If you’re afraid of needles, here’s some good news: you may not always be stuck with getting shots.
At present, injections are the best way to deliver certain kinds of drugs. For example, vaccines and drugs like insulin are made of large molecules that you can’t take orally because they would break down in your digestive tract. Some antibiotic and antiviral medications are also given as injections for this reason.
But needles suck. About 10 percent of patients who need regular injections don’t comply with their doctors’ instructions, according to 3M, partly because self-administering injections is difficult and painful. And injectable drugs are a hassle, too: they have to be stored at cold temperatures and have a limited shelf life.
That’s why biotech companies around the world are working on needle-free ways to deliver these drugs, with everything from high-tech pills to simple do-it-yourself patches.
Ever fancied having a superpower? Something you can call upon when you need it, to hand you extra information about the world? OK, it’s not X-ray vision, but your eyes do have abilities that you might not be aware of.
We are all familiar with color and brightness, but there is a third property of light: “polarization,” which tells us the orientation in which light waves are oscillating. Animals, like bees and ants, use the polarization patterns in the sky as a navigation aid. But few people, even in the scientific community, are aware that humans can sense the polarization of light with the naked eye.
In research we’ve just published in Proceedings of the Royal Society B, we used an experiment that was originally designed to test the visual abilities of octopuses and cuttlefish to investigate our human ability to perceive this polarized light.
“Breast is best”. So goes the message from the international and clinical guidance on what milk mothers should feed their babies. But it’s also more worryingly been adopted by a growing online community of adults wanting to buy and consume expressed breast milk for its perceived health benefits – or due to sexual fetishes.
Some online forums suggest cancer patients should drink breast milk because it is supposedly easier to digest, better tolerated, and full of immune benefits, including immunoglobulin (a protein used by the immune system). Meanwhile, fitness and diet forums preach the nutritional, energy or recovery benefits of such milk, suggesting it can work as a supplement to workout or bulking regimes.
A number of websites and online forums cater to those wishing to buy, sell and trade breast milk, alongside the use of more general social media platforms. This online marketplace allows women who are expressing milk to advertise with text and images, communicating details such as cost per ounce and a description of mother, milk and baby. Buyers can also advertise on such forums, detailing their own needs and volume requirements.
Individuals can then contact each other either to meet or arrange transport for the milk, which is often frozen or packed in dry ice, and shipped by express post or courier. Notably, the quality of packaging greatly varies, and studies have shown high levels of damage in transit.
The popularity of these sites varies by country depending on the availability of government-subsidized milk banks. But in the US, where regulated milk banks are costly, and the UK, where adult buyers are not catered for, online selling communities have been growing. New country-specific websites are now being launched, including using .co.uk addresses. Such growth has led commentators to label online breast milk sale a “booming market” around the world.
There is a good chance that your grandparents were born at home. I am going to go ahead and assume they turned out fine, or at least fine enough, since you were eventually born too and are now reading this.
But since the late 1960s, very few babies in the United States or the UK have been born outside of hospitals. As a result, you may find the new guidelines from the UK’s National Institutes for Health and Care Excellence (NICE) just as surprising as I did. For many healthy women, the NICE guidelines authors believe, there may be significant benefits to going back to the way things were.
Shortly after the NICE guidelines were issued, the New England Journal of Medicine invited me to write a response. The idea that any pregnant patient might be safer giving birth outside the hospital seemed heretical, at least to an American obstetrician like me. Knowing that no study or guideline is foolproof, I began my task by looking for holes to form a rebuttal.
I soon realized that this rebuttal largely hinged on flaws in the American system, not the British one. While we take excellent care of sick patients, we do less well for healthy patients with routine pregnancies – largely in the form of turning to medical interventions more than strictly necessary.
As the guidelines suggest, some women in the UK with low-risk pregnancies may be better off staying out of the hospital. Why? Because the significant risks of over-intervention in hospitals, such as unnecessary C-sections, may be far more likely (and therefore more dangerous) for patients than the risks of under-intervention at home or in birth centers. But women in the UK have access to greater range of settings where they can give birth. For women in much of the US, the choice is often the hospital or nothing.
The need to mend broken hearts has never been greater. In the USA alone, around 610,000 people die of heart disease each year. A significant number of those deaths could potentially have been prevented with a heart transplant but, unfortunately, there are simply too few hearts available.
In 1967 the South African surgeon Christiaan Barnard performed the world’s first human heart transplant in Cape Town. It seemed like a starting gun had gone off; soon doctors all around the world were transplanting hearts.
The problem was that every single recipient died within a year of the operation. The patients’ immune systems were rejecting the foreign tissue. To overcome this, patients were given drugs to suppress their immune system. But, in a way, these early immunosuppressants were too effective: they weakened the immune system so much that the patients would eventually die of an infection. It seemed like medicine was back to square one.
Kevin Tracey, a neurosurgeon based in New York, is a man haunted by personal events – a man with a mission. “My mother died from a brain tumor when I was five years old. It was very sudden and unexpected,” he says. “And I learned from that experience that the brain – nerves – are responsible for health.”
This background made him a neurosurgeon who thinks a lot about inflammation. He believes it was this perspective that enabled him to interpret the results of an accidental experiment in a new way.
In the late 1990s, Tracey was experimenting with a rat’s brain. “We’d injected an anti-inflammatory drug into the brain because we were studying the beneficial effect of blocking inflammation during a stroke,” he recalls. “We were surprised to find that when the drug was present in the brain, it also blocked inflammation in the spleen and in other organs in the rest of the body. Yet the amount of drug we’d injected was far too small to have got into the bloodstream and traveled to the rest of the body.”
After months puzzling over this, he finally hit upon the idea that the brain might be using the nervous system – specifically the vagus nerve – to tell the spleen to switch off inflammation everywhere.
It was an extraordinary idea – if Tracey was right, inflammation in body tissues was being directly regulated by the brain. Communication between the immune system’s specialist cells in our organs and bloodstream and the electrical connections of the nervous system had been considered impossible. Now Tracey was apparently discovering that the two systems were intricately linked.
The first critical test of this exciting hypothesis was to cut the vagus nerve. When Tracey and his team did, injecting the anti-inflammatory drug into the brain no longer had an effect on the rest of the body. The second test was to stimulate the nerve without any drug in the system. “Because the vagus nerve, like all nerves, communicates information through electrical signals, it meant that we should be able to replicate the experiment by putting a nerve stimulator on the vagus nerve in the brainstem to block inflammation in the spleen,” he explains. “That’s what we did and that was the breakthrough experiment.”
Let’s wallow in semen a little while longer, shall we? We have already seen that, even in humans, there is more to this substance than meets the eye. It contains proteins that, when mixed together, can forge a mating plug. It also contains sugars as sperm fuel, proteins that protect the sperm cells from the acidic vaginal environment, zinc that keeps the sperm’s DNA in good shape, and chemical compounds that prevent the sperm cells from becoming overenthusiastic prematurely.
But this list of ingredients is just the tip of the iceberg. Human ejaculates are home to hundreds of different proteins (which in certain women cause a kind of “sperm hay fever,” an allergic reaction to semen). And those are not trace amounts either; most of them occur in considerable concentrations, so they must be doing something important—we just don’t know what. Even in the ejaculate of the lowly banana fly Drosophila melanogaster, researchers have identified no fewer than 133 different kinds of proteins. One hundred and thirty-three! And this excludes the many proteins that are in the sperm cells themselves. These 133 are all produced by the banana fly version of the prostate, which releases them into the liquid portion of the semen.
For most of the common cancers, a major cause has been identified: smoking causes 90% of lung cancer worldwide, hepatitis viruses cause most liver cancer, H pylori bacteria causes stomach cancer, human papillomavirus causes almost all cases of cervical cancer, colon cancer is largely explained by physical activity, diet and family history.
But for breast cancer, there is no smoking gun. It is almost unique among the common cancers of the world in that there is not a known major cause; there is no consensus among experts that proof of a major cause has been identified.
Yet, breast cancer is the most common form of cancer in women worldwide. The risk is not equally distributed around the globe, though. Women in North America and Northern Europe have long had five times the risk of women in Africa and Asia, though recently risk has been increasing fast in Africa and Asia for unknown reasons.
Exposure to high levels of ionizing radiation is extremely bad for human health. Witness the effects of acute radiation sickness suffered by early scientists studying radioactive elements, or by survivors of atomic bomb blasts. Witness the complex procedures through which doctors must shield cancer patients from radiation therapy, and the long-term complications of adult survivors of cancer who were treated with earlier technology. In light of all this, it’s clear that high doses of ionizing radiation are dangerous.
But the science is less clear when it comes to low dose radiation (LDR). Medical science, the nuclear industry, and government regulatory agencies generally take a play-it-safe approach when considering LDR. In recent years, however, an increasing number of researchers (though still firmly in the minority) have questioned the assumption that all radiation is bad – and have begun studying whether low doses might in fact aid in genetic repair, prevent tissue damage, and other benefits.
One day in October 2010, at a school in the Gaibandha district of northwest Bangladesh, a pupil noticed that the label on a packet of crackers she was eating had darkened. Fearing the crackers were contaminated – “the devil’s deed”, as she put it – she almost immediately fell ill, complaining of heartburn, headache and severe abdominal pain.
The condition quickly spread among her fellow pupils, and later to other schools in the area. Yet toxicologists could trace no contaminant, and all those affected were quickly discharged from the hospital after doctors found no trace of illness. The following week, investigators diagnosed “mass sociogenic illness,” otherwise known as mass hysteria. The children, it seemed, had developed their symptoms simply because they had seen their classmates succumb.
Mass hysteria is thought to be an extreme example of a phenomenon that affects us all day-to-day: emotional contagion. Short of living in hermitic isolation, it is hard to escape it; we are vulnerable to the moods and behaviors of others to an extraordinary degree.
Emotional contagion caused the failure of successive banks at the start of the Great Depression in the 1930s, when investors suffered a collective loss of faith in the ability of these institutions to pay out. It is the force behind fuel crises, health scares and the spread of public grief (for example in Britain after the death of Princess Diana in August 1997). It is the reason why you are more likely to be obese if you have obese friends, and depressed if you are living with a depressed roommate.
But emotional contagion is not all bad – far from it. The mechanism behind it – our tendency to mimic each other’s expressions and behaviors – is crucial to social interaction. Without it, anything beyond superficial communication would be impossible.