A Different Kind of Surgery – Zero gravity, Robotics and a 3D printer

Illustration by Sam Wilson

Space has become a place that has provided Earth with incredible discoveries. In the process it has helped us answer how and why our planet is how it is, helped us advance technology due to our curiosity into space exploration and answers many theories scientists have and/or had about the universe.

Earlier this year, a study was carried out to assess the effect of space on the internal jugular vein. With those taking part not displaying any alarming symptoms, it would have been easy to miss a blood clot that had developed in one of the astronauts had it not been for the study.

Obviously, being very far from Earth at the International Space Station (ISS) it would be ludicrous to think of waiting for a doctor to make a ‘home visit’ to space to assess an astronaut. So instead, evaluation and treatment was attempted over a phone call. Normally, the use of blood thinners would be used over a course of months to prevent such a clot from getting any bigger but there is always increased risk that if an injury were to occur, taking blood thinners could cause internal bleeding that would be difficult to treat. Especially under zero gravity conditions and from our understanding that blood flow and tissue fluid shifts towards the head in space (EEK!).

The astronaut was eventually treated using an anticoagulant drug that was sent up after daily injections of blood thinners, which they had to take until they received the medication. Upon landing and after 24 hours they found the blood clot had disappeared. Having no symptoms or a family history of blood clots, the astronaut’s case was a clear indication that the human body undergoes changes in space that still surprise us and suggest there is still much to learn about aerospace medicine and space physiology.

That being said what would happen if an astronaut needed more than a life saving drug and instead needed immediate surgery? Would their guts and fluids just float around in Space? Is it even possible?

Many studies related to health and medicine have been carried out in space and continue to. January 1990: Three mission specialists on the Columbia STS-32 mission test out an Echocardiograph, a medical ultrasonic imaging system used with a lower body negative pressure unit. The test subject is G David Low, while Marsha S Ivins and Bonnie J Dunbar carry out the test. NASA/Space Frontiers/Getty Images

Researchers in space medicine say quite a few procedures have been carried out in zero gravity simulations with many challenges of performing surgery in a zero gravity environment being minimised using laparoscopic techniques (keyhole surgery).

According to Pete Hodkinson, specialty registrar in Aviation and Space medicine at the University of Cambridge, “it would be better to evacuate an individual requiring major surgery rather than attempt it in orbit” as there is a spacecraft attached to the ISS that could be used for emergency evacuation. Although without evacuation some surgeons speculate that surgery could be done but there is a lot to consider such as movement of organs during procedure, shelf life of medications for potential long missions such as a 3 year mission to Mars, how anaesthesia would work in space and if most procedures would be able to be carried out through telementoring techniques.

While use of robotic surgery and 3D printing technology have been considered in future methods for carrying out microsurgery and providing astronauts with the supplies they need to do such operations.

More on this can be seen here in this video.

Referring back to the use of 3D printing technology for uses in surgery and space medicine, one of the things scientists have been working on is the use of the 3D BioFabrication Facility (BFF) considered to be the first 3D printer capable of manufacturing human tissue in space conditions. Its success could lead to benefits down on Earth as well, with the ability to 3D print human organs that could be constructed from the patient’s own cells to reduce the possibility of the body rejecting the new organ. This could lead to organ donor waiting lists becoming a thing of the past and surgery that is far less risky.

Overall, there remains a lot for us to learn in the area of aerospace medicine and surgery but I’m positive that just like many discoveries we’ve made from learning about space, any further knowledge can help to benefit those who still have their feet planted firmly on solid ground.

Further reading and videos on this topic:

http://www.techshot.com/bioprinter/

Brad Pitt speaking to NASA Astronaut Nick Hague Aboard the International Space Station https://www.youtube.com/watch?v=_oVYSwmIrZk&t=208s

https://publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsbull.2015.97.5.208

https://theconversation.com/from-floating-guts-to-sticky-blood-heres-how-to-do-surgery-in-space-141837

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What does a US-UK trade deal mean for the food industry and our health?

Illustration by Sam Wilson

As the UK is beginning to start trade deal negotiations with the US, many people have been spamming social media with why we must protect the food standards we have in the UK and why we need to make our government listen to advice on maintaining the standards we have.

Two of the most controversial issues with food production in the US which we do not use in the UK are chlorinated chicken and the use of hormones in beef production. While they may be fine for the US, there are several things to consider as these changes may potentially roll out in the UK.

1. If we don’t use hormones in our beef production now then why do we need to use them in future?

2. The use of chlorinated chicken is currently banned in the UK. Why is this?

3. What would it mean for our health and immune systems?

Well, to address the first question we have to understand that the amount used in beef production is arguably smaller than the levels we produce naturally in our bodies. However there is still evidence that small amounts of hormones can disrupt processes in the body. Many studies into the use of hormones in food production have also found that a number of those used in US meat and dairy production are known to be carcinogenic to humans. So perhaps another question we should be asking is: “If hormones are to be used in food production how are they to be controlled or prohibited?” Growth hormones in beef production have also been linked to affecting prepubescent children, with some evidence suggesting it may have an effect on children entering early puberty. Although, there are other factors that can affect this.

In regard to the second question, the reason chlorinated chicken has been banned in the UK was due to EU experts arguing that the process introduced poor hygiene along the supply chain. So, there is already potential that the process could bring up other problems that the UK does not currently have to face. In addition to this, research into chlorine washing practices found that the process does not necessarily wash away all pathogens found on food and dangerously can in some cases make pathogens undetectable (more on this here).

From this information perhaps it is already fairly obvious to understand what this could mean for our health. Should we really consider accepting different food standards, when it is believed that in the US it is approximately seven times more likely to get food poisoning than in the UK?

Another consideration which has been somewhat triggered by me embarking on a FutureLearn course about antimicrobial resistance is the use of antibiotics in food production. While globally the use of antibiotics in agriculture and livestock is continuously being monitored as best it can, my question is: With the UK having a 5 year plan to reduce risks of AMR, will the use of antibiotics be tightly monitored as well? The overuse and misuse of antibiotics through prescriptions amongst other reasons has been a topic of significant importance for those in medicine and science. The overuse of antibiotics in food production can have a huge effect on the risks of AMR cases and is something we must think about especially for young children who are developing immune responses as they grow up.

The trade deal negotiations could potentially have an adverse effect on UK farmers and there have been many disgruntled opinions from the National Farmers Union at the moment prompting the government to consider maintaining our UK food and safety standards. The trade deal between the US and the UK has previously been of some concern to those in agriculture and farming as there has been continuous worry that imported food would greatly compete with UK produce in our supermarkets. However, the UK over the years has also seen the dairy industry export more products than they import and so in someways this could be beneficial to certain farmers. On the other hand, many members of the public have expressed concern over eating and buying food that has been washed with chlorine or that contains growth hormones. With this being said, if the government were to not listen to public opinion on the matter it could affect sales of meat and other produce from UK farms.

Personally, I am all for maintaining the food standards we have already but of course it all comes down to the decisions that end up being negotiated. While also taking into consideration; how we react to a trade deal weighing in favour of US food standards, the manner in which we ensure safety for ourselves in terms of limiting risks to our health (especially since having to deal with COVID-19) and how we can support the nation’s farmers at the same time.

If you have any food for thought on the matter, let us know or share your opinions using the hashtag #infectiousbiouk on social media.

The Second Brain: an exploration of how our gut microbiota and our brain work together

For the last century or so, scientists have been intrigued by the link between our diets and our mental health.
In fact, during the early 20th century Dr George Porter Phillips had a hunch that by looking at a patient’s gut, we could begin to comprehend the origins of depression. He had observed that many of his patients diagnosed with melancholia (a subtype of major depressive disorder) suffered from severe constipation along with other signs such as brittle nails and an unhealthy complexion.

Phillips wondered if by targeting the gut it would have a knock-on effect on his patients’ wellbeing. So, in his curiosity to find out he fed his patients a carefully restricted diet and offered them a fermented milk drink known as kefir, which contains lactobacillus bacteria. A microbe that is now commonly used in the manufacturing of probiotic products, with certain strains commonly found in the well known fermented milk drink, Yakult. Astonishingly enough it worked, with many of his patients either reporting no symptoms of melancholia or showing signs of significant improvement. It became some of the first evidence in suggesting that our gut flora can have a profound impact on our mental health.
Since this shred of evidence, research into the microbes of our gut has continued to reaffirm the fundamental idea of a gut-brain axis.
Additionally, the effect probiotics have on our gut flora is still of academic interest as I remember not too long ago writing a lab report during my degree on how the presence of milk proteins in Yakult increased the survivability of L.casei (the strain of bacteria in Yakult) in the gastrointestinal tract. Implying somewhat that probiotics in fermented milk products were superior in terms of ensuring they survived in the gut than opposing probiotic capsules.
Which makes sense, given the volume of advertising aimed at informing us how consuming yoghurts and fermented milk drinks will help promote and provide “tummy loving care”.

However, not only have probiotics become a staple in what is seen as a healthy balanced diet but they have also led researchers to discover that the gut microbiota when thriving, can naturally synthesize valuable neurotransmitters such as serotonin. While some antidepressant drugs have been used to increase serotonin uptake in the central nervous system, scientists have come to find that studies in mouse models provide evidence that the gut microbiota influences such levels. They where also able to discover that acetylcholine, an important neurotransmitter in cognitive function, particularly important in our ability to memorise and learn is a component of some bacterial strains found within our gut. So not only does our gut influence our happiness but it can also influence our ability to remember important details and learn new things. It clearly goes without saying that the gut is pretty special and crucial in determining what are bodies can and cannot do.

Alright let us draw our attention back to the brain now, shall we? There are a vast number of factors that can impact our mental health, ability to process emotions and thoughts, retain memories, our ability to move our bodies and continue to learn as we grow older. The main question is what can we do about these things by understanding our gut-brain link? Well …all of these things are now being considered by experts who study the brain and the gut (along with all the thriving bacteria found within it). With the aim being to develop therapies that work in favour of our gut, to treat or alleviate symptoms from conditions such as irritable bowel syndrome, anxiety, depression, autism, multiple sclerosis, chronic fatigue syndrome and neurodegenerative disorders such as Alzheimer’s and Parkinson’s disease.
These objectives provide us with hope that we can produce therapies that mirror the hidden world in our guts and that could help us improve people’s lives.

During my time at university, I came across the book ‘GUT: The Inside Story of Our Body’s Most Underrated Organ’ by Giulia Enders. Not only do I recommend it to those who have an interest and enthusiasm for gut health and science, but I also recommend it as a brilliant book for those interested in how our gut functions and impacts our central nervous system, the allergies and food intolerances we may have, how and why we poop (sorry not sorry) and how it really is our second brain.

“Were the gut solely responsible for transporting food and producing the occasional burp, such a sophisticated nervous system would be an odd waste of energy. Nobody would create such a neural network just to enable us to break wind. There must be more to it than that.”

– Giulia Enders, Gut: The Inside Story of Our Body’s Most Underrated Organ

Sources for those that wish to crawl further into the world of our guts and what’s inside them:

1. Phillips, J. (1910). The Treatment of Melancholia by the Lactic Acid Bacillus. Journal of Mental Science,56(234), 422-430. doi:10.1192/bjp.56.234.422
2. Gustaw W, Kozioł J, Radzki W, et al. The effect of addition of selected milk protein preparations on the growth of Lactobacillus acidophilus and physicochemical properties of fermented milk. Acta Sci Pol Technol Aliment. 2016;15(1):29‐36. doi:10.17306/J.AFS.2016.1.3
3. Wikoff WR, Anfora AT, Liu J et al. (2009) Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites. Proc Natl Acad Sci U S A 106, 3698–3703.
4. Girvin GT & Stevenson JW (1954) Cell free choline acetylase from Lactobacillus plantarum. Can J Biochem Physiol 32, 131–146.
5. Rowatt E (1948). The relation of pantothenic acid to acetylcholine formation by a strain of Lactobacillus plantarum.J Gen Microbiol 2, 25–30.
6. Horiuchi Y, Kimura R, Kato N et al. (2003) Evolutional study on acetylcholine expression. Life Sci 72, 1745–1756.
7. Probiotics For Mental Health And Wellbeing. [online] Available at: <https://pdfs.semanticscholar.org/18d7/a7ac2dd09f5a241072896262e978169392e2.pdf&gt; [Accessed 1 May 2020].
8. Nature.com. 2019. The Microbiota–Gut–Brain Axis. [online] Available at: <https://www.nature.com/articles/d42859-019-00021-3&gt; [Accessed 1 May 2020].
9. Image Source: https://www.monashfodmap.com/blog/functions-gut-microbiota/ [Accessed 1 May 2020]

Climate change and Covid-19 in cahoots?

Illustration by Sam Wilson

While the days seem to merge into one and the length of time during this pandemic seems to grow longer than the 2 metres I stand from people as I wait in the queue at the shop to buy my essentials. The vast amount of information soaring through the web has been catapulting at an incredible pace, so much so that it is almost impossible to write posts on here about ‘corona news’ without the worry I’ll be writing something contradictory the very next day.

However, the thread of information shaping opinions online of how we should act after this is all over and discussions over coronavirus versus climate change all seem to be trending following a similar pattern. You see, as people continue to discuss research, vaccines and the origins of the Covid-19 virus it is only natural that issues such as climate change are brought into conversation. Climate change can have an impact on pandemics and transmission, the rate at which many diseases spread with ease has often come from travel. Well , if you think about the amount of air travel from East Asia across to Europe (including the airports travellers pass through on the way) and vice versus it was almost inevitable that a virus originating from the city of Wuhan made its way to countries such as Italy, France and of course, the UK.

Social distancing and isolation is obviously not a cure for viral pandemics. In fact, the slow of transmission was put in place to help with the unbearable additional weight the NHS is having to carry on its back due to our government’s response to the outbreak. Although, the more I am socially distanced and admittedly appreciating the hushed silence on the streets when I go for my walk or run of the day, something has become very apparent to me.

Venice has seen calmer, clearer water running through its canals. China has seen clearer skies and I have breathed in air that smells a little bit crisper than usual? It might deceptively appear as though the planet seems to be feeling better from the restricted human activity however, scientists and those with expertise in climate change research are saying this virus is a wake up call NOT an immediate long term solution for our climate. In fact almost all, if not the majority of expert opinions on the matter are drawing the conclusion that not only is the work being put in now important for dealing with the current situation but what we choose to do after this time is crucial, to not just how we deal with current and future outbreaks but also how we can help our planet to heal.

Overall, it could be argued that although disease outbreaks occur naturally around the world, our stubbornness or rather our arrogance to deal with our long term issues (climate change being a rather big one) can lead to the fate of our short term problems such as the current coronavirus pandemic. Air travel increasing rate of transmission, deforestation forcing animals to migrate allowing transmission from animals to humans, weather aiding the spread of waterborne infections, temperature changes allowing infectious agents to survive and grow and so on and so on.

So if you are sitting at home twiddling your thumbs wondering what else to do after exerting all your energy into the same routine you’ve developed over the last few days, perhaps it is time to address how your own actions now could help with climate change in addition to the current pandemic. Not only that but how those actions can be carried forward into the future after this situation is over and how you should tell all your friends that its cool because you’re saving the planet even though you can’t provide an immediate cure for a virus you may very well know nothing about (may have stretched that a bit far, but ….it is cool to save the planet).

In fact, climate activist Greta Thunberg (even if you are not a fan) made an important statement recently saying that climate change should be tackled along with coronavirus simultaneously, with the concern that amidst the chaos politicians would brush it under the rug. Obviously, there is some argument to this. Many would say that coronavirus is something that is (hopefully) short term and needs to be addressed urgently in comparison to climate change which is and has been a long term issue. I would say that climate change is a measure that should be addressed because it provides a level of risk in triggering outbreaks similar to the one we are currently witnessing. It’s like hiding an anthill under a rug and just exterminating them when they appear on top of the rug. I can only hope that if that were to happen the army of ants don’t return in anger, fire in their eyes and more alarming numbers.

At the end of it all, I believe its fair to say looking at climate change now, reflecting on where we are and how fast everything is speeding past us, a lot of this reflection can help in us making sense of where we go wrong and how we can do better to prevent or at least lower the risk of such events arising again or sooner than we predict them.

To those who are working like clockwork; from the medical staff to the researchers, the pharmacists, the shelf stackers and anyone else I have shamefully failed to mention , thank you for everything you are doing and continue to do for us all.

Discovering the skull of a 100 million year old, 2- gram dinosaur

Photo in header of Oculudentavis khaungraae skull , Credit: Lida Xing

Discovering specimens preserved in Burmese amber has allowed Palaeontologists to identify an array of incredible dinosaurs, plants and insects that roamed Earth millions of years ago. The amber allows soft tissues, vertebrae and extra details such as feathers to remain almost completely in tact.

However, this most recent discovery of Oculudentavis khaungraae is thought to be 100 million years old and has a skull that is less than 2 centimetres in length. With large eyes, over a hundred teeth and a size similar to that of the world’s current smallest living bird; the bee hummingbird (Mellisuga helenae) its discovery is thought to explain how other creatures came to be so small. It also suggests that the bird was a predator, hunting small insects and other small invertebrates. With big eyes protruding from out of its skull implying it had no binocular vision (a common feature amongst predatory birds) and being the size it was, perhaps its easy to assume that regardless of the mass eradication of dinosaurs, it would have inevitably become extinct anyway.

Jingmai O’Connor and her team, at the Chinese Academy of Sciences Institute of Vertebrate Paleontology and Paleoanthropology in Beijing , assigned the animal a new genus and species, Oculudentavis khaungraae; with the genus name meaning ‘eye-teeth bird’. The dinosaur itself weighed perhaps two grams and lived during the Mesozoic era, which lasted from about 250 million to 65 million years ago.

Further research on the fossil could be extremely difficult however, as advanced research techniques will have to be in place to ensure the tissues remain preserved on inspection.

Unfortunately, most amber specimens are found in war torn Myanmar and so pose ethical questions to scientists working on these specimens, if they should be working on them at all.

The above video will explain the hunt for fossils in amber in more detail.

Pasta for dinner?= Fake news. Pigs to the rescue?= Possibly

After the World Health Organisation officially upgraded the current Coronavirus (Covid-19) outbreak as pandemic, the UK has come under the largest rise in coronavirus cases in a single day, with our own region , Norfolk confirming 3 more cases. Although there has been a vast number of announcements telling everybody not to panic, that facemasks are not the most preventable measure, to not touch your face (as public health official Dr Sara Cody in California flawlessly showed us) and to wash your hands more frequently, I still found Tesco to be completely out of hand wash and pasta this afternoon.

Source: Washington Post, Youtube. 05 March 2020

In fact, the impact of the outbreak and escalation as a result of fake news has led to the NHS pointing everybody’s attention to a part of their website that is dedicated to debunking tabloid myths after announcing they are working with social media giants, Instagram, Facebook, Twitter and Google in tackling any further spread of nationwide paranoia (source: https://www.england.nhs.uk/2020/03/nhs-takes-action-against-coronavirus-fake-news-online/). To reassure everyone more , the NHS have plans already in place to try and expand testing to 10,000 people a day as opposed to 1,500.

While Italy seems to be in total lockdown, the UK has 460 positive cases and is still set on finding a way to control transmission. Considering the number of cases, 8 people have died and the mortality rate has been confirmed as low, with those that are at high risk of the comparable influenza virus most likely to contract Covid-19.

https://www.bbc.co.uk/news/uk-51839106

While the NHS and W.H.O try their best to cover live news on the viral spread throughout the nation, local newspaper; Eastern Daily Press instead seem to be focussing on how persistent Norfolk is in tackling any signs of the virus.

The first story that understandably caught my eye was a report on the work of Norwich scientist, Professor George Lomonossoff. He has been concentrating his attention on a potential vaccine for Coronavirus in pigs, which if successful could form a great deal of knowledge on how to develop a vaccine for human cases. However, news that the virus can easily mutate has been confirmed as typical behaviour for the type of virus that causes Covid-19 and as a result could prove difficult when developing vaccines.

“The mutation rates make it difficult to catch, you are running to stand still. I hope that we can learn from what we are doing with coronavirus in pigs which could be applicable to the overall design of a vaccine against coronavirus in animals and also humans”

Source: Professor George Lomonossoff for Eastern Daily Press, 07 March 2020

Amidst all the warnings and the paranoia, the most important thing to take away from this is stay aware and take sensible precautions if you are considered to be in a high risk group.

Below you will find sites with information on Coronavirus (COVID-19) and how to protect yourselves as well as Q&A’s from W.H.O.

Source: video made by The World Health Organisation

Personally, given everything that has happened recently I believe there to be a lot more potential for a vaccine than we think and stocking up on pasta for the inevitable apocalypse is not going to stop you from contracting the virus nor help anyone else who is likely to contract it either. So, much like the face mask trend, raiding the shelves at your nearest supermarket should definitely be thrown out the window. We’re not going to run out of supplies that quickly anytime soon.

Look out for yourselves but look out for others too.

Some sources of information about Coronavirus:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/videos

https://www.nhs.uk/conditions/coronavirus-covid-19/

https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response