The idea behind Drew Magary’s great new book is simple: aging, as it turns out, is caused by one gene. Shut that gene off and you stop aging; accidents and disease are still a problem, but you’ve cured death by natural causes. Now compound that discovery with the fact that any person who gets the Cure simply stops aging. People don’t become younger, they just don’t get older, frozen at their “Cure age.” What happens next?

In an effort to find out, Magary takes us through the life of John Farrell, a New York lawyer who gets the Cure for aging at the age of 29 in the year 2019. From that point on, things go rather poorly for John and the rest of humanity. As one might expect, curing aging doesn’t cure social ills, over-population, ennui, or a host of other human hangups. Mark Frauenfelder has an excellent synopsis of the book over at boingboing.net, and I share his opinions about the book’s bleak tone and high quality.

Magary’s argument through the text is essentially this: death creates meaning. Not mortality, but guaranteed natural death due to aging. The idea that no matter what you do, how you live your life, the concept that you will be born, mature, grow old, and die creates human meaning. Magary has a point: from the riddle of the Sphinx to Tyler Durden to the final books of Harry Potter, aging and death seem to be at the epicenter of human thought. I don’t deny him that at any moment any one of us could meet a tragic end. Life is precious in part because it is not meant to last.

But here is where I struggle. The Postmortal is not about a post-mortal society, it is about a post-aging society. Lots and lots and lots of people die in Magary’s vision. In fact, he seems to argue that in the absence of death, people will not only seek death but will create circumstances that create death and thereby, create meaning. It is only when Farrell’s life is most in peril that he finds purpose in existence. But Farrell is never immortal, no one is. So my question is: is the process of aging as meaningful as the condition of being mortal?

This question vexed me, because I know a great many people who have aged with grace. They wear wizened white beards or crinkled smiles that highlight eyes behind inch-thick spectacles. Some people are just awesome at being old. They have custom canes and smoke ivory pipes and say saucy things that only they can get away with. To reference Harry Potter again, Voldemort, Mr.Flees-From-Death himself, is contrasted with Albus Dumbledore and Minerva McGonagall, both of whom are walking idealizations of what the aging process should look like.

But that’s just it, isn’t it? They are idealizations.

Reality presents a grimmer picture. Alzheimer’s, Parkinson’s, and a laundry list of other late-onset diseases savage the body just enough that modern medicine can step in to keep the heart beating and the organs limping along while the mind deteriorates to the point of nothingness. Aging in the modern era is about slow unstoppable loss – of hearing, of memory, of mobility, of continence, of dignity. What part of that process creates meaning in our lives? Or is it that to get the benefits of death, we must past through the fires of desperate and futile attempts to prevent it?

Magary’s vision is encapsulated by a character who appears at the end of the book. She is a prostitute who wants to die. She had her age frozen at 18 and, as a result, is seen as a perpetual teen mentally. That is, her additional decades on the planet have done nothing to shape her perspective, beyond making her more cynical. And so it is with everyone else on post-Cure Earth. In Magary’s mind, the stop of physical aging is the stop of maturation.

In this sense, I suspect Magary’s indictment is not of those like Aubrey de Grey who seek the end of aging, but of those who resist maturation. Magary’s values are essentially conservative. It isn’t until the main character is about to die that he realizes what matters: namely, his son (out of wedlock), getting married, and protecting an unborn life. Life in the post-aging world is plagued by those who devalue marriage, childbearing, and religion. Yup, even the secular “Church of Man” is shown to be the “right” answer by the end of the novel. While I don’t deny that these are all valuable pursuits (substituting religion for the broader philosophy of the examined life) I do deny that they would be annihilated by agelessness.

Human beings do not settle down because they age anymore than people have quarter-life or midlife or three-quarter life crises because they age. People are content or discontent based on the life they are currently living. I find it fascinating that Dumbledore and Ms. McGonagall are both single as they approach the sunset of life. Both are examples of doing precisely what Magary critiques, pursuing one’s passions while putting commitment and reproduction on hold. As it so happens, one can live a life of value to humanity, one can, in fact, contribute to the greater good, without maturing and aging as he prescribes. Only if Dumbledore and McGonagall didn’t have to age, one could argue they could have become master magicians and raised a family, had they so chosen. Why aging creates more options in Magary’s mind, I’m not quite sure.

Death, I don’t deny, creates meaning. Finitude and limits give us something against which to define our existence. But my meaning is not created by the knowledge that I will die at the ripe old age of 98 but simply by the knowledge that I will die. Maybe I’ll get lucky and live to be 500 only to be obliterated during an alien invasion. Or maybe I have a tumor right now and will be gone before this time next year. I don’t know. But knowing when we will die, be it young or old, has never been what created meaning. And gray hairs and crows feet have never been the cause of wisdom, merely the first signs of the very high cost of living long enough to acquire it.

Personally, I like the idea of having 100 years of wisdom and experience in the youthful body of a 29 year old. But maybe I’m not old enough to know better yet.

Follow Kyle on his personal blog, Pop Bioethics, and on facebook and twitter.

The future is impossible to predict. But that’s not going to stop people from trying. We can at least pretend to know where it is we want humanity to go. We hope that laws we craft, the technologies we invent, our social habits and our ways of thinking are small forces that, when combined over time, move our species towards a better existence. The question is, How will we know if we are making progress?

As a movement philosophy, transhumanism and its proponents argue for a future of ageless bodies, transcendent experiences, and extraordinary minds. Not everyone supports every aspect of transhumanism, but you’d be amazed at how neatly current political struggles and technological progress point toward a transhuman future. Transhumanism isn’t just about cybernetics and robot bodies. Social and political progress must accompany the technological and biological advances for transhumanism to become a reality.

But how will we able to tell when the pieces finally do fall into place? I’ve been trying to answer that question ever since Tyler Cowen at Marginal Revolution was asked a while back by his readers: What are the exact conditions for counting “transhumanism” as having been attained? In an attempt to answer, I responded with what I saw as the three key indicators:

1. Medical modifications that permanently alter or replace a function of the human body become prolific.
2. Our social understanding of aging loses the “virtue of necessity” aspect and society begins to treat aging as a disease.
3. Rights discourse would shift from who we include among humans (i.e. should homosexual have marriage rights?) to a system flexible enough to easily bring in sentient non-humans.

As I groped through the intellectual dark for these three points, it became clear that the precise technology and how it worked was unimportant. Instead, we need to figure out how technology may change our lives and our ways of living. Unlike the infamous jetpack, which defined the failed futurama of the 20th century, the 21st needs broader progress markers. Here are seven things to look for in the coming centuries that will let us know if transhumanism is here.

When we think of the future, we think of technology. But too often, we think of really pointless technology – flying cars or self-tying sneakers or ray guns. Those things won’t change the way life happens. Not the way the washing machine or the cell phone changed the way life happens. Those are real inventions. It is in that spirit that I considered indicators of transhumanism. What matters is how a technology changes our definition of a “normal” human. Think of it this way: any one of these indicators has been fulfilled when at least a few of the people you interact with on any given day utilize the technology. With that mindset, I propose the following seven changes as indicators that transhumanism has been attained.

1. Prosthetics are Preferred: The arrival of prosthetics and implants for organs and limbs that are as good as or better than the original. A fairly accurate test for the quality of prosthetics would be voluntary amputations. Those who use prosthetics would compete with or surpass non-amputees in physical performances and athletic competitions. Included in this indicator are cochlear, optic implants, bionic limbs and artificial organs that are within species typical functioning and readily available. A key social indicator will be that terminology around being “disabled”and “handicapped” would become anachronous. If you ever find yourself seriously considering having your birth-given hand lopped off and replaced with a cybernetic one, you can tick off this box on your transhuman checklist.

2. Better Brains: There are three ways we could improve our cognition. In order of likelihood of being used in the near future they are: cognitive enhancing drugs, genetic engineering, or neuro-implants/ prosthetic cyberbrains. When the average person wakes up, brews a pot of coffee and pops an over-the-counter stimulant as or more powerful than modafinil, go ahead and count this condition achieved. Genetic engineering and cyberbrains will be improvements in degree and function, but not in purpose. Any one of these becoming commonplace would indicate that we no longer cling to the bias that going beyond the intelligence dished out by the genetic and environmental lottery is “cheating.”

3. Artificial Assistance: Artificial Intelligence (AI) and Augmented Reality (AR) integrated into personal, everyday behaviors. In the same way Google search and Wikipedia changed the way we research and remember, AI and AR could alter the way we think and interact. Daedalus in Deus Ex and Jarvis in Iron Man are great examples of Turing-quality (indistinguishable from human intelligence) AI that interact with the main character as both side kicks and secondary minds. Think of it this way: you walk into a cocktail party. Your cyberbrain’s AI assist analyzes every face in the room and determines those most socially relevant to you. Using AR projected onto your optic implants, the AI highlights each person in your line of sight and, as you approach, provides a dossier of their main interests and personality type. Now apply this level of information access to anything else. Whether it’s grilling a steak or performing a heart transplant, AI assist with AR overlay will radically improve human functioning. When it is expected that most people will have an AI advisor at their side analyzing the situation and providing instructions through their implants, go ahead and count humanity another step closer to being transhuman.

4. Amazing Average Age: The ultimate objective of health care is that people live the longest, healthiest lives possible. Whether that happens due to nanotechnology or genetic engineering or synthetic organs is irrelevant. What matters is that eventually people will age more slowly, be healthier for a larger portion of their lives, and will be living beyond the age of 120. Our social understanding of aging will lose the “virtue of necessity” aspect and society will treat aging as a disease to be mitigated and managed. When the average expected life span exceeds 120, the conditions for transhuman longevity will have arrived.

5. Responsible Reproduction: Having children will be framed almost exclusively in the light of responsibility. Human reproduction is, at the moment, not generally worthy of the term “procreation.” Procreation implies planned creation and conscientious rearing of a new human life. As it stands, anyone with the necessary biological equipment can accidentally spawn a whelp and, save for extreme physical neglect, is free to all but abandon it to develop in an arbitrary and developmentally damaging fashion. Children – human beings as a whole – deserve better. Responsible reproduction will involve, first and foremost, better birth control for men and women. Abortions will be reserved for the rare accidental pregnancy and/or those that threaten the life of the mother. Those who do choose to reproduce will do so via assisted reproductive technologies (ARTs) ensuring pregnancy is quite deliberate. Furthermore, genetic modification, health screening, and, eventually synthetic wombs will enable the child with the best possibility of a good life to be born. Parental licensing may be part of the process; a liberalization of adoption and surrogate pregnancy laws certainly will be. When global births stabilize at replacement rates, ARTs are the preferred method of conception, and responsible child rearing is more highly valued than biological parenthood, we will be procreating as transhumans.

6. My Body, My Choice: Legalization and regulation will be based on somatic rights. Substances that are ingested – cogno enhancers, recreational drugs, steroids, nanotech – become both one’s right and responsibility. Actions such as abortion, assisted suicide, voluntary amputation, gender reassignment, surrogate pregnancy, body modification, legal unions among adults of any number, and consenting sexual practices would be protected under law. One’s genetic make-up, neurological composition, prosthetic augmentation, and other cybernetic modifications will be limited only by technology and one’s own discretion. Transhumanism cannot happen without a legal structure that allows individuals to control their own bodies. When bodily freedom is as protected and sanctified as free speech, transhumanism will be free to develop.

7. Persons, not People: Rights discourse will shift to personhood instead of common humanity. I have argued we’re already beginning to see a social shift towards this mentality. Using a scaled system based on traits like sentience, empathy, self-awareness, tool use, problem solving, social behaviors, language use, and abstract reasoning, animals (including humans) will be granted rights based on varying degrees of personhood. Personhood based rights will protect against Gattaca scenarios while ensuring the rights of new forms of intelligence, be they alien, artificial, or animal, are protected. When African grey parrots, gorillas, and dolphins have the same rights as a human toddler, a transhuman friendly rights system will be in place.

Individually, each of these conditions are necessary but not sufficient for transhumanism to have been attained. Only as a whole are they sufficient for transhumanism to have been achieved. I make no claims as to how or when any or all of these conditions will be attained. If forced to guess, I would say all seven conditions will be attained over the course of the next two centuries, with conditions (3) and (4) being the furthest from attainment.

Transhumanism is a long way from being attained. However, with these seven conditions in mind, we can at least determine if we are moving towards or away from a transhuman future.

Follow Kyle on his personal blog, Pop Bioethics, and on facebook and twitter.

Image of psychedelic human eye by Kate Whitley via dullhunk on Flickr Creative Commons.

Instead of attempting to root out the source of that instinct and investigating whether or not voluntary active euthanasia actually violates morality, many use the blurred line created as reason enough to oppose a chosen death. Ross Douthat of the New York Times argues that Jack “Dr. Death” Kevorkian’s efforts to provide assistance to those suffering created a moral slippery slope:

And once we allow that such a right exists, the arguments for confining it to the dying seem arbitrary at best. We are all dying, day by day: do the terminally ill really occupy a completely different moral category from the rest? A cancer patient’s suffering isn’t necessarily more unbearable than the more indefinite agony of someone living with multiple sclerosis or quadriplegia or manic depression. And not every unbearable agony is medical: if a man losing a battle with Parkinson’s disease can claim the relief of physician-assisted suicide, then why not a devastated widower, or a parent who has lost her only child?

Note that Douthat doesn’t consider Parkinson’s a medical disease. But more to the point – Douthat’s argument is that we don’t know what degree of suffering makes the choice to die morally palatable. Degree of suffering is the wrong criterion. None but the sufferer can define it and it can never be truly communicated. What is at stake here is not only the free and informed choice of the dying, but our very understanding of what it means to “die of natural causes.”

So how do we determine that the person choosing to die is doing so of sound mind, with all the necessary information and without coercion? Thankfully Sir Terry Pratchett has a suggestion:

That is why I and others have ­suggested some kind of strictly non-­aggressive tribunal that would establish the facts of the case well before the ­assisted death takes place. This might make some people, including me, a little uneasy as it suggests the govern­ment has the power to tell you whether you can live or die. But, that said, the government cannot sidestep the ­responsibility to ensure the protection of the vulnerable and we must respect that. It grieves me that those against assisted death seem to assume, as a matter of course, that those of us who support it have not thought long and hard about this very issue. It is, in fact, at the soul and centre of my argument.

The members of the tribunal would be acting for the good of society as well as that of the applicant – horrible word – to ensure they are of sound and informed mind, firm in their purpose, suffering from a life-threatening and incurable disease and not under the ­influence of a third party. It would need wiser heads than mine, though heaven knows they should be easy enough to find, to determine how such tribunals are constituted. But I would suggest there should be a lawyer, one with ­expertise in dynastic family affairs who has become good at recognizing what somebody really means and indeed, if there is outside pressure. And a ­medical practitioner experienced in dealing with the complexities of serious long-term illnesses.

I would also suggest that all those on the tribunal are over 45, by which time they may have acquired the rare gift of wisdom, because wisdom and compassion should, in this tribunal, stand side-by-side with the law. The tribunal would also have to be a check on those seeking death for reasons that reasonable people may consider trivial or transient distress. I dare say that quite a few people have contemplated death for reasons that much later seemed to them to be quite minor. If we are to live in a world where a ­socially acceptable “early death” can be allowed, it must be allowed as a ­result of careful consideration.

Douthat attempts to build a slippery slope argument out of the variety of human experience. Pratchett embraces that diversity and attempts to build a moral mechanism for dealing with the unpleasantness that comes with dying.

But there is a second problem with death. What if I don’t want to die a natural death? What if I want to live for a long long time, say 10,000 years? Interestingly, the same people who don’t want me to die when I want to don’t want me to live longer than I am “supposed to” either. To use technology to live beyond the statistical average lifespan is to violate some other set of values of humility in the face of death or some such pap. Bioconservative authors like Leon Kass and Frances Fukuyama have repeatedly argued that mortality is part of what gives human lives value. But here comes the twist. If you get sick, we’ll pump you full of chemicals and strap you to whatever machine your health care plan will begrudgingly pay for, but don’t live beyond the average. As Douthat says above, “we’re all dying, day by day.” What are our options here?

Again, the draconian mores of “nature” rear their ugly head.

Natural death as a concept binds us in the shackles of paradox. To make choices around death seem to violate a natural law to which we’ve all unconsciously agreed. None of us know when our time will come, but don’t try die too soon, and don’t try live too long. Death, it seems, is too important a decision for us to make. Like many anti-enhancement arguments, the answer is all too familiar: the most critical choices – those that impact our basic genetic code, what type of children we have, and how we die – ought be left to chance.

Transhumanism is, in large part, an opposition to the mentality that creates the paradox of death. Death of natural causes is not good, it’s just no one’s fault. But in a world where so much death is caused deliberately, maliciously, and pointlessly, a death of natural causes can seem not just a mercy, but a blessing. Thus, we have come to cherish and value that which is but a morally neutral necessity.

When another person chooses our death against our will, that is a moral wrong.

Death by natural causes is morally acceptable because we cannot choose otherwise. But it is not morally good.

Volitionally and autonomously choosing when one dies, now there is a moral good. There is no reason the circumstances of one’s biological make-up and environment that determine one’s expiration date must be abided by. If technology can allow us to stop short in the face of years of suffering or overcome an untimely gentle passing for another 20 years, why not?

A fetishization of natural death should not hold us hostage to the quality and duration of our lives.

Follow Kyle on his personal blog and on facebook and twitter.

Image of patient by José Goulão via Flickr Creative Commons (Licence)

Health care is broken. In the US quality of care is tanking. Even in countries with successful universal health care systems costs are rising too fast for the systems to cope. So what do we do?

Atul Gawande, who knows a thing or two about improving healthcare, argues in his commencement address to Harvard that doctors need pit crews:

We are at a cusp point in medical generations. The doctors of former generations lament what medicine has become. If they could start over, the surveys tell us, they wouldn’t choose the profession today. They recall a simpler past without insurance-company hassles, government regulations, malpractice litigation, not to mention nurses and doctors bearing tattoos and talking of wanting “balance” in their lives. These are not the cause of their unease, however. They are symptoms of a deeper condition—which is the reality that medicine’s complexity has exceeded our individual capabilities as doctors.

Gawande has two main arguments. First, that when doctors use checklists they prevent errors and quality of care goes way up. Second, that doctors need to stop acting like autonomous problem solvers and see themselves as a member of a tight-knit team. Gawande is one of the few sane voices in the health care debate. However, later on in his speech, he says that the solution to the health care conundrum is not technology. To a large degree, I agree with him. But not completely. Tech still has a big role to play. If we take a closer look at Dune and Star Trek, we’ll see why Qualcomm and the X-Prize Foundation are ponying up 10 million bucks to fund a piece of medical technology that could help make Gawande’s dream of team-based medicine a bit closer to becoming reality.

In Star Trek: The Next Generation, Beverly Crusher is responsible for a starship with just over a thousand crew members of varying ages and species. Sickbay is, however, not manned by a huge number of staffers. Normally it’s just Dr. Crusher and an assistant or two. Furthermore, Crusher is no Gregory House MD. She lacks both his encyclopedic mind and his caustic personality. Yet Crusher is able to handle a hypothetical complexity that should blow to smithereens anything current doctors could possibly face. How?

The X-Prize Foundation has some ideas – Crusher has a few pieces of tech that let her treat the patient instead of requiring her to be an all-in-one interspecies diagnostician, surgeon, disease knowledge database, and bedside manner superstar. Two tools – the tricorder and the ship’s computer – enable her to access a huge amount of precise data and then compare every known condition or disease against that data to find relevant and probable causes. Qualcomm has teamed up with the X-Prize foundation to fund what they call the Tricorder X-Prize. I wrote about the prize when it was first in the works a while ago. At that time, the prize was called the A.I. physician X-Prize. A new press release renamed the prize and Gawande’s Harvard address has cast the competition ($10 million are at stake) in a new light.

The goal of the prize is for a team “to develop a mobile solution that can diagnose patients better than or equal to a panel of board certified physicians.” Thanks to cloud computing and ubiquitous internet access, pretty much any smartphone can access a server-based data-bank of medical diagnostic information. The trick is to make symptom and data input consistent and accurate, such that the information can be processed and compared against the database. On first glance, it seems the prize may be misnamed. The tricorder only collects data, it is Crusher and the computer that diagnose the disease.

Yet for the solution to be a success, the mobile solution has to be able to, in a sense, force the person utilizing it to become the tricorder. That’s where we come back to Gawande and his justified love affair with checklists. My suspicion is that the winning team will use a checklist based interface to ensure the human-based proxy-tricorder gets all the details and data necessary to ensure a proper diagnosis.

For the Dune fans out there, the Qualcomm X-Prize may sound neither like an A.I. nor a Tricorder, but a digital mentat. Sentient or “thinking machines” are anathema to the inhabitants of the Dune Universe. As a result some human individuals undergo intense conditioning to train their brains in processing data and finding the most logical solution supported by the data provided. These individuals are called mentats. Give enough good data to a mentat and the mentat will provide the right answer. Mentats are used by everyone, particularly governments, to calculate outcomes of complex political decisions. Digital mentat may sound oxymoronic, but recall that a mentat is merely a person trained to achieve the skills of a computer without the risk of sentience. Data processing is the simplest of mentat tasks, but requires a level of mental acumen that is probably impossible in current real humans.

But consider who would be most qualified for this data collection and entry: nurses and physicians. Instead of burdening themselves with a crushing cognitive load of patient history, symptoms, measurements, test-results, and nuances of reporting, the doctor could focus on beside manner, coaching the patient’s treatment and seeking the most accurate and complete information possible. The digital mentat, given sufficient data, could do the diagnosis on its own, just as the ship’s computer does for Beverly Crusher.

Whether it comes in the form of a mobile solution, or even a piece of software connected to a secure database that coordinates symptom and data input, doctors are going to need a medical data processor on their pit crew. The Qualcomm X-Prize “mobile solution” will be a kind of medical mentat, able to deduce the diagnosis from the data provided. To get that data, the doctor and the rest of the medical team will have to become the Tricorder. Whether or not Qualcomm’s Tricorder X-Prize will make that happen, I just don’t know.But the $10 million Ansari X-Prize was enough to jump start a second space race. Maybe a combo of tech and teamwork will be enough to turn health care around.

Follow Kyle on his personal blog and on facebook and twitter.

Image via the X-Prize Foundation Qualcomm X-Prize press release page. Also strikingly familiar to the image I whipped up for my first article on the Tricorder X-Prize.

As part of a thread called “The Bias Against Short Men,” Andrew Sullivan’s The Dish published an email by a reader struggling with a difficult question:

The doctor noticed that my son was comfortably sitting at the bottom of the growth chart and that he would most likely end up a measly 5’5” (a little more than my wife and myself). He went on to say that this could qualify as “idiopathic short stature syndrom.” And that we could potentially get our son on HGH (actually, it’s called rGH I think – see here) if we felt that his projected short height could affect his self-confidence and ultimately, his mental health.

Unlike HGH in athletes, HGH used to treat medical conditions has clinically observable benefits. A child given HGH treatments will have an appreciable difference in height as an adult. The reader feels inclined to give his son the treatments, while the reader’s wife is appalled at the idea. When is it alright to use HGH to help your kid grow to a “normal” height? If you do “treat” a child’s shortness, does that mean it’s a disease?

Crack open any text on bioethics and I can almost guarantee that the “is shortness a disability” example will be somewhere among the pages. Shortness (and deafness, which The Dish is also exploring at the moment) sits right in the blurry space among disability, disease, and normal. How short is “too short?” Why is 5’2″ too short for a man, but not a woman? The answer is pretty much: because we think it is. Human height does fall along a bell curve, but it varies around the world and throughout history. Yet, at some point, being short goes from a relative and descriptive term (e.g. I am shorter than Yao Ming) to a normative one implying a disability.

We might think something is a disability for a few possible reasons. The first is that there is a clear physical issue that prevents events self-care. An example of this might be total-body paralysis. That person is literally unable to care for him or herself.

The second is that a person’s physical attributes allow them to care for themselves, but make it difficult to exist in a society set up for people abled in a different way. A good example of this is that those in wheelchairs are perfectly able to do everything a non-wheelchair bound person can do, it’s just that most things are designed with those who walk in mind. Arthur C. Clark’s Childhood’s End has a race of intelligent aliens that are winged. As a result their buildings have doors wherever they are convenient – as it so happens, ground level is rarely convenient. Stairs are unnecessary. Thus, a person who would be normal among human buildings is utterly disabled and helpless among the world of Clark’s winged aliens. Because most people are enabled in one way, those enabled in another become disabled due to the way things are built and designed.

Finally, and most confusing, are social disabilities. These are disabilities that are a result of the advance of civilization. Think of it this way. Today, we’d consider illiteracy a disability. It prevents a person from learning, pursuing most careers, and significantly lowers quality of life. Imagine trying to use the internet without being able to read or write. For our prehistoric ancestors on the savanna, no one could read, yet we’d hardly describe any of them as disabled. Social or civilizational disabilities are the result of cultural demands not necessarily health related.

Shortness (and deafness) move between those last two definitions if they are considered a disability at all. It’s critical to recognize that changes in social conventions and the way we design products and facilities can actually change what is a disability. Also, technologies that enable a person to do something which he or she was previously unable to do can dissolve the category of disability.

Which brings us back to the question of the Dish reader and his son. The son is short because the reader and his wife are short – genetics 101. Neither the father nor the mother consider themselves disabled, and the son is projected to be taller than his parents. Yet being tall can confer a huge social advantage. Heterosexual women tend to prefer taller men and taller people get bigger paychecks. On the other hand, the other side of the bell curve, too tall, is not much fun either. Taller folks are often crammed into cars and plane seats designed for a general population that needs less space. Additionally, excessive growth often has associated medical issues.

On issues such as this, I tend to defer to personal liberty and the discretion of the parents. The reader is clearly not taking the choice lightly. He sees both his wife’s concern and the doctor’s suggestion to use HGH as legitimate. He is considering letting his son get a bit older, so that his son can at least make something of a choice regarding the HGH injections. The relevant question isn’t “is shortness a disability we should treat with HGH” but, “would making a child who will likely be short a bit taller improve that child’s overall quality of life?” The question is complex and unique to each child, but if investigated earnestly and carefully, I see no reason why increasing a healthy child’s height would be wrong.

Follow Kyle on his personal blog and on facebook and twitter.

Image of frightening vegetable holding ruler to measure height by hoyasmeg via Flickr Creative Commons

Did anyone out there raise their hand? If you did, I congratulate you. But, if you’re like me, a list of minor malfunctions and maladies that you’d love to fix popped up in your head. None of us are perfect, there is always something to improve. We are, after all, only human. And most of us would jump at a chance to improve some of those little issues.

The last time I went to the doctor’s office, the nurse who took my vitals said, “What are you doing here? You’re as healthy as they come!” That can hardly be true. I eat street-vendor food more often than I go to the gym. How can I be a picture of health? The fact is, I’m not. Just because I’m not ill (save the sniffles from the end of a cold) and not injured, doesn’t mean that I am, by default, as healthy as I could be.

For some bizarre reason, we don’t think about our bodies that way when it comes to health care and self improvement. We don’t pursue excellent health the way we strive to be better in our hobbies and work. So, where did we get the idea that mediocre health is good enough?

It’s simple. When we look at our bodies, we apply the phrase “If it ain’t broke, don’t fix it.” I hate that saying. It’s one of the most anti-human phrases out there. No one who ever innovated, pioneered, explored or invented ever said that to themselves. The people who push the human race forward look at everything around them and say, “I think I might know how to make this better.”

As Oxford bioethicist and human enhancement proponent extraordinaire Julian Savulescu says, “to be human is to be better.”

To see the “If it ain’t broke, don’t fix it” mindset in action, let’s look at an example. The Independent‘s Jeremy Laurance investigation of cognitive enhancing drugs looks at possible problems, but only comes up with minor side effects. A fellow journalist with the Independent, Johann Hari, experimented with Provigil in 2009. Provigil is an anti-narcolepsy drug that improves mental focus and clarity with no known significant side-effects. Hari’s only complaint was that it seemed to mute his creativity when taken all the time. After reducing his dosage to only occasional usage, he was able to benefit from boosts in focus and clarity without losing his creative edge. Yet, according to Laurance, Hari eventually stopped: “I concluded that taking narcolepsy drugs when you don’t have narcolepsy is just stupid.”

Hari’s reaction that taking drugs for a disease he didn’t have was stupid is erroneous. He wasn’t taking Provigil for narcolepsy, he was taking it because he was burnt out. And Provigil helped. It’s right there in the article! He felt better, worked better, and thought more clearly. After finding the right dosage, he was able to keep creative dampening side effects to a minimum.

So why did taking Provigil seem stupid? Hari isn’t out of sync with most folks, who are wary of taking medicine for it’s prescribed use, let alone taking it for off label uses as Hari did. That is, we generally don’t trust drugs even if they have been tested and approved by the FDA for specific uses. Off label uses are all the more suspicious.

But here’s the interesting thing: neither the US nor the UK have regulations in place for prescription pharmaceuticals that are not therapeutic. Drugs that don’t cure an illness but still have a beneficial effect have one of two paths: either find an illness they do cure or invent an illness that the drug seems to cure. An example of the latter is Viagra. I don’t care what the DSM says, erectile dysfunction is not real illness. But Viagra works. It  doesn’t “cure” anything, but it sure makes a lot of people’s lives better, which is great thing. But it’s a massive problem that there is no way for drugs that make our health better to find their way onto the market.

And there in lies the problem. Save vaccines, modern medicine just doesn’t know what to do with medicine that prevents disease or improves a person’s life. But there is a branch of health care that does focus on preventative care: the dentist.

Compare an average visit to the doctor with a visit to the dentist. Dentists don’t say “no cavities, go home!” They poke and scrape and clean and x-ray and pester me to floss more often and to get a better toothbrush and to use clinically-tested toothpaste. When was the last time your doctor sent you a note that it was time for your biannual check up? Never. But like clockwork, every six-months I get a post card with a tooth holding a toothbrush beckoning me back for a cleaning. Dentists are always pointing out ways you can better take care of your teeth and pestering you to come in for a regular cleaning. Thus, dentists are in the business of preventing problems and teaching us how to improve our oral care.

Prevent and improve. Those are the two words I’d argue are most underused in every other aspect of human health care. Why does self-improvement not include pharmaceuticals that make us smarter or stronger or happier? Because we’ve been convinced and told and reminded and scolded that taking a pill means something is wrong with you.

For example, take the phrase, “feel better.” We’ve all felt better than we feel right at this moment. I have had a handful of moments of pure jubilation. But if you were to walk up to a friend who was laughing, pat them on the shoulder and say “Feel better!” that friend would probably stop laughing and ask what was wrong. It’s as if we’ve decided that, when it comes to our bodies, it doesn’t get any better than average. That needs to change. Because if we aren’t getting better, we aren’t being human.

Follow Kyle on his personal blog and on facebook and twitter.

Image of innovative preventative care device and associated cleaning gel by ToastyKen via Flickr Creative Commons

Floyd Landis wants to legalize doping in professional cycling. His argument is a reasonable one. Landis argues that, since everyone is doing it already and the tests will never keep up, might as well just legalize and regulate it instead of banning it entirely. Other cyclists and the governing bodies of competitive cycling have all but called Landis a complete nutter. Charges of doping brought against other cyclists, particularly Lance Armstrong, are met with refutations of “innocent until proven guilty.”

While I agree that doping should be allowed for cyclists, I disagree with the reason Landis gives:

You got to go about it another way and you’ve got to legalise doping. They [the testers] are so far behind in the testing organisations that there’s no way to change it now. Just accept that it’s here, that it’s not going away and that it’s just going to get more complicated and the fact that it’s not that complicated yet compared to what it will be. Ten years from now it’s going to be four times as hard as it now to test for things.

Laws and ethics are not based on what is easy and what is hard to control. They are based on standards of justice and what is ethically right. The reason I believe doping should be allowed is that I see nothing unjust or wrong about professional athletes using chemical compounds and medical knowledge to improve their abilities and performance. Let me rephrase that: there is nothing wrong with taking steroids.

The concern over professional athletes misusing steroids is always framed as some lone juicer injecting himself in his bedroom so he can get that extra home run. That’s not how it happens. Even illegal doping is under the watchful gaze of a team of professional athletic doctors, trainers and nutritionists. Do you think Floyd Landis mixed up his hyper-complex, nary-undetectible designer steroids and blood doping techniques in a lab in his basement? Or maybe he purchased all of his doping gear from a shady fella who hangs out at the track after midnight? No. Clearly, Landis (and every other competitor, probably) had assistance from highly trained professionals working to ensure he would be stronger, better, faster, with minimal risk to his overall performance and health.

Steroids are dangerous. But so are thousands of other prescription drugs for which we require doctor supervision. The only ethical reason to ban steroids if they are dangerous and harmful even when used properly. To say doping is wrong because it’s against the rules is circular, yet that’s what most arguments come down to once one is unable to prove steroids are harmful if used properly. Let’s stop pretending that most professional athletes 1) aren’t doping and 2) that they aren’t under strict supervision when they do. Let em take ‘roids.

Image of speedy cyclists via roy_appleyard on Flickr Creative Commons

A brief synopsis: Having run out of energy on Earth, humanity has gone to the Moon to extract helium-3 for powering the home planet. The movie begins with shots outside of a helium-3 extraction plant on the Moon. It’s a station manned by one worker, Sam, and his artificial intelligence helper, GERTY. Sam starts hallucinating near the end of his three-year contract, and during one of these hallucinations drives his rover into a helium-3 harvester. The collision causes the cab to start losing air and we leave Sam just as he gets his helmet on. Back in the infirmary of the base station, GERTY awakens Sam and asks if he remembers the accident. Sam says no. Sam starts to get suspicious after overhearing GERTY being instructed by the station’s owners not to let Sam leave the base.

So Sam tricks GERTY into letting him go out of the station in one of the rovers. He finds the first Sam who has crashed and brings him back to nurse him to health. The new Sam decides that chronic communication difficulties—which have only permitted seeing previously recorded messages from his wife and daughter waiting for him to return back on Earth—might be an elaborate deception. He goes far enough off base to get outside of the range of jamming antennas and calls back home to Earth to discover his daughter, who was an infant in the pre-recorded messages, is now a teenager, his wife is now dead—and her father Sam is there on Earth.

The sinister truth of the helium-3 base is now fully disclosed. What is actually happening is that the “first” Sam was himself a clone (where this means everything, including all his memories, not simply a genetic clone). Evidently, the copying occurred early in Sam 1’s stay at the station. Each clone is awakened with the thought of returning home to his family in three years. What actually happens at the end of those three years is that the clone is incinerated in the return capsule, and a new clone is awakened, to begin the cycle anew.

Near the end of the film comes a striking moment. The Sam that nearly died in the earlier crash has gotten increasingly sick and will die soon. The two Sams realize that the bosses of the station are coming to kill both of them and activate a new clone. They hatch a plan that has one of them leaving back to Earth in one of the helium-3 delivery shuttles. After newly awakened Sam tells dying Sam that he deserves to go back—“you did the three years”—dying Sam disagrees, and tells new Sam that he should return to Earth, because dying Sam is too sick to make it. This is a really powerful moment in the film, and our feelings about it are helpful in untangling our own mangle of thoughts about identity and death.

Dying Sam’s sacrifice seems less significant than, say, me telling an unrelated co-worker to take the capsule home. There are suggestive biological resonances to this feeling. Think of how, in social insects like bees, individuals give up the right to reproduce in order to facilitate the genetic continuity of individuals that they are closely related to. So, would the fact that you have a copy of yourself, which diverged from you even quite some while back (in this case, three years of solitude on a Moon base), ease your anxiety about dying?

Consider the following thought experiment. Rather than three-year stints, the clones of Moon get replaced on a 24-hour cycle. You fall asleep. Your memories and any other physical changes from the “base copy” get noted and propagated to a new clone. You are then, in Moon-like fashion, vaporized, and in the morning, a new clone is awakened after these changes have been “installed.” You awake, none the wiser for this change in body. Consciousness is not continuous, of course, and discontinuities such as sleep are natural places where we can do the “body change” business with minimal mess (not unlike what was depicted in the fantastic sci-fi film Dark City). The gap between what actually happens in sleep and this scenario seems too small to quibble over. Or is it?

As experiences and other physical changes separate you from your base clone as weeks, months, and years pass, your ability to separate your own identity from that of the clone grows similarly. It is like a core scene in the play “On Ego,” when a Star Trek-like teleporter fails to vaporize the original version of the protagonist. So two protagonists now exist. From that moment forward what was once one person is now two people, with increasingly different senses of self and experiences.

Your sense of how much you would sacrifice for your copy might be a good test for how different you feel from him or her. Your sense of how much comfort you would feel in dying, knowing that this other version of you lives on, might be another good test for how much of your identity has leaked out of the lump of tissue that has hitherto conveniently been bounded off by your jacket of skin. Perhaps in the first few days after such a teleporter accident, you would feel you could give up your life for your copy (and be relaxed about the idea of dying so that one of you can go on); after a few weeks, maybe something less than your life, and after some years of passed, perhaps you’d feel you could sacrifice nothing more than you would sacrifice for a close friend. (Topic for a future movie and post: Does forming a close friendship involve blurring and merging of your two identities?)

Here’s some final thought experiments for you to puzzle over. The great anthropologist Mary Douglas wrote in her paper “The Forensic Self,”

[In] western culture, whatever we say seriously about persons and selfhood needs to some extent to be compatible with what a jury in a court of law will accept.

For a graduate degree in philosophy with Ian Hacking many years ago, I once applied this idea to the issue of multiple personality disorder (MPD), to see how the judicial system dealt with defenses of MPD. The courts have mostly taken a view most eloquently put by Judge Birdsong in the case of Georgia v. Kirkland: “…we will not begin to parcel criminal accountability out among the various inhabitants of the mind.”

Rather than MPD, let’s see where we get when we apply Douglas’ insight to the problem of multiple person disorder: having multiple copies of yourself present at once. What if, just prior to copying, one of you formed a criminal intent. Because of slightly different post-copying existences, one of you now decide to stop the other. Would it be ethical to kill your copy? What would ethics require of how you treat one another? After all, we have sometimes odd ideas of what we are allowed to do to ourselves: Yes to smoking ourselves to death, no to elective limb amputations. These confusions would only be amplified by the peculiar situation of having multiple person disorder. Or being the victim of a sinister plot by Lunar Industries on the Moon.

With the headlines screaming “age-reversing” possibilities regarding the Dana-Farber Cancer Institute at Harvard University’s results with mice telomerase manipulation, I felt a bit of cold water was in order. I am as excited as can be about serious evidence for how important telomeres and telomerase is for anti-aging medicine, don’t get me wrong. But that evidence doesn’t mean there is going to be a longevity pill in our hands this year, this decade, or even this century. And more than a few folks with a grasp of science better than mine agree.

Thankfully, I’m not the only one. My fellow Discover blogger Jennifer Welsh has a great post on 80 Beats about why the discovery, though exciting, is far from a genuine anti-aging solution. The Harvard team showed the following. Mice engineered to lack telomerase aged prematurely. When given telomerase treatments, the mice rejuvenated to age-appropriate health without adverse side-effects. That’s it. That’s the extent of the discovery.

It still remains to be seen if telomerase treatments can delay normal aging, reverse normal aging, or extend life in any way in mice. From there scientists have to then figure out what side-effects there are, why those side-effects occur, and then somehow translate the results to human beings. In short, the Harvard team only confirmed the hypothesis that telomerase in mice impacts the aging process and that it may have potential uses in treating premature aging. Hypotheses beget hypotheses. And not all our hypotheses hinge on mice.

Bennett Foddy writing on the University of Oxford’s Practical Ethics blog doesn’t want us to just look at mice. He notes that lobsters don’t age the way we do. They stay youthful up until death. Foddy, though quite cautious in his excitement, is also an optimist:

For all that, this result is one of the most dramatic leaps made in recent years toward the dream of radical lifespan-extending medicine. David Brin recently argued that there is no ‘low-hanging fruit’ in the development of lifespan-extending medicine, since human bodies already use most of the biological ‘tricks’ that can extend life in simpler organisms. On this view, every hypothetical treatment that could extend the lives of humans faces major practical obstacles which will delay their development by hundreds of years. Yet the Harvard discovery shows that one of the major obstacles to telomerase-based treatments—cancer—may not be an obstacle after all.

King of the pessimists is Tom Junod, writing for Esquire, who does not believe we are going to live forever. He’s seen too many failed promises, too many “breakthroughs” that lead no where, too many brilliant young scientists who cannot translate their discovery from mice to men. Junod’s piece is more nuanced than can be summarized here, but his perspective is useful in understanding our reactions to major science news. How to get into his perspective? Consider just how wrong, consistently and empirically, Ray Kurzweil’s predictions have been. Think about how many “breakthroughs” you’ve read about in the past month, the past year, the past decade – now think about how many of them have made an impact. Going through my pile of old Popular Science mags is like learning Santa Claus isn’t real over and over again.

But in the end the study really is a major breakthrough in that it’s a start. Science has a way of making a big splash when something goes from impossible to plausible, and then again from plausible to possible, and then from possible to practical. Remember Dolly the cloned sheep? Well, she’s back as four new clones, easier to make and healthier than ever. Dolly proved cloning possible, her clones are proving that easy and safe cloning is possible. There are steps-within-steps, mini-discoveries and minor breakthroughs that aggregate and combine. Each one a little victory. Telomerase manipulation is that first step – anti-aging is now plausible. I just hope I’m not too gray before it’s practical.

Image via Steve jurvetson on Flickr

You see, I was merely quoting Margaret Somerville, the Director of the Centre for Medicine, Ethics and Law at McGill University in Canada. In addition to thinking gay marriage is bad for the kids, Somerville really does not like transhumanists. She thinks that  personhood is the “world’s most dangerous idea,” (sounds vaguely familiar) because if aliens, animals and robots have rights too, we won’t value humans anymore. In her recent piece, calmly titled “Scary Science Could Cause Human Extinction” Somerville makes a strange argument about xenotransplants (i.e. organ transplants). First, she beats up on transhumanists and our support of life-extension. She attempts to link life-extention with genetically modified animal organ transplants. She then argues that the transplants will, get this, cause a mutant virus leading to a global pandemic obliterating humanity. I am not joking:

[Using genetically modified pig-hybrid organs] poses a risk, not only to transplant recipients, their sexual partners, and their families, but also, possibly, to the public as a whole. An animal virus or other infective agent could be transferred to humans, with potentially tragic results – not just for the person who received the organ but for other people, who could subsequently be infected. And there might be a very remote possibility that it could wipe out the human race.

Somerville’s argument abuses the word “potentially” and its synonyms in a desperate attempt to draw a link in the reader’s mind between xenotransplants and a cataclysmic plague. Human-to-human disease transmission during transplants is extremely low, and the genetic differences between humans and animals, even hybrids, would lower the risk all the more. Martine Rothblatt, (a Fellow at the Institute for Ethics and Emerging Technologies) wrote a whole book, Your Life or Mine, addressing the fears around xenotransplantaion. In short, Somerville’s concerns about xenotransplantation are not based in science, but in bioLuddite hysteria. Somerville’s case against xenotransplantation is in terminal condition already, and things only get worse from here.

I would summarize the rest of her argument if it wasn’t, well, so incoherent. For example, Somerville is confused about anti-aging research. She seems to think that researchers are simply trying to slow down human maturation, “so that we would reach puberty around 40 years of age, early middle age at 80.” Um, no. The goal is not to slow the maturation process but to inhibit and potentially reverse the damage that accrues at the cellular level over time due to aging. Aubrey de Grey describes his anti-aging research as Strategies for Engineered Negligible Senescence, not Strategies for Twenty Years of Puberty (by Einstein’s mustache, that’s a dystopia if I’ve ever heard one). Humans would mature normally, we just wouldn’t age as rapidly once mature. Somerville’s misunderstanding on the anti-aging point is indicative her perspective throughout the article.

How Somerville gets from reversing cellular damage to pig-hybrid xenotransplants as a way to slow aging I’m not sure. I’ve never encountered an argument for life-extension based on total organ replacement, save perhaps Outnumbering the Dead. As Somerville’s article has no citations, so it’s hard to know where she’s getting her information. I imagine her thought process around life-extension and xenotransplants was something like this: Transhumanists probably support both of those things, why make logical connections when you’ve got a movement to smear, am I right?

But let’s say we grant Somerville all of her erroneous points, and agree that xenotransplants from animals is a terrible, dangerous idea that will cause global catastrophy. Guess what, it doesn’t matter. Pig-as-organ-farm idea went out of vogue right about when we realized we could, uh, forget the pig. MIT researchers are beginning to figure out how to use a hydrogel scaffold to support and guide the growth of stem cells into new organs. If they get technique perfected, single stand-alone organs could be grown from your own cells – perfect matches made on demand. Or maybe we’ll just build artificial organs, like kidneys and lungs, and make everyone into cyborgs. No worries of robot-to-human virus transmission. Feel better, Marge?

Image from K Sandberg at Vintage Collective via Flickr

The world is getting old. Most developed nations have an aging population that outnumbers the young ‘uns. Ted C. Fishman’s new book, Shock of Gray, argues that this huge wave of elderly just might change the world. Recently interviewed at Salon, Fishman talked about a potential anti-agism civil rights movement, globalization fueled by young people immigration (get on my lawn?), and my favorite old-person related topic, super-longevity:

Our life span averages have leaped in the past century, as you point out, and I wonder if you think there’s a point where we’ll hit a ceiling. Now that you’ve read the science, is there really a possibility for immortality?

I only read the science as a layman and I can only tell you who I trust, which is based on emotional signals as much as empirical ones. I do think maybe eventually we’ll be able to reengineer the human body so that it’s some mix of mechanization and biological miracle and we live forever. But in the lifetime of anybody who’s reading the book, I think there are big limits to the expansion of the human life span. Our genetic makeup is such that the genes that help us grow when we’re young tend to turn against us as we get old.

[What's] more important than antioxidants [for extending our lives]?

I don’t know, I’m not a scientist. But looking over all the places where longevity is more common, sociability is a telling characteristic. Antioxidants might be very promising, but this is the cycle of all promises of anti-aging — hype and debunking, hype, debunking. But we do know what the sure things are. Public health, sociability and literacy.

Those last three pieces  - public health, sociability, and literacy – would seem to rule out most of the “eat this food, not that food” logic around longevity. Combine that with advice of the oldest twins in Britain, to enjoy “laughter and having a joke with each other” and you’ve got a pretty good recipe for long life: read a bunch, hang out and laugh with friends, and live somewhere nice. That is a set of goals I can shoot for with gusto.

I do, however, hope that, as Fishman says, we might be able to “reengineer the human body so that it’s some mix of mechanization and biological miracle and we live forever.” While we’re waiting for that to happen, it seems the key to living a long time is to just enjoying being alive. Maybe if I enjoy being alive long enough, I’ll live to see super-longevity become a reality. Then I can enjoy being alive for a really, really long time. On that note, I’m going to go read a book and have a laugh.

Image from manuel | MC on Flickr

One of the major drawbacks of chemotherapy is that it damages far more of the body than just the malignant tumors it’s used to fight. In order to target just the cancerous areas, and not hit everything on the way there, researchers from the University of Texas in El Paso created a tiny solar cell. They attached model drugs to each side of the cell, one of which was positively charged, the other negatively. Once the tiny solar devices are in the body, doctors would blast the tumor with an infrared laser, causing the pholtovoltaic particles to release the drugs.

This would mean the medication would only be released at a specific location, and could be used to deliver the medical payload extremely specifically, and altering the intensity of light would control how much of the drug would be released.

At present, this work is just a proof of concept, and has a significant amount of work to go. We reported on a similar technique in November using fuzzy nanocubes.

Image of tiny photovoltaic flakes by Murat Okandan

This post originally appeared on io9.

io9. Escape to the world of tomorrow.

For years, researchers have been using fluorescent proteins in bacteria and animals to study everything from gene therapy and neural development to cancer and limb regeneration (and create some very pretty pictures). The concept is fairly simple: by inserting the gene for GFP (green fluorescent protein, originally found in jellyfish) at the end of another gene—say the gene for hemoglobin—its glow can be used to measure how much hemoglobin is produced and where it is produced in the cell.

Inspired by the success of GFP as a research tool (it earned its discoverers the Nobel Prize in Chemistry in 2008), scientists have adopted a similar approach to identify and locate transplanted stem cells in animal models. Except in their case, they’ve begun to use the gene for luciferase, the enzyme responsible for the mesmerizing glow of the firefly. And if this method works, it could make stem cells a potent tool for addressing heart disease.

Bioluminescent imaging (BLI), as the method is known, uses the light emitted when luciferase catalyzes the oxidation of luciferin, a pigment (which is strong enough to be perceived even across multiple tissue layers), to track embryonic and adult stem cells in small animals. Though it lacks the spatial resolution of more advanced imaging technologies such as magnetic resonance imaging, BLI has already proven useful in observing stem cells in vivo. What might make BLI even more useful is if it could also shed light (pun intended) on the stem cells’ differentiation status—that is, whether or not they are doing their job. For instance, if a doctor wanted to use stem cells to treat a stroke patient, it would be helpful if she could monitor the cells’ progress visually and determine whether or not they were forming new neurons. Thanks to some clever engineering, a group of researchers led by Steven Ebert of the University of Central Florida have developed a mouse embryonic stem (mES) cell line that glows more brightly the faster it develops into new cardiac tissue. This cell line could vastly improve doctors’ understanding of how diseased hearts recover and how stem cells can guide the regenerative process. Eventually, it could even eliminate the need for some forms of heart surgery.

They did so by tying the expression of the luciferase gene (LUC) to that of Ncx-1, a gene that encodes a protein that removes excess calcium ions from cells and is crucial for proper nerve function. Because the Ncx-1 gene is only expressed in new tissue, Ebert and his colleagues used it to quantify tissue growth. As a control, they created two other mES cell lines in which the expression of luciferase was tied to other genes. The cell lines were otherwise identical to the Ncx-1-LUC cell line.

They injected both undifferentiated and differentiated versions of the cell lines into the left ventricles of several mice and measured luciferase activity (i.e., look for the pretty light) immediately. While they could see light in a few specimens, most showed little to no luciferase activity for more than a few hours at a time. Several days later, however, the light signals became stable and, in some cases, grew stronger over time—which indicated that the heart was regenerating. The mice that exhibited the strongest bioluminescence following the onset of cardiac differentiation were those that had received the Ncx-1-LUC cell line. By contrast, the mice that had received the cell lines in which luciferase was linked to another gene did not display increased bioluminescence following differentiation. In fact, some displayed less bioluminescence.

Though all the usual caveats apply, the main advantage of this technique is that it could enable doctors to monitor the pace of recovery in a patient with cardiovascular disease without having to resort to surgery. After injecting the stem cells into the patient’s heart, a doctor would only need a microscope outfitted with a special camera lens to assess her progress. And the same approach could be used to evaluate a slew of other stem cell-based therapies. Since luciferase does not harm the stem cells’ performance or the human body, there is no reason why it couldn’t be used in other organs—perhaps the gene could be tweaked further to produce a unique glow for each organ. If and when the continuing litigation over embryonic stem cell funding is resolved, researchers will have a shiny new tool to aid them in their quest to turn stem cells into healers.

Image: Steven Ebert/UCF

I have seen the future, and it is cilia. Yes, you read that right: those trillions of tiny hair-like extensions that carpet every inch of your body could bring scientists’ visions of a universal class of “smart” materials that change and adapt when subjected to various stimuli closer to reality. These artificial cilia could one day do everything from testing drugs and monitoring air quality to measuring glucose levels and detecting electromagnetic fields.

While largely ignored over the past century (or, at best, dismissed as being purely vestigial), scientists are finally beginning to appreciate the many vital functions they perform in and outside of our bodies. Much like an antenna or sensor, cilia gather information from their surroundings and react—by activating a cellular process or shutting down cell growth, for example—if something seems amiss. They can also act as miniature roads or railways, carrying dirt, bacteria and other noxious materials out of our lungs or shuttling a fertilized egg from the ovary to the uterus. And, perhaps most importantly, cilia make it possible for us to see, hear, smell, and otherwise feel the outside world.

Now some researchers believe that cilia-like structures could bring their sensory prowess to medicine, environmental monitoring and a number of other fields. Leading the charge is Marek Urban of the University of Southern Mississippi who has created a copolymer film with hair-like filaments that mimics the functions of normal cilia.

Each of these artificial cilia is equipped with an array of sensors that enable it to respond to the slightest fluctuations in temperature, pH, or light by folding over, shrinking or even changing colors. These unique behaviors are the direct result of molecular rearrangements and conformational shifts in the structure of the copolymers. For instance, when Urban and his colleagues exposed the cilia to hydrochloric acid vapors, they immediately bent towards them and changed colors from yellow to red.

A longer exposure resulted in further bending and a change of color from red to purple. Yet when the researchers switched to using ammonium hydroxide vapors (which have a much higher pH), the cilia reverted to their original shape and color. The cilia similarly responded to variations in temperature and different wavelengths of light by shrinking, modifying their surface morphologies, and becoming fluorescent.

Though more proof of concept than anything else, this work clearly demonstrates the “smart” potential of these copolymers. And, as the NSF release notes, it looks like Urban and his collaborators aren’t wasting any time putting them through more trials and dreaming up new applications. If scientists can further expand their functionality and incorporate them into other technologies (eventually even our bodies), the cilia could become a ubiquitous component of our future everyday lives—helping to treat diseases or simply supplementing our sensory tool set by granting us new abilities.

Images: University of Iowa and Zina Deretsky/NSF

For many cancer patients, treatment can be a double-edged sword. While recent advances in chemotherapy, radiation therapy, and surgery have brought relief to millions of sufferers, a significant fraction have had to sacrifice their ability to have children in return. Going under the knife or being bombarded by high-energy rays—though often critical for therapy—can sometimes irreparably damage a woman’s eggs or man’s testes, robbing them of their fertility. To say that this leaves young patients pondering therapy with an unenviable set of choices would be something of an understatement.

Fortunately, thanks to some groundbreaking work by researchers from Brown University, female patients may soon never have to make this most difficult of decisions. A team led by Sandra Carson, a professor of obstetrics and gynecology, has built the first synthetic human ovary from scratch by cobbling together the three cell lines involved in egg development—the theca cells, granulosa cells, and egg cells themselves—into a fully three-dimensional honeycomb-shaped structure.

The hope is that the artificial ovaries could eventually be harnessed to nurture and grow immature eggs removed from patients about to undergo therapy. (For lengthier procedures, the extracted eggs could even be cryopreserved before being placed into the lab-grown organs.) Once the treatment is over, the mature eggs, or ova, would be reinserted into the patients’ ovaries or, if these have sustained too much damage, fertilized in vitro and implanted into the uterus.

The underlying tissue engineering technology, called the 3-D Petri dish, was developed by Carson’s colleague, bioengineer Jeffrey Morgan. As the name implies, 3-D Petri dishes do a lot more than simply provide a comfortable medium for the cells to grow: they also direct them to assemble into specific 3-D shapes that can be combined with other cell clusters, Lego block-style, to construct larger “microtissues.” With it, the researchers coaxed the theca cells to form tiny honeycomb structures that they then filled with clumps of granulosa cells and egg cells. Like a normal ovary, the theca cells closed around the eggs and granulosa cells a few days later. And, like its human counterpart, the artificial ovary successfully fostered the eggs’ growth to maturation.

In addition to helping keep the patients’ child-bearing dreams alive, these artificial organs could offer scientists an unprecedented look at how the natural ovary develops and how various problems, including exposure to chemicals and radiation, can inhibit or even shut down egg development. The research could also help oncologists design better treatments that are just as effective, or even more so, but much less risky for the patients (and future children).

Images: Carlson Lab/Brown University and Morgan Lab/Brown University

At last week’s American Chemical Society (ACS) meeting, a group of scientists from the United Arab Emirates University announced that it had broken this trend by conducting the first large-scale survey of frog skin compounds. Over the course of a year, they managed to isolate close to 200 novel substances, as SciDev.Net‘s Christine Ottery reports, mostly from species endemic to African countries—a small drop in the bucket when compared to the 6,000 frogs (and thus many hundreds, if not thousands, of unique skin secretions they hope to collect) they have received from labs all around the world, but a significant step forward nonetheless.

These potent compounds, collectively known as antimicrobial peptides (which are strings of amino acids), are not only found in frog skin secretions, but in a range of other animals as well (us included) where they do triple duty warding off wave after wave of bacterial, viral, and fungal broadsides. Think of them as the body’s own antibiotics. And unlike those you buy from the pharmacy, which mostly only put a cap on further bacterial growth, these antibiotics consistently go for the kill—often dismantling their victims’ cell membranes, targeting vulnerable cell structures or destroying them outright.

This aggressiveness has proven to be something of a double-edged sword. While antimicrobial peptides work wonders against the legions of micro-invaders laying siege against our bodies, their zealousness can also work the other way around, attacking the very cells they are meant to protect. The UAEU researchers have been trying to mitigate this problem by tinkering with the peptides’ structure to make them less dangerous for humans but more deadly for pathogens.

Among the standouts they’ve already identified are one compound from the mink frog that fights “Iraqibacter” (Acinetobacter baumanii), a bacterium that inflicts drug-resistant infections on (surprise) wounded Iraq War veterans, and another from the foothill yellow-legged frog that could upend the formidable methicillin-resistant Staphylococcus aureus (MRSA) and other multi-drug resistant bacterial strains. Though only time will tell if these AMPs can be refined and turned into viable drugs, the second compound alone would easily justify the extensive testing required. And, who knows, there’s always the slight chance that we’ll really luck out and stumble upon some new miracle compound, or several, that could cure our most intractable diseases and potentially ward off future plagues.

The other, perhaps more important, question is whether these substances will work just as well in the human body as in the laboratory setting, where all of these experiments have been done. Even putting aside the peptides’ potential for mutual destruction, there is no way of knowing how altering them to make them compatible with our bodies will affect their efficacy. According to the researchers, clinical trials may only get underway 5 years from now. Let’s just hope there will still be enough frogs by then to sustain their work. Though it’s hard to put a number on it, I’d wager that we have already lost a significant number of promising antibiotic substances through our destruction of the rainforest and other highly biodiverse environments. Some day, the only thing standing between mankind and a devastating new pandemic could very well be a frog- or other animal-derived antibiotic substance.

Image: rainforest_harley/Flickr

The major challenge that scientists face is developing a sensor that is both long-lived and biocompatible. The human body is extremely picky about implants, and will quickly reject or react poorly to most materials found in everyday electronics. Even the materials that make peace with the body’s immune system, like those found in pacemakers, are not always ideal. Some require constant maintenance, while others need to be replaced every few days and are inconvenient to install, to say the least.

But external devices have their own problems. Patients often forget to wear portable devices like glucose monitors, making it more difficult for their physicians to evaluate their condition over extended periods of time. And imagine how annoying it would be to walk around with several monitors because your doctor wanted to track multiple vital signs. A much better alternative would be a single, unobtrusive, and long-lived implant that could detect and measure several chemicals in the body at once.

Fiorenzo Omenetto, a biomedical engineer at Tufts University, may have the solution: a tiny flexible biosensor wrapped in silk and gold. Long-time DISCOVER readers will already be familiar with the many benefits of silk and its numerous potential applications in medicine—there’s a reason we’ve been trying to mass-produce spider silk for years. In addition to being super-tough and stretchy, silk also happens to be a great fit for most tissue surfaces in the body.

What makes gold an appealing component is its unique electromagnetic properties. Along with a number of other highly conducting metals, including silver and copper, gold can be tweaked on a nanoscale level and combined with other materials to respond to frequencies in the terahertz range, which sits at the far end of the infrared range. These artificial composites, called metamaterials, have vaulted into the popular imagination in recent years due to their frequent association with the Harry Potter invisibility cloak.

As it turns out, enzymes and other proteins in the body resonate at specific frequencies within this range (they have their own “T-ray” signatures), making them easy to identify with the right type of antenna—the biosensors. To build the sensors, Omenetto and his colleagues took 1 square centimeter silk film squares and sprayed them with a gold-based metamaterial sheen. They then folded them up into small cylinders and implanted them into muscle tissue. Even buried under several thin slices of muscle, the sensors still resonated at their characteristic frequencies.

The sensor works by detecting subtle changes in the silk substrate that are caused by blood proteins and other chemicals floating around it in the tissue. Once the metamaterial picks up on the molecules’ distinct T-ray signatures, it transmits the information back to the researchers. In the case of a diabetic patient, for instance, the metamaterial would be able to track minute variations in glucose and insulin levels. As Omenetto puts it, the sensor is effectively “a lot of small antennas that behave as one.”

The possibilities of this sensor in research and medicine could be limitless. The ability to detect tell-tale signs of diabetes, cancer and a variety of other severe diseases would make treatments much more effective and tailored to the individual patients. Though the field is still in its infancy, startups like GlySens Incorporated and Physiologic Communications are hoping to capitalize early on the growing wave of interest in this technology. In addition to tracking small-scale changes in protein levels, the sensors could eventually be used as remotes to activate other devices in the body, such as a wireless defibrillator or insulin pump. And there may come a day when we can check our health status via an iPhone app. Of course, I’m still holding out hope for Fantastic Voyage-style mini-submarines to monitor the body, but that’s a different story.

Image: Hu Tao/Tufts University

You may not be consciously aware of it, but at any given time your brain is playing host to billions of simultaneous conversations (and no, I’m not talking about those voices). I speak, of course, of the conversations between your neurons—the incessant neural jabbering that makes it possible for you to move your limbs, learn, remember, and feel pain. Every time we experience a new sensation or form a memory, millions of electrical and chemical signals are propagated across dense networks of axons and jump from one synapse to the next, building new neuronal connections or strengthening existing ones. And they are constantly changing—forming and reforming associations with other neurons in response to how the brain perceives and processes new bits of information.

Despite being central to our understanding of how the brain functions, these neural chats remain largely a mystery to scientists. What exactly are the individual neurons “saying” to each other? And how do these electrical and chemical “messages” become translated into actions, memories, or a range of other complex behaviors? To help decipher these discussions, a team of researchers from the University of Calgary led by bioengineer Naweed Syed have built a silicon microchip embedded with large networks of brain cells. The idea is to get the brain cells to “talk” to the millimeter-square chip—and then have the chip talk to the scientists through a computer interface.

Syed’s team demonstrated that it was possible to fuse neuronal networks to a microchip in 2004 when they created the original “brain on a chip,” the first bionic hybrid technology of its kind. The neurochip stimulates the cells and the resulting chatter—the activity of the neurons at the level of the ion channels and synaptic ends—can be recorded with a computer. At the time, Syed and his colleagues used the chips to eavesdrop on snail neurons, which are large (4 to 10 times larger than human neurons) and thus easier to cultivate than other animal brain cells.

The new version also relies on snail cells but is automated—a major improvement which means that just about anybody can now learn how to properly grow the cells on them. Furthermore, they offer a much higher degree of resolution and are more accurate. Whereas the first neurochips only enabled scientists to monitor the chatter between two brain cells, the new and improved models now allow them to listen in on entire networks and pick up on all the minute neural exchanges.

Aside from giving researchers unprecedented access to the brain’s innermost workings, the hope is that this technology will pave the way for new drugs to treat neurodegenerative disorders like Parkinson’s and advanced prostheses that better mimic normal human motion by communicating directly with the brain. Over the coming months, Syed and his team plan on cultivating the neurons of a group of epileptic patients on their chips in order to study the cells’ dysfunctional activity.

People who suffer from epilepsy are wracked by frequent seizures which are brought on by unusual and excessive neuronal chatter. By honing in on the defective ion channels that trigger these abnormal signals, Syed believes that his chips will yield crucial insights into the disease and lead to a more effective treatment. If proven successful, the same model could be applied to other brain disorders, eventually eliminating the need to test drugs directly on patients—or at least providing a good pilot study before moving on to patients—and thus greatly accelerating the pace of research and development. It’s the same principle as the lung-on-a-chip, which scientists hope will lead to new drug-testing protocols that obviate the need for animal subjects.

It’s certainly not hard to see the appeal of these technologies. Everyone can get behind the idea of faster drug-development cycles and more finely tuned treatments, especially if it means that no humans or animals will be harmed in the process. In several years, after they become more sophisticated and ubiquitous, these neurochips could give a big boost to the fight against brain disorders, which are some of the trickiest puzzles in medicine.

Image: Yale

“Who wants to live forever?” Freddie Mercury asks on behalf of the Highlander. Michio Kaku (whom you should be reading because he’s wonderful) has started a two-part investigation over at Big Think on just that query. The cliché question comes from the basic problem of living a long time: no one wants to die, but no one wants to get old either. Pulitzer Prize-winner Jonathan Weiner‘s new book Long For This World examines the science and scientists of gerontologology (aging). Stanford University professor of internal medicine Abraham Verghese reviewed Long For This World in The New York Times and was inspired by Weiner’s discussion of longevity. Verghese reflects on his own experience with terminally ill patients:

As a young physician caught up in the early years of the H.I.V. epidemic, I was struck by my patients’ will to live, even as their quality of life became miserable and when loved ones and caregivers would urge the patient to let go. I thought it remarkable that patients never asked me to help end their lives (and found it strange that Dr. Kevorkian managed to encounter so many who did). My patients were dying young and felt cheated out of their best years. They did not want immortality, just the chance to live the life span that their peers could expect. What de Grey and other immortalists seem to have lost sight of is that simply living a full life span is a laudable goal. Partial success in extending life might simply extend the years of infirmity and suffering — something that to some degree is already happening in the West.

I cannot get over the logic Verghese displays here. He notes the will of people to live in spite of suffering and lowered quality of life. The patients merely wanted “the chance to live the life span that their peers could expect.” Does he mean the life span science and civilization has already artificially extended fifty years beyond biological design? How does one differentiate between a 30-year-old who wants to be healthy enough to live to fifty and a 90-year-old who wants to be healthy enough to live to be over 100? Verghese is unable to reconcile the desire to live with a terminally low quality of life. The goal of anti-aging is not to simply increase the number of years a person spends alive; instead, the goal is to make every year, even into mid and late life, as healthy and youthful as possible.

In his post “Bullish on Longevity” Discover blogger Chris Mooney discusses a pill that would extend healthy life by about seven years. The trick is not to merely extend life, but to instead create a “compression of morbidity: The period of life beset by disease-related suffering and impairment would be compressed, and essentially come right at the end. You live long, you prosper–and then you die fairly quickly.”

Think of it this way: After taking a special test, you know you will die at the age of 77, but I offer you two options. Option one is that you live a normal life, aging naturally as your genes and lifestyle choices allow. Option two is that you take a pill that keeps you as healthy as you would be at age 30 until you were 74. You’d still mature mentally, build life experience, raise a family and expand your career. But at 70 you could be rock-climbing and getting your third PhD or running marathons and keeping pace with your grandchildren. Which option do you pick?

Aubrey de Grey, the prime subject of Weiner’s new book, focuses on making option two a reality. Contra Verghese, immortalists have their sights focused directly on allowing a full life span, instead of having the second-half hindered and hobbled by weakness, mental degeneration, and frailty. Alex Horne has a lovely article at the Guardian in which he interviews a bunch of old people who don’t seem to enjoy being old. Horne comes to the general conclusion that the death of friends, the Shakespearian loss of senses and abilities, and lack of purpose make being ancient less-than-spectacular. So the trick, as de Grey and other longevity supporters see it, is to stymie aging’s worse traits until the very last minute.

What Weiner and Verghese seem to miss is that longevity research isn’t necessarily about living forever, or even a spectacularly long time, but instead making the years one is alive less hindered by the very process of having lived so long. Make youthful health the bulk of life, not just the early peak.

Image: “Old persons home” by Sun Yuan and Peng Yu from Saatchi Gallery, London, via Wikipedia, shared through Creative Commons

In the not too distant future, the phrase “shooting up” could take on a whole new meaning. At least if the U.S. Army has its way. Wired‘s Danger Room blog reported a few days ago that the military is seeking bids for a high-tech form of vaccination that could be delivered quickly and efficiently to a large number of troops in the heat of battle. More specifically, the Pentagon wants a DNA vaccine that can be administered via a literal shot to the arm—and a jolt of electricity. All without causing too much “discomfort” to the patient, of course.

Suffice it to say that this futuristic-sounding vaccine would be a far cry from what you and I received as children. As last year’s swine flu epidemic made painfully clear, our current methods of vaccine development, which have remained essentially unchanged for decades, are woefully outdated. The vaccines take too long—upwards of seven months—to produce, are easily prone to failure if not prepared correctly and, in many cases, lose their potency after only a year. These failings have helped draw attention to DNA-based vaccines, cocktails of genetically engineered plasmids which offer the promise of inducing a stronger, and more targeted, immune response. Where regular vaccines are slow to develop and hard to combine, DNA vaccines can be made relatively quickly and mixed together to ward off multiple pathogens at once. They are also generally safer to produce and administer, more durable and can be scaled more easily.

Like other vaccines, however, they are still primarily injected into muscles and thus suffer from the same inefficiency problems. Because the DNA is not injected directly into the host cells but into the spaces between them (the “intracellular spaces”), the vaccine first needs to be taken up before the cells can mount a robust response and pump out the necessary disease-fighting proteins.

The two main alternatives cited in the Army’s solicitation are gene guns and intramuscular electroporation. The first gene gun was designed in the 1980s by a Cornell University scientist as a tool with which to transform plant cells by blasting them with microscopic DNA-coated gold or tungsten beads carried on a powerful whiff of helium gas.

Gene guns have since focused their crosshairs on animals and humans alike, particularly after the Army recently embraced them as their vaccine delivery method of choice. The main downside is that it can only deliver small quantities of DNA, not the two or more vaccines at a time that the Army wants. Intramuscular electroporation, which improves vaccine uptake by temporarily opening pores in their membranes through short bursts of electricity, can be used to supply sufficient amounts of DNA, but it comes at a cost: pain. So what ideal device would the Army like?

The optimal vaccination strategy would capitalize on the efficiency of electroporation, eliminate the discomfort associated with intramuscular injection, and be useful for simultaneous delivery of two or more DNA vaccines. A minimal successful outcome would provide effective delivery with reduced discomfort for one DNA vaccine.

For the moment, electroporation seems to be the method of choice among the companies operating in this burgeoning field. Inovio, a Pennsylvania-based startup that has emerged as one of the field’s dominant players, claims that its electroporation system can boost cellular uptake of a vaccine 1,000-fold or more. The company employs a handheld needle-electrode applicator tethered to an electric pulse generator to inject the vaccine into skin or muscle and deliver a few short zaps of electricity to jostle the cells into taking it up. Unlike most such electroporation systems, Inovio claims its own is relatively painless—”tolerable without anesthetic.” But it’s important to bear in mind that while DNA vaccines are making concrete progress, they still have quite a ways to go before they supplant conventional vaccines. (Plasmid purification, in particular, remains a challenge.) With any luck, the Army will have found its desired device by the time the first DNA vaccines hit the production line.

Image: alvi2047/Flickr

Doctors are not doing so well. In addition to being extremely expensive to train, maintain, and, of course, to visit, they have a lot of other problems. If your doctor is a drunk, an addict, or just plain-old incompetent, his or her colleagues may not tell you or anyone else.[1] Even when doctors are sober and sharp, their diagnoses are often, ahem, less than correct. Mark Walker’s “Uninsured, Heal Thyself” paints a pretty terrifying picture:

Physicians can and do misdiagnose frequently: they prescribe for nonexistent diseases or injuries and fail to notice symptoms or make the correct inferences. An article in the Journal of the American Medical Association noted: “Two 1998 studies validate the continued truth that there is an approximately 40% discordance between what clinical physicians diagnose as causes of death antemortem and what the postmortem diagnoses are” (Lunberg, 1998). This is a pretty shocking statistic: in 4 out of 10 deaths there is a disagreement between what physicians think is the cause of death prior to autopsy, and autopsy findings.[2]

Egads. Is there any solution to the doctor debacle? Walker proposes computer-aided diagnosis:

For example, in a well-known 1971 study, a computer diagnostic system was pitted against experienced physicians in the diagnosis of acute abdominal pain: computer diagnosis was 91.1% accurate compared to 79.7% for experienced physicians (de Dombal et. al., 1972). In another study, computer diagnosis matched that of neurosurgeons, orthopedic surgeons and general practitioners in overall average in diagnosing lower back pain. While humans surpassed computers in non-critical cases, computers surpassed humans in diagnosing more critical spinal symptoms in which quick intervention is correlated with better outcomes (Bounds et. al., 1998).

The X-Prize Foundation (famous for spurring the privatization of space flight) agrees with Walker. The foundation is developing a new prize: the “AI Physician X Prize, which will be won by the first team to build an artificial intelligence system that can offer a medical diagnosis as good as or better than a diagnosis from a group of 10 board-certified doctors.”[3] Ten doctors – forget a second opinion, every diagnosis would come with a tenth opinion!

And where would one keep such an artificial intelligence? Why in a smartphone, of course. A hand-held computer used to diagnose medical issues: that sounds suspiciously like something Dr. Bev Crusher might be using on the USS Enterprise; namely a tricorder. Or, as Dilbert creator Scott Adams calls it, an exobrain.[4] My iPhone already has access to Wikipedia, WebMD, the Mayo Clinic and a free app for the University of Maryland Medical System’s medical encyclopedia. In a pinch I could probably use it to help in an emergency until professionals arrived. My knowledge and intelligence is expanded instantly by virtue of owning a hand-held computer with a wireless data signal.

Now imagine an app as smart and accurate as a panel of ten doctors in the hands of a trained MD or EMT, emphasis on the “trained.” Walker’s essay focuses on allowing patients to self-diagnose, but the huge benefit would be for professional diagnoses. Instead of being required to memorize thousands of potential diseases and syndromes, each with their own fickle and bizarre permutations, a doctor’s two primary goals would become 1) ensuring accurate, exhaustive entry of symptoms into the tricorder and 2) giving comprehensive, patient oriented care. Diagnoses, particularly esoteric ones, would become the prerogative of the device, instead of certain hobbled, cantankerous MDs named “House.” In addition to the symptoms entered by the doctor, the tricorder would have access to the patient’s entire medical history — including reoccurring issues, worsening conditions, potential genetic dispositions, and a plethora of other minutia — that could be the difference between sending someone home with “drink fluids and come back if it gets worse” and hospitalization. Furthermore, long, infection-prone hospital stays for “observation” would be reduced or even eliminated thanks to better initial diagnoses.

With so much potential to help, the tricorder may become an ever-present part of the doctor’s uniform, just as the stethoscope did in a previous era.

1. “Doctors don’t rat out their incompetent colleagues,” Salon
2. “Uninsured, Heal Thyself” JET Press
3. “The Next Five Years of the X-Prize” CNET
4. “Exobrain” Dilbert Blog

On the battlefield, blood is a particularly valuable commodity since it is always in high demand but scarce supply. Wounded soldiers in Iraq and Afghanistan must endure weeks of waiting to receive “fresh” deliveries of donated blood that, by the time they arrive, have become stale—if not expired outright. Add on top of that the fact that the stuff is prone to contamination or carrying infectious diseases and that it needs to be matched up to a soldier’s blood type, and you have a wildly inefficient process in desperate need of improvement.

Which brings us to the notion of producing red blood cells (RBCs) from bone marrow-derived stem cells. Though the technology has been around for a few years—a company called Advanced Cell Technology produced the first lab-grown red blood cells from human embryonic stem cells in 2008—the real challenge lies in growing the trillions upon trillions of blood cells that would be needed for a single transfusion in a cost-effective manner. (A single liter of adult blood typically contains upwards of 4 to 6 trillion blood cells.) Now imagine having to scale that up to service thousands, if not tens of thousands, of individuals at one time, and you can understand why this technology has yet to make a significant impact beyond the lab setting.

It was with this goal in mind that DARPA (Defense Advanced Research Projects Agency), the Pentagon’s experimental research arm, kick-started its blood pharming program in 2008 and granted Arteriocyte, a biotech start-up based in Cleveland, Ohio, $1.95 million to come up with a solution. (If you’re wondering why ADT, which was the first to grow the cells in a lab, didn’t get the nod, it’s because the Pentagon stipulated that the RBCs had to be produced from adult stem cells.) Now, two years have passed, and the company has just sent its first batch of synthetic blood to the FDA.

The company grabs the hematopoietic stem cells from discarded umbilical cords and deploys its proprietary Nanofiber Based System (NANEX) technology to expand them 250-fold. Afterwards, the cells are cultured in self-contained units rich in nutrients and growth factor that are meant to imitate the conditions within bone marrow, which induces them to grow into RBCs. (Like all RBCs, these artificial ones lack nuclei, which makes the cells more compact and prevents them from dividing too much and becoming cancerous.) Arteriocyte claims that it can squeeze out the equivalent of 20 units of blood from each umbilical cord, more than twice the amount of blood (6 units) a wounded soldier typically needs for a transfusion.

At the moment, the company charges $5,000 a pop for each unit of blood that it produces—quite a bit, if you consider how many thousands of units the Pentagon would need to purchase regularly to satisfy demand. By ratcheting up the production process, it hopes to bring the cost per unit below $1,000, which, while still pricey, would make it a much more attractive alternative. To do so, the company really only has a few options: find more umbilical cords (probably not the case, unless we find a bunch sitting around), boost its technology’s ability to pump out more HSCs from the cords, or find a way to make the bone marrow-like chambers cheaper and more efficient.

Even if the world doesn’t become populated by blood-drinkers, a la True Blood and Daybreakers, it’s not hard to see why cheap, readily available synthetic blood w0uld be appealing–not only for U.S. soldiers but for civilian patients around the world, particularly in developing nations. It may also eventually help in treating individuals with crippling blood disorders like sickle-cell anemia by providing them with “designer” blood cocktails.

Image: The Franklin Institute

And she isn’t the only one:

Among cryonicists, Peggy’s reaction might be referred to as an instance of the “hostile-wife phenomenon,” as discussed in a 2008 paper by Aschwin de Wolf, Chana de Wolf and Mike Federowicz.“From its inception in 1964,” they write, “cryonics has been known to frequently produce intense hostility from spouses who are not cryonicists.” … Premonitions of this problem can be found in the deepest reaches of cryonicist history, starting with the prime mover. Robert Ettinger is the father of cryonics, his 1964 book, “The Prospect of Immortality,” its founding text. “This is not a hobby or conversation piece,” he wrote in 1968, adding, “it is the struggle for survival. Drive a used car if the cost of a new one interferes. Divorce your wife if she will not cooperate.”

Thankfully, Hanson and Jackson don’t seem to be heeding Ettinger’s advice. When asked to speculate why it might be that so many don’t see cryonics as a good decision, Hanson described cryonics as analogous to a “a one-way ticket to a foreign land.”

I suppose that works, but let’s flesh that analogy out a little bit more. Cryonics is like buying a ticket to a foreign land to which no one has been and may not even exist; in a vehicle that, if it stops working for just a couple of hours at any point on its indeterminately long journey, will kill (for real this time) everyone on board; all with the hopes that when you arrive the people of the foreign land will have the benevolence and the ability to not only bring you back to life, but also reverse the damage caused by rotting and freezing as well as the terminal issues that caused your death in the first place. Whew. Oh, and the ticket costs $100,000 and your current quality of life is reduced because you have to start paying for the ticket now.

You know what? I can see how that might strain my current friendships and/or sanity. You guys go on with out me. I’m going to keep holding out for Aubrey de Grey and the SENS Foundation to keep me from dying in the first place. Come ooooon, resveratrol.

Jonathan’s big smile and those of his happy parents are brought to you by the marvel of cochlear implants. That the above video is blowing up all over the tubes is a pretty good indicator that external, visible augmentation is moving steadily toward mainstream acceptance. Jonathan is joining the nearly 200,000 people world wide who’ve received a “bionic ear.” Buzzfeed has a bunch more videos of people hearing for the first time and I dare you to watch and not get a little weepy. At 8 months, the little guy should have no problem integrating into hearing society. Like anything that we aren’t born doing–be it walking, talking, or hearing with a bionic ear–we have to learn and practice. With cochlear implants, research confirms that the more time a child like Jonathan has to practice, the better he’ll be able to hear, understand, and speak.

The technology that lets Jonathan hear is the best we have right now, but a lot more options for the hearing-impaired are on the way. Amir Abolfathi, one of the minds behind Invisalign (the clear, plastic aligners that fix your teeth without obscuring your smile) has used his dental knowledge to create the SoundBite for single-side deafness. The Soundbite is a bone-conducting hearing aid that can be easily snapped onto or off of the molars on the same side as the deaf ear. It’s easier, cheaper, and safer than the current invasive technique.

Still, many in the deaf community would rather not undergo surgery or use other technologies to modify their bodies so that they can hear. For those with total deafness who don’t want to modify but are curious about the wonders of music, there’s a solution for that now too: the aptly (if not creatively) named Music for Deaf People. The device is a chic collar designed to rest on the shoulders and hug the neck. Fitted with a special electro-sensitive membrane, the collar converts audio signal (i.e. music, sound effects) into physical sensation. There are even different spots for treble and bass, like physical tweeters and woofers. Music for Deaf People still just a concept, but a rather smart one that doesn’t require deafness to enjoy. Can you imagine wearing one listening to, say, “We Will Rock You” or playing a first-person shooter? Sounds (feels?) like quite an experience.

Tech like cochlear implants is always a work in progress. Parts will get smaller, faster, cheaper, entirely new inventions will come along, and more profoundly deaf people will have the option to either permanently or temporarily modify their bodies to be able to hear. And that means more smiles like Jonathan’s are still to come.

As we’ve mentioned before, though, this is sometimes problematic when it comes to J.J. Abrams’s Fringe.  Still, we try not to critique.

Besides, Polite Dissent does such a good job of it already.  Head over to PD today for a recap of last night’s episode, including his ongoing homage to the Bulletin of Atomic Scientists.

But start reading enough about nanofilm, and anyone would discover there’s actually some real science out there that can justify parts of this plot. Think of the episode as a kind of pointillist canvas, with each dot of discovery forming the big picture of a Sci Fi plot device.

Nanofilms are, in general, a totally pedestrian concept. Put simply, it’s a layer of material that coats something else, only since it’s a nano-something,  the coating will only be a molecule or two thick, at the most. Several commercial companies make nanofilms that make glasses, computer monitors, or optical lenses resistant to fog and finger prints. Some of these are self-reactive (like on Elventh Hour, but without the picking up metals from their substrate part) in that they spread over the glass surface and bond with it.

Also, like in the show, researchers are studying the electronic applications of nanofilms. The Journal of Microelectromechanical Systems published an article in February suggesting that ti would not be difficult to create a nanofilm switch.  The film reacts to chemical stimuli and changes its resistance, altering the flow of electrons. There’s also been work looking at the the properties of nanofilms as self-generating, and electrically conducting, plastics, though early results have only just been published.

In medicine, there’s great hope that nanofilms will provide enormous benefits as the problems are worked out. An overview of the field published in Nanomedicine proposes several potential applications, including “coatings for medical implant devices, scaffolds for tissue engineering, coatings for targeted drug delivery, artificial cells for oxygen therapeutics, and artificial viruses for immunization.” The notion of using a nanofilm to coat an implanted medical device has already been patented. Nanofilms can be used both to protect the devicce from the body’s environment, and also can be designed to trigger the device when it experiences certain chemical changes.  Some Swiss researchers have also worked out a way to use a virus to deliver a nanofilm coated ball of DNA to a cell. Wait, hang on: Nanofilms and viruses? Bad idea, man.

But afterward I couldn’t help but wonder if maybe The Doctor was sitting a little stiffly on his high horse. As far as we can tell, Adipose represents a painless way to lose weight. Sure, it can be used to kill people, but it doesn’t have to be. It’s not inherent in the drug. I suspect Adipose would have a long line of customers even once full information was provided.

Naturally, people have been looking for a pill to help them lose weight since more or less forever. But consider that in recent years, obesity has been described more and more frequently in terms of an epidemic, right down to epidemiological studies of how the problem is spreading. Now blogger Jennifer Gibson pulls together some of the research to argue that obesity may in fact be caused, at least in some people, by a virus called Ad-36.

Early research found that 30% of obese people were infected with Ad-36, while only 11% of non-obese people were infected. New research finds that Ad-36 has a direct effect on human fat stem cells. The virus infects the fatty tissue and increases replication, differentiation, and accumulation of fat cells. Ultimately, this leads to larger fat cells, and more of them. The virus also increases lipid sensitivity and decreases leptin secretion of the new fat cells.

She also says that sometimes people who know other people who gain weight rapidly can even catch the virus. She goes on  to argue that the spread of obesity cannot entirely be explained by sociological factors like too much TV watching orpoor eating habits, that the existence of some kind of fat bug may go explain the speed with which the problem has progressed.  If Gibson is right, then some people may be able to solve some of their weight problems with the application of an anti-viral, or some other treatment that attacks viruses.

[Hat tip to io9]

In other news from nerdland:

• Want to build your own Death Star? Just pony up $15 septillion (15 followed by 24 zeroes). Rick Gold decided he had a few spare minutes to work out just how much the construction of the Death Star hurt the ole Imperial Budget.

• A man robbed a pair 7-11 stores in the Denver area armed with a bat’leth, the traditional weapon of the Klingons. The dude himself may represent a new high for geekery, but I also enjoyed the sourcing required by ABC-7 Denver to explain the bat’leth to viewers: “The Startrek.com Web site describes the Klingon weapon as crescent-shaped and about a yard long.” and then “Klingons were warlike enemies of the good-guy United Federation of Planets in the original “Star Trek” series but were allies in “Star Trek: The Next Generation.” (Hat tip to everyone, but in my case Geekologie)

• Scientists are getting so close to being able to implant drug delivery systems under the skin and control them via WiFi that other scientists are writing papers to express concern over security. I must admit, I’d hate to have my antibiotics hacked.

It turned out that the nearby NASA research facility was developing a version of the Streptoccucus bacteria that, when injected into a person, produced a ton of hydrogen sulfide, reducing the person’s breathing rate and core body temperature– essentially, hibernation.  As it happens, hydrogen sulfide (familiar to which anyone who’s ever smelt a rotten egg), is considered one of the possible options for inducing hibernation in mammals.

In 2003, Mark Roth, of the Fred Hutchinson Cancer Institute, saw a documentary on spelunkers that discussed the danger of hydrogen sulfide: the gas is produced by volcanoes and deep-earth vents, and it can rapidly induce a coma. Moth imagined that breathing a mixture of hydrogen sulfide and other gases could cut off just the right amount of oxygen to the blood to induce suspended animation in mammals. He experimented by putting a mouse in a chamber with 80 ppm hydrogen sulfide, and the mouse entered a state of hibernation (the character of Jacob Hood demonstrates this effect on the show). His results were replicated in May by scientists at Massachusetts General Hospital. Unfortunately, a January paper in Pediatric Critical Care Medicine showed that there were problems getting the technique to work on larger mammal, like pigs. Instead of inducing a state of hibernation, the study found the gas actually acted as a stimulant.

But there’s always the vampiric alternative. In 2005, Dr. Patrick Kochanek drained dogs of about half their blood and replaced it with a cold saline solution. The process actually put the dogs into totally suspended animation. As reported in DISCOVER, the dogs had no heartbeat, no breathing, nothing.  The dogs were left asleep for three hours before Kochanek pumped the saline out and the blood back in. Most of the dogs came back to life with no ill effects. A few dogs suffered from brain damage and lethargy, leading to charges of “zombie dogs”.

Following up on this research the next year, a scientist at Massachusetts General Hospital, Dr. Hasan Alam,  was looking into ways to keep a critically injured patient alive while awaiting surgery. Alam actually drained  a pig’s blood almost entirely before replacing it with a cold saline solution of nutrients. He left the pigs in this state of animation for two hours to approximate surgery, and then revived them. He’s tried his technique on 200 pigs and achieved a 90% success rate for revivals.

The way I figure it, putting humans into hibernation — even extreme hibernation —  isn’t going to make it possible for a single person to traverse the light years between us and our stellar neighbors. It just takes too long, even at an extremely slowed metabolic rate. For that we’ll still need either a generation ship or straight up cryonics. But for shorter, but still tedious,  journeys between planets, traveling in hibernation may be just the thing. Personally, I hope they’re able to improve on the hydrogen sulfide technique, rather than the cold-saline technique. I don’t think anyone likes the idea of traveling 100 million km to Mars with half their blood in the fridge.

Part way through the episode, one of the victims, Isaac, collapses while jogging. Our intrepid hero, Dr. Jacob Hood, rushes him  to the hospital and then has his comrade-at-investigations, Rachel Young, put out a Mayday for a decompression chamber. Amazingly, they locate a mobile chamber and have it rushed to the hospital (normally they fly patients with the bends to a chamber, rather then bring the chamber to it).  Once ensconced in the chamber and under high pressure, Isaac’s twitching stopped.

Scientifically, this chamber business makes sense so far. The bends are caused normally when nitrogen bubbles stored in tissue at a certain pressure are released as the pressure drops. Typically it’s a problem for divers who don’t follow their dive tables carefully: at depth, the nitrogen in SCUBA air gets stored in tissue, and as the divers come back up to the surface, the bubbles are released. It typically causes pain, but can lead to paralysis and death.

But dramatically speaking, the producers needed to ratchet up the tension. So the gene therapy continues to produce nitrous oxide gas at higher and higher rates, which forces the techs to raise the pressure on Isaac to keep the bubbles in his blood. And oh what pressure! Decompression chambers measure pressure in feet of sea water (fsw). They start him at 165 fsw.  Then they raise it to 300 fsw. 500! By the last cliffhanger they’ve maxed out the chamber at 1000 fsw. This is actually ridiculous. Look, SciNoFi makes a strong effort to let SciFi be SciFi, because, hey, who wouldn’t want an all-purpose sonic screwdriver? But sometimes a show just pushes the envelope too far, and this pushed my buttons, big time.

Let’s put that 1000 fsw in context. The all time record for a basic SCUBA dive is held by John Bennett, a famous technical diver, who descended to 838 feet. Isaac, therefore, was 162 feet “deeper” than the all time record. Also, 33 feet of sea water is one atmosphere. So 1000 feet of sea water is 30 atmospheres, enough to at least render poor Isaac completely immobile inside the chamber, and raise serious questions of whether he would be strong enough to inflate his lungs. And man, when Hood has to go inside the chamber to deliver the cure, that must have been a pain in the tuchus. That hyopdermic must have felt like it weight 30 pounds.

Oh yeah, and by the way, even the Navy’s decompression chamber can’t deliver 1000 fsw. It has an operating maximum of 7.5 bars, or about 244 fsw. Okay, we’re not in Fringe territory yet, but tsk, tsk, Eleventh Hour, we’ve come to expect more from you.