Human Biology Archives - The Sciku Project

June 24, 2022June 24, 2022

Dance Therapy by Dr Michael J. Leach

beating heart & drums—
she dances through the grey in
a persimmon dress
by Dr Michael J. Leach

This sciku suggests the therapeutic benefits of dancing through the bright orange colour persimmon—a symbol of happiness and good health. The therapeutic benefits of dancing, such as significantly reduced anxiety following dance movement therapy, were recently reported in a meta-analysis of individual studies by Koch et al. (2019).

In early 2022, therapeutic benefits of dancing were also artistically expressed in the music video for Florence + the Machine’s single ‘Free’ (directed by Autumn de Wilde):

This music video provided the visual inspiration for my sciku while the research paper by Koch et al. (2019) provided the underlying science.

Original Research:

Koch SC, Riege RFF, Tisborn K, Biondo J, Martin L, Beelmann A. Effects of dance movement therapy and dance on health-related psychological outcomes. A meta-analysis update. Frontiers in Psychology. 2019; 10: 1806. doi: https://doi.org/10.3389/fpsyg.2019.01806

Author Bio:

Michael J. Leach (@m_jleach) is an Australian poet and academic at Monash Rural Health. His poetry collections include Chronicity (MPU, 2020) and Natural Philosophies (Recent Work Press, forthcoming).

Check out more sciku by Michael, including ‘The Burden of Bushfire Smoke‘, ‘The Core Correlate of COVID-19 Vaccine Acceptance‘, ‘Drug-Induced Hip Fractures‘, ‘The Psychopharmacological Revolution‘, ‘Quality of Life at Seven Years Post-Stroke‘, ‘The Early Impacts of COVID-19 on Australian General Practice‘, A Sciku for Rayner Explainer, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner. Michael also has another Covid-19-related sciku published in Pulse which is well worth checking out: ‘flu shot announcement‘.

June 18, 2021June 18, 2021

Indirect Inequality

Covid cares not for
the racial disparity
of heart disease

It was well-known before the pandemic that different racial/ethnic populations in the United States had different burdens of cardiovascular disease, with Black populations the worst affected.

The Covid-19 pandemic, however, has found ways of making bad things even worse, with deaths from heart disease and cerebrovascular disease rising across the whole of the USA. Yet new research by Wadhra et al. (2021) suggests that these increases aren’t evenly distributed across all racial/ethnic populations. Black, Asian and Hispanic populations have experienced a much larger relative increase in deaths (~19%) than the non-Hispanic White population (~2%).

A number of factors could be combining to result in this disproportionate impact of the pandemic on different racial/ethnic groups, including “reduced access to healthcare services, increased health system strain, and hospital avoidance due to fear of contracting the virus in high-burden areas. In addition, inequities in the social determinants of health that are associated with cardiovascular risk, such as poverty and stress, have likely worsened for these groups.”

Whilst depressingly unsurprising, these results make it clear that the United States urgently needs public health and policy strategies to “monitor and mitigate the short- and long-term adverse effects of the pandemic on the cardiovascular health of diverse populations.”

Original research: https://doi.org/10.1161/CIRCULATIONAHA.121.054378

September 5, 2019January 28, 2022

The Psychopharmacological Revolution

’50s to ’60s
use of new psychotropics
soars in both genders
by Dr Michael J. Leach.

Psychotropic drugs act on the central nervous system to elicit a range of therapeutic effects, such as improved sleep and anxiety relief.

Barbiturate psychotropics are older medicines with narrow therapeutic indices, meaning that there is little difference between beneficial and harmful doses. Actress Judy Garland is one of many people who has tragically died from a barbiturate overdose.

Non-barbiturate psychotropics such as benzodiazepines, meanwhile, are newer and safer alternatives to barbiturates for the treatment of psychological disorders. An example of a psychotropic that is widely used in modern society is the benzodiazepine diazepam, which was first marketed under the brand name Valium.

Historically, the Psychopharmacological Revolution of the 1950s and 1960s saw the introduction of a wide range of non-barbiturate psychotropics onto a growing global pharmaceutical market. There has been little research into the gender-specific, community-level use of psychotropic drugs over the Psychopharmacological Revolution of the 1950s and 1960s.

In order to shed light on the origins of Australia’s relatively high modern-day consumption of psychotropics, my colleague and I conducted a study to explore gender-specific volumes of psychotropic dispensing at a Melbourne pharmacy during the 1950s and 1960s. This original research has been published in the peer-reviewed journal Pharmaceutical Historian.

In this study, I sourced data on the name of medicine dispensed, dispensing date during 1954 or 1961, and patient gender from a set of old prescription books that were kept at a community pharmacy in the inner Melbourne suburb of Toorak. I cross-referenced the dataset with historical pharmacy reference books to classify each medicine into one of the following mutually exclusive categories: barbiturate psychotropics, non-barbiturate psychotropics, and non-psychotropic medicines. After collecting data and classifying each medicine, I calculated the number of prescriptions dispensed in each year and adjusted for the size of the population residing in the surrounding local government area.

The study results indicated that twice and 1.7 times as many medicines were dispensed to females than to males during 1954 and 1961, respectively. Such gender differences were evident across all three categories of dispensed medicines: barbiturate psychotropics, non-barbiturate psychotropics, and non-psychotropic medicines. There was also a pronounced shift in psychotropic dispensing from the older, more dangerous barbiturates (77% in 1954; 38% in 1961) to newer, safer non-barbiturate psychotropics (23% in 1954; 62% in 1961). The extent of this shift over time to newer, safer psychotropics was similar in both genders.

Original research: Gender differences in psychotropic medicine dispensing at a pharmacy in Melbourne, Australia, 1954 and 1961 by Michael J. Leach and Rebecca Kippen.

Michael Leach (@m_jleach) is an Australian health researcher, biostatistician, and poet with a PhD in Pharmacoepidemiology and a passion for health humanities. Examples of his science poems are online here: https://imagesofhealth.wordpress.com/.

If you enjoyed this sciku, check out Michael’s other sciku ‘Quality of Life at Seven Years Post-Stroke‘ and ‘Drug-Induced Hip Fractures‘, ‘The Core Correlate of Covid-19 Vaccine Acceptance’, ‘The Early Impacts of COVID-19 on Australian General Practice‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner.

April 11, 2019April 11, 2019

Supine Risks

Supine position,
dreaming towards tragedy.
The risk of stillbirth.

New research has found that the risks of stillbirth are higher when the mother falls asleep lying on her back. Cronin et al (2019) analysed sleeping position and resulting birth success. Whilst no difference was found between going-to-sleep on the left or right side, the researchers found evidence that the supine going-to-sleep position is a contributing factor for late stillbirth. In fact, they suggest that if every pregnant woman of 28 weeks gestation and beyond settled to sleep on her side the number of late stillbirths could be reduced by 5.8%.

Original research: http://dx.doi.org/10.1016/j.eclinm.2019.03.014

April 5, 2019January 28, 2022

Drug-Induced Hip Fractures

psychoactive drugs
flood and fog brains soon before
falls and hip fractures
by Dr Michael J. Leach

There is an inherent poetry to pharmacy whereby medicines can help people through intended beneficial effects and harm people through unintended adverse events, including side effects and drug-drug interactions. It is crucial for prescribers to carefully weigh up the risks and benefits of treatment whenever a new medicine is considered for any given patient. As the modern world has an aging population, there have been rises in frailty, multiple morbidities (i.e. multimorbidity), and multiple medicine use. Multiple medicine use can be defined in terms of polypharmacy, which denotes the concurrent use of five or more drugs, and hyper-polypharmacy, which denotes the concurrent use of ten or more drugs. The increasing prevalence of polypharmacy and hyper-polypharmacy means that, in modern society, there is high potential for harmful side effects and drug-drug interactions.

Psychoactive medicines are examples of drugs that have unfavourable side effects and that can interact with one another to cause harm. Psychoactive medicines act on the central nervous system in different ways to elicit therapeutic and adverse effects. The main types of psychoactive medicines are antidepressants, antipsychotics, benzodiazepines, benzodiazepine-related drugs, opioid analgesics, anticholinesterases, antiepileptics, and anti-Parkinson medicines. A common side effect across all these psychoactive medicines is sedation. While treatment with benzodiazepines, benzodiazepine-related drugs, and antipsychotics may be aimed at helping people to relax or sleep at night, the sedative effect can still be harmful when there is unwanted daytime sedation or oversedation. The sedative effects of psychoactive medicines likely explain why these drugs increase the risk of falls and fractures, especially in older, frailer individuals. Furthermore, when any one psychoactive medicine is taken with another psychoactive medicine, there is an increased sedative burden on the patient. This increased sedative burden can place people at an even greater risk of falls and fractures.

Pharmacoepidemiology is the population-level study of medicine use. In original research conducted as part of my PhD in Pharmacoepidemiology, I used a number of study designs and statistical methods to quantify the risk of hip fracture following psychoactive medicine use in older people. I focused on particular types of psychoactive medicines (e.g. antipsychotic drugs and selective serotonin reuptake inhibitor [SSRI] antidepressants) used individually and in combination with one another. The risk of hip fracture was increased for a range of psychoactive medicines, most notably when they were used concurrently. This research is relevant to real world medical practice because the risk factors identified are potentially modifiable. If prescribers better understand the risks associated with psychoactive medicine use, then they can make more informed prescribing decisions and de-prescribe psychoactive medicines where appropriate. Older patients, their carers, and their family members, as well as nursing home staff, would also benefit from better understanding the significant risk posed by the use of psychoactive medicines.

The pharmacoepidemiological studies that make up my PhD thesis have been published in peer-reviewed journals and are available online:

Leach MJ, Pratt NL, Roughead EE. The risk of hip fracture due to mirtazapine exposure when switching antidepressants or using other antidepressants as add-on therapy. Drugs – Real World Outcomes. 2017; 4(4): 247-255. http://dx.doi.org/10.1007/s40801-017-0120-y

Leach MJ, Pratt NL, Roughead EE. The risk of hip fracture in older people using selective serotonin reuptake inhibitors and other psychoactive medicines concurrently: a matched case-control study in Australia. Drugs – Real World Outcomes. 2017; 4(2): 87-96. http://dx.doi.org/10.1007/s40801-017-0107-8

Leach MJ, Pratt NL, Roughead EE. Psychoactive medicine use and the risk of hip fracture in older people: a case-crossover study. Pharmacoepidemiology and Drug Safety. 2015; 24(6): 576-582. https://doi.org/10.1002/pds.3785

Leach MJ, Pratt NL, Roughead EE, Hayward K, Jenkins N. Medicine use among the elderly before and after hip fracture. Australian Journal of Pharmacy. 2014; 95(1125): 72-74. [A secondary publication arranged by the original publisher]. Available here.

Leach MJ, Pratt NL, Roughead EE. Medicine use among older Australians before and after hip fracture. Journal of Pharmacy Practice and Research. 2013; 43(4):265-268. https://doi.org/10.1002/j.2055-2335.2013.tb00271.x

If you enjoyed this sciku, check out Michael’s other sciku ‘Quality of Life at Seven Years Post-Stroke‘ and ‘The Psychopharmacological Revolution‘, ‘The Core Correlate of Covid-19 Vaccine Acceptance’, ‘The Early Impacts of COVID-19 on Australian General Practice‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner.

April 3, 2018April 10, 2018

Knuckle cracking maths

Knuckle cracking maths:

Synovial bubbles pop

in partial collapse.

The debate over how knuckles cause a popping sound when cracked has lasted for decades. Now, Chandran Suja and Barakat (2018) have created three equations to mathematically model how the sound is produced. The first equation describes variations in pressure inside the joint, the second describes how pressure variations results in bubble size variations, whilst the third equation links the size variation of bubbles with the production of acoustic pressure waves.

When cracking your fingers the joints are pulled apart, the pressure goes down and bubbles appear in the synovial fluid which lubricates the joint. During knuckle cracking the pressure changes within the joint causing the size of the bubbles to fluctuate quickly resulting in the popping sound. The new model reveals that the bubbles don’t need to completely collapse in order to produce the sound, explaining why bubbles are observed following knuckle cracking.

Original research: http://dx.doi.org/10.1038/s41598-018-22664-4

January 31, 2018January 28, 2022

Quality of Life at Seven Years Post-Stroke by Dr Michael J. Leach

Old stroke survivor

a life of low quality

yet high quantity.

A stroke, otherwise known as a cerebrovascular accident, is a serious health problem whereby blood flow to the brain is interrupted by a blocked or ruptured blood vessel. A stroke is life threatening and requires emergency medical attention. If an individual survives a stroke, then he or she may live with one or more long-term effects, such as memory loss, hemiplegia (i.e. paralysis on one side of the body), visual impairment, or speech problems. Such long-term effects can negatively impact on a stroke survivor’s quality of life across multiple domains: independent living, social relationships, illness, physical senses, and psychological wellbeing. While quality of life has been well studied in the short term after stroke, few studies have investigated quality of life among long-term stroke survivors.

In original research conducted as part of my Master of Biostatistics degree, I assessed quality of life at seven years post-stroke among people residing in the north-eastern suburbs of Melbourne. The validated Assessment of Quality of Life (AQoL) instrument was used to measure quality of life. In the AQoL instrument, scores range from -0.04 (worse than death) to 0.00 (death equivalent) to 1.00 (optimal). Among 1321 stroke cases with a mean age of 68 years, 413 (31% of stroke cases) were still alive at seven years post-stroke and 328 (79% of survivors) were assessed in my study. Of the 328 long-term stroke survivors assessed, 76 (23%) had very poor quality of life ranging from -0.038 to 0.100. Furthermore, 6% of patients had quality of life that healthy individuals deem worse than death (i.e. ranging from -0.038 to 0.00). The mean quality of life score at seven years post-stroke was 0.51. This score means that, if faced with the prospect of being an average seven-year stroke survivor, a given person in the general population would rather live in full health for half of his or her expected life span.

This research is important in that it highlights the dire need for interventions to improve quality of life in the long-term after stroke. Potentially modifiable factors associated with better quality of life in the long-term after stroke could be targeted to improve the quality of stroke survivors’ lives. In my original research, the potentially modifiable factors associated with better quality of life included lesser handicap and independence in activities of daily living (e.g. indoor mobility, dressing, and shopping). An example of a promising targeted intervention to improve post-stroke quality of life is cognitive training aimed at improving brain function. As cognitive training has been shown to make people more independent in activities of daily living over a five-year period, it is a promising intervention to improve quality of life in the long-term after stroke.

Original research:

Leach MJ, Gall SL, Dewey HM, Macdonell RAL, Thrift AG. Factors associated with quality of life in 7-year survivors of stroke. Journal of Neurology, Neurosurgery & Psychiatry. 2011; 82(12):1365-1371. http://dx.doi.org/10.1136/jnnp.2010.234765

Dr Michael J. Leach is an Australian health researcher, biostatistician, and poet with a PhD in Pharmaco-epidemiology and a passion for health humanities. Examples of his science poems are available online: https://imagesofhealth.wordpress.com/.

If you enjoyed this sciku, check out Michael’s other sciku ‘Drug-Induced Hip Fractures‘, ‘The Psychopharmacological Revolution‘, ‘The Core Correlate of Covid-19 Vaccine Acceptance’, ‘The Early Impacts of COVID-19 on Australian General Practice‘, ‘The Burden of Bushfire Smoke‘, and ‘Australian Science Poetry‘ with science communicator Rachel Rayner.

December 20, 2017December 20, 2017

Transcription by Prof Sridhar Hannenhalli

To express or not

Here now a bit or a lot

That is the question.

Every cell in an organism contains an identical copy of the genome, except for rare somatic mutations, that encodes its entire gene complement. Yet, each of the hundreds of individual cell types in an organism utilizes a well-defined subset of the genes – imagine your neurons expressing genes that are normally expressed in skin cells. Thus the cell, starting from the single-celled embryo, must have a mechanism to control when, and how much of, each gene is expressed. This control is exercised, in large part, at the level of transcription – the process of reading the DNA encoding a gene on the genome and copying it into a messenger RNA (mRNA), which is eventually translated into the final protein product (or otherwise processed into a final RNA product).

Besides controlling normal development and defining the identity of individual cells, the response to a change in environment is also managed at the level of transcription. This was first demonstrated by Jacques Monod and Francois Jacob in their seminal 1961 paper, showing that a group of E. coli genes that encode for proteins required to break down lactose is transcriptionally switched on or off depending on whether the growth medium is rich in lactose or glucose. They went on to win the 1965 Nobel Prize in Physiology or Medicine for their discovery.

Transcriptional control plays a critical role not only in development and environmental response, but also at a longer time scale in mediating evolutionary divergence across species. In their classic 1975 paper, Mary-Claire King and Alan C Wilson, observing very high levels of similarity between several proteins of chimpanzees and humans, concluded that the vast phenotypic differences between the two species could not be explained by such small degree of molecular divergence and are likely to be driven by the changes in the mechanisms controlling the gene transcription.

The role of transcriptional control in dictating natural diversity at multiple natural scales from cells within an organism, individuals within a species, and across species is now well established. This extends even to phenotypic changes associated with all complex diseases, and is underscored by the observation that the vast majority of genotypic signals associated with human diseases reside in non-protein-coding regions of the genome, thus focusing the research efforts in interpreting these signals in the context of transcriptional control.

Original research:

Jacob, F. & Monod, J. (1961) Genetic regulatory mechanisms in the synthesis of proteins. J Mol Biol 3, 318–356. http://biotheory.phys.cwru.edu/phys320/JacobMonod1961.pdf

King, M. C. & Wilson, A. C. (1975) Evolution at two levels in humans and chimpanzees. Science (80) 188, 107–116. https://doi.org/10.1126/science.1090005

Hindorff, L. A. et al. (2009)Potential etiologic and functional implications of genome-wide association loci for human diseases and traits. PNAS 106, 9362–9367. https://doi.org/10.1073/pnas.0903103106

Sridhar Hannenhalli is professor of Cell Biology and Molecular Genetics at the UMD, interested in transcriptional regulation and evolution. He is currently visiting IISc, Bangalore, as a Fulbright scholar. You can follow him on twitter @hannenhalli.

August 14, 2017September 8, 2017

Twisted naval string

Twisted naval string:

Forty turns of jelly and

contrary vessels.

Break benefits both before

severing the thread of life.

The umbilical cord has traditionally been cut (or at least clamped) 15-20 seconds after birth but increasingly research suggests that a longer delay before cutting is beneficial for both term and pre-term infants.

For term infants a delay of 30-60 seconds can increase haemoglobin levels at birth and iron stores in the first months of life. In preterm infants a delay can improve transitional circulation, result in the better establishment of red blood cell volume and decrease the need for blood transfusions.

A delay before clamping and cutting is therefore recommended by both the World Health Organisation and the American College of Obstetricians and Gynaecologists.

This sciku is actually an example of a tanka – the first two verses of a traditional renga, where haiku originate from. Learn more about haiku, renga and tanka here.

August 9, 2017August 9, 2017

Gamma sabres by Hannah Hall

Gamma sabres slay

Alzheimer’s amyloid plaques

with disco lighting.

Alzheimer’s disease is a neurodegenerative condition that worsens over time leading to problems with short-term memory, mood swings, behavioural issues and ultimately loss of bodily functions and death. But could flashing LED lights be a method of helping to treat the disease?

Exposing laboratory mice to LED strips flickering at 40Hz for an hour reduced beta amyloid plaque levels in the visual cortex by half, reduced Tau protein abnormalities and enhanced gamma oscillations (brain waves) – all of which are characteristics of Alzheimer’s disease. Iaccarino et al, 2016.

Hannah Hall is a Senior Consultant at Pragma Consulting Ltd in London. Though she studied Russian and French at university, she has broad interests and enjoys listening to the RadioLab podcast where she heard about this research.

May 18, 2017June 14, 2017

Locked-In

Complete locked-in state.

Infra-red plus oxygen:

Communication!

Complete locked-in state is a condition where patients are suffering from motor paralysis but retain their mental processing abilities. The inability to control their own body movements has made communication with people suffering from this condition effectively impossible. However, by using functional near-infrared spectroscopy measure changes in frontocentral oxygenation patients were able to answer yes and no questions. Chaudhary et al, 2017.