A friend indeed

Chatbots are becoming an extension of human capabilities of search and analysis, as they steadily grow better to perform a variety of tasks on our behalf.

Second runner-up, Nature India Essay Contest 2020

Arijit Goswami

Arijit Goswami

No stretch of time can fade my vivid memory of the fine afternoon when I first saw a computer before my eyes. Led in a queue by our class teacher into an air-conditioned room (the computers of those times were indeed spoiled brats under heat), I was no less enamored by the glow of the VDU, as I was enticed by the quirks of the friend I had inside the machine. Peeping from corners of application windows, the Microsoft Office Assistant interacted with me just like a real living-breathing friend. A friend that promised to not judge me, nor mock me, but be the personification of ‘a friend in need is friend indeed’.

Nineteen years later, I grieve the loss of that paperclip-shaped friend to oblivion, though I see it reincarnated everywhere across the world, living through smartphones, websites and a myriad of gadgets. Be it Google Assistant, Cortana, Siri or Amazon Alexa, chatbots have come a long way since then. These conversational interfaces are what infuse life into our gadgets, enabling them to interact with us just like any other human being. Leveraging AI and Natural Language Processing, these artificial machines accumulate, dissect, comprehend and respond to information from humans. Over the years, they have matured so well that one can not only resolve queries with these bots, but can also share some light moments with them and also get loads of work done seamlessly. So much so, that now chatbots are becoming an extension of human capabilities of search and analysis, as they steadily grow better to perform a variety of tasks on our behalf.

Today, I wake up to an alarm that I set the previous night, not through clicks on smartphone or by turning knobs behind a clock. I simply wish my Alexa ‘good night’ and tell her to set alarms for 7am and also at 8am, lest my slumber gets the better of me. I reach my office and log into my online bank account. Right at the bottom-right sits my friend eager to resolve any of my queries. I simply type in my query into the chat box, and regardless of whether I indulge in extreme politeness or utter rudeness, I am assured of a courteous response and quick resolution of my problems. The chatbot also does a wonderful job of recommending me products and services that are best suited to me. Guess what? I no longer need to get tossed around bank counters for getting my work done, no longer need to ask friends and relatives for best deals and no longer need to be distressed with irrelevant marketing calls as the bot knows what’s best suited for me as per my behavior.

By the end of my tiring day, I am too hungry. 10 years ago, I would have had to scavenge through the streets for restaurants. But no more! My smartphone glows up with a notification from Zomato recommending me deals. I confess to Zomato about my cheat day and make it my accomplice in food guilt. I simply need to type in a few keywords and my payment is automatically done, leading to an awesome conversational selling experience. While I wait for my order to be delivered, I interact with the chatbot. The conversational AI tracks my mood through text analytics and emotion analytics, and responds to me with emoticons and witty messages. And sometimes, out of the blue, I just wonder if it is really a bot or an actual human talking to me behind a veil of a software.

However, chatbots are going to transform this world and how we interact with devices in ways still unimagined. Can you imagine that we may soon have chatbots providing therapy to distressed people? Reports published by National Center for Biotechnology Information (NCBI) say that it is possible to automate the expertise of a therapist. Woebot is an automated conversational agent that uses a short user-friendly survey and adds a fine sense of humor to cheer up its users. Wysa is an AI penguin on smartphone that helps anxious people to improve focus, manage conflict and relax. And though they are still inept at handling nuanced concerns of humans, the day is not too distant that we will confide the emotions from our deepest recesses of mind and seek help of chatbots that will be the best ears to listen to us.

How would you react if someone told you that chatbots are helping refugees in rehabilitation? Syrian refugees in Lebanon are using a chatbot, Mona, to flag their cases to non-profits that help them connect to lawyers, doctors and authorities of host nations for resettlement. DoNotPay, a robot lawyer gives free legal aid to refugees seeking asylum in Canada, UK and US, through a seamlessly easy to use conversational interface. With Lucia, MarHub and even WhatsApp being leveraged by NGOs, non-profits, and even the United Nations, for refugee rehabilitation, the humanitarian future of chatbots looks bright.

Not to forget, that chatbots will soon become our virtual assistants in all matters of life, from handling our daily chores to keeping our fitness on track and being our omnipresent, omniscient and omnipotent secretary for life.

I can very well visualize the day when chatbots will grow quite mature in the way they handle not only our written text, but also our emotions, location and circumstances to proactively provide contextually-sensitive services. The day is not far when future generations of chatbots will be our closest friends, mentors and confidants. And maybe one day, I will wake up and stare at my tablet where the great grandchild of Office Assistant will peek from the corner of screen, wish me a pleasant morning, and provide me with updates of all household chores it has automatically completed on my behalf to make my life more blissful than ever.

[ Arijit Goswami is a manager at Capgemini India in Mumbai.]

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Mapping the malady of cancer

Mapping the malady of cancer

The demonstrations we were so proud to have put together garnered forced applause and empty smiles. We had not addressed their main concern, the sense of finality associated with cancer.

Second runner-up, Nature India Essay Contest 2020

Aditi Ghose

Aditi Ghose explaning an exhibit on COVID-19 at the Birla Industrial and Technological Museum, Kolkata.

A group of cancer patients under palliative care, aged under 15, were scheduled for a guided visit to our Science Centre. As a science communicator I was desperate to make it special. Having lined up the choicest of our expositions, I was adamant on giving them an amazing experience. From decking the halls with cheerful banners, to ensuring that they could touch and see science-in-action – I believed that all would take part.

At the end of the day though, I realised I couldn’t have been more wrong. Moving along on wheelchairs through decorated alleys, the children wore desolate looks. The demonstrations we were so proud to have put together garnered forced applause and empty smiles. No amount of enthusiasm from our side could counter the children’s vibe of helplessness. The care-givers thanked us for our initiatives that day, but we knew we had failed. We had not addressed their main concern, the sense of finality associated with cancer.

With the World Health Organisation reporting that one in six deaths is caused by it, cancer is aptly called ‘the Emperor of All Maladies’.  The messages about cancer can be conflicting. ‘Cancer cannot be prevented.’ ‘It is a death sentence.’ ‘It’s contagious.’ ‘Everything causes cancer.’ ‘Over-the-counter remedies can cure cancer’. ‘Children don’t develop cancer.’  Trying to turn these children away from their fears and divert them to our regular demonstration routine had been a mistake. They could be best addressed only where they hurt most — we had to show them how cancer is being challenged today. We called in a few favours and asked the children to visit again. This time we wanted to tell them of the Pan-Cancer Analysis of Whole Genomes (PCAWG) Project.

Featuring a cast of more than 1300 scientists and clinicians with 744 affiliations between them, across four continents, analyzing 2658 whole genomes for 38 types of cancer, the PCAWG Project had revealed, in a suite of six research papers, the most complete picture (yet) of how DNA glitches drive tumour cell growth. It had identified the driver mutations — limited between four of five in 95% of the samples —  that powered the typical shattering and rearrangement of cells in tumor growths. This implied that patients diagnosed with those hallmark mutations will, in principle, be matched to a drug that targets the protein made by that driver gene. Another paper revealed that these mutations cropped up years or decades before the actual cancers were diagnosed. Detecting such anomalies suggested that many could be detected and treated earlier now.

Processes such as defective DNA-repair mechanisms or exposure to environmental mutagens produce characteristic patterns of DNA aberrations. Expanding our knowledge of genomic data sets of these mutations, the current study had identified 97 such signatures, crucial to the refinement and extension our understanding. It introduced the idea of ‘molecular time’ to classify mutations in tumour cells – helping identify and perhaps monitor common mutational trajectories. Papers matching data to functionally link DNA and RNA alterations illustrated the power of their integrated analysis for cancer studies.

The efforts warranted hundreds of terabytes of data, spread across multiple data centres, exacting millions of processing hours, making this level of international collaboration a reality. Pinpointing 705 recurring mutations in cancer genomes, acquiring samples protecting patient privacy while generating terabytes of data for use by the researchers, the project was a milestone in cancer genomics, along with a marvel of cloud genomics. It was only fair that the findings and implications of this gargantuan scientific endeavor be put forward to those who hope and pray for such miracles day in and day out. All that was left to do was figure out how.

Poring over the original papers, I realised the research findings were basically a heat-map, identifying the causal regions responsible for the genetic aberrations. A similar heat-map, for an entirely different purpose, was devised in 1914. It was the First World War and the number of bomber-planes that made it home was central to deciding the outcome of the war. To turn the odds in their favour, researchers from the Center for Naval Analyses had devised a simple card containing the outline of the bomber-plane, to be handed over to the returning pilots, to mark out the areas where the plane had taken a hit. Stacking up such cards would lead to a heat-map indicating where the planes were receiving the most damage.

It turned out that these regions included the centre along the tail gunner and edges along the wings. These were the most resilient parts of the plane – they had managed to return home, hole and all. The parts that were left unscathed in the cardboard outline – the cockpit and the fuselage – warranted a layer of protective-cladding.  Planes that had been hit in those areas were lost forever. Taking the missing planes into account was seminal to the contemporary discipline of operational research. Similarly, identifying the driver mutations in each cancer cell is going to be decisive in developing precision medicine, tailored to understand cancer better. We decided to tell the data-intensive story of the latter while demonstrating the bomber plane heat-map on paper gliders.

Skeptical at first, the children were gradually drawn in to the floating gliders. By the end of the session, the room was resonant with their laughter while the floor was carpeted with their paper planes. We even saw their care-givers eyes sparkle. A few strategically reinforced bomber planes had not won the war for the Allies – but they certainly helped. The six PCAWG papers and global consortium of researchers are only perhaps the beginning – their collaborations, knowledge exchanges and insights are going to provide the air beneath the wings of all fighters who battle cancer — either for themselves or for someone they care about.

[Aditi Ghose is an Education Assistant at the Birla Industrial & Technological Museum, Kolkata. She can be reached at aditincsm@gmail.com.]

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From the frontline: A doctor’s tryst with COVID-19

When Viny Kantroo, a respiratory diseases specialist, started seeing COVID-19 patients in a Delhi hospital, a whole new world unfolded in front of her  – both personally and professionally. “It has never been so tough before, taking care of your own breathlessness and that of your patients’, simultaneously”, she says in this guest post.

Viny Kantroo

My heart skips a beat thinking of Thursday. That’s the day my scheduled week-long duty starts in COVID-19 wards and intensive care units (ICU) every fortnight.

The rotation means constantly staying awake, or rather alert, even when you close your eyes in the ward to catch a few winks. The phone generally rings the moment you are transitioning from stage 1 to stage 2 of what we call, in medical parlance, non-rapid eye movement (NREM) sleep. The mind works constantly with the adrenaline rush that comes with attending to patients with COVID-19. I have not mastered the art of calming down despite years of being in crunch situations.

On one such day in the second week of April 2020, I had to get to my hospital late in the evening to insert a chest tube in a COVID-19 patient with collapsed lungs (pneumothorax). I have never had such cold feet, even when I learnt this for the very first time. I was worried about hurting the patient and creating complications because of limited vision resulting from elaborate eye gears of my personal protective equipment (PPE), but more overwhelming was the fact that I was in the middle of a contagion, dealing with a disease with no proven treatment. Suddenly, I felt like a student again.

At the back of my mind, I was also constantly battling the burden of carrying infection home. When on COVID-19 duty, I cover myself up, or rather my fear, with an extra layer of surgical mask above my N-95 mask. This actually hampers my breathing. I start panting for breath while speaking, but at least my mind stays calm and focused on patients. It is not easy to experience strained breath. It triggers a vicious cycle inside the brain. This experience has actually given me the empathy to feel what my non-COVID asthma and Chronic Obstructive Pulmonary Disease (COPD) patients feel when they come short of breath every winter.

Coming back to that late evening scene in the COVID-19 ward –  I stood there mustering all my courage, my hands trembling as I punched in the code to open the ICU door. The smell in there is peculiar, different from outside these areas. This smell always has a strong relationship with emotions – it sets a chain reaction inside my imaginary world – that the air is full of virus but I have to make way to the donning room and preferably not touch the door handles or the door itself.

This comes naturally to me though. My parents taught me the science of fomites and their importance well before I studied medicine. I would wash hands after touching public lift buttons, electrical switches, door handles and staircase railings even in normal times. This has made me a villain at home many times and I have been labelled as having an obsessive compulsive disorder of sorts, but I have made this practice very clear to both family and friends. So while my colleagues are still coming to terms with the changed reality, I am way more confident of navigating through doors and handles. Also, getting ready within 15 to 20 minutes without exposing any part of your skin is a mental rather than a physical task. It requires sealing the gaps between eye sockets and visors.

I could feel a pronounced silence as I entered the patient area that evening. I had to be in very close contact with the patient. This was more than the normal daily ICU rounds. All I could see were the dark corners and a foggy tunneled central vision. This was partly the physical reality, partly the constant fogging of my visors and mostly psychological. I instantly thought of music. I had brought in a bluetooth speaker the previous day with me to leave in the ICU for everyone.

I inserted the chest tube in about 25 minutes, way beyond what it normally takes. The extra layers above my coveralls made me sweat profusely. I desperately wanted some air. I saw the other patients and tidied out their medication, checked ventilators and asked my staff if there was anything else I could do for them (not that I was more capable than them but sometimes asking makes all the difference). I left the area for the designated doffing region and slowly removed the body suit and layers in 15 minutes to avoid creating aerosols.

Viny Kantroo in protective gear that makes breathing difficult for all healthcare workers.

Each time I came out of the ICU after attending to patients, I felt a strange sense of relief. Whether this is because I helped somebody or whether I could breathe better, I don’t know. But I surely have started to value the small little things in life much more than I ever did in the past. One thing which remains universal among healthcare workers across the globe is everyone wants to ‘breathe’. Everyone is just tired of the FFP 1, 2, 3s and N-95s. It has never been so tough before, taking care of your own breathlessness and that of your patients’, simultaneously.

For my mental health, I feel COVID-19 has done more good than bad though. I no longer run constantly, struggling with road traffic or my own mind’s traffic. I have a clear sense of priorities now. My time management has improved and I am now ready to start my third week of COVID-19 rotation today. I strategically plan my weeks ahead so that I am able to spend some time with my family – be it ‘happy wedding anniversary’ moments or saying a virtual hello to my family members around the world during my weeks off COVID-19 patient areas.

I had elaborate plans for 2020, as I was away from my family for the last two years pursuing academic interests in London. I am content, however, that I manage to be around my small world – with my husband, who is also a doctor, and a four-year old son.

On the upside, I recorded a song in my voice after many years. This has been a very big boost as I had lost the capacity to sing when I lost my first child some years back. My voice had choked and I had accepted that this was permanent. I now understand nothing is permanent in this world, not even grief. I see things with more optimism now waiting for a time when I can take a long breath in the mountains with my feet in the river water underneath.

[Viny Kantroo is a Respiratory, Critical Care & Sleep Medicine  specialist at  Indraprastha Apollo Hospitals, New Delhi, India.]

A grain of truth

Idlies not only belong to society but to science too. A well-fed scientist may churn out more discoveries than a starving one.  What is the point of science if it can’t give back to society solutions to the miseries plaguing it?

Runner-up, Nature India Essay Contest 2020

Kavitha with a (hopefully) fluffy dosa.

Kavitha Sankaranarayanan

Unkempt hair, shabby clothes, huge spectacles precariously perched over the nose, a disoriented look, one who prefers agarose-gels to beauty-gels, who trouble-shoots experiments instead of shooting goals on the field — the societal image of a scientist, though perceived as madness by the majority has still caught the reverie of a few like me.

I still vividly remember my interaction with a ten-year-old on potential career choices. Being a freshly minted scientist then, I felt it was my responsibility to help him make an informed decision, and thus possibly inspire a potential future Nobel Laureate (My mission – win the Nobel and inspire others into making the plunge into the fascinating world of science). With gusto, I sat upright and asked him “How about becoming a scientist?” He replied instantly “Hey no no…”. I was shocked. I think suggesting becoming a criminal might have evoked a less contempt on his little innocent face. This awakened me to the perception of scientists by the society. (Note to reader: This boy now aspires to become an aerospace scientist, so my chance at having inspired a potential Nobel Laureate still lives on).

Back then, the scientific community was isolated in its own niche and considered an intelligent, less fun, unsociable crowd. Things have moved on and now we find scientists adept at not only their work, but also equally skilled at other ‘extra-academic pursuits’.

With the advent of social-media platforms, science has reached even the remotest areas and it is not uncommon to hear an octogenarian in a rural location rant away about coronavirus and remedies to cure it. This digitalisation of daily life has to a large extent bridged the gap between science and society. Science is not, and should not, be limited to journal publications, medals/awards and honorary membership in societies.  What then attracts some humans to it? This kept me pondering until I came up with a few plausible reasons. Science is for the curious in nature; while most of us get awed by nature and its wonders, a few seek to satisfy their innate curiosity by figuring out the ‘hows’ and ‘whys’ of these mysteries. Given such a scenario, this clan of professionals are very much linked to the society and help in its progress.

Let me outline a project of high societal and gastronomic importance being researched by my team. India, along with the rest of the world, is facing the effects of global warming and if I were to break the news that rice production is on the decline, as one tucks into steaming hot fluffy idlies or crispy dosas, it may be a big jolt. India’s best scientific brains has been coming up with various solutions to tackle this crisis.

Plants, like all living things, need water to survive and wilt during water-deficit conditions. The key to battling this situation, as logic suggests, is to increase/make more-efficient water-uptake from the soil and to decrease water-loss from the plant. While most drought-tolerant plants have innate mechanisms to overcome such situations, most pampered crop plants including rice, do not. An understanding of these mechanisms would provide the key to developing robust varieties of these commercially important crop plants. My group has been interested in this aspect of biology, motivated by the cause of ensuring that dosas remain a viable breakfast option.

We have been investigating water-uptake mechanisms in the root-cells of these plants and how some varieties seem to be more efficient than others in imbibing water from an arid soil. Such knowledge could provide the much-needed information on these weapons that could be implanted through crop breeding techniques into the ‘weaker’ commercially important crops.

While efficient water-intake methods do help, it may not be effective unless and until the plant does not waste water from its tissues. This is orchestrated by small pores (stomata) in the leaf guarded by cells (aptly called ‘guard-cells’) which control stomatal opening, thereby regulating water loss through transpiration. My team has identified some key proteins in these cells which keep the stomata open and this discovery could lead to a possible method to efficiently regulate stomatal-function during drought conditions. This could also revolutionise the means of selection of ideal parents for crop-breeding.

The reason this is of importance in rice is that commercially important varieties, especially the popular ‘idly’ rice, is very drought-sensitive, while robust drought-tolerant varieties may possibly make rock-hard idlies. How do we continue producing drought-tolerant idly rice while retaining the ‘aromatic fluffiness’ of the idlies? This is where discoveries step in.

So back to the question: What is the connect between science and society? In this case, idlies not only belong to society but to science too. A well-fed scientist may churn out more discoveries than a starving one.  What is the point of science if it can’t give back to society solutions to the miseries plaguing it. What is society if it cannot inspire science by supporting and recognising the efforts with ample feedback and encouragement? Children in our country idolise and get inspired by scientists like Dr. A.P.J. Kalam who have reached the pinnacle of success by sheer hard work and tenacity.

Scientists inspire society and society inspires scientists. This symbiotic relationship is what is going to usher in a golden era of progress in scientific understanding. Here is to a period of amalgamation of science with society and let the ‘scientific-madness’ spread to every individual and manifest as a curiosity to learn and seek knowledge.

[Kavitha Sankaranarayanan heads the Ion Channel Biology Laboratory at the AU-KBC Research Centre of Anna University in Chennai.]

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A predictive lifeline

A predictive lifeline

“As a new doctor I always felt guilty when a baby died just after my watch, this takes away so much of that feeling, I can watch them from wherever.”

Runner-up, Nature India Essay Competition 2020

Abhilash Gangadharan

A neonatal ICU.

A. Gangadharan

I spun around at the noise. A baby in the critical section of the neonatal ICU (NICU) had woken from sleep, and began to heave and regurgitate into the ventilator mouthpiece. As I watched, it started gasping for air. To confirm my worst fears, the monitor began to beep as the baby’s oxygen saturation started falling.

I was an intern with a research group applying predictive analytics on real-time physiological data from neonatal infants. We were installing data acquisition modules that aggregated data from patient monitors and ventilators and sent them to the cloud for real-time analysis and predictions. We had already implemented a way for doctors to monitor the NICU from anywhere, and check on the status of each baby by logging into a website accessible only to them. The baby’s status, updated to the last minute, was at their fingertips even while they were away from the hospital.

There weren’t any doctors around now though. It was  2 a.m., and I was watching a baby die. I rushed out of the room and saw a nurse in the main NICU standing across the hall. I gesticulated wildly until she noticed me, she came over and I motioned to the baby. She looked at the clearly distressed baby and said “this isn’t my shift”. She went back to the nurse’s room and called out for someone else to deal with the problem. The baby’s struggle to breathe began to subside and with horror, I thought it would pass in front of my eyes. All I could do was look on helplessly as it choked on vomit.

Out of nowhere, a doctor came in. I pointed and croaked “baby…choking”. The doctor looked and yelled for two nurses and equipment. Over the next 10 minutes they suctioned away the vomit from its airways and replaced the contaminated ventilator paraphernalia and the baby was breathing again, peacefully.

Abhilash Gangadharan

Drained, I made my way out of the NICU into the hospital corridor. As I stripped my protective covers, apron and mask, the doctor came out and said “Thanks for the app”. It dawned on me then that his arrival at the critical moment was not just good fortune. He continued, “I was just about to leave, and gave the babies monitored by the app a final look, and saw this baby had turned red”, he was referring to the software indication of abnormal vital signs. He continued, “This is really going to change the way things are done around here. As a new doctor I always felt guilty when a baby died just after my watch, this takes away so much of that feeling, I can watch them from wherever. Can you put in an alarm system for when a baby goes critical as well?”

That was the moment of realisation for me. Initially we had met quite a bit of resistance from doctors who regarded this as an intrusion of analytics which made them feel as if their work was being audited. But as they got used to the system and saw how all the information for every patient was available at their fingertips, they grudgingly agreed it was convenient. But none of the doctors wanted any data-driven insights, medical decision-making or suggestions from our platform, clearly telling what they considered their prerogative. This was the first time a doctor had clearly indicated approval.

With an increasing number of premature births, more infants are required to spend time in the NICU. These are often under-staffed, with over-worked nurses and doctors. Expecting meticulous care and attention to detail for every neonate is hoping for the impossible. Medical complications are more common in neonates, and keeping track of a baby’s real-time vital signs is intensive. Avoiding errors in medication is possible by screening out contra-indicated drugs. By using the aggregated history of a patient’s stay in the NICU, it is possible to implement dynamic calculation of drug doses using daily birth-weights. This reduces the mental load of having to keep track of every patient and gives the doctor space and time to think of the bigger picture. This also helps them study and keep abreast of the latest in neonatal research, allowing them to improve their skills and processes of neonatal care.

The complementing of medical infrastructure with artificial intelligence-based systems improves clinical outcomes. The increasing number of premature birth cases is correlated with the rising number of IVF procedures due to fertility problems. More infants need to spend time in the NICU until they can safely be sent home. Improving the health outcomes of neonatal infants assumes manifold importance in such a scenario. Monitoring them constantly using automated algorithms and generating timely alerts is very useful for doctors. In case of any complications during their stay in the NICU, such a system ensures hypoxia is avoided. Such medical lapses can cause life-long problems for neonates. Predictive real-time analytics on incoming data can predict sepsis even before it is apparent to doctors using changes in heart-rate-variability, making timely live-saving medical interventions possible.

Ultimately, science that works towards improving the health of the nation’s youth would be the most impactful and help in improving society.

[Abhilash Gangadharan  is a PhD scholar at the Institute of Genomics and Integrative Biology, New Delhi.]

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Memories of paati

A grain of truth

Memories of paati

As paati lost her memory and identity, we would sit by her side and recollect fond memories from the past, in the hope that our narration would magically revive her brain. With artificial intelligence and targeted therapies, perhaps there’s hope for millions like paati.

Winner of the Nature India Essay Competition 2020.

Gowri Natarajan

An old photo of Gowri Natarajan as a child with her grandmother (paati) Kamakshi at their home in Chennai.

My paati (Tamil for grandmother) once showed me her diary, in which she had written down names of some people in our family. I sensed a certain degree of disquiet, as she explained that she had trouble recollecting names now and then. At the time, paati was entering her 70s. Apart from forgetting names, she was in perfect health. Her subtle memory lapses indicated mild cognitive impairment (MCI), a condition that can be an early sign of Alzheimer’s Disease (AD). However, not all those who have MCI develop AD, and in people with MCI, the cognitive impairment does not interfere with day-to-day functioning and does not alter their behavior.

However, with time, paati’s memory lapses became more frequent. In addition, behavioral changes such as mood swings, irritability, and poor spatial navigation became apparent. A visit to the neurologist and a brain scan confirmed her diagnosis as moderate stage AD. As the years passed, paati’s condition worsened. Hallucinations, disturbed sleep patterns, anger, tantrums, fear, and confusion became frequent. At this stage, she could not identify others around her, and one could say that she lost her own identity as well. She was unable to perform basic tasks, and we had to appoint a nurse to care for her. During her last days, paati lost her ability to communicate, was bedridden, and her brain and body effectively shut down.

Around 50 million people have dementia worldwide, and AD is the most common cause of dementia in the elderly. The number of people with dementia is expected to reach ~75–80 million by 2030. The global annual cost of dementia, including social and economic costs, is about a trillion USD. The costs are predicted to increase and will likely present a grave social problem, given the greater proportion of older people in the world today due to improvements in health care.

AD is devastating not just for the sufferer, but also caregivers, health-care systems, and society. Paati‘s memory loss, confusion, and inability to perform basic tasks lead to isolation, depression, and withdrawal from society. From a caregiver’s perspective, I recall moments when my family and I would empathise with paati’s anger and confused state of mind, but there were also times when her mood swings and irritability took a toll on us. I remember a time when paati left the house thinking she lived elsewhere, and we found it quite challenging to convince her to return home.

Gowri Natarajan

During my doctoral pursuit in neuroscience, I was able to reflect on paati’s predicament through a scientific lens. When we see a familiar face, watch a scene from a movie, or visit a childhood haunt, these stimuli evoke certain memories, emotions, or responses that are unique to each of us. The human brain is an intricate network of neurons, the functional units in our brain. Different neuronal networks in our brain process various sensory stimuli from the world around us and consequently evoke responses that shape our personality and define who we are. In AD, neurons in the brain die and are unable to communicate with one another. The loss of neurons commences in the limbic network in the brain, which is critical for learning, memory, and emotions. As the disease progresses, the neuronal loss spreads to other regions in the brain that send commands to the body to perform basic tasks. At this stage, entire neuronal networks are disrupted and cease to function. In the final stages, widespread neuronal death occurs, with significant shrinkage of brain tissue.

Currently, there is no cure for AD. Although medications alleviate some behavioral symptoms, they do not halt the progression of AD. The treatment landscape has been riddled with failures in clinical trials due to several challenges. Firstly, a ‘single-target’ approach, in which a drug works to correct one aspect of the AD-afflicted brain, has not been effective, given the multiple ways in which the disease affects the brain. To address this challenge, scientists have been working to develop a better understanding of the biology of AD in animal models. This preclinical research has led to the discovery of several targeted therapies that, when administered together, could correct multiple aspects of this complicated disease simultaneously.

Another key challenge lies in the late diagnosis of AD. Often, a definitive diagnosis is made only when people begin to show overt symptoms beyond just memory impairment. At this stage, therapies often fail, since the disease has already progressed significantly and irreversibly. A glimmer of hope for addressing this challenge is emanating from the fascinating world of Artificial Intelligence (AI). In a study conducted in California, researchers successfully trained an AI learning algorithm to detect subtle changes in brain metabolism from brain scans of people referred to a memory clinic. The algorithm demonstrated 100% sensitivity for predicting AD in these people six years before the definitive diagnosis was made. Perhaps we might bear witness to a time in the near future when such learning algorithms could be used in neurologists’ clinics to predict AD in people who show memory impairments, thus providing excellent opportunities for early interventions.

In her active days, one could often find paati sitting on the kitchen floor with a large plate in front of her. The aroma of cocoa powder would waft through the air. I would rush into the kitchen, to find her busy mixing the special ingredients that went into making her homemade chocolates, using a recipe that she had committed to memory. As paati lost her memory and identity, we would sit by her side and recollect such fond nuggets from the past, in the hope that our narration would magically revive her brain. I imagine that countless others around the world must also be attempting such methods to rejuvenate the memories of their loved ones afflicted with AD.

With scientific advancements in the field of AI and targeted therapies, perhaps their hopes would become a reality some day.

[Gowri Natarajan is a neuroscientist based in Hyberabad.]

The silver linings: Working from home in a pandemic

When India announced a national lockdown on 24 March 2020 to fight the novel coronavirus, Vinu Valayil, a techie at Springer Nature Technology and Publishing Services, was on a holiday attending a family wedding in a picturesque Kerala village.

Read Vinu’s lighthearted take on what ensued when he had to ‘work from home’ stuck in his in-laws’ house. In his humorous, almost self-deprecating style, Vinu offers lessons in positivity for many of us struggling to work from home in these tough times.

I have mixed feelings about social distancing.

I totally understand why we have to do it but I am not sure if I like it (or not).

It feels like life threw a few sour lemons at me and now I’m basically sipping delicious lemonades while totally missing how it felt like to be working in the office.

I happened to be on a personal time off when the lockdown was declared in India. I am now stuck in a village in Kerala, hundreds of miles away from my work-city of Pune, working from what is essentially my father-in-law’s house. I was here to attend a supposedly big fat Indian wedding.

These days when you get on calls, the small talk has shifted from “How’s the weather” to “How are you coping?” or “How are you feeling?”.

I can possibly box my feelings in three specific categories (yes, being super nerdy is my super power):

The Box of Lemons

  • The People

People are lemons! People that are hoarding supplies from the local groceries, or still going to parties or gatherings, who are flouting the physical distancing principles.

And thank the good lord that this part of the world uses bidet showers, essentially eliminating the need to hoard toilet paper like the western world.

  • The Workplace 

There is a definite lack of a defined workplace. And there is an endless supply of distractions. My workplace is a chair, the end of a dining table, the hallway, the roof. This space is not my personal space. Gone are the days when I could put a “At work” sign on my door and expect to work without distractions.

  • Shared Video Conferences & Meetings

Once in a while, I’m frozen on my GotoMeeting. That isn’t the core problem.

The problem is I’m stuck in the weirdest pose ever. Why on earth can’t it find a decent, resting, smiling face to freeze on?

  • Workaholism

In Pune, I live about 24 kms away from my office. And the daily commute can go up to 3 hours. I now suddenly find myself flush with extra time. I have started taking less coffee breaks too. I feel exhausted at the end of the work day. I often forget the passage of time.

  • Mi Esposa

And then there’s my wife. Don’t get me wrong: I love her a lot. Unfortunately, she’s also undergoing these cabin-fever Work From Home (WFH) symptoms. Her creativity knows no bounds and she has taken it upon herself to paint my fingernails in the process.

The Crate of Lemonades

  • The People

My roots are in Kerala. Some of the oldest, cutest, most stubborn elders that I know, including my mother, reside in this place. A big part of my family tree. I am now being pampered with extra attention and I also feel blessed that I am around to be of assistance.

Being treated like a royal is absolutely a lemonade!

  • The Workplace

This place is ridiculously beautiful, calm and serene. To be in a workplace that is so close to nature is a privilege. To be able to step out into the untouched wilderness, to sit beside a pond to watch a heron hunt. I take some breaks during work just to recharge a bit. Breaks during work at this time are not optional, they are necessary.

  • Shared Video Conferences & Meetings

Regardless of how grainy and how terrible GoTo, Skype, Whatsapp Videos or Hangouts sometimes are, it is such a pleasure to see familiar faces. To see them laugh and share a virtual coffee with you. Isolation at work can be incredibly depressing. I heartily recommend getting on video calls or any sort of calls with your friends and co-workers from time to time. Bake that into your schedule!

  • Workaholism

Once in a while there is a side project that requires you to work extra hours. I had a lot of fun working on a holiday and partially through the weekend trying to help some colleagues get a report across that expressly talks about a curated section of recent Coronavirus research.

There is a joy in working beyond regular hours for a cause.

I also feel my other “work”, especially works of art and photography, have come back to my life.

  • Mi Esposa

We have been married for 5 years. She works and lives out of Mumbai. I work and live out of Pune. We meet on weekends & planned holidays.

This “living together” due to the lockdown is, by far, the longest we have ever been together together. We are rediscovering why we are each other’s favourite people.

Surely that’s a lemon martini, people!

And guess what, I love what she’s done with my nails.

The Uncategorised Box

  • I feel thankful for my support team at Springer Nature Technology and Publishing Solutions who have really gone above and beyond to help our colleagues transition to a WFH phase. Everything — from making policies remote friendly to actually shipping workstations to homes — demonstrates empathy and sensitivity.
  • I feel sorry for a lot of folks who have been affected badly by this lockdown. A lot of daily wage labourers in India are in the unregistered or unorganized workforce. These are tough times for them. Efforts are ongoing and all of us need to do our level best to support and donate. So if you feel like donating too, donate to your nearest government/private organisation to help them tide over this crisis.
  • The news has been depressing. While it is heartening to hear some countries have come back from complete lockdown, stories from other countries and their struggle to contain this pandemic are heart-breaking. I take it upon myself to be updated but it is really tough to not be affected.
  • I feel for my dog. My pet Oshie is stuck in a dog boarding facility in Mumbai. The good news is that we get insane videos of our dog chilling out, running around, eating heavily and making new friends. It looks like she’s not missing us. (Grrr).
  • Most of all I miss meeting people. I miss seeing familiar faces. I miss hugging my close friends, shaking the hands of those I don’t want to hug, having a real conversation face to face, dancing late night at Fly High. We spend so much time in the office; it has become a second family to all of us. This sudden change is of course hard to adjust to.

Physical distancing is a necessity and a harsh reality in these times. Yet, when all of this is over and we pick up the pieces and build our lives back, I am hoping it will give a new meaning to our bonds and to our shared experiences.

So I wish you are all safe and healthy and still in high spirits. To take a leaf out of my secret guilty pleasure and comfort series “Grey’s Anatomy”:

Every cloud has a silver lining. But it’s still a cloud. A cloud can mean a shower or a storm. So you take your good days where you can get them. Try to stay positive. You try to remember that, even in the bad news, there’s good news for someone.

If you are done reading this post, please wash your hands for 20 seconds.

[Vinu Valayil, is the Head of Development at SN Digital, Springer Nature Technology & Publishing Services, Pune. He can be reached at vinu.valayil@springernature.com .]

Starting a lab amidst a pandemic

Just about to start her own dream laboratory, Poonam Thakur found herself in the middle of a pandemic. She shares her feeling of helplessness as a scientist not trained in any aspect of fighting the coronavirus crisis.

And, her sense of relief on being able to contribute to the fight in a small way and beginning to lay the groundwork for her lab during the lockdown.

Poonam Thakur in her lab at IISER Thiruvananthapuram.

After years of insecurity with short term postdoctoral contracts, international moves and personal sacrifices, I had finally landed a coveted faculty position in a reputed institute. I was over the moon. I had finally ‘made it’ in the highly competitive academia, beating all odds. In the first time in years, I was going to start a life that won’t be uprooted, at least in the next 2-3 years.

In early March of 2020, I joined the Indian Institute of Science Education and Research (IISER) Thiruvananthapuram — a vibrant campus in the lush green hills of India’s western ghats — with lofty dreams of unrolling my neuroscience research and teaching programme. The first three-four days flew by in administrative formalities and in dealing with the realisation of suddenly becoming a Principal Investigator with more responsibilities, in furnishing the workplace and planning for the courses I would teach in the upcoming semester.

In the middle of this frantic activity, an email landed in my inbox about the precautionary measures the institute was undertaking against the spread of the novel coronavirus disease 2019 (COVID-19), a highly contagious viral infection that was spreading through the world like wildfire and was beginning to escalate in India. Classes were suspended and students living in the campus were asked to go home. Faculty living on campus were advised not to go out unless extremely necessary. No outsiders were allowed into campus and social distancing was encouraged.

A few days later, the India government announced a countrywide lockdown. That ensued closure of on-campus daycare leaving many of my colleagues in difficult circumstances. All research plans and purchases came to a screeching halt. Soon the labs started to shut down or operate with reduced capacity as most support staff was gone. A campus bustling with life only a few days ago, was deserted all of a sudden.

We were in middle of a pandemic.

Slowly, a constant barrage of news on the rapidly deteriorating situation and overwhelmed medical systems worldwide began making me anxious. As a researcher, I was trained to be perennially productive. I was concerned about the inevitable delay in starting my research programme and losing precious time from my research grant. I wasn’t trained either in the techniques that may help in COVID-19 diagnostics nor in studying the virus structure or finding a cure. So, in addition to the frustration of not being able to jumpstart my lab, I was fighting the feeling of inadequacy and helplessness as a scientist for not being able to help humanity in this crisis.

Joining the cause

For me, the hardest part was to deal with my own expectations. I had Roman emperor Marcus Aurelius words to fall back on: “You have power over your mind, not outside events. Realise this, and you will find strength’. Once I was able to tide over the feeling and acknowledge that it was reasonable to feel agitated, frustrated or unproductive in these extraordinary circumstances, it was easier to put everything in perspective.

Although I could not fight the pandemic from the bench, I tried to help in other ways.

I volunteered to translate infographics on coronaviruses and COVID-19 in my regional language and shared them through social media. I informed the dos and don’ts of this disease to my non-scientist friends, neighbours and family, and tried dispelling COVID-19-related myths in close circles.

At work, I started contacting several vendors to obtain quotes for the equipment I would need to start my lab. Luckily, several of them were still answering calls and responding to emails. I interacted with my colleagues living in the campus. They offered me not just advice and experience on setting up labs but also offered to share their lab equipment and resources until I set my own up. These interactions helped me immensely as I developed collegiality with these colleagues quickly. Under normal circumstances, it would have taken much longer with everyone busy in their teaching and research schedules.

Life beyond lockdown

Gradually, I started to take the lockdown in my stride. I finally had time to step back, pause and reflect on my long-term research goals and strategies. With a fresh mind and fewer distractions, I started working on the book chapter I had been procrastinating for long. I was able to focus on preparing material for the courses I would eventually teach. I took to running, taking advantage of the huge campus surrounded by forests and falls. Being close to nature, has indeed helped me find peace amidst all the chaos.

Being a neurophysiologist, I am always reminded of the story of Alan Hodgkin and Andrew Huxley, pioneers in the study of action potential in nerves. Shortly after their first recordings of intracellular action potential, they had to take part in war-related activities and suspend primary research for seven long years. Once the war dust settled, they were reunited and resumed work on action potentials that ultimately fetched them a Nobel Prize in Physiology and Medicine (1963).

Although we don’t know when the lockdown will be over, like everyone else I hope for a pandemic-free world where normal life can resume. Despite the fear that a battered economy may affect research funding, I am looking forward to conduct research with stronger resolve.

‘Was mich nicht umbringt, mach mich stärker’ (That which does not kill me, makes me stronger) — Nineteenth century German philosopher Friedrich Nietzsche.

[Poonam Thakur is a DBT/Wellcome Trust India Alliance Early Career Fellow and joined IISER, Thiruvananthapuram as an Assistant Professor in March 2020. She can be reached at poonam[at]iisertvm.ac.in]

Announcing winners of NI Essay Competition 2020

We are delighted to announce the winners of the Nature India Essay Competition 2020.

The first prize winner is Hyderabad-based neuroscientist Gowri Natarajan for her essay titled ‘Memories of paati, a story of her grandmother that advocates the need for employing artificial intelligence and targeted therapies for the management of Alzheimer’s disease. Her narrative strongly underlines the importance for socially-relevant science.

 

Gowri Natarajan

 

Kavitha S.

Abhilash Gangadharan

Two essays jointly take the second spot — Abhilash Gangadharan’s “A predictive lifeline, a compelling personal narrative on the need for better equipping our hospitals with neonatal medical diagnostic tools;  and Kavitha Sankaranarayanan’s A grain of truth“, her passionate, philosophical and humorous take on a drought-tolerant idly rice variety.

Abhilash is a PhD scholar at New Delhi’s Institute of Genomics and Integrative Biology and Kavitha heads the Ion Channel Biology Laboratory at the AU-KBC Research Centre of Anna University in Chennai.

Aditi Ghose

Arijit Goswami

On third position, again jointly, are Aditi Ghose and Arijit Goswami. While Aditi’s Mapping the malady of cancer talks of her learning from a failed science communication project that prompted her team to approach it better, Arijit’s A friend indeed is a well well-reasoned take on the omnipresence of artificial intelligence and chatbots in our everyday lives.

Aditi is an education assistant at Kolkata’s Birla Industrial and Technological Museum and Arijit is a manager at Capgemini India in Mumbai.

Shambhavi Naik

A special mention goes to Shambhavi Naik‘s essay Return of the Ridleys, a gripping narrative of a very important wildlife concern around the endangered Olive Ridley turtles, with on the ground reportage that offers solutions. Shambhavi is a fellow at Bangalore based Takshashila Institution and Director of CloudKrate Solutions Pvt Ltd.

Congratulations to all the winners! The winning essays will be published in the Nature India annual volume due for publication later this year as well as in the Nature India blog Indigenus soon. Stay tuned!

The top essays will win cash prizes, a three-year subscription to Nature, trophies and certificates. The special mention essay will receive a trophy and certificate of appreciation. We will also release a list, in due course, of some more honourable mentions in this essay competition and award them certificates of appreciation.

Nature India received more than 200 essays in a call opened in January 2020 in partnership with the Council of Scientific and Industrial Research (CSIR). The essay competition was aimed at providing young and experienced scientists, researchers and authors in India, a platform to share ideas on how socially-impactful science can advance and strengthen the country.

The Nature India essay competition was open for scientists, researchers, writers or authors aged 25 to 50. The essayists had an opportunity to draft a compelling narrative with personal anecdotes, emotion and a science-backed story that may become potentially historic in helping shape the roadmap for India’s scientific future. The submitted essays were judged by a panel of editors, scientists and science communicators.

My science failures: Get up fast after each fall

Science stories are equal to success stories. Right? Wrong. In thinking of scientists as successful people, many times we often assume that their career paths are straightforward, meticulously-planned and yield positive outcomes. However, things don’t always go as planned. Behind every small success, there’s probably a string of failures — work that did not make it to the curriculum vitae, rejected papers, turned-down applications, declined grants, unsuccessful job interviews, and many closed doors.

Science blooms in these failures as much as it does in the glory of accepted manuscripts, grants, awards and patents. In this blog series “My Science Failures” we will hear some straight-from-the-heart stories of these secret milestones in the lives of scientists — and learn how they turned these events on their head (or did not). You can join the resultant online conversation with the #mysciencefailures hashtag. Let us know at indigenus@nature.com if you would want to tell us your story.

Divya P. Kumar, is an Assistant Professor and DBT-Ramalingaswami Fellow at the Department of Biochemistry in J S S Medical College, Mysuru, Karnataka. As a young investigator, it took courage for her to talk about failures. But her belief to ‘do what’s right, not what’s easy’ saw her through this exercise in soul searching.

Divya P. Kumar

“Success is a public affair but failure is a private funeral.”

Failure is an integral part of any career path, but the irony is that one doesn’t dare to speak of it in public. We admire reading or watching stories of successful people who have failed at some point in their lives but are reluctant in accepting and overcoming our own failures. Fortunately things are changing and the world has started appreciating that it’s okay to fail rather than not trying, or quitting.

In the scientific world, we are more acquainted with failures than success – be it in experiments, grant proposals, job interviews, manuscripts or lab management. It is therefore important that we discuss failures, appreciate the attempt made and importantly, support each other to iron them out. Accepting failure is an integral part of career development.

My work is still in progress in terms of building a career path as a scientist. This blog piece is my humble effort to say out aloud to every research scholar, postdoctoral fellow or young investigator who has failed:  “You are not alone”. All scientific failure stories appear alike whereas success stories differ in their own way. I say this because while reading someone’s scientific failures, we often relate to them.

Science just happened

I never dreamt of becoming a scientist. Growing up in the southern India city of Mysore in Karnataka, the professions of choice were engineering or medicine (thankfully, it has changed now). Though I was interested in engineering, I did not make the cut in the entrance exams. I chose to study biotechnology.

During the great economic recession of 2009, I moved to the United States with my husband. My application to a graduate school got rejected. It made me realise how competitive the scene was. It also made me appreciate the importance of participation in summer research programmes, workshops, conferences, publications and extracurricular activities that count along with the regular academic requirements of the graduate programme.

Not losing hope of a PhD, I started volunteering in the lab and soon took up the job of a project assistant. The hard work paid off and I had a first-author publication and then got enrolled into a graduate programme.

All this happened while I was working in two different labs, the first one being a bitter experience because of micro-management by a rather insecure leader.

The PhD roller coaster

I decided to opt for a different lab for PhD. However, having one published paper, one co-authored manuscript in press and another first-author manuscript in the works, it was a tough call to leave the lab and start all over again. It was a structural biology lab and I had realized within one year that it was not my cup of tea. Setting up crystal trays needed a lot of patience and stamina (and I admire those in the field for that). I also had limitations with my knowledge of physics. It would perhaps have been easy for me if I put in some effort to get familiar with the work, the people and the ambience but I listened to my heart and got ready for the next challenge.

PhD was challenging. The research work demanded key expertise in islet isolation from mice as also working with mice and human islets in vitro. This expertise was not available in the lab. So I had the great opportunity to collaborate with scientists from a different University. Earlier, my first publication had been accepted within 3-4 days of submission in the journal Biochemical and Biophysical Research Communications, something I realised was a rarity. I got to taste the reality of PhD, struggling with the new expertise I had to master for nearly half a year. This was the best period of my PhD as I learnt how important mentors and their support are. I also learnt the life skills of troubleshooting, perseverance and patience and of loving one’s work despite uncertainties.

Managing a lab

Setting up a research lab and a team marks the beginning of an exciting phase in the career of all young investigators. It is challenging and does require management skills to build and run the lab effectively. Having realised this, I set up a new research team with academic values and good lab culture. As everything was falling in place, the two research scholars quit – one was selected for a government job and the other for her personal reasons. I had heard similar stories, but your heart breaks when it happens to you.

The time and effort invested at this initial stage of establishing your career seem to have gone to waste. However, I did appreciate the interest of the research scholars and their personal journeys.

I got back to the drawing board with renewed energy and inducted new research scholars in the lab. The exercise was humbling and taught me that ‘sometimes good things fall apart so better things can fall together for the best to happen’. We are just a couple of months into the new set up and it seems promising so far.

Being a young investigator, listing these failures in my scientific career took some courage. This introspection gives me a sense of pride for not letting failures break my self-trust. I have learnt from from them to go with the flow, re-envision my goals and seek inspiration from others. In the end, I have always believed in doing ‘what is right than what is easy’.

More in the series:

My science failures: All the light bulbs that did not work