Page 1

The Godolphin and Latymer School

DR DOLPHIN BIOMEDICAL MAGAZINE   

   

                     

Cover Drawing by Amelia Snook


DR DOLPHIN

SPRING/SUMMER 2019

Message from the editors Hi and welcome to the Spring/Summer 2019 edition of Godolphin’s very own biomedical  magazine, Dr Dolphin!  In this edition, we have a wide variety of articles from CRISPR to the discovery of  leukemia and even the use of cryonics. We have also compiled some useful  super-curricular resources including UVI university choice advice, lists of  interesting/unusual biomedical degrees and upcoming lectures/events that we thought  you, our readers, would enjoy attending!  We would like to give a huge thanks to all those who have contributed to this edition and  we hope that Dr Dolphin will give you some insight into the world of Biomedicine. If you  would like to have your article included in the next magazine, please email  asnook@godolphinandlatymer.com  From Millie, Jenna and Abby x           

1


DR DOLPHIN

SPRING/SUMMER 2019

CONTENTS Spotlight ……………………………………………....…..…………………………………​…….…………​…………………………………………………………. 4  The Discovery of Leukemia  Recent Equine Influenza Outbreak  New Frontiers …………………………………………………………………….……………………………………………………………………………………. 7  Genetic Engineering: To What Extent Should it be Promoted?  CRISPR  Cryonics  Synthetic Organisms - Revolutionising Medicine  Relationship between Tooth Enamel and Mental Health Problems    Repetitive Transcranial Magnetic Stimulation: A New Treatment for Depression  Stem Cells and the Treatment of Various Diseases …………………………………………………………………………………………………. 21  Parkinson’s Disease  Equine Tendonitis  Birth Defects  Burns  Age-related Macular Degeneration  Public Health ………………………………..…....….………​……………………………………​………………………………………….………………………. 31  Painkillers: Friend or Foe?    Euthanasia and Assisted Suicide  Work Experience ..……………………………………....….​…………………………………​…………………………………………………………………….. 35  University College London Hospital Work Experience  STEAM Week ………………………………………………………………………………………………………..………………………………………………... 40  Book Reviews ………………………………………………......….………………………​………………………………​………………………………………….. 48  Why We Sleep by Matthew Walker  The Guardian’s ‘Five Books to Read before Starting Medical School’ 

2


DR DOLPHIN

SPRING/SUMMER 2019

Artwork Related to Medicine and Biomedicine …………………………​…………………​.….……………………………………………….......... 51 Oil Painting of a Humerus Bone  Microscopy Investigations  GCSE Final Piece: The Anatomy of a Rabbit and the Human Impact on the Environment  Medical Equipment   Medical Events and Lectures in 2019 ...….……………………………………………………………………………………………………...……….. 55  Interesting and Unusual Biomedical/Medical Degrees ……………………………………………………………………………………………. 58  UVI University Advice Q&A ………………………………………………………………………………………………………………………………….….. 61  Medical Quiz …………………………………....….…………………………………………………………………………………………………………........ 64 

3


DR DOLPHIN

Spotlight  

The Discovery of Leukemia Whilst reading ‘The Emperor of All Maladies’ by Siddhartha Mukherjee, a biography of cancer which won the Pulitzer Prize for Non-Fiction in 2011, I became intrigued by the complexity of one type of cancer in particular, Leukemia. It emerged in the 19th century as one of the most controversial and lethal diseases and Mukherjee fervently tracks and follows scientists throughout history as they battle the challenge of finding a cure. When and where did it originate? It was first discovered by a Scottish physician, John Bennett in 1845 when a young patient of his developed a mysterious swelling in his spleen. He was spiralling from symptom to symptom with fevers, flashes of bleeding and sudden fits of abdominal pain. Bennett, not finding any previous records to identify these strange symptoms, treated his patient with customary leeches and purging. After carrying out an autopsy a few weeks later, Bennett was convinced he had found the reason behind his symptoms: his blood was chock-full of white blood cells. “The following case seems to me particularly valuable” he wrote “as it will serve to demonstrate the existence of true pus, formed universally within the vascular system”. However he could not find the source or origin to the “pus”. The blood seemed to combust spontaneously into white blood cells, it was spoiled of its own will. He called his case a “suppuration of blood” and left it at that. A mystery to be solved later.

SPRING/SUMMER 2019

And that was indeed the challenge taken up by the German researcher Rudolf Virchow not four months later when he published a case report with striking similarities to Bennett’s. Virchow was aware of Bennett’s theory and when he discovered layers upon layers of white blood cells in his patient’s spleen, he decided the problem was not a source of pus, but the abnormality of the blood itself. Unable to unify his ideas under a specific explanation, he decided to settle on naming this condition weisses Blut white blood - a literal description of the thousands of white blood cells he had discovered during his patient’s autopsy. In 1847, Virchow changed the name into “leukemia” - from leukos, the Greek term for “white”. However, neither scientist was fully able to explain its cause. Siddhartha Mukherjee summarises the roles of Bennett and Virchow in bestseller ‘The Emperor of All Maladies’: “Like Bennett, Virchow did not understand leukemia. But unlike Bennett, he didn’t pretend to understand it.” To understand leukemia, it was crucial for these scientists to understand human cells as a whole and the way in which they behave. Virchow dedicated his life to describing human diseases in simple cellular terms. When he first entered the world of science in the 1840s, he developed the “cellular theory”. This was made of two basic principles, all living organisms were made of building blocks called cells and secondly, ‘omnis cellula e cellula’- cells only arise from other cells. Although these principles may appear obvious now, the idea was not so simple then. Virchow’s insight allowed crucial hypothesis for the growth of human cells. Virchow subsequently continued to name the two

4


DR DOLPHIN

different ways cells could grow: hyperplasia, increasing their number and hypertrophy, increasing in their size without affecting the number of cells in a system. Every growing cell in the body can be described using those two terms, for example, muscle and fat cells grow by hypertrophy, blood and skin cells grow by hyperplasia. Virchow used this “cellular theory” to understand the idea of pathological hyperplasia - or in other words, cancer. Virchow examined the nature of leukemia and how every white blood cell seemed to have acquired a life of its own and start growing in number. This growth was not normal and he named this behaviour neoplasia. By the time Virchow died in 1902, there was already a better understanding of cancer as a whole. Looking back on the two reported cases of Bennett and Virchow, pathologists realised that although they both described leukemia, it came in different forms. Leukemia could be acute and violent, as seen in Bennett’s patient experiencing flashes of fever, fits of bleeding and rapid overgrowth of cells. Leukemia can also be chronic, slowly choking the spleen and bone marrow, as seen in Virchow’s patient. From this came the terms acute and chronic leukemia. Acute leukemia had two further subforms depending on which cells were attacked: myeloid or lymphoid cells.

SPRING/SUMMER 2019

a foundation to possibly find a cure in the future. Stella Champeaux, Y11 References and further reading: ● Main source: “The Emperor of All Maladies” Siddhartha Mukherjee ● Interview With Siddhartha Mukherjee, Author of The Emperor of All Maladies: https://www.oncnursingnews.com/pu blications/oncology-nurse/2011/febru ary-2011/interview-with-siddharthamukherjee-author-of-the-emperor-ofall-maladies● Leukemia: What you need to know: https://www.medicalnewstoday.com/ articles/142595.ph​z ● History of Rudolf Virchow: https://www.britannica.com/biograph y/Rudolf-Virchow

   

Our understanding of leukemia today is in part thanks to the research and logic conducted by Bennett and Virchow, which gave pathologists such as Farber (a scientist working in Boston in 1947 - a whole 100 years after Bennett and Virchow)

5


DR DOLPHIN

Recent Equine Influenza Outbreak On the 7th February 2019, it was announced by the British Horseracing Authority that all horse racing across Britain was to be cancelled due to an outbreak of equine flu. Equine influenza is a highly infectious virus caused by several strains and the symptoms can range from minor to severe. The strain responsible for this year's outbreak is the Florida clade 1 type and the outbreak has caused so much alarm because some of the horses affected were vaccinated including 3 young thoroughbreds in Cheshire and a further 8 in Suffolk. This could be because the FC1 strain was not included in all commercial vaccines as the strains included aim to give cross-protection against as many types as possible. It has been recommended by vets that horses that have not had boosters in the last 6 months do so as soon as possible to try and prevent infection by providing a higher antibody count. This type of influenza can affect the lower and upper respiratory tract of equines. After inhalation, the virus damages the epithelium of the airway causing it to become inflamed, which leads to a sore throat and dry cough. The damage also affects the ability of the body to remove mucus and thus prevent bacteria from entering the airway, which can then lead to secondary infections such as pneumonia. Symptoms of the virus are similar to that of human flu including a raised temperature (normal temperature is 37.5​o​C for equines), a dry cough, nasal discharge, lethargy and loss of appetite.

SPRING/SUMMER 2019

but can also be recognised by increasing levels of antibodies through repeated blood samples and simply a history of interaction with an infected horse. Equine influenza is transmitted through direct contact, inhalation of aerosols and through fomites which unfortunately makes it very contagious. Fomite transfer can occur on vehicles, clothing and veterinary equipment and the virus can travel around 5km and survive up to 36 hours in the air but most horses are infected through direct contact with equines that have contracted the virus. The vaccinations are normally inactivated antigens which activate the body to make antibodies to ward off the pathogen and give immunity for 1 year so annual boosters are necessary and are mandatory for many competitions. Scarlett Marshall, L6 References and further reading: ●

https://www.horseandhound.co.uk/n ews/new-strain-flu-behind-outbreakexperts-confirm-679512 https://www.sciencedirect.com/topics /veterinary-science-and-veterinary-m edicine/equine-influenza

The virus is commonly diagnosed using nasopharyngeal swabs to isolate the virus

6


DR DOLPHIN

New Frontiers Genetic Engineering: To What Extent  Should it be Promoted?    DNA can be found in all our cells, mostly located in the nuclei. It stores our genetic information. Genetic engineering has only been put into practice recently and involves altering this DNA in an organism to cause the proteins to code for characteristics different to the ones they otherwise would. Genes can be inserted, removed or altered. Thus, desirable characteristics can be achieved, for example, sheep can be made to produce the maximum amount of wool or milk. Lots of industries and businesses favour genetic engineering as it allows them to gain more profit, and many scientists favour it since it allows them to explore Genetics further, helping cure diseases and make new discoveries. Conversely, environmentalists and religious groups may disagree due to the artificial and unethical nature of the process. What are the advantages? Firstly, the organisms can be altered to ensure the most rapid and efficient growth in different environmental conditions. For example, crops are protected from factors like extreme weather and pests with drought- or pest-resistant genes respectively. This reduces death not only in plants and animals but also in humans, as famine and starvation can be prevented when crop yields are higher and more consistent. This is particularly useful in areas of the world where extreme weather destroys many crops and animals, for

SPRING/SUMMER 2019

example in the Sahel, a belt of land that stretches across the South of the Sahara desert, where the temperatures are far too hot for a great number of wildlife to survive. Furthermore, the nutritional content of crops can be increased, providing a denser nutritional profile than what previous generations were able to enjoy. In fact, the UN Food and Agricultural Organisation has pointed out that rice, which was genetically modified to produce high levels of Vitamin A, has helped to reduce global vitamin deficiencies. This suggests that genetic engineering can lead to increased long-term health with less reliance on medicine, something that could positively affect the population as a whole. In another attempt to protect their crops, some farmers use pesticides and herbicides to kill pests that could lower their crop yield. However, statistics show that over 98% of sprayed insecticides and 95% of herbicides reach a destination other than their target species, meaning that they could indirectly affect many other ecosystems. When pesticides are leached into large bodies of water like rivers they can have detrimental effects on the whole ecosystem, as food webs can become damaged when a significant proportion of the wildlife in them dies. Through genetic engineering this problem can be solved. Many less pesticides need to be used when growing genetically modified (GM) crops, as pest resistance can be induced in these organisms when altering their genetic material. What are the disadvantages? Some organisms contain sleeper genes that are only activated under certain conditions,

7


DR DOLPHIN

for example, under an attack from pathogens. When a new gene is inserted during genetic modification, a promoter gene is also inserted to switch it on. When this happens there is a possibility that the promoter could activate a sleeper gene accidentally, sometimes in inappropriate circumstances. However, sometimes the opposite can happen and the expression of active genes can be silenced as a result of unknown interactions with the inserted gene. Unfortunately, not enough research has been done yet on the long-term effects of genetic engineering. So, genes could potentially mutate, and mutations can, although they don’t always, hinder normal development or cause permanent medical conditions in an organism. Mutated genes could even be passed on for generations, affecting many organisms down the line. Another argument is that genetic engineering can be seen as unethical. Animals that lack favourable characteristics are often killed or left to die, and animals that do have them cannot consent to being experimented on. As well as this, experimentation can lead to animals suffering; for example, chickens that are engineered to be very muscly may struggle to stand up and move around. The fact that humans choose to put their lives over those of animals can be argued that scientists have started to ‘play God’, or that they believe that certain living beings don’t have the right to life, although others, such as environmental groups who want to promote the fair treatment of all wildlife, believe they should.

SPRING/SUMMER 2019

genetic diversity damages food webs and can have terrible possible future impacts, including many wildlife species going extinct. People with certain jobs, like fishers, will also feel the impacts when animals begin to disappear. In conclusion, genetic engineering should be used for research and to solve problems like diseases, however, negative impacts should always be considered. We should certainly not let genetic engineering be the solution to all problems – only a last resort. It is now for our generation to decide how far we will go with its development and in what ways we will or will not let it change our planet. Maria Baranova, Y11 References and further reading: ● https://medium.com/fhsaplang/geneti c-modification-disease-prevention-or -future-disaster-32b86a27cbd2 ● https://www.the-scientist.com/tag/ge netic-engineering ● https://www.nytimes.com/topic/subje ct/genetic-engineering ● http://theconversation.com/uk/topics/ genetic-engineering-10096

Finally, when natural selection is not allowed to take place as it should, there can be a change in biodiversity. Changing 8


DR DOLPHIN

CRISPR CRISPR is a tool for editing genomes that allows researchers to simply alter DNA sequences and modify the functions of genes. This enables us to correct genetic defects as well as to treat and prevent the spread of diseases. CRISPR-Cas9 is currently the simplest, most versatile and precise method of genetic manipulation. It is a combination of a scissor-like protein such as one called Cas9 and a guide moleculewhich is a small piece of RNA that binds to the target sequence of DNA in a genome. The guide molecule also binds to the Cas9 so that it in effect “guides” the Cas9 to the targeted location to cut the DNA. Scientists then use the cell’s own DNA repair mechanism to add or delete pieces of genetic material or to make changes to the DNA by adding in a customised DNA sequence. CRISPR was first discovered by Francisco Mojica, a scientist at the University of Alicante in Spain, in 1993. He proposed that CRISPRs serve as part of the bacterial immune system and defend against invading viruses. CRISPRs were first discovered in archaea and then later in bacteria. By 2015, around 1000 papers to do with CRISPR had been published, displaying a vast range of ways in which CRISPR had been used, including modifying yeasts used to make biofuels and to genetically modify crop strains. Earlier this year, a Swiss biotechnology company said that it has used CRISPR to treat a patient with beta-thalassemia (a blood disorder that reduces the production

SPRING/SUMMER 2019

of haemoglobin, therefore leading to a lack of oxygen to parts of the body). People who have beta thalassemia inherit defective copies of the gene responsible for the production of haemoglobin. However, everyone has a second copy of this gene that gets switched off after we are born called fetal haemoglobin, so the clinical trial is attempting to use CRISPR to turn on the fetal gene. Scientists have collected bone marrow stem cells from the patient, fixed their DNA in the lab, then reinfused the cells into the bloodstream. Although the trial was recent and CRISPR Therapeutics only released this information on February 25th, 2019, they are already planning to use CRISPR to treat patients with sickle-cell anemia using the same strategy. More recently, in 2018, scientists at Imperial College made crucial developments in their attempt to deal with increasingly pesticideresistant, malaria-carrying mosquitoes using CRISPR technology. The scientists had been working on this trial since 2003 and used CRISPR to input a fatal gene into the mosquito’s DNA which passes down to each generation and wipes out the insects. The trial was successful and promising, with the team wiping out the samples of malaria-carrying mosquitos in as few as seven generations. This is the first time there has been an annihilation of a population of animals using gene drive. In 2015, Chinese scientists reported editing human embryos. The team, lead by Junjiu Huang, attempted to modify the gene responsible for beta thalassaemia using CRISPR Cas9 technology. This was the first time the CRISPR Cas9 technology was shown to make effective gene edits of human embryos, but the study sparked an

9


DR DOLPHIN

SPRING/SUMMER 2019

outcry about the ethical implications of this development. Huang said that by using human embryos in his trail his team was able to “show our data to the world so people know what really happened with this model, rather than just talking about what would happen without data.” The CRISPR Cas9 system is relatively easy to create, use and access and some people fear that scientists in any part of the world will be able to work on improving Huang’s trail or conduct any sort of experiments that they desire. In addition, there has been a lot of interest in and also debate about the potential to edit germline cells, which would affect not only the person who has had their genes edited but the generations that follow. As any changes made in germline cells will be passed from generation to generation, there is a serious ethical concern and so it is currently illegal in the UK and most other countries.

Amy Bartholomew and Senara Gambhir, Y11 Related websites and more information: ● https://www.livescience.com/58790crispr-explained.html ● https://www.nature.com/news/chines e-scientists-genetically-modify-huma n-embryos1.17378 ● https://www.wired.com/story/heres-t he-plan-to-end-malaria-with-crispr-e dited-mosquitoes/ ● https://www.broadinstitute.org/whatbroad/areas-focus/project-spotlight/c rispr-timeline

10


DR DOLPHIN

Cryonics Cryonics is a way of potentially saving lives by using extremely low temperatures to preserve a person with a presently incurable illness for decades or centuries until a future medical technology can restore that person to full health. Quite simply, the patient is prepared, transported and stored in liquid nitrogen at which point they will be left until technology has been invented to revive them. The first case of cryopreservation was James Bedford, a professor of psychology at the University of California, who was cryopreserved on 12th January 1967. A small team of doctors and other enthusiasts froze him a few hours after he died from liver cancer that had spread to his lungs. Since then, an estimated 250​1​ have been cryopreserved in one of seven organisations (only 10 of these are British​2​). Furthermore, more than one thousand people have made legal and financial arrangements to preserve their bodies after their death, usually by means of affordable life insurance. There are five major steps to cryopreservation: 1. Death of the patient​ - minutes after the patient is declared legally ‘dead’, a team must be ready to stabilise circulation with a heart-lung resuscitator, keeping the brain (and the rest of the body) supplied with blood and oxygen to preserve minimal function. 2. Transport of the body ​- the body must be packed in ice for the transit and is aso injected with a blood thinning drug (usually heparin, an

SPRING/SUMMER 2019

anticoagulant) to help reduce blood clotting and damage to the brain. 3. Preparation of the body with cryoprotectants ​- once the body reaches the cryonics facility, the body is cooled to just above water’s freezing point before the water is

removed from the cells within the body (to help prevent cell damage by ice crystals) and replaced with cryoprotectants (also known as ‘human antifreeze’). 4. Initial cooling of the body​ - the body is put on a bed of dry ice until it cools to -130℃. 5. Freezing of the body in a container​ - normally up to 6 bodies are held in a large metal tank of liquid nitrogen at -196℃. The bodies are most often stored upside down to protect the head in event of a leak (it ensures that the brain would stay immersed in the freezing liquid). There are many risks involved from the very beginning to the end of the procedure. Even from the start, the longer the body is left without resuscitation, the more the brain is starved of oxygen and the more damage occurs. Teams must be ready within minutes to ensure that oxygen keeps being transported to the brain.

11


DR DOLPHIN

The technology needed to successfully ‘unfreeze’ or revive a human that has gone through this process has not actually been invented yet and so many take a major risk that they may never be revived - there is no guarantee that the process will work. However, many cryonic preservation enthusiasts believe that there are many reasons for justifying the process. Firstly, even though the organisations have to wait until the patient has been declared legally dead to begin the process, damage to the

brain can be reduced by ensuring oxygen levels are maintained - this is why the resuscitation process minutes after the heart stops beating is so important. Secondly, the low temperatures reduce the rate of the chemical processes within the body which means that any degradation of the body, due to illness or cancer for example, can be slowed down substantially. Scientists have been able to preserve brain tissue with a modern vitrification solution with hardly any freezing damage. Structures are still well-defined, as shown in the image below, suggesting minimal damage. Moreover, human embryos can be preserved for years at temperatures that completely stop the chemistry of life and even adult humans have survived cooling to temperatures that stop the heart, brain, and all other organs from functioning for up to an

SPRING/SUMMER 2019

hour. Finally, emerging science of nanotechnology will hopefully be able to repair any damage caused by the illness, by ageing or from the cooling process. It may even be possible to repair individual cells one molecule at a time. When a body is frozen in liquid nitrogen and then stored, the extreme temperature can have a harmful impact on the cells of the body. The water inside cells freezes and creates ice crystals. As ice is less dense than liquid water, it takes up more space. This means that the crystals pierce and damage the cells and their membranes which means that, in the future, when the body needs to be revived, the body will have suffered severely and may be irreparable. To overcome this issue and to prevent ice crystals from damaging cell membranes in the frozen state, organ preservatives as well as antifreeze compounds (known as cryoprotectants) have been used to replace the water in the blood supply. It is unknown whether this method will work and certain cryoprotectants may even be toxic to the body. So far, vitrification has been successful for very small things like insects as well as simple tissues like blood vessels. Cryobiologist Dr Dayong Gao from the University of Washington in Seattle explains that ‘this is because the smaller size makes it easier to control cooling and cryoprotectants can be properly diffused​3​. It is well known that cryopreservation uses ideas from other fields such as nanotechnology and vitrification was initially developed to preserve frozen eggs for fertility treatments. The topic of cryogenic preservation is a controversial one. For many, it gives the

12


DR DOLPHIN

opportunity for a second chance at life. This may be especially important for those who are terminally ill at a young age and want to be able to experience a longer life once a cure has been found. With the growing help of technology, many scientists believe cryonics will prove to be very successful in the future. However, if a way of ‘unfreezing’ the bodies is found, surely, with a vastly overpopulated planet, it will be unwise to bring potentially thousands more people ‘back from the dead’? Furthermore, it may also be hard for the unfrozen individuals to adapt to life in the future. Some scientists are skeptical of the amount of damage that could possibly be done to the bodies due to the extremely low temperatures they are exposed to - it would be unfair to put these people through more pain after effectively their first ‘death’. There is also controversy surrounding cryonics and religion. Many religions are against the idea of immortality. For example, Christians are likely to dislike the process as they believe that God is the only immortal being and has control over whether people live or die and Jesus is the only one who could be revived from the dead; they also have a strong belief in life after death in heaven and this process prevents this from occurring. Many state that the ‘revival’ after death goes against the Bible however organisations claim that in fact the people do not die: they are declared legally dead however it is only their heart that has stopped - their brains are still functioning for a limited time once the blood stops being pumped around the body. Cryonics is very expensive as well and some may argue that it favours the rich. Those on lower incomes are not able to

SPRING/SUMMER 2019

afford it - for this reason it could be described as being discriminatory. Could the money that goes towards cryonics instead be used elsewhere, perhaps to help find a cure for the illnesses people want to escape from? The Alcor Life Extension Foundation in Scottsdale, Arizona is the world’s largest facility for cryogenic preservation. It is distinguished among cryonics organisations by its advocacy of a medical approach to cryonics as well as its advanced technology. Normally, 4 whole body patients and between 4 and 9 neuro patients are stored in the same pod which contains up to 450 gallons of liquid nitrogen. How much does cryopreservation cost? The price of this process will vary depending on the organization but they can be as much as $200,000 or more for whole body cryopreservation and $80,000 for a "neuro"

(head-only) option​4​. The Alcor Life Extension Foundation charge $200,000 for whole body preservation and $80,000 for neuropreservation​5​ however this can be paid via life insurance over the course of many years. The Cryonic Institute charges a minimum of $28,000 for the body and they do not offer cryopreservation of just the head.

13


DR DOLPHIN

What are your thoughts? Is it morally right that people should be able to ‘cheat’ death and, effectively, become immortal? Send in your opinions to asnook@godolphinandlatymer.com​ - we would love to hear them!

SPRING/SUMMER 2019

● ● ●

http://www.bbc.co.uk/science/0/2369 5785 https://youtu.be/JwNNdG4MZvc  https://alcor.org/cryomyths.html#myt h4

Amelia Snook, L6 References and further reading: ● 1​According to nbc news https://www.nbcnews.com/mach/inn ovation/preserving-bodies-deep-free ze-50-years-later-n707856 ● 2​Figure taken from the Telegraph (as of November 2016). https://www.telegraph.co.uk/news/20 16/11/18/cancer-girl-14-is-cryogenic ally-frozen-after-telling-judge-she-w/ ● 3​Quote taken from a report on cryonics on BBC Science website. http://www.bbc.co.uk/science/0/2369 5785 ● 4​Prices of other organizations suggested by the Cryonics Institute https://www.cryonics.org/about-us/fa qs/ ● 5​Figure taken from the Alcor Life Extension Foundation website. https://alcor.org/FAQs/faq01.html#co st ● https://alcor.org/AboutCryonics/index .html ● https://www.youtube.com/watch?v=a HBHvI3hNHM  ● https://www.youtube.com/watch?v=X BDYlaO7Kd4  ● https://www.youtube.com/watch?v=5tZtYns6kE  ● https://www.theguardian.com/scienc e/2016/nov/18/the-cryonics-dilemma -will-deep-frozen-bodies-be-fit-for-ne w-life  14  


DR DOLPHIN

Synthetic Organisms - Revolutionising Medicine All organisms on Earth use the same genetic alphabet: the nucleotide Cytosine pairs with Guanine and Adenine with Thymine to constitute the building blocks to make DNA and provide the instructions for the production of polypeptides (proteins). All this was true until now. In 1999, Dr Floyd E. Romesberg and his team at ‘SYNTHORX’ in the Scripps Research Institute (La Jolla, California) began working on the creation of organisms with an additional two bases. They started exploring the idea seeking to develop a pair of DNA bases that were similar enough to those used naturally by living organisms so as to incorporate them into the genetic code without rejection. However, they also had to be unique enough relative to the other natural bases to ensure that they would not be paired with them and, thus, be effectively forgotten. In 2014, after many failed iterations, the creation of these artificial nucleotides was finally released to form d5SICSTP and dNaMTP, the vulgarised names being ‘X’ and ‘Y’. These two new bases join to form a third base pair. Instead of being joined by the traditional hydrogen bonds, however, they are attracted through the hydrophobic effect. Hydrophobicity is the tendency for substances in an aqueous medium to acervate, hence the reason why they stick together. This therefore ensures that the synthetic bases are unable to join to the natural ones and disrupt the genetic code, or be ‘forgotten’. The next hurdle was integrating X and Y into organisms in a way that would allow

SPRING/SUMMER 2019

them to synthesise the synthetic bases along with the natural ones. The researchers’ efforts culminated in the creation of the first semi-synthetic organisms: a culture of ​Escherichia coli​ with an ability to create completely new polypeptides. To produce these, scientists realised that by steadily feeding the bacteria the requisite nucleotides for X and Y, they would continue replicating them even after 15 hours, just as they would with a normal line of DNA. To provide these nucleotides, a nucleoside triphosphate (nucleotide) transporter from a foreign organism, Phaeodactylum tricornutum​ (a diatom which grabs pre-synthesised nucleotides to pull them into the cell), was used to import the unnatural bases from the bacterial cell medium and use them to replicate a plasmid containing the unnatural base pair. When the plasmids were replicated, the newly-imported X and Y were used rather

than the bacteria producing the nucleotides themselves. The abolition of the dogma regarding the sole existence of these four natural bases could be seen as either completely

15


DR DOLPHIN

demiurgic, or conversely reckless and

potentially life-threatening. One cannot help but ruminate about the repercussions of the genetically synthetic organisms spreading and reproducing with other natural organisms to form unimaginable new life forms. However, it is important to consider that there is a failsafe mechanism in play. If the bacteria are taken out of the laboratory and very controlled environments, they will simply return to their normal state. This is because the bacteria remain incapable of building X and Y themselves without the provision of this steady stream of nucleotides. Additionally, evolution requires gradual and nuanced changes in natural entities. Seeing as the X and Y nucleotides are completely unique and unlike those that occur naturally, the semi-synthetic organism could not reproduce and evolve to form genetically advanced ‘superbugs’. The most interesting part of this innovation is the potential applications although, for now, the X and Y pair is just analogous to what may be in the future: they simply show that the DNA can ‘hold’ the synthetic bases without rejection. Applications vary in an astounding heterogeneity from military to medical. The excitement surrounding this discovery originates from the fact that, instead of being able to produce only 20 amino acids, the semi-synthetic organisms are able to produce proteins with 172

SPRING/SUMMER 2019

additional amino acids. This could lead to the production of completely idiosyncratic proteins, specialised to carry out otherwise unattainable work, for example bacteria could be genetically modified to produce enzymes which break down oil, thus cleaning oil spills. Seeing as the pharmaceutical industry is predominantly resorting to use of organic cells to produce proteins for drugs, as polypeptides are difficult to synthesise in a non-cellular setting, they could also be used in medicine to prevent rejection of proteins that are usually ‘flushed out’ by the body by causing them to form fat globules around their surface. This is just the tip of the iceberg when considering the myriad of possibilities relating to the work being done at the Scripps Institute. Since 2018, they have started working on the integration of X and Y into larger organisms - semi-synthetic worms - and they hope to continue progressing onto more complex organisms in the near future. Violette Chereau, Y11 References and further reading: ● https://www.nature.com/articles/natu re24659 ● https://www.the-scientist.com/newsopinion/six-letter-dna-alphabet-produ ces-proteins-in-cells-30572  ● https://www.popularmechanics.com/ science/health/a10512/x-y-scientists -create-two-new-letters-for-dna-1676 9967/   

16


DR DOLPHIN

Relationship between Tooth Enamel and Mental Health Problems  One in four people in the UK will experience a mental health problem in any given year. 70% of these people won’t have had appropriate interventions at a sufficient age. Therefore it is is imperative that indications of those at risk of mental health problems should be recognised. However, could teeth be an indicator of this information? A study was carried about by Dr Dunn in California which tracked the milk teeth of 37 children from the ages of six. Parents were asked to donate their child’s lost milk teeth to allow its enamel1 and volume of pulp2 as well as other factors to be analysed in a lab. Results demonstrated a strong link between mental health symptoms and thin enamel as those with thinner enamel were more likely to suffer from emotional behavior problems including aggression, inattention, impulsivity and difficulties concentrating. Additionally, children with lower volumes of tooth pulp beneath the enamel were also prone to these mental health symptoms. Evidence indicates that this link between tooth enamel and mental health was stronger than the link between mental health and socioeconomic status, which is regarded as one of the strongest indicators of psychological problems. Hence, this suggests that teeth

​Enamel is the hardest and most mineralised substance in the body. It covers the outer layer of each tooth and is the part which is most visible. Its colour can vary from yellow to a grayish white due to its semi translucent nature. Enamel plays a decisive role in protecting your teeth from decay. 2 ​The pulp is the​ ​center of a tooth made up of living connective tissue and cells called odontoblasts. It provides the tooth with its sensory function and is responsible for the formation of dentine. 1

SPRING/SUMMER 2019

are a better predictor of whether a child will go on to develop mental health issues than family and social status.

Factors which are believed to cause this alternation in enamel thickness and pulp volume are trauma or stress suffered earlier in life. Teeth start to develop in the womb and complete their formation during the first year of a child’s life. Therefore, the trauma suffered in the womb which could be related to the mother’s nutrition or stress during pregnancy, results in the weakening of a child’s tooth. Ultimately, although these findings are very recent and lack sufficient research to justify teeth being decisive in identifying those at risk to mental health problems in the future, they offer a lot of untapped potential which significantly improve the way in which those who are at risk of mental health problems are treated. Abby Hunter, L6 References and further reading: ● https://inews.co.uk/news/science/wh y-milk-teeth-give-clues-into-your-chil ds-mental-health/ ● https://www.independent.co.uk/news /science/teeth-child-mental-health-pr oblems-behaviour-research-study-a8 780286.html

17


DR DOLPHIN

https://www.colgate.com/en-us/oralhealth/basics/mouth-and-teeth-anato my/what-is-tooth-enamel-0113 https://www.news-medical.net/news/ 20190218/Scanning-childrens-teethmay-predict-future-mental-health.as px

Times Newspaper (16/02/2019)

SPRING/SUMMER 2019

18


DR DOLPHIN

Repetitive Transcranial Magnetic Stimulation: A New Treatment for  Depression  A technique called Repetitive Transcranial Magnetic Stimulation (or rTMS) can have effects on emotion perception and dopamine release, among other things, which means it could be used to treat treatment-resistant depression. In the early 1990s the first trials showed some efficacy for rTMS in the treatment of depression, however, a lot has changed about the parameters in which rTMS is carried out, resulting in the more recent large scale studies of rTMS with psychotherapy in treatment-resistant depression. Their conclusions appear to be more promising, which hopefully means rTMS will become a legitimate treatment for depression in the near future. Transcranial Magnetic Stimulation is a non-invasive means of electrically stimulating neurons in the human cerebral cortex. A pulse of electric current is passed through a coil placed over the subject’s head which generates a rapidly changing magnetic pulse that penetrates the scalp and skull to reach the cortex. The pulse of the magnetic field, in turn, induces a secondary ionic current in the brain which can trigger action potentials in cortical neurons (neurons which have motor, sensory and visual functions as well as language and memory to some degree). rTMS can induce changes in the neuronal excitability (the intrinsic membrane property that allows a cell to generate electrical signals in response to stimuli of sufficient magnitude) that persist beyond the time of stimulation. It is reasonably safe with only mild side effects.

SPRING/SUMMER 2019

It has been shown that rTMS could be used to treat various brain disorders, most notably clinical depression in adult patients who are not improving with antidepressants. This is because rTMS has been proven to induce the release of dopamine, a compound present in the body as a neurotransmitter and a precursor of other substances, such as adrenaline, which helps regulate movement, attention, learning, emotional responses, and someone’s emotion perception. A dopamine deficiency might be the underlying cause of some people’s depression as motivation, concentration, pleasure, euphoria, focus and other positive feelings stem from our dopamine levels. Furthermore, when dopamine levels are low, nerve impulses cannot be transmitted properly and can impair brain functions like behaviour, mood,

cognition, attention, learning, movement and sleep. It has been proven that rTMS of the prefrontal cortex, which is cerebral cortex that covers the front part of the frontal lobe of the brain which is involved in planning complex behaviour, personality expression, decision-making and

19


DR DOLPHIN

moderation of social behaviour, induces the release of dopamine. This finding has implications for the therapeutic and research use of rTMS in neurological and psychiatric disorders as well as in the treatment of depression, as a dopamine deficiency-caused depression could be fixed by increasing levels of dopamine production. It is currently offered as a treatment for depression and anxiety in a small number of private practises in the UK, however, the NHS does not provide this as a legitimate treatment for depression yet.

SPRING/SUMMER 2019

Dopamine information: https://universityhealthnews.com/dail y/depression/8-natural-dopamine-bo osters-to-overcome-depression/ rTMS induces dopamine release: https://pdfs.semanticscholar.org/2b7 5/873297c57f74ab6377c96e1ab781 0b2b63d3.pdf Therapeutic application of rTMS: https://www.sciencedirect.com/scien ce/article/pii/S1388245701005855

A recent survey by the Royal College of Psychiatry revealed that some patients with mental health issues are waiting for up to 13 years for help and support from the NHS. This is due to a severe lack of staff in the mental health services, in particular, a demand for specialist nurses and therapists. rTMS seems to be a somewhat ‘quick fix’ in comparison to the years of therapy sometimes needed to help someone with depression and therefore could help improve the waiting time. Furthermore, it could save patients from having to take antidepressants for extended periods of time or even the rest of their lives. Therefore I think this development will play a very important role in how we treat mental health conditions, such as depression, in the future. Caroline Corrigan, Y11 References and further reading: ● Stats about NHS support of mental illnesses: https://www.theguardian.com/society /2018/oct/09/mental-health-patientswaiting-nhs-treatment-delays

20


DR DOLPHIN

Stem cells and the treatment of various  diseases   Parkinson’s Disease  Parkinson’s disease is a condition in which many parts of the brain become damaged. This tends to happen progressively over many years. It is caused by a loss of nerve cells in the substantia nigra which is located in the midbrain and plays an important role in reward and movement. The lack of neurons causes a reduction in the chemical dopamine in the brain. Dopamine functions as a neurotransmitter (a chemical that helps with the transmission of signals between neurons) and plays a vital role in regulating the movement of the body. This means that a reduction in the levels of the chemical can have debilitating consequences - this is responsible for many of the symptoms of Parkinson’s disease. The cause of Parkinson’s is still mostly unknown. However, in about 1 in 20 cases, it is caused by an inherited genetic problem that affects the production of the alpha-synuclein protein which helps with the regulation of the release of dopamine​1​. The rest of the cases are likely to be induced by genetics (either inheritance of a mutated gene or an increased risk of developing the disease due to certain gene variations) or by environmental triggers (such as exposure to certain toxins or factors that increase the risk of the disease). Many also believe that men are more likely to develop Parkinson’s disease and both old age and

SPRING/SUMMER 2019

heredity can increase your chances of being affected as well. Around 1 in 500 people are affected by Parkinson’s disease​2​ and most will begin to develop the symptoms when they are over 50. These symptoms usually emerge gradually and tend to be quite mild at first. The order in which they develop varies from patient to patient and the severity of each may also differ for each individual. The main symptoms of Parkinson’s disease affect physical movement. These include tremors (shaking), slowness of movement and muscle stiffness and cramps (dystonia) - the term ‘Parkinsonism’ is used to refer to these three key symptoms. Additional physical symptoms include loss of sense of smell (which is likely to be experienced at an early stage of the disease), dizziness, excessive sweating, insomnia and nerve pain (including burning sensations and numbness). Dementia, depression and anxiety are all linked to Parkinson’s as well. Currently, there is no cure for Parkinson’s disease. Treatments including supportive therapies, medication and surgery are often provided to alleviate the symptoms. These do not slow down or reverse the damage to nerve cells. Now scientists are investigating how stem cells could be used to help treat Parkinson’s disease. Already, stem cells are being used to grow diseased dopamine-producing nerve cells in the lab so that they can study the disease and try to get closer to finding the main cause and, therefore, a cure. It may also be possible to treat the disease by replacing the lost nerve cells with healthy new ones. Embryonic stem cells can be directed to make dopamine-producing neurons and

21


DR DOLPHIN

these could be transplanted into patients. They have to be taken from an embryo of a few days before they are differentiated. So far, the neurons have been made from both mouse and human embryonic stem cells in the laboratory. An embryonic stem cell can become any cell in the body - this means that it can be very difficult to ensure that it differentiates into a dopamine-producing stem cell. Once the ideal nerve cell has been formed from the stem cell, it can divide into lots more neurons - cell banks can be created so that the treatments can be used for hundreds of patients. As part of a study in 2014 by scientists from Lund University in Sweden, experiments were carried out in rat models of Parkinson’s disease. To produce a rat model of Parkinson's, the researchers destroyed the dopamine cells in one part of the rat's brain. The experiments revealed that dopamine cells made from human embryonic stem cells, when transplanted into the brains of the rats, behaved like native dopamine cells. It was noted that the transplanted cells “survived in the long term and restored the production of dopamine in the brain” and “functioned in a similar way to the dopamine cells of the ‘human fetal midbrain’”. Human trials will be their next project. Induced pluripotent (iPS) cells can also be made from a patient’s adult skin cells in the lab through genetic modification (so that they act like embryonic stem cells). They can then be used to produce dopamine-producing neurons. Japanese researchers from Kyoto University have been looking at how induced pluripotent stem cells can be used to treat Parkinson’s. A trial was conducted with monkeys with a version of the disease (which had been induced by a neuron-killing toxin). It showed

SPRING/SUMMER 2019

that the treatment improved their symptoms and seemed to be safe - in fact, the implanted cells survived in the brain for at least two years without causing any dangerous effects in the body. It is for this reason that the team began transplanting neurons made from induced pluripotent stem (iPS) cells into people with Parkinson’s in clinical trials in August 2018.

The main challenges for stem cell research include growing large quantities of dopamine-producing nerve cells; ensuring the new nerve cells survive; getting the cells to connect and work normally inside the brain; controlling newly transplanted cells to prevent tumours forming. The other issue is the ethics of stem cell implantation. Embryonic cells are extracted from embryos and originally these were donated from those left over after fertility treatment (now embryos can be specifically created in the laboratory). Normally, the embryos are destroyed when the cells are removed and there have been both religious and moral objections against this. Many believe that life begins at conception and therefore scientists are, effectively, committing murder when they destroy the embryo. There is uncertainty as to when the embryo itself has rights and also to who owns the genetic material that is being used for research. Due to this controversy, induced pluripotent stem cells are being used more

22


DR DOLPHIN

SPRING/SUMMER 2019

often and umbilical cord stem cells can also be taken, although they are multipotent, which restricts their usefulness. Amelia Snook, L6 References and further reading: ● 1​EuroStemCell article “Parkinson’s disease: how could stem cells help?” (2016). [Accessed January 2018] https://www.eurostemcell.org/parkins ons-disease-how-could-stem-cells-h elp ● 2​Figure taken from the NHS website. [Accessed January 2018] https://www.nhs.uk/conditions/parkin sons-disease/ ● https://learn.genetics.utah.edu/conte nt/genetherapy/success/ ● https://www.mayoclinic.org/diseases -conditions/parkinsons-disease/sym ptoms-causes/syc-20376055 ● https://www.cureparkinsons.org.uk/n ews/stem-cell-treatment-for-parkinso ns ● https://jnnp.bmj.com/content/87/7/69 7 ● https://www.nature.com/news/reprog rammed-cells-relieve-parkinson-s-sy mptoms-in-trials-1.22531 ● https://tmrwedition.com/2017/09/13/c ell-replacement-therapy-for-parkinso ns-disease-and-the-future-of-the-brai n/​ (Image 1)  

                                                                                   

23


DR DOLPHIN

Equine Tendonitis Tendonitis is the inflammation of a tendon most commonly from overuse. Equine tendonitis is relatively common in horses and can occur both in the hind and fore legs. If the front legs are affected it is more commonly the superficial digital flexor tendon that is damaged and in the hind legs it tends to be the deep flexor tendon. Tendonitis in horses is caused by repetitive strain on the tendon so it is particularly common in racehorses and event horses who work at high speed often on hard ground. The main symptoms of tendonitis include: ● Lameness ● Heat ● Swelling and pain - most often indicated through poor performance

SPRING/SUMMER 2019

The cells are then grown in culture to increase the sample size for 2 to 3 weeks and then they are injected back into the tendon or a local blood vessel. Researchers are currently looking into methods which will allow the obtaining of more mesenchymal stem cells more quickly such as using donor horses or making them from embryonic stem cells. Unfortunately, like so many other diseases and inflammations, there are ethical issues surrounding the use of stem cells as treatment - although they are slightly different to the problems faced by human treatment. Firstly, it can be difficult to get a big enough sample size from one horse so use of donor horses is being contemplated. However, is it fair to inflict pain on other horses against their will? Some horses benefit from less invasive measures such as ice therapy, and the success rate for stem cell use is not 100% with rehab tending to take 1 year, so is it humane to use stem cells as a treatment? Like the use of embryonic stem cells in human treatment, it is seen as unethical to use these stem cells

It is possible to use stem cells to treat equine tendonitis. Mesenchymal stem cells which are multipotent (​having the ability to differentiate to a limited number of cell fates or into closely related family of cells) ​are able to develop into types of cell belonging to skeletal tissues. Adult stem cells are harvested from the equine’s own bone marrow either from the pelvis or sternum. 24


DR DOLPHIN

SPRING/SUMMER 2019

due to the fact that the embryo is unable to protect itself and could potentially be considered to have human rights by those who believe that life begins at conception.

There are also a few general problems with the use of stem cells to treat tendonitis. In theory, stem cell treatment would work better if the cells were injected straight after harvest as the condition can worsen during the 2-3 growth period. Furthermore, treatment is expensive and many owners of horses may not be able to afford it. Scarlett Marshall, L6 References and further reading: ● https://bbsrc.ukri.org/documents/100 7-stem-cell-resourse-edition3-pdf/ ● http://www.blueridgeequine.com/ste m-cell-therapy/ ● https://pethelpful.com/horses/Harnes sing-Mesenchymal-Stem-Cells-for-E quine-Superficial-Digital-Flexor-Tend on-Injury-Therapy ● https://www.horseandhound.co.uk/h orse-care/vet-advice/explaining-stem -cell-therapy-310620 ● http://www.novobrace.com/tendonitis /    

25


DR DOLPHIN

SPRING/SUMMER 2019Â

Birth Defects Birth defects are either physical changes or health problems present in the baby at the time of the birth. Though some cases are very mild, others can be extremely severe or even life threatening. Birth defects are also called "congenital anomalies" or "congenital abnormalities." The word "congenital" means "present at birth." The words "anomalies" and "abnormalities" mean that there is a problem present in a baby. Most will die after a few months, or have an extremely reduced life expectancy, eg. to teens. Birth defects include: 1. Malformation at birth 2. Inborn issues with metabolism 3. Blood disorders 4. Chromosomal abnormalities 5. Prenatal or brain damage

The main causes of birth defects are inheritance (passing on of genetic abnormalities, mutations), teratogens (something in the environment that the mother may be exposed to during her pregnancy - for example, a prescribed medication, a street drug, alcohol use, or a disease that the mother has, which could increase the chance for the baby to be born with a birth defect) and finally multifactorial causes.

Some birth defects may be difficult or even impossible to identify. However, certain behaviors greatly increase the risk of birth defects. These include smoking, using illegal drugs, and drinking alcohol while pregnant. Other factors, such as exposure to toxic chemicals or viruses, also increase risk. Types of birth defects Structural defects are when a specific body part is missing or malformed. The most common structural defects are: heart defects (affecting the heart walls, valves and blood vessels and likely to require heart surgery); cleft lip or palate (an opening or split in the lip or roof of the mouth, which did not close properly during development); spina bifida (when the spinal cord does not develop properly during foetal development, a gap may occur - this can be fatal without being treated and corrected); and clubfoot (when the foot points inward instead of forward).

Functional defects are problems in how a body system works, leading to developmental disabilities. The most common types of functional or

26 Â


DR DOLPHIN

developmental birth defects include: Down syndrome (which causes delay in physical and mental development - it is due to an extra copy of the 21st chromosome, otherwise known as the 21st trisomy); sickle cell disease/anemia (which occurs when the red blood cells become misshapen, causing blockages, pain and damage to tissues as well as tiredness); and cystic fibrosis (which damages the respiratory and digestive systems, affecting the cells that produce mucus, sweat and digestive enzymes and causing bacteria to clog up passageway - this may be fatal if left untreated). Some children face physical problems associated with specific birth defects. However, many children show no visible abnormalities. Defects can sometimes go undetected for months or even years after the child is born.

SPRING/SUMMER 2019

The injected stem cells are able to migrate from the bloodstream to the brain for two reasons. First, the injured brain sends out chemical signals that recruit the cells. And second, brain damage can compromise the blood-brain barrier, which normally regulates which substances can cross the threshold into the brain. Of course there are ethical issues surrounding the use of embryonic stem cells, however, it is also important to understand the risks associated with this form of treatment. Using immunosuppressants after the treatment, for example, is dangerous as it increases the risk of bacterial infection (the immune system is weaker). Furthermore, when introducing foreign genes to the body, the risk of tumours increases - the stem cells could potentially begin to grow uncontrollably.

Stem cell treatment As for other neurological diseases, stem cells have the potential to be used to treat birth defects. A study that was conducted in 2009 showed that by directly injecting stem cells into the brain or the bloodstream of mice, many birth defects that were usually untreatable could not only be treated but even successfully reversed. Despite the fact that some of the stem cells did not work, the injections triggered the brain to carry out extensive repairs of its own.

Amy Jiang, L6 References and further reading: ● https://www.technologyreview.com/s /411569/stem-cells-undo-birth-defect s/ ● https://www.stanfordchildrens.org/en /topic/default?id=overview-of-birth-d efects-90-P02113  

27


DR DOLPHIN

Burns  Burns can be classified as first-, second- or third-degree burns. ​The severity of the

symptoms can differ but the degree of pain is not necessarily related to the severity of the burn, as most serious burns can be painless.​ 1. First-degree burns: cause mild pain and reddening. 2. Second-degree burns: cause more serious pain, redness, swelling and blistering. 3. Third-degree burns: cause white or blackened charred skin and possible numbness.

SPRING/SUMMER 2019

Stem cells are already used to treat burns. It is possible to produce new skin using embryonic stem cells to help repair the damaged area. This is much faster than the normal process of taking a graft from another part of the body which also poses the risk of infection or dehydration. There are many different applications for the use of stem cells as a form of treatment: topical application, local injection, intravenous or systemic injection, and dermal or carrier application. As with the treatment of other issues using embryonic stem cells, there is controversy and debates over their use - there are both religious and moral objections. Normally, the removal of stem cells from embryos results in the destruction of the embryos. Originally, embryos that were left over from fertility treatment (IVF) were used, however, laws have now been passed such that embryos can be specifically created in labs as a source of stem cells - perhaps this will reduce the objections that have arisen due to the belief that life begins after conception as the embryos are created in a laboratory. Ella Wilmot, L6

There are many different causes of burns but the most common causes come under thermal burns. Below are a few of these causes: ● Dry heat​ ● Wet heat​ ● Radiation​ ● Friction​ ● Heated objects​ ● The sun​ ● Electricity​ ● Chemicals

References and further reading: ● https://www.bioeden.com/uk/treatme nt/burns-tissue-repair/ ● https://cells4life.com/stem-cells-to-h elp-burns-victims-case-study/ ● https://www.ncbi.nlm.nih.gov/pubme d/28486306  

28


DR DOLPHIN

Age-Related Macular Degeneration Macular degeneration is an eye condition affecting the central field of vision. Its symptoms include blurring, distortion and loss of central sight. Age-related macular degeneration, or AMD, can be classified as ‘wet’ or ‘dry’. Dry is more common and less severe - the build-up of a fatty substance

called drusen on the back of the eye can be damaging to sight. Wet is less common and more severe abnormal blood vessels grow into the macula, attempting to repair the damaged macula. These leak blood or fluid, which leads to scarring of the macula and rapid loss of central vision. Wet AMD can begin suddenly but can be treated by injection of drugs directly into the eye to control the growth. Age-related macular degeneration has a few main causes: ● Smoking - massive risk factor that can increase risk by 4 times ● Poor diet - obesity can increase risk massively ● Lack of important vitamins (e.g. lutein, zethanaxin, A, C and E) that important for eye cellular health

SPRING/SUMMER 2019

Genetics play a factor

Stem cells can play a role in the treatment of age-related macular degenerative disease.

However, as with the stem cell treatment of other diseases, this form of treatment does raise ethical issues. The main problem is that when embryonic stem cells are obtained from the embryo, it will be destroyed. Many think that life begins at conception and therefore, if the embryos have life and thus human rights, this process is considered to be murder. There are also concerns surrounding the rights of the ‘parents’ of the embryos. Do they have a right to terminate the research on their embryo? Should they be allowed to obtain data from the research that is being conducted? Molly Bleach, L6 References and further reading: ● https://www.nhs.uk/conditions/age-re lated-macular-degeneration-amd/ ● https://www.rnib.org.uk/eye-health/e ye-conditions/age-related-macular-d egeneration-amd ● https://www.nhs.uk/news/genetics-a nd-stem-cells/new-stem-cell-treatme

29


DR DOLPHIN

SPRING/SUMMER 2019

nt-may-help-reverse-age-related-sig ht-loss/ https://www.genengnews.com/news/ stem-cell-therapy-patch-for-maculardegeneration-sees-the-light-of-day

 

30


DR DOLPHIN

SPRING/SUMMER 2019

being listed as one of the minimum medical needs for a basic healthcare system.

Public Health   Painkillers: Friend or Foe?

Painkillers are a normal part of most people’s lives. A large portion of the population uses them to either regularly help treat long-term medical conditions (such as the symptoms of arthritis), or irregularly for headaches and general pain. When taken cautiously and correctly they can prove quite effective in carrying out their raison d’être, however, it is vital to accept the dangers and threats that they pose to our bodies. Analgesics, specifically Ibuprofen, are non-steroidal anti-inflammatory drugs (NSAID’s) probably more commonly known by the general public through their brand names: Nurofen, Brufen or Advil - in the UK. The majority of the populace know the effects of NSAID’s, but few actually understand how exactly they take effect or function. In plain terms, Ibuprofen works by blocking the production of prostaglandins, hormones the body releases in response to illness and injury. As a non-selective inhibitor, Ibuprofen inhibits the release of the COX enzyme (cyclooxygenase), an enzyme which is vital for the production of prostaglandins – the enzyme converts arachidonic acid to prostaglandin. This in turn decreases the fabrication of prostaglandins and the inflammation seen in the wounded area, as well as the amount of pain felt by the individual. As prostaglandins are synthesized for different types of wounds in all areas of the body, NSAID’s like Ibuprofen are able to target almost anywhere where there may be pain and can even address multiple problems at once. This has made them a very useful drug, even being called an ‘essential drug’ by the World Health Organisation (WHO) and

Of course, there are always risks in taking any form of a drug and NSAID’s are no exception. For people with certain conditions such as heart disease or high blood pressure (hypertension), doctors always suggest being cautious when it comes to administering a dose, as taking anti-inflammatories with these conditions can lead to marked worsening of existing hypertension, worsening of heart failure, heart attacks or even a stroke. Another aspect of NSAIDs to be careful of is its interactions with certain other drugs. For example, when taking aspirin, doctors may highly advise you not to take Ibuprofen medication. This is due to the fact that when taken together, aspirin and ibuprofen can significantly raise the risk of stomach bleeding. It is extremely important to be aware of these risks when beginning a course of NSAID’s, especially if you have related pre-existing medical conditions, or if you are already taking other medication. The other obvious issue that people have with taking drugs, even prescribed ones, is the possibility and danger of addiction. This potential of addiction varies between opioid and opiate (non-opioid) analgesics. Unlike their non-opioid counterparts, painkillers that contain opioids – such as Codeine, Fentanyl and Methadone - are much less addictive, and may only have the chance to become addictive when used long-term. In the short-term, this is very unlikely as the body doesn’t have time to build up a tolerance to the drug or become dependent upon it to carry out daily function. And, as opiates are very tightly controlled in the EU – not sold over the counter (OTC) – the overall chance of becoming addicted if the drugs are taken correctly is very slim. However, all things considered, should we be taking anti-inflammatory drugs at all

31


DR DOLPHIN

SPRING/SUMMER 2019

given this exposure to danger? From the evidence above, it is clear that they have the ability to do harm, but on the other hand, there are countless cases of patients and people within the general public who swear by these drugs. After taking into consideration the pros and the cons it seems that, as long as we acknowledge the possible power drugs have over our lives and are cautious and correct in our use of them, we can learn to control this power, rather than being subjugated to it. Jenna Kruger, L6 References and further reading: ●

https://www.theguardian.com/lifeand style/2015/may/25/does-paracetamo l-do-you-more-harm-than-good https://www.bbc.co.uk/programmes/ articles/2sqKBbPH9djzWhF9wpfDd Hn/is-paracetamol-bad-for-me

32


DR DOLPHIN

Euthanasia and Assisted Suicide Euthanasia and assisted suicide are highly debated, controversial subjects. The terminology used in these discussions is often misunderstood. Euthanasia is an intervention undertaken with the intention of ending a life to relieve suffering, for example a lethal injection administered by a doctor. Assisted suicide is any act that intentionally helps another person kill himself or herself, for example by providing them with the means to do so, most commonly by prescribing a lethal medication. Assisted dying is usually used in the US and the UK to mean assisted suicide for the terminally ill only, as for example in the assisted dying bill in 2015.

SPRING/SUMMER 2019

Under what circumstances can these procedures occur? In the Netherlands, the patient's suffering must be unbearable, with no prospect of improvement. The suffering doesn’t need to be related to a terminal illness and is not limited to physical suffering such as pain. For example, it could be the prospect of loss of personal dignity or increasing personal deterioration. The law in Belgium is similar. The patient's suffering must be constant and unbearable, resulting from a serious and incurable disorder. There is no requirement that the patient be diagnosed with a terminal illness, although additional checks are imposed if the patient is not terminally ill.

Where are these practices permitted? As of March 2018, active human euthanasia is legal in the Netherlands, Belgium, Colombia, Luxembourg, and Canada. Assisted suicide is legal in Switzerland, Germany, the Netherlands, and in some states in the US. The Netherlands, Belgium and Luxembourg permit euthanasia and assisted suicide. Switzerland permits assisted suicide if the person assisting acts unselfishly. Canada will permit euthanasia and assisted suicide. Why is it legal there? In the Netherlands, euthanasia and assisted suicide were effectively legalised in order to prevent doctors from being convicted for providing euthanasia. In Colombia, Montana and Canada, the courts also took the lead in changing the law, on the basis of human rights claims.

Only two countries permit euthanasia for patients under the age of 18, Netherlands and Belgium. In the Netherlands, a competent patient between the ages of 16 and 18 may request euthanasia or assisted suicide. The parent or guardian does not have a veto, but must be consulted. Competent patients aged between 12 and 16 may also qualify, but only if their parent or guardian consents. However, in Belgium a competent patient under the age of 18 may request euthanasia with parental consent. Additional scrutiny of the child's competence is required, and suffering based on a psychiatric disorder isn’t permitted. Reconsiderations In the Netherlands, there was a 10% increase in assisted suicide between 2017-2018. The majority had cancer, heart and arterial disease, or nervous system diseases (e.g. Parkinson's or multiple sclerosis). Professor Theo Boer who supported the 2002 legislation who later resigned in 2014 from the regulatory body

33


DR DOLPHIN

SPRING/SUMMER 2019

over concerns about the rising numbers believes that supply has created demand and that society is becoming desensitised to euthanasia. Others see the increase as a natural reaction as more people are choosing to end their life with their personal dignity, for example in cases of severe dementia. Currently, death by euthanasia is 4% of all deaths in the Netherlands. United Kingdom Currently assisted suicide in the UK is a crime and those convicted could face up to 14 years in prison. In 2015, MPs in the UK voted against an assisted dying bill by 330 votes to 118. The campaign group ‘Dignity in Dying’ advocates a law based on the Oregon model, covering people with less than six months to live. 82% of the public support the choice of assisted dying for terminally ill adults. Aanya Arora, L6 References and further reading: ● https://www.bbc.co.uk/news/health-3 4208624 ● https://www.theguardian.com/society /2018/mar/17/assisted-dying-euthan asia-netherlands ● https://www.dignityindying.org.uk/as sisted-dying/

34


DR DOLPHIN

Work Experience

SPRING/SUMMER 2019

all the risks involved with every step during the patient’s time on the ward.

University College London Hospital work experience  Over the summer, I was fortunate enough to gain a week of work experience in the University College London Hospital (UCLH), Euston. I was able to learn about the life of junior doctors, midwives, surgeons and consultants in the hospital. Day 1 I spent the first day of my work experience on the labour ward. In the morning, I followed a consultant on his ward round. Each woman on the labour ward was assigned a midwife who assisted with the preparation and then the delivery of the baby as well. One of the key roles of the midwife is to check dilation of uterus: when the uterus reaches 9 cm during the labour, the mother can start pushing. The midwife must also check for any abnormalities - for example obstructed labour is indicated by blood in urine (since the baby is pressing on the bladder). The consultant talked to the patient and the midwife so that he could make sure that everything was running smoothly. Birth plans are also looked at and modified once the women arrive in the hospital. Patients who had been in labour for long periods of time were given a hormone drip of oxytocin which helped to speed up the contractions so that the baby could be delivered more quickly. The women were also asked if they would like an epidural (​a type of anesthetic used especially in childbirth to produce loss of sensation below the waist) to reduce the pain however this also increases the chance of assisted birth with forceps or with suction. I learnt about the importance of addressing

In the afternoon I talked to a nurse about her responsibilities on the labour ward. She discussed the number of stillborn babies she had had over her time on the ward and also explained to me how she had handled it. In just one week, she had delivered four stillborn babies including one set of twins. Naturally this was very upsetting for her however she explained the importance of carrying on as normal, not forgetting but not lingering on the past and focusing on the number of successful babies she had delivered in her career. A sad case that came up was a mother who had undergone IVF followed by an emergency C-section at 9 months with the delivery of a stillborn baby. IVF can be a very expensive process and those who undertake it may have so much hope for a success that when it does go wrong, the impact can be tough mentally. The risk of stillbirth in women who conceived after IVF tends to be 16.2 per 1000. The chance of a stillbirth is usually about four times greater in the IVF group compared to normal conception​1​. I was also lucky enough to be allowed into surgery to watch an emergency cesarean section. Sadly the baby was in the wrong position so it could not be delivered naturally. This meant that the consultant surgeon had to make a quick decision to take the woman into surgery in order to save the baby and the mother. An epidural was provided in order to numb the pain for the mother - general anaesthetic is not used for C-sections since there is a risk of the woman aspiring if she vomits during the procedure. Since she was awake, a screen was put up in front of her (in case she

35


DR DOLPHIN

passed out because of the blood) however once the baby was delivered, had started breathing and was checked over, she was given the baby to hold herself. When the baby was born there were a few complications as it was not breathing initially. The emergency button was immediately pressed by the nurse so the neonatal team (a large group of 15 people) rushed into the room in order to clear the airways of the baby (it had breathed in something when taken out). The collaboration between the various teams was so important here. Finally, at the end of the day, I watched an instrumental delivery of a baby. This delivery was also supposed to be natural however after many contractions and with the patient having been in labour for a long time, the midwife called a surgeon who had to make a cut in the woman’s vagina so that the baby could be taken out. The baby was dried and the midwife recorded its time of birth and gender (it was a girl!) before she was handed to the mother. The surgeon then stitched up the mother with dissolvable stitches and a plan for hourly observations was created. Day 2 On the second day of my work experience, I watched various surgeries in the gynaecology/urology theatre of the hospital. Issues to do with both urology and gynaecology include prolapse and incontinence. Firstly the ‘sign in’, held by the anaesthetist, occurred. Each person had to introduce themselves and outline their major responsibilities for the surgery. Next came the ‘time out’ where the surgeon outlined key factors such as expected blood loss, special equipment required, the patient’s

SPRING/SUMMER 2019

allergies, the antibiotics required, non-routine/critical steps and finally how long the case would take. Finally the theatre practitioner conducted the ‘sign out’ where he outlined the procedure and noted any issues. I watched five operations in total. The first involved the removal of a possibly cancerous polyp. A hysterectomy was carried out using cameras and then the polyp was sent to histology for analysis - if it was cancerous then the woman may need to be observed more carefully in case the cancer had spread further around her body. The initial plan of the last operation was to suspend the uterus using a mesh in a laparoscopic approach to the abdominal cavity. Unfortunately, a black mass possibly cancerous - was found on the ovary of the patient near the beginning of the procedure. This had not been seen in the previous scan 3 months earlier and so it was possible that it could be a fast-growing tumour or melanoma. The decision was quickly made to remove the ovary and it was placed in a bag which had been inserted into the body laparoscopically. If the regular procedure had been carried out, the mesh could have caused an infection which could reduce the chance of treatment or prevent another operation from being carried out (and the cancer could spread quickly). This operation taught me how important a fast response is and also how much it relies on the collaboration of the team so that it can be adapted to help care for the patient in the best way possible. Day 3 The morning of day three was spent in the preterm birth clinic. The majority of the

36


DR DOLPHIN

women who attended the clinic were those at risk of having a baby early. Specialist doctors have to observe the women and try to find a way to prevent this risk. These women have either had babies very early before or have previously had miscarriages. If a baby is born at 24 weeks then the baby may have disabilities and if it is born earlier than 20 weeks then the baby will be unable to survive - this is why these women must be monitored by specialist doctors and must attend the clinic regularly. The doctor I was shadowing conducted an ultrasound scan for each of the women he saw - this allowed him to measure the width of the cervix which helped to see the likelihood of a preterm birth. If the width was very close to the normal then a pessary or progesterone hormone can be used to widen it slightly. However if it is far off the normal then theatre may be required (e.g. if it is open then a suture is necessary to tie the cervix up). I was surprised at how much could be understood just from a simple ultrasound which took less than 10 minutes to occur. At 20 weeks you can definitely tell the gender - earlier than this, gender may be recognised but it depends on the clarity (sometimes umbilical cord may make the ultrasound unclear). I attended a twins clinic in the afternoon. Having twins holds a greater risk than having one child and so a clinic is necessary to ensure that the development of the babies runs as smoothly as possible. More regular scans are required and, leading up to the predicted delivery date, the twins must both be positioned correctly with their heads downwards. If this is not the case then an elective C-section may have to take place. Around 5% of deliveries occur

SPRING/SUMMER 2019

where one baby is delivered vaginally and the other via C-section and 30 to 40% of women with twins plan to have a natural delivery which turns into a C-section. This is to ensure that no harm comes to either baby or the mother. I also witnessed the end of the clinic on MFAU (Maternal Fetal Assessment Unit). This is almost like an ‘emergency’ ward just for pregnant women. The patients who come through are likely to have experienced unusual pain - similar to contractions - and need to be seen as quickly as possible in case they deliver early. Day 4 On the fourth day I attended an endometriosis clinic on Elizabeth Garrett Anderson Wing of the hospital. Endometriosis is a condition where the tissue that lines the womb (known as the endometrium) is found outside the womb, such as in the oviducts (fallopian tubes) or the ovaries​2​. It causes extreme pain due to the build-up of endometrium patches and cysts which have to be removed surgically. The cause of endometriosis is unknown however multiple theories have been suggested. During the clinic, I observed the clinician talking to a number of patients with endometriosis, which usually affects women or girls of childbearing age. The first girl who came in was only a few years older than I was and had experienced such great pain during her periods that sometimes she had not been able to go to school when she was younger. She had already endured multiple operations and now all the clinician was doing was treating the symptoms - each operation poses a great risk to the patient.

37


DR DOLPHIN

Since there is no cure for endometriosis her pain was treated with a contraceptive coil an Intrauterine system (IUS) which releases progesterone to stop you getting pregnant (therefore prevents menstruation) and lasts for 3 to 5 years. Unfortunately, endometriosis can also cause infertility since patches and lumps line the fallopian tubes and therefore block the pathway of the eggs. Another patient was hoping to have a child however she was having difficulty getting pregnant. The space between the womb and the bowel had been closed off by endometriosis (it had caused them to seal together) and surgery was necessary to remove the womb (which of course would mean that she would never be able to have a child again). She had to consider whether her fertility was worth the extreme pain she would have to endure if she got pregnant. Day 5 On day five, I went back to the labour ward but this time followed a consultant during the morning ward round. Starting off the day, I attended the handover meeting and then a very interesting discussion on the duty of candor (being open and transparent when talking to a patient), the mental capacity act (judging whether a patient has capacity to make decisions by themselves) and deprivation of liberty (knowing when it is right to prevent patients from being discharged perhaps based on their state of mind). Following this, I observed a manual displacement of a baby before a natural delivery. This is when the nurses move the baby to the side normally to relieve pressure on the aorta and vena cava. If there is a

SPRING/SUMMER 2019

sudden decrease in the blood pressure of the mother then it is likely that the baby’s weight is pressing down onto the aorta and vena cava. This is why manual displacement is necessary. I was also fortunate enough to help out during the delivery of a baby. I held up the legs of the patient whilst the midwife took the baby out and also provided the towels once the baby was delivered. It was an amazing experience being so close whilst the baby was born and the placenta was delivered. Throughout the week, I observed 2 caesarian sections, 2 instrumental deliveries (either with forceps or suction), 3 natural deliveries and over 8 operations in the gynaecology theatres. The week was an incredible experience and has only made me want to pursue a career in Medicine even more. I would recommend anyone who is interested in Medicine to try and gain some work experience at some point since it really opens your eyes and helps you to understand the life of those working in a hospital. Amelia Snook, L6 References and further reading: 1​ Research from the NHS website https://www.nhs.uk/news/pregnancy-and-chi ld/ivf-and-risk-of-stillbirth/ 2​ Definition of endometriosis according to the NHS https://www.nhs.uk/conditions/endometriosi s/ ●

http://www.uclh.nhs.uk/Pages/Home. aspx

38


DR DOLPHIN

SPRING/SUMMER 2019

https://www.mayoclinic.org/diseases -conditions/endometriosis/symptoms -causes/syc-20354656 https://www.gosh.nhs.uk/medical-inf ormation-0/procedures-and-treatmen ts/ureteric-re-implantation

39


DR DOLPHIN

SPRING/SUMMER 2019

STEAM week   This year, STEAM (Science,Technology, Engineering, Art and Maths) partnered up with Challenge Your Limits Week. Here, we will give you a summary of some of the exciting events set up by the Biology STEAM Team.

Biomed Society: How Dangerous is Snake Venom? by Jenna Kruger What is Snake Venom: Venom is not a poison. It is introduced into the body by injection where poisons are ingested. Venom can be classified as: Hemotoxic, Neurotoxic or Cytotoxic, and can have qualities of one or multiple of these groups. Each group exhibits different effects on a victim, either affecting their blood, tissue or nervous system. Effects of Snake Venom: Hemotoxins target the red blood cells to causes fatal bleeding which causes: ● Activates or inhibits blood clotting ● Haemorrhaging ● Strokes ● Heart failure Enzymes Snake Venom acts on: The first type of venom acts on enzymes that results in blood clots forming. This relies on activation of blood clotting factors in the victim's blood that can lead to life threatening blood clots forming. These blood clotting factors are normally only activated when someone is injured or a wound has been caused. These enzymes include: ● Thrombin- an enzyme that causes fibrin in the blood to stick together and form a blood clot ● Plasmin - destroys and breaks down

blood clots by attacking fibrin. The second type of venom acts on enzymes to cause the opposite, fatal bleeding. Depending on the specie of snake, some of its effects could be: Inhibition of thrombin, preventing the conversion of fibrinogen to fibrin, hence resulting in the inhibition of Factor X, which is a blood clotting factor such that when inhibited, prevents the body from forming clots and therefore possibly resulting in fatal bleeding. The overall effect of this is called coagulopathy – the reduced ability of the blood to clot The Effects of Snake Bite on Cytotoxins: ● ● ● ● ●

Painful progressive swelling at the bite Developing into blistering and bruising Hypovolemic shock Extensive tissue damage Necrosis of the affected limb amputation

40


DR DOLPHIN

SPRING/SUMMER 2019

victim usually dies within 30 minutes. The Effects of a Snake Bite on Neurotoxins ● ● ● ●

Descending neuromuscular paralysis Paralysis of the facial muscles Paralysis of the respiratory centre Animals that survive this rarely have sequelae (after effects like tissue damage)

Many paralysing venoms contain a cocktail of molecules that act together but in different ways to interfere with the transmission of nerve impulses. The most dangerous paralysing toxins destroy the nerves themselves. Once this latter type of damage occurs, it may take weeks for the nerves to repair and during this time, you may not be able to breathe without external support. An example of a neurotoxin and how it works: Cholinesterase -this enzyme is needed for normal functioning of the human nervous system -neurotransmitters (acetylcholine) carry nerve impulses across the synapses in the nervous system, including the junction between nerve and muscle to stimulate a muscle to move -normally after the muscle has moved, an enzyme called acetylcholinesterase is released to break down the neurotransmitter, to stop the muscle moving This means that if the enzyme is unable to break down the stimulant (in this case the acetylcholine) the muscle will move uncontrollably. This type of snake venom causes this uncontrollable movement. Repeated and unchecked firing of electrical signals can cause: uncontrolled and rapid twitching of some muscles, paralysed breathing, convulsions, and in extreme cases, death - all symptoms of receiving a snake bite with neurotoxic snake venom. In the case of this type of snake venom, the

The only way to save the life of a victim of a snake bite with high neurotoxin levels is to inject the appropriate antivenin shortly after the patient has been bitten or put them on an artificial respirator. Unsurprisingly, the type of snakes with this extremely dangerous venom belongs to a group called the elapines (short front fangs snakes), which include the cobra, mamba, and coral snakes. Therapeutic Uses of Snake Venom ACE Inhibitors: A peptide found in snake venom became a lead compound in the development of a class of hypertension (high blood pressure) drugs called ACE inhibitors. The Brazilian pit viper helped with the first venom-derived drug, Captopril (developed from a peptide in this species). ● The drug effectively turns off the body’s main pathways for vein constriction that increases blood pressure ● ACE Inhibitors can be used for congestive heart failure and kidney diseases Alzheimer’s prevention: Some snake venoms contain molecules that can help break down amyloid beta proteins – a central cause of the onset of Alzheimer’s. Research based in Australia discovered a molecule in snake venom that appears to activate the enzymes that break down amyloid plaques in the brain – a hallmark of Alzheimer’s.

This was found after the screening of various snake venoms

They have done research into developing synthetic versions of the molecule and initial tests in the lab done with human cells have shown

41


DR DOLPHIN

SPRING/SUMMER 2019

the same effects as the native version found in snake venom 20 Second Clotting: 2015 research showed that extracting batroxobin molecules from venom can help clot bleeding wounds within 20 seconds. Abby Hunter, L6 References and further reading: ● https://www.ncbi.nlm.nih.gov/pubme d/124647 ● https://febs.onlinelibrary.wiley.com/d oi/full/10.1111/j.1742-4658.2011.081 15.x ● https://www.nhs.uk/conditions/snake -bites/ ● https://www.bbc.co.uk/news/health-3 4214029 ● https://www.scienceabc.com/eyeope ners/why-does-snake-venom-kill-hu mans-but-not-the-snake-that-is-filled -with-venom.html Biomed Society: Wednesdays at 1.30pm in B1.

42


DR DOLPHIN

Natural Sciences Society: Snake Mimicry What is mimicry? Mimicry is a form of symbiosis where a species may mimic the colours, patterns, or even behaviour of another species for one of two reasons: 1. 2.

To be able to get closer to unsuspecting prey In the case of a harmless species, to gain protection by imitating a predator or poisonous species

SPRING/SUMMER 2019

However, it does take longer for a snake to evolve so that it is able to mimic other species. It is for this reason that mimicry is less well known. Camouflage can be considered a visual mimicry, when a chameleon changes colour and camouflages in its surroundings so that its prey can't spot it easily. There are many animals which mimic their surroundings or another species in the vicinity. Some examples are butterflies, beetles, some fish, and some amphibians. Batesian Mimicry

Reasons for mimicry ● ●

Animals must avoid being eaten by predators. Some animals are bad-tasting or dangerous & predators learn to recognize them by their bright colour patterns & leave them alone. Animals which are good-tasting & cannot defend themselves directly must resort to other ways to avoid being eaten. One way is to look like an animal which tastes bad or seems dangerous; the predator learns to avoid all those animals that look like noxious ones.

Mimicry vs camouflage When comparing mimicry with camouflage or deceptive behaviour, protection by mimicry is the most effective as the mimicking species does not have to change its behaviour or stay safe against a safe background to disguise itself.

It is a type of mimicry in which palatable animal mimics the bad-tasting or noxious prey enough so that predators may not distinguish between them. Named after English Naturalist Henry W Bates who published an explanation of this mimicry in 1862. Example:

Aanya Arora, L6 Natural Sciences Society: Thursdays at 1.30pm in MG7.

43


DR DOLPHIN

SPRING/SUMMER 2019

Dissection Club: Dissecting a Snake In Dissection Club, we dissected a snake. We learnt about the anatomical differences in the lungs and heart of snakes and humans. We also looked at how their organs are able to make room for the prey that they will swallow whole. We also attempted to determine the sex of our snakes, although it didn’t go quite as planned!

Nina Wittmann and Costanza Giovene, L6 Dissection Club: every other Tuesday at 1.20pm in B1.

44


DR DOLPHIN

Lecture: ‘Is Man Just Another Animal?’ by Professor Steve Jones As part of STEAM week, we went to Latymer Upper to watch a lecture by Professor Steve Jones, Emeritus Professor of Genetics at University College London and an author of many popular science books. He was Head of the Department of Genetics, Evolution and Environment at UCL from 2008 to 2010. The professor’s lecture, titled ‘Is man just another animal?’, looked at the evolution of humans as well as forming links with the origins of language. An interesting and controversial topic the Professor discussed was Jane Goodall’s belief that, since chimpanzees share 95% of human DNA, they should share 95% of human rights. This could mean that they have similar rights to those who are mentally incapacitated. She has campaigned for increased rights for animals like chimpanzees, to prevent them from being used for animal testing - this is understandable but surely we cannot provide them with all human rights given how far we have progressed as a society? Amelia Snook, L6 Talks/interviews: ● Genetics of Nature https://www.youtube.com/watch?v=n ZcRmZdn2Gc ● Nature or Nurture? https://www.youtube.com/watch?v=1 ksP34GYwbY ● Is human evolution over? https://www.youtube.com/watch?v=x BO2d39Tqgg

SPRING/SUMMER 2019

Evolution of humans https://www.youtube.com/watch?v= DIqEqp5tLm8

If you want to find out more about Jane Goodall's ideas about what separates us from chimpanzees, watch this TED talk: https://www.ted.com/talks/jane_goodall_on_ what_separates_us_from_the_apes?langua ge=en Books: ● The Language of Genes, 1993 ● Almost Like a Whale, 1999 ● Genetics for Beginners, 1993 ● Y: The Descent of Men, 2002 ● Darwin’s Ghost, 2000 ● The Serpent’s Promise: The Bible Retold as Science. 2013 ● In the Blood: God, Genes and Destiny, 1996 ● Darwin’s Island: The Galapagos in the Garden of England, 2009 ● Coral: A Pessimist in Paradise, 2007 ● The Single Helix: A Turn Around the World of Science, 2005 ● A Darwin Archipelago: The Naturalist’s Career Beyond Origin, 2011 ● Evolution (A Ladybird Expert Book), 2017 - this is recommended as a short book that helps with GCSE, A level and IB revision ● The Intelligent Warrior, 2004 .... and many more!!

45


DR DOLPHIN

SPRING/SUMMER 2019

Slitherami - Origami Snakes Continuing with the snake theme, the Biology STEAM Team set up an origami house event called ‘Slitherami’. To gain house points, students had to create origami snakes in their house colour and this was then used to create a large poster of snakes. It was challenging but lots of attempts were made and eventually we had a large number of paper snakes in the house colours.

46


DR DOLPHIN

SPRING/SUMMER 2019

Bake a Snake Every year, a biology baking competition is held but this year we asked everyone to bake snakes! We had some very impressive entrants and raised a total of £49 for charity. Thank you to everyone who contributed, and a massive well done to our winning entries: Winner of Most Realistic: Anna Vine (Y7) Winner Most Creative: Dorian Gilzene (Y9), Mia Zdrale (Y9) Here are some of the snake bakes:

47


DR DOLPHIN

Book Reviews   ‘Why We Sleep’ by Matthew Walker*    Scientists have discovered a revolutionary new treatment that makes you slimmer, smarter, happier, more attractive, reduces anxiety and increases life span. It also reduces risks of cancer, Alzheimer’s, dementia, heart attacks and strokes. The answer it turns out, according to Dr. Matthew Walker, is a good night's sleep. And Walker should know, as a neuroscientist who has dedicated much of his life researching sleep. In his book, “Why We Sleep​”​, he attempts to address the problem of what he describes as ‘society’s apathy to sleep’. I thought this book was a real eye-opener as it expressed the importance of a good night’s sleep in all aspects of life but especially learning. For example, in an experiment conducted by the two scientists Jenkins and Dallenbach which compared the memory retention of people over an eight hour period where one test group had been sleeping and one had remained awake, they found that the participants who had slept had a memory retention benefit of 20-40%. They even found that sleeping before learning can vastly improve memory retention ability which just proves that sleeping the night before an exam is always better than cramming information. In fact, Dr Walker, a Brit who is now a professor at the University of California, Berkeley, altered his testing methods from having one big final at the end of the year to consistent testing throughout the year to avoid his students cramming and

SPRING/SUMMER 2019

compromising their sleep. GCSEs, take note. For me, the most striking news in “Why We Sleep” is the lasting negative effects that sleeping too little even just once can have. Apparently, there is no such thing as “catching up on sleep on the weekend” because the sleep “spindles”, which would have been formed during sleep, cannot be formed at a later point. These spindles make connections between daily experiences and our previous experiences and then file the memories away into storage. In an experiment in the 1960s, researchers deprived teenage test subjects of REM sleep for just a week. REM sleep is the part during which we dream and make sleep spindles, which occurs during the second half of the night. They found that the test subjects became anxious, moody and started to hallucinate. When the researchers checked back with these teenagers in later years they found that many of them had developed mental health disorders. In contrast to this, the Stanford psychologist Dr Lewis Terman, the same man who created the IQ test, found that children who sleep longer are more intellectually gifted, no matter their age. However, one thing to bear in mind whilst reading “Why We Sleep” is that the book is

48


DR DOLPHIN

SPRING/SUMMER 2019Â

not designed to be read cover to cover. The author encourages us instead to dip in and out of sections of interest, which allows the book to appeal to a much wider audience. While, for example, a specialist might find the descriptions of clinical trials or the mechanisms behind dreams of interest, as a student I found myself much more engrossed by the effects of sleep on the teenage brain or the effects of sleep deprivation. The author also urges us to let the book put us to sleep - surely a first. Aurelia Elliott, Y11

49 Â


DR DOLPHIN

SPRING/SUMMER 2019

The Guardian’s ‘Five books to read before starting medical school’ 1. 2. 3. 4. 5.

The Other Side by Kate Granger The Man Who Mistook His Wife for a Hat by Oliver Sacks* The Checklist Manifesto by Atul Gawande* The Optimism Bias by Tali Sharot The Family That Couldn’t Sleep by D. T. Max

https://www.theguardian.com/education/2014/jul/15/five-books-to-read-before-medical-school

                   

*Available in the library as of March 2019.

50


DR DOLPHIN

Artwork Relating to Medicine and  Biomedicine   Oil painting of a humerus bone  This is a painting of a humerus bone found in the arm. I created this using oil paint since I believed that the ease of blending oil paints would better reflect the relatively smooth texture of the bone than acrylic paints or another medium. I used warm colours, such as red and yellow, in the shadows to produce a more three-dimensional image. I decided to draw a bone as part of my GCSE coursework because I wanted to present my theme of ‘Looking through’ using anatomy. Anatomy is the study of the structure and internal working of something, and so this bone reflects how someone can look through to see this structure that is hidden beneath the surface.

SPRING/SUMMER 2019

Microscopy investigations These photos are of specimen I collected in order to display a range of textures and surfaces; through examining different sections and areas of these objects, I was able to gain a fascinating insight into their microscopic structure and appearance. One of my favourite specimen to investigate was the Daphnia (Water-flea) as whilst the body itself was a light pink, it was also completely translucent, allowing for me to see all the matter within. Another slide I was investigating contained blood. This proved fascinating as it enabled me to see some of the components in substance, such as the plasma and clumps of red blood cells.

Erica Weiler, L6

  51  


DR DOLPHIN

SPRING/SUMMER 2019

reflected the intricacy and brilliance of the cells within the human body. However, upon reflection of these pieces, I realised that I could not only produce cell-like structures but also viruses - I believe that the green and black enhance this effect, since they are often colours that represent death and disease. In order to create the skull and bones, I painted with smooth brush strokes using a ‘bone’ colour produced by combining white with ochre. I emphasised the gradual change in tone from darker grey to pale white in order to create depth so that it was more realistic. I practised some mark-making beforehand by creating a drawing of a skull so that I was aware of the shadows and highlights before going into the final examination.

Nancy McCall, L6    GCSE art final piece: The anatomy of a  rabbit and the impact of humans on  the environment  For my final piece of the GCSE art course, I produced an oil painting of a dead rabbit including part of its bone structure and a human skull. This was much inspired by the work of Kate MacDowell, who has produced surreal sculptures, uniting nature with human forms. My theme is reflected by ‘looking through’ the body of the rabbit and links to my previous studies of the anatomy of a human. I completed this painting on a marbled background which I created using black and green inks. I had already explored the technique of marbling before and was impressed by the way the vivid colours

To paint the fur of the rabbit, I had to use a slightly different technique. Though I blended the dark brown base colour, I painted the lighter tones using a dry brush in order to form the ‘furry’ texture. This was a longer process since it was important to layer the tones without allowing them to merge - otherwise the ‘furry’ effect would not be obtained. The virus of the background combined with the human skull and the bone structure of the rabbit represent the ongoing struggle we are having to combat antibiotic resistance and the spread of disease. As the earth becomes hotter due to global warming, more disease-spreading organisms are able to survive and so the proliferation of diseases such as Malaria is becoming more problematic. However, the piece could alternatively represent the negative impact the human race is having on the

52


DR DOLPHIN

environment. We are polluting and destroying our surroundings and this is having an adverse effect on organisms such as the harmless and vulnerable rabbit in my painting. Overall I am very happy with my final piece since it encapsulates the key concept of anatomy that I have explored throughout my GCSE book and is definitely a successful realisation of my ideas. Perhaps if I were to complete the piece again, I might have painted the rabbit on a separate piece of paper before cutting it out and placing it on the background since not only did I have problems seeing the initial pencil drawing (of the outline of the rabbit) due to the dark

SPRING/SUMMER 2019

background but I was also faced with the challenge of preventing the blending of my paints and the black oil which was still wet from the marbling. This proved especially difficult when painting the skull and the bones of the body since the white paint blended and became much darker however I managed to overcome the issue by painting more layers with larger quantities of paint. I am most pleased with the texture of the rabbit fur since I was worried that I would blend it too much and it would not look realistic enough (especially without a real rabbit that I could observe). Amelia Snook, L6

53


DR DOLPHIN

SPRING/SUMMER 2019

Medical instruments

Nina Wittmann, L6

54


DR DOLPHIN

SPRING/SUMMER 2019

Medical events, short courses and lectures in 2019     Lecture/Event Title

Summary

Related subjects

Date and time

Location

Link

Dying in Today’s World

In this lecture, the concept what makes a ‘good death’ will be discussed. Controversial topics of physician-assisted suicide and euthanasia will also be tackled - a good opportunity to explore an area outside the GCSE, A level or IB syllabus.

Palliative medicine

Tuesday 9th April 2019, 1.00pm 2.00pm

Museum of London, 150 London Wall, Barbican, London, EC2Y 5HN

https://ww w.gresham .ac.uk/lectu res-and-ev ents/dyingtoday

Medical ethics

Thursday 2nd May 2019, 6.00pm 7.00pm

Barnard’s Inn Hall, Holborn, London, EC1N 2HH

https://ww w.gresham .ac.uk/lectu res-and-ev ents/childmedical-tre atment

The Child and Medical Treatment: The Chance to Live, or to Die with Dignity? Staying in Touch with Patients

Professor Roger Kneebone will demonstrate the importance of touch to the performance of medicine. The lecture will look at how touch is not only used to diagnose illness but allows healthcare professionals to express compassion and care.

Medicine

Wednesday 15th May 2019, 6.00pm 7.00pm

Museum of London, 150 London Wall, Barbican, London, EC2Y 5HN

https://ww w.gresham .ac.uk/lectu res-and-ev ents/stayin g-in-touchpatients

Energy and Matter at the Origin of Life

A lecture looking at how biology can now be used to explore the origin of life due

Biology, chemistry, genetics, evolution

Monday 20th May 2019, 6.00pm -

Museum of London, 150 London

https://ww w.gresham .ac.uk/lectu res-and-ev

55


DR DOLPHIN

SPRING/SUMMER 2019Â

to our greater understanding of gene sequences and cell growth under extreme conditions.

7.00pm

Wall, Barbican, London, EC2Y 5HN

ents/energ y-matter-ori gin-of-life

The Changing Impact of Infections as We Go Through Life and Age

The immediate and long-term effects of infections change throughout our life. Infections caught at a young age may be more severe if contracted as an adult. This lecture will highlight the different ways infections can present themselves depending on the age of the sufferer.

Medicine, biomedicine, biology, immunology

Wednesday 22nd May 2019

Museum of London, 150 London Wall, Barbican, London, EC2Y 5HN

https://ww w.gresham .ac.uk/lectu res-and-ev ents/infecti ons-as-weage

Biochemistry: The Molecules of Life

An interesting course tailored to 15 to 19 year olds who are studying biology and chemistry about the subject of biochemistry, future developments in bioenergy, new technologies and more!

Biochemistry

Course started 11th February 2019 (available for a few weeks)

Online course

https://ww w.futurelea rn.com/cou rses/bioche mistry#sect ion-dates

Genomic Medicine: Transforming Patient Care in Diabetes

This free course will teach you how developments in genomics are transforming our knowledge and treatment of conditions such as diabetes. It has been designed for anyone who wants to learn about the genomic era.

Medicine, biochemistry, biology

Course started 25th march 2019 (available for a few weeks).

Online course

https://ww w.futurelea rn.com/cou rses/diabet es-genomi c-medicine

56 Â


DR DOLPHIN

SPRING/SUMMER 2019

Introduction to Critical Care Medicine

Do you want to know more about how complex issues are faced in Critical Care Units? This introduction will help you to understand how to manage multi-organ failure in trauma, how to recognise and manage sepsis early and also how to prioritise the management of a trauma patient who needs resuscitation. This course requires no prior knowledge, experience or qualifications.

Medicine

Course started 25th March 2019 (available for a few weeks).

Online course

https://ww w.futurelea rn.com/cou rses/critical -care#secti on-require ments

It Starts with your Heart: Understanding Heart and Circulatory Diseases

This course will allow you to explore what heart and circulatory diseases and their risk factors are. It will help you to understand the impact they have on a global and local scale and will link nicely into your school studies of biology, at both GCSE level and IB/A level. No prior knowledge of heart or circulatory diseases is needed so why not give it a try?

Medicine, biology

Course started 25th March 2019 (available for a few weeks).

Online course

https://ww w.futurelea rn.com/cou rses/heartand-circula tory-diseas es

*Reservation is required for this event

  57  


DR DOLPHIN

SPRING/SUMMER 2019

Interesting/unusual medical/biomedical degrees Imperial College London

Biomaterials and Tissue Engineering (4 Years) (MEng) ● It is an exciting and dynamic subject to be a part of, particularly with new developments like ‘smart materials’, nanotechnology and biomimetics. ● This course focuses on understanding the relationship between the fundamental structure and properties of matter and allows you to specialise in ​manipulating and developing materials that can stimulate beneficial biological responses from the body​. ● In your third year you will begin to focus on biomaterials, studying cell biology, biocompatibility and biomaterials for hard tissue restoration. https://www.imperial.ac.uk/study/ug/courses/materials-department/biomaterials-a nd-tissue-engineering-meng/

University College London

Cancer Biomedicine (3 Years) (BSc) ● Taught by researchers working at the forefront of basic, translational and clinical cancer research. ● Focus of the degree is on cancer as a disease, its treatment, and the associated research and socio-economic impacts. It is a research-connected curriculum with teaching delivered by leading cancer scientists and clinicians ● You have the opportunity to undertake a unique research project working alongside world-class cancer researchers ● There is a wide choice of optional modules for you to select from, including the human microbiome, stem cell therapies, drug design and delivery, and nanomedicine https://www.ucl.ac.uk/prospective-students/undergraduate/degrees/cancer-biom edicine-bsc/2019 Infection and Immunity (3 Years) (BSc) ● This research-informed BSc programme delivers core biomedical science content as far as possible in an infection and immunity research context. It provides students with real insight into how discovery is carried out at the very highest levels. ● Students can gain in-depth understanding of the role of the immune system and infectious agents in health and disease as well as insight into current research in the pathogenesis, prevention and control of infectious diseases, mechanisms of immunity and immune dysfunction. https://www.ucl.ac.uk/prospective-students/undergraduate/degrees/infection-imm unity-bsc/2019

University of Manchester

Cognitive Neuroscience and Psychology (3/4 Years) (BSc/MSc) ● Combines major topics in experimental psychology and neuroscience to offer a broad grounding in this exciting field of behavioural science.

58


DR DOLPHIN

SPRING/SUMMER 2019

● The psychology component covers topics such as: how humans and animals think (cognitive processes), how the world is sensed (perception), comparative and developmental studies, abnormal psychology. ● The neuroscience component of the course covers topics such as: animal behaviour, learning and memory, the action of drugs on the nervous system, how humans and animals’ sense and respond to their environment. https://www.manchester.ac.uk/study/undergraduate/courses/2019/00550/bsc-co gnitive-neuroscience-and-psychology/course-details/#course-profile Developmental Biology (3/4 Years) (BSc/MSc) ● The course will show you how the single cell formed at fertilisation forms an embryo and then a fully formed adult organism. ● Developmental biology is a multidisciplinary field that integrates genetics, molecular biology, biochemistry, cell biology, anatomy, physiology and computer modelling, giving you a grounding in a range of biological discipline. ● Of particular interest is the use of stem cells to engineer replacement tissues and organs, which could revolutionise medicine. https://www.manchester.ac.uk/study/undergraduate/courses/2019/06625/bsc-de velopmental-biology/course-details/#course-profile Healthcare Studies (Audiology) (3 Years) (BSc) ● Train as a clinical audiologist and hearing aid dispenser. ● Complete 50 weeks of practical and clinical experience in a variety of clinical skills labs, the NHS and independent sector placements throughout the course. https://www.manchester.ac.uk/study/undergraduate/courses/2019/09104/bsc-he althcare-science-audiology/course-details/#course-profile University of Bristol

Gateway to Dentistry/Medicine/Veterinary Science (6 Years) (BDS/MB ChB/BVSc) ● The course is aimed at students who have the potential to become vets/dentist/doctors but do not meet the academic entry criteria to apply directly to the 5-Year course. http://www.bristol.ac.uk/study/undergraduate/2019/dentistry/bds-gateway-to-dent istry/ http://www.bristol.ac.uk/study/undergraduate/2019/medicine/mb-chb-gateway-tomedicine/ http://www.bristol.ac.uk/study/undergraduate/2019/vet-science/bvsc-gateway-toveterinary-science/

University of Exeter

Medical Imaging (Diagnostic Radiography) (3 Years) (BSc) ● Our BSc (Hons) in Medical Imaging (Diagnostic Radiography) aims to ensure that, on graduation, you have the skills required to successfully

59


DR DOLPHIN

SPRING/SUMMER 2019

embark on a career as a Diagnostic Radiographer and to be eligible to apply for registration with the Health and Care Professions Council (HCPC). https://www.exeter.ac.uk/undergraduate/degrees/medical-imaging/imaging/ Sport and Exercise Medical Sciences (3 Years) (BSc) ● The programme blends an understanding of the pathology, prevention and treatment of acute or chronic disease/injury, alongside an insight into the science underpinning the optimal preparation, performance and rehabilitation of the athlete or healing patient. ● The combination of medical sciences and sport and health science enables the student to develop a holistic understanding of the human body and exercise and physical activity. https://www.exeter.ac.uk/undergraduate/degrees/medicalsci/sport-exercise/

At the time of printing all of these courses were available. However, details and availability of the programmes may change over time.

                   

60


DR DOLPHIN

SPRING/SUMMER 2019

UVI University Advice Q&A As now is the time when the LVI begin to decide on their university courses, and those lower down in the school may start think about their future, we have decided to source some advice from the UVI who have already applied for, and received offers from their university choices. Many thanks to Libby, Taz and Sophie for their help!

Libby Bryant Medicine (A100) 

Tazeena Thorowgood  Biomedical  Sciences/Biology   

Sophie Carroll Dentistry   

What most interests you about  the course? Was  there something  special about this  specific course? 

I’ve known for a while that I wanted to have a people facing job (my work experience confirmed that I wanted to be a doctor!), however I have also really enjoyed Biology and Chemistry A-levels. At Cambridge you can continue with a science-based course whilst also still becoming a doctor at the end of it, which seemed ideal for me!

I am quite interested in brain diseases and conditions, Alzheimer’s and Dementia as well as Autism. I also find hormones really interesting, particularly female reproductive hormones (I read a really interesting book on the development of the contraceptive pill which also discussed its implications worldwide – quite linked to our geography course on epidemiology). Epigenetics really interests me too although I don’t know that much about it. I like the idea of the Durham course because I have breadth and depth, I am not sure which areas of biology I like most yet and I can refine my interests better there as well as

It is a niche area of medicine that allows you to carry out procedures as soon as you graduate dental school (As opposed to having to specialise further after medicine). Oral health has a huge effect on general health which many don’t realise, and therefore the social responsibility you have as a primary point of care, is really important. All dental courses are very similar with small differences such as how early clinical exposure is and if that university still carry out dissections.  

At Cambridge, there are 2 years of pure science, where you attend lectures with Natural Sciences students and Vets. I love the idea of the collaboration of thought between people studying different subjects! Also, the supervision system seems really exciting and challenging. The option to do 1 year on a research project or a field of

61


DR DOLPHIN

SPRING/SUMMER 2019

academia that is purely for self-interest during Year 3 is also really cool!

not closing off too many options. Durham also has good year abroad options, something I would like to do! Edinburgh has a 4-year course and so I can study modules from different subjects closely related e.g. Psychology in the first year as well as keeping breadth within my subject.

Is there anything about the course  that you find less  appealing? 

Everyone has warned me about how much hard work the course will be, also it’s 6 years which at the moment seems like a very long time! However, I think the positives outweigh the negatives so long as you’re aware that it’s going to be hard!

How is this course mainly taught? 

Mixture of lectures and supervisions (small group teaching sessions with an expert in the field) for the first 3 years. The second 3 years are predominantly in clinical environments.

I’m not sure how I will cope with huge labs and loads and loads of practical work, I find the theory more interesting on the whole.

It varies between the universities that I have applied for. At all there are lectures and labs, and at Durham tutorials. This means that there I like the idea of quite a lot are quite a lot of of contact time, also I contact hours, but I like knew I wanted something that because it gives that was quite science you some structure focused in the first few within the week which years, whereas other will hopefully keep me people may want to be more motivated and seeing patients from day 1. organized. I like Durham because it has the tutorials as well and I like learning one on

It is a course with a high workload and a lot is expected of you as a dental student.

Lectures and practical elements in which you carry out clinical procedures either on phantom heads or real patients. Some dental courses are taught as Problem Based Learning in which there are fewer lectures and much more self-directed research. This did not appeal to me as much as there is less clarity in what you are learning.

62


DR DOLPHIN

SPRING/SUMMER 2019

one more than in large groups.

Did you attend any subject  masterclasses or  taster sessions  related to your  course? Were there  any  super-curriculars  you used to  prepare you for  your application? 

I’d done various work experience, also Imperial run Medicine summer schools which I attended a few years ago and really enjoyed. I think masterclasses and tasters can be good to an extent, as they allow you to get more of an idea of what studying at university is going to be like. However, I wouldn’t say they’re necessary, going around on an open day in the summer of LVI is enough! 

I didn’t go to any masterclasses but I did go to a few lectures at the royal institute and watched some on YouTube. I also did some work experience in a hospital, which steered me towards biomed, not medicine.

I attended a summer program with debate chamber. This was really enjoyable and helped to understand the basics of dentistry however, was not useful for personal statement or interviews. The most useful thing is to visit lectures on oral health.  

What is the best piece of advice you  have heard on  choosing a course  at university? 

Do what you enjoy and go with your gut! Listen to the advice of others, but don’t be swayed too easily by what everyone else is thinking, as at the end of the day you’re the one who is actually going to be doing the degree!

Try to do what you like, not necessarily what you are best at.

Do your research. Write down a list of things you want in a job and work backwards from there as to what course you may need to get there.

63


DR DOLPHIN

SPRING/SUMMER 2019

Medical Quiz

1. 2. 3. 4. 5. 6.

What is phagocytosis? The pulmonary artery takes blood to where? A diet rich in what is likely to combat anaemia? What is a diploid cell? What was the name of the first animal to be cloned? By looking at the graph below, answer the following: a. What is the function of progesterone in the menstrual cycle? b. What does the luteinizing hormone do? c. What is the follicle stimulating hormone released by?

7. 8. 9.

What is the function of the vas deferens? What is its other name? What part of the body is referred to as the cranium? How many pints of air do we breathe roughly every minute? 10. How fast does the average person fall asleep?

Send your answers to ​asnook@godolphinandlatymer.com for the chance to win an edible prize!!

64


DR DOLPHIN

SPRING/SUMMER 2019

                       

65

Profile for godolphinandlatymer

Dr Dolphin Summer 2019  

Biomedical Magazine In this edition, we have a wide variety of articles from CRISPR to the discovery of  leukemia and even the use of cryoni...

Dr Dolphin Summer 2019  

Biomedical Magazine In this edition, we have a wide variety of articles from CRISPR to the discovery of  leukemia and even the use of cryoni...

Advertisement