SGU Episode 866: Difference between revisions

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== News Items ==
== News Items ==


'''S:'''
=== Treating Spinal Cord Injury <small>(18:22)</small> ===
* [https://theness.com/neurologicablog/index.php/incremental-advance-treating-spinal-cord-injury/ Incremental Advance Treating Spinal Cord Injury]<ref>[https://theness.com/neurologicablog/index.php/incremental-advance-treating-spinal-cord-injury/ Neurologica: Incremental Advance Treating Spinal Cord Injury]</ref>
 
'''S:''' All right let's dig into the news items. Have you guys seen the headlines about a new treatment for spinal cord injury that allows people to walk and have children?
 
'''J:''' Yes.
 
'''C:''' Who hasn't, it's everywhere.
 
'''S:''' I know I had to talk about this because it is everywhere but you know, the reporting is so bad.
 
'''C:''' Miraculously!
 
'''E:''' ''(laughs)'' Course, right.
 
'''J:''' So it's not true?
 
'''S:''' Even the BBC which is I know it's not beyond reproach but it's usually like a decent you know news outlets not trash, really got this wrong. I mean not, the details are fine but the hyping this as a breakthrough first of its kind blah blah blah is nonsense it just has nothing to do. This is a classic example of taking an incremental advance and turning it into a breakthrough. Classic. So you know the reporting they say like the headline is: "Paralyzed man with severed spine walks thanks to implant".
 
'''E:''' Steve you corrected it with the title of your blog post: [https://theness.com/neurologicablog/index.php/incremental-advance-treating-spinal-cord-injury/ Incremental Advance Treating Spinal Cord Injury] so thank you for that.
 
'''S:''' It was deliberately it was deliberate.
 
'''B:''' But Steve but Steve I was reading, I read your blog it was really good but "Incremental Advanced Treating Spinal Cord Injury" you know I mean it's so hard on science popularizes, right? Because it's like you got to go with lines like that you can't throw out there you know like the BBC News "Paralyzed man walks!", but you, Steve couldn't you have spiced it up a bit? Like couldn't you have said something like "Wonderfully Incremental Advanced Treating Spinal Cord Injury"?
 
'''S:''' I hear you Bob.
 
'''B:''' No I got more option.
 
'''S:''' I wanted to have a stark contrast to the to the mainstream reporting.
 
'''B:''' Okay well you didn't, you didn't have to go with boring how about this "Vastly More Interesting Incremental Advance than the Previous Incremental Advance" ''(laughter)'' that would have been good. I don't know it's tough, it's though.
 
'''S:''' But I don't think it's true. All right so let me tell you what the actual advance was. What they're doing is treating people who have like a crush injury of their spinal cord, who are completely paralyzed, so they have no motor or sensory function below the the damage, below the lesion right, complete like no sensation or or movement in their legs. And then they implant stimulators and it's interesting, they plant the stimulators on the dorsal roots, which are the sensory roots. Why would they be doing that you might ask, why aren't they why aren't they stimulating the motor roots, right, the whole point here is to get the legs to move. Because when you stimulate the dorsal roots that that stimulation gets into the spinal cord and then activates the motor neurons in the spinal cord, and it's just a it's a way of of stimulating an ensemble of motor units that can, or you could then control to create a specific effect like walking. Whereas if you stimulated the motor root, you, the whole leg would just twitch right, it wouldn't replicate a walking maneuver. So it's like you're going in through the back door because it gives you better control, essentially, over which muscles are contracting and what pattern. And of course they use computers to help you know control which muscles contract. They also use some stimulation which keeps the signal from spreading to the other side, you know I mean, like it runs interference. So they're kind of corralling the electricity so it's only stimulating the muscles they want it to. And then with this external stimulation, right, they you know it it with an external controller which could be built into a walker for example, you then will go through the sequence of artificially stimulating the legs so that they could you could walk, right? That's the technology. This technology has been around for decades. That basic technology what I just described for you.
 
'''C:''' So what's new?
 
'''S:''' What's new, I'll tell you what's new, they with the electrodes that we normally use for this kind of technology are repurposed electrodes designed to stimulate the dorsal ganglia to treat pain, right? So we took these dorsal ganglia pad electrodes and just repurpose them to to create this electronic stimulation to create walking and people who have spinal cord injury. The advance was they made slightly better electrodes. That's it. They made custom electrodes that are you know that are able to be positioned better because they're not repurposed electrodes from another function. They're made specifically for this so they're a little bit longer you know, they can reach a wider range of segments and get better into position. That's the entire advance, slightly better electrodes.
 
'''C:''' So did slightly better electrodes equal extremely better outcomes or just slightly better outcomes?
 
'''S:''' No, slightly better outcomes.
 
'''B:''' Incremental.
 
'''S:''' Incremental slightly better outcomes because you, there's they still like can't like walk every day you know, it still takes a lot of effort and training to be able to walk, they were able to train them more quickly, it was more natural, it's still a huge effort, it's still just a proof of concept really and it's mainly to help, help them move, help them get physical therapy help keep them more physically fit because they're moving more. But it really isn't to like enable them to walk normally you know.
 
'''C:''' So this is like to prevent muscle atrophy.
 
'''S:''' Yeah disused trophy and also it helps with their blood pressure and things like that. If you're sitting with paralyzed legs all day it's not good for you. So that's it, it's it's again it's the same basic technology with slightly better electrodes and they parlayed that into like this massive breakthrough. Again I'm not downplaying this research or these these advances are important. They did find something else that was very interesting. They found that so again these are people who have completed, three patients that that was the study, three subjects they had complete paralysis but their spinal cord was not completely severed and what they found was that after using the the stimulation for a while that they were able to like slightly modulate the way their legs moved. Which which seemed to imply that there was like some voluntary control of their muscle movements. And then they found, when they studied it, that that there was some activity getting through like getting across the injury. So what they think was happening was that you had some intact neurons some intact nerves, like that were that were survived, that were getting through the injury point but that they were basically not functioning, they were asleep because they were never being recruited they weren't being used. But the stimulation sort of woke them up─
 
'''C:''' That's pretty cool.
 
'''S:''' ─and got them to function. Yeah. So you had they so and after even without the stimulation like they were able to do a little bit of movement so they went from zero movement to a tiny bit of movement and this could this could be functionally significant you know if they're able to control the way their legs are moving even a tiny bit that─
 
'''B:''' Yeah exercise, rehab, yeah.
 
'''S:''' Might help them walk with the stimulator better than if they had zero movement.
 
'''C:''' But sadly this is not some sort of new hope for people who have a total spinal cord injury like if it's completely ablated there's nothing they're going to regain.
 
'''S:''' No so the BBC reporting got a lot of things wrong and even contradicted themselves, so first of all they said that the spinal cord was completely severed. No by definition it wasn't.
 
'''B:''' It's a crushing injury it's not a light saber injury.
 
'''S:''' Yeah because by definition there was some neurons that were surviving across the gap, if it was severed that wouldn't be the case. They also said that it was boosting the signal across the spinal cord. It's like well you know that only applied to this epiphenomenon of waking up a few of those neurons, it does not how the technology works. It works by you pushing a button to stimulate the spinal cord distal to the injury to just artificially stimulate and move the muscle. So they kind of got that wrong as well. So it just gave a really a completely different impression of what was going on. They also made it sound like one of the patients was able to have a child, has nothing to do with the re-establishment of any kind of neurological function. Like it was oh like a paralyzed guy who couldn't have kids because he was paralyzed like you know his reproductive organ isn't working and now it is working enough that he can't have a kid, right, that's kind of the impression you get when you read yeah it enables him, yeah that's not what happened at all. It was just that because he was able to to work out with this stimulator, it helped his blood pressure, it made him more active he had more energy and that enabled him to have the energy to raise a kid, that's it.
 
'''C:''' Oooh, that's insane.
 
'''S:''' It's like yeah I mean they say that they kind of─
 
'''C:''' It's terrible science reporting.
 
'''S:''' ─ I know it's terrible science, terrible.
 
'''J:''' And how deliberate is that misdirection?
 
'''S:''' I mean I think it's half and half. I think they're trying to juice this up as much as possible and they think the other half is they just misunderstood certain aspects of the science.
 
'''C:''' This what happens.
 
'''S:''' Of course I read the actual, I read the original study you know read the whole thing.
 
'''C:''' So should the science report like that's the problem with getting rid of all of your science reporters and and only having general assignment reporters doing this kind of work like─
 
'''S:''' Totally.
 
'''C:''' ─ they may not understand the science.
 
'''S:''' Yeah like not understanding that you can't have a signal getting across if it was completely severed, like that's a direct contradiction to that. So that means you're you don't understand something here so you better go back to the drawing board and find out what's going on.
 
'''E:''' Did the BBC not did the BBC not contact specialists to give them the real information?
 
'''S:''' Yeah they did, they did, but that doesn't mean anything. If you have a report or interviewing a scientist. What questions do they ask, how do you know, you can ask leading questions, you can take their answers out of context. Scientists complain about that all the time like "That's not what I said.", you know. So you yeah they interviewed the scientists and they have lots of quotes here but if you read the quotes, like what the actual quote is saying like they have done something that is that has not been done before. It's like okay that's true it's also pretty vague and but you could make it sound like it's something that it isn't, you know?
 
'''E:''' Right.
 
'''C:''' So when it was stimulated did they have an experience of feeling or not?
 
'''S:''' No.
 
'''C:''' Okay.
 
'''S:''' Because remember you're stimulating below the injury so that's a good way to stimulate the motor function because remember, in terms of the anatomy of the spinal cord you have the the motor cells right you have the cell is bull is in the spinal cord itself so and so and so the the cell is alive and its axon goes down the spinal cord out into the muscle, so if there's an injury above that nerve it doesn't affect that nerve that cell body or the nerve itself, it's still intact right.
 
'''C:''' Unless it just gets it disused.
 
'''S:''' Well then you get disused atrophy you know you don't get denervation atrophy, like if you destroy that neuron then yeah so you get much worse actually. What does happen is you don't normally the neurons above it that have been severed or that have been that are not working, they inhibit the tone in those motor neurons and so when you get spasticity, right? So that's a problem and that this doesn't fix the spasticity that has to be treated otherwise. But but the sensory nerves are going in the other direction so stimulating below the lesion doesn't get you anything across the lesion going up. But you're bypassing the lesion when you're stimulating going down to the motor pathway.
 
'''C:''' Right right I wasn't sure yeah I just wasn't sure if then there was some sort of feedback from the motor, so so you're stimulating the sensory portion it sends that signal down, you get this like motor contraction and then does the motor contraction then send any sort of feedback back up?
 
'''S:''' It does but and then there are feedback that will sort of like reflexes in the spinal cord itself. They won't perceive it in the brain because those signals are not getting up to the brain.
 
'''C:''' Gotcha. That must be so hard then because then you're you're like you're walking again like you said, like kind of clumsily and like you know with a lot of purpose or you're moving in such a way that's like with OT/PT people helping you but but you're not feeling what's happening.
 
'''S:''' Yeah.
 
'''C:''' That's so like, ugh, that would be really difficult.
 
'''S:''' Yeah so they did say like oh this isn't a cure for spinal cord injury and that's true, it's not a cure it's you can just bypassing it for the motor function and it's you know it's kind of clunky but it can't allow people to walk in like again with like a walker where they hit the buttons to stimulate their motor their muscles to to walk. It's really should be looked at as a rehab tool and sort of a health tool but not a fixing the problem with the spinal cord injury tool. I don't know if this kind of thing is even on that pathway you know? Even when this technology is mature what what it would really look like because again it doesn't really fix the sensory problem and and there's going to be inherent limits to how well you're going to be able to control those muscles. I guess you know the super mature version of this would be like you're you're you're wearing robotic limbs. Like that that are in your legs and then a computer is is entirely controlling them and making them walk in a natural way. And you know that that could give a measure of independence but again it would be weird because you'd be walking on these legs you can't feel.
 
'''C:''' You can't feel and you also are you lacking proprioception in a spinal cord injury too?
 
'''S:''' Yeah.


'''B:'''
'''C:''' Yeah, that's what I figured so you'd have to look at your feet.


'''C:'''
'''S:''' And if you look at the video you look at the video they are looking at their feet.


'''J:'''
'''C:''' Yeah it's the only way.


'''E:'''
'''S:''' Yeah so the the the better approach is to repair the cord itself you know get those nerves to regrow although you could use use a combination right, a hybrid Jay, you could get if you get any neurons like maybe there are some neurons in there that are that that could be coaxed back to life where you might get a few of them to be able to grow across across the gap. If you could restore 10 or 20% of the function just biologically with regeneration then it becomes easier to augment that function with this kind of external stimulation or robotics or whatever. So that may be where things are headed in this medium term until we could like fully repair spinal cords or like have fully robotic limbs or something. So again this is one little baby step on a very complicated long road that we're taking here─
<!-- ** the triple quotes are how you get the initials to be bolded. Remember to use double quotes with parentheses for non-speech sounds like (laughter) and (applause). It's a good practice to use brackets for comments like [inaudible] and [sarcasm]. -->


''(laughs)''
'''B:''' Incremental.
''(laughter)''
''(applause)''
[inaudible]


=== Treating Spinal Cord Injury <small>(18:22)</small> ===
'''S:''' ─but it's it's still nice it's still good. But really the actual innovation was they designed slightly better electrodes.
* [https://theness.com/neurologicablog/index.php/incremental-advance-treating-spinal-cord-injury/ Incremental Advance Treating Spinal Cord Injury]<ref>[https://theness.com/neurologicablog/index.php/incremental-advance-treating-spinal-cord-injury/ Neurologica: Incremental Advance Treating Spinal Cord Injury]</ref>
 
'''C:''' Which is has been a limiting factor we do talk about that a lot we need better electrodes.
 
'''S:''' Totally, but it's not a new approach to the electrode it's not like a new way in or a new new electrode technology it's just instead of repurposed they were custom. That was it. So they were slightly longer you know whatever that that was it's like.
 
'''B:''' So it's kind of low even low hanging fruit then.
 
'''S:''' Yeah totally like why didn't they do this years ago.
 
'''C:''' The obvious next step.
 
'''S:''' It was just a money thing it's like we have these electrodes, we'll repurpose them and they said let's just make special electrodes to see if that works better, oh it does work a little better, okay great. That's the whole thing.
 
'''B:''' Call the presses!
 
'''S:''' So it's exciting and frustrating at the same time, I don't want to downplay this research or what this means to patients getting any function back being able to to like stand up and walk even with a walker get your legs to move again. It's all huge but we got to put it into the context of what's actually happening here. And this creates a false impression that we're right around the corner to solving spinal cord injuries. Imagine if you had a spinal cord injury and you read this and you got a totally wrong oppression then someone's going to have to let you down.
 
'''E:''' Yeah emotional impact can be severe.
 
'''S:''' Anyway all right Jay you're going to tell us about a real breakthrough a new artificial enamel.
   
   
=== Artificial Enamel <small>(34:06)</small> ===
=== Artificial Enamel <small>(34:06)</small> ===
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== Who's That Noisy? <small>(1:08:47)</small> ==
== Who's That Noisy? <small>(1:08:47)</small> ==
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SGU Episode 866
February 12th 2022
866 riding a laser to mars.jpg
(brief caption for the episode icon)

SGU 865                      SGU 867

Skeptical Rogues
S: Steven Novella

B: Bob Novella

C: Cara Santa Maria

J: Jay Novella

E: Evan Bernstein

Quote of the Week

I strive to be a lifelong learner and I have never learned anything by being right.

Dr. R. Shulze, SGU listener

Links
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Show Notes
Forum Discussion

Introduction

Voice-over: You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello and welcome to the Skeptics' Guide to the Universe. Today is Wednesday, February 9th, 2022 and this is your host, Steven Novella. Joining me this week are Bob Novella...

B: Hey, everybody!

S: Cara Santa Maria...

C: Howdy.

S: Jay Novella...

J: Hey guys.

S: ...and Evan Bernstein.

E: Good Evening everyone.

B: How many episodes have we done?

S: This is episode 866.

B: So this was the first episode in 860 somehow that I've done where I was yawning right when you said "Bob".

(laughter)

E: It was bound to happen, wasn't it bound to happen?

B: I did well, I think you couldn't even tell.

C: No you recovered.

E: Wow, for 17 years.

J: Bob, what skill?

E: You've come a long way since "Hellooouu".

B: I didn't know I could do it.

S: But you broke your record so you got to start your count, one day without you yawning.

E: Zero days without an accident.

COVID-19 Update (0:57)

S: So we are on the down slope of the Omicron surge, numbers are plummeting.

E: Get outta here Omicron.

S: Yeah they peaked like 800 000 a day now they're down.

B: New cases, right?

S: New cases 200 000, hospitalizations are falling which is like you know, probably the most important thing.

B: Yeah.

S: Deaths always are a late sign, so they're they're just cresting.

C: But we did surpass 900 000 deaths just in America.

S: 910 000

B: 900? Oh my god.

C: 're million in America I think.

S: Yeah.

B: Of course. Oh my god.

C: Just, we're not per capita we're doing not well in this country, compared to other like industrialized countries.

S: No, no not at all.

B: We have crusted as well I would say.

J: I read a couple of days ago, Steve that we're we still have about 2 000 deaths a day, have you read any stats like that?

S: Yeah new daily reported deaths are still over 2 000.

J: Wow. That's still, you know think about what we've gotten used to, I mean it's horrifying, like it just happens every day and and most of us aren't even thinking about it.

C: Ooh yeah and in California they've announced a few days ago that they're about to lift mask mandates, same thing happened in New York just today or yesterday.

B: Connecticut as well for schools.

E: Illinois announced it as well, New Jersey I believe just announced it.

C: I'm not ready, I mean I am.

E: Continue wearing mask then.

S: You can still wear your mask if you want to.

C: I'm not ready to be around other people not wearing masks. I know it's weird.

B: I know it's weird, I mean I walk into my deli every you know five days a week I pop in grab my sandwich and pop out I'm done, I'm double masked double masked because I gotta get my sausage and egg sandwich, nothing's gonna stop that from happening, so I'm double masked and people just, most people that come in no mask at all this is like Connecticut I mean where it's kind of you know it's not like.

C: Is that legal? In California you can't do that, you can't walk into a restaurant without a mask.

E: There's not a government, yeah there is not a government mandate for masks right now.

C: I see. So that's kind of personal. In California you can't enter a public establishment without a mask and in order to enter or at least in Los Angeles, I don't know if this is statewide but at least in Los Angeles you can't dine in a restaurant without also showing your vaccine card because you're going to take your mask off.

S: Yeah you have to take your mask off to eat.

C: So it's I mean it's one of those things where I'm of two minds about it, like I'm not ready because I'm paranoid and because I you know I haven't gotten Covid, I'm like a unicorn and I don't want it.

B: Me yeah, I haven't either, but I wouldn't describe myself as a unicorn but I haven't either.

C: But also at the same time Bob like I don't want to wear a mask forever it's it's I'm over it, I feel like we're living in this super dystopian future where nothing's changing, like it feels like this is never going to end.

S: Well I mean it will end and the way out of this is going to be through science and technology.

E: Of course.

Nasal Spray Vaccine (3:53)

S: There's a couple a couple of things that I wanted to talk about, a researchers are developing a nasal spray Covid vaccine, so it's not a company yet this is just sort of research, this is done in mice, not even in people yet. But the idea was they developed very simple, it was a nasal spray that has the spike protein, that's it just the spike protein from the virus no adjuvant, nothing else in there so let's just spray spike protein in mouse's noses and see what happens. So they compared two groups, one group got one dose of an mRNA vaccine and then two weeks later got the nasal spray, and the other group just got the one dose of the of the vaccine. Then they exposed them to the Sars-CoV-2 virus. The group that had just the vaccine and not the nasal spray, 80 percent of the mice died.

C: Oh my god.

S: The group of like that got both, well they wanted to make you know, they wanted to have a high death rate because they needed to see what was happening.

C: So they like they exposed them to like some like a lot of viruses.

S: They have a high dose yeah yeah.

B: Mice catch Covid, I kind of didn't know that.

S: So did deer by the way.

C: So did dear, yeah (laughs).

E: Yeah I heard about the deer.

S: Now the group that got the nasal spray in addition to the one dose, guess guess how many died.

B: None.

S: Zero, none.

C: Well what happens─

E: That means nothing.

C: Did they not do a third where they just get the nasal spray?

S: No because it's really designed to be a booster, it's not a vaccine really it's a nasal spray booster and so that's that's what they were testing.

C: Because it would be interesting to see if they just get the spike protein.

S: Of course. And they may do that with later studies if it goes forward, but the idea is that you the the technique is called prime and spike. So first you prime the immune system with the dose of the vaccine and then you you give the spike protein into the into the respiratory tract and that because you know the respiratory mucosa has its own antibodies in, the IgA type antibodies, that's like a first line of defense of things getting into your body through your mucosa you know your respiratory mucosa. And so the idea is you have systemic immunity with the vaccine and then you'll have another layer of defense in your you know the nose and your lungs through the through the nasal spray and that approach seemed to work, at least in this you know this mouse study.

C: But that's also how most people catch the virus, like this is a respiratory virus.

S: Yes, that's that's the point.

C: I mean I'm sure you can still like lick the virus, I'm sure you can still like you know you can get it otherwise but it does seem like it would almost, I don't know it would be interesting to compare it to the main immunity from just the vaccine.

S: They only gave one dose not two and they they probably gave them a high inoculum, you know to really give them a high exposure. So if this develops into a full strategy but I don't think they would replace the second dose or even the booster shot but just as an additional layer of defense. You know the the higher we can push the the effectiveness of whatever vaccine strategy we come up with the better.

B: The less chance of a variant.

S: If we can go from 85 to 90% to 98-99%─

E: Now you're talking.

S: ─something like that, then yeah that that could really go a long way to tamping down this this pandemic even more. Of course we need to get the number of people getting anything you know up getting any vaccines up.

C: Yeah and that's the thing like nasal vaccines or in this case nasal boosters or nasal adjuvant kind of therapies, they are um so much easier to administer, like you don't need skilled technicians, I'd be interested to see─

S: You do it at home.

C: ─if yeah do you do it at home I wonder if this can be kept at room temperature, like this could be a game changer globally.

S: Yeah yeah so it's definitely a worth worthwhile research line. The other thing I wanted to mention, we talked about the combination Flu and Covid booster, I think we mentioned that Pfizer is developing one, Moderna also announced they're developing one and it's also they said it's going to be it's it's about to start trials with an Omicron version of their vaccine and they're developing the the combination Flu-Covid vaccine. Which they not they said by 2024 so that's not going to be for a while but but that may be fine, I mean once we get to the point where in where we are in maintenance mode like the pandemic is basically down to background levels, where it's endemic it's not going to go away of course but it's like a bad version of the flu, that's just going to be there and we're going to get our every six month or every one year vaccine this one I'm just hoping it's annual. But combining it with the flu you know that could be one jab instead of two might be easier to get compliance up.

E: Hell yeah.

S: And then you could you know have the other layer of some kind of nasal spray booster you know to really have super you know super immunity you know that could be you know really effective. And then then you then you go that Cara, that's when you go about your normal life. Because if you get it it's like you got a cold. Like we right we didn't have masks and distancing and everyone got sick two or three times a year with their with their colds and Flus and stuff you know you got your vaccine. And you just accept you're going to get sick a couple times a year and this will just be one more type of virus that's going to make you sick if you are protected. Because other things if you do get sick it's going to be minor. At least chances are─

C: Yeah if you're vaccinated.

S: If you're vaccinated yeah you probably won't get to go into a hospital or die from it. But, Covid's still a nastier virus than the Flu. That's the only thing is that the more we study it and the the long cove is like yeah this there's a lot of long-term symptoms the more you look for them the more you find them. And it's really shouldn't be thought of as a benign virus.

C: No, no no. But we also are developing more and better treatments not just preventive measures but more and better treatments as well, right? Because I know we mentioned once ages ago I said something about Tamiflu and a bunch of people reach out and they're like "Tamiflu sucks" and I was like oh I didn't really realize that we really there's kind of nothing you can do for the Flu except hydrate you know, supportive care like there's not a lot of treatment available if you have.

S: Yeah just sucks for a week or so.

C: Yeah yeah it just sucks and you have to hope that you don't have something underlying and that you don't get so sick that it turns into something else and you die.

S: That's why I got my flu vaccine it's a lot better than suffering with the flu I've had the flu before it's really tough.

Okay Evan, I believe this is the second time you're doing this, the name that quote segment?

Quotation Rotation (10:04)

E: That's right Name That Quote, also known as Quotation Rotation.

S: Okay, that's official name?

E: Well I'm also playing with Quotation Sensation, Quotation Nation, anything with a...

S: Quotidian?

E: (laughs) but I like quotation rotation so I'm going to work with that for that.

S: All right that's your working title.

E: And if you recall this is a game that we're going to play in which I'm going to give you a quote and each of you each of the four of you are going to say where you where you heard it from or who you think said it. We have a theme for this one─

B: Ugh.

E: ─and the theme is movies.

B: Ah!

E: So all of these quotes came from movies, that I think you've all seen. We're about to find out. And it's multiple choice which is nice so you just don't─

B: Yes, thank you.

E: Yes absolutely a b and c. All right. We've got five of these let's get through them.

First one here's the first quote: "Luckily in the history of humanity nothing bad has ever happened from lighting hydrogen on fire". Your choices are:

a) Contact

b) The Martian

c) Ad Astra

Bob we'll start with you.

B: Not the Hindenburg movie? Shit. (laughter) Oh Boy let's say Ad Astra.

E: Bob says Ad Astra okay Jay.

J: I'm gonna say The Martian.

E: Cara.

C: I said The Martian in my head before you gave us the options so I'm gonna have to stick with that.

E: And Steve.

S: Yeah I didn't see Ad Astra but that does sound, I do remember the quote so it has to be from one of the ones I seen and it sounds like the kind of snark I remember from The Martian so I'll go with The Martian as well.

B: Yeah me too, yeah me too.

E: Bob's gonna change his answer if he could to The Martian and the answer is b) The Martian, yes, Mark Watney, it's from the scene where he had to you know make water.

C: Make water.

S: Yeah, right.

E: And he goes through the whole process, it's nice it gives you a little chemical analysis on how it all works and wraps it up by saying: "And then if I just direct the hydrogen to a small area and burn it. Luckily in the history of humanity nothing bad has ever happened from lighting hydrogen". And boom. Goes up in flames.

B: I really recommend that book on unabridged on audio it's wonderful.

E: Next quote here we go: "Every time we have a chance to get ahead, they move the finish line.". Was that from:

a) The Right Stuff

b) Tucker: The Man and His Dreams

c) Hidden Figures

Now we're going to start with Jay.

J: I'm definitely going to go with the first one.

E: The Right Stuff? Jay says The Right Stuff. Okay Cara.

C: I've only seen Hidden Figures out of those three but I think it is Hidden Figures it sounds like they're talking about yeah moving the goal posts.

E: Steve.

S: Yeah I was thinking either Hidden Figures or the Tucker one because that is I do that is a lot of I'll do just to be different from Cara I'll say Tucker.

E: Okay Tucker and Bob.

B: I'm gonna say Hidden Figures great movie and this totally fits that movie I don't specifically remember that quote but it makes sense.

E: And the correct answer is c) Hidden Figures: "Every time we have a chance to get ahead they move the finish line.", let me see if I can tell you in what context it was happening, it was a conversation between Vivian Mitchell who was one of the employees at NASA and Mary Jackson who actually said the character Mary Jackson who said the quote, the person Mary Jackson I should say. And which they're exchanging you know a conversation about female engineers in the in the engineering training program and they require and Vivian says we require advanced extension courses through the University of Virginia in which you know of course black women could not attend to take those classes and then Mary Jackson yep "Every time we have a chance to get ahead they move the finish line", indeed.

All right third quote here we go: "We've always defined ourselves by the ability to overcome the impossible". Is that from:

a) Interstellar

b) 2001 a Space Odyssey

c) Gravity

All right Cara we'll start with you.

C: Uh I never saw Interstellar. I think it's probably Gravity it could have been Interstellar but I don't know, some some shit goes down in gravity so I'm gonna say it's Gravity.

E: Is there a reason you didn't see Interstellar?

C: I just never got around to it I heard such good things about the science you know that like Kip Thorne and you know all these great people were consulting but then I heard it wasn't that good a movie.

S: It was okay.

C: Yeah, so, you know I don't love sci-fi but if it like if it grabs me it grabs me but yeah just never got around to seeing it so, I'll go with Gravity.

E: Directed by Christopher Nolan too. Okay so you're saying Gravity. Steve.

S: Yeah I'll say Gravity as well, it's definitely not 2001 I mean I saw that movie so many times I don't remember that quote and there's so little dialogue in that movie like you would kind of remember every line. No I say Gravity.

E: Bob.

B: Yeah I think Gravity as well.

E: And Jay.

J: Gravity.

E: We have everybody in agreeance that it is Gravity. The answer is a) Interstellar.

C: Ah crap.

(laughter)

B: Wow, nice.

E: Don't you love it?

C: I do love it because that means I'm still ahead, whoo!

E: That's right yep so far, let's see Cara you've gotten two correct, Steve's gotten what, one correct, Jay's got one, Bob's got one. All right two more we'll see if we can break up this log jam, here we go.

The fourth one: "Advice about keeping secrets, it's a lot easier if you don't know them in the first place". Is that from:

a) A Beautiful Mind

b) The Manhattan Project

c) The Imitation Game

All right Steve, we'll start with you.

S: I don't recognize that quote but I'll say The Imitation Game.

E: And we move on to Bob.

B: Yeah Imitation Game. I think. Makes sense. I think, it just popped in my head. Imitation Game.

E: Jay.

J: This is a really hard one, I mean I'm just gonna go with these guys.

E: Okay and Cara.

C: That was my original instinct too and I'm probably screwing myself here and leveling the playing field out but I think I'm gonna go with The Manhattan Project. I can imagine a time when somebody would ask somebody something and they were like listen I'm not gonna tell you because if you don't know you won't have to keep it as a secret.

E: That's interesting Cara because you have two correct everyone else has one correct so if you're wrong and if the guys are right yeah that means it's a two-two tie from everyone going into the last question the answer is c) The Imitation Game.

C: Dang.

(laughter)

E: All right folks last one. This will be it. Here we go: "Perverted scientists who advance an insidious theory called evolution". Is that from the movie:

a) Creation

b) Inherit the Wind

c) Planet of the Apes

E: And we will start with Bob.

B: Inherit, Creation, I have no idea what the hell that is.

C: I don't know what Inherit the Wind is.

B: Scopes trial baby.

E: They have the monkey's scope trial.

C: Oh no way oh okay.

E: And Creation was a movie starring Paul Bettany as Darwin.

C: Damn now I wanna watch that.

E: Yeah.

B: All right create, I'll say Creation.

E: Okay Bob says Creation. Jay.

J: That would be Planet of the Apes.

E: Interesting. Cara.

C: No I want to go last.

B: Suck it up I went first twice.

C: I'll go Inherit the Wind, I never saw it.

E: Oh wow, we have a split, all right Steve break the tie.

S: I really think this is Planet of the Apes.

B: No way.

C: Seriously?

E: And the answer is c) Planet of the Apes.

B: No way.

E: Jay and Steve, well done.

J: I knew it for certain, I absolutely knew it.

B: Really?

C: You sounded like you knew.

E: From the courtroom scene.

S: A the courtroom scene, I was like 90% , I was like 90%.

B: Wow it's been too long that means it's been too long since I've watched it.

E: Absolutely.

C: Oh yeah, it's been forever because you're talking about the original Planet of the Apes.

E: 1968, Charlton Heston.

B: Great movie, great movie.

E: THE Planet of the Apes. The only one I can recommend, I can't recommend a single other. So good job guys it was very close and Jay and Steve you guys pulled around the end well done well done. Thanks for playing Quotation rotation this was fun.

S: Thanks Evan.

C: Thanks Ev.

E: Thank you.

News Items

Treating Spinal Cord Injury (18:22)

S: All right let's dig into the news items. Have you guys seen the headlines about a new treatment for spinal cord injury that allows people to walk and have children?

J: Yes.

C: Who hasn't, it's everywhere.

S: I know I had to talk about this because it is everywhere but you know, the reporting is so bad.

C: Miraculously!

E: (laughs) Course, right.

J: So it's not true?

S: Even the BBC which is I know it's not beyond reproach but it's usually like a decent you know news outlets not trash, really got this wrong. I mean not, the details are fine but the hyping this as a breakthrough first of its kind blah blah blah is nonsense it just has nothing to do. This is a classic example of taking an incremental advance and turning it into a breakthrough. Classic. So you know the reporting they say like the headline is: "Paralyzed man with severed spine walks thanks to implant".

E: Steve you corrected it with the title of your blog post: Incremental Advance Treating Spinal Cord Injury so thank you for that.

S: It was deliberately it was deliberate.

B: But Steve but Steve I was reading, I read your blog it was really good but "Incremental Advanced Treating Spinal Cord Injury" you know I mean it's so hard on science popularizes, right? Because it's like you got to go with lines like that you can't throw out there you know like the BBC News "Paralyzed man walks!", but you, Steve couldn't you have spiced it up a bit? Like couldn't you have said something like "Wonderfully Incremental Advanced Treating Spinal Cord Injury"?

S: I hear you Bob.

B: No I got more option.

S: I wanted to have a stark contrast to the to the mainstream reporting.

B: Okay well you didn't, you didn't have to go with boring how about this "Vastly More Interesting Incremental Advance than the Previous Incremental Advance" (laughter) that would have been good. I don't know it's tough, it's though.

S: But I don't think it's true. All right so let me tell you what the actual advance was. What they're doing is treating people who have like a crush injury of their spinal cord, who are completely paralyzed, so they have no motor or sensory function below the the damage, below the lesion right, complete like no sensation or or movement in their legs. And then they implant stimulators and it's interesting, they plant the stimulators on the dorsal roots, which are the sensory roots. Why would they be doing that you might ask, why aren't they why aren't they stimulating the motor roots, right, the whole point here is to get the legs to move. Because when you stimulate the dorsal roots that that stimulation gets into the spinal cord and then activates the motor neurons in the spinal cord, and it's just a it's a way of of stimulating an ensemble of motor units that can, or you could then control to create a specific effect like walking. Whereas if you stimulated the motor root, you, the whole leg would just twitch right, it wouldn't replicate a walking maneuver. So it's like you're going in through the back door because it gives you better control, essentially, over which muscles are contracting and what pattern. And of course they use computers to help you know control which muscles contract. They also use some stimulation which keeps the signal from spreading to the other side, you know I mean, like it runs interference. So they're kind of corralling the electricity so it's only stimulating the muscles they want it to. And then with this external stimulation, right, they you know it it with an external controller which could be built into a walker for example, you then will go through the sequence of artificially stimulating the legs so that they could you could walk, right? That's the technology. This technology has been around for decades. That basic technology what I just described for you.

C: So what's new?

S: What's new, I'll tell you what's new, they with the electrodes that we normally use for this kind of technology are repurposed electrodes designed to stimulate the dorsal ganglia to treat pain, right? So we took these dorsal ganglia pad electrodes and just repurpose them to to create this electronic stimulation to create walking and people who have spinal cord injury. The advance was they made slightly better electrodes. That's it. They made custom electrodes that are you know that are able to be positioned better because they're not repurposed electrodes from another function. They're made specifically for this so they're a little bit longer you know, they can reach a wider range of segments and get better into position. That's the entire advance, slightly better electrodes.

C: So did slightly better electrodes equal extremely better outcomes or just slightly better outcomes?

S: No, slightly better outcomes.

B: Incremental.

S: Incremental slightly better outcomes because you, there's they still like can't like walk every day you know, it still takes a lot of effort and training to be able to walk, they were able to train them more quickly, it was more natural, it's still a huge effort, it's still just a proof of concept really and it's mainly to help, help them move, help them get physical therapy help keep them more physically fit because they're moving more. But it really isn't to like enable them to walk normally you know.

C: So this is like to prevent muscle atrophy.

S: Yeah disused trophy and also it helps with their blood pressure and things like that. If you're sitting with paralyzed legs all day it's not good for you. So that's it, it's it's again it's the same basic technology with slightly better electrodes and they parlayed that into like this massive breakthrough. Again I'm not downplaying this research or these these advances are important. They did find something else that was very interesting. They found that so again these are people who have completed, three patients that that was the study, three subjects they had complete paralysis but their spinal cord was not completely severed and what they found was that after using the the stimulation for a while that they were able to like slightly modulate the way their legs moved. Which which seemed to imply that there was like some voluntary control of their muscle movements. And then they found, when they studied it, that that there was some activity getting through like getting across the injury. So what they think was happening was that you had some intact neurons some intact nerves, like that were that were survived, that were getting through the injury point but that they were basically not functioning, they were asleep because they were never being recruited they weren't being used. But the stimulation sort of woke them up─

C: That's pretty cool.

S: ─and got them to function. Yeah. So you had they so and after even without the stimulation like they were able to do a little bit of movement so they went from zero movement to a tiny bit of movement and this could this could be functionally significant you know if they're able to control the way their legs are moving even a tiny bit that─

B: Yeah exercise, rehab, yeah.

S: Might help them walk with the stimulator better than if they had zero movement.

C: But sadly this is not some sort of new hope for people who have a total spinal cord injury like if it's completely ablated there's nothing they're going to regain.

S: No so the BBC reporting got a lot of things wrong and even contradicted themselves, so first of all they said that the spinal cord was completely severed. No by definition it wasn't.

B: It's a crushing injury it's not a light saber injury.

S: Yeah because by definition there was some neurons that were surviving across the gap, if it was severed that wouldn't be the case. They also said that it was boosting the signal across the spinal cord. It's like well you know that only applied to this epiphenomenon of waking up a few of those neurons, it does not how the technology works. It works by you pushing a button to stimulate the spinal cord distal to the injury to just artificially stimulate and move the muscle. So they kind of got that wrong as well. So it just gave a really a completely different impression of what was going on. They also made it sound like one of the patients was able to have a child, has nothing to do with the re-establishment of any kind of neurological function. Like it was oh like a paralyzed guy who couldn't have kids because he was paralyzed like you know his reproductive organ isn't working and now it is working enough that he can't have a kid, right, that's kind of the impression you get when you read yeah it enables him, yeah that's not what happened at all. It was just that because he was able to to work out with this stimulator, it helped his blood pressure, it made him more active he had more energy and that enabled him to have the energy to raise a kid, that's it.

C: Oooh, that's insane.

S: It's like yeah I mean they say that they kind of─

C: It's terrible science reporting.

S: ─ I know it's terrible science, terrible.

J: And how deliberate is that misdirection?

S: I mean I think it's half and half. I think they're trying to juice this up as much as possible and they think the other half is they just misunderstood certain aspects of the science.

C: This what happens.

S: Of course I read the actual, I read the original study you know read the whole thing.

C: So should the science report like that's the problem with getting rid of all of your science reporters and and only having general assignment reporters doing this kind of work like─

S: Totally.

C: ─ they may not understand the science.

S: Yeah like not understanding that you can't have a signal getting across if it was completely severed, like that's a direct contradiction to that. So that means you're you don't understand something here so you better go back to the drawing board and find out what's going on.

E: Did the BBC not did the BBC not contact specialists to give them the real information?

S: Yeah they did, they did, but that doesn't mean anything. If you have a report or interviewing a scientist. What questions do they ask, how do you know, you can ask leading questions, you can take their answers out of context. Scientists complain about that all the time like "That's not what I said.", you know. So you yeah they interviewed the scientists and they have lots of quotes here but if you read the quotes, like what the actual quote is saying like they have done something that is that has not been done before. It's like okay that's true it's also pretty vague and but you could make it sound like it's something that it isn't, you know?

E: Right.

C: So when it was stimulated did they have an experience of feeling or not?

S: No.

C: Okay.

S: Because remember you're stimulating below the injury so that's a good way to stimulate the motor function because remember, in terms of the anatomy of the spinal cord you have the the motor cells right you have the cell is bull is in the spinal cord itself so and so and so the the cell is alive and its axon goes down the spinal cord out into the muscle, so if there's an injury above that nerve it doesn't affect that nerve that cell body or the nerve itself, it's still intact right.

C: Unless it just gets it disused.

S: Well then you get disused atrophy you know you don't get denervation atrophy, like if you destroy that neuron then yeah so you get much worse actually. What does happen is you don't normally the neurons above it that have been severed or that have been that are not working, they inhibit the tone in those motor neurons and so when you get spasticity, right? So that's a problem and that this doesn't fix the spasticity that has to be treated otherwise. But but the sensory nerves are going in the other direction so stimulating below the lesion doesn't get you anything across the lesion going up. But you're bypassing the lesion when you're stimulating going down to the motor pathway.

C: Right right I wasn't sure yeah I just wasn't sure if then there was some sort of feedback from the motor, so so you're stimulating the sensory portion it sends that signal down, you get this like motor contraction and then does the motor contraction then send any sort of feedback back up?

S: It does but and then there are feedback that will sort of like reflexes in the spinal cord itself. They won't perceive it in the brain because those signals are not getting up to the brain.

C: Gotcha. That must be so hard then because then you're you're like you're walking again like you said, like kind of clumsily and like you know with a lot of purpose or you're moving in such a way that's like with OT/PT people helping you but but you're not feeling what's happening.

S: Yeah.

C: That's so like, ugh, that would be really difficult.

S: Yeah so they did say like oh this isn't a cure for spinal cord injury and that's true, it's not a cure it's you can just bypassing it for the motor function and it's you know it's kind of clunky but it can't allow people to walk in like again with like a walker where they hit the buttons to stimulate their motor their muscles to to walk. It's really should be looked at as a rehab tool and sort of a health tool but not a fixing the problem with the spinal cord injury tool. I don't know if this kind of thing is even on that pathway you know? Even when this technology is mature what what it would really look like because again it doesn't really fix the sensory problem and and there's going to be inherent limits to how well you're going to be able to control those muscles. I guess you know the super mature version of this would be like you're you're you're wearing robotic limbs. Like that that are in your legs and then a computer is is entirely controlling them and making them walk in a natural way. And you know that that could give a measure of independence but again it would be weird because you'd be walking on these legs you can't feel.

C: You can't feel and you also are you lacking proprioception in a spinal cord injury too?

S: Yeah.

C: Yeah, that's what I figured so you'd have to look at your feet.

S: And if you look at the video you look at the video they are looking at their feet.

C: Yeah it's the only way.

S: Yeah so the the the better approach is to repair the cord itself you know get those nerves to regrow although you could use use a combination right, a hybrid Jay, you could get if you get any neurons like maybe there are some neurons in there that are that that could be coaxed back to life where you might get a few of them to be able to grow across across the gap. If you could restore 10 or 20% of the function just biologically with regeneration then it becomes easier to augment that function with this kind of external stimulation or robotics or whatever. So that may be where things are headed in this medium term until we could like fully repair spinal cords or like have fully robotic limbs or something. So again this is one little baby step on a very complicated long road that we're taking here─

B: Incremental.

S: ─but it's it's still nice it's still good. But really the actual innovation was they designed slightly better electrodes.

C: Which is has been a limiting factor we do talk about that a lot we need better electrodes.

S: Totally, but it's not a new approach to the electrode it's not like a new way in or a new new electrode technology it's just instead of repurposed they were custom. That was it. So they were slightly longer you know whatever that that was it's like.

B: So it's kind of low even low hanging fruit then.

S: Yeah totally like why didn't they do this years ago.

C: The obvious next step.

S: It was just a money thing it's like we have these electrodes, we'll repurpose them and they said let's just make special electrodes to see if that works better, oh it does work a little better, okay great. That's the whole thing.

B: Call the presses!

S: So it's exciting and frustrating at the same time, I don't want to downplay this research or what this means to patients getting any function back being able to to like stand up and walk even with a walker get your legs to move again. It's all huge but we got to put it into the context of what's actually happening here. And this creates a false impression that we're right around the corner to solving spinal cord injuries. Imagine if you had a spinal cord injury and you read this and you got a totally wrong oppression then someone's going to have to let you down.

E: Yeah emotional impact can be severe.

S: Anyway all right Jay you're going to tell us about a real breakthrough a new artificial enamel.

Artificial Enamel (34:06)

Laser Thermal Propulsion (45:07)

Chimps Self-Medicate (1:03:22)

Who's That Noisy? (1:08:47)


New Noisy (1:13:03)

[kids and adults talking to an animal lowing and making other low grunts]

... Just tell me what animal it is.

Announcements (1:14:32)

Questions/Emails/Corrections/Follow-ups (1:15:29)

Email #1: De-extinction

_consider_using_block_quotes_for_emails_read_aloud_in_this_segment_ with_reduced_spacing_for_long_chunks –

Science or Fiction (1:24:50)

Item #1: A new CT scanning technology uses the low end of the gamma ray spectrum, rather than X-rays, to form images with over 10 times the resolution.[5]
Item #2: Engineers have made a robot that can morph from one shape to another through liquid metal yet hold either shape with a rigid structure.[6]
Item #3: Scientists have discovered the first known metal alloy that does not soften as it is heated through a wide temperature range, above 1,000K.[7]

Answer Item
Fiction Gamma ray scanning tech
Science Morphing robot
Science
Tough metal alloy
Host Result
Steve
Rogue Guess
Bob
Morphing robot
Cara
Gamma ray scanning tech
Evan
Gamma ray scanning tech

Voice-over: It's time for Science or Fiction.

Bob's Response

Cara's Response

Evan's Response

Jay's Response

Steve Explains Item #3

Steve Explains Item #1

Steve Explains Item #2

Skeptical Quote of the Week (1:36:42)

I strive to be a lifelong learner and I have never learned anything by being right.
– Dr. R. Shulze, SGU listener


Signoff (1:38:36)

S: —and until next week, this is your Skeptics' Guide to the Universe.

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

[top]                        

Today I Learned

  • Fact/Description, possibly with an article reference[8]
  • Fact/Description
  • Fact/Description

Notes

References

Vocabulary


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