Impact of war and geopolitics on health in Palestine Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Life under occupation: the health and well-being of Palestinians Last updated: 08/01/26, 18:56 Published: 13/03/25, 08:00 Impact of war and geopolitics on health in Palestine This is article no. 1 in a series about global health injustices. Next article: Civil war in Sudan . Introduction Welcome to the Global Health Injustices Series, which will focus on critically examining the health inequalities and inequities faced by vulnerable populations within different countries and regions worldwide and even put forward actionable steps to improve their health and wellbeing. This series will begin with Palestine, as it has been an enduring crisis that should be addressed to include long-lasting benefits and outcomes for the Palestinians. Palestine: from a rich history to current occupation Palestine is a country in the Middle East (West Asia) mainly bordered by Israel. Palestine is unique in its various cultures and knowledge, moulded by multifaceted events and geopolitical shifts over centuries. The multidimensional cultural landscape of Palestine illustrates the impact of civilisations, such as the Romans, Byzantines, and Ottomans, who each had their religions, languages, and cultures, which still exist in various forms today. The resilience of the Palestinians is evident through their distinct traditions, art, food and environment, which are essential to their identity. With these testaments in mind, Palestinians are facing consistent strife because they are under constant occupation, blockade and cutting off of needed supplies carried out by Israel, as noted by several humanitarian and human rights non-governmental organisations (NGOs) like Amnesty International and Save the Children. These actions are facilitated by nations, notably the United States and the United Kingdom, through arms and weapons trade. Hence, the struggle for the Palestinians to have autonomy and freedom, among other human rights within their own homeland, is a consistent fight that requires ongoing international cooperation and solidarity. Geopolitics: its detrimental impacts on the Palestinians Given the currently divisive geopolitical landscape, it is essential to bring attention to the health outcomes of the Palestinian population, especially since at least half of them are children. A report from the Global Nutrition Cluster called “Nutrition Vulnerability and Situation Analysis / Gaza” had several key findings and tables (see Tables 1 and 2 ). Firstly, more than 90% of children less than a year old, along with pregnant and breastfeeding women, encounter high under-nutrition due to poverty. Another finding was that approximately 90% of children under five are impacted by at least one infectious disease, and 81% of households in Gaza lack clean and safe water. However, the authors noted limitations in their analysis, such as limited data sources because collecting it is difficult within the context of Gaza, and this was true for screening. Another report from the organisation Medical Aid For Palestinians (MAP), titled “Health Under Occupation” from 2017, discussed healthcare access and outcomes more broadly. For example, they noted that in 2016, up to one-third of patients’ permits to exit Gaza for healthcare access were either denied or delayed. Moreover, they stated that 40% of people in Gaza live below the poverty line. Given the recent geopolitical shifts in power, these findings from both reports will likely be higher now. This brings forthcoming uncertainty about whether the health outcomes of Palestinians will improve. In a recent qualitative study involving the views of Palestinian physicians in the West Bank, they shared their experiences of violence, threats of violence, issues with healthcare access for themselves and patients, financial difficulties to support their families, struggle to help their patients and limited access to education due to harsher life under occupation. Thinking more largely about emergency care in Palestine, one scoping review reported the depletion of healthcare resources such as medical equipment and medications. The authors even related how human rights violations and the destruction of the Palestinian healthcare system, including emergencies, have exacerbated outcomes; the most notable were stroke, myocardial infarction and traumatic injury, among other non-infectious diseases. Although the authors included this information from a human rights standpoint, they called for additional interventions and research to fill in and learn gaps within emergency care to enhance health outcomes for Palestinians. This review was published in 2022, and again, many geopolitical shifts in power have taken place within a few years. Therefore, it can be deduced that emergency care is drastically needed for the Palestinians; this is primarily compelled by the blockade in Gaza and occupation in the West Bank. Focusing on the mental health outcomes among Palestinians, they have become worse. In another scoping review, researchers focused on trauma among young Palestinian people in Gaza; the authors noted that events, such as exposure to devastation and violence, as well as the death or loss of friends and family, have contributed to mental health outcomes ranging from post-traumatic stress disorder (PTSD) to depression. Nevertheless, the authors stated that further qualitative research is vital to addressing gaps in knowledge and enhancing mental health outcomes among the Palestinian youth and the wider population. Connecting back to how the modern geopolitical landscape is very dynamic, the poorer mental health outcomes among Palestinians have conceivably increased. Urgent calls to action: recommendations from NGOs to upholding human rights Given all of these detrimental impacts on the health and wellbeing of Palestinians, there are recommendations from organisations, notably the United Nations (UN), for ways forward towards upholding the human rights of Palestinians: Immediately end all practices of collective punishment, including lifting its blockade and closures – and the “complete siege”- of Gaza, and urgently ensure immediate access to humanitarian and commercial goods throughout Gaza, commensurate with the immense humanitarian needs. Ensure that all Palestinians forcibly displaced from Gaza are allowed to return to their homes creating safe conditions and fulfil its responsibilities as an occupying Power in this regard. End the 56-year occupation of the Occupied Palestinian Territory, including East Jerusalem as part of a broader process towards achieving equality, justice, democracy, non-discrimination, and the fulfilment of all human rights for all Palestinians. These recommendations, among others mentioned in the report from the United Nations (UN) High Commissioner for Human Rights, were divulged in 2024; the year had been a challenging time, particularly in Gaza, due to the complete blockade of food, water and essentials like medical supplies; in addition to this, many explosives were dropped on Gaza, killing thousands of men, women and children. Finally, buildings, such as hospitals and homes, were destroyed. Conclusion: moving forward towards a equitable and equal future for Palestinians Reflecting on everything discussed in this article, the numerous injustices happening to Palestinians must not go on; they have been suppressed for nearly 75 years by governments and the mainstream media before receiving closer attention, examination and debate within Western society recently. Therefore, we need to take actionable steps by initiating more open discussions of justice and advocacy involving the voices of Palestinians, such as myself and others. Furthermore, it is crucial always to nudge those in positions of power worldwide to fulfil their responsibilities as civil servants and defend human rights for everyone. Both of these actions uphold the health and wellbeing of Palestinians living in Gaza and the West Bank, especially as enabling the recommendations from the UN and other NGOs. As for the wider international community, we must continue upholding human rights to maintain our health and wellbeing. In my next article, I will discuss Sudan because this population has also encountered many injustices, primarily the civil war that has been occurring since 2023. This has impacted the health and wellbeing of the Sudanese population, which requires thorough attention and discussion. Written by Sam Jarada Related articles: Gentrification and well-being / Health Inequalities / Impacts of global warming on NTDs / Global health injustices- Bangladesh , Sri Lankan Tamils REFERENCES Human rights in Israel and the Occupied Palestinian Territory. Amnesty International. 2022. Available from: https://www.amnesty.org/en/location/middle-east-and-north-africa/middle-east/israel-and-the-occupied-palestinian-territory/report-israel-and-the-occupied-palestinian-territory/ Occupied Palestinian Territory. Save the Children International. 2024. Available from: https://www.savethechildren.net/occupied-palestinian-territory Nutrition Vulnerability and Situation Analysis / Gaza. 2024. Available from: https://www.nutritioncluster.net/sites/nutritioncluster.com/files/2024-02/GAZA-Nutrition-vulnerability-and-SitAn-v7.pdf HEALTH UNDER OCCUPATION. Medical Aid For Palestinians. 2017. Available from: https://www.map.org.uk/downloads/health-under-occupation---map-report-2017.pdf Husam Dweik, Hadwan AA, Beesan Maraqa, Taher A, Zink T. Perspectives of Palestinian physicians on the impact of the Gaza War in the West Bank. SSM - Qualitative Research in Health. 2024 Nov 14;6:100504–4. Available from: https://www.sciencedirect.com/science/article/pii/S2667321524001136 Rosenbloom R, Leff R. Emergency Care in the Occupied Palestinian Territory: A Scoping Review. Health and Human Rights. 2022 Dec;24(2):255. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9790939/ Abdallah Abudayya, Fugleberg T, Nyhus HB, Radwan Aburukba, Tofthagen R. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Mental Health & Prevention. 2023 Nov 25;32:200305–5. Available from: https://www.sciencedirect.com/science/article/pii/S2212657023000478 M.I. Human rights situation in the Occupied Palestinian Territory, including East Jerusalem, and the obligation to ensure accountability and justice - Report of the United Nations High Commissioner for Human Rights - Advance unedited version (A/HRC/55/28) - Question of Palestine. United Nations. Available from: https://www.un.org/unispal/document/human-rights-situation-in-opt-unohchr-23feb-2024/ Project Gallery

A problem synthesising haem Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Sideroblastic anaemia 09/05/26, 14:50 Last updated: Published: 22/12/23, 15:20 A problem synthesising haem This is the fourth and final article in a series about anaemia. First article: anaemia . Previous article: Anaemia of chronic disease . Sideroblastic anaemia (SA) is like haemochromatosis as there is too much iron. Due to an absence of protoporphyrin, iron transport is inhibited. SA’s include hereditary and acquired conditions; these can be due to alcohol, toxins, congenital defects, malignancies, or mutations. This haem-synthesising defect can be caused by the X-linked chromosome, or the lead poisoning induced mutations- these are main mutations that interrupt the 8 enzymatic cascades in the biosynthesis of protoporphyrin, thus leading to defective haemoglobin (Hg)- moreover, iron accumulation in the mitochondria. X-linked protoporphyria is due to a germline mutation in the gene that produces δ-aminolaevulinic acid (δ-ala) synthase; this interrupts the first step of haem synthesis, Figure 1 . Lead poisoning can interrupt two stages of haem synthesis: δ-ala dehydratase (-δ-ala dehydratase porphyria) and ferrochelatase (erythropoietic protoporphyria). The first step devastates the production of haem, due to the chromosomal abnormality that stops the production of δ-ala dehydratase being X-linked porphyria. The second step and the final step are associated with lead poisoning, and this is more common in children. Ferrochelatase is a catalyst for the incorporation of iron to haem in the final stage of haemoglobin synthesis. This causes ferrochelatase erythrocytic protoporphyrin (FECH EPP). SA clinical presentation Common features of SA are general to microcytic anaemias such as teardrop and hypochromic cells. Dimorphism is common. Pappenheimer bodies and mitochondrial iron clusters which are found in bone marrow smears, where iron accumulates around 2/3 of the nucleus of erythroblasts. Without knowing the etiology of anaemia, standard FBCs and iron studies would be run to initially diagnosis the anaemia. With SA, the iron cannot be transported so transferrin will be reduced, alongside mean cell volume (MCV), haemoglobin and haematocrit (HCT). There will also be an increase in ferratin, % saturation and serum Fe. Microcytic anaemia presents in 20-60% of patients with FECH-EPP. Morphology will present as microcytic and hypochromic with the possible presentation of Pappenheimer bodies, ringed sideroblasts, dimorphism and basophilic stippling may be present in bloods of children suspected in lead >5 µg/dL. Lead poisoning can be misdiagnosed as porphyrin as lead is shed from the body slowly; this allows approximately 80% of the lead to be absorbed. Although lead exits the blood rather quickly, once it’s in the bone, it can have a half-life of 30 years. Written by Lauren Kelly Related articles: Blood / Kawasaki disease Project Gallery

How metal compounds can be used as anti-cancer agents Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Anticancer Metal Compounds 04/04/26, 16:58 Last updated: Published: 23/05/23, 09:17 How metal compounds can be used as anti-cancer agents Metal compounds such as platinum, cobalt and ruthenium are used as anticancer agents. Anticancer metal compound research is important as chemotherapy is not selective, being very toxic to patients damaging normal DNA cells. Such metal compounds act as anti-cancer agents with the metals being able to vary in oxidation states. Selectivity of metal compounds to target only cancer cells arises from the metals properties of varying oxidation states for redox reactions. As cancer exists in hypoxic environments, the oxidation state of the metal is able to vary releasing the cancer drug only in the cancer environment. For example prodrugs are relatively inert metal complexes with relatively high oxidation states. PtIV, and CoIII are selective carriers undergoing reduction by varying the metals oxidation state in cancerous hypoxic environments releasing anticancer drugs. CoIII reduced to CoII, PtIV reduced to PtII in hypoxic environments. CoIII two oxidation states: Cobalt (III) is kinetically inert with low-spin 3d6 configuration, CoII is labile (high-spin 3d7). When CoIII is reduced to CoII in hypoxic environments, the active molecule is released then restored to its active form killing cancer cells. Cobalt can also bind to ligands like nitrogen mustards and curcumin ligands, exhibiting redox reactivity for cancer therapy. Nitrogen mustards are highly toxic due to their DNA alkylation and cross-linking activity. In vivo they are not selective for tumour tissue however can be deactivated by coordination to CoIII, released on reduction to CoII in hypoxic tumour tissue. This reduces systemic toxicity concluding an efficient anticancer drug. Platinum anticancer metal compounds treat ovarian, cervical and neck cancer. Platinum ( Pt IV) (cisplatin) exhibits redox-mediated anticancer activity, highly effective towards tumours. Platinum causes severe side-effects for patients so PtIV prodrug is used selectively reducing tumour sites. Ruthenium is used for cancer therapy as a less toxic metal over platinum. Ruthenium targeted therapy selectively disrupts specific cellular pathways where cancer cells rely for growth and metastasis. Reduction of Ru (III) to Ru(II) selectively occurs in hypoxic reducing environments where tumours over express transferrin receptors, ruthenium binding to. Since platinum is toxic, the latest efforts in research are developing ruthenium, gold, copper, and iron complexes that have higher specificity and reduced toxicity. Overall, metal compounds for cancer treatment attracted high interest due to redox activity properties. Metal compounds are selective to cancer cells, limiting patients' side effects. Such therapy shows how inorganic chemistry is important to medicine. Written by Alice Davey Related article: MOFs in cancer drug delivery Project Gallery

And a hope for a more sustainable future Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Green Chemistry 04/04/26, 18:32 Last updated: Published: 29/06/23, 11:33 And a hope for a more sustainable future Green Chemistry is a branch of chemistry that takes into consideration the design of synthetic reactions to minimise the generation of hazardous by-products, their impact on humans and the environment. Often reactions are designed to take place at low temperatures with short reaction times and increased yields. This is preferred as fewer materials are used and it is more energy efficient. When designing routes it is important to consider ‘How green is the process?’ in this way we are shifting focus to a more sustainable future where we are emitting fewer pollutants, using renewable feedstocks and energy sources with minimal waste. In 1998, Paul Anastas and John Warner devised the twelve principles of Green Chemistry. They serve as a framework for scientists to design innovative scientific solutions to existing and new synthetic routes. Scientists are looking into environmentally friendly reaction schemes which can simplify production as well as being able to use greener resources. It is impossible to fulfil all twelve principles at the same time but making attempts to apply as many principles as possible when designing a protocol is just as good. The twelve principles are: Prevention: waste should be prevented rather than treating waste after it has been created. Atom Economy: designing processes where you are maximising the incorporation of all materials so all reagents are in the final product. Less Hazardous Chemical Synthesis : synthetic methods should be designed to be safe and the hazards of all the substances should be reviewed. Designing Safer Chemicals: designed to eliminate chemicals which are carcinogenic, neurotoxic, etc. essentially safe to the Earth. Safer Solvents and Auxiliaries: using auxiliary substances and minimising usage of solvents to reduce waste created. Design for Energy Efficiency: designing synthetic methods where reactions can be conducted at ambient temperature and pressure. Use of Renewable Feedstock: raw materials used for reactions should be renewable rather than depleting. Reduce Derivatives: reducing the steps required in a reaction by using catalysts/ enzymes and adding protecting or deprotecting groups or temporary modification of functionality. Extra steps require more reagents and generate a lot of waste. Catalysis: catalysts lower energy consumption and increase reaction rates. They allow for decreased use of harmful and toxic chemicals. Design for Degradation: chemical products should be designed so that they can break down and have no harmful effects on the environment. Real-time analysis for Pollution Prevention: analytical techniques required to allow monitoring of the formation of hazardous substances. Inherently Safer Chemistry for Accident Prevention: involves using safer chemical alternatives to prevent the occurrence of an accident e.g. fires; explosions. Some examples of areas where Green Chemistry is implemented: Computer Chips: the use of supercritical carbon dioxide as a step for the preparation of a chip. This has reduced the quantities of chemicals, water and energy required to produce chips. Medicine: developing more efficient ways of synthesising pharmaceuticals e.g. chemotherapy drug Taxol. Green Chemistry is widely being implemented in academic labs as a way to reduce the environmental impact and high costs. In 2026, green chemistry has evolved from a niche sustainability goal into a $1 trillion global industry. This branch in Chemistry is still fairly new and will likely be one of the most important fields in the future. Written by Khushleen Kaur Related article: The challenges in modern day chemistry Project Gallery

The same condition after all? Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder 26/04/26, 15:06 Last updated: Published: 20/01/24, 11:38 The same condition after all? Practice and progress in rheumatology The relationship between hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD) has been hotly debated in recent years, with research being published on a near-constant basis attempting to establish a valid symptomatological or causalogical difference between the two disorders. Now, a paper by Ritelli et al. (2022) threatens to end the savage cycle for all. Using RNA sequencing techniques and immunofluorescence, Ritelli et al. found identical gene expression and cellular characteristics in dermal biopsies from those with both conditions. Through immunofluorescence of biopsies from 20 women with hEDS, 16 women and 4 men with HSD and 40 controls, it was found that the shape and components of the extracellular matrix were greatly different in those with HSD/hEDS in comparison to those in the healthy control group. Abnormalities were discovered in the expression of cadherin-11, snail1, and αvβ3, α5β1 and α2β1 integrins. Integrins mediate the connections between the cell cytoskeleton and extracellular matrix to ensure they stay together, cell-to-cell adhesion is initiated by cadherin-11, and snail1 is localised close to the cyclin-dependent kinase inhibitor 2B (CDKN2B) gene. Snail1 can activate CDKN2B gene products when Snail1 is overexpressed to the point of reaching the general localisation of the CDKN2B domain. This demonstrates that there may be a similar causative link between the widespread inflammation and chronic pain in HSD/hEDS and rheumatoid arthritis. Li et al. (2021) proved that the polarisation of macrophages (white blood cells which destroy foreign products) was carefully controlled by the CDKN2B-AS1/ MIR497/TXNIP axis- the increased activation of which in rheumatoid arthritis catalyses the excessive polarisation of macrophages, which causes the macrophages to attack healthy cells. In rat studies published by Tan et al. (2022), it was found that rats with diabetes and induced sepsis experienced greater intestinal injury that control rats without any medical pathology who experienced induced sepsis. This was demonstrated to be due to interruptions in the miR-3061/Snail1 communication pathway. Research on this phenomenon in humans may elucidate the relevance of snail1 overproduction in hEDS/HSD sufferers to their complex gastrointestinal symptoms. If this pathway works similarly in human models of sepsis or localised GI infection, it may intimate that snail1 overproduction is responsible for the hyperpolarisation of macrophages in response to foreign product detection, which may cause immunological damage in the intestines. However, the relevance of this study to hEDS/HSD should be considered questionable until further human research into this avenue has been completed. The result of this research is that academia can potentially derive a genetic cause of the complex phenotypes demonstrated by sufferers of hEDS/HSD. This can be achieved by visualising the human genome, and testing genes like those above, or those implicated in modulating the activity of the genes above. Given this, the 2025 symposium discussed whether HSD and hEDS should be considered separate at all, with discussions around potentially reclassifying or merging them in the future, to improve access to care to patients. Written by Aimee Wilson Related articles: Ehlers-Danlos syndrome / Types of movement Project Gallery

Immunosenescence and related therapies Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Ageing and its association with immune decline Last updated: 24/02/25, 11:28 Published: 20/02/25, 08:00 Immunosenescence and related therapies Introduction Ageing is a profoundly complex and integral part of human life. As pharmaceutical developments have occurred, introducing new medicines and therapies such as biologics and antibiotics within the last 100 years, research has begun to look at malignancy at a more macro scale. To be clear, while it has become easier to combat infectious diseases in recent times, the combating of diseases tied to our genetic composition is far more complicated, whether it be autoimmune diseases or onset conditions such as cases of dementia. Ageing is one such case of a process that is hard to combat because the mechanisms that cause it are diverse and currently not fully understood. Strides have been made under a concept known as senescence, which continues to enlighten researchers and the anti-ageing pharmaceutical industry. This article provides a short summary of what immunosenescence is and how we can utilise our understanding to develop therapies for human immunity. What is immunosenescence? Immunosenescence is the change from a healthy, active immune cell phenotype to one that is no longer conventionally active and begins to secrete inflammatory chemical messengers known as the senescence-associated secretory phenotype (SASP) ( Figure 1 ). A most important aspect of senescence is that a cell undergoes cell cycle arrest, meaning it cannot proliferate. You may now question why cells are programmed to senesce if the outcomes are detrimental to the host? It prevents the continued proliferation of old or damaged cells, including cells with uncontrolled proliferation (such as cancer cells). If we stop senescence altogether, we run the risk of accumulating damaged and/or mutated cells, increasing the chances of disease progression, such as through fibrosis and tumorigenesis, so specific targeting and dosage of drug interventions have to be considered. The immune system in particular, displays biological changes that are indicative of senescent progression. These include thymic involution (shrinking of the thymus associated with a decrease in T cell production), inflammaging (chronic inflammation associated with SASP), an increase in mitochondrial stress through metabolic changes, and an increase in differentiated memory T cells (EMRA T cells). Knowledge of these changes can give insight into potential mechanisms to target for therapeutics. Current and developing therapies for immunosenescence Given our expanding understanding of senescence, as of the time of writing, there are no clinically approved drugs for senescence specifically. The development of therapies for diseases such as cancer, heart disease and diabetes (diabetic patients tend to exhibit increased levels of cellular senescence owing to “accelerated ageing”) have been implicated with suppressing senescence. These drugs would be mTOR inhibitors such as Rapamycin, statins, P13K inhibitors, as well as immune checkpoint inhibitors for T cells, such as anti CTLA-4 PD-L1 and PD-L2, and the anti-diabetic metformin, which have all shown in vitro to be effective against high levels of senescent cells. There was also the development of the recent first senolytic drugs dasatinib and quercetin in 2015 that kill senescent cells selectively against non-senescent cells and stand to provide a proof of concept for targeting disease through senescent mechanisms. Conclusion The field of senescence is certainly one to keep an eye on, with a bibliometric analysis in 2023 showing an increase every year in the number of published papers ( Figure 2 ). It may be sooner rather than later that we see this become a trending topic of discussion for treating an array of disease states. Continuous research into specific immune cell subtypes (B, T and NK cells) and their relation to a decline in immunity in response to age can tell us more about potential therapeutic pathways or lifestyle choices that can improve the health of the immunocompromised elderly. One such example of this is Treg-mediated increased glucose consumption in the tumour microenvironment leading to an increase in cell senescence in effector T cells, suggesting that high sugar diets can accelerate tumorigenesis. Our understanding of ageing through senescence will help reduce the mortality rates of elderly groups in decades to come through knowing that mechanisms such as the SASP and altered immune cell function, which can promote disease states. Written by Yaseen Ahmad Related articles: Genetics of ageing and longevity / Accelerated ageing REFERENCES Henson, S.M. and Aksentijevic, D. (2021) ‘Senescence and type 2 diabetic cardiomyopathy: How young can you die of old age?’, Frontiers in Pharmacology , 12. doi:10.3389/fphar.2021.716517. Wang, R. et al. (2017) ‘Rapamycin inhibits the secretory phenotype of senescent cells by a NRF2-independent mechanism’, Aging Cell , 16(3), pp. 564–574. doi:10.1111/acel.12587. Henson, S.M. et al. (2012) ‘Reversal of functional defects in highly differentiated young and old CD8 T cells by PDL blockade’, Immunology , 135(4), pp. 355–363. doi:10.1111/j.1365-2567.2011.03550.x. Islam, M.T. et al. (2023) ‘Senolytic drugs, dasatinib and quercetin, attenuate adipose tissue inflammation, and ameliorate metabolic function in old age’, Aging Cell , 22(2). doi:10.1111/acel.13767. Li, C., Liu, Z. and Shi, R. (2023) ‘A comprehensive overview of cellular senescence from 1990 to 2021: A machine learning-based bibliometric analysis’, Frontiers in Medicine , 10. doi:10.3389/fmed.2023.1072359. Herranz, N. and Gil, J. (2018) ‘Mechanisms and functions of cellular senescence’, Journal of Clinical Investigation , 128(4), pp. 1238–1246. doi:10.1172/jci95148. Li, L. et al. (2019) ‘TLR8-mediated metabolic control of human Treg function: A mechanistic target for cancer immunotherapy’, Cell Metabolism , 29(1). doi:10.1016/j.cmet.2018.09.020. Project Gallery

Second most common anaemia Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Anaemia of chronic disease 09/05/26, 14:55 Last updated: Published: 24/08/23, 17:06 Second most common anaemia This article is no. 3 of the anaemia series. Next article: sideroblastic anaemia . Previous article: Iron-deficiency anaemia. Pathogenesis The second most prevalent anaemia is anaemia of chronic disease (ACD); it is more often seen alongside chronic infections or malignancies. Other causes include infections, autoimmune diseases, and transplant rejection. The pathogenesis of the condition is greatly lead by the effectiveness of the immune system. The immune response to tumour cells and pathogens is to remove and deny access to iron, which is needed to thrive. The processes are mainly thought to be mediated through cytokines such as TNF, IL-6s and IFN as well as the acute phase protein hepcidin. IL-6 is a very powerful cytokine in that it can inhibit erythropoiesis through the downregulation of gene expression; SLC4a1 reducing haemoglobin production, it increases ferratin production whilst inhibiting TNF-α; this upregulates DMT-1, which is a protein (transmembrane) involved in iron uptake in macrophages, and it upregulates the production of hepcidin. Hepicidin Hepcidin is a peptide hormone, 25 amino-acid-chain protein, derived mainly from hepatic cells. Its synthesis is induced as a response to iron overload or inflammation. Its presence crucial in the diagnosis of ACD. IL-6 induces hepcidin release from hepatocytes. Upregulation causes the transport protein (ferroportin) degradation, inhibiting iron absorption in duodenum, enterocytes and macrophage recycling via upregulation of dMT-1, and mobilisation of stored iron, resulting in low iron plasma. Clinical presentation A patient with ACD may have low haemoglobin (Hb), and the reticulocyte index (new RBC) count may be reduced. Also, this is a common feature of an iron deficient anaemia (IDA). A blood film may help diagnose the underlying condition, but the red cell morphology varies greatly, as less than half can be microcytic or hypochromic. Iron studies are what helps ACD stand out from the other anaemias: raised IL-6, hepcidin and ferratin are the key markers; the presence of iron results with raised ferratin and iron will be seen if a blood film is stained correctly. There may also be reduced serum iron, % saturation and TIBC. Should erythrocyte sedimentation rates be high, rouleaux may be seen, which are aggregations of RBC. Conclusion The most efficient way to diagnose an anaemia is through serum biomarkers in a FBC, and iron studies. Hepcidin and other chemical markers play a key role in the diagnosis of ACD. Iron studies help to paint a clearer picture when diagnosing anaemias, but should be supported with a medical history alongside a clinical examination, as comorbidities may influence chronic inflammatory markers. Written by Lauren Kelly Project Gallery

Testing cancerous tumours Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link A new tool to diagnose: liquid biopsies 26/04/26, 14:55 Last updated: Published: 15/01/24, 23:48 Testing cancerous tumours Liquid biopsies are an example of integrating next-generation sequencing to diagnose and study tumours using only blood or other fluid samples rather than solid tissue. These biopsies are significant in modern medicine, particularly in treating cancer, as they enable the earlier detection of cancers in a less invasive manner. As of 2025-26, England's NHS is implementing liquid biopsy tests for thousands of lung and breast cancer patients, enabling faster access to targeted therapies. In this article, I aim to explore liquid biopsies, their role in disease detection and issues which arise from their usage. A liquid biopsy is a test which detects cancerous tumours from the pieces of tumour that break off and circulate in the bloodstream. A liquid biopsy involves a simple blood test and analysis in the lab with a machine that separates blood cells from the plasma, allowing a pathologist to examine the fluid and look for biomarkers. These include circulating tumour cells (CTC) or circulating tumour DNA (ctDNA). CTCs are cancer cells that disseminate from a tumour and travelling in the bloodstream, whereas ctDNA is a DNA fragment from the tumour circulating in the blood. See Figure 1 for a diagram summarising this process in more detail. Finding these biomarkers shows evidence of a malignant tumour, possibly revealing its stage of development and potential metastases. Oncologists use this information to form the basis of cancer prognosis. Furthermore, genetic data from these tests provides information on suitable and effective treatments specific to the patient. In particular, the suitability for targeted therapies, which target specific genes or proteins within the cancer. Furthermore, it can monitor how well a treatment is working by seeing if the tumour has stopped growing after treatment. Finally, it can be used to predict and help prevent recurrence of cancer or progression of cancer by detecting minimal residual disease (where a small number of cancer cells remain in the body after treatment). Liquid biopsies are perhaps better and more advantageous than normal biopsies, as the method is quicker without requiring surgical intervention. In addition, liquid biopsies provide a more comprehensive tissue profile by taking tumour heterogeneity into account. This includes revealing more information about genetic variations, monitoring clonal evolution, assessing treatment resistance, and aiding in the customisation of targeted therapies. This means a more comprehensive view is provided compared to tissue biopsies, which do not represent the entire genetic diversity of a tumour. Liquid biopsies excel in overcoming these limitations by providing a systematic and dynamic assessment of the entire tumour’s genetic diversity. Unlike tissue biopsies, which may miss subclones, liquid biopsies offer a more comprehensive understanding of the overall tumour, making them a valuable tool for precision oncology. The process is also minimally invasive and only causes minimal pain. While liquid biopsies offer a less invasive means of monitoring diseases, their sensitivity and specificity in detecting biomarkers, such as circulating tumour DNA (ctDNA) or circulating tumour cells (CTCs), might vary, leading to potential false positives or negatives. Additionally, the quantity and quality of biomarkers present in bodily fluids can fluctuate, impacting the reliability of liquid biopsy results for consistent monitoring. Furthermore, the associated cost of analysing liquid biopsy samples and the technology required for accurate detection can pose financial constraints for widespread implementation in healthcare systems. See Figure 2 which summarises the advantages and disadvantages of each method. Currently, there are a few liquid biopsy tests approved by the FDA to detect cancer within a patient. One example is the “Guardant 360 CDx”, approved for use in people with non-small cell lung cancer (NSCLC). Another example is the “Foundation One liquid CDx”, which is approved for use in people with a range of cancers such as NSCLC, prostate, ovarian and breast cancer. However, more research is needed to clinically evaluate the efficacy of liquid biopsies when compared to tissue biopsies. Nevertheless, liquid biopsies show a positive prospect for cancer diagnosis. Furthermore, liquid biopsies have also been used outside of cancer, such as in cardiovascular conditions such as myocardial infarction. In myocardial infarction, specific miRNA signatures released during myocardial necrosis provide accurate early detection of myocardial infarction. Further highlighting the multilevel potential of liquid biopsies. One of the main ethical concerns surrounding liquid biopsies involves the revealing of sensitive genetic information about a patient, encompassing medical history, and genetic identity, and potentially impacting familial relationships and legal affairs. This raises critical issues regarding privacy, consent, and the secure storage of such sensitive data. Additionally, challenges surrounding standardisation, cost-effectiveness, and the establishment of robust regulatory frameworks for the handling and storage of this genetic information further underscore the ethical complexities and necessity for stringent protocols in the implementation and management of liquid biopsy technologies. To conclude, it is clear that liquid biopsies have a lot of potential in diagnosing patients and, therefore, treating patients by aiding clinical decisions made by healthcare professionals. It has proven to be useful not just in diagnosing cancer but also in cardiovascular conditions such as myocardial infarction. The process has the potential to improve future patient outcomes. However, for this to happen, issues such as costs and ethics must be addressed so that liquid biopsies can be utilised more effectively in clinical practice. Written by Harene Elayathamby References: professional, C.C. medical Liquid biopsy: What it is & procedure details , Cleveland Clinic . Available at: https://my.clevelandclinic.org/health/diagnostics/23992-liquid-biopsy (Accessed: 19 December 2023). A tale of two biopsies: Liquid biopsy vs tissue biopsy (no date) Biochain Institute Inc. Available at: https://www.biochain.com/blog/a-tale-of-two-biopsies-liquid-biopsy-vs-tissue-biopsy/ (Accessed: 19 December 2023). Adhit, K.K. et al. (2023) ‘Liquid biopsy: An evolving paradigm for non-invasive disease diagnosis and monitoring in medicine’, Cureus [Preprint]. doi:10.7759/cureus.50176. Mannelli, C. (2019) ‘Tissue vs liquid biopsies for cancer detection: Ethical issues’, Journal of Bioethical Inquiry , 16(4), pp. 551–557. doi:10.1007/s11673-019-09944-y. Figures: Journey of a liquid biopsy (no date) Diagnostics . Available at: https://diagnostics.roche.com/global/en/article-listing/infographic-journey-of-a-liquid-biopsy.html (Accessed: 19 December 2023). A tale of two biopsies: Liquid biopsy vs tissue biopsy (no date) Biochain Institute Inc. Available at: https://www.biochain.com/blog/a-tale-of-two-biopsies-liquid-biopsy-vs-tissue-biopsy/ (Accessed: 19 December 2023) Project Gallery

The slippery property of a superfluid is caused by its ability to flow very easily Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The incredibly slippery nature of superfluids 03/04/25, 11:33 Last updated: Published: 24/05/23, 09:53 The slippery property of a superfluid is caused by its ability to flow very easily Slipperiness is a property that we often associate with everyday objects like ice, soap, and banana peels. However, there is a substance that is even more slippery than these: superfluids. A normal liquid becomes a superfluid when it is cooled down below a certain temperature. This temperature is unique to all fluids, for example for helium it is 2.17 K. Below this temperature, the superfluid will behave in completely unique ways. For example, if a container of water at room temperature was spun, you’d expect the water to also spin around, creating a whirlpool. Whereas a superfluid in a spinning container doesn’t spin at all, until it reaches a certain speed! The slippery property of a superfluid is caused by its ability to flow very easily. Usually it’s safe to leave a glass of water on a countertop (unless of course you’ve got a particularly excitable dog), but if you were to leave a glass of superfluid on a table, the liquid would creep out and escape. The tiny changes in temperature or pressure in the container cause it to flow, seemingly defying gravity. Unfortunately, superfluids cannot just be bought in the local supermarket! To produce a superfluid, devices known as cryostats can be used to cool a substance down to low temperatures. Using the ideal gas model, pressure, and volume can be related, so by reducing the pressure, the temperature of the device can also be decreased. The pressure is reduced using a vacuum pump, which works by removing particles from the cryostat. The applications of superfluids are limited as, due to the typically very low temperatures needed for a normal fluid to transition to a superfluid, there is difficulty in producing superfluids. Currently, scientists are working on finding fluids that enter a stable superfluid state at room temperatures. However, superfluids are used within many fields of physics to explain certain phenomena. One theory is that the core of collapsed large stars (neutron stars) is a superfluid, despite the very hot temperatures. The idea is that below a certain temperature, it uses less energy for the core to behave like a superfluid which cools the star down at an increased rate. The superfluid theory of neutron stars is just a hypothesis, however hints at the role superfluids play in all areas of physics. Written by Madeleine Hales REFERENCES/ FURTHER READING: https://www.aps.org/publications/apsnews/200601/history.cfm#:~:text=In%201927%20Willem%20Keesom%20and,helium%20I%20and%20helium%20II . https://physicsworld.com/a/neutron-star-has-superfluid-core/ Project Gallery

Have you perform the wrong exercises – You must keep revising your exercises and keep upgrading your knowledge about the proper use of equipment, and everything else related to fitness so that you don’t make any mistake in giving your clients the wrong exercises Go back Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Examples of negligence in personal training on the impact of physiology Last updated: 25/02/26 Published: 26/01/23 Negligence in personal training is a failure to look after clients to avoid them getting injured while training. There are many ways this can happen, below are some examples of negligence in personal training. Making use of equipment that is defective – Using a defective equipment can easily lead to injury or at least poor exercising form. Trainers should be able to differentiate between effective and defective equipment if they want to avoid negligence in training their clients. In that scenario, the best thing a personal trainer can do is to repair the equipment or replace it with new ones instead of putting a ‘defect’ or ‘out of order’ sign on it. An example is the case Stewart v. Fitness First (2024). Telling you to lift too much weight – You can’t just tell your clients to lift too much weight without even knowing their capacity, their way of eating and experience from past training. This is irrational and unprofessional, thus neglecting your clients directly which can lead to causing them injuries like muscle tears, muscle strains and even worse, a wrong death. Have you perform the wrong exercises – You must keep revising your exercises and keep upgrading your knowledge about the proper use of equipment, and everything else related to fitness so that you don’t make any mistake in giving your clients the wrong exercises to do that can lead to stopping them from achieving their desired physiques, and fitness goals. Muscle imbalances will occur as well if not done properly. Make you exercise for too long – Exercising for too long can cause excess fatigue and can lead to muscle strains and sprains. Coaches must not let their clients push themselves too far. It may sound cool but it is not really healthy. Everything we do must be done in an appropriate manner to avoid consequences that will harm us. Written by Kushwant Nathoo Related articles: A perspective on well-being / Gentrification in the context of health