MIL Submissions Engine

Source: The Conversation – UK – By Benedicta Quaye, Lecturer in Anatomy, Lancaster University

Around one in every 100 people worldwide has vitiligo – a chronic, autoimmune skin condition that causes the skin to appear lighter in patches.

The number of people affected by vitiligo makes it one of the most common skin disorders. Several studies also suggest that many cases still remain undiagnosed, meaning the true number of people living with vitiligo may even be higher.

Yet despite how common vitiligo is, many misconceptions still surround the condition. People who have the condition still face stigma, intrusive questions and may experience lower wellbeing as a result.

What causes vitiligo?

The human skin has two layers. The outer epidermis (which we can all see) and the inner dermis (which lies underneath the epidermis).

Skin colour is primarily determined by melanin, a pigment produced by specialised cells known as melanocytes that are found within the epidermis. All humans have melanocytes, but the amount and type of melanin the skin produces varies naturally between people and populations. Melanin also contributes to hair and eye colour.

Vitiligo occurs when a person’s immune system mistakenly thinks their melanocytes are dangerous to the body. This causes the immune system to target these cells and destroy them, leading to a loss of pigment.

Vitiligo is initially triggered by either a person’s genetics or certain environmental factors, such as stress, severe sunburn and exposure to melanocytotoxic chemicals, which are found in some cosmetics and households items. These factors either trigger an immune response or cause damage to melanocytes. As melanocytes disappear, affected areas of skin lose pigment and become lighter or completely white.

Vitiligo can affect people of all ethnic backgrounds, ages and skin types. However, it’s often more noticeable in people with darker skin tones.

Vitiligo may appear anywhere on the body. Commonly affected areas include the face, hands, arms, eyes and mouth. Hair growing from affected skin may also lose colour.

Vitiligo can develop gradually or rapidly. While some people develop only a few small patches, others may develop more widespread de-pigmentation over time. Most commonly, patches appear on both sides of the body and spread over time (non-segmental vitiligo). But in rarer cases, patches only appear on one side of the body (segmental vitiligo).

Some people may also notice mild itching, tingling or burning, especially as new patches appear. The affected skin can also be more sensitive to sunlight due to reduced melanin.

Because vitiligo is linked to a dysfunctional immune system, people with the condition may be slightly more likely to develop other autoimmune conditions, such as thyroid disease and type 1 diabetes.

Currently, there are several treatment options for vitiligo. These aim to control disease progression and improve long-term skin appearance.

A misunderstood condition

Despite the fact that vitiligo affects so many people globally, misconceptions and stigma about the condition still persist.

Studies have found that some people continue to wrongly believe vitiligo is contagious, linked to poor hygiene or socially undesirable. This highlights ongoing gaps in public education.

Many people with vitiligo have to endure staring, judgment, intrusive comments and insensitive questions about their appearance – sometimes daily.

Model Winnie Harlow, who has vitiligo and has been candid about her experience with the condition, shared in a recent interview that as a child, parents told their children not to play with her because they might “catch her skin”. Harlow also experienced bullying throughout her school years.

Numerous reports have also highlighted experiences of anxiety, depression, social exclusion and even low self-esteem in people with vitiligo.

Skin colour plays a major role in the development of someone’s identity and affects feelings of integration, acceptance and belonging. Visible changes in pigmentation experienced by people with vitiligo also exposes them to societal or social stigmatisation, social exclusion, loss of employment opportunities or even intrusive questions.

Societal perception needs to be corrected because at its core, vitiligo is a condition rooted in cellular biology and immune dysfunction. Knowing this is crucial because it significantly affects how society responds to those affected with visible medical conditions such as vitiligo.

Benedicta Quaye does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Vitiligo affects around 1 in 100 people worldwide – yet the skin condition remains misunderstood – https://theconversation.com/vitiligo-affects-around-1-in-100-people-worldwide-yet-the-skin-condition-remains-misunderstood-282451

Source: The Conversation – UK – By Chris Seenan, Senior Lecturer in Physiotherapy, University of Stirling

In a 2026 study I conducted with colleagues on people with peripheral arterial disease, one participant described how leg pain had disrupted his golf for years. It forced him to stop mid-round, shake his leg and apologise to his playing partners while he waited for the pain to pass. He found it mortifying. Then he tried a small electrical device that delivered gentle pulses through pads stuck to his skin. He still had pain. But he could get round the course.

When we measured his walking on a treadmill, we found no improvement. He had not noticed. That was not the outcome that mattered to him. Before the study ended, he had already gone out and ordered his own device.

A different participant reached the opposite conclusion. The pain was still there when he used the device, he said. It had not done him any good. And he was right, in a narrow sense. The device had not eliminated his pain. What it had done was reduce its intensity and delay its onset, allowing him to walk measurably further. His expectation of complete relief meant that genuine, partial relief felt like failure. He concluded the treatment did not work.

The study did not tell a simple story of success or failure. For some participants, standard treadmill measures did not capture what had changed in daily life. For others, measurable improvements still failed to feel meaningful because they fell short of what the person had hoped for. The difference was not only the treatment, or the severity of their condition. It was what each person had been led to expect.

Recognising relief

Both men were living with peripheral arterial disease, a condition caused by a build-up of fatty deposits inside the arteries that supply the legs. It affects an estimated 236 million people worldwide. Its hallmark symptom is a cramping pain in the calf during walking that eases with rest. Over time, it can shrink a person’s world, limiting independence and increasing the risk of serious cardiovascular problems.

The recommended first-line treatment is supervised exercise therapy: structured exercise sessions led by trained professionals. But in many countries, access to supervised exercise therapy remains patchy and under-resourced. That gap is fertile territory for the wellness market.

Transcutaneous electrical nerve stimulation, or Tens, delivers small electrical impulses through electrode pads on the skin to interfere with pain signals travelling to the brain. There is evidence that it can help with some kinds of pain, and it is used in hospital pain management settings. It is not a wellness product. In our study, we explored what happened when people with peripheral arterial disease used TENS independently at home, outside the controlled conditions of a clinical trial.

The findings point to something standard clinical tests rarely capture. Expectation can shape whether useful relief is recognised as useful.

That finding matters well beyond this particular device or condition. The global wellness industry is worth over a trillion dollars and operates with minimal regulatory oversight. People living with painful long-term conditions are among its most heavily targeted consumers. Companies sell electrical stimulation devices, supplements and wearable gadgets to people in chronic pain, using influencer testimonials in place of evidence and social media algorithms to reach people who are frightened, frustrated or in pain.

When a product fails to deliver the transformation it promised, patients rarely conclude they were misled. They conclude that nothing can help them. In conditions where reduced physical activity carries real health consequences, that conclusion is not merely disappointing. It is dangerous.

Poor communication can hinder treatment results

This is where the study speaks to a much wider problem. Whether a person is using a clinical device, a wearable gadget or a supplement sold online, they are often asked to judge it against expectations they did not set for themselves. Even legitimate, clinically tested treatments can be undermined by poor communication about what to expect.

The golfer’s experience illustrates this clearly. He valued an outcome that no clinical trial had thought to measure: the ability to play a round of golf without humiliation. Once he understood the device could offer that, it worked for him. His fellow participant was never given the chance to find his equivalent.

A market built around selling hope is poorly equipped for that kind of honesty. But the same danger can appear even when the person giving advice has medical credentials. Research shows that even medically qualified doctors who become prominent wellness influencers on social media are subject to many of the same pressures as their unqualified counterparts: to build a personal brand, produce content constantly, stand out from competitors and make advice sound more certain than it really is. Having a medical degree does not make someone’s Instagram post better at managing a patient’s expectations. It just makes it more convincing.

What actually helps requires something platforms cannot provide: time, a genuine clinical relationship and communication that is not contingent on making a sale. It requires asking a patient not just whether their pain has reduced, but what they were hoping to do that pain had been stopping them from doing. It requires explaining that partial relief is still relief and that the outcome worth measuring might not be the one on the form.

That kind of honesty does not feature in any influencer’s discount code, medical degree or otherwise. But for the person who just wants to get round the golf course, it might be the most important part of the treatment.

Chris Seenan receives funding from the Chief Scientists Office of the Scottish Government, the National Institute for Health and Care Research and Scottish Heart & Arterial disease Risk Prevention charity.

– ref. Why managing expectations matters in chronic pain treatment – https://theconversation.com/why-managing-expectations-matters-in-chronic-pain-treatment-282746

Source: The Conversation – UK – By Noemi Procopio, Professor of Forensic Sciences, School of Law and Policing, University of Lancashire

In the early 1990s, crime-loving television audiences could choose mainly between cozy, fictional detective series such as Columbo and Murder, She Wrote. The US docuseries Unsolved Mysteries brought a few real cold-case investigations to light, but coverage of forensic science on screen was still relatively simple.

Then, in May 1991, The Silence of the Lambs was released. Based on Thomas Harris’s 1988 novel, this big-budget thriller was darker, more disturbing and psychologically complex than most crime films of the time.

The protagonist, FBI trainee Clarice Starling (played by Jodie Foster), is a young woman working in a predominantly male environment – who is often underestimated by her colleagues. When she discovers key evidence through a suspenseful process of extraction from a young victim’s mouth, viewers are introduced to a field of criminal investigation they may never have considered before: forensic entomology.

Some kind of seed pod?

No, sir … that’s a bug cocoon.

Entomology – the scientific study of insects – is one of the oldest branches of the natural sciences. And the application of insects to criminal cases dates back almost as far. In the forensic text The Washing Away of Wrongs (1247), written by Chinese investigator Sung T’zu, flies attracted to traces of blood on a sickle helped identify a murderer.

However, it was not until the late 19th century that forensic entomology was formalised as a scientific discipline – thanks largely to the studies of Jean Pierre Mégnin. Influenced by his experiences on the battlefield, the French vet began investigating which insects were attracted to animal and human remains at different stages of decomposition.

These days, carrion insects are used to tell criminal investigators about the time since a victim’s death, whether their body has been moved, and if any drugs or toxins have contributed to their death.

Human remains are commonly colonised by blowflies and their maggots. But in The Silence of the Lambs, Starling was faced with something more unusual: the cocoon of a death’s-head hawkmoth (Acherontia atropos).

The cocoon, which the serial killer inserts into his victims’ throats, is identified by two entomologists who are clearly not forensically trained. Otherwise, they would have thought twice before cutting open the only piece of insect evidence without seeking permission for such a destructive analysis.

The film introduces murderous concepts such as “staging” – the intentional alteration of a crime scene – and a perpretrator’s modus operandi and criminal signature, relating to any distinctive methods they use.

Today, many of us working in forensic entomology and taphonomy (the study of what happens to organisms between death and discovery) are still told our work is “just like The Silence of the Lambs”. But 35 years after the film’s release, forensic entomology is no longer limited to microscopes, forceps and entomologists working alone.

Today’s criminal investigations often feature complex interactions between environmental conditions, decomposition processes and human activity. This makes collaborations between multiple scientific (and non-scientific) disciplines essential.

How the science has progressed

In the two decades preceding the film’s release, the biomedical and life sciences journal PubMed listed 37 publications on the subject of forensic entomology. Since then, there have been more than 1,800.

Methods used for insect identification and age estimation have changed dramatically. Today, molecular and chemical techniques can identify insect species and determine their stage in the lifecycle and geographic origin. These techniques are especially useful in cold cases or poorly preserved crime scenes, where samples may have been damaged or improperly stored.

Insects are also playing an increasingly accurate role in determining the time of death. As well as feeding on decomposing remains, they help spread the bacteria and other microorganisms involved in decomposition. These microbial communities change in predictable ways over time – even in extreme environmental scenarios – offering investigators a further indicator of the postmortem interval.

Chemical profiling of insect cuticular hydrocarbons (insect skin) provide definitive species and age signatures. These can reduce the risk of error associated with identification by people, and the time and costs of DNA sequencing.

Forensic entomology has also expanded into areas such as entomotoxicology, where insects feeding on decomposing remains are analysed for the presence of drugs, toxins or other chemical compounds. It is even possible to recover the DNA of the individual on whom an insect has been feeding directly from that insect’s gut contents.

In The Silence of the Lambs, investigators assume that “water leaves no trace evidence of any kind”. Yet today, aquatic forensic researchers examine not only insects but crustaceans, microorganisms and bone proteins associated with decomposing remains in water.

Revisiting the moth cocoon scene

The film’s infamous moth cocoon scene – which saw the extracted evidence collected with forceps, then taken for visual inspection at a museum – would be approached rather differently today.

Firstly, spoons are now recommended over forceps to avoid damaging the sample. Modern forensic practice aims to preserve specimens by taking photographs before any manipulation. Where possible, insects are reared to the adult stage which is often easier to identify with certainty.

Rather than opening the cocoon, it could be compared as is with museum reference collections or analysed using technology such as hyperspectral imaging. This would confirm the species and estimate its developmental stage without altering the evidence.

Many high-profile cases, including some wrongful convictions, have demonstrated how forensic entomology can be a key tool in the investigation of current and historical crimes – as well as of natural disasters and war crimes.

However, technological advances are not enough. The reliability of forensic entomology depends on appropriate crime scene protocols, evidence collection, ongoing research and, perhaps most importantly, specialist training and attention to detail. These qualities are certainly embodied by agent Starling.

But there is another major difference since the film came out in 1991. Unlike Starling’s experience, women now represent a major part of the forensic science workforce. They contribute to a discipline that has become far more diverse, collaborative and scientifically advanced than the one portrayed in The Silence of the Lambs.

This article features a reference to a book included for editorial reasons, and a link to bookshop.org. If you click on this link and go on to buy something from bookshop.org, The Conversation UK may earn a commission.

Noemi Procopio receives funding from UK Research and Innovation (UKRI) via a Future Leaders Fellowship, from National Institute of Justice (NIJ), and from Science and Technology in Policing.

Paola A. Magni does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The Silence of the Lambs introduced the world to forensic entomology – but how much has the science changed since? – https://theconversation.com/the-silence-of-the-lambs-introduced-the-world-to-forensic-entomology-but-how-much-has-the-science-changed-since-283243

Source: The Conversation – UK – By Marcin Kaczmarski, Lecturer in Security Studies, University of Glasgow

Less than a week after hosting Donald Trump, China’s leader Xi Jinping welcomed his Russian counterpart, Vladimir Putin, to Beijing. Unlike Trump’s visit, this was a routine meeting. The Chinese and Russian presidents have met more than 40 times since 2013, with the latest meeting marking Putin’s 25th visit to China.

The frequency of talks is itself a testimony to the expanding scope of shared interests between the two states. And, as is typical for Sino-Russian summits, Xi and Putin signed an array of documents following their meeting in areas ranging from energy to higher education and the media.

Xi and Putin may be close, but their promises of further cooperation hardly mean the friendship between them has “no limits”.

Opposition to US global primacy has formed the foundation of Sino-Russian cooperation since the end of the cold war. In a 1997 statement, the two nations condemned the “forcing of the international community to accept a uni-polar world pattern”. While not explicitly naming the US, they also added that no single country should monopolise international affairs.

Xi and Putin reiterated this message in Beijing. They adopted a statement in which they vowed to build a multipolar world order and a “new type” of international relations. However, putting this rhetoric into practice has consistently proved a complex undertaking.

Moscow and Beijing often choose the easiest and least expensive way of opposing the US. They have focused primarily on blocking US-backed initiatives and geopolitical strategies by vetoing UN Security Council resolutions.

But they have stopped short of launching any major joint effort to challenge US power. This was illustrated by the muted response of both countries to the ousting of Venezuelan leader Nicolás Maduro in January, as well as their limited support for Iran in its war with the US and Israel.

One reason for this is the asymmetry in their capacity to help each other. Russia lacks the capacity to support China in the economic and technological domains, which are central to the Sino-American rivalry.

In terms of overcoming the US tariffs imposed on Chinese goods, Moscow can offer Beijing neither an alternative or much relief. The Russian market is not rich or attractive enough for Chinese companies, even before the possible fallout from secondary sanctions is considered.

Russia is also limited in its ability to help Beijing bypass US export controls designed to restrict China’s access to advanced technologies, from semiconductor manufacturing equipment to artificial intelligence hardware.

Western sanctions and recurrent failures to modernise the Russian economy have caused Russia to fall behind in the global technology race. And since 2022, Russia has been forced to rely on China for a number of technologies, from cars and laptops to 5G mobile networks.

China is in a different position. It has political, financial and economic means to support the Kremlin in its confrontation with the west. However, keen to preserve its own global interests, Beijing is highly selective in the support it provides to Moscow.

Chinese state propaganda mirrors Russian talking points and repeats Russia’s justification for its war in Ukraine, blaming the west and its “expansion” into former Soviet territories. China has also provided Russia with dual-use components like chips and fibre-optic cables without which the Kremlin could not sustain its war effort.

But, at the same time, China has refrained from providing lethal weapons to Russia. And Chinese armed forces that conduct regular exercises with their Russian counterparts and carry out joint air and naval patrols around Japan and South Korea, do not participate in similar activities in Europe.

China has also consistently delayed its final commitment to the proposed Power of Siberia-2 gas pipeline. The planned pipeline would transport additional natural gas from Siberia to China, partially compensating Russia’s loss of revenue from the European market.

The deepening asymmetry

Clearly, it is Beijing that dictates the pace of and areas for cooperation between the two countries. And Russia’s leadership seems ready to accept this “junior partner” status.

The Kremlin has sought to reconcile conflicting interests between Russia and China in recent years, particularly in central Asia, rather than challenge Beijing. For example, Moscow has remained silent on the presence of Chinese troops in Tajikistan, which was part of Russia’s former sphere of influence.

It helps that China treads carefully and puts substantial effort into creating the illusion of equality between itself and Russia. Despite the negative impact of Russia’s aggressive policy towards Ukraine on Chinese plans to work with Ukraine as part of the China-Europe railway transport corridor, for instance, Beijing has refrained from criticising Moscow’s conduct.

However, some Russians continue to see China as a threat. In recent years, several Russian scientists working on military programmes have been imprisoned following accusations of spying for China. The Russian government is itself also acutely aware of its deepening asymmetric dependence on Beijing.

It is nourishing ties with other Asian states, including countries like India and Vietnam that have historically had troubled relations with China. While China is an indispensable partner for Russia, Moscow looks to be wary of Beijing dominating east Asia and the Indo-Pacific.

Marcin Kaczmarski does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Xi and Putin tout ‘new type’ of world order in Beijing – but is their alliance really that strong? – https://theconversation.com/xi-and-putin-tout-new-type-of-world-order-in-beijing-but-is-their-alliance-really-that-strong-283333