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Letters to the Editor Issue 272

by Letters(more info)

listed in letters to the editor, originally published in issue 272 - August 2021

Supporting Samaritans – Samarathon – Support Richard Millard

Samaritans know that life can sometimes be incredibly tough. The stresses felt by many during the COVID19 era have only increased the number of calls fielded by the Samaritans Freephone Helpline. Thanks to the dedication of more than 20,000 volunteers, Samaritans can be there for anyone, whatever they are going through and whenever they are struggling to cope. They are also at the heart of local communities, working with schools, workplaces, railways, prisons and hospitals to offer training and support, preventing suicide and helping people turn their lives around.

Supporting Samaritans

I have been a volunteer Listener manning the phones at our local Samaritans Branch for 3 years now. I know from the stories I hear, and the thanks often expressed at the end of a call, what a difference it makes for someone in distress to be able to talk in confidence – and without judgment – with another human being – whatever the cause of their troubles.

We are raising money to fund the continuing activities of our local branch – which has been an important part of the local community for more than 40 years. Please sponsor me on my Samarathon challenge. I’ll be racking up 26.2 miles over the course of July to raise vital funds for Samaritans.

You can sponsor me directly here. 

Samaritans’ life-saving work wouldn’t be possible without the amazing generosity of people like you. Thank you for any donation you can offer, no matter how small.

Best Wishes

Richard  Millard <>
Tel: 08456 120129;  01934 257066 [direct line]; 07732 212 945 – mobile



New Research into Malaria Is Next Step in Helping to Eradicate the Disease

Scientists at the University of Nottingham have made a major breakthrough in discovering how the malaria parasite is able to multiply rapidly in the mosquito gut, and how targeting it at this stage may stop the transmission of the disease.

The research, funded by the Medical Research Council and led by Rita Tewari, Professor of Parasite Cell Biology in the School of Life Sciences at the University, could pave the way in helping to eradicate the disease. The study, published in Communications Biology, [1] was a collaborative effort by scientists from the Universities of Leicester, Warwick, Oxford and the Francis Crick Institute in the UK, the King Abdullah University of Science and Technology (KAUST), Saudi Arabia, University of Geneva, Switzerland, University of Leuven, Belgium, Hokkaido University, Japan.

Malaria is still one of the biggest killer infections worldwide, with nearly half a million people dying of the disease last year - particularly in sub-Saharan Africa. The disease is caused by a single-celled parasite called Plasmodium, which is transmitted between people by the female Anopheles mosquito when they bite to take blood. In this new study, researchers wanted to uncover a role for a protein that is well known in humans and other species to co-ordinate the activity of other proteins called Protein Phosphatase 1, also known as PP1.

PP1 regulates how cells multiply through processes known as mitosis and meiosis. However, little is known about the role of PP1 in the malaria parasite, so the team looked at where PP1 is located in the cell and how blocking its activity affects Plasmodium growth.

Malaria Parasite Plasmodium at Specific Stages in the Mosquito Gut

Malaria Parasite Plasmodium at Specific Stages in the Mosquito Gut

Professor Tewari said:

“We have uncovered how PP1 regulates the unusual multiplication process the male sex cell undergoes within the mosquito gut. We found that this key molecule is present at specific points during cell multiplication and only on certain parts of the chromosome called the kinetochore, which is crucial for chromosome separation. 

“We wanted to understand how and when does the parasite use this protein for its rapid phase of cell multiplication in the male sex cells that gives rise to parasite male sperm cell? How does PP1 orchestrate parasite development during this stage? It is fascinating how a single cell can carry out DNA multiplication so rapidly, and we need to understand how it does this. This work commenced with Dr David Guttery when he was working at University of Nottingham and is presently working at University of Leicester.“

By analysing the parasite at specific stages present in the mosquito gut, the team of researchers found a new role for PP1 during Plasmodium mitosis in the male sex cells. They also found a surprising potential role in how the parasite changes from a round cell (zygote) into a banana-shaped ookinete, which is primed for moving through the mosquito gut ready for the next stage of development for transmission.

Dr Mohammed Zeeshan, from the School of Life Sciences at the University of Nottingham and lead scientist of the study said:

“By artificially removing PP1 from the parasite by genetic manipulation, we discovered that this dramatically affects development of the male sex cells and the ookinetes looked very abnormal. When we looked at the location of PP1 during ookinete development, we found there is a very intense localisation at the exact point where the round zygote cell develops a protrusion from its body when it starts to change its shape and become like a banana. This is fascinating, but we need to look into this more to understand how we can use this knowledge to follow drug discovery.” 

A full copy of the study can be found at


  1. Mohammad Zeeshan, Rajan Pandey, Amit Kumar Subudhi, David J. P. Ferguson, Gursimran Kaur, Ravish Rashpa, Raushan Nugmanova, Declan Brady, Andrew R. Bottrill, Sue Vaughan, Mathieu Brochet, Mathieu Bollen, Arnab Pain, Anthony A. Holder, David S. Guttery & Rita Tewari. Protein phosphatase 1 regulates atypical mitotic and meiotic division in Plasmodium sexual stages. Communications Biology (4) Article number: 760. 2021.

Further Information

More information is available from Professor Rita Tewari , from the University of Nottingham at  ; or Charlotte Anscombe, Media Relations Manager in the Press Office at the University of Nottingham, on  Tel: +44 (0)115 74 84417;   



Vitamin C Levels in Care Home Residents and Links to COVID-19

Grandparent’s lives matter - is vitamin C deficiency driving COVID care home deaths?

A new study, VitaC4Care, will test how much vitamin C is needed to achieve normal levels in care home residents. One of the most vulnerable groups susceptible to COVID-19 is older people. In the UK, almost half (47%) of all COVID-19 deaths in the first wave were in care homes.[1] In the US the Covid Tracking Project[2] estimates a third (34%) of deaths were in care homes. Could a lack of vitamin C, which is essential for optimising immune function and fighting viral infections,[3] be a major contributing factor?[3]

The VitaC4Care study is led by Professor Phyo Myint, Clinical Chair in Medicine of Old Age and Dr Alan Sneddon from the Rowett Institute’s Metabolic Health Unit, University of Aberdeen, UK, together with Dr Stavroula Kastora from NHS Grampian and vitamin C researcher Associate Professor Anitra Carr from New Zealand’s University of Otago.

 The latest UK government’s National Diet and Nutrition Survey estimate that almost half a million people over 65 have overt vitamin C deficiency (i.e. blood levels <11 µmol/L).[5] The survey, however, excludes care home residents.

A study from the MRC Human Nutrition Research Unit in Cambridge in the 1990s indicated that an estimated 40% in care homes had deficient vitamin C levels.[6] This study, now over 20 years old, is the only estimate of how widespread deficiency is in care homes.

“We have no idea how much vitamin C our vulnerable elderly actually need to be fully protected.” says Associate Professor Anitra Carr, who has teamed up with professors and doctors from the University of Aberdeen, the Rowett Institute and NHS Grampian to conduct the landmark VitaC4Care study in care homes across Scotland.

“This trial will help to establish optimal intakes of vitamin C for this important and often forgotten group within our society.” says Professor Carr.

People deficient in vitamin C are particularly susceptible to severe respiratory infections, such as pneumonia[7] and COVID-19 which cause vitamin C levels to drop dramatically due to increased need.[8]

A survey of elderly Scottish patients hospitalized with respiratory infections found that 40% had deficient levels of vitamin C.[9] Critical Covid patients have been reported to have depleted vitamin C the level of which predicts their chances of survival.[4] Older people who are already low in vitamin C before infection may not survive as a result.

Professor Jeanne Drisko, an expert in vitamin C from the University of Kansas Medical Center, USA says, “Aging individuals are particularly vulnerable to vitamin C deficiency and an effort to define the extent of deficiency is urgently needed.”

According to estimates made by the Linus Pauling Institute at the University of Oregon, their needs may be as high as 400mg a day, ten times the recommended intake in the UK. That equates to six oranges a day, hence supplementation may be essential for older people and care home residents.

The VitaC4Care study will start in Scotland in early autumn 2021.

The not-for-profit  project is crowdfunding to help fund the vital VitaC4Care research. For more details and to make a donation visit


  1. Oliver D. David Oliver: Let's be open and honest about covid-19 deaths in care homes. BMJ. 2020;369:m2334.
  2. See
  3. Carr AC, Maggini S. Vitamin C and immune function. Nutrients. 2017;9(11):E1211.
  4. Holford P, Carr AC, Jovic TH, Ali SR, Whitaker IS, Marik PE, Smith AD. Vitamin C - an adjunctive therapy for respiratory infection, sepsis and COVID-19. Nutrients. 2020;12(12).
  5. Bates B, Collins D, Cox L, Nicholson S, Page P, Roberts C, Steer T, Swan G. National Diet and Nutrition Survey Years 1 to 9 of the Rolling Programme (2008/2009- 2016/2017): Time trend and income analyses. In: England PH, editor. London: Public Health England; 2019. p. 56 pages.
  6. Bates CJ, Prentice A, Cole TJ, van der Pols JC, Doyle W, Finch S, Smithers G, Clarke PC. Micronutrients: highlights and research challenges from the 1994-5 National Diet and Nutrition Survey of people aged 65 years and over. Br J Nutr. 1999;82(1):7-15.
  7. Hemilä H. Vitamin C and infections. Nutrients. 2017;9(4):E339.
  8. Carr AC. Vitamin C in pneumonia and sepsis. In: Chen Q, Vissers M, editors. Vitamin C: New Biochemical and Functional Insights. Oxidative Stress and Disease. Boca Raton, FL CRC Press/Taylor & Francis; 2020. p. 115-35.
  9. Hunt C, Chakravorty NK, Annan G, Habibzadeh N, Schorah CJ. The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. Int J Vitam Nutr Res. 1994;64(3):212-9.

Further Information and Editor’s Notes:

Associate Professor Anitra Carr is available for a limited number of interviews.

Patrick Holford from   is available for interview.

For media enquiries please contact Sophie at Panpathic Communications   Tel:  07815 860 082;  01323 440 998.

About is an international campaign backed by over 900 professors, doctors, nutrition professionals and other healthcare practitioners, from over 50 countries. The campaign is calling for the government and its public health and nutrition agencies to take vitamin C seriously and thoroughly assess the evidence, fund studies of vitamin C in relation to COVID-19, and for 'vitamin C for COVID-19 or corona' no longer being classified as false information in both digital, broadcast and print media. The full scientific review paper, published in the journal Nutrients, is viewable in the ‘science’ section of



“Smart” Segmented Ring Device Delivers Medications to Stop HIV Transmission

Published from


Researchers have designed a device that delivers two medications that help stop HIV transmission.[1] Although condom usage is the best strategy for preventing HIV transmission, the researchers are working to design a device that can be used by sex workers and in situations where women are not in a position to negotiate condom use.

The device is an intravaginal ring (IVR) that can be inserted into the female genital tract where it will deliver medications known to decrease the transmission of HIV. The researchers examined how effectively their IVR delivered two medications – hydroxychloroquine (HCQ), an FDA approved medication, and a nanomedicine gene therapy developed by the team in previous research. Their results were published in a recent study.

“We’ve specifically engineered a combination IVR that can deliver two unique medications targeting different aspects of the HIV infection process,” said Emmanuel Ho, a professor in the University of Waterloo’s School of Pharmacy and study author. “Before, only one drug could be delivered from an intravaginal ring.”

The ring is made of medical-grade plastic and contains two-segmented sections. One section is solid and coated in a pH-sensitive polymer that releases the customized gene-therapy treatment specifically during sexual intercourse. The other half is a hollow ring with tiny pores that releases HCQ slowly over twenty-five days.

Photos of IVR Intravaginal Ring

Photos of IVR: the left half of the ring is a solid section that releases gene-therapy.
The right half of the ring is a hollow portion that releases HCQ.

The HCQ is the first line of defence that reduces the immune cell activation – meaning HIV cells have fewer host target cells to interact with. Doing this buys time for the gene therapy treatment which comes in specifically during sexual intercourse to further suppress the expression of cellular receptors that HIV cells attach to.

The team, which has previously partnered with the University of Nairobi in Kenya on related research, recognizes the importance of using medications as judiciously as possible given potentially limited healthcare resources.

The researchers wanted to have a system that can be placed in the vaginal tract but that only acts when there is sexual intercourse. The presence of semen increases the pH of the genital tract. Therefore, they designed the “smart” gene-therapy segment of the IVR to detect that change in pH and to release the nanomedicine at that point in time only.

“This IVR system will help women to protect themselves against HIV infection and greatly reduce drug usage when it is not necessary,” says Yannick Traore, a recent Waterloo PhD graduate and lead author on the study. “We are hoping that this will reduce the cost of drug therapy and also prevent users from developing drug resistance.”

The unique, segmented design of the IVR is effective. In lab tests, the HCQ segment successfully released the drug slowly and effectively over 25 days and the gene therapy segment responded to the presence of seminal fluid simulant by releasing 20 times more nanomedicine than was released in an environment of only vaginal fluid simulant. The next steps involve testing the IVR in animal models.

The study[1] was recently published in the journal Drug Delivery and Translation Research and features authors from Waterloo and the University of Manitoba.


  1. Traore, Y.L., Chen, Y., Padilla, F. et al. Segmented intravaginal ring for the combination delivery of hydroxychloroquine and anti-CCR5 siRNA nanoparticles as a potential strategy for preventing HIV infection. Drug Deliv. and Transl. Res. 2021.

Media Contact and Further Information

Ryon Jones Tel: 226-339-0894

Acknowledgement Citation

Published from



World’s First Online Cancer Recovery Platform Launches with £1.5m Backing from Leading Cancer Doctors

Perci Health, the world’s first online platform that gives people access to support from multidisciplinary cancer teams, has launched today with £1.5m of seed funding. The backers are an assortment of influential oncologists and cancer surgeons from major cancer centres across the UK.

Perci’s mission is to proactively challenge the current status quo for those living with cancer and change perceptions about life after treatment. It offers clients access to a range of vetted, high-quality cancer professionals – all with a minimum of three years cancer experience – focused on recovery from a physical, mental, social and emotional point-of-view. 

The company was co-founded by Kelly McCabe and Morgan Fitzsimons. McCabe – a registered oncology dietitian – was previously COO of cancer network, HCA International, and has more than 11 years’ experience in cancer care. Fitzsimons is the former global head of marketing at ASOS and digital director at CBS Television in New York.

McCabe said:

“People living with cancer experience a wide range of physical and psychosocial effects. Despite the fantastic treatment traditional healthcare providers offer, they’re not well-equipped to manage these diverse, on-going, personalised needs thereafter - and once the primary cancer treatment has come to an end, many people describe feeling ‘abandoned’. 

“At Perci, we’re focused on making affordable, high-quality cancer care more accessible to support people in making the best decisions about their long-term health and wellbeing. We strongly believe no treatable side effect should be left untreated.

“We’ve brought together an incredible collective of caring experts who are passionate about reducing the ripple effects of cancer, for individuals, their loved ones and society as a whole.”

Professor Peter Schmid, Lead of the Cancer Immune Therapy group at Barts Hospital, Professor of Cancer Medicine and Lead of the Centre of Experimental Cancer Medicine at Barts Cancer Institute, and Perci Health Medical Director, said:

"Having optimal supportive care networks is critical for patients recovering from cancer - for reintegration into a normal life, but also for long term survivorship. Currently, these services are not always easy to access. Perci Health has been designed to solve this problem by offering patients access to specialist cancer supportive care, provided by carefully selected specialists for their optimal recovery."

Beverley Longhurst, Oncology Clinical Nurse Specialist and Perci Health Professional, added:

"As a specialist cancer nurse, I'm excited to provide Hypnotherapy and Yoga on the world's first supportive oncology platform. Giving patients and carers the option of complementary therapy from an oncology specialist, who is part of a team, delivering safe, holistic, specialist support.  

“I've seen first-hand the empowering difference hypnotherapy can make to alleviate treatment side effects and restore relaxation and resilience yet this is not a therapy which is easy to access, until now."

The Perci Professionals can help with all sorts of problems that people living with cancer (and their families) may face. Everything is covered and will be completely tailored to the individual. These include:

  • The management of chronic fatigue
  • Relationship counselling
  • Advice on helping communicate with children
  • Support in safely returning to work
  • Genetic counselling for those with a strong family history of cancer
  • Management of sexual consequences or menopausal effects
  • Dietary advice 
  • And more

People can browse trusted and safe articles on the platform, as well as book a free session with a Perci Expert - who are all trained cancer nurses. Clients can also speak with a range of qualified cancer professionals; such as dietitians, psychologists, physiotherapists and psychosexual therapists (to name a few), who offer a range of personalised, holistic support. The designated professional will create a personalised plan for the individual which can also be shared with their medical team if requested. 

McCabe added:

”Our services are non-discriminative, with all cancer types, ethnicities and sexes catered for equally. We debunk a one-size-fits-all approach, championing an individually tailored approach which empowers people to become active participants before, during and beyond cancer treatment.”

Perci doesn’t offer alternative therapies, instead focuses on evidence-based and research-backed care delivered by qualified professionals to support and improve wellbeing, while being governed by the UK’s leading oncologist and cancer surgeons.

Perci Health Testimonials

  • Ruth:  I had a very positive experience using this platform. It’s easy to use, provides detailed information about the services available and the experts’ backgrounds. It quickly connected me to health experts in a range of fields who were available for consultation in a matter of days. All booking is online and I was able to select dates and times. To my surprise, I found services I had not considered but actually needed. The consultations were extremely valuable not only because the experts truly are experts and have vast experience of the issues I was having, but because they innately understood the emotional marathon that a cancer diagnosis and undergoing treatment brings into your life. To be able to quickly access the help I needed felt like a breath of fresh air after feeling alone with problems and having no energy to hunt down solutions. I would wholeheartedly recommend this service to anyone with a gap in the support they need.
  • Denise: I was very anxious and my personal cancer journey felt complicated and overwhelming, I didn’t know how to move on. After sessions with two very helpful Perci Professionals, I feel less alone knowing that they have taken the time to get to know me. I’m clear about the next step and feel a little more in control, I can start to look forward. Thanks so much. 
  • Caroline: Perci gave me quality practitioners at my fingertips, at a schedule that fitted in with my lifestyle. Easy to access. Highly recommend it.
  • Trish: I've been delighted with the support I've had from the Clinical Nurse Specialist on Perci. Now that my initial treatment is complete I'm starting to navigate the longer-term aspects of treatment and recovery. I had some particular issues and questions that I needed to talk through properly and Perci gave me the opportunity and space to do this. The advice and support that I received was extremely knowledgeable, practical and sympathetic. This has helped me to clarify my options and to identify a range of experts that I can consult as needed. Knowing that I have these options has allayed a lot of my anxieties. 
  • Corina: Highly professional service at a time and circumstances when you most need it. The most brilliant fact is the ability to access it from your own home. 
  • Steve: Support from Perci complemented NHS provision, helping me deal with the wider impact of cancer on my life.

Media Contact and Further Information

Stephen Murray"

Director Murray Comms



Heart Rate Variability (HRV) Associated with COVID-19 Severity; Lactate Dehydrogenase LDH (and related lactic acidosis) Associated with Poor Prognosis in  COVID-19 Patients

by Carlos ETB Monteiro

A recent study confirms and strength our prediction from June 2020, of our Letter to the Editor of Positive Health Online in Issue 263.

It was published in the article “Alteration of Autonomic Nervous System Is Associated With Severity and Outcomes in Patients With COVID-19”, published in Front. Physiol., May 19, 2021, at


  • Previous studies suggest that coronavirus disease 2019 (COVID-19) is a systemic infection involving multiple systems and may cause autonomic dysfunction;


  • To assess autonomic function and relate the findings to the severity and outcomes in COVID-19 patients;

Conclusion from this study:

  • “Heart rate variability (HRV) was associated with the severity of COVID-19. The changing trend of HRV was related to the prognosis, indicating that HRV measurements can be used as a non-invasive predictor for clinical outcome.”

Additionally, another recent study confirms what we have said in our Letter from June 2020 to Positive Health PH Online regarding lactate dehydrogenase (and its related lactic acidosis)

The Article is titled 'Prognostic value of elevated lactate dehydrogenase in patients with COVID-19: a systematic review and meta-analysis', Postgrad Med J 2021 published at 

Its Conclusion:

"LDH was associated with poor prognosis in patients with COVID-19."

About the Author

Carlos ETB Monteiro, Independent Researcher and Scientist, President, Infarct Combat Project



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