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From eye exams to blood tests and surgery: how doctors use light to diagnose disease

<p><em><a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals.</p> <p>You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging.</p> <p>Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease.</p> <h2>1. On-the-spot tests</h2> <p>Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis.</p> <p>The “flashlight” your GP uses to view the inside of your eye (known as an <a href="https://medlineplus.gov/ency/article/003881.htm">ophthalmoscope</a>) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/increased-intracranial-pressure-icp-headache">causing your headaches</a>.</p> <p>The invention of <a href="https://openmedscience.com/lighting-the-way-in-healthcare-the-transformative-role-of-lasers-in-medicine/">lasers and LEDs</a> has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab.</p> <p><a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">Pulse oximetry</a> is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by <a href="https://www.howequipmentworks.com/pulse_oximeter/">measuring</a> the different responses of oxygenated and de-oxygenated blood to different colours of light.</p> <p>Pulse oximetry is used at hospitals (and <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">sometimes at home</a>) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60107-X/fulltext">heart defects in babies</a>.</p> <h2>2. Looking at molecules</h2> <p>Now, back to that blood test. Analysing a small amount of your blood can diagnose <a href="https://theconversation.com/blood-tests-and-diagnosing-illness-what-can-blood-tell-us-about-whats-happening-in-our-body-80327">many different diseases</a>.</p> <p>A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a <a href="https://www.nuffieldhealth.com/article/inside-the-pathology-lab-what-happens-to-my-blood">snapshot</a> of your overall health.</p> <p>For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present.</p> <p>These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476943/#R88">spectrometer</a> can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels.</p> <h2>3. Medical imaging</h2> <p>Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging.</p> <p>A common example is an <a href="https://www.medicalnewstoday.com/articles/153737#risks-and-side-effects">endoscope</a>, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts.</p> <p>Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553337/">laparoscopic surgery</a> (also known as keyhole surgery) to diagnose and treat disease.</p> <h2>How about the future?</h2> <p>Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include:</p> <ul> <li> <p><a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.201903441">nanomaterials</a> (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests</p> </li> <li> <p><a href="https://www.nature.com/articles/s41587-019-0045-y">wearable optical biosensors</a> the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time</p> </li> <li> <p>AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a <a href="https://www.advancedsciencenews.com/powerful-diagnostic-approach-uses-light-to-detect-virtually-all-forms-of-cancer/">comprehensive database</a> of scatter patterns to detect <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202300006">any cancer</a></p> </li> <li> <p>a type of non-invasive imaging called <a href="https://www.ncbi.nlm.nih.gov/books/NBK554044/">optical coherence tomography</a> for more detailed imaging of the eye, heart and skin</p> </li> <li> <p>fibre optic technology to deliver a tiny microscope into the body on the <a href="https://www.uwa.edu.au/projects/microscope-in-a-needle">tip of a needle</a>.</p> </li> </ul> <p>So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231379/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/matthew-griffith-1539353"><em>Matthew Griffith</em></a><em>, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-eye-exams-to-blood-tests-and-surgery-how-doctors-use-light-to-diagnose-disease-231379">original article</a>.</em></p>

Body

Scurvy is largely a historical disease but there are signs it’s making a comeback

<p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Scurvy is often considered a historical ailment, conjuring images of sailors on long sea voyages suffering from a lack of fresh fruit and vegetables.</p> <p>Yet doctors in developed countries have recently reported treating cases of scurvy, including Australian doctors who <a href="https://casereports.bmj.com/lookup/doi/10.1136//bcr-2024-261082">reported their findings</a> today in the journal <a href="https://casereports.bmj.com/">BMJ Case Reports</a>.</p> <h2>What is scurvy?</h2> <p>Scurvy is a disease caused by a severe deficiency of vitamin C (ascorbic acid), which is essential for the production of collagen. This protein helps maintain the health of skin, blood vessels, bones and connective tissue.</p> <p>Without enough vitamin C, the body cannot properly repair tissues, heal wounds, or fight infections. This can lead to a range of <a href="https://www.degruyter.com/document/doi/10.1515/9781400884544/html">symptoms</a> including:</p> <ul> <li>fatigue and weakness</li> <li>swollen, bleeding gums or loose teeth</li> <li>joint and muscle pain and tenderness</li> <li>bruising easily</li> <li>dry, rough or discoloured skin (reddish or purple spots due to bleeding under the skin)</li> <li>cuts and sores take longer to heal</li> <li>anaemia (a shortage of red blood cells, leading to further fatigue and weakness)</li> <li>increased susceptibility to infections.</li> </ul> <h2>It historically affected sailors</h2> <p>Scurvy was <a href="https://pubmed.ncbi.nlm.nih.gov/23183299/">common</a> from the 15th to 18th centuries, when naval sailors and other explorers lived on rations or went without fresh food for long periods. You might have heard some of these milestones in the history of the disease:</p> <ul> <li> <p><strong>in 1497-1499</strong>, Vasco da Gama’s crew <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)13131-5/fulltext#:%7E:text=After%205%20weeks%20at%20sea,lemons%2C%20clearing%20up%20the%20condition">suffered severely from scurvy</a> during their expedition to India, with a large portion of the crew dying from it</p> </li> <li> <p><strong>from the 16th to 18th centuries</strong>, scurvy was rampant among European navies and explorers, affecting notable figures such as <a href="https://www.jstor.org/stable/26305889">Ferdinand Magellan and Sir Francis Drake</a>. It was considered one of the greatest threats to sailors’ health during long voyages</p> </li> <li> <p><strong>in 1747</strong>, British naval surgeon <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3536506/">James Lind</a> is thought to have conducted one of the first clinical trials, demonstrating that citrus fruit could prevent and cure scurvy. However, it took several decades for his findings to be widely implemented</p> </li> <li> <p><strong>in 1795</strong>, the British Royal Navy officially adopted the <a href="https://journals.sagepub.com/doi/pdf/10.1177/003591572601902602">practice of providing lemon or lime juice to sailors</a>, dramatically reducing the number of scurvy cases.</p> </li> </ul> <h2>Evidence of scurvy re-emerging</h2> <p>In the new case report, doctors in Western Australia <a href="https://casereports.bmj.com/lookup/doi/10.1136//bcr-2024-261082">reported</a> treating a middle-aged man with the condition. In a separate case report, doctors in Canada <a href="https://www.cmaj.ca/content/196/33/E1144">reported</a> treating a 65-year old woman.</p> <p>Both patients presented with leg weakness and compromised skin, yet the doctors didn’t initially consider scurvy. This was based on the <a href="https://www.mdpi.com/2072-6643/12/7/1963">premise</a> that there is abundant vitamin C in our modern food supply, so deficiency should not occur.</p> <p>On both occasions, treatment with high doses of vitamin C (1,000mg per day for at least seven days) resulted in improvements in symptoms and eventually a full recovery.</p> <p>The authors of both case reports are concerned that if scurvy is left untreated, it could lead to inflamed blood vessels (<a href="https://www.mayoclinic.org/diseases-conditions/vasculitis/symptoms-causes/syc-20363435">vasculitis</a>) and potentially <a href="https://www.sciencedirect.com/science/article/pii/S2211419X11001625">cause fatal bleeding</a>.</p> <p>Last year, a major New South Wales hospital undertook a <a href="https://www.mja.com.au/journal/2023/219/10/serum-vitamin-c-status-people-new-south-wales-retrospective-analysis-findings">chart review</a>, where patient records are reviewed to answer research questions.</p> <p>This found vitamin C deficiency was common. More than 50% of patients who had their vitamin C levels tested had either a modest deficiency (29.9%) or significant deficiency (24.5%). Deficiencies were more common among patients from rural and lower socioeconomic areas.</p> <p>Now clinicians are <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.52146">urged to</a> consider vitamin C deficiency and scurvy as a potential diagnosis and involve the support of a dietitian.</p> <h2>Why might scurvy be re-emerging?</h2> <p>Sourcing and consuming nutritious foods with sufficient vitamin C is unfortunately <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10260575/">still an issue</a> for some people. Factors that increase the risk of vitamin C deficiency include:</p> <ul> <li> <p><strong>poor diet</strong>. People with restricted diets – due to poverty, food insecurity or dietary choices – <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10296835/">may not get enough</a> vitamin C. This includes those who rely heavily on processed, nutrient-poor foods rather than fresh produce</p> </li> <li> <p><strong>food deserts</strong>. In areas where access to fresh, affordable fruits and vegetables is limited (often referred to as food deserts), people may <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9587807/">unintentionally suffer from a vitamin C deficiency</a>. In some parts of developing countries such as India, lack of access to fresh food is <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10296835/">recognised as a risk</a> for scurvy</p> </li> <li> <p><strong>the cost-of-living crisis</strong>. With greater numbers of people <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10935407/">unable to pay for fresh produce</a>, people who limit their intake of fruits and vegetables may develop nutrient deficiencies, including scurvy</p> </li> </ul> <ul> <li> <p><strong>weight loss procedures and medications</strong>. Restricted dietary intake due to weight loss surgery or weight loss medications may <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.24067">lead to nutrient deficiencies</a>, such as in this <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3320124/">case report of scurvy</a> from Denmark</p> </li> <li> <p><strong>mental illness and eating disorders</strong>. Conditions such as depression and anorexia nervosa can lead to severely restricted diets, increasing the risk of scurvy, such as in this <a href="https://pubmed.ncbi.nlm.nih.gov/32291151/">case report</a> from 2020 in Canada</p> </li> <li> <p><strong>isolation</strong>. Older adults, especially those who live alone or in nursing homes, may have <a href="https://doi.org/10.1136//bcr-2024-261082">difficulty</a> preparing balanced meals with sufficient vitamin C</p> </li> <li> <p><strong>certain medical conditions</strong>. People with digestive disorders, malabsorption issues, or those on restrictive medical diets (due to severe allergies or intolerances) can develop scurvy if they are <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8248877/">unable to absorb or consume enough vitamin C</a>.</p> </li> </ul> <h2>How much vitamin C do we need?</h2> <p>Australia’s dietary guidelines <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-c">recommend</a> adults consume 45mg of vitamin C (higher if pregnant or breastfeeding) each day. This is roughly the amount found in half an orange or half a cup of strawberries.</p> <p>When more vitamin C is <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release">consumed</a> than required, excess amounts leave the body through urine.</p> <p>Signs of scurvy can appear as early as a month after a daily intake of less than 10 mg of vitamin C.</p> <p>Eating vitamin C-rich foods – such as oranges, strawberries, kiwifruit, plums, pineapple, mango, capsicum, broccoli and Brussels sprouts – can resolve symptoms within a few weeks.</p> <p>Vitamin C is also readily available as a supplement if there are reasons why intake through food may be compromised. Typically, the supplements contain 1,000mg per tablet, and the <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-c">recommended upper limit</a> for daily Vitamin C intake is 2,000mg.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/scurvy-is-largely-a-historical-disease-but-there-are-signs-its-making-a-comeback-241894">original article</a>.</em></p>

Body

"Absolute breakthrough": New hope in search for Motor Neurone Disease cure

<p>Melbourne researchers are one step closer to finding a cure for Motor Neurone Disease, with the help technology and stem cell research. </p> <p>Scientists at The Florey Institute of Neuroscience and Mental Health have developed a world-first technology that will speed up the drug testing process to help find an effective treatment and maybe even a cure for the disease. </p> <p>New machines at the institute can now help determine whether drugs on the market could be used to treat MND in just weeks, a process which previously took decades. </p> <p>"This is an absolute breakthrough, it's at the cutting edge of technology," Florey MND researcher Professor Brad Turner said.</p> <p>Animal cells were previously used to test the efficacy of MND drugs, but now thanks to more than 100 MND patients who donated their skin cells to the institute, researchers have a library of stem cells to work with. </p> <p>The human stem cells can provide scientists with the full scope of the disease, something that they were previously unable to do with just animal cells. </p> <p>"This is really a game-changer in that we can use their own cells, and we can test drugs directly on their own cells," Florey MND researcher and neurologist Dr Thanuja Dharmadasa said. </p> <p>Large scale screening will commence thanks to a $5 million grant from the Australian Medical Research Future Fund.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">The research is expected to help people like Phil Camden who has been living with the disease for 10 years. </span></p> <p>"That's the key to all of us living with MND... we want to do what we can while we can," Camden said.</p> <p>"We know we're not doing it to find a cure for us. We're doing it for those in the future, my grandkids and their children."</p> <p>Scientists believe that medication or a cocktail of drugs tailored specifically to a patient is the way forward when it comes to treating the disease. </p> <p>"Therefore your drug treatments are tailed back to the clinical makeup in the dish and we call that personalised medical treatment," Turner said.</p> <p><em>Image: Nine News</em></p>

Caring

Is it really possible to have Alzheimer’s yet no symptoms?

<p><em><a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268"><em>University of East Anglia</em></a></em></p> <p>Some people seem to be more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003087/#:%7E:text=Some%20individuals%20are%20able%20to,into%20a%20widely%20debated%20concept.">resilient</a> to developing Alzheimer’s diseases, despite having the biological hallmarks of the devastating disease. For obvious reasons, scientists are very interested in studying this special group of people.</p> <p>Alzheimer’s disease, the most common form of dementia, is thought to start because of a build-up of two proteins in the brain: amyloid and tau. Once these proteins accumulate, for yet-to-be-determined reasons, they become toxic to brain cells (neurons) and these cells start dying. As a result, people develop symptoms such as memory loss because the brain can’t function properly with all these dead neurons.</p> <p>This cascade of events has been known for many years and is how the disease progresses in most people with Alzheimer’s. Most people, except a special group who are more resilient. But why are they resilient?</p> <p>A recent study in the journal <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-024-01760-9">Acta Neuropathologica Communications</a> investigated whether our genes might influence how resilient we are against Alzheimer’s disease symptoms when there are high levels of amyloid in our brain.</p> <p>The scientists conducted a study on the brains of three groups of people. The first group comprised people who had died with Alzheimer’s disease. The second were healthy people who died of natural causes. And the third comprised people who had high levels of Alzheimer’s proteins in the brain but never developed symptoms of the disease during their lifetime – or at least never had a diagnosis of Alzheimer’s disease.</p> <p>The last group, they considered as being resilient to Alzheimer’s disease since they had the proteins in their brains but did not have the symptoms or a diagnosis of Alzheimer’s disease during their lifetime.</p> <p>The scientists found that genes related to the activity of the immune system seem to have been more active in the Alzheimer’s resilient group. This would make sense as it is well established that the immune system helps clear the excess proteins from the brain, so genes that help this process might make us more resilient to developing symptoms of the disease.</p> <h2>How to become resilient – even if you don’t have the genes</h2> <p>This is great if you have inherited these genes from your parents, but what does it mean for the rest of us who do not have those genes? Is there a way we can make ourselves more resilient to developing Alzheimer’s disease regardless of our genes?</p> <p>“Yes” is the short answer.</p> <p>There is now good scientific evidence that <a href="https://theconversation.com/can-alzheimers-really-be-reversed-as-a-new-documentary-claims-230705">lifestyle changes</a> and drugs allow us to reduce our risk of developing Alzheimer’s disease in the future.</p> <p>In particular, physical activity has been shown to reduce our risk of developing Alzheimer’s, probably because it has a well-known beneficial effect on our immune system and hence helps clear those rogue proteins accumulating in our brains. This means that being more physically active might have the same effect on our Alzheimer’s resilience as those lucky people who have the “right” genes.</p> <p>Interestingly, we do not know how physically active the resilient people in the study were and how this might have influenced their resilience to Alzheimer’s disease.</p> <p>As so often in science, it is not clear whether nature (genes) or nurture (lifestyle) contributed to their resilience. The other interesting aspect is that the resilient people in the study died of another cause than Alzheimer’s disease, but they might have developed Alzheimer’s disease eventually if they had lived longer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230334/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, Professor of Applied Dementia Research, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-really-possible-to-have-alzheimers-yet-no-symptoms-230334">original article</a>.</em></p>

Mind

"Rest in love": All Blacks legend and Dancing with the Stars winner dies at 55

<p>The sports and entertainment communities are mourning the loss of former All Blacks hooker and <em>Dancing with the Stars</em> winner Norm Hewitt, who has passed away at the age of 55.</p> <p>Hewitt, a beloved figure both on and off the rugby field, succumbed to a lengthy battle with motor neurone disease, as confirmed by his family in a heartfelt statement.</p> <p>"Although rugby dominated his early life, he established a thriving human relations consultancy after retirement, and his services were much in demand both nationally and internationally," his family shared. "He walked confidently in both Māori and Pākehā worlds and was a particular role model for troubled youth, citing his own background, and offering inspirational teachings that one’s present life need not be one’s future."</p> <p>Hewitt leaves behind his wife Arlene and their two children, Elizabeth and Alexander. Born and raised in Pōrangahau, southern Hawke’s Bay, Hewitt's rugby career was nothing short of illustrious. Over 13 seasons, he played 296 representative matches for Hawke’s Bay, Southland and Wellington, earning 23 caps for the All Blacks. Hewitt was also a pivotal member of the Hurricanes during the formative years of Super Rugby, missing only one match in the first five years.</p> <p>The rugby community has been profoundly affected by Hewitt's passing. Former teammate Ofisa Tonu’u posted a touching tribute on Facebook: "I’m just devastated finding out the news today. I will never forget how you always stuck up for me during the Black Tracker days when no one else would, you always look after all the players and we always followed you into battle. No more pain, brother, you can now rest in Love. Fa’afetai tele lava my uso for having my back as I did yours. I know the other boys will be welcoming you with open arms at the gates. Rest in Love, Normy."</p> <p>Beyond his rugby career, Hewitt transitioned into a public speaker and mentor, focusing heavily on violence prevention programmes and advocacy. He worked with the SPCA as an animal cruelty and anti-violence publicity officer, visiting schools to spread his message. In 2005, Hewitt showcased his versatility by winning the first season of<em> Dancing with the Stars</em> alongside professional dancer Carol-Ann Hickmore.</p> <p>Hewitt's life was not without its struggles. In 1999, he made a public apology for a drunken incident in Queenstown, marking a turning point as he renounced alcohol and dedicated himself to helping others facing similar challenges.</p> <p>The outpouring of tributes was immediate, with The All Blacks expressing their sorrow: “We are saddened by the loss of All Black #938 Norm Hewitt who passed away yesterday in Wellington. Hewitt played 9 Tests and 14 Games between 1993 and 1998. Our thoughts are with Norm’s family and loved ones at this time.”</p> <p>Podcaster Martin Devlin shared his personal experience: “RIP Norm Hewitt. Not a lot of people know how kind & generous this man was. A truly wonderful person. Reached out to me and helped me considerably a long time ago when things were very rough. Love & respect.”</p> <p>Richard Hills echoed the sentiments of many: “This is bloody sad. A sad way to lose a kiwi icon so young. He had a really rough childhood and upbringing and faced it and turned his life around to become not only a rugby legend but also helped others who’d been through similar issues.”</p> <p>Norm Hewitt’s legacy will endure through the lives he touched and the positive change he inspired. His story is a testament to the strength of the human spirit and the profound impact one individual can have on the world.</p> <p><em>Image: Radio New Zealand</em></p>

Caring

"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

<p>An emotional final message from rugby legend Rob Burrow has been released in the days after his death. </p> <p>The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. </p> <p>Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled <em>There's Only One Burrow</em>, only agreeing to appear in the program on the condition it only be used after his death.</p> <p>In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research.</p> <p>"I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video.</p> <p>"In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a></p> </div> </blockquote> <p>His pre-recorded final words were shown to his friends and family on screen, reacting to his words.</p> <p>"I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said.</p> <p>"I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home."</p> <p>Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them."</p> <p>In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease.</p> <p>"I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled.</p> <p>When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." </p> <p>"I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them."</p> <p>Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this."</p> <p>"I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration."</p> <p>"My final message to you is whatever your personal battle to be brave and face it."</p> <p>"Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out."</p> <p><em>Image credits: BBC</em></p>

Caring

Rugby League hero dies at just 41

<p>Rugby League legend Rob Burrow has passed away at the age of 41 after a lengthy battle with motor neurone disease. </p> <p>The British footballer spent his career with the Leeds Rhinos and helped them win eight Super League titles, and while he never played in Australia, he won the World Club Challenge over NRL opponents three times. </p> <p>Just two years after his retirement in 2017, Burrows was diagnosed with MND. </p> <p>Despite his rapidly progressing condition, Burrows stayed in the public eye to raise money and awareness for MND, and soon became the face of the fight against the disease in the UK. </p> <p>He worked with former teammate Kevin Sinfield to raise millions for a new care centre for MND patients, as the pair competed in <a href="https://oversixty.com.au/health/caring/terminally-ill-rugby-player-carried-across-marathon-finish-line-by-his-best-mate" target="_blank" rel="noopener">marathons</a> today, with Sinfield often pushing Burrow the entire way. </p> <p>His former football club announced Burrow’s death on Sunday, just one day before the groundbreaking of the new Rob Burrow Centre for MND at Seacroft Hospital, which will go ahead at his request.</p> <p>“It is with deep sadness that we announce the death of our beloved son, husband, father, brother and friend,” the club said. </p> <p>“Rob has always been a true inspiration throughout his life whether that was on the rugby league field or during his battle with MND. He never allowed others to define what he could achieve and believed in his own ability to do more."</p> <p>“The outpouring of love and support that Rob and the whole Burrow family have received over the last four and a half years meant so much to Rob."</p> <p>“For those who knew Rob throughout his life, his determination and spirit in the face of MND over the last four and a half years came as no surprise. Rob never accepted that he couldn’t do something. He just found his way of doing it better than anyone else."</p> <p>“He will continue to inspire us all every day. In a world full of adversity. We must dare to dream.”</p> <p>Prince William, who awarded Burrow with a Commander of the British Empire (CBE) honour in January 2024, was among those to mourn his death on social media.</p> <p>“A legend of rugby league, Rob Burrow had a huge heart,” he wrote.</p> <p>“He taught us ‘in a world full of adversity, we must dare to dream’. Catherine and I send our love."</p> <p>Burrow is survived by wife Lindsey and their three children Macy, Maya and Jackson.</p> <p><em>Image credits: SplashNews.com/Matt West/BPI/Phil Noble-Reuters/POOL supplied by Splash News/Shutterstock Editorial</em></p>

Caring

Major TV star's 7-year-old undergoes third open heart surgery

<p>Jimmy Kimmel's seven-year-old son has undergone his third, and hopefully final open heart surgery after being born with congenital heart disease. </p> <p>In 2017, Jimmy <a href="https://www.youtube.com/watch?v=MmWWoMcGmo0" target="_blank" rel="noopener">revealed</a> that Billy was only three days old when had to undergo his first open heart surgery, after doctors found “a hole in the wall of the left and right side of his heart” that was preventing enough oxygen from reaching his blood. </p> <p>Billy was only seven months old when he had to undergo his second open heart surgery, and over the weekend he had to undergo his third major surgery at the Children's Hospital Los Angeles. </p> <p>A few days later, the TV host took to Instagram to share an update following his son's successful surgery. </p> <p>"We went into this experience with a lot of optimism and nearly as much fear and came out with a new valve inside a happy, healthy kid," Kimmel wrote, alongside a picture of his youngest son smiling in a hospital bed. </p> <p>He then thanked all the surgeons, doctors and other medical staff who "came through for us with immeasurable kindness and expertise." </p> <p>"Walking around this hospital, meeting parents at their most vulnerable, children in pain and the miracle workers who do everything in their considerable power to save them is a humbling experience," Kimmel continued.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Kimmel (@jimmykimmel)</a></p> </div> </blockquote> <p>He then highlighted the hospital's dedication to providing help to families "regardless of their ability to pay". </p> <p>Jimmy then extended his thanks to his family and friends and the "loving strangers who took time to pray for and send positive energy to our baby".</p> <p>He gave a special shout out to his wife Molly – for "being stronger than is reasonable for any Mum to be". The pair also share daughter Jane, nine. </p> <p>The late night TV host then praised his son for being "the toughest (and funniest) 7 year-old we know."</p> <p>"There are so many parents and children who aren't fortunate enough to go home after five days," he added and encouraged his followers to send their thoughts and prayers to these families. </p> <p><em>Image: Instagram/ X</em></p> <p> </p>

Caring

Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<p><em><a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January.</p> <p>Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”.</p> <p>The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate.</p> <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”.</p> <p>Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively.</p> <h2>What is cancer?</h2> <p>Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one.</p> <p>We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide.</p> <p>However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced.</p> <p>In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell.</p> <h2>What exactly are mutations?</h2> <p>Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix.</p> <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions.</p> <p>These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>.</p> <p>Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required.</p> <h2>How is cancer treated?</h2> <p>Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy.</p> <p>Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically.</p> <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence).</p> <p>Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally.</p> <p>Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients.</p> <p>Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history.</p> <h2>What you should do</h2> <p>Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to:</p> <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> <p>The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.</em></p>

Caring

"What a legend": Michael J Fox receives emotional standing ovation

<p>Michael J Fox, who has Parkinson's disease, made a surprise appearance at the BAFTA Awards in London. </p> <p><em>The Back to the Future</em> actor came onstage in a wheelchair, but he insisted on standing up at the podium to present the Best Film award. </p> <p>The star-studded audience all rose to their feet and gave the actor a standing ovation. </p> <p>When presenting the award, Fox described cinema as "magic" which can "change your life".</p> <p>"Five films were nominated in this category tonight and all five have something in common. They are the best of what we do," he said. </p> <p>He added that films can bring people together "no matter who you are or where you're from".</p> <p>"There's a reason why they say movies are magic because movies can change your day.</p> <p>"It can change your outlook. Sometimes it can change your life."</p> <p>Fox, who was diagnosed with Parkinson's in the 1990s, rarely makes public appearances. </p> <p>Many fans were pleasantly surprised at his appearance as he presented the night’s biggest award, Best Film, to <em>Oppenheimer</em>.</p> <p>"I was in tears the moment Michael J Fox came on the stage," one fan wrote on X, formerly known as Twitter.</p> <p>"THE MAN IS A LEGEND"</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">i was in tears the moment Michael J Fox came on the stage 😥😥😥</p> <p>THE MAN IS A LEGEND <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://twitter.com/hashtag/BAFTA2024?src=hash&ref_src=twsrc%5Etfw">#BAFTA2024</a> <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> <a href="https://t.co/Uud368S9gb">pic.twitter.com/Uud368S9gb</a></p> <p>— RanaJi🏹 (@RanaTells) <a href="https://twitter.com/RanaTells/status/1759323180060299726?ref_src=twsrc%5Etfw">February 18, 2024</a></p></blockquote> <p>"Michael J Fox. Absolute hero. What a legend," wrote another. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Michael J Fox. Absolute hero. What a legend. <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://t.co/62lxpCy3mn">pic.twitter.com/62lxpCy3mn</a></p> <p>— Jules 🌼 (@JulesItsjules) <a href="https://twitter.com/JulesItsjules/status/1759320058583568638?ref_src=twsrc%5Etfw">February 18, 2024</a></p></blockquote> <p>"All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend," added a third. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend. <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a></p> <p>— Declan Cashin (@Tweet_Dec) <a href="https://twitter.com/Tweet_Dec/status/1759319831696855281?ref_src=twsrc%5Etfw">February 18, 2024</a></p></blockquote> <p>"He's a total legend and wonderful human," wrote a fourth. </p> <p>The actor has spoken <a href="https://www.oversixty.com.au/health/caring/i-m-not-gonna-be-80-michael-j-fox-s-tragic-admission" target="_blank" rel="noopener">candidly</a> about his experience with Parkinson's over the years, and has said that he has made peace with the degenerative nature of the disease. </p> <p>In a previous interview with AARP magazine profile, the actor admitted that he did not fear death. </p> <p>“I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all," he told the publication. </p> <p><em>Images: Getty</em></p>

What happens to your liver when you quit alcohol

<p><em><a href="https://theconversation.com/profiles/ashwin-dhanda-1359529">Ashwin Dhanda</a>, <a href="https://theconversation.com/institutions/university-of-plymouth-717">University of Plymouth</a></em></p> <p>According to Greek mythology, Zeus punished Prometheus for giving fire to humans. He chained Prometheus up and set an eagle to feast on his liver. Each night, the liver grew back and each day, the eagle returned for his feast. In reality, can a liver really grow back?</p> <p>The liver is the largest internal organ in the human body. It is needed for hundreds of bodily processes, including breaking down toxins such as alcohol. As it is the first organ to “see” alcohol that has been drunk, it is not surprising that it is the most susceptible to alcohol’s effects. However, other organs, including the brain and heart, can also be damaged by long-term heavy alcohol use.</p> <p>As a liver specialist, I meet people with alcohol-related liver disease every day. It is a <a href="https://britishlivertrust.org.uk/information-and-support/liver-conditions/alcohol-related-liver-disease/">spectrum of disease</a> ranging from laying down of fat in the liver (fatty liver) to scar formation (cirrhosis) and it usually doesn’t cause any symptoms until the very late stages of damage.</p> <p>At first, alcohol makes the liver fatty. This fat causes the liver to become inflamed. In response, it tries to heal itself, producing scar tissue. If this carries on unchecked, the whole liver can become a mesh of scars with small islands of “good” liver in between – cirrhosis.</p> <p>In the late stages of cirrhosis, when the liver fails, people can turn yellow (jaundice), swell with fluid and become sleepy and confused. This is serious and can be fatal.</p> <p>Most people who regularly drink more than the recommended limit of 14 units of alcohol per week (about six pints of normal strength beer [4% ABV] or about six average [175ml] glasses of wine [14% ABV]) will have a fatty liver. Long-term and heavy alcohol use increases the risk of developing <a href="https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/">scarring and cirrhosis</a>.</p> <h2>Good news</h2> <p>Fortunately, there is good news. In people with fatty liver, after only two to three weeks of giving up alcohol, the liver can heal and looks and functions <a href="https://arcr.niaaa.nih.gov/volume/41/1/natural-recovery-liver-and-other-organs-after-chronic-alcohol-use">as good as new</a>.</p> <p>In people with liver inflammation or mild scarring, even within seven days of giving up alcohol, there are noticeable reductions in liver <a href="https://www.mdpi.com/2072-6643/13/5/1659">fat, inflammation and scarring</a>. Stopping alcohol use for several months lets the liver heal and return to normal.</p> <p>In heavy drinkers with more severe scarring or liver failure, giving up alcohol for several years reduces their chance of <a href="https://www.cghjournal.org/article/S1542-3565(22)01113-2/fulltext">worsening liver failure and death</a>. However, people who drink heavily can be physically dependent on alcohol and stopping suddenly can cause alcohol withdrawal.</p> <p>In its mild form, it causes shaking and sweating. But if severe, it can cause hallucinations, fits and even death. Going “cold turkey” is never recommended for heavy drinkers, who should seek medical advice about how to safely give up alcohol.</p> <h2>Other benefits</h2> <p>Giving up drinking also has positive effects on <a href="https://alcoholchange.org.uk/blog/benefits-of-dry-january-and-when-you-can-expect-to-see-them">sleep, brain function and blood pressure</a>.</p> <p>Avoiding alcohol for long periods also reduces the risk of several types of <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer">cancer</a> (including liver, pancreas and colon) and the risk of <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/effects-of-alcohol-on-your-heart">heart disease and stroke</a>.</p> <p>However, alcohol is not the only cause of ill health. Giving it up has many health benefits, but it is not a panacea. It should be seen as part of a healthy lifestyle, including a balanced diet and regular physical exercise.</p> <p>So, to answer the question posed by the myth of Prometheus, the liver has an amazing power to repair itself after it has been damaged. But it cannot grow back as new if it was already severely scarred.</p> <p>If you stop drinking and only have a fatty liver, it can quickly turn back to normal. If you had a scarred liver (cirrhosis) to start with, stopping alcohol will allow some healing and improved function but can’t undo all the damage that has already been done.</p> <p>If you want to look after your liver, drink in moderation and have two to three alcohol-free days each week. That way, you won’t have to rely on the liver’s magical self-healing power to stay healthy.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/220490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/ashwin-dhanda-1359529"><em>Ashwin Dhanda</em></a><em>, Associate Professor of Hepatology, <a href="https://theconversation.com/institutions/university-of-plymouth-717">University of Plymouth</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-to-your-liver-when-you-quit-alcohol-220490">original article</a>.</em></p>

Body

"I’m not going to be cured". How breast cancer awareness and support sidelines people with metastatic disease

<p><em><a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>There have been incredible <a href="https://www.cancer.gov/types/breast/research">advances</a> in breast cancer diagnosis and treatment in recent years. And stories about celebrities who have “beaten” breast cancer continue to be a source of inspiration for many people.</p> <p>However, this emphasis on fighting, beating and surviving cancer shuts out the voices of those who will not survive. That is, the many people diagnosed with incurable, life-limiting metastatic breast cancer, <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">which kills nine Australians every day</a> or nearly <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">3,300 people</a> a year. Yet an <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">estimated 10,000</a> Australians are living with the diagnosis.</p> <p>Being diagnosed with metastatic breast cancer, as one of the authors has been, means ongoing treatment to live as long, and as well, as possible. It also means an ongoing need for emotional and practical support.</p> <p>However, society, health-care professionals, cancer advocacy organisations, even a patient’s closest family and friends, can struggle to understand what it is like to live with an incurable and life-limiting cancer and how best to provide support.</p> <h2>Why is there so little awareness?</h2> <p><a href="https://www.breastcancer.org/types/metastatic">Metastatic breast cancer</a>, also called stage four breast cancer, is the most serious form of breast cancer. Unlike early breast cancer that is contained within the breast or nearby lymph nodes, metastatic breast cancer has spread to other parts of the body, most often the bones, lungs, liver, or brain.</p> <p>There is no cure for metastatic breast cancer despite decades of advocacy, funding and research. Treatment continues for as long as it helps to control the cancer and is tolerated by the patient. Median survival is <a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.51687">two to three years</a>, although newer, novel treatments mean some patients are living much longer.</p> <p>As a society, we can be uncomfortable <a href="https://theconversation.com/before-you-go-are-you-in-denial-about-death-34056">talking about and facing death</a>. When it comes to cancer, we usually prefer focusing on good news stories. These narratives are often perceived to be better for fundraising and are reassuring for people newly diagnosed. But they fail to <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">represent</a> the diversity and reality of cancer experiences.</p> <p>Despite considerable research into people with non-metastatic breast cancer, <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">relatively little</a> is known about Australians with metastatic breast cancer.</p> <h2>Feeling silenced and unsupported</h2> <p>Through our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">research</a> we wanted to better understand people’s experiences of metastatic breast cancer. We interviewed 38 participants from around Australia with diverse experiences of metastatic breast cancer. Participants were recruited through breast cancer and community organisations.</p> <p>We found messages and public campaigns about cancer survivorship, which emphasise hope and positivity, drowned out the voices of those with metastatic breast cancer. The focus on “success stories” about surviving breast cancer made some people feel like it was their responsibility to “beat” cancer. If they didn’t, it was their own fault. </p> <p>As one interviewee told us: "I react quite badly to all the, ‘we’ve had breast cancer and we beat it and we’ve survived. Aren’t we fantastic.’ There’s almost a feeling if you haven’t beaten your breast cancer you haven’t tried hard enough."</p> <p>Silence around metastatic breast cancer was common in research participants’ experiences. It prevented many from connecting with others and to the support they needed. It even affected relationships with those closest to them leaving them feeling misunderstood: "They don’t realise I’ve got to be on treatment forever. I’m not going to be cured. I think society thinks everything can be fixed; metastatic breast cancer actually can’t be fixed."</p> <p>Sharing deep fears and worries about their life expectancy can leave people with metastatic breast cancer feeling drained rather than supported. Many participants reported having to support and shield family, friends, acquaintances and work colleagues from the reality of their terminal diagnosis.</p> <p>"You hide how you feel because you don’t want to be avoided […] You put on that big, happy face. But like an onion if you peeled the layers away, you’d find out what’s going on."</p> <p>While many participants wanted to join a community of people with metastatic breast cancer, they struggled to know how to find one. Those who did, emphasised how invaluable it had been: "Being able to identify with and know that these people really get me is a huge relief and it reduces the isolation."</p> <p>These findings echo <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">previous research</a> demonstrating people with metastatic breast cancer have higher support needs than those with non-metastatic breast cancer. And these needs are <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">less likely to be met</a> by <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08269-8">health care, support services</a>, family or friends.</p> <h2>A new path</h2> <p>Being diagnosed with metastatic breast cancer can be terrifying, lonely and create significant support needs. It is essential people with metastatic breast cancer have their <a href="https://ascopubs.org/doi/10.1200/OP.20.00183">voices listened to</a> and their needs met.</p> <p>Next steps should include:</p> <ul> <li> <p><a href="https://bcna-dxp.azureedge.net/media/d32bhdzf/bcna_making-metastatic-breast-cancer-count_2022.pdf">improving data collection by cancer registries</a> so we know exactly how many people in Australia have metastatic breast cancer</p> </li> <li> <p>increasing representation of people with metastatic breast cancer in advocacy, support organisations and research</p> </li> <li> <p>nationwide access to peer-to-peer programs and professionally led metastatic breast cancer support groups.</p> </li> </ul> <p>We must ensure people with metastatic breast cancer are the ones to speak to their experience and needs. As a colleague with metastatic breast cancer said: "I read an article written by an early-stage breast cancer ‘survivor’. It felt like someone describing winter when they had only ever experienced autumn."</p> <p>If you or someone you know has metastatic breast cancer, these organisations may be able to support you or connect you with others with the same diagnosis:</p> <ul> <li> <p><a href="https://www.bcna.org.au">Breast Cancer Network Australia</a> for information and support</p> </li> <li> <p><a href="https://www.mcgrathfoundation.com.au/">McGrath Foundation</a> for information about access to metastatic breast care nurses.</p> </li> </ul> <hr /> <p><em>The authors would like to thank the members of Breast Cancer Network Australia’s Metastatic Breast Cancer Lived Experience Reference Group for their review of this article.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215458/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, Senior Lecturer, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, Research fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-not-going-to-be-cured-how-breast-cancer-awareness-and-support-sidelines-people-with-metastatic-disease-215458">original article</a>.</em></p>

Caring

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<p><em><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>.</p> <p>Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease.</p> <p>Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link?</p> <h2>What the study did and found</h2> <p>This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period.</p> <p>Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia.</p> <p>During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease.</p> <h2>Important considerations</h2> <p>In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk.</p> <p>Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively.</p> <p>These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable.</p> <p>Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves.</p> <p>This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association.</p> <h2>What does other evidence say?</h2> <p><a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both.</p> <p>High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too.</p> <p>For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life.</p> <h2>Why the link?</h2> <p>There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia.</p> <p>Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline.</p> <p>Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>.</p> <p>We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.</em></p>

Mind

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

<p><em><a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies.</p> <p>While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low.</p> <p>But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections.</p> <h2>What diseases can pets carry?</h2> <p>Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people.</p> <p>Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs.</p> <p>Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water.</p> <p>Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms.</p> <p>Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva.</p> <p>Dogs also commonly carry <em>Capnocytophaga</em> bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>.</p> <p>Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray.</p> <p>Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium <em>Bartonella henselae</em>.</p> <p>Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium <em>Staphylococcus aureus</em></a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission.</p> <h2>Birds, turtles and fish can also transmit disease</h2> <p>But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to <em>Salmonella</em> infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis.</p> <p>Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink.</p> <p>Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to <em>Pasteurella multicoda</em> infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats.</p> <p>Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets.</p> <p>Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed.</p> <p>For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>.</p> <h2>What should I do if I’m worried about catching a disease from my pet?</h2> <p>There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include:</p> <ul> <li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li> <li>not allowing your pets to lick your face or open wounds</li> <li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li> <li>wearing gloves when changing litter trays or cleaning aquariums</li> <li>wetting bird cage surfaces when cleaning to minimise aerosols</li> <li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)</li> <li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments</li> <li>seeking veterinary care if you think your pet is unwell.</li> </ul> <p>It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, Lecturer in environmental health, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Getty </em><em>Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-okay-to-kiss-your-pet-the-risk-of-animal-borne-diseases-is-small-but-real-210898">original article</a>.</em></p>

Family & Pets

“Invisible suffering”: Bella Hadid opens up about painful health battle

<p dir="ltr">Bella Hadid has shared a raw update to her fans, giving them further insight into her “painful” health battle with Lyme disease.</p> <p dir="ltr">On Sunday, the model took to Instagram to share a series of photos of her ongoing health battle, including photos of her medical records.</p> <p dir="ltr">“The little me that suffered would be so proud of grown me for not giving up on myself,” she began in the caption.</p> <p dir="ltr">She then thanked her mum, Yolanda Hadid, "for keeping all of my medical records, sticking by me, never leaving my side, protecting, supporting, but most of all, believing me through all of this”.</p> <p dir="ltr">She then continued to say that since contracting Lyme, her symptoms have gotten worse over time and it’s taken a toll on her in ways that are difficult for her to explain, but remained positive despite it.</p> <p dir="ltr">“To be that sad and sick with the most blessings/privilege/opportunity/love around me was quite possibly the most confusing thing ever,” she added before reassuring fans not to worry and that she is “okay”.</p> <p dir="ltr">The model also noted that despite her painful health battle, she “wouldn’t change anything for the world” and would go through it all again, as it has shaped who she is.</p> <p dir="ltr">“The universe works in the most painful and beautiful ways but I need to say that if you are struggling- it will get better,” she added.</p> <p dir="ltr">Bella also said that despite “almost 15 years of invisible suffering” she is grateful for the experience, and has so much “gratitude for and perspective on life” that has made her able to spread ”love from a full cup” and “truly” be herself.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Cvmz8ilAcxx/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Cvmz8ilAcxx/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bella 🦋 (@bellahadid)</a></p> </div> </blockquote> <p dir="ltr">“I tried to pick the most positive pictures I could because as painful as this experience was, the outcome was the most enlightening experience of my life filled with new friends, new visions and a new brain,” she added before thanking everyone who has supported her throughout this journey.</p> <p dir="ltr">“I’ll be back when I’m ready, I miss you all so much, I love you all so much,” she concluded.</p> <p dir="ltr">The model shared a few photos of herself getting treatment with IVs sticking out of her arm.</p> <p dir="ltr">In a few other photos, the model can be seen resting on the couch as she gets a blood transfusion, with her loyal pup, “Petunia aka Beans,” never leaving her side.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Cvm1ImkA-89/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Cvm1ImkA-89/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bella 🦋 (@bellahadid)</a></p> </div> </blockquote> <p dir="ltr">This is the model’s first health update after she revealed she was taking time off from modelling due to a flare-up in her Lyme disease.</p> <p dir="ltr"><em>Images: Instagram</em></p>

Caring

Why understanding how spiders spin silk may hold clues for treating Alzheimer’s disease

<p><a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em></p> <p>Really, we should envy spiders. Imagine being able to make silk like they do, flinging it around to get from place to place, always having a <a href="https://pubs.acs.org/doi/10.1021/acsmacrolett.8b00678">strong-as-steel safety line</a> or spinning a comfy hammock whenever they need a rest.</p> <p>The fascinating properties of spider silk make it no wonder that scientists have been trying to unravel its secrets for decades.</p> <p>If we could understand and recreate the spinning process, we could produce artificial spider silk for a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0141813021021292">range of medical applications</a>. For example, artificial silk can help <a href="https://doi.org/10.1016/j.biomaterials.2021.120692">regenerate the nerves that connect our brain and limbs</a>, and can shuttle <a href="https://doi.org/10.1021/acs.biomac.0c01138">drug molecules directly into the cells where they are needed</a>.</p> <figure><iframe src="https://www.youtube.com/embed/zNtSAQHNONo?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Spider silk is made of <a href="https://www.sciencedirect.com/topics/engineering/spidroins">proteins called spidroins</a>, which the spider stores in a silk gland in its abdomen. There are several types of spidroin for spinning different sorts of silk. Spiders <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673682/">store them as a liquid</a> that resembles oil droplets.</p> <p>But one of the questions that has eluded scientists so far is how spiders turn these liquid droplets into silk. We decided to investigate why the spidroins form droplets, to get us closer to replicating a spider’s spinning process.</p> <h2>Weaving a web</h2> <p>The trick that spiders use to speed up their spinning process can be used to spin better artificial silk, or even develop new spinning processes.</p> <p>In 2017, we learned to <a href="https://www.nature.com/articles/ncomms15504">make synthetic silk fibres</a> by emulating the silk gland, but we did not know how things work inside the spider. Now we know that forming droplets first <a href="https://pubmed.ncbi.nlm.nih.gov/37084706/">speeds up the conversion to these fibres</a>.</p> <p>An important clue to how the droplets and fibres are related came from an unexpected area of our research – on <a href="https://pubmed.ncbi.nlm.nih.gov/23013511/">Alzheimer’s and Parkinson’s diseases</a>. Proteins that are involved in these diseases, called <a href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/alpha-synuclein#:%7E:text=%CE%B1%2DSynuclein%20is%20a%20highly,linked%20to%20familial%20Parkinson%20disease.">alpha-synuclein</a> and <a href="https://www.alz.org/media/Documents/alzheimers-dementia-tau-ts.pdf">tau</a>, can assemble into tiny, oil-like droplets in human cells.</p> <p>Tau is a protein that helps stabilise the internal skeleton of nerve cells (neurons) in the brain. This internal skeleton has a tube-like shape through which nutrients and other essential substances travel to reach different parts of the neuron.</p> <p>In Alzheimer’s disease, an abnormal form of tau builds up and clings to the normal tau proteins, creating “tau tangles”.</p> <p>Alpha-synuclein is found in large quantities in <a href="https://www.webmd.com/mental-health/what-is-dopamine">dopamine-producing nerve cells</a>. Abnormal forms of this protein are linked to Parkinson’s disease.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Beautiful spider web with water drops close-up" /></a><figcaption><span class="caption">The trick spiders use to speed up their spinning process can be used to spin better artificial silk.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/beautiful-spider-web-water-drops-close-155560781">Aastels/Shutterstock</a></span></figcaption></figure> <p>Oil droplets of either one of these proteins form in humans when they become entangled, like boiled spaghetti on a plate. At first, the proteins are flexible and elastic, much like spidroin oil droplets.</p> <p>But if the proteins remain entangled, they get stuck together which alters their shape, changing them into rigid fibres. These can be toxic to human cells – for example, in neurodegenerative conditions such as Alzheimer’s.</p> <p>However, <a href="https://pubmed.ncbi.nlm.nih.gov/33148640/">spidroins can form droplets</a> too. This left us wondering if the same mechanism that causes neurodegeneration in humans could help the spider to convert liquid spidroins into rigid silk fibres.</p> <p>To find out, we used a <a href="https://www.nature.com/articles/nchembio.2269">synthetic spidroin called NT2RepCT</a>, which can be produced by bacteria. Under the microscope, we could see that this synthetic spidroin formed liquid droplets when it was dissolved in phosphate buffer, a type of salt found in the spider’s silk gland. This allowed us to replicate spider silk spinning conditions in the lab.</p> <h2>Silky science</h2> <p>Next, we studied how the spidroin proteins act when they form droplets. To answer this question, we turned to an analysis technique <a href="https://www.britannica.com/science/mass-spectrometry">called mass spectrometry</a>, to measure how the weight of the proteins changed when they formed droplets. To our surprise, we saw that the spidroin proteins, which normally form pairs, instead split into single molecules.</p> <p>We needed to do more work to find out how these protein droplets help spiders spin silk. Previous research has shown spidroins have different parts, called domains, with separate functions.</p> <p>The end part of the spidroin, called c-terminal domain, makes it form pairs. The c-terminal also starts <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1001921">fibre formation when it comes into contact with acid</a>.</p> <p>So, we made a spidroin which contained only the c-terminal domain and tested its ability to form fibres.</p> <p>When we used phosphate buffer to entangle the proteins into droplets, they turned into rigid fibre instantly. When we added acid without first making droplets, fibre formation took much longer.</p> <p>This makes sense since the spidroin molecules must find each other when forming a fibre. Entangling the spidroins like spaghetti helps them rapidly assemble into silk.</p> <p>This finding tells us how the spider can instantly convert its spidroins into a solid thread. It also uncovered how nature uses the same mechanism that can make brain proteins toxic to create some of its most amazing structures.</p> <p>The surprising parallel between spider silk spinning and fibres toxic to humans could one day lead to new clues about how to fight neurodegenerative disorders.</p> <p>Scientists may use spider silk research, including what we have learned about the spider silk domains, to keep human proteins from sticking together – to stop them from becoming toxic. If spiders can learn how to keep their sticky proteins in check, perhaps so can we.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, Researcher, Department of Microbiology, Tumor and Cell Biology, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, Researcher in Veterinary medicine biochemistry, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-understanding-how-spiders-spin-silk-may-hold-clues-for-treating-alzheimers-disease-205857">original article</a>.</em></p> <p><em>Images: Getty</em></p>

Body

Here’s how a new AI tool may predict early signs of Parkinson’s disease

<p>In 1991, the world was shocked to learn actor <a href="https://www.theguardian.com/film/2023/jan/31/still-a-michael-j-fox-movie-parkinsons-back-to-the-future">Michael J. Fox</a> had been diagnosed with Parkinson’s disease. </p> <p>He was just 29 years old and at the height of Hollywood fame, a year after the release of the blockbuster <em>Back to the Future III</em>. This week, documentary <em><a href="https://www.imdb.com/title/tt19853258/">Still: A Michael J. Fox Movie</a></em> will be released. It features interviews with Fox, his friends, family and experts. </p> <p>Parkinson’s is a debilitating neurological disease characterised by <a href="https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055">motor symptoms</a> including slow movement, body tremors, muscle stiffness, and reduced balance. Fox has already <a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">broken</a> his arms, elbows, face and hand from multiple falls. </p> <p>It is not genetic, has no specific test and cannot be accurately diagnosed before motor symptoms appear. Its cause is still <a href="https://www.apdaparkinson.org/what-is-parkinsons/causes/">unknown</a>, although Fox is among those who thinks <a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">chemical exposure may play a central role</a>, speculating that “genetics loads the gun and environment pulls the trigger”.</p> <p>In research published today in <a href="https://pubs.acs.org/doi/10.1021/acscentsci.2c01468">ACS Central Science</a>, we built an artificial intelligence (AI) tool that can predict Parkinson’s disease with up to 96% accuracy and up to 15 years before a clinical diagnosis based on the analysis of chemicals in blood. </p> <p>While this AI tool showed promise for accurate early diagnosis, it also revealed chemicals that were strongly linked to a correct prediction.</p> <h2>More common than ever</h2> <p>Parkinson’s is the world’s <a href="https://www.who.int/news-room/fact-sheets/detail/parkinson-disease">fastest growing neurological disease</a> with <a href="https://shakeitup.org.au/understanding-parkinsons/">38 Australians</a>diagnosed every day.</p> <p>For people over 50, the chance of developing Parkinson’s is <a href="https://www.parkinsonsact.org.au/statistics-about-parkinsons/">higher than many cancers</a> including breast, colorectal, ovarian and pancreatic cancer.</p> <p>Symptoms such as <a href="https://www.apdaparkinson.org/what-is-parkinsons/symptoms/#nonmotor">depression, loss of smell and sleep problems</a> can predate clinical movement or cognitive symptoms by decades. </p> <p>However, the prevalence of such symptoms in many other medical conditions means early signs of Parkinson’s disease can be overlooked and the condition may be mismanaged, contributing to increased hospitalisation rates and ineffective treatment strategies.</p> <h2>Our research</h2> <p>At UNSW we collaborated with experts from Boston University to build an AI tool that can analyse mass spectrometry datasets (a <a href="https://www.sciencedirect.com/topics/neuroscience/mass-spectrometry">technique</a> that detects chemicals) from blood samples.</p> <p>For this study, we looked at the Spanish <a href="https://epic.iarc.fr/">European Prospective Investigation into Cancer and Nutrition</a> (EPIC) study which involved over 41,000 participants. About 90 of them developed Parkinson’s within 15 years. </p> <p>To train the AI model we used a <a href="https://www.nature.com/articles/s41531-021-00216-4">subset of data</a> consisting of a random selection of 39 participants who later developed Parkinson’s. They were matched to 39 control participants who did not. The AI tool was given blood data from participants, all of whom were healthy at the time of blood donation. This meant the blood could provide early signs of the disease. </p> <p>Drawing on blood data from the EPIC study, the AI tool was then used to conduct 100 “experiments” and we assessed the accuracy of 100 different models for predicting Parkinson’s. </p> <p>Overall, AI could detect Parkinson’s disease with up to 96% accuracy. The AI tool was also used to help us identify which chemicals or metabolites were likely linked to those who later developed the disease.</p> <h2>Key metabolites</h2> <p>Metabolites are chemicals produced or used as the body digests and breaks down things like food, drugs, and other substances from environmental exposure. </p> <p>Our bodies can contain thousands of metabolites and their concentrations can differ significantly between healthy people and those affected by disease.</p> <p>Our research identified a chemical, likely a triterpenoid, as a key metabolite that could prevent Parkinson’s disease. It was found the abundance of triterpenoid was lower in the blood of those who developed Parkinson’s compared to those who did not.</p> <p>Triterpenoids are known <a href="https://www.sciencedirect.com/topics/neuroscience/neuroprotection">neuroprotectants</a> that can regulate <a href="https://onlinelibrary.wiley.com/doi/10.1002/ana.10483">oxidative stress</a> – a leading factor implicated in Parkinson’s disease – and prevent cell death in the brain. Many foods such as <a href="https://link.springer.com/article/10.1007/s11101-012-9241-9#Sec3">apples and tomatoes</a> are rich sources of triterpenoids.</p> <p>A synthetic chemical (a <a href="https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html">polyfluorinated alkyl substance</a>) was also linked as something that might increase the risk of the disease. This chemical was found in higher abundances in those who later developed Parkinson’s. </p> <p>More research using different methods and looking at larger populations is needed to further validate these results.</p> <h2>A high financial and personal burden</h2> <p>Every year in Australia, the average person with Parkinson’s spends over <a href="https://www.hindawi.com/journals/pd/2017/5932675/">A$14,000</a>in out-of-pocket medical costs.</p> <p>The burden of living with the disease can be intolerable.</p> <p>Fox acknowledges the disease can be a “nightmare” and a “living hell”, but he has also found that “<a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">with gratitude, optimism is sustainable</a>”. </p> <p>As researchers, we find hope in the potential use of AI technologies to improve patient quality of life and reduce health-care costs by accurately detecting diseases early.</p> <p>We are excited for the research community to try our AI tool, which is <a href="https://github.com/CRANK-MS/CRANK-MS">publicly available</a>.</p> <p><em>This research was performed with Mr Chonghua Xue and A/Prof Vijaya Kolachalama (Boston University).</em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/heres-how-a-new-ai-tool-may-predict-early-signs-of-parkinsons-disease-205221" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Mind

Bindi Irwin breaks down on camera about health condition

<p>Bindi Irwin has shown her vulnerable side in an emotional new video shared with fans about a personal ordeal.</p> <p>The 24-year-old spoke candidly to the camera for 15 minutes with guest appearances from husband Chandler Powell and their daughter Grace Warrior.</p> <p>In the video, Irwin recalled the “insurmountable” pain she experienced due to endometriosis before finally <a href="https://www.oversixty.co.nz/health/caring/how-did-you-live-with-this-much-pain-bindi-irwin-hospitalised" target="_blank" rel="noopener">undergoing surgery</a>.</p> <p>The wildlife warrior announced her diagnosis in March 2023, but the new video explains her symptoms - which started when she was just 14 - that left her with “extreme fatigue, nausea and pain”.</p> <p>“I had pain every single day of my life. No matter where we went, where we were going, I would be falling asleep. I felt like I constantly had the flu,” she said.</p> <p>The conservationist confessed she tried everything to solve the issue, undergoing CT scans, MRIs and ultrasounds.</p> <p>“I was always in pain. We tried for a year, and finally a doctor told me it was just part of being a woman.”</p> <p>Irwin said it was that comment from a doctor that led her to suffer in silence.</p> <p>However, after giving birth to her daughter in 2021, the pain “magnified” to a point where it was “out of this world”.</p> <p>“I remember countless times of Grace needing me, and me crawling to her cot at night,” she revealed, becoming emotional.</p> <p>“I can remember being with Grace and lying on the floor in agony. I had a stabbing pain in my side, I couldn’t get up or I would throw up, and I was scared I would pass out.</p> <p>“I was so scared because I was worried if I was alone with Grace, something would happen to me, and she would be on her own.”</p> <p>Irwin dubbed the pain “insurmountable” and something that “would knock me over”.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/Cr31hQDANTp/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/Cr31hQDANTp/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bindi Irwin (@bindisueirwin)</a></p> </div> </blockquote> <p>She said that after returning to new doctors, she was diagnosed with irritable bowel syndrome and chronic fatigue.</p> <p>It was not until she spoke to a friend, Leslie Mosier, who recently had endometriosis surgery that she realised they shared similar symptoms.</p> <p>“Leslie said the only way to diagnose for sure is through exploratory surgery.”</p> <p>Irwin said she decided to undergo surgery in the US as her daughter would have Powell’s parents, who live in Florida, nearby for support while she recovered.</p> <p>At this point in her video, Grace woke up and joined her mum on camera.</p> <p>“Mama went for surgery and they found 37 lesions and a chocolate cyst on my ovary,” she said in a child-like tone for the sake of her daughter.</p> <p>“Ovary!” Grace chirped.</p> <p>“After surgery mama feels a lot better hey? I had to recover for quite a while, and mama feels so much better, and she can run around with you!”</p> <p>Irwin went on to share what she has learned being a part of the endometriosis community.</p> <p>She revealed that excision surgery is considered the “gold standard” for the disease, where lesions and cysts are removed.</p> <p>“Everyone says we need to educate the public, but there also needs to be a shift in health care. Doctors need more information because endometriosis has myriad symptoms. Doctors need the right tools to diagnose.”</p> <p>She explained that her own endometriosis has been classified as severe, which means she may have to undergo more surgeries in the future to keep symptoms at bay.</p> <p>“I feel like. I got a second chance at life... I feel like a new woman.”</p> <p>In a final message of encouragement, Irwin said, “If you’re in pain, it’s so hard to get up every day and forge ahead.</p> <p>“Keep searching for those answers and never give up on you.”</p> <p><em>Image credit: Instagram</em></p>

Body

“I’m not gonna be 80": Michael J. Fox's tragic admission

<p>Beloved actor Michael J. Fox is acknowledging how difficult his more than 30-year battle with Parkinson’s disease has become.</p> <p>“I’m not gonna be 80,” the Back to the Future star said in a preview for an upcoming episode of the American current affairs program <em>CBS Sunday Mornin</em>g, according to <em>Page Six</em>.</p> <p>In the clip, Journalist Jane Pauley tells Fox that he has “not squandered” but that his condition will eventually “make the call” as to when it’s his time to go.</p> <p>“Yeah, it’s, it’s banging on the door,” the actor said.</p> <p>“I’m not gonna lie. It’s gettin’ hard, it’s gettin’ harder. It’s gettin’ tougher. Every day it’s tougher.”</p> <p>Fox revealed that he had surgery to remove a benign tumour on his spine, but the procedure “messed up” his walking and so he started to “break” other parts of his body, including his arm, elbow, face and hand.</p> <p>He added that the “big killer” of Parkinson’s disease is “falling” and can also be “aspirating food and getting pneumonia”, pointing out that it is “all these subtle ways that gets you.”</p> <p>You don’t die from Parkinson’s. You die with Parkinson’s,” he said. “So – so I’ve been – I’ve been thinking about the mortality of it.”</p> <p>The actor was diagnosed with the brain disorder at just 29. He has since become a leading advocate for research on the condition, with the launch of the Michael J. Fox Foundation in 2000 to help educate the public and fund studies.</p> <p>He has previously revealed that he does not fear death.</p> <p>“I’m really blunt with people about cures. When they ask me if I will be relieved of Parkinson’s in my lifetime, I say, ‘I’m 60 years old, and science is hard. So, no,’” he admitted in an AARP magazine profile in December 2021.</p> <p>“I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all.”</p> <p><em>Image credit: Instagram</em></p>

Caring

“Game-changer”: Michael J Fox shares huge medical news

<p dir="ltr">Michael J Fox has shared news of a medical breakthrough into Parkinson’s disease.</p> <p dir="ltr">The 61-year-old – who was diagnosed with the disease in 1991 – was thrilled to share the news, despite suffering a “terrible year”.</p> <p dir="ltr">Fox told <a href="https://www.statnews.com/2023/04/12/michael-j-fox-parkinsons-biomarker/" target="_blank" rel="noopener"><em>Stat News</em></a> that he had broken multiple bones after a fall, including some in his hand and face, but has said that in some ways he is “feeling better”.</p> <p dir="ltr">Despite his own personal battle, the <em>Back to the Future</em> star was overjoyed to share the breakthrough in Parkinson’s research.</p> <p dir="ltr">The study – funded by Fox’s charity organisation that aims to find a cure for Parkinson’s – found that a key Parkinson's pathology can now be identified by examining spinal fluid from living patients, allowing earlier intervention.</p> <p dir="ltr">“It’s all changed. It can be known and treated early on. It’s huge,” he said</p> <p dir="ltr">“This is the thing. This is the big reward. This is the big trophy.”</p> <p dir="ltr">The findings, published in <em>The Lancet Neurology</em>, are the result of a 1,123-person study that Fox’s foundation has put hundreds of millions of dollars into since it began in 2010.</p> <p dir="ltr">An editorial in the medical journal has also called this research “a game-changer in Parkinson’s disease diagnostics, research, and treatment trials”.</p> <p dir="ltr">In late 2022 the actor opened up about his struggle with Parkinson’s in his emotional acceptance speech for the <a href="https://www.oversixty.co.nz/health/caring/michael-j-fox-reveals-more-details-about-his-struggle-with-parkinson-s" target="_blank" rel="noopener">Jean Hershel Humanitarian Award</a>.</p> <p dir="ltr">In the speech he said that the hardest part “was grappling with the certainty of the diagnosis and the uncertainty of the situation,” but has since felt relieved after an “outpouring of support” from the public and his peers.</p> <p><em>Image: Frazer Harrison for Getty Images</em></p>

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