Houston Chronicle

News and notes about science

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It’s impossible to say that any particular scientific developmen­t was the most important in a given year. But if forced to choose some highlights, the New York Times would opt for these unforgetta­ble events and findings.

A TIDE OF OPIOID-DEPENDENT NEWBORNS FORCES DOCTORS TO RETHINK TREATMENT

RICHMOND, Ky. — From 2003-2012, the last year for which statistics are available, the number of babies born dependent on drugs grew nearly fivefold in the United States. Opioids are the main culprit, and states like Kentucky are particular­ly hard-hit: 15 of every 1,000 infants here are born dependent on opioids.

Babies with the worst withdrawal symptoms are routinely separated from their mothers and whisked by ambulance, at great expense, to hospitals hours away.

Urban medical centers nationwide are scrambling to expand neonatal intensive care units or to build separate facilities to accommodat­e a tide of opioid-exposed babies arriving from rural communitie­s.

The result, many experts say, is an exercise in good intentions gone awry.

After their babies are moved, many new mothers, poor and still struggling with addiction, cannot find transporta­tion or the resources to visit.

Moreover, a growing body of evidence suggests that what these babies need is what has been taken away: a mother.

Separating newborns in withdrawal can slow the infants’ recovery, studies show, and undermine a fragile parenting relationsh­ip. When mothers are close at hand, infants in withdrawal require less medication and fewer costly days in intensive care.

“Mom is a powerful treatment,” said Dr. Matthew Grossman, a pediatric hospitalis­t at Yale-New Haven Children’s Hospital who has studied the care of opioid-dependent babies.

The standard treatment is to drip tiny doses of morphine into the mouth with a syringe to make the newborn comfortabl­e enough to eat and sleep. Then, over two to 12 weeks, the infant is weaned off morphine.

But community hospitals in rural areas rarely have neonatal intensive care units in which staff can administer morphine. So infants in withdrawal are transferre­d to more sophistica­ted facilities.

Increasing­ly, experts fear that babies are being removed from mothers they need so they can get morphine they do not need. Now some researcher­s are urging hospitals to pursue a new strategy.

The strategy is called “rooming in.” In an experiment at Children’s Hospital at Dartmouth-Hitchcock in Lebanon, New Hampshire, for example, mothers and opioid-dependent newborns stayed together in the hospital, but outside the bustling NICU.

Rooming-in reduced the length of stay for morphine-treated infants to 12 days from nearly 17, and the average hospital costs per infant to $9,000 from roughly $20,000, according to a study published last year in the journal Pediatrics. Catherine Saint Louis

TO MENDA BIRTH DEFECT, SURGEONS OPERATE ON THE PATIENT WITHIN THE PATIENT

HOUSTON — The patient, still inside his mother’s womb, came into focus on flat screens in a darkened operating room. Fingers, toes, the soles of his feet — all exquisite, all perfectly formed.

But not so his lower back. Smooth skin gave way to an opening that should not have been there, a bare oval exposing a white rim of bone and the nerves of the spinal cord.

“All right, it’s the real deal,” said Dr. Michael A. Belfort, chairman of obstetrics and gynecology at Baylor College of Medicine and obstetrici­an and gynecologi­st-in-chief of Texas Children’s Hospital.

The fetus, 24 weeks and 2 days old, less than 2 pounds, was about to have surgery. He had a severe form of spina bifida, in which the backbone and spinal cord do not develop properly. Children born with this condition usually cannot walk, and suffer from fluid buildup in the brain, lack of bladder control and other complicati­ons.

A pediatric neurosurge­on, Dr. William Whitehead, joined Belfort at the operating table. Doctors have been performing fetal surgery to repair spina bifida since the 1990s; it is not a cure, but can lessen the degree of disability.

But now Belfort and Whitehead are testing a new, experiment­al technique — one that some in the field are eager to learn, but that others regard warily, questionin­g its long-term safety for the fetus.

The surgeons had made a wide incision in the mother’s lower abdomen, gently lifted out her uterus — still attached internally — and made two tiny, 4-millimeter slits. In one, they inserted a “fetoscope,” a small telescope fitted with a camera, light and grasping tool. The second slit was for other miniature instrument­s.

Lit from within, the uterus glowed, red and magical in the darkened room.

Spina bifida occurs early, at three to four weeks of pregnancy, when the tissue forming the spinal column should fold into a tube but does not close properly. There are 1,500 to 2,000 cases a year in the United States.

The causes are not fully understood, but in some cases a deficiency in the B-vitamin folic acid plays a role.

Spina bifida is generally not fatal, so the standard practice was to operate after birth. But the results of postnatal surgery were mixed: Most children could not walk and had other problems.

Doctors began to suspect that outcomes might be better if they could fix the defect before birth. Some of the spinal damage is caused by amniotic fluid, which turns increasing­ly toxic to the exposed nerve tissue as the pregnancy progresses and the fetus passes more and more wastes into the fluid.

Surgeons thought that if the opening could be closed before birth, sealing out the fluid, some of the nerve damage might be averted.

The ideal time for the surgery is from 24 to 26 weeks of pregnancy, Belfort said.

They operated on their first patient in July 2014. In August, in the journal Obstetrics and Gynecology, they reported on their first 28 cases. So far, the results have been good, though the numbers are small.

No fetuses have died, few have needed shunts, and some of the mothers have been able to have vaginal deliveries. Their pregnancie­s appear to last longer, coming closer to full-term than with the open procedure.

Doctors who practice the open procedure are critical, and warn that the carbon dioxide pumped into the uterus may harm the fetus

and cause neurologic­al problems. Belfort said there has been no evidence of harm. But time will tell. Denise Grady

WHAT SEPARATES WOLVES FROM DOGS

NICOLET, Quebec — I’m sitting in an outdoor pen with four puppies chewing my fingers, biting my hat and hair, peeing all over me in their excitement.

At 8 weeks old, they are 2 feet from nose to tail and must weigh 7 or 8 pounds. They growl and snap over possession of a much-chewed piece of deer skin. They lick my face like I’m a long-lost friend, or a newfound toy. They are just like dogs, but not quite. They are wolves.

When they are full-grown at around 100 pounds, their jaws will be strong enough to crack moose bones. But because these wolves have been around humans since they were blind, deaf and unable to stand, they will still allow people to be near them, to do veterinary exams, to scratch them behind the ears — if all goes well.

Yet even the humans who raised them must take precaution­s. If one of the people who has bottle-fed and mothered the wolves practicall­y since birth is injured or feels sick, she won’t enter their pen to prevent a predatory reaction. No one will run to make one of these wolves chase him for fun. No one will pretend to chase the wolf. Every experience­d wolf caretaker will stay alert. Because if there’s one thing all wolf and dog specialist­s I’ve talked to over the years agree on, it is this: No matter how you raise a wolf, you can’t turn it into a dog.

As close as wolf and dog are — some scientists classify them as the same species — there are difference­s. Physically, wolves’ jaws are more powerful. They breed only once a year, not twice, as dogs do. And behavioral­ly, wolf handlers say, their predatory instincts are easily triggered compared with those of dogs. They are more independen­t and possessive of food or other items. And they never get close to that Labrador retriever “I-love-all-humans” level of friendline­ss. As much as popular dog trainers and pet-food makers promote the inner wolf in our dogs, they are not the same.

The scientific consensus is that dogs evolved from some kind of extinct wolf 15,000 or more years ago. Most researcher­s now think it was a case of some wolves spending more time around people to feed on the hunters’ leftovers.

People must spend 24 hours a day, seven days a week, for weeks on end with wolf puppies just to assure them that humans are tolerable. Dog puppies will quickly attach to any human within reach. Even street dogs that have had some contact with people at the right time may still be friendly.

Despite all the similariti­es, something is deeply different in dog genes, or in how and when those genes become active, and scientists are trying to determine exactly what it is. James Gorman

THE GREAT AMERICAN ECLIPSE

Nothing brings people together like the sun hiding behind the moon.

On Aug. 21, the country came to a pause as millions of Americans — even the president — put on eclipse glasses and stopped to take in the first eclipse to cross the United States since 1918.

A study by the University of Michigan estimated that 88 percent of American adults — about 215 million people — watched the solar eclipse, either in person or electronic­ally.

Its path across the United States was a scientific bonanza for astronomer­s who were able to more easily point advanced equipment at the sun.

It’s not too soon to start making your plans for the 2024 solar eclipse. On April 8, 2024, a total solar eclipse will enter North America around Mazatlán, Mexico, and leave it just north of St. John’s, Newfoundla­nd. In between, it will traverse the United States from Texas to Maine. The New York Times

A MAUSOLEUM FOR ENDANGERED SPECIES

The cabinets and shelves of the National Wildlife Property Repository, just northeast of Denver, are crammed with stuffed monkeys and ivory carvings, snow leopard coats and dried seal penises, chairs with tails and lamps with hoofs. Most of them are contraband, seized at airports in New York City, Los Angeles and other major ports of entry; some are donated by people who have no use for them. The repository testifies to the human appetite for other species. Rachel Nuwer

AN EYE FOR BEAUTY COURTESTY OF DARWIN?

Not long ago, a physicist at Stanford posed a rhetorical question that took me by surprise.

“Why is there so much beauty?” he asked.

Beauty was not what I was thinking the world was full of when he brought it up. The physicist, Manu Prakash, was captivated by the patterns in seawater made as starfish larvae swam about. But he did put his finger on quite a puzzle: Why is there beauty? Why is there any beauty at all?

Richard O. Prum, a Yale ornitholog­ist and evolutiona­ry biologist, offers a partial answer in a new book, “The Evolution of Beauty: How Darwin’s Forgotten Theory of Mate Choice Shapes the Animal World — and Us.” He writes about one kind of beauty — the oh-is-he/ she-hot variety — and mostly as it concerns birds, not people. And his answer is, in short: That’s what female birds like.

This won’t help with understand­ing the appeal of fluid dynamics or the night sky, but Prum is attempting to revive and expand on a view that Charles Darwin held, one that sounds revolution­ary even now.

The idea is that when they are choosing mates — and in birds it’s mostly the females who choose — animals make choices that can only be called aesthetic. They perceive a kind of beauty. Prum defines it as “co-evolved attraction.” They desire that beauty, often in the form of fancy feathers, and their desires change the course of evolution.

All biologists recognize that birds choose mates, but the mainstream view now is that the mate chosen is the fittest in terms of health and good genes. Any ornaments or patterns simply reflect signs of fitness. Such utility is objective. Prum’s — and Darwin’s — notion of beauty is something more subjective, with no other meaning than its aesthetic appeal.

Prum wants to push evolutiona­ry biologists to re-examine their assumption­s about utility and beauty, objectivit­y and subjectivi­ty. But he also wants to reach the

public with a message that is clear whether or not you dip into the technical aspects of evolution. The yearning to pick your own mate is not something that began with humans, he says. It can be found in ducks, pheasants and other creatures.

For Prum, at least, there is a partial answer to the question posed by Prakash. Why are birds beautiful?

“Birds are beautiful because they’re beautiful to themselves.”

James Gorman

AS CANCER TEARS THROUGH AFRICA, DRUGMAKERS BEGIN TO DRAW UP A BATTLE PLAN

NAIROBI, Kenya — In a remarkable initiative modeled on the campaign against AIDS in Africa, two major pharmaceut­ical companies, working with the American Cancer Society, will steeply discount the prices of cancer medicines in Africa.

Under the new agreement, the companies — Pfizer, based in New York, and Cipla, based in Mumbai — have promised to charge rock-bottom prices for 16 common chemothera­py drugs. The deal, initially offered to a half-dozen countries, is expected to bring lifesaving treatment to tens of thousands who would otherwise die.

Pfizer said its prices would be just above its own manufactur­ing costs. Cipla said it would sell some pills for 50 cents and some infusions for $10, a fraction of what they cost in wealthy countries.

The price-cut agreement comes with a bonus: Top American oncologist­s will simplify complex cancer-treatment guidelines for underequip­ped African hospitals, and a corps of IBM programmer­s will build those guidelines into an online tool available to any oncologist with an internet connection.

Cancer now kills about 450,000 Africans a year. By 2030, it will kill almost 1 million annually, the World Health Organizati­on predicts. The most common African cancers are the most treatable, including breast, cervical and prostate tumors.

But here they are often lethal. In the United States, 90 percent of women with breast cancer survive five years. In Uganda, only 46 percent do; in Gambia, a mere 12 percent do.

The complicate­d deal was struck by the cancer society, along with the Clinton Health Access Initiative, founded in 2002 by former President Bill Clinton; IBM; the National Comprehens­ive Cancer Network, an alliance of top U.S. cancer hospitals; and the African Cancer Coalition, a network of 32 oncologist­s in 11 African countries.

Donald G. McNeil Jr.

7 EARTH-SIZE PLANETS IDENTIFIED IN ORBIT AROUND A DWARF STAR

Not just one, but seven Earth-size planets that could potentiall­y harbor life have been identified orbiting a tiny star not too far away, offering the first realistic opportunit­y to search for signs of alien life outside the solar system.

The planets orbit a dwarf star named Trappist-1, about 40 light years, or 235 trillion miles, from Earth. That is quite close in cosmic terms, and by happy accident, the orientatio­n of the orbits of the seven planets allows them to be studied in great detail.

One or more of the exoplanets in this new system could be at the right temperatur­e to be awash in oceans of water, astronomer­s said, based on the distance of the planets from the dwarf star.

“This is the first time so many planets of this kind are found around the same star,” Michael Gillon, an astronomer at the University of Liege in Belgium and the leader of an internatio­nal team that has been observing Trappist-1, said during a telephone news conference organized by the journal Nature, which published the findings in February.

Scientists could even discover compelling evidence of aliens.

“I think that we have made a crucial step toward finding if there is life out there,” said Amaury H.M.J. Triaud, an astronomer at the University of Cambridge in England and another member of the research team. “Here, if life managed to thrive and releases gases similar to that we have on Earth, then we will know.”

Cool red dwarfs are the most common type of star, so astronomer­s are likely to find more planetary systems like that around Trappist-1 in the coming years.

“You can just imagine how many worlds are out there that have a shot to becoming a habitable ecosystem,” Thomas Zurbuchen, associate administra­tor of NASA’s science mission directorat­e, said.

Telescopes on the ground now and the Hubble Space Telescope in orbit will be able to discern some of the molecules in the planetary atmosphere­s. The James Webb Space Telescope, scheduled to launch next year, will peer at the infrared wavelength­s of light, ideal for studying Trappist-1.

Kenneth Chang

CASSINI VANISHES INTO SATURN, ITS MISSION CELEBRATED AND MOURNED

PASADENA, Calif. — NASA’s Cassini spacecraft, the intrepid robotic explorer of Saturn’s magnificen­t beauty, ended a journey of 20 years on Sept. 15 like a shooting star streaking across Saturn’s sky.

By design, the probe vanished into Saturn’s atmosphere, disintegra­ting moments after its final signal slipped away into the background noise of the solar system. Until the end, new measuremen­ts streamed 1 billion miles back to Earth, preceded by the spacecraft’s last picture show of dazzling sights from around our sun’s sixth planet.

“The signal from the spacecraft is gone and, within the next 45 seconds, so will be the spacecraft,” Earl Maize, the program manager, announced in the control room at NASA’s Jet Propulsion Laboratory.

“To the very end, the spacecraft did everything we asked,” he said later.

Never again would Cassini send home the images and data that inspired discoverie­s and wonder during the probe’s 13 years in orbit around the ringed planet.

“For me, there’s a core of sadness, in part in thinking of the breakup of the Cassini family,” said Linda Spilker, Cassini project scientist. “But it’s both an end and a beginning as these people go off and work on other things.”

The mission for Cassini, in orbit since 2004, stretched far beyond the original four-year plan, sending back multitudes of striking photograph­s, solving some mysteries and upending prevailing notions about the solar system with completely unexpected discoverie­s.

“Cassini is really one of those quintessen­tial missions from NASA,” said Thomas H. Zurbuchen, NASA’s associate administra­tor for science. “It hasn’t just changed what we know about Saturn, but how we think about the world.”

Its end closes the chapter on the exploratio­n of Saturn for probably a decade or longer. Still, there is much left for scientists to study and decipher.

One of the mission’s most surprising discoverie­s was an ocean of water beneath the icy exterior of Enceladus that may be heated by hydrotherm­al vents similar to those at the bottom of oceans on Earth.

The water on this moon and the carbon compounds it contains are some of the key ingredient­s needed for life that scientists would have thought unlikely on a moon just 313 miles wide.

Kenneth Chang

 ?? Toni Greaves / The New York Times ?? On Aug. 21, the country paused as millions put on eclipse glasses and stopped to take in the first eclipse to cross the U.S. since 1918.
Toni Greaves / The New York Times On Aug. 21, the country paused as millions put on eclipse glasses and stopped to take in the first eclipse to cross the U.S. since 1918.
 ?? Beatrice de Gea / The New York Times ??
Beatrice de Gea / The New York Times
 ?? Christophe­r Capozzilel­lo / The New York Times ?? Richard O. Prum, a professor of ornitholog­y at Yale University, birdwatche­s in Hamden, Conn.
Christophe­r Capozzilel­lo / The New York Times Richard O. Prum, a professor of ornitholog­y at Yale University, birdwatche­s in Hamden, Conn.
 ??  ?? Surgeons perform surgery on a 24-week fetus at Texas Children’s Hospital in Houston. The doctors hope the fetal procedure will result in superior outcomes for children born with severe spina bifida.
Surgeons perform surgery on a 24-week fetus at Texas Children’s Hospital in Houston. The doctors hope the fetal procedure will result in superior outcomes for children born with severe spina bifida.
 ?? Ty Wright / The New York Times ?? A nurse feeds a baby going through opioid withdrawal after being born the day before.
Ty Wright / The New York Times A nurse feeds a baby going through opioid withdrawal after being born the day before.
 ?? NASA / JPL - Caltech via The New York Times ?? An artist’s conception of the Earth-size planets that orbit a dwarf star about 40 light years from Earth. Three of them may have the right conditions for life.
NASA / JPL - Caltech via The New York Times An artist’s conception of the Earth-size planets that orbit a dwarf star about 40 light years from Earth. Three of them may have the right conditions for life.
 ?? Tristan Spinski / The New York Times ?? A stuffed tiger’s head is among the oddities at the National Wildlife Property Repository near Denver.
Tristan Spinski / The New York Times A stuffed tiger’s head is among the oddities at the National Wildlife Property Repository near Denver.

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