SGU Episode 936: Difference between revisions

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== News Items ==
== News Items ==
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'''S:''' The news item that I got hit up with the most this week was the patient who had schizophrenia and then it was catatonic and then it was found that they actually had an autoimmune disease and when they were treated for their autoimmune disease they "woke up".
 
'''C:''' Doesn't that remind you so much of all of Oliver Sacks {{w|Awakenings (book)|Awakenings}}?
 
'''S:''' Yeah, totally.
 
'''C:''' Yes. It's like the subsection of people. Yeah, anyway.
 
'''S:''' But the reporting on it is I think misses the real story because they're focusing on the wrong things. And so the narrative that emerges in the lame press is that this person that actually it turns out that schizophrenia can be caused by autoimmune disease. And that this it was like this amazing discovery that this person who had catatonia for years just woke up when you treated them for their autoimmune disease.
 
'''C:''' As if that's what schizophrenia usually or even presents as.
 
'''S:''' I would frame it completely differently. This person it's not it doesn't turn out that autoimmune disease causes schizophrenia. This person did not have schizophrenia.
 
'''C:''' Exactly. Or they had a very specific subtype that was something.
 
'''S:''' So this gets to how we make diagnoses.
 
'''C:''' Yeah. Especially mental health diagnoses.
 
'''S:''' Especially mental health diagnosis. So schizophrenia is not a disease. It is a syndrome. And most you could say there's primary and secondary schizophrenia. I don't even think they do that.
 
'''C:''' No we say usually positive or negative symptoms. Yeah but what I mean is like if you have all right so I'm gonna part of this I'm coming out from a neurologist point. Whenever anyone gets a psychiatric diagnosis they refer them to a neurologist who rule out neurological causes.
 
'''C:''' Which is so funny because schizophrenia is partially neurological.
 
'''S:''' Well the thing is that there's there isn't a clean division between psychiatric and neurological. It's all brain stuff and the only real difference is what you specialize in treating. It's a psychiatrist specialize in treating disorders of mood, thought and behavior. And neurologists specialize in pretty much everything else that the brain does.
 
'''C:''' Cognition movements.
 
'''S:''' Exactly. Seizures and blah blah blah. And but but it's all brain stuff and we know it that's why there's the American board of psychiatry and neurology. It's the same board certifies both the neurologists and psychiatrists. And 20% of my neurologic boards was psychiatry and vice versa because we know that there's massive overlap. It's the same thing. But what so what is a psychiatric illness then? So it is one where there isn't a secondary cause. So if you have a brain tumor that causes a schizophrenia syndrome you don't have schizophrenia. You have a brain tumor.
 
'''C:''' Yeah literally everything in the DSM has a qualifier that says it's not better-
 
'''S:''' Right you can have a biology. So the way to look at it is that yeah it's gets a I mean psychiatric illness is when you have a disorder something. The brain isn't working in in an optimal way causing psychiatric like symptoms without demonstrable pathology because the the way the brain functions its function is determined biochemically, by the the networks and the wiring and all that sort of stuff, so you can have disorders of brain function without biological pathology. And so neurologists tend to deal with pathology of the brain and psychiatrists deal with the wetwere. Basically the bad wiring of the brain in the absence of pathology. Although even that split isn't clean because there's exceptions all over the place.
 
'''C:''' Schizophrenia is one of the lovely exceptions because there is clearly an organic thing going there.
 
'''S:''' Yeah but I think a lot of I thought of the big ones, I think anxiety has organic causes you can have organic depression.
 
'''C:''' They do. But you can't usually look at let's say an MRI of some of a person with anxieties brain and know they have anxiety. You can look at a schizophrenic brain.
 
'''S:''' You're right. I agree-
 
'''B:''' That could change though.
 
'''S''' That will change.
 
'''C:''' It will change when we have better resolution.
 
'''S:''' It's one of the more obvious biological psychiatric-
 
'''C:''' Yes that's a good way to put it.
 
'''S:''' I agree with that.
 
'''C:''' There are things like vascular depression, schizophrenia. There are a handful of psychiatric conditions that are more obviously organic. But that's only just because we're better at understanding.
 
'''S:''' Exactly. Well let me get back to the the core point was. From a practical point of view clinically if you have somebody who presents with a schizophrenia-like syndrome you have to rule out pathological disease and then you're left with schizophrenia as a diagnosis of exclusion. And so-
 
'''C:''' From a neurological perspective.
 
'''S:''' Yes it is. Practically from a clinical perspective it's like, for anything. If somebody has anxiety you rule out thyroid disease. It's the same thing. If there is some underlying non psychiatric pathology that's driving the alleged psychiatric illness and in the absence of that you're left with a psychiatric diagnosis. It is by definition a diagnosis of exclusion. When you have the positive features that meet that diagnostic criteria. So in fact I had a case that was very similar to this in that a patient was admitted to psychiatry while I was on the inpatient neurology service with a 20-year history of schizophrenia. And the family brought them in because they were getting worse and they couldn't take care of them at home anymore. And this patient was basically lost to medical follow-up for 20 years. The psychiatry unit admitted them with a decompensating schizophrenia diagnosis. They consulted neurology sit just for this like this person really hasn't had medical care in a while can you just make sure there's nothing neurological going on. It's like I know I'm sorry to bother you, it's kind of a bullshit we consult but just the attending wants to make sure we're not missing something. So then we review the case you're like yeah I you're probably not missing something. Their exam doesn't show any signs of neurological disease but let's get a CAT scan to be sure.
 
'''B:''' Just in case.
 
'''S:''' Just in case. We got a CAT scan. This guy has the front half of their brain filled with tumor. And it was a benign tumor. It was actually outside the brain. It was just pushing the frontal lobes.
 
'''B:''' Oh my god.
 
'''S:''' So the frontal lobes couldn't work creating a schizophrenia like syndrome. The neurosurgeons removed the tumor and the guy was cured. Recovered to his pre-schizofrenia baseline.
 
'''C:''' I mean it's great but-
 
'''B:''' How many years?
 
'''E:''' 20 years.
 
'''S:''' 20 years.
 
'''B:''' Who the hell screwed up.
 
'''S:''' Well in fairness the family took this guy home and took care of my home without any further medical follow-up. That was the problem. But anyway that's the same kind of serious and now you have this case of this woman who was in a catatonic state. It was thought that she had severe schizophrenia with catatonia. I don't know what kind of workup she had years ago when they first made the diagnosis.
 
'''C:''' Right she was older, right?
 
'''S:''' Yeah.
 
'''C:''' Catatonia was also. It was a diagnosis of exclusion. You look at the Parkinsonian post-encephalytic Parkinsonian patients and awakened things. All of them had diagnoses like catatonic schizophrenia like state.
 
'''S:''' Yeah right. Just placeholder diagnoses.
 
'''C:''' Yeah it was like I don't know what this is.
 
'''S:''' Not based on any demonstrable pathology or anything like that. So a psychiatrist saw this patient 20 years ago was involved with their like initial evaluation. And then is getting the presented the same case like 20 years later and it's like wait a minute is this that patient I saw 20 years ago?
 
'''B:''' This sounds familiar.
 
'''S:''' Yeah, this sound familiar. So he essentially initiated a rework up of the patient because he realized she's just been essentially warehoused for 20 years in chronic care, long-term care. They did a full workup and it turns out that she had encephalitis. She had lupus encephalitis. And they treated that. It's basically autoimmune disease her brain was inflamed. They treated it and she didn't just wake up. That's kind of- she's slowly improved over months with treatment.
 
'''C:''' Tons of rehab too.
 
'''S:''' Tons of rehab. She's significantly improved. She's still significantly impaired but she's much more functional than she was before treatment.
 
'''C:''' And also how much of that impairment is not having used your brain or body for 20 years.
 
'''S:''' Honestly it's probably a lot of it. But probably it's mostly that the brain's been inflamed for 20 years.
 
'''C:''' Right, and that can cause long-term damage.
 
'''S:''' Yeah yeah. That's probably just caused damage to the brain. So yeah it was missed 20 years ago that's just the bottom line. And this is a notoriously difficult diagnosis to make. I've had several patients with similar things. This is always the case as I like to say, this is the kind of case that gets presented on grand rounds. And when the other thing is like when when cases like this are being presented on grand rounds is a few things that's a good guess. Like the fact that this is being presented on grand rounds as a unusual case. Like there's a few things you're going to guess out of the block just as just like a chat GPT kind of statistical answer. And one of them is encephalitis. That limbic encephalitis or whatever somebody missed encephalitis.
 
'''C:''' Somebody who's been catatonic unresponsive in long-term care yeah. Like yes they could be schizophrenic but that's also I think what bugs me is the way that the media has presented this case. Like that is what schizophrenia looks like. And that no, that's a very small subsection of people who have the diagnosis where honestly I don't know if in time those people would still have that diagnosis. The better we get at figuring out what's really going on all of those people might, all of those people who have those presenting symptoms yeah may not end up being people with schizophrenia.
 
'''E:''' Sure I mean because you're basically putting them in a basket in which nothing else works. You're going to eventually learn more things and take them out.
 
'''S:''' Yeah we're constantly nibbling away at these kinds of scenarios where you have essentially, we don't have pathology, we don't know what you have we're going to diagnose you with this syndrome syndrome placeholder diagnosis but over time we realize oh a certain percentage of these patients actually have this disease. And another percentage have this other disease.
 
'''C:''' And even schizophrenia it's so like like I usually will say like psychotic disorder or thought disorder because also there are so many different things. There's schizopersonality disorder there's schizotipal, there's schizoaffective disorder. There's all these different disorders that have a psychosis component. Some are mood disorders with psychosis and some are psychosis with mood problems. And it's a whole specialty.
 
'''S:''' Absolutely.
 
'''C:''' It's not just oh yeah there's schizophrenia and all people with schizophrenia are the same because we also you mentioned but schizophrenia can have positive or negative symptoms. You can have people with schizophrenia who are paranoid delusional.
 
'''S:''' There was that study we talked about a few years ago were they identified five subtypes of schizophrenia.
 
'''C:''' Yeah I actually would need to look at and see how they're how are they slicing and dicing it today.
 
'''S:''' ANd there's genetic ways of slicing and dicing it now.
 
'''C:''' Yeah but this one is like this very very extreme case where they're so totally frozen catatonic that they're not even responsive.
 
'''S:''' And the other thing one final point before we move on is that because of this one of the things I learned over the years as I matured as a clinician is that when you see cases like this just give them steroids. When all else fails just empirically give them a round of IV steroids just to see if they wake up. Because you risk very little in doing that and just make sure you're not missing a case like this. Because these are notoriously hard to diagnose. The workup can be negative.
 
'''E:''' Why isn't that the standard then?
 
'''S:''' It basically is but it's like you have to identify when you're in the right clinical scenario where that's appropriate.
 
'''C:''' And it's only going to be the standard if you're if that person is in the hospital. If that person never makes it.
 
'''S:''' It's always in the context treatment when you're in the hospital.
 
'''C:''' Yeah they're not going to have an IV ever.
 
'''S:''' But sometimes I will do, I'll do like if I'm seeing somebody as an outpatient who I think might be at the beginnings of this I might give them a course of oral steroids. Like a weak pulse of steroids just to see if it dramatically helps then. It's a diagnostic therapeutic trial. Saying let me see if whatever you have is something that can respond to steroids. And sometimes the other point that I make to my residents. We get to the point where we've done all the workup and we don't know what's going on and something confusing is happening. I'm like all right, let's list all the things this could possibly be that's treatable.
 
'''C:''' Right. Do you workup for infection too?
 
'''S:''' Oh you always do that before.
 
'''E:''' Sounds like an episode of House.
 
'''S:''' Before you give the steroids you always rule out all kind of infections. The ID workup is completely negative. Whatever, you do all the things. They're not having seizures. They're not on drugs. You rule out all those things you just left with the brain cyst on fire it's just not working. Whatever's left, the list of things that we haven't ruled out that are treatable are all treatable by steroids. So let's just give them steroids and see what happens.
 
'''C:''' Because they're linked to inflammation.
 
'''S:''' Yeah it's just all that's what's left. It's just some kind of autoimmune inflammation and if they don't get better it's like okay well we could check that off list but sometimes they wake up. I've had patients who I did that too. I just gave empiric steroids and they got better because that was all that was left to do.
 
'''C:''' What's so interesting is that I wonder if that would have worked with Oliver Sacks patients because they used {{w|L-DOPA}} because it was actually a form of Parkinsonism.
 
'''S:''' Yeah no it would not have.
 
'''C:''' It might not but if it was post-encephalitic Parkinsonism so I wonder if there would have been like a little bit of an inflammation component?
 
'''S:''' I don't think so because they had well they had they had encephalitis lethargica.
 
'''C:''' Because they had encephalitis in like the twenties and then this was like in the fifties or something.
 
'''S:''' But what that did was it burned out their dopamine cells. And so the inflammation was gone but that cell population was destroyed. So they had acquired end stage Parkinson's disease from the infection. And so then then when you gave them to the L-DOPA they briefly woke up but that burned out whatever few neurons they had left. So it was a short window. So it's not Parkinson's disease it was Parkinsonism, secondary to a viral infection that happened to destroy that population of neurons.
 
'''C:''' That's what I remember. They were calling it post-encephalitic Parkinsonism.
 
'''S:''' Yeah, Parkinsonism not Parkinson's disease which is whatever, that has a more specific-
 
'''C:''' Fascinating.
 
'''B:''' Kind of like Parkinsons-ish.
 
'''S:''' Yeah well just Parkinsonism describes the syndrome. Parkinson's disease is a pathological entity.
 
'''C:''' Right so it's Parkinson's like symptoms.
 
'''B:''' Yeah like I said, ish.
 
'''S:''' All right let's move on.
 
=== 3D Printing Glass <small>(21:04)</small> ===
=== 3D Printing Glass <small>(21:04)</small> ===
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{{w|sintering}}
'''S:''' Jay tell us about 3D printing with glass.
[discussion about talking about sintering previously]{{link needed}}<ref group=v>[https://en.wiktionary.org/wiki/sintering Wiktionary: sintering] A process in which the particles of a powder are welded together by pressure and heating to a temperature below its melting point.</ref>
 
'''E:''' Glasses.
 
'''J:''' 3D printing is really starting to do some incredible stuff. I mean throughout the years just like most other things it's just getting better. Every year they keep making improvements and applying it to new and different things. So listen to this researchers at [https://www.kit.edu/english/ Karlsruhe Institute of Technology] have come up with a new process for producing transparent quartz glass structures at lower temperatures. That might not sound impressive to you but let's dig into the details a little bit. The ability to create transparent quartz at lower temperatures opens up new applications and optics photonics and semiconductor technologies. And this is important because especially with semi conductor technologies it allows us to do a lot more with semi-conductors. And that means more power which means smaller semi-conductors, less battery power, it bleeds into a lot of things. The historical way of creating transparent quartz involves a process called {{w|sintering}}. And sintering is the process of forming a solid mass of material through heat and pressure without melting to the point of liquidification. Did I say that correctly?
 
'''S:''' Yeah we talked about sintering a number of times on the show. {{link needed}}<ref group=v>[https://en.wiktionary.org/wiki/sintering Wiktionary: sintering] A process in which the particles of a powder are welded together by pressure and heating to a temperature below its melting point.</ref> I think the first time we talked about it in the context of platinum because platinum has a very high melting point but some cultures developed the ability to heat it to the point where they could sinter it. They could just make it sticky so they semi-melted so we could stick together but without liquefying it.
 
'''J:''' Keeping that in mind for transparent quartz silicon dioxide nanoparticles need to be at temperatures above 1100 Celsius. That's super hot.
 
'''S:''' That's very hot.
 
'''J:''' So it's way too high for a direct deposit onto a semi-conducting chip. So you couldn't take the quartz and put it onto a chip. It would it would destroy the chip. So the new process that they came up with which was led by dr. Jen's Bauer, they utilize a hybrid organic inorganic polymer resin call the name that nobody in this show could pronounce. Just forget it. I was going to leave and look it up I'm like I'm not going to bother, you're not going to remember anyway. So they have this polymer resin. The resin is 3D printed into nanostructures. So they make an architecture out of it and then they heat it to 650 degrees Celsius to remove the organic components and form a continuous quartz glass structure. So that process right there allows them to print right onto a semi-conductor chip. So they need half the temperature of conventional sintering methods. The end result is that the glass structure is high resolution. It has excellent mechanical properties and it's stable under challenging conditions.
 
'''S:''' Jay can I pause for a nerdy pedantic thing?
 
'''J:''' Yeah.
 
'''S:''' So you said half the temperature which all the reporting on it says the same thing. Although the mainstream reporting not the technical article. But just with temperature that kind of reference doesn't work unless you're talking about Kelvin.
 
'''J:''' Okay.
 
'''S:''' You know what I mean? Because it's not really half as hot. It's like 100 Celsius is not half as hot as 200 Celsius because it doesn't work that way. But 100 Kelvin is half as hot as 200 Kelvin.
 
'''C:''' Right because yeah-
 
'''S:''' Because it's absolute.
 
'''C:''' It's a lot cooler.


'''S:''' It's cooler, it's cooler but it just doesn't make any logical sense to say half the temperature unless you're dealing with kelvin because it's the absolute temperature.
'''E:''' That's a good [inaudible].
'''J:''' I didn't really know that Steve so that's a great thing to say.
'''E:''' Good reminder.
'''J:''' So anyway that was basically it. It's this new process that they came up with and it's going to make some what I think to be some significant changes and what they're going to be able to do. And think about it I mean this is 3D printing. The 3D printing process is doing this at those temperatures.
'''S:''' If you look at the pictures I mean there are 3D printing at like the nano scale, these really intricate structures. It's not just like a blob a glob of glass. It's like this these crystalline really complicated structures at the nano scale. So yeah it's one of those things where it sounds awesome and you're just wondering what they'll be able to do with it. They talked about printing directly onto circuit boards for example. And printing really tiny optics. Imagine being able to print a really tiny optics I could then go into your cell phone and you have like these incredible zoom cameras or whatever. I don't know. I don't know if that's going to be-
'''B:''' In the VR goggles.
'''S:''' Yeah. Or just even, exactly VR goggles. Holy shit I mean it even if it just reduces the cost of making them.
'''C:''' What about instead of VR goggles VR contacts?
'''S:''' Yeah, right. That's the ultimate.
'''B:''' Those bad boys.
'''C:''' Yeah.
'''S:''' All right thanks Jay.


=== Smoke Blocks Solar Energy <small>(26:02)</small> ===
=== Smoke Blocks Solar Energy <small>(26:02)</small> ===
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'''S:''' All right Cara. So this is upsetting but tell us about the effect of all of this smoke from the wildfires on solar energy.
'''C:''' Yeah so if you guys remember. We record the show usually on Thursdays. So last week, last Thursday when we were recording you guys were talking about Evan, you were like packing up a lung. And snotting everywhere. And you guys were talking about how bad it's been outside. That's because it turns out that June 7<sup>th</sup> top the charts. It was the worst day of wildfire smoke on record. Yep. So fun times. And now one week later we are getting a fair amount of data from kind of the effects of that. Obviously we don't know the effects yet on health and human safety. We know it's not good. But we do know some interesting things. It was the worst wildfire smoke on record. It was a record shattering air quality disaster. And you could physically see it the skies were actually hazy. So because of that at 1 PM last Wednesday compared to this Wednesday solar farms in New England produced 60% less electricity.
'''E:''' 60% drop.
'''C:''' 60% drop. We even saw in like the midwestern states as much as a 25% drop. And that might have been in places where it wasn't even perceptible. Like maybe your weather app on your phone was telling you it's a bad air quality day be careful but you didn't see it or smell it outside. New York was hit the hardest and here's another statistic. They lost over 1400 megawatts in solar energy between June 6<sup>th</sup> and June 7<sup>th</sup> and a 24 hour period. And I know we talk about this all the time and when we talk about it might years go I don't know what that means so for scale this verge article compared that. A single megawatt is about enough to power between 800 and a thousand homes. And they lost almost 1500 megawatts in one day because of the smoke.
'''S:''' Yeah.
'''C:''' There was like they do mention that there was a weird kind of positive benefit that it didn't net it out to zero but it sort of offset the burden of lowered production which is that the actual blockage of the sun made it cooler outside. And so people didn't have to crank their ACs up as much. But they couldn't, yeah, so but it didn't offset how little energy was produced. And ultimately it's very hard to predict these kinds of things with any fidelity. And so being able to calculate and predict energy demands during a wild fire season is now going to be very very difficult for these grid managers and for production. Now New York is probably not a place where the bulk of the energy production does come from solar. California's grid it's something, it's much higher. It's like 15%. Almost 15% of California's energy comes from solar. Across the country it's only about 3.5%. This thing that happened in New York is really salient or in New England is really salient right now because we just experienced it. But of course as you guys heard me say last week like welcome to our world on the west coast. We have seen like really bad wildfires in the past. And like for example there is a bad wildfire season in September '22. It cut solar power generation in California by 30% which was pretty crippling to the energy supply because again 15% of all power comes from solar there. And then we also saw that that year was a record year for blackouts. And now let's talk about something else that happens on top of this. When grid managers or production companies know that wildfires are afoot they will sometimes have to cut power because of the risk of fire. When the conditions are good for wildfire we've seen these like transformers and these large generators sparking. This has been the cause of a lot of some of the worst wildfires on the west coast has been old equipment that hasn't been well managed. And so you've got this added burden of now it's wildfire season, the wildfires themselves could potentially screw up our power production from solar but also even before it gets to that point we might need to cut power because we don't want to cause a fire.
'''S:''' Yeah. Cara, do you know what what percentage of wildfires in America are caused by human negligence?
'''C:''' Probably a lot of them. And wait, are we we're not counting just climate change being a function of human negligence, right?
'''S:''' No no.
'''C:''' We're actually like direct causes?
'''S:''' Direct cause. Like not lightning.
'''C:''' You're talking a flip cigarette bud, a camp fire or even are we also talking about the-
'''E:''' Probably not control burns.
'''C:''' Not control burns. But are we also talking about these power-
'''S:''' I don't know to be honest with you. It wasn't what explicitly listed or excluded.
'''C:''' It if includes that I'd say it's probably like half.
'''S:''' 80%. 80%. But the good news is that means we could prevent four out of five four fires just by not doing stupid stuff.
'''E:''' Smokey the bear was right. 50 years ago.
'''C:''' Smokey the bear was telling us to do that.
'''E:''' I mean, come on, since I was a kid.
'''C:''' So the good news is thiis is one of those tough things where it's like the good news is that theoretically in the bad news is we already knew that and still haven't made the change.
'''S:''' Right but there's, a lot could be handled with education. People don't realize that just if you're dragging your muffler or behind your car like that those sparks could set off as forest fire or shooting rifles and guns. Those sparks can set off fires as well.
'''C:''' Or doing a gender reveal party.
'''S:''' During gender reveal parties. Lighting those floating lanterns not knowing we they come down.
'''C:''' That's so sad though because-
'''E:''' Firework season is right now. It's happening everywhere.
'''C:''' I don't think it's that people don't realize I think it's that they don't care. I think you're right there's a certain percentage of people who don't realize but a larger percentage of people don't care.
'''S:''' They may be underestimating the risk. And they may be underestimating how significant it, like I think-
'''C:''' I love your endless optimism Steve.
'''S:''' I know like the {{w|Caldor Fire}} was caused by a father and a son who were just riding an ATV. All-terrain vehicle. ATV around. That was it.
'''C:''' Yeah I mean it's this really complex scenario that we're seeing where human behavior is causing these terrible wildfire. And we know that wildfires are natural and there is a healthy way for forest to burn they need to burn we do prescribe burns, it's a part of forest ecology. But the the quantity and the devastation of wildfires recently is clearly indicative of changes to the climate. So you've got these climate change either induced or exacerbated wildfires that as you just mentioned are often caused by more direct human behavior that now have this downstream negative effect of actually intervening. Screwing with the attempts that we have to circumvent or at least to mitigate climate change.
'''S:''' And it's kind of the feedback because the more climate change, the more wildfires, the less well are solar panels work.
'''C:''' Solar panels work.
'''S:''' And not only that Cara. I sent you, I pointed out to you when we were prepping for this-
'''C:''' Yes! Oh yes you did.
'''S:''' That the increased temperatures caused more droughts which means they have to shut off a lot of the hydroelectric plants too. So it's like we're burning coal to replace the electricity we can't produce because the climate change which is worsening climate change.
'''C:''' It's so, this negative feedback loop-
'''E:''' And the problem perpetuates.
'''C:''' And then you add geopolitical conflict to it and my head explodes. I just read an article the other day we won't get into this but about how we need I think a certain amount of these basic materials. Like uranium or something in order to do our, in order to make our nuclear power plants run and we rely on like a huge amount of that from Russia.
'''S:''' Yeah.
'''C:''' And it's like oh jeez, really? So it's complicated.
'''S:''' We need to develop other sources of the uranium.
'''C:''' Yes yes.
'''S:''' And the other thing is we often talk about like what was the cause of the the fire. And it's always multiple things at the same time. They're not mutually exclusive. So global warming makes it more likely to happen but there's often a trigger like human error, sometimes natural. Bt also it's bad forest management and this is-
'''C:''' Oh, it's a huge problem.
'''S:''' Yeah Canada has not especially in the east where these fires are coming from were not doing a good job of forest management. They didn't didn't have the resources, they didn't put the resources into it. You can't have a bunch of trees laying around drying in the in the warm sun and creating a bunch of fuel for these fires.
'''C:''' They may not have needed the same kind of forest management that they need now because of climate change and that's the other thing. Climate change is like you said at the beginning, these warmer temperatures are causing it combined with this combined with this but it's also exacerbating it. Not only are there more, they're also hotter and larger and harder to put out.
'''S:''' Right.
'''E:''' And they're happening in at times of the year which they're not used to.
'''C:''' Yes, exactly.
'''E:''' They say this was particularly early in the year to have the fires.
'''S:''' Fire seasons are growing and now it's just all year round in some places now. It's not even a fire season anymore.
'''C:''' So our old methodologies which weren't perfect even then even though, we know a lot about forest management we just don't always practice what we preach, might not be optimized anymore because the conditions have changed so rapidly.
'''S:''' Alright thanks Cara.


=== Retooling Ribosome Translation <small>(35:48)</small> ===
=== Retooling Ribosome Translation <small>(35:48)</small> ===
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}}
'''S:''' Bob tell us about retooling ribosome translation. That requires some backstory.
'''B:''' Yeah this this was pretty pretty cool. Scientists have made recent progress in this fascinating goal of programming cells or specifically ribosomes to create proteins that have never been made before in the history of the earth. So why are they doing that? What could it mean to humanity and especially of course what could it mean to me? So this is from the journal Nature Chemistry and ACS Central Science and these chemists were centered around University of California Berkeley. Okay so this news item is all about complex cellular nano machine known as ribosomes. So let's go over what a ribosome is before we do anything else. Now ribosomes exist within cells. They're essentially nano machines for making one of the most critical and versatile molecules of life - proteins. Did you know that the word protein is from a Greek word that means of utmost importance? I did not know that.
'''C:''' I didn't know that.
'''E:''' I didn't know that
'''B:''' So think of a mammal cell. Jay, I think you're a mammal. Well technically anyway. Each of your cells have about 10 million ribosomes. I had no idea. 10 million? I figured you got one big ribosome and you're good. No.
'''C:''' No, they're all over.
'''B:''' Million like-
'''C:''' And they're on the rough endoplasmic reticulum baby.
'''B:''' Yeah they're all over. They're in the core, they're in the outskirts are all over.
'''C:''' I love the core in the outskirts. This is how I want to start talking about cells.
'''B:''' I think it's called nucleos. I think it's the nucleosome in the interior and then by the cell wall. Because where the proteins are created actually determines where they're going to be used. I didn't know this either, this ribosomes got two subunits and they wrap around. They each wrap around the recipe that's in the messenger RNA and they start stringing together these amino acids. And once the string is done then the amino acids fold into any one of the the critical proteins that the organism needs as that's trying to create there. Now proteins of course are amazingly versatile. Surprisingly versatile. They can be purely structural molecules. They can be just protective. They can be used to transport. They could be storage. Proteins can be membranes, enzymes, even toxins. Most of what cells do essentially involve proteins in one way or the other. Pretty much all about proteins in a really important way. Now with all this versatility ribosomes though are still surprisingly limited in a way. The ribosomes can only choose among about 20 of the canonical so-called alpha amino acids. About 20, technically it's kind of- the amount of amino acids available can be 22 but that's as to you know we don't need to go that detailed. It's about 20 alpha amino acids that are used and that's all because of what? Contingencies of evolution, right? That's what evolution has made available to them, to the ribosomes. So why? Why is it just those 20 or so amino acids? Because there are a lot more that are not just not used and it's been described as a frozen accident in history. And it really is. It's hard to say precisely why this it's just those 20 but scientists generally think that the magic 20 are linked to a couple things like the frequency in meteorites. If you look at meteorites you're going to see those amino acids more than than other ones. And also that experiments that were done in the prebiotic soup billions of years ago. So based on the different kind of experiments that were done that long ago that kind of also makes sense that that's why it's those 20 that have been used.
'''C:''' Also isn't it just kind of a principle of biology conserving? It's like if these 20 are good enough. Why need more?
'''S:''' It's partly that. Also there's, we need the genetics to control the amino acids and we have the trinucleotide system. So would we need to go to four if if we had more amino acids that we had to code for?
'''B:''' Right.
'''C:''' Right.
'''S:''' But it is, it's like it's like somebody who's famous for being famous. This is the system we have because this is the system we have. At some point it gets locked in.
'''C:''' Exactly.
'''B:''' Yeah, right.
'''C:''' Yeah, it's what worked and then we didn't feel the need to improve it.
'''B:''' Yeah and I read one comment somebody was saying that if you reset evolution that there probably would be 75% of the ones that are used now would probably still be used. But there still would be a 25% variation potentially. And that's assuming all things were essentially the same as as they were. But how many proteins are possible if you thought of that. What's like the total space of possible proteins.
'''E:''' Viable proteis?
'''B:''' 20. No. Possible proteins.
'''E:''' Possible.
'''B:''' [inaudible] puts it at 20 to 50,000.
'''C:''' Yeah.
'''B:''' That's a big number. But that's kind of like the total space. That's just the outer limits. More realistically if you assume say approach a typical protein length of say 300 amino acids which is reasonable. Then those 20 amino acids can conceivably be arranged to 10<sup>390</sup> different proteins. Still a gargantuan. If you made a molecule-
'''E:''' 10<sup>390</sup>? It wouldn't fit in the universe.
'''B:''' You're right. There's not enough atoms to create an example of each one of those. So that's an amazingly high number. But you can get even more even more realistic than that only about one in a billion of those are actually stable and usable. Any of the other ones that were not stable, they would not have lasted long. They would not have been passed down and that's why we're not seeing a lot of those unstable ones of course. Now far fewer than those have actually been created on the earth. Humans use about 20,000 distinct proteins. Estimates vary but 20,000 is the number I see most often. 20 to 25,000.
'''E:''' Is that true with most mammals? Are they around that number you think?
'''S:''' No, there's huge differences.
'''B:''' Even more variable though was the entire earth's proteome. One number that seemed hopefully maybe more reliable than others. Maybe 10 million unique proteins potentially. Some have much higher numbers and that but 10 million seems reasonable. What if we can create proteins using that much wider palette of amino acids. What can we do? Is it worthwhile to use far more than the 20 alpha amino acids that are available to biology on earth. So that is what these chemists from the National Science Foundation Center for Genetically Encoded Materials. C-GEM, it's called C-GEM. That's what they've been working on. They want to retool the cells polypeptide manufacturing plant as they put it, the ribosome, to make what nature cannot make. Now the the crux of this latest new item is the fact that three separate papers have been published recently covering significant advances in this field. One paper dealt with how to reprogram cells so that ribosomes can handle these different building blocks that I've been talking about. The second paper talked about how to predict which building blocks make the best substrates. That's important to know which ones are worthwhile pursuing in terms of the substrate. The third paper dealt with how to change ribosomes to actually use these new building blocks and make them into polymers. Now sure they haven't solved these problems but they've made some significant strides in these three key areas to achieve these goals. Now speaking of goals, their ultimate goal here the scientists say is to be able to make this new system fully programmable as they put it. So that the new mRNA instructions and the new building blocks can be made available to the cell so that it could then essentially make an unlimited variety of new molecular chains. Things that have never been seen before. These can be made into new biomaterials. They could be made into new enzymes, new drugs. Maybe even, Jay, maybe even new and revolutionary types of meatballs. You never know. So see the C-GEM director Alana Sheppard was a distinguished chair and chemistry professor of molecular and cell biology at UC Berkeley. She said C-GEM was working to biosynthesize molecules that have never before been made in a cell. That are designed to have unique properties. The tools could be applied broadly by polymer chemists medicinal chemists and biomaterial scientists to generate bespoke materials with new functions. Now these novel polymers could have specific applications that have been specifically designed or they could be created just to see what was created and what new applications could be there that have never been imagined before. They offer a couple of examples. One was creating new compounds to deal with antibiotic resistance which of course is hugely popular especially with the potentially new era of antibiotic resistance in the future would be devastating. Oh my god. So another possibility that they discussed involves synthesizing a protein-like polymer that's a mixture of spider silk and nylon. Think about that. Mixing spider silk and nylon. Microbes could then make an essentially infinite variety of these. Each they say. Maybe near infinite. Not technically infinite. But each compound would be new to chemists and with never before seeing properties. I mean what would you even call a mix of silk and nylon. Maybe a sylon?
'''E:''' Absolutely.
'''B:''' Maybe that wouldn't be a good portmanteau. But very cool stuff. I'll be tracking this. This is one of those advances in synthetic biology that I think is just has such an amazing potential. It would be a major game changer. Talk about potentially disruptive new technology. Fascinating stuff.
'''S:''' All right, thanks Bob.


=== Ivory-billed Woodpecker (Again) <small>(45:48)</small> ===
=== Ivory-billed Woodpecker (Again) <small>(45:48)</small> ===
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'''S:''' Evan.
'''E:''' Yep.
'''S:''' The {{w|ivory-billed woodpecker}} is back. Or at least discussions about the ivory-billed woodpecker.
'''E:''' Yes.
'''S:''' Maybe not the woodpecker itself.
'''E:''' Steve have you ever seen an ivory-billed woodpecker?
'''S:''' Nope. I've seen pileated woodpeckers.
'''E:''' Now is that page even in a bird book? In other words does a bird book have all the birds in it and then you check them as you see them? Is that how that works?
'''S:''' There are but no one book has every single bird in it. It's usually just a subset. It may be a regional or birds of North America. But even then there's like there's a lot of birds. But yes, some do have a lifeless checklist for you where you could check birds off. Yeah, sure. Those exist. But not all bird books have that necessarily.
'''E:''' Well you might have been able to check this particular one off if you lived in the southeastern United States or Cuba. Maybe about 80 or 90 years ago. Which is about the last time perhaps there was an official sighting of the ivory-billed woodpecker. The bird itself, it averages 20 inches from beak to tail. It was the largest of the woodpeckers north of Mexico and third largest in the world. And of course it is no longer around. At least we believe because of the destruction of its habitat. Severe population declines and the 1800s almost wiped them out. Only a small number survived in the 20th century. And again it's believed to have gone extinct in the middle of the 20th century when one of the last official reported sightings was made in 1944. But do you guys remember back in 2004? I recall this was a big news at the time.
'''S:''' Oh yeah.
'''E:''' Bird was reportedly rediscovered in Arkansas.
'''B:''' Yeah. People went crazy.
'''E:''' Yeah. That led to a multi-year search effort for the elusive ivory-billed woodpecker. However the Cornell laboratory of ornithology, which was involved in that search for the bird reached a conclusion saying having searched more than 523,000 acres over eight states, beginning in Arkansas where the compelling sightings and a few seconds of video were captured in 2005 no definitive evidence for surviving ivory-billed woodpecker population was found during the searches. So yeah, could not substantiate it unfortunately. But the reports have continued. None has reached the threshold of quality for general acceptance by ornithologists or the bird watching public. And in 2021 the US Fish and Wildlife Service opened for public comment a proposal to declare the species extinct. And the US Fish and Wildlife they're proposing removing the bird from the List of Endangered Species and that report or that decision is expected later this year. Yeah, it's technically still there but they're supposed to make a decision later this year which my guess is they'll probably make it officially extinct at that point. At least by their measures. However don't don't don't close the door immediately because a recent study published last month in the Journal of Ecology and Evolution suggests that multiple lines of evidence suggest the persistence of the ivory-billed woodpecker in Louisiana. And that's that's the title of the actual paper in fact. Present evidence suggest the presence of the ivory-billed woodpecker at this study site based on a variety of data collected over a 10 year search period. 2012 through 2022. These data are drawn from visual observations. Roughly 70,000 hours of recordings. These are acoustic recordings. 472,500 camera hours by camcorders or recorders captured by 34 trail cameras. And over a thousand hours of video drawn from drone flights. Over 3200 drone flights.
'''B:''' Cool man.
'''E:''' Here was the-
'''B:''' Drone flights?
'''E:''' Yeah.
'''B:''' That's the best man. What's the best evidence?
'''E:''' Yeah what is the best evidence? Here's their conclusion. They say using these multiple lines of evidence the data suggests intermittent but repeated presence of multiple individual birds with field marks and behaviors consistent with those of the ivory-billed woodpecker. Data indicate repeated reuse of foraging sites and core habitat. The findings and the inferences drawn from them suggest that not all is lost for the ivory-billed woodpecker and that it's clearly premature for the species to be declared extinct.
'''S:''' The thing is if we had evidence of an ivory-billed woodpecker we wouldn't need multiple lines of evidence. We would need one piece of evidence. You would need one clear photograph. That's all you would need.
'''B:''' That's like low-grade pseudo science.
'''E:''' Yeah.
'''S:''' Well I think it's again falling into that pattern of the ambiguity is the phenomenon. The fact that all of this, it's all the evidence that's right at the limit of our detection in terms of being able to distinguish a pileated woodpecker from an ivory-billed woodpecker. So after all of those hours and all of they had one solid piece of evidence. That's the only thing that we would be seeing. But they don't have that.
'''B:''' One good video, one clear close-ups video would do it.
'''E:''' I know and unfortunately they're blurry images and things.
'''S:''' Or they're just too far away.
'''B:''' Blobsquatch.
'''S:''' So I looked at one of the videos that's on this article and it shows a pretty good video of a woodpecker flying and then landing on the side of a tree. But it's at that distance where you could tell yeah it's definitely either a pileated or an ivory-billed but you can't tell between the two of them. And I'm not seeing the like clear markings of a ivory-billed. Or you're not getting a good enough view of the bill itself which is like a very distinguishing feature from a pileated. And you have to wonder why that's the evidence that we're seeing. Now I'm a part-time amateur birter who occasionally picks up a camera if I think I'm gonna see birds. I have perfect close-up full-frame pictures of pileated woodpeckers.
'''E:''' There you go, right.
'''S:''' They're big birds so they're easy to get nice pictures of and they're not skittish. And they're not that fast. They don't like these little birds that are constantly flitting about. They're these big birds. They're easy to get really good pictures of. And I think the fact that we don't have a definitive picture is because they're extinct. And this edge of detection kind of evidence is just never going to cut it.
'''B:''' I'd be surprised if it weren't there that low-grade evidence. What about DNA?
'''S:''' Yeah.
'''B:''' DNA evidence? Corpses.
'''S:''' No. Yeah, that's right.
'''E:''' Can't find them.
'''B:''' The same arguments for Bigfoot. Same arguments.
'''E:''' Piece of a shell from an egg? Something?
'''S:''' The thing is when you do enough birding you realize that what's presented as this is like the type of this species there's a lot of variation. And there's regional variation. So I wonder if we're just looking at a sub-population of pileated woodpecker that's just a little bit different than the main population. And maybe it even has a little bit of blood from 100 years ago from from the ivory-billed woodpecker.
'''E:''' It's a hybrid.
'''S:''' Yeah.
'''B:''' Humans with Neanderthal blood.
'''S:''' Yeah, exactly.
'''E:''' Of all the footage they took Steve and they I didn't see this in the paper or anyone else picked up, where are the pictures of the pileated woodpeckers that these drones captured, that these cameras captured. Right? Like you said.
'''S:''' I don't know.
'''E:''' I mean isn't that part of the body of evidence is like we have all these clear pictures of the pleated woodpecker but only perhaps these possible blurry images of something resembling the ivory-billed woodpecker. And to me that that's a stark contrast and I think says a lot.
'''B:''' Yeah, right?
'''S:''' Yeah I don't know what, I don't know if they have... If that evidence includes definitive pictures of other birds we know we're not extinct. I don't know.
'''E:''' I didn't see anywhere where that was considered a part of the evidence.
'''S:''' That would be a really good point though. If that same body of evidence includes definitive pictures of pileated woodpeckers that would be a really I think fatal argument against.
'''B:''' But wouldn't it have to? Think about it.
'''S:''' I don't know. Unless it's just the nature of the where they have the-
'''B:''' If that's the nature of it then they're doing a crappy job.
'''E:''' Well-
'''S:''' I just mean because they have like camera traps and stuff like that but I had a camera trap once. I got a lot of close to pictures of a lot of birds. It just boggles the mind that they did they don't have one piece of clean evidence.
'''E:''' Yeah.
'''S:''' Unfortunately because I would love for the thing to so exist.
'''E:''' Yeah. It would be would be quite the story.
'''B:''' They're dead. Steve, they're dead.
'''E:''' The bird is dead.
'''S:''' All right, thanks.
'''E:''' If Woody have had gone right to the police this would never have happened. Thank you.
'''S:''' All right thanks Evan.


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== Who's That Noisy? <small>(54:55)</small> ==
== Who's That Noisy? <small>(54:55)</small> ==
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SGU Episode 936
June 17th 2023
936 Ivory-billed Woodpecker.jpg

The Ivory-billed woodpecker isn’t extinct (again!) [1]

SGU 935                      SGU 937

Skeptical Rogues
S: Steven Novella

B: Bob Novella

C: Cara Santa Maria

J: Jay Novella

E: Evan Bernstein

Guest

KJ: David Kyle Johnson,
professor of philosophy

Quote of the Week

All photographs are memento mori. To take a photograph is to participate in another person's mortality, vulnerability, mutability. Precisely by slicing out this moment and freezing it, all photographs testify to time's relentless melt.

Susan Sontag, American writer

Links
Download Podcast
Show Notes
Forum Discussion

Introduction, In Memoriam: Bruce Press, preparing for death

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 Thursday, June 15th, 2023, 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.

S: How is everyone doing this evening?

C: All right.

E: Not bad. Still light out in its quarter of nine.

S: Yeah I know we're getting to the longest day of the year.

C: Wait it's still light out for you guys?

S: Yeah.

E: I mean it must be for you as well.

C: No. Pitch black out.

S: It's getting a little, it's starting to get dark.

C: No it's hitch black for me. It must be a latitude thing.

S: Maybe.

C: Because we are at the same time zone that's fascinating.

E: It's a little further. You're a little further east than we are I suppose.

C: Do you, no, I think it's because I'm farther south no?

E: Is it south? I though that was an east west thing. Not an north south.

C: Time zones are east west.

S: Yeah but if you're a farther south you should have more light.

C: In the summer I should have. Oh you're right I should have more light in the summer less light in the winter. You're right. So why the f*** is it dark here? Maybe I am farther.

E: I mean it's not blazing sun out but you know I can still.

C: No but for me it's dark dark. I see city lights.

B: But there's photons.

S: We still have like a little glow after the sun. The sun dips below the horizon but the sky is still light you know.

E: I love this time of year.

S: Yeah me too. That's gorgeous. Unfortunately we do need to start this show with a little bit of sad news. Our very good friend Bruce Press died this week. So we knew he was sick. He had pancreatic cancer. He learned about it not too long ago. This is honestly faster than we thought. We were I think hoping he would make it to the end of the year. But the disease just the chemo didn't work out. Progress very quickly as liver failed. He was in the hospital for a week and unfortunately he succumbed very quickly. But just want everyone to know who Bruce Press was. First of all totally awesome guy. One of the just awesome people that we met in the skeptical community.

B: Oh my god, right?

S: Yeah. He was a professional photographer and we first met him at a lot of the live events where he would do a lot of photography with Tim and other events. And just so close friend of our other close friend George Hrabb and just became part of our circle. And the thing I just wanted to point out is that we had dinner with him not too long ago. And this is obviously he knew what his prognosis was. And I was struck I'm sure you guys were too by just how totally he had a shit together. So here he is staring down.

B: Oh my god.

S: His own mortality.

B: What an attitude.

S: Yeah and he had like this and he said to his skepticism really is helping him deal with this. He's not having to deal with any kind of bullshit supernatural stuff. It's just he was just very pragmatic and accepting and just and I hope I have my shit half as together as that if I had to face general right.

E: Especially yeah.

C: It's interesting how much I've been seeing that in my work on my dissertation working with people who are approaching death. Many of them are very secular and very skeptical and very just matter fact and they have high mortality salience. And there's something really humbling about talking to them about their intentions and their experience. I always say like dying I think is the bravest thing anybody can do because it's like the ultimate unknown.

S: Right.

C: And so when you see somebody go into it with such bravery wow it's I don't know it's humbling.

J: I think it needs to be said that we've met so many people throughout the years making this podcast all the live performances that we've done. Bruce was a total standout incredibly high quality person that was giving.

S: A classy guy.

J: Yeah he was so generous with his time and patience and that's who long ago we did a show in Bethlehem and he showed up to take pictures and Ian and I were setting up our game show set which we've never done before. It took us hours. For no reason Bruce just made it his project and helped me through that whole process. That's the kind of guy he was like he would just fill, he saw a need you can tell that I was stressing out and he's like I'm going to help Jay for the next four hours.

S: Not only that he always seemed to be having a good time right like the guy always had a smile on his face it was like what was happening never seemed stressed it was always just like he was enjoying whatever we were doing.

C: Yeah absolute mention and I feel like I can see it in the photos because of course we're all tagged in so many different photos that he took over the years. And he had this way of capturing us having fun. Capturing us in the moment really in it and I think that there's something really beautiful about his ability to see people and capture them that were so lucky that we have this now this kind of memento.

S: Yeah I mean I think that I think you're right I think like he had to like in this very rational logical secular attitude towards life that was also very positive. He enjoyed life he enjoyed what everything he did. I know Jay later on life like around the same I think that his pandemic project was to get into a bread baking just like you did recently. And he got awesome at it. He bring us these like incredibly awesome loaves of bread.

B: They were delicious.

S: Yeah he just again just sunk his teeth into life in a way that I think is admirable.

C: That we could all learn from.

S: Yeah, definitely.

E: Sure.

S: Definitely.

E: No doubt about it.

S: Just one of those random tragic crappy things that happen. I remember when we heard the diagnosed like oh Bruce like the nicest guy just gets this random crappy diagnosis. That's the universe for you. All right so but we did want to remember the good things about him again he was just a great person to to meet through what we do. We were lucky to be friends with them with real definitely gonna miss him. Sorry to see him go. But we do have a full show for you. We have a great interview coming up with philosopher David Kyle Johnson and I think you're gonna find very interesting. We're gonna get started with some news items.

News Items

Schizophrenia and Auto-Immune Disease (6:09)


S: The news item that I got hit up with the most this week was the patient who had schizophrenia and then it was catatonic and then it was found that they actually had an autoimmune disease and when they were treated for their autoimmune disease they "woke up".

C: Doesn't that remind you so much of all of Oliver Sacks Awakenings?

S: Yeah, totally.

C: Yes. It's like the subsection of people. Yeah, anyway.

S: But the reporting on it is I think misses the real story because they're focusing on the wrong things. And so the narrative that emerges in the lame press is that this person that actually it turns out that schizophrenia can be caused by autoimmune disease. And that this it was like this amazing discovery that this person who had catatonia for years just woke up when you treated them for their autoimmune disease.

C: As if that's what schizophrenia usually or even presents as.

S: I would frame it completely differently. This person it's not it doesn't turn out that autoimmune disease causes schizophrenia. This person did not have schizophrenia.

C: Exactly. Or they had a very specific subtype that was something.

S: So this gets to how we make diagnoses.

C: Yeah. Especially mental health diagnoses.

S: Especially mental health diagnosis. So schizophrenia is not a disease. It is a syndrome. And most you could say there's primary and secondary schizophrenia. I don't even think they do that.

C: No we say usually positive or negative symptoms. Yeah but what I mean is like if you have all right so I'm gonna part of this I'm coming out from a neurologist point. Whenever anyone gets a psychiatric diagnosis they refer them to a neurologist who rule out neurological causes.

C: Which is so funny because schizophrenia is partially neurological.

S: Well the thing is that there's there isn't a clean division between psychiatric and neurological. It's all brain stuff and the only real difference is what you specialize in treating. It's a psychiatrist specialize in treating disorders of mood, thought and behavior. And neurologists specialize in pretty much everything else that the brain does.

C: Cognition movements.

S: Exactly. Seizures and blah blah blah. And but but it's all brain stuff and we know it that's why there's the American board of psychiatry and neurology. It's the same board certifies both the neurologists and psychiatrists. And 20% of my neurologic boards was psychiatry and vice versa because we know that there's massive overlap. It's the same thing. But what so what is a psychiatric illness then? So it is one where there isn't a secondary cause. So if you have a brain tumor that causes a schizophrenia syndrome you don't have schizophrenia. You have a brain tumor.

C: Yeah literally everything in the DSM has a qualifier that says it's not better-

S: Right you can have a biology. So the way to look at it is that yeah it's gets a I mean psychiatric illness is when you have a disorder something. The brain isn't working in in an optimal way causing psychiatric like symptoms without demonstrable pathology because the the way the brain functions its function is determined biochemically, by the the networks and the wiring and all that sort of stuff, so you can have disorders of brain function without biological pathology. And so neurologists tend to deal with pathology of the brain and psychiatrists deal with the wetwere. Basically the bad wiring of the brain in the absence of pathology. Although even that split isn't clean because there's exceptions all over the place.

C: Schizophrenia is one of the lovely exceptions because there is clearly an organic thing going there.

S: Yeah but I think a lot of I thought of the big ones, I think anxiety has organic causes you can have organic depression.

C: They do. But you can't usually look at let's say an MRI of some of a person with anxieties brain and know they have anxiety. You can look at a schizophrenic brain.

S: You're right. I agree-

B: That could change though.

S That will change.

C: It will change when we have better resolution.

S: It's one of the more obvious biological psychiatric-

C: Yes that's a good way to put it.

S: I agree with that.

C: There are things like vascular depression, schizophrenia. There are a handful of psychiatric conditions that are more obviously organic. But that's only just because we're better at understanding.

S: Exactly. Well let me get back to the the core point was. From a practical point of view clinically if you have somebody who presents with a schizophrenia-like syndrome you have to rule out pathological disease and then you're left with schizophrenia as a diagnosis of exclusion. And so-

C: From a neurological perspective.

S: Yes it is. Practically from a clinical perspective it's like, for anything. If somebody has anxiety you rule out thyroid disease. It's the same thing. If there is some underlying non psychiatric pathology that's driving the alleged psychiatric illness and in the absence of that you're left with a psychiatric diagnosis. It is by definition a diagnosis of exclusion. When you have the positive features that meet that diagnostic criteria. So in fact I had a case that was very similar to this in that a patient was admitted to psychiatry while I was on the inpatient neurology service with a 20-year history of schizophrenia. And the family brought them in because they were getting worse and they couldn't take care of them at home anymore. And this patient was basically lost to medical follow-up for 20 years. The psychiatry unit admitted them with a decompensating schizophrenia diagnosis. They consulted neurology sit just for this like this person really hasn't had medical care in a while can you just make sure there's nothing neurological going on. It's like I know I'm sorry to bother you, it's kind of a bullshit we consult but just the attending wants to make sure we're not missing something. So then we review the case you're like yeah I you're probably not missing something. Their exam doesn't show any signs of neurological disease but let's get a CAT scan to be sure.

B: Just in case.

S: Just in case. We got a CAT scan. This guy has the front half of their brain filled with tumor. And it was a benign tumor. It was actually outside the brain. It was just pushing the frontal lobes.

B: Oh my god.

S: So the frontal lobes couldn't work creating a schizophrenia like syndrome. The neurosurgeons removed the tumor and the guy was cured. Recovered to his pre-schizofrenia baseline.

C: I mean it's great but-

B: How many years?

E: 20 years.

S: 20 years.

B: Who the hell screwed up.

S: Well in fairness the family took this guy home and took care of my home without any further medical follow-up. That was the problem. But anyway that's the same kind of serious and now you have this case of this woman who was in a catatonic state. It was thought that she had severe schizophrenia with catatonia. I don't know what kind of workup she had years ago when they first made the diagnosis.

C: Right she was older, right?

S: Yeah.

C: Catatonia was also. It was a diagnosis of exclusion. You look at the Parkinsonian post-encephalytic Parkinsonian patients and awakened things. All of them had diagnoses like catatonic schizophrenia like state.

S: Yeah right. Just placeholder diagnoses.

C: Yeah it was like I don't know what this is.

S: Not based on any demonstrable pathology or anything like that. So a psychiatrist saw this patient 20 years ago was involved with their like initial evaluation. And then is getting the presented the same case like 20 years later and it's like wait a minute is this that patient I saw 20 years ago?

B: This sounds familiar.

S: Yeah, this sound familiar. So he essentially initiated a rework up of the patient because he realized she's just been essentially warehoused for 20 years in chronic care, long-term care. They did a full workup and it turns out that she had encephalitis. She had lupus encephalitis. And they treated that. It's basically autoimmune disease her brain was inflamed. They treated it and she didn't just wake up. That's kind of- she's slowly improved over months with treatment.

C: Tons of rehab too.

S: Tons of rehab. She's significantly improved. She's still significantly impaired but she's much more functional than she was before treatment.

C: And also how much of that impairment is not having used your brain or body for 20 years.

S: Honestly it's probably a lot of it. But probably it's mostly that the brain's been inflamed for 20 years.

C: Right, and that can cause long-term damage.

S: Yeah yeah. That's probably just caused damage to the brain. So yeah it was missed 20 years ago that's just the bottom line. And this is a notoriously difficult diagnosis to make. I've had several patients with similar things. This is always the case as I like to say, this is the kind of case that gets presented on grand rounds. And when the other thing is like when when cases like this are being presented on grand rounds is a few things that's a good guess. Like the fact that this is being presented on grand rounds as a unusual case. Like there's a few things you're going to guess out of the block just as just like a chat GPT kind of statistical answer. And one of them is encephalitis. That limbic encephalitis or whatever somebody missed encephalitis.

C: Somebody who's been catatonic unresponsive in long-term care yeah. Like yes they could be schizophrenic but that's also I think what bugs me is the way that the media has presented this case. Like that is what schizophrenia looks like. And that no, that's a very small subsection of people who have the diagnosis where honestly I don't know if in time those people would still have that diagnosis. The better we get at figuring out what's really going on all of those people might, all of those people who have those presenting symptoms yeah may not end up being people with schizophrenia.

E: Sure I mean because you're basically putting them in a basket in which nothing else works. You're going to eventually learn more things and take them out.

S: Yeah we're constantly nibbling away at these kinds of scenarios where you have essentially, we don't have pathology, we don't know what you have we're going to diagnose you with this syndrome syndrome placeholder diagnosis but over time we realize oh a certain percentage of these patients actually have this disease. And another percentage have this other disease.

C: And even schizophrenia it's so like like I usually will say like psychotic disorder or thought disorder because also there are so many different things. There's schizopersonality disorder there's schizotipal, there's schizoaffective disorder. There's all these different disorders that have a psychosis component. Some are mood disorders with psychosis and some are psychosis with mood problems. And it's a whole specialty.

S: Absolutely.

C: It's not just oh yeah there's schizophrenia and all people with schizophrenia are the same because we also you mentioned but schizophrenia can have positive or negative symptoms. You can have people with schizophrenia who are paranoid delusional.

S: There was that study we talked about a few years ago were they identified five subtypes of schizophrenia.

C: Yeah I actually would need to look at and see how they're how are they slicing and dicing it today.

S: ANd there's genetic ways of slicing and dicing it now.

C: Yeah but this one is like this very very extreme case where they're so totally frozen catatonic that they're not even responsive.

S: And the other thing one final point before we move on is that because of this one of the things I learned over the years as I matured as a clinician is that when you see cases like this just give them steroids. When all else fails just empirically give them a round of IV steroids just to see if they wake up. Because you risk very little in doing that and just make sure you're not missing a case like this. Because these are notoriously hard to diagnose. The workup can be negative.

E: Why isn't that the standard then?

S: It basically is but it's like you have to identify when you're in the right clinical scenario where that's appropriate.

C: And it's only going to be the standard if you're if that person is in the hospital. If that person never makes it.

S: It's always in the context treatment when you're in the hospital.

C: Yeah they're not going to have an IV ever.

S: But sometimes I will do, I'll do like if I'm seeing somebody as an outpatient who I think might be at the beginnings of this I might give them a course of oral steroids. Like a weak pulse of steroids just to see if it dramatically helps then. It's a diagnostic therapeutic trial. Saying let me see if whatever you have is something that can respond to steroids. And sometimes the other point that I make to my residents. We get to the point where we've done all the workup and we don't know what's going on and something confusing is happening. I'm like all right, let's list all the things this could possibly be that's treatable.

C: Right. Do you workup for infection too?

S: Oh you always do that before.

E: Sounds like an episode of House.

S: Before you give the steroids you always rule out all kind of infections. The ID workup is completely negative. Whatever, you do all the things. They're not having seizures. They're not on drugs. You rule out all those things you just left with the brain cyst on fire it's just not working. Whatever's left, the list of things that we haven't ruled out that are treatable are all treatable by steroids. So let's just give them steroids and see what happens.

C: Because they're linked to inflammation.

S: Yeah it's just all that's what's left. It's just some kind of autoimmune inflammation and if they don't get better it's like okay well we could check that off list but sometimes they wake up. I've had patients who I did that too. I just gave empiric steroids and they got better because that was all that was left to do.

C: What's so interesting is that I wonder if that would have worked with Oliver Sacks patients because they used L-DOPA because it was actually a form of Parkinsonism.

S: Yeah no it would not have.

C: It might not but if it was post-encephalitic Parkinsonism so I wonder if there would have been like a little bit of an inflammation component?

S: I don't think so because they had well they had they had encephalitis lethargica.

C: Because they had encephalitis in like the twenties and then this was like in the fifties or something.

S: But what that did was it burned out their dopamine cells. And so the inflammation was gone but that cell population was destroyed. So they had acquired end stage Parkinson's disease from the infection. And so then then when you gave them to the L-DOPA they briefly woke up but that burned out whatever few neurons they had left. So it was a short window. So it's not Parkinson's disease it was Parkinsonism, secondary to a viral infection that happened to destroy that population of neurons.

C: That's what I remember. They were calling it post-encephalitic Parkinsonism.

S: Yeah, Parkinsonism not Parkinson's disease which is whatever, that has a more specific-

C: Fascinating.

B: Kind of like Parkinsons-ish.

S: Yeah well just Parkinsonism describes the syndrome. Parkinson's disease is a pathological entity.

C: Right so it's Parkinson's like symptoms.

B: Yeah like I said, ish.

S: All right let's move on.

3D Printing Glass (21:04)


S: Jay tell us about 3D printing with glass.

E: Glasses.

J: 3D printing is really starting to do some incredible stuff. I mean throughout the years just like most other things it's just getting better. Every year they keep making improvements and applying it to new and different things. So listen to this researchers at Karlsruhe Institute of Technology have come up with a new process for producing transparent quartz glass structures at lower temperatures. That might not sound impressive to you but let's dig into the details a little bit. The ability to create transparent quartz at lower temperatures opens up new applications and optics photonics and semiconductor technologies. And this is important because especially with semi conductor technologies it allows us to do a lot more with semi-conductors. And that means more power which means smaller semi-conductors, less battery power, it bleeds into a lot of things. The historical way of creating transparent quartz involves a process called sintering. And sintering is the process of forming a solid mass of material through heat and pressure without melting to the point of liquidification. Did I say that correctly?

S: Yeah we talked about sintering a number of times on the show. [link needed][v 1] I think the first time we talked about it in the context of platinum because platinum has a very high melting point but some cultures developed the ability to heat it to the point where they could sinter it. They could just make it sticky so they semi-melted so we could stick together but without liquefying it.

J: Keeping that in mind for transparent quartz silicon dioxide nanoparticles need to be at temperatures above 1100 Celsius. That's super hot.

S: That's very hot.

J: So it's way too high for a direct deposit onto a semi-conducting chip. So you couldn't take the quartz and put it onto a chip. It would it would destroy the chip. So the new process that they came up with which was led by dr. Jen's Bauer, they utilize a hybrid organic inorganic polymer resin call the name that nobody in this show could pronounce. Just forget it. I was going to leave and look it up I'm like I'm not going to bother, you're not going to remember anyway. So they have this polymer resin. The resin is 3D printed into nanostructures. So they make an architecture out of it and then they heat it to 650 degrees Celsius to remove the organic components and form a continuous quartz glass structure. So that process right there allows them to print right onto a semi-conductor chip. So they need half the temperature of conventional sintering methods. The end result is that the glass structure is high resolution. It has excellent mechanical properties and it's stable under challenging conditions.

S: Jay can I pause for a nerdy pedantic thing?

J: Yeah.

S: So you said half the temperature which all the reporting on it says the same thing. Although the mainstream reporting not the technical article. But just with temperature that kind of reference doesn't work unless you're talking about Kelvin.

J: Okay.

S: You know what I mean? Because it's not really half as hot. It's like 100 Celsius is not half as hot as 200 Celsius because it doesn't work that way. But 100 Kelvin is half as hot as 200 Kelvin.

C: Right because yeah-

S: Because it's absolute.

C: It's a lot cooler.

S: It's cooler, it's cooler but it just doesn't make any logical sense to say half the temperature unless you're dealing with kelvin because it's the absolute temperature.

E: That's a good [inaudible].

J: I didn't really know that Steve so that's a great thing to say.

E: Good reminder.

J: So anyway that was basically it. It's this new process that they came up with and it's going to make some what I think to be some significant changes and what they're going to be able to do. And think about it I mean this is 3D printing. The 3D printing process is doing this at those temperatures.

S: If you look at the pictures I mean there are 3D printing at like the nano scale, these really intricate structures. It's not just like a blob a glob of glass. It's like this these crystalline really complicated structures at the nano scale. So yeah it's one of those things where it sounds awesome and you're just wondering what they'll be able to do with it. They talked about printing directly onto circuit boards for example. And printing really tiny optics. Imagine being able to print a really tiny optics I could then go into your cell phone and you have like these incredible zoom cameras or whatever. I don't know. I don't know if that's going to be-

B: In the VR goggles.

S: Yeah. Or just even, exactly VR goggles. Holy shit I mean it even if it just reduces the cost of making them.

C: What about instead of VR goggles VR contacts?

S: Yeah, right. That's the ultimate.

B: Those bad boys.

C: Yeah.

S: All right thanks Jay.

Smoke Blocks Solar Energy (26:02)


S: All right Cara. So this is upsetting but tell us about the effect of all of this smoke from the wildfires on solar energy.

C: Yeah so if you guys remember. We record the show usually on Thursdays. So last week, last Thursday when we were recording you guys were talking about Evan, you were like packing up a lung. And snotting everywhere. And you guys were talking about how bad it's been outside. That's because it turns out that June 7th top the charts. It was the worst day of wildfire smoke on record. Yep. So fun times. And now one week later we are getting a fair amount of data from kind of the effects of that. Obviously we don't know the effects yet on health and human safety. We know it's not good. But we do know some interesting things. It was the worst wildfire smoke on record. It was a record shattering air quality disaster. And you could physically see it the skies were actually hazy. So because of that at 1 PM last Wednesday compared to this Wednesday solar farms in New England produced 60% less electricity.

E: 60% drop.

C: 60% drop. We even saw in like the midwestern states as much as a 25% drop. And that might have been in places where it wasn't even perceptible. Like maybe your weather app on your phone was telling you it's a bad air quality day be careful but you didn't see it or smell it outside. New York was hit the hardest and here's another statistic. They lost over 1400 megawatts in solar energy between June 6th and June 7th and a 24 hour period. And I know we talk about this all the time and when we talk about it might years go I don't know what that means so for scale this verge article compared that. A single megawatt is about enough to power between 800 and a thousand homes. And they lost almost 1500 megawatts in one day because of the smoke.

S: Yeah.

C: There was like they do mention that there was a weird kind of positive benefit that it didn't net it out to zero but it sort of offset the burden of lowered production which is that the actual blockage of the sun made it cooler outside. And so people didn't have to crank their ACs up as much. But they couldn't, yeah, so but it didn't offset how little energy was produced. And ultimately it's very hard to predict these kinds of things with any fidelity. And so being able to calculate and predict energy demands during a wild fire season is now going to be very very difficult for these grid managers and for production. Now New York is probably not a place where the bulk of the energy production does come from solar. California's grid it's something, it's much higher. It's like 15%. Almost 15% of California's energy comes from solar. Across the country it's only about 3.5%. This thing that happened in New York is really salient or in New England is really salient right now because we just experienced it. But of course as you guys heard me say last week like welcome to our world on the west coast. We have seen like really bad wildfires in the past. And like for example there is a bad wildfire season in September '22. It cut solar power generation in California by 30% which was pretty crippling to the energy supply because again 15% of all power comes from solar there. And then we also saw that that year was a record year for blackouts. And now let's talk about something else that happens on top of this. When grid managers or production companies know that wildfires are afoot they will sometimes have to cut power because of the risk of fire. When the conditions are good for wildfire we've seen these like transformers and these large generators sparking. This has been the cause of a lot of some of the worst wildfires on the west coast has been old equipment that hasn't been well managed. And so you've got this added burden of now it's wildfire season, the wildfires themselves could potentially screw up our power production from solar but also even before it gets to that point we might need to cut power because we don't want to cause a fire.

S: Yeah. Cara, do you know what what percentage of wildfires in America are caused by human negligence?

C: Probably a lot of them. And wait, are we we're not counting just climate change being a function of human negligence, right?

S: No no.

C: We're actually like direct causes?

S: Direct cause. Like not lightning.

C: You're talking a flip cigarette bud, a camp fire or even are we also talking about the-

E: Probably not control burns.

C: Not control burns. But are we also talking about these power-

S: I don't know to be honest with you. It wasn't what explicitly listed or excluded.

C: It if includes that I'd say it's probably like half.

S: 80%. 80%. But the good news is that means we could prevent four out of five four fires just by not doing stupid stuff.

E: Smokey the bear was right. 50 years ago.

C: Smokey the bear was telling us to do that.

E: I mean, come on, since I was a kid.

C: So the good news is thiis is one of those tough things where it's like the good news is that theoretically in the bad news is we already knew that and still haven't made the change.

S: Right but there's, a lot could be handled with education. People don't realize that just if you're dragging your muffler or behind your car like that those sparks could set off as forest fire or shooting rifles and guns. Those sparks can set off fires as well.

C: Or doing a gender reveal party.

S: During gender reveal parties. Lighting those floating lanterns not knowing we they come down.

C: That's so sad though because-

E: Firework season is right now. It's happening everywhere.

C: I don't think it's that people don't realize I think it's that they don't care. I think you're right there's a certain percentage of people who don't realize but a larger percentage of people don't care.

S: They may be underestimating the risk. And they may be underestimating how significant it, like I think-

C: I love your endless optimism Steve.

S: I know like the Caldor Fire was caused by a father and a son who were just riding an ATV. All-terrain vehicle. ATV around. That was it.

C: Yeah I mean it's this really complex scenario that we're seeing where human behavior is causing these terrible wildfire. And we know that wildfires are natural and there is a healthy way for forest to burn they need to burn we do prescribe burns, it's a part of forest ecology. But the the quantity and the devastation of wildfires recently is clearly indicative of changes to the climate. So you've got these climate change either induced or exacerbated wildfires that as you just mentioned are often caused by more direct human behavior that now have this downstream negative effect of actually intervening. Screwing with the attempts that we have to circumvent or at least to mitigate climate change.

S: And it's kind of the feedback because the more climate change, the more wildfires, the less well are solar panels work.

C: Solar panels work.

S: And not only that Cara. I sent you, I pointed out to you when we were prepping for this-

C: Yes! Oh yes you did.

S: That the increased temperatures caused more droughts which means they have to shut off a lot of the hydroelectric plants too. So it's like we're burning coal to replace the electricity we can't produce because the climate change which is worsening climate change.

C: It's so, this negative feedback loop-

E: And the problem perpetuates.

C: And then you add geopolitical conflict to it and my head explodes. I just read an article the other day we won't get into this but about how we need I think a certain amount of these basic materials. Like uranium or something in order to do our, in order to make our nuclear power plants run and we rely on like a huge amount of that from Russia.

S: Yeah.

C: And it's like oh jeez, really? So it's complicated.

S: We need to develop other sources of the uranium.

C: Yes yes.

S: And the other thing is we often talk about like what was the cause of the the fire. And it's always multiple things at the same time. They're not mutually exclusive. So global warming makes it more likely to happen but there's often a trigger like human error, sometimes natural. Bt also it's bad forest management and this is-

C: Oh, it's a huge problem.

S: Yeah Canada has not especially in the east where these fires are coming from were not doing a good job of forest management. They didn't didn't have the resources, they didn't put the resources into it. You can't have a bunch of trees laying around drying in the in the warm sun and creating a bunch of fuel for these fires.

C: They may not have needed the same kind of forest management that they need now because of climate change and that's the other thing. Climate change is like you said at the beginning, these warmer temperatures are causing it combined with this combined with this but it's also exacerbating it. Not only are there more, they're also hotter and larger and harder to put out.

S: Right.

E: And they're happening in at times of the year which they're not used to.

C: Yes, exactly.

E: They say this was particularly early in the year to have the fires.

S: Fire seasons are growing and now it's just all year round in some places now. It's not even a fire season anymore.

C: So our old methodologies which weren't perfect even then even though, we know a lot about forest management we just don't always practice what we preach, might not be optimized anymore because the conditions have changed so rapidly.

S: Alright thanks Cara.

Retooling Ribosome Translation (35:48)


S: Bob tell us about retooling ribosome translation. That requires some backstory.

B: Yeah this this was pretty pretty cool. Scientists have made recent progress in this fascinating goal of programming cells or specifically ribosomes to create proteins that have never been made before in the history of the earth. So why are they doing that? What could it mean to humanity and especially of course what could it mean to me? So this is from the journal Nature Chemistry and ACS Central Science and these chemists were centered around University of California Berkeley. Okay so this news item is all about complex cellular nano machine known as ribosomes. So let's go over what a ribosome is before we do anything else. Now ribosomes exist within cells. They're essentially nano machines for making one of the most critical and versatile molecules of life - proteins. Did you know that the word protein is from a Greek word that means of utmost importance? I did not know that.

C: I didn't know that.

E: I didn't know that

B: So think of a mammal cell. Jay, I think you're a mammal. Well technically anyway. Each of your cells have about 10 million ribosomes. I had no idea. 10 million? I figured you got one big ribosome and you're good. No.

C: No, they're all over.

B: Million like-

C: And they're on the rough endoplasmic reticulum baby.

B: Yeah they're all over. They're in the core, they're in the outskirts are all over.

C: I love the core in the outskirts. This is how I want to start talking about cells.

B: I think it's called nucleos. I think it's the nucleosome in the interior and then by the cell wall. Because where the proteins are created actually determines where they're going to be used. I didn't know this either, this ribosomes got two subunits and they wrap around. They each wrap around the recipe that's in the messenger RNA and they start stringing together these amino acids. And once the string is done then the amino acids fold into any one of the the critical proteins that the organism needs as that's trying to create there. Now proteins of course are amazingly versatile. Surprisingly versatile. They can be purely structural molecules. They can be just protective. They can be used to transport. They could be storage. Proteins can be membranes, enzymes, even toxins. Most of what cells do essentially involve proteins in one way or the other. Pretty much all about proteins in a really important way. Now with all this versatility ribosomes though are still surprisingly limited in a way. The ribosomes can only choose among about 20 of the canonical so-called alpha amino acids. About 20, technically it's kind of- the amount of amino acids available can be 22 but that's as to you know we don't need to go that detailed. It's about 20 alpha amino acids that are used and that's all because of what? Contingencies of evolution, right? That's what evolution has made available to them, to the ribosomes. So why? Why is it just those 20 or so amino acids? Because there are a lot more that are not just not used and it's been described as a frozen accident in history. And it really is. It's hard to say precisely why this it's just those 20 but scientists generally think that the magic 20 are linked to a couple things like the frequency in meteorites. If you look at meteorites you're going to see those amino acids more than than other ones. And also that experiments that were done in the prebiotic soup billions of years ago. So based on the different kind of experiments that were done that long ago that kind of also makes sense that that's why it's those 20 that have been used.

C: Also isn't it just kind of a principle of biology conserving? It's like if these 20 are good enough. Why need more?

S: It's partly that. Also there's, we need the genetics to control the amino acids and we have the trinucleotide system. So would we need to go to four if if we had more amino acids that we had to code for?

B: Right.

C: Right.

S: But it is, it's like it's like somebody who's famous for being famous. This is the system we have because this is the system we have. At some point it gets locked in.

C: Exactly.

B: Yeah, right.

C: Yeah, it's what worked and then we didn't feel the need to improve it.

B: Yeah and I read one comment somebody was saying that if you reset evolution that there probably would be 75% of the ones that are used now would probably still be used. But there still would be a 25% variation potentially. And that's assuming all things were essentially the same as as they were. But how many proteins are possible if you thought of that. What's like the total space of possible proteins.

E: Viable proteis?

B: 20. No. Possible proteins.

E: Possible.

B: [inaudible] puts it at 20 to 50,000.

C: Yeah.

B: That's a big number. But that's kind of like the total space. That's just the outer limits. More realistically if you assume say approach a typical protein length of say 300 amino acids which is reasonable. Then those 20 amino acids can conceivably be arranged to 10390 different proteins. Still a gargantuan. If you made a molecule-

E: 10390? It wouldn't fit in the universe.

B: You're right. There's not enough atoms to create an example of each one of those. So that's an amazingly high number. But you can get even more even more realistic than that only about one in a billion of those are actually stable and usable. Any of the other ones that were not stable, they would not have lasted long. They would not have been passed down and that's why we're not seeing a lot of those unstable ones of course. Now far fewer than those have actually been created on the earth. Humans use about 20,000 distinct proteins. Estimates vary but 20,000 is the number I see most often. 20 to 25,000.

E: Is that true with most mammals? Are they around that number you think?

S: No, there's huge differences.

B: Even more variable though was the entire earth's proteome. One number that seemed hopefully maybe more reliable than others. Maybe 10 million unique proteins potentially. Some have much higher numbers and that but 10 million seems reasonable. What if we can create proteins using that much wider palette of amino acids. What can we do? Is it worthwhile to use far more than the 20 alpha amino acids that are available to biology on earth. So that is what these chemists from the National Science Foundation Center for Genetically Encoded Materials. C-GEM, it's called C-GEM. That's what they've been working on. They want to retool the cells polypeptide manufacturing plant as they put it, the ribosome, to make what nature cannot make. Now the the crux of this latest new item is the fact that three separate papers have been published recently covering significant advances in this field. One paper dealt with how to reprogram cells so that ribosomes can handle these different building blocks that I've been talking about. The second paper talked about how to predict which building blocks make the best substrates. That's important to know which ones are worthwhile pursuing in terms of the substrate. The third paper dealt with how to change ribosomes to actually use these new building blocks and make them into polymers. Now sure they haven't solved these problems but they've made some significant strides in these three key areas to achieve these goals. Now speaking of goals, their ultimate goal here the scientists say is to be able to make this new system fully programmable as they put it. So that the new mRNA instructions and the new building blocks can be made available to the cell so that it could then essentially make an unlimited variety of new molecular chains. Things that have never been seen before. These can be made into new biomaterials. They could be made into new enzymes, new drugs. Maybe even, Jay, maybe even new and revolutionary types of meatballs. You never know. So see the C-GEM director Alana Sheppard was a distinguished chair and chemistry professor of molecular and cell biology at UC Berkeley. She said C-GEM was working to biosynthesize molecules that have never before been made in a cell. That are designed to have unique properties. The tools could be applied broadly by polymer chemists medicinal chemists and biomaterial scientists to generate bespoke materials with new functions. Now these novel polymers could have specific applications that have been specifically designed or they could be created just to see what was created and what new applications could be there that have never been imagined before. They offer a couple of examples. One was creating new compounds to deal with antibiotic resistance which of course is hugely popular especially with the potentially new era of antibiotic resistance in the future would be devastating. Oh my god. So another possibility that they discussed involves synthesizing a protein-like polymer that's a mixture of spider silk and nylon. Think about that. Mixing spider silk and nylon. Microbes could then make an essentially infinite variety of these. Each they say. Maybe near infinite. Not technically infinite. But each compound would be new to chemists and with never before seeing properties. I mean what would you even call a mix of silk and nylon. Maybe a sylon?

E: Absolutely.

B: Maybe that wouldn't be a good portmanteau. But very cool stuff. I'll be tracking this. This is one of those advances in synthetic biology that I think is just has such an amazing potential. It would be a major game changer. Talk about potentially disruptive new technology. Fascinating stuff.

S: All right, thanks Bob.

Ivory-billed Woodpecker (Again) (45:48)


S: Evan.

E: Yep.

S: The ivory-billed woodpecker is back. Or at least discussions about the ivory-billed woodpecker.

E: Yes.

S: Maybe not the woodpecker itself.

E: Steve have you ever seen an ivory-billed woodpecker?

S: Nope. I've seen pileated woodpeckers.

E: Now is that page even in a bird book? In other words does a bird book have all the birds in it and then you check them as you see them? Is that how that works?

S: There are but no one book has every single bird in it. It's usually just a subset. It may be a regional or birds of North America. But even then there's like there's a lot of birds. But yes, some do have a lifeless checklist for you where you could check birds off. Yeah, sure. Those exist. But not all bird books have that necessarily.

E: Well you might have been able to check this particular one off if you lived in the southeastern United States or Cuba. Maybe about 80 or 90 years ago. Which is about the last time perhaps there was an official sighting of the ivory-billed woodpecker. The bird itself, it averages 20 inches from beak to tail. It was the largest of the woodpeckers north of Mexico and third largest in the world. And of course it is no longer around. At least we believe because of the destruction of its habitat. Severe population declines and the 1800s almost wiped them out. Only a small number survived in the 20th century. And again it's believed to have gone extinct in the middle of the 20th century when one of the last official reported sightings was made in 1944. But do you guys remember back in 2004? I recall this was a big news at the time.

S: Oh yeah.

E: Bird was reportedly rediscovered in Arkansas.

B: Yeah. People went crazy.

E: Yeah. That led to a multi-year search effort for the elusive ivory-billed woodpecker. However the Cornell laboratory of ornithology, which was involved in that search for the bird reached a conclusion saying having searched more than 523,000 acres over eight states, beginning in Arkansas where the compelling sightings and a few seconds of video were captured in 2005 no definitive evidence for surviving ivory-billed woodpecker population was found during the searches. So yeah, could not substantiate it unfortunately. But the reports have continued. None has reached the threshold of quality for general acceptance by ornithologists or the bird watching public. And in 2021 the US Fish and Wildlife Service opened for public comment a proposal to declare the species extinct. And the US Fish and Wildlife they're proposing removing the bird from the List of Endangered Species and that report or that decision is expected later this year. Yeah, it's technically still there but they're supposed to make a decision later this year which my guess is they'll probably make it officially extinct at that point. At least by their measures. However don't don't don't close the door immediately because a recent study published last month in the Journal of Ecology and Evolution suggests that multiple lines of evidence suggest the persistence of the ivory-billed woodpecker in Louisiana. And that's that's the title of the actual paper in fact. Present evidence suggest the presence of the ivory-billed woodpecker at this study site based on a variety of data collected over a 10 year search period. 2012 through 2022. These data are drawn from visual observations. Roughly 70,000 hours of recordings. These are acoustic recordings. 472,500 camera hours by camcorders or recorders captured by 34 trail cameras. And over a thousand hours of video drawn from drone flights. Over 3200 drone flights.

B: Cool man.

E: Here was the-

B: Drone flights?

E: Yeah.

B: That's the best man. What's the best evidence?

E: Yeah what is the best evidence? Here's their conclusion. They say using these multiple lines of evidence the data suggests intermittent but repeated presence of multiple individual birds with field marks and behaviors consistent with those of the ivory-billed woodpecker. Data indicate repeated reuse of foraging sites and core habitat. The findings and the inferences drawn from them suggest that not all is lost for the ivory-billed woodpecker and that it's clearly premature for the species to be declared extinct.

S: The thing is if we had evidence of an ivory-billed woodpecker we wouldn't need multiple lines of evidence. We would need one piece of evidence. You would need one clear photograph. That's all you would need.

B: That's like low-grade pseudo science.

E: Yeah.

S: Well I think it's again falling into that pattern of the ambiguity is the phenomenon. The fact that all of this, it's all the evidence that's right at the limit of our detection in terms of being able to distinguish a pileated woodpecker from an ivory-billed woodpecker. So after all of those hours and all of they had one solid piece of evidence. That's the only thing that we would be seeing. But they don't have that.

B: One good video, one clear close-ups video would do it.

E: I know and unfortunately they're blurry images and things.

S: Or they're just too far away.

B: Blobsquatch.

S: So I looked at one of the videos that's on this article and it shows a pretty good video of a woodpecker flying and then landing on the side of a tree. But it's at that distance where you could tell yeah it's definitely either a pileated or an ivory-billed but you can't tell between the two of them. And I'm not seeing the like clear markings of a ivory-billed. Or you're not getting a good enough view of the bill itself which is like a very distinguishing feature from a pileated. And you have to wonder why that's the evidence that we're seeing. Now I'm a part-time amateur birter who occasionally picks up a camera if I think I'm gonna see birds. I have perfect close-up full-frame pictures of pileated woodpeckers.

E: There you go, right.

S: They're big birds so they're easy to get nice pictures of and they're not skittish. And they're not that fast. They don't like these little birds that are constantly flitting about. They're these big birds. They're easy to get really good pictures of. And I think the fact that we don't have a definitive picture is because they're extinct. And this edge of detection kind of evidence is just never going to cut it.

B: I'd be surprised if it weren't there that low-grade evidence. What about DNA?

S: Yeah.

B: DNA evidence? Corpses.

S: No. Yeah, that's right.

E: Can't find them.

B: The same arguments for Bigfoot. Same arguments.

E: Piece of a shell from an egg? Something?

S: The thing is when you do enough birding you realize that what's presented as this is like the type of this species there's a lot of variation. And there's regional variation. So I wonder if we're just looking at a sub-population of pileated woodpecker that's just a little bit different than the main population. And maybe it even has a little bit of blood from 100 years ago from from the ivory-billed woodpecker.

E: It's a hybrid.

S: Yeah.

B: Humans with Neanderthal blood.

S: Yeah, exactly.

E: Of all the footage they took Steve and they I didn't see this in the paper or anyone else picked up, where are the pictures of the pileated woodpeckers that these drones captured, that these cameras captured. Right? Like you said.

S: I don't know.

E: I mean isn't that part of the body of evidence is like we have all these clear pictures of the pleated woodpecker but only perhaps these possible blurry images of something resembling the ivory-billed woodpecker. And to me that that's a stark contrast and I think says a lot.

B: Yeah, right?

S: Yeah I don't know what, I don't know if they have... If that evidence includes definitive pictures of other birds we know we're not extinct. I don't know.

E: I didn't see anywhere where that was considered a part of the evidence.

S: That would be a really good point though. If that same body of evidence includes definitive pictures of pileated woodpeckers that would be a really I think fatal argument against.

B: But wouldn't it have to? Think about it.

S: I don't know. Unless it's just the nature of the where they have the-

B: If that's the nature of it then they're doing a crappy job.

E: Well-

S: I just mean because they have like camera traps and stuff like that but I had a camera trap once. I got a lot of close to pictures of a lot of birds. It just boggles the mind that they did they don't have one piece of clean evidence.

E: Yeah.

S: Unfortunately because I would love for the thing to so exist.

E: Yeah. It would be would be quite the story.

B: They're dead. Steve, they're dead.

E: The bird is dead.

S: All right, thanks.

E: If Woody have had gone right to the police this would never have happened. Thank you.

S: All right thanks Evan.

Who's That Noisy? (54:55)

New Noisy (58:42)

[animal chitting/cackling laugh sounds]

J: ... Well you're just going to have to wait, just have to wait until next week.

Announcements (59:28)

Questions/Emails/Corrections/Follow-ups (1:00:42)

Question #1: UFO Sighting

Been listening since 2006ish, love you guys. Had feet in hot tub with wife and we noticed a string of lights in the sky. Immediately joked it was a UFO but it was something I've never seen in 13 years in Ocean View, Norfolk [Virginia, USA]. To me it reminded me of the speed of a slow plane pulling a sign message. Not sure how how to get images but it would be awesome to share. If you debunk I'll sign up to patreon!

Very respectfully, Andrew Albertson, Norfolk, VA, USA
[top]                        

Interview with David Kyle Johnson (1:04:14)

S: Joining us now is Dr. David Kyle Johnson. David, welcome back to the Skeptics' Guide.

KJ:

The Evolution argument (1:29:16)

[top]                        

Science or Fiction (1:40:17)

Item #1: A new study finds that human redistribution of fresh water has caused the Earth's rotational pole to drift 78.48 cm between 1993 and 2010.[6]
Item #2: A recent analysis of the Geminids meteoroid stream indicates that it likely originated from the Moon.[7]
Item #3: Scientists have developed a wireless muometric navigation system that uses muons from cosmic rays as their reference and can work even deep underground.[8]

Answer Item
Fiction Geminids from the Moon
Science Redistribution of water
Science
Muometric navigation
Host Result
Steve win
Rogue Guess
Bob
Geminids from the Moon
Cara
Geminids from the Moon
Jay
Redistribution of water
Evan
Geminids from the Moon

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

Bob's Response

Cara's Response

Jay's Response

Evan's Response

Steve Explains Item #3

Steve Explains Item #2

Steve Explains Item #1

Skeptical Quote of the Week (1:59:13)


All photographs are memento mori. To take a photograph is to participate in another person's mortality, vulnerability, mutability. Precisely by slicing out this moment and freezing it, all photographs testify to time's relentless melt.

 – Susan Sontag (1933-2004), American writer, philosopher, and political activist 


Signoff

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[9]
  • Fact/Description
  • Fact/Description

References

Vocabulary

  1. Wiktionary: sintering A process in which the particles of a powder are welded together by pressure and heating to a temperature below its melting point.
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