Marijuana is more popular and accessible in the U.S. than any other street drug. In national surveys, 48 percent of Americans say they have tried it, and 6.5 percent of high school seniors admit to daily use. So it was not too surprising when two states, Washington and Colorado, became the first to legalize recreational marijuana in the November 2012 general election, albeit in limited quantity, for anyone over the age of 21. Activists expect that similar measures will soon win approval in other parts of the country.

Some success with medical marijuana helped to pave the road to wider legalization of pot. Eighteen states and the District of Columbia permit possession and consumption of the drug for medical purposes. Doctors in those jurisdictions may prescribe cannabis to treat or manage ailments ranging from glaucoma—an eye disease in which the optic nerve is damaged—to menstrual cramps. Cancer patients sometimes smoke pot to relieve the pain and nausea brought on by chemotherapy, and some people with the inflammatory disease multiple sclerosis rely on marijuana to ease muscle stiffness.

Although many physicians agree that marijuana is safe enough to temporarily alleviate the symptoms of certain medical conditions, the safety of recreational use is poorly understood. Researchers worry that both the short- and long-term use of the drug may harm the body and mind. Marijuana's continued popularity among teenagers raises particular concern because the drug might hinder the ongoing maturation of the adolescent brain. Making matters worse, new growing techniques for the Cannabis sativa plant—from which marijuana is prepared—have dramatically increased the drug's potency. Some experts suggest that such high-octane weed is fueling a rise in cannabis addiction. Finally, although investigators still debate how the legalization of recreational marijuana will change road safety overall, studies indicate that the drug slows reaction time and impairs distance perception behind the wheel. Despite such evidence, most new marijuana regulations, for medical or recreational use, fail to account for these potential risks.

Weeded Out

Whether rolled into a joint or mixed into brownie batter, marijuana profoundly changes behavior and awareness. The primary psychoactive compound in marijuana, tetrahydrocannabinol (THC), mimics the structure of molecules called endocannabinoids that the human body produces naturally. Endocannabinoids act on a group of cell-surface molecules called cannabinoid receptors that help to regulate appetite, mood and memory. Because of its shape, THC fits into these receptors, too. After all, jokes neuroscientist Giovanni Marsicano of the University of Bordeaux in France, “We don't have a receptor in the body just to smoke marijuana.”

When THC strikes specific cannabinoid receptors, it triggers domino chains of interacting molecules in neurons that culminate in both unusually elevated and abnormally low levels of various neurotransmitters (the molecules that brain cells use to communicate with one another). The result is the well-known “high” of marijuana. Suddenly, the mundane seems hilarious, and ordinary foods taste delicious. People generally feel merry, relaxed and introspective, although undesirable effects—such as paranoia and irritability—are common as well.

Marijuana also temporarily impairs an array of mental abilities, especially memory and attention. Dozens of studies have shown, for example, that people under the influence of marijuana perform worse on tests of working memory, which is the ability to temporarily hold and manipulate information in one's mind. Participants in these studies have greater difficulty remembering and reciting short lists of numerals and random words. Research has further revealed that cannabis blunts concentration, weakens motor coordination and interferes with the ability to quickly scan one's surroundings for obstacles.

Such mild cognitive deficits may not endanger anyone if a marijuana user lazes on the couch, but it is a different story when someone takes that high on the road. In driving-simulation and closed-course studies, people on marijuana are slower to hit the brakes and worse at safely changing lanes. Investigators still debate, however, at what point these impairments translate to more traffic accidents. A 2009 study found an increased risk of accidents for levels of THC higher than five nanograms per milliliter of blood, which some evidence indicates is as impairing as a blood alcohol concentration around the legal limit of 0.08 percent. Typically one would have to take several puffs of a joint to reach such a concentration. Consequently, voters in Washington State have adopted 5 ng/mL as the upper threshold for drivers.

Enforcing that limit presents a technical challenge, however. Unlike alcohol, marijuana cannot be detected with a relatively unobtrusive Breathalyzer test. Police officers would have to look for it in blood—something that often requires a warrant. “There is currently no practical method for law-enforcement officers at the scene to collect blood samples from suspected DUI cannabis drivers in a timely manner,” says Paul Armentano, deputy director of the Washington, D.C.–based National Organization for the Reform of Marijuana Laws, which advocates the legalization of marijuana. Instead of using a blood test, Armentano says that police should look for poor maneuvering and the smell of pot wafting from the vehicle.

Smoke Signals

Although marijuana's immediate effects are relatively easy to monitor in the lab, the drug's long-term effects on body and mind are harder to determine. So far the results—which admittedly are subject to multiple interpretations—indicate the need for caution. In one recent study, clinical psychologist Madeline Meier of Duke University and her colleagues examined data from 1,037 New Zealanders. They found that people who began using pot earlier in life and used it most frequently over the years experienced an average decline of eight IQ points by the time they turned 38. By comparison, those who never smoked pot had an average increase of one IQ point by the same age.

A reanalysis of the New Zealand data by Ole Røgeberg of the Ragnar Frisch Center for Economic Research in Oslo, however, suggested that the IQ difference could be explained by socioeconomic factors. People who start smoking marijuana at an earlier age are often less intelligent to begin with. Even if this is true, Meier says, her study shows that the IQ drop is greatest for those who started smoking pot as teenagers rather than in adulthood, indicating a worrisome cumulative effect regardless of intelligence. This finding, she thinks, makes it all the more important to discourage the early use of marijuana among teens.

Increasingly potent marijuana of recent years may be driving a sharp rise in cannabis addiction among adolescents, according to a report released last year by the American Society of Addiction Medicine. Between 1993 and 2008, the average concentration of THC in confiscated marijuana jumped from 3.4 to 8.8 percent. Meanwhile hospital and rehabilitation center admission rates for minors abusing marijuana soared by 188 percent between 1992 and 2006. In contrast, admissions for alcohol abuse for the same group over the same period declined by 64 percent.

In addition to tracking levels of THC itself, some researchers have focused on the dangers of lingering contaminants in marijuana sold on the street. Dealers typically sell cannabis by weight, so some use sand or glass beads to make their products heavier. Breathing in these particles over the years may inflame and eventually scar the lungs. An analysis published last year of data on more than 5,000 Americans did not find a decline in lung function among individuals who smoked joints two or three times a month over two decades. The authors emphasize, however, that they did not assess the effect of daily use on lung health. “Somebody should do that study if marijuana is going to become legalized and prescribed” more widely, says Mark Pletcher, an epidemiologist at the University of California, San Francisco, who co-wrote the paper.

Some opponents of legalization worry that lax regulation of medical marijuana foretells even looser laws concerning recreational marijuana. In states that have legalized medical pot, current laws do not guarantee the safety or quality of cannabis products or standardize levels of THC. In Oakland, Calif., people can fill a marijuana prescription at Harborside Health Center, a massive dispensary with a strict quality-control system. Elsewhere in the state, however, people get their medical marijuana at mom-and-pop outfits or on the street. The next big round of ballot initiatives to legalize cannabis in states other than Washington and Colorado could happen as soon as three years from now, in the 2016 presidential election. Until then, researchers have plenty of marijuana health risks to weed through.

Late last night, Portlanders rejected a plan to fluoridate their city’s water supply (and the water of over a dozen other cities). It’s the fourth time Portland has rejected the public health measure since 1956. It’s the fourth time they’ve gotten the science wrong.

When new medical treatments are implemented, when new drugs are introduced into the populace, there is always some hesitation. There are (hopefully) some clinical trials to back up the new intervention, but the long-term implications are often unclear. Water fluoridation doesn’t have this problem. For over 65 years, it has been rigorously tested as a public health measure, and considered one of the most successful measures of the last 100 years, alongside others like recognizing that tobacco use is a health hazard.

Simply put, the refusal of water fluoridation doesn’t have any scientific support. A review on fluoride’s effect on IQ out of Harvard was waved about as the main scientific opposition, but has since been thoroughly refuted. Decades of studies in different cities in different states, involving millions of people, have concluded that there is a safe level of fluoride—one part-per-million—that can be added to water for enormous benefit to our teeth and oral health with little to no adverse effects.

Without a study to stand on, the main opposition to water fluoridation seems to be political. It is almost understandable that Portland could stand up to health experts and refuse fluoride. Part of the American experiment was letting states decide for themselves what’s best for them and giving citizens the freedom to criticize government action. But the opponents of water fluoridation are boxing with a ghost. There are no known victims of water fluoridation. There are no cities receiving a toxic concentration of the ion. Water fluoridation isn’t just the addition of fluoride; it’s the regulation of fluoride in the water supply. The ion occurs naturally in ground water in varying levels, some that are in fact too high. When this is the case fluoride is actually removed from the water to get the greatest benefit. Arguing against having a regulated supply of fluoride in your water is like an anemic refusing to take iron supplements. The doctor isn’t trying to add enough iron to your blood so that Magneto could pull it out; she is trying make sure the levels in your blood are right for health.

“Keep Portland Weirdly Out Of Touch With Modern Medicine”

Portland is a lovely, if a little rainy, city replete with greenery, mountains, and some of the most interesting nightlife you will ever see. But chemophobia is in the air. Fluoride—an aggressively electronegative atom with an extra electron—has been singled out for scrutiny with a smear campaign. The charge against this negatively charged particle uses propaganda laced with a high concentration of fear-inducing terms and mischaracterizations to rally a small but highly vocal base.

Because there is no evidence that a regulated amount of fluoride in our water is causing harm—the reality is just the opposite—graphic posters like this one on the right color the conversation. Poison? Insecticides? Bone cancer? Why would Portland fluoridate if this poster were right?

But it isn’t. The fear of fluoride follows the same playbook for mischaracterizing chemicals. First, the chemical is labeled “toxic,” but it isn’t mentioned that everything is toxic in the appropriate amounts. Advil and Tylenol are toxic at high enough concentrations, as is water. Many chemicals are harmless within a range of toxicity, and many are beneficial up to certain point. Next, the chemical’s dangerous effects at massive concentrations are stated. But 1/100 or 1/10 of an ounce of fluoride would never be in a glass of tap water in a regulated area—indeed, you are much more likely to find dangerously high levels of fluoride in unregulated water supplies. One part-per-million is the recommended dose, and so one ion floats among a million water molecules. What happens at higher doses can be terrible, which is precisely why you won’t find those levels in regulated water supplies.

The final effort is to link the chemical to other scary things that contain it. This may come as a surprise, but it shouldn’t scare you—your body produces formaldehyde. It does so naturally, but the chemical doesn’t damage or kill you. It’s all about the dose; it makes the poison. Just as a natural amount of formaldehyde in your body isn’t a cause for alarm, neither is a regulated, and proven beneficial, amount of fluoride in your water.

And the fear is selective. Where is the anti-chlorine lobby? Chlorine is a chemical—also an ion—added to water, also considered one of the greatest public health measures in history. It too is proven to reduce disease and create a more healthy population. Chloride has all the attributes that make fluoride “scary.” When an identical situation produces almost no blowback, it speaks to the basis of fluoride fear. It’s not science.

Posters and information campaigns like the one above have caused more damage to the reputation of chemicals than yesterday’s vote. The chemophobia playbook has tattered edges and frayed bindings. The game plan for destroying public support for a chemical is tired, disparaging, inaccurate, and it worked in Portland.

Chemical Conspiracy

“Portland is wrong about fluoridation” is exactly what a government shill would say, isn’t it?

The claims against fluoride are overblown, the science deems it safe, so what’s left are the conspiracy theories claiming it to be a mind control agent or a dumbing-down recipe fed to the helpless sheeple. Though a conspiracy is nigh impossible to refute—every piece of evidence against the conspiracy is “part of the conspiracy”—the supposed fluoride conspiracy is nigh impossible to accept. While we sit in stagnant congressional deadlock, accepting a fluoride conspiracy means answering “yes” to all the following:

Could the government…?

• Control each and every scientist who has ever published a study on water fluoridation?
• Control each and every website that promotes the use of fluoridation?
• Have significant private control of the infrastructure of the Internet to suppress conspiracies?
• Keep every government employee or scientist who knew about fluoridation for the last 65 years from mentioning one word about its dangers at recommended levels?
• Control and coordinate advocacy groups on the local level to write reports and organize in favor of the process?
• Have the time and resources to conduct all these suppressive operations for half a century?

Fluoridation conspiracy theorists can’t trust the government to safely add/remove something to/from their water—as they do for chlorine, cryptosporidium cysts, carbon-based solids, oil, grease, arsenic, lead, and selenium—but will give the government the benefit of the doubt when it comes to policing every shred of information on fluoridation for the last 65 years. As with most conspiracies, pulling on the thread unravels the theory.

And if water fluoridation is a grand conspiracy, at least it’s a safe and cost-effective one. The CDC estimates that every $1 invested in the practice saves approximately $38 in dental costs.

The freedom to question the government that makes America great is a banner that shades our most cherished values. Sometimes, the shadow creeps too far. Should we have the freedom to refuse a critically important public health measure? When the enshrinement of autonomy bleeds into areas where personal opinion is the lowest form of evidence, it leads to perplexing questions about whether or not we have a right to be less healthy by choice.

Portland has the right to keeps fluoride out of its water because the battle cry of American freedom trumps a data point on a graph. Even when surveys of 1^st-3^rdgrader’s dental health recommend water fluoridation, the issue is contorted and amplified into a political screech with unpleasant lows and cringe-worthy highs. Portland remains out-of-step with dental health by choice, by political motivations, and by often-valid concerns over government intrusion. Yesterday’s vote was a failure of science communication, and it falls on public health officials to rectify that, to take back the word “chemical.” Perhaps re-framing the conversation in terms of dental health or water fluoridation as regulation, not just addition, could help. Until political questions are seriously informed by scientific answers, fear and freedom beats facts.

Science can lead a man to fluoridated water, but it can’t make him drink.

In April 15, 2013, Dove launched a 3-minute video entitled “Dove Real Beauty Sketches.” The video achieved instant popularity and has been watched millions of times -- a successful viral campaign which has been widely talked about. In the video, a small group of women are asked to describe their faces to a person whom they cannot see. The person is a forensic artist who is there to draw pictures of the women based on their verbal descriptions. A curtain separates the artist and the women, and they never see each other. Before all this, each woman is asked to socialize with a stranger, who later separately describes the woman to the forensic artist. In the end, the women are shown the two drawings, one based on their own description, the other based on the stranger’s description. Much to their amazement and delight, the women realize that the drawings based on strangers’ descriptions depict much more beautiful women. The video ends: “You are more beautiful than you think.”

The idea is quite appealing. Perhaps too many women are unhappy with their looks. It would be a big relief if we all suddenly realized, like Christian Andersen’s ugly duckling, that we are in fact beautiful.

However, what Dove is suggesting is not actually true. The evidence from psychological research suggests instead that we tend to think of our appearance in ways that are more flattering than are warranted. This seems to be part of a broader human tendency to see ourselves through rose-colored glasses. Most of us think that we are better than we actually are -- not just physically, but in every way.

The most direct evidence that the Dove commercial is misleading comes from the work of Nicholas Epley of the University of Chicago and Erin Whitchurch of the University of Virginia. In a series of studies, Epley and Whitchurch showed that we see ourselves as better looking than we actually are. The researchers took pictures of study participants and, using a computerized procedure, produced more attractive and less attractive versions of those pictures. Participants were told that they would be presented with a series of images including their original picture and images modified from that picture. They were then asked to identify the unmodified picture. They tended to select an attractively enhanced one.

Epley and Whitchurch showed that people display this bias for themselves but not for strangers. The same morphing procedure was applied to a picture of a stranger, whom the study participant met three weeks earlier during an unrelated study. Participants tended to select the unmodified picture of the stranger.

People tend to say that an attractively enhanced picture is their own, but Epley and Whitchurch wanted to be sure that people truly believe what they say. People recognize objects more quickly when those objects match their mental representations. Therefore, if people truly believe that an attractively enhanced picture is their own, they should recognize that picture more quickly, which is exactly what the researchers found.

Inflated perceptions of one’s physical appearance is a manifestation of a general phenomenon psychologists call “self-enhancement.” Researchers have shown that people overestimate the likelihood that they would engage in a desirable behavior but are remarkably accurate when predicting the behavior of a stranger. For example, people overestimate the amount of money they would donate to charity while accurately predicting others’ donations. Similarly, people overestimate their likelihood to vote in an upcoming presidential election, while accurately predicting others’ likelihood to vote.

Most people believe that they are above average, a statistical impossibility. The above average effects, as they are called, are common. For example, 93 percent of drivers rate themselves as better than the median driver. Of college professors, 94 percent say that they do above-average work. People are unrealistically optimistic about their own health risks compared with those of other people. For example, people think that they are less susceptible to the flu than others. Stock pickers think the stocks they buy are more likely to end up winners than those of the average investor. If you think that self-enhancement biases exist in other people and they do not apply to you, you are not alone. Most people state that they are more likely than others to provide accurate self-assessments.

Why do we have positively enhanced self-views? The adaptive nature of self-enhancement might be the answer. Conveying the information that one has desirable characteristics is beneficial in a social environment. People may try to deceive others about their characteristics, but deception has two main disadvantages. First, it is cognitively taxing because the deceiver has to hold two conflicting representations of reality in mind: the true state of affairs and the deception. The resulting cognitive load reduces performance in other cognitive functions. Second, people are good at detecting deception and they show strong negative emotional reactions toward deceivers. Since in self-enhancement people truly believe that they have desirable characteristics, they can promote themselves without having to lie. Self-enhancement also boosts confidence. Researchers have shown that confidence plays a role in determining whom people choose as leaders and romantic partners. Confident people are believed more and their advice is more likely to be followed.

Dove’s premise is wrong. But thinking we are more beautiful than we really are may not be such a bad thing.

Identification and treatment issues surrounding attention deficit hyperactivity disorder (ADHD) are challenging enough. Now research is shedding light on long-term outcomes for people with ADHD. A recent study in Pediatrics reports that men who had ADHD in childhood are twice as likely to be obese in middle age, even if they no longer exhibit symptoms of ADHD.

ADHD is a mental disorder characterized by hyperactivity, impulsivity, inattention and inability to focus. It affects approximately 6.8 percent of U.S. children ages 3 to 17 in any given year, according to a recent report by the CDC. Medications used to treat ADHD, such as Ritalin (methylphenidate) or Adderall (dextroamphetamine and amphetamine), are stimulants that can suppress appetite, however, a couple recent retrospective studies have pointed to a possible increased risk for obesity among adults diagnosed with ADHD as children.

The new 33-year prospective study started with 207 healthy middle-class white boys from New York City between 6 and 12 years old, who had been diagnosed with ADHD. When the cohort reached an average age of 18, another 178 healthy boys without ADHD were recruited for comparison. At the most recent follow-up when the participants were an average age of 41, a total of 222 men remained in the study.

A troubling pattern emerged: A comparison of the men’s self-reported height and weight revealed that twice as many men with childhood ADHD were obese than those without childhood ADHD. The average body mass index (BMI) of the men with childhood ADHD was 30.1 and 41.4 percent were obese, whereas those without the condition as kids reported an average BMI of 27.6 and an obesity rate of 21.6 percent. The association held even after the researchers controlled for socioeconomic status, depression, anxiety and substance abuse disorders.

The results have implications for parents currently raising kids with ADHD. “Many parents are concerned that their children may not be gaining as much weight as they should because [ADHD] medications can decrease appetite in the short run, but these results would lead me to be much less worried about that now,” says corresponding author F. Xavier Castellanos of the Phyllis Green and Randolph Cowen Institute of Pediatric Neuroscience at NYU Langone Medical Center. “It helps us to realize that over the long run, the potential risks of obesity, of overeating and of dysregulation, are a more prominent long-term concern.”

The study is case-controlled, which means researchers identified participants (cases) with the condition and then matched them to a control population to compare outcomes and look for risk factor differences. Therefore, it cannot prove causation because it’s observational. Only a randomized, controlled trial could show that obesity is caused by ADHD, but it’s impossible to randomize participants to have ADHD, both because it’s unethical and because researchers do not know precisely what causes ADHD. Possible causes could include genetics, nutrition, environmental factors or brain injuries.

These findings, however, are similar to results in other studies that have found links between ADHD and obesity. The previous studies, however, were retrospective (relying on participants’ recall), did not focus exclusively on ADHD (included other conduct disorders) or compared only men with adult ADHD to men with remitted childhood ADHD, rather than to controls without ADHD. This prospective study is the most long-term and the first to focus exclusively on adult obesity rates in men with childhood ADHD compared to men without childhood ADHD. Its findings therefore contribute to the growing evidence base for an association between obesity and childhood ADHD.

An unclear mechanism

A link between obesity and childhood ADHD could be explained by either a neurobiological or a psychological mechanism, the authors proposed. With the former, it is possible that something similar genetically underlies both ADHD and obesity; Castellanos and his colleagues note that dysfunction in the dopamine pathways of the brain have been found among both people who are obese and people with ADHD. As for the psychological mechanism, the impulsive behaviors and diminished inhibitions associated with ADHD “may foster poor planning and difficulty in monitoring eating behaviors, leading to abnormal eating patterns and consequent obesity,” the team wrote.

“One of the aspects of ADHD is this tendency to focus on ‘I want it now’ and not waiting for something, not delaying gratification, so we think that may lead people to eat more than they physiologically might need,” Castellanos says. Eating just an extra 100 calories a day than the total burned can easily lead one to accumulate extra pounds. Appetite regulation is complex but usually balances out in healthy individuals — unless they eat when they’re not actually hungry.

Some researchers are dubious about both the neurobiological and the psychological explanations. Lawrence Diller, a behavioral developmental pediatrician at the University of California, San Francisco, and author of Remembering Ritalin and Running on Ritalin, says he finds the idea of dysregulation in adulthood unlikely for adults who no longer have symptoms of ADHD. “The finding is real -- no question about it -- but the explanations are poor,” says Diller. “If the ADHD is remitted, then why should the impulsivity and poor judgment still be there?”

Of the 111 men with childhood ADHD in this study, 87 no longer had ADHD symptoms (remitted) and 24 still had ADHD (persistent). Those with remitted ADHD had relatively higher obesity rates than the persistent-ADHD men, though the small number of men with persistent ADHD makes it difficult to draw any substantial conclusions about this difference.

Diller suggested that the long-term impact of ADHD medication may play a part. “We know that stimulants very much affect the satiety thermostat in people who take them,” he says. “There is the question of whether or not the long-term suppression of appetite somehow affects the brain so that when you’re no longer taking the drugs, it takes more [food] to make you feel full.” Diller pointed to research showing that long-term use of ADHD stimulants can lead to an inch or two of lower-than-predicted height in adults, although the adults in this new study showed no significant differences in height. “That doesn’t mean you shouldn’t take the medicine, but in weighing the pros and cons, it’s one more thing for parents to think about in treatment,” Diller says. “The idea that impulsivity and poor judgment may play a role is possible, but I think my idea of adjusting the satiety thermostat long-term is just as plausible as theirs.”

A different possible mechanism, proposed by Juan Salinas, a lecturer specializing in the neuropharmacology of learning and memory at the University of Texas at Austin, resembles the neurobiological hypothesis, given that ADHD involves a dysfunctional release of dopamine in the brain. “From more basic research into the neurobiology of reward, it’s suggestive that maybe somehow these people who do not have ADHD anymore may have an alteration in the dopamine pathways, and maybe some of the eating may be a way to self-medicate to increase dopamine release,” Salinas says. “It’s not so much impulse control, but it’s a self-medicating idea.” The implications of the study, then, Salinas says, are that parents need to train their children with ADHD early to eat healthily, exercise and practice a healthy lifestyle.

Another line of thought, proposed by Stephen Hinshaw, a psychology professor specializing in ADHD at the University of California at Berkeley and at San Francisco, extends the poor impulse control hypothesis. “It’s plausible that there are biological underpinnings of both ADHD and obesity,” he says, “but the more parsimonious explanation from other research is that ADHD portends problems in self-regulation over time.” In other words, adults who once had ADHD might later be able to sit in a chair and refrain from fidgeting, but emotional and physical regulation issues could linger in the form of less-than-ideal eating habits.

"Devastating" long-term consequences

Hinshaw’s own work with ADHD in girls and other research into long-term outcomes support this idea that the challenges of self-regulation may not fade when the outwardly clinical symptoms of hyperactivity do. His 10-year study of 140 girls with ADHD found much higher rates of self-cutting, self-burning and suicide attempts in this group than were found in a control group.

Additionally, he says, recent research has found high levels of unemployment and underemployment and poorer work productivity among adults who had childhood ADHD than among those who did not. The men with childhood ADHD in the new study also had significantly lower socioeconomic status than those in the control group, even though the groups had been matched initially for parental socioeconomic status and geography. “ADHD still gets ridiculed in the press -- saying it’s a made-up disease or that we just don’t tolerate fidgety kids -- but it has really devastating long-term consequences, and we have to take it seriously,” Hinshaw says.

Rising rates of ADHD diagnoses could be related to both improved health care access for more children and possible misdiagnoses due to the inadequate time spent on assessments in pediatricians’ offices. “We need to insist upon a much higher level of diagnosis and evaluation so that we’re really sure that it’s ADHD and not maltreatment or family conflict or normal-range behavior,” Hinshaw says. For those who really suffer from ADHD, this study provides more evidence of the challenges those children will face in adulthood. “ADHD has staying power,” he says, “regardless of whether the symptoms on the surface improve or not.”

On a rooftop in New York City’s Chelsea neighborhood, two students are collecting soil samples from boxes planted with species from two native plant communities: Hempstead Plains, which are grasses belonging to a prairie community originally found on Long Island, and Rocky Summit grasslands, which grow on the tops of mountains and ridges throughout southern New England and all of New York State. They carefully place the dirt from the soil core into a plastic bag and seal it up to be taken to the lab for analysis.

These two students are part of a research team that is trying to figure out how to maximize the benefits of green roofs. The problem has taken on practical significance as grass and other plants sprout on rooftops all over Manhattan and in other cities. For the past two years, New York City Mayor Michael Bloomberg’s PlaNYC initiative has offered tax abatements for green roof construction and grant money for projects to capture storm water. Rooftop gardens have the potential of lowering energy usage for heating and air-conditioning as well as reducing rainwater runoff, but their effectiveness is not well established.

Researchers are trying to identify the best plant species suitable to green roofs, with an eye to designing ones that fulfill their promise. A 2007 study in the journal BioScience found that green roofs can potentially help manage stormwater runoff, reduce urban heat-island effects and regulate building temperature. To deliver these benefits, rooftop vegetation has to be able to survive the high winds, prolonged UV radiation and unpredictable fluctuations in water availability. To resist these harsh environments, a majority of green roofs are planted with sedum, a non-native species that can survive wind and long periods withoutrainfall. A roof planted with sedum, however, is no greener, from the standpoint of sustainability, than is ordinary tar or asphalt.

Sedum does not absorb water as efficiently as other plant species, according to Scott MacIvor, a PhD student in biology at York University in Toronto who studies bee and wasp habitats on green roofs there, and co-wrote the city’s new guidelines for biodiverse green roofs. At certain times of the year, he says sedum actually absorbs heat instead of reflecting it. “The problem is that sedum plants aren’t really performing on green roofs,” he notes. “They’re just there.” One of the plant’s biggest failings, it turns out, is that it does not encourage biodiversity of plant species on the roof. According to MacIvor’s research, green roofs provide the most benefit when they are planted with a diverse group of species that are adapted to local conditions.

Krista McGuire has taken sedum’s inadequacy as a challenge. The assistant professor of biological sciences at Barnard College wanted to see if a variety of native plants could survive on green roofs and how well they would deliver the desired benefits. Since 2010, the year Bloomberg announced his green roof initiative, McGuire has been comparing soil samples from 10 roofs planted with native vegetation with soil from five city parks spanning New York’s five boroughs, seeking to identify the microbial communities that thrive on green roofs to better to understand how healthy rooftop ecosystems sustain themselves.

Her study, published in PLoS ONE last April, found that green roofs have distinct fungal communities that help plants to thrive in harsh, polluted environments and filter heavy metals. On average, 109 different types of fungi were present on each roof including Pseudallescheria fimeti, a fungus that grows in polluted soils and human-dominated environments. Rooftop soil also contained fungi from the genus Peyronellaea, which live in the tissues of plants to help them take in nutrients.

McGuire hopes her research will be able to help inform green roof companies on planting the best species for each rooftop. Three of the rooftops, which received more intensive sampling, showed that fungal communities are different from one roof to another. Roofs are microclimates, McGuire says. Fungal growth depends on the position of the roof, pollution levels in the area, temperature and how much rainfall it receives. “Plant species are adapting to new environments,” she says. “Without the fungi, the plants would not be able to grow and survive.”

“In the long term, this information may help individuals decide which types of soil microbes to amend on their green roofs, so that they can maximize plant survival and minimize management,” she says.

Out of sight (and smell), natural gas slowly bubbled up into Norma Fiorentino’s private water well near the town of Dimock in northeastern Pennsylvania — in the heart of the new fracking boom in the U.S. Then, on New Year's Day 2009, when a mechanical pump flicked on and provided the spark, Fiorentino's backyard exploded. She and many others blame the blast on fracking — the colloquial name for the natural gas drilling process that combines horizontal drilling and the fracturing of shale deep underground with high-pressure water to create a path for gas to flow back up the well.

The fracking revolution has freed up previously inaccessible natural gas in shale formations like the Marcellus, which underlies states from New York down to West Virginia and has been heavily tapped in Pennsylvania. On May 16 the U.S. Department of Interior released its new guidelines for such fracking on public lands. And a new review article funded by the National Science Foundation and published in Science on May 16 examines what fracking may be doing to the water supply. "This is an industry that's in its infancy, so we don't really know a lot of things," explains environmental engineer Radisav Vidic of the University of Pittsburgh, who led this review. "Is it or isn't it bad for the environment? Is New York State right to ban fracking, and is Pennsylvania stupid for [allowing it]?"

According to the review, the answer is no. "There is no irrefutable impact of this industry on surface or groundwater quality in Pennsylvania," Vidic says.

That's not to say there haven't been problems. That's because there are many ways for things to go wrong with a natural gas well during the fracking process. A new well — or the 100,000 or so existing but forgotten wells — can allow natural gas from either the Marcellus or shallower deposits to migrate up and out of the rock and into water or basements. Leaking methane, in addition to being a potential safety hazard, is also a potent greenhouse gas that exacerbates climate change, although that environmental impact was not examined in this study.

The key environmental safety factor is the casing, the industry term for the sheath of cement that surrounds a newly drilled well. If improperly made, gas can migrate along the outside of this sheath. The gas can also itself leave cracks in the sheath if it is poorly made, freeing yet more gas. According to citation records from the Pennsylvania Department of Environmental Protection (DEP), from 2008 to 2013, 6,466 wells were issued 219 violation notices for well construction problems, suggesting that such problems afflict roughly 3 percent of all wells. The DEP is "not seeing any evidence for groundwater contamination from methane leaks," Vidic adds, noting that government and industry are working on better ways to ensure cement integrity in fracked wells. But problems persist. For example, a test well drilled this past October near Owego, N.Y., continues to leak.

At the same time, wells in New York State where there has been no fracking show similar concentrations of methane to those in Pennsylvania where fracking is abundant. Northeastern Pennsylvania — where Dimock is located — seems to be a hotspot for such methane contamination, even compared with other parts of the same state. "These formations in northeastern Pennsylvania are, for whatever reason, more problematic," Vidic says, adding that in the future a more precise understanding of the constituents in natural gas from various regions may allow accurate identification of where any contamination comes from, whether the Marcellus or shallower coal seams. "But there's no irrefutable, sustained evidence of contamination going on continuously, so [the gas industry] must be doing something right."

One reason there is no such irrefutable evidence is because of a lack of publicly available baseline data for the condition of groundwater prior to any drilling and fracking. That data is collected, often by the gas companies themselves, but not shared due to privacy issues. (For example, it may affect the potential sale value of property found to have existing contamination.) And Pennsylvania also lacks good groundwater monitoring because it is not required by law. "If we forced Pennsylvania to enact that rule, that would be a good outcome," Vidic says.

A study in 2011 found levels of methane contamination were higher closer to fracking among 60 wells tested, although Vidic suggests that the levels were close to the background levels published by the U.S. Geological Survey (USGS).

Not all experts share that interpretation — or the generally rosy outlook of the new Science review. "I don't agree that the levels we found were similar to background levels found by USGS," argues environmental scientist Robert Jackson of Duke University, who lead that study and was not involved with this one. "This review is a mixed bag. Its call for additional monitoring makes perfect sense. Its dismissal of all environmental concerns doesn't."

Another particular concern is the potential for the fracking fluid itself to contaminate water. The exact fracking fluid cocktail is kept secret, although it can range over some 750 secret ingredients, such as coffee grounds or methanol. Each well requires some 7.5 million to 26.5 million liters of water for the fracking operation itself. Such tainted water has been found outside the Marcellus shale zone deep underground, although still more than a kilometer beneath groundwater supplies. And shallow wells fracked in other regions, such as West Virginia and Wyoming, have contaminated the groundwater. But as of yet, fracking fluid has not yet fouled Pennsylvania’s groundwater. "I'll take my chances on winning the lottery over the chances of frack fluid in the groundwater," Vidic says, noting that water from specific formations could also be tracked like the gas itself.

Another potential environmental problem comes from all the wastewater that flows back up the well and has to be properly disposed of. At present, Marcellus shale wells are mostly absorbing the water pumped in to them. But at some point in future, all of these wells will begin to produce water that carries toxic and even radioactive contaminants leached from the surrounding rock along with lots and lots of salt. That is already happening; contamination seems to be showing up in the state's rivers, streams and other waterways, according to the review. And if Pennsylvania were to decide to deal with such water by evaporating it, Vidic notes, they will have to figure out how to get rid of the 10 million metric tons of sodium chloride left over. "The entire U.S. uses maybe 15 million tons for de-icing,” he adds, “and you can't put it in a landfill because it will just dissolve."

Other states use disposal wells to dump the water back down deep underground where it came from, but that's not an option in Pennsylvania due to the underlying geology and regulations. As a result, drillers and gas companies in the state increasingly reuse the water in new wells. In fact, in the first six months of 2012 they achieved a reuse rate of 90 percent. "The best thing to do with wastewater is to recycle or reuse it," Duke's Jackson says. "Industry deserves credit for increasingly doing this." But that won't last forever.

Ultimately, the question becomes: What will be the long-term legacy of these wells? After all, the now-moribund coal industry left the Keystone State a toxic legacy it is still coping with today. Although some provisions have been put in place to deal with future abandoned wells, there is not enough money set aside to deal with these future liabilities. "Do we leave them or plug them up, and what are the potential impacts?" Vidic asks. "Now's the time to think about who's going to pay for it when the wells have run their course."

Ancient philosophers were far from alone in their musings about time. Playwright Tennessee Williams wrote in 1944 that time is the longest distance between two places. And the years since have proved him right. Fast travel, instant communications and express deliveries between opposite ends of the world mean, more than ever, that time is not only relative but also an illusion.

But time is also money, or so the axiom goes. Certainly both time and money are precious, exist in limited quantities and can be intimately intertwined. Have you ever longed to get away but lacked the money or time to take your ideal vacation? In our travels we have noticed that airports, surprisingly, are a favorite location for high-end watch displays. It is as if travelers commonly must decide before imminent takeoff whether to pop into the newsstand to grab some gum and a copy of Scientific American or stop by the adjoining jewelry counter for a $10,000 Rolex. Who chooses the latter? We can't, unfortunately, although we do like to window shop. Next time you do, pay special attention to the watch displays and see if you notice anything unusual. You may see how advertisers exploit the intersection of time and illusion to sell their products.

Accurate Twice Each Day

Search for the term “watch images” on your favorite Internet browser, and you'll find something bizarre. Almost every watch is set to 10:10. What belief, what powerful insight, what shared brain mechanism could cause salespeople to hock their clocks with that setting? Is it that shoppers preferentially like to make purchases just after morning tea? Or, as conspiracy theorists have suggested, because 10:10 is the hour when John F. Kennedy, Martin Luther King, Abraham Lincoln or John Lennon was assassinated? Or when Fat Man and Little Boy burned the sky above Nagasaki and Hiroshima? Nope. All such proposals are factually incorrect.

According to the New York Times, the Hamilton Watch Company was among the first to set its products to 10:10—in the 1920s. The previous standard setting was 8:20. Some advertising executives now assume that the switch occurred to turn the watches' 8:20 “frown” upside down, into a “smile.”

But to visual neuroscientists like us, all this speculation begs the question as to why clock hands were set to oblique 8:20/10:10 positions in the first place. It seems unlikely that pre-1920 watchmakers wanted their watches to frown. One possibility is that oblique watch-hand orientations are best at keeping company logos uncovered—but, if so, horizontal positions such as 9:15 or 2:45 would be even better. Because horizontal orientations have never been popular in watch advertisement, we can rule this idea out.

Could it then be that oblique orientations result in higher watch sales than do cardinal—or vertical and horizontal—orientations? The answer may well be affirmative, and the neuroscience of perception and cognition reveals why. Scientists have long known that we can detect cardinal orientations more easily than oblique orientations. The visual cortex, moreover, responds to oblique orientations more weakly, as if they had lower contrast than cardinal orientations of the same physical brightness. In addition, fewer neurons are sensitive to oblique than to cardinal orientations. As a result, obliquely oriented watch hands are a bit more difficult for us to see.

At first, this fact may seem like bad news for marketing timepieces, especially if you think that watch hands should be as visible as possible in ads. But neuroscience tells us why it is actually a benefit. To maximize the potential for sales, you really want your customers to rivet their attention on your product—and the visual challenge of seeing the oblique position draws that attention. Visual attention has the effect of enhancing the perception of low-contrast image elements in perception. As it happens, the enhancement is most valuable when those elements are difficult to detect because attention is stronger when the object of interest is hard to see—such as watch hands that are oriented obliquely.

If Mad Men (and Women) intuited that obliquely oriented lines are attention getters, people in other fields may have arrived at similar conclusions. We looked for prominently featured clocks in fine art paintings and—violà!—Marc Chagall used the time 10:10 in his famous series of clock paintings dating as far back as 1914, before the watch industry's own 10:10 preference.

Time's Arrow

Watch manufacturers are not the only companies that have toyed with the interaction of time and illusion in commercial advertising. When you use FedEx courier services to buy yourself some time, you may overlook the clever illusion hidden in the company's iconic logo: time's arrow, pointing toward the future. You can see either the white arrow or the FedEx letters, but not both at once, because one is always the background to the other.

The current FedEx logo was shortened from the earlier company name Federal Express and given a new snazzy illusory design element, the background arrow between the “E” and the “x.” Did the company shorten the name to reduce the amount of paint needed for signage on its planes and trucks? That explanation makes no sense, unless the painters could use only one font size. Once the name was shorter, they could just paint the letters larger to take up the same space and use about the same amount of paint. In fact, according to Linden Leader, the graphic artist who designed the new logo, the FedEx CEO specifically requested that the logo be easily legible on every truck from five blocks away.

Instead the change resulted from a thorough analysis of the company's name recognition in the market. Why might the new logo be more effective? One reason is that the arrow, a symbol that has special meaning to our cognitive system, helps to draw attention to the logo as a whole. Arrows indicate what scientists call “implied motion.” Visual neuroscientists Anja Schlack and Thomas Albright of the Salk Institute for Biological Studies have shown that neurons that respond preferentially to specific directions of motion in the world are also activated by arrows pointing in the corresponding direction, even though the arrows are not themselves moving but just represent the concept of motion.

The FedEx arrow pointing to the right signifies motion toward the future for those who write in English and other left-to-right languages. Moreover, because our motion areas also have more neurons that prefer cardinal rather than oblique directions, here the arrow invokes a powerful competition with the FedEx name itself, so our perception vacillates between “FedEx” and forward momentum. In languages read right to left, the FedEx arrow points toward the left, such as in the Arabic version of the logo, consistent with the corresponding cognitive representation of time's arrow.

This same left-to-right effect works to express temporal order of pictograms grouped in sequences, such as in the famous representation of human evolution from prehominin to Homo sapiens. The direction of the sequence is fundamentally arbitrary, yet if you grouped it the wrong way, it would look like a time reversal.

So time may fly like an arrow, but it is your attention to time that advertisers care about.

Saturn's rings are such a spectacle that you can see them through even a modest telescope. Made mostly of water ice, the rings contain countless particles, large and small, that orbit the planet in a thin plane. For decades scientists have known that gravitational tugs from Saturn's many moons imprint patterns on the rings. Now they have discovered a new ring sculptor: oscillations of the planet itself, which promise insight into the interior of the solar system’s second-largest planet.

The discovery came about because of a close inspection of Saturn’s rings. From outermost to innermost, the three main rings are named A, B and C. In 1980, when the Voyager 1 spacecraft flew past, it found grooves in each ring that resemble those on a vinyl record. The gravitational pulls of Saturn's moons make waves, mostly in the A ring, because that's the one closest to the moons.

In 1991, however, Paul Rosen, then at Stanford University, and his colleagues used Voyager data to discover waves in the C ring, the one nearest the planet. Although the moons accounted for some of these waves, no one knew what caused the others.

Then, in 2004, the Cassini spacecraft began orbiting Saturn, and Matthew Hedman and Philip Nicholson at Cornell University used Cassini to observe background stars through the C ring. By measuring how much starlight different parts of the ring absorb, the scientists mapped six of the mystery waves in detail. "We found that Saturn probably is affecting the rings just as the moons do," Hedman says. As he and Nicholson will report in a future issue of The Astronomical Journal, the pattern speeds of the six waves around Saturn match those that should result as Saturn's interior sloshes back and forth and alters its gravitational field.

The discovery has stirred other planetary scientists. "It's incredibly important," says Jonathan Fortney at the University of California, Santa Cruz. "It opens up the possibility of using seismic data to understand the structure of a giant planet, which has been phenomenally successful for the sun and for Earth."

"The rings are a seismograph," says Mark Marley of NASA Ames Research Center, who in 1990 earned his doctorate for predicting that Saturn's oscillations would affect its C ring. Then, after the discovery of the mystery waves, he and planetary scientist Carolyn Porco, then at the University of Arizona, proposed that the planet's oscillations were producing those waves, whose characteristics match the properties of the six waves Cassini has examined. The recent discovery is "a brand-new window into the interior structure of the planet," Marley says.

"I've been skeptical for a long time that you could do this kind of seismology at all," says David Stevenson of Caltech, who nonetheless thinks the discovery is genuine and notes that French astronomers have recently reported detections of oscillations on Jupiter. "Maybe we are on the verge of having a new way of understanding giant planet structure."

The waves' properties indicate that current models of Saturn's interior are approximately correct. The waves also present a puzzle, however. Marley and Porco's calculations had suggested that each ripple in the rings should arise from a different type of oscillation inside Saturn—but instead Hedman and Nicholson found multiple waves resulting from the same type of oscillation. "That was not predicted," Hedman says. "That implies there is something missing in the models."

Now that Hedman and Nicholson have succeeded in mapping six Saturn-induced ring waves, other planetary scientists will refine their models of the planet's interior. They already know Saturn consists mostly of hydrogen and helium, which surround a core of ice, rock and iron, but the core's exact weight—thought to be roughly 10 to 20 Earth masses—is unknown.

Models of Saturn carry implications beyond the solar system. "Many of the extrasolar planets we see are gas giants," Hedman says. "Jupiter and Saturn provide close-by versions of what gas-giant planets are, so if we can understand the interior structure of these guys pretty well, we should be able to better understand other giant planets too."

No one knows whether giant planets elsewhere sport beautiful rings. Astronomers can't yet discern rings around extrasolar planets, and the sun's other giant worlds—Jupiter, Uranus and Neptune—possess only faint rings. This observation raises the intriguing possibility that rings as spectacular as Saturn's could be rare in the Milky Way, which would make our solar system one of the few to boast such a stunning sight.

Think about the last time you were about to interview for a job, speak in front of an audience, or go on a first date. To quell your nerves, chances are you spent time preparing – reading up on the company, reviewing your slides, practicing your charming patter. People facing situations that induce anxiety typically take comfort in engaging in preparatory activities, inducing a feeling of being back in control and reducing uncertainty.While a little extra preparation seems perfectly reasonable, people also engage in seemingly less logical behaviors in such situations. Here’s one person’s description from our research:I pound my feet strongly on the ground several times, I take several deep breaths, and I "shake" my body to remove any negative energies.  I do this often before going to work, going into meetings, and at the front door before entering my house after a long day.While we wonder what this person’s co-workers and neighbors think of their shaky acquaintance, such rituals – the symbolic behaviors we perform before, during, and after meaningful event – are surprisingly ubiquitous, across culture and time. Rituals take an extraordinary array of shapes and forms. At times performed in communal or religious settings, at times performed in solitude; at times involving fixed, repeated sequences of actions, at other times not. People engage in rituals with the intention of achieving a wide set of desired outcomes, from reducing their anxiety to boosting their confidence, alleviating their grief to performing well in a competition – or even making it rain.

Recent research suggests that rituals may be more rational than they appear. Why? Because even simple rituals can be extremely effective. Rituals performed after experiencing losses – from loved ones to lotteries – do alleviate grief, and rituals performed before high-pressure tasks – like singing in public – do in fact reduce anxiety and increase people’s confidence. What’s more, rituals appear to benefit even people who claim not to believe that rituals work. While anthropologists have documented rituals across cultures, this earlier research has been primarily observational. Recently, a series of investigations by psychologists have revealed intriguing new results demonstrating that rituals can have a causal impact on people’s thoughts, feelings, and behaviors.

Basketball superstar Michael Jordan wore his North Carolina shorts underneath his Chicago Bulls shorts in every game; Curtis Martin of the New York Jets reads Psalm 91 before every game. And Wade Boggs, former third baseman for the Boston Red Sox, woke up at the same time each day, ate chicken before each game, took exactly 117 ground balls in practice, took batting practice at 5:17, and ran sprints at 7:17. (Boggs also wrote the Hebrew word Chai (“living”) in the dirt before each at bat. Boggs was not Jewish.) Do rituals like these actually improve performance? In one recent experiment, people received either a “lucky golf ball” or an ordinary golf ball, and then performed a golf task; in another, people performed a motor dexterity task and were either asked to simply start the game or heard the researcher say “I’ll cross fingers for you” before starting the game. The superstitious rituals enhanced people’s confidence in their abilities, motivated greater effort – and improved subsequent performance. These findings are consistent with research in sport psychology demonstrating the performance benefits of pre-performance routines, from improving attention and execution to increasing emotional stability and confidence.

Humans feel uncertain and anxious in a host of situations beyond laboratory experiments and sports – like charting new terrain. In the late 1940s, anthropologist Bronislaw Malinowski lived among the inhabitants of islands in the South Pacific Ocean. When residents went fishing in the turbulent, shark-infested waters beyond the coral reef, they performed specific rituals to invoke magical powers for their safety and protection. When they fished in the calm waters of a lagoon, they treated the fishing trip as an ordinary event and did not perform any rituals. Malinowski suggested that people are more likely to turn to rituals when they face situations where the outcome is important and uncertain and beyond their control – as when sharks are present.

Rituals in the face of losses such as the death of a loved one or the end of a relationship (or loss of limb from shark bite) are ubiquitous. There is such a wide variety of known mourning rituals that they can even be contradictory: crying near the dying is viewed as disruptive by Tibetan Buddhists but as a sign of respect by Catholic Latinos; Hindu rituals encourage the removal of hair during mourning, while growing hair (in the form of a beard) is the preferred ritual for Jewish males.

People perform mourning rituals in an effort to alleviate their grief – but do they work? Our research suggests they do. In one of our experiments, we asked people to recall and write about the death of a loved one or the end of a close relationship. Some also wrote about a ritual they performed after experiencing the loss:

I used to play the song by Natalie Cole “I miss you like crazy” and cry every time I heard it and thought of my mom.

I looked for all the pictures we took together during the time we dated. I then destroyed them into small pieces (even the ones Ireally liked!), and then burnt them in the park where we firstkissed.

We found that people who wrote about engaging in a ritual reported feeling less grief than did those who only wrote about the loss.

We next examined the power of rituals in alleviating disappointment in a more mundane context: losing a lottery. We invited people into the laboratory and told them they would be part of a random drawing in which they could win $200 on the spot and leave without completing the study. To make the pain of losing even worse, we even asked them to think and write about all the ways they would use the money. After the random draw, the winner got to leave, and we divided the remaining “losers” into two groups. Some people were asked to engage in the following ritual:

Step 1. Draw how you currently feel on the piece of paper onyour desk for two minutes.
Step 2. Please sprinkle a pinch of salt on the paper with your drawing.
Step 3. Please tear up the piece of paper.
Step 4. Count up to ten in your head five times.

Other people simply engaged in a task (drawing how they felt) for the same amount of time. Finally, everyone answered questions about their level of grief, such as “I can’t help feeling angry and upset about the fact that I did not win the $200.” The results? Those who performed a ritual after losing in the lottery reported feeling less grief. Our results suggest that engaging in rituals mitigates grief caused by both life-changing losses (such as the death of a loved one) and more mundane ones (losing a lottery).

Rituals appear to be effective, but, given the wide variety of rituals documented by social scientists, do we know which types of rituals work best? In a recent study conducted in Brazil, researchers studied people who perform simpatias: formulaic rituals that are used for solving problems such as quitting smoking, curing asthma, and warding off bad luck. People perceive simpatias to be more effective depending on the number of steps involved, the repetition of procedures, and whether the steps are performed at a specified time. While more research is needed, these intriguing results suggest that the specific nature of rituals may be crucial in understanding when they work – and when they do not.

Despite the absence of a direct causal connection between the ritual and the desired outcome, performing rituals with the intention of producing a certain result appears to be sufficient for that result to come true. While some rituals are unlikely to be effective – knocking on wood will not bring rain – many everyday rituals make a lot of sense and are surprisingly effective.

Clean greens are healthy greens.

Or so thought a coalition of farmers, growers and processers in California when, in response to a deadly spinach outbreak of the bacteria Escherichia coli (E. coli), they created a new set of bacteria-minimizing standards for growing and handling leafy greens.

Although the standards were designed to eliminate potential sources of contamination by mandating that crop sites be cleared of vegetation and kept a certain distance from wildlife and natural bodies of water, they have had some unintended consequences—namely, the destruction of habitats, the degradation of soil and the pollution of rivers and streams.

Researchers found that the 2006 regulations, a system of voluntary corporate standards enforced through third-party audits, have not only been ineffective at reducing the risk of food-borne illness, but have contributed to a loss of ecological diversity in the Salinas River Valley, an area of California prized for its variety of animal and plant life and the center of production for 70 percent of America’s leafy greens.

A study, published in the May 6 edition of Nature, measured changes farmers and growers made to the environment between 2005 and 2009. Using satellite images from the National Agriculture Imagery Program, researchers broke the 15,000-hectare study area into ecological communities defined by vegetative type. The greatest amount of habitat loss, they found, occurred in transitional communities, where fast-growing grasses, shrubs and trees depend on constant disturbance for survival.

Researchers discovered that the new farming practices have further de-incentivized growers from farming in ways that take into account the importance of natural systems of resource cycling and plant regeneration. Instead, many have cleared land of native vegetation, erected fences and laid poison to deter the presence of wildlife. As a result of growers’ attempts to control for all potential variables on crop sites, farmed areas have become not only uninhabitable for wildlife but also more vulnerable to climate change.

Study authors say the practices are an overzealous attempt to respond to consumer concerns about foodborne illness. “There is this pressure from consumers and buyers to go above and beyond what’s necessary for clean food,” says ecologist Sasha Gennet, a researcher at The Nature Conservancy and the lead author of the study.

The impact of the regulations on foodborne illness has not yet been proven. Since the 2006 outbreak of E. coli was linked with spinach grown in California, at least 15 more domestic E. coli outbreaks have been reported. More than half included cases reported in California.

Iowa State University landscape ecologist Lisa Schulte Moore says the study carries important implications for the future of farming. As the epicenter for the majority of America’s leafy greens, the Salinas Valley is seen as a model of successful farming practices. If these practices continue, Moore says, other states could begin implementing farming regulations that harm the environment. “As someone who lives in one of the biggest farming states in the country, what I’m worried about is, what is this going to mean for other farmers?”

But growers say their methods are necessary to protect consumers. The 2006 E. colioutbreak, for example, sickened nearly 300 people and cost San Juan Bautista–based company Earthbound Farms over $70 million in damages.* But after an investigation into the source of the outbreak turned up no leads, Will Daniels, the company’s director of farm and food safety, led an overhaul of the entire production line. Thanks to a new system of intensive safety precautions—which includes irradiating crops with bacteria-killing UV rays and distancing crop sites from potential sources of microbial contamination, such as streams or animal habitats—Daniels says consumers can be assured that the product they are buying is safe to eat.

Without knowledge of the cause of bacterial outbreaks, California farmers and growers are going too far in their efforts to ensure crops are grown in virtual isolation from their surrounding environment, says Moore. “The main problem is that there’s this understanding in the community that everything we do to improve food safety is great. But it’s this overzealous attempt to improve upon a good thing that’s really costly for the environment.”

A University of Texas at Austin law student has demonstrated to the world that any ambitious tinkerer can make a handgun almost entirely out of 3-D printed parts. Cody Wilson’s revelation is not likely to lead to an arsenal of plastic zip guns anytime soon, but it does raise a number of hairy questions about a technology that, until now, has been highly touted as central to the future of manufacturing in the U.S.

Images and video of Wilson posing with and firing his “Liberator” handgun have made the rounds on the Internet in recent days. It’s a stark contrast to the image that 3-D printing, or “additive manufacturing,” proponents have pursued thus far, where the world benefits from robotic prosthetics, replacement hips and other biomedical wonders manufactured layer by layer out of molten plastic or metal, as dictated by a CAD (computer-aided design) file.

Wilson’s gun consists of 15 parts assembled after being printed individually in a Stratasys Dimension SST machine out of white ABS plastic—a polymer made from the chemical compounds acrylonitrile, butadiene and styrene. Only the gun’s firing pin (a common nail) and an obligatory piece of steel embedded in the handle—so that it does not violate the Undetectable Firearms Act (pdf)—are metal. Wilson has made the design files needed to create the Liberator—that fires standard handgun rounds—available as a free download for anyone interested in replicating his work.

Wilson positions himself as a protector of civil liberties—in particular “popular access to arms”—and has founded a nonprofit called Defense Distributed to further this goal. His libertarian views are not unlike those of free, open-source software advocates or hackers who take down Web sites and pick apart popular software like Windows to prove they are not as secure as they appear—except for the small detail that he wants to empower people to make devices that can harm or kill other people. (He’s also published blueprints for 3-D printing part of an AR-15 semiautomatic rifle.)

Technically speaking, Wilson’s so-called “Wiki Weapon” pushes the boundaries of 3-D printing capabilities, especially those of lower-end systems not able to work with anything stronger or more durable than ABS plastic. Although the Liberator currently fires only a single shot, better materials as well as improved designs and post-processing techniques might ultimately lead to a weapon that can shoot multiple rounds without breaking down.

To learn more about the potential impact of Wilson’s work on the world of 3-D printing, Scientific American spoke with Ryan Wicker, director of the University of Texas at El Paso’s W. M. Keck Center for 3-D Innovation. Wicker shared his thoughts about Wilson’s invention, the technical challenges of making a 3-D printed gun and the reality that the unbridled creativity promoted by 3-D printing was destined to take a darker turn.

[An edited transcript of the interview follows.]

What was your reaction when you learned that someone had printed nearly all of the components needed to assemble a handgun using a 3-D printer?

This story has been developing for months, if not years, so it was pretty anticlimactic. I probably first became aware of what [Wilson] has been doing when Stratasys went in and confiscated the printer they leased to him [in October. I have been hearing for years about people using 3-D printers to make parts for guns. In the evolution of 3-D printing it’s certainly natural for things like this to happen.

Are there specific challenges to making a working firearm using 3-D printed parts?

Building the parts with a high level of dimensional accuracy would be one challenge and the material performance would be another. A firearm experiences a high-energy impulse in the chamber, where the gun components start off at ambient conditions but are subjected very quickly to higher temperatures and pressures. This sudden change can compromise the structural integrity of the gun, even possibly making it explode.

What is the significance of Wilson making most of his gun parts out of ABS plastic?

ABS is an inexpensive polymer typically used by the type of 3-D printer that he used. There are plastics that are stronger, more durable and perform much better than ABS, but those higher-end materials require higher-end machines than what he had.

Why is ABS the standard plastic for lower-end systems?

ABS is just a commodity, a commonly used plastic that the automotive industry has used for years to create injection-molded parts. Different 3-D printing systems work differently, but [Wilson’s] uses an extrusion-based process that’s analogous to a hot-glue gun. ABS’s extrusion temperature [the point at which the polymer starts to deform and can be squeezed out into layers] is lower than other, more capable plastics. It doesn’t require a more expensive system that can [operate at] higher temperatures.

Why not use a more durable plastic?

Stratasys offers a more expensive plastic called Ultem, which potentially would be a better performer than ABS for this application. But you can’t print this type of high-end material using the low-end [$20,000] industrial printer that [Wilson] used. You need a high-end machine that costs anywhere between $100,000 and $400,000 to be able to use those better plastics. Although it’s not possible now, that doesn’t mean someone couldn’t develop the capability to work with better plastics on low-end systems.

Other than the materials that can be used, what limitations do lower-end 3-D printers have at this time?

Another limitation is accuracy. These machines don’t have the temperature control of higher-end systems, and consequently the dimensional accuracies suffer. The more expensive industrial systems take into account how much a part will change as it goes through the process of being made. Better temperature control enables a printer to better adjust for changes in the material as it is layered, solidifies and shrinks. If you don’t take those changes into account, some layers might be farther apart, creating voids that prevent the finished product from being as strong as it could be.

All of these things can be overcome. There are lots of people working in their homes on inexpensive desktop systems [like those MakerBot produces] who are going to be geeky, experimenting and optimizing their systems. They’ll write their own code and figure out how to compensate for their equipment and materials. That’s what my students do. There is some knowledge that you have to develop to use these systems optimally.

As inventors develop this knowledge, are there concerns that more of them will experiment with 3-D printed weapons?

3-D printing is not the only enabling technology here. 3-D printers may be a little less complicated to use than [some computer numerical control (CNC) systems that manufacturers use to make tools], but you still can buy a CNC machine today and use that to build weapons. In fact, I would be much more scared of people who have expertise in machine shops [making weapons] than I would of someone using a 3-D printer.

And, even if you don’t print the parts for the weapons yourself, there’s an entire industry that makes parts on demand today using 3-D printing. You can upload your file online without even speaking with anyone and pay for it with your credit card.

How soon will higher-end 3-D printers capable of using better materials become affordable for hobbyists and inventors?

I don’t know how much the cost can come down for some high-end systems because they are big machines and they use more expensive industrial components, which limits how much the price can be reduced. And the price of high-end systems may not be the limiting factor for hobbyists because they can take a desktop system [like those made by MakerBot] and supercharge it, and there’s no technical reason you couldn’t use it to print a weapon.

How would you supercharge a desktop 3-D printer to give it that capability?

I may enclose it so that I can reach higher temperatures and work with [stronger, more durable] materials. I might also do this by modifying the printer’s heater to make the printhead hotter.

People are less likely to modify an industrial system because companies like Stratasys don’t give you access to their printer’s source code. MakerBot and other desktop printer–makers do. That means I can write my own code to change things on these lower-end systems but I can’t [change] that on a Stratasys system. Even the materials used by industrial systems are controlled. A canister of material used in a Stratasys printer even has a microchip that knows what and how much material it contains.

What impact will Wilson’s experiment have on 3-D printing?

It concerns me a little, but I think this type of project was inevitable. We would all like these technologies to be used for the benefit of society, and I believe these benefits far outweigh the risks. There are lots of wonderful examples—customized hearing aids, 3-D printed electronics and even shoes as well as [efforts to print artificial human] organs. The government will ultimately decide whether the technology should be regulated, but I see these technologies completely disrupting the way we make products, and bringing innovative, entrepreneurial manufacturing work back to the U.S. We’ve traveled too far down the road to turn back at this point. With these technologies, the future is limited only by one’s imagination.

Into brains of newborn mice, researchers implanted human “progenitor cells.” These mature into a type of brain cell called astrocytes (see below). They grew into human astrocytes, crowding out mouse astrocytes. The mouse brains became chimeras of human and mouse, with the workhorse mouse brain cells – neurons – nurtured by billions of human astrocytes.

Neuroscience is only beginning to discover what astrocytes do in brains. One job that is known is that they help neurons build connections (synapses) with other neurons. (Firing neurotransmitter molecules across synapses is how neurons communicate.) Human astrocytes are larger and more complex than those of other mammals. Humans’ unique brain capabilities may depend on this complexity.

Human astrocytes certainly inspired the mice. Their neurons did indeed build stronger synapses. (Perhaps this was because human astrocytes signal three times faster than mouse astrocytes do.) Mouse learning sharpened, too. On the first try, for instance, altered mice perceived the connection between a noise and an electric shock (a standard learning test in mouse research). Normal mice need a few repetitions to get the idea. Memories of the doctored mice were better too: they remembered mazes, object locations, and the shock lessons longer.

The reciprocal pulsing of billions of human and mouse brain cells inside a mouse skull is a little creepy. Imagine one of these hybrid mice exploring your living room. Would you feel like a Stone Age tribesman observing a toy robot? Does the thing think?

Neuroscience has no idea – none – of how a mind rises like a genie from the fleshy human brain. It supposes, however, that the magic trick’s spoiler will turn out to reside in physics and chemistry of brain cells. That is the discipline’s fundamental assumption. Nowhere else can the mystery be hiding.

But we have no idea what’s happening as billions of human astrocytes animate rodent awareness inside the tiny skulls. And “awareness” is one quality of “mind.” Do billions of human cells have no effect on mouse awareness? That seems unlikely.

Most adults have bad breath occasionally, particularly when their mouth dries out after, say, a full night's sleep or a long, dehydrating plane flight. About 25 percent of people worldwide, however, have chronic foul breath. Researchers around the world figured out years ago that gas-emitting bacteria on the tongue and below the gum line are largely responsible for rotten breath. But determining how best to eradicate these microbes' tenacious odors has been difficult.

Solutions to date offer only temporary relief. Even scrupulously skipping onions and garlic, swishing mouthwash after every meal, and brushing and flossing one's teeth until they gleam like pearls will probably not sweeten a case of stubbornly stinky breath. Lightly scraping away any coating on the tongue can greatly improve the fragrance of one's breath for at least a few hours. Certain bacteria-slaying mouthwashes provide short-term freshness, too, although many produce unpleasant side effects, such as a tingling sensation in the mouth. Lately some scientists have developed innovative mouth rinses that neutralize the rancid compounds produced by bacteria.

Recent evidence from international research suggests, however, that the most effective strategy for beating back bad breath may be more about nurturing helpful bacteria in the mouth than about destroying the offending germs and their by-products. Instead of singling out ostensible culprits, microbiologists are now shifting their focus to entire communities of microbes on the tongue, gum and teeth to figure out why some people have a sweeter-smelling oral village than others.

Breath's Chemical Code

Bad breath has, of course, plagued humans for ages. Young girls, Hippocrates advised, should regularly rinse their mouths with wine, anise and dill seed. By the early 1970s Joseph Tonzetich of the University of British Columbia had begun to tackle the problem with technology. He used his lab's gas chromatograph, a machine that separates a complex gaseous bouquet into its constituent compounds, to tease out reeking breath's signature chemicals.

Sulfur compounds that easily vaporize were among the stinkiest chemicals Tonzetich identified in bad breath, especially hydrogen sulfide, which smells like rotten eggs, and methyl mercaptan, which smells like rotten cabbage. Since then, scientists have detected around 150 molecular components of human exhalations, many of them putrid. Dimethyl sulfide (think rotten seaweed) and the tellingly named cadaverine, putrescine and skatole are just a few such pungent molecules. Still, hydrogen sulfide and methyl mercaptan stand out: in study after study, the higher the levels of these two molecules in breath, the more that breath offends the human nose.

These smelly compounds are waste products released by the millions of bacteria feasting on particles of food and tissue in our mouth. Above the gum line, gram-positive species, which have relatively simple cell walls, dominate dental plaque—the living film of bacteria coating teeth. Streptococcus mutans and other sugar-loving gram-positives spew acid and dissolve enamel but are not heavy producers of foul-smelling compounds. In contrast, gram-negative bacteria—which have an extra cell wall layer—live mostly below the gum line and are much gassier. Some of these resilient bacteria, including Porphyromonas gingivalis, Treponema denticola andPrevotella intermedia, thrive in gaps between the gum and tooth and in the mosh pit crevices of the tongue.

Bacterial Colleagues

Gram-negative bacteria on the tongue may produce most of the foul odors in breath, but recent research emphasizes that no single type of oral bacterium creates bad breath on its own. Mel Rosenberg, an emeritus professor of microbiology at Tel Aviv University, and his colleague Nir Sterer recently found, for example, that some strains of gram-positive bacteria secrete an enzyme that clips sugar molecules off the proteins found in food, which in turn makes those proteins more digestible for nearby gram-negative organisms. The more proteins the gram-negatives digest, the more odors they emit.

Such interactions illustrate why researchers are increasingly interested in oral ecology, viewing the mouth as a kind of densely populated tide pool. Fresh breath reflects a healthy mouth, which is not necessarily one that lacks “bad” bacteria, scientists are realizing, but rather one in which overlapping bacterial colonies hold one another in check.

Bacterial geneticists contributing to the Human Microbiome Project, funded by the National Institutes of Health, have so far identified about 1,000 species of bacteria that commonly inhabit human mouths. Yet one person's particular mix of “bacterial colleagues,” as Rosenberg calls them, is probably quite different from another's. “Each person has maybe 100 to 200 of those bacterial species colonizing their mouth at any given time,” says Wenyuan Shi, a microbiologist at the University of California, Los Angeles.

During birth our previously sterile mouth picks up some of our mother's bacteria, and in childhood we quickly acquire new microbial colonizers. Studies suggest that a preschooler's population of mouth microbes most closely mimics his or her primary caregiver's. As the years go on, diet, stress, illness, antibiotics and other forces can shift the demographics of an individual's microbial community—and change its collective aroma. When bacteria that release smelly compounds dominate, chronic bad breath may be one of the consequences.

Many current treatments do not improve oral ecology—in fact, they might make matters worse. Although some mouthwashes merely mask unpleasant odors, alcohol-based rinses sold in drugstores and prescription rinses containing chlorhexidine or other antiseptics target all oral bacteria, stinky and otherwise. Shi says that approach has several drawbacks. A chlorhexidine rinse, for example, may improve breath for as long as 24 hours but can temporarily change the taste of food. In one study, 25 percent of subjects experienced a tingling or burning sensation on the tongue after a week of use. Heavy use of rinses with alcohol can dry out the mouth, sometimes exacerbating bad breath. Further, wiping out too many of the mouth's native bacteria could disrupt the usual checks and balances, making way for opportunistic species responsible for gum disease and other infections to move in and take over.

A number of researchers are now working on promising alternatives to basically carpet bombing all oral bacteria. Some new mouthwashes go after the stink rather than the stinkers with ions of zinc or other metals that bind and neutralize sulfur compounds. Rosenberg, who started his career as a petroleum microbiologist, has developed a two-phase oil-and-water rinse that temporarily reduces bad breath by sopping up some of the oral debris and microbes that toothbrushing, flossing and tongue scraping miss.

Other teams are investigating whether probiotics rife with a gram-positive bacterial strain known as Streptococcus salivarius K12 can fight halitosis. A common resident of the mouth and respiratory tract, S. salivarius K12 is benign and known to produce substances that deter harmful bacteria. In a recent study by researchers in New Zealand and Australia, volunteers gargled with a chlorhexidine mouthwash to clear their palate of many native bacteria and subsequently sucked on lozenges laced with K12. Seven and 14 days later they had much sweeter breath. Presumably K12 outcompeted its foul-smelling kin, opening up niches for less offensive species.

At U.C.L.A., Shi and his team are working on a mouthwash that contains a peptide—a chain of amino acids smaller than a protein—tailored to selectively kill S. mutans, the ringleader behind tooth decay. Researchers could develop an analogous peptide to weed out the bacteria behind bad breath, Shi says. A rinse containing such peptides might free up real estate on the tongue for less malodorous microbes, if used in moderation. Rinsing every day risks a sudden and drastic shift in oral ecology that could have unexpected repercussions.

Shi himself brushes and flosses daily but does not use a mouthwash or even a tongue scraper because his family assures him that his breath smells fresh. “I'm one of the lucky ones,” he says. “My goal is to help other people be lucky, too.”

Common Scents

Researchers have identified around 150 different molecules in human breath, many of which offend the human nose. Here are what some of the more malodorous compounds smell like.

Rotten eggs
Hydrogen sulfide (H₂S)

Rotten cabbage
Methyl mercaptan (CH₃SH)

Garlic
Allyl mercaptan (C₃H₆S)
Allyl methyl sulfide (C₄H₈S)

Fish
Dimethylamine (C₂H₇N)
Trimethylamine (C₃H₉N)

Everyone knows that cigarettes are bad for you. Yet 45 million Americans smoke, a habit that shaves a decade off life expectancy and causes cancer as well as heart and lung diseases. Nearly 70 percent of smokers want to quit, but despite the deadly consequences, the vast majority of them fail.

Going cold turkey works for fewer than 10 percent of smokers. Even with counseling and the use of aids approved by the U.S. Food and Drug Administration, such as the nicotine patch and non-nicotine medicines, 75 percent of smokers light up again within a year. “We need better treatments because the current ones just aren’t working all that well,” says Jed Rose, director of the Duke Center for Smoking Cessation.

To create treatments that are more up to snuff, researchers are tinkering with combinations of existing drugs, looking at the role genetics plays in who gets hooked and turning to social media as a counseling platform. What’s more, a new smoking cessation medicine could be approved this year: electronic cigarettes, which have existed for a decade but only recently become the focus of efficacy trials.

The grip of addiction

Smoking at once relaxes and stimulates the body. Seconds after inhalation nicotine reaches the brain and binds to receptor molecules on nerve cells, triggering the cells to release a flood of dopamine and other neurotransmitters that washes over pleasure centers. A few more puffs increase heart rate, raising alertness. The effect does not last long, however, spurring smokers to light up again. Over time the number of nicotinic receptors increases—and the need to smoke again to reduce withdrawal symptoms such as irritability. On top of that, smoking becomes linked with everyday behavior or moods: drinking coffee or a bout of boredom, for instance, might also trigger the desire to reach for a cigarette—all making it difficult to kick the habit.

Smoking treatments help users gradually wean themselves off cigarettes or put an end to their cravings—most commonly via delivery of nicotine in patches or chewing gum. In addition, two non-nicotine drugs are available: a sustained-release form of the antidepressant bupropion reduces cravings; varenicline blocks nicotine receptors in the brain, reducing the flood of dopamine.

New research is teasing out why the seven FDA-approved medications have seen only limited success. For instance, researchers recently showed that some people are genetically predisposed to have difficulty quitting: Particular variations in a cluster of nicotinic receptor genes (CHRNA5–CHRNA3–CHRNB4) contribute to nicotine dependence and a pattern of heavy smoking. Moreover, a study of more than 1,000 smokers reported in a 2012 The American Journal of Psychiatry paper found that people with the risk genes don’t quit easily on their own whereas those lacking the risk genes are more likely to kick the habit without medications.

New research also suggests that the sexes respond differently to the drugs. Rose and colleagues have found that giving a combination of bupropion and varenicline to people who have worn a nicotine patch for a week raised the quit rate of patch users to 50.9 percent up from 19.6 percent—but only in men. “We don’t know why the effect seemed entirely confined to male smokers,” Rose says. “Bit by bit we’re starting to learn how to tailor treatment to sex, early response to nicotine patches, and genomic markers.”

New treatment hope

A reason for the limited success of nicotine treatments may be that they do not address a crucial aspect of cigarette use: the cues that prompt smoking. Electronic cigarettes have as a result become a popular alternative to lighting up for those seeking to quit. E-cig users inhale doses of vaporized nicotine from battery-powered devices that look like cigarettes. Carcinogen levels in e-cig vapor are about one thousandth that of cigarette smoke, according to a 2010 study in the Journal of Public Health Policy.

Anecdotal evidence indicates that the devices, on the market for about a decade, help smokers quit. Yet there’s little hard science to back up the claim, and the gadgets are not regulated as medicines. (In 2010 a court overturned the FDA’s effort to treat e-cigs as “drug delivery devices.”) “We just don’t know if they are as good as existing nicotine-replacement therapies,” says David Abrams, executive director of the nonprofit Schroeder Institute for Tobacco Research and Policy Studies and former director of the Office of Behavioral and Social Sciences Research at the National Institutes of Health.

That’s about to change. Two e-cig trials will report results this year. The first is a study of 300 smokers in Italy. It is a follow-up to a similar study in which 22 of 40 hard-core smokers had after six months either quit or cut cigarette consumption by more than half. Nine gave up cigarettes entirely, although six continued using e-cigs. The findings of the larger study, which is to be published this month in PLoS One, are “in line with those reported in our small pilot study,” says lead researcher Riccardo Polosa of the University of Catania in Italy.

Interestingly, he adds, a control group of smokers who used an e-cig without nicotine also showed a significant drop in tobacco cigarette consumption—although not as great as those using the nicotine e-cig. This decline, he says, “suggests that the dependence on the cigarette is not only a matter of nicotine but also of other factors involved,” like the need to relieve stress or activities that trigger smokers to reach for a cigarette.

What is mental illness? Schizophrenia? Autism? Bipolar disorder? Depression? Since the 1950s, the profession of psychiatry has attempted to provide definitive answers to these questions in the Diagnostic and Statistical Manual of Mental Disorders. Often called The Bible of psychiatry, the DSM serves as the ultimate authority for diagnosis, treatment and insurance coverage of mental illness.

Now, in a move sure to rock psychiatry, psychology and other fields that address mental illness, the director of the National Institutes of Mental Health has announced that the federal agency–which provides grants for research on mental illness–will be “re-orienting its research away from DSM categories.” Thomas Insel’s statement comes just weeks before the scheduled publication of the DSM-V, the fifth edition of the Diagnostic and Statistical Manual. Insel writes:

“While DSM has been described as a ‘Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been ‘reliability’–each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better.”

Insel said that the NIMH will be replacing the DSM with the “Research Domain Criteria (RDoC),” which define mental disorders based not just on vague symptomology but on more specific genetic, neural and cognitive data. But then, immediately after making this dramatic announcement, Insel added that “we cannot design a system based on biomarkers or cognitive performance because we lack the data.”

Huh? So the NIMH is replacing the DSM definitions of mental disorders, which virtually everyone agrees are profoundly flawed, with definitions that even he admits don’t exist yet! What more evidence do we need that modern psychiatry is in a profound state of crisis?

Insel’s statement is also an implicit admission that there is no real theoretical basis for drug treatments for mental illness. As I have pointed out previously, drug treatments have surged over the past few decades, while rates of mental illness, far from falling, have risen.

Ironically, some pharmaceutical companies that have enriched themselves by selling psychiatric drugs are now cutting back on further research on mental illness. The “withdrawal” of drug companies from psychiatry, Steven Hyman, a psychiatrist and neuroscientist at Harvard and former NIMH director, wrote last month, “reflects a widely shared view that the underlying science remains immature and that therapeutic development in psychiatry is simply too difficult and too risky.” Funny how this view isn’t incorporated into ads for antidepressants and antipsychotics.

NIMH director Insel doesn’t mention it, but I bet his DSM decision is related to the big new Brain Initiative, to which Obama has pledged $100 million next year. Insel, I suspect, is hoping to form an alliance with neuroscience, which now seems to have more political clout than psychiatry. But as I pointed out in posts here and here on the Brain Initiative, neuroscience still lacks an overarching paradigm; it resembles genetics before the discovery of the double helix.

Since I became a science writer 30 years ago, I have heard countless claims about breakthroughs in our understanding and treatment of mental illness. And yet as the NIMH decision on the DSM indicates, the science of mental illness is still appallingly primitive. Instead of forming fancy new programs and initiatives and alliances, leaders in mental health should perhaps do some humble, honest soul searching before they decide how to proceed. And they should think of what’s best not for their professions or the pharmaceutical industry but for those suffering from mental illness, who deserve better.

Google Glass is just the beginning. The search giant’s smartglasses are in the headlines, but numerous other players are also looking to cash in on what’s expected to be a boom in eyewear that puts virtual and augmented reality face-front.

Smartglasses overlay digital information onto the wearer’s view of the real world. Usage scenarios are limited only by developers’ imaginations. Google Glass has apps for search, navigation, photo capture and sharing, to name a few. Commercial possibilities include enhanced vision systems for use in manufacturing, engineering, health care and other industries. A surgeon could have all of a patient’s vital information literally in front of his eyes while operating, for example.

There’ll be no shortage of smartglass systems in as little as one to two years. Research firm Gartner says there are about a dozen companies with products in the works, many of them ready for prime time. There could be as many as 10 million smartglasses sold worldwide by 2016, if software developers can come up with appealing applications that provide wearers with useful, nonobvious information about their surroundings, according to IMS Research, which defines smartglasses as “wearable computers with a head-mounted display.” Without good apps, the number of smartglasses sold could number only about one million by 2016, IMS adds.

“This stuff is bubbling up and it’s going to happen,” says Trae Vassallo, a partner in venture capital firm Kleiner Perkins Caufield & Byers, which has joined with fellow firms Andreessen Horowitz and Google Ventures to fund smartglass app development. Vassallo sees big potential: Kleiner Perkins’s investment will “depend on the quality of the ideas and the entrepreneurs.”

One such company is Rochester, N.Y.–based Vuzix Corp. Its M100 Smart Glasses, now shipping to developers, can run any existing Android app. CEO Paul Travers says developers are building augmented reality (AR) apps for the M100 in areas like fitness, navigation and gaming. “There will be a lot of people in the consumer space that will like these gizmos,” Travers says.

Like Google Glass and most other smartglasses, the M100 has a built-in video camera that projects an image of the real world onto an eyepiece that is essentially a prism. This so-called “wave guide” approach lets developers layer information and graphics into the wearer’s view. Advances in optics and microprocessors fueled by the smartphone revolution are what’s behind the expected boom. “The killer app for all of this are things that allow immersive AR with sensors you can fit in a phone,” says Dan Small, a research principal at Sandia National Laboratories, which has conducted extensive research into augmented reality for the military.

There are limitations: Both Google Glass and the M100 are monocular systems that use a single eyepiece to deliver an augmented field of view of about 14 degrees. Humans’ natural field of view is roughly 180 degrees, so there’s a keyhole effect.

Some manufacturers are developing binocular systems that resemble conventional sunglasses, in part to achieve a wider field and 3-D viewing. Israel-based Lumusmakes AR shades that wouldn’t look out of place at a ski resort. “Google is basically a beam-splitter technology. Looking through that, your view of the world is skewed,” says Lumus business development manager Ari Grobman. “We’re giving you a pair of glasses and overlaying information on that.” He adds Lumus is in licensing talks with several major electronics companies. “We’re hot and heavy in terms of pushing into consumer applications.”

Also taking the binocular approach is Epson Corp. Its Android-powered Moverio BT-100 smartglasses give users the impression they are looking at information on an 80-inch screen through a 23-degree field. Being binocular “is very critical because it allows you to overlay 3-D content in the center of your field of view,” says Eric Mizufuka, new products manager at Epson.

Epson, a division of Seiko, is targeting the commercial market. Partner Scope AR has created BT-100 AR software for use in industrial training. One of its apps overlays images of tools that the wearer would need to fix high-tech equipment, and shows where the parts should go. “We can take someone who’s been working at McDonald’s and turn them into to the equivalent of a worker with 30 years training on that machine,” says Scope founder, Scott Montgomerie.

Other companies developing smartglasses include Olympus, Sensics and AR contact lens developer Innovega. Microsoft and Apple, which holds AR patents, are also said to be eyeing the smartglass market.

Experts say today’s optics and chip technologies are for the first time sufficient for functional AR. What’s needed to deliver fully immersive virtual reality or AR experiences, a la The Matrix, are breakthroughs in tracking technology. To track head movements, AR glasses need fast internal sensors, or an external system. The slightest lag can be disconcerting. “Humans are very adept at picking up latency,” says Sandia’s Small. “The problem is that sensors don’t track like chips do with Moore’s Law.”

Still, it’s expected that the sight of smart-bespectacled workers and consumers won’t be uncommon within a year or two once prices hit the sub-$500 mark—Google Glass prototypes sell for $1,500, if you can get them.
Widespread smartglass use will raise a host of privacy and regulatory issues. “We’re already hearing the term ‘glassholes’,” says Gartner’s Angela McIntyre. And you thought the jerk with the cell phone was bad.