The Nobel Prize Goes To…

The Nobel Prize for Physiology or Medicine 2016 has been awarded this year to Yoshinori Ohsumi for his discoveries on the mechanisms of autophagy.

Autophagy is when a cell destroys its own contents and effectively recycles itself. This mechanism has been very difficult to capture, and therefore little progress has been made in understanding the core physiology behind this concept.

Ohsumi’s work that has been going on since the late 1980s means that he has managed to identify the first genes essential for autophagy in a human cell, and outline the cascade of proteins and protein complexes that lead to the autophagy as a response to external stresses faced by a cell such as starvation and viral infection.

This news should be insightful to anyone doing Medicine, Biological Sciences, Biomedicine or Biochemistry. All the students of the mentioned subjects can look at how gene encoding works, why a cell would want to destroy itself, and looking in deeper detail into the internal compartments of a cell. Given that the initial experiments were carried out by Ohsumi on yeast cells, students can look at why yeast cells are commonly used as the model cells for cell behaviour, and how they are similar to human cells.

With only twelve days’ notice, UK hospitals are finding themselves in an unenviable position, having to prepare themselves for what has been described by Jeremy Hunt as “the most devastating doctors’ strike in NHS history”.

This is the first time that junior doctors will be striking for five consecutive days, from 12^th-16^th September, 08:00-17:00.  As a result of this strike, 100,000 operations have been cancelled, and over a million hospital appointments have been postponed, raising serious concerns about the quality of patient welfare.  It has been revealed by the BBC that, in confidential papers drawn up by the BMA, it is possible that there will be five day strikes each month for the rest of the year.

Jeremy Hunt has naturally found himself in the firing line, however, he has stated that he has made 107 concessions in the junior doctors’ contract, “bending over backwards” to be accommodating, as a result of meeting with the royal colleges and BMA in May.  This contract was subsequently rejected by the junior doctors in July.  The BMA stated that the junior doctors felt that not enough was done to “reward” those who, for example, work the most weekends.  With the new contracts offering an increase in pay of 10-11%, weekend supplements of 10%, and nights being paid at 37% above the normal time, there have been allegations that these strikes are driven more by financial greed than patient welfare.

Dr Mark Porter, who is chairman of the BMA council, stated that the BMA was “united” behind junior doctors, he declined to comment on whether the council voted on this latest strike by a very small majority (16 vs 14).  If this is the case, junior doctors might find themselves having less and less support, both in terms of the public and medical spheres, should their striking continue as is currently envisaged.

If you are thinking of applying to study Medicine, you may wish to explore the ethics of the junior doctor strike, and detractors from the strikes.

Danish scientists may have accidentally discovered the cure for cancer, during an experiment looking for ways to protect pregnant women against malaria.

Malaria can cause huge problems for pregnant women because it attacks the placenta. However, the scientists’ discovery suggests that malaria proteins can also attack cancer cells. The malaria protein attaches itself to a carbohydrate which ensures the placenta grows quickly, prohibiting its progress. The scientists have shown how the protein can have the same effect in tumours, attaching to the same carbohydrate that encourages the growth of cancerous cells. This comes after years of scientists searching for a connection between the placenta and tumours, due to their similar, aggressively rapid growth. In combining the part of the protein that the malaria vaccine uses to bury into cells with a toxin, they created a molecule that can bury into cancer cells and release the toxin, thereby killing them off.

The scientists have already tested the process in cells and on mice with cancer and hope to be able to test the method on humans within the next four years. The tests on mice produced wide success; the process was tested on three different types of cancer and all three showed improvement following the treatment as many of the cancer cells were killed.

Biology and Chemistry students should investigate the process by which malaria and cancer affect the body and what other diseases may have similar connections. Medicine applicants should look further into the methods used by scientists to cure diseases, including the ethical principles that involve testing new treatments.

The University of Cambridge has released a study finding that viruses are more effective in the morning.

As Biology applicants will know, viruses rely on using human cells to replicate, and the composition of the cell changes over the course of a day. The researchers infected mice with influenza or herpes, and found that mice infected in the morning had ten times the viral levels of those infected in the evening.

The scientists found that late viruses were failing to inhabit the cell in the same way as early morning infections – Professor Akhilesh Reddy, one of the researchers, explained that “the virus needs all the apparatus available at the right time, otherwise it might not ever get off the ground, but a tiny infection might perpetuate faster and take over the body.”

HSPS and Medicine applicants should consider how this might make some demographics of the population more susceptible to disease than others, particularly shift workers who may have a disrupted body clock from working nights.

The Court of Arbitration for Sport has suspended regulations on hyperandrogenism – a condition which causes excessive testosterone which clouded Caster Semenya’s high profile victory in the World Championships.

In 2009, at the height of controversy of hyperandrogenism, Caster Semenya’s victory was shadowed by accusations that she was not fit to compete in the women’s championships. Commentators doubted her gender and Semenya was subject to gender tests. The tests revealed that Semenya was chromosomally a female, with higher levels of testosterone than the average female.

Sports scientist Ross Tucker argues that high levels of testosterone in female athletes confers an unfair advantage and suggests that a good performance by Semenya or Dutee Chand, an Indian sprinter, would give the ruling body the evidence they need to class hyperandrogenism as an unfair advantage.

However, other commenters have pointed out that even if this is a genetic advantage in sports, it is one of many that are not regulated by ruling sporting bodies. More than 200 genetic variations have been identified that provide an advantage in elite support, such as improving blood flow to muscles and increased energy production.

Had hyperandrogenism been considered an unfair advantage, both Chand and Semenya may have been forced to undergo androgen suppression therapy. Medicine applicants should investigate the ethics of medical intervention that isn’t medically necessary. Human Sciences and HSPS applicants should consider the social policing of women’s bodies in sport, and why strong female athletes are often faced with criticism about their appearance and perceived masculinity.

With doping an ever-present subject of sports news headlines, a study has shown that an energy supplement drink can improve athletes performance, and is completely legal, after the World Anti-Doping Agency ruled against it being banned after the initial study in 2011.

The drink is known as ∆G, and works by releasing a ketone chemical that muscles can use to produce energy. The initial study of the supplement was conducted on 22 elite rowers and those who were drinking the supplement achieved ten season best performances, six personal bests and even a world record. The most recent study by Kieran Clark at Oxford University has bolstered these results. The team gave the drink to elite cyclists completing a 30-minute time trial and found they were able to cycle an average of 411 metres further during the trial than those drinking glucose drinks.

The supplement works by providing another source of energy for athletes. Ketones are naturally produced by the body when fat is broken down, and normally only occurs when energy reserves are running low (for example when starving, or on a low-carb, high fat diet). The supplement provides ketones in the form of beta-hydrozybutyrate, allowing athletes access to this source of energy that they would only normally have when their energy reserves are depleted. Thus, their muscles are able to draw energy from ketones, fat, and glucose at the same time. This also lowers the athlete’s likelihood of ‘hitting the wall’, as the glucose reserves can be preserved. This theory is supported by the observation that the cyclists who consumed the glucose drink produced significantly less lactic acid, which is a product of burning glucose.

There is some scepticism about the findings, which may prompt further studies into the supplement. However, the athletes who have used it so far (more than 300) have reported positive results. The World Anti-Doping Agency made the decision not to ban the supplement because ketones can be increased naturally through the diet.

Biology and Medicine applicants should investigate in more depth the bodily reactions that take place during exercise and how the supplement works to improve performance. Law students should look into the laws and recent legal battles surrounding doping in sport, and should, along with Anthropology and HSPS students considering the ethical implications of using any performance enhancer in competitive sport. 

A recent study has stated that the commonly heard advice from dentists to floss may not be as good advice as we think.

The study investigated the long-term impacts of flossing over a decade, looking at 25 case studies. The study sought to understand whether flossing and brushing was a better combination than just brushing alone – and the conclusion was very much inconclusive.

“The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal,” reads a section of the study. The original piece also argues that the Dietary Guidelines for Americans, without much fanfare, removed its imperative for Americans to floss between its 2010 and 2015 editions, with the latter making no mention of floss as a useful hygenic practice.

Despite this argument, many dentists would still recommend flossing as a way to prevent gum disease despite tenuously proven links between the two. Wayne Aldredge, president of a peridontists’ group, argues that not flossing is “like building a house and not painting two sides of it.” HSPS applicants should consider the changing role of medical practices in modernity, and how reporting of new medical studies can often be misleading in the media. Medicine applicants should consider the ways in which patients receive their medical advice, and how these communications mix inherited wisdom and new studies.

Many of us think as dying as the worst thing that could happen as the result of sickness – but a new poll of severely ill patients found a different response.

From July 2015 to March 2016, researchers spoke to 180 patients admitted to a Pennsylvania Hospital with terminally ill or severe conditions. While the patients may not necessarily have been suffering from similar ailments, they all found that there were worse ‘living limitations’ than death. Patients agreed that certain living conditions would make living as bad or worse than death – with the highest proportion stating that incontinence or living with a breathing machine would be worse.

None of the patients surveyed suffered from these problems themselves, but Medicine applicants should consider what this study means for patient care. The authors of the study state that work in intensive care units in hospitals “commonly ignore [patient] preferences, assuming implicitly or explicitly that death is an outcome to be avoided no matter what the alternatives are.” Those applying for Medicine should consider the balance medical practitioners need to make between obeying a patient’s wishes and preserving a life.

The development of new drugs is big business, costing up to £850 million to get a single treatment to the point it can be sold and used in the clinic. A new study published in the International Journal of Epidemiology has found that genetic research in large-scale prospective biobank studies may significantly improve the drug development pipeline, thereby reducing costs.

New treatments are discovered by exploring biological pathways that cause disease, but can be modified by drugs, and the route to a successful drug is littered with those that have fallen by the wayside at various points during development. However, a study of one such unsuccessful drug has pointed to a way that could reduce costs. 

Researchers at the University of Oxford and the Chinese Academy of Medical Sciences joined forces with Glaxo SmithKline (GSK) to explore whether the disappointing results of previous research into cardiovascular disease could have been predicted by using a genetic variant that mimics the drug effect.

People with a non-functioning variant have lower levels of Lp-PLA2 so the idea is to see if these people have a lower risk of cardiovascular disease than those with functioning variants. In a study of over 90,000 participants in the prospective China Kadoorie Biobank (CKB) study, the association between this genetic variant and a range of cardiovascular and non-cardiovascular diseases was explored. This method is termed ‘Mendelian randomization’ because it relies on the way the play of chance determines the genetic variants inherited at conception, and allows nature to mimic randomised controlled trials. 

The researchers found that people with a non-functioning genetic variant were not at lower risk of developing cardiovascular (and other non-cardiovascular) diseases – upholding the trial findings. Compared with the many steps in the traditional pathway to drug development (at a cost of several billion dollars) the availability of large scale biobanks make the cost of carrying out Mendelian randomization analyses trivial. This methodology is likely to be much more widely used to examine the causal nature of biological pathways involved in diseases before mounting large-scale trials in the future. Medicine applicants should consider how this step will help with drug trialling in future, and Experimental Psychology applicants should explore the benefits of studying failed research to provide better, more scientifically rigorous methodologies for experiments.

Many people enjoy the odd glass of wine with their meal and it is often the drink of choice at social events. However, new research from the University of Cambridge has suggested that selling wine in larger wine glasses may encourage people to drink more, even when the amount of wine remains the same.

The Behaviour and Health Research Unit (BHRU) at the University of Cambridge set out to explore whether the size of glass in which alcohol is served affects consumption. The study was entitled ‘The Pint Shop’ and was conducted in Cambridge mid-March to early July 2015. The results were published in the journal BMC Public Health and found that increasing the size of wine glasses led to an almost 10% increase in wine sales.

Medicine and Biological Sciences applicants should consider the link between an increase in alcohol consumption and diseases such as diabetes, cancer and liver disease. HSPS applicants should also consider whether the government should play in regulating this, and the extent to which government involvement in personal healthcare decisions should be encouraged in a democracy.