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What being a physician taught one astronaut about living in space

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What being a physician taught one astronaut about living in space


How have these experiences colored and affected your time in space? 

Every astronaut is different. There is no set path. What space agencies really look for is a kind of jack-of-all-trades, because once you are up in space, you have to be able to tackle pretty much any problem. 

I really am an engineer at heart. My fundamental inclination is a love for machines. I just like to solve problems and then put them in a box. I think the fundamental definition of medicine is really an interest in people. You’re putting yourself in someone’s shoes and then deciding, “What would I do if that was me, or my brother, or my mom?” That’s what I found fascinating in medicine. It brings you right at the core of what it is to be human. It helps you cut through the noise of culture, to reach to the heart of individuals. It’s super useful in space. You can speak in a really reassuring way and put things in perspective and be helpful. And it’s always reassuring if there’s a condition on board. For the crew, it’s kind of up to us to take care of each other.

You’ve gone back to being a practicing physician during the pandemic. Has being in space changed how you approach medicine? 

I do strongly feel that I’m still in space—I’m just on mothership Earth. That perspective never leaves me. From space, you glimpse the Earth, and it’s of course beautiful: a glowing blue, and the oceans and the city lights at night are a gracious kind of dance of life. But what is most impressive is when you turn your back from Earth and look the other way. And all you see is nothing—just emptiness. You can imagine that goes on forever. It’s very endearing to see how exposed humans are on this little fragile miracle of a planet. It’s given me a kind of a very endearing love for humans, and how it’s incredible that we are clinging on to this place and develop all this culture and raise children and be inventive and create art. It’s made me love people.

For people who are unfamiliar with how space and medicine intersect, how would you describe some of the ways that the medical research we’re doing in space will benefit people on Earth? 

We do a lot of research in space on the astronauts. Because there’s a bunch of ailments that affect astronauts. Just being in the environment of space is bad for you. No sense of gravity; space, radiation, isolation, and confinement—the stress of this environment is just very bad for you. So we’re like perfect guinea pigs for medical research: bone health, cardiovascular health, cerebral health, psychology, psychology, hematology, immunology—you name it.

The other aspect is in medical technology. We need to make the astronauts capable of helping themselves and helping each other in this super-remote environment. That problem is identical to the problem faced here on Earth when we’re enabling medical care for people that live in rural areas and remote areas, for workers in dangerous environments, for our military on a mission, for big expeditions, or for elderly people who are too frail to even go to a clinic. So that problem of bringing medicine to the patient is a very modern thing. And I think the pandemic has given us all a great appetite for that capacity to bring medicine to the patient—using space to test how these things work.

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These robots know when to ask for help

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These robots know when to ask for help


A new training model, dubbed “KnowNo,” aims to address this problem by teaching robots to ask for our help when orders are unclear. At the same time, it ensures they seek clarification only when necessary, minimizing needless back-and-forth. The result is a smart assistant that tries to make sure it understands what you want without bothering you too much.

Andy Zeng, a research scientist at Google DeepMind who helped develop the new technique, says that while robots can be powerful in many specific scenarios, they are often bad at generalized tasks that require common sense.

For example, when asked to bring you a Coke, the robot needs to first understand that it needs to go into the kitchen, look for the refrigerator, and open the fridge door. Conventionally, these smaller substeps had to be manually programmed, because otherwise the robot would not know that people usually keep their drinks in the kitchen.

That’s something large language models (LLMs) could help to fix, because they have a lot of common-sense knowledge baked in, says Zeng. 

Now when the robot is asked to bring a Coke, an LLM, which has a generalized understanding of the world, can generate a step-by-step guide for the robot to follow.

The problem with LLMs, though, is that there’s no way to guarantee that their instructions are possible for the robot to execute. Maybe the person doesn’t have a refrigerator in the kitchen, or the fridge door handle is broken. In these situations, robots need to ask humans for help.

KnowNo makes that possible by combining large language models with statistical tools that quantify confidence levels. 

When given an ambiguous instruction like “Put the bowl in the microwave,” KnowNo first generates multiple possible next actions using the language model. Then it creates a confidence score predicting the likelihood that each potential choice is the best one.

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The Download: inside the first CRISPR treatment, and smarter robots

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The Download: inside the first CRISPR treatment, and smarter robots


The news: A new robot training model, dubbed “KnowNo,” aims to teach robots to ask for our help when orders are unclear. At the same time, it ensures they seek clarification only when necessary, minimizing needless back-and-forth. The result is a smart assistant that tries to make sure it understands what you want without bothering you too much.

Why it matters: While robots can be powerful in many specific scenarios, they are often bad at generalized tasks that require common sense. That’s something large language models could help to fix, because they have a lot of common-sense knowledge baked in. Read the full story.

—June Kim

Medical microrobots that travel inside the body are (still) on their way

The human body is a labyrinth of vessels and tubing, full of barriers that are difficult to break through. That poses a serious hurdle for doctors. Illness is often caused by problems that are hard to visualize and difficult to access. But imagine if we could deploy armies of tiny robots into the body to do the job for us. They could break up hard-to-reach clots, deliver drugs to even the most inaccessible tumors, and even help guide embryos toward implantation.

We’ve been hearing about the use of tiny robots in medicine for years, maybe even decades. And they’re still not here. But experts are adamant that medical microbots are finally coming, and that they could be a game changer for a number of serious diseases. Read the full story.

—Cassandra Willyard

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5 things we didn’t put on our 2024 list of 10 Breakthrough Technologies

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5 things we didn’t put on our 2024 list of 10 Breakthrough Technologies


We haven’t always been right (RIP, Baxter), but we’ve often been early to spot important areas of progress (we put natural-language processing on our very first list in 2001; today this technology underpins large language models and generative AI tools like ChatGPT).  

Every year, our reporters and editors nominate technologies that they think deserve a spot, and we spend weeks debating which ones should make the cut. Here are some of the technologies we didn’t pick this time—and why we’ve left them off, for now. 

New drugs for Alzheimer’s disease

Alzmeiher’s patients have long lacked treatment options. Several new drugs have now been proved to slow cognitive decline, albeit modestly, by clearing out harmful plaques in the brain. In July, the FDA approved Leqembi by Eisai and Biogen, and Eli Lilly’s donanemab could soon be next. But the drugs come with serious side effects, including brain swelling and bleeding, which can be fatal in some cases. Plus, they’re hard to administer—patients receive doses via an IV and must receive regular MRIs to check for brain swelling. These drawbacks gave us pause. 

Sustainable aviation fuel 

Alternative jet fuels made from cooking oil, leftover animal fats, or agricultural waste could reduce emissions from flying. They have been in development for years, and scientists are making steady progress, with several recent demonstration flights. But production and use will need to ramp up significantly for these fuels to make a meaningful climate impact. While they do look promising, there wasn’t a key moment or “breakthrough” that merited a spot for sustainable aviation fuels on this year’s list.  

Solar geoengineering

One way to counteract global warming could be to release particles into the stratosphere that reflect the sun’s energy and cool the planet. That idea is highly controversial within the scientific community, but a few researchers and companies have begun exploring whether it’s possible by launching a series of small-scale high-flying tests. One such launch prompted Mexico to ban solar geoengineering experiments earlier this year. It’s not really clear where geoengineering will go from here or whether these early efforts will stall out. Amid that uncertainty, we decided to hold off for now. 

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