The nature and consequences of a nuclear war: lessons for prevention from Ukraine 2022.

This article attempts to put the Ukrainian conflict in the wider context of nuclear weapons possession and potential use, to point out how its conduct should affect public perception of such use, and the urgency for effective nuclear arms control measures including a determined resolve to implement the United Nations' 2017 Treaty on the Prevention of Nuclear Weapons.

Nuclear war and public health: preparedness, protection and the case for prevention.

BACKGROUND: According to the Stockholm International Peace Research Institute, the year 2018 saw a continuing 'drift into global instability' in which 'both the USA and Russia are on a path of strategic nuclear (weapons) renewal' with 3750 nuclear bombs globally deployed 'ready to fire'. Treaties are being abrogated with increasingly aggressive language exchanged, and discredited tactics such as 'limited use' revived. These developments risk an amplifying cascade of nuclear weapon fire, whether started by intent, miscalculation or unintentionally. RESULTS: A nuclear war would cause immediate and massive loss of human life, unprecedented damage to societal infrastructures and climatic disruption resulting in a 'nuclear winter' or 'nuclear famine'. CONCLUSIONS: The systems defending national territory against nuclear warhead missiles do not guarantee protection, and neither would hastily erected domestic shelters. Any post-survival world would be utterly different and severely challenging. The only effective preventative measures require nuclear disarmament through treaty.

Ionising radiation and childhood leukaemia revisited.

Increased incidences of childhood acute leukaemia were noted among survivors of the atomic bombings of Hiroshima and Nagasaki. In Western societies, Childhood Acute Lymphoblastic Leukaemia has a distinct epidemiology peaking at 3 years old. Exposure to ionising radiation is an established hazard but it is difficult to gauge the precise risk of less than 100 mSv. Since 1983 significant leukaemia incidences have been reported among families residing near nuclear installations. The target cells (naïve neonatal lymphocytes) get exposed to multiple xenobiotic challenges and undergo extraordinary proliferation and physiological somatic genetic change. Population movements and ionising radiation are considered taking account of updated understanding of radiation biology, cancer cytogenetics and immunological diversity. Double Strand Breaks in DNA arise through metabolic generation of Reactive Oxygen Species, and nearly always are repaired; but mis-repairs can be oncogenic. Recombinant Activating Gene enzymes in rapidly dividing perinatal pre-B lymphocytes being primed for antibody diversity are targeted to Signal Sequences in the Immunoglobulin genes. off target pseudo-sequences may allow RAG enzymes to create autosomal DSBs which, when mis-repaired, become translocated oncogenes. Immunogens acting by chance at crucial stages may facilitate this. In such circumstances, oncogenic DSBs from ionising radiation are less likely to be significant.

Can the health of a nation be correlated to its state of internal peace?

The Institute for Economics and Peace has ranked 162 territories within the United Nations according to how they score on a scale of 1.0 (most peaceful) to 5.0 (least peaceful) in a 'Global Peace Index' (GPI). The GPI 2015 values range from 1.148 (Iceland) to 3.645 (Syria). In this pilot study, we report significant correlations (Spearman rank coefficients) between each country's GPI and indicators of the health of its citizens (life expectancies, death rates and health expenditures): these significances are marginally enhanced when Sub-Saharan African countries are excluded. Our findings may indicate avenues for promoting a healthy global society, but more detailed and comprehensive analyses should be conducted in order for the factors behind the correlations to be identified and applied with more certainty.

Dangers associated with civil nuclear power programmes: weaponization and nuclear waste.

The number of nuclear power plants in the world rose exponentially to 420 by 1990 and peaked at 438 in 2002; but by 2014, as closed plants were not replaced, there were just 388. In spite of using more renewable energy, the world still relies on fossil fuels, but some countries plan to develop new nuclear programmes. Spent nuclear fuel, one of the most dangerous and toxic materials known, can be reprocessed into fresh fuel or into weapons-grade materials, and generates large amounts of highly active waste. This article reviews available literature on government and industry websites and from independent analysts on world energy production, the aspirations of the 'new nuclear build' programmes in China and the UK, and the difficulties in keeping the environment safe over an immense timescale while minimizing adverse health impacts and production of greenhouse gases, and preventing weaponization by non-nuclear-weapons states acquiring civil nuclear technology.

Blood transfusion and the World Wars.

This article summarizes the remarkable development in the science and practice of blood transfusion during the 20 years either side of 1900, progressing through the challenges of surgical vascular access, the propensity of shed blood to clot and the more mysterious apparently arbitrary acute reactions (later revealed as due to blood group incompatibility), to describe in more detail, the developments at the Western Front, then giving a précis of the advances in the interwar years through to the mid-twentieth-century 'blood-banking'.

External financial aid to blood transfusion services in sub-Saharan Africa: a need for reflection.

Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.

Thomas Addis, MD (1881-1949): Scottish-American clinical laboratory researcher, social activist and pioneer of renal medicine.

Addis was born and educated in Edinburgh, from the University of which he graduated MB in 1905, and MD in 1908, in which year he also gained membership of Edinburgh's Royal College of Physicians. After researching disordered haemostasis associated with various clinical conditions, he spent over a year in Germany: in Berlin with Dr. E.L. Salkowski learning urinalysis and at Heidelberg under Ludolph von Krehl studying haemophilics. Back in Edinburgh he concluded that the ultimate cause of haemophilia was an 'anatomical defect in the molecule of prothrombin'. He was the first to monitor the effects on plasma clotting times of transfusion of anticoagulated blood into a haemophilic. In 1911 he was recruited by Ray Lyman Wilbur, the first dean of the Stanford University School of Medicine, to investigate metabolic disorders including jaundice, diabetes and ultimately chronic renal disease. In 1917 he described the 'urea ratio'--the mathematical and conceptual forerunner of clearance formulae--and over the next 30 years developed a combined clinical and laboratory service for patients with inexorably failing kidneys. He devised an effective, rational and individually based dietary treatment--some patients such as Linus Pauling, who presented in 1941 with marked nephrosis, responded completely. Addis' Calvinist upbringing gave him a strong sense of 'mission' which during the American Depression developed into support for poverty-stricken workers in America, and against the fascists in Spain. He died before the full development of the 'McCarthy Witch Hunts' of the 1950s, although many associates, including Robert Oppenheimer, were interrogated.