The Skeptics Guide #1035 - May 10 2025

Quickie with Bob: Fusion Rockets; News Items: Falling Space Debris, What Makes People Flourish, Pig Heart Xenografts, Chiropractic Stroke, Breathable Algae Drug Delivery; Who's That Noisy; Your Questions and E-mails: Faster Than Light Expansion, Autism Self-Diagnosis; Science or Fiction

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  From kickoff to the final whistle, trade the biggest moments in football with Kalshi, America's number one prediction market platform. Next Sunday, Tampa Bay takes on 5-2 Chicago. Tampa Bay is currently trading at 38% to win. A $100 trade pays out over $190 if they come out on top. Download Kalshi. Use code HOOPS to get $25 when you trade $25. K-A-L-S-H-I. Kalshi, trade what's next. 18 plus only. Restrictions and eligibility requirements apply. Event contract trading involves risk and may not be suitable for all investors. Kalshi products are not available in all jurisdictions. Prices, values, and available markets may differ from those mentioned. For more information, see kalshi.com/ regulatory.

• 0:42Speaker 01

  You're listening to The Skeptic's Guide to the Universe, your escape to reality.

• 0:48Speaker 02

  Hello and welcome to The Skeptic's Guide to the Universe. Today is Wednesday, May 7, 2025, and this is your host, Stephen Novella. Joining me this week are Bob Novella. Hey, everybody. Cara Santa Maria.

• 0:59Cara Santa Maria?

  Howdy.

• 1:00Speaker 02

  Jay Novella.

• 1:00Cara Santa Maria?

  Hey, guys.

• 1:01Speaker 02

  And Evan Bernstein.

• 1:02Speaker 04

  Good evening, everyone.

• 1:04Speaker 02

  Cara, welcome back. How was your trip?

• 1:06Cara Santa Maria?

  It was amazing. I was gone for a month. Did you guys notice?

• 1:09Speaker 02

  We did. What was the most amazing thing?

• 1:11Speaker 04

  Yes.

• 1:11Cara Santa Maria?

  Oh, I can't pick the most amazing thing. Everything's so different. What's the least amazing thing?

• 1:18Speaker 04

  Yeah, right.

• 1:19Cara Santa Maria?

  I mean, for me, it's China. It's not my favorite country to visit. I'm gonna be honest. I do love that I went and saw giant pandas at a breeding center. That was kind of cool. And red pandas, like right up close and personal. They're sort of just out in the reserve, but then they'll cross in front of you over little bridges and things. And red pandas are just the cutest. They're my absolute favorite.

• 1:41Speaker 02

  Yeah, they are cute.

• 1:41Cara Santa Maria?

  So, yeah, that was, that was pretty fun. But China on the whole is a little bit difficult. You know, it's a, it's a closed country, and so it just feels different. You can't access things on the internet. Using money there is very difficult. I think I was really excited about Vietnam. I had never been there. So I went to Hong Kong for two weeks, mainland China, up in the Chengdu, in the Sichuan region. And I had really good hot pot. Spilled it in my lap, got a horrific second degree burn. Second.

• 2:10Speaker 02

  Cara, it's a really good thing you don't have balls.

• 2:12Speaker 04

  Did it come with a warning that it was hot?

• 2:15Cara Santa Maria?

  I mean, I knew it was hot. But the bowl was like flower shaped. And so when I put the soup in the bowl, it just like splashed right over the side. Oh. Uh, yeah, it was brutal. Um, so that that put a little bit of a damper on on the trip. But then I I spent a week in central Vietnam. I happened to be there during reunification day. Yeah. Yeah, that's April thirtieth. I know the 50th anniversary of that. So it was like kind of a really big deal while I was there. I was interested and surprised and A, everybody's very, very warm towards Americans. I didn't feel any sort of hostility. And I was in central Vietnam. I was near Da Nang, hanging out in like Hoi An, hanging out in Hoi in a small town called Lankou.

• 2:58Cara Santa Maria?

  Th- this was the front lines in central Vietnam. Yeah. And so, yeah, I was, I was like pleasantly surprised that when I asked people, they were like, it's a big Vietnamese holiday. And I was like, oh, what is it? And they were like, it's kind of like our Independence Day, but they didn't say like from you. Yeah. So, um, so it was really interesting. There were obviously Vietnamese flags everywhere. The the hotels were really bumping with a lot of partying and stuff. There was a weird experience where they they closed the main road to scooters. And I I was there with a friend who lives in Asia and is very comfortable on a scooter. So that's how we rode around the whole time I was on the back of a scooter. And, uh, we had to take a mountain pass to be able to get to different cities, which doubled our length of time.

• 3:42Cara Santa Maria?

  At the top of this one mountain is a basically like a military fort, like a post from Vietnam. Uh, that's now sort of a museum. And there were people doing tours there and they were doing tours in American Jeeps. Hmm. Like it was really kitschy. You know, there's a lot of this kind of propaganda posters and a lot of kitsch around Vietnam. But I thought it was really strange that there were Vietnamese folks running Vietnamese tours using American military vehicles with all of the like imagery that goes along with it. So it's interesting, you know, knowing that there are people alive right now, plenty of people, who fought in this war, who lost their lives, who lost limbs, who lost their

• 4:24Cara Santa Maria?

  mental health, who got diseases from the horrific chemicals that were used during this war. But also, there are people, so many people alive right now, to whom this was, it's history in a history book.

• 4:36Speaker 04

  Right.

• 4:37Cara Santa Maria?

  You know, I wasn't alive during this. I was born very soon after. But to me, you know, it's, I've read about it.

• 4:43Speaker 04

  Bob was born on the 4th of July.

• 4:45Speaker 02

  That's true.

• 4:46Cara Santa Maria?

  Yep.

• 4:46Speaker 02

  Kara, I just want to point out, just because that you said, there are people alive today who lost their lives in the Vietnam War.

• 4:52Cara Santa Maria?

  Oh, I did, yeah. Oh, that's awesome. Write that down. That doesn't make a lot of sense, does it? Perhaps not. You know what I mean?

• 4:57Speaker 02

  I know, I do know what you mean, but technically, that's what you said.

• 5:01Cara Santa Maria?

  I am glad you did point that out. There are people, okay, you're right, there are people alive today who are deeply affected and who lost loved ones.

• 5:08Speaker 02

  Who know, yes, who lost, absolutely, who lost loved ones in the war, yes.

• 5:12Cara Santa Maria?

  Yes. So it is, I don't know, it's an interesting thing, history, and living through history, and not having lived through history, and how quickly things can change. Like, while I was there, I felt not only so incredibly safe, but really welcome. I actually loved Vietnam so much that I've added it to my list of, there are about four countries that I would like to live in, if I leave the US, and I've added it to my list because I enjoyed it that much. But to think about how unstable it was not that long ago, I mean, and of course, all of the, whatever, we won't get into the politics of it, but how difficult the relationship was, and all of the mistakes that, I don't want to call them mistakes, the very bad things that the US did to that country.

• 5:51Speaker 02

  Bad choices, bad choices.

• 5:52Cara Santa Maria?

  Yeah, yeah.

• 5:54Speaker 02

  When we were younger, because like, you think, like, I was born in 64, so essentially, the Vietnam War was the first 10 years of my life. And in our family, in our household, it was just the war.

• 6:06Cara Santa Maria?

  Mm-hmm.

• 6:06Speaker 02

  Right? And so, I always just heard reference to the war. I thought there was one war. You know what I mean? Like, in my mind, in my childhood, like, five, six-year-old mind, there was just this one war.

• 6:18Cara Santa Maria?

  Yeah, like, the world was at war out there somewhere.

• 6:20Speaker 02

  And, yeah, that's always been going on, and, like, there's only this one war, and then...

• 6:24Cara Santa Maria?

  That's very 1984.

• 6:25Speaker 02

  When the war ended, it's like, oh, the war ended, there's no more war, you know?

• 6:29Speaker 04

  Right, oh, that's that. We'll never see that again.

• 6:32Cara Santa Maria?

  I went into this one shop that I really, really liked, where they, they had a lot of propaganda, and kind of young artists reimagining things. And they sold a lot of T-shirts that had pretty provocative statements about communism, or about, you know, these different inflection points. But one of the shirts that I really, really loved, it said, "Vietnam, it's a country, not a war."

• 6:56Speaker 02

  Yeah.

• 6:56Cara Santa Maria?

  Because so many people only relate to an entire culture of people because of the war in Vietnam. But, yes, when I hear the word Vietnam, I think of the country.

• 7:06Speaker 02

  Yeah, but that's an artifact of, of media as well. If every, every time you're seeing Vietnam, or people speaking Vietnamese, whatever, it's in the context of the Vietnam War, that's what you associate it with. I told you, guys, like, when I went to Vienna, and I heard people speaking German there, I realized that, oh, holy shit, every single time, pretty much, in my life, I hear somebody speaking German, they're a Nazi, in a movie. And so, like, that association was so strong, I didn't even realize it.

• 7:38Cara Santa Maria?

  Yeah.

• 7:38Speaker 02

  You know?

• 7:39Cara Santa Maria?

  And it's, it's so dangerous, you know? I, I think about just this idea that there's a whole beautiful culture, a whole interesting people, and propaganda did that, right? Like, it was all propaganda. And when you see Vietnamese propaganda, that, that, to me, was some of the most fascinating, is seeing all this Vietnamese propaganda, you know, that people sell posters. I actually bought some of the posters, I think they're really interesting. And, and seeing that, and thinking, oh, my goodness, look at all of this, and then going, we have the same thing. Like, every time there's a war, it's one side... Making all these claims about how they're superior and that other group is evil. And then it's the other side doing the same thing.

• 8:20Bob Novella?

  True of everyone.

• 8:21Cara Santa Maria?

  It's fascinating.

• 8:22Speaker 02

  Yeah, and that's why it's so good to visit other cultures and get different perspectives and be cosmopolitan, right? You don't, you get, you're not trapped in this very narrow perspective.

• 8:32Cara Santa Maria?

  Oh, absolutely. And, and just to be lucky enough to be there on this, like, really important day and to talk to some of the people about it. But yeah, I had a great time. Oh, oh, and I have news. While I was gone, guess what happened? Breaking news. It was only a few days ago, actually. Uh, the Board of Psychology issued me my license. Nice. Congratulations. Thank you. I am now a licensed psychologist and do not have to practice under supervision anymore. Hooray.

• 8:58Speaker 02

  Awesome. All right, Bob, you're gonna start us off with a quickie. What's this about a nuclear fusion rocket? What?

• 9:05Bob Novella?

  What? No way. Well, yeah, I mean, they're working on it. They're working on it. They don't have it, obviously. It's not ready yet. But I liked some of their ideas. So this is, uh, yes, fusion rockets in the news. This is Pulstar Fusion. It's a UK-based aerospace startup. It's founded by entrepreneur, uh, Richard Dynan. And they released, uh, some plans relatively recently, and I was quite intrigued. So they see nuclear fission rockets as a, as a big thing. They, they do say that, but big in the midterm. Uh, and I've been waiting decades for that damn midterm, and it's not happened yet, but apparently it's coming. They say that if you want to move a lot of equipment to Mars and through deep space, then rocket exhaust speeds become even more critical, obviously. And they, they call fusion the king of propulsion, uh, which I can't disagree with.

• 9:50Bob Novella?

  So they envision, it's interesting, they envision, uh, fusion space tugs in orbit, multiple space tugs waiting in orbit to attach to rockets that launch on the Earth and approach them, and they, uh, they will dock to the side of the rocket. And of course, they would have to be built in a way that they can actually dock and, and then be used as fusion propulsion to speed them on their way, wherever, wherever they happen to be going. So that's a kind of a different, interesting idea. And it makes a lot of sense, because you can't launch fusion rockets from the, the surface of the Earth, uh, so you'd have to kind of do it once you're out into space. So that's an interesting design. Kind of creative. I hadn't seen that before. Now their design is magneto-inertial fusion, which we haven't talked about much. It's kind of a hybrid fusion approach. It's a hybrid.

• 10:35Bob Novella?

  Yes, yes, thank you. It fuses deuterium and helium 3, and it does that by rapidly compressing a magnetized target. The plasma compression happens in repeated pulses, which creates bursts of fusion energy rather than maintaining this continuous plasma confinement as other methods. So here's some of the stats. I mean, obviously, this is not proven. It hasn't been accomplished yet, but they're working on it. They're planning on making this happen. They didn't give a timeframe of when it could be completed, just, you know, steps to get to that, to those final prototypes or whatever. But some of their, some of their numbers are interesting. For example, going to Mars with a chemical rocket is typically seven to eight months. They said with their fusion design, it could be four months. So they

• 11:17Bob Novella?

  cut that in half, which is, which is pretty slick. What really got my attention is specific, their specific impulse measurements, which we've talked about on before. It's, it's related to the efficiency of the fuel usage. So the higher the number, which is in seconds, is the better. So chemical rockets have a specific impulse of 450. Their design, they say, is 10,000 to 15,000 seconds, specific impulse, Steve. That's impressive. Those are some damn big numbers. So, so that could imply that they could burn their rocket for far, far longer than a chemical rocket, depending on how the fuel is used, though. And typically, those, in those scenarios, that there's, there's less thrust. So there's a lot of variables to take into account. But an ISP of 10,000 to 15,000 is just like,

• 12:02Bob Novella?

  wow, jaw dropping. This one is even a little bit better. For Saturn, chemical rockets could take six and a half years. They say they could do it in a year with this technology, once they perfected. A year, that's, you know, a lot of years saving. And they threw a number out there of how much money it could save in US dollars. They said $1.2 billion it would save.

• 12:22Speaker 04

  So faster and less expensive?

• 12:25Bob Novella?

  Yeah, apparently.

• 12:26Speaker 04

  Both.

• 12:26Bob Novella?

  Yeah, that's what they're saying.

• 12:28Speaker 02

  Which makes sense because, you know, less you don't have to maintain the mission for five years.

• 12:33Bob Novella?

  CEO Richard Dynamaid, he made an interesting point when he said, people say doing fusion on Earth is proving to be really hard. Doing it in space must be a crazy proposition. But actually, there's a lower bar in space. Part of the problem is doing fusion in the atmosphere. And that's correct. You don't need to create a vacuum in space. It's already there. But if you're going to do this on the Earth, you're going to need that. And that's very, it's expensive. It's complex. It's a pain in the butt, especially when you need big vacuum areas in closer vacuum. The other angle here is that fusion reactors on the Earth, they're being made to make cheap plentiful energy, right? That's the goal. You want to make as much energy as you can, as cheaply as you can.

• 13:15Bob Novella?

  And they will be able to do that once they have a nice reactor working. But for fusion rockets, though, it's a different deal. You don't need to be efficient. You don't need it to be cheap. You just, if you make it work, that's probably going to be good enough. So space-based fusion propulsion seems to have a lower bar technologically and atmospherically. And if you think about that joke for a minute, I think you're going to really like it. This has been your Lower Bar Quickie with Bob. Back to you, Steve.

• 13:43Speaker 02

  Yeah, it's interesting to think about that because using fusion to make electricity on Earth is really hard for a lot of reasons that just don't exist in space. If you're using it just for propulsion, it doesn't have to be sustained. It could be putts, like putt putt putt. It doesn't have to be sustained fusion. You don't have to convert it into electricity, right? You don't have to, again, create a vacuum. And it's actually a lot easier technologically to do that.

• 14:10Bob Novella?

  But by the way, they also said that it can also be used to generate power. So they said that you can get to your destination with two megawatts available. Like, damn. So that's pretty slick.

• 14:19Speaker 02

  Right, and it doesn't have to be cheaper than solar, it just has to be cheaper than chemical rockets, which are really expensive.

• 14:25Bob Novella?

  Right, right, and don't forget those, the deeper you go though, solar becomes less and less helpful, so, uh, so for deep space, you gotta carry, you gotta carry.

• 14:33Speaker 02

  I mean, but, but, what I meant was, like, on Earth for power, a fusion reactor would be competing with solar power for energy, for the cost of energy.

• 14:43Bob Novella?

  Right.

• 14:44Speaker 02

  Or with, right, or with wind, but, but as a propulsion system, it's competing with other propulsion systems, which are all really expensive.

• 14:53Bob Novella?

  Yep.

• 14:54Speaker 02

  So again, yeah, the calculus gets a lot more favorable, so, yeah, we may see fusion rockets before we see fusion power.

• 15:01Bob Novella?

  I, I think we might, I think we might, and it's funny, because we might even have the potential to, to create, you know, working fusion reactors on the Earth, but it's like, it's just not gonna be worth it, it might not be worth it for them to do it, it's like, ah, sorry, it's just, it's just not gonna be worth it, it's just, it can't compete, you know, with, with solar and wind and all that, and all that stuff, so that, that's a, a future we may encounter, where, like, holy crap, it just never happens on the, you know, it never happens.

• 15:25Speaker 02

  On Earth, it's great in space.

• 15:26Bob Novella?

  For power generation, uh, because it's just not worth it, we got better, but, but it's a good problem to have, because that means there's other cheaper alternatives, which is fine, but I, I wanna see it in space, and, and as we've said in our, uh, forget.

• 15:38Speaker 02

  You're, you're breaking the, the law of the quickie, Bob, all right.

• 15:43Bob Novella?

  This one was on the edge, this one almost wasn't.

• 15:48Jay Novella?

  Love quickie dynamics.

• 15:49Speaker 02

  Speaking of space, Jay, what comes up has to come down, right?

• 15:53Jay Novella?

  Right. On Earth. That's a very interesting way to put it.

• 15:56Bob Novella?

  Yep.

• 15:57Jay Novella?

  All right, I wanna, I wanna start with a question.

• 15:59Speaker 02

  Yeah.

• 16:00Jay Novella?

  Cause I'm constantly looking up into the night sky, you guys have seen satellites in orbit, right? Yes.

• 16:05Speaker 02

  Oh, yeah.

• 16:06Jay Novella?

  Many times. Yeah, I mean, basically, the, uh, other than the space station, which I was tracking for a couple of years, I was, you know, whenever it was passing overhead, I was, I was watching it. It is neat to see that thing go zooming by. I've seen satellites, but they're just literally a pixel of light, there's like nothing to it, however, I have never seen a satellite enter the Earth's atmosphere, have you guys ever caught that?

• 16:27Speaker 02

  No.

• 16:28Jay Novella?

  No.

• 16:29Speaker 02

  I don't think so.

• 16:29Bob Novella?

  Yeah, I s- wait, what did I say? No, I didn't see. You're right. Not entering. No.

• 16:33Speaker 02

  Unless something that I thought was a meteor was a satellite re-entering.

• 16:36Bob Novella?

  That's true. Or pieces of something that broke up. Steve, do you remember that meteor we saw back at Mom's house? Look at that. That was the best I've ever seen. Broke into and it left a trail that persisted. You could see that that trail. It was mind-boggling. I loved it. Loved it.

• 16:51Jay Novella?

  So this is this is a news item that I stumbled on recently that I found to be, you know, really interesting, particularly because what the future holds. So there was a a considered to be a very rare and complicated field operation that happened. A European scientist actually pursued a falling satellite in a business jet. I'm assuming they mean like a Lear jet. And they did this to collect data on what is considered to be a littlely a little understood, but potentially pretty serious environmental issue. And this is essentially satellite pollution in the Earth's upper atmosphere. Specifically, when the satellite burns up and breaks apart and everything, you know, what is it putting into the atmosphere?

• 17:35Jay Novella?

  So on September 8th of 2024, a retired European space agency, the satellite that was retired called Salsa, S A L S A. This is one of four satellites in a something called the Cluster Mission. This particular satellite re-entered Earth's Earth's atmosphere over the Pacific Ocean. So they they took off from Easter Island and it was a multinational research team. I guess it was getting some hype because of, you know, what they were trying to do. You know, this was a really crazy way to to gain data, right? To like fly in a commercial, you know, in in a private Lear jet style jet to go up and go super high and see the satellite come, you know, come down into the Earth's atmosphere.

• 18:19Jay Novella?

  So what they wanted to do and what they successfully did do was they were able to capture the event. They had 26 high-speed multispectral cameras. And the team successfully recorded the fragmentation and the chemical signatures of this disintegrating spacecraft. Now, their findings were presented in April of 2025, and that's why we're talking about this now. This was at the European Conference on Space Debris in Germany. This is all important data to collect because approximately, how many satellites do you think re-enter the Earth's atmosphere on a daily basis?

• 18:52Bob Novella?

  Daily? Daily. Daily. Daily? Sat- satellites? Twenty.

• 18:57Jay Novella?

  No.

• 18:58Speaker 04

  No. Oh my gosh, every day?

• 19:00Jay Novella?

  That seems too high. Evan, I'm curious to hear what your number is.

• 19:03Speaker 04

  If it's one, that seems high.

• 19:05Jay Novella?

  So it turns out it's on average three satellites a day. Jesus. Which is over, it's pretty much, you know, it's over a thousand a year. That's right now.

• 19:14Speaker 04

  That's crazy.

• 19:15Jay Novella?

  You have a thousand satellites re-entering the Earth's atmosphere. I think that's a lot, you know what I mean?

• 19:20Speaker 04

  Yeah, I must be woefully ignorant about the number of satellites that are up there. Is there a hundred thousand items up there?

• 19:26Jay Novella?

  There is a ton, Evan. Oh my God, there is so much stuff. Now, keep in mind, we have these mega constellations that are going up now by SpaceX and then Amazon's gonna do it. And this is gonna blow out that three satellite a day number. Like, that number is gonna dramatically increase and it's gonna be, it's gonna happen very quickly, right? It's gonna be happening within the next couple of years. We're gonna start to see a lot more re-entries happening. Controlled re-entries? Well, you hope that it's controlled enough where they can dump it in the ocean. Or, you know, you don't want, definitely don't want any of this happening over populated areas. But they're supposed to, like, there's some protocols that have been put in place where they have to meet certain criteria in order to re-enter, right?

• 20:11Jay Novella?

  Meaning that they have to have that. But they're really small, right? They're not as small as you think. Really? I figured they'd burn up in the atmosphere. They don't? Yeah, well, that's what I thought. Ah, okay. Okay, so Starlink is launching thousands of these, of their Starlink satellites into orbit. And these satellites, they do, technically, they burn up in the atmosphere. But that process of them burning up in the atmosphere, even if they do burn up in the atmosphere, it's not like this routine thing that, oh yeah, it comes down, burns up in the atmosphere, whatever's left, you know, hopefully gets dumped in the ocean and we never have to talk about it again. That's not what's actually happening. So when satellites incinerate... Unfortunately, they released metallic aerosols into the upper atmosphere,

• 20:54Jay Novella?

  which is part of the atmosphere you don't want to mess with. And particularly aluminum oxide. And that can damage the ozone layer and it can alter Earth's thermal balance, right, by reflecting solar radiation. Which, you know, depending on how you look at it, you know, that could be a good thing. It could be a bad thing. So these, these are definitely, you know, well-known and well-established mechanisms in atmospheric chemistry. And the amount of aluminum oxide released into the atmosphere during re-entry is, it's a complete mystery. But, but now we're on to it, right? So we figured out a way to essentially find the data that we need. And this first test that they did, you know, it was definitely, they didn't know what the results were going to be. They had no idea if they were going to even find anything. But here's what happened.

• 21:39Jay Novella?

  I thought, I thought it was pretty cool. So they, they, according to Stefan Lowell at the University of Stuttgart, he said it was unexpectedly faint, meaning they didn't capture a lot of light. And this, the reason is that the satellite probably fragmented into super small pieces that would emit less light, right? Because you, there was, there's, even though there might be more of it, each one individually produces less light and it's not like combined together anymore. Right? So the team were able to track up the breakup for about 25 seconds. And then they lost sight of it as it, it descended down to about 25 miles in altitude. So they did collect spectral analysis of that fragmentation cloud

• 22:22Jay Novella?

  and it revealed chemical traces of lithium, potassium and aluminum. And these are materials that you don't want in the atmosphere. Now, it's unclear how much of the vaporized material, you know, turned into an aerosol form? And will it have atmospheric effects? At what volume would, would the material have to be at to have atmospheric effects? You know, versus how much of it, you know, turned into microscopic debris that came all the way down to the Earth's surface? The titanium fuel tanks, as an example, from the Salsa satellite, say that three times fast. They think that those fuel tanks survived and they landed in the Pacific Ocean intact.

• 23:03Jay Novella?

  And that is definitely a plausible outcome for larger and sturdier satellites. You know, that is a concern too, because that debris could be dangerous. But, you know, this, this is not what they're specifically studying. So getting back to Starlink and to answer Kara's question. You know, these are new satellites. They're heavier than most people think and they're larger than most people think. So what do you guys think that a Starlink, you know, single Starlink satellite weighs?

• 23:29Speaker 00

  Eight tons.

• 23:30Jay Novella?

  I was gonna say like one ton. So they're coming in at 2,750 pounds.

• 23:35Speaker 00

  Yeah, you're right, Kara.

• 23:37Jay Novella?

  Yep, or one, you know, 1,250 kilograms.

• 23:40Speaker 00

  Kilos.

• 23:41Jay Novella?

  Now SpaceX says, yes, they burn up completely and flowers come out when they burn, you know, like, right? Like, there's like, nothing to see here. But they did acknowledge that some fragments do occasionally reach the ground when they come back in. So, you know, again, these are bigger than we thought. You know, there's a ton of them. There's going to be a ton of these reentering because they don't have an incredibly long lifespan. So they're just going to be constantly coming back down and replenishing and coming down and replenishing. So there is a few things of particular concern. So one of them is molten aluminum, right? So as a satellite disintegrates, the aluminum compounds that are in it, they melt. And they can either vaporize into aluminum oxide aerosols or they can cool into nano and micro, micrometer sized droplets.

• 24:26Jay Novella?

  Those two eventually fall to the earth. Of course, the aerosols don't. The aerosols are the ones that pose the most risk to the ozone and to the climate. And the researchers, they just can't quantify how much aluminum takes what form yet, right? Again, because this is the initial study that's going to set off, it's the flick of the marble that's going to, they set off a whole bunch of studies to come. So that's the real issue. We have, you know, we have a data gap, you know, with over, like I said, with over 1,000 reentries per year. We could potentially be injecting a large amount of these exotic materials into a very sensitive layer of our atmosphere. You know, we don't want to do that. We don't want to do anything that's going to make global warming any worse.

• 25:09Jay Novella?

  We don't want to have any bad, negative health effects. If even a small percentage of it is, you know, turned into aerosol and it's up in the upper atmosphere, there could be a cumulative impact. That could rival other existing pollutants that we are very well aware of. But of course, we won't know until they do further study. So what comes next? You know, they have, there's other cluster satellites, the Rumba, Tango, and Samba, which are part of that set that I told you about before. They're going to come down this year and next year. And they're, unfortunately, you know, they're going to happen during daylight hours, which is not ideal, but it's still, we'll still be able to collect data on it.

• 25:49Speaker 02

  Yeah, so whenever you do anything on that scale, you gotta really track it. Like, you know, we're putting thousands of satellites up. There's going to be thousands of satellites coming down every year.

• 26:00Jay Novella?

  Yep.

• 26:00Speaker 02

  It adds up.

• 26:01Jay Novella?

  Just another little thing to worry about, team.

• 26:03Speaker 02

  There's a lot of issues with space. You know, just the sheer amount of space debris, we've talked about this before, is becoming a huge problem.

• 26:11Bob Novella?

  Oh, yeah, man, just waiting for the event to happen.

• 26:15Speaker 04

  The event.

• 26:16Speaker 02

  The cascade of satellites crashing into other satellites.

• 26:21Bob Novella?

  Yeah, Kessler syndrome.

• 26:22Speaker 02

  All right. Kara?

• 26:25Cara Santa Maria?

  Yep.

• 26:25Speaker 02

  What does it take to make people flourish?

• 26:28Cara Santa Maria?

  You know why I like this story? Because it's a good news, everyone.

• 26:32Speaker 04

  Yeah, good news.

• 26:35Cara Santa Maria?

  I feel like we don't have that often.

• 26:37Speaker 04

  Not enough.

• 26:38Bob Novella?

  I got some good news too this week, so you go first.

• 26:40Cara Santa Maria?

  Okay, so a new study was published. Where was it published? I'm about to tell you. In Nature Mental Health, just about a week or two ago, called The Global Flourishing Study. Study Profile and Initial Results on Flourishing. And really, this is one of those large multinational, multi-research site studies where multiple authors contributed. We're talking a longitudinal panel study of over 200,000 participants across 22 different countries that span all six populated continents. They use nationally representative sampling, and they intend to collect data for five years.

• 27:24Cara Santa Maria?

  And the idea here is to assess aspects of flourishing and possible determinants of flourishing. But what is flourishing?

• 27:34Cara Santa Maria?

  Well, I'm going to read you a quote directly from the publication. Flourishing is an expansive concept. And then there's like six different citations after just those words. And the working definition underpinning the GFS, that is the Global Flourishing Study, has been, quote, "the relative attainment of a state in which all aspects of a person's life are good, including the contexts in which that person lives." So then they dive into different aspects of that definition and they further break it down into different, what they call, well-being domains. So what do you think some of these different domains might be that make up how we measure, or how these researchers at least have decided to measure flourishing?

• 28:19Speaker 02

  Health.

• 28:20Cara Santa Maria?

  Okay, yeah, they talk about physical well-being.

• 28:24Speaker 02

  Happiness.

• 28:25Cara Santa Maria?

  Happiness is emotional well-being.

• 28:27Bob Novella?

  Yeah, emotional, mental.

• 28:29Cara Santa Maria?

  Mm-hmm.

• 28:30Bob Novella?

  Financial. Financial.

• 28:32Cara Santa Maria?

  Financial, yep. And they talk about what they call material well-being, which they call financial security.

• 28:38Speaker 02

  How about liberty, freedom?

• 28:41Cara Santa Maria?

  Interestingly, they actually don't talk about that, but they do talk about volitional well-being, which they define as character.

• 28:48Bob Novella?

  Okay.

• 28:49Cara Santa Maria?

  So sort of their choice. And they also talk about cognitive. Yeah, we already did physical. Yeah, they also talk about cognitive well-being, which they define, it's a little bit weird. Their well-being domains, I wouldn't choose. But basically, they talk about meaning. So we've got health, happiness, meaning or purpose, character, financial security. And then what do you think the last one is? We're leaving something really important out here. Do you exist in a vacuum?

• 29:15Bob Novella?

  What's that? Social.

• 29:16Cara Santa Maria?

  Right, yeah, relationships.

• 29:18Bob Novella?

  Yeah.

• 29:19Cara Santa Maria?

  Yeah. So, and then they define each of them. So relationships, for example, is the relative attainment of a state in which all aspects of a person's social life are good. So they go through and yeah, what they want to do or what they did is they came up with basically an index of well being across all these different domains. And they just used, basically, it's, this is a big data study, right? Two hundred thousand people, ask them a bunch of questions, ask them all the same questions, which they do later define as both a study limitation, but also, I guess, a boon for the study. So I kind of want to stop there and not give you all of the results.

• 30:02Cara Santa Maria?

  But before we go into the results, which I can't give you all of them anyway, it would take too long. But before we go into some of the results, why do you think it's both a good thing and a bad thing that they asked all the different people in the study the exact same questions?

• 30:14Speaker 02

  Well, you can, you can do statistics and you can compare them.

• 30:17Cara Santa Maria?

  Right, yeah, it's, it's much more feasible to do a large statistical analysis when you do a study this way. But as they define it, they did this study in an etic way, not an emic way. Do you guys know the difference between those two sociological concepts?

• 30:33Bob Novella?

  Say those two words again.

• 30:34Cara Santa Maria?

  Etic, E-T-I-C, versus emic, E-M-I-C.

• 30:37Bob Novella?

  Oh, damn.

• 30:38Speaker 04

  I don't know the comparison.

• 30:40Cara Santa Maria?

  So in an etic study, what they're basically doing is they're saying, I am outside of your culture and I'm going to look inward and ask you questions and then, you know, make comments about your culture. Whereas an emic study utilizes researchers or individuals living within that culture and formulates the questions to be meaningful or, or contextualized within the culture.

• 31:02Speaker 02

  So like endemic, same kind of word?

• 31:05Cara Santa Maria?

  Yeah, maybe it's the same word. Yeah, I'm not sure, actually. Well, what's the word on that sometimes? But, but basically, we, we do see more of a movement towards emic approaches in sociology over time. When we think back to like super colonial approaches, they were all very etic. But it does, in this specific situation, allow direct comparisons. The problem is, some context is probably lost and there's always going to be an implicit bias then. Because who defined these questions, right? And is that perspective now going to measure that more so in a culture that utilizes some of these different, these measures? We don't know. So it is important that they they list that as a limitation of a study,

• 31:49Cara Santa Maria?

  but they also talk about why it made it really easy to compare all 200,000 participants to each other, to compare different countries, different age groups, different genders, all these different ways that you could slice and dice this demographic data. And they asked a lot of questions. They asked things like, let's see, how old are you? What's your gender? Are you married? Are you employed? Do you attend religious services? How much education do you have? What's your immigrant status? What country are you from? What was your relationship like with your mother growing up? Your father growing up? What was the financial status of your family growing up? Was there abuse? You know, they asked so many different questions to try and understand what people's life is like now

• 32:34Cara Santa Maria?

  and what they went through throughout the lifespan to get to where they are today. And then they made a bunch of comparisons and they found some kind of interesting outcome. So so let's start with what they basically define as who is flourishing and why? That's a big question that they asked. Who is flourishing and why? When it comes to age, what do you think? Who are flourishing the most across the lifespan?

• 33:00Speaker 02

  I think generally speaking, the older you get, the more you're going to flourish.

• 33:04Cara Santa Maria?

  That's true, but a lot of studies previously didn't show that. A lot of studies previously showed that that older adults were the ones who were struggling the most. But this study shows that it's relatively flat between about 18 to 50. And then you just see a slow, steady increase in flourishing and the highest flourishing is amongst the oldest group. Yeah, usually in the past, studies showed a U-shaped curve where you had this dip in the middle, in middle age, but you had kind of higher, earlier and older. But not, not this study. It just shows kind of a slow, steady increase.

• 33:38Speaker 02

  Yeah, well, you get, you get better at the whole life thing when you get older.

• 33:41Cara Santa Maria?

  Um, I find this one really, really interesting. They're showing that being married have higher flourishing scores across the board. So it goes married, then widowed, then domestic partner, then single, never married, then divorced, then separated. But they don't divide it by gender. And so I would be really interested to see, because previously studies, previous studies have shown that married men have the highest, at least, life satisfaction, followed by single women, followed by single men, followed by married women are at the bottom. So, um, so it would be interesting to see their flourishing, um, scores divided not just by marital status, but also by gender. They do look at gender and they find that

• 34:25Cara Santa Maria?

  gender is pretty even across the board, but there are differences from country to country. So in some countries, women flourish, uh, less than men. Um, but across the board, when they look at all of the aggregate data, it's pretty, pretty even. 7.19 is, you know, they have this like, um, this measure that they use. 7.19 for men, 7.12 for women, pretty much the same. This one might surprise you. What do you think across, and I don't, I know I didn't tell you what the 22 different countries are, but what countries do you think people are flourishing in the most?

• 35:00Speaker 02

  I'd say high socioeconomic status countries.

• 35:03Cara Santa Maria?

  Right? Yeah. You'd think kind of richer, uh, richer countries, countries with more wealth. So like the United States is on the list and it is definitely in the bottom third.

• 35:13Bob Novella?

  That good, huh?

• 35:14Cara Santa Maria?

  And they look at it with and without financial indicators. And across the board, the number one country was Indonesia, followed by Mexico and then the Philippines.

• 35:22Bob Novella?

  Mexico. Excellent. That's what I thought. Awesome.

• 35:25Cara Santa Maria?

  From their write up in the conversation, quote, "Indonesia is thriving. People there scored high in many areas, including meaning, purpose, relationships, and character. Indonesia is one of the highest scoring countries in most of the indicators in the whole study. And Mexico and the Philippines also show strong results. Even though these countries have less money than some others, people report strong family ties, spiritual lives, and community support. The lowest scores were in Japan and Turkey. And even though, for example, Japan has a strong economy, people reported lower happiness and weaker social connections. They also think maybe long work hours and stress contribute to to lower flourishing scores. Turkey, obviously there, they they describe political and financial challenges and, you

• 36:09Cara Santa Maria?

  know, just difficulty with secure, like individual security. So they talk about how it's surprising that richer countries like the US and Sweden aren't actually flourishing as well as some others. They do well on financial stability, but their scoring-

• 36:24Speaker 04

  That doesn't translate necessarily to across the board flourishing.

• 36:28Cara Santa Maria?

  No, because that was only one of the measures. They're showing lower scores in meaning, lower scores in relationships. They found that countries with higher income across the board do tend to show lower levels of meaning and purpose. And then countries with higher fertility rates often have, show higher ratings of meaning and purpose.

• 36:46Speaker 04

  Mm hmm. Okay. That that seems reasonable.

• 36:49Cara Santa Maria?

  Yeah, yeah. I mean, it's it's interesting when you look at these big takeaways because you you can sort of predict some things and other things. It feels a little like science or fiction where you could make a case for it to go either way. Like, one of the things that they talk about, and we've seen this across other studies, is that individuals who are highly involved in religious services tend to have higher ratings of flourishing. So those who go more than once a week are higher than those who go one time per week, higher than those one to three times a month, down to a few times a year, down to never. Never is on the very, very bottom. And they saw that this was the case even in secular, countries that were more secular. And so, you know, we've talked about this in the past.

• 37:32Cara Santa Maria?

  It doesn't really necessarily have anything to do with religion, per se, but it has to do more with community. So they cite the the literature in the psychology of religion where they talk about things that they call the four Bs. Belonging, bonding, behaving, and believing. So belonging is social support, bonding is spiritual connection, behaving is cultivating character and virtue through practices and rituals and norms. And then believing, which does contribute to hope, forgiveness, spiritual convictions. So, you know, they do include the actual act of believing as something that contributes, but this is not the main sort of predictive variable here.

• 38:17Cara Santa Maria?

  We know that people who attend religious services tend to have more community, and that seems to carry a lot of weight there. But they also found that people who go to religious services reported more pain and suffering. And it's hard to know if that's because it's sort of a bias, right? They're going because they're experiencing more pain and suffering. That's why they're seeking out religious community, or some other reason. And of course, adverse childhood experiences do have some impact on flourishing. If you were a kid with excellent health, it's the most predictive of you flourishing later in life. If you're a kid who had a good relationship with your mom, if you went to religious services,

• 38:59Cara Santa Maria?

  if your family was financially comfortable, if you had a good relationship with your dad, that's less predictive. You tend to be flourishing more. If your parents were divorced, you had financial hardships, they were single, your parents died, your health was poor, or you experienced abuse. Experiencing abuse was the most predictive of low flourishing, which makes sense. Not a lot of like, big wows here, but the main takeaway is that it's very, very hard to pick one variable. This is a very complex interplay of a lot of things, and it is probably very, very culture-bound. And so, this massive group of researchers are excited to continue to dig through the

• 39:44Cara Santa Maria?

  data and to continue to ask questions, because we don't have a lot of studies on things like flourishing. We have a lot of studies on what happens when things go wrong. But it is exciting to say, okay, what are some of the reasons that people are feeling fulfilled in life and that they're doing well? And how can we learn from those reasons?

• 40:03Speaker 02

  Yeah, and it's good to look at these like just big endpoint kinds of studies like flourishing or happiness or whatever, because I do think that in life, people do a lot of things that they think will make them happy, or think will make their life better, but they actually end up doing the opposite, right? Like, working really hard to make money. They go, money's gonna make me happy, but you're working yourself to death, and you're miserable.

• 40:26Speaker 04

  The problem is, until you do it, you don't know that.

• 40:30Speaker 02

  Well, it's not like you don't have eight billion other people on the planet that you could sort of look at and get, you know, you could learn from other people's life experiences. You don't have to necessarily make every mistake yourself. I know generally we do, but that's what mentors are for, and parents, and, you know, and whatever, you know, people...

• 40:47Cara Santa Maria?

  And reading.

• 40:48Speaker 02

  Yeah, and reading.

• 40:49Cara Santa Maria?

  Science, you know, like, talking to, to, or reading what these researchers are finding. But I, I will be interested in more kind of culture-bound and culture-specific examples, because I think it's really easy to say, okay, this country versus that country, or people who do this versus people who do that. But where are all of the moderating and mediating variables here? Like, really understanding, not just that these are interesting predictors, but these are how the predictors affect one another. I think it can get complicated really quickly statistically, but it could also give us a wealth of information.

• 41:26Speaker 02

  All right, thanks, Kara.

• 41:27Cara Santa Maria?

  Yep.

• 41:28Speaker 02

  All right, guys, I'm gonna talk to you about heart transplant.

• 41:31Cara Santa Maria?

  Cool.

• 41:32Speaker 02

  You know that we have a-

• 41:33Speaker 04

  Heart to heart.

• 41:35Speaker 02

  We have a, we have a huge deficit in organs for transplant, right?

• 41:40Speaker 04

  I imagine that's always the case.

• 41:41Speaker 02

  So, in the US alone, there's, generally speaking, over 100,000 people on the waiting list for an organ transplant, but only about 23,000 organs become available each year, and about 6,000 people die each year while on the waiting list.

• 41:57Cara Santa Maria?

  And that's for all organs?

• 41:59Speaker 02

  Yeah.

• 41:59Cara Santa Maria?

  Okay.

• 42:00Speaker 02

  Yeah.

• 42:00Speaker 04

  So, this is in the US?

• 42:01Speaker 02

  Just the US.

• 42:02Speaker 04

  Okay.

• 42:03Speaker 02

  Obviously, the numbers-

• 42:03Speaker 04

  I'm a donor.

• 42:04Speaker 02

  Numbers are a lot bigger in the world. Yeah, and this is a problem that could be solved, if just people, more people become organ donors. There would definitely be a huge benefit to, you know, the health of the world, you know, if we had essentially an unlimited supply of donor organs. If the supply was greater than the demand, like, that wasn't the limiting factor.

• 42:26Cara Santa Maria?

  Of course.

• 42:27Speaker 02

  Um, yeah. So, how do we get there?

• 42:29Cara Santa Maria?

  Grow them.

• 42:30Speaker 04

  Line them up, take their organs.

• 42:32Cara Santa Maria?

  Grow them.

• 42:33Speaker 04

  Yeah, grown.

• 42:34Cara Santa Maria?

  Well, really, because like, if you look at organ donation, I don't, I, I work in a hospital and I've worked with a lot of individuals on the heart transplant list, like with the psychology of what it means to get a new heart. I mean, it's really intense, right? And so I have noticed when I'm, when I'm doing the inpatient work, that there's a massive difference in the parameters and just the like rigidity between the heart transplant patients and for example, a kidney transplant patient.

• 43:01Speaker 02

  Yeah.

• 43:02Cara Santa Maria?

  Because it's just easier to get a kidney.

• 43:04Speaker 02

  It is.

• 43:04Cara Santa Maria?

  There are more kidneys.

• 43:06Speaker 02

  Because people can donate one kidney.

• 43:07Cara Santa Maria?

  Yep.

• 43:08Speaker 04

  Right. Yes.

• 43:09Cara Santa Maria?

  Like a family member can give you a kidney and then you have a kidney.

• 43:12Speaker 02

  Can't give you a heart.

• 43:12Speaker 04

  I can't give you a liver. I can't give.

• 43:14Cara Santa Maria?

  Exactly. Well, and even liver transplant is a little less intense. Yeah. Cause you can give a lobe of a liver and it regenerates.

• 43:20Speaker 04

  That's enough to keep someone alive?

• 43:21Speaker 02

  Yeah.

• 43:22Speaker 04

  Ah.

• 43:23Cara Santa Maria?

  Heart is a very, very different animal.

• 43:27Speaker 02

  Yeah.

• 43:27Cara Santa Maria?

  Like it's, and, and the, the threshold for how healthy you have to be, to be able to get that heart, or not healthy, but how capable you have to be to be able to get that heart is much higher.

• 43:38Speaker 02

  Yeah. So that's, that's a good point. And that raises another wrinkle here is that the numbers I just gave you are a massive underestimate of the demand because people don't even get on the waiting list. If it's like you're, listen, you're, you're never going to get an organ, right? Cause you're.

• 43:53Cara Santa Maria?

  Yeah. I saw a lot of patients like that.

• 43:54Speaker 02

  Yeah. You're, you're just.

• 43:55Cara Santa Maria?

  They fail out of the actual.

• 43:57Speaker 02

  Yeah. They're, they're, they're already filtered out at the first level.

• 44:00Speaker 04

  Pre-screen.

• 44:01Cara Santa Maria?

  Yeah. They're ineligible for transplant.

• 44:03Speaker 02

  Not because it couldn't work. It's because like, there's no way we're going to get that far down the list to get to somebody with your characteristics, right? Your high risk or whatever. So just forget about it. No point in even putting you on the list. So, but again, if, if, if the source were no, no limit, then a lot of people who don't even get on the list would be able to get a transplant. We know somebody, a very dear friend of ours, Michael LaSalle, who died on the waiting list for a heart transplant. And actually he didn't even get on the list. They were like, yes, you know, you know, he, he,

• 44:33Cara Santa Maria?

  That's hard.

• 44:34Speaker 02

  Yeah.

• 44:34Speaker 04

  Yeah. And this didn't develop later in his life that he needed it. They knew early on, right?

• 44:39Speaker 02

  It was, it was congenital. He was born, born with, with.

• 44:42Speaker 04

  His organs were. With a defect.

• 44:43Speaker 02

  With a heart defect. And his whole life was like, at some point it's going to get bad enough that you're going to need a transplant. And then they said, it's too bad. It's like, he was waiting, waiting, waiting. Oh, it's too late, is basically what happened.

• 44:55Cara Santa Maria?

  And even, I mean.

• 44:56Speaker 04

  Died at like 40.

• 44:56Speaker 02

  Yeah.

• 44:57Cara Santa Maria?

  I've met patients who. Were eligible, who made it to the top of the list, who got a new heart, and then there was some rejection or some sort of.

• 45:05Speaker 02

  Oh yeah, it's not a guarantee either way. Yeah. All right. So what are the options for, for alternatives to organ donation, right? Carrie, you mentioned growing them. What do you mean by that?

• 45:17Cara Santa Maria?

  Well, I mean, like organoids or something like that. So whether we're growing it in another animal or in a, in a Petri dish, like basically, that's been a huge, you know, goal, right?

• 45:28Speaker 02

  It's tricky because it's hard to get the organ to develop properly outside of the environment of a full organism. But that's one approach. Another approach is to print them with stem cells, right? But then you need scaffolding and usually those are obtained from the organ itself. So it doesn't really solve the problem.

• 45:50Cara Santa Maria?

  Right.

• 45:50Speaker 02

  You need the donor organ to, then you denutitive cells and you 3D print stem cells on it. The only advantage there potentially is that you could use stem cells derived from the recep, the ultimate recipient, right?

• 46:02Cara Santa Maria?

  Right. So you don't.

• 46:02Speaker 02

  So reduces rejection. But we're not anywhere close to that at this point.

• 46:06Cara Santa Maria?

  Oh, what about animal like?

• 46:08Speaker 02

  There you go.

• 46:08Cara Santa Maria?

  Right now, we're talking about cadavers, but yeah, animals.

• 46:11Speaker 02

  Animals are, in my opinion, the, the, the best chance and the closest. For some organs, for the heart, the heart is different than the, than the liver and the kidney in that you can make a mechanical heart. You can't really make a mechanical kidney. I mean, you can, it's a dialysis.

• 46:32Cara Santa Maria?

  Ooh, that'd be so complicated.

• 46:33Speaker 02

  But it's really, you can't have it in, inside the patient, right?

• 46:37Cara Santa Maria?

  Mm hmm.

• 46:37Speaker 02

  But yeah, but we might be able to at some point make a mechanical kidney. And we do, again, we do have them, they're just not really for transplant, they're more just for dialysis.

• 46:45Cara Santa Maria?

  But not liver, right?

• 46:47Speaker 02

  But not liver, it's really, I mean, not anytime soon, like bionic liver, it's not, not even on the drawing board at this point in time.

• 46:53Cara Santa Maria?

  But yeah, lots of patients are on bridge to transplant.

• 46:55Speaker 02

  Yes.

• 46:56Cara Santa Maria?

  Waiting for heart and they're on LVAD for like.

• 46:58Speaker 02

  Exactly.

• 46:58Cara Santa Maria?

  A while. Keep, keep, keep sustaining.

• 47:00Speaker 02

  So there is, there is a bridge to transplant and then there's the ultimate transplant and then there might be a retransplant. So let's talk about pig hearts for xenographs. Because again, hearts are difficult and we definitely don't have enough to go around. And you know, we were nowhere close to printing hearts or growing them just in a vat or whatever. But what you can do is genetically engineer, genetically modify a pig so that it has something more like a human immune system. And then you basically are growing, it's a xenograft. Technically, that means from another species as opposed to an allograft, same species.

• 47:39Speaker 02

  But it's a xenograft that behaves like an allograft because you've genetically modified the immune markers on it. And then you just raise a pig, right? You just clone these pigs, you raise them up, you know, and then you harvest their organs. It's the lowest tech way to do it. And the highest tech aspect of it is the genetic modification. And we got that, like, we are all over that, you know what I mean? Like that, we have the technology to do the genetic modification.

• 48:04Speaker 00

  We have the technology.

• 48:05Speaker 02

  We do, and we could make clones. So we could do, so essentially, the technology is to, you take a pig genome, you make edits to specific genes that, again, alter the immune system so that it won't be, it won't look like a different species to the intended recipient. And then you clone it, you put that DNA into an embryo where it's, the DNA was removed. And then you induce it to form, you know, to reproduce and divide and form a fetus, right? So there's a company already doing that. And they just, this is the news item, is they've completed a trial where they were, they were donating pig hearts into baboons.

• 48:51Speaker 02

  They did 14 transplants. The 14 baboon recipients survived for at least several months, with the longest surviving one being 21 months, which is a pretty long time. So and then in one of the cases, they followed up the xenograft with the genetically engineered pig heart with an allograft, basically another baboon heart. Because they wanted to just proof of principle, show that. That that could happen and there would be nothing about the xenograph that would prevent the allograft from working. Now, why did they do that, though? Because, as you said, Cara, they're they're first looking at this as a bridge, not as the final transplant.

• 49:35Cara Santa Maria?

  Gotcha.

• 49:35Speaker 02

  So if you could get this to work so that, on average, you know, the recipient of this genetically modified xenograph, the pig heart, can survive for three or four years, then that that's your bridge. That gives you time to be on your waiting list for a permanent human heart for three to four years without having to without requiring the LVAD, right? Which is basically a mechanical mechanical heart. It's a left ventricular assist assist device. It's not a completely mechanical heart. It it just helps pump blood through your own ventricle.

• 50:11Cara Santa Maria?

  And some people have to be like in the hospital the whole time they have it.

• 50:14Speaker 02

  Yeah, they're like in the hospital for months. Yeah.

• 50:16Cara Santa Maria?

  Yeah, yeah, yeah.

• 50:17Speaker 02

  It's not great. And there's another population where this might be especially useful. And that is the pediatric population, especially infants. So some infants are born with congenitally bad hearts that need to be replaced, like they're incompatible with life kind of hearts. Like a single vet, they have a single ventricle. And those don't make a good connection to the mechanical hearts that we have and don't work well with LVAD. And so a lot of these infants die while they're on the waiting list for a transplant because because infant hearts are in really short supply, right? So the this may be the first thing that they go for is to do a

• 50:57Speaker 02

  a pig heart, a genetically modified pig heart as a bridge heart for an infant while they're on the waiting list for a donated human heart. Of course, the ultimate goal is to make these so good. That it can be your permanent forever heart or organ, or any organ like you just we're just growing and harvesting organs that are, you know, as good as allograft don't, you know, transplants and maybe even eventually better. Now, the, the company that did this recent study, they did 10 genetic modifications, just 10 modifications. That's not a lot, but what happens when we figure out 20 or 50 or 100 modifications

• 51:38Speaker 02

  that we can do that will essentially eliminate any rejection. So in, in the ideal world, the ultimate expression of this technology is genetically modified animals like pigs that, from which we can harvest organs that will, where there's zero rejection and they survive for the lifetime of the recipient. Uh, and then we just have essentially an unlimited supply as much as we need of, you know, of any of those organs to donate without having to do cadaveric donation or somebody donating a kidney or whatever, not having to do any of that without having to do any bridging maneuvers. Just, we can just say, oh yeah, we'll just grow you a heart. Here you go.

• 52:22Speaker 02

  So, and the, the, I don't know if we can get to that with a generic, you know, pig xenograft or if, in order to get that good, if you would have to basically give it the recipient's immune system, you know what I mean?

• 52:37Cara Santa Maria?

  Yeah.

• 52:38Speaker 02

  Where you have to raise the pig for them, but that's totally plausible, right? You know, or at the very, or yeah, at the very least, we might have subdivisions, right? To the, the, where it's like, basically there are, people fall into different groups in terms of their immune system markers. And we could say, or, you know, if you're, you have like one of 10 immune types, we're going to give you a donation from a pig that's in your type, even though it may not be individual to you as a specific person. It's like blood type, you could think about it that way. We're going to give you a pig that has your type, your blood type, your immune type, you know, and that will be better than just like a generic human pig.

• 53:21Speaker 02

  It's not just humanized, it's specific to a subtype and then maybe eventually specific to an actual individual person.

• 53:28Cara Santa Maria?

  Yeah, I could see getting there. I mean, I feel

• 53:30Speaker 02

  We could absolutely get there.

• 53:31Cara Santa Maria?

  I know it's different, but things like CAR-T therapy, you know, CAR-T cell, like where we take The information from us.

• 53:39Speaker 02

  Yeah.

• 53:39Cara Santa Maria?

  And then we modify it and put it right back in us, like modify it, put it in the pig.

• 53:43Speaker 02

  Yep. The thing is, we can do it. We can use CRISPR or whatever to genetically modify these genomes. We can clone them and we can raise viable animals. We can harvest their organs, we can transplant them and they work. The whole thing from soup to nuts works. It's just a matter of getting incrementally better at this point. And the next step they're going to do, they're applying to the FDA for permission to do human trials. So that's the next step. So we could be, I know this is the joke on the show, we could be five to 10 years away from this being in the clinic, from actual patients receiving pig xenographs from this technique. That's way closer, decades closer than any of the other techniques.

• 54:28Speaker 02

  The other techniques may not even ever pan out, but this is happening now, at least at the animal level, and human research is coming up. That's the next step. So we may see this in our lifetime, you know, people start to receive pig xenographs.

• 54:44Cara Santa Maria?

  So how different are pig, you know, obviously we talk about rejection being an issue, like an immune issue. But how different is the physical organ? Like are all the connections really easy or do we have to modify things?

• 54:56Speaker 02

  There's a reason why they chose the pig. It's very similar, just happens to be very similar to the human. And so their hearts are good, they're mechanically a good fit for a human. And we know how to genetically modify them to make them smaller, so they're a human sized.

• 55:12Cara Santa Maria?

  Yeah. I wasn't sure if like because we are bipedal and pigs are quadrupedal. Like sometimes that affects the orientation of like vessels and things like that, but I guess.

• 55:27Speaker 02

  Yeah, as long as the hookups are close enough that you could surgically connect them.

• 55:31Cara Santa Maria?

  Kind of bend them.

• 55:31Speaker 02

  Yeah. Yeah. So it's plug and play, basically. And of course, a living organ is better than like a mechanical heart in that it's more physiologically responsive, like moment to moment to the demands of blood flow to the lungs and to the body.

• 55:48Cara Santa Maria?

  Right, and potentially more resilient, too.

• 55:51Speaker 02

  And gentler on the blood. The biggest limitation with mechanical hearts is that they're very destructive to blood cells. You know, first of all, you got to give blood thinners so they don't clot. And then, you know, people, their, their blood cells don't survive as long when they're being pushed around by a mechanical heart. Now, again, that technology may advance to the point where it gets as good as a human heart and that'd be great. Of course, that does, you know, it's going to be a lot harder to do that for other organs. But we don't know, I don't know how far away we are from that. That's very, very tough nut to crack. Again, I think this is the best, this is the best way to go.

• 56:25Cara Santa Maria?

  Yeah. And even, we've got to remember that even if you're lucky enough to get a human heart, you are on anti-rejection medication for the rest of your life.

• 56:31Speaker 02

  Yeah. Imagine if you can make this so good that there's no rejection. You don't have to be on immunosuppressive drugs.

• 56:37Speaker 04

  That's the holy grail.

• 56:38Speaker 02

  That's the holy grail. Again, that's the ultimate expression of this. It's a new heart, no rejection, no drugs. Have a nice day. You know, that's it. And yeah, and again, we're just incrementally away from that. We just have to keep making advancements, but it, the whole, it works. Every, all the pieces are in play. So very exciting. All right, Evan, give us an update on chiropractic and stroke, something we've talked about a few times in the past.

• 57:04Speaker 04

  We have, and it has come up again in a recent article, but I want to ask you all a couple of things. But I want to, what I want, let's see how much we all remember about chiropractic. Steve, maybe you should give others a chance to answer these before you. I know you've written quite a bit over the years about the history of chiropractic. Okay. But for the other rogues, what, when do you think it started? What year was the practice invented?

• 57:31Speaker 02

  Oh, of chiropractic.

• 57:32Cara Santa Maria?

  1920.

• 57:33Speaker 04

  Hmm. Okay.

• 57:35Cara Santa Maria?

  Maybe that's too new. 1840.

• 57:36Speaker 02

  1885.

• 57:37Speaker 04

  Oh, you're close, Bob.

• 57:38Speaker 02

  1850s, I think.

• 57:39Speaker 04

  1895, Bob. Good job. And, and who is credited with its invention? What's the name of the fellow?

• 57:45Bob Novella?

  Oh, that punk.

• 57:48Cara Santa Maria?

  Doctor chiropractor.

• 57:49Speaker 04

  Doctor punk.

• 57:51Speaker 02

  Can I say it now?

• 57:52Speaker 04

  You can, Steve.

• 57:53Speaker 02

  Dee Dee Palmer.

• 57:54Speaker 04

  Dee Dee Palmer, yes.

• 57:55Bob Novella?

  Yep, yep.

• 57:56Speaker 02

  Yo, Dee Dee.

• 57:57Bob Novella?

  It's still in my memory banks.

• 57:59Speaker 04

  His first patient had an ailment that was said to be cured by his chiropractic procedure. What was that ailment?

• 58:09Cara Santa Maria?

  Did it have to do with bones?

• 58:10Speaker 04

  Yes, deafness, hearing loss.

• 58:12Cara Santa Maria?

  Deafness?

• 58:12Speaker 04

  That's right.

• 58:13Cara Santa Maria?

  Come on.

• 58:14Speaker 04

  And do we know what the word chiropractic is? Or from what, what words you put together to make chiropractic?

• 58:22Speaker 02

  Chiro is hand.

• 58:23Speaker 04

  Yes, hand.

• 58:24Cara Santa Maria?

  Hand manipulation, like practice?

• 58:26Speaker 04

  Well, practice, right. And practicos, yes, done by hand. And finally, the idea that misalignments of the vertebrae called subluxations can interfere with the nervous system and cause a wide range of health problems beyond back or neck pain is basically what Palmer came up with. So that's the origin.

• 58:45Cara Santa Maria?

  Yeah.

• 58:46Speaker 04

  And that's the history, just a little backstory for you guys. Now, New Yorker magazine recently put out a article on their health section in which the headline reads, Instagram has made chiropractic neck adjustments more appealing than ever before, but physicians say the maneuver is dangerous. This is not some, this is not new news, okay, to us and many people in this audience.

• 59:10Speaker 04

  The author of this article, her name is Katie Arnold Ratliff. She's a freelance writer and editor for their health section. Here are, here are the relevant parts of this article. Last fall, a tweet by Los Angeles cardiologist Danielle Bellardo, M.D. illustrates the stakes involved with chiropractic manipulation and strokes. Quote, here's the tweet from that doctor. Heartbroken after seeing a young patient with no medical history end up with a B I F F L grade two dissection of the vertebral artery and subsequent acute PICA, P I C A, infarct immediately after a neck adjustment from the chiropractor. This has to stop. Chiropractors, you have to stop in caps. So what does that mean? Yeah.

• 59:55Speaker 04

  A neck adjustment caused a tear in the tissue lining of the patient's vertebral artery, which is known as a vertebral artery dissection. And the tear impacted their blood flow so severely that it cut off a portion of their brain from oxygen. Immediately that that patient experienced vision changes, difficulty walking and started to develop weakness on one side of her body. And the person who had their neck, this person had their neck adjusted and then they what had a stroke.

• 1:00:22Speaker 02

  Yeah, it's a it's a lateral medullary stroke and it's like a brain stem stroke. It's pretty severe.

• 1:00:30Speaker 04

  Pretty severe. I don't recall us speaking about this particular case before. It was also written about in Women's Health Magazine. This was back in November of 2024. They covered it. They went on to say in that article, they indicate that this was the fourth time in Dr. Bellardo's career, she's the cardiologist, where one of her patients suffered a stroke due to chiropractic manipulation. Dr. Bellardo says she wished she had spoken up sooner. After seeing the first patient with this condition, she feels guilty for not having alerted people to this health problem sooner. Now, her tweet, Dr. Bellardo's tweet, has been shared almost 6 million times. And I think we can think, okay, that's good. Her post has been shared quite a bit and hopefully made many more people aware of

• 1:01:13Speaker 04

  the risk. However, we have Instagram and we have TikTok and other social media platforms. That is an ocean in which chiropractors and their patients share videos and experience on all the joys and wonderfulness of chiropractic. No mention whatsoever of this particular risk or any other risks associated with chiropractic. Now, I don't have the numbers to share. I tried looking it up to try to quantify it, but it's that's almost impossible. But a cursory search for chiropractic on these sites opens up the floodgates. So much so to the point that, you know, even a respected cardiologist warning people the dangers of stroke via chiropractic and with 6 million views, that really doesn't even hold a candle

• 1:01:55Speaker 04

  to those who are promoting the practice. Back to the New Yorker magazine article, we have a local connection here inside of that article. For us, the SGU, right here in our home state, Connecticut, University of Bridgeport. Oh, my gosh. How long have we been talking about the University of Bridgeport? Even before we were skeptics guide to the universe, when we were the Connecticut Skeptical Society, basically.

• 1:02:20Speaker 02

  Thirty years.

• 1:02:21Speaker 04

  Exactly. I know. Thirty years of that as well. We've been skeptical activists for like half of our lives. It's amazing to think of that. The University of Bridgeport, yeah, mainly since nineteen, since the 1980s, the, which is when the university was basically bought out by, or taken control of by the Unification Church, Dr. Sung Young Moon, the Moonies, they owned, they operated the university right up through 2019. I didn't realize they were still involved that late into it, but 2019. We are very familiar with the antics and pseudoscience and cult-like atmosphere that has permeated the University of Bridgeport now for decades. Well, in any case, they quote in that article, "Gentleman James Lehman,

• 1:03:04Speaker 04

  a chiropractic orthopedist and the director of the Health Scientist Postgraduate Education Department at the University of Bridgeport, he is a neck adjustment defender." Here's what he says, "Statistically, if you had 57 chiropractors do 100 cervical manipulations a week for 52 weeks for 20 years, one out of those 57 chiropractors would encounter this particular situation, meaning an arterial dissection and subsequent stroke."

• 1:03:33Cara Santa Maria?

  That's too many.

• 1:03:35Speaker 04

  Well, yeah, that, that is too many, and it doesn't exactly jive with other research on this. Now, the research also is, that has been done on this, is a bit, mm, what, uh, spread out. There are studies, apparently, in which the frequency of this takes place in one in 20,000 events, one, one time out of 20, and then there's another one that I think was like one in 2 million. So you have kind of this very large range here. So I imagine that has to do with, you know, quality of the study and so many other mitigating factors. Really hard to kind of pinpoint exactly. So I'm not even really sure where he is coming up with this particular set of numbers. I imagine

• 1:04:18Speaker 04

  he found the most favorable one and he just kind of parrots that as he goes along in defense.

• 1:04:22Speaker 02

  But as Kara said, so yeah, first of all, yeah, he's probably using the most favorable numbers, and even the, the worst numbers are probably an underestimate because chiropractors have no motivation and no incentive to track this, and so they don't.

• 1:04:35Cara Santa Maria?

  Yeah.

• 1:04:35Speaker 02

  Um, so we're basically the only, most of the data comes from physicians who are on the receiving end of these, uh, of the strokes, of the dissections and right? So that's just not a thorough sample and it's probably under counting them. But even still, even if that, even if those numbers were correct, as Kara said, it's too many because medicine is a risk versus benefit game.

• 1:05:00Speaker 04

  Correct. That's the bottom line here.

• 1:05:01Speaker 02

  And there's no benefit. So zero benefit, you know, compared to, yes, statistically rare, but when they do occur, you're basically causing a stroke and/or death to an otherwise young, healthy person. So there's a pretty bad, it's not like, you know, a mild adverse event. This is a, a serious, potentially fatal adverse event. None of it's justified if there's no proven benefit. There's, and which there isn't. There's no proven benefit to chiropractic manipulation of the neck. And let me clarify that because that's a specific thing. It's not any manipulation of the neck. It's not any physical therapy. Like, physical therapists do neck mobilization, for example, right? When they're trying to

• 1:05:46Speaker 02

  like, you know, if you have like a locked joint in your neck or you have muscle spasm, whatever. That's different. What chiropractors are doing are high velocity, very rapid manipulations of the neck.

• 1:05:59Speaker 04

  Mm-hmm.

• 1:06:00Speaker 02

  It's much more violent. It's way more risky.

• 1:06:02Speaker 04

  It's rough.

• 1:06:03Speaker 02

  Yeah. And it's

• 1:06:04Speaker 04

  Like a whiplash event.

• 1:06:05Speaker 02

  Exactly. And there's no indication for it. There's no theoretical basis for it. And there's no evidence of any benefit from it. It's just pure risk. Saying that the risk is low is not a defense. It's just an illustration of their ignorance of how clinical medicine works.

• 1:06:22Speaker 04

  And Steve, not only do they say that, that they offer these very low, you know, statistics.

• 1:06:27Speaker 02

  Yeah.

• 1:06:27Speaker 04

  But they also said that, look, how do you know the patient didn't already have some kind of tear in there? And just the, the manipulation revealed that issue.

• 1:06:36Cara Santa Maria?

  Well, you don't, which is why you don't go manipulating their necks.

• 1:06:39Speaker 04

  Right.

• 1:06:40Speaker 02

  That's not a defense because you absolutely should not be manipulating somebody's neck if they have a dissection. So they're basically saying, no, it's not this kind of malpractice. It's this completely other, different kind of malpractice. It's not, it's not a defense.

• 1:06:53Speaker 04

  Right.

• 1:06:54Speaker 02

  It is not a defense. But also, there are cases, there are plenty of cases where the cause and effect is pretty clear. Where the person like basically stroked out on the chiropractor's table.

• 1:07:04Speaker 04

  Yep.

• 1:07:04Speaker 02

  You know? So that's just, it's just silly.

• 1:07:07Cara Santa Maria?

  It's terrifying. And that's only one of so many possible negative outcomes.

• 1:07:12Speaker 02

  Right.

• 1:07:13Cara Santa Maria?

  It's just a pretty violent one.

• 1:07:14Speaker 04

  Right, right. And there does not appear to be either laws or guidance in place in which the chiropractors are supposed to be disclosing this to all of their patients.

• 1:07:25Speaker 02

  They're basically self-regulated.

• 1:07:26Speaker 04

  Right. They self-regulate. And in fact, the person who wrote this particular article said, who didn't, who said, look, I didn't come into this, you know, one way or the other, pro or con. But basically, the reason why she said she would not do this is because if she knows about even this very small chance of risk of this stroke, regardless of which set of statistics you want to use, she would choose to not do it based on that. So if you had more people ahead of time being made aware of this, or it was mandatory to be made aware of this, then you would have people making better decisions about going to the chiropractor for the specific purpose.

• 1:08:02Cara Santa Maria?

  There's also like this whole secondary thing, which I don't think we've talked about, which is that because chiropractors are not physicians, when something bad does happen, they're not trained in what to do. So like, there are situations where there are lower risk outpatient procedures, where patients will be working with nurse practitioners or physicians. And, you know, sometimes there's a complication, but there's a protocol in place for how to get them to an ED quickly, and for what kind of first aid to do in the meantime. But like, a chiropractor isn't trained in how to do that. They don't have those pipelines in place.

• 1:08:36Speaker 02

  They don't. They say they are, but it's a lie. They are absolutely not. They do not have the same training that physicians have.

• 1:08:43Cara Santa Maria?

  Terrifying.

• 1:08:44Speaker 02

  They like to pretend that they do. And if those, listen, if all chiropractors were doing was like lower back, you know, Lower back, right. Manipulation for acute uncomplicated lower back strains, like the one thing for which you could say that maybe there's some evidence that it's as good as other things that you can do for lower back strain. Like massage or something? Yeah, exactly. Or even giving a pamphlet on good back hygiene is just as effective, you know, in the literature. But whatever, if they were just doing that, or if they basically was another avenue to become like a sports medicine person or whatever, then who cares, right? But it's because they do this sort of thing, because they're not science-based, and they don't really have the same kind of ethical structure that mainstream medicine has. Mm-hmm.

• 1:09:28Speaker 02

  They, and right, they don't really self-police well. There's just so much pseudoscience and crankery and malpractice happening under the umbrella of chiropractic. They just need to just purge themselves of that, get rid of subluxation theory. Right. You know, just practice evidence-based, you know, whatever chiropractic, and then nobody would care. It would be fine. But they don't. But that's not, but they don't. And lest we forget that they do this on animals and children, too. Children and babies. Babies. Babies. Completely, and it's, and it's basically... Higher, much higher risk group. The thing is, it's their fault. It is 100% their fault. So, little bit more of a history lesson, if you go back 120 years, you know, when chiropractic

• 1:10:11Speaker 02

  was in early days, there was another similar profession that also believed in manipulation to free up the flow of life energy, but they thought it was flowing through the blood vessels, not the nerves. You know who those were? The blood letters? Not blood letters, osteopaths. Oh, osteopaths. Oh. DOs. That's interesting. That's the foundation. DOs. That's how they started. But they cleaned up their act. Yeah, they got rid of it. After, after medicine, you know, the, basically, you know, there was a huge shakeup where American medicine decided to adopt the standards of European medicine and become very scientific. We, half of American medical schools closed down, they merged, the standards were put in place, et cetera, et cetera.

• 1:10:55Speaker 02

  Basically, they went to chiropractors and osteopaths and said, "Well, do you want to join us and become science-based and ethical?" And the osteopath said, "Yes," and the chiropractor said, "No."

• 1:11:09Cara Santa Maria?

  Wow.

• 1:11:10Speaker 02

  They said, "Screw nerds to you, we're going our own way, we don't need your stinking science." And they, so they, they were given the olive branch and they rejected it. And they've had a hostile relationship with, with medicine ever since, but it's all on them, it really is. Whereas DOs are basically MDs.

• 1:11:27Cara Santa Maria?

  DOs practice in every, yeah.

• 1:11:28Speaker 02

  They're MDs. Right, yeah. And we don't care. I, I practice side by side with DOs. They're basically MDs. It's, it's not about like competition or whatever, it's just about, you know, what they do. It's about being legitimate. And this is one of the reasons, if they, you know, there's no way physicians would get away with this. A procedure that doesn't have a proven efficacy, that occasionally strokes people's out and kills them, forget about it. Right?

• 1:11:57Cara Santa Maria?

  It's insanity.

• 1:11:58Speaker 02

  It's insanity. It is. All right, let's move on before I have an aneurysm. Oh my gosh. Bob, tell us about this breathable drug delivery system.

• 1:12:07Bob Novella?

  All right. All right, guys, so researchers have developed a non-invasment, fucked up already. All right, guys, researchers have developed a non-invasive treatment for respiratory diseases that use, get this, an inhalable form of green algae. How does this work? Why do we even need such a thing? So you can read about it in Nature Communications. The title of the paper is Inhalable Biohybrid Microrobots: A Non-Invasive Approach for Lung Treatment. Okay, now we know respiratory diseases are on the rise. Scientists are increasingly looking for ways to treat ailments like pneumonia, asthma, tuberculosis, COPD. So part of the problem is that the lungs, even though they're inside us, they're potentially at risk with every breath we take, from pollutants,

• 1:12:50Bob Novella?

  viruses, bacteria, irritants, on and on. You know, they are inside us, but they have such a direct line with everything you breathe in. It's like, it makes them almost uniquely vulnerable compared to other, you know, internal organs that we have. The evolutionary development of Lungs has actually done an impressive job protecting that that pathway to our lungs. So tell me, how do you, how do you, what do you guys think? What are some of the ways that the lungs protect itself from anything getting in? What's going on in the body?

• 1:13:18Speaker 02

  They have a lot of ciliary things that, you know, the cilia that constantly moving stuff out of the lungs. And you can cough to, to expel things from your lungs.

• 1:13:27Bob Novella?

  Yeah, all, all good stuff. So the, the first line of defense is the nose hairs. They're, they're encountered first. They filter out the larger, the larger things like dust and pollen. You know, to a certain extent, they're not perfect, of course. The next step was the mucus in our windpipes. And we know how nasty and sticky that, that stuff is, right? That just grabs the dust and pollen as well as other micro, you know, as well as microorganisms itself. And they're caught in these like, these little hair like structures called cilia. And that, and that moves the stuff up, you know, in a coordinated way, up and away from, from, from our lungs. Sometimes it's coughed up. So you guys are basically right. Now, whatever makes it past those defenses though, can end up right in our lungs. But then they face the gatekeepers of our lungs immune system, the macrophages, the dreaded macrophages.

• 1:14:12Bob Novella?

  So these, these guys do many, many beneficial things. But in this context, they clear away anything that you breathe in that you shouldn't. From bacteria, viruses, fungi, fungi, and on and on. And they also can do, one of the other things that they can do in this, in this way is, is they could bring in other types of, of immune cells as needed, like lymphocytes. Ironically, I didn't know this. Ironically, some of these macrophages have actually been implicated in some disease progressions like asthma and COPD. So whoops, evolution. So yeah, nothing's perfect. Kind of weird that the protectors of the lungs can actually damage it in that way. So, but all of these layered lung defenses, they're great. They're obviously fantastic, but with all these layered defenses.

• 1:14:56Bob Novella?

  It's really great, but it does have a downside. It makes it harder for doctors to heal the lungs because they have to get by that stuff, too. So in order to do that, they often have to take an indirect route to the lungs, right? Like injecting antibiotics. But the problem with that is that only you have to give a big dose, right? Because only some of that medicine that you inject is actually going to find its way to the lungs, which means you need, like I said, you need a larger dose than what is strictly necessary, and that can create unwanted side effects. So you always want to do the minimal dose necessary. And indirectly injecting, you know, antibiotics to get a pathway to the lungs that's not direct, not ideal. So researchers have actually tried other inhaled forms of medicines, like nanoparticles filled with medicine that go straight to the lungs.

• 1:15:41Bob Novella?

  So that's, that's great. But the problem is that they get cleared away by those damn macrophages. So it's not, doesn't work as good as they wanted it to do. So the researchers needed a new approach, a completely new approach, for this direct medical treatment of the lungs, something that's non-invasive, but also with the ability to last long enough to spread this medicine around and get it all over the lungs. So surprisingly, they turned to a tiny green ally. I'm not talking about Yoda or even kazoo. Look that one up. But something much more microscopic, green algae. I did a little bit of a dive into green algae, so to speak. It's really quite fascinating. Oh, okay. Yeah, yes. Right. They're, they're like plants.

• 1:16:26Bob Novella?

  They, in that they use photosynthesis to make food, but there's nothing classically plant-like about them. There's no leaves, there's no roots or anything like that. Interestingly, did you know that plants actually evolved from green algae, they think, about 480 million years ago? So I didn't know that. Did you know that plants evolved from green algae? I didn't. So thank you, green algae. So why use green algae for, for drug delivery? Do you, this is a tough one. I don't suspect. Expect that you would have any ideas of why green algae is the one that they went to probably fairly quickly? That's because they chose green algae because it's better than bacteria and blue green

• 1:17:09Bob Novella?

  algae because those two have surface features that make them relatively easy to be detected by our immune system. So, green algae does not have any of those structures on its surfaces, so it's just generally safer for biomedical uses. So, that's the one that they jumped to. But, there's also other reasons. So, they take these green algae and they say in the paper, I love this use of the word, they say they functionalized each cell by coating them with the medicine that they want to deliver to the lungs. But, you can't just take any old green algae. You need a green algae that has very specific characteristics. So, number one, they had to be very, very small. So, they picked this picoeukaryotic algae.

• 1:17:52Bob Novella?

  Picoeukaryotic algae, very tiny, about 1/50th the size of a hair, each one. You could line up 50 of them before it matches the diameter of a hair. So, that tiny size was needed so that they can be absorbed by aerosolized water droplets, right? So, you've got these water droplets that can be easily, they're so small, they're just suspended in the air and you could just breathe them in without even thinking about it, like by using a nebulizer. And it just bypasses the nose hairs, it bypasses the throat mucus, and it gets inhaled directly right into the lungs. So, number two, the green algae needed to have flagella so that they can swim away fast enough to escape the dreaded macrophages.

• 1:18:34Bob Novella?

  So, that was one of the critical benefits of the green algae is that that flagella can let them move away at a decent enough speed to escape their macrophages, and that's something that some other microorganisms wouldn't have been able to do. So, that was a key component right there. There was one other final obstacle, guys. The medicine that they put on the green algae could potentially be detected by the macrophages, and that would just set off its immune alarms. And they wanted to avoid having that happen before the drug can spread itself. around in the lungs. So to deal with that, they actually cloaked the drug in a membrane from a platelet cell. All right. So they took the drug and they coded basically in the in

• 1:19:15Bob Novella?

  the membrane of another cell that the macrophages would if they came across it, they would say, oh, okay, that's, you know, that's fine. They would they would basically say it's an older platelet code, but it checks out, right? They would just let it go by and they and they wouldn't, they wouldn't bother that that weird medicine that's on the green algae. So here's the question. So pay attention, punks. This is the question. These are so we got green algae cells, right? And they're coded with a medicine and that medicine has been covered with a common cell membrane to hide it. And the researchers called these micro robots. Does that annoy you a little bit? They're calling these micro robots? It's basically

• 1:19:53Speaker 04

  Is that a very technical definition?

• 1:19:56Bob Novella?

  No, it's not. I don't know. It's not. I mean, it's

• 1:19:59Cara Santa Maria?

  Yeah, that's not a robot.

• 1:20:00Bob Novella?

  A robot has baggage, you know, it's got these implications, these things that make you think, I don't think of a natural cell. I mean, this is essentially 99% of natural cell and they're calling it a robot.

• 1:20:12Cara Santa Maria?

  Yeah, call it like a biomedical packet or something.

• 1:20:16Bob Novella?

  Yeah, like now, to be fair to the to the authors of the study, half the time they refer to it as a bio hybrid micro robot. And that's a little bit more palatable to me. That bio hybrid is nice.

• 1:20:30Cara Santa Maria?

  Why is it a robot? It's not programmable. It's not

• 1:20:33Speaker 04

  It's not all caps like

• 1:20:34Bob Novella?

  It's not constructed. It's not. It's not. Even though it's funny, though, because even though I think of single cells as very, very complex machines, calling them micro robots just rubbed me the wrong way. And I wanted to get your take on that. Steve, you didn't say anything about that. What do you think?

• 1:20:48Speaker 02

  We know like he

• 1:20:49Bob Novella?

  Okay, very good. We have an accord. Okay, great. So the end result here, good participation, people. The end result here is you end up, we have green algae that has three to five days, a lot of time, a lot more time than been ever before, three to five days to distribute the medicine throughout the lungs. The overall dose is lower, which greatly minimizes any side effects. And A few days, the green algae is cleared out naturally by the lungs. So it's all good. So the next question is, how does it work? So they tested these on mice with nasty MRSA infections. That's bad stuff. I guess for people it is. I guess it is for mice as well.

• 1:21:31Bob Novella?

  Actually, I know it is for mice because of what I'm going to say in about 11 seconds. The results were pretty amazing, if you ask me. All the poor control mice that had conventional treatment or no treatment at all died within three days. All of the green algae mice survived. It's like, OK, that's pretty perfect, if you ask me, as far as I could tell, anyway. So, all right, so what about the future of this technique? So I'll quote the co-lead of this project, Professor Liang Fangzong. He said, "As basic research in micro robotics continues to advance, I expect these technologies will gradually move toward clinical testing for a range of biomedical applications, particularly for the localized and active delivery of medicine." So, yes, he's very confident, I think as he should be.

• 1:22:16Bob Novella?

  And I'm going to end the quote by Lisa Labios from University of California, San Diego. She wrote an article about this in Physork. And she said, "This sort of breakthrough, which could one day be a game-changing medical treatment, is all thanks to federal funding that allows researchers to push past science fiction and into the vault." And the vault, she means the lungs are the vault because they're very locked down and very hard to get into. But I just loved that she says, she seems to me, in my mind, she stresses it's all thanks to federal funding. So let's please not cut federal funding because without it, we wouldn't have some

• 1:22:58Bob Novella?

  potentially life-saving treatments for people in the future. It's all because of federal funding without any necessary end game. Just like, let's see what we can discover by happy accident. It's been done in the past. It's saved so many lives, it's can't even count it. So I just wanted to end with that quote. Thank you.

• 1:23:16Speaker 02

  All right. Thanks, Bob. Jay, it's Who's That Noisy time? All right, guys. Last week, I played This Noisy.

• 1:23:48Speaker 04

  Exterminate?

• 1:23:50Jay Novella?

  I know, right?

• 1:23:51Speaker 02

  No, no, no. It's the Millennium Falcon trying to go to light speed.

• 1:23:55Speaker 04

  Ah, yes, and failing.

• 1:23:59Jay Novella?

  So a listener named Jason S. wrote in and said, "Hi, Jay." He said, "His name is Jason, the dual patron here." He said, "This week's noisy definitely sounds like an electric motor spooling up and shifting through some gears." "I think it's Hoover's new five-speed electric right on vacuum cleaner." Okay, that's not it. He said, "Seriously, though, it's a killer cycle or similar electric motorcycle." "If you haven't seen this thing, it's a drag racer that does 0 to 60 in .97 seconds." "And it pulls 2.5 Gs." Not correct, but that was definitely a cool guess. A listener named Joe Crean Zeke, and that is not how his name was spelled. It's just that he gave me the pronunciation. I would never, if my life counted on it and I had a year to research it, I wouldn't have been able to pronounce that name.

• 1:24:42Jay Novella?

  "Love what you do. Whatever comes, please keep going in these weird times." And we will. As a matter of fact, we're going to do more than we're doing right now very soon. Just pay attention and you'll see all the new stuff we have coming down the pike. He said, "This week's noisy sounds extremely familiar. I think it's an electric motor from a tram, train, probably on a test bench in a workshop. You can hear the gears switching up and down exactly like the trams I used to get into Cologne, my hometown, to party as they accelerated and de-accelerated before and after each stop." So, yeah, I mean, you're not 100% wrong, but you didn't get close enough. A listener named Marcus Digney from Parksville, Western Australia says, "Good day there. Love the show and listen to every episode since discovering it several years ago. First time having a guest.

• 1:25:28Jay Novella?

  Is it the sound from inside the cockpit of a Formula One car or some other high-powered racing car?" It is not, but you represent many people who wrote very similar, a very similar guess to that. So I'm going to click right over to the winner. This winner's name is Frank Burgum, and he said, "I'm pretty sure that this noisy is an AC motor controller with a variable frequency three-phase inverter, probably on a large motor such as an electric train engine." And then he goes on to say, like, in the 1980s, he worked on developing AC motor speed controllers, which made exactly that noise. "The gear changes are required because the switching frequency of the inverter has to be kept in a narrow range." It gets, it's technical stuff, but basically, my, after doing some research and looking

• 1:26:13Jay Novella?

  up about what this thing is, specifically, it's a variable frequency drive, VFD, in an electronic device used to control the speed and torque of an AC electric motor by varying the frequency and voltage of the power supplied to the motor. And this capability allows for precise control of motor operation, leading to improved energy efficiency and performance in various applications. Let me play that back for you guys. I won't play the whole thing, but you'll get the idea.

• 1:26:51Jay Novella?

  It has a tron noise to it.

• 1:26:52Speaker 02

  Oh, yeah, totally. A tron cycle. Yeah, totally.

• 1:26:55Jay Novella?

  Oh, I remember that now. I thought that was a really cool sound. Alright, guys, I have a new noisy for you, and it was sent in by a listener named Wayne Sibley.

• 1:27:17Jay Novella?

  If you think you know this week's noisy, or you heard something cool, don't hesitate, because I need those noisies. Send them to [email protected]. Steve, why am I so freaking excited? What is tonight?

• 1:27:32Speaker 02

  This is the last episode to go up before Nauticon.

• 1:27:36Jay Novella?

  Correct. Yeah, so what's happening is this will be the last time you hear us talk about Nauticon, you know, before Nauticon, and this is the last time you'll hear us say that there are tickets still available if you're interested. We actually had a lot of people buy tickets over the last week, which is exactly what I predicted, because I've done this so many times, I know that that happens. But please do consider coming if you're free. It's going to be in White Plains, New York, which means that you could use the Westchester Airport or the New York City airports. It's not that long of a wait. And this conference, guys, is essentially, we call it Nauticon because it's not like your standard conference. This isn't a bunch of lectures, you know, skeptical and science-based lectures.

• 1:28:19Jay Novella?

  This conference revolves around, you know, basically celebrating our podcast, our patrons, you know, listeners of the show. There's lots of time to socialize. We have a ton of super fun events that we're going to be putting on both Friday and Saturday. And then we have nighttime activities as well. We're going to be doing a boomer versus zoomer game show. We're going to pick people out of the audience to be the contestants. And then Saturday night, we have a Beatles sing-along. There is going to be heavy activity by all of us involved in the music playing. It's really a big deal. We're really excited about it. We came up with some awesome bits that we were so psyched about, the content that we have for this year. We're all looking forward to it.

• 1:28:58Jay Novella?

  There'll be some brand-new swag, and it's just going to be a great time. So if you're interested, go to noticoncon.com or go to theskepticsguy.org, and you can get a link there to the website. Please join us. It's going to be great, and we hope that everyone has safe travels, and I can't wait to see everybody.

• 1:29:15Speaker 02

  Yay. Thank you, Jay. Couple of quick emails. These are both sort of not-so-much corrections as additional information about two topics. Bob, let's start with you, actually. Last week, I think, we talked about the email about the Big Bang and the universe expanding at greater than the speed of light, but it's actually more complicated than what we said.

• 1:29:36Bob Novella?

  Yeah, there's more to it. I want to approach this from a probably a better angle. Primarily, the premise is wrong, that the universe was, you know, that's, we, science says that the universe was expanding faster than the speed of light during the Big Bang. So that premise is, it's a common misconception. The universe's expansion, in fact, does not really have a speed. Its expansion rate doesn't use the same units as speed, so you can't even directly compare the two. Just not meaningful at all. Instead, the universe's expansion rate is all about how distance changes an object's apparent velocity. And that's what Hubble's famous parameter tells us. The farther away two objects are, the faster they're separating from each other. And we know that at enough of a distance, that speed can be faster than light.

• 1:30:20Bob Novella?

  General relativities mathematics tells us that. That faster-than-light separation of objects beyond a certain distance, it's true now, it's true during inflation, even though the forces that are driving that expansion are quite different. Dark energy is doing it now, and was not dark energy during, after the Big Bang. So this expansion of space isn't the same as an object speeding through space. It's kind of like the bottom, bottom line, maybe, for the, for the email writer. So no laws of physics are being broken during the Big Bang.

• 1:30:49Speaker 02

  Yeah, it's a nuance, right? I mean, you're being a little pedantic, but yeah, we want to be technically accurate here. Though I just was interpreting that charitably. You know, if you look at two objects within the universe, they can be moving away from each other at greater than the speed of light, if that, if that movement is due to the expansion of the universe. And that's because they're not moving within the universe at greater than the speed of light, they're just being carried along with the expansion of the universe. And that's why, at some point, like, the visible universe, there's, so there's the visible universe, and how do you describe the universe that we could theoretically get to? Because the visible universe is more about the age of the universe, right?

• 1:31:32Speaker 02

  It's only as far away as the universe is old.

• 1:31:36Bob Novella?

  Yeah, let's not even go there, Steve. That's a...

• 1:31:38Speaker 02

  Well, I'm just saying, there's a point, something could be so far away that we could never theoretically get there because it's moving away from us at the speed of light.

• 1:31:46Bob Novella?

  Oh, yeah, there's a big chunk of the universe itself that we will never be able to get to because you would have to go faster than the speed of light. But still, there's something like 18 billion galaxies that we could get to if we started really trying. But, yeah, that number's getting smaller and smaller all the time, which is another fun fact.

• 1:32:04Speaker 02

  All right. And then the other, we got a bunch of emails about our autism discussion, which is, you know, it was a good conversation because, you know, this is a very, very complicated issue. I tried to reflect that complexity. We were talking about RFK's comments about autism, but how narrow his perspective is when, in fact, you know, autism is a very complicated spectrum, right? But at one point, the issue of self-diagnosis came up, and several people pushed back on the fact that both Cara and I had the immediate same knee-jerk reaction, like, oh, self-diagnosis, you don't want to do that. And they were like, really? Well, what is wrong with somebody self-diagnosing with autism?

• 1:32:49Speaker 02

  If you're interested, I wrote an article about it on Neurologica explaining why Cara and I, as clinicians, both had that reaction, which I think is legitimate. Self-diagnosis is essentially fraught with a lot of logical pitfalls and cognitive biases.

• 1:33:07Cara Santa Maria?

  Right. We can't diagnose ourselves with, I don't diagnose myself with anything psychological.

• 1:33:12Speaker 02

  It's generally not a good idea. You could fall for a confirmation bias.

• 1:33:14Cara Santa Maria?

  Yeah, you don't diagnose yourself with neurological things. Why don't you talk to another neurologist?

• 1:33:18Speaker 02

  Exactly. I wouldn't even diagnose myself with something neurological, yeah.

• 1:33:22Cara Santa Maria?

  Exactly.

• 1:33:23Speaker 02

  You can't be objective.

• 1:33:24Cara Santa Maria?

  No, you can't.

• 1:33:25Speaker 02

  But also, there's just so many types of errors that you could make in diagnosis. And, like, for example, you might, there's the representativeness heuristic, there's also the availability heuristic. Like, you're going to settle on a diagnosis that's available to you, that's in the popular culture. You won't necessarily be considering the full differential diagnosis.

• 1:33:45Cara Santa Maria?

  True. Yeah, it could be something else. Also, there's the thing, and I'm not saying that this is what our listeners did, but we've all seen this. Every like neuro or psych student who goes through training thinks they have a lot of things that they're actively learning about.

• 1:34:03Speaker 02

  Every medical student, it's a joke in medical school, medical student syndrome, like you think you have every disease. That's the Forer effect, right? Because you have to learn how to put symptoms into context. And you have to know the difference between symptoms that are specific versus nonspecific, etc., and how predictive value works and all that stuff.

• 1:34:22Cara Santa Maria?

  Yeah, but the DSM, it's really hard because things are mostly

• 1:34:25Speaker 02

  It's even harder.

• 1:34:26Cara Santa Maria?

  Dimensional.

• 1:34:27Speaker 02

  Exactly.

• 1:34:28Cara Santa Maria?

  Yeah, you can kind of go, well, I've been depressed, or I've had anxiety.

• 1:34:31Speaker 02

  Fidgety, whatever.

• 1:34:32Cara Santa Maria?

  Exactly.

• 1:34:33Speaker 02

  Everything requires judgment, and you could see yourself almost in any description. But having said that, that doesn't mean that any self-diagnosis is wrong, and some are easier than others. And, you know, so just putting things into context, like I've been practicing neurology now for 30 years. People come in to see me almost on a daily basis with some kind of self-diagnosis, even if just to say, I'm concerned that I have X, right? So I have a pretty good feel for how people are at thinking about what diagnosis they might have. There's a massive false positive problem, and there are some diagnoses that people

• 1:35:16Speaker 02

  self-diagnose that are almost always incorrect, and there are some that are almost always correct. There are some where it's actually pretty easy to self-diagnose because there are some pretty specific symptoms that people recognize.

• 1:35:29Cara Santa Maria?

  Like, when I have a UTI or yeast infection, it's pretty easy for me to tell my doctor my symptoms and say, I think this is a UTI. They go, yeah, it sounds like one. Here's what we'll do about it.

• 1:35:40Speaker 02

  Right, right.

• 1:35:41Cara Santa Maria?

  But that doesn't mean I'm going to the pharmacist and saying, I think I have a UTI.

• 1:35:44Speaker 02

  Writing yourself a prescription, yeah.

• 1:35:45Cara Santa Maria?

  Exactly. That's the difference. I'm coming within With a hypothesis.

• 1:35:51Speaker 02

  Yeah.

• 1:35:51Cara Santa Maria?

  And then I'm working with a professional to determine whether it meets the threshold for diagnosis.

• 1:35:56Speaker 02

  Right, exactly. And just, you know, you're going through a clinical algorithm of work up and treatment and making sure it's not something else.

• 1:36:04Cara Santa Maria?

  If you are somebody with diagnosable autism spectrum disorder and you are looking for accommodations for that diagnosis, you have to have a diagnosis on paper.

• 1:36:17Speaker 02

  Yeah, so now I think a few people pointed out, though, that, like, and sometimes they were referring to themselves, like, I diagnosed myself because I don't have the resources to get a formal diagnosis. It's hard to find a practitioner who will do it. And it's too expensive or insurance doesn't really cover it very well, et cetera, et cetera. So it was basically my only choice. And I get that. And of course, I think the solution to that is better resources, not relying on self-diagnosis. But in the world we live in today, that may be your only option. But the thing is, what do you then do about it?

• 1:36:52Cara Santa Maria?

  Yeah, it doesn't mean anything in a practical sense. It means something from an identity perspective.

• 1:36:57Speaker 02

  From an identity perspective, that's what I think what they were saying. They just helped me deal with my life and understand myself. It's like, okay, that's fine, as long as you're not then going for chelation therapy, whatever, like getting a treatment based upon that without going through a professional or like making major life decisions. Or then, again, just got to be aware of the fact that it's like thinking that you're a certain astrological sign. You start to then perceive yourself, then the confirmation bias kicks in, right?

• 1:37:26Cara Santa Maria?

  For sure.

• 1:37:26Speaker 02

  Once you think that you have a label, then you will make it make sense, you know?

• 1:37:30Cara Santa Maria?

  And there are things on the spectrum, there are diagnostic criteria that all of us could point to and say, I'm a little bit like that. I've got a little bit of that.

• 1:37:39Speaker 02

  And the other thing is, like, you may be right, but incomplete. Like, you may, yeah, you may have autism and you may be correctly seeing the signs and symptoms of that in yourself, but that doesn't mean you don't also have another diagnosis and maybe something else that does need to be treated.

• 1:37:55Cara Santa Maria?

  Or you may be neurodivergent and not qualify for a diagnosis. And I think that's a big thing that I talk to a lot of people in my life about. Where they're like, I want to go get diagnosed. And I'm like, Here's what you do. This is the protocol for doing it, but I can tell you right now, based on the MiG DAS or the ADOS that I've done in the past, you will not qualify for a diagnosis.

• 1:38:15Speaker 02

  Right.

• 1:38:15Cara Santa Maria?

  Like, and that does happen, and it's a bummer, but there is a minimum threshold.

• 1:38:19Speaker 02

  Mm-hmm. Yeah, and sometimes they actually make sense in medicine. You know, they're, they're based on, the evidence shows at this threshold, you, it predicts your response to treatment, or whatever.

• 1:38:29Cara Santa Maria?

  Right.

• 1:38:30Speaker 02

  Like, there's some reason for it.

• 1:38:31Cara Santa Maria?

  Right.

• 1:38:31Speaker 02

  Not always. It always depends on what fit, where we are in sort of our understanding of the disease and the availability of treatments, et cetera.

• 1:38:37Cara Santa Maria?

  For sure. But almost everything in the DSM, and this is a bigger question of whether or not this is, you know, like, with deftness, an identity versus a, quote, disorder. Like, and I'm just saying that because it's the Diagnostic and Statistical Manual of Mental Disorders. But like everything in the DSM, there is a range where you might be on the spectrum of, let's say, anxiety or sadness, where you do not have a clinical diagnosis.

• 1:39:04Speaker 02

  Right.

• 1:39:04Cara Santa Maria?

  You do not hit the threshold, because everybody gets depressed, everybody gets sad. Some people are sad more than others, but there's a point where it, it falls under some form of clinical depression.

• 1:39:15Speaker 02

  Right.

• 1:39:15Cara Santa Maria?

  You know, persistent depressive disorder, whatever.

• 1:39:16Speaker 02

  And I have, I have, you know, seen people misdiagnose family members as autistic, because they, based on a superficial understanding of what it is.

• 1:39:27Cara Santa Maria?

  For sure.

• 1:39:27Speaker 02

  It happens.

• 1:39:27Cara Santa Maria?

  And again, this isn't a perfect system. When we talk about it, like, this is how you do it, and, and I know that people will often be like, "Yeah, but you're relying too heavily on a medical model, or you're relying too heavy." This is what we have. It's all constructed. All of it.

• 1:39:41Speaker 02

  Yeah.

• 1:39:41Cara Santa Maria?

  The labels are constructed, the way that we identify people and put people in different boxes are constructed, the books we use, the way that we, it's all constructed, but we have to work within the same system, otherwise we'd be all over the place.

• 1:39:54Speaker 02

  Right. And so, if you're, if you are interested in this topic generally, or just for you, for you personally, you know, I do recommend you read my articles, because I do go through all of the aspects of, that are, that we consider when we make a diagnosis, and why, and all of the potential pitfalls of self-diagnosis. So at least go into it with your eyes open, if you, if you feel like you need to do that. All right, guys, let's go on with Science or Fiction?

• 1:40:31Speaker 02

  Each week I come up with two science news items for facts, two real and one fake. And then I challenge my panel of skeptics, tell me which one is the fake. Just three regular news items this week. You guys ready?

• 1:40:46Speaker 02

  Okay. Here we go. Item number one, scientists have developed a micro pipette capable of delivering ions only without fluid to a single neuron. Item number two, a new extensive analysis finds that climate change is now the most significant driver of biodiversity loss in insects. And item number three, engineers have developed a process for spinning industry quality cellulose fibers from cow manure. Bob, go first.

• 1:41:20Bob Novella?

  All right, you know, none of these are leaping out at me in any real way. I mean, of course, this is a micro pipette delivering just an ion, no fluid to a single neuron. What the hell? I really want that to be true. I might not be able to vote against it. So, climate change in insects biodiversity, eh, are they that sensitive? Who knows? Let's see, let's see, engineers, industry quality cellulose fiber from cow manure? I mean, you gotta be shitting me.

• 1:41:56Speaker 02

  Good one.

• 1:41:57Bob Novella?

  Kara, what do you think?

• 1:42:00Bob Novella?

  Never mind. All right, I'm gonna say that the micro pipette, because if I'm right, I'm happy, and if I'm wrong, I'm also happy. So, fiction.

• 1:42:10Speaker 02

  All right. Evan?

• 1:42:13Speaker 04

  All right, the micro pipette, that's not a word I come across often in my life. If I knew what the significance of being able to deliver an ion to a single neuron is, perhaps this would be maybe more impressive. Because I, okay, why would, let's deliver an ion to a neuron? So, why, what, what's big about, why is that a big deal? But apparently it is, I'll assume it is. The second one about climate change, now the most significant driver of biodiversity loss in insects, I have a feeling that one's correct, because if history has shown us everything, we are... Certainly responsible for the majority of climate change going on and we are excellent

• 1:42:58Speaker 04

  at kind of destroying things. And this would, I think, fit neatly into that package. This last one about spinning industry quality cellulose fibers from cow manure. Ooh, I guess that's a, that'd be a good use for cow manure. Quality cellulose fibers. Maybe, I don't know, it's either going to be the micro pipette or the cow manure one. I'll, I'll spread it out. I'll spread it around. I'll spread the cow manure around and I'll say the cow manure one is fiction, but I can't really pinpoint why.

• 1:43:32Speaker 02

  Okay, Kara.

• 1:43:33Cara Santa Maria?

  The micro pipette capable of delivering ion, that doesn't so, I mean, it's cool as hell, but like, I don't understand why this is that different from patch clamping. Like, with patch clamping, you're reading the ion transfer. You're sort of looking at the voltage.

• 1:43:46Speaker 04

  Oh, so you understand like what the significance of this is?

• 1:43:50Cara Santa Maria?

  Of course. Yeah. I mean, this is the kind of research I used to do. So like, if you imagine a micro pipette, like a teeny tiny glass thing that like sucks to the outside of a cell, you know, back in the day, we would already do this and would clamp to the cell and then we could measure like intro versus extracellular voltage changes to understand excitability of the cell. So I don't see why it would be that hard to like pump some sodium or potassium in or out.

• 1:44:13Speaker 04

  So if you have some laboratory experience, this means a lot more.

• 1:44:15Cara Santa Maria?

  Yeah. I mean, it's probably hard. That's probably why we didn't do it until now, but it doesn't, it doesn't like blow my mind or anything. It's cool. Um, yeah, we could do a lot with it. Like we could change the excitability of tissue and stuff. And then you chose that the process for spinning industry quality cellulose fibers from cow manure. Yeah, I guess cows eat grass. So if you could take the cellulose back out, there's cellulose, can they digest it? I don't think so. I don't think animals can digest cellulose. I think the only time you see that is in like termites, but it's not actually the termites. It's like the bacteria inside of them. I feel like I remember that from somewhere. So yeah, there's probably a bunch of cellulose in the poop. So they figured out how to recapture

• 1:45:00Cara Santa Maria?

  the cellulose. I don't know. So that, that leads me to think that this, the insect one is not climate change, that it's like pesticides or something, or like monocropping, or I don't know, something that's like, it's probably climate change is a driver, but I feel like there's all sorts of other stuff. So I'm going to say that one's the fiction.

• 1:45:18Speaker 02

  All right, Jay, so they're all spread out. You're gonna break the tie.

• 1:45:22Jay Novella?

  Well, I want to first say that I am so happy that they finally found something useful to do with poop.

• 1:45:29Speaker 04

  Finally.

• 1:45:30Jay Novella?

  There's a lot of, I mean, I'm, I'm half joking and half serious because there is a lot of cow poop in the world, guys. Like lots of.

• 1:45:37Speaker 04

  Cowenures for lots of different things, actually.

• 1:45:40Speaker 02

  It fertilizes half of our food.

• 1:45:42Speaker 04

  Yeah, it's a.

• 1:45:44Jay Novella?

  I'm glad they found something else to do with cow poop.

• 1:45:47Speaker 04

  And I think they used, used to use it in the mortar and adobes or something's the thing they would build.

• 1:45:53Jay Novella?

  You ever been to a dairy farm? I've been to a couple and they, they have poop pits.

• 1:45:58Speaker 04

  Sure.

• 1:45:59Jay Novella?

  It's a big deal, you know, it's a lot, it's a lot to make.

• 1:46:01Speaker 04

  Oh, you have to, yeah, corral that stuff.

• 1:46:03Jay Novella?

  So I agree with Kara, yeah, like grass is, has a ton of cellulose in it, you know, cows are eating it. I mean, they've got to be able to, um, digest cellulose, though, they have to. I mean, I'm sure they, you know, they have multiple stomachs.

• 1:46:16Speaker 04

  One of their four stomachs, right?

• 1:46:17Jay Novella?

  Or a four-chambered stomach or whatever, right? So, yeah, I, I think that one is science. I think that, um, you know, I, I gotta just say, I don't know a lot about the, um, the micro pipette and I don't really know a lot about that. I mean, it wouldn't surprise me that they were able to, you know, do something like this. Um, but it's very hard for me to comment on that. But the one thing that is sticking out to me, uh, it's the one about the climate change and how it's, they're saying it's the most significant driver of biodiversity loss in insects, right? I thought that pesticides were the number one killer of insects. I haven't, I don't know about climate change having a massive effect yet on insects. I'm sure it's going to. I just don't think we're, we've hit that marker yet for,

• 1:47:00Jay Novella?

  for their habitats. So I think that was a fiction.

• 1:47:03Speaker 02

  All right. So you guys are nicely spread out. So we'll take these in order. Start with number one, scientists have developed a micro pipette capable of delivering ions only without fluid to a single neuron. Bob, you think this one is the fiction. Everyone else thinks this one is science. And this one is science. So you're happy, Bob, it's science. Um, yes, so what, there's a, a couple of things here that are new. One, this is smaller than any previous micro pipette. Um, cause it can, and they, and they designed it specifically because they want to be able to manipulate the environment both inside and outside of a single brain cell. Not just the neurons, but also the glia. Yeah. Oh, that's cool.

• 1:47:48Speaker 02

  Because they haven't really been able to study that before. But the other bit, which none of you commented on, and Cara, you didn't comment on either, was the without fluid part. Like, it's just delivering ions. It's not delivering ions in water or in Right. fluid. It's just ions. The reason for that is because if you are studying the, the reaction of a neuron, let's say, to changing the potassium concentration outside the cell, but you're doing, you're also injecting fluid at the same time, that also influences the environment. Yeah, you'd have to calculate it, like, perfectly. And, like, so many things happen, pressure and whatever. So you can't really isolate the, the ions as the variable. But now, but now, they can.

• 1:48:32Speaker 02

  And so this is going to be a huge boon to research, especially with the glia, actually, even though I, you know, mentioned neuron, but the, because, as you say, with patch clamping, we can study the electrical activity of neurons. But glia are mostly, they're not electrically active, they are chemically active, right? So if we want to, and that they're basically half the brain, right? Half of the cells in the brain are glia. And they're not just support cells. They are support cells, but they're not just support cells. They actually influence the functioning of the brain as well, but chemically more than electrically. And we haven't really been able to study it that well before this reason. No, for the, but it's limited for the reasons that I stated. Like, we can't do the kind of, like, manipulating the environment in order to see how they respond, how they react to it.

• 1:49:17Bob Novella?

  Well, have there been any good discoveries?

• 1:49:20Speaker 02

  Yeah, there have been, but again, it's difficult because you have all these other variables that come into play. We haven't had the level of control we would like to have in order to, like, really control these variables. So, anyway, this is like just taking that research to the next level, where now we can manipulate the environment inside and outside of single cells with the ionic environment without having to introduce a lot of fluid as another variable. All right, let's go on. Number two, a new extensive analysis finds that climate change is now the most significant driver of biodiversity loss in insects. Jay and Cara, you think this one is the fiction. Bob and Evan, you think this one is science. Now, of course, the key phrase here There's a new extensive analysis. Whoever they used to think about what was the primary

• 1:50:02Cara Santa Maria?

  Pesticide?

• 1:50:04Speaker 02

  It may be different now. And yeah, I think the idea is that climate change is now the most significant driver of biodiversity.

• 1:50:13Speaker 04

  But?

• 1:50:13Speaker 02

  But this one is the fiction.

• 1:50:15Cara Santa Maria?

  Is it the other way around?

• 1:50:16Speaker 02

  No, no. We're not there yet. Climate change is a contributor, but it's not anywhere near the biggest one.

• 1:50:23Speaker 04

  Is it still pesticide?

• 1:50:24Speaker 02

  It's not. It's not pesticides per se. It's a bigger concept. It's agriculture.

• 1:50:31Cara Santa Maria?

  Oh, okay.

• 1:50:31Speaker 02

  Yeah, so.

• 1:50:32Cara Santa Maria?

  So like pollution, kind of, or just like?

• 1:50:34Speaker 02

  Well.

• 1:50:34Cara Santa Maria?

  Oh, yeah, because I also said like monocrop.

• 1:50:36Speaker 02

  Yeah, so monocrop, but not just that. It's basically habitat loss. That's the biggest single.

• 1:50:41Cara Santa Maria?

  That makes sense.

• 1:50:42Speaker 02

  That's the biggest single contributor is habitat loss because.

• 1:50:44Cara Santa Maria?

  Clear cutting forest.

• 1:50:45Speaker 02

  Yeah, we're clear cutting land. And just and replacing it with monocropping or with agriculture.

• 1:50:52Speaker 04

  And remember, there are a lot of insects. I mean, a lot more than we think.

• 1:50:58Speaker 02

  And then the insects that can thrive in that environment are the ones we kill, right? Because they're the pests. We call them pests and we try to kill them.

• 1:51:05Speaker 04

  Oh, my gosh, we must be eliminating insects. We don't even know they're there and we're eliminating them.

• 1:51:08Speaker 02

  Yeah, so there's a pretty significant loss of. So what the study showed was, first of all, yes, the biodiversity is taking a nosedive, but it's they actually separate out two different kinds of biodiversity, what they call taxonomic diversity and phylogenetic diversity. So it's not just a loss of diversity within a species. Actually, there's less evolutionary branching. You know what I mean? Like, you're actually losing evolutionary branches so that you have fewer genera, fewer families, et cetera. It's pretty significant, you know,

• 1:51:46Speaker 02

  about 44% total insect species diversity in agricultural landscapes specifically. That's the amount of decline. So it's just land use is the big factor and everything that goes along with that, of course, yes, absolutely, it's pesticides, it's, you know, it is monocropping, it is climate change now. As well, all these things are just all stressors. But but land use is the loss of habitat due to land use is the big one. Which means that engineers have developed a process for spinning industry quality cellulose fibers from cow manure. Cow manure is science. So, yes, so first of all, cows do digest cellulose.

• 1:52:30Speaker 02

  But Kara, you're correct in that it is also not the cows themselves, but the microorganisms in their rumen that are doing it.

• 1:52:39Jay Novella?

  Okay.

• 1:52:39Speaker 02

  That's why they have to have different chambers, have to sit there so that the microorganisms can break down the cellulose.

• 1:52:44Jay Novella?

  Well, that goes that goes for all mammals. You know, we need, we need, we have a flora that we can't live without.

• 1:52:51Speaker 02

  Yeah, but we don't eat like the heavy cellulose. We don't eat grass, right? We're not grass eaters. Or leaves or things like that. We eat stuff that's easy to digest. We don't have. Or we cook it. The stomachs, yeah, to do it, yeah. So, but they, but, but some cellulose still survives. So there's undigested cellulose in cow manure. And they basically modified a pre-existing technique. The same researchers, the same people developed about 10 years or so ago, or so ago, developed a technique that uses a jet, like it's pressured, they call it pressurized spinning. But it, but it's arranged vertically, like the jet stream is arranged vertically. And basically, all they found is that they have to just make it horizontal.

• 1:53:37Speaker 02

  And then, and they got it to work with, they basically, you know, clean up the manure so that they just have just the cellulose left. And then they used now horizontal pressurized fiber spinning in order to turn that into, you know, actual cellulose fibers. And they were able to create what they call industry-grade cellulose fibers using this technique. This is huge because this horizontal nozzle pressurized spinning technique can be very easily adapted and cost-effective. And this kind of cellulose fibers are widely used in industry from all kinds of textiles and plastics and masks and all kinds of stuff. And so be, you know, having another method, another, you know, plus, not just another method, but another source material,

• 1:54:22Speaker 02

  feedstock for, for creating these cellulose fibers could, could be huge. Yeah, could be huge. So, good job Kara and Jay. Yeah.

• 1:54:33Jay Novella?

  Yeah, Jay.

• 1:54:33Speaker 02

  Well done, folks.

• 1:54:34Jay Novella?

  Good job Kara.

• 1:54:36Speaker 02

  All right, Evan, give us a quote.

• 1:54:38Speaker 04

  "Sit down before a fact as a little child. Be prepared to give up every preconceived notion. Follow humbly wherever and to whatever abysses nature leads, or you shall learn nothing."

• 1:54:52Speaker 04

  Thomas Henry Huxley.

• 1:54:54Speaker 02

  You know, Evan, this was my, the quote in my yearbook, my schoolbook at college.

• 1:54:59Speaker 04

  No, are you kidding me?

• 1:55:01Speaker 02

  Nope, that was my personal quote.

• 1:55:03Speaker 04

  I didn't know you knew this quote for that long.

• 1:55:07Speaker 02

  Yeah.

• 1:55:08Speaker 04

  From way back.

• 1:55:08Speaker 02

  It's great. It's great. Tia Chucksley.

• 1:55:10Speaker 04

  It's quite a quote.

• 1:55:11Speaker 02

  Yeah, he was, he was something. Very skeptical philosopher, you know, Darwin's mouthpiece, of course. Instrumental in promoting acceptance of evolutionary theory. But also, yeah, just a great, you know, critical thinking, logical philosopher. You know, the quotes like this indicate that.

• 1:55:31Speaker 04

  The quote was suggested by a listener, Hannah, Hannah T. Thank you, Hannah.

• 1:55:34Speaker 02

  Thank you, Hannah.

• 1:55:35Speaker 04

  We appreciate that very much.

• 1:55:37Speaker 02

  All right, guys, so when this episode goes up, you'll have one week to buy tickets for Nauticon. There's still time. Get them now. But not much time.

• 1:55:49Speaker 04

  Yeah, not much time.

• 1:55:50Speaker 02

  And you, you know, hell, we, you know, we will do tickets at the door, so if you just want to show up, you can show up. But it does help if you buy tickets, we know how many people are going to be there. And the next episode will be coming out on the Saturday during the second day of Nauticon, essentially.

• 1:56:07Speaker 04

  Yeah, we warp time and space to make that happen when we do live performances on a weekend.

• 1:56:12Speaker 02

  And we'll be recording two live shows during Nauticon.

• 1:56:16Speaker 04

  Oh, that's more reason to come out and see us.

• 1:56:19Speaker 02

  Absolutely.

• 1:56:21Speaker 02

  All right, well, we look forward to that, and thank you all for joining me this week.

• 1:56:25Speaker 04

  Thanks, Dr. Steve.

• 1:56:26Speaker 02

  And until next week, this is your Skeptic's Guide to the Universe.

• 1:56:33Speaker 02

  Skeptic's Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to [email protected]. And if you would like to support the show and all the work that we do, go to patreon.com/skepticsguide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.

• 1:57:10Speaker 00

  From kickoff to the final whistle, trade the biggest moments in football with Kalshi, America's number one prediction market platform. Next Sunday, Tampa Bay takes on 5-2 Chicago. Tampa Bay is currently trading at 38% to win. A $100 trade pays out over $190 if they come out on top. Download Kalshi. Use code HOOPS to get $25 when you trade $25. K-A-L-S-H-I. Kalshi, trade what's next. 18-plus only. Restrictions and eligibility requirements apply. Event contract trading involves risk and may not be suitable for all investors. Kalshi products are not available in all jurisdictions. Prices, values, and available markets may differ from those mentioned. For more information, see kalshi.com/ regulatory.