Unanimity on Death with Dignity — Legalizing Physician-Assisted Dying in Canada .


Canada legalized physician-assisted dying — a first among countries with common-law systems, in which law is often developed by judges through case decisions and precedent. The Supreme Court of Canada issued the decision in Carter v. Canada,1 and its reasoning and implications for clinical practice bear examination.

Canada’s path to this point has not been short. In 1993, the Court rejected legalization of physician-assisted dying on a 5-to-4 vote, and Parliament has since considered the issue several times but demurred — though the province of Quebec passed a “medical aid in dying” law in 2014. The Carterjudgment triggered a year-long grace period during which Canada’s federal and provincial governments and the medical profession must arrange for an orderly transition so that by early 2016, Canadian patients can choose to die with a doctor’s help.

Physician-assisted dying is ethically and legally controversial, and few countries or states have embraced it (see timelineLegal Milestones in Physician-Assisted Dying, 1994–2015.). Yet Canadians apparently overwhelmingly believe that its time has come. Strikingly, the Court’s nine justices ruled unanimously, without dissent. Fully 78% of Canadians polled after their decision agreed, 60% “strongly” so, with only 9% strongly opposed.2Anticipating the Court’s ruling, the Canadian Medical Association dropped its opposition to physicians aiding in death. So what is it about the Court, or Canada’s medical, legal, and social tapestry, that has rendered a typically flammable proposition so acceptable?

The Criminal Code of Canada protects life sedulously. It forbids counseling, aiding, or abetting a person in committing suicide, and if such help even indirectly causes death it is considered homicide, even if the person consented. But Canada’s constitution, which is higher law, emphasizes autonomy and dignity. Under the Canadian Charter of Rights and Freedoms, everyone has the “right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice,” although society can impose reasonable limits on such rights. When a mentally competent person freely wills to die and wants a physician’s help in doing so, it’s unclear whether the Criminal Code’s prohibition or the Charter’s rights take priority.

In considering physicians’ involvement in a patient’s death, medical practice usually distinguishes between causes of omission (adhering to a “do not resuscitate” order is allowed) and causes of commission (administering excess barbiturates is prohibited). This distinction is applied daily in critical and palliative care wards, but many legal scholars and judges have long considered it illogical. In 1993, for instance, England’s top court considered whether doctors could, with the family’s consent, lawfully stop nasogastric tube feeding of a patient in a persistent vegetative state.3 The court struggled over the questions of whether extubating the patient was a homicidal act of commission, whether ceasing to feed the patient was a humane act of omission, and whether leaving the patient intubated but starving somehow made a moral difference — questions that devolve into “intolerably fine distinctions,” as one judge complained. Ruling for extubation, Lord Goff of Chieveley rightly foresaw “a charge of hypocrisy, because it can be asked why, if the doctor, by discontinuing treatment, is entitled in consequence to let his patient die, it should not be lawful to put him out of his misery straight away, in a more humane manner, by a lethal injection, rather than let him linger on in pain until he dies.”

In public health, this would be called a harm-reduction argument. And Canada’s Supreme Court is fond of harm reduction. Since 2011, unanimous judgments have invoked the Charter’s right to “life, liberty and security of the person” in legalizing supervised injection centers for drug addicts and brothels for prostitutes, because evidence showed that injecting drugs and selling sex are safer with oversight and shelter than without. Similarly, regarding physician-assisted dying, the Court reasoned that traditional methods of suicide infringed patients’ “security of the person” more than clinical methods pursued under a physician’s watch.

The justices then went further, observing that when the Criminal Code thwarts a person’s ability to make decisions about something so personal as his or her own death or bodily integrity, this deprivation of autonomy causes psychological harm and distress, infringing the Charter’s right to liberty. “An individual’s response to a grievous and irremediable medical condition,” the Court writes, “is a matter critical to their dignity and autonomy. The law allows people in this situation to request palliative sedation, refuse artificial nutrition or hydration, or request the removal of life-sustaining medical equipment, but denies them the right to request a physician’s assistance in dying. This interferes with their ability to make decisions concerning their bodily integrity and medical care and thus trenches on liberty.”

The justices avoided the omission–commission distinction, concluding that as long as a patient in grievous and irremediable straits can give informed consent, it doesn’t matter whether a physician assists actively or passively, because the patient’s dignity and autonomy demand control in either case. Although the Court did not cite the concept of “patient-centered care,” it was clearly on the same wavelength as modern medicine in giving patients choice, whether for palliative care or physician-assisted dying. Viewed through this lens, the Court’s decision seems not radical but modest.

Canada’s government argued that giving patients choice would create a dangerously slippery slope for “decisionally vulnerable” patients — such as those who are coerced, cognitively impaired, disabled, or mentally ill — who might end up dead if physician-assisted dying were not criminal. The Court was unpersuaded. Risks for such patients at the end of life “are already part and parcel of our medical system,” it wrote, and it credited physicians with generally assessing those risks wisely. The justices said that familiar methods of gauging informed consent — relying on advance directives or surrogate decision makers, for example — should suffice.

Nobody yet knows how physician-assisted dying will unfold in practice; that’s what the grace period is for. Canada’s justice minister discounted the option of overriding the Court’s judgment using the Charter’s “notwithstanding clause” — a controversial trump card that Parliament has never used — and in an election year, the federal government has higher priorities than regulating physician-assisted dying. It could even leave physician-assisted dying unregulated, as it did abortion, which it has never reregulated in the decades since the Court struck down the Criminal Code provisions governing it.4

It would then fall to Canada’s 10 provincial governments either to generate legal guidance, as Quebec has done, or to do nothing and let the medical profession delineate its own practice. Two unanswered questions are especially challenging: first, how to define the type of “grievous and irremediable medical condition” for which the Court insists physician-assisted dying be offered, since controversially, this category might apply to some persons who are neither terminally nor physically ill, such as those with treatment-resistant depression; and second, how to organize the profession to accommodate the rights of doctors with religious or conscientious objections to physician-assisted dying without interfering with patients’ rights. The Canadian Society of Palliative Care Physicians says that most of its members do not want to aid patients in dying; they will not take the lead in answering these questions.5 Time will tell who does lead, or whether a new subspecialty in physician-assisted dying emerges. Meanwhile, it is striking that even in the face of so much uncertainty, Canadian society generally seems trustful rather than fearful, and the Court’s decision has hardly triggered a culture war.

The judgment probably portends changes outside Canada. Imitation is a feature of the common-law world, and if physician-assisted dying is litigated in England, India, or South Africa, for example, odds are high that judges would draw on the Canadian Court’s reasoning. Societies are also changing, and in coming decades aging populations with growing affluence and incidence of chronic illness will increasingly question the medical and legal orthodoxies regarding the end of life. Given the flow of legal ideas and shifting demographics, change and convergence around physician-assisted dying as a standard of care seem inevitable.

These developments will trouble people who instinctively find legalized physician-assisted dying repellent. But increasingly, society is acknowledging that denying people the right to die with dignity and safety is even more repellent.

Laser weapons get real .


Long a staple of science fiction, laser weapons are edging closer to the battlefield — thanks to optical fibres.

Silently, the drone aircraft glides above the arid terrain of New Mexico — until it suddenly pivots out of control and plummets to the ground.

Then a mortar round rises from its launcher, arcs high and begins to descend towards its target — only to flare and explode in mid-flight.

On the desert floor, on top of a big, sand-coloured truck, a cubic mechanism pivots and fires an invisible infrared beam to zap one target after another. This High Energy Laser Mobile Demonstrator (HEL MD) is a prototype laser weapon developed for the US Army by aerospace giant Boeing of Chicago, Illinois. Inside the truck, Boeing electrophysics engineer Stephanie Blount stares at the targets on her laptop’s screen and directs the laser using a handheld game controller. “It has a very game-like feel,” she says.

That seems only natural: laser weapons are a staple of modern video games, and ray-guns of various sorts were common in science fiction for decades before the first real-life laser was demonstrated in 1960. But they are not a fantasy anymore. The Boeing prototype is just one of several such weapons developed in recent years in both the United States and Europe, largely thanks to the advent of relatively cheap, portable and robust lasers that generate their beams using optical fibres.

The output of these fibre weapons is measured in kilowatts (kW), orders of magnitude less than the megawatt-class devices once envisioned for the US Strategic Defense Initiative — an ultimately unsuccessful cold-war plan that sought to use lasers to disable ballistic missiles carrying nuclear warheads.

But the modern, less ambitious, weapons are on the brink of real-world deployment. Tests such as those of the Boeing system show that the lasers have enough power to overcome threats from terror groups — at a fraction of the price of conventional defences. “It’s a very cost-effective solution to taking out cheaply made weapons like small mortars or rockets made out of sewer pipe,” says Blount.

In late 2014, for example, the US Navy showed that a ship-mounted laser-weapon system called LaWS could target small boats, such as those used by terrorists and pirates. That experimental weapon is currently installed on the USS Ponce, an amphibious support ship in the Gulf.

The power predicament

Laser weapons have long fascinated weapons developers — most notably during the heyday of the Strategic Defense Initiative, nicknamed Star Wars, in the 1980s and 1990s. US spending on laser-weapons research peaked in 1989 when, according to the CNAS report1, the government spent the equivalent of US$2.4 billion in 2014 dollars. Funding has continued at lower levels ever since. Yet the original goal, of being able to shoot down incoming ballistic missiles, proved unattainable.

The trick with any laser weapon is to focus its energy into a spot that is small enough to heat up and damage the target — and to do that with a machine that is compact and portable enough for the battlefield. This is easier said than done. In 1996, for example, the US Air Force initiated the Airborne Laser project as one of its contributions to defence against ballistic missiles. Because it was impossible at the time to generate the required megawatts of optical power electrically, the developers chose a chemical oxygen iodine laser (COIL) that could be fuelled by a chemical reaction. But the COIL was so bulky that it could only be carried on a Boeing 747, and left little space for laser fuel. “It needed remote mixing units and chemicals weighing tens of thousands of pounds,” says Paul Shattuck, head of directed-energy systems for Lockheed Martin Space Systems, which provided the project’s beam-control technology.

Another major problem was the atmosphere, says Phillip Sprangle, senior scientist for directed-energy physics at the Naval Research Laboratory in Washington DC. Not only was the beam scattered by dust and natural turbulence, he says, but its passage caused ‘thermal blooming’. When the beam propagated at very high powers, Sprangle explains, “the atmosphere absorbed laser light, heating the air and causing the laser beam to spread out”. That spreading, in turn, dissipated the laser’s energy.

The good news for the Airborne Laser project was that this issue, at least, had a solution: adaptive optics technology similar to that used by astronomers to clarify their view of the stars (see Nature517, 430432; 2015). The technology uses mirrors to automatically distort the laser beam in a way that cancels the effects of the turbulence, with the same result as a pair of glasses correcting for aberrations in the eye. “As the laser beam passes through the atmosphere,” says Shattuck, “it cleans up, and it’s nice and tight when it gets to the target.”

By 2010, the adaptive optics was good enough for the Airborne Laser to destroy a ballistic missile in flight. By then, however, logistical issues such as the size problem had led the Department of Defense to lose its enthusiasm for energy weapons in general. It cancelled the Airborne Laser programme outright by early 2012. At the same time, the department’s spending on high-energy lasers in general was falling; it dropped from $961 million in 2007 to $344 million in 2014.

Fibres in the spotlight

The money did not vanish entirely: attention was already shifting to fibre lasers as a way to deliver results more economically. Fibre lasers were invented in 1963, and since the 1990s they have been advanced almost entirely by IPG Photonics in Oxford, Massachusetts. Whereas other solid-state lasers use rigid rods, slabs or discs of crystal to generate the beam, and so have to be fairly large, fibre lasers use thin optical fibres that can be wrapped into compact coils (see ‘Fibre power’). The fibres can collect their optical energy from brighter versions of the cheap laser diodes used in DVD players, and then amplify the light to higher power, with overall electrical-to-optical conversion efficiencies greater than 30%. This is at least double the efficiency typical of other solid-state lasers, and close to that of chemical lasers such as COIL. And, being intrinsically long and thin, the fibres have a high surface area to volume ratio and can radiate away waste heat very quickly — an ability that helps to give the lasers a long working life and low maintenance requirements.

These advantages first attracted attention during the 1990s, when fibre lasers began to be used to beef up optical signals carrying Internet data through undersea cables. But since the early 2000s, IPG has focused on developing kilowatt-class industrial lasers for welding, drilling and cutting — devices that also attracted the attention of military researchers.

Around 2010, recalls Shattuck, he and his colleagues at Lockheed Martin heard from Israeli civilians targeted by rockets launched from the Gaza Strip. “The mayor of a village stood up and said, ‘Please, give me some kind of defence,’” Shattuck says. This inspired Lockheed Martin to develop the Area Defense Anti-Munitions (ADAM) system, which uses an off-the-shelf 10-kW laser from IPG to keep costs down. Since 2012, the company has shown that ADAM can disable targets such as boats, drones and simulated small-calibre rockets from about 1.5 kilometres away. Although unwilling to disclose the price of ADAM — or whether anybody has bought one — Lockheed Martin says that it is now ready to provide the system to customers.

Blount is less reticent about Boeing’s HEL MD prototype, which also uses a commercial 10-kW fibre laser. With the system drawing its power from the vehicle engine or a separate generator, she says, “it takes less than two cups of fuel to fire the laser for long enough to disable many targets.” This makes it much cheaper to use for defence than conventional missiles. “An inexpensive missile is $100,000 and that’s one shot,” says David DeYoung, Boeing’s director of directed-energy systems. “To shoot a laser-weapon system once is less than $10.”

Blount stresses that the resurgence of laser weapons owes at least as much to advanced image-recognition and targeting systems as to the laser itself. “The better the pointing and tracking system,” she says, “the better able you are to put the beam on the most vulnerable point of a target.”

Thanks to computerized aiming, HEL MD can operate in wholly autonomous mode, which Boeing tested successfully in May 2014 — although the trials uncovered an unexpected challenge. The weapon’s laser beam is silent and invisible, and not all targets explode as they are destroyed, so an automated battle can be over before operators have noticed anything. “The engagements happen quickly, and unless you’re staring at a screen 24–7 you’ll never see them,” Blount says. “So we’ve built sound in for whenever we fire the laser. We plan on taking advantage of lots of Star Trek andStar Wars sound bites.”

Strength in numbers

Aiming and targeting may be battle-ready, but power is still a problem. A commercial laser’s 10-kW output is at the low end of what is useful for laser weapons. And using fibres puts limits on the beam’s power and quality — not least because at high powers, the cascade of photons surging through the fibre can heat it up faster than it can radiate the energy, and can thus cause damage. To avoid this, researchers are working to combine the output from several lasers.

The ideal way to do this would be ‘coherent combining’, in which the waves from each laser march together in tightly synchronized formation. This technique is widely used in radio and microwave applications, says Tso Yee Fan, a laser scientist at the Massachusetts Institute of Technology’s defence-oriented Lincoln Laboratory in Lexington. But coherence is much tougher to achieve with visible and infrared light. The waves from each laser must have almost identical wavelengths, the planes of their oscillations must precisely align, and the peaks and troughs of each wave must coincide. “In radio-frequency or microwaves, the wavelength’s a few centimetres,” Fan says. “In optics, the wavelength’s around a micrometre, so being able to do those kinds of controls has been really difficult.”

But that may not matter much, says Sprangle. In 2006, he and his team reported computer simulations suggesting that an ‘incoherent combination’ of several fibre-laser beams hitting a single spot would be almost as effective as a coherent combination2. With either approach, he says, “when you’re propagating over long ranges through atmospheric turbulence, you get approximately the same power on the target”. In 2009, his group confirmed this theory by using mirrors to combine 4 fibre-laser beams into a 5-centimetre spot on a target more than 3 kilometres away3.

Building on Sprangle’s work, the US Office of Naval Research has developed the 30-kW LaWS, which incoherently combines six commercial fibre-lasers. LaWS has been installed on the USSPonce since September 2014, and has been tested on objects such as small boats and drones.

The missile-specialist MBDA Germany in Schrobenhausen has developed a similar approach4. In October 2012, the firm successfully used its 40-kW combined fibre-beam system to destroy model artillery shells towed through the air some 2 kilometres away. MBDA’s tests have also helped to debunk the science-fiction idea that reflective armour would defend against laser weapons. They found that any dust on the mirrored surface would get burned in, and lead to the destruction of the target even faster than with a non-reflective surface.

Markus Martinstetter from MBDA’s Future Systems Directorate argues that high-precision targeting minimizes the chances of accidentally hurting bystanders while trying to shoot down targets, especially compared with conventional explosives. “There is no risk from fragmenting ammunition and we only start the irradiation when the aim point is exactly on target,” he says.

Lockheed Martin is also working on laser weapons that can take on targets that are more complex or farther away than can be tackled by its low-cost ADAM system. In March, for example, the company reported that its Advanced Test High Energy Asset (ATHENA) system could disable the running engine of a small truck mounted on a test platform. ATHENA uses a similar adaptive-optics system to the Airborne Laser, coupled with Lockheed’s Accelerated Laser Demonstration Initiative (ALADIN) fibre-laser system.

Boeing

The High Energy Laser Mobile Demonstrator can take down drones.

ALADIN combines the output of several fibre lasers, each with a slightly different wavelength, into a single 30-kW beam. This ‘wavelength beam combining’ approach originated at the Lincoln Laboratory5 and is similar to methods that channel Internet traffic into fibre-optic cables. Fan notes that this method is easier than coherent combining, but gives better-quality beams than incoherent combining, so it can more easily hit smaller targets from longer distances.

Jason Ellis, a visiting fellow at the CNAS and lead author of the think tank’s laser-weapons report1, says that such developments convince him that fibre-laser weapons are coming of age — and that emerging advances could take them to hundreds of kilowatts and extend their range to hundreds of kilometres.

Despite such advances, a February 2014 poll6 of US national-security specialists found that just one-fifth believed that directed-energy weapon technologies would be mature within a decade.

Michael Carter, a programme manager for photon science at Lawrence Livermore National Laboratory in Livermore, California, cautions that today’s lasers are a very long way from their science-fiction counterparts. “They’re not yet the Star Trek phaser,” he says. “People talk about speed-of-light engagement, but it still takes time to demolish targets. At the most basic level, if you can’t see it — if there’s too much rain or fog — your laser can’t hit it.” He suggests that the greatest value of the current generation of demonstration systems may be in working out how to handle such broader challenges before better lasers emerge. “Don’t mistake what they’re doing on the USSPonce for a new strategic superiority,” Carter warns. “It may be the first step in that direction but it’s not going to change the game by itself.”

Even the weapons companies are cautious not to overstate their case. For example, MBDA expects that it will take 3–5 years for truly operational systems to appear even in the tens of kilowatts range. And in some circumstances — such as a foggy day — conventional weapons will always be more effective. “You give the defender of the future both, and put the choice in their hands,” DeYoung recommends.

Despite their modest capabilities, Scharre claims that fibre-laser weapons could find a niche in US military defence in 5–10 years. “They may not be as grand and strategic as the Star Wars concept,” he says, “but they could save lives, protect US bases, ships and service members.”

Watch the video. URL: https://youtu.be/2RyFcBcLOZM

Every world in a grain of sand: John Nash’s astonishing geometry – ScienceAlert


The mathematics of a beautiful mind.

As has been widely reported, John Forbes Nash Jr died tragically in a car accident on May 23 of this year. Many tributes have been paid to this great mathematician, who was made famous by Sylvia Nasar’s biography A Beautiful Mind and the subsequent movie based on that book.
Much has been said about Nash’s work on game theory. But less has been said about Nash’s other mathematical achievements. Many mathematicians who understand Nash’s work would agree, I think, that although his work in game theory had the most impact on other fields, Nash made other breakthroughs which were even more impressive.

Apart from game theory, Nash worked in fields as diverse as algebraic geometry, topology, partial differential equations and cryptography.

But perhaps Nash’s most spectacular results were in geometry. To honour Nash’s life, I would like to try to give a flavour of some of this work.

John Nash and pure mathematics

A great deal of Nash’s work was in the field of geometry. But this kind of geometry – differential geometry – is very different from the geometry learned at high school. It is not about trigonometry or Pythagoras, as found in secondary maths textbooks. Rather, it is about topics like surfaces, curvature and smoothness.

Like all pure mathematicians, Nash proved theorems: logical statements that are rigorous, precise and absolutely true, with no tolerance for vagueness. The world of pure mathematics is austere and often abstruse, but its claims to truth are eternal and absolute.

Well, that’s the theory at least. Breakthroughs in pure mathematics are often at the very limits of human understanding. It takes time, even for those in the field, to fully comprehend new developments.

Nash’s work was an extreme case. His papers could be chaotically presented, hard to follow and his approaches to problems were often unlike anything that had come before him, bamboozling students and experts alike. But he was almost otherworldly in his creativity.

While mathematical arguments are tightly constrained by the rigorous requirements of logic, Nash’s constructions and methods were wild. And nowhere was this more so than in his work on geometry.

Nash’s geometry

Take a flat sheet of paper. You can bend it, but without ripping it or creasing it, what shapes can you make? You can’t make a sphere, or even a section of a sphere, because a sphere is curved, while the paper is flat.

But you can make a cylinder. And even a cone, as you’ll know if you’ve ever seen a dunce’s hat. (This fact is also useful for making waffle cones, as shown below.)

image-20150527-11280-1fztjxw web

As it turns out, even though a cylinder or a cone looks curved, it is intrinsically flat. In an undergraduate course on differential geometry (such as the one I teach at Monash), one studies this intrinsic curvature, and it turns out that there are lots of flat surfaces.

image-20150527-25090-9hpk1f

These ideas were around for hundreds of years before Nash, but Nash took them much further.

The embedding problem

Nash took up the idea of ’embedding’ a surface: placing it into space without tearing, creasing or crossing itself. An embedding which does not distort the surface’s intrinsic geometry is ‘isometric’. In other words, the surfaces above are ‘isometric embeddings’ of the plane into 3-dimensional space.

The isometric embedding question can be asked not just for the plane, but for any possible surface: spheres, donuts (which mathematicians call tori to try to sound respectable) and many others.

As it turns out, there are surfaces that are so strongly curved or tangled up that they cannot be embedded into 3-dimensional space at all. In fact, they can’t even be embedded into 4-dimensional space.

But Nash showed that any surface can be embedded into 17-dimensional space. Extra dimensions, far from making the problem even more difficult, actually make it easier – giving you more room to embed your surface! Later on, Nash’s work was improved by others, and we now know that any surface can be embedded into 5-dimensional space.

However, surfaces are only 2-dimensional. And Nash was interested in surfaces of any possible dimension. These higher dimensional analogues of surfaces are known as ‘manifolds’.

Nash proved that you can always embed a manifold into space of some dimension, without distorting its geometry. With this momentous result, he solved the isometric embedding problem.

Nash’s proof of the isometric embedding problem came as a complete surprise to much of the mathematical community. His methods were revolutionary. The great mathematician Mikhail Gromov said that Nash’s work on the embedding problem struck him to be “as convincing as lifting oneself by the hair”. But after great effort, Gromov finally understood Nash’s proof: at the end of Nash’s lengthy argument, Gromov said, Nash “miraculously, did lift you in the air by the hair”!

Isometric embedding in action

Gromov went on to develop his own ideas, inspired by Nash’s work. He wrote a book – similarly renowned among mathematicians for its incomprehensibility, just like Nash’s work – in which he developed a method called ‘convex integration’.

Gromov’s method had several advantages. One is that it is easier to draw pictures of an embedding made with his convex integration method. Prior to Gromov, we knew isometric embeddings existed, and had wonderful properties, but had a very tough time trying to visualise them, not least because they were often in higher dimensions.

In 2012, a team of French mathematicians produced computer graphics of isometric embeddings using Gromov’s convex integration methods. They are extremely intricate, almost fractal-like, yet smooth. Some are shown below.

The world in a grain of sand

Nash’s work on the isometric embedding problem has many facets and has led to huge amounts of subsequent research.

One particularly amazing aspect is how isometric embeddings are constructed. Nash’s work, combined with subsequent work by Nicolaas Kuiper, showed that if you wanted to isometrically embed a surface in 3-dimensional space, it’s enough to be able to shrink it.

If you have a ‘shrunken’ embedding of your surface – that is, with all lengths decreased – then Nash and Kuiper show how you can obtain an isometric embedding of your surface just by adjusting your shrunken version a bit.

This sounds ridiculous. For instance, take a sphere – say the surface of a tennis ball – and imagine shrinking it down to have a nanometre radius. Nash and Kuiper show that by ‘ruffling’ the surface sufficiently (but always smoothly; no creasing or folding or ripping or tearing allowed!) you can have an isometric copy of your original tennis ball, all contained within this nanometre radius. This type of ‘ruffling’ of the surface was reproduced in the French team’s computer graphics.

The French team considered taking a flat square piece of paper. Glue the top side to the bottom side, to get a cylinder. Now glue the left side to the right side. If you think about it, you might be able to see that you get a donut. But you’ll find the paper is now creased or distorted.

Can you embed it into 3-dimensional space without distortion? Nash and Kuiper say “yes”. Gromov says “use convex integration”. And the French mathematicians say “this is what it looks like”!

 

More pictures are available at the Project’s website.

But the mathematical theorem doesn’t just apply to tennis balls or donuts: the theorem holds for any manifold of any dimension. Any world can be contained in a grain of sand.

How did he do it?

Nash had a rare combination of genius and hard work. In her biography of Nash, Sylvia Nasar details his formidable intensity and effort spent working on the problem.

As is well known from the movie, Nash came to believe in outlandish conspiracy theories involving aliens and supernatural beings, as a result of his schizophrenia. When later asked why he, an extremely intelligent scientist, could believe in such things, he said those ideas “came to me the same way that my mathematical ideas did. So I took them seriously”.

And frankly, if my head told me ideas as accurate and as insightful as those needed to prove the isometric embedding theorem, I’d likely trust it on aliens and the supernatural too.

Typical American diet can damage immune system .


Inflammation, autoimmune problems and even cancer can result

doughnuts

FOOD FIGHT  The body’s bacterial community helps train the immune system to recognize and fight off invaders. New evidence suggests that those helpful microbes don’t care for fatty, sugary or salty foods.

It was not entirely surprising: Many reports have observed that heavier patients appear more likely to come down with infections during a hospital stay, acquire weaker protection from vaccinations and, as with River, suffer more complications from the flu.

Weight alone may not be the entire explanation. A tantalizing line of evidence suggests that unhealthful foods — fatty, salty, sugary, processed foods — may disrupt the body’s defenses in a way that promotes inflammation, infection, autoimmune diseases and even illnesses like cancer.

While the interplay between diet and immunity is complex — and still largely uncharted — many researchers believe some foods perturb gut microbiota, the body’s inner bacterial community that may be as important to proper health as any major organ (SN: 6/18/11, p. 26).

Among their long list of tasks, gut bacteria may help train the immune system to distinguish between human and microbe so that it can confront what’s bad, tolerate what’s not, and recruit a diverse army of cellular foot soldiers to stop invading germs. Writing in Nutrition Journal in June 2014, one scientistlikened gut microbiota to a sparring partner, providing a regular workout that strengthens the contender for a true opponent.

To function at their best, though, gut microbes, like most living things, need to be well fed. And many of the species responsible for immune equilibrium don’t seem to care for junk food. In a study reported inNature Communications in April, African-American volunteers who shifted from an American diet to high-fiber, low-fat African cuisine experienced a drop in inflammation in just two weeks.

“It’s becoming clear that the typical American diet can damage the immune system,” says Ian Myles, a physician and researcher at the National Institute of Allergy and Infectious Diseases in Bethesda, Md. After a lethal infection, most of the blame is understandably leveled against the microbe responsible, Myles says. “It’s harder to make the connection that it may have had something to do with what you’ve been eating the past 30 years.”

A slow boil

In a series of experiments over the last decade, scientists have made the case that a poor diet and an out-of-balance intestinal ecosystem can unleash a persistent, low-level immune activation. This is not to be mistaken with the good kind of inflammation, which occurs when bacteria, viruses or anything else foreign slips into the bloodstream. Immune cells rally to surround and eliminate the threat. It’s a healthy response necessary for survival.

But this life-saving reaction turns sour when the immune system gets stuck on a slow, endless burn. In an ironic twist of biology, one of the consequences of an immune system that never takes a rest is that it may be asleep when it’s really needed. Like an annoying car alarm that everyone hears but no one responds to, chronic activation might desensitize the system to actual danger.

There is also evidence that certain kinds of fats and refined sugar, consumed in excess, may compromise the inner lining of the intestine, allowing microscopic leaks that trigger unrelenting immune activation. Also, adipose tissue, or body fat, is so capable of hormone production that it is often referred to as an endocrine organ by itself, able to kindle a low-grade inflammation that stresses tissues and promotes disease.

Taken together, Myles says, the combination of unhealthy diet and obesity explain in part the rise in autoimmune conditions such as celiac disease, type 1 diabetes and other illnesses that occur when the body turns on itself. (For instance, a 2012 report found that the prevalence of inflammatory bowel disease is rising, and rates are highest in Westernized parts of the world.) The connection also suggests avenues for management. One study reported that probiotic foods might help increase insulin sensitivity among diabetics. That’s not to say that diet is completely at fault. Why auto-immune diseases occur is a mystery — and theories abound — but a large body of evidence gives some culpability to changes in gut bacteria.

Small world

Until recently, bacteria in the intestine were largely unexplored because they are difficult to grow in a laboratory. Thanks to advances in molecular tools that work outside a petri dish, researchers are getting a better handle on a partnership that serves both host and microbes. While about 1,000 species of bacteria are thought to live in the intestine, only a portion are dominant players. As with ecosystems throughout nature, diversity rules, and an abundance of species signals a healthy environment.

In general, beneficial bacteria appear to prefer certain foods — such as fiber and the complex carbohydrates found in vegetables and whole grains — and dislike others, such as refined sugar and (according to some experiments) saturated fat. Essentially, it’s possible to satisfy your own sweet tooth while starving a lot of your microscopic friends.

A landmark experiment in 2009 found that among mice carrying the same microbes found in humans, a high-fat, high-sugar diet caused certain bacterial populations to drop and others to rise. As a result, the microbial community was “dramatically altered over a time scale of hours,” researchers from Washington University School of Medicine in St. Louis and the University of Colorado Boulder reported in Science Translational Medicine.

In a follow-up study with human volunteers published last year in Nature, a team from Harvard and the University of California, San Francisco found similarly abrupt responses (SN Online: 12/11/13). A day after volunteers started a diet dominated by animal products, bacterial diversity in their intestines dropped, which coincided with a bloom in Bilophila wadsworthia, a normally minor occupant that has been associated with inflammatory bowel disease.

“There aren’t too many microbes that like to live in the presence of certain types of fat. It’s too difficult for them to use as a food source,” says Vanessa Leone, a nutrition scientist at the University of Chicago. “So you’re selecting for micro-organisms that can live in that environment.” In 2012, Leone’s team reported inNature that a diet high in saturated fat also increases the production of one type of bile. The digestive enzyme made by the liver favors some microbes while killing off others. (And as in other experiments, a major beneficiary appears to be B. wadsworthia.)

In experiments in mice published in PLOS ONE and the British Journal of Nutrition in 2013, Gibson and her colleagues reported that diets high in omega-6 fatty acids disrupted gut microbiota. The researchers also saw the kinds of increased inflammatory responses that lead to colitis, a condition resulting from inflammation in the colon.

The mechanisms in the intestine that trigger inflammation are still not fully understood. But toll-like receptors, molecules that sit on certain immune cells, appear to be important players. Once activated, toll-like receptors are capable of setting off alarms. Some respond to the presence of lipopolysaccharides, molecules that are part of the membranes of some bacteria.

Normally, bacteria in the gut hardly come in contact with the rest of the body, because the mucus and epithelial cells lining the intestine keep them in the gut. But diets high in sugar and fat and low in fiber may cause the intestine to become porous. Writing last year in Cell Metabolism, researchers from Stanford University pointed out that the calories contained in refined sugars — which constitute an ever-growing part of the American diet — aren’t a good food source for the gut’s microbiota. In response, evidence suggests, some of the bacteria will eat the mucus lining of the intestine, which may cause the lining to deteriorate.

Eventually, some gut organisms slip through and encounter toll-like receptors on immune cells, setting off an immune reaction. Some experiments also suggest that saturated fat itself may stimulate toll-like receptors.

It’s still too early to draw firm conclusions, however. Researchers in South Carolina and Iowa tested the ability of three different diets to activate the toll-like receptors TLR2 and TLR4 on macrophages, key immune cells. All three diets had the same amount of fat, but varied in the proportion of saturated fat: 6 percent, 12 percent or 24 percent. (The diet with 12 percent saturated fat mimicked typical American eating patterns.)

Based on previous studies, the scientists expected the diet with the highest saturated fat to produce the most inflammation. To their surprise, the highest inflammation, and greatest body fat accumulation, occurred with the 12-percent saturated fat diet, the team reported in the Journal of Lipid Research in 2013. Since all the diets had the same proportion of total fat, the authors speculate that the combination of different types of fat is responsible for the overall effect.

Salt of the girth

Fat isn’t the only thing on the drive-through menu. The average American gets more than twice as much salt as recommended, a problem largely driven by heavy consumption of processed and prepackaged foods. In a study published last year in Pediatrics, adolescents who ate the most salt were more likely than others to be obese and have signs of inflammation.

Such results are not conclusive; salty foods could also have a high sugar and fat content. But many studies are not reassuring. A multinational research team fed each of six volunteers four diets that differed only in the amount of salt: 12 grams per day, 9 grams, 6 grams, then 12 again. Immune activation spiked on the high-salt diet. More important, in a trend suggesting cause and effect, levels of most immune cytokines gradually fell as salt intake diminished. “These findings raise the possibility that high salt intake might trigger tissue inflammation and autoimmune disease in humans,” the scientists wrote last year inTranslational Research.

Other studies have raised similar concerns. In 2013, researchers demonstrated that excess salt in the diets of mice could increase activity of certain  T cells that have a role in autoimmunity. There’s more to learn, cautions immunologist Markus Kleinewietfeld of Yale University and TU Dresden in Germany, lead author of the study, published in Nature. “Salt seems to be, in general, a proinflammatory signal for the immune system, but the physiology is not well understood,” he says.

There may be situations where the presence of salt is beneficial. He points to a study published this springin Cell Metabolism suggesting that sodium storage in the skin may help protect against infection from a parasite that causes leishmaniasis.

The implications for T cells may be especially important because of their complex role not just in fighting germs, but also in autoimmunity and cancer. T cells may either suppress or promote cancer depending on the circumstances, and their proper balance may rest in part on the health of the gut microbiota.

Studies find that the ebb and flow of these cells depends highly on gut bacteria. Germ-free mice — raised in sterile environments with squeaky-clean intestines — are depleted of Th17 cells. But when the mice’s insides are populated with certain bacteria, Th17 cells reappear. Furthermore, a study published inNature Medicine in 2009 reported that when mice predisposed to colon cancer were exposed to bacteria that promote Th17 growth, tumor cells grew more aggressively. In short, gut bacteria in the intestine appear to serve as a thermostat for Th17 and T-reg cells.

Gut instincts

The good news is that just as a bad diet might promote inflammation, foods that promote healthy microbiota appear to restore order. Microbes that get the food they crave not only maintain normal bacterial ratios, but also produce beneficial fermentation products such as butyrate. (In several studies, butyrate is emerging as a natural compound that tamps down inflammation.)

Other food components also appear to be anti-inflammatory, including omega-3 fatty acids, which are common in fish and nuts. And in one experiment, published in PLOS ONE in 2013, Yale’s Kleinewietfeld and collaborators used bacteria found in yogurt to reverse the inflammation from a fast food–like diet in mice. The treatment seemed to protect against some of the weight gain such food encourages. Other work by some of the same researchers also raises the possibility that disease risk from microbiota can cross generations (see sidebar below).

In any case, it is clear that diet can affect gut microbiota, says cancer biologist Susan Erdman of MIT, senior author of the 2013 study in PLOS ONE. “And those changes seem to influence the immune system,” she says. “We need a diet that supports the microbes that become an important part of who we are.” In other words, choose foods that keep gut bacteria healthy, and odds are, they’ll return the favor.

Could computers reach light speed?


Light waves trapped on a metal’s surface travel nearly as fast as light through the air, and new research at Pacific Northwest National Laboratory shows these waves, called surface plasmons, travel far enough to possibly be useful for ultra-fast electronic circuit interconnects. The PNNL team captured, on video, surface plasmons moving at least 250 microns across the surface.

Because circuit interconnects based on surface plasmons could be much faster than current interconnects, this basic research could lead to faster computer circuits and provide significant advances in the chemical, biological, and health fields. Also, the results give insights about these trapped to the scientific communities. The study experimentally confirms the linear relationship between the input light waves and generated surface plasmons. It also indicates the plasmons have a long life and low dissipation, critical fundamental information needed to use the waves in circuits and other applications.

When a surface plasmon is generated on a metal surface, it can be observed by using laser light to emit electrons. By detecting these photo-electrons, with a special instrument called a photoemission electron microscope (PEEM), the scientists explored the nature of surface plasmons.

In their experiments, the team applied two laser pulses to the sample: one is called the pump, used to generate the surface plasmon; the other is called the probe, used to detect the plasmon. The probe pulse strikes the sample and detects the plasmon at different time delays. By continuously tuning the time delay between the pump and probe pulses, the team monitored the motion of the plasmon on the gold surface, finding that the wave traveled up to 250 microns on the .

This image, taken with a photoemission electron microscope, shows the spatially separated pump and probe pulse. Credit: American Chemical Society

“The distance is surprisingly long because plasmon don’t propagate like a normal free space wave,” said Dr. Yu Gong, a scientist at PNNL and the lead author on this study. “In our case, the plasmons travel unexpectedly long distances in metal films.”

The team applied numerical simulations to further confirm their experimental results.

What’s Next? Now, the team is exploring how to control the propagation of the plasmon. For example, how efficiently can the be generated? How can it be guided? How can it be stopped? The scientists are using the PEEM and other resources, including those in DOE’s EMSL, to answer these and other questions. The results are crucial to making circuits that operate at light speed a reality.

How sleep helps us learn and memorize .


Sleeping triggers the synapses in our brain to both strengthen and weaken, which prompts the forgetting, strengthening or modification of our memories. Credit: Blanco et al. PLoS Computational Biology, 2015

       

Sleep is important for long lasting memories, particularly during this exam season. Research published in PLoS Computational Biology suggests that sleeping triggers the synapses in our brain to both strengthen and weaken, which prompts the forgetting, strengthening or modification of our memories in a process known as long-term potentiation (LTP).

Researchers led by Sidarta Ribeiro at the Brain Institute of the Federal University of Rio Grande do Norte, Brazil, measured the levels of a protein related to LTP during the sleep cycle of rats. The authors then used the data to build models of sleep-dependent synaptic plasticity.

The results show that sleep can have completely different effects depending on whether LTP is present or not. A lack of LTP leads to memory erasure, while the presence of LTP can either strengthen memories or prompt the emergence of new ones.

The research provides an empirical and theoretical framework to understand the mechanisms underlying the complex role of sleep for learning, which involves selective remembering as well as creativity.

 

Breast cancer could be ‘stopped in tracks’ by cheap drugs .


A major study suggests thousands of breast cancer deaths could be prevented using osteoporosis drugs which cost just £1 a day

Breast cancer

Cheap drugs used to treat osteoporosis could save 10,000 lives in Britain every year by “stopping breast cancer in its tracks,” new research suggests.

A study at the Institute of Cancer Research has an identified an enzyme which causes disease to spread to the bone, causing the majority of breast cancer deaths.

Tests found that a cheap class of drugs, already used to prevent osteoporosis, could prevent the changes in the bone, blocking the spread of disease.

Researchers from the Universities of Sheffield and Copenhagen said they were “really excited” about the findings, published in the journal Nature, which could potentially save thousands of lives.

Breast cancer is the most common cancer among women in the UK, with around 50,000 cases a year, and 12,000 deaths.

Almost nine in ten deaths occur because disease has spread to the bone.

The new trials, in mice, identified an enzyme which is triggered by tumours in the breast, causing holes in the bones, which make them susceptible to the spread of disease.

The study found that treatment with bisphosphonate – an existing drug used to prevent and treat osteoporosis, was able to prevent changes to the bone, and block spread of disease.

The drugs, which prevent the loss of bone mass, are already prescribed to those at risk of osteoporotic fractures at a cost of around £1 a day.

Researchers said they now wanted to carry out research to establish exactly how the bone cells and enzymes interact, to develop the most effective treatments to block the spread of disease.

Dr Janine Erler, Associate Professor at the Biotech Research & Innovation Centre at the University of Copenhagen, study co-leader said the findings could transform treatment for breast cancer.

“Once cancer spreads to the bone it is very difficult to treat,” she said. “Our research has shed light on the way breast cancer cells prime the bone so it is ready for their arrival. If we were able to block this process and translate our work to the clinic, we could stop breast cancer in its tracks thereby extending patients’ lives.”

Co-author Dr Alison Gartland, from the University of Sheffield’s Department of Human Metabolism said the findings could extend thousands of lives.

“We are really excited about our results,” she said.

“This is important progress in the fight against breast cancer metastasis and these findings could lead to new treatments to stop secondary breast tumours growing in the bone, increasing the chances of survival for thousands of patients.”

The research, conducted at The Institute of Cancer Research, London, found that the enzyme LysYl Oxidase (LOX) released from the primary tumour causes holes in bone and prepares the bone for the future arrival of cancer cells.

Identifying LOX in oestrogen receptor negative (ER negative) breast cancer patients early, could allow doctors to block the enzyme’s activity, preventing bone damage and the spread of tumour cells to the bone (metastasis), halting the progression of the disease.

The researchers showed that treatment with bisphosphonate, an existing class of drug which prevents the loss of bone mass and is already used to treat diseases such as osteoporosis, was able to prevent the changes in the bone and the spread of the disease in mice.

Katherine Woods, Senior Research Communications Manager at Breast Cancer Campaign and Breakthrough Breast Cancer, said the findings opened up a whole new avenue for research for new treatments to block the spread of breast cancer.

She said: “The research also adds weight to the growing body of evidence supporting the role of bisphosphonates in stopping secondary breast cancer in its tracks.”

The charity said women living with secondary breast cancer were currently left to suffer bone pain and fractures, requiring surgery during the precious time they had left with loved ones.

Ms Woods said: “Secondary breast cancer kills 1,000 women each and every month in the UK alone and yet we still don’t know enough about how and why breast cancer spreads to stop it.”

The world’s first ocean cleaning system will be deployed in 2016 .


There are five gigantic patches of swirling plastic throughout the Earth’s oceans, known as gyres.

Because of ocean currents, a great majority of the plastic that ends up in the oceans finds its way into these garbage patches, poisoning marine life and ending up in the food supply of the planet.  Toxic chemicals like PCBs and DDTs are absorbed by the plastic and cause diseases like cancer, malformation and impaired reproductive ability.

That the plastic lands in these rotating patches is a double edged sword.  It is horrible, yes, and causes a multitude of problems, but it also localizes the pollutants and gives us a place to start when cleaning up.  It’s estimated that 1/3rd of the world’s oceanic plastic pollution is within the great Pacific Garbage Patch (number 01 on the map above).

One young man saw the problem early in his life.  Boyan Slat, at the age of 18, gave a riveting Ted Talk unveiling his plan to clean the pollution using passive flotation devices and the ocean’s own current.  After all, “why move through the oceans, if the oceans can move through you?”  In 2014, at the age of 19, he realized the plan was actually feasible, and now it’s going into effect off the coast of Japan.

The currents pull the sea life under the floatation devices but the lighter-than-water plastics float into the barriers.  What would have taken humanity 70,000 years to clean with boats and nets can be cleaned, instead, in decades.

It’s estimated that a single, 100km cleanup array will clean 42% of the ocean’s plastic in 10 years.  The first array will be deployed in 2016 and technology is underway to recycle the plastic into biofuel.

6 Things You Didn’t Know About How Your Brain Works .


We’re hasty, sloppy, and biased, and that’s just for starters.

“I think therefore I am,” Descartes said. While writing my book, Quitting, I analyzed how people think, process, and make decisions. While I fancied myself a thoughtful, detail-oriented, and thorough person, my research revealed the blind spots we all share when processing details to make smart choices.

If you are about to make a change or a decision, the quality of the choice depends on your ability to think through options. But are your thought processes dependable? The science says no. The degree to which our thinking is unconscious, automatic, influenced by external cues, and biased may come as a shock to you, as it certainly did to me.

Following are 6 myths I believed about thinking, and the real story:

1. I base my decisions on facts.

We might not ponder our decisions as much as we think. According to Nobel Prize winners Daniel Kahneman and Amos Twersky, we rely on the “availability heuristic” most often when we make a choice or decision. This mental shortcut—highlighting the most recent, mentally available “facts”—gives our brain a break when making a decision. Quick “connect the dots” thinking was valuable in human evolutionary history when dangers and perils required fast response. In today’s hyper-connected world, we are more susceptible to the “available” facts as they pop up.

2. I weigh the pros and cons carefully when considering options.

Not really. Though we consider ourselves open to new opportunities and risk, more often we prioritize how much time, energy, and money we’ve already invested in a given path. The “sunk-cost fallacy” motivates us to stay in unsatisfying relationships, jobs, and everything else long past their expiration date.

3. I think more logically than other people

You probably don’t. Repeated studies show that Americans think of themselves as “above average” in almost every domain. A famous study in the 1970s conducted by the College Board showed that 70% of those surveyed thought they had better-than-averageleadership skills. When asked to rate their ability to get along with others, 60% put themselves in the top 10%, and 25% ranked themselves as being in the first percentile. (So, where do all the difficult people come from?)

A paper by David Dunning, Chip Heath, and Jerry M. Suls suggests that almost everything we think about ourselves is colored by one bias or another. This includes our ability to forecast how generous we will be, how quickly we will complete a task, and how we will act or react in a future situation.

4. I am an objective thinker.

Perhaps not. While we may notice other peoples’ biases, researchers Emily Pronin, Daniel Lin, and Lee Ross found that most people have a “bias blind spot” toward themselves. When it comes to self-assessment, David Dunning and his colleagues report that, “in general, people’s self-views hold only a tenuous relationship with their actual behavior and performance.”

5. I am good at anticipating my own reactions.

According to Timothy Wilson and Daniel Gilbert, when we imagine a future scenario, we simplify it. The more complex a future situation turns out to be, then, the more unlikely that your prediction about how you will react will be accurate.

Julia Woodzicka and Marianne La France conducted an experiment in which they asked nearly 200 women how they would react if an older male asked them inappropriate questions during a job interview—such as, whether they had a boyfriend, whether men found them desirable, or whether they thought women should wear bras to work—and 62% of the women imagined that they’d be proactive, telling the guy off in some way, while 28% said they would simply bail and walk out; 65% said they’d refuse to answer at least one question.

Then the researchers had the participants go for what they believed was a real interview for a lab assistant position. Half of the women were asked the harassing questions by the male interviewer; the control group was asked odd, random questions which weren’t harassing. More than half of the women ignored the harassment. And while 36% asked why they were being asked these questions, four out of six of those participants only asked at the end of the interview. And no one walked out.

6. I pay close attention to detail. 

Your brain is bombarded by so many stimuli that it has to use shortcuts so that you can form a picture, filling in the blanks so that you achieve coherence. In their article, “Gorillas in Our Midst,” Daniel Simons and Christopher Chabris show how limited our powers of perception are when we are concentrating. The experimenters asked participants watching a video of a basketball game to count either the number of passes or bounces among the players; seconds into the video, someone dressed in a gorilla costume walked into the middle of the players. More than half of the people missed the gorilla.

The experiment exposed what is called “inattentional blindness,” which refers to our inability to notice or register the alteration of an important detail. Studies have shown that people fail to notice that heads on a photograph of two people have been switched; similarly, an experiment conducted by Daniel Simons revealed that change blindnessactually took place in real-life situations. An experimenter posed as someone lost on a college campus, map in hand; he solicited the advice of passersby. But, as the experimenter and the pedestrian were talking, two men carrying a door passed between them, blocking the experimenter from view for a few moments. Another experimenter took the first experimenter’s place, also holding a map. Once again, only half of the pedestrians noticed the switch.

VISIT ME ON ,http://www.Facebook.com/PegStreepAuthor(link is external) and READ MY NEW BOOK: Mastering the Art of Quitting: Why It Matters in Life, Love, and Work(link is external)

REFERENCES

Kahneman, Daniel. Thinking, Fast and Slow. New York:Farrar, Straus& Giroux, 2011

http://www.geog.ucsb.edu/events/department-news/1195/forget-sharks-cows-are-more-likely-to-kill-you/(link is external)

Dunning, David, Chip Heath, and Jerry M. Suls, “Flawed Self-Assessment: Implications forHealth, Education, and the Workplace,” Psychological Science in the Public InterestDecember 2004 vol. 5 no. 3 69-106.

Pronin, Emily, Daniel Y. Yin, and Lee Ross, “The Bias Blind Spot: Perceptions of Bias in Self versus Others,” Personality and Social Psychology Bulletin, 28, no. 3(March 2002): 369-381

Wilson, Timothy and Daniel Gilbert, “Affective Forecasting,” Advances in Experimental Social Psychology, 35 (2003): 346-411.

Woodzicka, Julia and Marianne La France, “Real versus Imagined Gender Harassment,”Journal of Social Issues, 57, no. 1 (2001): 15-39.

Simons, Daniel J. and Christopher F. Chabris, “Gorillas in our midst: sustained inattentional blindness for dynamic events,” Perception, vol, 28 (1999), 1059-1074.

Blood Tests That Don’t Hurt? Tasso Inc. Receives $3 Million To Advance Painless Prototype


Blood tests are painful and inconvenient — but Tasso Inc., a company run by former students of the University of Wisconsin-Madison, is closer to developing a painless alternative.

According to a press release from UW-Madison, Tasso is in the process of perfecting a prototype device the size of a ping-pong ball that extracts small blood samples when held against the skin for two minutes. A “slight vacuum” in the device is what helps blood flow into an attached tube, which can then be mailed or handed to a lab. Ben Casavant, vice president and co-founder of Tasso, explained “the technology relies on the forces that govern the flow of tiny fluid stream.”

“At these scales, surface tension dominates over gravity, and that keeps the blood in the channel no matter how you hold the device,” he said.

Casavant was studying microfluidics — the study of cell biology — at UW-Madison when he and his two co-founders, Erwin Berthier and Ben Moga, realized they wanted to start a company, not necessarily what kind of company. He and his fellow classmates just knew they wanted to apply what they were learning in the classroom in some way so that they could help others. Enter: pain-free blood tests.

Blood tests Tasso Inc.’s prototype, painless blood test. David Tenenbaum, University of Wisconsin-Madison

Apparently, those who have used the device so far have said it’s almost entirely painless. Even better, the Defenses Advanced Research Projects Agency (DARPA) granted the company an additional $3 million to advance their device, so it may soon be something everyone can experience. This grant will primarily “fund work with companies that make blood preservatives” in an effort to ensure the extracted samples remain fit for analysis.

Reduced pain is a major selling point for those currently afraid to get a blood test or too busy to drive to get tested in the first place. But, from a health practitioner’s perspective, Casavant said the device could simplify manufacturing and cut costs.

The DARPA grant is a big deal, too, because Casavant said initially, investors were skeptical of their device. Now that they’re receiving major grants from reputable companies, Tasso is starting to be taken seriously. Next, the company hopes to find “the killer application,” which is to say who is going to buy the device and for how much?

UW-Madison reported if all goes well, Tasso will submit an application for the device to the Food and Drug Administration later this year.

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