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September: my manic month

Milan was the first stop in a manic month of travel.  I was hosting Live@ERS, a daily TV feed at the European Respiratory Society international congress.

Our Live@ERS set

This is a huge meeting attended by some 22,000 respiratory professionals. The thing I love about attending big medical congresses is the vibe you pick up about what’s hot in the science.  It’s partly seeing the queues outside particular sessions but it’s also hearing the chatter over the coffee.  The lung microbiome was definitely hot.  Not that long ago, medical students were taught that the inner reaches of the lung were sterile.  We now know that they team with bacteria, which strongly influence the onset of disease.  For instance, studies of the microbiome in children with and without lower respiratory infection show that infection is the outcome of an ongoing turf war in the lung.  Resident non-harmful bacteria normally keep potentially harmful bugs in check, but some children either don’t have those peacekeepers or their efforts are overwhelmed.  There was a host of other presentations showing the role of the microbiome in COPD (chronic progressive lung diseases), cystic fibrosis, asthma and many others.  All of these illustrated the complex interplay between your environment, your bugs and you.  What does this work mean?  I think in the future you will see less emphasis on antibiotics and more on manipulating the lung environment to favour ‘good’ bacteria.  I think you will see testing of the microbiome in the initial workup as the microbiome of the lung may be a way of phenotyping (essentially a way to sort people with the same symptoms into different treatment baskets) which in itself may mean more effective treatment. Before you ask, live ‘good’ bugs pumped into your lung?  Unlikely I think.

 

The other thing that was hot was a big study from China on early-stage COPD.  If you’re a smoker, listen up. Normally, treatment is offered to those with symptoms, which means that their disease is already well on the march.  Those in the earliest stages, when lung function is about 80% of what it should be, typically don’t think there is anything wrong with them beyond a bit of a cough – “which is normal right if you smoke?” Yet their lung function is already declining.  There is no screening for early-stage COPD because there’s no evidence that treating it at this stage makes any difference.  Now we have the first indications that this might not be the case. Giving a broncho dilating drug called tiotropium reduced the expected annual decline in lung function in the treatment group compared to placebo. It’s a highly significant finding in China which is facing a vast problem caused not just by smoking but also by pollution and biomass burning.  It’s a study that potentially also opens the way to mass screening, say a lung function test for everyone, starting with smokers.  Some might say why not just ban smoking – well, both and of course –  but don’t forget that there are a significant number of people who get COPD despite being never smokers.

Finally, an observation from me about the newly published Mirror study, which compared patient’s and doctor’s views of their relationship Patients admitted fibbing, being far less than honest than even their docs had imagined.  Doctors also vastly underestimated the impact of severe lung disease on their patient’s daily lives and were much more concerned by their lung measurements than with what patients could or couldn’t do.  It’s a bit like us and the US, isn’t it.  Divided by a common language.  My advice to patients is to tell your doctors what’s important to you. And my advice to doctors is to ask ..and take what you’re told with a pinch of salt or three.

Future Energy Forum, Astana

I’ve spent some time last month in Kazakhstan hosting two conferences in the Future Energy Forum series, one on the role of cities and the other on the role of policy.  A standout speaker was Professor Mohan Munasinghe, joint winner of the Nobel Prize for Peace with Al Gore.  The conferences took place in the Kazakh capital, Astana which is hosting the World Energy Expo. Of course, I enjoyed the British Pavilion, designed by superstar architect British architect Asif Khan but the Kazakh pavilion (which is in the globe) was incredibly impressive.  You walked from the top down and around different levels, each representing separate renewable energies: wind, solar, biomass, hydro and space.  What struck me was the number of kids there, completely starry eyed, mouths open, gulping all this future down.  I suspect they will remember it all their lives and that it will prompt them to do two things; the first to dream of becoming an astronaut (the biggest queues were on the space level) and the second, cement in their minds that renewables are their future.

For older Kazakhs this is difficult to imagine – after all, their whole economy is based on the country’s production of abundant fossils fuels and their power is, by our standards, astonishingly cheap. Climate change doesn’t have the traction with them that it does elsewhere for they already live in the harshest of climates  – it can reach -60c in winter and +40c in summer.  So how do you persuade?  At a political level, one of the most persuasive arguments is economic. As other countries leave fossil fuels behind, the price will fall and the Kazakhs will begin to see their economy and influence in central Asia diminish. This is driving government.  As for ordinary Kazakhs, starting where they are and focusing on reducing energy use by increasing energy efficiency is the first step – that and inspiring a whole new generation with Expo.  It’s a strategy that I think will work – as it must.

I’m listening here to the Chief Engineer of the Kazakh state railway. A brief welcome was supposed to be his brief but bless him, the opportunity to tell a captive audience about the engines of his trains was an opportunity too irresistible to pass up. Engineers. They’re enthusiasts in every language.

The thing that most impressed me whilst I was in the country was its celebration of women warriors.  This is a Muslim country but Kazakh women enjoy high status and traditionally fought alongside men, typically as lethal horseback archers.  We celebrate Jane Austen, a writer of sharp social observation who dueled with her pen, on our bank notes.  The Kazakhs celebrate Queen Tomyris who personally killed Cyrus the Great of Persia in a 5th Century battle on their notes.  Gosh.

August: A month of rest for most, but not me!

We are only 10 days into the month of August and so far I have been very busy. Here are three completely contrasting things I have been doing so far:

Here’s a commentary from me, just published in Nature .

Everyone is getting in a froth about gene edited embryos and talking about the need for ‘conversations’.  I am making the point that the really urgent conversations that need to be had are about genomics which is now entering mainstream NHS care, rather than about a technology which is many years ahead and likely to be for the very few.  I say this particularly in the context of the UK Chief Medical Officer’s report ‘Genome Generation’ which calls for a social contract between patients and the NHS, especially about the use of data.

Here’s a piece that I wrote for the Mail on Sunday about the Princess of Wales and the furore over a documentary revealing tapes recorded by her voice coach. 

Astonishingly, it is 20 years since the death of the Princess of Wales.  I worked with Diana for 12 years while she was Patron of Birthright, the mother and baby research charity that was then part of the Royal College of Obstetricians and Gynaecologists.  I was its National Organiser, running the research programme but also all its fundraising events

I was a rookie charity organiser aged 26 and Diana was a rookie princess when we first met in 1982 at an event, ‘The Brilliant and Beautiful Evening of Fashion’ at London’s Guildhall.  We got on famously.  I called her ‘Miss’ and she mocked me for my short skirts and my ever constant clipboard.  I watched her grow from anxious ingenue to confident world superstar and she was a very important part of my life for over a decade. After her death, I became a Trustee of the Diana Memorial Fund.   Although it is now two decades ago, the week between her death and her funeral was one of the most extraordinary in British history and remains sharp in my memory.

And here’s a pic of the World Energy Expo.  I recently visited Astana in Kazakhstan for the World Energy Expo where I facilitated two conferences for the Future Energy Forum.

Astana is the capital of Kazakhstan and the Kazakh Expo pavilion (which was inside a huge ball) was outstanding, incredibly well presented and thought out.  After going up in a lift to the top, you made your way down through different levels, with each one representing a different sort of renewable energy – solar, wind, biomass, space and so on.  It was fascinating.  I watched a lot of very excited Kazakh children in the space section and wondered if a decade or so hence, they will be the astronauts and engineers of the future, having been inspired by their visit to Expo as children. In the UK I am sure that we will have a Tim Peake generation of engineers in the same way that there is a generation (who constantly tell me this) that were inspired to take up engineering and science by watching Tomorrow’s World.

I also visited the Great Britain pavilion which has a fascinating installation of a yurt made of perspex struts which lit up when you touched them, completely surrounded by a landscape panorama.  As the yurt lights came on, so the representation of light in the corresponding piece of the panorama changed, going from day to night or from sunny to cloudy. Sounds weird on paper but it was mesmerising to watch.

I was in Astana to facilitate two conferences of the 12 conference series, ‘Future Energy Forum’.  Kazakhstan has vast reserves of oil and gas and a booming economy based on oil but seem committed to a future in which renewables become more and more important.  They are especially interested in energy efficiency, as well they might be with a temperature range of over 80 degrees, running from +40 in the summer to -40 in the winter (Oh, and add a windchill factor of another 20 degrees).  I really enjoyed talking to young Kazakhs in particular at the conferences.

For Women in Science 2016

Just before Easter, I found myself in Paris making a series of daily films for CNN for the L’Oreal UNESCO For Women in Science programme, now its 18th year.

Here’s a link to the second one

http://discov-her.com/en/article/l-oreal-unesco-for-women-in-science-daily-episode-2-thuesay-march-22nd

As you will see, I managed to get a sneak peek inside the French Academy of Sciences.  I felt like a bit of an outsider and not just because I was a Brit, or as the French refer to us, un rosbif.  The place is awash with statues of men, with not a single women in sight.

Pictures of the Laureates are everywhere in Paris.  Mrs Parry in homage here
Pictures of the Laureates are everywhere in Paris. Mrs Parry in homage here

It was an enormous privilege meeting the 2016 Laureates.  They included Quarraisha Abdool Karim, a South African epidemiologist who was absolutely determined to find an HIV prevention method that could be used by women.  Vaginal microbicides were an obvious answer but decades of research by many teams across the world delivered nothing but disappointment.   Abdool Karim kept going, finally developing one containing the antiretroviral tenofovir which, although not yet perfect is a great deal better than nothing.   Another Laureate was Chinese professor, Hualen Chen who protects us all from deadly flu pandemics through her surveillance and through the development of novel vaccines.  And there were the CRISPR queens, Emmanuelle Charpentier and Jennifer Doudna – CRISPR-cas9 is the gene editing technology that has taken the scientific world by storm. But the Laureate who most impressed me personally was Argentinian, Professor Andrea Gamarnik, who works on the structure of viruses, particularly the flaviviruses which include dengue and also of course, zika.  South America is experiencing very serious outbreaks of dengue at present. It wasn’t just her fascinating research, it was her passion for what she did and her knockout speech of acceptance.   I also fell in love with her 80 year old dad, an activist for social justice throughout his life who was experiencing the proudest moment of his life.

The Abel Prize; the last interview with John Nash

When my friends at the Norwegian Academy of Science asked me to interview the winners of the 2015 Abel Prize, I said yes, of course.  They are very, very nice people and more than that, I love Norway. What’s not to like?  The problem for me was that the Abel is one of the world’s great math prizes and I am shamingly bad at math.

The winners were Louis Nirenberg of the Courant Institute in New York over 90 but still brim full of vigour and great charm and John Nash, 86 whose life is more familiar perhaps to us than his math because of ‘A beautiful Mind’ in which he was played by Russell Crowe.  It documented his battle with schizophrenia.  I prepared more for these interviews than perhaps any other in my life.  Did by the end, I understand partial differential equations.  Dear reader, it was the North Face of the Eiger and I failed to make it to base camp.  All I can tell you is that PDEs have had an extraordinary impact in the world, making it possible to model the unpredictable.  And remember Nash also gave us the Nash Equilibrium, kickstarting Game Theory and once again, having an extraordinary impact on everything from organ donor allocation to broadband auctions.

During the interview, Nash’s voice was faint, making it hard to follow what he said.  He was very frail, with a stooping, shuffling walk – a great contrast to his wife Alicia who although only a couple of years younger seemed much more robust.  Nash was very interesting about his illness.  I asked whether there was a problem that he would have tackled had he not been so ill.  He replied something to the effect that his mind went on strike but that he was now back in control adding that being in good health does not guarantee that you can discover, let alone think through a problem – which of course is right.

There was a wonderful dinner for Nirenberg and Nash at the Akershus Castle in Oslo, in the presence of the King of Norway.  I went there with Cedric Villani, the French mathematician, media personality and spider lover (he always dresses immaculately and wears big spider brooches).

I came back to London briefly and then left for Seville for a cardiology congress. At the very moment that I was telling a group of cardiologists about my encounter with Nash, someone said they had just received a news alert on their phone.  Both Nash and his wife were dead, killed in a car crash on the New Jersey Turnpike.  It was deeply shocking.

The world contains all sorts of people.  Nash was challenging but he also had extraordinary insight, making leaps of intuition that almost no-one else could. He was genuinely that very rare thing.  A genius

 

 

 

Tulips. I love ’em

I love tulips.  I can enthuse about almost any sort, except those funny ones with fringed petals.  Some people treat tulips like annuals, digging them all up once they have flowered which gives you the luxury and fun of choosing a whole new colour scheme next year.  Fine plan but it comes expensive, not to mention time consuming.  So I’ve been looking for tulips that you can leave year to year.

Species tulips in general are the gem like tiddlers, hailing from places like bare mountain slopes in Turkey.  The hotter they bake during the summer, the better they perform.  They hate to be wet so plant them somewhere free draining in full sun or plant them in pots, one sort to a pot and they’ll multiply with time and give you a great display every year.  Sudden disappearances are almost always down to mice who love tulips more than life itself.

So what about the fancy tulips?  A reliable friend from year to year is the orange ‘Ballerina’ which is unusual for a tulip in that it is scented.  I plant it with red kingsblood. In this picture, the red tulips are flowering for their third and fourth season.  This won’t be the case for all tulips and some, like parrot tulips never seem to come again although I have tried.   I have just been to the Chelsea Flower Show and the Bloms stand was magnificent, with tulips of great opulence and beauty.   I order loads and then usually  forget what I have ordered but whilst  I still remember it was several different shades of apricot and orange parrot tulips

For pots, I try different tulips each year.  This candy stripe one is Carnaval de Nice.  It looks like the sort of tulips you see in Dutch still life pictures

I’ve tried many different bulb suppliers.  My favourite for tulips is De Jaeger, followed by Bloms.  For more specialist bulbs, I use Avon Bulbs which have some beautiful species tulips.  Try Battalini Bright Gem.

 

Girls, girls, girls

Iris 15 (2)

Girls, girls, girls

How gorgeous are these girls? All are dwarf iris and all named after girls which seems appropriate as we come up to International Women’s Day. Katharine Hodgkin, the unmistakeable pale blue and yellow, Lady Beatrix Stanley (that mass of mid blue) and Pauline, elegant in deep purple. The great plantsman, E B Anderson crossed two rare irises in the 1960s and named the stunning result after his chum Eliot Hodgkin’s wife. Katharine. The colours are so elegant, the patterns a joy – how wonderful to have something quite so beautiful forever bear your name.

I use three suppliers of bulbs – these come from Avon Bulbs http://www.avonbulbs.co.uk/. This is about their third or fourth outing. When the flowers die away, I feed them all with a liquid feed.

I am also feeding my Fritillaries now, even though the shoots are still tiny. This is because the fritillary bulbs are even now bulking up for the future and need some extra help. They smell really strongly of foxes but unfortunately this does not deter lily beetles who love them almost as much as lilies themselves.

Now sowing tomatoes.  Trying more bush tomatoes.  This is really hope over experience because I know my cold Oxfordshire garden isn’t really tomato heaven.  But that’s the deliciousness of gardening.

Bring on spring

Lachenalia liliiflora
Bring on spring
There’s something about freezing weather in February that has me rushing out to the greenhouse with packets of seeds, as if by doing so I could conjure up warmer weather.  This week it has been aubergines (Black Beauty) since you ask and Padron peppers.  If you haven’t tried growing these before, these are the classic Spanish tapas peppers.  They are easy to grow but need to be started soon because with our cooler temperatures, they require a really long growing season.  Once they are big enough to handle, put them first in three inch pots, and then pot them on into big pots or, as I do, into growbags, with three plants to a bag.  They start off little and green (which is when you pick them) and then, if you leave them, turn red.  Be warned.  For inexplicable reasons, one or two of every couple of dozen little green ones are ferociously hot.  There is no way of telling them apart so it’s a bit like Russian Roulette.  They also get hotter as the season progresses so that by August almost all of them are eye watering.  Flash fry them in olive oil, sprinkle with sea salt – fantastic.
 
I am very taken with Lachenalias.  These are bulbs from South Africa.  Lachenalia liliflora has glorious spotty leaves and stems and flower spikes that are a mass of translucent violet tubes each with a little natty white fringe  of protruding stamens and I have been admiring them in the greenhouse whilst planting my seeds and fussing with my pelargoniums.  Every couple of weeks I move the resting pelargoniums (well actually some of them haven’t been resting, it’s been so warm, they are getting all enthusiastic with leaf) around a bit and remove all the dead leaves.  I am Mrs Messy indoors but in the greenhouse, I suddenly become Mrs V. Tidy – but that’s only because long experience has told me that messy things turn into mouldy things which then infect the whole greenhouse.   But there’s one pelargonium that I leave outside all winter – astonishingly, even in our cold frosty garden, Pelargonium sidoides ‘Pink Fizz’, a species pelargonium from South Africa which spreads through underground tubers – seems untroubled by cold.  It’s more than you can say for me.

Wonders of proton beam therapy

PBT
Wonders of proton beam therapy
I am making a film about proton beam therapy which is a highly advanced form of radiotherapy.  Sometimes there are facts that stop you in your tracks.  At the heart of the kit that hurls proton at tumours is something the size of a car which weighs as much as a Boeing 747.  Huge gantries, each the size of a three storey house, house tubes down which protons are accelerated, guided by magnets.  The exquisite precision of PBT, which is used to treat deep or awkwardly sized or placed cancers in the head, neck and spine, is down to the Bragg Effect, an explosion of energy that is only released as the protons reach their target.  It means there is hardly any collateral damage to tissue whilst the tumour gets a pinpoint nuclear strike.  One of these machines is being built at UCL and the other in Manchester, which is very appropriate given that Ernest Rutherford, discoverer of the proton, was at the University of Manchester (and yes for those Trans Pennine-ists, Bragg the Younger after whom the effect was named did work in Leeds).
Installing this kit requires vast quantities of special concrete and a hole which, in London, is deeper than tube train tunnels. 
And now see the film here: http://youtu.be/2MadsdvYOis
Note how we magically transformed a grey cold Manchester day  into a sunny one, courtesy of our brilliant post production team.

The Crucible Programme

The Crucible Programme
I’ve just had the joy of facilitating the 7th Heriot-Watt Crucible.  The Crucible programme was begun by the innovation charity Nesta back in 2005.  It brings together some 30 early to mid career researchers, all of whom have been identified as potential high flyers for three residential sessions helping them to communicate, collaborate in an interdisciplinary way and develop leadership skills.
For many years,  I have led the first of these sessions which helps these young research stars communicate, unravels the mysteries of the media for them and, perhaps most important of all, helps them understand how best to talk to policy makers.  If you are a young researcher, you need to know how the research firmament revolves and, if you really want to make an impact on the world and your research is of this type, how to make sure that you get heard in the right places.  Impact is a bit of a dirty word amongst researchers but it shouldn’t be.  People don’t do research simply for their own pleasure.  They do it because they want to make a difference.  But policy makers speak a different language and, a bit like journalists, operate to a different time scale to the average researcher.  Academics need to understand how they work if they want to communicate the importance of their work.
 
The Heriot-Watt Crucible, like the Scottish Crucible (which I will be facilitating in April) spend a day in the Scottish Parliament. As ever, there were some absolutely outstanding individuals from some astonishingly diverse disciplines.  In this session we had someone who studied the anthropology of children’s clothing, another whose area was shipping and supply chains, another in photonics, another in memory research and so on.  They were dazzling.  How lucky am I to be able to spend time talking to such a talented bunch of people?  I always learn something new.  This time it was about what landscapes submerged beneath the waves can tell you about how the future climate change will affect dry land.  Dr Claire Mellett you were brilliant.