived areas compared to their White counterparts, Bangladeshi and Pakistani individuals often face the dual challenge of food deserts and food swamps. This means they lack access to affordably priced, high-quality groceries while being surrounded by an overabundance of cheap junk food. In addition, research collated by the King’s Fund shows that Black Caribbean and Black African individuals experience higher rates of hypertension and stroke, and have higher rates of admission to psychiatric hospitals with psychotic illness diagnoses. This is also driven by an array of factors, including lifestyle and diet, but also socioeconomic status and deprivation. Maternal mortality for Black women is almost three times higher than for White women, partly due to socioeconomic factors, as well as underlying health conditions. Furthermore, Office for National Statistics data from 2022 shows that infant mortality is tragically twice as high for Black infants and nearly twice as high for Asian infants compared with White infants, as seen in Figure 1 . Again, this is partly due to higher socioeconomic deprivation, among other factors. Experiences of ethnic health inequalities and the role of structural and institutional racism Even though the NHS generally provides free universal access to primary care, access to and experience of healthcare services for ethnic minority groups often differ compared to their White counterparts. The NHS Race and Health Observatory has conducted research on racism and has found that there are disparities in areas like hospital and dental services: for example, there aren’t enough interpreting services for those whose first language is not English, which limits effective communication between patients and healthcare professionals. This also makes it harder for patients to stick to their treatments. Repeated negative experiences have led to a lack of trust in the health system among some ethnic minority communities. Patients from these groups consistently report less favourable experiences across various services, as seen in Figure 2 . A review by the UCL Institute of Health Equity reported that some indicators of this are longer waits for GP appointments, needing multiple visits before cancer referral, and overall lower satisfaction with hospital and mental health care. This poor experience is often characterised by stereotyping, disrespect, cultural insensitivity, and discriminatory treatment from healthcare staff, leading to delayed diagnoses, inappropriate interventions, and poorer health outcomes. The review also explained that these systemic issues can manifest in the NHS workforce, where ethnic minority staff face discrimination and harassment, impacting morale, retention, and ultimately the quality of care provided to patients. Conclusion Ethnic health inequalities, like all other types of health inequalities, are avoidable, unfair, and systematic failures. They have persistent impacts across different ethnic groups, leading to poorer health outcomes. Beyond clinical outcomes, ethnic minority patients also encounter systemic barriers such as a lack of interpreting services and discriminatory treatment, including stereotyping and cultural insensitivity, leading to a breakdown of trust in the healthcare system. These issues impact everything from GP wait times to the morale of the NHS workforce, where ethnic minority staff face discrimination that can ultimately impact the quality of care provided. It’s important to note that other factors like lifestyle, diet, genetics, and socioeconomic backgrounds have a part to play; however, the examples in this article are strongly influenced by systemic disadvantage due to bias and racism, as well as the above factors. Therefore, a comprehensive strategy which considers the impacts of all these factors is needed to remove these barriers and provide equitable care for everyone. The next article will be the final article in the series, and will look more in detail at how to address health inequalities, so watch out for that! Written by Naoshin Haque Related articles: Eelam Tamil health impacts / Rohingya community / Syria and Lebanon health injustices Project Gallery

Nanogels are tiny, water swollen polymer networks and encapsulate therapeutic agents Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Nanogels: the future of smart drug delivery Last updated: 17/07/25, 11:54 Published: 17/07/25, 08:00 Nanogels are tiny, water swollen polymer networks and encapsulate therapeutic agents Nanomedicine is a rapidly advancing field, with nanogels emerging as promising innovations for drug delivery applications. Nanogels are soft nanoscale hydrogels that are transforming how we deliver drugs and treat diseases. Whilst hydrogels themselves have long been used in biomedical applications such as tissue engineering and wound healing, their relatively larger sizes (above 100 micrometres) limits their ability to interact with cells and cross biological barriers. Nanogels, however, are thousands of times smaller, and offer unique advantages as a result. What are nanogels? Nanogels are tiny, water swollen polymer networks and are made up of crosslinked polymer chains to form a 3D matrix. Nanogels can encapsulate therapeutic agents inside their porous core shell structure. This swelling allowing nanogels to carry payloads, such as drugs, proteins, nucleic acids and these cargo materials are protected from degradation in the body whilst enabling controlled and targeted delivery. Due to their small sizes, nanogels can penetrate tissues and even enter cells, which overcomes the limitations faced with hydrogels. The surface of nanogels can also be engineered for specificity, to allow for precise targeting of drugs to receptors on diseased cells or inflamed tissues. Advantages over other nanocarriers Compared to liposomes and polymeric micelles, nanogels have a larger inner surface, which means they can carry more payload. The higher loading capacity improves the therapeutic efficiency whilst reducing the risks of side effects cause by off-target drug release. Nanogels also undergo the enhanced permeability and retention (EPR) effect - a phenomenon where the nanoparticles naturally accumulate in tumour or inflamed tissues due to leaky blood vessel, and as a result this improves drug delivery to targeted disease sites. Stimuli responsive ‘smart’ nanogels A key feature of nanogels is their stimuli responsiveness, or ability to act as ‘smart’ materials. The nanogels can be designed to respond to environmental triggers such as changes in pH, temperature, light, redox conditions, pressure and more. This responsiveness enables controlled release of drugs exactly when and where they are needed12. For example, thermoresponsive nanogels can change their structure at body temperature or when exposed to localised heating, making them ideal for applications like wound healing and cancer therapy. This controlled release prevents premature drug leakage, reduces systemic toxicity and overall improves the precision of the treatment. The future of nanogels in medicine Nanogels have huge potential as customisable drug delivery systems to target specific disease systems. They are biocompatible, stable, and have high drug loading capacities and are stimuli responsive; these properties combined make them a powerful tool in applications such as targeted drug delivery and gene therapy. As nanomedicine research progresses, nanogels are set to revolutionise healthcare with smarter, safer and more targeted therapies. Written by Saanchi Agarwal Related articles: Nanomedicine / Nanoparticles and diabetes treatment / Nanoparticles and health / Nanocarriers / Silicon hydrogel REFERENCES L. Blagojevic and N. Kamaly, Nanogels: A chemically versatile drug delivery platform, Nano Today, 2025, 61, 102645. F. Carton, M. Rizzi, E. Canciani, G. Sieve, D. Di Francesco, S. Casarella, L. Di Nunno and F. Boccafoschi, Use of Hydrogels in Regenerative Medicine: Focus on Mechanical Properties, Int. J. Mol. Sci. , 2024, 25 , 11426. N. Rabiee, S. Hajebi, M. Bagherzadeh, S. Ahmadi, M. Rabiee, H. Roghani-Mamaqani, M. Tahriri, L. Tayebi and M. R. Hamblin, Stimulus-Responsive Polymeric Nanogels as Smart Drug Delivery Systems, Acta Biomater. , 2019, 92 , 1–18. N. Rabiee, S. Hajebi, M. Bagherzadeh, S. Ahmadi, M. Rabiee, H. Roghani-Mamaqani, M. Tahriri, L. Tayebi and M. R. Hamblin, Stimulus-Responsive Polymeric Nanogels as Smart Drug Delivery Systems, Acta Biomater. , 2019, 92 , 1–18. A. Vashist, G. P. Alvarez, V. A. Camargo, A. D. Raymond, A. Y. Arias, N. Kolishetti, A. Vashist, P. Manickam, S. Aggarwal and M. Nair, Recent advances in nanogels for drug delivery and biomedical applications, Biomater. Sci. , 2024, 12 , 6006–6018. K. S. Soni, S. S. Desale and T. K. Bronich, Nanogels: an overview of properties, biomedical applications and obstacles to clinical translation, J. Control. Release Off. J. Control. Release Soc. , 2016, 240 , 109–126. A. Bordat, T. Boissenot, J. Nicolas and N. Tsapis, Thermoresponsive polymer nanocarriers for biomedical applications, Adv. Drug Deliv. Rev. , 2019, 138 , 167–192. K. S. Soni, S. S. Desale and T. K. Bronich, Nanogels: an overview of properties, biomedical applications and obstacles to clinical translation, J. Control. Release Off. J. Control. Release Soc. , 2016, 240 , 109–126. T. Alejo, L. Uson, G. Landa, M. Prieto, C. Yus Argón, S. Garcia-Salinas, R. de Miguel, A. Rodríguez-Largo, S. Irusta, V. Sebastian, G. Mendoza and M. Arruebo, Nanogels with High Loading of Anesthetic Nanocrystals for Extended Duration of Sciatic Nerve Block, ACS Appl. Mater. Interfaces , 2021, 13 , 17220–17235. S. V. Vinogradov, Nanogels in The Race for Drug Delivery, Nanomed. , 2010, 5 , 165–168. Project Gallery

How botox works in the cosmetic industry Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link From botulism to beauty: the evolution of botulinum toxins and botox 09/07/25, 15:10 Last updated: Published: 03/10/23, 15:07 How botox works in the cosmetic industry Botulinum neurotoxins (BoNTs) rank amongst the most potent and lethal neurotoxins known to science. Yet, it's a fascinating journey to discover how these deadly substances have found their way into one of the most renowned cosmetic procedures in the world: Botox. BoNTs originate from the bacterium Clostridium botulinum , which produces some of the most potent neurotoxins in existence. They are central to the development of botulism, a condition that relentlessly targets the body's nervous system, resulting in challenges in breathing and muscle paralysis. Despite their perilous origins, these toxins have undergone a fascinating metamorphosis into a popular cosmetic procedure. They have been studied substantially due to their ability to block nerve functions leading to muscle paralysis and their unique pharmacological properties in therapeutic and cosmetic uses. They affect the neurotransmission process by blocking the release of acetylcholine that allows muscle contraction in the body. The toxins bind pre-synaptically to recognition sites on cholinergic nerve terminals resulting in the inhibition of neurotransmitter release. The toxin consists of a heavy chain and a light chain connected by a disulphide bond. This disulphide bond is vital in the entry of the metalloprotease chain in the cytosol. BoNTs have a unique binding characteristic as a dual receptor binder, which allows them to achieve a high affinity for neurons. These proteins possess the remarkable ability to specifically target and interfere with the neurotransmission process. At their core, BoNTs are proteases, enzymes specialised in cleaving specific proteins involved in nerve signal transmission. When administered as Botox, BoNTs are skillfully harnessed to their advantage due to these properties. By injecting small, controlled amounts into specific facial muscles, they temporarily disrupt the nerve signals that stimulate muscle contraction. This action leads to muscle relaxation, smoothing out wrinkles and lines on the skin's surface. Importantly, the effects are localised, preserving the natural expressiveness of the face. In 1989, BoNTs made their debut in the medical community by being recognised as a safe and effective treatment by the FDA for blepharospasm, which affects eye muscle control. However, in 2002 the FDA extended its endorsement, propelling Botox into the realm of beauty. This pivotal decision forever reshaped the landscape of cosmetic procedures, solidifying Botox's status as an iconic treatment for rejuvenation and enhancement. In conclusion, the evolution of botulinum toxins and the rise of Botox is a captivating journey that traverses the realms of science, medicine, and evolving beauty ideals. Written by Anam Ahmed Project Gallery

Discussing Peto's Paradox in cancer Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Why blue whales don't get cancer 09/05/26, 14:57 Last updated: Published: 16/10/23, 22:22 Discussing Peto's Paradox in cancer Introduction: What is Peto’s Paradox? Cancer is a disease that occurs when cells divide uncontrollably, owing to genetic and epigenetic factors . Theoretically, the more cells an organism possesses, the higher the probability should be for it to develop cancer. Imagine that you have one tiny organism – a mouse, and a huge organism – an elephant. Since an elephant has more cells than a mouse, it should have a higher chance of developing cancer, right? This is where things get mysterious. In reality, animals with 1,000 times more cells than humans are not more likely to develop cancer. Notably, blue whales, the largest mammals, hardly develop cancer. Why? In order to understand this phenomenon, we must dive deep into Peto’s Paradox. Peto’s paradox is the lack of correlation between body size and cancer risk. In other words, the number of cells you possess does not dictate how likely you are to develop cancer. Furthermore, research has shown body mass and life expectancy are unlikely to impact the risk of death from cancer . (see figure 1) Peto’s Paradox: Protective Mechanisms Mutations, otherwise known as changes or alterations in the deoxyribonucleic acid (DNA) sequence, play a role in cancer and ageing. Research scientists have analysed mutations in the intestines of several mammalian species , ranging from mice, monkeys, cats, dogs, humans, and giraffes, to tigers and lions. Their results reveal that these mutations mostly come from processes that occur inside the body, such as chemicals causing changes in DNA. These processes were similar in all the animals they studied, with slight differences. Interestingly, annually, animals with longer lifespans were found to have fewer mutations in their cells ( figure 2 ). These findings suggest that the rate of mutations is associated with how long an animal lives and might have something to do with why animals age. Furthermore, even though these animals have very different lifespans and sizes, the amount of mutations in their cells at the end of their lives was not significantly different – this is known as cancer burden. Since animals with a larger size or longer lifespan have a larger number of cells (and hence DNA) that could undergo mutation, and a longer time of exposure to mutations, how is it possible that they do not have a higher cancer burden? Evolution has led to the formation of mechanisms in organisms that suppress the development of cancerous cells . Animals possessing 1,000 times as many cells as humans do not display a higher susceptibility to cancer, indicating that natural mechanisms can suppress cancer roughly 1,000 times more efficiently than they operate in human cells . Does this mean larger animals have a more efficient protective mechanism against cancer? A tumour is an abnormal lump formed by cells that grow and multiply uncontrollably. A tumour suppressor gene acts like a bodyguard in your cells. They help prevent the uncontrollable division of cells that could form tumours. Previous analyses have shown that the addition of one or two tumour suppressor gene mutations would be sufficient to reduce the cancer risk of a whale to that of a human. However, evidence does not suggest that an increased number of tumour suppressor genes correlated with increasing body mass and longevity. Although a study by Caulin et al . identified biomarkers in large animals that may explain Peto’s paradox, more experiments need to be conducted to confirm the biological mechanisms involved. Perillo et. al (2023) was an investigation of existing evidence on such mechanisms, and revealed a list of factors that may contribute to Peto’s paradox. This includes replicative immortality, cell senescence, genome instability and mutations, proliferative signalling, growth suppression evasion and cell resistance to death. As far as we know, different strategies have been followed to prevent cancer in species with larger sizes or longer lifespans . However, more studies must be conducted in the future in order to truly explain Peto’s paradox. Peto’s Paradox: Other Theories There are several theories that attempt to explain Peto’s paradox. One of which explains that large organisms have a lower basal metabolic rate, leading to less reactive oxygen species. This means that cells in larger organisms incur less oxidative damage, causing a lower mutation rate and lower risk of developing cancer. Another popular theory is the formation of hypertumours . As cells divide uncontrollably in a tumour, “cheaters” could emerge. These “cheaters”, known as hypertumours, are cells which grow and feed on their original tumour, ultimately damaging or destroying the original tumour. In large organisms, tumours have more time to reach lethal size. Therefore, hypertumours have more time to evolve, thereby destroying the original tumours. Hence, in large organisms, cancer may be more common but is less lethal. Clinical Implications Curing cancer has posed significant challenges. Consequently, the focus on cancer treatment has shifted towards cancer prevention . Extensive research is currently underway to investigate the behaviour and response of cancer cells to the treatment process. This is done through a multifaceted approach; investigating the tumour microenvironment and diagnostic or prognostic biomarkers. Going forward, a deeper understanding of these fields enables the development of prognostic models as well as targeted treatment methods. One example of an exciting discovery is the revelation of TP53 . The discovery of this tumour suppressor gene indicates that it plays a role in making elephant cells more responsive to DNA damage and in triggering apoptosis by regulating the TP53 signaling pathway. These findings imply that having more copies of TP53 may have directly contributed to the evolution of extremely large body sizes in elephants, helping resolve Peto’s paradox . Particularly, there are 20 copies of the TP53 gene in elephants, but only one copy of the TP53 gene in humans (see figure 3 ). Through more robust studies and translational medicine, it would be fascinating to see how such discoveries could be applied into human medicine ( figure 4 ). Conclusion The complete mechanism of how evolution has enabled organisms that are larger in size and have longer lifespans than humans is still a mystery. There is a multitude of hypotheses that need to be extensively investigated with large-scale experiments. By unravelling the mysteries of Peto’s paradox, these studies could provide invaluable insights into cancer resistance and potentially transform cancer prevention strategies for humans. Written by Joecelyn Kirani Tan Related articles: Biochemistry of cancer / Orcinus orca (killer whale) / Canine friends and cancer Project Gallery

Differences in brain structure Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Brief neuroanatomy of autism 26/04/26, 15:18 Last updated: Published: 26/12/23, 20:38 Differences in brain structure Autism is a neurodevelopmental condition present in both children and adults worldwide. The core symptoms include difficulties understanding social interaction and communication, and restrictive or repetitive behaviours such as strict routines and stimming. When the term autism was first coined in the 20th century, it was thought of as a disease. However, it is now described as a cognitive difference rather than a disease; that is, the brains of autistic individuals – along with people diagnosed with dyslexia, dyspraxia, or attention deficit hyperactive disorder – are not defective, but simply wired differently. The exact cause or mechanism for autism has not been determined; the symptoms are thought to be brought about by a combination of genetic and environmental factors. Currently, autism disorders are diagnosed solely by observing behaviours, without measuring the brain directly. However, behaviours may be seen as the observable consequence of brain activity. So, what is it about their brains that might make autistic individuals behave differently to neurotypicals? Total brain volume Back before sophisticated imaging techniques were in use, psychiatrics had already observed the head size of autistic infants was often larger than that of other children. Later studies provided more evidence that most children who would go on to be diagnosed had a normal-sized head at birth, but an abnormally large circumference by the time they had turned 2 to 4 years old. Interestingly, increase in head size has been found to be correlated with the onset of main symptoms of autism. However, after childhood, growth appears to slow down, and autistic teenagers and adults present brain sizes comparable to those of neurotypicals. The cortex Research from the UC Davis MIND Institute (May 2024) found that at the age of 3, autistic girls have a thicker cortex than non-autistic girls, with these differences becoming less pronounced by age 12- due to faster cortical thinning in autistic girls. A major study published in Molecular Psychiatry (Oct 2024) found that, for the first time in living adults, autistic brains have approximately 17% lower synaptic density compared to neurotypical individuals. A lower density of these nerve cell connections was directly correlated with more pronounced differences in communication. The amygdala As well transient increase of total brain volume and differences in the cortex, the size and volume of several brain structures in particular seems to differ between individuals with and without autism. Most studies have found that the amygdala, a small area in the centre of the brain that mediates emotions such as fear, appears enlarged in autistic children. The amygdala is a particularly interesting structure to study in autism, as individuals often have difficulty interpreting and regulating emotions and social interactions. Its increased size seems to persist at least until early adolescence. However, studies in adolescents and adults tend to show that the enlargement slows down, and in some cases is even reversed so that the number of amygdala neurons may be lower than normal in autistic adults. Moreover, higher neuron density was found in the amygdala in children, with lower neuron density in other brain areas- as described by a study in Autism Research (Oct 2024). The cerebellum Another brain structure that tends to present abnormalities in autism is the cerebellum. Sitting at the back of the head near the spinal cord, it is known to mediate fine motor control and proprioception. Yet, recent literature suggests it may also play an important role in some higher other cognitive functions, including language and social cognition. Specifically, it may be involved in our ability to imagine hypothetical scenarios and to abstract information from social interactions. In other words, it may help us recognise similarities and patterns in past social interactions that we can apply to understand a current situation. This ability is poor in autism; indeed, some investigations have found the volume of the cerebellum may be smaller in autistic individuals, although research is not conclusive. Nevertheless, most research agrees that the number of Purkinje cells is markedly lower in people with autism. Purkinje cells are a type of neuron found exclusively in the cerebellum, able to integrate large amounts of input information into a coherent signal. They are also the only source of output for the cerebellum; they are responsible for connecting the structure with other parts of the brain such as the cortex and subcortical structures. These connections eventually bring about a specific function, including motor control and cognition. Therefore, a low number of Purkinje cells may cause underconnectivity between the cerebellum and other areas, which might be the reason for functions such as social cognition being impaired in autism. Written by Julia Ruiz Rua Related article: Epilepsy Project Gallery

Observations suggest that aspects of their design were purposeful for other reasons Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The astronomical symbolism of the Giza Pyramids Last updated: 09/10/25, 11:03 Published: 06/03/25, 08:00 Observations suggest that aspects of their design were purposeful for other reasons This is Article 2 in a series about astro-archaeology. Next article: The celestial blueprint of time: Stonehenge, UK . Previous article: Cities designed to track the heavens: Chaco Canyon, New Mexico The Giza Pyramids of the ancient Egyptian civilisation may be most well known as one of the Seven Wonders of the Ancient World, but they also harbour astronomical secrets. The three Great Pyramids (Khafre, Khufu, and Menkaure) are incredible feats of engineering, with heights measuring 146.6 meters, 143.5 meters, and 64.5 meters, respectively. No documentation has been found explaining the planning or construction processes behind the creation of these magnificent structures, yet observations suggest that aspects of their design were purposeful for reasons other than simply erecting the pyramid. Example 1: The square bases of the pyramids are very carefully oriented to the cardinal points with the Khufu Pyramid aligning within 4 arc minutes of the north-south line. For context, if you were to hold your index finger up, it would cover a portion of the sky that measures about 10 degrees across. 1 arc minute is a unit of measurement equal to 1/60 of 1 degree, which means that the orientation of the Khufu Pyramid only deviates from the north-south line by less than 4/60-degree error. Today, we would calculate this using a GPS or other technical equipment, but what did the ancient Egyptians use? Well, astronomy! While the exact method of calculation is not known, researchers believe that the ancient engineers aligned the pyramids to the constellation Orion and the star Sirius as they are circumpolar stars, never rising nor setting, and are therefore visible every night as a useful guide. This may also have religious implications relating to immortality, perhaps adding to the desire to align the Pharoah’s tombs with such a symbolic constellation. Example 2: The south-eastern corners of the three Giza Pyramids all point toward the nearby great solar temple of Heliopolis, which was a major religious centre of the sun god Atum-Ra. According to the Pyramid Texts, Heliopolis was the location that the god-creator Atum emerged from chaos and begun creation. These texts suggest that the ancient Egyptians believed that the Pharaohs join Atum-Ra in the afterlife, and they together cross the sky in Atum-Ra’s sun boat as part of the rebirth process. Upon investigation, the three pyramids seem to be aligned with various solar events as well as the city of the sun god: the setting sun is aligned with the northern side of the Khafre pyramid and the southern side of the Khufu pyramid during the equinoxes the causeways point to the setting sun behind the pyramid twice per year, which are distanced the same number of days from the winter/summer solstices each of the two causeways point towards sunset in two separate locations that are halfway between the equinoxes and solstices, respectively (not according to the calendar year, but according to the astronomical year) on the summer solstice, the sun sets directly between the two great pyramids when viewing from the Sphinx area of the pyramidal complex Example 3: the position of three Great Pyramids with respect to each other mimics the position of the stars in the constellation Orion’s belt with respect to each other. Astronomical calculations show that the orientation and position of the Khufu, Khafre, and Menkaure pyramids align together in exactly the same way that the Alnitak, Alnilam, and Mintaka stars align in Orion’s belt. Of course, there is a small percentage of error, but it is because of naked eye observations instead of mathematical miscalculations. While there are still many secrets hidden in and around the Great Pyramids of ancient Egypt, they can continue to provide insight into how ancient peoples interconnected architecture, astronomy/mathematics, and religious beliefs within their societies. Written by Amber Elinsky REFERENCES Magli, G. (2009). Archaeoastronomy at Giza: the ancient Egyptians’ mathematical astronomy in action. In: Emmer, M., Quarteroni, A. (eds) Mathknow. MS&A, vol 3. Springer, Milano. https://doi.org/10.1007/978-88-470-1122-9_10 . Orofino, V. and P. Bernardini. Archaeoastronomical Study of the Main Pyramids of Giza, Egypt: Possible Correlations with the Stars?. Archaeological Discovery: 1 (2016), vol 3. https://www.scirp.org/journal/paperinformation?paperid=61389 . Verner, Miroslav, 'Heliopolis: The City of the Sun', in Anna Bryson-Gustová (ed.), Temple of the World: Sanctuaries, Cults, and Mysteries of Ancient Egypt (Cairo, 2013; online edn, Cairo Scholarship Online, 18 Sept. 2014), https://doi.org/10.5743/cairo/9789774165634.003.0002 . https://pyramidtextsonline.com/translation.html Project Gallery

Research confirms anxiety disorders do have a genetic side Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Does anxiety run in families? Here's what genetics tells us Last updated: 10/07/25, 19:26 Published: 19/06/25, 08:00 Research confirms anxiety disorders do have a genetic side Have you ever noticed anxiety can pop up in several members of the same family? Maybe your sister worries constantly, or your brother gets nervous around people. It might feel like anxiety is passed down through generations. But is that really how it works, or is it just a coincidence? Here's what science has to say. Your DNA can affect anxiety Research confirms anxiety disorders do have a genetic side. That means you're more likely to have anxiety if someone in your family, like your mum, dad, sibling, or even a grandparent, has it too. But this doesn't mean anxiety is certain. Instead, genes increase your chances, accounting for about 30% to 40% of your risk. Scientists work this out by comparing identical and fraternal twins and by following anxiety diagnoses across generations; those studies repeatedly find that roughly one-third to two-fifths of a person’s risk is genetic. So, if genetics only make up part of the picture, what's the rest? That's where your environment steps in. Your life experiences matter a lot. Things like your relationships, stressful situations, and even your physical health can tip the scales one way or another. Genes set the stage, but they don't control the outcome. Think of your genes as nudging you towards anxiety rather than pushing you into it completely. The rest depends on what happens to you. How genes shape your brain Scientists have pinpointed several genes linked to anxiety. One of these genes affects serotonin, a brain chemical that helps regulate your mood and manage stress. When serotonin works well, you feel calm and can handle stressful events better. But if your genes make serotonin less effective, stress hits you harder. This can make anxiety more likely during tough times, even when others around you seem okay. There's another important point: your brain structure. Genes influence parts of your brain, especially the amygdala. Think of the amygdala as your internal alarm system. It warns you when something feels dangerous. In people with certain genes, the amygdala is extra sensitive. That means their "alarm" goes off more easily, causing anxiety even when there's no real danger present. However, not everyone with these genetic variations experiences anxiety. Your brain adapts throughout life, changing how genes affect you. This ongoing flexibility is called neuroplasticity: experience can strengthen or weaken neural circuits and can even add or remove chemical tags, such as DNA methylation, that switch genes on or off, reshaping how your stress system responds. Anxiety isn't just genetic; here's why It's tempting to blame your genes entirely if anxiety runs in your family. But life is more complicated. Even if you inherit genes that make anxiety more likely, the disorder usually develops when certain environmental conditions come into play. Stressful life events like losing a loved one, ongoing conflict at home, bullying, or trauma can trigger anxiety symptoms. Someone might have anxiety-related genes but never experience anxiety if their life stays relatively stress-free. On the other hand, someone without these genes can still develop anxiety if they experience severe stress or trauma. Lifestyle choices also make a big difference. Regular exercise, healthy eating, good sleep, and support from friends and family can protect against anxiety. Studies show these lifestyle habits are powerful, even if your genes are pushing in the opposite direction. Can you change your genetic destiny? Understanding that anxiety has a genetic basis can help. It means anxiety isn't just a character flaw or personal weakness. It's something partly built into your biology, something real and valid. Realising this can reduce shame and make people more willing to seek help. And here's another benefit: knowing your family history allows you to spot anxiety sooner. If you understand that anxiety might run in your family, you can pay attention to early signs, like trouble sleeping, excessive worry, or panic in social settings. Catching anxiety early means getting support earlier, making treatments like therapy or lifestyle changes more effective. Anxiety might run in your family, but you get to decide how far it goes. Written by Rand Alanazi Related articles: Depression / South Asian mental health / Physical and mental health / Does insomnia run in families? REFERENCES National Institute of Mental Health. Anxiety disorders [Internet]. Bethesda (MD): National Institute of Mental Health; 2024 [cited 2025 May 29]. Available from: https://www.nimh.nih.gov/health/topics/anxiety-disorders Mayo Clinic. Anxiety disorders [Internet]. Rochester (MN): Mayo Foundation for Medical Education and Research; 2018 [cited 2025 May 29]. Available from: https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961 Leyfer O, Woodruff-Borden J, Mervis CB. Anxiety disorders in children with Williams syndrome, their mothers, and their siblings: implications for the aetiology of anxiety disorders. J Neurodev Disord . 2009 Feb 13;1(1):4-14. Martin EI, Ressler KJ, Binder EB, Nemeroff CB. The neurobiology of anxiety disorders: brain imaging, genetics, and psychoneuroendocrinology. Psychiatr Clin North Am [Internet]. 2009 Sep;32(3):549-75. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684250/ McEwen BS, Eiland L, Hunter RG, Miller MM. Stress and anxiety: structural plasticity and epigenetic regulation as a consequence of stress. Neuropharmacology . 2012 Jan;62(1):3-12. Xie S, Zhang X, Cheng W, Yang Z. Adolescent anxiety disorders and the developing brain: comparing neuroimaging findings in adolescents and adults. Gen Psychiatry [Internet]. 2021 Aug 4;34(4):e100542. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8340272/ Zhang K, Ibrahim GM, Venetucci Gouveia F. Molecular pathways, neural circuits and emerging therapies for self-injurious behaviour. Int J Mol Sci [Internet]. 2025 Feb 24;26(5):1938. Available from: https://www.mdpi.com/1422-0067/26/5/1938 Chaves T, Fazekas CL, Horváth K, Correia P, Szabó A, Török B, et al. Stress adaptation and the brainstem with focus on corticotropin-releasing hormone. Int J Mol Sci [Internet]. 2021 Jan 1;22(16):9090. Available from: https://www.mdpi.com/1422-0067/22/16/9090 Project Gallery