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Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Understanding diverticular disease 27/11/24, 11:31 The prevalence of diverticulosis is increasing in developed countries Diverticulosis, diverticula, diverticulum, and diverticulitis - they may sound similar, but each term describes a specific aspect of diverticular disease. Before diving into diverticular disease, let’s clarify these key terms: Diverticulum: a small, bulging pouch that forms in a weak spot in the lining of the large intestine. Diverticula: the plural form of a diverticulum, indicating multiple bulging pouches in the large intestine's lining. Diverticulosis: a condition where multiple diverticula are present in the large intestine. Diverticulitis: this occurs when one or more diverticula become inflamed or infected. What is diverticular disease? Diverticular disease can be broadly categorised into two main conditions: diverticulosis and diverticulitis. Both involve the presence of diverticula in the colon, but the key difference lies in inflammation. In diverticulitis, the diverticula become inflamed or infected, leading to symptoms. On the other hand, diverticulosis is typically asymptomatic. However, there is a third condition, referred to as symptomatic uncomplicated diverticular disease (SUDD), where diverticula are present without inflammation, but the patient still experiences symptoms. The prevalence of diverticulosis is increasing in developed countries, largely due to the typical 'Western diet', which is high in red meat and low in fibre. Additionally, lifestyle factors such as obesity, smoking, and physical inactivity contribute to this rise. Age is also a significant factor, with 85% of diverticulosis cases occurring in individuals over the age of 50. Pathophysiology The formation of diverticula in the colon is primarily due to three factors: structural abnormalities in the colonic wall, disordered intestinal motility, and a deficiency of dietary fibre. The large intestine has two layers of muscle that work together to move its contents: an inner circular layer and an outer longitudinal layer. The outer layer consists of three bands called the taeniae coli, which run longitudinally along the colon. The gaps between these muscle bands are areas of weakness, making them vulnerable to the development of diverticula. Age-related weakening of the connective tissue further increases the risk of developing diverticula in these vulnerable areas. In some patients, abnormal gut motility can lead to areas of high pressure in the bowel, causing the mucosa to bulge outward, forming diverticula. Similarly, a lack of fibre in the diet can increase bowel pressure and lead to irregular movement, which also promotes outpouching. As we've discussed, some patients with diverticula may remain asymptomatic, while others experience varying levels of discomfort. The transition from diverticulosis to diverticulitis occurs when undigested food or a fecalith becomes trapped in these pouches, causing a blockage. This leads to bacterial growth and multiplication, resulting in infection and inflammation of the pouch. Symptoms Diverticular disease comes with a range of symptoms, some of which are quite common and could be easily mistaken for other conditions. General symptoms like nausea, vomiting, diarrhoea, and fever often overlap with other digestive problems, making diagnosis tricky. However, certain symptoms can hint more strongly at diverticular disease. For instance, experiencing pain in the lower left side of the abdomen (known as the left iliac fossa) or noticing rectal bleeding are more specific indicators that may point towards this condition. Recognising these symptoms can help in getting a more accurate diagnosis and appropriate treatment. Management Managing diverticular disease depends on the individual patient and the severity of their symptoms. For some, simple, conservative treatments are enough—this might include staying hydrated, eating a high-fibre diet, and giving the bowel a short rest by temporarily avoiding food. However, if a patient is experiencing significant pain or signs of infection, medical treatment is necessary. This may involve pain relief based on the WHO pain ladder or antibiotics to tackle the infection. In more serious cases, where other treatments haven’t worked or the patient is in a life-threatening situation, surgery might be required. A common procedure for these severe cases is the Hartmann’s procedure. This surgery removes the damaged section of the large intestine, usually due to infection or blockage. The healthy end of the intestine is brought out through an opening in the abdomen, creating a temporary colostomy that allows waste to leave the body through a bag. This setup gives the intestine time to heal, and in some cases, a follow-up surgery can reconnect it for normal function. Complications There are both short-term and long-term complications associated with diverticulitis, particularly in more severe cases that require more aggressive treatment such as surgery (see Figure 4 ). Future directions Recent changes in the management of diverticulitis have shifted how clinicians approach treatment. One significant update involves the use of antibiotics. Traditionally, diverticulitis was treated with routine antibiotic prescriptions. However, newer guidelines suggest that antibiotics may not be necessary for uncomplicated cases, helping to reduce both antibiotic resistance and the potential medication side effects for patients. Another emerging trend is treating uncomplicated diverticulitis on an outpatient basis. This allows patients to be managed at home with pain relief and dietary adjustments, which in turn frees up hospital resources for those with more severe conditions. Additionally, the management of complicated diverticulitis has evolved. For instance, abscesses may now be treated with percutaneous drainage rather than resorting to emergency surgery. Conclusion In summary, diverticular disease can vary widely in its symptoms and required treatments, ranging from dietary changes to surgical interventions for severe cases. Identifying specific signs and understanding the treatment options can empower patients and help them make informed choices. Advances in treatment approaches are also helping to improve outcomes and quality of life for those affected. Written by Abbasali Gulamhussein REFERENCES Cater, M. (2023). Foods for Diverticulosis and Diverticulitis . [online] www.hopkinsmedicine.org . Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/foods-for-diverticulosis-and-diverticulitis . Matrana, M.R. and Margolin, D.A. (2009a) Epidemiology and pathophysiology of diverticular disease , Clinics in colon and rectal surgery . Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC2780269/ (Accessed: 12 October 2024). Miller, A.S. et al. (2021) The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery , Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland . Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9291558/ (Accessed: 12 October 2024). NHS (2019). Diverticular disease and diverticulitis . [online] NHS. Available at: https://www.nhs.uk/conditions/diverticular-disease-and-diverticulitis/ . Sciencedirect.com . (2019). Hartmann Procedure - an overview | ScienceDirect Topics . [online] Available at: https://www.sciencedirect.com/topics/medicine-and-dentistry/hartmann-procedure . Singh, B., May, K., Coltart, I., Moore, N. and Cunningham, C. (2008). The Long-Term Results of Percutaneous Drainage of Diverticular Abscess. The Annals of The Royal College of Surgeons of England , [online] 90(4), pp.297–301. doi: https://doi.org/10.1308/003588408x285928 . Ubhi, L. (2023). Prescribing Analgesia and the WHO Analgesic Ladder | Geeky Medics . [online] geekymedics.com . Available at: https://geekymedics.com/prescribing-analgesia-and-the-who-analgesic-ladder/ . Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Investigating the interplay of hormones and the microbiome 08/11/24, 12:00 Known as microbial endocrinology, it is a complex field The microbiome The human body hosts a vast ecosystem of bacteria, with trillions crawling on our skin, colonising our gut, and living throughout our bodies. Most of these microbes serve to protect us against infections influencing our metabolism and even our behaviour. However, scientists have started to question the mechanisms by which these bacteria affect our bodily functions and characteristics. Scientists have studied these communities of microorganisms residing within our bodies and the genes they contain, yielding new and exciting perspectives… …Welcome to the human microbiome. The microbiome is the dynamic community of microorganisms (like fungi, bacteria and viruses) that exist in a particular environment. In humans, the term is most often used to describe the collection of microorganisms that inhabit a particular body area, such as the gastrointestinal tract, mouth or skin. While a person’s core microbiome is established within the first few years of life, its composition can shift over time in response to factors like medication, such as potent antibiotics and environmental factors. Researchers have uncovered that the gastrointestinal microbiota can influence some physiological processes, including a direct line of communication between the gut and the brain. But what facilitates this dialogue? What mechanisms enable the gut to relay signals to the brain? The answer is hormones. Hormones and the endocrine system The endocrine system is a network of glands that produce and release chemical messengers known as hormones. They travel via the bloodstream and bind to specific receptors on their target tissues. This binding of hormones to their receptors triggers a response in the target tissue. For instance, during stressful situations, epinephrine (also known as adrenaline) is produced by the adrenal medulla, the inner region of the adrenal glands. This hormone, released into the bloodstream, acts on target tissues such as the heart, where it increases heart rate. Hormones regulate most of the body’s vital functions through their release. Some of these crucial processes include growth, metabolism, and reproduction. In the following sections, however, we specifically focus on how hormones influence the microbiome. The interactions between hormones and the microbiome Exploring the relationship between hormones and the microbiome is known as microbial endocrinology; it is a complex field because there are numerous interactions to account for, and the effects of each one can have lasting impacts on human physiology. For example, epinephrine and norepinephrine can lead to more bacteria, notably E. coli and Pseudomonas aeruginosa , signifying that imbalance could harm humans. Also, parts of the host, ranging from mood to gender, impact hormones, bacterial presence and activity ( Figure 3 ). An emerging area of microbial endocrinology is how the microbiome and sex hormones engage with each other in disease and female health. One paper noted that disorders from metabolic syndrome (MetS) to type 2 diabetes (T2D) have distinctions in the levels of sex hormones and gut microbiota, indicating that they are essential to understanding in developing those conditions. The influence of gut microbiota on sex hormones can occur through various mechanisms, such as bacteria controlling the activity and expression of endocrine receptors and even bacteria metabolising sex hormones; this knowledge can help create treatments against polycystic ovarian syndrome and ovarian cancer, among other diseases that usually impact females due to gut microbiome imbalances ( Figure 4 ). Another part of microbial endocrinology being researched is how the microbiome impacts human growth. In one study involving adult male mice, decreased growth hormone (GH) led to undeveloped microbiomes, while surplus GH was linked to an expanded microbiome; this depicts that bacteria influences development via the growth hormone-insulin-like growth factor 1 (GH-IGF-1) axis; maintaining a steady dynamic between the microbiome and this axis is vital for development ( Figure 5 ), particularly in children. In puberty, hormones and the gut microbiome interact, as observed in obesity and precocious puberty. Hence, a deeper awareness of the bacteria and sex hormones during puberty is crucial to designing targeted medicines for growth disorders. Moreover, patients with GH-secreting pituitary adenoma (GHPA) have modified gut microbiota, like increased Alistipes shahii and Odoribacter splanchnicus . Still, more research is needed to investigate this. Conclusion The microbiome refers to the millions of microorganisms on and within the human body that influence various physiological functions ranging from digesting food to outcompeting pathogens for resources. Also, the microbiome can affect the endocrine system, which consists of hormones that control glucose and reproduction, among other processes. This bridge, known as microbial endocrinology, has critical applications for understanding women’s health and growth disorders; this emerging area is growing, so it can address knowledge gaps in diseases like cancer and even improve other medical treatments. Written by Sam Jarada and Fozia Hassan The interactions between hormones and the microbiome, and Conclusion sections by Sam The microbiome, and Hormones and the endocrine system sections by Fozia Related articles: The gut microbiome / Dopamine and the gut / The power of probiotics REFERENCES “The Human Microbiome and Its Impacts on Health - PWOnlyIAS.” PWOnlyIAS , 18 Jan. 2024, pwonlyias.com/current-affairs/gut-microbiome-and-health/ . Accessed 17 Oct. 2024. Mittal, Rahul, et al. “Neurotransmitters: The Critical Modulators Regulating Gut-Brain Axis.” Journal of Cellular Physiology , vol. 232, no. 9, 10 Apr. 2017, pp. 2359–2372, www.ncbi.nlm.nih.gov/pmc/articles/PMC5772764/ , https://doi.org/10.1002/jcp.25518 . Accessed 17 Oct. 2024. Neuman, Hadar, et al. “Microbial Endocrinology: The Interplay between the Microbiota and the Endocrine System.” FEMS Microbiology Reviews , vol. 39, no. 4, 1 July 2015, pp. 509–521, academic.oup.com/femsre/article/39/4/509/2467625 , https://doi.org/10.1093/femsre/fuu010 . Hiller-Sturmhöfel S, Bartke A. The Endocrine System: An Overview. Alcohol Health and Research World. 2024;22(3):153. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6761896/ Neuman H, Debelius JW, Knight R, Koren O. Microbial endocrinology: the interplay between the microbiota and the endocrine system. FEMS Microbiology Reviews [Internet]. 2015 Feb 19 [cited 2024 Sep 18];39(4):509–21. Available from: https://academic.oup.com/femsre/article/39/4/509/2467625?login=false Jose Antonio Santos-Marcos, Mora-Ortiz M, Tena-Sempere M, José López-Miranda, Camargo A. Interaction between gut microbiota and sex hormones and their relation to sexual dimorphism in metabolic diseases. Biology of Sex Differences. 2023 Feb 7;14(1). He S, Li H, Yu Z, Zhang F, Liang S, Liu H, et al. The Gut Microbiome and Sex Hormone-Related Diseases. Frontiers in Microbiology. 2021 Sep 28;12. Siddiqui R, Makhlouf Z, Alharbi AM, Alfahemi H, Khan NA. The Gut Microbiome and Female Health. Biology [Internet]. 2022 Nov 1;11(11):1683. Available from: https://www.mdpi.com/2079-7737/11/11/1683 Jensen E, Young JA, Jackson Z, Busken J, List EO, Ronan O’Carroll, et al. Growth Hormone Deficiency and Excess Alter the Gut Microbiome in Adult Male Mice. Endocrinology [Internet]. 2020 Feb 26 [cited 2023 Nov 9];161(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341558/ Jensen EA, Young JA, Mathes SC, List EO, Carroll RK, Kuhn J, et al. Crosstalk between the growth hormone/insulin-like growth factor-1 axis and the gut microbiome: A new frontier for microbial endocrinology. Growth Hormone & IGF Research. 2020 Aug;53-54:101333. Huang C, Meng D, Li Y, Lu S, Yang W, Wu B, et al. Gut microbiota composition alteration analysis and functional categorization in children with growth hormone deficiency. Frontiers in Pediatrics. 2023 Feb 24;11. Calcaterra V, Rossi V, Massini G, Regalbuto C, Hruby C, Panelli S, et al. Precocious puberty and microbiota: The role of the sex hormone–gut microbiome axis. Frontiers in Endocrinology. 2022 Oct 21;13. Lin B, Wang M, Gao R, Ye Z, Yu Y, He W, et al. Characteristics of Gut Microbiota in Patients with GH-Secreting Pituitary Adenoma. Microbiology Spectrum [Internet]. 2022 Feb 23 [cited 2023 Aug 7];10(1):e0042521. Available from: https://pubmed.ncbi.nlm.nih.gov/35019688/ Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link From genes to joints: how Ehler-Danos Syndrome is shaped by genetics 08/11/24, 11:40 Mutations in collagen and related proteins are the primary cause of EDS Ehlers-Danlos Syndrome (EDS) is a group of 13 inherited disorders that affect connective tissues, particularly collagen. Collagen is a crucial protein in the body that provides structure and strength to skin, joints, and blood vessels. Mutations in collagen or collagen-modifying proteins are the primary cause of the types of EDS. EDS manifests through a range of symptoms that vary significantly depending on the specific type of EDS. However, there are common symptoms that many individuals with EDS experience, particularly related to joint and skin issues. For instance, joints can move beyond the normal range, leading to frequent dislocations and subluxations, also called joint hypermobility. Additionally, the skin can be stretched more than usual, which creates a soft and velvety appearance known as skin hyperextensibility. As mentioned in Figure 1 , skin bruising, scarring and tearing are common symptoms, leading to individuals often experiencing chronic pain. Life expectancy for individuals with EDS varies depending on the type of disorder an individual has. This is due to how specific forms can have structural changes in organs and tissues, which can lead to serious life-threatening complications. For example, vascular EDS (vEDS) is associated with a significantly reduced life expectancy due to the risk of spontaneous rupture of major blood vessels, intestines, and other hollow organs. Most other forms of EDS, such as classical EDS (cEDS), hypermobile EDS (hEDS), and kyphoscoliotic EDS (kEDS), generally do not significantly affect life expectancy. However, the health complications that patients have can substantially impact their quality of life. Genetic basis As stated, the various types of EDS encompass many genetic defects, for example, cEDS is linked to mutations in the COL5A1 or COL5A2 genes, which encode the α1 and α2 chains of type V collagen. Following an autosomal dominant inheritance pattern, 50% of cEDS diagnoses inherit the condition from an affected parent, while the other half from a new (de novo) pathogenic variant. Diagnosing EDS encompasses a variety of methods. Firstly, differential diagnosis may be used to distinguish between subtypes like cEDS and hEDS by evaluating clinical features such as the presence of joint hypermobility, skin characteristics, and scarring patterns. Clinicians use these specific symptoms along with family history to differentiate between the subtypes since some, like hEDS, lack identified genetic markers, making this clinical assessment essential for accurate diagnosis and management. This process helps exclude other conditions and accurately identify the EDS subtype. Also, suggestive clinical features identifying pathogenic or likely pathogenic variants in the COL5A1 or COL5A2 genes can be done through molecular genetic testing. This testing can be approached in two ways: targeted multigene panels, which focus on specific genes like COL5A1 and COL5A2 . Alternatively, comprehensive genomic testing, such as exome or genome sequencing, does not require preselecting specific genes and is useful when the clinical presentation overlaps with other inherited disorders. Mutations in COL5A1 and COL5A2 can include missense, nonsense, splice site variants, or small insertions and deletions, all of which impair the function of type V collagen. Missense mutations result in the substitution of one amino acid for another, disrupting the collagen triple helix structure and affecting its stability and function. On the other hand, nonsense mutations lead to a premature stop codon, producing a truncated and usually non-functional protein. Splice site mutations interfere with the normal splicing of pre-mRNA, resulting in aberrant proteins. These mutations in COL5A1 and COL5A2 lead to the characteristic features of cEDS, such as highly elastic skin and joint hypermobility. Furthermore, different types of EDS are caused by specific genetic mutations, each affecting collagen in distinct ways and necessitating varied treatment approaches. VEDS is caused by mutations in the COL3A1 gene, which affects type III collagen and leads to fragile blood vessels and a higher risk of organ rupture. kEDS results from mutations in the PLOD1 or FKBP14 genes, impacting collagen cross-linking, and presents with severe scoliosis and muscle hypotonia. Arthrochalasia EDS (aEDS), due to mutations in the COL1A1 or COL1A2 genes that affect type I collagen, features severe joint hypermobility and congenital hip dislocation. Dermatosparaxis EDS (dEDS) is caused by mutations in the ADAMTS2 gene, which is crucial for processing type I collagen, leading to extremely fragile skin and severe bruising. Each type of EDS highlights the critical role of specific genetic mutations in the structural integrity and function of collagen, which consequently influences treatment approaches. Treatment Treatments for EDS primarily focus on managing symptoms and preventing complications due to the underlying genetic defects affecting collagen. Pain relief through nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and sometimes opioids is common, addressing chronic pain related to joint and muscle issues. Moreover, physical therapy may help strengthen muscles around hypermobile joints, reducing the risk of dislocations and improving stability. Orthopaedic interventions, such as braces and orthotics, are also used to support joint function, and surgery may be considered in severe cases. Cardiovascular care is crucial, especially for vEDS, involving regular monitoring with imaging techniques to detect arterial problems early. Preventive vascular surgery might be necessary to repair aneurysms or other vascular defects. Wound care includes using specialised dressings to handle fragile skin and prevent extensive scarring, relevant to mutations in genes like COL5A1 and COL5A2 in classical EDS. Understanding the specific genetic mutations helps tailor these treatments to address the particular collagen-related defects and associated complications in different EDS types. Moreover, clinical trials for treating EDS have shown both positive and negative results. For example, trials investigating the efficacy of physical therapy in strengthening muscles around hypermobile joints have shown positive outcomes in reducing joint instability and improving function. On the other hand, trials aiming to directly modify the underlying genetic defects in collagen production have faced significant challenges. Gene therapy approaches and other experimental treatments targeting specific mutations, such as those in COL5A1 or COL3A1 genes, have shown limited success and faced hurdles in achieving sufficient therapeutic benefit without adverse effects. This is evident as in mouse models the deletion of COL3A1 resulted in aortic and gastrointestinal rupture meaning that simply restoring one functional copy may not be sufficient to prevent the disease. Moreover, the unknown and partial success in identifying mutations responsible for all EDS cases has further bolstered the struggle for researchers to establish comprehensive treatment strategies. In vEDS, as it is a dominantly inherited disorder, adding a healthy copy of the gene (a common strategy in gene therapy) is ineffective because the defective gene still produces harmful proteins. Research has highlighted, however, that the combination of RNAi-mediated mutant allele-specific gene silencing and transcriptional activation of a normal allele could help as a promising strategy for vascular Ehlers-Danlos Syndrome. In the experiment, researchers used small interfering RNA (siRNA) to selectively reduce the mutant COL3A1 mRNA levels by up to 80%, while simultaneously using lysyl oxidase (LOX) to boost the expression of the normal COL3A1 gene. This dual approach successfully increased the levels of functional COL3A1 mRNA in patient cells, suggesting a potential therapeutic strategy for this condition. Conclusion In conclusion, EDS represents a diverse group of inherited connective tissue disorders, primarily caused by mutations in collagen or collagen-modifying proteins. These genetic defects result in a wide range of symptoms, including joint hypermobility, skin hyperextensibility, and vascular complications, which vary significantly across the 13 different types of EDS. Diagnosing and treating EDS is complex and largely dependent on the specific genetic mutations involved. While current treatments mainly focus on managing symptoms and preventing complications, advances in genetic research, such as RNAi-mediated gene silencing and transcriptional activation, show promise for more targeted therapies, especially for severe forms like vascular EDS. However, challenges remain in developing comprehensive and effective treatments, underscoring the need for ongoing research and personalised medical approaches to improve the quality of life for individuals with EDS. Written by Imron Shah Related article: Hypermobility spectrum disorders REFERENCES Malfait, F., Wenstrup, R.J. and De Paepe, A. (2010). Clinical and genetic aspects of Ehlers-Danlos syndrome, classic type. Genetics in Medicine, 12(10), pp.597–605. doi: https://doi.org/10.1097/gim.0b013e3181eed412 . Miklovic, T. and Sieg, V.C. (2023). Ehlers Danlos Syndrome. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK549814/ . Sobey, G. (2014). Ehlers–Danlos syndrome – a commonly misunderstood group of conditions. Clinical Medicine, [online] 14(4), pp.432–436. doi: https://doi.org/10.7861/clinmedicine.14-4-432 . Watanabe, A., Wada, T., Tei, K., Hata, R., Fukushima, Y. and Shimada, T. (2005). 618. A Novel Gene Therapy Strategy for Vascular Ehlers-Danlos Syndrome by the Combination with RNAi Mediated Inhibition of a Mutant Allele and Transcriptional Activation of a Normal Allele. Molecular Therapy, [online] 11, p.S240. doi: https://doi.org/10.1016/j.ymthe.2005.07.158 . FURTHER READING The Ehlers-Danlos Society - A global organisation dedicated to supporting individuals with EDS and raising awareness about the condition by providing extensive information on the different types of EDS, updates on research, and resources for patients https://www.ehlers-danlos.com/ PubMed - For those interested in academic research, articles and studies on EDS. https://www.ncbi.nlm.nih.gov/pmc/?term=ehlers-danlos+syndrome Cleveland Clinic – A clinic with an extensive health library providing easy to understand and informative information about the syndrome. https://my.clevelandclinic.org/health/diseases/17813-ehlers-danlos-syndrome Project Gallery

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Search Index All (250) Other Pages (231) Forum Posts (19) 250 items found Other Pages (231) The dopamine connection | Scientia News Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The dopamine connection How your gut influences your mood and behaviour Introduction to dopamine Dopamine is a neurotransmitter derived from an amino acid called phenylalanine, which must be obtained through the diet, through foods such as fish, meat, dairy and more. Dopamine is produced and released by dopaminergic neurons in the central nervous system and can be found in different brain regions. The neurotransmitter acts via two mechanisms: wiring transmission and volume transmission. In wiring transmission, dopamine is released to the synaptic cleft and acts on postsynaptic dopamine receptors. In volume transmission, extracellular dopamine arrives at neurons other than postsynaptic ones. Through methods such as diffusion, dopamine then reaches receptors in other neurons that are not in direct contact with the cell that has released the neurotransmitter. In both mechanisms, dopamine binds to the receptors, transmitting signals between neurons and affecting mood and behaviour. The link between dopamine and gut health Dopamine has been known to result in positive emotions, including pleasure, satisfaction and motivation, which can be influenced by gut health. Therefore, what you eat and other factors, including motivation, could impact your mood and behaviour. This was proven by a study (Hamamah et al., 2022), which looked at the bidirectional gut-brain connection. The study found that gut microbiota was important in maintaining the concentrations of dopamine via the gut-brain connection, also known as the gut microbiota-brain axis or vagal gut-to-brain axis. This is the communication pathway between the gut microbiota and the brain facilitated by the vagus nerve, and it is important in the neuronal reward pathway, which regulates motivational and emotional states. Activating the vagal gut-to-brain axis, which leads to dopamine release, suggests that modulating dopamine levels could be a potential treatment approach for dopamine-related disorders. Some examples of gut microbiota include Prevotella, Bacteroides, Lactobacillus, Bifidobacterium, Clostridium, Enterococcus, and Ruminococcus , and they can affect dopamine by modulating dopaminergic activity. These gut microbiota are able to produce neurotransmitters, including dopamine, and their functions and bioavailability in the central nervous system and periphery are influenced by the gut-brain axis. Gut dysbiosis is the disturbance of the healthy intestinal flora, and it can lead to dopamine-related disorders, including Parkinson's disease, ADHD, depression, anxiety, and autism. Gut microbes that produce butyrate, a short-chain fatty acid, positively impact dopamine and contribute to reducing symptoms and effects seen in neurodegenerative disorders. Dopamine as a treatment It is important to understand the link between dopamine and gut health, as this could provide information about new therapeutic targets and improve current methods that have been used to prevent and restore deficiencies in dopamine function in different disorders. Most cells in the immune system contain dopamine receptors, allowing processes such as antigen presentation, T-cell activation, and inflammation to be regulated. Further research into this could open up a new possibility for dopamine to be used as a medication to treat diseases by changing the activity of dopamine receptors. Therefore, dopamine is important in various physiological processes, both in the central nervous and immune systems. For example, studies have shown that schizophrenia can be treated with antipsychotic medications which target dopamine neurotransmission. In addition, schizophrenia has also been treated by targeting the dysregulation (decreasing the amount) of dopamine transmission. Studies have shown promising results regarding dopamine being used as a form of treatment. Nevertheless, further research is needed to understand the interactions between dopamine, motivation and gut health and explore how this knowledge can be used to create medications to treat conditions. Conclusion The bidirectional gut-brain connection shows the importance of gut microbiota in controlling dopamine levels. This connection influences mood and behaviour but also has the potential to lead to new and innovative dopamine-targeted treatments being developed (for conditions including dopamine-related disorders). For example, scientists could target and manipulate dopamine receptors in the immune system to regulate the above mentioned processes: antigen presentation, T-cell activation, and inflammation. While current research has shown some promising results, further investigations are needed to better comprehend the connection between gut health and dopamine levels. Nevertheless, through consistent studies, scientists can gain a deeper understanding of this mechanism to see how changes in gut microbiota could affect dopamine regulation and influence mood and behaviour. Written by Naoshin Haque Related articles: the gut microbiome / Crohn's disease Project Gallery How does moving houses impact your health and well-being? | Scientia News Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link How does moving houses impact your health and well-being? Evaluating the advantages and disadvantages of gentrification in the context of health Introduction According to the World Health Organization (WHO), health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Another way to define health is an individual being in a condition of equilibrium within themselves and the surrounding environment, which includes their social interactions and other factors. Reflecting on historical views of health, ancient Indian and Chinese medicine and society in Ancient Greece thought of health as harmony between a person and their environment, which underlines the cohesion between the soul and body; this is similar to the WHO’s definition of health. Considering these ideas, one key determinant of health is gentrification (see Figure 1 ). It was first defined in 1964 by British sociologist Ruth Glass, who witnessed the dilapidated houses in the London Borough of Islington being taken over and renovated by middle-class proprietors. The broader consequences of gentrification include enhanced living conditions for the residents, differences in ownership prerequisites, increased prices of land and houses, and transformations in the social class structure. Also, these changes cause lower-income inhabitants to be pushed out or go to poorer neighbourhoods, and the conditions in these neighbourhoods, which can include racial separation, lead to inequities and discrepancies in health. For example, a systematic review discovered that elderly and Black residents were affected more by gentrification compared to younger and White citizens; this highlights the importance of support and interventions for specific populations during urban renewal. Given the knowledge provided above, this article will delve further into the advantages and disadvantages of gentrification in the context of health outcomes. Advantages of gentrification Gentrification does have its benefits. Firstly, it is positively linked with collective efficacy, which is about enhancing social cohesion within neighbourhoods and maintaining etiquette; this has health benefits for residents, like decreased rates of obesity, sexually transmitted diseases, and all-cause mortality. Another advantage of gentrification is the possibility of economic growth because as more affluent tenants move into specific neighbourhoods, they can bring companies, assets, and an increased demand for local goods and services, creating more jobs in the area for residents. Additionally, gentrification can be attributed to decreased crime rates in newly developed areas because the inflow of wealthier citizens often conveys a more substantial sense of community and investment in regional security standards. Therefore, this revitalised feeling of safety can make these neighbourhoods more appealing to existing and new inhabitants, which leads to further economic development. Moreover, reducing crime can improve health outcomes by reducing stress and anxiety levels among residents, for example. As a result, the community's general well-being can develop, leading to healthier lifestyle choices and more lively neighbourhoods. Furthermore, the longer a person lives in a gentrifying neighbourhood, the better their self-reported health, which does not differ by race or ethnicity, as observed in Los Angeles. Disadvantages of gentrification However, it is also essential to mention the drawbacks of gentrification, which are more numerous. In a qualitative study involving elderly participants, for example, one of them stated that, “The cost of living increases, but the money that people get by the end of the month is the same, this concerning those … even retired people, and people receiving the minimum wage, the minimum wage increases x every year, isn’t it? But it is not enough”. Elderly residents in Barcelona faced comparable challenges of residential displacement between 2011 and 2017 due to younger adults with higher incomes and those pursuing university education moving into the city. These cases spotlight how gentrification can raise the cost of living without an associated boost in earnings, making it problematic for people with lower incomes or vulnerable individuals to live in these areas. Likewise, a census from gentrified neighbourhoods in Pittsburgh showed that participants more typically conveyed negative health changes and reduced resources. Additionally, one study examined qualitative data from 14 cities in Europe and North America and commonly noticed that gentrification negatively affects the health of historically marginalised communities. These include threats to housing and monetary protection, socio-cultural expulsion, loss of services and conveniences, and raised chances of criminal behaviour and compromised public security. This can be equally observed during green gentrification, where longtime historically marginalised inhabitants feel excluded from green or natural spaces, and are less likely to use them compared to newer residents. To mitigate these negative impacts of gentrification, inclusive urban renewal guidelines should be drafted that consider vulnerable populations to boost health benefits through physical and social improvements. The first step would be to provide residents with enough information and establish trust between them and the local authorities because any inequality in providing social options dramatically affects people’s health-related behaviours. Intriguingly, gentrification has been shown to increase the opportunity for exposure to tick-borne pathogens by populations staying in place, displacement within urban areas, and suburban removal. This increases tick-borne disease risk, which poses a health hazard to impacted residents ( Figure 2 ). As for mental health, research has indicated that residing in gentrified areas is linked to greater levels of anxiety and depression in older adults and children. Additionally, one study found young people encountered spatial disconnection and affective exclusion due to gentrification and felt disoriented by the quickness of transition. Therefore, all of these problems associated with gentrification reveal that it can harm public health and well-being, aggravating disparities and creating feelings of isolation and aloneness in impacted communities. Conclusion Gentrification is a complicated and controversial approach that has noteworthy consequences for the health of neighbourhoods. Its advantages include enhanced infrastructure and boosted economic prospects, potentially leading to fairer access to healthcare services and improved health outcomes for residents. However, gentrification often leads to removal and the loss of affordable housing, which can harm the health of vulnerable populations. Therefore, it is vital for policymakers and stakeholders to carefully evaluate the likely health effects of gentrification and enforce alleviation strategies to safeguard the well-being of all citizens (see Table 1 ). Written by Sam Jarada Related article: A perspective on well-being REFERENCES WHO. Health and Well-Being. Who.int . 2015. Available from: https://www.who.int/data/gho/data/major-themes/health-and-well-being Sartorius N. The meanings of health and its promotion. Croatian Medical Journal. 2006;47(4):662–4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/ Krahn GL, Robinson A, Murray AJ, Havercamp SM, Havercamp S, Andridge R, et al. It’s time to Reconsider How We Define Health: Perspective from disability and chronic condition. Disability and Health Journal. 2021 Jun;14(4):101129. Available from: https://www.sciencedirect.com/science/article/pii/S1936657421000753 Svalastog AL, Donev D, Jahren Kristoffersen N, Gajović S. Concepts and Definitions of Health and health-related Values in the Knowledge Landscapes of the Digital Society. Croatian Medical Journal. 2017 Dec;58(6):431–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778676/ Foryś I. Gentrification on the Example of Suburban Parts of the Szczecin Urban Agglomeration. remav. 2013 Sep 1;21(3):5–14. Uribe-Toril J, Ruiz-Real J, de Pablo Valenciano J. Gentrification as an Emerging Source of Environmental Research. Sustainability. 2018 Dec 19;10(12):4847. Schnake-Mahl AS, Jahn JL, Subramanian SV, Waters MC, Arcaya M. Gentrification, Neighborhood Change, and Population Health: a Systematic Review. Journal of Urban Health. 2020 Jan 14;97(1):1–25. Project Gallery The chemistry of an atomic bomb | Scientia News Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The chemistry of an atomic bomb Julius Oppenheimer Julius Robert Oppenheimer, often credited with leading the development of the atomic bomb, played a significant role in its creation in the early 1940s. However, it is essential to recognize the collaborative effort of many scientists, engineers, and researchers who contributed to the project. The history and chemistry of the atomic bomb are indeed fascinating, shedding light on the scientific advancements that made it possible. The destructive power of an atomic bomb stems from the rapid release of energy resulting from the splitting, or fission, of fissile atomic nuclei in its core. Isotopes such as uranium-235 and plutonium-239 are selected for their ability to undergo fission readily and sustain a self-sustaining chain reaction, leading to the release of an immense amount of energy. The critical mass of fissionable material required for detonation ensures that the neutrons produced during fission have a high probability of impacting other nuclei and initiating a chain reaction. To facilitate a controlled release of energy, neutron moderation plays a crucial role in the functioning of an atomic bomb. Neutrons emitted during fission have high velocities, making them less likely to be absorbed by other fissile material. However, by employing a moderator material such as heavy water (deuterium oxide) or graphite, these high-speed neutrons can be slowed down. Slowing down the neutrons increases the likelihood of their absorption by fissile material, enhancing the efficiency of the chain reaction and the release of energy. The sheer magnitude of the energy released by atomic bombs is staggering. For example, one kilogram (2.2 pounds) of uranium-235 can undergo complete fission, producing an amount of energy equivalent to that released by 17,000 tons (17 kilotons) of TNT. This tremendous release of energy underscores the immense destructive potential of atomic weapons. It is essential to note that the development of the atomic bomb represents a confluence of scientific knowledge and technological advancements, with nuclear chemistry serving as a foundational principle. The understanding of nuclear fission, the critical mass requirement, and the implosion design were key factors in the creation of the atomic bomb. Exploring the chemistry behind this devastating weapon not only provides insights into the destructive capabilities of atomic energy but also emphasises the responsibility that accompanies its use. In conclusion, while Oppenheimer's contributions to the development of the atomic bomb are significant, it is crucial to acknowledge the collective effort that led to its creation. The chemistry behind atomic bombs, from the selection of fissile isotopes to neutron moderation, plays a pivotal role in harnessing the destructive power of nuclear fission. Understanding the chemistry of atomic weapons highlights the remarkable scientific achievements and reinforces the need for responsible use of atomic energy. By Navnidhi Sharma Project Gallery View All Forum Posts (19) Quizzes #3 In Questions & Answers · 15 February 2023 Form of energy which is due to an object/ particle's motion? A. Kinetic energy B. Gravitational potential energy C. Potential energy D. Thermal energy 0 1 16 Quizzes #5 In Questions & Answers · 4 March 2023 0 1 22 Forum rules In General Discussion · 13 December 2022 We want everyone to get the most out of this community, so we ask that you please read and follow these guidelines: Respect each other Keep posts relevant to the forum topic No spamming 1 0 6 View All

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