Our next TalkScience event will explore the impacts of fishing on the marine realm. But how long have humankind been fishing for food? Peter Spooner delves into the British Library collections to find out.

Archaeology and Ancient Poems

Anatomically modern humans (Homo sapiens sapiens) have been eating seafood for at least 164,000 years. Caves in South Africa contain the very earliest evidence for humans eating shellfish, as well as evidence for humans eating shallow-water fish 140,000 years ago¹. However, complex fishing equipment probably did not arise until much later. For example, the oldest known fishing hooks come from a cave in East Timor, South-East Asia, dating to 40,000 years BC².

Mosaic with fish, Pompeii, 1st Century B.C., http://commons.wikimedia.org/wiki/File:Mozaiek-uit-woonhuis-Pompei.jpg

By the time of the ancient Egyptians, and  then the Greeks and Romans, fishing with all kinds of equipment was common. Passages  in the works of Homer (8^th century BC)³ and whole volumes by other scholars including Pliny the Elder (1^st century AD)⁴, Ovid (1^st century BC to AD) and Oppian (2^nd century AD)⁵ describe fishing methods and the natural history of marine animals⁶. The latter works explain in incredible detail the habits and habitats of many animals, with examples including the migrations of tuna and the cleverness of dolphins.

These texts also provide interesting insights into the early development of some controversial fishing practices. For example, passages in Oppian’s ‘Halleutica’ and Pliny’s ‘Natural History’ describe early fish aggregation devices (FADs), which usually involve floating an object in the sea. Fish are attracted to the object and gather around it. They can then be easily captured. Today this is a method which risks causing overfishing⁷. Ancient versions of the FAD technique included hanging baskets in the water, or men venturing out day after day and feeding the fish by a particular rock until so many fish had gathered that it was easy to pull them into the boat. Another story in Oppian describes the use of a poison – derived from cyclamen root – to drive fish into waiting nets. Today, the use of poisons such as cyanide in fishing is described by the United Nations as a ‘destructive’ fishing technique⁸. But there are other ancient passages which refer to a much more wonderful kind of fishing.

Spiderweb fishing net from Pratt (1906)

Weird and Wonderful

One fishing method recorded by both Oppian and Pliny seems almost too remarkable to be true. It was written that in certain towns, fishermen would wade out into the water carrying nets or spears in readiness. Then they would shout and wait until dolphins came in from the sea, and the dolphins would drive schools of fish into the shallows where they could be caught. The men would reward the dolphins with fish and, according to Pliny, bread mash dipped in wine! This incredible practice still exists today in Brazil (though not, as far as I know, the wine), and fishing with the help of tame animals – such as otters and cormorants – still occurs in Asia⁹ (see reference for videos).

Amongst other almost magical fishing methods, people in New Guinea have used spiders to spin fairy-like fishing nets¹⁰. By setting a wooden frame in an area where spiders lived, they could entice the spiders into creating nets of just the right shape and size. Spider silk has also been used for centuries in kite fishing, where the silk lure is dangled below a kite at the surface of the water¹¹.

First page of Ælfric's Colloquy, British Library

Medieval mismanagement

Compared to the ancient techniques  described above, modern industrial methods seem far more likely to result in unsustainable fishing. After all, how could a few hooks and nets pulled by hand or sailing boat catch enough fish to be a problem? Probably the earliest description of fishing in the English language is contained in the Colloquy of Ælfric¹², a teaching manual for languages written in the late 10^th or early 11^th centuries. The description is in the form of a conversation between teacher and student, who is speaking in the role of a fisherman in England at the time. The teacher asks ‘Forhwi ne fixast þu on sæ?’: why don’t you fish at sea? The student replies lazily that it is too  far to row; he fishes in rivers instead¹³. But archaeologists have discovered that a major shift in English diet from freshwater fish to saltwater species was occurring almost as  this text was written. This shift has been linked to unsustainable management of freshwater systems, including the building of dams and the effects of farming on rivers¹⁴, and seems to be an early example of fishery expansion after local stocks collapsed. Given a few more years fishermen might have had to row the distance after all.

As illustrated by this example, sustainable fisheries management requires consideration of the whole ecosystem within which the fish live, as well as the needs of those who depend on the seas for their livelihood. Our next TalkScience event, ‘Fishing and marine protection: What’s the catch?’ will explore some of these issues. If you would like to be part of the discussion, tickets cost £5 and are available from our website.

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¹ C. W. Marean et al., 2007. Early human use of marine resources and pigment in South Africa during the Middle Pleistocene. Nature, 449, pp. 905-908, doi: 10.1038/nature06204. BL shelfmark: 6045.000000

² S. O’Connor et al., 2011. Pelagic fishing at 42,000 years before the present and maritime skills of modern humans. Science, 334, pp. 1117-1121, doi: 10.1126/science.1207703. BL shelfmark: 8130.000000

³ For an example see: Homer, The Odyssey, Book XII lines 243-250. Translation by B. B. Powell. Oxford University Press, Oxford, 2014. BL shelfmark: General Reference Collection YC.2015.a.5169 

⁴ Pliny the Elder, Natural History / Introduction by Anthony T. Grafton, Translated by H. Rackham, [W.H.S. Jones and D.E. Eichholz]. Volume 2, Book IX. Folio Society, London, 2012. BL shelfmark: General Reference Collection YC.2012.b.985

⁵ Oppian, Colluthus, Tryphiodorus. With an English translation by A. W. Mair, pages 201-515. William Heinemann, London, 1928. BL shelfmark: General Reference Collection 2282.d.106. 

⁶ W. Radcliffe. Fishing from the earliest times. John Murray, London, 1921. BL shelfmark: Document Supply W18/7736

⁷ http://www.nature.com/news/use-of-fish-aggregating-devices-could-be-unsustainable-1.14593

⁸ http://www.fao.org/fishery/topic/12353/en  

⁹ Videos of each of these practices can be found here. http://www.bbc.co.uk/nature/humanplanetexplorer/survival_skills/fishing#p009j8f5

¹⁰ A. E. Pratt. Two years among New Guinea cannibals: A naturalist’s sojourn among the aborigines of unexplored New Guinea. Seeley and Co. Limited, London, 1906. BL shelfmark: General Reference Collection 10492.g.15.

¹¹ https://www.youtube.com/watch?v=N-hmHuRKYP8

¹² http://www.bl.uk/learning/timeline/item126530.html

¹³ Ælfric’s Colloquy, edited by G. N. Garmonsway. Exeter Medieval English Texts, University of Exeter, 1978, pg 28. BL shelfmark: General Reference Collection X.908/42593

¹⁴ J. H. Barrett et al., 2004. The origins of intensive marine fishing in Medieval Europe: The English evidence. Proceedings of the Royal Society B, 271, pp. 2417-2421, doi: 10.1098/rspb.2004.2885. BL shelfmark: 6804.600000

Related articles

The Ocean: A sustainable future or the end of the line?

Peter Spooner dives into the issues of seafood sustainability in advance of our upcoming TalkScience event on 23^rd June. Tickets are available from the box office.

The ocean is a vast place, covering some 70 % of the surface of the Earth. If Mount Everest sat at the bottom of the deepest ocean trench, two kilometres of water would still lie above it. It is baffling to try and imagine the numbers of creatures that survive and thrive in the swirling currents of the sea; and yet that is the task of scientists worldwide, trying to piece together scattered information to build a picture of the health of life in the ocean. But why has such research become so important?

Food for thought

Fish is an important source of protein, vitamin D and omega-3 fatty acids¹. The government recommends that we eat at least two portions every week. A booming human population, growing appetites for fish and improvements in fishing technology mean that we now use at least 160 million tonnes of fish, shellfish and other marine life every year, mostly for food, and mostly taken wild from the ocean².

Many scientists believe that such fishing pressure is not sustainable³. For the fish species where we have good data, populations have declined by 38 % since the 1970s⁴. Historical accounts of fish populations suggest that they have declined even more over the last century⁵. The fraction of global fish stocks fished at sustainable levels is also decreasing, with 30 % of fish populations now assessed as being overfished². Wholesale species extinctions are currently rare in the ocean but local extinctions are increasingly common⁶. A famous example is that of the cod in the Northwest Atlantic, which were fished down to less than 10 % of their original stock over a period of about 30 years, and have not recovered⁷. Similarly massive reductions in populations have been recorded on a global scale for some fish including the Southern Bluefin Tuna⁸, and a quarter of all shark species are considered threatened⁹ (40 % in Europe¹⁰). Some fishing practices also cause extensive damage to the seafloor habitats that give many animals food and shelter. The accidental catching of species that are not the targets of fishing, such as turtles, is a major on-going problem.

Image Credit: DJMattaar Thinkstock

Balancing the scales

Fishing and fish farming provide livelihoods for 10-12 % of the world’s population². In order for fish and other marine life to continue providing an important source of protein, livelihoods in fishing and tourism, and benefits to the global environment, most agree that measures are needed in order to conserve fish stocks and to make them sustainable. In areas where action is being taken, such as the Northeast Atlantic, some species are showing signs of recovery². However, there is disagreement about which strategies are the best. For example, marine protected areas are often favoured by conservationists due to their positive impacts on fish abundance, biodiversity and habitats¹¹. When fully protected, they can offer an insight into what the ocean was like before fishing began. However, the creation of such areas may simply move fishing elsewhere and could take jobs away from local fishermen. In many parts of the world, enforcing protected areas without the support and help of local people is very difficult. Other controversial marine protection strategies are also hotly debated. For example, fishing quotas restrict landings of fish beyond specified levels, but often result in excess fish being discarded at sea.  How can we decide on the best strategies for ensuring sustainable seas? Should marine protection strategies be driven by governments or by those ‘on the ground’ (fishermen, local communities and consumers)? Does the best strategy change depending on where we are in the world? Is sustainability enough or should we be aiming to recreate the oceans of the past?

Seas of change

These questions become even more difficult to answer when we consider that the ocean and its ecosystems are in a state of continual change, driven by anthropogenic global warming, ocean acidification and nutrient pollution. Examples of the impacts of such changes include species moving poleward as the oceans warm, destruction of habitats including coral reefs, and the expansion of marine ‘dead zones’, where oxygen levels drop perilously low⁵. How might these changes affect the fishing industry? And how will our planning and implementation of marine protection strategies have to take these changes into account?

On the 23^rd June the British Library will host our 29^th TalkScience event: ‘Fishing and marine protection: What’s the catch?’ With the help of our audience, our panel of experts including Dr. Helen Scales, Professor Callum Roberts (University of York), Barrie Deas (NFFO) and Dr. Alasdair Harris (Blue Ventures) will attempt to answer some of the difficult questions posed here. If you would like to be part of the discussion, tickets (£5) can be booked via our website.

 

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References with links to the articles and British Library holdings

[1] http://www.nhs.uk/livewell/superfoods/pages/is-oily-fish-a-superfood.aspx

[2] FAO, 2014. The State of World Fisheries and Aquaculture 2014 http://www.fao.org/3/a-i3720e/i3720e01.pdf

[3] D. Pauly, et al., 2002. Towards sustainability in world fisheries. Nature, 418, pp. 689-695, doi: 10.1038/nature01017, BL shelfmark: 6045.000000

[4] J. A. Hutchings, et al., 2010. Trends in the abundance of marine fishes. Can. J. Fish. Aquat. Sci. 67, pp. 1205–1210 doi: 10.1139/F10-081, BL shelfmark: 3031.490000

[5] C. Roberts, 2012. Ocean of Life: How are seas are changing. Allen Lane, Penguin Publishing. BL shelfmark: General Reference Collection YK.2013.a.1526

[6] D. J. McCauley, et al., 2015. Marine defaunation: Animal loss in the global ocean. Science, 347, pp. 1255641, doi: 10.1126/science.1255641

[7] R. A. Myers, et al., 1997. Why do fish stocks collapse? The example of cod in Atlantic Canada. Ecological Applications, 7, pp. 91-106, doi: 10.2307/2269409, BL shelfmark: 3648.855000

[8] http://discover.iucnredlist.org/species/21858

[9] N. K. Dulvy, 2014. Extinction risk and conservation of the world’s sharks and rays. ELIFE, 3, e00590, doi: 10.7554/eLife.00590

[10] IUCN, 2015. European red list of marine fishes. doi: 10.2779/082723

[11] S. E. Lester and B. S. Halpern, 2008. Biological responses in no-take reserves versus partially protected areas. Marine Ecology Progress Series, 367, pp. 49-56, doi: 10.3354/meps07599, BL shelfmark: 5373.904000 

 

If you couldn’t make it to our most recent TalkScience event fear not. The latest instalment in our TalkScience series is now available on YouTube for your viewing pleasure.

In the 28^th event of our popular series we discussed what we have learnt from doing science in extreme environments, and if it is worth the high financial and human cost. The event was chaired by author and broadcaster Dr Gabrielle Walker who kindly stepped in at the last minute. Our expert speakers were Professor Jane Francis, Dr Michael Bravo and Dr Kevin Fong.

As ever the debate was thoughtful and wide ranging. We discussed how extreme environments affect the scientists' ability to actually do the research, and debated whether the development of new technologies is reducing the need for humans in future explorations. We were also privileged to hear our four panellists’ personal experiences of doing science in extreme environments. Jane Francis shared a particularly memorable experience: When she first started researching in the Antarctic female researchers had to wear men’s thermal underwear as female specific kit was not available. As the first female director of the British Antarctic Survey, Jane was pleased to report that this is no longer the case! There was also interest from the audience on the issue of diversity in extreme science. Although historically exploration has been the preserve of white males this is certainly not the case nowadays.

 

We also discussed the unexpected serendipity of historic data informing the present and the challenge of doing extreme science when many projects with more tangible and immediate benefits lack funding. Kevin Fong spoke of his own internal conflict when going to NASA to discuss plans for a multibillion pound mission to Mars while back home he was working in intensive care units where they desperately needed an extra dialysis machine.

At the end of the evening our four panellists were in broad agreement about the importance of extreme exploration with Kevin pithily summing up with:

“To explore we must survive but, as a species, to survive we must explore”.

We are currently hatching plans for TalkScience 29 which will take place at the end of June. Check back soon to find out more.

 Katie Howe

EThOS at the British Library and our partners Research Councils UK and Vitae recently ran our inaugural #ShareMyThesis competition. The competition challenged PhD students past or present to summarize why their research is/was important in 140 characters or less. For more information see the competition webpage here.

The overall winner was Sarah Wiseman who succinctly conveyed the importance of her PhD research at UCL in the following tweet:

#ShareMyThesis Typing numbers wrongly in hospitals can kill people. Understanding why it happens can help design better systems and stop it!

— Sarah Wiseman (@oopsohno) January 21, 2015

Here we re-post Sarah’s winning article:

Have you ever dialled a phone number incorrectly and ended up talking to the wrong person on the end of the line? Most people have, and it can be a little embarrassing (although occasionally it has been known to result in romance). Now, have you ever typed a number wrongly when setting up a bank transfer? That’s a bit more annoying, and many people have lost a lot of money by sending it to the wrong person. But that’s only money. Sometimes the consequences of number entry error can be even more severe: when a doctor or nurse types a number incorrectly into a medical device the patient can receive a serious overdose. This, unfortunately, is not a rare occurrence, and there are regularly cases reported in the news of a number entry error resulting in the harm or even death of a patient.

Often in the media the response is to blame the nurse or doctor for being sloppy. This reaction means that medical workers can themselves become victims of the incident as they are portrayed as being solely responsible for the otherwise avoidable death of a patient.

Although they have different consequences, the reasons we make errors when typing numbers in the hospital is no different from when we dial the wrong phone number. Sometimes we just make an error when entering numbers because humans are fallible and are even more so when asked to work in high-stress environments such as the hospital. Blaming the medical workers involved in these cases will not help to prevent future errors from happening.

Image:Shutterstock

One way to reduce the number of these tragic incidents from occurring is to improve the design of medical devices. It has been shown that some number entry interfaces found on medical devices, such as those used to administer drugs to patients, can be unpredictable. Other interfaces obscure key numbers from users, making it difficult for them to notice any errors they’ve made. In safety critical situations it is important the device interfaces are as intuitive and easy to use as possible.These systems are poorly designed partly because we haven’t understood how people type numbers. It is for this reason that I focussed on understanding how users transcribe numbers in my PhD thesis. During my research I was able to show that there are patterns in the numbers entered by medical workers when programming some devices, and that these patterns affect the way that the numbers are transcribed. These common numbers have so far been overlooked when testing number entry interfaces. By incorporating this information into the testing process, interfaces can be examined in more realistic ways.

It isn’t just testing practices that could be improved however; the design of the number entry interfaces themselves can also be altered. Further research in my PhD showed that adapting the interfaces to match these regularly used numbers significantly reduced the number of key presses required, which could reduce the opportunity for error.

These were just a few insights from my PhD work, but they highlight that current practices in number entry research and design stand to be updated and improved. Knowing more about the number entry task can allow for more thorough and accurate testing of interfaces. This would mean that they could be made as error proof as possible. Hopefully by incorporating the number entry research that both myself and others are doing, medical devices in the future can be designed with the user in mind. In doing so we might be able to reduce the occurrence of avoidable, and life altering errors.

Sarah completed her PhD with Anna Cox at UCL’s Interaction Centre. Her work was funded by UCL Psychology and Languages Department with additional funding from EPSRC through the CHI+MED project. Her thesis is available here. Sarah is now working as a post doctoral researcher based at both University College London and the Open University. At the OU she is working on a project that aims to explore how technology can improve accessibility to the arts for people with visual impairments. At UCL she is continuing her PhD topic by researching number entry error and the possible causes.

Related articles

#ShareMyThesis winners announced - Living Knowledge blog

A medieval potion, described in a 1000 year-old manuscript kept at the British Library, has recently been shown to have 'astonishing' antibiotic properties, capable of defeating the 'superbug' MRSA. Boudewijn Dominicus looks at the science behind this 'ancientbiotic'.

Medieval medicine is often seen as a bit of an oxymoron. With practices such as bloodletting commonplace¹, many would say this reputation is deserved. Indeed the word for ‘leech’, a creature synonymous with medicine of the era, is derived from the Anglo-Saxon word for physician ‘laece’².

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Although many treatments were ineffective or even harmful, careful analysis of Old English medical texts has revealed that not all of them were as backwards as we imagine. For example, there is evidence that honey was used as an antiseptic – its high sugar content and low levels of hydrogen peroxide destroying bacterial cells³.  Another example was the use of the herb marrabium vulgare (horehound) to treat coughs – horehound is still used today in some throat lozenges⁴. Some of these treatments required specific identification of herbs, careful preparation and appropriate administration. Such examples show that Anglo-Saxon physicians were willing to experiment, see what worked and from that, occasionally, find an effective cure – formulating simple compound drugs using a prototypical scientific method.

But now, researchers from the University of Nottingham have discovered a medieval treatment for eye infections which puts even some modern medicines to shame. The eye salve described in Bald’s Leechbook, a 9^th century medical manuscript held by the British Library, was tested by a team of microbiologists at Nottingham University’s Centre for Biomolecular Sciences and was shown to kill one of today’s most notorious antibiotic-resistant bacteria: Methicillin-resistant Staphylococcus aureus (MRSA).

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Dr Christina Lee, an Anglo-Saxon expert from the University’s School of English, translated the recipe which was made from a mixture of garlic, onions, wine, and bovine bile salts, all of which were then brewed in a brass cauldron and let sit for nine days:

“take cropleek and garlic, of both equal quantities, pound them well together, take wine and bullocks’ gall, of both equal quantities, mix with the leek, put this then into a brazen vessel, let it stand nine days in the brass vessel, wring out through a cloth and clear it well, put it into a horn, and about night time apply it with a feather to the eye.”

The microbiologists made three batches and tested them on cultures of three commonly found and hard to treat bacteria, Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa in both synthetic wounds and in infected wounds in mice. The results were then compared to a control treatment using the same recipe, but without the vegetable compounds. On their own the ingredients had no measureable effect, but when combined the mixture was startling effective: only about one in a thousand bacteria survived application. Vancomycin, the current antibiotic of choice against MRSA, has approximately the same level of antibacterial activity.

The scientists then diluted the eye salve, investigating its effectiveness at different concentrations and exploring its possible mechanism of action. Interestingly, they found that when the medicine was too dilute to kill Staphylococcus aureus, it interfered with bacterial cell-cell communication (quorum sensing). Quorum sensing is essential to the formation of biofilms; a means by which bacteria aggregate together to form a cell colony. Biofilms can promote bacterial antibiotic resistance by forming a dense outer film around a colony which is impervious to antimicrobials such as antibiotics and detergents. As such, many microbiologists think that blocking this behaviour could be a means of combatting antibiotic resistance. 

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Bald’s remedy certainly confirms that this approach is promising. Many of the microbiologists involved were surprised by the efficacy of the treatment. Dr Freya Harrison, who led the work in the laboratory at Nottingham, commented that they were “hopeful that Bald’s eyesalve might show some antibiotic activity, because each of the ingredients has been shown by other researchers to have some effect on bacteria in the lab – copper and bile salts can kill bacteria, and the garlic family of plants make chemicals that interfere with the bacteria’s ability to damage infected tissues. But we were absolutely blown away by just how effective the combination of ingredients was.”

The next step is to investigate why the combination confers such powerful antibiotic activity; in isolation each individual ingredient has little effect. Understanding how and why these ingredients interact may inform the development of new drugs which could help us combat the ‘evil that is antibiotic resistance’.

 

Boudewijn Dominicus

References

¹http://britishlibrary.typepad.co.uk/digitisedmanuscripts/2013/10/anglo-saxon-medicine.html

²http://bjgp.org/content/bjgp/20/97/63.full.pdf

³http://europepmc.org/abstract/MED/23569748

⁴http://www.vikingsofmiddleengland.co.uk/surgery-medicine.html

The winners of the Access to Understanding science writing competition are revealed.

On Friday 27 March, under the striking façade of the King’s Library Tower, the British Library played host to the Access to Understanding Awards 2015. The event was a celebration of excellent science writing: an evening to recognise the efforts and accomplishments of our entrants and also, more broadly, to recognise the value of clear science communication. But before we reflect on the evening’s festivities, first we take a look back at the competition as a whole.

The competition is run in partnership by The British Library, eLife and Europe PMC. We asked entrants to write a summary of a research article at a level that an interested member of the public would understand. Each summary needed to explain why the research was done, what was done and why it was important, all in fewer than 800 words. Entrants could choose from twelve articles, freely available from Europe PMC.

Looking back at the competition...

Now in its third year, the competition has gone from strength to strength. We received over 300 entries and a record number of votes were cast for the People’s Choice Award (1604). If ever evidence were needed that there is a demand for plain-English science, from both the public and the scientific community, then Access to Understanding provides it.

The need for plain-English science summaries was further underlined by Professor Jim Smith, Deputy CEO of the MRC, in his keynote speech where he stated that “such summaries would be a huge contribution to our attempts to explain science and its significance”. He felt that, in combination with further open access publishing, “this democratisation of science is very important, [perhaps] the most radical change in science communication since… the first journal 350 years ago.” Simon Denegri, NIHR National Director for Patients and the Public in Research and chair of our judging panel, echoed the importance of plain-English science in his speech emphasising that “the knowledge gained from good [science] writing is empowering”.

Professor Jim Smith giving his keynote speech

Now, our shortlist represents some of the best plain-English science writing around, but who was the best?

Our shortlist (from left to right): Sabrina Talukdar (People's Choice), Elizabeth Randall, Hannah Ralph, Hannah Mackay, Carly Lawler, Natalie Edelman, Minghao Chia, Peter Canning (3rd), David Bowkett, Philippa Matthews (1st), Sophie Regnault, and chair of our judging panel Simon Denegri.

First place was awarded to Philippa Matthews for her entry ‘Rolling back malaria: A journey through space and time’, which described research exploring the changing patterns of malaria risk across Africa. Second place went to Juliet Lamb for her entry ‘Who you are, or who you’re with? Age predicts disease risk’. And third place was awarded to Peter Canning for his entry ‘Breaking through cancer’s acid shell’ which discussed drug absorption in the acidic environment around tumours. The People’s Choice Award – a key part of our competition – was won by Sabrina Talukdar for her entry ‘The persistent perils of puberty’. For more on these winning entries, please check out our previous blog announcing the competition winners.

Our winners (clockwise from top left): Peter Canning (3rd), Philippa Matthews (1st) and Sabrina Talukdar (People's Choice)

These Pulitzers of plain-English science are the culmination of several months of hard work – by entrants, funders and judges alike – without them there would be no competition. We’d like to thank everyone involved for their efforts and we look forward to doing it all over again in 2016!

With the Access to Understanding awards ceremony just about wrapping up, we can now announce the winners…

First place was awarded to Philippa Matthews for her entry ‘Rolling back malaria: A journey through space and time’, which described research exploring the changing patterns of malaria risk across Africa. The piece was praised by our judges for its enthusiasm, clear writing style, and sense of narrative; “using the facts to tell the story” with a “sense that the research team were on an expedition”. Congratulations Philippa!

Second place went to Juliet Lamb for her entry ‘Who you are, or who you’re with? Age predicts disease risk’. The judges felt that it was “confidently written” and did a “great job of clarifying the use of mathematical models in research”. And third place was awarded to Peter Canning for his entry ‘Breaking through cancer’s acid shell’ which “didn’t shy away from the hard science” of drug absorption in the acidic environment around tumours.

And finally, the People’s Choice Award – a key part of our competition – read by you and voted for by you. The overwhelming response to the award, with over 1600 votes across all entries, yet again demonstrates the public appetite for accessible science writing. This year’s winner with over 400 votes was Sabrina Talukdar with her entry ‘The persistent perils of puberty’. One reader commented that it was a “well written piece, making the original paper very accessible to lay people” which is exactly what Access to Understanding is about.

The standard of entries this year was very high, and it’s great to see the enthusiasm, talent and motivation of all the scientists who entered the competition.

You can read all of the shortlisted articles on our website, with topics ranging from body clocks to tinnitus. If you want to delve deeper, every article is also accompanied with a link to the original research paper freely available from Europe PMC – the European gateway to biomedical research.

Boudewijn Dominicus

Continuing our series about the scientific advancements that emerged from the First World War, Paul Allchin examines how shell shock led to the development of treatments for Post-Traumatic Stress Disorder (PTSD).

Confronted with the scale of shell shock during trench warfare, the British establishment and medical profession responded by gradually changing attitudes to mental illness from organic causes and punitive treatments to more sympathetic psychotherapeutic interventions. 

Dr William Halse Rivers Rivers is best known for his work with shell shocked soldiers during World War One. He and his contemporaries debated long after the war the merits of the organic versus psychotherapeutic approaches to treating shell shock. One of Rivers’ patients at Craiglockhart War Hospital near Edinburgh was the war poet Siegfried Sassoon. In Sassoon’s fictionalised autobiography, “The Complete Memoirs of George Sherston”, he described his observations of shell shock and its effects on soldiers:

“How many a brief bombardment had its long-delayed after effects in the minds of these survivors, many of whom had looked at their companions and laughed while inferno did its best to destroy them. Not then was their evil hour, but now; now, in the sweating suffocation of nightmare, in paralysis of limbs, in the stammering of dislocated speech. Worst of all in the disintegration of those qualities through which they had been so gallant and selfless and uncompromising – this, in the finer types of men, was the unspeakable tragedy of shell-shock …”

By June 1918, the government established a network of specialist hospitals to treat shell shock victims and specialist centres at Maghull and Netley for training medical field officers. However it was not until 1930 that the new Labour government changed UK legislation by removing the death penalty for desertion and cowardice in the armed forces.

Dr. Rivers. Dr. William Brown and Dr. Elliot Smith. Military hospital, Maghull, 1915. © The British Library Board

In contrast to the imperialist courage and valour expressed by war poets in the Victorian era, World War One saw a sea change in the way poetry and the theatre depicted the reality of war and disillusionment of those returning from battle. Sassoon's poem “Survivors” describes the experience of some.

It could well be argued that the government and establishment were very slow in responding to the needs of shell shock victims. Military authorities believed that training, morale, and discipline could prevent shell shock, and did not maintain a psychiatric service. When the Second World War broke out, only six regular officers in the British army had psychiatric training. Equally it was not until 1930 that the Mental Treatment Act made provision for voluntary treatment at outpatient clinics, providing the mentally afflicted with an alternative to the asylum.

Even though shell shocked veterans benefitted from special clinics, many also experienced considerable difficulties in claiming pensions for psychological injury and it was many years before an adequate mental health care system was established.

World War One accelerated advances in theory, practice and research in psychiatry, psychological medicine and psychotherapy, especially the cognitive model of PTSD treatment based on prompt intervention, re-processing the trauma, conceptual meaning making and reframing, developing the therapist/client alliance and reclaiming personal control in victim’s lives. These themes are echoed in the lives of all adults and children following their personal self-healing journeys whether they are male or female and whether their battles are in the military or domestic arenas. The social taboos and misunderstandings surrounding mental illness remain a challenge even today as mental health awareness programmes still need to remind us that we are human and not machines.

Shellshock in World War One. Image: Wikipedia; Public Domain

Our current understanding of shell-shock and PTSD is described in a chapter on trauma and stress in the American Psychiatric Association’s diagnostic manual DSM-5, Diagnostic and statistical manual of mental disorders, 5th edition, 2013 used throughout the medical profession today.

Paul Allchin

Reference Specialist – Science, Technology and Medicine

See here for a detailed bibliography and suggestions for further reading

Antibiotic resistance poses one of the biggest threats to medicine in the 21^st century. In this blog post, Boudewijn Dominicus explores the exciting new strategies scientists are developing to combat this threat, ranging from new antibiotic classes to bacterial decoys.

In a class of its own

Scientists at Northeastern University recently announced the discovery of teixobactin, a compound that represents a new class of antibiotics¹. Teixobactin has a unique mechanism of action: it works by binding to two types of fat molecule some bacteria use to build their cell walls. Cutting off their supply means the cell walls cannot be maintained and eventually fall apart. This mechanism has the added advantage of making it very difficult for bacteria to develop resistance against it. The majority of antibiotics target proteins, which can be readily altered by mutation without severe consequences. By contrast, changing both types of fat molecules to evade antibiotic action would require a fundamental change in how bacteria construct their cell walls, not an easy step. As such, the team behind teixobactin believe it will take as much as 30 years before bacteria develop resistance to this class of antibiotic.

What made the discovery of teixobactin even more noteworthy was how it was discovered. As mentioned in the previous blogpost, many bacteria produce their own antibacterial compounds to keep competing species at bay. Screening these (often soil-based) bacteria for potential new antibiotics would be a potent source of new antibacterial therapies; however until now 99% of these bacteria couldn’t be grown and tested in the lab. The scientists solved this by developing a new screening device known as the iChip, which allows bacteria to be cultivated in their natural habitat. Bacteria are introduced between two permeable sheets inside the device, which is then put back into the nutrient-rich soil, allowing the bacteria to grow into larger colonies which can then be screened for antibiotic activity.

The iChip represents a great new tool in the search for novel antibiotic therapies. Source: Slava Epstein

Just a passing phage…

Another exciting strategy is to turn a resistant bacterium’s immune system against itself, an idea developed by a team of scientists at MIT². Bacteria have an immune system, known as CRISPR, which protects them from bacteriophage (a type of virus that infects bacteria). One component of this system is a protein known as Cas9, which can recognise and ‘digest’ certain foreign DNA sequences. Cas9 is guided by targeting molecules which are specific to these sequences.

By modifying these targeting molecules to recognise DNA sequences corresponding to resistance, scientists were able to make the CRISPR system exclusively digest the bacteria’s own antibiotic resistance genes, thereby killing them. The modified targeting molecules were smuggled into the bacterium, ironically, by a bacteriophage which acts like a sort of living syringe – injecting them into the bacterial cell. What makes this treatment even better is that it is specific; non-resistant beneficial bacteria are left alone.

Targeting molecules are packaged into bacteriophage which injects them into the bacterium. These molecules then guide CRISPR to digest DNA containing antibiotic resistance genes (including DNA found on plasmids – a DNA structure some bacteria use to exchange genes with each other) Source: BBC News

Tackling toxins

Ultimately one of our best defences against bacteria is our own body’s immune response. What if we could minimise the damage done by the toxins produced by bacteria, while leaving the immune system to fight the infection? This is the philosophy followed by a team at the University of Bern who have developed ‘decoy targets’ for bacterial toxins³.

The team engineered artificial nanoparticles, known as liposomes, made from a mixture of cholesterol and a molecule called sphingomyelin. Since toxins primarily use these two molecules to target animal cells, a liposome containing high proportions of these makes a very ‘attractive’ target. With toxins diverted away from animal cells, bacteria are rendered relatively harmless. Mice, treated with liposomes within 10 hours of being infected by bacteria such as S. aureus and S. pneumonia, survived without additional antibiotic therapy (though the scientists envisage liposomes could be used in tandem with limited antibiotics). Since the bacteria themselves aren’t being targeted, this approach has the added benefit of not promoting further antibiotic resistance.

Fleming later said of his discovery: “When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionise all medicine by discovering the world’s first antibiotic, or bacteria killer.” Nearly 80 years on, scientists worldwide are still striving to keep this revolution, and us, alive.

Boudewijn Dominicus

References

¹Ling LL, Schneider T, Peoples AJ, et al. A new antibiotic kills pathogens without detectable resistance. Nature. 2015

² Citorik RJ, Mimee M, Lu TK. Sequence-specific antimicrobials using efficiently delivered RNA-guided nucleases. Nat Biotechnol. 2014;32(11):1141-5.

³Henry BD, Neill DR, Becker KA, et al. Engineered liposomes sequester bacterial exotoxins and protect from severe invasive infections in mice. Nat Biotechnol. 2015;33(1):81-8.

On the 60^th anniversary of Alexander Fleming’s death, in a two-part blog Boudewijn Dominicus investigates Fleming's prescient predictions about antibiotic resistance and what scientists are doing today to overcome it.

You’d think that an untidy desk is hardly the best place to start when trying to make a revolutionary medical discovery. But it was exactly that which led to Alexander Fleming, who died 60 years ago today, to discover penicillin¹. On the morning of 28 September 1928, having returned from his summer holiday, Fleming was clearing away a mess of plates left out on his desk when he noticed a Petri dish contaminated by a blue-green mould (later found to be Pencillium notatum). This mould demonstrated a halo of antibacterial activity around it, destroying all the Staphylococcus bacterial colonies in its vicinity. 

 

Fleming’s original lab notes can be seen right here at the British Library in the Sir John Ritblat Treasures Gallery. Source: The British Library

He isolated the mould’s active component, named it penicillin, and over the following few years investigated its remarkable potency and potential. By 1944 penicillin was ready for mass production, in large part due to the invaluable work carried out by Florey and Chain in isolating and purifying it², heralding the start of the antibiotic revolution. Unfortunately it seems that this revolution may be coming to an end, as antibiotic resistance renders traditional antibiotics increasingly ineffective.

For someone whose laboratory and written work was so chaotic (researchers at the British Library have spent hours trying to make sense of his scrawled and scrambled notebooks), some of Fleming’s conclusions were remarkably forward-thinking. By the time industrial-scale antibiotic production became a reality, Fleming was already warning of the risks of antibiotic resistance. Indeed, in 1945 he gave a speech to the American Association of Penicillin Producers³ where he warned that misuse of penicillin would result in bacteria that "are educated to resist penicillin and a host of penicillin-fast organisms [will be] bred out which can be passed on to other individuals and perhaps from them to others until they reach someone who gets septicemia [infection in the blood stream] or a pneumonia which penicillin cannot save". So how exactly are bacteria ‘educated to resist’ antibiotics?

The Rise of Resistance

Antibiotic resistance is actually a naturally occurring phenomenon, which arises through random mutations in bacterial DNA, allowing bacteria to in some way circumnavigate an antibiotic’s normal mechanism of action. Resistance mutations can take many forms: some block the route by which antibiotics enter the bacteria, while others produce pumping mechanisms that eject the antibiotic. Some eliminate or change the antibiotic’s target; others enable the bacteria to ‘digest’ the antibiotic.

Such mutations can still confer a small advantage in the absence of manmade antibiotics – some bacteria produce antibacterial compounds to kill off competing species, and resistance genes allow these competing species to survive such an antibiotic attack. However, in nature this occurs on such a small scale that it doesn’t make the characteristic commonplace. Unfortunately, large-scale and indiscriminate human antibiotic usage has made this characteristic far more advantageous, making resistant strains significantly more prevalent than before.

Source: Centre for Disease Control, “Antibiotic Resistance in the United States”, 2013

Herein lies one of the most important solutions to antibiotic resistance: reduce our excessive antibiotic usage and you reduce the selective pressure in favour of resistant strains.

This means cutting down on a culture of needless prescription. Viral infections like colds cannot be treated with antibiotics; a practice Fleming described as “a waste of [a doctor’s] time, a patient’s time and a waste of penicillin”. When antibiotics are required, we should use them in a targeted manner based on precise infection diagnoses, as promoted by the 2014 Longitude Prize. We also need to limit industrial scale usage in farming with up to 50% of antibiotics given to livestock, primarily to compensate for the crowded conditions commonly found in factory farms.

The ever-prescient Fleming took a hard line against abuses of his newly discovered medicine, writing in the New York Times in 1945⁴ that “the thoughtless person playing with penicillin treatment is responsible for the death of the man who eventually succumbs to infection with the penicillin-resistant organism. I hope this evil can be averted.” Careful stewardship of antibiotic usage may just give scientists enough time to find new ways of 'averting the evil' of antibiotic resistance. Check out our next blog to find exactly how scientists across the globe are doing just that.

Boudewijn Dominicus

References

¹ Fleming A. On the antibacterial action of cultures of a penicillium, with special reference to their use in the isolation of B. influenzae. 1929. Bull World Health Organ. 2001;79(8):780-90.

² Chain E, Florey HW, Adelaide MB, et al. Penicillin as a chemotherapeutic agent. 1940. Clin Orthop Relat Res. 1993;(295):3-7.

³ Fleming A. Speech by A. Fleming at a banquet in his honour at the Waldorf Astoria, New York, 25 June, 1945. American Association of Penicillin Producers. Typewritten. British Library Add. MS 56122, ff. 232-242

 ⁴Penicillin’s finder assays its future. New York Times. 1945 June 26;:21