The University of Southampton

Month: March 2023

Treating the Invisible Pain: Prosthetics and Phantom Limb Pain

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I was initially intrigued by the concept of Phantom Limb Pain (PLP) because I was fascinated by how someone could experience pain in a body part they no longer possessed. The depiction of PLP in the sci-fi movies I watched when I was younger seemed to be a figment of the imagination; it appeared to be a mysterious occurrence, somewhat fantastical and an element of creative licence adding dramatic effect.

After further research, I discovered that this perplexing phenomenon is real, not make-believe! The basis of PLP although unclear, is suggested to be due to changes in an amputee’s brain organisation; more specifically, alterations in the somatosensory cortex responsible for processing sensory information such as sight and touch, thus affecting the perception of pain sensitivity.

For those who are unaware, PLP can occur within the first few days after amputation; and can persist without intervention. The symptoms vary from the perceived ability to voluntarily move the phantom limbs to intense pain and tingling sensations. PLP treatment is usually with pharmacotherapy, and prosthetic use is considered an adjuvant therapy.

So where do prosthetics come in?

A prosthesis is an artificial device that substitutes for part of the body that is absent due to amputation as a result of a disease or traumatic injury.

Weiss et al. (1999) investigated how increased use of the residual limb by a prosthetic could alleviate PLP by comparing the amount of PLP experienced by upper extremity amputees who wore either the Sauerbruch prosthesis or a cosmetic prosthesis. The Sauerbruch prosthesis allows for the performance of several activities by being connected to one of the muscles of the arm through a surgically created tunnel with cables that operate a rod inserted into the arm, allowing for the contraction and relaxation of the muscle connected to the prosthesis and therefore promotes substantial use of the residual limb. Contrastingly, a cosmetic prosthesis has little functional value and usually leads to the non-use of the affected limb in most individuals who use one. The study concluded that individuals using the Sauerbruch prosthesis have substantially less PLP due to direct motor control of and somatosensory feedback from the prosthetic hand originating in the muscle of the residual limb than those using a cosmetic prosthesis.

The original Sauerbruch arm
Cosmetic Prosthesis
Depiction of the functionality of the Sauerbruch Prosthesis

Modern myoelectric prostheses function like the Sauerbruch prosthesis, however, they utilise electrodes in the prosthesis to detect nerve and muscle activity along the residual limb musculature, which triggers motors in the prosthetic to control and produce the movement intended.

Basic Diagram of a myoelectric limb

Final Thoughts:

The understanding of PLP and prosthetics as an adjuvant treatment allowed me to consider further; whether cosmesis of prosthetics(making artificial limbs look lifelike, similar to the original missing limb) aids the alleviation of PLP, as the somatosensory cortex also processes visual information.

My learning extended to another study suggesting that the correction of body perception may modulate PLP. This hypothesis stems from the prosthetic ownership concept, whereby prosthetic use is experienced as part of the body rather than an attached device foreign to it. This added to my insight into the prosthetic treatment of PLP as the brain combines visual input and direct cortical-somatosensory electrical stimulation by the prosthetic, creating a multisensory illusion that an artificial limb actually belongs to the body, thereby reverting the somatosensory cortex to a healthy state.

Overall, PLP accounts for a significant reduction in the quality of life of amputees; thus, the development of prostheses with somatosensory feedback and a cosmesis effect is a promising therapeutic tool to reduce PLP.

Sustainability in Replacement Body parts

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Replacement body parts are a central part of the medical world with anything from an organ to a finger able to be replaced in a human body. With the world population growing and the expectation for a certain quality of life rising, demand for replacements are at an all time high but the issue coupled with this demand is the environmental impact of designing, producing and implanting replacement body parts into patients. One of the biggest issues in the world today is the battle against climate change and not only how individuals can combat this issue but how bigger corporations like the NHS can contribute to the fight, and as a knock on effect, this alters the way in which replacement body parts can be manufactured.

Waste in the NHS

Biodegradable materials in medicine

I’ve always been a keen enthusiast of lowering carbon footprint and doing my part to contribute towards sustainability in the world and I’m also very keep on advancing medicine but the true inspiration for this literature came from my work experience at Bournemouth Hospital in the orthopaedics unit. Shadowing an anaesthesiologist allowed me to encounter many different angles of a working hospital but the most interesting area was the orthopaedics unit. I watched several knee replacement surgeries and the hundreds of pieces of sterile machinery and equipment used in the replacements but also the amount of waste produced. It made me question all the waste produced on the bigger scale and the negative environmental impact the manufacturing of the tools and prosthesis used in everyday surgeries and procedures.

Impact of sustainability on replacement body parts

A visit from MatOrtho in a module workshop highlighted how the pressure for the NHS to have net zero emissions by 2045 put immense pressure on them as manufacturers of replacement body parts to find more eco-friendly ways of producing what they already produce. With there already being so many limitations and restrictions to the way prosthesis can be produced, finding sustainable ways to carry on with their work is proving challenging but what I question is, at what point can you justify the production of carbon emissions in order to improve the quality of someones life through the creation of replacement body parts?

I was surprised to find the arguments of some claiming that the state of global health is a greater issue than the quality of life of those with a debilitating injury or loss of a limb but with the rise of sustainability activists like Greta Thunberg, the whole world needs to be thinking of ways to be more sustainable, not just the bigger corporations.

What does this mean for the future of replacement body parts?

3D printed heart using organoids and stem cells

Medicine is constantly advancing and nearly everyday there are discoveries or advances in the scientific world that lead to the improvement or saving of someones life so at what point do you limit that? As of 2022, there were 7000 patients on a waiting list for an organ transplant in the UK but this number is expected to decrease as organoids have opened up a whole new pathway in the world of organ transplants.

However this research could be restricted with the increasing regulations placed upon industries in order to preserve global health. But, if you were to break it right down to the foundations of transplants and prosthesis to the patients and family, if you were given the option to change your mothers, fathers, partners life by giving them the opportunity to undergo replacement surgery but the outcome may result in damaging the planet, would you go through with it? I know I would.

An Extra Brain Just in Case?

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I was reading about how stem cells are used so much in research in recent years to grow and develop organs in the lab. In particular, the advancements being made in growing mini brains. How amazing would it be if we were one day able to develop a fully functioning brain from our own brain cells that could be transplanted into brain dead patients!

So how close have scientists got to creating a fully developed and functioning brain?

Many ongoing experiments have been able to take human tissue and develop it into cerebral organoids, better known as mini brains. But what is the science behind this? I read an article written by Tiare Dunlap from University of California, Los Angeles. The article explains that scientists take the human tissue and engineer it to become induced pluripotent cells. Induced pluripotent cells are cells that can differentiate into any cell type in the body. They can then take these cells and by changing the environment the cells are in they can make them become neural stem cells. These neural stem cells are capable of developing into most of the types of cells found within the brain. The article also explained how there is no set protocol that is used across labs resulting in huge differences between ongoing experiments. I suppose the differences obtained in the results of the experiments can be a good thing in such a new and developing area of science. However, it did make me question if discoveries could ever be backed up with more evidence if each experiment carried out is slightly different. Is it limiting the discoveries that could be made within this highly important research? (https://newsroom.ucla.edu/releases/making-mini-brain-organoids-brainier#:~:text=To%20produce%20mini%E2%80%93brain%20organoids,cell%20type%20in%20the%20body.)

I found this video which gives a good summary of the the ongoing research and some of the science behind it.

What can we do with mini brains?

This is an image of cerebral organoids that were grown in a lab. At the minute, the mini brains are being used to research neural development, creating models to research neurodevelopmental disorders and for testing drug administration and responses.

But the big question is how far can we go with these mini brains?

A large amount of ongoing research is aimed at developing mini brains that can be conscious. There has been a few experiments that have shown that it is possible for the organoids to develop properties of a conscious brain. This includes, in 2019, Muotri’s group published a paper showing the creation of human brain organoids that produced coordinated waves of activity, resembling those seen in premature babies.

At the present time, there is no evidence that cerebral oranoids can become fully conscious, but the theory behind it has sparked many ideas on how we can further develop and use cerebral organoids. The downloadable PDF written by Sara Reardon gives a great insight to some further research ideas that are starting to become a reality.

can_lab_grown_brains_become_conciousDownload

Further reading and research into my initial question; whether a fully functioning brain could be developed from our own cells, has shown that there is still a lot of research to be done if it is to become a reality. And although the reality of this happening is still far down the line it was extremely interesting to see how far science has come.

Henrietta Lacks: The Immortal Woman

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If you’ve taken any lecture within the realm of cell biology – be it about cell division, transport, signalling, and so on – you’ve most likely encountered an experiment involving the use of HeLa cells. I certainly did, and after repeatedly seeing images of those strange, purple cells on my lecture slides, it made me wonder “What exactly is so special about HeLa cells that they are used in virtually every experiment to do with human cells?” This blog post is about these cells: what exactly makes them so remarkable, their polarising legacy, and the important bioethical discussions they raise about medical consent and racism.

An image of stained HeLa cells under a microscope.

What are HeLa Cells?

HeLa cells are an immortal cell line derived from the cervical cancer cells of Henrietta Lacks, a 31-year-old black woman and mother of five. They are the oldest and most used human cell line in scientific research and have contributed to countless scientific studies since their discovery in 1951.

Lacks was a patient at Johns Hopkins Hospital, Baltimore, Maryland in 1951, being treated for a very aggressive form of cervical cancer. Several months before her death, a sample of her tumour was given to George Gey, the head of tissue culture research at Hopkins at the time. Gey had been searching for an immortal human cell line to study cancer with for two decades and he had finally struck gold: Lacks’ cells multiplied faster than any cells he had ever seen, reproducing an entire generation every 24 hours. Unfortunately, it was this rapid and unlimited division that caused Lacks’ cancer to metastasise to virtually every organ in her body within months. She passed away on October 4, 1951.

The dicey bioethics of HeLa cells

It is quite difficult to put into words just how impactful Henrietta’s cells have been on medical research. They were used to develop the polio vaccine, study leukaemia, AIDS, and cancer, and more recently, help develop COVID-19 vaccines. Since their isolation, HeLa cells have been used in more than 70,000 scientific studies around the world as of 2022. There is a darker side to this story, however.

After her passing, Henrietta Lacks was buried in an unmarked across from her family’s tobacco farm in Virginia. For the next twenty-odd years, her family had no clue her cells had been shipped worldwide and were being used pioneering medical research. It wasn’t until 1975 that the Lacks family even were made aware about the widespread use of her cells in said research.

Henrietta’s cells were taken without her consent, which was legal at the time. Since then, policy changes have been made, and ethical guidelines for medical research have been put in place like the Declaration of Helsinki, which places emphasis on the informed consent of patients. In the USA, changes are being attempted to be made to the Common Rule, the set of ethical policies for research with human subjects, to make its consent rules more far-reaching.

Racism in science and Henrietta’s legacy

In my opinion, what Lacks’ story really highlights is the racism that has historically plagued science, particularly medical research and services in the United States. Hopkins, where she was treated, was one of the few American hospitals at the time that would admit black people. None of the multiple biotechnology companies whose research benefitted from her cells have financially compensated her family. In the 1840s, James Marion Sims, known as the “father of modern gynaecology”, infamously conducted experimental gynaecological surgery on enslaved black women without anaesthesia. There was also the Tuskegee Syphilis Study, when hundreds of black men in the 1930s were denied treatment for syphilis by researchers so the progression of their symptoms could be studied. I have linked further reading on both cases and more general scientific racism at the end of this blog.

While it is important to reflect on these past injustices, what the Lacks family would like to shift the focus is to is the legacy of Henrietta herself. In 2010, the Henrietta Lacks Foundation was established by Rebecca Skloot, the author of a book about Lacks, which awards grants to her descendants and other family members of people whose bodies were used without consent in research. In 2020, on her centennial year, the Lacks family started the #HELA100 initiative to celebrate her life and legacy.

Henrietta loved to dance and cook. She dressed stylishly and wore red nail polish. And most importantly, in the words of her grandson: “[Her cells] were taken in a bad way but they are doing good for the world.”

Henrietta Lacks (HeLa): The Mother of Modern Medicine by Kadir Nelson is a portrait of Lacks which has been on view in the Smithsonian Institute’s National Portrait Gallery in Washington D.C. since 2018.

My thoughts

I wanted to write about Henrietta Lacks for my blog post because as someone who wishes to work in biomedical research in the future, I will probably end up working with these cells myself and I think it is important to highlight the legacy of these cells: both the unjust way in which they were acquired, and what we and the scientific community at large can learn from these past injustices so we do not repeat them.

As a woman of colour myself, I have rather mixed feelings on HeLa cells. It is chilling thinking about the horrific treatment people of colour, and especially women of colour have faced in historical medical research. However, HeLa cells have done so much good for the world and do so for all ethnicities. As long as we acknowledge the story of Henrietta and continue to compensate her descendants, I think HeLa cells can continued to be used in research.

Much progress has been made on bioethics and informed consent in medical research and treatment since that extraction was made from Henrietta’s tumour all the way back in 1951. However, as biotechnology continues to advance and gene editing and the like becomes more commonplace, the door has opened to once again start having these important discussions on how to ethically apply these new technologies.

References

Johns Hopkins Medicine (2023) The Importance of HeLa Cells, Johns Hopkins Medicine. The Johns Hopkins University, The Johns Hopkins Hospital, and The Johns Hopkins Health System Corporation. Available at: https://www.hopkinsmedicine.org/henriettalacks/importance-of-hela-cells.html (Accessed: March 8, 2023).

Martinez, I. (2022) What are HeLa cells? A cancer biologist explains, The Conversation. The Conversation Trust. Available at: https://theconversation.com/what-are-hela-cells-a-cancer-biologist-explains-169913 (Accessed: March 8, 2023).

Nature (2020) Henrietta Lacks: Science must right a historical wrong, Nature. Springer Nature. Available at: https://www.nature.com/articles/d41586-020-02494-z (Accessed: March 8, 2023).

Skloot, R. (2000) Henrietta’s Dance, Johns Hopkins Magazine. Johns Hopkins University. Available at: https://pages.jh.edu/jhumag/0400web/01.html (Accessed: March 8, 2023).

More Reading

Racism in science

James Marion Sims’ experiments on enslaved women

The Tuskegee Syphilis Experiment

The Immortal Life of Henrietta Lacks by Rebecca Skloot is a great non-fiction book about Lacks and HeLa cells, and goes into great detail on the ethical issues of race and class in medical research. There is also a film adaptation of the same name that can be watched on HBO and HBO Max.

The future of prosthetics – mind control

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Prosthetics have come a long way, from wooden toes in the Egyptian era, to now, where mind controlled prosthetics are enabling people to feel again. Prosthetics are artifical limbs, which replace those lost either from birth or from complications later in life, and they come in 4 different types. These are transradial (below the elbow), transhumeral (above the elbow), transtibial (below the knee) and transfemoral (above the knee). Prosthetics that begin below the joint are able to have a greater range of movement easier, but developments in research are finding ways for above the knee/ elbow prosthetics to have a better range of movement and capabilites.

A recent development in prosthetics are mind controlled prosthetics. These are more technically known as neuromusculoskeletal prosthesis. By connecting to the individuals skeleton, muscles and nerves, the prosthesis can be controlled by the individual much easier, and research has found, can enable them to feel the sensation of touch. This is a major development, impacting the individual greatly.

The neuromusculoskeletal prosthesis, and how it interacts with the arm. (Irving, 2020)

A small study, which focused on people with osseointegrated prosthetics, changed their prosthesis so that electrical connectors were embedded within their nerves and muscles, to understand its functionality as well as the impact it had on their lives. The individuals mental health and social life was followed, providing great insight into how these devices can really help someone.

This study of 3 individuals, all of which had socket fittings prior to their osseo integrated prosthesis, looked at their experinece of the attachment, control, sensory feedback, practice and use, phantom limb, self image and social relations. All of which are massivly important to the individual and all impact quality of life. It was found that the osseo integrated limb was more comfortable and easy to use, and they had better control of their prosthesis, due to embedded electrodes instead of surface ones, which would often interact with signals from their environment. It was found that the limb enabled sensory feedback but wasn’t described as natural. Although the participants did not seem to overly mind this lack of natural feeling. The prosthesis was found to increase the amount of activities the individuals could participate in, and they found an increase in self-esteem.

Overall, this development in technology has greatly improved the quality of life of the individuals within the study. In the future, the industry hopes to improve the sensory feedback of these mind controlled prosthesis, allowing for better sensation of touch. Hopefully, these prosthetics will continue to improve the quality of life for these individuals and be introduced to more people.

References

IRVING, M. 2020. Mind-controlled prosthetic arms “feel” like the real thing [Online]. New Atlas. Available: https://newatlas.com/medical/mind-controlled-prosthetic-arm/ [Accessed 09/03/2023].

MIDDLETON, A. & ORTIZ-CATALAN, M. 2020. Neuromusculoskeletal Arm Prostheses: Personal and Social Implications of Living With an Intimately Integrated Bionic Arm. Frontiers in Neurorobotics, 14.

ORTIZ-CATALAN, M., MASTINU, E., SASSU, P., ASZMANN, O. & BRÅNEMARK, R. 2020. Self-Contained Neuromusculoskeletal Arm Prostheses. New England Journal of Medicine, 382, 1732-1738.

PROSTHETICS, H. S. O. A. 2019. Prosthetics: What are They and How Do They Work? [Online]. Horton’s Orthotics and Prosthetics Available: https://www.hortonsoandp.com/prosthetics-what-are-they-and-how-do-they-work/ [Accessed 06/03/2023].

SURGICAL, P. 2017. History of Prosthetics [Online]. Premier Surgical Available: https://www.premierprosthetic.com/02/history-of-prosthetics/#:~:text=Ancient%20Greece%20and%20Rome%20through,Ages%20saw%20only%20limited%20progress. [Accessed 09/03/2023].

Reduce, Re-use, Recycle – Environmentally Friendly Prosthetics?

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Following both prosthetic workshops and after hearing about the ZeroThirty initiative hoping to see the NHS carbon neutral by 2030, I began to wonder whether the conventional plastic used in prosthetic components could be sustainably sourced or even recycled. Being someone who is passionate about developing a greener future and currently conducting a research project in sustainable land management, this led me to wonder whether environmentally friendly prosthetic limbs already exist via the creation of new prosthetics re-using wasted materials or recycling those that no longer serve their owner purpose.

By prolonging the working lifespan of such a persistent material, could this reduce the unnecessary contribution of yet another source of plastic to the growing waste accumulation and help keep the NHS on track towards its target?

Recycled Plastic Prosthetics:

Prosthetic leg structure. https://www.physio-pedia.com/File:AKparts-of-a-prosthesis-268×300.jpg

While you wouldn’t expect false limbs to make up a large portion of landfills, the materials used to make prosthetic sockets and implant components, include high density molecular weight polyethylene (UHMWPE) and other thermoplastic polyethylene. UHMWPE has a very high strength to density ratio needed to withstand large amounts of stress while being relatively lightweight compared to titanium or ceramic materials that have also been used. One key feature of UHMWPE is its longer chain structure which is able to resist heavy loads more effectively resulting in being a high impact strength. However, thermoplastics do not biodegrade and will therefore persist in the environment.

UHMWPE components used in artificial joints. http://article.sapub.org/10.5923.j.ijbe.20110101.02.htm

This only becomes an issue when prosthetics are no longer required by a person, due to outgrowing replacements, gaining upgrades or eventual death. In 2019, researchers from De Montfort University (DMU), developed a recycled prosthetic limb by pulverizing plastic bottles and spinning them into polyester yarns that were moulded upon heating. Dr Kandan stated that, “Upcycling of recycled plastics and offering affordable prosthesis are two major global issues that we need to tackle.” Not only is this solution more cost-effective, but it is also more durable. The DMU team claimed that price per socket could be reduced from £5000 to only £10.

Evolution of recycled plastic prosthetic development. From discarded plastic bottle, to polyester yarns and finally moulded prosthetic limbs. https://www.weforum.org/agenda/2019/10/plastic-bottles-waste-prosthetic-limbs/

In 2015, the World Health Organisation estimated there were 40 million amputees in the developing world with only 5% having access to prosthetic care. Due to the staggering cost reduction, the largest beneficiaries of the recycled prosthetic limb are presumed to be amputees in developing counties, bringing a more financially accessible option to areas with limited resources and narrowing the inequality treatment gap. Although, there is little long-term evidence that this creation performs the same quality of function as modern prosthetics, so it is difficult to assess long-term benefits (or possible disadvantages) of using a prosthetic limb that is so different from all that came before it. Another issue is the weakened chemical structure of the plastics and questionable longevity once in use again. Are these unknown risks going to do more damage? Only time will tell …

Re-using prosthetics:

After further research into solutions to tackle the barriers of cost, supply and demand of prosthetics for amputees in developing countries, I discovered the Legs4Africa charity which does exactly that. Relying on public donations, recycled prosthetic legs are shipped worldwide to Africa. Since 2014, over 12,000 prosthetic legs have been collected, allowing amputees to return to work and regain a higher quality of life.

Pie chart showing the proportion of prosthetic leg donations from each country involved in Legs4Africa. UK has the highest number of donations of all participating countries. https://www.legs4africa.org/recycling/

The short video below demonstrates the incredible work Legs4Africa has achieved making a huge difference to the lives of so many.

Final thoughts:

Though both aspects explored in this blog are small contributions, they are headed in the right direction. Extending the life of prosthetics to fulfil pressures of demand and repurpose existing materials to limit consumption and waste generation could become revolutionary. There is a long way to go, and I believe that with a scrupulous trial of performance, recycled prosthetics could really take off. This topic is so important and I find it fascinating that large prosthetic manufacturers have not yet made the link between sustainable regeneration of plastics in prosthetics. What does this suggest about its reality?

The Mystery of Extreme Sleep Deprivation

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We all know the effects of a late night, especially if we need to get up early in the morning. We’re more irritable, less focused and less alert. I previously thought that symptoms of extreme sleep deprivation of around 48 hours or more, might be similar. However, this is not the case. Interestingly, in extreme cases, your perception of reality can become very distorted and you may experience intense hallucinations. The first symptoms can be seen within 24-48 hours of no sleep.

What is Microsleep?

Sleep is essential for maintaining pathways in the brain that are important for forming memories and retaining information. I wanted to focus on one symptom that can been seen in both minor and extreme cases, known as microsleep. During microsleep, your brain is not processing external information and you have a reduced response to external stimuli such as noise. This happens for around 10 seconds and most people may not realise it happening. Have you ever been stuck at a red light and felt yourself drift off even though your eyes are still open?

Summer, J. (2023) Microsleep: Symptoms, causes, and safety risks, Sleep Foundation. Edited by A. Rehman. Available at: https://www.sleepfoundation.org/how-sleep-works/microsleep (Accessed: March 8, 2023).

Attached is a podcast with Professor Russell Foster talking about the effects of sleep deprivation and the relationship between sleep and mood disorders and abnormal cognitive behaviour. Here he discusses microsleep and the long-term effects of night shifts. This is a trustworthy source as he has scientific explanations for his conclusions but uses language that is easy to understand.

The Dangers Of Sleep Deprivation 2016 – Prof Russell Foster, Oxford UK

How can we further our understanding of extreme sleep deprivation?

Brain waves can be measured with the help of an electroencephalogram (EEG) and fMRI scans to show active areas of the brain whilst sleep deprived and compare this to the patient when well rested. The benefits of these methods are that the patient can remain awake so a real-time impression of the brain can be made. However, the patient must be made aware of the short and long-term risks associated with sleep deprivation and in order for the study to be controlled, the patient may need to be observed to ensure they are not asleep.

This was discovered in a 2018 study on sleep deprivation, where results were gathered from 760 participants, where first symptoms, around 24-48 hours in, included:

  • Distorted perception
  • Anxiety
  • Depersonalisation – an altered sense of self where you feel disconnected from your own thoughts and body.
  • Loss of time and sense of orientation

From 48 hours:

  • Hallucinations
  • Delusions
  • Disorientation
  • Depression
  • Euphoria
  • Anger/Hostility

From 72 hours:

  • Complex hallucinations – including visual, sensory and auditory disturbances.
  • Elaborated delusions
  • Aggressive attacks
  • Mood changes

This is because the brain still undergoes R.E.M (rapid eye movement) phase whilst awake so you experience a dream-like state whilst still awake. This has been observed in multiple experiments and is known as sleep deprivation psychosis.

Sutherby, R. (2022) Can sleep loss cause symptoms of schizophrenia?, Psych Central. Psych Central. Available at: https://psychcentral.com/health/sleep-deprivation-psychosis#what-causes-the-psychosis (Accessed: March 8, 2023).

Many ethical questions arise when trying to conduct experiments to understand sleep further. When mice have been tested in the past, they have all died as a result of sleep deprivation. So, extreme caution must be taken when testing humans. Older experiments can tell us what happens when we don’t just miss an hour per night, but go weeks without any sleep.

This YouTube video briefly highlights the different attempts made by scientists throughout history to further our understanding of sleep that had unfortunate effects. This video is animated and in laymen’s terms so is highly engaging and easy to understand.

Human Sleep Experiment That Went Horribly Wrong – The Infographics

Conclusion and Reflection

I chose this topic because it had a really interesting link between science and ethics. I find the topic of sleep fascinating, and what makes this topic even more interesting is that it is incredibly difficult to study. Nowadays, it is considered unethical to conduct experiments exceeding 48 hours of sleep deprivation. After watching the videos and listening to the podcasts, I found myself wondering if sleep deprivation is described as a physical or mental health illness.This means the topic of sleep is one big mystery and there is still so much we don’t know, or may never know.

A Better Solution for Human Cloning: The CRISPR/Cas9 Technology

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Cloning is the technique of generating organisms that are exact genetic duplicates of one another. Scientists’ major goal is to discover the “ultimate code” that produces a “perfect” organism – a body free of diseases and anomalies. Cloning, in this opinion, is beneficial in reducing the spread of fatal inherited disorders. Dolly the sheep was the first organism to be successfully cloned.

Cloning Process of Dolly the Sheep

This case intrigued the psychologist in me, who wondered why some scientists are so eager to legalize this process when Dolly’s case was the 277th attempt. Thus, the unsuccessful 276th attempts have either failed to develop into a viable embryo or been aborted after they showed signs of abnormality. Such, high chances of failure with the accompanying issues of wastage of human embryonic material are not acceptable. However is it correct to think that cloning does not happen in the scientific community?

The Two types of Human Cloning

There are primarily two methods of cloning in which an embryo is formed other than by sperm fertilisation of an egg. Embryo splitting, also known as reproductive cloning, is a method of artificially stimulating the natural process of producing identical twins. This type of cloning was used in the production of Dolly. Somatic cell nuclear transfer or ‘therapeutic cloning’ is the only process capable of generating clones of living humans. It is a sort of non-reproductive cloning used to obtain stem cell lines for research. Stem cells are undifferentiated cells that can self-renew or develop into multiple cell types. Stem cells are classified into two types: multipotent stem cells (also known as “adult cell cells”) and pluripotent stem cells (also known as “embryonic stem cells”). The latter are derived from early embryos and have seen extensive study use.

The process of reproductive cloning is as follows: all genetic material carried by a single ovum (egg) is contained within a nucleus; if this nucleus is removed (ovum enucleation) and then replaced with the nucleus of a somatic cell (from the body of an embryo), an embryo genetically identical to the donor of the somatic cell nucleus can be created. The resultant embryo is subsequently implanted into a surrogate mother’s womb for gestation and delivery. The described approach has been applied in a process called ‘three-parenting IVF’. It enables women with mitochondrial disease to have a genetically related child free of the disease.

The mitochondrion has its own genome, the mtDNA, which encodes 13 proteins that are subunits of respiratory chain complexes. Mutations stop the mitochondria from converting food and oxygen into food, affecting negatively the heart, brain, and lungs. Dysfunctional mitochondria are implicated in several neurodegenerative diseases including Parkinson’s disease. Therefore, ‘three-parenting IVF’, or mitochondrial transfer in IVF could be considered an effective preventive strategy. However, it crosses ethical boundaries as it interferes with germ-line, not to forget the psychological and social implications.

Nevertheless, the CRISPR/Cas9 technology could be regarded as a better solution. It has grown in prominence due to its low cost and possible applicability in the treatment of genetic diseases. It is capable of strong gene editing. However, it may not affect all mtDNA, but it may change enough to lower the individual’s illness threshold, offering therapeutic benefits. This innovative technology could be utilised to treat diseased people as well as IVF embryos prior to implantation. It provides a reduction in mutation load, which lowers symptoms and disease burden. The CRISPR/ Cas9 editing of embryonic mtDNA may appeal as a more socially acceptable option to ‘three-parenting IVF’. Rather than merging the genetics of three people, it allows a couple to conceive without the need for donor genetic material.

The video shows the process of CRISPR/Cas9

The logic of human cloning and the logic of therapeutic cloning are identical; the spare embryo is created to expire. Nevertheless, a much better alternative could be the CRISPR / Cas9 gene editing technology, which attempts to cut off parts of defective DNA and subsequently reinstall it in the embryo. It can lead to reduced mtDNA disease, perhaps saving many affected people.

Reference list:

Brand, M.D. and Nicholls, D.G. (2011) Assessing mitochondrial dysfunction in cells, The Biochemical journal. U.S. National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/21726199/.

Gurnham , D. (2016) The mysteries of human dignity and the Brave New World of human cloning …, Sage Journals . Available at: https://journals.sagepub.com/doi/abs/10.1177/0964663905051219.

How CRISPR let you edit DNA (2019) YouTube. YouTube. Available at: https://www.youtube.com/watch?v=6tw_JVz_IEc.

José , V.D. (2008) Cloning humans, cloning literature: Genetics and the imagination deficit, New genetics and society. U.S. National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/17256208/.

O’Mathúna, D.P. (2002) What to call human cloning – EMBO press, Viewpoint. Available at: https://www.embopress.org/doi/full/10.1093/embo-reports/kvf122.

Rulli , T. (2016) What is the value of three-parent IVF?, The Hastings Center report. U.S. National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/27198755/.

ASLAN- Connecting The Silent World

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Prosthesis and robotics have the capability of allowing sign language users to connect to those who do not understand.

Sign language is the fourth most used language in the UK however it is still taboo in the general population. At a selection of schools sign language is an optional extra however it is not part of the national curriculum.

There is an outcoming number of benefits from teaching BSL (British Sign Language) at schools. From an academic foresight there are many qualifications and careers you can pursue through BSL alone. More importantly, it allows effective communication and overcome discriminative barriers. I have experienced these barriers myself working in customer service. I feel helpless when a regular comes in who can only sign or write. It feels dehumanising asking him to write the Lego piece that he wants as it is complex to sign for, the ASLAN would eradicate this for my workplace and improve the quality of life for people; to the extent of scenarios others may take for granted.

There is more than 11 million people in the UK with some form of hearing loss, or one in six of the population.

This number is only expected to increase.

British Academy of Audiology- (Hearing Link Services, 2022)

Engineering students at the University of Antwerp have developed a device called ASLAN. It is a significantly cheap prosthetic that uses artificial intelligence to translate sign language, made at around £400. It allows to overcome the barrier between Sign language users and those who do not understand it, which will be highly beneficial to the quality of life of those with hearing impairments.

The team from Belgium in action working on ASLAN- (Fisher- Wilson, 2017)

ASLAN works by users sending messages which then are finger spelt in sign language. I believe that ASLAN has created a wider topic of research using prosthesis and robotics in conjunction to allow barriers involved with sign language to be completely overcome.

Further development of the ASLAN

There are countless possibilities I have thought further about from coming across the ASLAN such as creating an orthotic glove which the user will wear on their hands and whilst they sign, signals transduce to a system which will convert this to speech using graphite resistance technology or accelerometers. Or in scenarios where a deaf person may not have hands, inspired by ASLAN a prosthetic could be made which signs for the user.

Concepts of the ASLAN

A huge economic benefit of the ASLAN is that it is cheap and easy to make from a 3D printer. The ASLAN can also be mobile, these benefits combined would create less discrimination in industries such as schools and workplaces. Sign users would gain more independence in their day to day lives without the use of an interpreter, positively impacting societal and ethical fields of interest.

Controversies of the ASLAN

In dispute, this could be seen as attempting to replace interpreters, however the creators have assured this is not their intentions and they are developing ASLAN more for situations such as a student who cannot hear in class could use this to communicate convienently.

Another controversy of this topic is if it can be classed as a prosthetic? The ALSAN does replace a body part however it replaces the persons hand who is lacking sign language communication, not the direct user. It however does not attach to that person’s body in anyway therefore it could be classed as an indirect prosthetic. Therefore it could be argued as an orthotic as it aids function.

Further Information

This video from Hubs on You tube, displays some of the features of the ASLAN in more detail

To conclude the ASLAN opens a world of further research to improve the quality of life for BSL users and help overcome communication barriers. I believe this technology paired with increased awareness and education in schools would lead to connecting our two worlds.

References

Fisher- Wilson, G. (2017) There’s not enough sign language translators, so these students 3D printed a humanoid robot | Hubs. Available at: https://www.hubs.com/blog/theres-not-enough-sign-language-translators-so-these-students-3d-printed-a-humanoid-robot/ (Accessed: 9 March 2023).

Hearing Link Services (2022) Deafness & hearing loss facts – Hearing Link Services. Available at: https://www.hearinglink.org/your-hearing/about-hearing/facts-about-deafness-hearing-loss/ (Accessed: 9 March 2023).

Man vs machine: A New Chimera

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Think back to your childhood and the incomparable difference of the technology then and now. Now think of the possibilities that future technology could consist of.

“Back when I was child we didn’t have all this technology”

The loss of limbs has significant impacts on individuals and can occur due to car accidents, wars or even a defect at birth. In America alone there are 185,000 amputees per year and this number is growing Medical and technological advances have currently provided us with some forms of myoelectric bionic arms so what could the future hold for us?

Listen here: Cochlear implants are redefining hearing

When understanding medical and technological advances it must be recognised that for innovative advances in prosthetics, both the scientific and technological aspects have to be advancing at a suitable rate. For example, in order for cochlear implants to of been created, a deep understanding of the physiological antinomy of the ear and nervous system had to be understood. We needed to recognise that individuals with auditory disabilities often stem from the concept of damaged hair cells in the inner ear. By recognising this we used developing technology to replace the need of these hairs. The implant serves to process sound waves through the use of a microphone and are able to convert these sound waves into electrical signals. These can bypass the cochlear hairs and stimulate the auditory nerve fibres. This begs the question, well what other lost functions can we restore?

This singular device has such a huge impact on millions of peoples life’s. Could a prosthetic like this be adapted to have hearing beyond the capability of current humans?

How prosthetic limbs are giving amputees a helping hand !

Currently, we have myoelectric prosthetics which are important in replacing the function of a lost limb such as an arm. These work by using the muscles in the residual limb to send signals to the bionic arm. These signals will inform the electric arm to contract or relax etc. This is done through the stretching and contractions of the muscles from the residual limb. As impressive as this is… it’s not ideal. The user has limited options in what the hand can do, such as very limited finger individual finger movement. Moreover, if there’s a lack of suitable muscle by the residual limb or no residual limb then it becomes almost impossible for the hand and arm to work. A battery is also required meaning the device needs charging or batteries frequently. This is important as in terms of living in society, the individual is still at a disadvantage and due to a limited mobility, the product may not satisfy the consumer enough.

Current research is focusing on fully integrated prosthetics. This would have a huge impact on our society. Fully integrated prosthetics involves solely involves the nervous system to bring about a response. To the user this would almost feel the same as if they had an arm or leg. They would “think” about moving a finger and it would move. In addition, as the interface is controlled by the individual’s own biology, no battery would be required in the same way the average individual doesn’t require a battery. However ethically and legally this could cause concern. Although this would be very effective for the amputee, you would effectively be building a chimera between man and machine. This could be militarised as rather than just restoring the function of an arm or leg, you could enhance it for military purposes. Even having such specific control over a carbon fibre arm; in public this could be conceived as dangerous. New military laws and national laws would have to be introduced.

When designing a product like this, the potential danger that could be introduced to society needs to be examined yet the number of people’s lives that could be improved is incredible. So, the question is… Is it possible to advance/improve our civilisation technologically without causing a new problem? …No, I don’t think so. Do you?