Bitter pill to swallow

Debashish Munshi & Priya Kurian

The bestselling author of Bad Science and physician-turned-writer Ben Goldacre has taken the gloss off the sugar-coated world of pharmaceutical research with his latest tome Bad Pharma. Goldacre’s sensational expose of the suppression of negative data from drug trials hit the news when a chapter from his new book was published in The Guardian in September this year. Since then, the mediasphere and the blogosphere have been agog with commentaries on and reviews of the book, including in The Telegraph and the New Statesman.

So what are the key charges Goldacre levels at pharmaceutical companies? According to him, they publish and publicise only positive results from trials; cover up results they don’t like; carry out tests on relatively small samples of what he calls “unrepresentative patients”, analyse data with flawed techniques statistical analysis, and “exaggerate the benefits of treatments”. What is perhaps worse is that, as Goldacre alleges, such practices have gone unchallenged by regulatory bodies and academic journals, leaving frontline physicians none the wiser.

In a letter to the New Statesman, the Association of the British Pharmaceutical Industry, on its part, denies that negative trial data are deliberately hidden and insists that 90 per cent of medicines now in use have been developed by the pharmaceutical industry through “incremental innovation”. The industry does acknowledge though that there is “still work to be done in ensuring the publication of negative trial data within journals, and in ensuring greater transparency all round within the industry”.
The ongoing controversy has of course put question marks around the integrity of drug trials and the vulnerability of physicians and patients alike to risks associated with real or perceived distortions of trial data. But it has also raised some red flags on the culpability of academic journals in the dissemination of such data.

Goldacre takes academia to task in the chapter excerpted in The Guardian  saying: “Finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies”. This charge echoes the charges made in the award-winning documentary Inside Job against some business school academics, economists, and state officials who knowingly or otherwise condoned the practices that led to the catastrophic financial crisis in the world.

Connected to this issue of appropriate communication of research results, a recent study in France published in PLOS Medicine found that around half the press releases on randomized controlled trials contained “spin” that inaccurately represented the findings of the actual trials, and were subsequently reproduced in media coverage. A significant finding of this study was that such spin in the press releases and media coverage, which distorted the actual findings of the research, reflected the spin in the published journal articles, namely in the abstract conclusions. The study called for journal editors and reviewers to take greater responsibility to ensure that research findings were accurately presented in article abstracts and press releases.

It seems clear that without open access to raw data, and given the continued conflict of interest between some researchers and those sponsoring the drug trials, it will be difficult for journalists to ask hard questions of the press releases that come their way.

Science rumblings

The conviction of six scientists and a government official in Italy for failing to warn the public about an impending earthquake has sent tremors down the scientific community in general. 

According to reports published in the international media, the scientists were given a six-year prison sentence for manslaughter for their negligence in keeping people informed about the risks of the earthquake which killed over 300 people in the Italian town of L’Aquila in 2009.

The conviction has, predictably, generated a huge controversy with a Guardian headline “From Galileo to the L'Aquila earthquake: Italian science on trial” comparing the recent trial of the six seismologists to the infamous trial of the legendary astronomer Galileo nearly 400 years ago.

For readers of the Public Understanding of Science, the key issue is that the trial of the seismologists is more about communicating science than about science per se. As the New Scientist reports: “The prosecution made it crystal clear all along that their case was about poor risk communication; it was built on an accusation of giving out "inexact, incomplete and contradictory information".

The issue of communication itself is rather murky. A more recent New Scientist article reports on the discovery of taped conversations at a risk assessment meeting in which a senior civil protection official “ordered one of the defendants to issue a reassuring statement.” This is another example of the power tussles among politicians, bureaucrats, and scientists given the diversity of their respective constituencies.

Predicting an earthquake is obviously not an exact science and many scientific bodies have rightly taken exception to the perception that the seismologists may have failed in their scientific endeavours. Two senior scientists in Italy, including the physicists in charge of the National Commission for the Prediction and Prevention of Major Risks, have also resigned in protest against the convictions. But as many commentators have pointed out, the convictions were not about the failure to predict the tremors but the failure in communicating the risks in a timely manner. So the challenge that the case throws up relates to the pitfalls of not communicating science appropriately.

Should scientists get media training to communicate their findings of public interest directly to the media? Are there ways in which science, policy, and media can work together to make sure scientific data and findings are understood clearly by people at large? One such initiative to give scientists training to be media savvy has recently taken off in New Zealand. Learning to communicate in an accessible and jargon-free language is of course important for scientists. But having institutional mechanisms to resist political bullying is perhaps even more important.

Are you my Mummy?

Without words to mean what we say, how do we say what we mean? In her last post, our guest blogger Rebecca Bollard discussed new reproductive technologies that create the space for ‘three-parent babies’. In this post, she talks about the linguistic gymnastics required to clearly convey what the notion of three-parent babies might mean.

The word ‘mother’ is typically used to refer to a person on whom the biological, legal, and social aspects of parenting rest.  Adoption splits the biological from the social and legal aspects. Egg and sperm donations open up such divides too. Divorce and remarriage can split social and legal parenthood from each other while surrogacy adds another layer of complexity by splitting the biological from the gestational. But now pronuclear transfer (PNT) and maternal spindle transfer (MST) offer ways to further divide the biological down into nuclear DNA and mtDNA donors.

So now the word ‘mother’ has five components – social mother, legal mother, gestational carrier, mtDNA donor, and nuclear DNA donor. Some of these are complex concepts that can barely be conveyed in easily understood plain English words. So, in addition to understanding the relatively complex science behind modern reproductive technology, the public must also grapple with concepts that have no clear semantic expression.

The term ‘mother’ also carries a load of normative values and social connotations, not easily defined. We have long been aware that words are not value neutral. When I write ‘gestational surrogate’, I mean the women who carries a foetus and then gives birth to the baby. This woman is generally the legal mother until adoption procedures are completed. That relationship is considerably more complex than the almost mechanical one suggested by the technical terms ‘gestational surrogate’ and ‘gestational carrier’.

So how do we conduct public debates on issues where there are no words to convey what we are talking about? And can we deal with a situation where words are not neutral descriptors of a common concept, but rather value-laden parts of a broader discourse?

Let us know what you think – in plain English, if possible.

Too many parents spoil the child?

When does a genetic donor become a biological parent and how many biological parents are too many? In this post, our guest blogger, REBECCA BOLLARD, looks at the recent technological developments around the possibility of three-parent babies.

In human fertilisation an egg cell is fertilised by a sperm cell, and each has 23 chromosomes. The fertilised cell has 46 chromosomes (the standard number for a human) and develops into an embryo. Chromosomes are made of DNA and exist in an area of the cell called the nucleus, and contain genes. This is what most people think of when talking about DNA – half comes from each biological parent and combines to form a new person. Every person has two biological parents no matter how complicated the legal or social arrangements may be.

This is, however, not quite the full story. Human cells also contain mitochondria, tiny organelles responsible for making a specific chemical that the cells need to function. Human mitochondria contain a small amount of DNA (often called mitochondrial DNA or mtDNA) in the form of a single chromosome. This chromosome is inherited exclusively from the egg cell and therefore the biological mother. mtDNA consists mostly of genes devoted to the maintenance and running of the mitochondria. Defects in these genes can lead to a range of serious diseases, including a range of incurable heart and muscle problems.

Several technologies may overcome mitochondrial disease. Pronuclear transfer (PNT) and maternal spindle transfer (MST) both allow the nucleus of the mother’s egg to be placed inside the egg from a woman with no mitochondrial issues. Thus, the resulting embryo would have three genetic donors – the man who supplied the sperm, the woman who supplied the egg nucleus, and the woman who supplied the egg and therefore the mtDNA. The first two of these would have supplied most, but certainly not all, of the DNA in the embryo (and resulting person). So, perhaps that person would have three genetic parents?

These techniques could also be used in other circumstances, such as where an intending mother has no eggs or has gone through menopause. Scientists believe they can take a cell from elsewhere in a woman’s body and halve the chromosomes using electricity. This cell could then be used with the egg cell (and mtDNA) of another woman.

The UK Human Fertilisation Embryology Authority (HFEA) recently began a consultation on whether such techniques could be used to help the 1 in 200 children born every year in the UK with mitochondrial diseases. This has led to much discussion in the press, including in the Daily Mail and in The Guardian. This follows earlier works by the Nuffield Council on Bioethics that such techniques would be ethical once proved safe and efficient.

Bioethics professor John Harris argues that mtDNA donors would not be genetic parents as “DNA contained in the donated mitochondria comprises much less than 1% of the total genetic contribution and does not transmit any of the traits that confer the usual family resemblances and distinctive personal features... No identity-conferring features are transmitted by the mitochondria”. He then goes on to argue that he would be more upset at having a mitochondrial disease than “having some third-party DNA in my genome”.

So, when does a genetic donor become a biological parent? The two people donating nuclear DNA are obvious candidates, but what about mtDNA donors? What about gestational surrogates, particularly as the evidence builds that gestation is not a simple relationship (see e.g. the research article by Chen et al in Plos One)? Does it matter, when the biological, social, and legal aspects of parenthood are split more than ever?

Should the number of parents in technology-driven reproduction matter? Or is it irrelevant when we’re talking about serious and otherwise incurable disease?

Do images colour perceptions?

With the increasing use of functional Magnetic Resonance Imaging (fMRI), the activities of a human brain at work are now routinely depicted in three-dimensional colour images. These attractive pictures of the brain are near mandatory appendages to news stories on neuroscience in the popular media and have been shown to have a persuasive effect on readers.

In an article in Cognition a few years ago, David McGabe and Alan Castel had famously shown how brain images had a hugely persuasive influence on public perceptions of stories on neuroscience. These images affected people’s judgements of scientific reasoning because they provided a tangible physical representation of brain activity.

One of the reasons of this appeal of brain images is, as John Grohol says, quite simply because “the pretty, compelling pictures of fMRI” add a colourful layer to otherwise boring psychological research – they “seem to illustrate a direct, causative relationship … even if one doesn’t exist.” This is, of course, a major challenge and, as Grohol points out, fMRI images are not always an accurate reflection of a brain’s activity and does not capture “the complexity of human behaviour.”

So yes, fMRI brain images have a persuasive influence on readers of popular science stories. But do these images have a greater persuasive effect than other kinds of images on how readers perceive a story?

Not really, going by a new study by David Gruber of the City University of Hong Kong and Jacob Dickerson of Georgetown College, USA. In an article forthcoming in the Public Understanding of Science, the two researchers report on a study in which they monitored the effect on participants of a variety of images attached to news articles on neuroscience. The images shown to the participants included fMRI images, artistic drawings and still images from science fiction films. “There is no significant difference between readers’ evaluations of an article regardless of the associated image,” the researchers say.

What this means is that each image may be persuasive in its own right. But there’s no way to predict if one kind of image is more persuasive than the other at a general level. This then is a significant extension of the McCabe & Castel study.

As Gruber and Dickerson point out, research would need to explore how images interact with a specific text and the specific context of a particular reader to affect understanding of a news story on neuroscience.

In another study focused more broadly on the impact of pictures accompanying true or false claims, Eryn Newman, a PhD student from Victoria University of Wellington, New Zealand, with researchers from the University of Victoria in British Columbia, Canada, found empirical evidence for the notion of “truthiness”— popularised by US comedian and satirist Stephen Colbert. Colbert defines truthiness as “the truth that you feel in your gut regardless of what the facts support.” The research, published in Psychonomic Bulletin and Review, found that people are more likely to believe a claim, even if it is untrue, if it is accompanied by decorative pictures:

In a series of four experiments in both New Zealand and Canada, Newman and colleagues showed people a series of claims such as, “The liquid metal inside a thermometer is magnesium” and asked them to agree or disagree that each claim was true. In some cases, the claim appeared with a decorative photograph that didn’t reveal if the claim was actually true—such as a thermometer. Other claims appeared alone. When a decorative photograph appeared with the claim, people were more likely to agree that the claim was true, regardless of whether it was actually true.

The Art of Science

The excitement in our children’s eyes when they looked through a large concave lens to see a furnished apartment transformed into the face of the Hollywood star of yesteryear Mae West said it all. Sure, they hadn’t heard of Mae West – after all she was in her prime in the early part of the 20^th century, a time when even their grandparents were not born. But to see a lens reconfigure an odd assortment of furniture in a room with a shiny wooden floor into a glamorous face was enough to get them thinking about the mysteries of science.

We were at the Dalí Theatre-Museum in Figueres, Spain, and the exhibit in question was the famous Mae West Room in the museum. It was created by the enigmatic, surrealist artist, Salvador Dali, who had a deep interest in science. As an education resource at the National Gallery of Victoria in Australia says, the artist “described himself as a fish swimming between ‘the cold water of art and the warm water of science’”.

Art is such a fabulous way to raise public understanding of science, we thought, as we spent an entire afternoon at the museum mesmerised by the thought-provoking art of Dalí. One of the more striking paintings at the museum is the Galatea of the Spheres, an oil-on-canvas work that is, as the catalogue describes it, “the outcome of a Dalí impassioned by science and for the theories of the disintegration of the atom”. There is a sense of awe in this painting – the exuberance of scientific discovery bridled by a sense of its destructive potential captured by the disintegrating spheres that make up the model’s face.

Even before you enter the museum, what catches your eye in the courtyard outside is a sculpture offering Homage to Newton and a motif on the hydrogen atom. Amidst the array of masterpieces inside the museum are many that mesh art and science to create hidden images within paintings – the face of Abraham Lincoln embedded in what looks superficially to be the back of a woman in the nude. There are also precious art works that use holography and a range of optical illusions.

Art and Science have, of course, had close links for centuries. The Master of the Renaissance era, Leonardo da Vinci was both an artist and a scientist, combining extraordinary skills in painting and sculpting with a legendary prowess in mathematics and engineering. In recent times, there has been an increasing push to bring art and science together as is being done by the Catalyst Collaborative at MIT, for example. Also, as the Arthur I. Miller exhibition on Art & Science: Merging Art & Science to Make a Revolutionary New Art Movement in London says, ‘Artists are bringing science out of the laboratory’.

In an earlier blog, we talked about an innovative exhibition of art, sculpture, and narratives on the future at the ASU Art Museum in Tempe that featured ‘a collaborative interaction between art and science, society and academy, the grassroots and the elite.’

                                     

If you have examples of how art is enhancing public understanding of science anywhere in the world, do let us know.

Unseen Treasures of the Natural World

We were in Oxford, the city of Matthew Arnold’s ‘dreaming spires’, recently to talk about our research on building fresh values of citizenship and equity around the uses of new and emerging technologies at an international conference on Environmental Justice and Global Citizenship. For us, as with many other scholars, public understanding of, and engagement with, science and technology is a core element of citizenship.

At this conference, we heard a very stimulating presentation by Alison Pouliot on a crucial domain of the natural sciences that very few people have a thorough understanding of – fungi. Alison Pouliot, who is an independent photographer (the photos on this page are by her) and researcher, is our guest blogger for this edition. Her blog follows:

---

Dirt isn’t usually well regarded.  It’s the stuff that we spit on, dig up, wage wars on, bury toxins in, suck resources from and sweep from sight.  Yet the subterranean world of dirt, of soil, often symbolic of darkness and inertia, is in fact a living and astonishingly diverse part of our biosphere.  It is the realm of dynamic webs of relationships of a most curious kingdom of organisms - a kingdom that is little known and largely overseen.  And that is the Kingdom of Fungi. 

Like dirt, the larger implications of fungi rarely enter our minds despite them underpinning every terrestrial ecosystem on the planet.  For some of us, fungi are a delectable culinary treat or the psychedelic culprits that inspired Lewis Carol’s enchanted stories.  Indeed both are fungi.  But mushrooms represent only the fungal fruit body or reproductive structure.  The actual fungal ‘body’ or mycelium is a labyrinthine matrix of tubular filaments called hyphae, hidden beneath the soil.

It is the underground workings of fungal mycelium that provide a vast communicative network, connecting landscapes and kingdoms of organisms, creating soils through the breakdown of minerals and organic matter, enabling plants to access nutrients, maintaining soil fertility, hydrology, climate and sustaining human civilization.

Despite the obvious importance of fungi, they’ve been almost entirely overlooked in global conservation.  Fungi rarely attract the attention of the supposedly more charismatic flora and fauna that dominate the world’s RED lists.  But the survival of flora and fauna is inseparably intertwined with fungi.  For example, over 95 per cent of plant species including those on RED lists rely on mutually beneficial symbioses formed with their subterranean fungal partners.  It seems a rather gross oversight that charismatic organisms are protected while their vital partners down in the dirt are forgotten.

The great challenge for scientists, conservationists and advocates of

fungi is finding innovative and inspiring ways to communicate their  importance, not just for the health of ecosystems, but also for humanity.

The true nature of charisma goes beyond attractiveness to include the exceptional and the extraordinary.  It is perhaps through highlighting these qualities in fungi that their significance could be promoted.  Science has informed us of the astonishing intricacies, complexities and importance of fungi but other disciplines such as arts and aesthetics could provide further conduits to communication, to reconnecting people with their inspirational aspects.  It is indeed challenging to visualise this vast underground network of connective fungal mycelium but the fruit bodies, through their remarkable diversity of forms, bizarre habits and evanescent beauty, could be key in igniting curiosity and advocacy. 

Finding ways to communicate the importance of fungi could not only improve the potential for their conservation but also foster biophilia for all of nature.  Fungi are a fabulous metaphor for the interconnectivity of our world; for the linking of systems, of kingdoms, of timescales, of humanity with nature.  Their potential to catalyse public understanding of science remains largely unexplored.

---

We invite people to reflect on Alison’s post and join the conversation on expanding and extending public understanding of fungi.

Nano Futures

Tiny robots with cameras, scalpels, and sensory equipment are already being used by surgeons to unclog, excise, snip, tie, and mend diseased organs of the human body, going by an Associated Press report published worldwide this week, But now medical researchers say that even smaller nanobots that can freely roam around the body, fixing problems as they arise, are on their way.

The AP report quotes Dr Michael Argenziano of New York-Presbyterian Hospital and Columbia University’s Medical Center as saying “It won’t be very long before we have robots that are nanobots, meaning they will actually be inside the body without tethers.” In other words, unlike the surgical robots in use today, the nanobots will potentially be free agents that are not remotely connected to an anchor elsewhere.

This is clearly a revolutionary development and the report has been picked up by several science news sites such as Phys.org and has been the subject of intense debate and discussion on a number of social news sites as well (see e.g., Reddit). 

But as with possibly all radical developments in technology, the most significant challenge is to be able to anticipate and understand potential and unplanned consequences. How much public, or even scientific, understanding is there about the uses of nanotechnology, the science of the miniscule, in medicine or other fields? While it does open the doors to enhancing and even prolonging human life, could there be other consequences that are hard to imagine and therefore respond to? 

Science fiction is often something people go to for a handle on futuristic science and this tends to be more dystopic than utopic. We’ve just finished reading Michael Crichton’s last novel Micro in which nanobots, invisible to microscopes, can enter a person’s body and destroy the vital organs with such precision that even those conducting a post-mortem have no clue about the cause of death. This new novel, left unfinished by Crichton at the time of his death and completed by Richard Preston, has a feel for the world of nanoscience and the new frontiers it is reaching out to.

In the world of Micro, devious corporations, ostensibly manufacturing nanobots for medical uses, pillage the earth’s mineral and biological resources by bio-prospecting at a micro level. They even have a “tensor generator” that can shrink humans to miniscule sizes to get closer to parts of the world that humans can barely see. 

Nanotechnology is one of those new and emerging technologies that few people know enough about. And this is what makes public engagement with it very difficult. Among the institutions working on making public engagement on nanotechnology more meaningful is the Center for Nanotechnology in Society (CNS) at the Arizona State University in Tempe, Arizona, USA. 

One of us was in Tempe recently and got to see an innovative exhibition of art, sculpture, and narratives on the future at the ASU Art Museum called Emerge: Redesigning the Future that provides a glimpse into how people can visualise the future through a collaborative interaction between art and science, society and academy, the grassroots and the elite. The exhibition, on until mid-August, is an offshoot of a path-breaking workshop/seminar/meeting-of-minds get-together of “artists, engineers, bio-scientists, social scientists, storytellers and designers to build, draw, write and play with the future” organised by CNS in March this year. 

Such collaborative endeavours that allow us to envision and create scenarios that anticipate the uses and challenges of new and emerging technologies are perhaps one way of engaging with imagined futures.