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Earlier this week, Americans cast their votes in a seminal presidential election. But it wasn’t just the future president of the US that was on the ballot. Ten states also voted on abortion rights.

Two years ago, the US Supreme Court overturned Roe v. Wade, a legal decision that protected the right to abortion. Since then, abortion bans have been enacted in multiple states, and millions of people in the US have lost access to local clinics.

Now, some states are voting to extend and protect access to abortion. This week, seven states voted in support of such measures. And voters in Missouri, a state that has long restricted access, have voted to overturn its ban.

It’s not all good news for proponents of reproductive rights—some states voted against abortion access. And questions remain over the impact of a second term under former president Donald Trump, who is set to return to the post in January.

Roe v. Wade, the legal decision that enshrined a constitutional right to abortion in the US in 1973, guaranteed the right to an abortion up to the point of fetal viability, which is generally considered to be around 24 weeks of pregnancy. It was overturned by the US Supreme Court in the summer of 2022.

Within 100 days of the decision, 13 states had enacted total bans on abortion from the moment of conception. Clinics in these states could no longer offer abortions. Other states also restricted abortion access. In that 100-day period, 66 of the 79 clinics across 15 states stopped offering abortion services, and 26 closed completely, according to research by the Guttmacher Institute.

The political backlash to the decision was intense. This week, abortion was on the ballot in 10 states: Arizona, Colorado, Florida, Maryland, Missouri, Montana, Nebraska, Nevada, New York, and South Dakota. And seven of them voted in support of abortion access.

The impact of these votes will vary by state. Abortion was already legal in Maryland, for example. But the new measures should make it more difficult for lawmakers to restrict reproductive rights in the future. In Arizona, abortions after 15 weeks had been banned since 2022. There, voters approved an amendment to the state constitution that will guarantee access to abortion until fetal viability.

Missouri was the first state to enact an abortion ban once Roe v. Wade was overturned. The state’s current Right to Life of the Unborn Child Act prohibits doctors from performing abortions unless there is a medical emergency. It has no exceptions for rape or incest. This week, the state voted to overturn that ban and protect access to abortion up to fetal viability. 

Not all states voted in support of reproductive rights. Amendments to expand access failed to garner enough support in Nebraska, South Dakota, and Florida. In Florida, for example, where abortions after six weeks of pregnancy are banned, an amendment to protect access until fetal viability got 57% of the vote, falling just short of the 60% the state required for it to pass.

It’s hard to predict how reproductive rights will fare over the course of a second Trump term. Trump himself has been inconsistent on the issue. During his first term, he installed members of the Supreme Court who helped overturn Roe v. Wade. During his most recent campaign he said that decisions on reproductive rights should be left to individual states.

Trump, himself a Florida resident, has refused to comment on how he voted in the state’s recent ballot question on abortion rights. When asked, he said that the reporter who posed the question “should just stop talking about that,” according to the Associated Press.

State decisions can affect reproductive rights beyond abortion access. Just look at Alabama. In February, the Alabama Supreme Court ruled that frozen embryos can be considered children under state law. Embryos are routinely cryopreserved in the course of in vitro fertilization treatment, and the ruling was considered likely to significantly restrict access to IVF in the state. (In March, the state passed another law protecting clinics from legal repercussions should they damage or destroy embryos during IVF procedures, but the status of embryos remains unchanged.)

The fertility treatment became a hot topic during this year’s campaign. In October, Trump bizarrely referred to himself as “the father of IVF.” That title is usually reserved for Robert Edwards, the British researcher who won the 2010 Nobel prize in physiology or medicine for developing the technology in the 1970s.

Whatever is in store for reproductive rights in the US in the coming months and years, all we’ve seen so far suggests that it’s likely to be a bumpy ride.

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My colleague Rhiannon Williams reported on the immediate aftermath of the decision that reversed Roe v. Wade when it was announced a couple of years ago. 

The Alabama Supreme Court ruling on embryos could also affect the development of technologies designed to serve as “artificial wombs,” as Antonio Regalado explained at the time.

Other technologies are set to change the way we have babies. Some, which could lead to the creation of children with four parents or none at all, stand to transform our understanding of parenthood.  

We’ve also reported on attempts to create embryo-like structures using stem cells. These structures look like embryos but are created without eggs or sperm. There’s a “wild race” afoot to make these more like the real thing. But both scientific and ethical questions remain over how far we can—and—should go.

My colleagues have been exploring what the US election outcome might mean for climate policies. Senior climate editor James Temple writes that Trump’s victory is “a stunning setback for climate change.” And senior reporter Casey Crownhart explains how efforts including a trio of laws implemented by the Biden administration, which massively increased climate funding, could be undone.

From around the web

Donald Trump has said he’ll let Robert F. Kennedy Jr. “go wild on health.” Here’s where the former environmental lawyer and independent candidate—who has no medical or public health degrees—stands on vaccines, fluoride, and the Affordable Care Act. (New York Times)

Bird flu has been detected in pigs on a farm in Oregon. It’s a worrying development that virologists were dreading. (The Conversation)

And, in case you need it, here’s some lighter reading:

Scientists are sequencing the DNA of tiny marine plankton for the first time. (Come for the story of the scientific expedition; stay for the beautiful images of jellies and sea sapphires.) (The Guardian)

Dolphins are known to communicate with whistles and clicks. But scientists were surprised to find a “highly vocal” solitary dolphin in the Baltic Sea. They think the animal is engaging in “dolphin self-talk.” (Bioacoustics)

How much do you know about baby animals? Test your knowledge in this quiz. (National Geographic)

There’s a trendy new cure-all in town—you might have seen ads pop up on social media or read rave reviews in beauty magazines. Exosomes are being touted as a miraculous treatment for hair loss, aging skin, acne, eczema, pain conditions, long covid, and even neurological diseases like Parkinson’s and Alzheimer’s. That’s, of course, if you can afford the price tag—which can stretch to thousands of dollars.

“They’re magic!” claims one YouTube review. One US clinic exhorts: “Unlock the fountain of youth with exosome therapy.” “All aspects of skin health improve with exosome therapy,” states one UK clinic’s website, adding that “this is as cutting-edge as it gets.” Exosome particles could be used to treat “any inflammatory disease you could think about, which is almost all of them,” the founder of an exosome company says in a video on YouTube.

But there’s a big problem with these big promises: We don’t fully understand how exosomes work—or what they even really are. 

We do know that exosomes are tiny particles that bud off from cells and that their contents can vary hugely, depending on the source of the cell (some popular options include human umbilical cords, salmon testicles, and roses) and how healthy or stressed it is. Even cell biologists can’t agree on what, exactly, is inside them, and how beneficial—or dangerous—those contents may be.  

The world of exosome treatments is being likened to a “Wild West” by some researchers. Rigorous trials have not been conducted, so we don’t know how safe it is to spray on or inject these tiny mystery blobs. Exosome products have not been approved by regulatory agencies in the US, UK, or Europe, where the treatments are growing in popularity. Nor have they been approved for medical uses in Japan or South Korea, two other countries where exosome treatments are popular. Still, “exosomes have emerged as a sort of panacea for almost everything,” says Leigh Turner, a bioethicist and public health researcher at the University of California, Irvine, who tracks direct-to-consumer marketing of unapproved health products. “Risks are commonly minimized, and benefits are commonly exaggerated.”

This hasn’t stopped customers from flocking to the growing number of aesthetic centers, stem-cell clinics, and medspas offering exosome treatments, hoping for a miracle fix. The global market for exosome skin-care products was valued at $256 million in 2023 and is forecast to grow to $674 million in the next six years. 

Mystery blobs

Technically referred to as vesicles, exosomes are made inside cells before being released. They’ve long been mysterious. The term “exosome” was introduced in the 1980s. Before that, tiny particles that are now thought to have been exosomes were described as “platelet dust” or “matrix vesicles.”  

At first, scientists assumed that exosomes functioned as trash bags, shuttling waste out of the cell. But research in 1996 suggested that exosomes might also work to help cells communicate by delivering signals between them. If a cell is dying, for instance, it could perhaps send a signal to neighboring cells, giving them a chance to produce more protective substances in order to save themselves from the same fate. Cancer cells, on the other hand, could potentially use exosomes to send signals that co-opt other cells to support the growth of a tumor. Still, it’s not fully understood what signals are actually being sent.

Another major mystery is what, exactly, is inside exosomes. “It depends who you ask,” says James Edgar, who studies exosomes and similar vesicles at the University of Cambridge, UK. Cell biologists agree that exosomes contain proteins, lipids, and other molecules that result from cell metabolism. Some believe they also contain DNA and RNA, but not everyone is convinced. “It’s just very difficult to prove or disprove,” says Edgar.

That’s partly because exosomes are so small—only about 70 nanometers wide, around one-hundredth the size of a red blood cell. While the first images of them were published in the 1970s, we still don’t even know for sure what they look like; Raghu Kalluri at MD Anderson Cancer Center in Houston and his colleagues are studying the shape of exosomes to figure out if they are round, oval, or rod-like, for example.

Further complicating all of this, cell biologists don’t know what triggers the release of an exosome from a cell. Most cells release them at a relatively steady pulse. Some cells release a lot of exosomes; others release a relatively small number. Immune cells, for example, release more exosomes than cancer cells. “We don’t really understand why that’s the case,” says Edgar.

“Fundamentally, we don’t know enough,” he adds. “We don’t quite know yet where these things go when they hit cells, and if they’re released into that cell—or how any of it happens, basically.”

Exosome explosion

Despite these enduring questions, exosomes have taken off as a beauty and health treatment. Turner has been tracking stem-cell clinics both in the US and globally for years. When he and his colleagues assessed US clinics offering direct-to-consumer treatments in 2016, exosomes “just didn’t pop up at all,” he says. When he did the same analysis in 2021, he identified around 100 clinics in the US offering exosome therapies.

It’s not clear why exosomes are taking off now. “It’s not as though there’s an overwhelming amount of safety and efficacy data,” says Turner. “I think it might be more of a buzz kind of phenomenon. This seems to be kind of a moment for exosomes.”

There are many different types of exosomes available on the market. Some are from human cells, including those from the placenta or umbilical cord. Some companies are selling exosomes from plants and animals. In the US, exosomes are regulated as drugs and biological products when they are “intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” and “intended to affect the structure of any function of the body of man or other animals,” according to the Food and Drug Administration, which regulates medicines in the US. 

Clinics get around this by using them as cosmetics, defined in law as “articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body … for cleansing, beautifying, promoting attractiveness, or altering the appearance.” What practitioners are not allowed to do is make claims about the health benefits of exosomes. After all, even anti-dandruff shampoo, which purports to treat a skin condition, is considered a drug by the FDA.

Dev Patel offers exosome treatments at his “anti-aging and skin rejuvenation” clinic, Perfect Skin Solutions, in Portsmouth, UK. Over the last 10 years, he says, he has noticed a trend: Customers are less interested in injectable treatments that merely give an impression of youth, like fillers and Botox, and more interested in the idea of treatments that can rejuvenate their skin. The demand for devices like lasers, which create heat on the skin and trigger repair, has “gone through the roof,” he says. Now, exosomes are catching on too.

Patel—who has a medical degree, served in the Royal Navy, and holds a postgraduate diploma in dermatology—left his job in the UK’s National Health Service to start his clinic around 10 years ago. He didn’t start offering exosome treatments until 2020, after he heard about them at a meeting for aesthetic clinicians. 

The first treatment he offered involved unapproved exosomes derived from human fat cells—making them illegal to sell in Europe, he says. Patel says that he didn’t realize this until after he’d bought the exosomes and started using them, partly because of the misinformation he’d been fed by the distributor. He says some of the sellers were telling doctors that they were allowed to use the exosomes topically (on a person’s skin) and then inject them as part of an “off-label” use. Patel won’t name the distributor he bought from, but he says the company continued to sell its exosome products to clinics in the UK for at least two years after that point.

Patel stresses that as soon as he found out about the regulations surrounding exosomes derived from human cells, he stopped using the product. “I had probably had £5,000 [around $6,500] worth of product sitting in my clinic, and it was just thrown away,” he says. Instead, he switched to exosomes from plant cells and, more recently, others derived from salmon testes.

For hair regrowth, Perfect Skin Solutions offers a course of five exosome treatments, each delivered during a half-hour appointment, at a total cost of £2,000. When it comes to skin treatments, Patel recommends two or three sessions—more for those who are looking to counter the signs of aging. “By harnessing the power of exosomes, you can achieve a more youthful and radiant complexion, while also addressing specific skin concerns and promoting overall skin health,” according to the company’s website.  

Patel says he uses the exosomes to treat clients for baldness around four times a week. He and his team members will first perform microneedling on the scalp. This technique uses tiny needles to make miniature holes in the skin—“80,000 holes a minute,” he says. Microneedling is often used to trigger a wound healing process that can improve the look of the skin. But after Patel performs the procedure on a person’s head, he uses a “jet propulsion device” that uses carbon dioxide to spray cooled salmon exosomes into the tiny indentations. “You basically create these … micro-icicles containing the product,” he says. “They pierce the skin, but you don’t feel it. It feels quite nice, actually.” After six to 10 weeks, customers can expect healthier skin and thicker, stronger hair, he says.

“The results are amazing,” says Patel. “I’ve had it done on my hair, which is probably why it’s looking out of control now,” he adds, pointing to his thick but neatly styled do, combed back and shaved at the sides. 

Not everyone is as enthusiastic. Sarah, who is being identified by a pseudonym to protect her professional image, tried exosomes last year, though not at Patel’s clinic. Now in her 30s, she had acne as a teenager, and her dermatologist suggested that rubbing exosomes from human umbilical-cord cells into her face after a microneedling treatment might reduce the scarring. But he didn’t fully explain exactly what exosomes are or what they were expected to do, she says. 

“I feel like it’s a little bit of health marketing bullshit,” she says. “I don’t really understand how they work.”

Sarah received three treatments, three months apart, as part of a trial her dermatologist was participating in. As a participant, Sarah didn’t have to pay for her treatment. In each of the sessions, the doctor numbed Sarah’s face with lidocaine cream before microneedling it. “Then they kind of dribbled the exosomes on with a syringe,” she recalls. She was advised to sleep on a clean pillow and avoid washing her face that evening. “There was some redness … but my skin was mostly back to normal the following day,” she says.

Her last treatment was a year ago. And she hasn’t seen a reduction in her scarring. “I don’t think I’d recommend it,” she says. “The results were very underwhelming.”

Safety in salmon?

In theory, exosomes should be safer than stem-cell therapies. Cells can be thought of as “living drugs,” while exosomes are non-living collections of biological molecules, says Ke Cheng at Columbia University in New York, who is doing more conventional research into potential applications of exosomes. Cheng is exploring the use of engineered exosomes for heart diseases. Exosomes are less likely than cells to trigger an immune response, and because they can’t replicate, the risk of tumor formation is also lower. 

But that, of course, does not make them risk-free. There are no established standards or regulations for the manufacture of exosomes to be used in people. This leaves plenty of room for companies to manufacture exosomes in different ways—and for disagreements over which method is the best and safest. 

The product Sarah tried that was derived from human umbilical-cord cells is called Age Zero. Erin Crowley and her father, Michael Crowley, who manufacture and sell the product, have a team that grows the cells and then harvests the exosome-containing liquid surrounding them at a clean lab in Rochester, New York. 

“We have in stock right now about $3.5 billion worth of exosomes,” says Michael Crowley. That’s enough for millions of treatments, he says, although the figure will depend on what they are used for: The pair have different companies that sell exosomes for experimental medical use (25 billion to 100 billion exosomes per treatment) and cosmetic use (5 to 10 billion). Cosmetic clinics can buy vials that the company says contain 5, 10, 50, or 100 billion exosomes. Those with 10 billion exosomes are sold in packs of nine for $1,999, according to the company’s website.

“Right now, we’re in about a little less than a thousand medspas, aesthetician offices, dermatologists, plastic surgeons with our cosmetic product,” Erin Crowley says. “We can sell direct to consumer, but the product really works great after microneedling or after laser or dermaplaning.” They have been selling in the US for the last year and half; she says the product is also available in the UAE, Pakistan, Lebanon, Canada, and Turkey. 

The Crowleys argue that because their exosomes come from human umbilical-cord cells, they are more effective than those from other sources, although again, rigorous side-by-side comparison studies have not been done. Exosomes from plant or fish cells “just don’t have the right language to speak to human cells,” says Erin Crowley, who has a background in mechanical engineering and quality control. She says that she analyzed the exosome market a couple of years ago and was “appalled” at what was on offer. 

“The industry now … is very, very confused, and the marketing is very confused,” she says. Across the board, production quality standards are low, she says, adding that she and her dad hold their product to higher standards by testing for potential sources of infections (which can arise from contamination) and using devices to count exosomes.

On the other hand, Primacure, the company that sells the product derived from salmon testicles, argues that fish exosomes are safer than those taken from human cells or from other animals. These exosomes are collected from cells grown in a medium that contains a mix of growth factors and peptides, and the team uses ultrasound to release the exosomes from the cells, according to a video presentation by Mike Lee, CEO of Primacure. “We want to refrain from using products that are human-derived, or maybe even animal-derived, that can transmit diseases to humans,” Lee says in the video. 

There are no known cases of exosomes causing such diseases in people. But some practitioners buy that argument: “Fish present a very low-risk option in terms of disease transmission,” says Patel. Turner, though, isn’t convinced: “I don’t see any reason why they would be [safer],” he says, adding that usually, biological materials from other animals are seen as posing a greater risk to patients. The use of animal cells or tissues in humans carries risks of infection, for example.

We can’t be sure either way, because rigorous research comparing these exosomes and their safety simply has not been done. “If they are from different sources, their outcomes and effects will be different,” says Cheng. “You need to have science; you need to know why they work.”

Exosomes derived from human cells will still have molecules that are foreign to a person’s body and could trigger an immune response, says Edgar. He is also concerned that because exosomes may hold the original cell’s waste, they could be introducing things that a recipient’s cells would rather be rid of. They might, for example, shuttle excess receptors for growth factors out of a cell. If another cell takes these up, it might end up with too many growth factor receptors, which could help drive cancer, he says. “We do need to understand the basics of what’s going on here before we jump into the clinic,” he adds.

At any rate, there are no rigorous human studies to support the safety or effectiveness of using exosomes for skin health, hair growth, or anything else. Look at any clinic website, and it will probably have some impressive-looking before-and-after photos of a customer or two. But these individuals are often having several treatments at the same time. Microneedling alone has been used for decades as an aesthetic treatment. And Patel says he delivers each vial of exosomes alongside a second vial containing a concoction of many other ingredients that are thought to be beneficial to skin health.

So how can a clinician be sure that the apparent effects are due to the exosomes? I put this question to Patel. “I can’t answer that,” he told me. “I’ve never just used the mix on its own to see [what it does]. You’d have to do countless patients with either [vial] to know.”

Beyond beauty

While many of the clinics offering exosome treatments are focused on their purported cosmetic benefits, a significant number claim that they can treat diseases. In the three months between November 2021 and January 2022, Turner and his colleagues identified 16 businesses that were marketing exosome-based therapies to treat or prevent covid-19 or long covid, for example. Others claim exosomes can treat sports injuries and even disorders like Alzheimer’s disease. Again, there is no rigorous research to support these claims.

There have been some promising early studies in animals, and a handful of small, weak phase I trials exploring the use of exosomes in medical treatments. But these fall way below the approval standards of the FDA. 

“There are currently no FDA-approved exosome products for any use,” Paul Richards, an FDA representative, wrote in an email to MIT Technology Review. Because of this, no exosome product should be marketed for any medical use.

“There is an abundance of misleading information in the public domain regarding regenerative medicine products, including exosome products,” wrote Richards. “The FDA continues to remind consumers to be cautious of any clinics, including regenerative medicine clinics, health-care providers, physicians, chiropractors, or nurses, that advertise or offer anything purported to be an exosome product. These products are not without risk and are often marketed by clinics as being safe and effective for the treatment of a wide range of diseases or conditions, even though they haven’t been adequately studied in clinical trials.” 

No exosome-based products have been approved by the UK’s Medicines & Healthcare products Regulatory Agency (MHRA) or by the European Medicine Agency (EMA), either.

“They’re unproven technologies, at least from the perspective of the FDA,” says Dave Carter, head of research at the biotech company Evox, which is exploring the use of exosomes for drug delivery. “We don’t really understand [how they work] … I personally would be somewhat wary of these types of things outside of the context of proper clinical trials.”

The FDA has issued letters to some of the clinics providing these treatments. In 2020, for example, the organization wrote to Douglas Spiel, president of Regenerative Solutions of New Jersey, about its claims—being published on Facebook at the time—that exosomes could “mitigate, prevent, treat, or cure” covid. The company was also marketing exosome products for a range of other disorders, including spinal cord injury, Parkinson’s, Alzheimer’s, lupus, and multiple sclerosis.The FDA letter listed the problematic posts and requested a response within 30 days. Spiel’s current clinic doesn’t make any claims about exosomes. 

Turner is concerned that letters like these have little impact. “It’s not terribly consequential,” he says. “No one has to surrender their medical license, and there are no automatic financial penalties.”

Beyond potential harm to individual patients, both scientists and regulatory agencies are concerned that unapproved, untested, and unregulated exosome “treatments” could set back an exciting field of research. Potential uses of exosomes to diagnose and treat diseases are being explored through lab-based research and early-stage clinical trials. Companies making unsubstantiated claims to sell products could undermine that progress.

These marketing claims are often “a mishmash of marketing froth, marketing hype, and some credible claims cut and paste[d] from [scientific] papers and websites,” says Turner. “It makes it more challenging for us to have any kind of meaningful public understanding or discussion.”

In the meantime, Turner is one of many scientists cautioning people against the use of exosomes. “I would say that it’s a bit of a Wild West out there with respect to how these are being used,” says Kalluri of MD Anderson Cancer Center. “Ultimately, some science needs to be done to show that this actually works.”

“From a very basic point of view, we don’t really know what they’re doing, good or bad,” says Edgar, from the University of Cambridge. “I wouldn’t take them, let’s put it that way.”

Even Sarah, who received three exosome treatments last year, agrees. “I think there needs to be more research around it … I would just hold on and see,” she says. “Maybe [I would feel] different if I looked a million years younger after using it. But that wasn’t the case.”

Under a slice-of-heaven sky, 150 acres of rolling green hills stretch off into the distance. About a dozen people—tree enthusiasts, conservationists, research biologists, biotech entrepreneurs, and a venture capitalist in long socks and a floppy hat—have driven to this rural spot in New York state on a perfect late-July day. 

We are here to see more than 2,500 transgenic chestnut seedlings at a seed farm belonging to American Castanea, a new biotech startup. The sprouts, no higher than our knees, are samples of likely the first genetically modified trees to be considered for federal regulatory approval as a tool for ecological restoration. American Castanea’s founders, and all the others here today, hope that the American chestnut (Castanea dentata) will be the first tree species ever brought back from functional extinction—but, ideally, not the last.

Living as long as a thousand years, the American chestnut tree once dominated parts of the Eastern forest canopy, with many Native American nations relying on them for food. But by 1950, the tree had largely succumbed to a fungal blight probably introduced by Japanese chestnuts. “Now after hard work, great ideas, and decades of innovation, we have a tree and a science platform designed to make restoration possible,” American Castanea cofounder Michael Bloom told the people squinting in the sun.

As recently as last year, it seemed the 35-year effort to revive the American chestnut might grind to a halt. Now, federal regulatory approval is expected soon. And there’s millions of dollars in new funding coming in from private investors and the federal government. One conservation nonprofit is in discussions with American Castanea to plant up to a million of its chestnuts per year as soon as they’re ready and approved. 

Nothing like this has ever been tried before. But the self-­proclaimed “nutheads” believe the reintroduction of a GMO, blight-resistant American chestnut at scale could also become a model for how environmentalists can redeploy trees in general: restoring forests and shifting food production, all to combat climate change and biodiversity loss. 

“It’s a hard time to be a tree,” says Leigh Greenwood, director of the forest pest and pathogen program at the Nature Conservancy, which has been supportive of the GMO chestnut’s regulatory application. “But there’s some really interesting promise and hope.”  

Four billion trees dead 

“Charismatic megafauna” is the scientific term for species, like pandas and blue whales, that draw a disproportionate amount of love and, thus, resources. The nearly vanished American chestnut may be the most charismatic tree east of the Rockies. Because of its historical importance, fast growth, and abundant productivity of both nuts and timber, it’s drawn an exceptional amount of interest among biologists, conservationists, and a new crop of farmers. 

Trees that die back from blight occasionally resprout. Volunteer groups like the American Chestnut Cooperators’ Foundation have been working for decades to gather and crossbreed wild trees in the hopes of nudging along natural resistance to the blight. Meanwhile, the State University of New York’s College of Environmental Science and Forestry (ESF), with the support of a different group, the American Chestnut Foundation (TACF), has been pursuing genetic engineering in its labs and on its 44 wooded acres outside Syracuse. 

When ESF biologist Bill Powell and his colleagues began working with chestnut embryonic cells in 1989, it took them a decade just to optimize the growing process to make research practical. After that, researchers in the small lab inserted a wheat gene in embryos that inactivated oxalic acid, the toxin produced by the blight fungus. Gathering results on these transgenic trees takes time, because each generation has to grow for a few years before it produces the most useful data. But they eventually created a promising line, named Darling-58 after Herb Darling, a New York construction magnate who funded this research through TACF. Darling-58 was not perfect, and results varied from tree to tree and site to site. But eventually, the data showed slower infections and smaller cankers, the bulbous growths produced by the blight. 

In 2020, Darling-58 became, in all likelihood, the first genetically modified forest tree to be submitted for federal regulatory approval to the US Department of Agriculture’s Animal and Plant Health Inspection Service, the EPA, and the FDA to determine the safety of introducing it in the wild. 

“It’s a hard time to be a tree. But there’s some really interesting promise and hope.”

It is this genetically engineered strain of chestnut that American Castanea, too, is now planting and propagating in New York state, under a nonexclusive commercial license from ESF. They want to sell these trees, pending approval. And then they want to keep going, engineering ever-better chestnuts, and selling them first to enthusiasts, then to farmers, and finally to conservationists for timber, reforestation, maybe even carbon capture. 

To aid the effort, the company is looking for extraordinary wild specimens. In early 2024, it purchased an orchard that had been lovingly cultivated for three decades by a conservationist. The windy hilltop spot houses hundreds of trees, collected like stray kittens from a dozen states throughout the chestnut’s natural range. 

Most of the trees are homely and sickly with blight. They have bulging cankers, “flagging” branches sporting yellow and brown leaves, or green shoots that burst each season from their large root systems only to flop over and die back. “They make me a little sad,” admits Andrew Serazin, cofounder of American Castanea. But a few have shot up as tall as 40 feet, with only a few cankers. All these specimens have been sampled and are being analyzed. They will become the basis of a chestnut gene database that’s as complete as American Castanea can make it. 

From there, the plan is: Apply bioinformatics and AI techniques to correlate genetic signatures with specific traits. Borrow techniques developed in the cannabis industry for seedling production, cloning, and growth acceleration in high-intensity light chambers—none of which have yet been yet applied at this scale to forest trees. Develop several diverse, improved new strains of chestnut that are blight-resistant and optimized for different uses like forest restoration, nut production, and timber. Then produce seedlings at a scale previously unknown. The hope is to accelerate restoration, cutting down the time it would take resistant strains of the tree to propagate in the wild. “Tree growth takes a long time. We need to bend the curve of something that’s like a 30-year problem,” says Serazin.

The breadtree revival

The chestnut has not disappeared from the US: In fact, Americans eat some 33 million pounds of the nuts a year. These are European and Asian varieties, mostly imported. But some companies are looking to expand the cultivation of the nuts domestically. 

Among those leading the quest is a company called Breadtree Farms in upstate New York, named for a traditional nickname for the chestnut. In March, it won a $2 million grant from the USDA to build the largest organic chestnut processing facility in the US. It will be up to eight times larger than needed for its own 250 acres of trees. The company is dedicated to scaling the regional industry. “We have a list of over 100 growers that are, and will be, planting chestnut trees,” says Russell Wallack, Breadtree’s young cofounder.

Chestnuts have a nutritional profile similar to brown rice; they’re high in carbohydrates and lower in fat than other nuts. And unlike other nut trees, the chestnut “masts”—produces a large crop—every year, making it far more prolific.

That makes it a good candidate for an alternative form of agriculture dubbed agroforestry, which incorporates more trees into food cultivation. Food, agriculture, and land use together account for about one-quarter of greenhouse-gas emissions. Adding trees, whether as windbreaks between fields or as crops, could lower the sector’s carbon footprint.

Many different trees can be used this way. But Joe Fargione, science director for the Nature Conservancy’s North America region, says the chestnut is a standout candidate. “It’s great from a climate perspective, and there’s a lot of farmers that are excited about it,” he says. “Chestnuts end up being big trees that store a lot of CO₂ and have a product that can be very prolific. They have the potential to pay for themselves. We want not just environmental sustainability but economic sustainability.”

The passion for chestnut revival connects the foresters and the farmers. Farmers aren’t waiting for the GMO trees to get federal approval. They are planting existing Chinese varieties, and hybrids between American and Chinese chestnuts, which thrive in the East. Still, Fargione says that if nut cultivation is going to scale up, farmers will need reliable seed stock of genetically improved trees. 

On the other hand, those foreign orchard varieties would be considered invasives if planted in the wild. And they wouldn’t feed wildlife in the same way, says Sara Fern Fitzsimmons, chief conservation officer of the American Chestnut Foundation. “Wild turkeys prefer American chestnuts,” she says. “And the blue jay—since the American chestnut is smaller, he can fit more in his crop,” a food storage area inside a bird’s throat. For forest restoration you need American chestnuts or something as close to them as possible. That’s where the genetic engineering and crossbreeding projects will be crucial. But that path has been full of pitfalls.

Switched at birth

In late 2023, a biologist at the University of New England discovered evidence that Darling-58 was not what people thought it was. For nearly 10 years, all the data that ESF had painstakingly gathered on the strain actually pertained to a different line, Darling-54, which has its wheat gene in a different place on the genome. The promising results were all still there. The trees had simply been mislabeled that entire time. 

 A few weeks later, in December 2023, the American Chestnut Foundation suddenly announced it was withdrawing its support of ESF’s Darling tree research, citing the 54-58 mix-up, as well as what it called “disappointing performance results” for 54. 

But Andy Newhouse, director of the American Chestnut Project at SUNY ESF, says the mislabeling is not a deal-breaker. The research doesn’t “need to start from scratch,” he says. “This is correcting the record, making sure we have the appropriate label on it, and moving forward.” Newhouse says the regulatory application is ongoing (the USDA and FDA declined to comment on a pending regulatory application; the EPA did not respond to requests for comment). 

Newhouse defends the documented blight response of the trees that, we now know, are actually Darling-54.

And besides, he says, they’ve got a potentially better strain coming: the DarWin. The “Win” stands for “wound-inducible.” In these trees, the anti-blight action turns on—is induced—only when the tree’s bark is wounded, working something like an animal’s immune response. This could be more efficient than continuously expressing the anti-blight gene, the way Darling-54 does. So DarWin trees might reserve more of their energy to grow and produce nuts. 

The DarWin trees are about three years old, meaning data is still being collected. And if the Darling trees are approved for safety, it should smooth the path for a much faster approval of the DarWin trees, Newhouse says.

There was another reason, though, that TACF dropped its support of the Darling regulatory petition. In a FAQ on its website, the foundation said it was “surprised and concerned” that ESF had made a licensing deal for the Darling and DarWin trees—potentially worth millions—with a for-profit company: American Castanea.

TACF said it had been supporting the project under the assumption that the results would be available, for free, to anyone, in the “public commons.” Commercialization, it says, could make the trees more expensive for anyone who might want to plant them. Fitzsimmons wouldn’t comment further. 

The biotech boys

American Castanea’s Andrew Serazin is a Rhodes scholar whose scientific background is in tropical disease research. He rose in the ranks in global philanthropy, running million-­dollar grant competitions for the Gates Foundation, funding projects like vitamin-­enhanced “golden rice” and HIV vaccines. 

He was president of the Templeton World Charity Foundation in 2020 when it gave a “transformational” $3.2 million grant to SUNY ESF’s chestnut project. Serazin became convinced that the chestnut could be the seed of something much, much bigger. It didn’t hurt that he had a sentimental chestnut connection through his wife’s family farm in West Virginia, which dates back to the time of George Washington. 

With pests and pathogens threatening so many different species, “there’s a huge potential for there to be precision management of forests using all of the same capabilities we’ve used in human medicine,” he says. 

For that, Serazin was convinced, they needed money. Real money. Venture capital money. “I mean, really, there’s only one system that we know about that works the best for this kind of innovation, and that’s using incentives for companies to bring together these resources,” he says. 

Serazin teamed up with his friend Michael Bloom, an entrepreneur who’s sold two previous companies. They incorporated American Castanea for certification as a public benefit corporation in Delaware, pledging to balance profit with purpose and adhere to a high degree of transparency on social and environmental impact. They went to “impact investors” to sell the vision. That was part of what was going on at the seed farm on that July day; the company has $4 million in seed financing and wants to raise $7 million to $10 million more next year. 

What he’s offering investors, Serazin says, isn’t quick returns but a chance to “participate in the once-in-a-lifetime opportunity to bring back a tree species from functional extinction, and participate in this great American story.” 

What they’re proposing, over the next several decades or more, is no less than replanting the entire Eastern forest with a variety of genetically superior breeds, on the scale of millions of trees. 

It sounds, at first blush, like a sci-fi terraforming scenario. On the other hand, Leigh Greenwood, at the Nature Conservancy, says every species group of tree in the woods is threatened by climate change. Pathogens are emerging in new territories, trees are stressed by extreme weather, and the coldest winter temperatures, which used to reliably kill off all manner of forest insects and diseases at the edges of their habitats, are getting milder.

Besides chestnut blight, there’s Dutch elm disease, the emerald ash borer, butternut canker, oak wilt, and white pine blister rust. The southern pine beetle now ranges as far north as Massachusetts because of milder winters. The spongy (formerly gypsy) moth is a champion defoliator, munching enough leaves “to make an entire forest look naked in June,” says Greenwood. A new nematode that attacks leaves and buds, previously unknown to science, has emerged near the Great Lakes in the last decade. Sick and dying trees stop sequestering carbon and storing water, are prone to wildfire, and can take entire ecosystems down with them. 

“Invasive species are moving faster than biological time,” Greenwood says. “What we have to do is speed up the host trees, their natural selection. And that is an enormous task that only in very recent times have we really developed the tools in order to figure out how the heck we’re going to do that.” 

By “recent tools,” Greenwood means, more or less, what American Castanea is trying: genetic analysis and advanced horticultural techniques that allow resistant trees to be propagated and introduced into the wild more quickly. 

Greenwood is quick to say that the Nature Conservancy also supports the American Chestnut Cooperators’ Foundation, which crossbreeds wild American chestnuts for blight resistance. They are a small, all-volunteer organization with no university affiliation. They mail their crossbred chestnuts out to hobbyist landowners all over the country, and president Ed Greenwell tells me they don’t really know exactly how many are growing out there—maybe 5,000, maybe more. He has seen some that are big and healthy, he says. “We have many trees of 40-plus years of age.” 

What they don’t have is a sense of urgency. “We’re self-funded, so we could do our breeding as we choose,” says Greenwell. “Our method is tried and true, and we have no pressure to take shortcuts, like genetic modification, which theoretically could have shortened the time to get trees back in the woods.” 

The whole idea of a GMO forest tests our concept of what “nature” is. And that may just be a marker of where we are at this point in the Anthropocene.

Greenwell is not the only one to object to GMO chestnuts. In 2023, Joey Owle, then the secretary of agriculture and natural resources for the Eastern Band of Cherokee Indians, told Grist magazine that while the group was open to introducing transgenic trees on its land if necessary, it was the “last option that we would like to pursue.”

Greenwood led the writing of an expert letter, something like an amicus brief, in support of SUNY ESF’s regulatory petition for the Darling tree. She takes such objections seriously. “If we do not address the human dimensions of change, no matter how good the biological, chemical designs are,” she says, “those changes will fail.” 

That July day out at the seed farm, sitting under a tent with plates of pork barbecue, the scientists, conservationists, and businesspeople started debating how deep these GMO objections really run. Serazin said he believes that what people really hate is corporate monopoly, not the technology per se. “It’s really about the exertion of power and capital,” he said. He’s hoping that by incorporating as a public benefit corporation and making the trees widely available to conservation groups and responsible forest product and nut producers, he can convince people that American Castanea’s heart is in the right place. 

Still, others pointed out, the whole idea of a GMO forest tests our concept of what “nature” is. And that may just be a marker of where we are at this point in the Anthropocene—it’s hard to envision a future where any living creature in the ecological web can remain untouched by humans. 

That responsibility may connect us more to the past than we realize. For centuries, Native people like the Haudenosaunee Nation practiced intentional land management to improve habitat for the chestnut. When the Europeans began clearing land for farming and timber, the fast-growing tree was able to claim proportionately even more space for itself. It turns out the forest those colonists embraced—the forest dominated by chestnut trees—was no true accident of nature. It was a product of a relationship between people and chestnuts. One that continues to evolve today. 

Anya Kamenetz is a freelance reporter who writes the Substack newsletter The Golden Hour.

In the 1960s, Norman Borlaug, an American biologist, helped spark a period of transformative agricultural innovation known as the Green Revolution by selectively breeding a grain-packed, dwarf variety of wheat. (He would win a Nobel Peace Prize for this work.) In Asia, the Philippines-based International Rice Research Institute (IRRI) had similar success with rice. By the 1990s, the yields of wheat and rice had doubled worldwide, staving off bouts of recurring famine. The Green Revolution was so successful that dire predictions of worse famine to come—fueled by alarming population growth—no longer seemed likely.

But the Green Revolution had its limits—only so much yield could be coaxed from plants using conventional breeding techniques. Breeding gene pools are limited by sexual compatibility, and it’s also difficult to control which traits will be passed on. Plus, crossbreeding new varieties to produce desirable traits can take decades. A 1982 MIT Technology Review feature described efforts to overcome such conventional plant-breeding constraints by recombining genes from different species but they were still time-consuming, costly, and unpredictable.

Even today, with more precise gene-editing technologies like CRISPR, the lab-to-seed product life cycle can take 10 to 15 years, according to Keith Slotkin, a biological sciences professor at the University of Missouri and principal investigator at the Donald Danforth Plant Science Center. To shave time, Slotkin’s lab recently developed a more efficient genome-editing technique, transposase-assisted target-site integration, or TATSI. When coupled with CRISPR, TATSI enables scientists to insert a piece of DNA into a plant’s genome more precisely. Instead of having it randomly inserted, which can require growing and testing many iterations of a plant to determine the right location, “we can predetermine exactly where in the genome we want it inserted,” Slotkin explains. Such precision could save years on the time it takes for new plant varieties to make it from the lab to federally approved seed products.

Beyond reducing time to market, modern plant engineering efforts have shifted from yield per plant—a hallmark of the Green Revolution—to yield per acre. Slotkin cites corn: “By removing what’s called shade avoidance and increasing the leaf angle, you can seed at a denser rate.” Today, nearly 95% of all corn and soybeans grown in the US are genetically engineered to improve yield per acre, chiefly through herbicide- and insect-tolerant traits.

Plant scientists have also fortified staple crops with essential nutrients. Golden rice, for example, uses corn genes to produce beta-carotene, the precursor to vitamin A. Purple tomatoes have been genetically modified with snapdragon DNA to contain high levels of anthocyanins, the antioxidants found in blueberries and blackberries. Some plant engineers favor designer species, like non-browning Arctic apples and sweet Pinkglow pineapples. 

Despite such advances, a 2020 poll by the Pew Research Center found that only 27% of Americans trust genetically engineered crops, even though a comprehensive 2016 report from the National Academies of Science found no evidence that genetically engineered food is less safe than conventional. But as climate change ratchets up its toll on agricultural yield and the global population continues to grow, genetically engineered crops with climate-friendly features—such as the ability to thrive in droughts or floods, generate their own fertilizer, and optimize land use—will likely become less the exception than the norm. 

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

There have been plenty of reports of potentially concerning viruses this last year. Covid is still causing thousands of deaths, and bird flu appears set to make the jump to human-to-human transmission. Now there are new concerns over Oropouche, a virus largely spread by bites from insects called midges (sometimes called no-see-ums in the US).

There have been outbreaks of the Oropouche virus in Latin America for decades. But this one is different. The virus is being detected in all-new environments. It is turning up in countries that have never seen it before. The spread is being described as “unprecedented.”

It may also be causing more severe disease. People with Oropouche fever typically have a sudden fever, aches and pains, and nausea. Most cases are mild, but some people have developed encephalitis and meningitis. And this year, two otherwise healthy young women who caught the virus have died.

Oropouche can be passed from mother to fetus, and it has been linked to stillbirths and birth anomalies. There are no treatments. There are no vaccines, either. This week, let’s take a look at why Oropouche is spreading, and what we can do about it.

Oropouche virus was first identified in 1955, in a person and a pool of mosquitoes from the village of Vega de Oropouche in Trinidad and Tobago. It was found in a sloth in Brazil in 1960. Since then, there have been over 30 outbreaks—in those countries as well as Peru, Panama, Colombia, French Guiana, and Venezuela. At least 500,000 cases have been reported in South America, largely in areas close to forest.

That’s probably because of the way the virus is transmitted. Oropouche virus is thought to be carried by some populations of sloths, and potentially some nonhuman primates. These animals can host the virus, which can then spread to people via insect bites, usually from midges or some types of mosquitoes.

Since late 2023, outbreaks have been reported in a number of countries in South America, Central America, and the Caribbean, including Cuba, a first for the country. 

There has been an especially large surge of cases in Brazil. Since the beginning of this year, 10,275 cases of Oropouche have been confirmed in the Americas, according to a situation summary report published by the Pan American Health Organization (PAHO) earlier this week. And 8,258 of them were in Brazil. Travelers have also imported cases to the US and Europe for the first time—90 such cases have been reported in the US, and 30 in Europe.

Another change is that this time around, the virus has been infecting people in urban settings far from forests. It is not entirely clear why, but there are probably a few reasons. Climate change, for a start, has led to increased temperatures and rainfall, both of which can help create breeding grounds for the insects that transmit the virus. And deforestation and urbanization, both of which have caused people to encroach on the habitats of wild animals, have also raised the risk of transmission to people, says Ana Pereiro do Vale, a veterinarian and microbiologist at University College Dublin in Ireland.

The virus itself also appears to have changed, according to new research published this week. William de Souza at the University of Kentucky and his colleagues analyzed blood samples taken from people with an Oropouche diagnosis between 2015 and 2024, enabling them to compare the form of the virus that is currently circulating with a historical strain.

The team found evidence that the virus has swapped genetic material with a related one, creating a new “virus reassortment.” It is this new form of the virus that has spread since the end of 2023, the team says.

That’s not all. The genetic changes have endowed the virus with new features. The current reassortment appears to be better at replicating in mammalian cells. That might mean that infected people—and sloths—have more of the virus in their blood, making it easier for biting insects to pick it up and pass it on.

The new form of the virus also seems to be more virulent. The team’s lab tests suggest that compared with the historical strain, it appears to cause more damage to the cells it infects.

We are still getting to grips with how the virus can spread, too. We know midges and mosquitoes are responsible for spreading Oropouche, but the virus can also pass to a fetus during pregnancy, with potentially harmful consequences. According to the PAHO report, Brazil has reported “13 fetal deaths, three spontaneous miscarriages, and four cases of birth anomalies” linked to Oropouche infections.

In a separate study published earlier this week, Raimunda do Socorro da Silva Azevedo at the Evandro Chagas Institute in Ananindeua, Brazil, and her colleagues assessed 65 unexplained cases of microcephaly—a birth anomaly in which babies have an unexpectedly small head—that had been recorded in Brazil between 2015 and 2024. The team found evidence of an Oropouche infection in six of the babies—and in all three that had been born in 2024.

It’s still not clear whether or how the virus might affect fetuses and babies, and research is ongoing. But the US Centers for Disease Control and Prevention (CDC) recommends that pregnant travelers “reconsider non-essential travel” to Cuba. 

Some scientists worry that the virus might also spread via sex. In August, a 42-year-old Italian man who fell ill after returning from a trip to Cuba was found to have Oropouche virus in his semen. And it was still there 58 days later. The CDC currently recommends that men diagnosed with Oropouche should use condoms or not have sex for at least six weeks from the start of their symptoms. They should avoid donating semen, too, according to the organization.

There are a lot of unanswered questions when it comes to Oropouche. Some scientists have suggested that this is because outbreaks have historically been seen in poorer countries in the Global South.

“There is sufficient colonialism in disease research—if it doesn’t affect the industrial world and Western business interests, it’s not important,” Shahid Jameel, a virologist at the University of Oxford, told Gavi, an organization focused on global vaccination efforts. “Now that the virus has been found in Cuba—not far from Miami—the wheels of public health will turn.”

Let’s hope they get in gear quickly. As Vale says: “We don’t know what will happen with the virus, the mutation rate of the virus, or if the virus will jump to another host. We need to be careful and pay attention.”

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Oropouche infections can look similar to dengue—another viral disease, also spread by mosquitoes, that affects people in Brazil. The country is attempting to tackle the problem with bacteria-infected mosquitoes, Cassandra Willyard reported in March.

The spread of bird flu in dairy cattle in the US has virologists worried. The virus could stick around on US farms forever and is raising the risk of outbreaks in mammals—including humans—around the world.

Flu season is officially upon those of us in the Northern Hemisphere. This year, it could enable the creation of an all-new bird flu, too. 

Could gene editing help curb the spread of bird flu? Abdullahi Tsanni explored the possibility of using CRISPR to make chickens resistant to the virus.

Another option, of course, is vaccines. Most flu vaccines are made, ironically, in chicken eggs. mRNA vaccines could provide an alternative, egg-free approach.

From around the web

A fertility clinic in London has helped two transgender individuals have a baby in a process that involved egg freezing, donated sperm, IVF, embryo storage, and surrogacy. “To our knowledge this is the first report of family building by a transgender couple in which both partners had successfully achieved gender reassignment and the creation of a family through surrogacy,” write the team. (Reproductive BioMedicine Online)

“They showed me them in a mirror … and I looked like a witch,” says one woman who has experienced the horror of dental veneers gone wrong. Veneers have become as routine as Botox and lip filler. But what can people do when their dream of a perfect smile turns into a nightmare? (The Guardian)

Thinking about deleting your 23andMe data? The company will hold on to some of it regardless, to comply with legal regulations. Some of your genetic information, your date of birth and your sex, and data linked to your account deletion request will all be retained. (MIT Technology Review)

Pet dogs are spending more time indoors, in environments they aren’t suited to. Service dogs, on the other hand, are uniquely well adapted to life in the 21st century, say two researchers at the Duke Canine Cognition Center. Humans need to breed and train more puppies like service animals, they argue. (The Atlantic)

MIT Technology Review’s How To series helps you get things done. 

Things aren’t looking good for 23andMe. The consumer DNA testing company recently parted ways with all its board members but CEO Anne Wojcicki over her plans to take the company private. It’s also still dealing with the fallout of a major security breach last October, which saw hackers access the personal data of around 5.5 million customers.

23andMe’s business is built on taking saliva samples from its customers. The DNA from those samples is processed and analyzed in its labs to produce personalized genetic reports detailing a user’s unique health and ancestry. The uncertainty swirling around the company’s future and potential new ownership  has prompted privacy campaigners to urge users to delete their data.

“It’s not just you. If anyone in your family gave their DNA to 23&Me, for all of your sakes, close your/their account now,” Meredith Whittaker, president of the encrypted messaging platform Signal, posted on X after the board’s resignation. 

“Customers should consider current threats to their privacy as well as threats that may exist in the future—some of which may be magnified if 23AndMe were sold to a new owner,” says Jason Kelley, activism director at the Electronic Frontier Foundation. “23AndMe has protections around this much of this. But a potential sale could put your data in the hands of a far less scrupulous company.”

A spokesperson for 23andMe said that the company has strong customer privacy protections in place, and does not share customer data with third parties without customers’ consent. “Our research program is opt-in, requiring customers to go through a separate, informed consent process before joining,” they say. “We are committed to protecting customer data and are consistently focused on maintaining the privacy of our customers. That will not change.”

Why deleting your account comes with a caveat

Deleting your data from 23andMe is permanent and cannot be reversed. But some of that data will be retained to comply with the company’s legal obligations, according to its privacy statement. 

That means 23andMe and its third-party genotyping laboratory will hang onto some of your genetic information, plus your date of birth and sex—alongside data linked to your account deletion request, including your email address and deletion request identifier. When MIT Technology Review asked 23andMe about the nature of the genetic information it retains, it referred us to its privacy policy but didn’t provide any other details.

Any information you’ve previously provided and consented to being used in 23andMe research projects also cannot be removed from ongoing or completed studies, although it will not be used in any future ones. 

Beyond the laboratories that process the saliva samples, the company does not share customer information with anyone else unless the user has given permission for it to do so, the spokesperson says, including employers, insurance companies, law enforcement agencies, or any public databases.

“We treat law enforcement inquiries, such as a valid subpoena or court order, with the utmost seriousness. We use all legal measures to resist any and all requests in order to protect our customer’s privacy,” the spokesperson says. “To date, we have successfully challenged these requests and have not released any information to law enforcement.”

For those who still want their data deleted, here’s how you go about it.

How to delete your data from 23andMe

1. Log into your account and navigate to Settings.
2. Under Settings, scroll to the section titled 23andMe data. Select View.
3. You may be asked to enter your date of birth for extra security. 
4. In the next section, you’ll be asked which, if any, personal data you’d like to download from the company (onto a personal, not public, computer). Once you’re finished, scroll to the bottom and select Permanently delete data.
5. You should then receive an email from 23andMe detailing its account deletion policy and requesting that you confirm your request. Once you confirm you’d like your data to be deleted, the deletion will begin automatically and you’ll immediately lose access to your account. 

What about your genetic sample?

When you set up your 23andMe account, you’re given the option either to have your saliva sample securely destroyed or to have it stored for future testing. If you’ve previously opted to store your sample but now want to delete your 23andMe account, the company says, it will destroy the sample for you as part of the account deletion process.

What if you want to keep your genetic data, just not on 23andMe?

Even if you want your data taken off 23AndMe, there are reasons why you might still want to have it hosted on other DNA sites—for genealogical research, for example. And some people like the idea of having their DNA results stored on more than one database in case something happens to any one company. This is where downloading your data comes into play. FamilyTreeDNA, MyHeritage, GEDmatch, and Living DNA are among the DNA testing companies that allow you to upload existing DNA results from other companies, although Ancestry and 23andMe don’t accept uploads.

How to download your raw genetic data

1. Navigate directly to you.23andme.com/tools/data/.
   
2. Click on your profile name on the top right-hand corner. Then select Resources from the menu.
   
3. Select Browse raw genotyping data and then Download.
   
4. Visit Account settings and click on View under 23andMe data.
   
5. Enter your date of birth for security purposes.
   
6. Tick the box indicating that you understand the limitations and risks associated with uploading your information to third-party sites and press Submit request.

23andMe warns its users that uploading their data to other services could put genetic data privacy at risk. For example, bad actors could use someone else’s DNA data to create fake genetic profiles.

They could use these profiles to “match” with a relative and access personal identifying information and specific DNA variants—such as information about any disease risk variants you might carry, the spokesperson says, adding: “This is one reason why we don’t support uploading DNA to 23andMe at this time.” 

Update: This article has been updated to reflect that when asked about the nature of the genetic information it retains, 23andMe referred us to its privacy policy but didn’t provide any other details.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

This week, an office conversation turned to body weight. We all know that being overweight is not great for your health—it’s linked to metabolic diseases like diabetes and cardiovascular problems. But weighing yourself won’t tell you all you need to know about your disease risk.

A friend of mine is a super-fit marathon runner. She’s all lean muscle. And yet according to her body mass index (BMI), which is a measure of weight relative to height, she’s overweight. Which is frankly ridiculous.

I, on the other hand, have never been all that muscular. I like to think I’m a healthy weight—but nurses in the past have advised me, on the basis of my BMI, to eat more butter and doughnuts. This is advice I never expected to receive from a health professional. (I should add here that my friend and I are roughly the same height and wear the same size in clothes.)

The BMI is flawed. So what should we be using instead? There are several high-tech alternatives, but a simple measure that involves lying on your back could also tell you about how your body size might influence your health.

First, let’s talk about fat—the most demonized of all body components. Fat is stored in adipose tissue, which has some really important functions. It stores energy, keeps us warm, and provides protective cushioning for our organs. It also produces a whole host of important substances, from hormones that control our appetite to chemicals that influence the way our immune systems work.

Not all fat is equal, either. Our bodies contain white fat, brown fat, and beige fat. While white fat stores energy, brown fat helps burn calories. Beige fat tissue contains a mixture of the two. And white fat can also be broken down into two additional categories: the type under your skin is different from that which covers your internal organs.

It’s the visceral fat—the type surrounding your organs—that is thought to be more harmful to your health, if there’s too much of it. Having more visceral fat has been linked to an increased risk of diabetes and cardiovascular disease. (That relationship isn’t straightforward either, though; studies have shown that removing this “excess” fat doesn’t improve metabolic health.)

Either way, having a good idea of how much fat is in your body, and where it is, would be valuable. It might at least give us some idea of our risk of metabolic disorders. There are quite a few different ways of measuring this.

BMI is the most widely adopted. It’s the official measure the World Health Organization uses to define overweight and obesity. On the plus side, it’s very easy to calculate your BMI. Unfortunately, it doesn’t tell you very much about the fat in your body or how it corresponds to your health. After all, your body weight includes your bones, muscles, blood, and everything else, not just your fat. (And as we’ve seen, it can lead well-meaning health practitioners to recommend weight loss or weight gain when it’s really not appropriate.)

Scanners that can specifically measure fat are more useful here. Typically, doctors can use a DEXA scan, which relies on x-rays, to give an idea of where and how much body fat a person has. CT scanners (which also makes use of x-rays) and MRI scanners (which use magnets) can give similar information. The problem is that these are not all that convenient—they’re expensive and require a hospital visit. Not only that, but standard equipment can’t accommodate people with severe obesity, and people with some medical implants can’t use MRI scanners. We need simpler and easier measures, too.

Measuring the circumference of a person’s waist seems to yield more useful information than BMI. Both waist-to-hip and waist-to-height ratios can give a better idea of a person’s risk of developing diseases associated with excess weight. But this isn’t all that easy either—measuring tapes can stretch or slip, and it can be difficult to measure the exact same part of a person’s waist multiple times. And the measure seems to be a better indicator of health in men than in women.

Instead, Emma Börgeson, who studies cardiometabolic disease at Aarhus University in Denmark, and her colleagues recommend the SAD measure. SAD stands for sagittal abdominal diameter, and it’s a measure of the size of a person’s belly from back to front.

To measure your SAD, you need to lie on your back. Bend your knees at a 90-degree angle to make sure your back is not arching and is flush with the floor. Then measure how much your belly protrudes from the ground when you exhale. (The best way to do this is with a sliding-beam caliper.)

In this position, the fat under the skin will slide to the sides of your body, while the visceral fat will be held in place. Because of this, the SAD can give you a good idea of how much of the more “dangerous” kind of fat you have. The fat can be trimmed down with diet and exercise.

This measure was first proposed in the 1980s but never took off. That needs to change, Börgeson and her colleagues argue in a paper published in Nature Reviews Endocrinology a few months ago. “SAD is simple, affordable, and easier to implement than waist-to-hip based measurements,” the team writes. “We would argue for its extended use.”

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Weight-loss drugs like Ozempic, Wegovy, and Mounjaro are wildly popular and effective; they were named one of MIT Technology Review’s 10 Breakthrough Technologies of 2024. Abdullahi Tsanni explored what we know—and don’t know—about their long-term effects.

Over the last couple of years, those weight-loss drugs have taken over the internet, with users sharing stories of their miraculous results on social media. But the day-to-day reality of weight-loss injections isn’t always pleasant—and some side effects are particularly nasty, Amelia Tait reported last year.

A future alternative could be vibrating pills that trick you into feeling full. For now, it seems to work in pigs, as Cassandra Willyard reported last year.

When you lose weight, where does it go? It kind of depends on your metabolism, as Bonnie Tsui explains.

We don’t fully understand how weight-loss drugs like Ozempic work. That’s partly because we don’t fully understand how hunger works. Adam Piore reported on the painstaking hunt for the neurons that control the primitive urge to eat.

From around the web

Hospitals in the US are facing shortages of IV fluids in the wake of Hurricane Helene. Some are having patients drink Gatorade instead. (STAT) 

Marcella Townsend’s face became unrecognizable after a propane explosion left her with second- and third-degree burns over most of her body. In an attempt to help her recover, surgeons applied a thin layer of donated placenta to her face. It was “the best thing they could have done, ever,” says Townsend, who says her face now “looks exactly like it did before.” (The New York Times)

Intermittent fasting can help mice live longer—but genes have a bigger effect on lifespan than diet does. (Nature)

This one-millimeter-long, doughnut-shaped robot can swim through snot. (Popular Science)

In the decade-long fight to control CRISPR, the super-tool for modifying DNA, it’s been common for lawyers to try to overturn patents held by competitors by pointing out errors or inconsistencies.

But now, in a surprise twist, the team that earned the Nobel Prize in chemistry for developing CRISPR is asking to cancel two of their own seminal patents, MIT Technology Review has learned. The decision could affect who gets to collect the lucrative licensing fees on using the technology.

­­The request to withdraw the pair of European patents, by lawyers for Nobelists Emmanuelle Charpentier and Jennifer Doudna, comes after a damaging August opinion from a European technical appeals board, which ruled that the duo’s earliest patent filing didn’t explain CRISPR well enough for other scientists to use it and doesn’t count as a proper invention.

The Nobel laureates’ lawyers say the decision is so wrong and unfair that they have no choice but to preemptively cancel their patents, a scorched-earth tactic whose aim is to prevent the unfavorable legal finding from being recorded as the reason. 

“They are trying to avoid the decision by running away from it,” says Christoph Then, founder of Testbiotech, a German nonprofit that is among those opposing the patents, who provided a copy of the technical opinion and response letter to MIT Technology Review. “We think these are some of the earliest patents and the basis of their licenses.”

Discovery of the century

CRISPR has been called the biggest biotech discovery of the century, and the battle to control its commercial applications—such as gene-altered plants, modified mice, and new medical treatments—has raged for a decade.

The dispute primarily pits Charpentier and Doudna, who were honored with the Nobel Prize in 2020 for developing the method of genome editing, against Feng Zhang, a researcher at the Broad Institute of MIT and Harvard, who claimed to have invented the tool first on his own.

Back in 2014, the Broad Institute carried out a coup de main when it managed to win, and later defend, the controlling US patent on CRISPR’s main uses. But the Nobel pair could, and often did, point to their European patents as bright points in their fight. In 2017, the University of California, Berkeley, where Doudna works, touted its first European patent as exciting, “broad,” and “precedent” setting.

After all, a region representing more than 30 countries had not only recognized the pair’s pioneering discovery; it had set a standard for other patent offices around the world. It also made the US Patent Office look like an outlier whose decisions favoring the Broad Institute might not hold up long term. A further appeal challenging the US decisions is pending in federal court.

Long-running saga

But now the European Patent Office is also saying—for different reasons—that Doudna and Charpentier can’t claim their basic invention. And that’s a finding their attorneys think is so damaging, and reached in such an unjust way, that they have no choice but to sacrifice their own patents. “The Patentees cannot be expected to expose the Nobel-prize winning invention … to the repercussions of a decision handed down under such circumstances,” says the 76–page letter sent by German attorneys on their behalf on September 20.

The chief intellectual-property attorney at the University of California, Randi Jenkins, confirmed the plan to revoke the two patents but downplayed their importance. 

“These two European patents are just another chapter in this long-running saga involving CRISPR-Cas9,” Jenkins said. “We will continue pursuing claims in Europe, and we expect those ongoing claims to have meaningful breadth and depth of coverage.”

The patents being voluntarily disavowed are EP2800811, granted in 2017, and EP3401400, granted in 2019. Jenkins added the Nobelists still share one issued CRISPR patent in Europe, EP3597749, and one that is pending. That tally doesn’t include a thicket of patent claims covering more recent research from Doudna’s Berkeley lab that were filed separately.

Freedom to operate

The cancellation of the European patents will affect a broad network of biotech companies that have bought and sold rights as they seek to achieve either commercial exclusivity to new medical treatments or what’s called “freedom to operate”—the right to pursue gene-slicing research unmolested by doubts over who really owns the technique. 

These companies include Editas Medicine, allied with the Broad Institute; Caribou Biosciences and Intellia Therapeutics in the US, both cofounded by Doudna; and Charpentier’s companies, CRISPR Therapeutics and ERS Genomics.

ERS Genomics, which is based in Dublin and calls itself “the CRISPR licensing company,” was set up in Europe specifically to collect fees from others using CRISPR. It claims to have sold nonexclusive access to its “foundational patents” to more than 150 companies, universities, and organizations who use CRISPR in their labs, manufacturing, or research products.

For example, earlier this year Laura Koivusalo, founder of a small Finnish biotech company, StemSight, agreed to a “standard fee” because her company is researching an eye treatment using stem cells that were previously edited using CRISPR.

Although not every biotech company thinks it’s necessary to pay for patent rights long before it even has a product to sell, Koivusalo decided it would be the right thing to do. “The reason we got the license was the Nordic mentality of being super honest. We asked them if we needed a license to do research, and they said yes, we did,” she says.

A slide deck from ERS available online lists the fee for small startups like hers at $15,000 a year. Koivusalo says she agreed to buy a license to the same two patents that are now being canceled. She adds: “I was not aware they were revoked. I would have expected them to give a heads-up.” 

A spokesperson for ERS Genomics said its customers still have coverage in Europe based on the Nobelists’ remaining CRISPR patent and pending application.

In the US, the Broad Institute has also been selling licenses to use CRISPR. And the fees can get big if there’s an actual product involved. That was the case last year, when Vertex Pharmaceuticals won approval to sell the first CRISPR-based treatment, for sickle-cell disease. To acquire rights under the Broad Institute’s CRISPR patents, Vertex agreed to pay $50 million on the barrelhead—and millions more in the future.

PAM problem

There’s no doubt that Charpentier and Doudna were first to publish, in a 2012 paper, how CRISPR can function as a “programmable” means of editing DNA. And their patents in Europe withstood an initial round of formal oppositions filed by lawyers.

But this August, in a separate analysis, a technical body decided that Berkeley had omitted a key detail from its earliest patent application, making it so that “the skilled person could not carry out the claimed method,” according to the finding. That is, it said, the invention wasn’t fully described or enabled.

The omission relates to a feature of DNA molecules called “protospacer adjacent motifs,” or PAMs. These features, a bit like runway landing lights, determine at what general locations in a genome the CRISPR gene scissors are able to land and make cuts, and where they can’t.

In the 76-page reply letter sent by lawyers for the Nobelists, they argue there wasn’t really any need to mention these sites, which they say were so obvious that “even undergraduate students” would have known they were needed. 

The lengthy letter leaves no doubt the Nobel team feels they’ve been wronged. In addition to disavowing the patents, the text runs on because it seeks to “make of public record the reasons for which we strongly disagree with [the] assessment on all points” and to “clearly show the incorrectness” of the decision, which, they say, “fails to recognize the nature and origin of the invention, misinterprets the common general knowledge, and additionally applies incorrect legal standards.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

September will soon be drawing to a close. The kids are back to school, and those of us in the Northern Hemisphere are experiencing the joys the end of summer brings: the cooling temperatures, the falling leaves, and, inevitably, the start of flu season.

I was reminded of that fact when my littlest woke me for an early-morning cuddle, sneezed into my face, and wiped her nose on my pajamas. I booked her flu vaccine the next morning.

In the US, the Centers for Disease Control and Prevention recommends the flu vaccine for everyone over six months old. This year, following the spread of the “bird flu” H5N1 in cattle, the CDC is especially urging dairy farm workers to get vaccinated. At the end of July, the organization announced a $10 million plan to deliver free flu shots to people who work with livestock.

The goal is not only to protect those workers from seasonal flu, but to protect us all from a potentially more devastating consequence: the emergence of a new form of flu that could trigger another pandemic. That hasn’t happened yet, but unfortunately, it’s looking increasingly possible.

First, it’s worth noting that flu viruses experience subtle changes in their genetic makeup all the time. This allows the virus to evolve rapidly, and it is why flu vaccines need to be updated every year, depending on which form of the virus is most likely to be circulating.

More dramatic genetic changes can take place when multiple flu viruses infect a single animal. The genome of a flu virus is made up of eight segments. When two different viruses end up in the same cell, they can swap segments with each other.

These swapping events can create all-new viruses. It’s impossible to predict exactly what will result, but there’s always a chance that the new virus will be easily spread or cause more serious disease than either of its predecessors.

The fear is that farm workers who get seasonal flu could also pick up bird flu from cows. Those people could become unwitting incubators for deadly new flu strains and end up passing them on to the people around them. “That is exactly how we think pandemics start,” says Thomas Peacock, a virologist at the Pirbright Institute in Woking, UK.

The virus responsible for the 2009 swine flu pandemic is thought to have come about this way. Its genome suggested it had resulted from the genetic reassortment of a mix of flu viruses, including some thought to largely infect pigs and others that originated in birds. Viruses with genes from both a human flu and a bird flu are thought to have been responsible for pandemics in 1918, 1957, and 1968, too.

The CDC is hoping that vaccinating these individuals against seasonal flu might lower the risk of history repeating. But unfortunately, it’s not an airtight solution. For a start, not everyone will get vaccinated. Around 45% of US agricultural workers are undocumented migrants, a group that tends to have low vaccination rates. 

Even if every farm worker were to be vaccinated, not all of them would be fully protected against getting sick with flu. The flu vaccine used in the US in 2019-2020 was 39% effective, but the one used in the 2004-2005 flu season was only 10% effective.

“It’s not a bad idea, but I don’t think it can get anywhere close to mitigating the underlying risk,” says Peacock.

I last reported on bird flu in February 2023. Back then, the virus was decimating bird populations, but there were no signs that it was making the jump to mammals, and it didn’t appear to be posing a risk to humans. “We don’t need to panic about a bird flu pandemic—yet,” was my conclusion at the time. Today, the picture is different. After speaking to virologists and scientists who are trying to track the spread of the current bird flu, I’ll admit that I am much more concerned about the potential for another pandemic.

The main advice for people who don’t work on farms is to avoid raw milk and dead animals, both of which could be harboring the virus. For the most part, we’re reliant on government agencies to monitor and limit the spread of this virus. And the limited actions that have been taken to date don’t exactly inspire much confidence.

“The barn door’s already open,” says Peacock. “This virus is already out and about.”

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We don’t know how many dairy herds in the US are infected with H5N1 as the virus continues to spread. It could end up sticking around in farms forever, virologists told me earlier this week.

Manufacturing flu vaccines is a slow process that relies on eggs. But scientists hope mRNA flu vaccines could offer a quicker, cheaper, and more effective alternative.

Some flu vaccines are already made without eggs. One makes use of a virus synthesized in insect cells. Egg-free vaccines might even work better than those made using eggs, as Cassandra Willyard reported earlier this year.

Chickens are especially vulnerable to H5N1. Some scientists are exploring ways to edit the animals’ genes to make them more resilient to the virus, as Abdullahi Tsanni reported last year.

From around the web

Microplastics are everywhere. They even get inside our brains, possibly via our noses. (JAMA Network Open)

The majority of face transplants survive for at least 10 years, research has found. Of the 50 first face transplants, which were carried out across 11 countries, 85% survived for five years, and 74% for 10 years. (JAMA Surgery)

Don’t throw away that placenta! The organ holds clues to health and disease, and instead of being disposed of after birth, it should be carefully studied instead, scientists say. (Trends in Molecular Medicine)

In June, the drug lenacapavir was shown to be 100% effective at preventing HIV in women and adolescent girls. But while the drug was tested on women in Africa, it remains unavailable to most of them. (STAT)

We’re still getting to grips with what endometriosis is, how it works, and how to treat it. Women with the condition appear to have differences in their brain’s gray matter that can’t be explained by pelvic pain alone. (Human Reproduction)

Bird flu has been spreading in dairy cows in the US—and the scale of the spread is likely to be far worse than it looks. In addition, 14 human cases have been reported in the US since March. Both are worrying developments, say virologists, who fear that the country’s meager response to the virus is putting the entire world at risk of another pandemic.

The form of bird flu that has been spreading over the last few years has been responsible for the deaths of millions of birds and tens of thousands of marine and land mammals. But infections in dairy cattle, first reported back in March, brought us a step closer to human spread. Since then, the situation has only deteriorated. The virus appears to have passed from cattle to poultry on multiple occasions. “If that virus sustains in dairy cattle, they will have a problem in their poultry forever,” says Thomas Peacock, a virologist at the Pirbright Institute in Woking, UK.

Worse, this form of bird flu that is now spreading among cattle could find its way back into migrating birds. It might have happened already. If that’s the case, we can expect these birds to take the virus around the world.

“It’s really troubling that we’re not doing enough right now,” says Seema Lakdawala, a virologist at the Emory University School of Medicine in Atlanta, Georgia. “I am normally very moderate in terms of my pandemic-scaredness, but the introduction of this virus into cattle is really troubling.”

Not just a flu for birds

Bird flu is so named because it spreads stably in birds. The type of H5N1 that has been decimating bird populations for the last few years was first discovered in the late 1990s. But in 2020, H5N1 began to circulate in Europe “in a big way,” says Peacock. The virus spread globally, via migrating ducks, geese, and other waterfowl. In a process that took months and years, the virus made it to the Americas, Africa, Asia, and eventually even Antarctica, where it was detected earlier this year.

And while many ducks and geese seem to be able to survive being infected with the virus, other bird species are much more vulnerable. H5N1 is especially deadly for chickens, for example—their heads swell, they struggle to breathe, and they experience extreme diarrhea. Seabirds like puffins and guillemots also seem to be especially susceptible to the virus, although it’s not clear why. Over the last few years, we’ve seen the worst ever outbreak of bird flu in birds. Millions of farmed birds have died, and an unknown number of wild birds—in the tens of thousands at the very least—have also succumbed. “We have no idea how many just fell into the sea and were never seen again,” says Peacock.

Alarmingly, animals that hunt and scavenge affected birds have also become infected with the virus. The list of affected mammals includes bears, foxes, skunks, otters, dolphins, whales, sea lions, and many more. Some of these animals appear to be able to pass the virus to other members of their species. In 2022, an outbreak of H5N1 in sea lions that started in Chile spread to Argentina and eventually to Uruguay and Brazil. At least 30,000 died. The sea lions may also have passed the virus to nearby elephant seals in Argentina, around 17,000 of which have succumbed to the virus.

This is bad news—not just for the affected animals, but for people, too. It’s not just a bird flu anymore. And when a virus can spread in other mammals, it’s a step closer to being able to spread in humans. That is even more likely when the virus spreads in an animal that people tend to spend a lot of time interacting with.

This is partly why the virus’s spread in dairy cattle is so troubling. The form of the virus that is spreading in cows is slightly different from the one that had been circulating in migrating birds, says Lakdawala. The mutations in this virus have likely enabled it to spread more easily among the animals.

Evidence suggests that the virus is spreading through the use of shared milking machinery within cattle herds. Infected milk can contaminate the equipment, allowing the virus to infect the udder of another cow. The virus is also spreading between herds, possibly by hitching a ride on people that work on multiple farms, or via other animals, or potentially via airborne droplets.

Milk from infected cows can look thickened and yogurt-like, and farmers tend to pour it down drains. This ends up irrigating farms, says Lakdawala. “Unless the virus is inactivated, it just remains infectious in the environment,” she says. Other animals could be exposed to the virus this way.

Hidden infections

So far, 14 states have reported a total of 208 infected cattle herds. Some states have reported only one or two cases among their cattle. But this is extremely unlikely to represent the full picture, given how rapidly the virus is spreading among herds in states that are doing more testing, says Peacock. In Colorado, where state-licensed dairy farms that sell pasteurized milk are required to submit milk samples for weekly testing, 64 herds have been reported to be affected. Neighboring Wyoming, which does not have the same requirements, has reported only one affected herd.

We don’t have a good idea of how many people have been infected either, says Lakdawala. The official count from the CDC is 14 people since April 2024, but testing is not routine, and because symptoms are currently fairly mild in people, we’re likely to be missing a lot of cases.

“It’s very frustrating, because there are just huge gaps in the data that’s coming out,” says Peacock. “I don’t think it’s unfair to say that a lot of outside observers don’t think this outbreak is being taken particularly seriously.”

And the virus is already spreading from cows back into wild birds and poultry, says Lakdawala: “There is definitely a concern that the virus is going to [become more widespread] in birds and cattle … but also other animals that ruminate, like goats.”

It may already be too late to rid America’s cattle herds of the bird flu virus. If it continues to circulate, it could become stable in the population. This is what has happened with flu in pigs around the world. That could also spell disaster—not only would the virus represent a constant risk to humans and other animals that come into contact with the cows, but it could also evolve over time. We can’t predict how this evolution might take shape, but there’s a chance the result could be a form of the virus that is better at spreading in people or causing fatal infections.

So far, it is clear that the virus has mutated but hasn’t yet acquired any of these more dangerous mutations, says Michael Tisza, a bioinformatics scientist at Baylor College of Medicine in Houston. That being said, Tisza and his colleagues have been looking for the virus in wastewater from 10 cities in Texas—and they have found H5N1 in all of them.

Tisza and his colleagues don’t know where this virus is coming from—whether it’s coming from birds, milk, or infected people, for example. But the team didn’t find any signal of the virus in wastewater during 2022 or 2023, when there were outbreaks in migratory birds and poultry. “In 2024, it’s been a different story,” says Tisza. “We’ve seen it a lot.”

Together, the evidence that the virus is evolving and spreading among mammals, and specifically cattle, has put virologists on high alert. “This virus is not causing a human pandemic right now, which is great,” says Tisza. “But it is a virus of pandemic potential.”

Have you ever found yourself lost in a building that felt impossible to navigate? Thoughtful building design should center on the people who will be using those buildings. But that’s no mean feat.

It’s not just about navigation, either. Just think of an office that left you feeling sleepy or unproductive, or perhaps a health center that had a less-than-reviving atmosphere. A design that works for some people might not work for others. People have different minds and bodies, and varying wants and needs. So how can we factor them all in?

To answer that question, neuroscientists and architects are joining forces at an enormous laboratory in East London—one that allows researchers to build simulated worlds. In this lab, scientists can control light, temperature, and sound. They can create the illusion of a foggy night, or the tinkle of morning birdsong.

And they can study how volunteers respond to these environments, whether they be simulations of grocery stores, hospitals, pedestrian crossings, or schools. That’s how I found myself wandering around a fake art gallery, wearing a modified baseball cap with a sensor that tracked my movements.

I first visited the Person-Environment-Activity Research Lab, referred to as PEARL, back in July. I’d been chatting to Hugo Spiers, a neuroscientist based at University College London, about the use of video games to study how people navigate. Spiers had told me he was working on another project: exploring how people navigate a lifelike environment, and how they respond during evacuations (which, depending on the situation, could be a matter of life or death).

For their research, Spiers and his colleagues set up what they call a “mocked-up art gallery” within PEARL. The center in its entirety is pretty huge as labs go, measuring around 100 meters in length and 40 meters across, with 10-meter-high ceilings in places. There’s no other research center in the world like this, Spiers told me.

The gallery setup looked a little like a maze from above, with a pathway created out of hanging black sheets. The exhibits themselves were videos of dramatic artworks that had been created by UCL students.

When I visited in July, Spiers and his colleagues were running a small pilot study to trial their setup. As a volunteer participant, I was handed a numbered black cap with a square board on top, marked with a large QR code. This code would be tracked by cameras above and around the gallery. The cap also carried a sensor, transmitting radio signals to devices around the maze that could pinpoint my location within a range of 15 centimeters.

At first, all the volunteers (most of whom seemed to be students) were asked to explore the gallery as we would any other. I meandered around, watching the videos, and eavesdropping on the other volunteers, who were chatting about their research and upcoming dissertation deadlines. It all felt pretty pleasant and calm.

That feeling dissipated in the second part of the experiment, when we were each given a list of numbers, told that each one referred to a numbered screen, and informed that we had to visit all the screens in the order in which they appeared on our lists. “Good luck, everybody,” Spiers said.

Suddenly everyone seemed to be rushing around, slipping past each other and trying to move quickly while avoiding collisions. “It’s all got a bit frantic, hasn’t it?” I heard one volunteer comment as I accidentally bumped into another. I hadn’t managed to complete the task by the time Spiers told us the experiment was over. As I walked to the exit, I noticed that some people were visibly out of breath.

The full study took place on Wednesday, September 11. This time, there were around 100 volunteers (I wasn’t one of them). And while almost everyone was wearing a modified baseball cap, some had more complicated gear, including EEG caps to measure brainwaves, or caps that use near-infrared spectroscopy to measure blood flow in the brain. Some people were even wearing eye-tracking devices that monitored which direction they were looking.

“We will do something quite remarkable today,” Spiers told the volunteers, staff, and observers as the experiment started. Taking such detailed measurements from so many individuals in such a setting represented “a world first,” he said.

I have to say that being an observer was much more fun than being a participant. Gone was the stress of remembering instructions and speeding around a maze. Here in my seat, I could watch as the data collected from the cameras and sensors was projected onto a screen. The volunteers, represented as squiggly colored lines, made their way through the gallery in a way that reminded me of the game Snake.

The study itself was similar to the pilot study, although this time the volunteers were given additional tasks. At one point, they were given an envelope with the name of a town or city in it, and asked to find others in the group who had been given the same one. It was fascinating to see the groups form. Some had the names of destination cities like Bangkok, while others had been assigned fairly nondescript English towns like Slough, made famous as the setting of the British television series The Office. At another point, the volunteers were asked to evacuate the gallery from the nearest exit.

The data collected in this study represents something of a treasure trove for researchers like Spiers and his colleagues. The team is hoping to learn more about how people navigate a space, and whether they move differently if they are alone or in a group. How do friends and strangers interact, and does this depend on whether they have certain types of material to bond over? How do people respond to evacuations—will they take the nearest exit as directed, or will they run on autopilot to the exit they used to enter the space in the first place?

All this information is valuable to neuroscientists like Spiers, but it’s also useful to architects like his colleague Fiona Zisch, who is based at UCL’s Bartlett School of Architecture. “We do really care about how people feel about the places we design for them,” Zisch tells me. The findings can guide not only the construction of new buildings, but also efforts to modify and redesign existing ones.

PEARL was built in 2021 and has already been used to help engineers, scientists, and architects explore how neurodivergent people use grocery stores, and the ideal lighting to use for pedestrian crossings, for example. Zisch herself is passionate about creating equitable spaces—particularly for health and education—that everyone can make use of in the best possible way.

In the past, models used in architecture have been developed with typically built, able-bodied men in mind. “But not everyone is a 6’2″ male with a briefcase,” Zisch tells me. Age, gender, height, and a range of physical and psychological factors can all influence how a person will use a building. “We want to improve not just the space, but the experience of the space,” says Zisch. Good architecture isn’t just about creating stunning features; it’s about subtle adaptations that might not even be noticeable to most people, she says.

The art gallery study is just the first step for researchers like Zisch and Spiers, who plan to explore other aspects of neuroscience and architecture in more simulated environments at PEARL. The team won’t have results for a while yet. But it’s a fascinating start. Watch this space.

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Brain-monitoring technology has come a long way, and tech designed to read our minds and probe our memories is already being used. Futurist and legal ethicist Nita Farahany explained why we need laws to protect our cognitive liberty in a previous edition of The Checkup.

Listening in on the brain can reveal surprising insights into how this mysterious organ works. One team of neuroscientists found that our brains seem to oscillate between states of order and chaos.

Last year, MIT Technology Review published our design issue of the magazine. If you’re curious, this piece on the history and future of the word “design,” by Nicholas de Monchaux, head of architecture at MIT, might be a good place to start

Design covers much more than buildings, of course. Designers are creating new ways for users of prosthetic devices to feel more comfortable in their own skin—some of which have third thumbs, spikes, or “superhero skins.”

Achim Menges is an architect creating what he calls “self-shaping” structures with wood, which can twist and curve with changes in humidity. His approach is a low-energy way to make complex curved architectures, Menges told John Wiegand.

From around the web

Scientists are meant to destroy research samples of the poliovirus, as part of efforts to eradicate the disease it causes. But lab leaks of the virus may be more common than we’d like to think. (Science)

Neurofeedback allows people to watch their own brain activity in real time, and learn to control it. It could be a useful way to combat the impacts of stress. (Trends in Neurosciences)

Microbes, some of which cause disease in people, can travel over a thousand miles on wind, researchers have shown. Some appear to be able to survive their journey. (The Guardian)

Is the X chromosome involved in Alzheimer’s disease? A study of over a million people suggests so. (JAMA Neurology)

A growing number of men are paying thousands of dollars a year for testosterone therapies that are meant to improve their physical performance. But some are left with enlarged breasts, shrunken testicles, blood clots, and infertility. (The Wall Street Journal)

In an era of unprecedented technological advancement, the health-care industry stands at a crossroad. As health expenditure continues to outpace GDP in many countries, health-care executives grapple with crucial decisions on investment prioritization for digitization, innovation, and digital transformation. The imperative to provide high-quality, patient-centric care in an increasingly digital world has never been more pressing. At the forefront of this transformation is imaging IT—a critical component that’s evolving to meet the challenges of modern health care.

The future of imaging IT is characterized by interconnected systems, advanced analytics, robust data security, AI-driven enhancements, and agile infrastructure. Organizations that embrace these trends will be well-positioned to thrive in the changing health-care landscape. But what exactly does this future look like, and how can health-care providers prepare for it?

Networked care models: The new paradigm

The adoption of networked care models is set to revolutionize health-care delivery. These models foster collaboration among stakeholders, making patient information readily available and leading to more personalized and efficient care. As we move forward, expect to see health-care organizations increasingly investing in technologies that enable seamless data sharing and interoperability.

Imagine a scenario where a patient’s entire medical history, including imaging data from various specialists, is instantly accessible to any authorized health-care provider. This level of connectivity not only improves diagnosis and treatment but also enhances the overall patient experience.

Data integration and analytics: Unlocking insights

True data integration is becoming the norm in health care. Robust integrated image and data management solutions (IDM) are consolidating patient data from diverse sources. But the real game-changer lies in the application of advanced analytics and AI to this treasure trove of information.

By leveraging these technologies, medical professionals can extract meaningful insights from complex data sets, leading to quicker and more accurate diagnoses and treatment decisions. The potential for improving patient outcomes through data-driven decision-making is immense.

A case in point is the implementation of Syngo Carbon Image and Data Management (IDM) at Tirol Kliniken GmbH in Innsbruck, Austria. This solution consolidates all patient-centric data points in one place, including different image and photo formats, DICOM CDs, and digitalized video sources from endoscopy or microscopy. The system digitizes all documents in their raw formats, enabling the distribution of native, actionable data throughout the enterprise.

Data privacy and edge computing: Balancing innovation and security

As health care becomes increasingly data-driven, concerns about data privacy remain paramount. Enter edge computing—a solution that enables the processing of sensitive patient data locally, reducing the risk of data breaches during processing and transmission.

This approach is crucial for health-care facilities aiming to maintain patient trust while adopting advanced technologies. By keeping data processing close to the source, health-care providers can leverage cutting-edge analytics without compromising on security.

Workflow integration and AI: Enhancing efficiency and accuracy

The integration of AI into medical imaging workflows is set to dramatically improve efficiency, accuracy, and the overall quality of patient care. AI-powered solutions are becoming increasingly common, reducing the burden of repetitive tasks and speeding up diagnosis.

From automated image analysis to predictive modeling, AI is transforming every aspect of the imaging workflow. This not only improves operational efficiency but also allows health-care professionals to focus more on patient care and complex cases that require human expertise.

A quantitative analysis at the Medical University of South Carolina demonstrates the impact of AI integration. With the support of deep learning algorithms fully embedded in the clinical workflow, cardiothoracic radiologists exhibited a reduction in chest CT interpretation times of 22.1% compared to workflows without AI support.

Virtualization: The key to agility

To future-proof their IT infrastructure, health-care organizations are turning to virtualization. This approach allows for modularization and flexibility, making it easier to adapt to rapidly evolving technologies such as AI-driven diagnostics.

Container technology is playing a pivotal role in optimizing resource utilization and scalability. By embracing virtualization, health-care providers can ensure their IT systems remain agile and responsive to changing needs.

Standardization and compliance: Ensuring long-term compatibility

As imaging IT systems evolve, adherence to industry standards and compliance requirements remains crucial. These systems need to seamlessly interact with Electronic Health Records (EHRs), medical devices, and other critical systems.

This adherence ensures long-term compatibility and the ability to accommodate emerging technologies. It also facilitates smoother integration of new solutions into existing IT ecosystems, reducing implementation challenges and costs.

Real-world success stories

The benefits of these technologies are not theoretical—they are being realized in health-care organizations around the world. For instance, the virtualization strategy implemented at University Hospital Essen (UME), one of Germany’s largest university hospitals, has dramatically improved the hospital’s ability to manage increasing data volumes and applications. UME’s critical clinical information systems now run on modular and virtualized systems, allowing experts to design and use innovative solutions, including AI tools that automate tasks previously done manually by IT and medical staff.

Similarly, the PANCAIM project leverages edge computing for pancreatic cancer detection. This EU-funded initiative uses Siemens Healthineers’ edge computing approach to develop and validate AI algorithms. At Karolinska Institutet, Sweden, an algorithm was implemented for a real pancreatic cancer case, ensuring sensitive patient data remains within the hospital while advancing AI validation in clinical settings.

Another innovative approach is the concept of a Common Patient Data Model (CPDM). This standardized framework defines how patient data is organized, stored, and exchanged across different health-care systems and platforms, addressing interoperability challenges in the current health-care landscape.

The road ahead: Continuous innovation

As we look to the future, it’s clear that technological advancements in radiology will continue at a rapid pace. To stay competitive and provide the best patient care, health-care organizations must prioritize ongoing innovation and the adoption of new technologies.

This includes not only IT systems but also medical devices and treatment methodologies. The health-care providers who embrace this ethos of continuous improvement will be best positioned to navigate the challenges and opportunities that lie ahead.

In conclusion, the future of imaging IT is bright, promising unprecedented levels of efficiency, accuracy, and patient-centricity. By embracing networked care models, leveraging advanced analytics and AI, prioritizing data security, and maintaining agile IT infrastructure, health-care organizations can ensure they’re prepared for whatever the future may hold.

The journey towards future-proof imaging IT may seem daunting, but it’s a necessary evolution in our quest to provide the best possible health care. As we stand on the brink of this new era, one thing is clear: the future of health care is digital, data-driven, and more connected than ever before.

If you want to learn more, you can find more information from Siemens Healthineers.

Syngo Carbon consists of several products which are (medical) devices in their own right. Some products are under development and not commercially available. Future availability cannot be ensured.

The results by Siemens Healthineers customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption), it cannot be guaranteed that other customers will achieve the same results.

This content was produced by Siemens Healthineers. It was not written by MIT Technology Review’s editorial staff.