Is mental health data more sensitive than physical health data?














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Post by: Sarah Fox

The science behind the stories: drug treatment to slow progress of Huntington’s disease.

Microscope image of a neuron (yellow) showing a collection of Huntington’s disease proteins collecting at it’s core (orange).

Huntington’s is a devastating genetic disease, described by patients as being like “Parkinson’s, Alzheimer’s and motor neurone disease rolled into one”. In most cases the disorder can be traced back to an inherited genetic mutation which increases the length of the Huntingtin gene. The mutated gene harbours an abnormally long sequence of the DNA base pairs C A and G (this type of mutation is known as a CAG expansion). Sufferers commonly have one normal copy of the Huntingtin gene and one mutant copy and, over time, mutant Huntingtin protein builds up in the brain, damaging neurons and ultimately leading to the devastating symptoms of the disease.

A recent wave of articles (here, here, here) suggest that scientists may be on the cusp of a groundbreaking leap in treating this disorder; giving sufferers hope that a new drug could soon stop the march of Huntington’s in its tracks.

This drug has been named Ionis-HTTRx and, despite its dull moniker, it represents a pretty spectacular breakthrough in the field of Gene silencing.

But what is Gene silencing and what does this drug actually do?

Genes are segments of DNA which contain the instructions for making different proteins. These proteins perform a huge range of essential functions in our bodies; from signalling between cells, speeding up biological reactions to forming structural support for our cells.

So, to understand Gene silencing, we first need to understand the journey from Gene to protein.

Genes sit nestled within the tight curls of the DNA double helix. Specialised molecular machinery within the cell’s nucleus can break open the DNA helix and read individual Genes, creating an almost identical, single sided copy of the Gene known as mRNA. You could think of DNA as a hybrid between a ladder and a spiral staircase, while mRNA looks a bit like a small segment of that ladder which has been split down the middle. It is this mRNA which can slip outside the cell’s nucleus and act as a template for the creation of a protein (through a process known as transcription).

How can this process be silenced?

Gene silencing targets mRNA. Scientists have designed molecules which recognise the mRNA produced by specific genes, home in on these strands and stop them from being transcribed into proteins. This means that researchers can target specific proteins and selectively reduce the amount produced in cells.

Ionis-HTTRx is a antisense oligonucleotide which looks a bit like a mirror image of the huntingtin mRNA and, due to its structural similarity to the mRNA, it binds to the huntingtin mRNA stopping the transcription process – therefore silencing the gene’s effect.

Back in 2012 studies in a mouse model of Huntington’s disease found that when this drug was administered directly into the animal’s spinal fluid, mice showed a delay in disease progression and ‘sustained disease reversal’. While the most recent study involving 46 men and women in the early stages of Huntington’s found that 4 spinal injections, each one month apart, lead to a significant drop in the amount of harmful huntingtin protein present in spinal fluid samples. The trial did not last long enough to uncover whether this drop in harmful protein would ultimately translate into a reduction of clinical symptoms but a second trial, aimed at answering this question, is definitely on the cards.

Not only is this discovery exciting for those harbouring the huntingtin mutation, some suggest that the theory behind this treatment could be extrapolated to other conditions – namely Alzheimer’s disease. Our current understanding of Alzheimer’s disease suggests that it is also caused by misbehaving proteins. However, since the genetic causes of Alzheimer’s are more complex and less well understood than those underlying Huntington’s it is yet to be seen whether similar therapies would prove effective in this case.

Post by: Sarah Fox

A random blog post

The seemingly innocuous word ‘random’ is often misused in the English language. This is true of many words but I want to dedicate some time to discuss the word ‘random’ because of its fascinating mathematical meaning and the importance of truly random processes to the world around us.

One of the fantastic comics from XKCD…

What does random actually mean in mathematics?

Firstly lets talk about what it doesn’t mean. For most people, being random is akin to being strange, weird or erratic. This has become its common usage, the Oxford English Dictionary has a similar definition: ‘being made, done or happening without method or conscious decision’ (OED 10th Edition). So what’s the problem here? The issue is that the word random has a hidden mathematical meaning, something that most people are completely unaware of, even as the word emanates from their lips.

In mathematics, something that is random has no predictability or correlation. If you have a random sequence of numbers, then picking one number will give you no clue about what number came before it or what number will follow afterwards. It’s a very simple concept on paper but to actually calculate or observe truly random and unpredictable behaviour in the real world is very difficult. The problem is that in the natural world, almost every event that ever happens (for things larger than atoms) has an effect on something else which leads to a constantly growing web of interconnected events. Our reality is in fact a result of an almost infinite combination of interconnected events from the past affecting every aspect of the present. This interconnectivity means that most events that appear random such as the result of a dice throw or the positions of grains of sand on a beach are in fact predictable but only if you know all the smallest details of past events and how they affect each other.

Let’s take a simple coin throw as an example, on the surface the result (heads or tails) appears random and unpredictable).

However, a study by Persi Diaconis found that when a machine flips a coin with identical force and spin, the outcome is highly predicable. Not only that but different coins have different biases to fall on one particular side, and the result of a coin toss is highly dependent on the angle that the initial force is applied to the coin. All these factors are well known to magicians who can toss a coin is a seemingly natural way whilst being able to predict the outcome with amazing certainty.

Computers also suffer from the problem of non-randomness. When you command a computer to generate a sequence of random numbers it actually starts from a seed number (any number can be a seed) and then it runs a complex (but predicable) algorithm to generate seeming uncorrelated, random numbers. Here’s a gif of a program I made to illustrate random number generation…

A program that generates psudo-random numbers between 0 and 1.

Because these numbers are generated from a fixed seed in a predictable way, we call these numbers psudo-random. They are not safe to use for encrypting data or securing your computer. To produce better randomness, some computers measure difficult-to-predict things such as the time of your keystrokes, or the electronic noise in a circuit.

My point is that most random events that we experience in everyday life are far from random. By labelling such things as random we are actually obscuring the fact that they only appear random because of our own lack of understanding about all the factors that control them.

So, are there any examples of truly random events? The answer is yes, but for these examples, you need to delve into the quantum world of atoms and electrons. In quantum mechanics, interactions and movements are not governed by basic cause and effect but by probability. For example, electrons do not orbit in circles around atoms, they appear and disappear within a cloud surrounding the atom. If you look close to an atomic nucleus (the dark area in the diagram – right) you may spot electrons appearing and disappearing but, you will never know exactly when or where this is going to happen (this event is random). The further you move from the nucleus the rarer these appearances and disappearances become, still following a random sequence.

When a radioactive element decays, the nuclei of its atoms change or shed mass. When you are observing trillions of atoms you can predict how many will decay per hour, but if you isolate just one atom you will never know exactly when it will decay.

The exact time that a radioactive atom (black pixel on left plot) decays is unknown, but when the number of undecayed atoms (remaining nuclei in right graph) are plotted against time, a clear pattern emerges. Animation and plotting made by author.

For me this final point is the most fascinating. When you look at a single randomly behaving system (like the decay of atoms or the movement of electrons) by themselves they appear completely unpredictable. If you look at a single black pixel (representing an undecayed atom) in the above left plot, there is no way to tell when it will decay and become white. However when you observe large numbers of them the random behaviour ‘smooths’ out to produce a predicable pattern; just look how the decay curve on the right is showing a clear, predictable decrease.

This idea of large-scale patterns emerging out of small scale randomness extends to our entire world. Everything we interact with and experience which can be though of as ultimately predictable is, in fact, composed of tiny particles moving about, interacting and decaying in a completely random and unpredictable way.

Pretty random really…

Post by: Daniel Elijah

Wolves: the power of the pack












Post by: Dr Alex Ryan



Comment: Why being ‘overweight’ means you live longer: the way scientists twist the facts.

OK, so a friend of mine recently posted a link on Facebook to an article entitled ‘Why being ‘overweight’ means you live longer: the way scientists twist the facts’. I can’t lie, just the title alone made my blood boil. My main concern was, aside from what appeared to be an oversimplification of a phenomenon that scientists know as the ‘obesity paradox’, the title also plays beautifully into the ‘us vs them’ notion that academics are somehow untrustworthy. But, after my blood pressure settled, I decided to give it the benefit of the doubt and read the whole article – I’ve heard at numerous ‘media training’ workshops that it’s not uncommon for editors to alter article titles just before print to make them more appealing and more likely to garner views, so perhaps the body of the article was a bit more nuanced?

The article overall gave the impression that the author was well versed in scientific literature, using well placed quotes from research papers to highlight important points. For example, the author quotes a study from 2005 which used medical data (collected between 1971 and 1994) to show increased mortality (risk of death) in those with BMI’s (Body Mass Index) over 30 (i.e. those classified as obese). He correctly points out that the title of this paper (‘Excess deaths associated with underweight, overweight and obesity’) is misleading and implies that being overweight (i.e. having a BMI of between 25 and 30) increases your risk of mortality, when the study actually finds lower mortality in those with BMI’s between 25 and 30 than for individuals in the ‘ideal’ BMI range (18.5-25), I.e. being moderately overweight is good for you.

These findings do actually agree with a number of similar studies. In fact, in addition to these findings, there are also a whole host of studies which suggest that being overweight can lead to better survival rates following a large range of medical conditions (for example coronary heart disease, chronic heart failure, stroke and more).

So, do I agree with this article? Well, partially.

I agree that the obesity paradox exists and these findings are not often spoken about. However, the reason that they are not often publicised is not because academics want to ‘twist the facts’ or, as the author states, that ‘no one can bring themselves to say: Sorry, we were wrong. A BMI between 25 and 29 is the healthiest weight of all. For those of you between 20 and 25, I say, eat more, become healthier’. It’s because there is much more to these findings than first meets the eye.

I don’t think many doctors or researchers would argue that obesity, especially weight carried around the stomach, is a major risk factor for type 2 diabetes, lipid disorders, hypertension, coronary heart disease and some cancers. A quick search of Google Scholar will turn up a stack of articles suggesting that increased weight is linked to a whole range of long-term conditions.

But, how can both these findings be correct? How can it be possible that being overweight can mean you live longer but you are also more likely to suffer from a chronic illness (i.e. diabetes or heart disease)?

I believe that this is the question we are yet to find a satisfactory answer to, and therefore the reason it’s best to be cautious about making statements such as “being “overweight” is the healthiest and most “normal” weight of all”.

A paper entitled ‘The Obesity Paradox Does Exist’ expressed this problem very well, stating: “the discussion over the existence of the obesity paradox cannot lead to an underestimation of obesity as a crucial risk factor for the development of cardiovascular and metabolic diseases that requires comprehensive prevention and management strategies”.

But what’s my overall impression of this article?

I believe that it does raise awareness of a medical phenomenon which needs to be discussed but, that it does so in a dangerous and inflammatory way. Blaming scientists and accusing them of manipulating/twisting results is not helpful. Neither is writing a biased article which does not acknowledge the breadth and depth of understanding around a topic – i.e. it’s just as dangerous to tell individuals that it’s entirely healthy to be overweight (in the case of this article to even go as far as to suggest that the dangers of obesity are greatly overrated) as it is to ignore this obesity paradox entirely and blame everything on excessive weight. We need to be smart and realise that any reference to things being ‘black or white’ is probably dangerously misleading.

So, what can we take from this article and the related research?

Well, certainly not that it’s always going to be OK to be overweight. But, perhaps that we put too much stock in BMI calculations? Especially when this calculation (weight in kilograms divided by the square of your height in meters) does not take into account the extra weight carried in muscles, an individual’s body shape, fat distribution across the whole body or overall fitness level – all of which are important indicators of whether or not the weight we carry could be harmful. In fact, many of the academics studying this paradox suggest that it may actually be caused by problems related to the BMI measurement rather than any actual protection afforded by excess weight. That means that if you eat well and exercise regularly, even If your BMI is high, you are probably going to be healthier than someone who eats badly, smokes, and rarely gets off the sofa (whatever their BMI). At the end of the day it’s just a number, we all know how healthy our lifestyles are so we shouldn’t believe that such measurements can 100% predict our health outcomes. Hopefully, in the future, researchers can plan studies which allow them to look beyond BMI and work out how different types of fat, where it’s stored on the body and our overall fitness level affect our health – this might give us a better picture of what is really good for us.

Post by: Sarah Fox


Excess deaths associated with underweight, overweight and obesity

The Obesity Paradox: Perception vs Knowledge

Obesity Paradox Does Exist



Citizens across the North invited to get moving and help heart research in UK digital health first

The University of Manchester’s Connected Health Cities and Nokia partner to organise an 8 week step challenge across the North

Nokia and the Connected Health Cities (CHC) programme have launched CityMoves, an eight-week step challenge taking place from 23rd October to 21st December 2017.

I’ve already downloaded the app and am having a bit of fun logging my weekly activity. It seems I’m all systems go during the week but make up for it by lazing around over the weekend!

The challenge promotes healthy living and the positive use of data and technology in health and research. It’s also an opportunity for citizens across Greater Manchester to help advance science’s understanding of how low-intensity exercise improves heart health. Scientists know that intense exercise, like marathon running, will reduce your resting heart rate. But, they know less about how well moderate exercise such as walking can cause this reduction. Hopefully data from this app could provide an answer.

Participants will be able to track their steps through the Nokia Health Mate app, which also allows users to measure their pulse rate using their smartphones camera. Although this does take a bit of practice… Actually I was a bit worried by how my pulse spiked from simply climbing the stairs to my office, I’m blaming my technique but perhaps I just need a bit more gym time?

The project will be delivered across Connected Health Cities four city regions including Greater Manchester, Yorkshire, Liverpool and the North West Coast and Newcastle and the North East. Each region will be able to see how the amount of steps they have taken over the period compares to the others’.

As well as daily updates on the dedicated website, each week users get personalised feedback with information about their progress and how they compare to others from across the North – A bit of healthy northern competition! Throughout the eight weeks of the challenge CHC and Nokia will keep people motivated with motivational content, seasonal tips to get moving more, hundreds of fitness tracker give-aways and awareness messages on how to keep your heart healthy.

After the 8-week period de-personalised data will be sent to The University of Manchester’s Connected Health Cities programme where data scientists will look for changes in heart rate across the study period.

Prof John Ainsworth, Director of Connected Health Cities said:

“More effective use of data and technology has great potential to deliver health benefits for all of us. The CityMoves study is a great example for people to see the positive impact that their data can have.

“In CityMoves study we aim to develop a better understanding of the relationship between increased physical exercise and resting heart rate, a key indicator of health.”

To join the programme participants can register at, choose their team and begin measuring their steps and watch as they rise up their team’s leader board. @CHCNorth #DataSavesLives



What colour is your pain?







Post by: Kay Gallacher


Healthy eating: not always as healthy as you might think.

I have a confession to make.

When it comes to healthy eating I’m absolutely useless. Spending extended periods of time in the kitchen is my idea of hell, especially when I could be doing better things (like blogging about how I don’t like spending time in my kitchen). So, when meal time comes around, I usually either rely on my long suffering husband’s culinary skills or trust in the marketing I see on supermarket shelves, erring towards products labeled as as ‘Fat Free’, ‘Healthy Living’ or ‘Nutritious’. This has always seemed like a pretty solid game plan and I’m sure I’m not the only one who uses this method to try and move towards a healthier, more balanced diet.

However, as part of my interest in health apps, I downloaded the NHS’s Change4Life app which allows you to play food detective, scanning different products and giving a simple overview of how much sugar, saturated fat and salt they contain and the results were pretty eye opening.

The app looks friendly enough with it’s vibrant yellow background and quirky cartoon interface but after a few well meaning scans I started to feel that this app was probably not my friend.

My first scan was something I knew would flag up as being unhealthy but I wanted to see just how bad it actually was. So I scanned a box of my favourite chocolate cereal and waited for the result. What I found was pretty shocking. It seems that, for each bowl of tasty chocolate goodness, I’m actually eating the equivalent of 3 cubes of sugar and half a sachet of salt. Since the recommended daily sugar intake for an adult woman is 25 grams (just over 6 sugar cubes), this means that one bowl of my favourite cereal is about 44% of my recommended sugar fix for the whole day – talk about starting the day off on the wrong foot! I must admit I felt that I may have been happier not knowing this information but I certainly wouldn’t be healthier.

After this chocolatey revelation, I thought I’d use the app to perform a broad sweep of a range of products in my local supermarket, focusing on those marketed as being healthy.

One of the most striking things I found as I scanned around the shelves was that a fair number of products which I always assumed were relatively healthy, usually because that was how they were marketed, just weren’t.

I’m not going to name names (download the app and try for yourself) but here are a few of the shockers that I uncovered:

Sticking with my theme of breakfast revelations, I scanned a pack of popular breakfast biscuits which are marketed as ‘A perfect source of nutritious sustained energy’. I found that each portion contained almost a whole cube of sugar (1 sixth of your daily allowance in one, supposedly healthy, biscuit), 0.2 grams of saturated fat, and 0.2 sachets of salt. The app’s handy traffic light system rated sugar in this product as being high (red) while saturated fat and salt were both medium (orange). So perhaps this is not the best breakfast option?

Next I decided to move away from breakfast and try out a lunch option. The lunch pot I scanned was marketed as a ‘light lunch’, which I, and I’m sure many others, would assume should be a healthy option. This product was a winner when it came to sugar and saturated fat, being low (green) for both but then I looked at the salt. Registering as medium for salt content, one portion contained the equivalent of 3.6 sachets, that’s almost 2 grams or around a third of your daily recommended intake. Although salt often takes a back seat to sugar and saturated fat when we talk about healthy eating, it’s important to know that too much salt in our diets can increase our risk of high blood pressure and heart disease. It’s recommended that we don’t eat more than 6 grams of salt per day, that’s less than one teaspoon!

From here I thought I’d move on to look at a few larger ready meals, focusing on supermarket own-brand ‘healthy living’ meals. I was hopeful. The first meal I scanned was low in sugar but contained 5.1 grams of saturated fat and 0.6 grams of salt per portion, this registered as being medium or orange for both. My next two scans sadly seemed to followed the same trend.

So, although there were exceptions, it seemed that many of the meals and snacks I scanned which were marketed as healthy or balanced were actually much less healthy than I would have first thought. I also noticed a trend that products which were marketed as being ‘low fat’ were often particularly high in sugar. I guess this is the trade off the manufacturers make but perhaps it should state on the packaging ‘low in fat but packed with sugar to compensate’.

Finally, and one of the biggest revelations for me, was when I tried comparing a named-brand wheat biscuit breakfast cereal with the supermarket’s own-brand alternative. The named brand cereal was one of my first ‘all green’ scans with low levels of sugar, saturated fat and salt – pretty much what I would have expected from a simple wheat cereal. However, when I scanned the supermarket’s own product I was suddenly confronted by a unnerving orange traffic light for salt.The app showed that the own-brand cereal contained 0.3 grams of salt per serving, compared to 0.1 for the named brand. I think this is still at the lower-end of medium but I was shocked that this difference existed at all between two brands of what is essentially the same product. I guess that this proves, even if we think we know a product, it’s important to be sure exactly how different brands alter their ingredients.

For me, playing with this app has been amazingly interesting. Although the information the app gives you is no different from what you could read yourself on an ingredients list, the app interface gives you a quick and easy way to gauge, in a comparative way, how healthy each product really is. It also offers tips for healthier alternatives and recipes which has given me something extra to think about during my weekly shop.

I’m not going to kid myself though, I’m no saint when it comes to food and I don’t think I ever will be but I know how important it is to try and maintain a reasonable balance. This is why the most worrying discovery I made using this app is not the amount of sugar and fat in the foods which I know are bad for me (the things I try to eat in moderation) but it’s the figures the app shows for foods I would otherwise have assumed to be a ‘healthy alternative’. So, I really do recommend downloading the app and trying it out for yourselves, it may just be the fist step on the path to a healthier life.

Post by: Sarah Fox



Normalising cancer.

Working in the area of medical research I hear a lot about cancer. From the development of algorithms that can predict who is most at risk of developing the disease to the best ways to support patients through surgery, the big C is still top of the research agenda for many academics. Therefore, I’m slightly embarrassed to admit that when I sidestepped away from neuroscience into the broader field of health research I wasn’t entirely prepared for the deluge of cancer research about to fall on my lap.

But this shouldn’t have come as a surprise, especially since it is currently suggested that one in 2 people will, at some point in their lives, develop cancer and that deaths from cancer are higher in Greater Manchester than the rest of the UK. I’m sure I’m not alone in finding these facts excessively scary and, if I’m honest, I don’t know if I’ll ever be comfortable with the idea that one in 2 of us will suffer from cancer at some point in our lives (flip a coin, heads you win tails you lose).

However, it’s exactly these feelings of fear and disassociation I want to explore.

With the sword of Damocles resting maliciously above our heads and knowing that our best weapon against the big C is early diagnosis, is it time for cancer to be dragged out of the shadows and for us all to have a good look?

Earlier this year I took my mum to a talk called ‘Identity and Illness’ which was billed as an exploration of the way we build our identities up around our illnesses and what role diagnosis plays in this process. For some reason I built this up in my mind as being about mental illness, a topic I’m very interested in, and was shocked when we turned up and found that it was actually an exploration of how a cancer diagnosis influences identity. It had been a long day at work, I was tired and cancer was not something I wanted to think about. However, I’m glad I avoided the temptation to stick my fingers in my ears and hum loudly because the discussion soon took a very interesting turn. The speakers began to question why as a society we bury our heads in the sand when it comes to cancer, softly repeating the mantra it won’t be me, when the upsetting truth is that it’s pretty likely to be you and that your best chance of survival is vigilance and acceptance. Why are we so reluctant to confront illness as part of our everyday lives and would that feared diagnosis be easier to stomach if information, frank discussion and disease role models were a more common part of our daily lives?

People just don’t want to talk about serious illness and it’s rarely addressed in the media. Who else was shocked last year by what seemed to be the sudden death of David Bowie shortly after releasing his poignant music video Lazarus (“look up here I’m in heaven, I’ve got scars that can’t be seen”). In fact, studies suggest that it’s not rare for people to try to hide serious illness, with a quarter of people actively hiding their diagnosis from colleagues and, if possible, even from their family and friends.

But, however far under the rug we try to sweep illness it won’t go away. No family is immune and it can affect people of any age, wealth, profession and education. So, would we be better off opening the box on cancer and other serious illnesses and trying to integrate them back into society. Should illness be the norm rather than just our dirty little secret and would this mindset improve diagnosis, survival rates and the quality of life for sufferers?

Perhaps encouraging more transparency and better dialogues would even go some way to tackling some of the damaging and pervasive myths surrounding cancer. It’s much easier to build up false narratives around something which is hard to see than around things which are common parts of our everyday lives.

I do recognise that this is a difficult topic but it’s one that needs to be addressed. Rather than fearing illness, we should be prepared to increase our awareness, using all the knowledge at our disposal to recognise the earliest symptoms and be prepared to fight as soon as it raises its ugly head. And yes, like many of you, I know that no matter how loud my logical brain shouts that illness and cancer are just a part of life and that knowledge is our best weapon, there will always be a part of me that wants to hide away and ignore it. But, cancer research is moving forward in leaps and bounds and survival rates associated with early diagnosis have never been higher. So, it’s never been more important to face this monster head on – shout it’s name from the rooftops and assert that we will beat it.

Post by: Sarah Fox








Post by: Stephanie Macdonald

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