6 January 2018 New Scientist 2036957815

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BRAINWAVE THERAPY

Sound, light and hums set to shake up Alzheimer’s treatment

OUT OF A BLACK HOLE

Bizarre quantum theory solves greatest paradox in physics

THE DEVIL RIDES AGAIN

How Australia’s last big predator is biting back

WEEKLY 6 January 2018

VERY HIGH FASHION Spacesuits get a long-overdue makeover

SPECIAL REPORT

2018 THE YEAR OF THE FLU

How to survive the worst outbreak in living memory

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PLUS INFECTION-FIGHTING FAT / LOVE AT FIRST SIGHT / WANDERING MOONS / ALPINE PYRAMIDS / RECYCLING CRISIS / REPLACEMENT BONES / BOOKS OF 2018

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CONTENTS

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Volume 237 No 3159

News Can sound help against Alzheimer’s plaques? 6

On the cover

Leaders

Brainwave therapy Sound, light and hums set to shake up Alzheimer’s treatment

14 Out of a black hole Bizarre quantum theory solves greatest paradox in physics

33 Very high fashion Spacesuits get a long-overdue makeover

UK Newsstand

28 2018: The year of the flu How to survive the worst outbreak in living memory

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Plus Infection-fighting fat (16). Love at first sight (8). Wandering moons (16). Alpine pyramids (26). Recycling crisis (25). Replacement bones (14). Books of 2018 (42)

This year’s flu should shake us out of complacency. We need a vision to solve impaired sight

News 6

THIS WEEK Sound therapy zaps Alzheimer’s plaques. Marijuana legalised in California. China tackles climate change

8

NEWS & TECHNOLOGY There’s no such thing as love at first sight. A survivor from a lost age. How our lust for chocolate changed cocoa trees. Google’s robot voice gets an upgrade. Too much gaming really can be bad for you. Genital crabs can’t find sex. Learning not to fall over. Parallel universes solve black hole problem. 3D-printed bones. Fat fights infections. Cast-off moons roam the cosmos

38 The devil rides again How Australia’s last big predator is biting back

Event director Mike Sherrard Creative director Valerie Jamieson Sales director Jacqui McCarron Event manager Henry Gomm Conference producer Natalie Gorohova

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Executive chairman Bernard Gray Publishing director John MacFarlane Finance director Matthew O’Sullivan Strategy director Sumit Paul-Choudhury Human resources Shirley Spencer Non-executive director Louise Rogers

19 IN BRIEF Mars water slurped by rocks. Cuddly crows. CRISPR slows deafness. Killer cells feed fetuses

Analysis 22 Drug substitutes The NHS wants to use cheaper versions of certain drugs, but some doctors aren’t sure 24 COMMENT Don’t count on the CiCo diet. Is supersonic air travel worth reviving? 25 INSIGHT China’s ban on imported Western rubbish could backfire

Features 28 2018: The year of the flu What you need to know about the worst outbreak in living memory 33 Very high fashion The iconic spacesuit gets a long-overdue makeover 38 The devil rides again How Australia’s last big predator is biting back 40 PEOPLE Andrew Bastawrous, the doctor who wants to teach the world to see

Culture 42 A cultural year The books and events that will shape 2018 44 You’ve just crossed over… A 1950s TV show takes to the stage – and it really works

Regulars 26 APERTURE Alien world of the Alps 52 LETTERS Morality in a driverless car 55 OLD SCIENTIST Januaries past 56 FEEDBACK Predicting bitcoin’s future 57 THE LAST WORD Human attraction

6 January 2018 | NewScientist | 3

LEADERS

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Reporters (UK) Andy Coghlan, Jessica Hamzelou, Michael Le Page, Timothy Revell, Clare Wilson, Sam Wong, (US) Leah Crane, Aylin Woodward, (Aus) Alice Klein

Features Chief features editor Richard Webb Editors Catherine de Lange, Gilead Amit, Catherine Brahic, Julia Brown, Daniel Cossins, Kate Douglas, Alison George, Joshua Howgego, Tiffany O’Callaghan, Sean O’Neill

Culture and Community Editors Liz Else, Mike Holderness, Simon Ings, Frank Swain

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Atishoo, we all fall down This year’s flu should shake us out of our complacency FLU season stalks the northern hemisphere. That is not news – it happens every year, and for most of us it is usually little more than a nuisance. But the flu of 2018 could be as bad as an annual winter outbreak gets (see page 28). You may think you have heard it all before, but you probably haven’t. To be clear, we are not talking about an emerging strain of bird or swine flu, the kind that keeps virologists awake at night fearing a pandemic. Right now the warnings are about regular winter flu. But it looks like a bad one. For people vulnerable because of age, pregnancy, obesity or other risk factors, it could be a killer.

And yet the world remains astonishingly cavalier about a virus that regularly kills hundreds of thousands and occasionally more. We fend it off half-heartedly with a vaccine from the 1940s, which is better than nothing – but we know we can do more. We spend a pittance on developing vaccines that will actually defeat it, even though researchers have some very promising leads. Why? Partly because of complacency: most of us have had flu and lived to tell the tale. Partly because denialists peddle the lie that the threat is overstated so pharma companies can sell vaccines and drugs. And partly

Sight for more eyes IF YOU are among the estimated one-in-four people with eyeballs that are the wrong shape, try to imagine life without glasses or contact lenses. In the UK, that would mean roughly 10 million people with eyesight too poor to drive legally or read a classroom whiteboard. The impact on education, the economy and society would be appalling.

That is the reality for millions living in parts of Asia and Africa, where refractive errors – short and long-sightedness and astigmatism – too often go undiagnosed and uncorrected. This has been known for decades, but it is increasingly hard to see why the world allows it to persist. Glasses can be produced for less than £1 a pair. Admittedly,

because a better vaccine won’t be blockbuster-profitable. This month also marks 100 years since the outbreak of the so-called Spanish flu, the worst pandemic we know about. This year’s “Aussie flu” is a descendant of that virus. It won’t be as bad, but we must hope that its inevitable impact is enough to tell the world that ordinary flu is still a serious disease and that a repeat of 1918 is bound to happen. In the UK, centenarians are entitled to a birthday message from the queen. She should send one to the 1918 flu too, to remind us that it is still with us. ■

diagnosing the several billion people who need them is a bigger hurdle. But smartphone technology is increasingly up to the challenge (see page 40). It is time for world leaders to develop a vision to deal with this under-reported and unnecessary problem. If the humanitarian arguments don’t talk loudly enough, money might. Impaired sight costs the global economy trillions every year. How much of an eye-opener do we need? ■ 6 January 2018 | NewScientist | 5

THIS WEEK

Brainwave therapy for Alzheimer’s Can flickering lights, low hums and vibrating pads zap brain plaques? presented the team’s work at the Society for Neuroscience conference in Washington DC in November. The findings are promising, says David Reynolds of the charity Alzheimer’s Research UK. But we can’t assume that people with Alzheimer’s will respond to the 40 hertz in the same way as the mice, he says.

Clare Wilson

Trying it right away

JUAN GAERTNER/SCIENCE PHOTO LIBRARY

LISTENING to low-pitched noise seems to induce high-speed brainwaves that break down protein plaques in the brain linked with Alzheimer’s. The approach has had promising results in mice and is now being tested in people with the condition. Brainwaves are the result of large networks of brain cells firing rhythmically and in synchrony. Much about their function is unclear, but measuring these waves via electrodes on the scalp tells us that their frequency tends to reflect how awake and alert we feel. Brainwaves are slowest during deep sleep, and faster when we’re awake and relaxed. The fastest brainwaves are called gamma waves, and they cycle at around 40 times a second, or 40 hertz, when we are concentrating, making decisions and using our memory. People with Alzheimer’s disease often produce fewer gamma waves, prompting researchers to experiment with ways of inducing break down proteins like amyloid. this type of brain activity. Last But this effect was apparently year, Li-Huei Tsai’s group at confined to the brain’s visual the Massachusetts Institute of cortex, leaving the crucial Technology showed that exposing memory region unaffected. This mice to a light flickering at a area, called the hippocampus, is frequency of 40 hertz induces among the first regions of the gamma waves in the part of the brain that processes information “Mice played frequencies near the lowest E on a from the eyes, the visual cortex. piano had half as many When they tried the light amyloid plaques” treatment for 1 hour a day in mice genetically altered to develop Alzheimer’s-like symptoms, they brain to be affected by amyloid found that this reduced deposits plaques (see picture). of amyloid and tau proteins – key Now it looks as if sound is a features of Alzheimer’s disease. more promising therapy. For an The flickering light seemed to hour a day, Tsai’s team played be boosting the activity of the mice a 40 hertz noise, which brain’s immune cells, which can is similar to the lowest E on a 6 | NewScientist | 6 January 2018

standard piano. When slices of brain were then viewed under a microscope, there were about half as many amyloid plaques in both the auditory cortex regions, where sound is processed, and the hippocampus, as were seen in control mice, the team found. The effect of 40 hertz frequencies may spread more easily to the hippocampus when induced by sound, because these areas are closer to the auditory cortex than the visual cortex. Alternatively, the pathways linking the auditory cortex to the hippocampus could be more direct, involving fewer synapses – the gaps between neurons – says Anthony Martorell of MIT, who

However, because gamma wave therapy seems relatively safe, it can be tried right away, without the years of animal testing that potential Alzheimer’s drugs usually undergo. Tsai’s spin-off company, Cognito Therapeutics, has already begun trialling a form of gamma wave therapy in people with Alzheimer’s. The approach they are trying combines sound, light and vibration – all at 40 hertz. Flickering light, low sounds and vibrating pads placed on the hands are being tested together on 12 people with mild or moderate Alzheimer’s disease at a nursing home in Boston. There is no placebo group, but the firm is planning a larger, placebocontrolled trial. Some people are already trying the therapy for themselves, however. Since the team’s first results were announced last year, lamps that flicker at 40 hertz have been marketed as a dementia treatment, and several websites play a 40 hertz sound on loop. Reynolds says, though, that families shouldn’t get their hopes up just yet, because Alzheimer’s in mice is different from the human disease. However, tests should show if it works in humans too. “Listening to a noise is an entirely doable kind of therapy,” he says. ■

ROBYN BECK/AFP/GETTY

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Pot for fun in California

CHINA has upped the ante in its efforts to curb climate change. It is launching a nationwide carbon market to push power companies to cut greenhouse gas emissions. China releases more than a quarter of global greenhouse gas emissions each year because of its huge population – it emits less per person than the US. Though China invests heavily in green technologies, its emissions have tripled since 2000. Five cities and two provinces in China already have carbon markets, where companies trade the right to emit greenhouse gases. But these are specific to certain sectors like steel. The new nationwide project will focus on power generation, which emits 3.3 billion tonnes of carbon dioxide every year. Europe’s carbon trading system covers just 2 billion tonnes. “In principle, it’s exceptionally important,” says Robert Stavins at Harvard University. The market may end up as big as “all existing carbon markets combined”.

Such a market gives companies a financial incentive to cut emissions. Each year, permits are distributed to big energy-hungry companies, stating how much greenhouse gas they can emit. Permits can be traded: a company that cuts emissions can sell to a more polluting company. But this only works if permits are limited, forcing companies to take action. The EU system has often issued too many. China has yet to reveal details of its scheme, so it is unclear if it will do better.

Control, around 100 dispensaries were licensed to sell cannabis for recreational use from Monday. The bureau had worked over the holiday period to try to process 1400 licence applications for marijuana-related firms. Recreational marijuana has already been legalised in Alaska, Colorado, Nevada, Oregon and Washington. Legal sales of the drug are expected to begin in Massachusetts later this year. “A third of the US now has legal access to marijuana for non-medical use,” says Steve Rolles of the UK drug regulation think tank Transform. “California may be the straw that breaks the camel’s back, forcing the government to review federal legislation which currently rules the drug to be illegal.”

ride to its chosen destination. CAESAR aims to send a craft to comet 67P/ChuryumovGerasimenko and bring back 100 grams of rock and ice. Dragonfly is a concept for a drone-like spacecraft to land on Titan. The idea is to check out the hazy world’s habitability and look for precursor molecules for the evolution of life. Dragonfly would fly around Titan and land at dozens of spots, testing surface and atmospheric compositions as it goes along.

Shaken baby verdict overturned

Comet or Titan for NASA in 2025 NASA has selected two finalists in its New Frontiers programme: one is a mission to bring back bits of a comet, and the other is a spacecraft for landing on the surface of Saturn’s moon Titan. Each team will receive $4 million to develop its concept, and in July 2019, NASA will choose a single mission to launch in 2025. The winner will get $850 million and a rocket

NASA

China bites bullet on climate change

ON 1 January, California became the sixth US state to make cannabis legally available for recreational use. Because the state is the nation’s most populous, the move could hasten marijuana’s legalisation across the US. California banned cannabis in 1913, but penalties for using the drug have eased since the 1970s. In 1996, it was the first state to legalise marijuana for medicinal purposes. Since 2016, it has been legal to grow, possess and use small amounts of the drug. The state already has a booming marijuana industry, producing as much as seven times more cannabis than is consumed there. Much of this is sold illegally in other states. According to Alex Traverso of California’s Bureau of Cannabis

A FATHER convicted of killing his baby daughter has been freed following repudiation of the expert medical evidence of “shaken baby syndrome” that was pivotal to the original verdict. Zavion Johnson was convicted in 2002. He said that his daughter had slipped out of his hands in the shower, but because she displayed the triad of symptoms associated with shaken baby syndrome – bleeding behind the retinas, bleeding in the brain and brain swelling – he was convicted of murder. Since then, research has challenged the dogma that this triad is proof of child abuse, and that explanations such as Johnson’s must be ruled out. Asked to re-evaluate their original evidence as part of an appeal, two key prosecution witnesses repudiated their testimony. As a result, the Sacramento County district attorney conceded the conviction was wrongful, and freed Johnson on 8 December. At least 14 people in the US have had their convictions reversed in shaken baby cases since 2011. 6 January 2018 | NewScientist | 7

NEWS & TECHNOLOGY

What love at first sight really is In it, 282 volunteers were shown pictures on the internet of six people of the gender they found attractive, and were then surveyed on their feelings about them. Around half the volunteers were in relationships. They were also asked about the early days of those relationships. A similar experiment involved showing 50 volunteers nine pictures. Zsok and his team also studied the reactions of 64 people who

YOU may remember your eyes meeting across a crowded room and your life changing forever. But was it really love at first sight? One in three people say they have fallen in love as soon as they laid eyes on someone. However, a study suggests the phenomenon probably doesn’t exist. “People think of love at first sight as a lightning strike as soon as they see a person,” says Florian Zsok at the University of Zurich, Switzerland. Until now, research into the experience has mostly focused on people who are in relationships, which is likely to distort our understanding of it. Such people are more likely to remember the beginning of that relationship in an exaggeratedly positive light. So Zsok and his colleagues conducted a series of experiments in which volunteers saw new people for the first time. Each person filled in a survey and was asked how they felt about the people they saw or met. The first experiment was designed to mimic online dating.

Mystery fossil may be a beast out of time AN ODD 380-million-year-old fossil that looks like a worm might be the last known survivor of an early form of life. But some palaeontologists are sceptical. The Ediacarans were some of the earliest multicellular life forms. They were weird, bag-like organisms, a few millimetres thick and up to 2 metres long. Nobody knows if they were 8 | NewScientist | 6 January 2018

effect. This might help explain why people think they are falling in love with someone at first sight, says Zsok. “What you feel is lust at first sight and is largely subconscious,” says Anna Machin at the University of Oxford. “Love is an attachment that comes later. It is more complex and involves conscious reflection on a relationship.” In reality, it is unlikely that people ever form this kind of connection upon meeting one another, says Zsok. “People like this romantic idea, but you have to read between the lines.” So why do so many people feel like it has happened to them? People often misremember the early stages of what is now a successful relationship, says Machin. “It’s an unconscious attempt to underpin a relationship,” she says. “Telling someone 20 years down the line that you loved them at first sight is a lovely thing to say and a good way to maintain a relationship.” But Sandra Langeslag at the University of Missouri-St Louis disagrees. The fact that some people said they felt love at first sight means it does exist, as long as you use a broad definition of what love is, she says. “A lot of people refer to the deep love you experience in a relationship, but I would call infatuation and sexual desire a type of love.” ■

They are a few centimetres long and look a bit like segmented worms. Retallack has revisited the sites and discovered four more. Thin slices show that Protonympha fossils had an organic, iron-rich body wall – like some Ediacarans (Lethaia, doi.org/chpr). What’s more, the Protonympha fossils are between 3 and 4 millimetres thick, and are preserved as chambers filled with sediment. Many Ediacarans

are similar, but fossilised worms are usually squashed flat, says Retallack. We don’t know what Protonympha was, but it is possible it was an Ediacaran, says Retallack. “An Ediacaran survivor in [such young rocks] would indeed be very unexpected, and would be met with scepticism,” says Duncan McIlroy at the Memorial University of Newfoundland in Canada. “The similarities are intriguing, but that is as far as I would go,” says Simon Conway Morris at the University of Cambridge. Colin Barras ■

GETTY IMAGES

Jessica Hamzelou

met each other face-to-face, either at a bar, during speed dating or at a food-based event designed to allow people to meet in groups of four. Of the 396 volunteers across all arms of the study, 32 reported experiencing love at first sight (Personal Relationships, doi.org/ chkg). However, none of these people matched, says Zsok. “There was no reciprocated love.” Analysing the surveys showed that people are most likely to report love at first sight when they find someone physically attractive. We tend to associate a range of positive attributes to good-looking people, a phenomenon known as the halo

animals, plants or something else. Ediacarans first appear in the fossil record about 600 million years ago. They are thought to have vanished 60 million years later, after animals burst onto the scene in the Cambrian period. They may all have been eaten. However, Gregory Retallack at the University of Oregon thinks some Ediacarans clung on for a long time in the age of animals. He says a mystery fossil called Protonympha might be one – despite living 160 million years after its cousins seemingly died. Four fossils were found in upstate New York in the early 20th century.

“Ediacarans were weird, bag-like organisms. They may have been animals, plants or something else”

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WHEN machines speak, they sound stilted, robotic and mechanical — but they are getting better. Google’s latest text-to-speech system, called Tacotron 2, generates sounds entirely from scratch. The search giant claims the results are as good as those built using professional voice artists. Most previous systems produce speech by assembling humanrecorded vocal sounds into words and sentences. In comparison, Tacotron 2 was trained on more than 24 hours of human speech and corresponding transcripts, and could then generate completely new audio of phrases from a given text even if it had never seen some of the words before. The system relies on a type of algorithm called a neural network, inspired by the way neurons connect in the brain. Stephen Cox at the University of East Anglia, UK, says the Google system is “impressive” because it learns all aspects of speech — including punctuation, prosody (the “tune” of the voice) and intonation — without expert intervention. However, it is only the best examples that are really good, says Antti Suni at the University of Helsinki in Finland. “In longer utterances, the lack of understanding of the content of the text would likely be heard,” he says. The Google researchers admit in a blog post that the system stumbles over complex words, such as “decorum” and “merlot”, and can sometimes produce random strange noises. Plus, it can’t generate audio in real time, or be controlled to sound a certain way, such as happy or sad. Other rival systems exist, such as Deep Voice produced by the Chinese internet company Baidu. The latest iteration, Deep Voice 3, is set to be unveiled at a conference in April. “The indications are that we are witnessing the birth of a new generation of speech synthesisers whose speech quality is virtually indistinguishable from human speech,” says Cox. Nicole Kobie ■

INGO ARNDT/NATUREPL

Google’s new voice is as good as your own

Lust for chocolate has fatally weakened the tree THE world loves chocolate, but are extreme challenges to cocoa as thousands of years of selective a crop. As a chocolate company… breeding have drastically changed we want to protect cocoa.” the genome of cocoa trees. The team found mutations that The plants now produce tastier compromise productivity in many chocolate, but they also make less trees from different populations. of it due to harmful mutations These mutations were particularly that are putting the future of our pronounced in a rare kind of chocolate supply at risk. cocoa bean called Criollo, which To understand what is “There is a small global happening, a team led by Juan surplus of cocoa now, but Motamayor, a geneticist at we may face shortages as chocolate maker Mars, has now soon as 2020” sequenced 200 genomes of domestic and wild trees. It is the first study of cocoa on such a scale has a nutty flavour and is used to The key ingredient in chocolate make some of the most expensive is the seeds of the cocoa or cacao chocolate (bioRxiv, doi.org/chpx). tree (Theobroma cacao), a native of This could be due to breeding the tropical forests in Central and efforts to produce cocoa that South America. Today, most cocoa tastes less bitter, says Motamayor. beans are grown in West Africa. “That created an accumulation of However, the trees are tricky mutations that led to a loss of to grow. They are susceptible to fitness, where these cocoa trees many diseases and become less produce very little.” productive as they age. There is a Although most chocolate is small global surplus of cocoa, but made from other beans, genetic we may face shortages by 2020. material from Criollo is found in Mars says it funds Motomayor’s many of them. For example, CCNwork to protect its business:“There 51, a key cultivar used for breeding

in Latin America, owes 22 per cent of its ancestry to Criollo. The research suggests the bean’s domestication began 3600 years ago. In line with this, pottery from the Olmec city of San Lorenzo in what is now Mexico, from 1600 to 1800 BC, has traces of theobromine – a chemical found in cocoa. When the researchers compared genomes from today’s Criollo and other trees, they found that domesticated Criollo had genes that are possibly associated with lower levels of chemicals called polyphenols. If so, that could account for its cocoa tasting less bitter than it once did. The study should be “a huge contribution to cacao genomics science”, says molecular biologist Mark Guiltinan at Pennsylvania State University in Philadelphia. Understanding the cocoa tree’s genetic diversity will help breed disease-resistant plants, he says. The chocolate market is worth over $100 billion per year, says research firm Markets and Markets, and demand continues to grow. We need to breed robustness back into cocoa trees, says Kevin Folta at the University of Florida in Gainesville. The 200 genomes should allow advantageous traits from wild trees to be bred into domestic plants, he says. This task is urgent, “because the tree takes so long to grow”. This is especially important in west Africa, which produces around two-thirds of the global cocoa supply. The ageing West African population is yet another genetic bottleneck, and is showing reduced disease resistance and lower crop yields. “Right now, we’re fitting one variety to God knows how many landscapes, soils, water and climate regimes,” says Carl Wahl, an agriculture adviser at Concern Worldwide in London. “It would be nice if farmers and the agriculture industries in these countries had a few different things to work with when they are plant breeding.” Chris Baraniuk ■ 6 January 2018 | NewScientist | 9

NEWS & TECHNOLOGY

Additionally, the draft says that adverse gaming behaviour will normally need to have continued for at least a year before a person’s diagnosis can be confirmed. “Health professionals need to recognise that gaming disorder may have serious health consequences,” says Vladimir Poznyak at the WHO’s Department of Mental Health and Substance Abuse. Most people who play video games don’t have a disorder, just like most people who drink alcohol don’t have a disorder either. However, in some circumstances overuse can lead to adverse effects, says Poznyak.

CAN playing too many video games be a mental health condition? In some circumstances, the World Health Organization thinks that it can, New Scientist has learned. The WHO is to include gaming disorder in its International Classification of Diseases for the first time. This widely used diagnostic manual was last updated in 1990, and the latest version – called ICD-11 – is set to be published in 2018. The wording of the gaming disorder entry that will be included in ICD-11 is yet to be finalised, but the draft currently “Most people who play lists a variety of criteria clinicians video games don’t have a disorder. But overuse can could use to determine whether lead to adverse effects” a person’s gaming has become a serious health condition. According to this draft, someone The WHO first began has gaming disorder if they give considering gaming disorder increasing priority to gaming as a medical condition a decade “to the extent that gaming ago. Through consultation with takes precedence over other mental health professionals, the life interests”, and that they agency has decided to officially will continue to game despite recognise gaming disorder in its negative consequences. next diagnostic manual, but not

Sex organ parasites have trouble mating CASTRATOR pea crabs live up to their name. They reside in the sex organs of molluscs and stop them reproducing. But the pea crabs’ odd lifestyle also makes it tricky for them to find a mate. The crabs (Calyptraeotheres garthi) are tiny parasitic crustaceans found off the east coast of South America. They spend most of their adult lives in the sex organs of slipper limpets, a type of snail. 10 | NewScientist | 6 January 2018

“They castrate, which means that they halt or stop the reproduction of the snail they use as host,” says Emiliano Ocampo at the National University of Mar del Plata, Argentina. Pea crabs only seem to parasitise female limpets. These molluscs store eggs in their sex organs, but won’t lay any if they have a resident pea crab. There is just one problem with the pea crabs’ lifestyle: it is hard to find a mate when everyone is hiding inside a limpet’s gonads. Juvenile pea crabs live in the open ocean and only settle down in limpets when they are older. So researchers assumed they must mate as juveniles and store sperm for later.

other conditions linked to technology, such as smartphone addiction or internet addiction. “There is simply a lack of evidence that these are real disorders,” says Poznyak. The prevalence of gaming disorder is largely unknown. A range of criteria and definitions exist, and estimates of the proportion of gamers who have a problem range from 0.2 per cent up to 20 per cent, depending on which study you read. “This is a very big discrepancy. The reason this work is so important is because it will allow standardisation of diagnostic criteria across the world,” says Daria Kuss at Nottingham Trent

University in the UK. But Allen Frances at Duke University in North Carolina worries that official recognition of gaming disorder could lead to the diagnosis being misapplied. “Tens, perhaps hundreds, of millions of recreational gamers without severe impairment will likely be mislabelled and overtreated,” he says. “Soon we may have calls for ‘shopping disorder’, ‘jogging disorder’, ‘workaholic disorder’, ‘binge watching disorder’ and my own personal favourite ‘beach bum disorder’,” says Frances. “Everything people passionately like doing can be degraded into fake mental illness.” ■

A castrator pea crab (Calyptraeotheres garthi)–

To confirm this, Ocampo and his colleagues examined females using a scanning electron microscope. But they found the sex organs of juvenile females cannot store sperm (Journal of Morphology, doi.org/chpk). There have been observations of males leaving their hosts and wandering about. Ocampo says it is likely males do this to look for females. “The female lives inside the host and waits for the male pea crab to copulate with them,” he says. The find implies that limpets hosting male pea crabs may be better off than those with females because, as well as being smaller, males may ultimately leave. Joshua Rapp Learn ■

DR NICOLAS CHIARADIA

Timothy Revell

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Gaming really can be bad for you

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NEWS & TECHNOLOGY

How to not trip up at home MY FOOT slips on a loose tile and for a split-second I’m flailing in mid-air, but then I feel a comforting tug as my harness pulls me upright. I’m at the falls prevention lab in Sydney, where a first-of-its-kind obstacle course has been designed to make seniors fall over – and then instinctively learn how not to.

“Conventional balance training doesn’t prepare you for a wet floor or a pet camouflaged on a carpet” One-third of people over the age of 65 fall every year, often as a result of poorer eyesight, weaker muscles or dizziness from illness or medication. When older people fall, they are more likely to break bones, setting off a chain of health problems – a quarter of adults aged 69 or older who fracture their hip die within a year. Training to prevent this usually involves balance exercises, such as standing on one leg. But these don’t adequately prepare people for unexpected hazards like a wet floor or a pet camouflaged on a 12 | NewScientist | 6 January 2018

carpet, says Stephen Lord at Neuroscience Research Australia. “That’s why we designed this obstacle course, so that people can learn to react better when things like this come up in real life.” Before I try out the course, I strap on knee, shin and toe pads. Next, Lord and colleague Yoshiro Okubo attach my harness, which is like a big nappy hanging from the ceiling. Finally, they cover me in reflective stickers so they can track my motion using cameras. The 10-metre-long obstacle course looks pretty benign – similar to a tiled bathroom floor. However, it is actually full of booby traps, including loose tiles and spring-loaded planks of wood that pop up without warning. I’m a little nervous as I gingerly step onto the course. I can’t help shrieking when the first trap gives me a fright and makes me stumble. But then it starts to become fun, and I relax enough to notice how my body instinctively keeps me on my feet. “You’re gradually building up muscle memory so you remember how not to fall,” says Okubo. The researchers monitor my progress by recording how heavily

I fall each time. If the harness catches 30 per cent of my body weight or more, they know I would have hit the floor without it. Fortunately, my average fall load is about 10 per cent of my body weight, which I’m told is appropriate for my thirtysomething age bracket. They also analyse how I react by studying the stick-figure avatar that has been copying my movements (pictured below). It shows that I instinctively stop myself from falling by flinging my arms out sideways and bending my knees at the right angle to NEUROSCIENCE RESEARCH AUSTRALIA

Alice Klein

Monitoring how people react to the traps helps them stay on their feet

maintain my centre of balance. So far, 40 people between the ages of 65 and 90 have been trained on this course, each undergoing three 40-minute sessions. Tests show that by the end, participants were half as likely to fall on the obstacle course as those who had undergone sham training in which no traps were set on the course. The team is planning to study whether this training results in fewer falls in real life. “Anecdotally, participants have told us it’s helped them and they’re even getting their friends to sign up,” says Okubo. Next, the lab wants to start inviting people with Parkinson’s disease and multiple sclerosis – who are especially at risk of falling. Anne Tiedemann at the University of Sydney says research is showing that exercises that challenge balance and involve lots of movement work best for preventing falls. These should ideally begin before older people have their first fall, she says. “Most falls will just result in a minor cut or bruise, but it’s the psychology that changes,” she says. “People often become more fearful about falling and stop doing physical activity and going out, and that’s when things can go downhill.” Lord thinks the training has even helped him. After doing some pilot testing of the obstacle course himself earlier this year, he slipped on a wet grassy slope while walking back to his car. “I didn’t see it coming – I just felt the ground suddenly give way – but I was able to quickly react and stay on my feet,” he says. “It made me think, ‘OK, that wasn’t so bad, I feel more confident now’.” After the harness comes off and I have to support my own body weight again, I find that I am more conscious of where I place my feet and how my leg muscles stabilise the rest of my body. Hopefully next time my cat suddenly runs between my legs, I will be able to put my new skills to good use. ■

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Anil Ananthaswamy

WHEN it comes to black holes, we are caught between a rock and a hard place. A black hole, it seems, is either enveloped by a blazing “firewall”, defying Einstein’s general relativity, or it destroys information in violation of quantum mechanics. But a new analysis using the “many worlds” interpretation of this theory, which says that each possible outcome of a quantum event exists in its own world, shows that black holes present no such paradoxes. In the 1970s, Stephen Hawking showed that all black holes give off thermal radiation and eventually evaporate. In doing so, they seemed to be destroying information contained in the matter that fell into them, thereby falling foul of a cardinal rule of quantum mechanics: information cannot be created or destroyed. Some argued that the outgoing “Hawking radiation” preserved the information. However, if this were the case, then given certain assumptions, the event horizon – the black hole’s boundary of no return – would

3D-printed bones turn into the real deal NO METAL plates or screws needed: a new 3D-printed ceramic implant mends broken legs by holding the fractured parts together, then turning into natural bone. The implant has the same strength as real bone, and is made by Hala Zreiqat at the University of Sydney in Australia and her colleagues. In previous studies, they showed that 14 | NewScientist | 6 January 2018

become intensely energetic, forming a firewall. But such firewalls go against the tenets of general relativity, which says that space-time near the event horizon should be smooth and devoid of any highenergy flare-ups. The black hole firewall paradox was born. Now, Sean Carroll at the California Institute of Technology and his colleagues have shown that the paradox disappears when the evolution of black holes is understood in the context of the many-worlds interpretation of quantum mechanics. The quantum state of the universe is described by something called the global wave function. According to traditional quantum mechanics, whenever there are many possible outcomes for a physical process, this wave function “collapses” to represent one outcome. But in the manyworlds interpretation, the wave function doesn’t collapse – rather it branches, with one branch for each outcome. The branches evolve independently of each other, as separate worlds. In this way of thinking, the formation of a black hole and its

the material could completely heal broken leg bones in rabbits. Now, in work yet to be published, they have shown it can also repair large leg fractures in sheep. The eight sheep in the study were able to walk on the implants immediately after surgery, with plaster casts helping to stabilise their legs for the first four weeks. The researchers saw complete healing in 25 per cent of the fractures after three months and 88 per cent after one year. X-rays showed that as the real bones grew back, the scaffolds gradually dissolved away. “They got

SCIENCE PHOTO LIBRARY/ALAMY STOCK PHOTO

Parallel universes fix black hole hitch

evaporation due to Hawking radiation – both of which are quantum mechanical processes with different possible outcomes – lead to multiple branches of the wave function. An observer monitoring a black hole also splits into multiple observers, one in each branch. The new work shows that from the perspective of an observer in a given branch, space-time behaves as ordained by general relativity and the black hole has no firewall. But does that imply loss of information? No, says team member Aidan Chatwin-Davies, also of Caltech. That is because the principle of preservation of information applies to the global wave function and not to its

individual branches, he says. Information is preserved across all branches of the global wave function, but not necessarily in any one branch. Given this scenario, a black hole that doesn’t lose information and yet has a smooth, uneventful event horizon without a firewall isn’t a contradiction (arxiv.org/ abs/1712.04955). Yasunori Nomura at the University of California at Berkeley has independently arrived at similar conclusions in his work. He agrees that the many-worlds approach resolves the paradox around information loss from black holes. “Many worlds should be taken seriously,” he says. ■

their old bones back,” says Zreiqat. The team found that the sheep tolerated the implants well and that there were no toxic side effects as they dissolved. They probably melded easily with existing bones because they had a similar composition, says Zreiqat. This contrasts with many of the currently available treatments for broken bones. For example, metal leg

plates and screws frequently cause discomfort, and bone grafts are often rejected by the recipients’ immune systems. The “ink” the team used in the 3D-printing process was a mixture of calcium silicate, a mineral called gahnite, and small amounts of strontium and zinc that are found as trace elements in bone. The implants were designed to be porous scaffolds so that natural bone and blood vessels could grow through them and restore the skeleton. The next step for the team is to test the implants in people. Alice Klein ■

“X-rays showed that as the real bones grew back, the scaffolds gradually dissolved away”

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NEWS & TECHNOLOGY

Body fat helps fight infections Belkaid’s team found that monkeys also have plenty of memory T-cells in their body fat, and that these cells worked better than those from other organs. “It means that fat tissue is not only a reservoir for memory cells, but those memory cells have enhanced function,” says Belkaid.“The tissue is like a magic potion that can optimally activate the T-cells.” In a further experiment, the

DID you pile on the pounds this Christmas? At least you can take some comfort in the fact that not all fat is bad. Evidence in mice and monkeys suggests it is important for storing essential immune cells and may even boost their effectiveness at fighting infection. Yasmine Belkaid at the US National Institutes of Health and her team have found that a type of immune cell – called a memory T-cell – seems to be stored in the body fat of mice. These cells learn to fight infection. Once exposed to a pathogen, they mount a stronger response the next time they encounter it. When the researchers infected mice with parasites or bacteria, they found that memory T-cells clustered densely in the animals’ body fat. Tests showed that these cells seemed to be more effective than those stored in other organs, for example by being better at replicating and at releasing infection-fighting chemicals. After exposing the mice to the same pathogens again, the memory T-cells stored in their fat were the fastest to respond.

Cast-off moons doomed to roam the cosmos THE universe may be awash with wandering, rejected moons, expelled from their planets’ orbit long ago. Nobody has ever conclusively seen a moon orbiting a planet in another star system. While their small size and great distance makes them tough to find, it is also possible that there just aren’t very many out there anymore. Sean Raymond at French national 16 | NewScientist | 6 January 2018

The findings should change the way we think about fat, says Anthony Ferrante at Columbia University, New York. “If you picked up a textbook, it would list the immune organs as the lymph nodes, thymus, but this study and others are changing that.” Fat should be considered an immune organ, too, he says. Not all fat is good. When people become obese, the relationship between fat tissue and immune cells seems to change, leading to harmful inflammation. However, having some fat is very healthy, says Belkaid. “I don’t think the small perturbations in fat we experience from having a bit too much goose at Christmas are going to affect our immune systems,” says Ferrante. “But one perhaps can take some solace in [the knowledge] that good things are going on in our fat while we’re eating.” Belkaid is now looking for immune cells in biopsies of human fat tissue. If she finds them, she will try to discover what exactly the fat cells do to increase their power. She hopes this could lead to new ways to boost our body’s immune response to infections, cancer and vaccinations. “You could take immune cells from a person, make them more aggressive and more able to fight cancer, and then put them back,” she says. ■

there could be 1 to 100 wandering moons for every star in the Milky Way. In the simulations, moons orbiting close to their planets were the only ones to survive – those further away ended up on the loose. Our solar system with its many moons may be an anomaly, Raymond says. The biggest planets are fairly far from the sun, with stable circular orbits. That could have spared their

moons some of the early chaos. One intriguing outcome from the model is the possibility that some cast-off moons may not escape altogether but instead stay orbiting their home stars as dwarf planets like Pluto. Sometimes, a whole planet can be cast away from its star but still hang onto its moon. If that moon is close enough to its parent planet, it could have warmth and chemical complexity driven by tidal heating, making for an oddly habitable world around a planet with no sun in its sky. John Wenz ■

EBBY MAY/GETTY

Jessica Hamzelou

team took body fat from mice that had been exposed to a pathogen, and implanted it in mice that had never been infected with it. When these mice were then exposed to the bacteria or parasite, the memory cells in the donated fat kicked into gear, giving them as much protection as if they had encountered the pathogen before (Immunity, doi.org/chcd). “It is sufficient to provide good protection against an infection,” says Belkaid. She thinks these memory T-cells are particularly powerful because they may be feeding on the energy-rich fat tissue they are stored in. “It has an enormous amount of nutrients,” she says.

research agency the CNRS in Paris and his colleagues used simulations to figure out what happens to moons as their planets are still forming (arXiv.org/abs/1712.06500). Planets are born in the chaos of early stellar systems, where they can easily be jostled out of position by neighbouring worlds. This can have a catastrophic effect on any moons hanging around. The researchers’ model showed that in 80 to 90 per cent of cases, planets shed their primordial moons. Most of them were cast into interstellar space, and Raymond says

“There could be 1 to 100 former moons wandering through space for every star in the Milky Way”

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IN BRIEF Gene editing slows hearing loss

Mars-sized rock smashed Earth to make the moon A SMALL rock can pack a mighty punch. The object that smashed into Earth about 4.5 billion years ago to create the moon was relatively small — roughly one-tenth the mass of Earth, about the mass of Mars, according to the latest modelling. Astronomers have long suspected that the moon was created when a giant protoplanet called Theia struck the newly formed Earth. The collision created a cloud of debris, which quickly coalesced into our planet’s partner. But this giant impact idea alone cannot explain why the moon and Earth are chemically identical.

Later, two other hypotheses arose for why the moon is Earth’s chemical clone, but they predict radically different masses for Theia. The chemical effects of the collision depend on Theia’s mass, so James Badro at the Paris Institute of Earth Physics and his colleagues set out to determine how each idea matches up with our planet’s chemistry (Geophysical Research Letters, doi.org/chnp). They ran more than 2 billion simulations of the crash, tweaking Theia’s mass and other properties of young Earth, such as whether it was entirely molten or not. No matter the scenario, they found that an impactor larger than 15 per cent of the mass of Earth cannot produce the chemistry we see in Earth’s mantle. A heavier object assembles a mantle too rich in nickel and cobalt. So Theia was probably not the behemoth we thought it to be.

Invincible animals meet their match THEY can survive freezing, total desiccation, and being sent into space. But climate change might be too much for the world’s hardiest animal, the tardigrade. Tardigrades, or water bears, live in many environments. They are one of the few organisms that are abundant in Antarctica. Lorena Rebecchi at the University of Modena and Reggio Emilia, Italy, and her colleagues

subjected Antarctic tardigrades to dehydration, rising temperatures, and ultraviolet radiation. The animals coped well with individual stressors. They handled desiccation by shutting down their metabolism, entering a state known as anhydrobiosis. They also tolerated periods of temperatures up to 33°C and, separately, high ultraviolet radiation – which might come

about from damage to the ozone layer. However, high temperatures and high radiation together often proved fatal for these Antarctic denizens. Those that endured radiation reached sexual maturity later, laid fewer eggs and sometimes developed abnormally (Journal of Experimental Biology, doi.org/chnr). Nevertheless, Rebecchi says tardigrades are more resistant to change than most species.

HEARING loss in mice with a form of progressive deafness has been slowed by CRISPR genome editing. Our cells have two copies of most genes, but a mutation in just one copy can sometimes cause disease. Such disorders could in theory be cured by switching off only the mutated copy. David Liu at Harvard University and his colleagues have tried doing this with CRISPR in mice carrying a mutated copy of the gene TMC1, which causes a rare form of hearing loss in people. They injected the CRISPR protein and an RNA guide designed to target only faulty versions of the gene into the ears of the mice. It wasn’t a complete cure, but injected mice could still hear very loud sounds when they were 8 weeks old, unlike uninjected mice (Nature, doi.org/chnx). If improved, the approach might lead to treatments for inherited deafness in people.

Google AI made to look foolish TRICKING artificial intelligence has never been easier. One way to fool an AI into misclassifying an image is by adding in small perturbations that make the AI think it looks like something else. Such “adversarial examples” can now be generated a thousand times faster than before. Anish Athalye at the Massachusetts Institute of Technology and colleagues have created an algorithm that, by changing an image pixel by pixel, produced a thousand adversarial examples to fool Google’s image recognition system (arxiv.org/ abs/1712.07113). One was an image of a dog that was wrongly identified as two people skiing. If driverless cars are confused just as easily the consequences may be severe. 6 January 2018 | NewScientist | 19

IN BRIEF

For new stories every day, visit newscientist.com/news

Plants’ sand shield Red Planet rubble may have stolen its water repels caterpillars WATER-slurping rocks may be In an effort to figure out what left behind would have floated

ERIC LOPRESTI

20 | NewScientist | 6 January 2018

to blame for the Red Planet’s arid surface. Billions of years ago, Mars probably had just as much water as Earth – but most of that is now gone. It has been suggested that it vanished once Mars lost the magnetic field that protected it from the harsh solar wind, allowing the planet’s early atmosphere and surface water to escape into space. But recent research has shown that this process may be unable to account for the loss of all the water.

else could explain it, Jon Wade at the University of Oxford and his colleagues simulated the planet’s early geological reactions with water. They found that because Martian rocks are full of iron oxide, they can drink in about 25 per cent more water than rubble on Earth (Nature, doi.org/chnd). Once the water soaked into the rock, it couldn’t seep back out. That’s because the iron oxide would have incorporated the water’s oxygen atoms into its structure, while the free hydrogen

out to space. The rocks then would have sunk deep into the Martian mantle, hiding the oxygen away and stealing the planet’s water for good. As the rocks sank, so did Mars’s chances for life. For complex life as we know it to evolve, a world needs to have water for billions of years, says Wade. With almost all the water sucked away into the ground early in Mars’s history, it is unlikely that anything more than microbes could have evolved there. DUNCAN USHER/MINDEN PICTURES/FLPA

SOME plants have an odd defensive tactic against insects. It seems they use sand grains as abrasive armour that damages the insects’ teeth. These “psammophorous” plants have sticky surfaces to which sand adheres. This sand was suspected to be involved in protecting against herbivorous insects, but this was only tested in 2016. Eric LoPresti of the University of California, Davis, showed that plants with sand coats are eaten less. LoPresti and his colleagues have now examined why. The team raised caterpillars on beach plants called sand verbenas (Abronia latifolia), which were either sand-covered or “clean”. Some caterpillars were white-lined sphinxes, which take big bites of leaves. Others were “leaf-miners” that eat the leaf interior. The team tracked their growth and behaviour. The leaf miners were equally happy on sandy or clean plants, but more than 80 per cent of white-lined sphinx caterpillars preferred clean foliage. Eating sand hobbled their development, slowing their maturation and stunting their growth. The rough sand also eroded their mandibles, making it harder for them to feed (Ecological Entomology, doi.org/chnj). “We were astounded by how worn down the caterpillars’ mandibles got after less than a week of feeding,” says LoPresti.

Killer cells keep fetuses healthy YOUR body’s natural killer (NK) cells have a soft side. These immune cells normally take out cancer cells and pathogens, but it seems they also nourish early fetuses, helping them grow. Zhigang Tian at the University of Science and Technology of China and his team have found a subset of the cells in mice that are made only during early pregnancy in the uterus. These cells produced large quantities of two proteins vital for growing fetuses: pleiotrophin and osteoglycin. The team examined uterine tissue from 54 women and found that those who had recently experienced miscarriages had fewer of these uterine NK cells than people whose pregnancies had been successful. When the team genetically engineered female mice to be unable to make these NK cells, the animals had fetuses that were half normal size. Giving uterine NK cells to these mice when pregnant, however, boosted the size of offspring (Immunity, doi.org/chnz). Tian’s team hopes these cells can be used to treat women who have recurrent miscarriages or underweight babies.

Crows make up after food fights EVEN a murder of crows has a soft side. The birds will make up or seek comfort after a fight, whether it was with a friend or a stranger. Crows belong to a group called corvids, known for their intelligence. They form long-lasting relationships with other members of their gang. To find out how they form new relationships, Miriam Sima at the Max Planck Institute for Ornithology in Germany and her colleagues studied crows that were unfamiliar to each other. They wanted to see how the crows would react to scuffles between relative strangers.

The team kept carrion crows in a cage. When they put food in, the birds fought more when the food was limited. The food shortage caused tempers to flare. If the crows were only mildly aggressive, the aggressor would often seek the victim out after the food was gone. It would sit close by, touching and preening the victim’s feathers (Ethology, doi.org/chnk). However, if the violence was more severe, perpetrators gave victims a wide berth, and victims often sought consolation from a crow that hadn’t been involved in the squabble.

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ANALYSIS DRUG SUBSTITUTES

The imitation game What will happen now that the NHS is substituting expensive biological drugs with cheaper knock-offs, asks Alice Klein BIOLOGICAL drugs are the new darlings of medicine. In recent years, they have doubled treatment rates for several cancers, arthritis and Crohn’s disease. But these medicines, which are large, complex molecules produced by living cells, carry hefty price tags, and now comprise eight of the world’s top 10 money-spinning drugs. A one-year course of the biological breast cancer drug trastuzumab (sold as Herceptin), for example, costs $50,000. In the UK, biologics have contributed to a 29 per cent rise in National Health Service spending on drugs since 2010. That’s why, starting this year, the NHS plans to substitute all

termed biosimilars, aren’t exact copies. “Whereas aspirin is like a bicycle – it doesn’t have many parts and is easy to copy – a biological drug is more like a jetplane,” says Gregory Moore at Monash Medical Centre in Melbourne. But that hasn’t stopped firms developing biosimilars as patents for the first wave of blockbuster biologics expire. Biosimilar

versions of the arthritis drugs infliximab, etanercept and rituximab became available in the UK in 2015, 2016 and 2017 respectively. Biosimilar versions of trastuzumab and bevacizumab – another cancer medicine – were approved by the US Food and Drug Administration (FDA) in the past four months, and many more are in the pipeline. However, uptake has been

patchy. NHS figures show that in some UK regions only 10 per cent of patients are being switched to infliximab biosimilars, compared with 100 per cent in others. In the US, biosimilars have captured just 7 per cent of the infliximab market, while in Australia they have grabbed a mere 4 per cent. Clearly, there is a need for change. Norway introduced a similar policy to the NHS’s plan,

brand-name biologics for cheaper generic versions, hoping to cut costs by up to 70 per cent. Some doctors are worried these cheaper copies won’t work as well or as safely, saying that competing firms won’t be able to perfectly replicate complex biologics. Are these fears justified or simply big pharma scaremongering? Because biologics are made by cells, they are tricky to copy. Trastuzumab, for instance, is a multichained protein secreted by Chinese hamster ovary cells. Different cell batches and even temperature and light can subtly alter the product. So unlike chemical drugs such as aspirin, generic biologics, Biological drugs, like trastuzumab, are tough to perfectly replicate 22 | NewScientist | 6 January 2018

ALFRED PASIEKA/SCIENCE PHOTO LIBRARY

“Some doctors are worried these cheaper copies won’t work as well or as safely. Are these fears justified?”

For daily news stories, visit newscientist.com/news

and has seen a big impact. Since 2014, the country has required all patients who are newly prescribed infliximab to be given the cheapest biosimilar available. Companies compete to win an annual tender to supply the drug, which has seen the drug price drop by 72 per cent from about $2500 per dose. A randomised, doubleblind controlled trial funded by the government found no significant differences when 482 patients with arthritis, Crohn’s disease and other inflammatory conditions were maintained on brand-name infliximab or switched to a biosimilar for one year. Other Nordic countries have also enthusiastically adopted generic biologics. Infliximab biosimilars now make up 96 per cent of the market share in Denmark, 88 per cent in Finland and 34 per cent in Sweden. There have been no significant problems with the swap. In Denmark, where a nationwide registry was set up to monitor all patients switched to biosimilar infliximab, no worsening in their disease was observed after a year.

Safe to swap? However, doctors in other countries remain wary. A 2016 study found that only 45 per cent of 1200 surveyed US physicians thought biosimilars were safe and appropriate to prescribe. Patients are also uncertain. A 2016 survey of more than 3000 people in the US, UK, France, Spain, Germany and Italy found that the vast majority of the general public had never heard of biological drugs or biosimilars. Of those being treated with biologics, only 10 per cent were aware of biosimilars, and less than half of those said they would feel comfortable with switching, fearing their safety and efficacy. But why? Lack of evidence doesn’t seem to be the issue. Regulators like the FDA and European Medicines Agency require manufacturers to prove

Top 10 drugs with the highest global sales (Biological drugs in orange) Drug

2016 sales ($billion)

Adalimumab

16.1

Arthritis, IBD*

Ledipasvir/sofosbuvir

9.1

Hepatitis C

Etanercept

8.9

Rituximab

8.6

Infliximab

7.8

Arthritis, IBD*

Lenalidomide

7.0

Multiple myeloma

Bevacizumab

6.8

Trastuzumab

6.8

Insulin glargine

6.1

Pneumococcal vaccine 5.7

Condition

Arthritis Arthritis, leukaemia

Bowel, lung, kidney, cervical cancer Breast and stomach cancer Diabetes Pneumonia prevention

*Inflammatory bowel disease SOURCE: www.genengnews.com/the-lists/the-top-15-best-selling-drugs-of-2016/77900868

their products are just as effective Rheumatology, titled “The data and safe before they can be sold. is not convincing”. Fleischmann This includes running a clinical confirmed he had received trial that compares the biosimilar payments from AbbVie, but with the brand-name product. declined to discuss their amount Dozens of trials have confirmed or purpose with New Scientist. that they are as good as the In the US, insurers are also originals. So why are some limiting access to biosimilars. doctors so reluctant to use them? For example, 58 per cent of health Belinda Wood, departing plans don’t cover infliximab CEO of Australia’s Generic and biosimilars. In September, Biosimilar Medicines Association, Pfizer, which makes one of these which represents manufacturers, biosimilars, sued originator puts it down to two factors: company Johnson & Johnson for brand loyalty and big pharma allegedly arranging “biosimilar fearmongering. “The fact that exclusion” deals with insurers. these are called ‘similar’ means “Things get nasty,” says Wood. that originators can say, ‘Hey “We’re talking about big-dollar doctor, they’re not quite the products here, so companies have same, maybe you should be a a heck of a lot to lose.” bit worried’,” she says. Then again, Moore says doctors Companies with patents on have legitimate concerns about the original biologics appear to be heavily investing in shoring up “Only 45 per cent of 1200 surveyed US physicians brand support. For example, drug thought biosimilars were firm AbbVie made $45 million in safe to prescribe” payments, including speaking and consulting fees, to more than 27,000 US doctors between 2013 biosimilars. One is that they only and 2015 related to its biological need to be shown to be equivalent arthritis drug adalimumab. This to the originator drug for one is currently the world’s top-selling condition, say rheumatoid drug, but biosimilar competitors arthritis, to gain regulatory are due in October. approval. That means they can be Influential doctors are a prime used to treat another condition, target. For instance, AbbVie paid like inflammatory bowel disease, more than $50,000 in consulting without needing further trials. fees and expenses between 2013 Moreover, because biologics and 2015 to Roy Fleischmann at usually target the immune the University of Texas, who last system, slightly different versions year gave a talk on biosimilars could potentially cause severe at the annual meeting of the allergic reactions in some American College of patients, says Moore. That is why

his hospital, where he is head of inflammatory bowel disease, has a policy of not prescribing biosimilars, he says. AbbVie pays speaker fees to Moore and is a major financial supporter of his hospital, but Moore says patient safety, not brand loyalty, is his concern. “When the originator drug has kept your patient well for years, and a new player comes to market that doesn’t have quite the same robustness, that’s going to play on your mind.” Fleischmann says he has the same mindset. “It may be fine to switch patients to biosimilars, but what if it isn’t? We don’t have enough evidence yet.” On the other hand, Jeffrey Aronson, a clinical pharmacologist at the Centre for Evidence-Based Medicine at the University of Oxford, says the same concerns should apply to brand-name biologics. “The great difficulty for all biological drugs, originators included, is that manufacturing variability means that each batch is slightly different,” he says. For this reason, he would like to see better monitoring of both originators and biosimilars after they enter the market. At the moment, the UK Medicines and Healthcare products Regulatory Agency invites patients and doctors to report any drug problems. Biosimilar manufacturers are also required to monitor small groups of patients after they start using the drugs. But Aronson believes a nationwide registry that monitors all patients taking biologics would be helpful, so that any dodgy batches could quickly be identified and pulled. Clearly, biosimilars must be evaluated properly before and after they enter the market, but so far it seems there is no real reason to fear them. With the NHS strapped for cash, switching to cheaper drugs seems an obvious move. Patients don’t care who makes their drugs – they just want them to work. ■ 6 January 2018 | NewScientist | 23

COMMENT

Slim chance of success Calories in, calories out, or CiCo to its new devotees on social media, is all the dietary rage. It just doesn’t add up, says Anthony Warner ANYTHING with an acronym is not to be trusted in my view, so I was dismayed to hear that the CiCo diet was spreading like wildfire across social media. CiCo stands for “calories in, calories out” and is based on the notentirely-revolutionary principle that if you eat fewer calories than you burn, weight loss will ensue. The seemingly attractive notion of eating whatever you want as long as you stick to this principle, plus anecdotes of success, seems to have fanned the flames of this idea for a new generation of devotees. Having spent a lot of time staring into the dark heart of diet culture, I’m relieved it is at least a long way from the guilt-inducing language of the various exclusion regimes that have dominated online in the past few years. CiCo does not classify any foods as clean, unclean, toxic, super or acidic, and in that respect is more

sensible. And it’s honest in acknowledging that an energy deficit is required for weight loss. But with its simplicity come difficulties and dangers. When people restrict what they eat, keeping nutrition balanced and adequate can be harder, especially if you opt to get all your calories from cheese and onion crisps. For me though, the main issue with CiCo is that despite initial weight loss being likely, the odds are it will not work for long. Our bodies have complex and potent mechanisms that try to keep us at a particular weight, even when society does not deem that weight ideal. The vast majority of dieters regain lost kilos within four or five years. Some studies show just 5 to 10 per cent manage to keep weight off for that long, with plenty ending up heavier in the long term and risking their health. I’m sure CiCo will continue to

Second time lucky? Supersonic air travel is coming back. Will it be for keeps this time, asks Paul Marks HALF a century ago, in Toulouse, France, a hangar door swung upward to reveal a wonder of the age: the prototype of Concorde. This gorgeous, delta-winged Anglo-French jet could fly at twice the speed of sound. It was a marvel of power, metallurgy and aerodynamics. But Concorde was a financial white elephant. Its 24 | NewScientist | 6 January 2018

like Mick Jagger to fly from London to New York in three-anda-half hours instead of eight”. After Concorde’s retirement in 2003, the idea of a supersonic reprisal often surfaced. Only now does it look likely, with a growing roster of plans for new aircraft. Their real challenge is not to break the sound barrier, but to make doing so affordable. Among the most advanced is a scaled-down Concorde: a 55-seat, all-business-class, delta-wing jet

“aesthetic and technological triumph still tends to outweigh its monumental commercial failure”, writes James Hamilton-Paterson in his history of British aviation, Empire of the Clouds. “For Concorde’s successors, The plane’s £1.1 billion, statethe challenge isn’t breaking backed development, he says, the sound barrier, but to meant that French and British make doing so affordable” families paid “to enable people

set for service in the mid-2020s. Developed by Boom Supersonic of Colorado, it promises a quicker, quieter flight than Concorde and fares on a par with subsonic business-class travel. Lockheed Martin and partners, including Airbus, also have a Mach 2 design on the drawing board. Then there’s the new breed of space-flight firms. SpaceX said its BFR rocket – ostensibly for Mars and moon missions – could provide anywhere-on-Earth, cityto-city transport in under an hour. And Virgin Galactic, focused on suborbital tourist trips with its rocket plane, also has city-to-city travel on its radar. So a supersonic

For more opinion articles, visit newscientist.com/opinion

Anthony Warner is a food industry development chef who blogs about dietary pseudoscience. He is author of The Angry Chef (Oneworld)

future is a done deal? One barrier to a spaceplane route is that the US may deem landing a rocket abroad as breaching a ban on exporting this technology. A wider issue is that consumers might not agree that faster is better. For example, I treasure the respite long-haul flights can offer from the hectic pace of life. But as the White House showed by ordering a return to the moon, former glories seem all the rage. If we must relive them, let’s just hope that this time around the supersonic dream is affordable. ■ Paul Marks is a technology, aviation and space-flight writer based in London

INSIGHT Global recycling

JIE ZHAO/CORBIS VIA GETTY IMAGES

proliferate, because framing weight loss as a simple matter of self-control is a sales strategy as old as the hills. Persuading us that failure is our fault is how any diet with a poor long-term success rate stays popular. In reality, people gain weight for many reasons, including genetic susceptibility, hormonal imbalances, psychological issues, stress, side effects of medicine, disrupted sleep, stigmatisation, eating disorders and perhaps even a history of restrictive dieting itself. To simply cut calories without considering deeper problems or causes is akin to spooning water out of a sinking ship while ignoring the leaks below deck. Being overweight or obese is not a single disease with a simple cure, it is the physical expression of a huge variety of complex factors and conditions. The only way to really tackle this is to work with individuals and understand their particular problems. Sadly, this is expensive, difficult and hard work, and it is far easier to just blame people for their behaviour. Against that backdrop, diets like CiCo just don’t add up. ■

China’s banon‘foreign garbage’maybackfire Andy Coghlan

Western exporters of the banned waste, who want to try to agree a much longer transition. The WTO and exporting countries have appealed for a five-year transitional period. China has so far agreed a grace period, delaying enforcement of the ban until 1 March. But there are some glimmers of hope that a backlash from Chinese companies equally affected by the ban might add domestic pressure for a calmer transition. The biggest piles of newly orphaned waste are plastics and mixed paper waste — things like food packaging and newspapers. In 2016,

FORGETTING to put the bins out is one thing, but this is a whole other recycling disaster. Monday saw the notional start of China’s ban on waste imports, which is threatening to cause global panic, because the nation is the world’s largest recycler of scrap metals, plastic and paper. It’s not that we weren’t warned. Last July, China declared that it was no longer willing to accept yang laji, or “foreign garbage”, from 1 January 2018. It notified the World Trade Organization (WTO) of its plan to ban the import of 24 types of scrap, including plastics for recycling, waste “Alibaba, the Chinese equivalent of Amazon, is textile materials and all unsorted having to import cardboard waste paper — basically the sort of boxes from Vietnam” paper that accumulates in household bins. Likewise, imports of cardboard the US alone sent China 13.2 million for recycling must be much “cleaner” tonnes of scrap paper and 775,000 and free of gravel, dust and stones. tonnes of plastics scrap, says Mark So where will this mountain of Carpenter of the US Institute of waste go instead? And it really is a Scrap Recycling Industries. mountain – China and Hong Kong Much of this mixed paper — along imported 70 per cent of the world’s with cardboard itself — gets converted plastic waste in 2016. within China into cardboard boxes and Frantic negotiations are still under packaging for dispatching Chineseway between Chinese authorities and

made goods to domestic and Western customers – a neat cycle of global reuse. But there are reports since the July announcement that the ban is already biting, leading to shortages of cardboard. “Chinese companies are already running out of cardboard boxes,” says Simon Ellin, chief executive of the UK Recycling Association. “Alibaba, the Chinese equivalent of Amazon, is having to import cardboard boxes instead from countries like Vietnam.” Ellin says that confusion over China’s demand for cleaner cardboard is also contributing to the shortage, as some exporters are withholding cargoes in case they get turned back for being too dirty. “It’s a big risk to a business if you don’t know what happens when it gets there,” he says. Ellin suspects that the recipient companies in Chinese ports are equally unhappy with the speed of the transition. “They are not ready for increased inspections, spelling chaos at the ports, with containers of waste backed up like traffic jams,” he says. “I think the impact of the whole strategy on China itself can’t be underestimated.” Precisely for that reason — to avoid harming its own economy – Ellin is hopeful that China will eventually agree to a more measured and pragmatic transition. Otherwise, Westerners better hope that local recycling firms can rapidly fill the void, before the plastic begins to pile up. ■ 6 January 2018 | NewScientist | 25

APERTURE

26 | NewScientist | 6 January 2018

Alien world of the Alps YOU don’t need a spaceship to see alien landscapes up close. Just take a hike in the South Tyrol in northern Italy, where fog and the glow of dawn help create an otherworldly spectacle. These strange formations are called Erdpyramiden in German and Piramidi di terra in Italian, which both translate to earth pyramids. Their origins lie in the boulder-studded moraine clay deposited by glaciers during the last ice age. Torrential rain erodes exposed clay, while the rocks protect material directly beneath them. When the conditions are just right, over time the rocks “rise” out of the landscape. German photographer Kilian Schönberger describes them as “one of the strangest landscape elements of the Alps”. This example, near Plata in the Puster valley, is one of the most admired of several similar formations across the province. Other striking examples can be seen in the hills above the city of Bolzano. Inevitably, such places inspire tales of petrified witches or cursed meadows. Other myths are more original. “For one of these areas there is a prophecy that doomsday arrives when the erosion reaches the stove of a nearby farm,” says Schönberger. The march of nature being what it is, it may be best to get along and see them soon.

Jon White

Photographer Kilian Schönberger kilianschoenberger.de

6 January 2018 | NewScientist | 27

COVER STORY

WINTER FLU

EVERYTHING YOU NEED TO KNOW

PLAINPICTURE/HOLLANDSE HOOGTE/RICHARD BROCKEN

The annual flu epidemic is stalking the northern hemisphere. If it is anything like what just hit the southern hemisphere, the winter is going to be a rough ride, says Debora MacKenzie

28 | NewScientist | 6 January 2018

Influenza A strains are named after their two main surface proteins, haemagglutinin (H) and neuraminidase (N). There are 18 types of H and 11 of N in bird viruses, and immune-system antibodies that attack one type don’t recognise another. Only viruses H1N1, H2N2 and H3N2 have fully adapted to humans, and only H1N1 and H3N2 currently circulate in us. People sometimes catch other strains of bird flu, for example H5N6, but they cannot spread. Dominant strains of both A and B circulate together in the northern and southern hemisphere winters, infecting up to half of all people and causing disease in between 10 and 15 per cent. Influenza A is of extra concern because new viruses, or just viral genes, sometimes jump from birds to humans and the novel virus can cause an especially severe pandemic flu.

WHY DOES FLU KEEP COMING BACK?

WHYAREPEOPLE WORRIEDTHISYEAR?

Flu is unique among human diseases. It circulates constantly in cool, dry areas of east Asia, conditions the virus prefers, but when temperatures drop during the northern and southern winters, it breaks out and begins a tour of the relevant hemisphere. Because it spreads from person to person efficiently in exhaled droplets, and can be picked up from contaminated surfaces, nearly everyone is exposed. And unlike, say, measles, having flu once doesn’t make you immune to catching it. The virus is uniquely talented at dodging our immune systems. The big haemagglutinin protein on its surface gets most of your immune system’s attention, and this protein constantly mutates at seven hotspots. Every few years it racks up such a number of mutations that many antibodies you made to your last infection don’t recognise the virus, and you get sick again. You still have some immunity to kinds of flu that are only a little different from viruses you have seen before, which is why much winter flu isn’t as severe as flu can be. The strains best able to evade this kind of prior immunity dominate the annual epidemic in each hemisphere, so we only need one vaccine per season – but a new one each year.

A record number of flu strains are currently circulating, two in the influenza B group and two influenza A strains, H1N1 and H3N2. H3N2 is the real problem. Our strongest immunity is to the first kind of flu we caught. Between 1918 and 1968, no H3N2 viruses circulated as winter flu, so people born before 1968 have weaker immunity to it. That includes elderly people, whose faltering immune systems make them more vulnerable. There are more than four times more deaths in seasons dominated by H3N2, amounting to 220,000 last winter in Europe. This year’s H3N2 seems to be especially severe: in Australia in the winter just past, it caused more than three-quarters of all flu cases this year (see diagram, below), and more than 2.5 times more people than usual sought medical help. The likelihood of dying was relatively high, with most deaths among elderly people – although not all. “We don’t really know what makes some winter flu viruses more severe than others,” says Colin Russell at the University of Amsterdam. It’s a mix of the virus’s inbuilt weaponry to defeat our immune system and our system’s ability to recognise and respond to it fast enough. With this year’s H3N2, it could be either or both, says Derek Smith at the University of Cambridge – virologists can’t yet tease all the variables apart. >

A global lab network reports the number of specimen samples in suspected outbreaks that test positive for different flu strains. The H3N2 strain’s dominance made the recent southern hemisphere flu season more severe 30

Northern hemisphere winter flu

B (lineage not determined) B (Victoria lineage) B (Yamagata lineage) A (not subtyped) A (H3N2) A (H1N1 2009)

25

20

15 Southern hemisphere winter flu

10

5

0 Week 50 2016

SOURCE: WHO

Flu is a small virus with just 11 genes made of RNA. One type, influenza B, infects only humans, and two strains of it are circulating this year: Yamagata and Victoria. The other common type of flu is influenza A. Its many strains mostly, and in large part harmlessly, infect waterfowl, but three varieties have adapted to humans. Those three plus a few more infect other mammals, notably pigs.

Number of specimens (thousands)

WHAT IS FLU?

1

10

20

30

40

49

2017 6 January 2018 | NewScientist | 29

NEW AND DEADLY

WHAT MAKES FLU LETHAL?

Birds and some mammals are reservoirs for influenza A viruses. When unfamiliar strains jump species to us, and develop the capability to spread from human to human, there is little natural immunity, and pandemics can result

1.0

20

250

16

200

12

150

8

100

4

50

0

2000

0

2005

2010

SOURCE: OFFICE FOR NATIONAL STATISTICS

30 | NewScientist | 6 January 2018

2015

Influenza-like illness incidence rate (per 100,000 population)

Weekly deaths from all causes (thousands)

As elsewhere in the world, an annual spike in the overall death rate in England and Wales corresponds with the arrival of winter flu

0.8 Deaths (millions)

Flu’s familiarity belies its deadliness. This year marks the centenary of the deadliest pandemic of recent years, the Spanish flu of 1918 that killed up to 100 million, some 5 per cent of humanity at the time. The way flu kills directly is mostly by causing viral pneumonia, a deep infection that damages the lungs’ oxygen-absorbing membranes. Pneumonia can also happen indirectly if the flu virus wipes out immune cells that normally keep bacteria in your lungs at bay, triggering a bacterial infection. Compromised immune systems, for example in elderly people and pregnant women, allow the virus to replicate more freely and make flu more dangerous. Especially in elderly people flu can also cause excessive levels of inflammation, normally a broad immune defence against germs. Each year, right after flu season, there is a second, broadly equal wave of deaths from inflammation-triggered conditions such as heart attack and stroke. Chronic conditions that boost inflammation such as obesity can make flu more dangerous. Pneumonia linked to flu is the fourth biggest killer of women in the UK, and the sixth biggest killer of men (see diagram, below). According to the first worldwide direct estimate, published by the World Health Organization (WHO) in December 2017, the yearly toll is up to 650,000 just from lung disease, and 1.3 million from all causes – twice what we thought. “If we had another vaccine-preventable virus killing that many people we’d be outraged,” says Bram Palache of FluPal Consultancy in Amsterdam.

1918

1957

Spanish flu 50-100 million dead

Asian flu

0.6

1889 0.4

Asiatic or Russian flu

1968 Hong Kong flu

0.2

0 H1N1 Influenza A strains

H3N8 First identified

Influenza B 1880

H2N2

Constantly present in human populations 1900

SHOULD I GET A FLU JAB? Yes. Ignore people who swear the vaccine gave them flu: the virus in the vaccine is dead, or so crippled it can’t replicate. That said, very recent observations suggest that past vaccination may sometimes mean worse flu in years when the vaccine doesn’t closely match the circulating virus. While virologists don’t quite know what to make of this yet, it is clear that flu vaccines can protect, especially if you are in a vulnerable group or prone to nasty complications. Unfortunately, flu vaccination isn’t effective or popular enough to stop flu entirely through “herd immunity”. Each person vaccinated has about a 60 per cent chance of being protected, and even in the US, where vaccination is recommended for everyone over 6 months old, less than half get it. Numbers are similar overall in Europe. The UK has some of the highest vaccination rates, at over 70 per cent for the over 65s. The vaccine takes two weeks to kick in, so get it soon. Consider the pneumococcal vaccine, which protects against post-flu bacterial pneumonia. Children shed more virus for longer, and respond better to the vaccine, so vaccinating them helps protect older people and babies, creating a kind of herd immunity within households.

1920

1940

1960

Children don’t even face a needle: the UK and other countries give them nose drops containing weakened live virus. This induces a broader range of immune reactions and so offers better protection, but official caution about giving live vaccine to elderly people or pregnant women, and the small number of manufacturers, have otherwise limited its use. The antiviral drug Tamiflu can help if you are severely ill. But you should start taking it within two days of symptoms starting, which is generally before you know whether it will be bad.

WHY ISN’T THE FLU VACCINE BETTER? Nearly all flu vaccines are made of viruses grown in hens’ eggs, a process dating from the 1940s that takes between six and eight months. One egg is inoculated with a flu virus that grows well in eggs and has been equipped with the H and N proteins from a virus strain thought likely to circulate next winter. The world has the capacity to make 1.5 billion doses of vaccine each protecting against three or four strains, and so each requiring three to four eggs. Vaccines this

2013 H7N9 Avian flu virus crosses to people. Unofficial death toll: 127 1997 H5N1

2009

Bird flu virus transmitted to people 6 fatalities in Hong Kong

CAN WE MAKE A BETTER VACCINE?

Swine flu 300,000400,000 dead

1977 Russian flu. Figures not available H1N1

H1N1 (2009)

H3N2

1980

that one mutation common in egg-grown H3N2 makes unexpectedly large changes to the injected virus’s surface protein, so antibodies the immune system produces to this don’t recognise the wild virus. It still makes sense to get vaccinated: fewer vaccinated than unvaccinated people got sick in Australia this past season.

2000

2020

year contain both the circulating A strains, and one or both of the Bs. Actual production varies with predicted demand. This process means virologists must predict months in advance which viruses will circulate so companies can grow the right vaccines. Sometimes they get it wrong, although this year the vaccine virus was a good match, says Ian Barr of the University of Melbourne. There is still a problem, though. A review last year found that the main, injected vaccine, made of killed viruses,protected only 33 per cent of recipients against H3N2 – which is the dominant strain this year. This fell to 24 per cent in the over-65s. In the Australian winter just past, the vaccine protected only 10 per cent of recipients of any age from H3N2, and made no difference in elderly people, although it worked as well as usual against the other strains. The same vaccine is being used for the northern flu season. That seems to be down to mutations during the vaccine’s production. In October, researchers at the University of Melbourne found that antibodies to the H3N2 strain used to make the vaccine worked fine against the H3N2 viruses that actually circulated, but when it was grown in eggs, the viruses that emerged induced antibodies that missed circulating strains a third of the time. Simultaneously, a California team showed

Growing annual flu vaccine in hens’ eggs is cheap. A few manufacturers grow vaccine virus in cultured mammalian cells, but this is 20 times more expensive, still takes between six and eight months, and may be no more effective. One innovative technology is to base vaccines not on a whole virus, but on just its surface proteins. Protein Sciences of Meriden, Connecticut, puts genes for flu’s big surface protein into insect cells and harvests the protein. The vaccine has been approved in the US, and Sanofi, the world’s biggest maker of flu vaccine, has bought the company. Medicago of Quebec City in Canada is in the later stages of testing a similar process using plant cells. These vaccines could be made in large quantities in weeks, not months – and shortly before flu season, making them more likely to match what circulates, without egg-based mutations. The real game changer, though, would be a “universal” vaccine that elicits immunity against parts of the flu virus that stay the same over time or between strains. This wouldn’t need to change every year, and could be stockpiled for pandemics. People have been trying to develop one for years, and there are promising candidates. But the world spends only $35 million on the research each year, says Mike Osterholm of the University of Minnesota, hardly enough to bring a vaccine to market. With millions sunk into making the existing vaccine, companies have little incentive to spend on new ones. Governments are funding efforts to fix that same market failure for other potential plagues such as Ebola. But no one is doing it for flu, even though as populations age ordinary winter flu can only become a bigger killer – even if you don’t count pandemics. >

HOW ELSE CAN I PROTECT MYSELF AND OTHERS? Vaccination is the best way to reduce your likelihood of getting flu, or getting it badly – but there are a few other do’s and don’ts to limit the risk to yourself and those around you

 Wash your hands.

Hands pick up virus when you touch contaminated surfaces, then infect you when you touch your mouth or nose, something we all do constantly (try not to for a minute).

 Use a face mask.

Only an N95-rated hospital-grade mask keeps virus out, and these make it so hard to breathe that hospitals requiring front line staff to get vaccinated or wear one quietly report a jump in vaccination rates.

 Elbow-bump instead of

shaking hands. Or cover coughs and sneezes with a sleeve, not the hand you are about to touch a doorknob or shake with.

 Go to work.

Presenteeism is not a virtue if you are infectious, so work from home for the duration – usually about a week.

 Migrate.

Avoiding winter entirely by moving between northern and southern hemispheres every six months will reduce your exposure – although watch out crossing the tropics, as flu can crop up sporadically there all year round.

 Use most flu “remedies”.

Painkillers and decongestants can make flu’s symptoms more bearable, but they can’t shorten the misery. Eat sensibly, drink fluids (sorry, no alcohol, but yes to chicken soup) and rest.

6 January 2018 | NewScientist | 31

NATIONAL MUSEUM OF HEALTH AND MEDICINE/SPL

The Spanish flu that began in 1918 killed 5 per cent of humanity

IS THIS THE FLU OR JUST A COLD? If you are ill outside the local flu season, it is unlikely to be flu, but colds happen when flu is around and can have similar symptoms. Flu feels worse and is more likely to feature fever, headache, muscle pain, a dry cough and a sore throat, and perhaps eye and joint pain, plus sudden fatigue. Trouble breathing or other severe symptoms require immediate medical attention. Children might have vomiting and diarrhoea with flu, although adults usually don’t – “stomach flu” is probably something else. If children become extremely irritable, have trouble breathing, have a fever with a rash, bluish skin or trouble waking, get help. In babies, the warning signs are fewer wet nappies than usual, no tears when crying and trouble breathing. At any age, if you seem to get better, then get sick again with a worse cough, see a doctor. Flu cannot be treated with antibiotics, but a secondary bacterial lung infection can be. New diagnostic tests can distinguish colds, flu and bacterial lung infections, but are not in general use, which is a major factor in antibiotic misuse. 32 | NewScientist | 6 January 2018

IS A BIG PANDEMIC COMING? The Spanish flu of 1918 remains the worst flu pandemic on record, but there have been several milder ones since (see “New and deadly”, page 30). A pandemic is a global epidemic and, in theory, flu does that every year in the northern and southern winters. But with flu, the term is reserved for when an influenza A virus emerges that isn’t just a slightly mutated version of last winter’s flu, but a complete novelty, with surface proteins most people have no immunity to. Novel viruses are constantly evolving in the birds, pigs and other animals that also carry influenza A, and they can shuffle their genes with human strains, or just adapt to mammals directly. Virologists consider flu pandemics inevitable. The World Bank says a bad one “could cost $3 trillion… and cause misery, economic decline, and societal disruptions on a global scale”. Like winter flu, the impact of pandemic flu depends on both the virus’s abilities and people’s immunity. The swine flu that went pandemic in 2009 was already adapted to causing only relatively mild illness in mammals. It still killed some 300,000 people. For once, older people were better protected: many people over 52 had immunity thanks to a related winter flu that circulated before 1957. In 1918, many people over 71 were also protected, since a related winter virus seems

to have circulated before 1847. But the Spanish flu was a bird flu that learned to transmit between mammals, and was equipped with fast gene-replicating enzymes that were adapted well to birds, but deadly in mammals. Young adults especially died in droves. Our knowledge of the flu strains circulating in the past century means we are pretty sure almost no one will have encountered relatives of the next bird flu to go pandemic. Virologists sounded the alarm in 1997 when H5N1 bird flu jumped to people, but so far it has not acquired the mutations that would let it spread from human to human, a necessary condition for going pandemic. H7N9, which started infecting people in China in 2013, seems to have the required mutations already: a strain isolated recently spread readily, and lethally, among experimental mammals, and was evolving resistance to Tamiflu, an antiviral drug crucial in saving severely ill people in 2009. If a pandemic strikes, what could we do? The world’s single-strain vaccine production capacity has grown from 1.8 to 6.4 billion potential doses since 2006, with World Health Organization backing. But most producers grow vaccines in eggs, which takes months. In 2009, there was no vaccine before the first wave of swine flu was nearly over. Also, manufacturers have only the egg supplies for each hemisphere’s yearly production. There may not be enough eggs when everyone wants pandemic vaccine at once – especially if the emerging flu also kills chickens. “A technological jump is required – either a universal flu vaccine or a rapid production platform”, such as insect cells or plants, says Martin Friede of the WHO. Facilities designed to combat pandemic flu will have to stay fighting fit by making other vaccines when there is no pandemic – not impossible, but commercially unprecedented. Both efforts could use a lot more funding. “The Manhattan project is an overused metaphor, but that is really what we need for flu vaccine,” says Osterholm. Yet the world has flu fatigue. A decade ago, the emergence of H5N1 caused widespread panic. Now public investment has fallen, partly because the relatively mild 2009 pandemic wasn’t the disaster we feared. The real problem, say epidemiologists, is that flu is so familiar. It can be mild – except when it isn’t. Until we recognise flu for the killer it is, we won’t do better at stopping it. Q Debora MacKenzie is a New Scientist correspondent based in Geneva, Switzerland

NASA

Cosmic couture The spacesuit hasn’t changed for 40 years. Time for a wardrobe refresh, says Leah Crane

OUG WHEELOCK never really liked his spacesuit. “It may look cool, but it’s 35 years old, smells like a locker room and there’s some discolouration on the inside,” he says. Yet that dilapidated old thing was all that stood between him and deadly cold nothingness during the NASA astronaut’s six spacewalks. “It’s actually kind of scary when you think about it,” he says. Wheelock is talking about the puffy-looking white suit with the reflective visor that NASA calls the Extravehicular Mobility Unit (EMU).

D

These suits are among the most famous pieces of clothing ever worn, but they are well past their shelf life. When Apollo astronauts visited the moon in the 1960s and 70s, they stayed for a few hours, so it didn’t matter if the suits were a little on the basic side. Now, though, space agencies and commercial companies are planning to revisit the moon with more ambitious objectives, like setting up long-term bases. With Mars in their sights too, they are working to refresh the space wardrobe. That means it’s

out with the iconic white get-up, and in with a new generation of spacesuits that can combat withering cold, intense radiation, piercing dust and muscle deterioration – and do it all for longer than ever. There’s no mistaking the importance of this pursuit for our space exploration ambitions. “A spacesuit is actually an anthropomorphic, miniature spacecraft with the complexity of a larger space vehicle,” says engineer Vinita Marwaha Madill at the European Space Agency (ESA). NASA has already spent at > 6 January 2018 | NewScientist | 33

GEMINI G4C

(previous page) The “Mercury Seven” – NASA’s first astronaut class – wore modified pressure suits.

NASA

(right) In 1965, Ed White became the first American to spacewalk, wearing the G4C suit. He stepped outside the orbiting Gemini spacecraft and used a handheld oxygen-jet gun to propel himself away from the ship and back again several times. On the third time, the gas ran out, so he pulled himself back using the gold tether. Billed as the “bridge to the moon”, NASA’s project Gemini explored some of the techniques astronauts would need in the Apollo missions, like getting out of the spacecraft.

least $200 million on its spacesuit renewal programme, and now the first designs are leaving the dressing room for tests. When NASA first put people in orbit in the 1960s, they sported modified pressure suits from high-altitude jet planes. By 1981, that had evolved into the EMU, which astronauts still wear when they venture outside the International Space Station (ISS). These suits come in sections, and only a few handfuls of each section were ever made. Take the life-support backpacks, the most expensive and complicated part: only 11 of 18 originals are still in working order. If we were to build new EMUs today, NASA estimates they would cost perhaps $250 million apiece, partly because the technology is so outdated that it is hard to reproduce. Meanwhile, the need to do something about our ageing space apparel has become ever more apparent. In 2013, astronaut Luca Parmitano was on a spacewalk when water began leaking into his helmet and floated into his nose and mouth, raising fears he might drown. Fellow astronaut Christopher Cassidy 34 | NewScientist | 6 January 2018

averted catastrophe by quickly helping him back inside the ISS. The EMU isn’t the only garment approaching expiry. Astronauts must cope with a diverse set of environments, during launch, spacewalks and potentially planetary exploration. Inside a launch capsule on their way into space, they need a suit that will

“The ‘space hoodie’ design is far less clunky than the old fish-bowl helmets ” pressurise quickly if the life-support systems fail. It must also fit in the capsule’s cramped seats and plug into its life support systems. The only vehicle shuttling people to the space station at the moment is the Russian Soyuz, so astronauts and cosmonauts alike wear the matching Russian Sokol (or “Falcon”) suit during launch and re-entry. That suit is even older than the EMU, but now new capsules such as NASA’s Orion and

Starliner are in preparation. The Orion capsule is due to make its first trip to the ISS in the early 2020s. Both capsules need bespoke suits to go with them. NASA has contracted Boeing to make the Starliner capsule and suits, and the firm unveiled the prototype garb in January 2017: a bright blue suit made with lighter materials and more flexible joints than previous offerings. It has a soft helmet that is attached to the suit like a hood; astronauts pull it over their heads and zip it down in an emergency. This “space hoodie” design is far less clunky than the traditional fish-bowl helmets. “In the last 60 years, there’s been no suit lighter than this one,” says Kavya Manyapu, a Boeing engineer. That lightness isn’t just for comfort. Every gram of material on a rocket adds to the cost of fuel, so for private space firms such as SpaceX, cutting down on weight could provide a commercial advantage. The company is developing its own suit for its reusable Crew Dragon capsule, which is scheduled to start carrying people to the ISS in August. We know

APOLLO AL7 (centre) As Apollo 17 astronaut Harrison Schmitt gathered moon rock in December 1972, he was wearing the iconic AL7 suit. Composed of multiple layers, with water cooling tubes sewn in, the suit was difficult to bend down in, and so astronauts used poles to pick up samples.

EXTRAVEHICULAR MOBILITY UNIT (left) First worn in 1981, the EMU is still the suit of choice for spacewalks, for example if astronauts need to pop outside the International Space Station. Here astronaut Kathryn Thornton is servicing the Hubble Space Telescope.

little about the suit yet, but snaps posted online by the firm’s founder Elon Musk show a sleek black and white design. A slinky number is fair enough for a transport capsule, but it wouldn’t be sufficiently robust for spacewalks. For US astronauts, the only option there remains the EMU. For Russian cosmonauts, there’s the Orlan suit, which had its first outing in 1977. NASA has been working on replacements for the EMU since at least 2007 – and it’s looking to future-proof its vision. Its new suits aren’t just designed for spacewalks, but for walking and spending significant time on extraterrestrial surfaces. In the first instance that means the lunar surface. Just last month, US President Donald Trump signed a directive instructing NASA to focus its efforts on human space exploration, particularly the moon. The Apollo astronauts took just 18 moonwalks, exploring six small areas. Future explorers would be aiming to go further afield, hunting for reservoirs of water under the moon’s surface and clues about the birth of the solar system hidden in the rock.

They might also build a moon base as a way station and testing ground for missions to worlds further afield. That’s something for which the iconic Apollo moonwalk suits won’t cut the mustard. “The spacesuit technology developed during the mid-20th century was originally designed for short-duration missions to the moon,” says Marwhala Madill. The suits were uncomfortable and tough to manoeuvre in. The Apollo astronauts couldn’t bend down to pick up rocks; they had to use a pole. The EMU evolved from those suits and isn’t a lot better. It has a limited field of view and no neck joint, which means astronauts must turn their entire bodies if they need to look at anything that isn’t in front of them. “Ninety per cent of the battle with an EMU suit is getting into the correct body position to get at whatever it is you’re trying to repair,” says Wheelock. Amy Ross designs NASA’s new spacesuits, and since 2013 that has included prototype “extra-vehicular” suits called the Z-1 and Z-2. These are heaps better than the Apollo and

EMU suits, she says. The Z-2 shoulder joints and lower body have a broader range of motion than previous suits, with a waist that can turn and flex so that astronauts can look around and walk more easily. It is also more modular than previous versions, with different arm and leg lengths so the suit can be personalised. It has already performed well in tests in NASA’s Neutral Buoyancy Laboratory in Houston, Texas. This contains a giant pool used to simulate microgravity where astronauts can work with a full-size mock-up of the ISS. Even so, Ross admits that fundamental advances in materials science are needed before spacesuits can actually be described as comfortable. For her and her fellow spacesuit designers, the stickier problem is moon dust. On Earth, tiny meteors burn up in the atmosphere, but on the airless moon, space debris can hit the surface at 160,000 kilometres per hour, melting and smashing rocks and sticking the shards together in jagged dust particles. This dust is not only nastily abrasive, but has a static electric > 6 January 2018 | NewScientist | 35

BILL STAFFORD AND ROBERT MARKOWITZ/NASA

BOEING

charge, and so sticks everywhere. It was a nightmare for the Apollo astronauts: it stuck to their helmets, gummed up their suit joints, and grated through layers of spacesuit material. When they tracked it into the lunar module they breathed it in and contracted “space hay fever”. A lunar dust buster that would suck the stuff up has long been tossed around as a solution. The idea of one prototype called SPARCLE, developed in 2009, was to spray the dust with electrons to render it negatively charged, then suck it into a positively charged nozzle. SPARCLE looks to have been mothballed because the researchers involved either moved on or retired, but a similar device is still under development. This electrodynamic dust shield casts an electric field over solar panels, electronics and potentially suits, to prevent dust from accumulating on them. NASA is planning to start testing it on the ISS. It would still be prudent to make suits that are tough, though, so Ross and her team are working on an Environmental Protection Garment that will form the Z-2 suit’s outer 36 | NewScientist | 6 January 2018

MAKING MOON DUST There’s no plentiful supply of moon dust on Earth, so spacesuit developers need artificial moon dust. NASA began trying to make it in the early 1990s. Its first batch, known as JSC-1, was made by pulverising and milling volcanic ash into a powder, adding larger pebbles from the ash to get a mix of different sized particles. It may not sound like much, but each tonne cost $1000 to make. Aside from using it to test spacesuits, the agency showed that you could extract oxygen from the dust and

layer. They are trying to figure out which fabrics will be able to withstand the grating moon dust and how to attach those fabrics to the rest of the suit to minimise leaks. Once the fabrics are chosen, Ross’s team do standard stretching tests before the crucial “rock tumbler test”. This is exactly

form it into bricks. But not all moon dust is equal; in the lunar highlands it contains lots of aluminium, and near the poles there is a small amount of water ice. So, more recently another two strains of simulated moon dust known as NU-LHT-1D and CLDS-i have been developed. Just last July, Chinese scientists unveiled a third, which they say can mimic the fine dust kicked into swirling storms by the moon’s electric field at sunrise – an achievement not to be sneezed at.

what it sounds like: swathes of fabric are tossed around with rocks and moon dust to see how badly the fabric degrades. Real moon dust is rather too precious for this purpose – the Apollo astronauts brought back only about 380 kilograms of the stuff – so the first step for Ross is to get her hands

PROTOTYPE EXPLORATION SUIT

BOEING BLUE (far left) This blue suit will be worn by people on board the Starliner capsule being built by Boeing, which should carry astronauts to space in the 2020s. It is the lightest spacesuit ever made, the firm claims, with a flexible helmet that pulls up like a hoodie and zips in place. It is not designed for spacewalks — just as a backup in case life support systems fail.

(left) Alongside the Z-1, which could be used on the International Space Station as soon as 2020, NASA is working on a more speculative prototype. One of the most innovative features is the torso, which is made of fabric supported by metal rods. That means it’s easy to resize, compared with the solid torso of previous suits, which smaller astronauts can find hard to move.

Z SERIES

on some ersatz dust (see “Making moon dust”, above). Some people are suggesting more radical anti-dust measures in next-generation spacesuit design. For the most part, astronauts exit rovers or landers using a mechanism that first shuts them in a chamber, then depressurises and opens its other end to space: an airlock. But that way, the spacesuit has to be traipsed through the airlock. Instead, why not attach the spacesuit directly to the side of the craft and let the astronaut climb in through a hatch in the back? That would stop the dust ever coming inside. This “suitport” idea was patented by NASA in 1989, and a team from the agency’s Langley Research Center proposed installing suitports in future rovers in 1995. Soon afterwards, a team at another NASA lab tried it out on Earth, installing such a suitport in a personnel carrier used to clean up hazardous materials. And in 2012, NASA built a prototype Z-1 suit with matching suitport and tested it in a vacuum chamber. Most people managed

BILL STAFFORD/NASA

(left) NASA is working on new multipurpose spacesuits the Z-1 and Z-2 (pictured). Both are designed to be worn on spacewalks, as well as for exploring the moon and maybe Mars. They are more flexible than previous suits and astronauts can climb into them through a hatch in the back, which means there’s no need to use an airlock to enter and exit spacecraft.

to climb in and out fairly easily, but a couple had difficulty working their feet past the knee joint. Wheelock says the Z-2 suit may be ready for the ISS by 2020, but NASA also has another spacesuit research project up its sleeve. The Prototype Exploration Suit (PXS) is primarily

“For spacewalks, a suit with a more flexible torso would be a boon” billed as a suit for spacewalks, where its more flexible torso would be a boon, but it is also a testbed for more speculative technology – some of which might be useful on Mars. There, everything will be harder. The dust is less spiky than on the moon, but Martian dust grains get more highly electrostatically charged as they rub together in the thin, dry air, to the extent that they might disrupt electronics if brought back into a spacecraft. The dust can also become acidic and corrosive when

combined with oxygen and water vapour, which spacesuits tend to be full of – making something you really do not want to inhale. And on Mars, there is even less chance than there is on the moon of resupply in the event of an accident. That’s why it is good news that at least some parts of the PXS can be 3D printed. At the moment, this functionality is to make suits adaptable to different bodies, but it could also mean that Mars explorers could print their own replacement suit parts. That is far from a done deal, but our attire for at least one part of any future Mars mission does look sorted. The ESA has developed a “skinsuit” made from elastic material that replicates gravity by putting just the right amount of pressure on the body. This should counteract the muscle wastage and bone problems that come from a long journey in microgravity. Best of all, these suits are painstakingly fitted to each astronaut, which means no rubbing up against other people’s sweat stains. Doug Wheelock will be pleased. Q Leah Crane is a reporter and editor for New Scientist 6 January 2018 | NewScientist | 37

A freakish contagion looked set to wipe out Tasmania’s iconic marsupial, but the devil is fighting back, finds Erica Tennenhouse

38 | NewScientist | 6 January 2018

WO decades ago, at the north-eastern tip of Tasmania, a single cell near the whiskers of a Tasmanian devil mutated and turned cancerous. That animal was bitten in the face by another devil, which was then bitten by another, and the cancer has been spreading ever since. It has taken a oncecommon species to the brink of extinction. To date, the contagious cancer known as devil facial tumour disease (DFTD) has annihilated 85 per cent of the population. There may be fewer than 20,000 Tasmanian devils left in the wild. Worse still, the species has been hit by another deadly disease. Yet these animals are living up to their feisty reputation. With a combination of remarkably rapid evolution and some groundbreaking work by conservationists, they seem determined to survive. Tasmanian devils once roamed widely across Australia. But when dingoes were introduced to the mainland at least 4000 years ago, those living there were probably hunted to oblivion, along with their relatives, Tasmanian tigers. Consequently, Tasmania is now the sole residence of the world’s largest living meat-eating marsupial. The devils have attained a sort of celebrity status there, with their likeness gracing coins, sports jerseys and even beer labels. An adult devil is about the size of an obese domestic cat, but like other marsupials, they are tiny at birth – about the size of a grain of rice. As they grow, so do their appetites. A full-sized devil can consume 15 per cent of its body weight in a single day. Luckily, they are unfussy eaters. They scavenge and hunt, happily devouring any creature including maggots, tadpoles, frogs, wombats, wallabies and possums. Their unusually large heads provide extra space, not for bigger brains, but for the massive jaw muscles that enable them to crack and crush bones. When they feast on a carcass, nothing goes to waste. Devils are a combative bunch, frequently biting each other’s faces and jaw-wrestling to secure a mate or defend a meal. It is during these fights that cancer cells get dislodged from one animal and infect another. Then, as the cancer proliferates, bulging black and red lumps begin to bloom on their cheeks and jaws, over their eyes and in their mouths. These growths can hinder feeding so severely that afflicted animals starve to death. Transmissible cancers are exceedingly rare. Cells normally have proteins on their surfaces known as the major histocompatibility complex (MHC), which are like labels saying “I belong here”. These allow the immune

BEN185/GETTY

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system’s T-cells to identify and attack foreign cells, including cancerous ones. But DFTD is believed to have originated in the nervous system, where cells often hide their MHC labels to prevent immune attacks that might damage the brain. “Because the cancer started off in these cells, it already had those immune escape mechanisms in place,” says immunologist Gregory Woods at the University of Tasmania. “Then it just amplified those mechanisms by turning off MHC completely.” Intriguingly, however, the devils seem to be evolving defences against DFTD. Recently, a comparison of tissue samples from devils that died before the cancer emerged and others living after the disease had taken hold revealed that two distinct stretches of DNA have mutated faster than the rest of their genome. Most genes in these regions have

“It is as though the devils have been struck by lightning twice” cancer-fighting or immune-boosting functions. “That is what you would see if there was selection for resistance,” says Hamish McCallum, a wildlife disease ecologist at Griffith University in Queensland. The devils may be gaining resistance, but David Pemberton, who manages the government-run Save the Tasmanian Devil Program, isn’t prepared to simply hope for the best. As the number of devils drops, so does their genetic diversity, he says, meaning fewer opportunities for natural selection to find ways to resist the cancer. Low numbers also increase the risk from other threats that could lead to extinction, including inbreeding and road deaths. So Pemberton is on a mission to bring the devils’ numbers up, and fast. To that end, he and his colleagues have started dipping into an insurance population – about 700 disease-free devils held in captivity across Australia – and transferring some of them to Tasmania’s wilderness. But the programme is controversial. McCallum worries that these captive-born devils could slow down or even reverse the evolution of resistance. “It’s a bit like if you had a herd of pedigree dairy cows,” he says. “You wouldn’t just throw in a random bull from somewhere.” At the very least, he thinks susceptible devils should be released into disease-prone regions only once an effective vaccine against DFTD has been developed.

Woods is working on this. When his team discovered that a handful of devils can survive DFTD, he became convinced that the others simply needed an immune boost. For the past few years, he has been testing immunotherapies by inoculating captive devils before their release. As of August 2017, three of the 85 vaccinated and released animals had developed tumours. It is a small percentage, but suggests that the formulation needs tweaking. Woods was recently tinkering with the vaccine when he discovered something quite remarkable. He grew tumour cells in a liquid spiked with cytokines, which are molecules that turn on a cell’s MHC labels. Then he injected the cells into afflicted devils. Over time, their tumours began to shrink and, in some cases, disappeared completely. “It’s a bit odd, treating cancer with cancer,” says Woods. Still, he can’t argue with the striking results. You might think that means things are looking up for the devils. However, a second contagious cancer has struck. This slowly spreading strain has caused curiosity and concern since its discovery in 2015. Given that only two other contagious cancers have ever been seen – one in dogs, the other in shellfish – it is as though the devils have been struck by lightning twice. The second strain may indicate that they are highly susceptible to these diseases. Then again, if they have a history of encountering and overcoming contagious cancer, that’s an encouraging sign. How quickly this second cancer will burn through the population is still unknown. “We just don’t know what it is going to do,” says Woods. “We don’t understand much about it at all.” However, according to the latest estimates, the original strain is finally beginning to wane. What’s more, many of the devil populations predicted to be extinct by now haven’t succumbed. McCallum expects that one or both cancer strains will persist at some level for the foreseeable future, suppressing devil numbers. That means Tasmania’s ecosystems will continue to suffer. Devils are the top predator and with so few of them around, feral cats have flourished, devouring the island’s small native animals such as bilbies and bandicoots. Still, all the signs suggest that Tasmanian devils will ultimately survive. In fact, McCallum believes they are already out of the woods: “It’s fairly clear now that what we thought was a real possibility of extinction is no longer likely to happen.” ■ Erica Tennenhouse is a writer based in Toronto 6 January 2018 | NewScientist | 39

JOAN BARDELETTI/PEEK/ROLEX

Eye phone to the rescue Driven by a keen sense of injustice, Andrew Bastawrous is leading a technological shake-up to give millions of people back their sight, as Douglas Heaven discovers AKE a wild guess at how many people in the world are seriously visually impaired or blind. Wrong, higher. A quarter of a billion. And that’s not even the shocking part. More than half could see clearly with a treatment so simple and cheap that in the West we don’t even think about it – glasses. The technical problems of fixing failing vision are largely solved, yet to our collective shame it remains one of the most debilitating health problems in the developing world. But not if Andrew Bastawrous can help it. “If you ask people if they’d rather give up their shoes, their wallet or their glasses, most would give up their shoes or wallet first,” the eye surgeonturned-CEO tells me. “You lose your vision,

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40 | NewScientist | 6 January 2018

you risk your independence and your dignity.” So he is pioneering a radical technological approach to fixing the world’s eyesight. Bastawrous was 12 when he found out he could barely see. He was socially awkward, failing at school and terrible at ball games. “The football used to hit me in the face before I could head it,” he says. As kids do, he assumed it was the same for everyone, and coped. Instead of copying what his teacher was writing on the board, he would look at what the child next to him was writing. He was good at running though. “I used to run in second place behind someone and try to overtake at the very end,” he says. When his mother finally insisted he got his

eyes tested, the optician was shocked that Bastawrous had got by for so long without glasses. “I could only see 30 centimetres in front of me,” he says. Glasses turned his life around, yet even as a child he was acutely aware of how lucky he was: Bastawrous grew up in the UK, but his family would visit poor parts of Egypt, where his parents were from. “Nobody there wore glasses, no other kids, but I knew some of them needed them,” he says. “It felt incredibly unfair. At 16, I decided I wasn’t going to feel guilty about it any more.” He resolved there and then to become an eye surgeon. Despite still being driven by a burning sense of injustice, his vibe when we meet is more

doctor than man on a mission. That makes sense, given he spent a few years as an ophthalmologist working for the UK’s National Health Service. He is calm, kind and excellent at getting his message across. Globally, about 220 million people have vision that is moderately to severely impaired, and 36 million are blind. The good news is that more than three-quarters of all visual impairment is avoidable, typically by treating conditions such as nearsightedness or operating on cataracts. This “good news”, and the people it applies to, is what keeps Bastawrous awake at night. With 90 per cent of the global problem in poorer nations, the issue comes down to resources and logistics – a fact Bastawrous ran into in rural Kenya in 2012 when investigating the prevalence of blindness in 100 local populations. He and his wife packed up their house, sold their car and moved with their 1-year-old son to a small town 5 hours’ drive from Nairobi. They had limited electricity and running water. “It was scary,” he says. “It was an adventure, in hindsight, but probably the most difficult thing we’ve done.” For 18 months, every time Bastawrous and his 15-strong team set up their “mobile” eye clinic in yet another new location, they had to lug bulky, fragile hospital equipment cross-country. “It was like taking your TV and the entire contents of your kitchen and setting it up over and over again,” he says. “Many villages had no roads. Even when there was a road, our vehicles often got stuck and we’d have to walk for hours carrying heavy kit.” Hillary Rono, an ophthalmologist who collaborates with Bastawrous and who runs an eye unit in Kitale, Kenya, serving 1.5 million people, sums up another problem. There’s a big shortage of personnel, he says, and training costly eye specialists takes four years.“We don’t even have enough doctors in this country and now you also want ophthalmologists? That’s probably a pipe dream.” All this convinced Bastawrous that something radical was needed. So he started exploring ways to replace his clinic with a single, portable device: a smartphone. He co-developed an app-based visual acuity test that gathers as much information as the classic backlit letter-chart test, using similar principles. He field-tested the app, called Peek Acuity, in Kenya. The crucial difference is that virtually anyone can administer the test after just a few minutes of training. Bastawrous also co-founded a charitable company called Peek Vision, based in London, to develop and apply the technology more widely.

JOAN BARDELETTI

PEOPLE

PROFILE Andrew Bastawrous is co-founder and CEO of Peek Vision, based in London, and an assistant professor in international eye health at the London School of Hygiene and Tropical Medicine

In Kenya, for example, 25 teachers, each armed with a smartphone, were able to screen 21,000 children in nine days. Now 12 of them are setting off to screen 300,000 children across the region. Bastawrous’s team has also developed a clip-on lens that turns a smartphone camera into an ophthalmoscope that captures

“We don’t even have enough doctors, and now you also want ophthalmologists?” hospital-grade images of the back of the eye (see main photo). It can reveal conditions such as glaucoma, cataracts and age-related macular degeneration, though it has yet to be widely deployed. These technologies transform mobile eye clinics from a large team, a truckload of fragile equipment and an expensive eye specialist into a smartphone in the hands of a local healthcare worker or teacher. But technology alone won’t help.“We don’t invite people to the restaurant unless we know there’s food,” says Bastawrous. A doctor still needs to diagnose the problem, treatment must be available – from glasses to cataract surgery – and the outcome assessed. Peek Vision makes sure that the whole pipeline is

set up before even offering anyone an eye test. “Some ask why we’re replacing pieces of card with an expensive smartphone just for a vision test,” says Bastawrous. “But it’s not just about the test.” In the case of schoolkids, when the app identifies someone with a vision problem, it can automatically send messages to their teacher or family members, set up a referral at the nearest clinic and so on. This integrated approach works. In one screening project for 49 schools in Botswana, 96 per cent of the children found to have a vision problem turned up for treatment. Traditional screening programmes often get as little as 15 per cent, says Bastawrous. “It’s a complete privilege to give someone back their sight,” he says. And it usually changes the life of more than one person. He tells me about Mama Philip in rural Kenya, who had been blinded by cataracts for 25 years. Her son lived in the hut next door and she would shout to him when she needed help, which was often. “It took a lot of persuading to convince her that her vision could even be restored,” says Bastawrous. On the way home after surgery, Mama Philip started recognising things she knew, but was confused by the man she found standing outside her hut. She hadn’t seen her son since he was a boy. “Why have you got so old?” she said. Persuading individuals to fix their eyes is satisfying, but the goal is to get governments on board. “The economic argument is a strong one,” says Bastawrous. Fixing vision brings cascading benefits: more children go to school and do better once they are there, and more adults can work rather than rely on family or state aid. Peek Vision is already working in Kenya and India, and will be expanding into Rwanda, Zimbabwe, Pakistan and Indonesia this year, but Botswana is the first government to agree to fund Peek’s projects within its borders. Based on an economic analysis of World Bank data, Bastawrous estimates that by investing $8.5 million to screen and treat every child in the country, Botswana could avert $1.3 billion of lost productivity. That’s a pretty good start, but Bastawrous has his sights set sky high. In April, 52 nations will convene at the Commonwealth Heads of Government Meeting in London, and he is lobbying hard. “If vision is on the agenda, it could change the lives of millions, or even billions, of people,” he says. Will that ease his burning sense of injustice? “I feel we’re at a tipping point now where this enormous problem will become a historical thing. That’s when I’ll sleep easy.” Q 6 January 2018 | NewScientist | 41

CULTURE

The ideas driving 2018 There are many ways to choose the books that will shape a year: by the “big” names on whose reputations much still stands, by emerging trends, by beguiling titles or just by gut feeling. This year, Liz Else and Simon Ings based their choices on themes, ranging from human evolution to genetics

How we think

Humans evolving

To get your bearings and a feel Heyes, our impressive cognitive for neuroscience, try two books equipment is shaped by cultural by Yale University Press. First rather than genetic evolution. is Think Tank by David Linden At birth, she argues, babies are at Johns Hopkins University only subtly different from in Maryland. He asked newborn chimps. But expose 40 researchers, including Miguel babies to the deep culture of Nicolelis at the Walk Again Project human environment and and Cynthia Moss at the Amboseli amazing effects occur. Trust for Elephants, which idea Ironically, and like no other about brain function they would creature (probably), these effects most like to explain to the world. let us think about thinking. How The ideas and scope range from “Surface is everything: we love and sex to personality and are characters of our own perception – and how individual creation, creating and experiences radically change the improvising our behaviour” make-up of the brain. What all this means is explored in Minds Make Societies by else would we have come up with Pascal Boyer, which is fuelled by the novel theories about causality his professorships in collective and the brain in The Book of and individual memory, and in Why by Judea Pearl and anthropology and psychology. Dana Mackenzie (Basic Books), In it, he argues there is no good which may have implications for reason why human societies artificial intelligence? Or worked “should not be described and out why we defend what we explained with the same believe even when it is wrong, precision and success as the as James Alcock explains in rest of nature”. The basis is Belief (Prometheus Books)? cultural transmission, drawing Perhaps the ultimate takedown on human communication, of such overreaching tendencies the nature of memory in our is The Mind Is Flat by Nick Chater brains and the motivation (Allen Lane). This is a total assault underpinning group formation on all lingering psychiatric and and cooperation. psychoanalytic notions of mental The role of culture in shaping depths to be plumbed. For Chater, human minds and societies is also surface is everything: we are all at the heart of Cognitive Gadgets characters of our own creation, by Cecilia Heyes (Harvard busily creating and improvising University Press). The title only our behaviour based on sounds like those 1990s books experience. Light the touchpaper about hard-wired instincts: for and stand well back...

Think human evolution, think toothache. Our crooked, crowded teeth are a dismal evolutionary consequence of our need for cooked food. Craniofacial specialist Sandra Kahn and biologist Paul Ehrlich get to the root of the matter in Jaws: The story of a hidden epidemic (Stanford University Press). Meanwhile, Sang-hee Lee’s Close Encounters with Humankind (W. W. Norton) offers additional vistas on our unique plight, including how comparisons of skull and pelvic fossils chart our development as a social species. In The Great Apes: A short history (Yale University Press), Chris Herzfeld, an artist and historian specialising in primatology, offers illustrated insights about our perceptions of apes, as well as of the boundary between “human” and “ape”. What boundary, you might well ask. We have recently discovered that our evolutionary cousins, the chimpanzees, plot coups, wage territorial wars, pass on traditions and scheme for resources. In The New Chimpanzee (Harvard University Press), Craig Stanford lets apes guide our idea of what it means to be human.

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Universal truths Cosmology is an overlong chicken-and-egg joke. For our theories to work, the laws of

nature have to be constant, and this means the universe cannot have generated them. Three new books wriggle around this puzzle. In Conjuring the Universe (Oxford University Press), Peter Atkins considers the minimum effort needed to equip the universe with laws, and explains how they can spring from very little – or even nothing. Roy Gould goes further: Universe in Creation (Harvard University Press) revives the anthropic principle to explain why the universe seems to be becoming more ordered, rather

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and DNA research is the history of the Celts. It will be interesting to see what this does for Barry Cunliffe’s seminal The Ancient Celts, which has a reworked new edition (Oxford University Press). A decent origins story also needs input from other disciplines. Jack Hartnell’s Medieval Bodies (Profile Books) is a novel take on the way medieval people explored and experienced their physical beings. Art, cultural and social history come together with painful accounts of medieval medicine. And then there is Mary Beard’s How Do We Look (Profile Books), which asks why most cultures have invested heavily in images of the body – and why a 2500-yearold style of representation still determines how we look at the human form today.

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By selection

than the other way around. The fact we are here to observe our universe is significant in another way, too, as Californian physicist A. Zee reveals. Though On Gravity (Princeton University Press) begins its tour of Einstein’s general theory of relativity with the discovery of gravitational waves, and lands the reader deep in the mysteries of dark matter and energy, Zee never forgets that, in the end, humans perceive the universe with the only instruments they can ever truly rely on (rightly or wrongly): their senses.

Origins of everything David Reich puts a determined stamp on present and past in his book Who We Are and How We Got Here (Oxford University Press). Whole genome mapping hasn’t just revolutionised our world, it has helped us rethink our past, revealing waves of migrations, with or without Neanderthal or Denisovan genetic components. Naturally, all of this creates societal sensitivities, as with racial identity or deep divides between peoples. Among the many mysteries that could be solved by genetics

For a century or so, people have wrestled over whether genes alone transmitted biological information across generations and provide the raw material for natural selection. Books like Extended Heredity by Russell Bonduriansky and Troy Day (Princeton University Press) show how far the mainstream has shifted to include epigenetic forces alongside genes as drivers of who and what we are. Other parts of the genetics story are fascinating but scary. Genetics in the Madhouse by Theodore M. Porter (Princeton University Press) uses data collection in psychiatric hospitals to show the stakes when research straddles subjectivity and science. Firmly back in the objective camp is First in Fly by Stephanie Elizabeth Mohr (Harvard University Press). This run through of research using the fly Drosophila shows why the tiny insect has been of such value to gene research. A very short life, prolific reproduction and easy-tospot mutant phenotypes are the secrets of its success. ■

It’s shaping up for an eventful year ARE we headed towards a bright tomorrow or hurtling towards eternal perdition? The festivals and exhibitions so far announced for 2018 cannot make up their minds. Will the future be kind? This is the question looming over Beveridge 2.0, a festival at the London School of Economics that will consider what is in store for William Beveridge’s 75-year-old vision of the welfare state (19 to 24 February). There is fascinating scientific insight to be had from talks examining the evolution and likely future of work, ageing and altruism. Those of a more visionary bent should head to Trondheim in Norway between 8 March and 6 May. Here the art and technology festival meta.morf will consider the “beautiful accident” that is the human species, “seated in economy class, sipping on Piña Coladas, listening to the Beach Boys while blissfully sailing into the ultimate sunset”. Opening on 21 April is the Fashioned from Nature exhibition at London’s Victoria and Albert Museum. This promises 300 beautiful, intriguing and unsettling objects that highlight fashion’s dependence on the natural world. Happily, there is more to the future than resource depletion, and three weeks later, on 12 May, the V&A launches The Future Starts Here, which will explore the power of design in shaping the world of tomorrow. Finally, two future-facing stalwarts return to London in 2018. FutureFest, a two-day celebration of impending possibilities, returns to Tobacco Dock on 6 and 7 July, while the London Design Biennale (4 to 23 September) explores how design affects every aspect of our emotional lives. Will the future be kind? This may be the year we find out.

6 January 2018 | NewScientist | 43

CULTURE

You’ve just crossed over… A 1950s TV show takes to the stage – and it really works, finds Stewart Pringle

THE last time London saw a play by award-winning US writer Anne Washburn it was Mr Burns – a journey into a post-apocalyptic future, where the remnants of human civilisation clung to halfremembered fragments of The Simpsons. Fitting, then, that she should return to skewer the strange times we live in through the hallucinatory lens of The Twilight Zone. Rod Serling’s genre-defying anthology series was first broadcast in 1959, in an America haunted by the cold war, a world of reds beneath the bed where the threat of strange objects in the night sky wasn’t confined to alien visitors. Here, Washburn selects eight out of the 150-plus episodes in the original series, and weaves them into a narrative that is part larky pastiche, and part dire warning about the slippage of cultural memory, the rise of fake news and global paranoia. Rather than selecting a grab bag of greatest hits, the episodes Washburn has chosen are bound by unsettling trends that ran, almost unnoticeably, through the series. People go missing, are mistaken for enemies, turn on one another and forget their own identity. There are no gremlins on the wings of aeroplanes (as in the famous “Nightmare at 20,000 feet” episode), no cookbook on how “To serve man”, stories which have been lampooned so often, including in The Simpsons, that to On stage, each story is as crisp as when it was first broadcast 44 | NewScientist | 6 January 2018

retread them would be pointless. episode, or the visitor who haunts In their place come tales like her recent Antlia Pneumatica, “Nightmare as a child”, the story but here it is like the ghost of an of an impossible little girl with a entire era, returned to warn a new disturbing premonition, “And A-bomb-happy age of the deadly when the sky was opened”, where perils of nuclear escalation. three hero astronauts who survive Where the message may be a deadly crash simply wink out of bleak, however, the tone is often existence one by one. Best of all is buoyant, gently mocking the “The shelter”, which Washburn has conventions of the original series. expanded from its simple premise There are some brilliant segments into a culture war of simmering “The narrative is a dire racial and class tension. warning on the slippage of Collaged together, the stories cultural memory and rise reflect on one another, as motifs of fake news and paranoia” and images return in new and peculiar shapes. It should be a tumult, a nonsense, but that rib-poke Serling’s starched somehow the power of Serling’s on-camera narration, and a storytelling is never diminished: recurring visual gag with each story is as crisp as when it cigarettes magically produced was first broadcast. through sleight of hand. This It is also a surprisingly effective is a neat reminder of both the match for Washburn’s own ubiquity of fags on the show itself, dramatic universe. She returns and the fact that nothing is quite to ghosts again and again in her what it seems, and memory and work, whether it is the phantom reality are constantly vulnerable of a long-lost “Sideshow Bob” to fracture.

Performances are also modelled on the slight allAmerican stiffness of the 50s series, which gives the entire production a distinctly unreal and dream-like quality. Much less effective are some of director Richard Jones’s other creative choices, with a set by Paul Steinberg that feels fake in all the wrong ways, and bizarrely flat lighting by Mimi Jordan Sherin. Fortunately, the sound by Christopher Shutt is an absolute standout, as weird voices echo and emerge from every corner of the auditorium. Minor flaws aside, this is a remarkable production. A journey into the imagination that’s at once a celebration of humanity’s imaginative powers, and a portent of doom for a world increasingly incapable of separating fact from fiction. Q Stewart Pringle is a playwright, critic and theatre producer

MARC BRENNER

The Twilight Zone by Anne Washburn, Almeida Theatre, London, to 27 January

LETTERS

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EDITOR’S PICK

Dial M for morality in a driverless car

From Ed Hillsman, Albuquerque, New Mexico, US

While reading Abigail Beall’s analysis of the ethics of self-driving cars, it occurred to me that one way to help would be to set the default mode to “full altruist”, which would involve sacrificing the occupants to prevent a collision (21 October 2017, p 11).

To change this default, the driver would need to accept limitations on the performance of the vehicle, with these chosen to reduce the likelihood that it would be involved in a crash. So it might be directed to travel more slowly, or enter intersections more cautiously, for example, or take other measures to avoid situations in which a crash might be more likely or more consequential for others. Going progressively further toward the “full egoist” end of the scale would require greater limitations on the vehicle. This would introduce some measure of responsibility for avoiding the need to sacrifice someone else. I don’t think it would greatly increase the complexity of the underlying code, but it might increase the complexity of the decision-making when choosing the setting.

Fresh thinking needed on dark matter mystery From Eddy Richards, Allanton, Scottish Borders, UK Gilead Amit describes various explanations to account for the expansion of the universe, and concludes with the quote that “none of it feels right” (9 December 2017, p 28). I would go further: these explanations remind me of nothing so much as phlogiston or the luminiferous ether – other arbitrary inventions with no physical basis conjured up to explain observations that contradicted existing assumptions. I wonder if there might be alternative explanations that re-examine the assumptions being made. What if one or more fundamental constants, such as the speed of light or the

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gravitational constant, varied across time or space, for example? While these might be unpleasant alternatives, at least we wouldn’t have to invoke energy and matter that we can’t detect to make our models work. From David Myers, Commugny, Vaud, Switzerland While any attempt to shed some light on the origins of dark matter and dark energy is to be welcomed, I would point out that the article by Gilead Amit failed to mention the recent paper by André Maeder of Geneva Observatory, Switzerland, which suggests that both of these may be due to the scale invariance of empty space (The Astrophysical Journal, doi.org/cg6c). This proposal avoids both the requirement for a zoo of missing particles as well as an implausible value of the Einstein

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“Told you they were useful for something” Michael Rozdoba on the news that sperm have been weaponised in the fight against cervical cancer (23/30 December 2017, p 17)

cosmological constant 120 orders of magnitude larger than the observed one.

The pervasive problems of groupthink From Elizabeth Belben, Radstock, Somerset, UK In your article on counterfactual beliefs, you don’t discuss the evidence that there is no God, but simply point out that many people have committed atrocities in the name of religion (16 December 2017, p 28). This doesn’t disprove God’s existence, any more than atrocities committed in the name of socialism disprove left-wing economics. As violent and intolerant acts can be committed by people with left-wing or rightwing views, and by those who either do or do not believe in God, they are more likely to be the

result of other mental traits discussed in your article, such as tribalism and stereotyping. Without the assumption that my tribe is different to the ones other people belong to, believing that God loves me would make me more likely to think that God probably loves everyone else and wants me to love them as well. As Stephen Jay Gould concluded, the fact that some scientists believe in God, some don’t and some believe we cannot know suggests that science and religion may be non-overlapping magisteria.

exclusively as low-status non-competitors who trigger feelings of pity. However, those of us with mobility disabilities will be aware that the sight of someone with a disability using reserved disabled seating, a “blue badge” for parking in special bays or a Motability rental car all too often provokes envy, or worse, rather than pity. Perhaps the research needs to consider national or cultural differences, or indeed history. I fear at this time of year, the ghost of Tiny Tim haunts the pages of New Scientist.

From David Fulford-Brown, Cardiff, UK Your feature on stereotypes seems to have fallen victim to the same phenomenon. I notice that in the diagram on the four categories stereotyping can take, those with disabilities are classed

Environmental fighters are on the ropes From Marc Smith-Evans, Bagabag, Philippines Your recent leader suggests that we should be optimistic about the future of the biosphere

(9 December 2017, p 5). I don’t share this optimism. When I graduated in the late 1960s, nobody was an “environmentalist” – the concept didn’t then exist. However, my career has led me down a path that identified me as an environmental scientist. In this role, I have worked in many countries, for client, consultant and contractor, to champion the environmental cause. Sadly, the overall impact that I have had has been pitiful, a sentiment shared by my peers. We haven’t been effective, despite a strong desire to protect our planet. Simply put, the power brokers, developers, politicians and investors have done little more than pay lip service to the environmental cause. The adage that every victory is temporary and every defeat is permanent summarises the >

6 January 2018 | NewScientist | 53

LETTERS view of those who care about our planet. In more than 40 years, I have seen many defeats and very few victories. The health of the biosphere isn’t going to get better, only the rate of deterioration can be ameliorated by those who care, and there are precious few of us with any power to affect change. Where are the leaders who advocate a better environment for our children?

No sex please, we’re viruses From Eric Kvaalen, Les Essarts-le-Roi, France Unfortunately, the idea of an “extinction drive” won’t work for poliovirus, as suggested by Bruce Denness (Letters, 16 December 2017). The method is based on sexual reproduction, and a virus doesn’t reproduce sexually.

On the hunt for Japan’s master setters From Steve Abrahams, London, UK I just finished reading Douglas Heaven’s review of Puzzle Ninja, TOM GAULD

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Alex Bellos’s book on Japan’s brain-teaser industry and the enigmatologists who power it (2 December 2017, p 46). Though I have been spared an addiction to the country’s most successful export, sudoku, I recently downloaded an app called Logic Games and find myself playing it at odd times of the day. As its tag states, it truly is a time killer. I checked the credits and sure enough, most of the puzzles are credited to the magazine Nikoli and Miyamoto, one of the puzzle masters mentioned by Heaven in his review.

Can big tech shield us from cyberweapons? From Elizabeth Bell, Hungerford, Berkshire, UK Your analysis about the situation we all may be facing from cyberweapons gave me much food for thought, particularly concerning the limited efficacy of various governmental and international agencies in dealing with it (9 December 2017, p 22). The role of international

governmental organisations such as NATO and the United Nations will always be key to controlling cyberweapons. However, as these directly threaten the internet and various computer systems, is this perhaps something that might best be solved by major companies such as Microsoft and Google? I can envisage these companies setting up a joint agency that would hire the very best experts to research weaknesses and threats, and find solutions to those issues that ultimately threaten their customers and therefore their businesses. This agency would avoid sometimes inappropriate and conflicting government agendas. Government organisations that create and distribute cyberweapons, even accidentally, would have much to fear from such a privately funded agency, which could provide strong independent evidence and advice to NATO, the UN and others. I don’t generally see corporate agendas as possible routes to salvation, but in this case, they might be.

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Signalling other planets is a dangerous gamble From Ben Haller, Ithaca, New York, US Douglas Vakoch glibly dismisses fears that sending signals to other worlds might pose a risk to Earth (2 December 2017, p 24). Quite a few illustrious thinkers disagree with him, including Stephen Hawking, Elon Musk and Geoff Marcy. They believe that deliberate transmissions of this sort are too dangerous and so we shouldn’t send them. It is the height of irresponsible arrogance for Vakoch to override such concerns and broadcast nevertheless, as he has just done. He is gambling the entire future of humanity upon his personal assessment of the risk posed. Such unilateral action is completely unacceptable and ought to be illegal.

Prices that turn quicker than an avocado From John Widdowson, Melbourne, Australia I was saddened to read that David E. H. Jones, better known on these pages as Daedalus, had passed away (Old Scientist, 2 September 2017). In the past, Daedalus was always my first port of call when reading New Scientist. One story stuck with me. He described a supermarket where the price of articles changed as they were sold. If something was selling quickly the price went up, and went down if it wasn’t moving. I seem to remember reading this when computerised supermarkets weren’t common. A good bit of prediction. Letters should be sent to: Letters to the Editor, New Scientist, 25 Bedford Street, London, WC2E 9ES Email: [email protected] Include your full postal address and telephone number, and a reference (issue, page number, title) to articles. We reserve the right to edit letters. New Scientist Ltd reserves the right to use any submissions sent to the letters column of New Scientist magazine, in any other format.

54 | NewScientist | 6 January 2018

OLD SCIENTIST What was New Scientist talking about in Januaries past?

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HOW many pieces of scientific research have been embraced by Hollywood film-makers? Probably fewer than should have been, but perhaps more than we might have expected. Older readers may remember The Poseidon Adventure, a 1972 disaster movie in which an ocean liner is capsized by a monster wave. In our 6 January 1977 issue, we warned that such waves, though poorly understood, were certainly more common than had been thought. “Killer waves”, we reported, were more likely at the continental edge where the sea-floor topography suddenly rises more steeply. We surmised that the loss of the SS Waratah off South Africa in 1909 could be explained by such a wave. More movie science, sort of, in our 16 January 1986 issue. James Bond’s Q would no doubt have been delighted to read that the world’s smallest video camera had been released by Toshiba. It was, we announced excitedly, “the size of your thumb” and you would be able to view the images on a “big-screen display”. Most of us now have cameras a fraction of the size in our phones, and carry the viewing screen around within the same piece of hardware. It is practically compulsory for just about every shoot-’em-up movie nowadays, but that red dot the bad guy sees on his jacket just before the cops dispatch him with a hail of bullets was worthy of its own news story in 1995. “Beware the red spot, warn New York’s finest” was the headline in our 14 January edition. For the first time, police patrolling the subway would have laser technology to pick out a felon in the gloom, using sights that made aiming in the dark a safer prospect. Unless, of course, you were a criminal and the red dot suddenly appeared in the middle of your chest. Mick O’Hare Q

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PAUL MCDEVITT

FEEDBACK

TO SPIN a phrase, the best time to buy bitcoin was in 2009, and the second best time is now. The cryptocurrency continues to soar eye-wateringly in value, which makes it useless as a way of buying things, but very attractive as an investment. This has led to all manner of people trying to discern if this stratospheric rise will continue. And who better to ask than an astrologer? Over at Medium.com Ekaterina Vasyanova, a graduate of the “scientific astrology school”, has turned her keen eye to the fortunes of the world’s favourite decentralised currency. The horoscope of bitcoin is “rational, carefully thought out, but shrouded in mystery”, we are told, computed using esoteric connections with the “North node with Neptune” and “the stellium of planets in Aquarius”, among others. Sadly, “a system based on astrology cannot predict the certain price of currency”, says Vasyanova. “But it can accurately forecast its dynamics during certain periods.” Hindsight is of course 20/20, and past movements in

For more feedback, visit newscientist.com/feedback

the price of bitcoin indeed “would have” predicted dramatic growth for 2017. Funny that! The Venn diagrams describing cryptocurrency fans and those who believe in magical thinking might well have some overlap (23/30 December 2017). If so, take note: Vasyanova predicts a downturn in bitcoin fortunes come March.

MEANWHILE, the trade in bitcoin, predicated on intentionally laborious calculations, continues to devour ever more power. Some estimates put the bitcoin network’s energy demand as being comparable to that of the entire nation of Belarus, or about a tenth of the UK’s. If this trend continues, it won’t be long before someone tries to build a Dyson sphere, enveloping the entire sun, to power the trade in cryptocurrencies. Which perhaps explains why we haven’t heard from any Kardashev type 2 civilisations yet – they are all busy mining bitcoin.

A possible side effect of Alex Chanas’s new medicine reads: “your heartbeat becomes very slow and stops beating.” It adds, helpfully, “If this happens, go to hospital straight away” 56 | NewScientist | 6 January 2018

’TIS the season to be extra-sceptical of medical papers, as our colleagues have noted (16 December 2017, p 25). Yet Feedback cannot help but share findings published in Imagination, Cognition, and Personality, which suggest that young children think birthdays are the cause of ageing. Two studies of 99 3 to 5-year-olds found significant confusion about the role of birthday parties in the ageing process. The authors note that “children, like adults, are especially driven to seek explanations for personal, meaningful events” and that the “ubiquitous human tendency to misattribute causation in the presence of simple co-occurrence” results in many preschool-age children believing that birthday celebrations themselves cause ageing. Which, as any parent who has had to manage a dozen unruly toddlers at a cake-strewn party will tell you, is absolutely true.

IT’S also that time of year when festivities mean snow – in the mind of advertisers and publicists, at any rate. Izzy Hanson writes “as most of us are aware, the snowflake is a wonderful example of hexagonal symmetry. Alas, images of eightpointed snowflakes turn up all over the place.” Certain quarters should know better. Izzy reports a programme of events illustrated by the eightpointed variety and titled “Winter Wonders… a feast of festive fun, with a generous topping of excitement” organised by… the Dundee Science Centre. WHAT to do when the turkey leftovers run out? Rob Milne received a dangerous-sounding suggestion from his energy supplier EDF, which prompts him to “optimise your self-consumption with an optional home battery”. We’re not sure how a battery will help, but it’s one way to shed that holiday-season weight.

BEWARE of Greeks bearing gifts, especially if they are the internetconnected kind. Mike Anon reports that he bought a remotely

controlled “intelligent” mains switch for his home. “To make it work, I had to give my Wi-Fi network name and password to the server in China,” he says. “When I downloaded the app to control the switch, it asked for permission to access everything on my phone.” This would enable the server, in theory, to allow the app to snoop on his online activity, as well as his phone use. According to its installation report, he tells us, the app now has access to his device history, browsing activity, bookmarks, contacts, location, SMS messaging, phone, call log, photos and media files, hard drive, camera, microphone and much more besides. “I’ve wrapped it in foil and put it in a dark place,” says Mike, who has gone back to manually operating his power switches.

CONSTRUCTIVE criticism: Barbara Wager is left scratching her head over recent figures on the mountains of toxic e-waste produced by the world’s tech industry. A widely quoted UN-backed report tells her that “around 44.7 million tonnes of e-waste” were generated in 2016, which has been helpfully translated as weighing the equivalent of “4,500 Eiffel Towers” or “almost nine Great Pyramids of Giza”. Might Feedback start a new logbook of mutually incomprehensible units?

You can send stories to Feedback by email at [email protected]. Please include your home address. This week’s and past Feedbacks can be seen on our website.

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THE LAST WORD Human attraction How small would something need to be for the gravitational field of a human to significantly affect it? At what point would something be attracted to someone or able to establish an orbit?

■ There is no limit to how

small an object can be to exert “significant” gravitational attraction. Any two bodies could in principle orbit each other, because the limiting factors are not their size, but how far apart they are and their relative velocities, plus external variables such as radiation and the tidal influences of nearby bodies. For very small bodies at anything but the lowest speeds, it also depends on the shape and density of the orbiting masses, because small bodies couldn’t get close enough together to remain in mutual orbit. Centres of mass determine attraction between bodies only when they are so far apart that shape becomes irrelevant, unless they are spheres with symmetrically distributed mass. So, for example, 1-milligram spheres of osmium could orbit each other more closely and at higher speed than balls of fluff of the same mass. Jon Richfield Somerset West, South Africa

might be the practical minimum. The speed of one body orbiting another larger one can be worked out by multiplying the universal gravitational constant G by the mass of the body being orbited, dividing this by the orbital radius and taking the square root. For a 70-kilogram person, that gives an orbital speed of just under 70 micrometres per second. It would take about 150 minutes to complete an orbit of a little over 6 metres – the circumference of a circle with a radius of 1 metre. The mass of the orbiting body doesn’t come into the calculation, but it must possess mass, no matter how tiny. It couldn’t be a charged particle, or an isolated neutron, because this will quickly decay into a proton and an electron. Neutrinos are neutral but tend to travel at close to the speed of light, so go too fast to stay in orbit. A hydrogen atom, however, is neutral, so would work. The human would need to be far from other bodies, so the forces they exert couldn’t perturb the atom’s orbit. Even in outer space, any orbit would be short-lived, because a passing cosmic ray could kick the atom out of orbit, as could the fact humans aren’t symmetrical, spherical blobs. Mike Follows Sutton Coldfield, West Midlands, UK

there is no theoretical minimum for an object orbiting an isolated human. But a hydrogen atom

■From Newton’s law of gravity, we can calculate the gravitational acceleration of an object that is r metres from a 100-kilogram human towards the body’s

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■ Provided that it has mass,

centre of gravity. For this to be “significant” (say at least 1 per cent of Earth’s gravitational acceleration), then the object would need to be just 0.26 millimetres from your centre of gravity. However, this would place it inside your body! So, on Earth, the gravitational field of your body will never be significant compared with the planet’s. However, if you were in free fall, or in space with no other gravitational field acting, then to put an object into orbit around yourself, you would need to match the required centripetal force with the gravitational force. If you weighed 100 kilograms and the object was 1 metre away, you would need to set it in motion at a tangential velocity of 0.08 millimetres per second and wait 21 hours for it to orbit you. Simon Iveson University of Newcastle New South Wales, Australia

Secret stash In the spring, deciduous trees add huge amounts of foliage very quickly. How do they suddenly produce this? They must be drawing on stored material and energy, but where are these stores?

■In summer and autumn, deciduous trees store energy in the sugar-water mix that is their sap. During winter, sap is stored in the roots of trees. When a tree detects warmer temperatures, it pumps sap up to the branches to

allow rapid regrowth. At night, if the tree gets too cold, it pumps sap back to the roots to avoid the sap freezing. Then, during the day the sap is pumped back up the tree. Through this process enough sap travels up and down to be siphoned off for maple syrup, which is why syrup is produced in places with long periods of cold nights and warm days. Angus Abercrombie Belmont, Massachusetts, US ■In spring and summer, the leaves of deciduous trees photosynthesise, using energy from light to make organic compounds required for growth and reproduction. Some compounds are used during the growing season, but the tree also sets some aside for long-term storage, principally in the form of starch inside structures called amyloplasts in non-photosynthetic cells – for example in the roots. This starch can be broken down by enzymes into sucrose, the main transport sugar of plants, which travels around the tree via phloem transport tissues. Sucrose can be metabolised for energy and used to form other organic compounds. Over winter, this sustains vital physiological processes when photosynthesis isn’t possible. Come spring, sucrose travels to the growing and dividing cells at the leaf buds to fuel new growth. Sam Buckton Churchill College, Cambridge, UK