COMMENTARY Unwanted outcomes of Earth processes

Protecting intermittent waterways

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LETTERS I BOOKS I POLICY FORUM I EDUCATION FORUM I PERSPECTIVES

LETTERS edited by Jennifer Sills

WILLIAM BRUCE WEAVER Monterey Institute for Research in Astronomy, Marina, CA 93955, USA. E-mail: [email protected]

References and Notes 1. Committee for a Decadal Survey of Astronomy and Astrophysics, National Research Council, New Worlds, New Horizons in Astronomy and Astrophysics (National Academies Press, Washington, DC, 2010). 2. W. B. Weaver, in The Future of Small Telescopes in the New Millennium, Vol. 1, T. Oswalt, Ed. (Kluwer, Boston, 2003), p. 21. 3. W. J. Cocke, M. J. Disney, D. J. Taylor, Nature 221, 525 (1969). 4. A. Hewish, S. J. Bell, J. D. H. Pilkington, P. F. Scott, R. A. Collins, Nature 218, 709 (1968).

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A Safety Net for Diabetics D. CLERY’S NEWS FOCUS STORY “A PANCREAS in a box” (10 January, p. 133), which discusses progress toward an artificial pancreas, outlines the fervent wishes of all but articulates a view of the future that potentially overlooks the “good” in a quest for the “perfect.” Industry is still perfecting sensors that have adequate sensitivity to safely drive an insulin pump unattended by human oversight. Contrary to Clery’s assertion that continuous glucose monitor (CGM) sensors replace fingerstick readings, today’s CGM sensors are considered to be “adjunctive devices.” FDA labeling of such devices typically reads: “[product …] does not replace the information obtained from a standard home blood glucose meter but rather, it is used to complement the information obtained from the blood glucose meter” (1). A particular challenge for CGM is that the sensor measures interstitial glucose, a parameter which may lag arterial glucose, particularly in times of flux. CGMs do display critical— potentially lifesaving—directional trends in glucose and may alert patients of impending hypo- and hyperglycemic events, but are not yet approved by the FDA for the purpose of insulin dosing by the patient, much less by an automated algorithm. Hypoglycemia remains a major cause of morbidity and mortality in patients with type 1 diabetes (2). The literature documents that physical exertion may be a significant factor in the development of dangerous episodes of hypoglycemia (3). Prevention of exercise-

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THE CLOSING OF LICK OBSERVATORY (“LICK Observatory in trouble as austerity starts to bite,” Y. Bhattacharjee, News & Analysis, 13 December 2013, p. 1299) and all the major national optical telescopes on Kitt Peak National Observatory (“Money woes cloud future of workhorse U.S. telescopes,” Y. Bhattacharjee, News & Analysis, 20 December 2013, p. 1425) should hardly come as a surprise to astronomers. For many years, we have argued to funding agencies, often through prestigious decadal surveys [e.g., (1)], that to do the most important astronomy, only the largest and most expensive telescopes would suffice. Now that the funding agencies believe us, we are facing the consequences. The endgame of advocating increasingly expensive instruments has already been demonstrated by particle physicists with the cancellation of the Superconducting Super Collider in 1993. Lick Observatory Many of the greatest discoveries in astronomy (2) in the 20th century were made with small telescopes of their time. Optical pulsars (3), radio pulsars (4), and exoplanets (5, 6) were all first observed with small telescopes. Some discoveries made with large telescopes could have been made with small telescopes [such as quasistellar objects (7)], and others were made by both large and small telescopes [such as Sco X-1 (8, 9)]. The initial evidence for dark matter came from an 18-inch telescope (10). With the advent of affordable, back-illuminated charge-coupled devices, a 1-m telescope can explore an order of magnitude more of the universe than could the Palomar 200-inch telescope (now considered a candidate for small-telescope funding) in the photographic era. Astronomers are getting what they asked for: A very limited number of telescopes so large and expensive that the workhorses of astronomy, the smaller telescopes that can afford to do the riskier and potentially more rewarding science, have been sacrificed. Lick Observatory, one of the most prestigious in the world, and all the important optical telescopes at Kitt Peak National Observatory are not the first. The smaller telescopes at Kitt Peak National Observatory and Lick had already been shuttered. More ominous, along with the hardware, the astronomers and students at the many smaller institutions are being sacrificed as well.

CREDIT: © LAURIE HATCH/WWW.LAURIEHATCH.COM

Small Telescopes, Big Rewards

5. M. Mayor, D. Queloz, Nature 378, 335 (1995). 6. G. W. Marcy, R. P. Butler, Astrophys. J. 464, L147 (1996). 7. The first quasistellar object discovered, 3C 273 (11), has a visual magnitude of 12.8, which is bright enough to be easily observed spectroscopically and photographically with a 1-m telescope. 8. H. Johnson, C. B. Stephenson, Astrophys. J. 146, 602 (1966). 9. A. R. Sandage et al., Astrophys. J. 146, 316 (1996). 10. F. Zwicky, Astrophys. J. 86, 217 (1937). 11. M. Schmidt, Nature 197, 1040 (1963).

Epigenetics may drive evolution

Molecular mechanisms meet evolution

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1088 the addition of remote telemetry and an added safety net. Why not give Americans with diabetes the same level of additional safety that we accord their automobiles and homes? JONATHAN C. JAVITT Johns Hopkins University, Bethesda, MD 20814, USA. E-mail: [email protected]

References

CREDIT: © IRCM/MEDTRONIC INC.

Technology in progress. The artificial pancreas has yet to be perfected.

induced hypoglycemia in a closed-loop system may require additional sensors that assess physical activity and algorithms that reduce or suspend insulin delivery during periods of high exertion. As we strive for the perfect closed-loop pancreas system, we should not forgo the near-term opportunity to develop remotely monitored, patient-controlled systems with real-time connectivity to a central monitoring station. Such systems would over time include the use of automated algorithms, but in the near term can alert qualified health care personnel of medically actionable conditions. Monitoring station personnel could relay over-the-air modifications to the insulin pump, disable the pump if needed, and in an emergency, geolocate the patient and dispatch emergency assistance. Compared to going to sleep or exercising with an unmonitored pump, this provides the potential for increased safety. This level of telemetry and assistance is becoming commonplace in modern automobiles through telemetry systems such as OnStar® and in increasingly intelligent home-monitoring systems for burglary, fire, flood, and other hazards. Since type 1 diabetics are well known to suffer multiple hypoglycemic events per year, at an estimated average cost of $3200 per person-year for attendant hospitalization (4), there is a plausible economic as well as medical argument for such monitoring. All that is required is the incorporation of a cellular radio into the controller of every insulin pump. Whereas the closed-loop artificial pancreas will raise patient safety concerns that will take time to overcome, few could argue that an insulin pump wearer would not be safer today with

1. FDA, Medical Devices, Dexcom G4 PLATINUM Continuous Glucose Monitoring System—P120005 (www.fda. gov/MedicalDevices/ProductsandMedicalProcedures/ DeviceApprovalsandClearances/Recently-ApprovedDevices/ ucm323661.htm). 2. O. Awoniyi, R. Rehman, S. Dagogo-Jack, Curr. Diab. Rep. 13, 669 (2013). 3. P. E. Cryer, S. N. Davis, H. Shamoon, Diab. Care 26, 1902 (2003). 4. G. G. Rhoads et al., J. Occup. Environ. Med. 47, 447 (2005).

Supporting Mavericks P. A. SHARP AND A. I. LESHNER (“MEETING global challenges,” Editorial, 7 February, p. 579) correctly draw attention to the need for scientists and engineers to engage more meaningfully with business, cultural, and political leaders if we are to meet our most

urgent global challenges. They also stress the importance of research and teaching institutions providing appropriate training and incentives to encourage these behaviors. But there is another dimension. A study of 36 individuals who have successfully tackled many of the world’s most pressing economic, social, and environmental challenges (1) shows that most of them don’t wait to reach consensus. They push on, regardless. Consider the persistence of Nobel Laureate Barry Marshall, who overturned conventional wisdom on the genesis of gastric ulcers despite the entrenched opposition of grant agencies and the medical establishment; the self-belief that enabled environmental solutions pioneer Olivia Lum, abandoned as an infant and brought up in a palm hut without running water, to build a water purification industry that now spans the planet; and the commitment that enabled U.S. gynecologist Mitch Besser to reduce mother-to-child transmission of HIV AIDS in South Africa from 40% to 4% over the space of 10 years. Certainly, we need to encourage collaboration in the ways identified by Sharp and Leshner. But we also need to find ways to support those with the courage to go it alone, regardless of the odds. PETER ANDREWS Queensland University of Technology, Brisbane, QLD, Australia. E-mail: [email protected]

Reference 1. P. Andrews, F. Wood, Überpreneurs: How to Create Innovative Global Businesses and Transform Human Societies (Palgrave Macmillan, London, 2014).

CORRECTIONS AND CLARIFICATIONS News Focus: “Eavesdropping on ecosystems” by K. Servick (21 February, p. 834). On p. 836, Amandine Gasc’s name was misspelled in the photo credit. In a caption on the same page, French Guiana was misidentified as Guinea. The HTML and PDF versions online have been corrected. News of the Week: “Young editors ask neuroscientists: ‘Why should I care?’” by E. Underwood (24 January, p. 355). The article stated that the Nature Publishing Group has launched an online research journal geared toward young adults called Frontiers for Young Minds. In fact, the open access publisher Frontiers, part of Nature Publishing Group, launched the journal. The HTML and PDF versions online have been corrected. News & Analysis: “Industry lobbying derails trawling ban in Europe” by T. Rabesandratana (1 November 2013, p. 544). The article incorrectly stated that the European Parliament plenary cannot reinstate the full ban on deep-sea trawling and bottom-set gillnetting proposed by the European Commission. The plenary could reconsider a full ban after the fisheries committee rejected it. The HTML and PDF versions online have been corrected. Reports: “Stress in puberty unmasks latent neuropathological consequences of prenatal immune activation in mice” by S. Giovanoli et al. (1 March 2013, p. 1095). Joram Feldon, of the Laboratory of Neurobiology, ETH Zurich, 8092 Zürich, Switzerland, should be added to the authors before Manfred Schedlowski. Affiliations should be renumbered accordingly. J. Feldon should be removed from the acknowledgments. The HTML and PDF versions online have been corrected.

Letters to the Editor Letters (~300 words) discuss material published in Science in the past 3 months or matters of general interest. Letters are not acknowledged upon receipt. Whether published in full or in part, Letters are subject to editing for clarity and space. Letters submitted, published, or posted elsewhere, in print or online, will be disqualified. To submit a Letter, go to www.submit2science.org.

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Small telescopes, big rewards.

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