Welcome to t ch bioscience contributes to the sustainable progression of our species and planet. In this issue, we embark on a journey to ‘’Sustaining Humanity’’ where each article sheds light into innovative research, groundbreaking technologies, and insightful perspectives that illuminate the path for a greener, healthier, and flourishing future.
This issue explores various career pathways, ranging from a Private Secretary in the UK Government’s Department of Science, Research and Innovation to dentistry. We also explore the requirements of good professional practice and accountability in biomedical science leading to improved service provision. We elaborate on stem cells usage in multiple sclerosis research, COVID-19/Flu combination vaccines, plastic eating bacteria, using AI-prediction in biotechnology, xenotransplantation, and many more.
We are proud to feature our Biomedicine Society’s newest creation. ‘Biomedically Speaking…’ podcast started by Marriam Yaqoob. The project aims to take the learning beyond the lecture theatre and bring light to biomedicine hot-topics, careers, and opportunities, as well as connect our students with academics in an accessible and engaging way. Make sure to check it out, the podcast is available on our Instagram, TikTok, and even Spotify!
We extend our gratitude to our writers, researches, and professional contributors who have shaped this issue and provided thought-provoking content to inspire us to thrive for a sustainable tomorrow. We expanded our graphic design team to include Natalia Robak and Natalia Skorek, from the School of Arts and Media, with the team being led by Issue 4 designer Harriet Burrow. We thank them for their time, dedication, and talent, which has made this fantastic issue impossible to put down.
As always, we remain committed to delivering inspiring content designed to captivate you with the wonderful scientific community and everything it has to offer. Thank you for joining us in exploring the vital theme of sustaining humanity!
Sara Alnasir Kassam and Wiktoria Wisniewska
CO-EDITORS-IN-CHIEF
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CONTENTS BIOSCIENTIST MAGAZINE
BIOTECHNOLOGY:
Wiktoria Wisniewska discusses Dr Joe Latimer’s study
Jeylani delves into
EDITORS' NOTE
BIOMEDICINE
SCIENCE IN THE NEWS
Hepcidin: A Lifesaver
Novel Advancement in Biotechnology: Alphafold
Anastrozole: Breast Cancer Prevention
Unveiling a New Era in Pancreatic Cancer
Detection and treatement
RESEARCH SPOTLIGHT
Stem Cell Regenerative Technologies In Multiple Sclerosis Are Combination Vaccines Against Influenza and COVID-19 possible?
TOPICS IN BIOMEDICINE
Infertility: Exploring Male and Female Rates and Its Impacts on Society Will Plastic-Eating Bacteria Shift Towards Sustaining and Improving Our Environment?
Balancing Bytes and Bliss: Sustaining
Happiness In a Digital Age
Xenotransplantation: The End of Organ Shortage Crisis?
Inflation in Climate Change
SALFORD SCIENCE
Wiktoria leads an interview with Dr Joe Latimer regarding the research on Antimicrobial Resistance in Klebsiella pneumoniae
BIOSCIENTIST MAGAZINE
CAREERS
SOARING HIGH: FROM SALFORD TO SCOTLAND, TO THE STATES AND SOUTH HAMPTON
Dr Ali Roghanian in conversation with Sara Alnasir Kassam
BEHIND THE SMILES
An interview with Dr Evgeny Kushnerev, Senior Clinical Lecturer in Dentistry at the University of Manchester
INTERVIEW WITH DR BRIONY LABRAM A PRIVATE SECRETARY IN THE UK GOVERNMENT’S DEPARTMENT OF SCIENCE RESEARCH AND INNOVATION
Exploring a career working for the government.
The HCPC standards of proficiency, how they relate to fitness to practice and how this can be maintained
Dr Caroline Topham, Lecturer in Biomedical Science at the University of Salford, was in conversation with Laiba Usman
Elaine is a Level 4 Human Biology and Infectious Diseases student at the University of Salford. She tells her story about her journey to Salford She explores her life before Salford, her motivations to come back to education and what she aims to do upon graduation from her course
Faatima Patel explores the revolutionising Anastrazole drug, helping to prevent breast cancer
The HCPC and the changes to their standards to maintain fitness to practice
In conversation with Laiba Usman, discussing the theme of selfsabotage and Dr Topham’s Coffee with Caroline support sessions
Hepcidin - Its use in the human body and bactericidal properties
BIOSCIENTIST MAGAZINE
THE BIOMEDICINE SOCIETY
67 A NIGHT TO REMEMBER
Tasfia Hazari, biomedicine society president recalls the winter dinner
BIOMEDICINE SOCIETY
SCAVENGER HUNT
68
TESTING 1,2,3....
Afifah Makda discusses the planning and execution of a society event and the foundation for the scavenger hunt
Biomedically Speaking - the biomedicine society podcast and how the secretary Marriam Yaqoob started it
66 31 31
SCAVENGER HUNT
The Biomedicine Society scavenger hunt - planning and execution
BALANCING BYTES AND BLISS
Sustaining happiness in a digital age
B I O M E D I C I N E
pg.2 pg.2
SCIENCE IN THE NEWS SCIENCE IN THE NEWS
Hepcidin: A Lifesaver
Novel Advancement In Biotechnology: Alphafold
Anastrozole: Breast Cancer Prevention
UROPANC Trial: Unveiling a New Era In Pancreatic Cancer Detection and Treatement
pg.18 pg.18
RESEARCH SPOTLIGHT RESEARCH SPOTLIGHT
Stem Cell Regenerative
Technologies In Multiple Sclerosis Are Combination Vaccine Against Influenza and COVID-19 possible?
pg.23 pg.23
TOPICS IN BIOMEDICINE TOPICS IN BIOMEDICINE
Infertility : Exploring male and female rates and its impact on society
Will Plastic-Eating Bacteria Shift Towards Sustaining and Improving Our Environment?
Balancing Bytes and Bliss: Sustaining Happiness In a Digital Age
Xenotransplantation: The End of The Organ Shortage Crisis?
Inflation In Climate Change
pg.43 pg.43
SALFORD SCIENCE SALFORD SCIENCE
Salford Scientist’s Research on Antimicrobial Resistance in Klebsiella pneumoniae in Gaza
SCIENCE IN THE NEWS
Hepcidin: A Lifesaver
BY IQRA ZULFIQAR
What is Hepcidin?
A cysteine-rich peptide containing 25 amino acids and four disulfide bridges, hepcidin (hepatic bactericidal protein), is produced in the liver as the final mediator in a complex pathway to regulate iron levels in the human body⁷ The available amount of iron for essential bodily functions, like making hemoglobin, and erythrocytes, is regulated by hepcidin, as well as limiting the available amount of iron in the body to avoid iron overload in the cells⁴ .
How does Hepcidin act?
Iron homeostasis is regulated by hepcidin Hepcidin levels increase, due to the increased levels of iron storage, infection, and inflammation. Low tissue oxygen or increased erythropoietic demand reduce hepcidin concentration When the iron levels are decreased, or more iron is required to carry out the cellular processes, the hepcidin levels go down as it would help iron to enter the plasma⁵ A feedback loop present between the iron and the hepcidin works as a bridge, to trigger an appropriate physiological concentration of iron in case of lower iron levels in the plasma⁵ .
Molecular Mechanism of Hepcidin: Activators
HJV is a BMP (Bone Morphogenetic Protein which regulates hepcidin expression) coreceptor, proved a link between the bone morphogenetic protein (BMP) signaling pathway and iron metabolism in Figure 1²
Figure 1: A diagram showing the role of bone morphogenetic protein (BMP) signaling pathway, HJV, HFE, and TFR2 to sense iron and regulate hepcidin in the liver When responding to iron, to activate the SMAD1/5/8 pathway, BMP6 binds to the HJV. Activated SMAD1 directly binds to the BMP and REs to induce hepcidin transcription To bind HFE to TFR1, TF-Fe causes HFE displacement to create a complex with TFR2 and TF-Fe to induce hepcidin expression. TMPRSS6, the serine protease, works to suppress hepcidin expression if iron deficiency is detected in the body²
Bone morphogenetic protein (BMP) is part of the transforming growth factor β (TGF - β) which binds to the cell-surface type I and type II serine-threonine kinase receptors. After the formation of the complex, the process of phosphorylating continues from type I receptors phosphorylating type II receptors to SMAD1, SMAD5, and SMAD8 proteins If there are low levels of BMP ligands, the HJV would bind to BMP ligands and receptors to enhance intracellular SMAD signals BMP-SMAD signals are responsible for increasing hepcidin expression at the transcriptional level² The importance of the BMP-HJV-SMAD signaling pathway in maintaining hepcidin expression, and iron homeostasis in vivo, is supported by different lines of evidence A test result proved that targeting disruption of the SMAD4 in the mouse liver could lead to low hepcidin levels and iron overload².
Molecular mechanism: Iron
Iron activates BMP6-HJV-SMAD signaling pathway to stimulate hepcidin expression⁵ In the hepatocyte culture, a BMP-SMAD signaling would decide if the holotransferrin will increase the hepcidin expression or not, as the holotransferrin is blocked by the BMPSMAD signaling pathway inhibitors² The BMP inhibitors work the same in zebra fish, blocking the increase of hepcidin expression, proving that iron activates the BMP6-SMAD signaling pathway in the liver, and depends on the BMP-SMAD signaling to increase hepcidin expression However, the researchers are still trying to understand the mechanism in depth that senses iron levels to increase BMP6-HJVSMAD signaling². Increase in the iron levels make the holotransferrin bind to TFR1 in the liver, displacing HFE, that results in increased hepcidin levels through on interaction with TFR2 and transferrin as shown in Figure 1 All the information provided above concludes that whether HFE and TFR2 induce hepcidin expression by interacting with the BMP6-HJVSMAD or separate, but the signaling pathway is not fully understood²
What if the human body fails to produce enough Hepcidin?
Infectious Disease (Mycobacterium tuberculosis): Researchers have concluded that a single nucleotide change in a gene, that is responsible for the hepcidin production, could make a human body prone to extrapulmonary tuberculosis as a body with this condition tend to produce significantly less amount of hepcidin if exposed to infection, Mycobacterium tuberculosis, a powerhouse of TB⁶ . The less the Hepcidin, the less the ability of macrophages to destroy Tuberculosis Not being stopped by security upon entering the body, would allow the bacteria to slowly spread and destroy the lungs and other parts of the body travelling through the circulation, eventually leading a human being to death⁶
Genetic Disease (Hemochromatosis):
A genetic disease, hemochromatosis (HH), is caused when the body fails to produce enough hepcidin, resulting in absorbing more iron than needed This condition can be treated by removing the surplus metal, up to 29 liters per year in extreme cases A few years back, this was the only way to save a precious human life, regardless of how uneasy or painful it would be for every patient But now, the science has shown its life-saving magic, and the scientists have been successful to produce minihepcidin (a molecule that works the same as the hepcidin), effectively reversing iron overload, infections, and bacteria that loves to stay at a place where there is iron present¹.
Hepcidin being
a
lifesaver for the Human Body?
As the hepcidin takes the responsibility to fight off the killer bacteria, responsible of causing bacterial pneumonia, makes it a lifesaver for the patients with no hope left In the cases of pneumonia quickly growing resistant to antibiotics, hepcidin comes up as ray of a new life for vulnerable patients A researcher, Kathryn Michels said, a new drug is being made to carry out the same function as hepcidin and would be effective to control iron overload in conditions like hemochromatosis and treat infections such as pneumonia³
Biotechnology was developed in the 19th Century, as Mendel’s studies on genetic trait transmission came to be complete Biotechnology has resulted in the identification of therapeutic proteins and improving the function and the development of medications AlphaFold technology, uses DeepMind's AlphaFold artificial intelligence (AI) programme employs a deep learning algorithm to predict protein structures precisely, advancing medication development and personalised medicine Research has helped tackle pre-existing and prolonged problems such as developing antidepressants without side effects AI in AlphaFold has resulted in amazing developments in understanding the cellular and molecular machinery in humans and other organisms giving biological insights into the roles of proteins The future generation of AlphaFold can now push scientific research further, as Google DeepMind and Isomorphic Labs are developing a more advanced AI model to increase the range of molecules to proteins Steps have been taken to accelerate biological advances and the next age of 'digital biology', giving new insights into disease pathways, genomics, and drug design procedures⁷ .
Proteins are an integral part of life as they control and maintain every cell in your body This has been researched extensively in biotechnology and the outcomes of the studies behind proteins are fascinating such as unravelling the structure of a nuclear pore complex However, biotechnology goes beyond proteins to predict other biomolecular structures such as ligands, nucleic acids, molecules with post translational modifications⁷ Biotechnology has influenced many industries, including medical, agricultural and environment
AlphaFold is an artificial intelligence computer program developed by Google’s DeepMind to help solve and understand protein folding It has structural modelling sequences which enhance experimental accuracy. The software was released in 2021 and can predict almost every protein molecule in the protein data bank (PDB), as well as ligands, DNA, RNA and post translation modifications⁷ Due to AlphaFold technology, our understanding of protein structure and function has enhanced An example of this is a recent discovery of Gametocyte surface protein P45 and P48 taken from the malaria parasite is used in vaccines⁹ ¹⁰ This allows us to use this new innovative biotechnological advancement to predict the protein structure of the whole human proteome,which can be used to transform drug development and discovery¹⁴ AlphaFold helps researchers learn how proteins interact with medications and other molecules; these drugs are intended to be more effective and have fewer adverse effects However, this programme does not find pharmaceuticals, but rather aids in the process of discovering drugs. There has been no current medication development because the technology is mostly upcoming, however new potential psychedelic compounds that can be exploited to produce new types of antidepressants have been discovered. The work demonstrates that AlphaFold predictions can be as beneficial for drug development as empirically generated protein structures, which can take months or years to identify.
However, there are some limitations to Alphafold technology Computational costs increase as the length of a protein chain increases, due to a limitation to the protein chain size of up to hundreds of residues. AlphaFold's technique can occasionally become stuck owing to incorrect force-fields, resulting in false findings These force fields determine how the protein folds, and any errors damage the final prediction¹¹.
Furthermore, the sheer volume of projected interactions might result in false-positive finds, delaying validation attempts¹ AlphaFold is excellent in structure prediction, but its capabilities are restricted in other stages of drug development. It struggles to simulate protein-drug interactions and anticipate the consequences of mutations on protein structure For example, it may not correctly represent the physical interactions between medicines and proteins¹³. AlphaFold is not intended to anticipate the influence of mutations (such as disease-causing mutations) on protein structure⁴ When evaluating how mutations impact protein stability, experimental data frequently contradict the predictions¹²
Protein structures used to be determined by X-ray crystallography, and Nuclear magnetic resistance (NMR)². Both older methods compared to AlphaFold alignments tool have multiple differences AlphaFold uses advanced biotechnology and AI to help determine longer protein structures over a shorter period Compared to the older methods, which take longer to understand the structure of a protein despite its size
AlphaFold is also used to build on the knowledge of remote evolutionary relationships such as researching into ancient protein families Protein structures are analysed by researchers who discovered ancient protein families that had survived evolutionary time These families share folds and functions, even in distantly related species Examples include metabolic enzymes and structural proteins such as collagen⁶
Overall, AlphaFold technology can be used for medical and research purposes such as enabling us to revisit the discovery of drugs for neglected disease or drugs to combat antibiotic resistance. The CDC predicted in 2019 that antibiotic resistance costs the US economy $55 billion per year This is unsustainable, but the positives of antibiotic resistance research costs outweigh the negatives³.
AlphaFold can help reduce costs by assisting in effective drug compositions, aiming to combat antibiotic resistant pathogens, such as Psuedomonas aeruginosa
The latest edition of AlphaFold is built on a unique machine learning approach Fundamental principles about protein structure are incorporated into the deep learning algorithm's design
AlphaFold can be used to research and transform scientists’ understanding of many biological phenomena and action against a vast array of global health challenges Examples include studying nuclear pore complex, gaining a deeper understanding of genetic variation, developing novel vaccines for diseases such as malaria, and assessing the impact of rotavirus on gastroenteritis³
AlphaFold was also used in recent research, which resulted in a significant increase in the synthesis and discovery of a medication to treat hepatocellular carcinoma (HCC)¹⁷ In a ground-breaking work, AlphaFold was used to power an end-to-end AI drug development process While AlphaFold has not directly identified drugs for HCC, it has greatly increased our understanding of protein structures, which contributes to drug discovery¹ The current research focuses of AlphaFold technology is protein structure prediction, real world impact such as using AI technology in other fields and scientific studies like medicine and biotechnology. Lastly AlphaFold wants to refine and push the boundaries of what AI can achieve in science
The finding of researchers at MIT used some AlphaFold models which did not perform like the current model known as molecular docking simulations This was because the goal was to identify new compounds that target previously untargeted proteins However, their predictions were only slightly better than chance.
Researchers used machine learning techniques to refine the protein results produced Research is currently and will continue to use AlphaFold technology to its full potential to identify novel compounds and targeting previously untargeted proteins to address antibiotic resistance Despite the breakthrough of AlphaFold, further advancements in protein modelling are required for successful drug discovery. This study was part of the Antibiotics AI project, which focuses to use AI for designing and discovering new antibiotics¹⁶
Understanding the structure and function of proteins has improved because of AlphaFold technology¹⁰ AlphaFold, a novel biotechnological innovation, allows for the visualisation of a protein's 3D structure
Because AlphaFold is a relatively new biotechnology process, there may be some gaps, such as complex interactions, mutation and disease effects, protein sizes and computational costs, erroneous force fields and it yet cannot go beyond protein structure prediction Yet its influence on healthcare and research might bring a revolutionary shift in everyone's life AlphaFold has predicted the structures of 350,000 proteins, including those encoded by the human genome, allowing it to predict the whole human proteome This thorough understanding of the human proteome serves as a foundation for personalised therapy¹⁵ . This is viewed as a good and exciting chance to broaden our understanding and bridge gaps in the everchanging path to protein unravelling However, there are some ethical considerations of AlphaFold technology for example data privacy and security, equitable access, transparency and interpretability, bias, and fairness, opens science and intellectual property as well as clinical applications and safety⁴ ⁵ ⁸ . Security can be a huge problem as the data is open to the public Overall, AlphaFold can be employed more widely in medicine and has had a positive influence on the development of numerous contemporary challenges.
References:
1
Arnold, C (2023) AlphaFold touted as next big thing for drug discovery but is it? Nature 622(7981) 15-17
https://doiorg/101038/d41586-023-02984-w
2
Bordin N Dallago C Heinzinger M Kim S Littmann M Rauer C Steinegger M Rost B & Orengo C (2023) Novel machine learning approaches revolutionize protein knowledge TrendsinBiochemical Sciences 48(4) 345-359 https://doiorg/https://doiorg/101016/jtibs202211001
3
4
Buntz B (2022) 7 ways DeepMinds AlphaFold is being used in life sciences
Callaway E (2022) What's next for AlphaFold and the AI proteinfolding revolution Nature 604(7905) 234-238 https://doiorg/101038/d41586-022-00997-5
Cusack, S, Eustermann, S, Kleywegt, G, Kosinski, J, Mahamid, J, Marquez, J A, Müller, C, Schneider, T, Thornton, J, Vamathevan, J, Velankar, S, & Wilmanns, M (2021) Great expectations – the potential impacts of AlphaFold DB Retrieved 26/02/2024 from https://wwwemblorg/news/science/alphafold-potential-impacts/
Google DeepMind I L (2023) Aglimpseofthenextgenerationof AlphaFold Google DeepMind Retrieved 26/02/2024 from https://deepmindgoogle/discover/blog/a-glimpse-of-the-nextgeneration-of-alphafold/
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Grover N (2021) AI firm DeepMind puts database of the building blocks of life online Retrieved 26/02/2024 from https://wwwtheguardiancom/technology/2021/jul/22/ai-firmdeepmind-puts-database-building-blocks-life-human-proteinstructure-free-online
Hassabis, D (2022) AlphaFold reveals the structure of the protein universe https://deepmindgoogle/discover/blog/alphafold-revealsthe-structure-of-the-protein-universe/
9 Jumper J Evans R Pritzel A Green T Figurnov M Ronneberger O Tunyasuvunakool K Bates R Žídek A Potapenko A Bridgland A Meyer C Kohl S A A Ballard A J Cowie A Romera-Paredes B Nikolov S Jain R Adler J Hassabis D (2021) Highly accurate protein structure prediction with AlphaFold Nature 596(7873) 583589 https://doiorg/101038/s41586-021-03819-2
10 Marcu Ş-B Tăbîrcă S & Tangney M (2022) An Overview of Alphafold's Breakthrough [Mini Review] FrontiersinArtificial Intelligence 5 https://doiorg/103389/frai2022875587
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11 Omicstutorials (2024) HighSchoolersRevealLimitationsof AlphaFoldforPredictingMutationalEffects Retrieved 26/02/2024 from https://omicstutorialscom/high-schoolers-reveal-limitations-ofalphafold-for-predicting-mutational-effects/
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Quach, K (2022) Hype versus reality: What you can't do with DeepMind's AlphaFold in drug discovery Retrieved 26/02/2024 from https://wwwtheregistercom/2022/09/08/deepmind alphafold perfor mance/
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Ren F Ding X Zheng M Korzinkin M Cai X Zhu W Mantsyzov A Aliper A Aladinskiy V Cao Z Kong S Long X Man Liu B H Liu Y Naumov V Shneyderman A Ozerov I V Wang J Pun F W Zhavoronkov A (2023) AlphaFold accelerates artificial intelligence powered drug discovery: efficient discovery of a novel CDK20 small molecule inhibitor [101039/D2SC05709C] ChemicalScience 14(6) 1443-1452 https://doiorg/101039/D2SC05709C
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Warner E (2023) New study uses AlphaFold and AI to accelerate design of novel drug for liver cancer https://wwwartsciutorontoca/news/new-study-uses-alphafold-and-aiaccelerate-design-novel-drug-liver-cancer 17
Anastrozole: Breast Cancer Prevention
BY FAATIMA PATEL
Patented in 1984 and approved for medical use in 1995, Anastrozole has become one of the most prescribed drugs for postmenopausal women to prevent the development of breast cancer It works by lowering the oestrogen levels of postmenopausal women and slows or reverses the growth of hormone receptor-positive breast cancer Anastrozole is often given to patients whose cancer has progressed even after taking the drug Tamoxifen, which also works by lowering oestrogen levels. There are many side effects that come with Anastrozole, and so precaution must be taken when prescribing the drug because the side effects will vary depending on how it interacts and metabolises within the patient’s body. Research is being conducted to test if the effectiveness of Anastrozole can be increased if taken with other drugs, such as palbociclib; however, the economic costs on health institutions around the world must be considered It may also be possible for Anastrozole to be genotyped for a specific individual to maximise its affect and reduce the risk of developing the side effects
Anastrozole is one of the hormonal treatments for breast cancer
Sold under the brand name, Arimidex, Anastrozole is a nonsteroidal aromatase inhibitor (AI) and is most often prescribed to postmenopausal women suffering from breast cancer³ It works by blocking the enzyme aromatase, lowering the oestrogen levels lowered (Figure 1) Breast cancer is an oestrogen-dependent cancer Postmenopausal women usually suffer from a type of breast cancer, wherein hormonereceptor-positive tumours are prevalent and spread if oestrogen concentrations are high. Anastrozole is usually taken as tablets once a day for five years
The patients who are prescribed Anastrozole experience a variety of side effects, such as hot flushes, vaginal dryness or bleeding, difficulty sleeping, tiredness, nausea, muscle or bone pain, skin rash, hair loss, low mood or depression, headaches, nausea, joint pain, tiredness, bone thinning, allergic reactions, liver injury that may result in autoimmune hepatitis, carpal tunnel syndrome, and severe skin reactions⁹ Furthermore, older women and women who drink alcohol or smoke have some predisposing risk factors Your doctor must be consulted if you are affected by any of these risk factors Older women are more likely to have osteoporosis, cardiovascular disease, or other health problems due to Anastrozole. Women who smoke have an increased risk of lung damage and reduced bone density and in turn an increased risk of bone fracture, whilst women who drink alcohol have an increased risk of liver damage and face interferences with the absorption of Anastrozole Women who smoke and drink alcohol are both at risk of high blood pressure and the recurrence of breast cancer due to Anastrozole It is advised that women on Anastrozole take Calcium and Vitamin D supplements to prevent bone loss and fractures
Those who smoke and drink alcohol are advised to quit so heart, lung, and liver problems can be avoided In addition to this, exercising regularly will help maintain a healthy weight, improve your mood, energy, and overall health It is advised to seek support from healthcare, family, and friends to help deal with the emotional and physical effects of Anastrozole
As of November 7th, 2023, around 289,000 postmenopausal women in England are at moderate or high risk of developing breast cancer, based on their family history² As a result, Anastrozole has been made accessible through the NHS After a consultation with their GP, women can be referred for treatment.
Anastrozole is a prophylactic treatment that can reduce the risk of breast cancer by up to 50% of women, depending on if they have a family history of the cancer
Figure 1: Inhibition of the aromatase enzyme Aromatase inhabitors (AIs) bind to oestrogen receptors and prevent the Aromatase enzymes from working This stops oestrogen levels rising, which stops the proliferation of cancer cells⁶
Currently, research is being conducted to determine the efficacy of Anastrozole along with other drugs for breast cancer prevention. Anastrozole was paired with baseline oestradiol serum and a casecontrol study was carried out based on the IBIS-II prevention trial, which investigated the effect of Anastrozole on preventing breast cancer in postmenopausal women Overall, the study found that the drug was effective in preventing the risk of breast cancer by 49% compared to the placebo over a median follow-up of 131 months; however, the benefit was limited to women with a ratio of medium or high levels of oestradiol to sex hormone binding globulin (SHBG) Women with a low ratio of oestradiol to SHBG did not benefit from the anastrozole treatment⁵ .
The study concluded that measuring serum hormone concentrations could help identify which women would benefit from being treated with anastrozole, which could improve the risk management and personalised treatment of postmenopausal women at high risk of breast cancer Despite the results, the study also acknowledges the limitations with case-control studies, such as a lack of hormone receptor data, which is a key prognostic and predictive factor for breast cancer, as well as to identify if the effects of Anastrozole will vary depending on the different subtypes of hormone receptors. Furthermore, an unproportionally representative sample due to the study population being comprised mainly of White European women at high risk of breast cancer because of their family history, which means ethnicity and those at lower risk have been disregarded so the findings may not be applied to women of these backgrounds Further research must be carried out to verify these findings.
Another study was conducted using AIs in tandem with palbociclib for the treatment of advanced breast cancer¹ Anastrozole is one of the AIs used to evaluate the effectiveness of palbociclib.
The results were then compared to the results of the PALOMA-2 trial. The PALOMA-2 trial was a double-blind, phase 3 randomised controlled trial that evaluated the efficacy and safety of palbociclib in combination with Letrozole, which is an AI, for the treatment of ER-positive and HER2-negative advanced breast cancer The study used a populationbased registry (RON) to identify all patients who received AIs along with palbociclib in Portugal between 2017 and 2019 Overall, the combination of AIs with palbociclib had agreeable effectiveness in terms of progression-free survival (PFS), especially when used on patients with similar characteristics to the patients used in the PALOMA-2 trial, the median PFS was 19.5 months, which means half of the patients had disease progression or died before 19 5 months and the other half had it after, whilst the 1 year PFS was 67 9% and the 2 year PFS was 42 0%; however, similar to the oestradiol combination, the effectiveness varied. With palbociclib, the effectiveness of the treatment differed on the prognostic status of each patient, such as the presence of visceral metastases, which have a poorer PFS than those with bone-only or nonvisceral metastases⁴ . Therefore, the future of anastrozole prescriptions will depend on the individual assessments of each patient’s clinical situation and the expected outcomes Furthermore, the study states that the cost of palbociclib will have a major impact on health systems and should be considered. During a cost-effectiveness analysis of palbociclib and other endocrine therapies, compared to placebo and endocrine therapy, in the UK, it was found that palbociclib-Anastrozole had an Incremental Cost-Effectiveness Ratio (ICER) of £79,947 per Quality-Adjusted Life Year (QALY)⁷ This far exceeds the willingness-topay threshold of £20,000-£30,000 per QALY The study concludes that the combination of palbociclib-Anastrozole is not cost-effective in the UK
The future of breast cancer prevention in postmenopausal women looks to be steady With the current scheme of making the treatment much more accessible to postmenopausal women who may be at risk, a step in the right direction is being taken. One possible avenue of exploration is genotyping, which is a process that determines the genetic makeup of an individual by examining their DNA sequence It is possible to use Anastrozole in conjunction with genotyping to identify genetic factors that may affect how receptive or resistant an individual is to the drug Studies were conducted to review the mechanisms of resistance to Ais It was found that single-nucleotide polymorphisms (SNPs), variations in a single base pair of DNA that occur in a certain percentage of the population, are one of the factors that may affect the effectiveness of AI therapy⁸
References:
1 Belderbos H (2023) Breast cancer drug made accessible to 289000 women in England https://wwwopenaccessgovernmentorg/breastcancer-drug-made-accessible-to-289000-women-in-england/169660/
Alves da Costa F Cardoso Borges F Ramos A Mayer A Brito C Ramos C Bernardo C Cossito M Furtado C Ferreira A R MartinsBranco D da Costa Miranda A & Lourenço A (2023) Effectiveness of palbociclib with aromatase inhibitors for the treatment of advanced breast cancer in an exposure retrospective cohort study: implications for clinical practice Breast Cancer Research 25(1) 78 https://doiorg/101186/s13058-023-01678-5
2 Cancer Research UK (2023) Anastrozole (Arimidex) Retrieved 22/02/2024 from https://wwwcancerresearchukorg/aboutcancer/treatment/drugs/anastrozole
3 Chia, S, Burstein, H, & Vora, R (2020) Prognostic and predictive factors in metastatic breast cancer UpToDate Burden 20
4 Cuzick, J, Chu, K, Keevil, B, Brentnall, A R, Howell, A, Zdenkowski, N, Bonanni B Loibl S Holli K Evans D G Cummings S & Dowsett M (2024) Effect of baseline oestradiol serum concentration on the efficacy of anastrozole for preventing breast cancer in postmenopausal women at high risk: a case-control study of the IBIS-II prevention trial The Lancet Oncology, 25(1), 108-116 https://doiorg/https://doiorg/101016/S1470-2045(23)00578-8
5 Gallego P (2022) Tamoxifen vs Aromatase Inhibitors – How do they work? Retrieved 22/02/2024 from 6 Le V Zhong L Narsipur N Hays E Tran D K Rosario K & Wilson L (2021) Cost-effectiveness of ribociclib plus endocrine therapy versus placebo plus endocrine therapy in HR-positive HER2-negative breast cancer J Manag Care Spec Pharm 27(3) 327-338 https://doiorg/1018553/jmcp2021273327
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7 Miller W R & Larionov A A (2012) Understanding the mechanisms of aromatase inhibitor resistance Breast Cancer Research, 14(1), 201 https://doiorg/101186/bcr2931
National Health Service (2021) Anastrozole Retrieved 22/02/2024 from https://wwwnhsuk/medicines/anastrozole/ 9
UROPANC Trial: Unveiling a New Era In Pancreatic Cancer Detection and Treatement
BY MYA BRISCOE
The Silent Killer: Pancreatic Ductal Adenocarcinoma
Pancreatic ductal adenocarcinoma remains one of the most challenging cancers to detect and treat PDAC's fiveyear survival rate is less than 7%¹⁰ It is a disease that often remains hidden until it is too late, making early detection not just a medical challenge but a dire necessity It is the fifth biggest cancer killer in the UK and, by 2030, is predicted to overtake breast cancer, the fourth largest cancer killer⁹
UROPANC Trial: A Ray of Hope
The UROPANC trial, led by Professor Crnogorac-Jurcevic at Queen Mary University of London, marks a potential breakthrough in early PDAC detection The novel urinary biomarker panel originated from findings where patient urine samples were used, uncovering the discovery of the original three-protein biomarker panel, LYVE-1, REG1A, and TFF112 These biomarkers can detect patients with early-stage PDAC, and their small-scale study reported miRNA in urine for this early detection¹² The existing urinary panel was improved by substituting REG1A with REG1B to enhance the performance of the biomarker panel⁶ . With PanRISK, the UROPANC trial aims to identify PDAC at a more resectable stage (stages I and II)²
Figure 1 Histological image of typical glands immediately adjacent to artery depicted by haematoxylin and eosin stain¹⁵
Why This Matters: The Challenge of PDAC Diagnosis
The insidious nature of PDAC lies in its obscurity and asymptomatic progression14
The pancreas, nestled deep within the abdomen, betrays little of the turmoil within until the cancer has advanced significantly Due to the tumour being near-impossible to see or feel during routine medical examinations, 80% of PC patients get diagnosed, often when cancer has metastasised (physiological symptoms appear), and the options for effective treatment diminish drastically The average survival is only 2-6 months⁹ This stark mortality rate underscores the urgent need for a reliable early detection method, which the UROPANC trial seeks to provide The PancRISK algorithm is used in conjunction with CA19-9 as a tool for diagnosis for detecting PDAC up to 2 years before diagnosis⁵ The cancer can be found up to 2 years before diagnosis, so surgical intervention can be soon employed to target the cancer at its emergence
Decoding the Biomarker Panel: REG1B, LYVE1, TFF1
Central to the trial is the PancRISK algorithm, which employs biomarkers Regenerating Family Member 1 Beta (REG1B), Lymphatic Vessel Endothelial Hyaluronan Receptor 1 (LYVE1), and Trefoil Factor 1 (TFF1)² These markers in urine could revolutionise PDAC detection by signalling the disease's presence early before symptoms manifest The biomarker panel incorporated in PancRISK may improve early diagnosis and patient outcomes To delve briefly into the mechanism, REG1B is an early indicator of pancreatic issues –secreted by pancreatic cells in response to injury or inflammation In the context of PDAC, elevated levels of REG1B may indicate abnormal cellular activity, tissue damage, or the presence of a tumour. LYVE1 detects abnormal activity, such as lymphangiogenesis, which may contribute to tumour growth, invasion, and metastasis by providing a route for cancer cells to spread to distant sites¹³
While TFF1 indicates a response to potential threats such as tissue damage, as PDAC often arises from precancerous lesions or damaged pancreatic tissue TFF1 may be involved in repairing and maintaining the integrity of the pancreatic mucosa in response to tissue damage, resembling the body's way of defending itself¹⁶ Together, these biomarkers contribute to the early detection of PDAC by providing crucial signals that can alert healthcare professionals to the presence of the disease
Trial Dynamics: Objectives and Methodology
By enrolling over 3,000 participants who are both symptomatic and asymptomatic, the UROPANC trial has set out to validate these biomarkers independently and in conjunction with CA19-9, another marker typically associated with pancreatic cancer⁴
Compared to CA19-9, which primarily measures the levels of a specific antigen associated with pancreatic cancer, the biomarkers REG1B, LYVE1, and TFF1 target distinct biological pathways involved in pancreatic cancer pathogenesis The biomarkers and CA19-9, in conjunction, could provide a more comprehensive assessment of PDAC by capturing different aspects of the disease development and enhancing the accuracy of PancRISK This comprehensive approach aims to solidify the reliability and effectiveness of the biomarker panel. The trial's methodology involves a detailed comparison of biomarker readings with imaging and histological data to validate accuracy and reliability³
Figure 2: The levels of the 3 biomarkers, REG1B, LYVE1, TFF1, in control, benign, and pancreatic ductal adenocarcinoma (PDAC) samples Violin plots are illustrated for each protein The number of samples per group is shown in parentheses All data were creatinine normalised. Upper bars: Kruskal–Wallis test, Dunn’s multiple comparisons⁷
Advancing Beyond Current Limitations
CA19-9, a current standalone biomarker diagnostic method, can result in false positives – elevated levels are seen in nonpancreatic conditions like liver disease Increased false positivity was found in the presence of obstructive jaundice (10-60%)¹ Also, it is not specific to pancreatic cancer as there are elevated levels in other types of cancer, such as hepatocellular carcinoma CA19-9 cannot distinguish between PDAC and other conditions like distal cholangiocarcinoma (DCCA)⁸ DDCA and PDCA are anatomically proximal, symptomoverlapping, and histologically similar; their biomarkers overlap This lack of specificity can lead to misdiagnoses and delayed treatment The UROPANC trial's biomarker panel aims to address these shortcomings, offering a more precise and early detection tool For patients, the implications of the UROPANC trial are profound Early detection can mean the difference between a terminal diagnosis and a treatable condition It opens the door to earlier interventions, including surgery, which could significantly extend life expectancy and improve the quality of life for PDAC patients. However, the need for patient lifetime treatment monitoring would depend on individual patient factors, the type and stage of cancer, and the risk of recurrence; UROPANC would allow healthcare providers to personalise a patient treatment plan based on the diagnosis The benefits would reflect in the socioeconomic factors; this highly accurate and non-invasive diagnostic test would bridge the gap of the clinical need for screening patients at risk: proactively tackling the disease before symptoms occur Consequently, there would be less strain on resources needed in diagnostic care and treatment, and the patient backlog would decrease as PancRISK and the urinary biomarker panel offer a quick and inexpensive method Treatment would mean less invasive procedures, leading to higher patient satisfaction
Potential Impact and Future Prospects
Successful validation of this biomarker panel could revolutionise how PDAC is diagnosed and treated It represents a leap towards more cost-effective and noninvasive detection methods, potentially significantly increasing the five-year survival rate For decades, pancreatic cancer has been underfunded and only receives 3% of the UK cancer research budget¹¹ Additionally, as the PancRISK algorithm uses the three-urinarybiomarker-panel to signal the presence of PDCA, the trial’s findings could pave the way for similar breakthroughs in other types of cancer, broadening the horizon of cancer research and treatment. While it is a valuable tool for early detection through detecting the presence of levels of expression, it may not necessarily serve as a monitoring tool for ongoing assessment Additional medical tests and evaluations may be required to assess the need for monitoring and ongoing assessment Current research strives to validate the urinary biomarker panel to implement for clinical use.
Conclusion: A Beacon of Hope in PDAC Battle
In conclusion, the UROPANC trial showcases a pivotal moment in the fight against pancreatic cancer Its success could mark the beginning of a new era in which PDAC is no longer a silent killer but a detectable and treatable condition This trial is more than a scientific endeavour; it symbolises a future filled with hope for patients and a new direction in cancer research
References:
1
Ballehaninna U K & Chamberlain R S (2012) The clinical utility of serum CA 19-9 in the diagnosis prognosis and management of pancreatic adenocarcinoma: An evidence based appraisal J Gastrointest Oncol, 3(2), 105-119 https://doiorg/103978/jissn207868912011021
Blyuss, O, Zaikin, A, Cherepanova, V, Munblit, D, Kiseleva, E M, Prytomanova, O M, Duffy, S W, & Crnogorac-Jurcevic, T (2020) Development of PancRISK a urine biomarker-based risk score for stratified screening of pancreatic cancer patients Br J Cancer 122(5) 692-696 https://doiorg/101038/s41416-019-0694-0
2 Cancer Research UK (2022) Research on the use of urine biomarkers for early detection of pancreatic cancer Barts Cancer Institute Retrieved 21/11/2023 from https://wwwbartscancerlondon/interviews/2022/11/research-on-theuse-of-urine-biomarkers-for-early-detection-of-pancreatic-cancer/
3 Crnogorac-Jurcevic T (2022) New tests for early detection of pancreatic cancer offer significant hope Queen Mary University of London Retrieved 29/11/2023 from https://wwwqmulacuk/research/featured-research/new-tests-forearly-detection-of-pancreatic-cancer-offer-significant-hope/
4 Debernardi, S, Blyuss, O, Rycyk, D, Srivastava, K, Jeon, C Y, Cai, H, Cai, Q, Shu, X O, & Crnogorac-Jurcevic, T (2023) Urine biomarkers enable pancreatic cancer detection up to 2years before diagnosis Int J Cancer 152(4) 769-780 https://doiorg/101002/ijc34287
5 Debernardi S O’Brien H Algahmdi A S Malats N Stewart G D Plješa-Ercegovac M Costello E Greenhalf W Saad A Roberts R Ney A Pereira S P Kocher H M Duffy S Blyuss O & CrnogoracJurcevic T (2020) A combination of urinary biomarker panel and PancRISK score for earlier detection of pancreatic cancer: A case–control study PLoS Medicine 17(12) e1003489 https://doiorg/101371/journalpmed1003489
6 Debernardi S e a (2020) The levels of the 3 biomarkers in control benign, and pancreatic ductal adenocarcinoma (PDAC) samples In journalpmed1003489g001 (Ed), (Vol 6304x29371) Plosmedicine: Journal pubmed
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7 Lv, T-R, Wang, J-M, Ma, W-J, Hu, Y-F, Dai, Y-S, Jin, Y-W, & Li, F-Y (2022) The consistencies and inconsistencies between distal cholangiocarcinoma and pancreatic ductal adenocarcinoma: A systematic review and meta-analysis [Systematic Review] Frontiers in Oncology 12 https://doiorg/103389/fonc20221042493
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Pancreatic Cancer UK (2015) Pancreatic Cancer: Some Key Facts
Pancreatic Cancer UK Retrieved 26/11/2023 from https://wwwpancreaticcancerorguk/wpcontent/uploads/2020/10/mp-pancreatic-cancer-briefing-notespdf
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Pancreatic Cancer UK (2023) Pancreatic Cancer Statistics
Pancreatic Cancer UK Retrieved 27/11/2023 from https://wwwpancreaticcancerorguk/what-we-do/mediacentre/pancreatic-cancer-statistics/
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Pancreatic Cancer UK (2023) We fund research breakthroughs Retrieved 01/02/24 from https://wwwpancreaticcancerorguk/whatwe-do/research/
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Radon T P Massat N J Jones R Alrawashdeh W Dumartin L Ennis D Duffy S W Kocher H M Pereira S P Guarner L MurtaNascimento C Real F X Malats N Neoptolemos J Costello E Greenhalf W Lemoine N R & Crnogorac-Jurcevic T (2015)
Identification of a Three-Biomarker Panel in Urine for Early Detection of Pancreatic Adenocarcinoma Clinical Cancer Research 21(15) 3512-3521 https://doiorg/101158/1078-0432Ccr-14-2467
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13 UCLA Health (2022) Pancreatic cancer is almost impossible to detect early UCLA Health Retrieved 29/11/2023 from https://wwwuclahealthorg/news/pancreatic-cancer-is-almostimpossible-to-detect-early
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Shen C N Goh K S Huang C R Chiang T C Lee C Y Jeng Y M Peng S J Chien H J Chung M H Chou Y H Hsieh C C Kulkarni S Pasricha P J Tien Y W & Tang S C (2019) Lymphatic vessel remodeling and invasion in pancreatic cancer progression EBioMedicine, 47, 98-113 https://doiorg/101016/jebiom201908044
Wei Chen M D PhD (2021) Atypical glands immediately adjacent to artery In pancreasductalChen002jpg (Ed) (Vol 501x551) pathologyoutlinescom: Pathology outlines
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Yamaguchi J Yokoyama Y Kokuryo T Ebata T Enomoto A & Nagino M (2018) Trefoil factor 1 inhibits epithelial-mesenchymal transition of pancreatic intraepithelial neoplasm The Journal of Clinical Investigation 128(8) 3619-3629 https://doiorg/101172/JCI97755
RESEARCH SPOTLIGHT
Stem Cell Regenerative Technologies In Stem Cell Regenerative Technologies In Stem Cell Regenerative Technologies In
Multiple Sclerosis (MS) is a chronic autoimmune disease impacting the central nervous system (CNS) distinguished through primary demyelination and a variable extent of axonal loss⁷ MS is caused by the existence of several merging demyelinated lesions in the grey and white matter of the CNS which is also present in the cortex and brain stem as shown in the MRI (Magnetic Resonance Imaging) of Figure 1⁷ The progression of MS is exceedingly variable and unexpected as most patients experience transient neurological abnormalities at first followed by gradual neurological deterioration5 MS is diagnosed based on tests carried out by a neurologist through the observation of a person ’ s symptoms (checking movement, balance, or vision) or from pictures obtained by a magnetic resonance imaging (MRI) of the brain. An MRI monitors the quantity of water in the body¹² Due to various areas of the brain containing varying amounts of water, the MRI can differentiate them and create images of the central nervous system¹² The protective myelin covering is fatty and repels water This implies that we can assess the amount of myelin present since it appears differently on a scan than nerves and other brain cells¹²
Additionally, MS has no established origin although it appears to be caused by a combination of genetic predisposition and nongenetic triggers such as viruses or environmental factors which results in recurring immunological attacks on the CNS⁵ . Although MS is not inherited, people with relatives containing the disease are more susceptible of having this disease The genes linked to the predisposition are HLA-DRB1 locus in the class II region.
Furthermore, earlier studies regarding the heredity of MS had revealed a recurring relative risk for siblings¹. The possibility of MS is significantly increased when both parents have MS, but the probability of half siblings is lower than that of full siblings being affected by MS¹¹ Therefore, the chance of MS recurrence increases in proportion to the amount of genetic sharing with the afflicted family member but not in a liner manner¹¹ A review of over 500 research revealed that there was a recurrence rate of 18 2% for monozygotic twins and 2 7% for siblings¹¹
Figure 1: MRI scans comparing brain of a person with and without MS³
Stem cell technologies have been investigated in reducing the progression of aggressive multiple sclerosis The main ones being autologous haematopoietic stem cell transplantation (aHSCT) and mesenchymal cell therapy (MCT). aHSCT, often referred to as a bone marrow transplant, involves the removal of a person ’ s immune system cell then regrowing it using haematopoietic stem cell which develop into different types of blood cells such as red or white blood cells¹³ Thus, aHSCT infusions enhance bone marrow healing and immunological regeneration, aiming to avoid the progression of neurological impairments9. This potentially strengthens neurological function as well as containing numerous benefits, it aids bone marrow function by 'rebooting' the body's immune system via renewal and re-diversification of the T and B-cell repertoire, as well as heightened regulatory T-cell activity¹⁴ In a prospective investigation of MS patients who underwent aHSCT, over half lived without neurological deterioration for 5 years following the transplant⁹ Additionally, it generates functional cells that replace dysfunctional nerve cells in diseases other than MS such as immune deficiency syndromes6. From the beginning to numerous weeks after the procedure, the patient requires monitoring and additional treatments In recent times, improvements to AHSCT process have resulted in a reduction in treatment-related mortality (TRM) from 7 3% to less than 0 5%⁸ Fifty percent of patients treated with aHSCT recovered from their condition after ten years⁸
MCT involves eliminating a person ’ s MCT from their bone marrow or tissue which is multiplied in a laboratory then numerous MCT are reintroduced¹³. MCT has emerged as a possibly safe cellular treatment for MS however the dosage,
method, and administration must be examined and further quantified⁴ Stem cells are similar to tumour cells in certain ways because of their capacity to proliferate for an extended length of time, high vitality, and resistance to apoptosis10. Their ability to proliferate for pro longed amount of time is dependent on their ability of dividing Patients who are transplanted with stem cells frequently have long-term chemotherapy or radiation, so their immune system does not perform correctly, which can also relate to the risk of tumorigenesis¹⁰ Effects of chemotherapy include constant fatigue, being sick and increased risks of infections.
Whereas, the aHSCT technique has been found to provide long term sustained emission but also requires more research to determine the conditioning plan to be implemented⁴ More research is required due to increased risk of infection due to immunodeficiency which are current concerns of aHSCT as well as associations of rare cases of death As aHSCT can cause residual cancer and requires a donor that is suitable, fitting to the recipient, they are the current focus of research². Whereas for MCT, the current focus for research is finding a way to ease the side effects which include fever, headaches, and urinary tract infection
References:
1
Alfredsson, L , & Olsson, T (2019) Lifestyle and Environmental Factors in Multiple Sclerosis Cold Spring Harb Perspect Med, 9(4) https://doi org/10 1101/cshperspect a028944
Bazinet A & Popradi G (2019) A General Practitioner’s Guide to Hematopoietic Stem-cell Transplantation Current Oncology 26(3) 187-191 https://www mdpi com/1718-7729/26/3/5033 2
3
Crommelin D J Broich K Holloway C Meesen B Lizrova Preiningerova J Prugnaud J -L & Silva-Lima B (2016) The regulator’s perspective: How should new therapies and follow-on products for MS be clinically evaluated in the future? Multiple Sclerosis Journal, 22(2 suppl), 47-59 https://doi org/10 1177/1352458516650744
Muraro P A Pasquini M Atkins H L Bowen J D Farge D Fassas A Freedman M S Georges G E Gualandi F Hamerschlak N Havrdova E Kimiskidis V K Kozak T Mancardi G L Massacesi L Moraes D A Nash R A Pavletic S Ouyang J Group f t M S A H S C T L -t O S (2017) Long-term Outcomes After Autologous Hematopoietic Stem Cell Transplantation for Multiple Sclerosis JAMA Neurology 74(4) 459-469 https://doi org/10 1001/jamaneurol 2016 5867
Musial-Wysocka, A , Kot, M , & Majka, M (2019) The Pros and Cons of Mesenchymal Stem Cell-Based Therapies Cell Transplant, 28(7), 801-812 https://doi org/10 1177/0963689719837897 11 Patsopoulos N A (2018) Genetics of Multiple Sclerosis: An Overview and New Directions Cold Spring Harb Perspect Med 8(7) https://doi org/10 1101/cshperspect a028951
Roberts K (2017) MRI and MS: 7 things you need to know MS Society Retrieved 22/02/2024 from https://www mssociety org uk/research/latest-research/latest-research-news-and-blogs/mri-and-ms-7-things-you-need-to-know 13 Rowden, A (2021) Stem cell therapy for multiple sclerosis Retrieved 22/02/2024 from https://www medicalnewstoday com/articles/stem-cell-multiple-sclerosis 14 Snowden, J A , Sharrack, B , Akil, M , Kiely, D G , Lobo, A , Kazmi, M , Muraro, P A , & Lindsay, J O (2018) Autologous haematopoietic stem cell transplantation (aHSCT) for severe resistant autoimmune and inflammatory diseases – a guide for the generalist Clinical Medicine, 18(4), 329 https://doi org/10 7861/clinmedicine 18-4-329
RESEARCH SPOTLIGHT
Are Combination Vaccine Against Influenza Are Combination Vaccine Against Influenza Are Combination Vaccine Against Influenza
and COVID-19 possible? and COVID-19 possible? and COVID-19 possible?
BY SANARIA FATHULLA
What are combination vaccines?
Combination vaccines are a mixture of different individual vaccines that are then administered in vivo (within a living organism), the first of its kind being the diphtheria, tetanus, and pertussis vaccines (DTP)¹⁸ COVID vaccines work like most vaccines, exposing the immune system to antigens of COVID-19. In mRNA vaccines, the vaccine helps the body make the antigens found on COVID-19 which is then displayed on the cell surfaces in your body his stimulates antibody secretion which can be later utilised for a faster immune response¹⁰ As a result, the next time the body contracts COVID-19, the immune response will be much quicker and efficient due to the body already having specific antibodies to the COVID-19 antigen.
There are three types of COVID vaccines: mRNA, protein subunit and viral vaccine The flu vaccine works in a similar way, containing two major antigens: haemagglutinin (HA) and neuraminidase (NA). These vaccines are reformulated every year to be specific to the current strand of influenza circulating around due to the preserving antigen drift found in the influenza virus. Antigenic drift is an evolutionary process characterised by the accumulation of viral proteins that change the amino acid sequence, thus becoming unrecognisable to the hosts antibodies⁴ . There are three main types of influenza vaccines worldwide: inactivated influenza vaccine (IIV), live attenuated influenza vaccine (LAIV), and recombinant HA vaccine¹⁴ .
A common use of combination vaccines is for diseases with several serotypes or variants, influenza being an example The general aims for combination vaccines are to cut time and increase the efficacy of the vaccines A study done in California from Andrejko et al, suggested that having both the COVID-19 and influenza was more effective than having either alone¹
Whilst several studies show that the combination vaccine is useful, many members of the public remain wary about the side effects and long-term issues; this is known as vaccine hesitancy A cross-sectional online survey of the population in England 31% of participants said they would not take the Influenza vaccine whilst 21.4% said they were unsure.
For the COVID-19 vaccine, the figures were 23 7% and 37 3% respectively² Campaigns, various community health workers and educational videos have been used in recent years to educate the population in order to reduce vaccine hesitancy¹⁷ From a group of chosen articles, the combination of influenza and COVID-19 vaccine had generally increased the uptake of the latter due to the familiarity of the flu jab, proving to be another effective strategy against vaccine hesitancy¹⁹ .
Current advances on combination vaccines of influenza and COVID-19
Combination vaccines against influenza and COVID-19 remain an area of active research Moderna a well-known biotechnology company, have already started clinical trials comparing the combination vaccine mRNA1083 against a standard dose of the influenza vaccine alone⁵ . Any adverse reactions from the combination vaccine were similar to reactions from the standalone COVID-19 vaccine group in the trial, such as a fever, injection sight pain, headache and fatigue¹⁶ . Potential regulatory approval for the combination vaccine is expected in 2025¹² The vaccine is an investigational messenger RNA vaccine which helps the body produce specific proteins that can aid your immune system when you catch a certain disease or to prevent it all together¹¹
Effect in wider picture
As most of the population is accustomed to taking influenza vaccines, using a combination vaccine against influenza and COVID-19 could increase the number of people who are vaccinated against debilitating and often lifethreatening respiratory infections¹⁹ Large-scale vaccination programmes could also increase the general immunity of the population through herd immunity. Recent research suggests that vaccine hesitancy during the COVID-19 pandemic was particularly high amongst members of the ethnic minority community. A study carried out in Greater Manchester suggested that those who were Black or Black British had lower vaccination uptake values amongst all minority ethnic groups which were collectively lower in comparison to white individuals Similar trends can be seen with uptake of the influenza vaccine previously⁶ Low vaccine uptake was also observed in the most deprived communities in Greater Manchester, suggesting that socioeconomic status also plays a role in vaccine uptake rates Socioeconomic factors show there was a decrease in vaccines administered in those with high income deprivation compared to those without
This may be because those with less income may have difficultly accessing vaccines sites Factors such as language barriers may also interfere and reduce vaccine uptake alongside communities with racial segregation, making transport difficult and costly²⁰ Taking these factors into account the success of combination vaccines may be limited so long as vaccine uptake remains low in many communities
Future of the combination vaccines
There are some developments in combination vaccines against the four strains of influenza and COVID-19, but due to the nature of combination vaccines, they are multifaceted due to regulations, efficacy and safety⁷ With increasing knowledge in biotechnology progress in combination vaccines is advancing quickly Pfizer and BioNTech have also developed mRNA-based vaccines using BioNTech’s mRNA platform technology; the hemagglutinin proteins of the four strands of influenza are used in the vaccine making it much more effective⁸ ¹⁵ Novavax are also developing a combination vaccine against COVID-19 and influenza using the technology of nanoparticles The antigens of recombinant spike proteins of COVID-19 and the recombinant hemagglutinin proteins from influenza are manipulated into nanoparticle complexes which can be recognised by the immune system for a faster response⁹ ¹³ Icosavax, a subsidiary of AstraZeneca, have made some progress in combination vaccines however, against human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) However, they are currently looking to develop other potential vaccines like those against COVID-19 and influenza³
Conclusion
Despite the several challenges faced particularly due to the recent COVID-19 pandemic, scientists and researchers have persevered leading to recent developments of combination vaccines to protect the general population
References:
1
Andrejko, K L , Myers, J F , Openshaw, J , Fukui, N , Li, S , Watt, J P , Murray, E L , Hoover, C , Lewnard, J A , Jain, S , Pry, J M , & Team, t C CC -C S (2022) Receipt of COVID-19 and seasonal influenza vaccines in California (USA) during the 2021-2022 influenza season medRxiv 2022 2010 2021 22281343 https://doi org/10 1101/2022 10 21 22281343
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Antonopoulou V Goffe L Meyer C J Grimani A Graham F Lecouturier J Tang M Y Chadwick P & Sniehotta F F (2022) A comparison of seasonal influenza and novel Covid-19 vaccine intentions: A cross-sectional survey of vaccine hesitant adults in England during the 2020 pandemic Hum Vaccin Immunother 18(5) 2085461 https://doi org/10 1080/21645515 2022 2085461
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AstraZeneca (2023) AstraZeneca to acquire Icosavax including potential first-in-class RSV and hMPV combination vaccine with positive Phase II data Retrieved 04/03/2024 from https://www astrazeneca com/media-centre/pressreleases/2023/astrazeneca-to-acquire-icosavax-including-potentialfirst-in-class-rsv-and-hmpv-combination-vaccine-with-positive-phaseiidata html#: :text=Icosavax's%20lead%20program%20is%20a and%20S ARS%2DCoV%2D2
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4 Clinicaltrials gov (2023) A Study of mRNA-based Influenza and SARSCoV-2 (COVID-19) Multi-component Vaccines in Healthy Adults Moderna Retrieved 18/02/2024 from https://www clinicaltrials gov/study/NCT05827926? id=NCT05827926&rank=1
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Boni M F (2008) Vaccination and antigenic drift in influenza Vaccine 26 C8-C14 https://doi org/https://doi org/10 1016/j vaccine 2008 04 011
Coupland C Harcourt S Vinogradova Y Smith G Joseph C Pringle M & Hippisley-Cox J (2007) Inequalities in uptake of influenza vaccine by deprivation and risk group: Time trends analysis Vaccine 25(42) 7363-7371 https://doi org/https://doi org/10 1016/j vaccine 2007 08 032
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Domnich A Orsi A Trombetta C -S Guarona G Panatto D & Icardi G (2022) COVID-19 and Seasonal Influenza Vaccination: CrossProtection Co-Administration Combination Vaccines and Hesitancy Pharmaceuticals 15(3) 322 https://www mdpi com/1424-8247/15/3/322
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Harris E (2023) Combined COVID-19 Flu Vaccine Candidate Headed to Phase 3 Trials JAMA 330(21) 2044-2044
https://doi org/10 1001/jama 2023 22353
9 Mayo Clinic (2021) Different types of COVID-19 vaccines: How they work Mayo Clinic Retrieved 26 Jan 2024 from https://www mayoclinic org/diseases-conditions/coronavirus/indepth/different-types-of-covid-19-vaccines/art-20506465
Massare M J Patel N Zhou B Maciejewski S Flores R GuebreXabier M Tian J -H Portnoff A D Fries L Shinde V Ellingsworth L Glenn G & Smith G (2021) Combination Respiratory Vaccine Containing Recombinant SARS-CoV-2 Spike and Quadrivalent Seasonal Influenza Hemagglutinin Nanoparticles with Matrix-M Adjuvant bioRxiv 2021 2005 2005 442782 https://doi org/10 1101/2021 05 05 442782
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Moderna Inc (2023) Moderna Announces Positive Phase 1/2 Data from mRNA-1083 the Company s Combination Vaccine Against Influenza and COVID-19 ACCESSWIRE News Room Retrieved 04/03/2024 from https://www accesswire com/789816/moderna-announces-positivephase-12-data-from-mrna-1083-the-companys-combination-vaccineagainst-influenza-and-covid-19 12
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15 Saeed B Q Al-Shahrabi R Alhaj S S Alkokhardi Z M & Adrees A O (2021) Side effects and perceptions following Sinopharm COVID-19 vaccination International Journal of Infectious Diseases 111 219-226 https://doi org/https://doi org/10 1016/j ijid 2021 08 013
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Pfizer (2022) Pfizer and BioNTech Receive U S FDA Fast Track Designation for Single-Dose mRNA-Based Vaccine Candidate Against COVID-19 and Influenza https://www pfizer com/news/announcements/pfizer-and-biontechreceive-us-fda-fast-track-designation-single-dose-mrna-based
Singh P Dhalaria P Kashyap S Soni G K Nandi P Ghosh S Mohapatra M K Rastogi A & Prakash D (2022) Strategies to overcome vaccine hesitancy: a systematic review Systematic Reviews 11(1) 78 https://doi org/10 1186/s13643-022-01941-4
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Watkinson R E Williams R Gillibrand S Sanders C & Sutton M (2022) Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester UK: A cohort study PLoS Med 19(3) e1003932 https://doi org/10 1371/journal pmed 1003932
TOPICS IN BIOMEDICINE
INFERTILITY: EXPLORING MALE AND FEMALE
EXPLORING MALE AND FEMALE
EXPLORING MALE AND FEMALE
RATES AND ITS IMPACT ON SOCIETY RATES AND ITS IMPACT ON SOCIETY RATES AND ITS IMPACT ON SOCIETY
BY EGHOSA ENORIOMWANIHA
What is infertility?
Infertility is defined as the inability to achieve a clinical pregnancy after a year of frequent, unprotected sexual intercourse Around 8-12% of couples in the reproductive age range are thought to be affected by infertility globally¹⁹ . It is estimated that couples in the UK (roughly 3.5 million people) suffer slightly higher levels, with approximately 14% of couples (1 in 7) experiencing infertility¹⁶
There are two types of infertility broadly categorised into primary or secondary infertility Primary infertility is the inability of a couple to conceive after multiple efforts at consistent, unprotected sexual intercourse Secondary infertility is when a couple has successfully conceived in the past but is having difficulties getting pregnant again
The most common risk factors for infertility include old age, smoking, being obese, drug abuse, underlying health conditions like ovulatory disorders, endometriosis and PCOS, drinking alcohol excessively and using certain prescribed medicines like chemotherapy, antipsychotic medicines, and anabolic steroids¹⁶
Does infertility have an effect on the world’s population?
Rates of fertility affect the growth and decline of the population which impacts various elements of society such as workforce and the economy Globally, there are significant differences in the demographic patterns of infertility
While most developed countries face concerns related to ageing populations, low fertility rates and the associated decline in population size decrease, the poorest countries have rapid population growth and high fertility rates¹⁹
Fertility rates are higher in poorer countries due to fewer opportunities for female education as well as poor access to contraceptives¹³
Other reasons including marriage, family traditions, social and economic factors could be the cause of the higher fertility rates in developing countries as some Asian, African, and Latin American communities encourage early marriage¹⁷ Based on lifestyle decisions linked to economic status where contraception is accessible to everyone and the childcare expenses due to housing and education for example, developed countries typically have lower fertility rates¹³. Resolving this problem will help the preservation of sustainability, which is necessary to reach the necessary birth rates and have young people to support national and global developments.
Figure 1: Infertility rates in different areas of the world⁷
Infertility in men
Men make up approximately 50% of cases of fertility overall and they are also found to be mainly responsible for 20–30% of infertility cases¹⁹
The data presented in this figure was gathered from a study that examined global rates of male infertility by reviewing the most recent literature Since most of the figures displayed are based on self-report, they vary significantly Most developed nations like North America, Europe, and Australia have organisations that publish statistics with the highest accuracy which explain why infertility rates are more accurate in these regions than in less developed ones The rates of male infertility in North Africa, Sub-Saharan Africa, and Eastern Europe are similar to some of the highest percentages recorded globally
Men are usually viewed as the dominant member in a household family and in communities, especially in Africa. Men refuse to disclose their infertility because they feel it devalues them to not be able to begin a family with a woman, particularly in Africa and the Middle East Because of this men in these societies frequently refuse treatment and blame women for not being able to reproduce children After reviewing the literature and gathering the findings, the analysis showed that worldwide rates of male infertility vary from 2 5% to 12%¹
Previous investigations found that some factors affecting male fertility were testicular deficiency which is when testicles are unable to produce enough sperm or testosterone, sperm quality and consanguinity which is not common in Europe as it is usually practised by some ethnic and religious minorities¹⁹ Other causes for male infertility include low testosterone production, previous vasectomy and injuries to the testicles, sexual dysfunction and malignancies.
Some lifestyle choices that could improve male infertility include doing exercise regularly, having a health body weight and having a balanced diet³ Other ways to improve male infertility are surgeries like sperm extraction or assisted reproductive technology procedures like in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI)¹⁵
It is commonly known that younger women have a higher chance of a successful pregnancy through IVF treatment, but its success rate also relies on the age of the woman receiving treatment¹⁴ As ICSI is so effective at assisting sperm and egg fertilisation success rates are usually quite similar to those of IVF⁸ Approximately 50–80% of cases with ICSI treatment result in successful fertilisation, even though there are several factors that influence the outcome of the pregnancy⁶
Studies have also found that COVID-19 infection may impact male fertility. Evidence suggests that severe COVID-19 infections are associated with a reduction in fertility or even infertility¹⁰ This occurs when the virus seems to affect the testis directly through cellular infection This induces a cytokine storm (interleukins, tumour necrosis factor, interferons) and because of adverse effects resulting from the administration of antiviral and immunological therapies such as the longterm use of non-steroidal anti-inflammatory medicines, it lowers the sperm quality by decreasing mobility, vitality, count and morphology The chronic use of corticosteroids can also reduce testosterone levels and trigger erectile dysfunction².
Figure 2: Estimate percentages of global male infertility cases in different regions¹.
Infertility in women
A previous study showed that some of the main health conditions that caused female infertility were endometriosis (15%) ovulatory disorders (25%) tubal blockage (11%), pelvic adhesions (12%) and hyperprolactinemia (7%)²⁰ Other causes that contribute to female infertility are irregular menstrual periods genetic disorders uterine fibroids and sterilisation reversal
Women tend to have children later in life because of pursuing professional occupations and higher education Due to a lack of flexible and part-time employment opportunities, socioeconomic factors have caused women to delay having children, which has resulted in low fertility rates. Considering ovarian ageing and associated factors lower the likelihood of conception, this has resulted in a decrease in their fertility levels¹³
Does infertility affect personal lives?
The lives of infertile couples are negatively affected by infertility, especially for women who are more likely to face social stigma, abuse, divorce, psychological stress, anxiety, depression, and low confidence²¹ There is a link between psychological stress and infertility as past research found that, in comparison to healthy couples, infertile couples experience higher levels of stress and are more likely to experience mental illnesses Infertility can enter a vicious cycle as research has also shown that that significant levels of psychological stress also contribute to infertility¹⁸
Infertility can also influence the mental health of individuals whilst undergoing treatment as they can go through intense emotions which can lead to stress, anxiety, low self-esteem, frustration, depression, and grief due to failed fertility treatments¹²
How is male and female infertility a concern in the UK?
A previous study revealed that 53 2% of men and 57 3% of women who suffered from infertility sought out medical treatment or professional help⁴
Like other European nations, the Department of Health is currently in charge of funding and controlling fertility treatments in the UK Fertility treatment is not a top priority in healthcare as there are other current issues like cancer, treating the elderly, and acute medical conditions Because of this, there are worries about inequality and lack of funding. Lack of governmental support for fertility services could lead wealthy individuals to be the only ones able to afford fertility treatments The long-term result of this will be societal inequity¹³.
According to another study, being from a higher socioeconomic class, marrying or settling with a partner at a later age and older people that previously had children at a younger age are all linked to an increased prevalence of infertility⁴ Higher educated and employed individuals are more likely than others to seek medical advice for fertility issues and clinical practice and public health should take these disparities in help-seeking into consideration⁴
The quintile of socioeconomic deprivation also significantly affected the agespecific rates of reproductive issues. It was found that among younger women, deprivation was linked to greater rates of infertility as results in research showed that women between the ages of 30 and 34 had the highest incidence rate of documented problems with fertility⁵ .
When it comes to the incidence of male factor infertility and the need for medical services for male infertility diagnosis and treatment there is a major knowledge gap This is due to the fact that males are less likely than women to seek medical evaluations for a variety of reasons including fear, cultural norms lack of insurance or social reasons As a result there are fewer opportunities for patient education regarding the causes, diagnosis, and treatments of male infertility¹¹
How can infertility be managed?
Infertile couples now have access to a greater variety of treatment choices thanks to the rapid development of reproductive medicine and the knowledge learned from managing infertility. Fertility treatments can be grouped into three categories: medical (including ovulation induction therapy), surgical (including laparoscopy and hysteroscopy), and assisted reproductive procedures The selection of a treatment for infertility is frequently influenced by factors such as cost, side effects and effectiveness. A couple's options for treatment will also depend on how long their infertility has been going on, which partner is suffering, the age of the female partner, whether she has had children in the past, underlying pathological issues and whether the treatment will be financed privately or by the NHS⁹ .
When planning and implementing fertility services, general practitioners, primary care trusts, and policy makers can benefit greatly from having data on the prevalence and distribution of fertility issues that are reported in primary care. There has been no regional variation in the high prevalence of infertility; however, given the age limits on the availability of fertility treatments in the UK, it is important to acknowledge the significant impact of infertility among younger, more disadvantaged women who often delay seeking support or face societal barriers when asking for help.
To sustain humanity, more resources are needed to address modifiable risk factors to reduce fertility issues in addition to ensuring that treatment is accessible to all and distributed more fairly throughout socioeconomic groups. The stigmas attached to infertility because of cultural and religious beliefs should be addressed as a society and since there are generally fewer men seeking support for their infertility, initiatives need to be implemented to increase public awareness about the issue. The government aid in setting up clinics to help men and women become more fertile by educating them about the factors that affect fertility and assisting them in conceiving naturally would be highly advantageous In order to offer further treatment cycles within the guidelines of the health budget, they could also provide safe and affordable assisted reproduction treatment options with single embryo transfer, as well as flexible, part-time job opportunities for women¹³
1
Agarwal, A , Mulgund, A , Hamada, A , & Chyatte, M R (2015) A unique view on male infertility around the globe. Reproductive Biology and Endocrinology, 13(1), 37 https://doi org/10 1186/s12958-015-0032-1
2
Ardestani Zadeh, A , & Arab, D (2021) COVID-19 and male reproductive system: pathogenic features and possible mechanisms. Journal of Molecular Histology, 52(5), 869-878 https://doi org/10 1007/s10735-021-10003-3
3
Dabaja, A A , & Schlegel, P N (2014) Medical treatment of male infertility Translational Andrology and Urology, 3(1), 9-16. https://tau amegroups org/article/view/3512
5
Datta, J , Palmer, M J , Tanton, C , Gibson, L J , Jones, K G , Macdowall, W , Glasier, A., Sonnenberg, P., Field, N., Mercer, C. H., Johnson, A. M., & Wellings, K (2016) Prevalence of infertility and help seeking among 15 000 women and men Human Reproduction, 31(9), 2108-2118 https://doi.org/10.1093/humrep/dew123
4 Dhalwani, N N , Fiaschi, L , West, J , & Tata, L J (2013) Occurrence of fertility problems presenting to primary care: population-level estimates of clinical burden and socioeconomic inequalities across the UK Human Reproduction, 28(4), 960-968 https://doi org/10 1093/humrep/des451
Diaz-Garcia, C (2021) ICSI Explained: Success Rates, Risks and What to Expect https://www ivi uk/blog/icsi-ivf-success-rates-risks/
6 Ely, J (2023) Staggering one in six adults of childbearing age across the world are infertile, landmark WHO report claims https://www dailymail co uk/health/article-11933331/Staggering-one-sixpeople-world-infertile-landmark-report-claims html
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7 Human Fertilisation & Embryology Authority. (n.d.). Intracytoplasmic sperm injection (ICSI) Retrieved 03/03/2024 from https://www hfea gov uk/treatments/explore-all-treatments/intracytoplasmicsperm-injection-icsi/
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Kamel, R M (2010) Management of the infertile couple: an evidence-based protocol Reproductive Biology and Endocrinology, 8(1), 21 https://doi.org/10.1186/1477-7827-8-21
Leslie, S W , Soon-Sutton, T L , & Khan, M A B (2023) Male Infertility In StatPearls StatPearls Publishing
Leung, A K , Henry, M A , & Mehta, A (2018) Gaps in male infertility health services research Translational Andrology and Urology, S303-S309 https://tau amegroups org/article/view/19367
Lewis, R (2022) How Fertility Treatment May Affect Your Mental Health Retrieved 03/03/2024 from https://www healthline com/health/infertility/mental-health-during-fertilitytreatment
Nargund, G (2009) Declining birth rate in Developed Countries: A radical policy re-think is required Facts Views Vis Obgyn, 1(3), 191-193
National Health Service (2017) IVF Retrieved 03/03/2024 from https://www nhs uk/conditions/ivf/
National Health Service (2017) Low sperm count Retrieved 03/03/2024 from https://www nhs uk/conditions/low-sperm-count/
National Institute of Health and Care Excellence (NICE). (2023). Infertility. Retrieved 03/03/2024 from https://cks nice org uk/topics/infertility/
Pan, J (1984) [An analysis of the fertility transition in developing countries] Renkou Yanjiu(1), 53-57.
Simionescu, G , Doroftei, B , Maftei, R , Obreja, B -E , Anton, E , Grab, D , Ilea, C , & Anton, C (2021) The complex relationship between infertility and psychological distress (Review). Exp Ther Med, 21(4), 306. https://doi org/10 3892/etm 2021 9737
Vander Borght, M , & Wyns, C (2018) Fertility and infertility: Definition and epidemiology. Clinical Biochemistry, 62, 2-10. https://doi org/https://doi org/10 1016/j clinbiochem 2018 03 012
Walker, M H , & Tobler, K J (2022) Female Infertility In StatPearls
World Health Organization (2023) Infertility Retrieved 03/03/2024 from https://www.who.int/news-room/fact-sheets/detail/infertility
TOPICS IN BIOMEDICINE
Will Plastic-Eating Bacteria Shift Towards Sustaining and Improving Our Environment?
BY CHARLES MIDDLETON
Sustainability within a growing population presents significant challenges especially amongst waste that is generated in our communities Each year it is estimated that around 250 billion plastic bottles alone are not recycled with over 29 million tonnes of plastic waste contaminating oceans⁷ ⁸ This magnitude of waste is increasing each year, meaning that we must aim to minimise the use of plastic and be very conscious of how our waste is disposed of Ethical issues arise with plastic waste such as the extreme environmental damage observed in countries such as China and Malaysia amongst others. It has been reported that recycling from the UK is often shipped abroad and recycling standards are not upheld, meaning that significant proportions could end up in landfills unnecessarily⁵
The sheer quantity of our waste poses substantial threats to marine wildlife and their habitats, with up to 700 species impacted, for example, seabirds, whales, and dolphins¹ The highest cause of death within marine wildlife involves entanglement and starvation because of plastic contamination It is noteworthy that ecological disruption may impact food production and climate change.
In 2016, Ideonella sakaiensis was identified as a candidate bacterium for plastic-eating bacterial research¹³. I sakaiensis are aerobic gram-negative rod-shaped bacteria with structural capabilities that enable resistance and degrade polyethylene terephthalate (PET), commonly found in plastic bottles
Plastic-eating bacteria provide a variety of benefits such as degrading plastic waste and converting polyethylene terephthalate into adipic acid, which is useful in pharmaceuticals, the food industry along with others¹². Research has also found other species such as strain-specific Escherichia coli, which has been genetically modified in vitro to amplify enzyme synthesis thus, more effectively breaking down PET into adipic acid¹²
Figure 1: E coli degrading polyethylene terephthalate illustration³
Several bacterial candidates for genetic engineering to enhance plastic breakdown have been identified However, there are currently limitations exhibited in plastics with characteristics such as longer polymer chains and additives such as heat stabilisers affecting the rate of breakdown² Other microorganisms have also been identified that bio deteriorate heated, or UV-treated polypropylene (PP), such as the soilbased fungi Aspergillus terreus and Engyodontium album⁹ PP plastic has only a 1% rate of recycling and has been observed as the highest proportion of plastic pollutants (see Figure 2) It is also evident that different bacterial species are affected by physicochemical influences such as such as specific temperatures that do not occur naturally in the environment, and each type of plastic has different structural properties which means that not all plastics can be broken down by one type of bacteria presenting further complexity⁶
Genetic engineering poses a wide array of ethical implications and poses challenges such as unpredicted ecological impact and questions around biodiversity amongst existing bacterial species in our ecosystems. With genetic engineering careful consideration of environmental impacts, biological diversity, and societal impacts they present For example, if imbalances were to occur within the environment where the genetically engineered bacteria had been released, this may pose a threat to other bacterial species in the same environment in terms of competition and survival, in turn affecting plant life Another example may be that some genetically engineered organisms may pose potential threats to human health.
Another challenge is the proportion of bacteria compared to the amount of plastic waste Thus, will there be enough quantity of bacteria to sustainably breakdown all our plastic waste?
Lack of funding may also be a potential drawback of generating and deploying plasticeating bacterial species, which may also disproportionally impact lower socio-economic countries
Currently in the UK BBSRC (Biotechnology and Biological Sciences Research Council) and NC3Rs (National Centre for the Replacement, Refinement and Reduction of Animals in Research) is funding approximately £4 7 million into research alongside biome bioplastics¹⁰ NERC (Natural Environment Research Council) has funded £3 million in research from 2020-2023 in Southeast Asia due to the concerns of this region producing the highest plastic pollution globally¹¹ With the funding currently being spent on research, more is needed to combat the scale of the problem.
To conclude, plastic-eating bacteria provide significant potential in degrading a variety of plastics. However, more research is needed to determine the complexities behind additional challenges presented in the deployment of these species into our environment. As beneficial as these species may be, additional measures must also be used in conjunction such as education on recycling schemes, waste reduction methods, change in packaging manufacturing processes, and environmental clean-up volunteering
Figure 2: Plastic pollution per type of plastic⁴
References:
1
Center For Biological Diversity (n d ) OCEAN PLASTICS POLLUTION. Retrieved 04/03/2024 from https://www biologicaldiversity org/campaigns/ocean pla stics/
2. Dutfield, S (2022) Plastic-eating bacteria: Genetic engineering and environmental impact Retrieved 04/03/2024 from https://www livescience com/plasticeating-bacteria
Darakhshanda Iram, R. a. R., Rana Khalid Iqbal. (2019). Usage of Potential Micro-organisms for Degradation of Plastics Open Journal of Environmental Biology, 007015. https://doi.org/10.17352/ojeb.000010
3 Geyer, R , Jambeck, J R , & Law, K L (2017) Production, use, and fate of all plastics ever made Science Advances 3(7) e1700782 https://doi org/10 1126/sciadv 1700782
4 Hughes, D (2018) UK waste sent overseas for recycling could end up in landfill instead, says watchdog. https://www independent co uk/news/uk/homenews/recycling-waste-uk-overseas-landfill-pollution-naoenvironment-defra-a8458991 html
5 Oliveira, J , Belchior, A , da Silva, V D , Rotter, A , Petrovski, Ž , Almeida, P L , Lourenço, N D , & Gaudêncio, S P (2020) Marine Environmental Plastic Pollution: Mitigation by Microorganism Degradation and Recycling Valorization [Review] Frontiers in Marine Science, 7 https://doi org/10 3389/fmars 2020 567126
6 Organisation for Economic Co-Operation and Development (OCED) (2022) Plastic pollution is growing relentlessly as waste management and recycling fall short, says OECD Retrieved 04/03/2024, from https://www.oecd.org/environment/plastic-pollution-isgrowing-relentlessly-as-waste-management-andrecycling-fall-short htm
7 Parker, L. (2018). A Whopping 91 Percent of Plastic Isn t Recycled Retrieved 04/03/2024, from https://education nationalgeographic org/resource/whop ping-91-percent-plastic-isnt-recycled/
8. Samat, A F , Carter, D , & Abbas, A (2023) Biodeterioration of pre-treated polypropylene by Aspergillus terreus and Engyodontium album npj Materials Degradation, 7(1), 28 https://doi org/10 1038/s41529-023-00342-9
9 UK Research and Innovation (UKRI). (2022). Innovations to solve the planet’s plastic problem Retrieved 04/03/2024 from https://www ukri org/news-andevents/responding-to-climate-change/topicalstories/innovations-to-solve-the-planets-plastic-problem/ 10. UK Research and Innovation (UKRI) (2022)
11
Understanding plastic pollution impact on marine ecosystems in Southeast Asia Retrieved 04/03/2024 from https://www ukri org/what-we-do/browse-our-areasof-investment-and-support/understanding-plasticpollution-impact-on-marine-ecosystems-in-southeastasia/
12
Valenzuela-Ortega, M , Suitor, J T , White, M F M , Hinchcliffe, T , & Wallace, S (2023) Microbial Upcycling of Waste PET to Adipic Acid ACS Central Science, 9(11), 2057-2063 https://doi org/10 1021/acscentsci 3c00414
Yoshida S Hiraga K Takehana T Taniguchi I Yamaji H , Maeda, Y , Toyohara, K , Miyamoto, K , Kimura, Y , & Oda, K (2016) A bacterium that degrades and assimilates poly(ethylene terephthalate) Science, 351(6278), 1196-1199 https://doi org/10 1126/science aad6359 13
TOPICS IN BIOMEDICINE
Balancing Bytes and Bliss: Sustaining Balancing Bytes and Bliss: Sustaining Balancing Bytes and Bliss: Sustaining
Happiness In a Digital Age Happiness In a Digital Age Happiness In a Digital Age
BY HARRIET BURROW
In a growing digital age, it is not new information that technology is creating an “antisocial” generation But have these technologies created platforms for positive change as well?
In 2024, 98% UK adults aged 16-24 now have a smartphone¹ These can be amazing tools for networking, studying and relaxing, however the majority of time spent on these is used watching TV and scrolling social media In a Uswitch survey in 2022 the average person in the UK’s screen time is over 5 hours⁴ . This is over 20% of their day spent looking at a screen. Overall, the time spent studying or relaxing is significantly lower than time spent online, this cannot be beneficial to a young adult’s mental or physical health Moderate usage of these technologies is proved the most productive, due to its connectivity enhancement, financial inclusion, and access to information In short, digital technology is a double-edged sword.
What is happiness?
There are so many definitions for happiness and therefore many say it is difficult to pinpoint Aristotle thought of happiness as a combination of “pleasure” and “ a life well lived ” These principles have formed a solid base for how scientists monitor and measure happiness Pleasure engages multiple regions of the brain; most studies conclude this is due to the release of dopamine, serotonin, oxytocin, and endorphins as well as cortisol and adrenaline⁶ Physical health has been concluded to have a large effect on underlying happiness There are many physical and biological factors which contribute Oxytocin is released from the pituitary gland and causes a spectrum of behavioural and physiological effects, there is a significant correlation between oxytocin levels after a positive stimulus and a reported level of happiness Cortisol is released by the adrenal glands in response to inflammation, its role is to manage stress This has been shown as a consistent biomarker for depression and salivary cortisol is a good indicator of happiness Adrenaline produces similar effects to Cortisol, such as increased heart rate and immune system suppression Research indicates that urinary adrenaline is another good indicator³
The rapidly advancing digital world sustaining happiness is a challenge and a necessity It is vital to navigate social media with mindfulness and integrity. A study in 2017 indicated teenagers with higher social media usage are reportedly three times more likely to feel socially isolated Social media platforms create feelings of jealousy and relational aggression⁷ . We rely hugely on technology in accessing educational resources and following personal interests
But how do the youth of today manage the pros and cons of a growing virtual world? They must be mindful of excessive screen time, social media comparison, and information overload diminishing the positive effects technology can have.
So how can we maintain a healthy relationship with technology while staying connected to the real world? It is important to engage meaningfully in the digital realm over passive scrolling Preserving mental wellbeing in a world of social media can be difficult however there are a few rules to consciously follow to prolong happiness while still using social media Most sources say avoid comparison with others, surround yourself with positive influences and spread happiness through your own platform to boost joy in others' lives¹⁰ Most pivotally, do not be afraid to log off. Setting boundaries and assigning specific times for technology usage can be an excellent way to disconnect from time to time Some browsers and sites have options to block or limit certain social media based on your preferences
The power of connection with the non-digital world is even greater in the 21st century Focussing on hobbies and interests which rest your mind and bring positivity is key Exercise and experiencing the outdoors releases endorphins and serotonin which operate as neurotransmitters promoting feelings of positivity and satisfaction after something like exercise⁵ . Many of the population practice mindfulness techniques in the form of yoga or meditation which are proven to increase levels of these neurotransmitters and calm your mind and body. For those who find exercise or meditation difficult there are surprising foods which aid your serotonin and dopamine production Probiotics promote gut (where serotonin and dopamine are produced) and brain health and therefore can benefit both your mental and physical wellbeing⁵ Some everyday food which contain omega-3, folate or B12 can increase neurotransmitter production having the same effect on a person's happiness
Researchers are evaluating the use of technology positively and how this sustains mental wellbeing The “positive technology” approach has been introduced, applying the use of technology for improving the quality of personal experience through its structure, augmentation, or replacement⁸ Technology is constantly changing and in the 21st century we quickly become accustomed to these changes, and they no longer provide contentment Some of our generation would argue that happiness can be found within the confines of social media, however the repetitive dopamine deliverance from constant scrolling is not sustainable in the long term. In many ways the structure of technology, more specifically social media, creates individuals with shorter attention spans and fewer social skills From a student's perspective social media creates a distraction from studies in more than one way, aside from it being the perfect tool for procrastination the construction of social media trains the brain to respond to constant dopamine hits rather than sustain a constant level of happiness This consequently reduces focus and productivity when trying to study as the brain is looking for these monotonous dopamine releases to keep happy
In an exponentially developing digital era there are now apps which are designed to build gratitude, mindfulness, and emotion regulation² In particular, Unmind is a workplace mental health platform which gives organisations and their employees power over their stress using a clinically supported assessment tool to monitor their mental health This app allows colleagues to identify stress in themselves and others and develop pathways to support the workforce effectively Another application, Sanvello provides clinically validated techniques based on cognitive behavioural therapy and mindfulness meditation This connects science, technology, and therapy in a positive way to create a community and tailored pathways to tackle stress And finally, “Youper,” this piece of software helps us to take control of our emotional wellbeing This app uses quick nudges to positively change your day. For example, reminding you to drink water, eat healthy and guided meditation The data collected enables mood tracking and the adaptation of techniques to specific types of stress9
But what happens when it all goes wrong, and happiness is no longer sustained? Celeste Foster, a lecturer at the University of Salford and child mental health specialist, is working with a specialised team to develop a piece of software called “Mood on the Move” She explores happiness as not being the ultimate goal but for young people to be able to understand all emotions that they feel The software is directed at those suffering from thoughts of self-harm and designed to help them identify what triggers these thoughts This application uses a smart watch and emojis to express how a person is feeling throughout the day, track their heart rate comment on what triggers these emotions and be used to devise a plan to avoid and manage these triggers effectively It was important to Celeste to involve the affected young people in the development of the application to ensure its suitability and usability The overall goal is for young adults to gain a better understanding of their mood changes overtime, to promote wellbeing and happiness and to engage with all emotions
All these platforms form the argument that technology can be used to sustain a constant level of happiness; however, the key is in the balance between these mindfulness exercises and our social media use. The process could be counterintuitive if these are not regulated. It is a personal process those wanting to sustain their mental wellbeing must undergo. This may be reducing screen time or keeping connected. It is all down to you.
References:
2
1 Davis, T (2019) Four Ways Technology Can Make You Happier https://greatergood berkeley edu/article/item/ four ways technology can make you happi er
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Baker, N (2024) UK mobile phone statistics, 2023 USwitch Retrieved 01/03/2024 from https://www uswitch com/mobiles/studies/mo bile-statistics/
Dfarhud, D , Malmir, M , & Khanahmadi, M (2014). Happiness & Health: The Biological Factors- Systematic Review Article. Iranian journal of public health, 43(11), 1468-1477.
3 Hiley, C. (2022). Screen Time Report 2022. USwitch. Retrieved 01/03/2024 from https://www.uswitch.com/mobiles/screentim e-report/
5 Kringelbach, M L , & Berridge, K C (2010) The Neuroscience of Happiness and Pleasure Social research, 77(2), 659-678 https://doi org/10 1353/sor 2010 0049
Integris Health (2022) How You Can Benefit from Happy Chemicals Retrieved 01/03/2024 from https://integrishealth org/resources/onyour-health/2022/july/happy-chemicals
6 Regis College (2020, 25/10/2021) How Technology and Isolation May Affect Mental Health Retrieved 01/03/2024 from https://online regiscollege edu/blog/technolo gy-and-social-isolation/
8
7 Riva, G , Baños, R M , Botella, C , Wiederhold, B K , & Gaggioli, A (2012) Positive technology: using interactive technologies to promote positive functioning Cyberpsychol Behav Soc Netw, 15(2), 69-77 https://doi org/10 1089/cyber 2011 0139
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Superscript (2020) 5 awesome apps for wellbeing https://gosuperscript com/newsand-resources/5-awesome-apps-forwellbeing/
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Tennova Healthcare (n d ) Using Social Media to be Happier Retrieved 01/03/2024 from https://www tennovanorthknoxville com/healt h-library/253
TOPICS IN BIOMEDICINE
Xenotransplantation: The End of The Organ Xenotransplantation: The End of The Organ Xenotransplantation: The End of The Organ
During the early 1900s, medical professionals tried to perform xenotransplantation by replacing damaged human organs with organs obtained from frogs, pigs, or primates However, these initial procedures were unsuccessful, and further research was halted until the reason for the failed transplants could be determined⁴ ⁹ . In 1944, Peter Medawar made a significant discovery that posttransplantation, the recipient's immune system identifies organs as foreign and attacks them, resulting in transplant rejection and failure³⁴ . In 1954 Dr Joseph Murray accomplished the first successful kidney human-to-human transplant between identical twin brothers Due to genetic similarity, the receiving twin accepted the organ without immune suppression. Nonetheless, successful transplants between non-identical donors were difficult to achieve until antirejection measures were developed³⁴ In the early 1960s, scientists discovered the first immunosuppressive drugs Researchers then set out to determine whether these drugs could also prevent the rejection of xenotransplants³⁴ In 1963, Dr Thomas Starzl transplanted baboon kidneys into six human recipients with survival periods ranging from 19 to 98 days Despite further attempts over the following decades, success rates remained non-existent³⁴ Since the mid-1990s, scientists have focused on genetically modifying donor animals to prevent organ rejection, which brings us closer to the possibility of xenotransplantation⁵ ³⁴
What is Organ Rejection and the Types of Organ Rejection?
Organ rejection can be defined as a biological process whereby the recipient's immune system recognises the transplanted organ as a foreign tissue and initiates an immune response to eliminate it This process is akin to an immune response directed against an unwanted infection. Organ rejection (organ failure) is a significant challenge that limits the success of organ transplantation procedures and is a subject of ongoing research in the field of transplant immunology¹⁴ ¹⁷ .
In the case of a transplant, hyperacute rejection can occur within minutes if the antigens are incompatible. Immediate removal of the tissue is crucial to prevent fatality Acute rejection can take place within the first week to three months, as the recipient's immune system is activated against the donor tissue. Chronic rejection is a gradual process that occurs over years as the recipient's immune system slowly damages the donor tissue¹⁷ ¹⁸ No organ rejection and prevention of organ failure are the main objectives of xenotransplantation
The cellular plasma membrane is coated with multiple unique molecules, providing the cells with a unique fingerprint The immune system therefore can capably distinguish whether a cell is ‘self,’ ‘foreign,’ or cancerous The surface molecules central to this role are human leukocyte antigens HLA, specifically the MHC class I and its antigen-presenting pathway³ Non-HLA molecules play a less critical role yet contribute to cell recognition²².
All nucleated cells present small fragments of digested glycoproteins via the Major Histocompatibility Complex (MHC) class I at the cell surface The displayed proteins in MHC class I are receptors for CD8+ T cells, ensuring appropriate cell functions in signalling when encountering a compromised state¹⁵ ²⁷ .
The larger proteins are broken down into peptides by proteasome enzymes in the cytoplasm Only peptides sized 8 to 9 amino acids long are transferred into the lumen of the Endoplasmic Reticulum (ER) via Transporter Associated with antigen Presentation (TAP) In the lumen of the ER, those peptides are loaded onto MHC class I molecules, forming peptide-MHC class I complexes Finally, peptide-MHC class I complexes are transported out of ER by the Golgi apparatus to fuse with the cells' plasma membrane for CD8+ T cell receptors (TCR)²⁷ .
There are 20 naturally used amino acids²⁶ This means that a peptide, presented on the cell plasma membrane can potentially have 208 (= 25,600,000,000) to 209 (=512,000,000,000) possible combinations allowing CD8+ T cells to discriminate against cells of its own, same species and different species
Non-HLA antibodies and Xenotransplants
Non-HLA antibodies can be classified into two categories, alloantibodies, and autoantibodies Alloantibodies specifically target polymorphic antigens that differ between the donor and recipient, while autoantibodies recognise selfantigens⁴⁴ The development of antibodies against non-HLA autoantigens is associated with rejection and reduced long-term graft survival. Immunological recognition of cells is mainly governed by the MHC molecules The immune system also recognises specific molecules on the cell surface unrelated to the MHC class I receptors like perlecan, angiotensin type 1 receptor, and collagen which play a significant role in the process of antibody-mediated acute and chronic rejection⁴⁴ . The role of non-HLA antibodies in antigen presentation and immune surveillance has been extensively researched in immunology and organ transplantation, but the knowledge remains incomplete⁴⁴ .
Role of genetic engineering in Xenotransplantation
Genetic engineering has revolutionised how we understand and manipulate living organisms. Altering the genes involved in cell surface molecules within the animal organ of choice can trick the immune system into believing the cell is ‘self.’ This is the essence of xenotransplantation
Two major real-life cases have involved heart xenotransplantation: David Bennet, Sr, who lived two months after xenotransplantation, and Lawrence Faucette, who lived six weeks after xenotransplantation¹⁹ ³⁵ . Genetically engineered pig hearts were used in both cases, but why were pig hearts used instead of the hearts of chimpanzees or baboons? Which are more genetically similar to us¹ ²⁰ ³⁰ ³⁹?
The domesticated pig, scientifically known as Sus scrofa domesticus, lives up to 20 years and can reach up to 240cm Pig organs, especially the heart, have a striking similarity to their human counterparts¹⁶ ⁴¹ ⁴²
Figure 1: MHC class I antigen-presenting pathway²⁷ .
Unlike our primate cousins, pigs have a higher breeding potential, are widely available, and are not endangered The low maintenance costs and extensive genetic engineering experience with pig cells make them an attractive alternative Furthermore, using pig organs for medical research and transplantation poses fewer ethical objections, as pigs are commonly raised as farm animals This introduces interest in developing pig-tohuman organ transplantation to address the shortage of human organs available for transplantation¹² ⁴³
In the case of Mr Bennet’s heart xenotransplantation, four genes were removed, and six genes were added Three genes (GGTA1, CMAH, and β4GalNT2) involved in adding carbohydrate molecules to the plasma membrane have been knocked out to prevent hyperacute rejection⁶ ³² ⁴⁰ The growth hormone receptor (GHR) gene was removed from the pig's heart to ensure it would grow to an adequate size for human recipients during xenotransplantation to prevent fatal compression of the heart² ¹³ ¹⁶
Six genes have been introduced for the heart to be recognised as less foreign to the immune system The Human CD55 and Human CD46 genes mimicked the necessary surface signals to prevent humoral xenograft rejection and arterial blood clots through eliminating antibody binding and natural killer cell adhesion Furthermore, human thrombomodulin and human endothelial C receptors were added to prevent thrombotic microangiopathy, as pig thrombomodulin does not bind well to human thrombomodulin Finally, the inclusion of the Human heme oxygenase-1 gene helped to reduce inflammation and apoptosis At the same time, the human CD47 gene aided the suppression of T cells and macrophages by human phagocytes This improves the compatibility of the organ with the recipient's body³²
The good and the bad:
Despite its potential, xenotransplantation still presents numerous challenges Xenotransplantation advocates argue that the procedure can provide an efficient organ pool, hence saving lives and reducing suffering However, assuming that xenotransplantation is successful, the patient will likely have to take long-term immunosuppressants with unclear long-term effects Human-to-human organ transplant studies have observed that missing a single dose of medication can increase the risk of rejection via reactivating the immune system Furthermore, patients who use immunosuppressants are at a higher risk of infections, cancer, and high blood pressure Some patients also experience digestive issues like Gastrointestinal discomfort as a side effect⁷ ²⁵ ³⁸ Using immunosuppressants means that zoonotic infections can potentially worsen long-term health outcomes Microorganisms like the porcine endogenous retrovirus (PERV) can infect both human and pig cells as well as cause cancer⁸ This highlights the need for continued research like CRISPR genetic engineering PERV virus out of pigs and vigilant monitoring technologies such as PCR, droplet digital PCR, DNA and RNA analysis to prevent the spread of such infections and mitigate their impact on human health²³ ²⁴ ³¹
There is an indication that some individuals who receive animal organs may experience a shift in their self-perception, potentially impacting their identity. While this phenomenon can occur with human organ transplants as well, it may be a more significant issue with animal organs, given the recipient's awareness that they are receiving a nonhuman organ This loss of identity threatens the fundamental principle of autonomy that underlies all medical interventions¹¹ ²¹ ³¹ ³³ .
Additionally, animal welfare is a crucial concern regarding genetic modification and xenotransplantation These practices often involve subjecting animals to various forms of suffering, such as isolation, monitoring, and invasive investigations Additionally, the long-term effects of genetic modifications on animals are not yet fully understood There is also the potential for many animals to be subjected to cloning, which raises ethical concerns For instance, a disease could be highly effective at damaging or killing a specific clone line of Xeno-pig-organs This could pose a problem for both the patient's health and the pigs as some may have already received xenotransplants from these pigs Infected pigs are usually subjected to euthanasia. As such it is essential to carefully consider the impacts of genetic modification on animal welfare and take steps to mitigate any adverse effects²¹ ³¹ Accurately estimating the risk of zoonosis to both the recipient and society is challenging, making vigilant post-operative monitoring necessary.
As a precaution against the potential risk of zoonosis to the broader public, recipients may need to restrict physical relationships, daily activities, and socialisation. These limitations could even involve staying home, resulting in temporary detention By consenting to xenotransplantation, the individual would enter a binding contract for a lengthy period, potentially without the ability to withdraw This contract could include restrictions or even deprivation of human rights, impeding the ability to give fully informed consent, even for an informed patient It is difficult to anticipate future limitations on one's freedom, further restricting the ability to provide informed consent²¹ ³¹
For example, Jewish and Islamic individuals may exhibit a lower acceptance rate of pig organs due to religious beliefs As a result, alternative sources of organs may need to be explored for these communities to ensure equitable access to life-saving medical procedures
Xenotransplantation regulations are evolving globally, with the US, Japan, EU, and the UK having specific regulations³⁷ . Academic groups and biotechnology companies, for example, United Therapeutics Corporation, are actively researching and developing genetically modified pigs to provide compatible organs for human transplantation²⁸ ³⁶ . Researchers are addressing safety, efficacy, immune responses, infection transmission, and long-term survival and function of xenotransplants through clinical trials²⁸ ³⁶
Xenotransplantation is a promising solution to address the shortage of human organs available for transplantation. With thousands of people waiting for transplants in the UK and the US, the need for viable organ donors is critical Though initial attempts at xenotransplantation were unsuccessful, advances in medical research and genetic engineering have brought us closer to making this a viable option. The immune system plays a crucial role in organ rejection, which limits the success of transplant procedures However, by genetically modifying donor animals, we may be able to prevent organ rejection and save countless lives. It is worth reemphasising that the longest an organ has survived following xenotransplantation in humans is two months, indicating the tremendous amount of further research and practical applications to consider it a standard healthcare procedure sustaining humanity
References:
3
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Inflation In Climate Change Inflation In Climate Change Inflation In Climate Change
BY DONA GIGY PARAMBY
Climate change is defined as gradual variations within the weather pattern from normal expectations Long-term changes of climate change can be observed locally, regionally, and globally Geographical studies declared that human activities such as burning fossil fuels are one the major causes of weather fluctuations in the 20th century¹⁰ It has been announced as an inter-governmental issue that affects ecological, environmental, socio-political, and economic aspects Precautions are initiated as early as possible to prevent the massive blocks of ice sheets found in the majority of Antarctica and Greenland from melting
World Wildlife Fund research found that the Arctic is melting at the speed of 13% per decade The Arctic and Antarctica are fundamental areas of the world with less human activity as most of the surroundings are covered in ice and snow⁵ Therefore, powerful actions should be undertaken to prevent ice from dissolving as it can have major effects globally Many parts of the world may undergo severe heatwaves as less ice leads to a decreased amount of reflection Therefore, this implies that if there are less ice found it suggests the earth is warming up, so temperature increases in the environment This rise in temperature leads to hot and dry heatwaves as less precipitation occurs⁵ . The sea level data gathered informs that from 1901 to 2018 it has increased by 20cm Over time, this increment of water levels would lead to coastal flooding and erosion⁶ . This could cause buildings to collapse near the coastal areas because of the force of water eroding the inner coastline Scientists have estimated that one million habitats near the coastal area wall are to disappear because of natural disasters such as flooding⁶
Global warming plays the largest part in contribution to climate change It has vastly increased from the pre-industrial period through the burning of fossil fuels as well as unconventional products that generate greenhouse gases¹⁰ Quantitative data collected from different studies informs that the rates of carbon dioxide, nitrous oxide, and methane are huge greenhouse gas contributors from 1750, with an increase from 20% to 150% Carbon dioxide has been emitted the most from 22 15 to 36 14 billion metric tons by 2014⁷
Cattle also aids the production of methane gases which are harmful for the environment These processes cause the release of greenhouse gases therefore warms up the atmosphere In reverse shown in the form of complex weather changes such as intense heat in some regions or through harsh winters¹⁰
Figure 1: The pie chart shows the global greenhouse gas emissions from 2024¹³.
The Amazon rainforest is one of the important pillars of the world that has been around for sixty-five million years. However, satellite reports have made alerts that global warming has made impacts from the 2000s onwards, but extreme disasters are rising such as droughts and fire breakouts⁴ . Amazon rainforest houses various diverse animals and plants; there are 15,000 tresses and 99% of them are rare Furthermore, dense forests would inhibit carbon dioxide release as data collected interprets that the forest stores 15-20 years of carbon dioxide⁴ This has limited global warming as the forest manages evapotranspiration, which is a process that supports the Earth’s cooling by the uptake of water into the atmosphere through evaporation and transpiration¹⁴ Immediate actions are needed for conservation like reducing deforestation. Deforestation is currently happening at a significantly high rate in many parts of the forest for different purposes like farming Through deforestation, less photosynthesis takes place, leading to less rainfall and more carbon released, contributing to global warming⁴
Species in the Arctic areas are adapted to freezing weather so the disappearance of snow can have negative effects on their physiology leading to challenged survival and extinction of species¹⁰ It can also make it challenging to understand the depth of species interconnections in the ecosystem¹⁰
An example of how global warming has made great impacts on ecosystems are polar bears. Many studies conducted by the World Wildlife Funds claimed to have recorded significantly lower numbers of polar bears compared to historical data At present 22,000 polar bears are surviving the intense climate changes¹⁵
The BBC studies show that by 2100, most or all polar bears will go extinct Polar bears would become extinct due to ice breaking and solidifying, meaning that the bears will be forced to travel to further areas² They travel to maintain the temperatures of their body and to find food for themselves and their cubs.
Prevention strategies are undergoing to maintain polar bears for a balanced ecosystem such as charity fundraising programs and conservation talks² The polar bears are known to be the largest land-based carnivores whose existence is needed in the artic a for a healthy food chain as they are found to be the apex predators² These animals are beneficial in research and aid the understanding of how the species are interconnected and their adaptation methods as the Arctic areas are less touched by human activities¹⁵
Figure 2: The photograph represents the global impact on polar bears²
The Paris Agreement was a global decision undertaken to reduce climate change for future generations The main goal of the agreement was to ensure all nations reduce or maintain with a maximum rise accepted to 1.5°C¹.The agreement came into effect on 4 November 2016 covering 196 countries on a five-year renewal plan to enhance the methods for future improvements¹². Over the years, remarkable changes have been demonstrated Most countries involved are executing plans for zerocarbon solutions with special emphasis on the power and transport sector¹². They have introduced efficient ways to reduce greenhouse gases through electric solar power, geothermal energy, and many more sources¹² The data regarding the solar panels’ efficiency in mitigating greenhouse gases gave shocking revelations such as it can save 900kg of carbon dioxide per year If more people install solar panels, it will decrease the greenhouse gases further down⁹
Mitigation strategies are also implemented through the COP28 which are held in Dubai, United Arab Emirates It is estimated that 70,000 delegates attend the conference from various parts of the world to plan how to reduce climate change in reference to the Paris Agreement¹¹. After debates and analysis of different perspectives, crucial decisions are taken to address the representative countries to reduce the immense amounts of greenhouse by 2030 to 43% compared to data from 2019¹¹.
Afforestation and reforestation are techniques introduced to capture and hold greenhouse gases for long-term storage Forests tend to be destroyed by the removal of trees to use the land for repurposing This leads to less reabsorption of greenhouse gases Other benefits of afforestation are fruit trees grown which can be used to harvest productive items for daily life such as dietary products and supplements³. There is an emerging approach known as the direct carbon capture and storage method which is a form of collecting carbon dioxide from the air through a chemical process and storing it in geological reservoirs for later uses to make mineral carbonates and chemical substances³
Furthermore, one way most individuals and industries can make an impact in mitigating global warming is with renewable energy Most household objects emit a lot of greenhouse gases in different ways⁸ Renewable technologies can substitute burning fossil fuels by using solar, wind, and geothermal energy. Tester et al in 2005 addressed the definition of sustainable energy as a dynamic harmony that can be maintained through the output of giving energy without disrupting the ecosystem of the world for the future⁸ Renewable energies are natural and there would be infinite production throughout a lifetime such as the light rays⁸
Direct solar intakes suns light energy that can be contributed for the common usage The process involves the usage of photovoltaics to produce energy from solar irradiance that is converted for different purposes such as lighting and thermal8. Another renewable source is geothermal energy which involves the generation of energy from the earth’s crust in the form of heat Areas of the earth that contain geothermal reservoirs are drilled through wells under certain geothermal gradients The energy collected on land is converted according to various temperatures to produce electricity⁸
In conclusion the urgency of the climate change cannot be overstated. It is evident that global warming poses a significant threat to our planet and ecosystems, however, there is hope in collective action, technological innovation, and policy reform By working together, we can minimise the effects of climate change and foster a sustainable environment for future generations
References:
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2 Fawzy, S, Osman, A I, Doran, J, & Rooney, D W (2020) Strategies for mitigation of climate change: a review Environmental Chemistry Letters 18(6) 2069-2094 https://doiorg/101007/s10311-020-01059-w
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Malhi G S Kaur M & Kaushik P (2021) Impact of Climate Change on Agriculture and Its Mitigation Strategies: A Review Sustainability 13(3) 1318 https://doiorg/103390/su13031318
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The National Aeronautics and Space Administration (2022) What is Climate Change? Retrieved 05/02/2024 from https://sciencenasagov/climatechange/what-is-climate-change/
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12
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United States Environmental Protection Agency (2016) Global Greenhouse Gas Emissions Data Retrieved 31/03/2024 from https://wwwepagov/ghgemissions/global-greenhouse-gas-emissions-data
Water Science School (2018) Evapotranspiration and the Water Cycle US Geological Survey Retrieved 31/03/2024 from https://wwwusgsgov/specialtopics/water-science-school/science/evapotranspiration-and-watercycle#overview 14
WWF-UK (2016) POLAR BEAR: ICON ON ICE Retrieved 31/03/2024 from https://wwwwwforguk/learn/wildlife/polar-bears
United nations climate change (nd) The Paris Agreement Retrieved 06 February 2024 from https://unfcccint/process-and-meetings/the-parisagreement
Anya Biferno(202430 January )What is climate change? Retrieved 04 march2024from https://climatenasagov/what-is-climatechange/#: :text=Climate%20change%20is%20a%20longare%20synonymous%2 0with%20the%20term
United Nations Climate Change (nd) About COP 28 Retrieved 04 march2024 from https://unfcccint/process-and-meetings/conferences/un-climate-changeconference-united-arab-emirates-nov/dec-2023/about-cop-28#Why-is-COP28important
WWF-UK (nd) POLAR BEAR: A POWERFUL PREDATOR ON ICE SPECIES Retrieved 04 march2024 from https://wwwwwforguk/learn/wildlife/polarbears
Helen Briggs and Victoria Gill (202020 July) Climate change: Polar bears could be lost by 2100 Retrieved 04 march2024 from https://wwwbbccouk/news/science-environment-53474445 21
United states environmental protection agency( 20247 February) Global Greenhouse Gas Emissions Data Retrieved 04 march2024 from https://wwwepagov/ghgemissions/global-greenhouse-gas-emissions-data
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Water Science School ( 2018 12 June) Evapotranspiration and the Water Cycle Retrieved 27 march2024 from https://wwwusgsgov/special-topics/waterscience-school/science/evapotranspiration-and-water-cycle#overview
SALFORD SCIENCE
DR JOE LATIMER IN CONVERSATION WITH WIKTORIA WISNIEWSKA
We all know that antimicrobial resistance (AMR) is a huge, and very worrying problem What we might not all be so aware of is that AMR, like too many other awful things in our world, disproportionately affects the world’s poorest and most vulnerable people Dr Latimer works with collaborators around the world to explore how and why the bacteria in resource-poor counties resist antibiotics and what we might be able to do about it
Currently, Dr Latimer's group is investigating the sensitivity of clinical isolates of K pneumoniae to important antibiotics, and how well-adapted they are to cause severe disease. The results so far are not good – they are resistant to multiple classes of antibiotic K pneumoniae can cause severe disease such as pneumonia, wound infections, and septicaemia, and is on the WHO priority watchlist of pathogens The isolates that Dr Latimer is working with were collected from patients from six hospitals throughout Gaza These strains are now likely spreading within the population, particularly since so many people are displaced, injured and/or suffering from lack of water and food. Medical capacity, of course, is also severely limited, and only one of the six hospitals still stands.
This interview will shed light on this ongoing research and its wider contextual impact on antimicrobial resistance
Could you tell me about your academic background and what interested you in microbial resistance?
I completed my undergraduate degree in Biological Sciences at Lancaster University, where in my final year I specialised in microbiology and physiology under the supervision of Dr Jackie Parry who got me interested in the microbiology of biofilms This was when I realised that I need to follow a career in microbiology So, after travelling for a year, I did my masters in medical and molecular microbiology in the University of Manchester which focused on the diversity of bacteria that cause disease, how they adapt to their environments and how to identify them My PhD was at the University of Sheffield under Professor Robert Poole, looking at the fundamental nature of biofilms, using a technique called transcriptomics I then worked in rural Malawi, teaching science, and helping to develop their biomedical science provision
After returning to the UK, I worked for a spin-off company, NeuTec Pharma, developing their antibody therapies for Clostridium difficile. Then I went back into academia and worked as a postdoc in oral microbiology focussing on dental plaque During these five years, I became interested in how microbes interact with human hosts A senior postdoctoral position came up in Manchester investigating host-microbe interactions in human skin As the year progressed, I felt that it was time to pursue a lectureship and was encouraged by my boss Dr Cath O’Neill to pursue an independent research career ’ Here I decided to go down the lectureship route because as much as I love research I also really enjoy teaching After securing an interview for a lectureship at Salford, I vividly remember feeling like I would fit in with the team there
I have been interested in AMR in resource poor countries for a while To set the scene, in the UK we have good routine microbiology hospitals reference labs where we can easily track infection and resistance rates. As soon as you start getting to countries with lower incomes, this starts to fall apart and the central focus becomes treatment rather than surveillance or research When I was working in Malawi, I was interviewing doctors about the guidelines for prescribing antibiotics for conditions like tuberculosis, malaria, or UTIs, and the most common story was ‘if we even have any antibiotics in, we use them ’ That is quite a shocking state of affairs because not only can they not keep track of resistance rates, but it is also impossible for them to follow treatment guidelines. The upshot of this is that even in in resource poor countries even when politically stable, it is difficult to know what is going on When you add occupation and displacement of dense populations caused by war, it makes the situation even more difficult I am collaborating with Dr Nabil El Aila, a microbiology professor at Al-Aqsa University in Gaza City, who devotes most of his research to trying to track what is going on He is particularly worried about the extended spectrum beta lactamases in bacteria. Before the current war, we were conversing about Klebsiella pneumoniae which is a Gram-negative pathogen from WHO priority watchlist and how prolific it is
Over a course of a couple months, he took samples from six hospitals and managed to get them over to Salford where we have started to characterise them The professor came here for a few months for a visit and arrived back at Gaza two days before the war started He was able to escape to Belgium just before Christmas and because of that we can maintain contact and push this research forward
Who is involved in the project and what is the main aim of this research?
Dr Nabil El Aila also has close connections with a group in Paris from South Paris University Hospital While Dr Nabil is the linchpin of the entire investigation, Dr Tierry Naas and his group provide experience, particularly in the genomic side of things while our work focuses on the phenotypic side One of our previously undergraduate HBID student Ruby NaylorAdamson has been working on strengthening our understanding of Klebsiella biofilms and its ability to resist antibiotics The main aim of the investigation as it currently stands is to provide enough information on the infectious pathogens in Gaza. The priority is to obtain a detailed picture of antibiotic susceptibility and share this with organisations such as UN, MSF, Red Cross charities to help them guide operations to treat these infections I am a strong believer in multidisciplinary team effort and as this project expands, we are going to need to collaborate with experts in environmental sciences to assess what is happening with these bacteria and its resistance in long term and how it relates to air quality for example, to make the impact of the study even more clinically relevant
Why
is Klebsiella pneumoniae the focus of the
study?
Klebsiella penumoniae is on the WHO pathogen watchlist alongside Enterobacteriaceae, P. aeruginosa, Staphylococcus aureus, etc., addressing great threat to human health The current literature indicates that Klebsiella is starting to overtake these in terms of importance and virulence The main phenotypes of - that we find are hyper mucoid or normally virulent and this will be something that we will investigate too. We have 126 isolates as well as samples’ origin information and clinical presentation of the patient. These data will help us correlate the clinical results, the infection site, as well as the susceptibility We understand this may shift slightly once we obtain the genomics work details, but the samples represent a snapshot of demographics and origins
In developed countries such as the UK, our surveillance would be able to pick this up, however, in resource poor countries, this may not be the case At some point, we would like to do a similar multicentre study focusing on the situation in different parts of the world to compare the findings. When conducting these studies, it is always important to take into account that the situations in cities is not the same as it is for the majority of the populations that live in rural environments Interestingly, our academics Prof Chloe James and Prof Richard Birtles are doing work in Uganda where they do not only focus on the capital Kampala but the situation in the rural areas too. When it will become possible, we may consider clinical samples to track the transmission and resistance rates further
Figure 2: Previous work from Dr Latimer’s lab has shown that K. pneumoniae adapts very quickly to last-line antibiotics, becoming resistant after just 10 exposures This work was done by a previous PhD student, Alex Thompsett in 2019¹.
Figure 1: Photo of Nabil and his family after escaping from Gaza to Belgium - Jan 2024
What were the main challenges in transporting the isolates?
It was horribly difficult Nabil was able to bring the clinical isolates from Gaza into Egypt and obtained the paperwork and permissions to fly them from Cairo to Paris, which we thought would be the hardest bit We then tried to get a courier to pick them up from Paris and bring it over here, however, even to organise that ended up being extremely difficult. When we finally got it sorted, the isolates were picked up from Paris and lost! At that point I got all the necessary permissions, settled all the paperwork, got a flight booked and had a very short 24-hour-long holiday to Paris to bring them back!
What about the technical aspects of the experiment?
Genome sequencing will be done in collaboration with Dr Tierry Naas and his group with support of their national databases We assess the biofilm and planktonic growth dynamics We used the crystal violet method as confirmation which is useful for large scale screening What we wanted to do that is not commonly done is to look at biofilm formation as relative to overall growth rate as we often see isolates being identified as strong biofilm producer, but it may be possible that this strain just tends to grow faster than the others This is why we normalise our data with respect to overall growth rate We will try to assess detailed biofilm growth on Mueller Hinton agar as well as more clinically relevant conditions too, for instance wound or urine medium. We will also aim to look at the concentration of a given antibiotic needed to inhibit or kill the bacteria in both biofilm (via disc diffusion) and planktonic cells. We are also interested in looking at microfluidics and examine the biofilm formation in this environment We use a wide range of antibiotic classes such as penicillins, tetracyclines, fluoroquinolones, and many more, and we are looking forward to assessing any interesting synergies between their effects
Are there any more notable interesting methods that will be employed as a part of this study?
We are also very keen to investigate virulence, so we will assay the strains for their ability to produce specific bacterial virulence factors We will also use an invertebrate virulence model to evaluate and compare overall pathogenicity This model, which employs waxmoth larvae, is fantastic because it allows us to assess virulence in the presence of host factors We will also examine whether antibiotic susceptibility varies when the bacteria are in a host environment
There is a lot of work to do, and we are looking forward to taking on more postgraduate research students to continue this research.
Are there any reliability concerns?
As scientists we always need to be careful with our research As your research experience develops, you become more confident in your ability to ask the right questions. You also tend to become more critical and get better at experimental design with relevant controls and consideration for statistical significance There are always different test conditions to think about like why was this result anomalous, will it work in a different pH or anaerobically, why is it producing an unexpected pigment, why did the colony morphologies change? These are the things we would consider The 15 antibiotics that we selected first are based on the EUCAST guidelines from which the data analysis will be based on To avoid a completely Eurocentric point of view, we will also consider guidelines from other parts of the world to judge the results through different worldview perspectives.
Can this research contribute to the understanding of disease transmission and outbreaks?
As of now, it is impossible to say No one is allowed in or out of Gaza, so we simply do not know It is frustrating, it is upsetting, because we would love to look at the geospatial aspect of the problem. Most of the northern Gaza has been demolished with a million people displaced and having to move multiple times This mass movement and hospital breakdowns make it impossible to control the situation and I am not sure what levels of aid are currently allowed in Once we can get clinicians and researchers in, we might be able to start building up a picture again, however, I cannot say with confidence that it will be anytime soon The opportunities to implement this research into public health depends on how the situation develops and if we continue to receive the funding to expand the study Potentially we may be able to trace infectious diseases as the country begins to rebuild itself. It is always a challenge to find funding, however, we are hoping that once we have published a review explaining what the situation looked like up until the start of the war, this would encourage the readers to engage and then the first and the second paper on the work will start a critical mass thinking and hopefully contribute to the outreach and expansion of the investigation
Lastly, is there anything we can do to raise awareness about microbial resistance?
I think the best thing that we can do as scientists is communicate the problem to family, friends, the public, and say it in a way that people will understand. We are much better now at sharing resources and teaching the basics Antibiotics are absolutely wonderful, and we need to keep them for as long as we can If you take antibiotics unnecessarily, it increases the chances that when you are 80 years old and get pneumonia, there is nothing to treat the infection with We are already starting to see strains of Klebsiella becoming resistant to certain classes of antibiotics. It is also worth reminding people that when we kill bacteria with antibiotics, we also kill an important part of our own bodies - our microbiome Through overusing antibiotics or not completing the antibiotic course, the bacteria grow more tolerant to treatment hence become more resistant Some people tend to use antibiotics for flu which are completely ineffective or using antibiotics from previous prescriptions without realising that different drugs work on different types of bacteria, never mind the variations in dosage and treatment times Antibiotics will not treat any given infection There is a finite number of antibiotics as of now with last one being discovered about 40 years ago, while bacteria are mutating all this time winning the arms race. Hopefully, as a society we will be more conscious of this issue In the future, it is quite possible that we will introduce specific treatment methods that do not necessarily affect the microbiota such as phage therapy or anti-virulence drugs which do not kill the bacteria but stop them from going through an evolutionary pressure to develop resistance.
It is clear that antimicrobial resistance demands our urgent attention We must recognise our role in this challenge, whether it is being mindful of antibiotic use, supporting research efforts, or advocating for social awareness, every action counts Hopefully with continued collaboration, we can ensure a more vigilant and proactive approach to combat AMR.
Interested in the study? Dr Latimer is looking to take on a small group of postgraduate students to support this incredible research If you would like to have a chat or express your interest in getting involved, feel free to reach out to Dr Latimer at j.latimer2@salford.ac.uk.
References
Tompsett, A., Ngoc, L. N., Goodhead, I., Withers, S., & Latimer, J. (2019). Towards a clinically relevant model for investigation of host-microbe interactions in ventilator-associated pneumonia Access Microbiology, 1(1A) 1.
C A R E E R S
CAREER INSIGHTS CAREER INSIGHTS
pg.48 pg.48
SOARING HIGH: FROM SOARING HIGH: FROM SALFORD TO SCOTLAND, TO SALFORD TO SCOTLAND, TO THE STATES AND THE STATES AND SOUTHAMPTON. SOUTHAMPTON.
Dr Ali Roghanian in conversation with Sara Alnasir Kassam
BEHIND THE SMILES BEHIND THE SMILES pg.53 pg.53
An interview with Dr Evgeny Kushnerev, Senior Clinical Lecturer in Dentistry at the University of Manchester.
pg.55 pg.55
INTERVIEW WITH DR BRIONY INTERVIEW WITH DR BRIONY LABRAM A PRIVATE LABRAM A PRIVATE SECRETARY IN THE UK SECRETARY IN THE UK GOVERNMENT’S GOVERNMENT’S DEPARTMENT DEPARTMENT OF SCIENCE RESEARCH AND OF SCIENCE RESEARCH AND IINNOVATION NNOVATION
Exploring a career working for the government.
pg.57 pg.57
SUSTAINING HUMANITY SUSTAINING HUMANITY THROUGH BEING FIT TO THROUGH BEING FIT TO PRACTICE PRACTICE
The HCPC standards of proficiency, how they relate to fitness to practice and hpw this can be maintained
CAREER INSIGHTS
Soaring High: From Salford to Scotland, to the States and Southampton.
DR ALI ROGHANIAN
IN CONVERSATION WITH SARA ALNASIR KASSAM
Dr Ali Roghanian, Associate Professor in Cancer Immunology and Immunotherapy at the University of Southampton, is a University of Salford alumni (1998-2002) He sat down with co-editor-in-chief Sara Alnasir Kassam to talk about his career thus far Sara and Dr Roghanian discuss the ups and downs of a career in academia and scientific research and explore how crucial Salford was in Dr Roghanian's journey.
Sara: Can you tell us about the main origin point of your career?
Ali: I have always been interested in scientific research, particularly translational research, which means my work can contribute to developing therapeutics used in the clinic that will hopefully directly benefit patients I think what initially inspired me was my dad, who was a scientist and a university lecturer back home in Iran
S: Let's talk about your transition to Salford. What was it like when you first started at Salford? What were your first memories?
A: After arriving to the UK at the age of 14, I initially lived in Sheffield, where I went to high school As you’d expect, it was a bit of a struggle at first There were cultural differences and the language barrier In addition to the GCSE core subjects, I was keen in design and technology disciplines, and in fact did my work placement in an architecture office! However, for my A levels I selected science over arts, which somehow surprised my teachers! It was a decision that was made based on my growing interest in biology and chemistry, and my aim to become a scientist
I wanted to study at a good university, and Salford was a very good choice, as it had a strong Biological Sciences Department that had achieved 24/24 in the national Teaching Quality Assessment So, I moved to Salford to study for a BSc (Hons) degree in Biochemical Sciences (with industrial placement) I chose this degree because it's a broad subject offering a mixture of modules that cover anything from biology and immunology to pure biochemistry and biomedical sciences
It was a very friendly university, and we had fun and interactive sessions with the academics, many of whom I still remember to this day and am very grateful to; in particular those who inspired me during my studies, including but not limited to Drs Thomas, Moore, Butler, Rogan, Foster and Wakeford The approachability of these excellent educators gave me inspiration to achieve my goals, as they were very supportive
S: What was the transition like from Salford to Edinburgh? What made you decide on your speciality? What made you choose what you did?
A: In the final year of my degree, I started looking for postgraduate courses and managed to get a few PhD interviews. I think having a PhD qualification in our field will help you accelerate your career prospects Dr Thomas, one of my favourite biochemistry lecturers, at the time said:
“you’d need to go and visit the university, and ideally the labs, as you don't want to end up somewhere you don't enjoy working at” .
The University of Edinburgh was amongst my favourite destinations, so I contacted a number of academics there One of the group leaders I met particularly liked my CV, as it aligned with their research interests, and he subsequently supported my application to join his laboratory at the Centre for Inflammation Research Because of the nature of my sandwich year project that I did at the Department of Genomic Medicine, University of Sheffield, and the modules we were doing at Salford, I had developed a strong interest in immunology And again, my dad's background was influential, as he was also a lecturer in immunology and microbiology That directed me towards this field at Edinburgh The Medical School at Edinburgh has an excellent reputation in the field and is very research orientated At the time, Salford wasn't a research university; it was mostly a teaching university, so naturally it was a significant change. Many of my peers had more prior knowledge and experience than me and had been exposed to more research and labbased projects However, this did not phase me and despite initially needing to work harder to catch up, I was able to be competitive Nevertheless, with the help of my supervisors, I managed to successfully navigate through my postgraduate studies, and my PhD thesis contributed to a few peer-reviewed papers, review articles and book chapters, which I’m very proud of
S: When you got to Edinburgh, how did you overcome imposter syndrome, given that your origin was from a small university?
A: I had this goal ever since I moved to the UK I just said “I want to have a PhD by the age of 2526; I want to do this ” I had a journey plan and a goal in mind from the beginning This goes without saying that there are usually obstacles and occasional failures along the way but if you stay focused and work hard you can succeed It helps, of course, if you have tenacity, persistence and patience I believe having a positive attitude and resilience can immensely help you achieve your goals Once you start making accomplishments along the way, then you feel less and less like an “imposter” and gain the much-needed confidence and momentum to push you towards and even beyond your set targets
S: You go from England to Scotland, and then back to England and now to the United States at the Massachusetts Institute of Technology (MIT), which is amazing. How did you end up at MIT?
A: I finished my PhD at Edinburgh around 2006 and planned to go to the US But then, for personal reasons, I decided to stay in the UK and got an offer to do my postdoctoral research at the Department of Pathology in Cambridge University (2006-2008) I then worked as a Senior Study Manager at a contract research organisation in life sciences outside Cambridge for a year. I learned a lot during this period but my heart was still in academia So, I decided to switch back with the longer goal of becoming an academic and a principal investigator (PI) I wanted to lead my projects and design the next generation of therapeutics based on the knowledge that I’d gained so far I was specifically interested in monoclonal antibodies and cancer immunotherapy research, in which Southampton has a long history Hence, I applied for a job vacancy at Southampton and was successfully accepted as a research fellow in cancer immunotherapy. As part of my project, we collaborated closely with a biotech company and characterised a panel of monoclonal antibodies using bespoke preclinical models available at Southampton, helping them select the lead candidates for clinical trials Parallel to this, I started my own projects by looking at other targets for cancer therapy Cutting edge research heavily relies on the latest technology and preclinical models and is also very costly (hundreds of thousands) Hence, through a very competitive Blood Cancer UK (BCUK) Visiting Fellowship, I went across the Atlantic and worked at the Koch Institute for Integrative Cancer Research in MIT
S: What was the move from England to the States like?
A: Although I was very excited with the prospects of experiencing life as a scientist in the US, when I arrived, I realised there were a lot of differences, and again, the way of life was quite different to that of back home in the UK! Nonetheless, I thoroughly enjoyed working with an excellent group of fellow scientists and got exposure to a lot of fantastic science, and was trained in cutting-edge techniques
S: What made you then transition back to England and to Southampton? What made you come back home?
A: Well, it was part of the agreement that I had with BCUK and Southampton, that I would return to establish my independent group as a lecturer While I was away, a new centre was being built at our medical campus that provided the ideal place to do cancer immunology and immunotherapy research The Centre for Cancer Immunology opened its doors in 2018 It brings together interdisciplinary teams, including fundamental immunology researchers, clinical oncologists, pathologists and clinical trial managers, to train the next generation of scientists and develop new cancer treatments. Therefore, despite enjoying my time in the US, it was very exciting to return home
S: Your journey was not linear at all. It was very much up and down; how did you deal with that?
A: In science, they say that mobility is very important. If you stay in one place, you will learn, but your knowledge is likely to be limited By being at Salford, I learned the basics of biochemical and biomedical sciences Then, during my placement year at Sheffield, I learnt the techniques and the basics of doing research in a laboratory setting, and, of course, Edinburgh broadened my horizons
But again, when I went to Cambridge, Southampton, and US, each had their unique features and environments. Had I stayed in one place, I wouldn't have been exposed to such different cultures and environments
S: As you have moved around, it has been quite chaotic. Still, I'm pretty sure it's shaped you into who you are as a scientist; let's transition to your academic life. What was the journey to that stage?
A: Doing research as a young scientist can be quite intense You’re expected to put in a lot more hours, have fewer holidays, and be very competitive I learned several very useful techniques in my previous jobs and then at MIT, before returning to Southampton after the end of my secondment in the US. Setting up my independent laboratory here at Southampton was initially difficult and time-consuming but very rewarding
The main part of becoming a PI is mapping your research activities, developing new ideas and importantly applying for and managing your funding You must stay updated with the literature and write and submit many grant proposals, most of which are typically rejected! Overtime, I was awarded more and more research funding, and I currently co-supervise 8 PhD students, and a postdoctoral research fellow
S: What is it like when you're teaching? Do you enjoy that?
A: Teaching is also a fundamental part of academic work, and it's quite rewarding to teach undergraduate and postgraduate students Drug development and discovery, preclinical models, and immunology and cancer immunotherapy are some of the topics that I normally lecture on It’s always very rewarding when the students start asking questions during my lectures or when they tell me how much they enjoyed the topics
S: What is your life like outside of the university, outside of your lab? How do you manage to maintain a work-life balance?
A: I have a number of hobbies, including travelling and sports, which I keep up with as much as I can. But truth to be told I didn’t always maintain a healthy work-life balance in my early days as a scientist, as I often had to work long hours or at weekends Specially, in the US, sometimes people were working throughout the day and night, and did not take a single day off for months! So, as you can imagine it isn't always easy to start a family While working in the US, in my spare times and holidays, I got involved with a lot of sports activities, such as football, volleyball and hiking I also visited different corners of the US, many of which were truly spectacular and breathtaking. These days, in addition to my travels, I spend more time with my family and friends as well as going to the gym and visiting the local nature reserves, such as the New Forest and Jurassic Coast. Overtime I have learned to become more efficient with my time and to balance work and family commitments
S: In the harder times, there are always ups and downs, especially in the scientific life when things don't go as expected. What keeps you going? What is your main motivation?
A: There are a lot of times when you get disappointed when doing discovery and translational research Scientific research involves more failure than success; it’s like you go one step forward and two steps back! It's a very, very slow process but you should keep your goals in mind and persevere Despite all this, there are many reasons that motivate me to continue with more impetus, including making new discoveries and helping treat patients, as well as training young scientists and students and being part of their journeys, while studying at the University and beyond
S: Let's discuss your future. You're in Southampton now. Are there any further plans?
A: It’s almost 15 years since I first moved to Southampton, a place that I’ve since called ‘home’! I'm very happy here, and the Centre for Cancer Immunology is an amazing place to be working in, alongside some of the most amazing people In general, our University provides a nurturing and supportive environment to its students and staff and I thoroughly enjoy doing my research and lecturing here As part of my duties, I also work and collaborate with other institutions, biotech and pharmaceutical companies. Additionally, I occasionally work with national and international organisations, such as reviewing grant applications for cancer societies/charities, or peer-reviewing manuscripts for publication in scientific journals.
Some of the work I’ve done has resulted in new investigational medicines, which have now been through a number of successful early clinical trials You can see my work by following the links below:
Impact of Work Done At Southampton On Clinical Trials Immunotherapy and My Work With FcγRIIB
Celebrating Receiving Approval From The US FDA Organisation To Carry Out Research
My future plan is to continue to contribute towards developing treatments for cancer patients and improve people’s quality of life
S: Lastly, if you could journey back in time to the Ali who attended Salford, sit down and chat with him based on your journey; what advice would you give him?
A: I’d advise him to relax and enjoy the moments more! But also, to seek help and support by engaging more with his lecturers and peers, both at personal and academic level. Building strong relationships is an integral part of a successful career Next, I’d advise him to have clear short-term and long-term ‘SMART (specific, measurable, attainable, realistic and timebound) goals’; and to determine them by talking to as many people as possible and exploring different options and avenues Lastly, I’d tell him to
“keep going and have the tenacity needed to get you through the challenges that life throws at you.”!
That consistency is important Undoubtedly, there will be ups and downs, but you need to be quite adamant about what you want to achieve, seek help when in need, keep up your faith and never give up easily, even if you have to start all over again!
Thank you very much for this interactive interview, Sara - you ’ re all doing a great job with your Bioscientist Magazine Here’s one of my favourite quotes from Jay McLean to end this conversation with:
“Be strong when you are weak, brave when you are scared, and humble when you are victorious. ”
S: Thank you so much, Dr Roghanian, for providing insight into your career journey. Thank you for teaching us not to give up, to keep going, and to aim high.
CAREER INSIGHTS
Behind the Smiles
NOOR ALI NAJAM INTERVIEWS DR EVGENY KUSHNEREV, SENIOR CLINICAL LECTURER IN DENTISTRY AT THE UNIVERSITY OF MANCHESTER.
First-year Biomedical Science student Noor Ali Najam sat down with Dr Evgeny Kushnerev to get an insight into the career and explore various pathways within dentistry They discussed the difficulties dentists face throughout dental school Noor came to the conclusion that the transition from dental school to working as a dentist is not as easy as most people think However, she is still aiming to pursue this career path, as she is someone who thoroughly enjoys challenges and has the capability to work calmly under pressure Read on to find out what Noor and Dr Kushnerev discussed
Tell me about your career journey, starting from choosing your career pathway, and why did you choose dentistry?
My mother was a nurse, and I was almost certain from a very young age that I wanted to work in healthcare in the future I originally wanted to study medicine but rather preferred pursuing dentistry due to the surgical aspects of it I found dentistry more hands-on and engaging I was accepted to study dentistry in 2005 at Moscow State University of Medicine and Dentistry
What kept you motivated throughout dental school?
I enjoyed my years in dental school despite of it being a longer-than-usual course I maintained my work-life balance by going out with my friends. My friends and I would go to the cinema, park and occasionally even nightclubs I spent time outside the university doing things I enjoyed like playing the piano and taking violin lessons. I did not stop doing things I enjoyed whilst being in the dental school which helped me manage my professional life without it taking a toll on my well-being I even invited my friends as my patients in my later years of dental school Moscow is a large city, and my placements were scheduled in different hospitals around the city I enjoyed working in various parts of the city. I used to take the metro in my initial years of university to avoid traffic, which left me with extra time before class I productively spent this extra time in the library reading before my lectures.
What would you do differently if you could go back in time while making a career choice?
Initially I wanted to become a pathologist but things did not work as planned However, I always wanted to become an academically related clinician I am now a senior lecture consultant and my role includes managing PBL sessions and supervising several Masters and PhD students on Stem Cell Research Additionally, my duties involve clinical teaching undergraduate and graduate dental students. When I first moved to England, I sat an exam which I failed at the time It had financial implications hence I had to return to Russia and work in a private practice. I was working in a senior position which enhanced my leadership qualities It is a key transferable skill so in hindsight, everything worked out well and I now have my dream job. I would not change my journey because it exactly led me to where I always wanted to be
What motivated you to do an MSc and how did you make that decision for yourself?
I always wanted to study further so after I graduated from dental school, I was looking at places to study further. I was keen on getting an offer from England as my partner at the time had also moved to London I was drawn towards Manchester as it was not as expensive as compared to London and the University of Manchester had the programme I was interested in I went on to study an MSc in Oral & Maxillofacial Surgery following successful completion, I enrolled to do a PhD degree in the Department of Oral and Maxillofacial Surgery in the Blond McIndoe Laboratory
What qualities make a good dentist?
My first answer would be resilience We are all humans, and even as dentists we need to let things go. Showing compassion, empathy, honesty, and sympathy are qualities expected from a good dentist
Do you think there are any drawbacks to dentistry as a career?
Dentistry can be challenging, especially for newly qualified dentists who take criticism personally. Patients leaving unhappy can be challenging to overlook Increased workload makes it difficult to meet required targets which affects performance Due to the increased NHS load, there is less one-to-one consulting time. Dentistry can be especially tough when students are not fully aware of the required roles and expectations The suicide rate among dentists is very high due to the constant pressure and competition
What is expected from a dentist whose peer is being dishonest?
The good thing to do is to have a private conversation with the individual and de-escalate the matter quickly Try and talk to your colleagues and put things in the right direction. Double-check before involving higher authority We are all humans and misunderstandings are uncommon in any workplace
You have published an article about wrongsite surgery, what are the consequences of wrong-site surgery?
In the rare case of wrong-site surgery, patients are informed immediately. No single individual is blamed A chain of events leads to wrong-site surgery Further training and discussion take place The patient is given the chance to complain or even request for compensation.
You are currently researching the isolation and differentiation of adult dental pulpderived stem cells, what is a regular day like during your research period?
Every day is different in research Research is pretty much independently managing work rather than having a uniform timetabled schedule. We are expected to come up with a proposal, apply for grants, attend conferences, and read articles The clinical side of my career is with similar if not the same tasks I get the best of both worlds, which is why I like my job.
Do you have an experience in the admission panel? What would you advise all aspiring dentists?
I was an examiner for medicine, dentistry, and physician associate I am a MMI examiner and the best way to get around the interview questions is to listen to the question carefully and do not beat around the bush The quality of your answer is marked rather than the quantity I recommend studying a basic degree before studying dentistry because I find mature students have an easier time throughout dental school
How do dentists become a member of societies like the International Association for Dental Research (IADR), Association of British Academic Oral and Maxillofacial Surgeons (ABAOMS) and International Society for the Study of Surrealism (ISSS)?
I joined ISSS because of my leisure interest in oil painting Dentists sign up with different societies as per their interest in a specific field of work Joining societies is beneficial in building networks, getting funds, and attending conferences Joining some societies may require a joining fee however it is beneficial in the long run
CAREER INSIGHTS
Interview with Dr Briony Labram, a Private Secretary in the UK Government’s Department of Science Research and Innovation
POPPY GETHIN-JONES
One of the most exciting things about a degree in Biomedical Sciences and closely related degrees is that it can lead to a wide range of career options Previous issues of Bioscientist magazine have explored well-known and popular biomedicine aligned careers In this issue I will be exploring a career working for the government Dr Briony Labram delves into an unusual graduate destination I was delighted to secure an interview with Dr Labram, who after successfully completing a degree in Biology, went on a career journey that took her to the UK Government’s Department of Science Research and Innovation
What is your current role? Is this what you set out to do?
I am currently the Private Secretary to the National Technology Adviser Dr Dave Smith My role is focused is on integrating academic and industry expertise with government to boost UK’s superpower ambitions The National Technology Adviser also advises the Technology Secretary on the best approach to building and enhancing the UK’s technology strengths, working across government to champion the science and tech industries, and build networks across industry and academia to draw the best minds into policymaking. The Private Secretary role acts as the primary link and channel of communication between the Minister and the rest of the department, working closely with the rest of the Private Office team. As a Private Secretary I must ensure that the National Technology Advisers views are represented on areas of policy across the department There will also be many people who would like to meet with Dave, both internally and externally, and it is the Private Secretaries job to scope out these meetings to understand the purpose behind them and to ensure that they align with the National Technology Adviser’s priorities
What has been your journey from undergraduate student to private secretary?
I completed an undergraduate degree in Biology and Biomedical Sciences and did a placement at public health England working in a lab for a year.
I knew I wanted to do a PhD and finished my PhD (Defining the Cellular and Molecular Mechanisms Regulating Aspergillus fumigatus Induced Airway Wall Remodelling in Asthma) in 2017 and then left academia and research. I joined the civil service after finding out about it from a careers fair as I knew there were many roles there where the different skills that I learnt during my PhD would be of use and I would be doing a job to benefit society I started around 5 years ago at the medicines and health care regulatory agency But since then, I have worked in lots of different departments in the civil service I have also worked in the government office of science for Sir Patrice Vallance in his private office which is when I decided that I wanted to do a role in private office. Following this I moved into the national technology advisor’s office which is where I am now, and I really like this job
What are the positive aspects to working within the civil service?
There are many different science-based jobs within the civil service with plenty if scope to move around different departments People within the civil service generally do not stay in roles for very long, a year to eighteen months maximum. It is very different from other workplaces in this respect, in the civil service people move around a lot more The work is always varying and interesting You also have a great work life balance as well as job security which is not common with certain sciencebased jobs such as a research career Which is what first attracted me to working within the civil service.
Where
are you based?
I work for the Department of Science Research and Innovation and my office is based in London, but our second headquarters is in Salford at Trinity Bridge House We are currently trying to get more people working in Salford at our second headquarters The offices are moving to the north The department of Culture, media and sport and the department of work and pensions have offices in Manchester now. The department of health and social care has an office in Leeds There are lots of jobs outside London now
government within science and engineering You would go into the government office of science and work as an intern for up to a year. There are around 20 places per year You will have a sixmonth probation period and then after this you will be working in a permanent position within the civil service. You can apply for jobs across the civil service There are many fast streams as well There are some graduate fast stream schemes such as science and engineering fast stream at department of health and social care which is more policy related It is a permeant position There are summer internships you can do which are really good Keep an eye on LinkedIn because they advertise these internships.
What is progression like within the civil service?
I would say it is really good. There are lots of different opportunities that you can take You start off as an EO after a year you progress to an HEO after a few years you will then become an SEO. You can move up the ranks quite quickly and that why I had a PhD I did not come in as an intern although some interns do have PhDs as it is a great way to get in and they know that once they are in the should progress quite quickly It is quite common for a person to go into the civil service after finishing their PhD Sometimes when you get higher up it can take longer to progress but nonetheless, I would say that progression is really good
I have worked for research funder at UKRI which was interesting This involved reviewing what people had submitted what they want to research. At the MHRA working with the data from clinical trials Following that I worked at the government office of science on the covid enquiry with Sir Patrick Vallance You can also help with coordinating group that provide science advice These groups are called SAGE groups during disasters such as the COVID outbreak or a natural disaster such as if a dam burst You could also help with different policy areas such as policy for health like obesity or with the NHS
How do you manage your time now as a private secretary compared with your time as an undergraduate student?
My schedule now is typically 9-5 during the weekdays and very few weekends The hours are very regular which is something that is nice about working in the civil service There are a few trips which is similar to when I was completing my PhD Although your days are busier during your 9-5 it is easier to manage your time
CAREER INSIGHTS
Sustaining Humanity Through Being Fit to Practice
BY JOY CHUKWUDOLUE
The Health & Care Professions Council, who regulate biomedical scientists and other professions, define fitness to practice as having the knowledge, skills, health, and character to practice your profession safely and effectively².
Being fit to practice equips a Biomedical scientist with the skills and knowledge needed to perform a task safely and effectively in the laboratory To understand fitness to practice better, I spoke with Tahmina Hussain and Ian Davies who collectively have decades of experience working as biomedical scientists Mrs Tahmina Hussain has a background as a biomedical scientist, a pathology training coordinator and is currently a university lecturer Mr Ian Davies has over 20 years of experience working as a biomedical scientist, progressing to a senior Biomedical scientist role and then to a laboratory manager. Currently he works as a university lecturer at Staffordshire University and a panel member for Health & Care Professions Council (HCPC) fitness to practice hearings
As a biomedical scientist, in order to practice safely and effectively, it is necessary that you keep your skills and knowledge current and up to date. This is part of maintaining your Continuous Professional Development (CPD) which is mentioned in the HCPC Standards of Proficiency (SoP) 1 3³ It is difficult to practice effectively if you are following comparatively outdated methods Examples of CPD activities are attending seminars, going to conferences, reading, and then reflecting on recently published journal papers. It is important to link these activities back to how they impact the practice of a biomedical scientist
The title biomedical scientist is protected by the law and users have to be registered with the HCPC to use this title¹ Professionals who have protected titles are expected to have a trustworthy character and thus conduct themselves appropriately in line with the HCPC standards
Mrs Hussain believes fitness to practice can be shown in many more ways including the following:
Being trained and competent in your role
Being able to recognise the limits and scope of your practice
Being confident enough to report when things go wrong
Maintaining physical health, mental health, and your wellbeing
Being respectful of colleagues and service users
In the laboratory, becoming competent involves undergoing a period of training and a competency assessment This ensures the person performing the task or skill is performing it correctly and safely according to the Standard Operating Procedures Biomedical scientists have a duty to work safely and respectfully as they handle sensitive patient samples As Mrs Hussain mentions, it is important to keep in mind that there is a person at the end of each sample
The Institute of Biomedical Science (IBMS) is a professional body They support scientists, support workers, and students in the biomedical science field to deliver excellence in healthcare⁴ The IBMS provide the registration portfolio that applicants must complete before they can be HCPC registered Completing the IBMS registration training portfolio takes the trainee biomedical scientist on a journey to become fit to practice while applying the scientific knowledge and theory they have gained during their degree to practice They gather evidence to showcase how they have developed the skills, knowledge, and character they need to practice as a biomedical scientist Moreover, they learn about the importance of maintaining their mental health, physical health, and their wellbeing
Mrs Hussain gave a simplified overview of fitness to practice: “expecting someone untrained to run a test on a sample who knows nothing about the test, how to process the sample, or how to interpret the result breaches the HCPC Standards of Proficiency.” It is dangerous and could result in a patient being harmed This is where HCPC fitness to practice hearings come in I spoke to Mr Davies who is a panel member at these hearings to find out more.
When someone raises a concern to the HCPC about a registrant, it is screened to see if it is valid and meets the threshold for investigation. If so, the HCPC’s legal team puts a case together They gather evidence through witness statements and accounts from the registrant, colleagues, and employers, as well as any involved patients
The fitness to practice hearings are conducted by the HCPC Tribunal Service (see Figure 1). Those involved in a final hearing include a chairperson, a biomedical scientist (a registrant), and a lay member of the public In Mr Davies’ experience, the chairperson usually has a legal background such as a barrister or solicitor and the lay person has experience working on other disciplinary panels
As a panel member Mr Davies examines the evidence provided by both the HCPC and the accused registrant to prove that they are true After testing the evidence, the panel determines whether the registrant is fit to practice It is important to note that HCPC fitness to practice hearings occur to uphold the safety of the public Rather than punishing the accused, the aim is to prevent the mistakes made from reoccurring.
A variety of reasons may cause a panel to deem a registrant unfit to practice:
A lack of competence has made them a danger to themselves, their colleagues, and the public
The registrant is poor at recognising the limits of their practise e.g. made multiple errors
Misconduct: dishonesty, poor communication skills, intolerance to colleagues, or committed a criminal offence (which shows unprofessionalism)
In some cases, the accused registrant has already reflected on their behaviour and done more training. In this case they are now safe to practice, and no further action is needed Most cases are unlike this
Depending on the severity of impairment of practice, a variety of actions can be taken The HCPC can put a caution on the registrant’s record; if the mistake repeats, it clearly displays a lack of improvement.
In one condition of practice, an accused Biomedical scientist cannot release certain results unless they have been verified by a registered Biomedical scientist Another condition of practice asks the accused Biomedical scientist to retrain and show evidence of it Also, the accused could be ordered to go on an anger management course and show a reflective diary of how they have controlled their behaviour.
If the Biomedical scientist has provided no evidence of adhering to these sanctions or the panel deems it is not enough then the Biomedical scientist would be suspended from the register for about 1-2 years During this period, they cannot practise or work as a biomedical scientist. If the Biomedical scientist still does not correct their behaviour or the allegation is quite serious, the Biomedical scientist would be struck off the register That individual will never be able to work as a biomedical scientist again This affects their livelihood, their families, their reputation Mr Davies stated that this is not a decision that is taken lightly.
Mr Davies shared some advice to future (and current) biomedical scientists on maintaining fitness to practice:
“Being fit to practice is a responsibility a biomedical scientist carries throughout their career. It is not just about following [HCPC] standards of proficiency and doing a normal job. It is about having that understanding of autonomy and how you are now responsible for your decisions and behaviour and how you speak to people and how you work with different groups.
The standards of proficiency are there to stop you getting to that point [of being struck off the register]. Always keep in mind what the public and patients expect of you. If you base your decisions around that, then you will not get to the point of having a fitness to practice hearing.
The HCPC standards of proficiency are there for a good reason. Embrace them as you go through your career.”
References
1
Health & Care Professions Council (2018) Professions and protected titles. Retrieved 27/03/2024 from https://www hcpcuk org/about-us/who-we-regulate/theprofessions/
2.
Health & Care Professions Council. (2019). Fitness to Practice Retrieved 27/03/2024 from https://www hcpc-uk org/concerns/what-weinvestigate/fitness-to-practise/
Health & Care Professions Council (2023) The Standards of Proficiency for Biomedical Scientists. Retrieved 28/01/2024 from https://www hcpc-uk org/standards/standardsof-proficiency/biomedical-scientists/ 3 Institute of Biomedical Science (2017) About IBMS https://www ibms org/about/about-ibms/ 4
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S T U D E N T S
COFFEE WITH CAROLINE COFFEE WITH CAROLINE pg.62 pg.62
Dr Caroline Topham, Lecturer in Biomedical Science at the University of Salford, was in conversation with Laiba Usman
MY JOURNEY TO SALFORD pg.64 pg.64
Elaine is a Level 4 Human Biology and Infectious Diseases student at the University of Salford She tells her story about her journey to Salford. She explores her life before Salford, her motivations to come back to education and what she aims to do upon graduation from her course
STUDENTS
Coffee With Caroline
Self Sabotage
DR CAROLINE TOPHAM, LECTURER IN BIOMEDICAL SCIENCE AT THE UNIVERSITY OF SALFORD, WAS IN CONVERSATION WITH LAIBA USMAN
Dr Caroline Topham, Lecturer in Biomedical Science at the University of Salford, was in conversation with Laiba Usman, where they discussed the theme of “self-sabotage” Dr Topham has previously hosted ‘Coffee with Caroline’ drop-in sessions for students to discuss their wellbeing. In this article, Caroline answers some of your submitted queries presented by Laiba Do you have more? Email c h topham@salford ac uk
How to deal with a person who ruins the relationship by self-sabotaging without realising?
Sometimes we notice patterns of behaviour in the people close to us that seem to be unhelpful, or even harmful This can include how someone is behaving in relationship to us, or to themselves If it feels important to confront someone about this, I believe it’s vital to keep in mind that nothing you can say or do is going to change someone ’ s behaviour, they have to do that themselves and they have to WANT to do it! However, what we can do is bring things into their awareness that they may not consciously know, so they have more information about themselves and their impact on others This may be enough to inspire a change in behaviour, but it may not
My top tip for talking to people about behaviours that we are finding hurtful is to keep the focus on yourself by using ‘I’ statements instead of ‘ you ’ statements This can help to reduce a defensive reaction in the other person It can also be helpful to request the behaviours you would like to experience from them instead of the ones you are currently experiencing e g ‘I feel like you don’t care about me when you are late to meet me, please can you be on time instead?’ is more likely to start a constructive conversation than ‘You’re always late to meet me ’
What stops us from trying to stop our selfsabotage?
There are a few steps in the process of changing our self-sabotaging behaviours, and sometimes just knowing that we are doing it isn’t enough for us to change If you ’ ve noticed a pattern of behaviour in yourself that you are finding hard to change, be curious about the emotions that come up in that situation, some examples include fear of failure, anxiety about your performance, or anger
Your challenge then is to examine the beliefs you hold that underlie those fears; are they valid or can you let go of them? You might be able to do this by having honest conversations with friends and family members you trust, or you might need the support of a counsellor or psychotherapist For more practical advice on over-coming self-sabotage see this helpful resource
How do you recognise signs of self-sabotage in your own behaviour?
My advice would be to notice patterns of behaviour in yourself that you find frustrating, or which often cause you stress For example, do you usually start assessments a day or two before the deadline, resulting in a very stressful couple of days and possibly sleepless nights? Does this prevent you from doing your best work and getting high grades and so feeds your false belief that you ’ re not really smart enough to succeed? This is an example of how we subconsciously reinforce our negative beliefs about ourselves using self-sabotage. Working on improving your self-esteem around your intelligence and your capacity to succeed could be the way to end this self-sabotaging behaviour.
Another example could be that when you become anxious about something, you hide your feelings and pretend that you are fine, which leads to you feeling isolated and more anxious Perhaps subconsciously you believe that your feelings are not important, and no-one has time to listen to you, so you must hide them. In fact, it's very likely that you have people in your life who want to support you, and that sharing with them your feelings of anxiety may help to relieve them, instead of making them worse by hiding them Questioning this belief may help you to realise that you are sabotaging yourself by hiding these feelings
How do external factors contribute to or mitigate self-sabotage tendencies?
This is a great question! We don’t exist in isolation as human beings, we are constantly influenced by our external environments which includes the events happening in our personal lives as well as what is happening in our wider society, and the world in general Systemic structures of oppression and discrimination also influence our beliefs about ourselves and our cultures Having curiosity about yourself and the beliefs you hold about yourself is a great skill to cultivate and can lead to some really interesting, and sometimes challenging, conversations with friends and family
What negative self-talk do you have that may be based on false beliefs about yourself? What have you been told about yourself that actually doesn’t actually apply to you, and that you can let go? For example, perhaps in your family the narrative is that your sibling is the clever one and you are the sporty one, and so you have low expectations for yourself around your academic performance Ask yourself, is this really true for you? What does ‘clever’ mean in this context? Can you not be both ‘clever’ and sporty at the same time? Questioning these ideas can be a great way to get to know yourself better.
Inwhat ways can individuals create an environment that minimizes the likelihood of self-sabotage in their personal and professional lives?
Again, a really great question. We are more likely to move into self-sabotaging behaviours when we are not aware of them, so the best way to create an environment to minimize these behaviours is to get to know yourself Really get to know yourself, warts and all! In the therapy world this is often called ‘Shadow Work’ and involves getting to know the parts of yourself that you repress or would prefer not to acknowledge Ask people you trust what they notice about your patterns of behaviour that you may not notice yourself We all have a ‘shadow self’ and it can be uncomfortable work but ultimately the more knowledge you have about yourself, the better equipped you are to make good decisions for yourself
My Journey to Salford
ELAINE COATES
Elaine is a Level 4 Human Biology and Infectious Diseases student at the University of Salford. She tells her story about her journey to Salford. She explores her life before Salford, her motivations to come back to education and what she aims to do upon graduation from her course.
I have always loved science I started a biology degree in 1987. I enjoyed the course, but I also enjoyed spending rather too much time in Manchester’s rock clubs I did enough work to get by but not much more so I only managed a 2ii I applied for a couple of degree-related jobs and didn’t get them, I had no clear idea of what I wanted to do so after a year of temp jobs I ended up training as an accountant Life doesn’t always take you in the direction you expect
Fast forward roughly 30 years to spring 2022; I had a successful career as an accountant, but the project I was working on was due to end in 2023 and I was likely to be redundant at the end of it I started thinking about the kinds of finance roles I could go for next, and I just couldn’t get excited about any of them I didn’t want to be doing the same thing until I retired Meanwhile my kids had left home, and as things started to get back to normal after the COVID-19 pandemic I realise I was bored What did I actually want to do with this next phase of my life?
I initially started looking at taking a part-time course just as a hobby I had always kept up with science news and I knew there were entire fields such as genomics and bioinformatics which didn’t exist when I did my first degree I looked into studying something like that, but the courses were all at Masters level. I was excited by the idea of studying though, and meanwhile I’d been looking at my finances and worked out I didn’t have to go straight into another job. I realised this was an opportunity to change direction altogether
I looked into what I would need to return to university as a mature student, and found that an Access to HE course was probably the best route It turned out that the college a 10 minute walk from my house offered a Healthcare Science Access course two evenings a week- It was perfect
The next step was to talk to my family I hadn’t expected any major objections but I thought they might challenge whether I was sure Did I really want to risk giving up my job? Could I handle being a student again? But everyone was really supportive right from the start, which was great
I started the Access course in September 2022 The next few months was tough Access is the equivalent of 3 A-levels done part time over one academic year so it’s pretty intense I was working full time in a demanding job with long hours, then going to college two evenings and spending my other evenings and weekends completing the assignments. I had no spare time, but I enjoyed the course I got good marks for my essays, and it gave me the confidence that yes I could do this
I had decided I wanted to do focus on human disease so I initially looked at Biomedical Sciences at Manchester Metropolitan University, the University of Salford and the University of Manchester My first degree was from Manchester but the open day left me feeling I’d just get lost there as a mature student Salford seemed to cater well for commuting and mature students, and the Human Biology & Infectious Diseases course really appealed to me I met Professor Nirmalan on an open day and she said, “please come ” and somehow it stuck with me After a second visit I made Salford my first choice and I’m happy that I did
In the end, when the project I was working on went live, the company did offer me the option of moving into another role, or taking redundancy. Giving up my income was a bit scary but by that point I had made up my mind about what I wanted to do, and I knew I definitely didn’t want the job on offer I left at the end of July 2023 and started at Salford in September
It took a little while for me to settle in, but after the first few weeks I started to see how the different modules fit together and it all started to make sense I was a bit intimidated going back into a lab after so much time, but a couple of my lab partners had done a foundation year and they helped me find my way around Joining the Mature Students society and meeting other people who have come back to education later in life has also helped me to feel at home.
It is still early days, but I have no regrets. I am enjoying the course and I hope that the degree combined with the transferrable skills I have will mean I can finally find my career in science I may even consider a PhD
The Salford Biomedicine Society culminated 2023 with a dinner event, bringing members together to celebrate what has been a fantastic year! President of the Biomedicine Society, Tasfia Hazari, reflects on this event and tells us what it was like to organise and attend this unmissable event
2023 was a year to celebrate, so we knew it deserved an extravagant send-off. We planned a night meticulously, booking a stunning venue and decorating the space to add to the enchantment of the night. Snowflake crochet coasters graced the tables to fit our winter theme. Might I add this was a thoughtful touch that not only enhanced the aesthetic but also served as charming keepsakes
Once the guests had arrived and settled down we all started to indulge in the exquisite cuisine However, to make the event more wholesome, the guests were told to add a song to make our own BiomedSoc music playlist The curated soundtrack, food, laughs and wholesome atmosphere truly made this a night we shall all remember
Feedback from our attende t l th wonder of the event W attended and everyone w behind the scenes to make t
It was nice to see the society leadership had organised this social event. It was very kind of you to invite the academic team we really enjoyed the meal thank you!
Dr Sara Namvar
I think it was generally great, we had a lot of fun The snowflake crochets made by Tasfia were a nice addition for academics to remember this event by and the vibes were generally good and we gave a chance for the attendees including ourselves to show our elegant and fancy fashion taste with the dress code, so it was a nice addition overall
Ali M Tae (events manager)
It was fun being out with the academics outside the lectures Dressing extra was nice too I forgot how the food tasted but I enjoyed it with everyone Nafisa
The food was good It was a good environment, everyone was nice, and I enjoyed myself.
Daniaal Ahmed
Experienced a delightful ambiance filled with exquisite cuisine, charming decor, and unforgettable moments The presence of educators added a unique touch, fostering genuine connections beyond the confines of traditional academic environments
Alvina Imran (Bio-art lead)
I really appreciated meeting new individuals and interacting with them in a setting other than lectures The food was also wonderful, and it was nice to see everyone enjoying the friendly atmosphere as they conversed Aruba
Thank you to the BiomedSoc members for organising the winter dinner and extending the invite to academic staff, it was an excellently organised event and a great way to finish off 2023 " Dr Matthew Jones
BY AFIFAH MAKDA
The event was envisioned with a theme of murder mystery, aligning it with the aura of the Halloween season, linking it with biomedical science. My next step was creating a storyline. I was inspired by murder mysteries and true crime dramas such as American Murder, True Detective, Dahmer, and Sherlock Holmes which proved to be a useful stepping stone for the event’s storyline.
In the end, J. B. Priestley, an Inspector Calls characters allowed the story to come to life. The list of suspects and their background information, relationship to the victim, their alibis, and motives to commit the crime evolved as I developed the narrative. The next step was generating the clues and finding suitable locations for the evidence to be concealed. Finally, I set up riddles for the participants to solve.
The scavenger hunt started with us meeting participants at Maxwell Building, where the lead detective on the case gave the briefing on the murder. The participants were split into teams. Each team was given different clues that would lead them around the university campus to find the evidence. Once all the clues were gathered and the evidence analysed, participants reconvened and collated the evidence to solve the mystery, once and for all. Despite the hunt taking place on a late chilly evening, the members were happy to engage with the activity and eager to revel the truth being the mystery. The main participants of this event were first–year students, which made for a delightful mini tour around the campus for those who did not have the pleasure to explore it yet.
The hunt was an entertaining way to use the knowledge we gained from lectures. Examples included DNA blood analysis using chromatography and electrophoresis and latent print evidence (fingerprints and footprints). While the scavenger hunt did not offer an entirely accurate depiction into the workings of a forensic scientist, the event aimed to ignite interest in the field. And finally, I would like to give a thanks to the committee members that helped set up the event with me to make all off it possible.
1,2,3,
Testing...
Testing...
1,2,3
1,2,3 1,2,3,
Hello, readers My name is Marriam Yaqoob I’m a level 5 Biomedical Science student and the Secretary of the Salford Biomedicine Society
I recently started the first ever Biomedicine Society podcast, called “Biomedically Speaking ” The name of the podcast was picked by the Biomedicine Society members; there were multiple names put forward but “Biomedically Speaking ” got the most votes “Biomedically Speaking ” seeks to build the Salford community by connecting students with academics, alumni, and external stakeholders in an accessible and engaging way
On the podcast, the invited guests give an insight into different topics related to biomedicine Alumni and current students give personal advice, as well as hints and tips to help new and existing students meet the challenges of university life. Through “Biomedically Speaking…”, I wish to help new students know that they are not alone and build a support network with fellow students. I also wanted students to have someone they can relate to and understand that even though, at times, university can be overwhelming and scary, there's always someone out there.
The very first episode of the podcast involved an interview with Dr Arijit Mukhopadhyay, Associate Professor in Precision Health at the University of Salford He discussed his film, his career, gene editing and so much more Through the podcast, students learnt about the struggles Dr Arijit went through to get to where he is now; this meant no sugar-coating the hardships At one point, Dr Arijit was rejected from seven job applications in one go; all this was necessary in his path to success Dr Arijit gave advice to his younger self and students that they should be open to the idea of trusting their gut feeling, emphasising how it was okay to fail as failing is a part of success
When I was appointed as Secretary, I really wanted students to see a friendlier side to the professors and have an understanding of the degree they have enrolled themselves onto I also really like being in front of the camera (I always wanted to be a movie star as crazy as that sounds), so this was like a calling to me
My aims with “Biomedically Speaking ” is to bring to light the vast range of biomedicine-aligned topics of interest, careers and opportunities, but also the interdisciplinary nature of the future of science. With this in mind, the podcast will include a diverse range of guests from across the sector and beyond As much as I enjoy creating the podcast, I want other society members to get in on the fun, by tuning in, joining in with the conversations and making suggestions for future podcast episodes This is our chance to take our learning and growth far beyond the lecture theatre!
I also want everyone to see that university can be so much fun alongside studying extracurricular projects and getting to know the people around you will enrich our university experience. This will also be an excellent insight to the future committee members that the society can be so much more fun and so many opportunities are open for you once you take on a role As scary as the role of the Secretary might’ve been when I first started, I’ve honestly had so much fun with building connections, strengthening many skills, and starting this unique project!
The podcast is available on several platforms such as the Society’s Instagram and TikTok The podcast is now live to stream on Spotify. Any feedback or suggestions for new guests or topic discussions are welcome; please feel free to reach out and email me at salfordbiosoc123@outlook.com
BY MARRIAM YAQOOB
BIOSCIENTIST
EXPLORE THE WORLD OF BIOMEDICINE WITH US
EDITORS-IN-CHIEF / WIKTORIA WISNIEWSKA, SARA ALNASIR KASSAM
WRITERS / AFIFAH MAKDA, CHARLES MIDDLETON, DONA GIGY PARAMBY, EGHOSA ENORIOMWANIHA, ELAINE COATES, FAATIMA PATEL, FAATIMAH
JEYLANI, HANNAH BASHIR, HARRIET BURROW, IQRA ZULFIQAR, JOY CHUKWUDOLUE, LAIBA USMAN, MARRIAM YAQOOB, MYA BRISCOE, NOOR
ALI NAJAM, POPPY GETHIN-JONES, SAHIL CYCLEWALA, SANARIA FATHULLA, SARA ALNASIR KASSAM, TASFIA HAZARI, WIKTORIA WISNIEWSKA
FEATURED CONTRIBUTORS / DR ALI ROGHANIAN, DR BRIONY LABRAM, DR CAROLINE TOPHAM, DR EVGENY KUSHNEREV, DR JOE LATIMER, MR IAN DAVIES, MRS TAHMINA HUSSAIN
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