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Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Life under occupation: the health and well-being of Palestinians Last updated: 13/03/25, 11:44 Published: 13/03/25, 08:00 Impact of war and geopolitics on health in Palestine This is article no. 1 in a series about global health injustices. Next article: Civil war in Sudan (coming soon). Introduction Welcome to the Global Health Injustices Series, which will focus on critically examining the health inequalities and inequities faced by vulnerable populations within different countries and regions worldwide and even put forward actionable steps to improve their health and wellbeing. This series will begin with Palestine, as it has been an enduring crisis that should be addressed to include long-lasting benefits and outcomes for the Palestinians. Palestine: from a rich history to current occupation Palestine is a country in the Middle East (West Asia) mainly bordered by Israel. Palestine is unique in its various cultures and knowledge, moulded by multifaceted events and geopolitical shifts over centuries. The multidimensional cultural landscape of Palestine illustrates the impact of civilisations, such as the Romans, Byzantines, and Ottomans, who each had their religions, languages, and cultures, which still exist in various forms today. The resilience of the Palestinians is evident through their distinct traditions, art, food and environment, which are essential to their identity. With these testaments in mind, Palestinians are facing consistent strife because they are under constant occupation, blockade and cutting off of needed supplies carried out by Israel, as noted by several humanitarian and human rights non-governmental organisations (NGOs) like Amnesty International and Save the Children. These actions are facilitated by nations, notably the United States and the United Kingdom, through arms and weapons trade. Hence, the struggle for the Palestinians to have autonomy and freedom, among other human rights within their own homeland, is a consistent fight that requires ongoing international cooperation and solidarity. Geopolitics: its detrimental impacts on the Palestinians Given the currently divisive geopolitical landscape, it is essential to bring attention to the health outcomes of the Palestinian population, especially since at least half of them are children. A report from the Global Nutrition Cluster called “Nutrition Vulnerability and Situation Analysis / Gaza” had several key findings and tables (see Tables 1 and 2 ). Firstly, more than 90% of children less than a year old, along with pregnant and breastfeeding women, encounter high under-nutrition due to poverty. Another finding was that approximately 90% of children under five are impacted by at least one infectious disease, and 81% of households in Gaza lack clean and safe water. However, the authors noted limitations in their analysis, such as limited data sources because collecting it is difficult within the context of Gaza, and this was true for screening. Another report from the organisation Medical Aid For Palestinians (MAP), titled “Health Under Occupation” from 2017, discussed healthcare access and outcomes more broadly. For example, they noted that in 2016, up to one-third of patients’ permits to exit Gaza for healthcare access were either denied or delayed. Moreover, they stated that 40% of people in Gaza live below the poverty line. Given the recent geopolitical shifts in power, these findings from both reports will likely be higher now. This brings forthcoming uncertainty about whether the health outcomes of Palestinians will improve. In a recent qualitative study involving the views of Palestinian physicians in the West Bank, they shared their experiences of violence, threats of violence, issues with healthcare access for themselves and patients, financial difficulties to support their families, struggle to help their patients and limited access to education due to harsher life under occupation. Thinking more largely about emergency care in Palestine, one scoping review reported the depletion of healthcare resources such as medical equipment and medications. The authors even related how human rights violations and the destruction of the Palestinian healthcare system, including emergencies, have exacerbated outcomes; the most notable were stroke, myocardial infarction and traumatic injury, among other non-infectious diseases. Although the authors included this information from a human rights standpoint, they called for additional interventions and research to fill in and learn gaps within emergency care to enhance health outcomes for Palestinians. This review was published in 2022, and again, many geopolitical shifts in power have taken place within a few years. Therefore, it can be deduced that emergency care is drastically needed for the Palestinians; this is primarily compelled by the blockade in Gaza and occupation in the West Bank. Focusing on the mental health outcomes among Palestinians, they have become worse. In another scoping review, researchers focused on trauma among young Palestinian people in Gaza; the authors noted that events, such as exposure to devastation and violence, as well as the death or loss of friends and family, have contributed to mental health outcomes ranging from post-traumatic stress disorder (PTSD) to depression. Nevertheless, the authors stated that further qualitative research is vital to addressing gaps in knowledge and enhancing mental health outcomes among the Palestinian youth and the wider population. Connecting back to how the modern geopolitical landscape is very dynamic, the poorer mental health outcomes among Palestinians have conceivably increased. Urgent calls to action: recommendations from NGOs to upholding human rights Given all of these detrimental impacts on the health and wellbeing of Palestinians, there are recommendations from organisations, notably the United Nations (UN), for ways forward towards upholding the human rights of Palestinians: Immediately end all practices of collective punishment, including lifting its blockade and closures – and the “complete siege”- of Gaza, and urgently ensure immediate access to humanitarian and commercial goods throughout Gaza, commensurate with the immense humanitarian needs. Ensure that all Palestinians forcibly displaced from Gaza are allowed to return to their homes creating safe conditions and fulfil its responsibilities as an occupying Power in this regard. End the 56-year occupation of the Occupied Palestinian Territory, including East Jerusalem as part of a broader process towards achieving equality, justice, democracy, non-discrimination, and the fulfilment of all human rights for all Palestinians. These recommendations, among others mentioned in the report from the United Nations (UN) High Commissioner for Human Rights, were divulged in 2024; the year had been a challenging time, particularly in Gaza, due to the complete blockade of food, water and essentials like medical supplies; in addition to this, many explosives were dropped on Gaza, killing thousands of men, women and children. Finally, buildings, such as hospitals and homes, were destroyed. Conclusion: moving forward towards a equitable and equal future for Palestinians Reflecting on everything discussed in this article, the numerous injustices happening to Palestinians must not go on; they have been suppressed for nearly 75 years by governments and the mainstream media before receiving closer attention, examination and debate within Western society recently. Therefore, we need to take actionable steps by initiating more open discussions of justice and advocacy involving the voices of Palestinians, such as myself and others. Furthermore, it is crucial always to nudge those in positions of power worldwide to fulfil their responsibilities as civil servants and defend human rights for everyone. Both of these actions uphold the health and wellbeing of Palestinians living in Gaza and the West Bank, especially as enabling the recommendations from the UN and other NGOs. As for the wider international community, we must continue upholding human rights to maintain our health and wellbeing. In my next article, I will discuss Sudan because this population has also encountered many injustices, primarily the civil war that has been occurring since 2023. This has impacted the health and wellbeing of the Sudanese population, which requires thorough attention and discussion. Written by Sam Jarada Related articles: A perspective on well-being / Gentrification and well-being REFERENCES Human rights in Israel and the Occupied Palestinian Territory. Amnesty International. 2022. Available from: https://www.amnesty.org/en/location/middle-east-and-north-africa/middle-east/israel-and-the-occupied-palestinian-territory/report-israel-and-the-occupied-palestinian-territory/ Occupied Palestinian Territory. Save the Children International. 2024. Available from: https://www.savethechildren.net/occupied-palestinian-territory Nutrition Vulnerability and Situation Analysis / Gaza. 2024. Available from: https://www.nutritioncluster.net/sites/nutritioncluster.com/files/2024-02/GAZA-Nutrition-vulnerability-and-SitAn-v7.pdf HEALTH UNDER OCCUPATION. Medical Aid For Palestinians. 2017. Available from: https://www.map.org.uk/downloads/health-under-occupation---map-report-2017.pdf Husam Dweik, Hadwan AA, Beesan Maraqa, Taher A, Zink T. Perspectives of Palestinian physicians on the impact of the Gaza War in the West Bank. SSM - Qualitative Research in Health. 2024 Nov 14;6:100504–4. Available from: https://www.sciencedirect.com/science/article/pii/S2667321524001136 Rosenbloom R, Leff R. Emergency Care in the Occupied Palestinian Territory: A Scoping Review. Health and Human Rights. 2022 Dec;24(2):255. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9790939/ Abdallah Abudayya, Fugleberg T, Nyhus HB, Radwan Aburukba, Tofthagen R. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Mental Health & Prevention. 2023 Nov 25;32:200305–5. Available from: https://www.sciencedirect.com/science/article/pii/S2212657023000478 M.I. Human rights situation in the Occupied Palestinian Territory, including East Jerusalem, and the obligation to ensure accountability and justice - Report of the United Nations High Commissioner for Human Rights - Advance unedited version (A/HRC/55/28) - Question of Palestine. United Nations. Available from: https://www.un.org/unispal/document/human-rights-situation-in-opt-unohchr-23feb-2024/ Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The Biggest Innovations in Biosciences 06/02/25, 11:55 Last updated: Published: 25/03/24, 11:43 CRISPR-Cas9, CAR T-cells, incretins, and iPSCs We are in the era of innovation and cutting-edge technology in biosciences and health. This article goes through some of the most remarkable technologies slowly conquering the world of biosciences. Gene editing and CRISPR-Cas9 Gene editing is based on the idea that correcting the genetic mistake that causes a disease offers a permanent result than curing the symptoms. This technique allows scientists to alter the DNA of cells by deleting, adding or modifying genes. There are numerous ways to edit a gene. The most widely used and revolutionary method for gene editing is CRISPR-Cas9, which stands for Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR- associated protein 9. The process begins with the design of a synthetic RNA molecule, known as guide RNA (gRNA) that matches the target gene sequence. The gRNA, combined with the Cas9 protein, forms a complex that is then introduced into the target cells. Cas9 acts like scissors, guided by the gRNA, to locate the precise location on the DNA where the genetic modification is intended. Once the target site is identified, Cas9 induces a break in the DNA strand. The cell's natural DNA repair mechanisms then come into play. The non- homologous end joining pathway introduces insertions and deletions at the site, resulting in gene knockout or inactivation. On the other hand, once a DNA template with homology to the sequences is present, the homology-directed repair pathway allows the incorporation of a desired genetic sequence, facilitating gene insertion or replacement. Several other gene-editing techniques have been developed, each with unique approaches. Zinc Finger Nucleases (ZFNs) and Transcription Activator-Like Effector Nucleases (TALENs) are two examples. These methods also use proteins that act as molecular scissors to cut the DNA at specific locations. ZFNs use zinc finger proteins to bind to target DNA sequences, while TALENs use transcription activator-like effector proteins. As the field of gene editing rapidly advances, these diverse methods contribute to the expanding toolkit available for researchers and hold promise for addressing a wide array of applications, from medical treatments to agricultural improvements. CAR T-cells Chimeric antigen receptor T-cells (CAR T-cells) are a new type of immunotherapy, considered to be the new fighters in the war on cancer. In general, immunotherapies use the patient’s immune system to fight the cancer. This therapy promises more specificity than traditional therapies and more permanent results. T-cells naturally exist in the human organism, supporting the adaptive immune system. They are a group of lymphocytes in the blood or lymph tissue that target or kill specific pathogens. Each type of T-cell recognises specific pathogens. T-cells have proteins on their outer surface, called receptors and these receptors recognize specific proteins on the outer surface of the pathogen. Depending on the type of T-cell, after recognizing the specific pathogen, they are either killing the pathogen (killer T-cells) or signaling to other elements of immune system to attack the pathogen (helper T-cells). CAR T-cell therapy involves modifying a patient’s own T-cells to express a specific CAR on their surface. The receptor is designed to recognise antigens commonly found on the surface of cancer cells. To introduce CARs on the outer surface of T-cells, the patient’s T-cells are genetically modified in the lab. A viral vector is often used to knock out the original T-cell receptors and express the CAR construct. The newly created CAR-T-cells are introduced into the patients, where they target and destroy cancer cells expressing the specific antigen for which the CAR is designed. Incretins The scientific journal “Science” proclaimed glucagon-like peptide-1 (GLP-1) receptor agonists The Breakthrough of 2023. These medications, originally approved for type 2 diabetes, demonstrated remarkable weight-loss benefits. GLP-1 is a natural hormone produced in the intestines that plays a role in regulating blood sugar levels. When we eat a meal, incretins, GLP-1 and Glucose-dependent insulinotropic polypeptide (GIP), are released into the bloodstream. They bind to specific receptors on the beta cells of the pancreas, triggering insulin release. Incretins also suppress the release of glucagon, a hormone that increases blood sugar levels by promoting the breakdown of stored glucose. GLP-1 receptor agonists are medications that mimic the effects of GLP-1. They bind to the GLP-1 receptors on pancreatic beta cells, promoting insulin secretion and suppressing glucagon release. By mimicking the actions of GLP-1, these medications help to lower sugar levels, improve glucose control, and reduce the risk of hypoglycemia. At the same time, they seem to regulate the appetite and delay gastric emptying. iPSCs Induced pluripotent stem cells (iPSCs) are becoming a new powerful weapon in lab research. They are a type of stem cell that can be generated from adult cells, such as skin or blood cells, through reprogramming. The process of creating iPSCs involves introducing a set of specific genes into the adult cells. These reprogramming factors reset the adult cells' developmental clock, turning them back into a pluripotent state, similar to embryonic stem cells. Once iPSCs are generated, they can be expanded indefinitely in the laboratory and induced to differentiate into various cell types. iPSCs are a valuable tool for studying human development and disease, as well as for drug discovery and regenerative medicine. iPSCs can be derived from patients with genetic diseases or other conditions, allowing researchers to study disease mechanisms in a dish. By differentiating iPSCs into the relevant cell types affected by the disease, researchers can observe how the disease develops and test potential treatments. Moreover, iPSC-derived cells can screen potential drugs for safety and efficacy. Because iPSCs can differentiate into many different cell types, they provide a more accurate model of human biology than traditional cell culture methods. Finally, because iPSCs can be derived from individual patients, they offer the potential for personalised therapies. iPSCs could be used to generate patient-specific cells for transplantation or to test drugs for individual patients. Conclusion These cutting-edge technologies offer unprecedented opportunities for targeted interventions in the treatment of genetic disorders, cancer, diabetes, and a myriad of other diseases. However alongside their immense promise, these biotechnological techniques and therapies also raise important ethical, social and regulatory considerations. The implications of gene editing on human germline cells, the accessibility of advanced therapies, and the long-term safety of these interventions are critical areas that warrant careful attention and thoughtful deliberation. Embracing these innovative techniques with diligence holds the key to unlocking a future where previously incurable conditions become manageable, and where the boundaries of medical possibility are continually expanded. Written by Matina Laskou Related articles: Medical biotechnology / Mesenchymal stem cells Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Delving into the world of chimeras 05/02/25, 16:22 Last updated: Published: 03/02/24, 11:13 An exploration of this genetic concept The term chimera has been borrowed from Greek mythology, transcending ancient tales to become a captivating concept within the fields of biology and genetics. In mythology, the chimera was a monstrous hybrid creature. However, in the biological context, a chimera refers to an organism with cells derived from two or more zygotes. While instances of natural chimerism exist within humans, researchers are pushing the boundaries of genetics via the intentional creation of chimeras, consequentially sparking debates and breakthroughs in various fields, spanning from medicine to agriculture. Despite the theory that every cell in the body should share identical genomes, chimeras challenge this notion. For example, the fusion of non-identical twin embryos in the womb is a way chimeras can emerge. While visible cues, such as heterochromia or varied skin tone patches, may provide subtle hints of its existence, often individuals with chimerism show no overt signs, making its prevalence uncertain. In cases where male and female cells coexist, abnormalities in reproductive organs may exist. Furthermore, advancements in genetic engineering and CRISPR genome editing have also allowed the artificial creation of chimeras, which may aid medical research and treatments. In 2021, the first human-monkey chimera embryo was created in China to investigate ways of using animals to grow human organs for transplants. The organs could be genetically matched by taking the recipient’s cells and reprogramming them into stem cells. However, the process of creating a chimera can be challenging and inefficient. This was shown when researchers from the Salk Institute in California tried to grow the first embryos containing cells from humans and pigs. From 2,075 implanted embryos, only 186 developed up to the 28-day time limit for the project. Chimeras are not exclusive to the animal kingdom; plants exhibit this genetic complexity as well. The first non-fictional chimera, the “Bizzaria” discovered by a Florentine gardener in the seventeenth century, arose from the graft junction between sour orange and citron. Initially thought to be an asexual hybrid formed from cellular fusion, later analyses revealed it to be a chimera, a mix of cells from both donors. This pivotal discovery in the early twentieth century marked a turning point, shaping our understanding of chimeras as unique biological phenomena. Chimera is a common form of variegation, with parts of the leaf appearing to be green and other parts white. This is because the white or yellow portions of the leaf lack the green pigment chlorophyll, which can be traced to layers in the meristem (areas found at the root and shoot tip that have active cell division) that are either genetically capable or incapable of making chlorophyll. As we conclude this exploration into the world of chimeras, from the mythological realm to the scientific frontier, it’s evident that these entities continue to mystify and inspire, broadening our understanding of genetics, development, and the interconnectedness of organisms. Whether natural wonders or products of intentional creation, chimeras beckon further exploration, promising a deeper comprehension of the fundamental principles that govern the tapestry of life. Written by Maya El Toukhy Related article: Micro-chimerism and George Floyd's death Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Building Physics Last updated: 24/02/25, 11:28 Published: 20/02/25, 08:00 Implementing established physical theories into the constructions of the future From the high rise establishments that paint the expansive London skyline to the new build properties nestled within thriving communities, buildings serve as a beacon of societal needs. The planned and precise architecture of buildings provides shelter and comfort for individuals, as well as meet business agendas to promote modern day living. Additionally, buildings serve a purpose as a form of protection where, according to the World Health Organisation (WHO), the design and construction of buildings is to create an environment suitable for human living: more favourable than the state of the natural environment outdoors construction and building protects us from: extremes of temperature moisture excessive noise To sustain these pivotal agendas, a comprehensive analysis of the physical factors within the environment of buildings, including temperature, light and sound are required for design and legislation for a building to function. The field of ‘Building Physics’ primarily addresses these physical factors to innovate ‘multifunctional solutions’, be more efficient, and build upon present designs, which can be adapted for future use. Moreover, the built environment is regarded as one of the biggest carbon emissions on the planet, so using building physics as an early design intervention can reduce energy consumption and minimise carbon emissions. This supports global manifestos of moving towards net zero and decreasing the likelihood of the detrimental effects caused by climate change. The main components of Building Physics Building Physics is composed of examining the functions of an interior physical environment, including air quality, thermal comfort, acoustics comfort (sound), and light : Air quality: Ventilation is needed for maintaining a safe environment and reducing the quantity of stale air - consisting of carbon dioxide and other impurities - within an interior environment. Air infiltration also contributes to a significant heat loss, where it is important to provide intentional ventilation to increase the efficiency of energy transfers within the building. Thus, good ‘airtightness’ of a building fabric, which can be considered as the building’s resistance to unintentional air infiltration or exfiltration, can enable planned airflows for ventilation. Thermal: The biggest influence within the field of Building Physics stems from an understanding of heat conductivity depending on the density and moisture content of the material, as well as heat transfers - conduction, convection, radiation and transition - to determine the suitability of materials used for construction. For example, a material such as a solid wood panel for walls and ceilings is favourable as it can be installed in layers, providing even temperature fields across the surface. It is important that a building has the ability to isolate its environment from external temperature conditions and have the correct building envelope - a barrier that separates the interior and exterior of a building. Acoustics: A regulated control of sound within buildings contributes towards maintaining habitable conditions for building users to make sure that sound is loud, undistorted, and the disturbances are reduced. Acoustics can be controlled and modified through material choices, such as installing sound-absorbing material. These materials can be adapted to reduce sound leakage, which are common in air openings, such as ventilators and doors, that are more likely to transmit sound than adjacent thicker walls. Light: Light provides an outlook of viewing an environment in an attractive manner, particularly using daylight as a primary source of enhancing the exterior of a building, whilst also functioning within a building. One strategy used to fulfil the purpose of light in buildings is designing windows for the distribution of daylight to a space. The window design has a divisive effect on the potential daylight and thermal performance of adjacent spaces, so it needs to be closely checked using the standardised methods, in order to be suitable for use. Additionally, as windows are exposed to the sky, daylighting systems can adapt windows to transmit or reflect daylight as a function of incident angle, for solar sharing, protection from glare and redirection of daylight. Overall, a key objective of sustaining a safe and eco-friendly building is to ensure that the space has proper heat and humidity aligning with a suitable degree of acoustic and visual comfort in order to sustain the health of the people using the building. Particularly within modern society, a combination of Building Physics principles and digitalised software, such as Building Information Modelling (BIM), can enhance the design process of a building to provide healthy environments for generations to come. Written by Shiksha Teeluck REFERENCES Unsplash. A construction site with cranes [Internet]. [Accessed 2 January 2025]. Available from: https://unsplash.com/photos/a-construction-site-with-cranes-mOA2DAtcd1w . Katunský D, Zozulák M. Building Physics . 2012. ISBN: 978-80-553-1261-3. Partel. Building Physics [Internet]. [Accessed 2 January 2025]. Available from: https://www.partel.co.uk/resources/building-physics/#:~:text=According%20to%20WHO%20(World%20Health,%3A%20in%20contrast%2C%20allows%20productions . RPS Group. A day in the life of a senior building physics engineer [Internet]. [Accessed 4 January 2025]. Available from: https://www.rpsgroup.com/insights/consulting-uki/a-day-in-the-life-of-a-senior-building-physics-engineer/ . Cyprus International University. What is Building Physics and Building Physics Problems in General Terms [Internet]. [Accessed 6 January 2025]. Available from: /mnt/data/What_Is_Building_Physics_and_Building_Ph.pdf. Centre for Alternative Technology. Airtightness and Ventilation [Internet]. [Accessed 6 January 2025]. Available from: https://cat.org.uk/info-resources/free-information-service/eco-renovation/airtightness-and-ventilation/#:~:text=With%20good%20airtightness%2C%20effective%20ventilation,won't%20work%20as%20intended . KLH. Building Physics [Internet]. [Accessed 6 January 2025]. Available from: https://www.klh.at/wp-content/uploads/2019/10/klh-building-physics-en.pdf . Watson JL. Climate and Building Physics [Internet]. [Accessed 6 January 2025]. Available from: https://calteches.library.caltech.edu/98/1/Watson.pdf . Ruck N, Aschehoug Ø, Aydinli S, Christoffersen J, Edmonds I, Jakobiak R, et al. Daylight in Buildings - A source book on daylighting systems and components . 2000 Jun. Synergy Positioning Systems. How BIM Saves Time & Money for Construction Businesses [Internet]. [Accessed 6 January 2025]. Available from: https://groupsynergy.com/synergy-positioning-news/how-bim-saves-time-money-for-construction-businesses . Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Advancements in Semiconductor Laser Technology 09/02/25, 11:15 Last updated: Published: 23/06/24, 09:39 What they are, uses, and future outlook Lasers have revolutionised many fields starting from the telecommunications, data storage to medical diagnostics and consumer electronics. And among the semiconductor laser technologies, Edge Emitting Lasers (EEL) and Vertical Cavity Surface Emitting Lasers (VCSEL) emerged as critical components due to their unique properties and performance. These lasers generate light through the recombination of electrons and holes in a semiconductor material. EELs are known for their high power and efficiency and they are extensively used in fiber optic communications and laser printing. VCSELs on the other hand are compact and are used for applications like 3D sensing. Traditionally VCSELs have struggled to match the efficiency levels of EELs however a recent breakthrough particularly in multi junction VCSEL, has demonstrated remarkable efficiency improvements which place the VCSELs to surpass EELs in various applications. This article focuses on the basics of these laser technologies and their recent advancements. EELs are a type of laser where light is emitted from the edge of the semiconductor wafer. This design contrasts with the VCSELs which emit light perpendicular to the wafer surface. EELs are known for their high power output and efficiency which makes them particularly suitable for applications that require long-distance light transmission such as fiber optic communications, laser printing and industrial machining. EELs consist of an active region where electron hole recombination occurs to produce light. This region is sandwiched between two mirrors forming a resonant optical cavity. The emitted light travels parallel to the plane of the semiconductor layers and exits from the edge of the device. This design allows EELs to achieve high gain and power output which makes them effective for transmitting light over long distances with minimal loss. VCSELs are a type of semiconductor laser that emits light perpendicular to the surface of the semiconductor wafer unlike the EELs which emit light from the edge. VCSELs have gained popularity due to their lower threshold currents and ability to form high density arrays. VCSELs consist of an active region where electron-hole recombination occurs to produce light. This region is situated between two highly reflective mirrors which forms a vertical resonant optical cavity. The light is emitted perpendicular to the wafer surface which allows for efficient vertical emission and easy integration into arrays. Recent advancements in VCSEL technology marked a significant milestone in the field of semiconductor lasers. And in particular the development of multi junction VCSEL which led to the improvements in power conversion efficiency (PCE) of the laser. Research conducted by Yao Xiao et al. and team has demonstrated the potential of a multi junction VCSELs to achieve efficiency levels which were previously thought unattainable. This research focuses on cascading multiple active regions within a single VCSEL to enhance gain and reduce threshold current which leads to higher overall efficiency. The study employed a multi-junction design where several active regions are stacked vertically within the VCSEL. This design increases the volume of the gain region and lowers the threshold current density resulting in higher efficiency. Experimental results from the study revealed that a 15-junction VCSEL achieved a PCE of 74% at room temperature when driven by nanosecond pulses. This efficiency is the highest ever reported for VCSELs and represents a significant leap forward from previous records. Simulations conducted as part of the study indicated that a 20-junction VCSEL could potentially reach a PCE exceeding 88% at room temperature. This suggests that further optimization and refinement of the multi-junction approach could yield even greater efficiencies. The implications of this research are profound for the future of VCSEL technology. Achieving such high efficiencies places VCSELs as strong competitors to EELs particularly in applications where energy efficiency and power density are critical. The multi junction VCSELs demonstrated in the study shows promise for a wide range of applications and future works may focus on optimizing the fabrication process, reducing thermal management issues and exploring new materials to further enhance performance. Integrating these high-efficiency VCSELs into commercial products could revolutionize industries reliant on laser technology. Written by Arun Sreeraj Related articles: The future of semi-conductor manufacturing / The search for a room-temperature superconductor / Advances in mass spectrometry Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Using Natural Substances to Tackle Infectious Diseases 21/02/25, 12:22 Last updated: Published: 06/06/23, 17:06 Natural substances and their treatment potential Introduction There is increased concern of antimicrobial resistance, especially when referring to bacteria with superbugs such as Methicillin-resistant Staphylococcus aureus (MRSA) and Carbapenem-resistant Enterobacteriaceae (CRE) as they impact lives globally, mainly through fatalities. Given this predicament, It seems that humanity is losing as a result of this pressing issue. However, it is possible for healthcare professionals to utilise more natural products, which are chemicals made by plants, animals and even microorganisms. This includes resources such as wood and cotton aside from food like milk and cacao. In the context of medicinal treatments, an important justification for using more natural products is because although synthetic or partially synthetic drugs are effective for treating countless diseases, an article found that 8% of hospital admissions in the United States and approximately 100,000 fatalities per year were due to people experiencing unfortunate side effects from these drugs. This article explores three specific natural products, where each have similar and unique health properties that can be harnessed to tackle infectious diseases and its subsequent consequences when left sufficiently unaddressed (i.e. antimicrobial resistance). Honey One of the most famous natural products that has been referenced in various areas of research and has been a food and remedial source for thousands of years is honey. It has properties ranging from antibacterial to antioxidant, suggesting that when honey is applied clinically, they have the potential to stop pathogenic bacteria. For example, honey can protect the gastrointestinal system against Helicobacter pylori , which causes stomach ulcers. In disc diffusion assays, the inhibitive properties of honey were shown when honey samples were evaluated holistically as opposed to its individual ingredients. This implies that the macromolecules in honey (carbohydrates, proteins and lipids) work in unison with other biomolecules, illustrating that honey is a distinctive remedy for preventing bacterial growth. For tackling infectious diseases, particularly against wound infections among others, honey’s medicinal properties provide a lot of applications and because it is a natural product, honey would not present any drastic side effects to a patient upon its administration. Garlic Another natural product that can be effective against microorganisms is garlic because similar to honey, it has antimicrobial and antioxidative compounds. A study judged different garlic phenotypes originating from Greece and discovered that they were beneficial against Proteus mirabilis and Escherichia coli aside from inhibiting Candida albicans and C. kruzei . As for fresh garlic juice (FGJ), it increases the zone of inhibition in various pathogens at 10% and more along with it displaying minimum inhibitory concentrations (MICs) in the 4-16% range. Therefore, garlic in solid or liquid form does show potential as a natural antimicrobial agent, especially against pathogenic bacteria and fungi. With this in mind, it too has multiple applications like honey and should be further studied to best isolate the chemical compounds that could be involved in fighting infectious diseases. Turmeric Curcuma longa (also known as turmeric) is one other natural product with unique properties like garlic and honey, making it a suitable candidate against various microbes. One specific pigment that is part of the ginger family and found in turmeric is curcumin, which can tackle diverse microbes through numerous mechanisms illustrated below in Figure 2 . With this said, curcumin has drawbacks: it is highly hydrophobic, has low bioavailability and quickly breaks down. Although when paired with nanotechnology for delivery into the human body, its clinical applications can be advantageous and an additional observation about curcumin is that it can work collaboratively with other plant derived chemicals to stop antibiotic resistant bacteria. One specific bacterial strain that turmeric can attack is Clostridium difficile, a superbug that causes diarrhoea. A study had 27 strains to measure the MICs of turmeric constituents, particularly curcuminoids and curcumin. The results showed reduced C. difficile growth in the concentration range 4-32 μg/mL. Moreover, they had no negative impacts on the gut microbiome and curcumin had more efficacy in stopping C. difficile toxin production compared to fidaxomicin. Thus, turmeric is efficacious as a natural antimicrobial chemical and with further experimentation (same as honey and garlic), it can be harnessed to prevent infectious diseases besides their impact on human lives. Conclusion Considering the above examples of natural products in this article and others not mentioned, it is clear that they can be powerful in the battle against infectious diseases and the problems associated with them, mainly antimicrobial resistance. They are readily available to purchase in markets and shops at low cost, making them convenient. Moreover, populations in Eastern countries like China and India traditionally have used, and are still using these materials for curing pain and illness. In turn, manufacturing medicines from natural products on a larger scale has the prospect of preventing infectious diseases and even alleviating those that patients currently have. Written by Sam Jarada Related article: Mechanisms of pathogen evasion Project Gallery

Conservation, diseases, animal behaviour, adaptation and survival. Expand your knowledge on the incredible diversity of life on Earth with these articles. Zoology Articles Conservation, diseases, animal behaviour, adaptation and survival. Expand your knowledge on the incredible diversity of life on Earth with these articles. You may also like: Biology , and Ecology Deception by African birds The species Dicrurus adsimilis uses deception by flexible alarm mimicry to target and carry out food-theft attempts An experiment on ochre stars Investigating the relative fitness of the species Pisaster ocharceus Orcinus orca A species report Rare zoonotic diseases We all know about COVID-19. But what about the other zoonotic diseases? Marine iguanas Their conservation The cost of coats 55 years of vicuna conservation in South America. Article #1 in a series on animal conservation around the world. Conserving the California condor These birds live on the west coast of North America. Article #2 in a series on animal conservation around the world.

An introductory and comprehensive review of complex diseases and their environmental influences. Using schizophrenia as an example, we are interested in exploring one of the biggest questions that underlie complex diseases. Go Back Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The environment on complex diseases: schizophrenia Last updated: 18/11/24 Published: 08/05/23 An introductory and comprehensive review of complex diseases and their environmental influences. Using schizophrenia as an example, we are interested in exploring one of the biggest questions that underlie complex diseases. Introduction: Not Exactly a Yes or No Question Many things in science revolve around questions. It is remarkable to find the number of questions left for scientists to answer or those that will remain unanswered. Indeed, one of the most daunting tasks for any scientist would be to see through every detail of a piece of information, even if everyone has seen it, but with different sets of lenses and asking different sets of questions. After all, “why did the apple fall from its tree?”. However, asking questions is one thing. Finding answers and, more importantly, the evidence or proof that supports them does not always yield conclusive results. Nevertheless, perhaps some findings may shine a new light on a previously unanswered question. We can categorise the study of genetics into two questions: “What happens if everything goes well?” and “What happens if it goes wrong?”. Whilst there are virtually limitless potential causes of any genetic disease, most genetic diseases are known to be heritable. A mutation in one gene that causes a disease can be inherited from the parents to their offspring. Often, genetic diseases are associated with a fault in one gene, known as a single-gene disorder, with notorious names including Huntington’s disease, cystic fibrosis, sickle cell anaemia, and familial hypercholesterolaemia. These diseases have different mechanisms, and the causes are also diverse. But all these diseases have one thing in common: they are all caused by a mutation or fault in one gene, and inheriting any specific genes may lead to disease development. In other words, “either you have it, or you do not”. The role of DNA and mutations in complex diseases. Image/ craiyon.com Multifactorial or complex diseases are a classification geneticists give to diseases caused by factors, faults or mutations in more than one gene. In other words, a polygenic disease. As a result, the research, diagnosis, and identification of complex diseases may not always produce a clear “black-and-white” conclusion. Furthermore, complex diseases make up most non-infectious diseases known. The diseases associated with leading causes of mortality are, in their respective ways, complex. Household names include heart diseases, Alzheimer’s and dementia, cancer, diabetes, and stroke. All of these diseases may employ many mechanisms of action, involving multiple risk factors instead of direct cause and effect, using environmental and genetic interactions or factors to their advantage, and in contrast to single-gene disorders, do not always follow clear or specific patterns of inheritance and always involve more than one problematic genes before the complete symptoms manifest. For these reasons, complex diseases are infamously more common and even more challenging to study and treat than many other non-infectious diseases. No longer the easy “yes or no” question. The Complex Disease Conundrum: Schizophrenia Here we look at the case of a particularly infamous and, arguably, notorious complex disease, schizophrenia (SCZ). SCZ is a severely debilitating and chronic neurodevelopmental disorder that affects around 1% of the world’s population. Like many other complex diseases, SCZ is highly polygenic. The NHS characterise SCZ as a “disease that tends to run in families, but no single gene is known to be directly responsible…having these genes does not necessarily mean one will develop SCZ”. As previously mentioned, many intricate factors are at play behind complex diseases. In contrast, there is neither a single known cause for SCZ nor a cure. Additionally, despite its discovery a century ago, SCZ is arguably not well understood, giving a clue to the sophisticated mechanisms that underlie SCZ. To further illustrate how such complexities may pose a challenge to future medical treatments, we shall consider a conundrum that diseases like SCZ may impose. The highly elaborate nature of complex diseases means that it is impossible to predict disease outcomes or inheritance with absolute certainty nor rule out potential specific causes of diseases. One of the most crucial aspects of research on complex diseases is their genetic architecture, just as a house is arguably only as good as its blueprint. Therefore, a fundamental understanding of the genes behind diseases can lead to a better knowledge of diseases’ pathogenesis, epidemiology, and potential drug target, and hopefully, one day bridge our current healthcare with predictive and personalised medicine. However, as mentioned by the NHS, one of the intricacies behind SCZ is that possessing variants of diseased genes does not translate to certainty in disease development or symptom manifestation. Our conundrum, and perhaps the biggest question on complex diseases like SCZ is: “Why, even when an individual possesses characteristic genes of a complex disease, they may not necessarily exhibit symptoms or have the disease?”. The enigma surrounding complex diseases lies in the elegant interactions between our genes, the blueprint of life, and “everything else”. Understanding the interplay of factors behind complex diseases may finally explain many of the intricacies behind diseases like SCZ. Genes and Environment: an Obvious Interaction? The gene-environment important implications on complex disease development were demonstrated using twin studies. A twin study, as its name suggests, is the study of twins by their similarities, differences, and many other traits that twins may exhibit to provide clues to the influences of genetic and external factors. Monozygotic (MZ) twins each share the same genome and, therefore, are genetically identical. Therefore, if one twin shows a phenotype, the other twin would theoretically also have said genes and should exhibit the corresponding trait. Experimentally, we calculate the concordance rate, which means the probability of both twins expressing a phenotype or characteristic, given that one twin has said characteristic. Furthermore, the heritability score may be mathematically approximated using MZ concordance and the concordance between dizygotic twins (twins that share around half a genome). These studies are and have been particularly useful in demonstrating the exact implications genetic factors have on phenotypes and how the expression of traits may have been influenced by confounding factors. In the case of SCZ, scientists have seen, over decades, a relatively low concordance rate but high heritability score. A recent study (published in 2018) through the Danish SCZ research cohort involved the analysis of around 31,500 twins born between the years 1951 and 2000, where researchers reported a concordance rate of 33% and estimated heritability score of 79%, with other older studies reporting a concordance rate up to and around 50%. The percentages suggest that SCZ is likely to be passed down. In other words, a genetically identical twin only has approximately 1 in 2 risks of also developing symptoms of SCZ if its opposite twin also displays SCZ. The scientists concluded that although genetic predisposition significantly affects one’s susceptibility or vulnerability against SCZ, it is not the single cause of SCZ. Demographically, there have been studies that directly link environmental risks to SCZ. Some risk factors, such as famines and malnutrition, are more evident than others. However, some studies also associate higher SCZ risk among highly industrialised countries and first or second-generation migrants. For instance, few studies point out an increased risk of SCZ within ethnic minorities and Afro-Caribbean immigrants in the United Kingdom. Hypotheses that may explain such data include stress during migration, potential maternal malnutrition, and even exposure to diseases. With this example, hopefully, we all may appreciate how the aetiology of SCZ and other complex diseases are confounded by environmental factors. In addition, how such factors may profoundly influence an individual’s genome. SCZ is a clear example of how genetic predisposition, the presence of essential gene variants characteristic of a disease, may act as a blueprint to a terrible disease waiting to be “built” by certain factors as if they promote such development. It is remarkable how genetic elements and their interactions with many other factors may contribute almost collectively to disease pathogenesis. We can reflect this to a famous quote amongst clinical geneticists: “genetics loads the gun, and environment pulls the trigger.” Carrying high-risk genes may increase the susceptibility to a complex disease, and an environment that promotes such disease may tip the balance in favour of the disease. However, finding and understanding the “blueprints” of SCZ, what executes this “blueprint”, and how it works is still an area of ongoing research. Furthermore, how the interplay between genetics and external factors can lead to profound effects like disease outcomes is still a relatively new subject. The Epigenome: the Environment’s Playground To review, it is clear that genes are crucial in complex disease aetiology. In the case of SCZ, high-risk genes and variances are highly attributed to disease onset and pathogenesis. However, we also see with twin studies that genetics alone cannot explain the high degree of differences between twins, particularly when referring to SCZ concordance between identical twins. In other words, external factors are at play, influencing one’s susceptibility and predisposition to SCZ. These differences can be explained by the effects epigenetics have on our genome. Epigenetic mechanisms regulate gene expression by modifying the genome. In short, on top of the DNA double strands, the genome consists of additional proteins, factors, and even chemical compounds that all aid the genetic functions our body heavily relies on. The key to epigenetics lies in these external factors’ ability to regulate gene expression, where some factors may promote gene expression whilst others may prevent it. Epigenetic changes alter gene functions as they can turn gene expression “on” and “off”. Furthermore, many researchers have also shown how epigenetic changes may accumulate and be inherited somatically with cell division and even passed down through generations. Therefore, epigenetic changes may occur without the need to change any of the DNA codes, yet, they may cause a profound effect by controlling gene expression throughout many levels of the living system. These underlying mechanisms are crucial for the environment’s effect on complex diseases. Some external factors may directly cause variances or even damage to the genome (e.g. UV, ionising radiation), and other sources may indirectly change gene expression by manipulating epigenetic changes. The exact molecular genetics behind epigenetic mechanisms are elaborate. However, we can generally find three common epigenetic mechanisms: DNA Methylation, Histone Modification, and Non-coding RNA. Although each method works differently, they achieve a common goal of promoting or silencing gene expression. All of these are done by the many molecular components of epigenetics, altering the genome without editing the gene sequence. We refer to the epigenome, which translates to “above the genome”, the genome itself and all the epigenetic modifiers that regulates gene expression on many levels. Environmental factors and exposure may influence epigenetic mechanisms, affecting gene expression in the cell or throughout the body, sometimes permanently. Therefore, it is clear how the epigenome may change throughout life as different individuals are exposed to numerous environmental factors. Furthermore, each individual may also have a unique epigenome. Depending on which tissues or cells are affected by these mechanisms, tissues or cells may even have a distinct epigenome, unlike the genome, which is theoretically identical in all cells. One example of this is the potential effects of DNA methylation on schizophrenia epidemiology. DNA methylation can silence genes via the enzymes DNA methyltransferases (DNMT), a family of enzymes capable of catalysing the addition of methyl groups directly into the DNA. The DNMT enzymes may methylate specific nucleotides on the gene, which usually would silence said gene. Many researchers have found that the dysregulation of DNA methylation may increase the risk towards the aetiology of numerous early onset neuro-developmental disorders. However, SCZ later-onset development also points towards the influence of environmental risk factors that target DNA methylation mechanisms. Studies show links between famines and SCZ increased prevalence, as the DNMT enzymes heavily rely on nutrients to supply essential amino acids. Malnutrition is thought to play a considerable role in DNA methylation changes and, therefore, the risk of SCZ. Small Piece of a Changing Puzzle Hopefully, we can see a bigger picture of the highly intricate foundation beneath complex diseases. Bear in mind that SCZ is only one of many complex diseases known. SCZ is ultimately not a pristine and impartial model to study complex disorders. For instance, concordance rates of complex diseases change depending on their genetic background. In addition, they may involve different mutations, variance, or dysregulation of differing pathways and epigenetic mechanisms. After all, complex diseases are complex. Finally, this article aimed to give a rundown of the epigenetics behind complex diseases like SCZ. However, it is only a snapshot compared to the larger world of the epigenome. Furthermore, some questions remain unanswered: the genetic background and architecture of complex diseases, and ways to study, diagnose, and treat complex diseases. This Scientia article is one of the articles in Scientia on the theme of complex disease science and genetics. Hopefully, this introductory article is an insight and can be used to reflect upon, especially when tackling more complicated subjects of complex diseases and precision medicine. Written by Stephanus Steven Related articles: Schizophrenia, Inflammation, and Accelerated Ageing / An Introduction to Epigenetics

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link How does physical health affect mental health? Last updated: 24/02/25, 11:31 Published: 30/01/25, 08:00 Healthy heart, healthy mind Introduction Over the last decade, maintaining good mental health has become an increasing global priority. More people are committing time to self-care meditation, and other cognitive practices. We have also seen a rise in people taking care of their physical health through exercise and clean eating. This is fantastic – people are making time for one of the most important aspects of life, their health! But with the fast-paced nature of modern lifestyles, it is hard to devote separate time each week to purely mental and physical wellbeing. What if there were ways we could enhance both physical and mental wellbeing at the same time? Are both forms of health completely distinct from one another, or could a change in one have an effect on the other? If you’re looking for ways to improve your self-care efficiency, this may be the article for you! Healthy heart, healthy mind Physical health is a lot easier to define, on account of it being largely visible. Mental health on the other hand lacks much of a concrete definition. What is widely agreed is that emotions and feelings play a large part in making up our mental health. Emotions are largely determined by how we feel about our current internal and external environment, meaning bad bodily signs (as part of our internal environment) will have a negative effect on our overall mood. This is why being ill puts us in such a bad mood – even a blocked nose can annoy us by affecting how we do everyday activities. Poor fitness levels are likely no different – not being the most physically capable and finding everyday physical tasks challenging will likely have an effect on your mood and your confidence. Recent studies have backed up this idea, namely that signs of bodily inflammation are associated with increased risk of depression and negative mood. The role of neurotransmitters So being physically fit is associated with having better mental health, but does that mean exercise itself is mentally health as well, or is it just the effect of exercise that makes us happy? In other words, we seem to enjoy the result, but do we enjoy the process too? Studies have found that exercise increases dopamine levels in the brain. Dopamine is a neurotransmitter (a chemical messenger in the brain) that signals reward and motivation, similar to when we earn something for the work we put in ( Figure 1 ). Exercise is therefore seen as rewarding to the brain. There is also a lot of evidence suggesting exercise increases serotonin levels in both rats and humans. Serotonin is also a neurotransmitter, associated with directly enhancing mood and even having anti-depressant effects. Experiments in rats even suggest that increases in serotonin can decrease anxiety levels. Now, this does not mean exercise alone can cure anxiety disorder or depression, but could it be a useful variable in a clinical setting? Clinical uses Studies in depressive patients suggest that, yes, exercise does lead to better mental and physical health in patients with depression. This pairs well with another common finding that depressed patients are very rarely willing to complete difficult tasks for reward. So even on an extreme clinical scale, mental ill-health can have very damning consequences on maintaining good physical health. On the other hand, simple activities such as light jogs or walks may be the key to reversing negative spirals and getting on the right track towards recovery ( Figure 2 ). Conclusion and what we can do So far we have pretty solid evidence that mental health can impact physical health and vice versa, both negatively and positively. Going back to the introductory question, yes! We can find activities that improve both our physical and mental health. The trick is to find exercises that we find enjoyable and rewarding. On the clinical side, this could mean that physical exercise may be as effective at remitting depressive symptoms as antidepressants, likely with a lot fewer side effects. With that said, stay active and have fun, it helps more than you think! Written by Ramim Rahman Related articles: Environmental factors in exercise / Stress and neurodegeneration / Personal training / Mental health awareness REFERENCES Nord, C. (2024) The balanced brain . Cambridge: Penguin Random House. Osimo, E.F. et al. (2020) ‘Inflammatory markers in depression: A meta-analysis of mean differences and variability in 5,166 patients and 5,083 controls’, Brain, Behavior, and Immunity, 87, pp. 901–909. doi:10.1016/j.bbi.2020.02.010. Basso, J.C. and Suzuki, W.A. (2017) ‘The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: A Review’, Brain Plasticity , 2(2), pp. 127–152. doi:10.3233/bpl-160040. [figure 1] DiCarlo, G.E. and Wallace, M.T. (2022) ‘Modeling dopamine dysfunction in autism spectrum disorder: From invertebrates to vertebrates’, Neuroscience & Biobehavioral Reviews, 133, p. 104494. doi:10.1016/j.neubiorev.2021.12.017. [figure 2] Donvito, T. (2020) Cognitive behavioral therapy for arthritis: Does it work? what’s it like?, CreakyJoints. Available at: https://creakyjoints.org/living-with-arthritis/mental-health/cognitive-behavioral-therapy-for-arthritis/ (Accessed: 06 December 2024) Project Gallery

Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Hypertension: a silent threat to global health Last updated: 13/03/25, 11:38 Published: 13/03/25, 08:00 Causes, symptoms, diagnosis and management Introduction Did you know that hypertension, also known as high blood pressure, is a leading cause of premature death, affecting 1.28 billion adults aged 30-79 worldwide? According to the World Health Organisation (WHO), two-thirds of these individuals live in low and middle-income countries. Despite its widespread prevalence, many people remain undiagnosed as most cases are asymptomatic, and individuals are unaware they have the condition. Hypertension can lead to serious clinical manifestations such as heart disease. It can also cause eye retinopathy, causing vision problems and kidney damage, including proteinuria. It also contributes to vascular contributions like atherosclerosis, leading to stenosis and aneurysms. It also significantly raises the risk of stroke and heart failure (Figure 1 ). Addressing hypertension through early diagnosis, improved access to treatment and lifestyle changes is essential to reducing its global burden. This article aims to explore the causes, diagnosis and treatments. What drives hypertension? Hypertension is characterised by persistently elevated BP in the systemic arteries. Blood pressure is typically presented as a ratio: systolic BP, which measures the pressure on arterial walls during heart contraction, and diastolic BP, which reflects the pressure when the heart is at rest. Hypertension is diagnosed when the systolic blood pressure is 130 mmHg or higher and/or diastolic blood pressure exceeds 80 mmHg based on multiple readings taken over time ( Figure 2 ). In contrast, secondary hypertension occurs only in 5% of cases and is caused by an underlying condition, such as kidney disease, hormonal imbalances, or vascular problems. This form of hypertension is often reversible if the underlying cause is treated. Common causes of secondary hypertension include chronic kidney disease, polycystic kidney disease, hormone excess (such as aldosterone and cortisol), vascular issues like renovascular stenosis and certain medications. Drugs that can cause secondary hypertension include chronic use of non-steroidal inflammatory drugs (NSAIDs), antidepressants and oral contraceptives. Hypertension, regardless of its cause, can be exacerbated by certain health behaviours, including excessive dietary salt, a sedentary lifestyle, heavy alcohol consumption, and diets low in essential nutrients, such as potassium. These factors contribute to the development and worsening of high blood pressure. However, blood pressure can be improved by reversing these behaviours, as well as following a diet rich in fruits and vegetables, which helps to mitigate the negative impact on blood pressure. Spotting hypertension: how it is diagnosed Hypertension is usually detected when blood pressure (BP) is measured during regular checkups. Since it often doesn’t show symptoms, all adults must check their BP regularly. The most common way to diagnose hypertension is by measuring BP several times in a doctor’s office. To get an accurate reading, BP must be measured carefully. Since BP can vary throughout the day, multiple measurements are needed. Doctors have recently started using home BP monitoring (HBPM) and ambulatory BP monitoring (ABPM) to check BP outside of the office. ABPM records BP every 20-30 minutes over 24 hours, while HBPM lets patients measure BP at home. These methods help identify conditions like 'white coat hypertension' (high BP in the doctor’s office but normal at home) or 'masked hypertension' (normal BP at the doctor’s office but high at home). When diagnosing hypertension, doctors also look for other health issues related to high BP, such as heart disease or kidney problems. If high BP is sudden or difficult to control, doctors may suspect secondary hypertension, which is caused by another condition, like kidney disease or hormonal imbalances. A thorough medical history is essential. This includes asking about past BP readings, medications, and lifestyle factors such as smoking and diet. Doctors also check for other risk factors like diabetes or high cholesterol, increasing heart disease risk. A physical exam helps confirm the diagnosis of hypertension and checks for any damage to organs like the heart and kidneys. BP should be measured on both arms and if there's a significant difference in readings, further tests may be needed. If necessary, doctors may also check for conditions like atrial fibrillation or perform ultrasounds to look for heart or kidney problems. Blood tests can also help identify risk factors, confirm or rule out secondary hypertension, and assess overall heart health. Managing hypertension, from lifestyle changes to medications Studies show that weight loss can reduce systolic blood pressure by 5 to 20 mmHg, making it an effective strategy for managing hypertension. However, the exact "ideal" body weight or Body Mass Index (BMI) for controlling blood pressure is not clearly defined, but small weight reductions can make a difference. Reducing salt intake, staying active, and managing sleep apnoea also help. While smoking does not directly raise blood pressure, quitting reduces long-term heart risks. Overall, lifestyle changes alone can cut cardiovascular events by up to 15%. Most national and international guidelines recommend the use of angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs), and thiazide or thiazide-like diuretics as first-line pharmacological treatments for hypertension. Conclusion Hypertension is a prevalent and often silent condition with serious health consequences, including heart disease, stroke, and kidney failure. Its widespread impact on global health, particularly in low- and middle-income countries, underscores the importance of early diagnosis and proactive management. While lifestyle modifications are crucial in managing blood pressure, medications remain essential for many individuals. By raising awareness, promoting regular blood pressure checks, and ensuring access to both preventative and therapeutic measures, we can reduce the burden of hypertension and improve long-term health outcomes globally. Written by Michelle Amoah Related article: Cardiac regeneration REFERENCES Iqbal, A. M., and Jamal, S. F. (2023). Essential hypertension. In StatPearls [Internet]. StatPearls Publishing. Retrieved from [ https://www.ncbi.nlm.nih.gov/books/NBK539859/ ] Schmieder, R. E. (2010). End Organ Damage In Hypertension. Deutsches Ärzteblatt International. https://doi.org/10.3238/arztebl.2010.0866 Touyz, R. M., Camargo, L. L., Rios, F. J., Alves-Lopes, R., Neves, K. B., Eluwole, O., Maseko, M. J., Lucas-Herald, A., Blaikie, Z., Montezano, A. C., and Feldman, R. D. (2022). Arterial Hypertension. In Comprehensive Pharmacology (pp. 469–487). Elsevier. World Health Organization. (2023). Hypertension. Retrieved [24th January 2025], from https://www.who.int/news-room/fact-sheets/detail/hypertension Project Gallery