Archive for the '[Science in Society]' category

For Dottie (And Me)

May 30 2015 Published by under [Science in Society]

Microbiome research makes headlines often, especially when folks start talking about "fecal transplants" (yup, eating shit). There's a whole microscopic world living in our guts that influences all sorts of things about us. We have only just begun to explore this fascinating area of research.

Now a group is raising money to document the feline microbiome, a Kickstarter project dubbed the Kittybiome. For various amounts of money you can sponsor study of a shelter cat, your own cat, or even other goodies. My friend Michelle Banks, an artist who specializes in science-inspired designs, is creating a Kittybiome scarf. Given the lovely silk items I have previously purchased from her site, I decided to kick in enough to study a shelter cat and buy the scarf.

Dottie Hinson Lane

Dottie Hinson Lane

Why am I doing this (besides my need desire for another scarf)? The little lady in the photo is my inspiration. Dottie Hinson Lane, named for the Geena Davis character in A League of Their Own, has suffered from a diarrheal illness this year. Cat diarrhea is at least as annoying as diarrhea in your offspring. The more we learn about the cat gut, the better as far as I am concerned.

We have Dottie's symptoms controlled at the moment. I still want us to learn more about what goes on in those feline guts.

You should consider supporting this project as well; if nothing else, you can score a cool scarf!

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What's New: #ISpyPhysiology

Dec 11 2014 Published by under [Science in Society]

The last day or so I have engaged with other members of the American Physiological Society's (APS henceforth) Communication Committee. We kicked around all sorts of ideas for improving outreach to the non-physiologist world, as well as continuing internal communication in an effective manner. Since I had my twitter feed open during the meeting, I tried out one of our hashtag ideas:

 

The idea of the hashtag is to highlight physiology in everyday life. The link in the tweet takes you to this infographic, Cleveland Clinic's Top Ten Healthcare Transformations for 2015. Let's take a look at the physiology of a couple of these innovations:

  • Mobile stroke units: Strokes, or cerebral vascular accidents in doctor-speak, cause death and disability in lots of people. Basic science study of the brain and its response to loss of blood flow reveals that rapid response to an event can minimize the damage and improve outcomes. These data (many from animal studies) resulted in rapid-response stroke teams in many US hospitals so that patients get their clot-busters ASAP. Taking that one step further is the stroke-mobile, with personnel who can initiate treatment while the patient travels to the hospital. As time = brain, this seems like a winning approach and an excellent result of brain physiology studies.
  • PCSK9 inhibitors for high cholesterol levels: Despite the widespread, near-universal prescribing of statins, many people still have elevated cholesterol levels and high risk of heart disease. This new class of drugs reduces bad LDL cholesterol. Antibodies to proprotein convertase subtilisin/kexin type 9 (yeah, that's why we abbreviate these things) give doctors another weapon for patients who respond inadequately to other measures. Finding this enzyme that controls cholesterol resulted from studies of normal metabolism in cells and animal models. In other words, Physiology!

I am not waiting for approval or permission (I'm a badass that way); I am plowing ahead with #ISpyPhysiology and invite all my physiologist friends to participate. Read your newsfeed, mine your twitter feed, and find examples of physiology affecting everyday life. They are out there waiting!

We just need to spy them!

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The Real Problem with Marie Curie

Nov 18 2013 Published by under [Science in Society]

So hot...like radioactive...

The internet went all a-twitter over the weekend about a video posted by Joe Hanson (@jtotheizzoe) in which he imagines the scientist bobble-heads in his collection joining him for Thanksgiving dinner. In it, the Einstein bobble-head repeatedly makes sexual advances toward the Curie figure, assaulting her at the end of the piece.  Certainly tasteless, even with bobble-heads, especially given recent events in the world of online science communication. Sophomoric? Certainly. Criminal? Hardly.

This video is part of Hanson's work for PBS Digital Studios, an ongoing series called It's Okay to be Smart. I am still unclear what this video had to do with Thanksgiving, being smart, or anything else, other than an excuse to play with bobble-heads. An apology eventually appeared, but the video remains on the internet. I wish PBS would take it down, but they haven't. There have been calls to fire Hanson. That seems a bit over-the-top to me, but then I watch Family Guy.

Then it came out that Joe Hanson will be moderating a session at Science Online in 2014. Moderaters were selected weeks ago; those in control could not have anticipated this unfortunate turn of events. At this point I tweeted a tongue-in-cheek suggestion that we dress up as Curie and beat the snot out of him at his session. I imagined a group of 20 bobble-head look-alikes coming at him...well, my attempt at humor also bombed. Repeated tweets have called for a serious, non-violent response.

It's kind of like TSA began running twitter: "Do not joke about weapons on the plane" or violence at the unconference.

What I would like to point out is the real problem here: Marie Curie is the only female bobble-head! In that setting, gender becomes the most obvious characteristic of the bobble-head. Why should the male bobble-heads consider her scientific accomplishments when she is merely the token woman? Clearly, her only raison d'etre must be her sex! In real life, such tokenism contibutes to an environment that permits marginalization of women (and other minorities) and likely contibutes to harassment. Does that excuse Einstein's douchebaggery? Hell no - dudes (even resin bobble-heads) should be able to keep their pants on and zipped! But the dynamics would have been different had Rosalind Franklin, Gerty Cori, and Linda Buck bobble-heads joined the party. Why can't I buy bobble-heads of these Nobel laureates? It's like Marie Curie is the only woman scientist ever!

So perhaps we should all step back and take a deep breath. We have an episode here that illustrates a lot of issues that lead to a hostile environment for women in science. No one has been physically harmed, although good taste was violated. Let's use this episode to learn and grow, rather than blame and shame.

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Rebirth in Boston

Apr 21 2013 Published by under [Science in Society]

Keep calm and talk science

Saturday afternoon the healing in Boston began unofficially with the crowd at Fenway cheering David Ortiz's R-rated comments and blasting out the "ba-ba-ba" as Neil Diamond led them in Sweet Caroline. Across the town, Experimental Biology was reborn for 2013. The American Physiological Society (APS, my FASEB org) kicked off its annual get-together with the Water B. Cannon Award Lecture. 

This year's talk held special relevancy for me. No, it was not nephro-centric; instead, it was delivered by Michael Joyner, MD, an anesthesiologist at the Mayo Clinic who addressed the question, "Is Physiology Redundant?" He pointed out first that redundant has two meanings: the first revolves around being unnecessary. Twenty years ago, many thought that genomics and cellular biology would make physiology research unnecessary. Like gross anatomy, it would become something to teach to medical students, but would not require a department because there was nothing left to learn. I was entering my career about that time, and I remember the grant reviewers who could not understand why I wanted to explore something in humans or animal models instead of cultured cells. Despite my assertions that I could not study the interactions of puberty and diabetes across multiple organ systems in a dish, it took several years of preliminary data before I convinced anyone to show me the money.

The second meaning of redundant deals with back-up or failsafe systems. As someone who studies a fibrotic process, I remember how surprised many scientists were that the transforming growth factor beta knock-out mouse shows no detectable phenotype at birth. Of course, this led to the discovery of a number of other TGF-betas, any of which may fill in for the others in some situations. Joyner discussed the fact that one gene may be messed up in a given physiological system, but its dysfunction can be compensated for by other gene products. Of course, When we see most diseases in our patients, some combination of perturbations has occurred. From patient to patient, the exact combination of elements will differ, even though the clinical endpoint appears the same. 

Even with diseases that we know are due to a single gene defect, things like cystic fibrosis, muscular dystrophy, and polycystic kidney disease, the clinical manifestations and outcomes will be influenced by other genes and the exact nature of the mutation. Throw in epigenetics and protein processing to increase the complexity, and you will soon realize that we need physiology more than ever to integrate all the "omic" fields. 

Dr. Joyner studies exercise physiology, and he showed a number of examples of the need for whole animal and clinical-translational studies, all of which are physiology. We simply cannot solve the way the body works and responds to pathology without this discipline!

I like this message because I have been screaming the same message for two decades as well. Perhaps if we all scream together, along with the APS, our voices will be heard and we may win this battle.

Now we just have to get the NIH to fund the science. That's the war.

The Cannon Award lectureship, established in 1982, is the highest award of the APS. The award goes to an individual selected by the President-Elect, with approval of the Council, to lecture on "Physiology in Perspective."

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With a Grain of Salt

The biggest improvements in human health occur with systematic changes. Clean water systems make a huge differences. Wide-spread immunization requirements conquered illnesses.

Success of Back-to-Sleep
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For a more recent example, I present Back-to-Sleep, a recommendation from the American Academy of Pediatrics in 1992. Placing most infants on their backs for sleep seemed to reduce the risk of sudden infant death syndrome (SIDS), also known as crib death. In October, about the time  my son came into the world, they began a blast of public health announcements to put infants on their backs unless your pediatrician instructed otherwise. The risks of positioning infants this way seemed minimal, and the costs negligible. The effects have been impressive, with a 50% reduction in deaths over a decade (see graph).

The message was simple and easily followed. Statistical modeling suggested a major effect from the intervention, and we see it in the data. Unfortunately, preventative measures for other disorders do not meet these criteria.

A recent article examines salt and public health, an area of intense debate.

Ronald Bayer, Daveid Merritt Johns, and Sandro Galea. Salt and Public Health: Contested Science and the Challenge of Evidence-Based Decision Making. Health Affairs 31:2738, 2012 DOI:  10.1377/hlthaff.2012.0554

The authors describe the issue at hand:

 For more than four decades, starting in the late 1960s, a sometimes furious battle has raged among scientists over the extent to which elevated salt consumption has adverse implications for population health and contributes to deaths from stroke and cardiovascular disease.

...

In 2011 two authors involved in the conduct of systematic reviews on salt declared, “It is surprising that many countries have uncritically adopted sodium reduction, which probably is the largest delusion in the history of preventive medicine.”3 Concurrently, a group of scientists long associated with studies on the harmful consequences of salt consumption wrote, “Denial and procrastination about dietary salt reduction will be costly in terms of avoidable illness and costs; it will also be ethically irresponsible.”4

The article discusses the evidence regarding sodium and blood pressure over the past 40 years, including systematic reviews of these data. Weighing both quality and quantity of data, the Cochrane group reported in 2011:

The second 2011 Cochrane report went further. After examining the potential impact of salt reduction on hormones and lipids in people with normal blood pressure, it concluded that the available evidence did not permit a conclusion as to whether low-salt diets improved or worsened health. It was possible, the authors concluded, that further research might be able to detect the beneficial impact of salt reduction, but “after more than 150 RCTs and 13 population studies without an obvious signal in favor of sodium reduction, another position could be to accept that such a signal may not exist.”55(p18)

Click for source

Clearly, many people with hypertension have salt-sensitivity and could benefit from reduced sodium intake; however, we cannot see the benefits when large general populations are examined. Just as clinicians have to make decisions about individual patients despite scientific uncertainty, policy makers must do the same for large groups. Several considerations must be weighed:

  • What are the benefits of reducing salt intake?

Those who have salt-sensitive hypertension have received the most attention in this debate; however, the reduction in blood pressure from sodium restriction alone amounts to only 1-2 mmHg in most people. Other populations might also benefit from global reduction in food salt content. Chronic kidney disease rates are rising as our population ages, and high salt intake complicates treatment of this group. High sodium intake can also induce kidney stones, and may be a major factor in this condition in the US.

  • Are there risks to health of reducing salt intake?

The answer here is about as clear. Some studies have suggested that patients with a number of chronic disorders may not fare as well with severe salt restriction. Just as there are biologically plausible hypotheses for the benefits of salt restriction, the activation of the renin-angiotensin-aldosterone system by low salt intake provides fodder for the other side. As the authors note, "medicine and public health are replete with examples of seemingly sound ideas that had devastating unintended consequences. One hundred percent oxygen for newborns can cause blindness. Extensive use of x-rays for screening purposes is associated with greater risk of cancer. The risk of unintended consequences grows dramatically when interventions are translated to a populationwide scale."

  • What is the cost of reducing salt intake?

The short answer: I have no idea. Salt initially served a preservative function in our food, but we no longer need it for that reason. However, people's palates have grown accustomed to its presence. Try a can of no-salt green beans sometime; they taste wrong, even when salted at the table. Manufacturers could begin cutting salt out of their processes and slowly getting us accustomed to its absence; some have started to do this with a variety of products. However, I have no idea what this change may cost at the factory or in the store.

The authors of the Health Affairs article do not solve this big hairy dilemma for us; they wrote this piece to demonstrate  "the role that judgment and values must play in evidence-informed policy making."

 As Roger Chou, a central figure in the conduct of systematic reviews for the US Preventive Services Task Force, has stated, “The evidence can tell us the likely benefits and likely harms, burdens and costs, but it does not directly tell us how to weigh all of these factors.”60(p10) Policy makers must ask: Are the burdens of public health interventions too great, and for whom? Are the expected benefits sufficient given the potential costs? These are not questions that can be answered in the absence of normative judgments.

As a doctor whose patients must often restrict salt intake, I know it would be in their best interest to systematically reduce salt in foods in the US. I do not know if it would benefit the general population enough to be considered successful on the same level as Back-to-Sleep.

The debate rages on. More data will be published.

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Value Added

Feb 13 2012 Published by under [Science in Society]

A few years back I decided I needed some business training to pursue my administrative goals. A big piece of this education included financial materials. One problem involved valuing a business.  Sure, you have the building and supplies and widgets, and usually some cash is on hand as well. However, businesses come with intangible assets. What is the name "Disney" worth, for example? How about "Enron," now versus 1998?

The only way to really find out the value of a business or other entity is to sell it. Like houses, they are worth whatever someone will pay.

In scientific publishing, someone has paid for the data before submission to the journal. What value does the journal add?

  • Peer-review - Yes, I realize most of this is done by volunteers, but there is infrastructure to maintain.
  • Editing - Do you put spaces on one or both sides of the "<" sign? Thanks to hired punctuation police, scientists do not have to think about this. Of course, most of us can get the message from the unedited manuscript (regardless of the quality of the grammar and kerning), so this function can be perceived as beautification with little true value.
  • Distribution - Costs are lower via the internet, but not yet zero. Even publishers have to buy servers and pay electric bills. We also expect the information to be maintained in perpetuity, no matter how few people access it.
  • Reputation - Each journal adds intangible value to the articles within, a value most difficult to quantify.

These are the things we pay for with subscriptions, page fees, and download prices. How do we judge what is fair? We can look to Open Access publications for an idea of the overall costs for the first three items. What we cannot learn as easily is the price of reputation. A publication in Nature may be worth $35 per download in perpetuity. Is a 5-year-old article in Pathophysiology (Impact Factor not available) really worth $22?

I am not certain what the solution will be. The internet has clearly disrupted publishing of all sorts, and scientific journals will not be exempt. Until that magical reputation factor drops lower in value, I doubt that the glamor rags will suffer.

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What I Am Reading: #scio12 swag, Before the Lights Go Out

Feb 06 2012 Published by under [Science in Society]

One of the joys of attending Science Online can be a  pain as well. With all of those authors in the group, dragging home books can result in excess baggage fees. This year a lottery book distribution limited the problem. As I took my tickets down the rows of books and advance proofs, I picked some that looked delightful for me and some that family members would enjoy.

Available April 10, 2012

I won one of the latter, one I chose because my son is a first-year engineering student at Minnesota with a vague interest in green, clean energy:

Before the Lights Go Out: Conquering the energy crisis before it conquers us.

Maggie Koerth-Baker, currently affiliated with BoingBoing.net, explores our relationship with energy in the US. Early on, she points out that energy can be viewed through many lenses. Some people wish to end out dependency on foreign resources. Others are concerned about climate changes. Most people hope to save a few bucks along the way, even if that is not the primary motive.

Unfortunately, individual actions cannot achieve the changes we must make to preserve our way of life. Even if we all immediately change our light bulbs and buy electric vehicles, the same issues continue since generation of electricity constitutes our major consumption of energy and our major source of pollution. Why not build more renewable generators, like windmills, solar panels, and hydroelectric plants? We can; but electricity must enter the grid in the correct amount at the correct time. We simply cannot generate energy from these sources until we can store it for when and where we use it.

She examines each alternate source of energy in its turn, as well as many conservation options. Ultimately, our energy infrastructure built up to support our current lifestyle, and changing our relationship with energy will require big, expensive changes to infrastructure before anything of real significance can happen.

Does that observation mean that Maggie Koerth-Baker does not believe we should be changing light bulbs and buying more efficient vehicles? Absolutely not! Conservation remains part of the strategy - it just cannot be the sole approach.

The book ends with descriptions of some projects involving decentralization of energy generation. Local biofuel generation in Madelia, MN, particularly fascinated me. An environmentalist became concerned about topsoil loss in the area. Wanting to prevent erosion by encouraging farmers to plant "Third Crops (native grasses that take less toll on the soil but have little economic benefit), Linda Meschke needed to find a way to make these plants profitable. The solution came in collaboration with the University of Minnesota. They towed in  a microwave pyrolysis system to convert those cellulosic stalks into energy.

Pyrolysis involves heating organic material in an oxygen-free environment to just under 950 degrees Farenheit, a process that releases a bunch of volatile gases that can be condensed into liquid fuel. The solids that remain are biochar, a charcoal-like substance that traps carbon in ring structures for a long, long time. This energy generation is carbon neutral, and the biochar can bind nitrogen, perhaps making it a good fertilizer.

Wonderful! Why don't we go cut kudzu and crank out these microwave pyrolyzers?

First, the liquid fuel can be used as home heating oil or in place of industrial petroleum, but its acidic pH will not let it substitute for gasoline. Second, the data about biochar is preliminary; only long-term field tests will confirm its use as fertilizer. Finally, the system is not yet ready to be scaled up. While it is allowing farmers around Madelia to save a few bucks and profit from "Third Crops," it has not taken the town off the grid or closed the local gas station. It is a tantalizing first step, though.

The bottom line is that solving the energy/pollution/climate change crisis will depend on a lot of smaller experiments, novel technology, and infrastructure changes. No single solution will provide "The Answer" for the entire problem. Ultimately, some big, costly, large-group changes will be needed.

I hope we can find our way to make them happen.

 

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Courtesy of Google Ads

Oct 28 2011 Published by under [Science in Society]

I am a little unmotivated today, given the late but favorable outcome of last night's World Series Game 6 (Go Cardinals!). As I read stuff in emails and my feeds, I got directed to a couple of postings over at Free Thought Blogs by Jen McCreight.Once again, a young woman has been told to shut up so she does not offend anyone.

I clicked through to read the edited version of the original "offensive" post, which I found completely inoffensive. Of course, being a liberal scientist-type woman whose life has been spent mostly in the bible belt, I found much to identify with and appreciate. I particularly liked this bit, when someone felt that Jen should not be shocked that biology majors may not accept evolution:

We don’t give chemistry degrees to people who believe in alchemy. We don’t give aerospace engineering degrees to people who think planes are held up by fairies. We don’t give geology degrees to people who think the Earth is made of chocolate pudding.  But we have no problem giving biology degrees to people who think an invisible supernatural being created life, despite it having as much evidence as Puddingology. I should feel shocked that people who reject the fundamental concepts of their field can still successfully earn a degree.

Of course, the side-splitting part of the whole endeavor occurred when I scrolled down toward the comments. Google Ads helpfully placed this at the bottom of the post:

Irony Courtesy of Google Ads

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Criminal Behavior

Click for source

Office stocking has proceeded to the point where I can catch up on some reading. Science from August 19 includes a special section devoted to Investing in Early Education. The ten articles present compelling data regarding the efficacy of preschool. By the 1980s early education had enough documented benefits that randomized controlled trials were deemed impossible (because parents would refuse to be in the control group) or unethical (because effective "therapies" would be withheld), leading to a case-control design for the first large longitudinal study.

I encourage you to read the whole section; it's worth it, even if  you have to pay!

The first article in particular asks a major question: why isn't early education offered to all children who need it, given its documented benefits? Three long-running studies are reviewed, all of which demonstrate significant benefits well into adult life (see figure).

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HighScope/Perry first demonstrated the benefits of early learning in 123 students with a return on investment of $16 for every dollar spent. The intervention cost almost $18,000 per student for half-day attendance during the school year. Subsequently, the Abecedarian study also used a randomized control design from age 6 weeks to 5 years with full-day year round classes. Costs rose appreciably to just over $70,000 per subject; ROI dropped to $2.5 per dollar invested.

The Chicago study did not boast a randomized design, but did involve 1,539 students at a cost of only $8,224 per student for half-day, school year programs. Each dollar spent produced $10 of benefits over time. Sounds like this one hit a sweet spot in terms of "bang for the buck."

What benefits are we measuring? Graduating from high school, better employment, and lower incarceration rates. All of these factors also correlate with better health.

So why don't we have universal preschool, at least for high risk children? We have lots of data showing benefit and excellent ROI for society! A variety of issues come into play.

The nature of "at risk children" changes over time. At present, many more immigrant, English-as-second-language children are in the US than in these earlier studies. Will similar programs translate to these youth? Only time and tracking will tell. While I tend to err on the side of intervention (I mean, do we really think it would hurt?), those who control the funds often come out on the other end of the equation (we can do nothing till we know what works!). Now we also must contend with those who believe only stay-at-home-mommies are the answer. Which brings us to politics.

And that's the real issue. Children do not vote. These programs primarily help bridge the gap between advantaged and disadvantaged kids; those who fund political campaigns generally do not look for this sort of extremely long-term return on investment. Even though we would all be better off with better educated, skilled workers who stay out of jail (thus providing the labor force and tax base we need for our society and economy to thrive), many in the US consider this unnecessary spending.

If we withheld a treatment this effective in the practice of medicine, it would be criminal.

One could argue the same in this situation.

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"You Don't Belong"

The current issue of Nature Chemistry includes a commentary by Michelle Francl, Sex and the citadel of science. Click over and read it, if you can. Her thoughts on the lack of female achievement in science one hundred years after Marie Curie's second Nobel Prize provoked more thoughts on my part.

Click for source

Dr. Francl reviews her own story as well as the prevailing hypotheses to explain the lack of women scientists:

(1) the fraction of women who have the native intellectual capacity to do science, particularly at the highest levels, is much smaller than the fraction of men, (2) an inherent lack of interest among women in the hard sciences and engineering, and (3) societal and cultural biases that push women out of the pipeline and lead to the devaluation of the contributions of those who remain.

Data debunk the first two hypotheses, leaving us with societal and cultural biases that push women out of science. Of most interest to me were the discussions of architecture and color.

Built space is not neutral, as Winston Churchill noted, “we shape our buildings, and afterwards our buildings shape us”. As much as scientists use labs to create science, labs themselves create scientists.

Dr. Francl discusses the difficulties of being "vertically challenged," at least in comparison to the typical male scientist for whom lab benches, podiums, and even lecture hall chairs have been designed. As I sit in a standard office chair writing this with my feet on a riser and the chair in its lowest position, I understand her views. I am average height for a US woman; I have friends who must special order chairs! Consider how awkward things can be if a woman failes to wear a jacket with pockets for a seminar. She has no place to put the microphone power pack during her talk. As Dr. Francl points out:

Ginger Rogers may have had to do everything Fred Astaire did backwards and in high heels, but a female speaker who forgets to don something with pockets or lapels may find herself having to do what her male colleague does, but with both hands tied up.

Are any of these things game-ending? No, but each is a subtle reminder that we women "don't fit" the standard.

Color provides other cues, with children as young as three years understanding the association of pink with girls. Dr. Francl Googled images for "chemistry laboratory" and sorted by color; six-fold more equipment appeared in blue, green, or other earth colors than in "girly" pastels. The shift to real lab equipment typically occurs in middle school, about the time that girls lose interest in math and science. Color provides one more subtle cue that these things are not feminine.

Dr. Francl admits that each of these feels trivial alone, but provides an analogy that illustrates the cumulative risk of such things on girls:

Of course, chemists regularly separate closely related materials, by simply repeating the separation process many times on a chromatographic column. The ability to chromatographically resolve two samples depends not only on the selectivity of the process, but on the number of theoretical plates. Think about the number of times a child encounters the standard gender colour-coding scheme every day — the number of theoretical plates is extraordinarily high.

So what can we do to assure that all capable individuals of both sexes can achieve their potential in science?

We may not be able to avoid the gender-linked colour-coding imposed by the larger society, but we can be more attentive to the spaces we create in which we do and talk about science, as well as the materials we use to do it. Even small tweaks in the conditions under which a chromatography column is run can affect the separation.

Don't dis the pink telescope or the lavendar microscope. That may be what it takes to get a girl hooked on science early.

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