Nuclear medicine shortages and Jane Goodall on COP29

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You're listening to BBC Inside Science, first produced on the 14th of November 2024.

I'm Marnie Chesterton.

Hello.

We still have a window of time to start slowing down climate change and loss of biodiversity.

But it's a window that's closing.

That's legendary chimpanzee researcher Jane Goodall.

Plenty more from her coming up on Inside Science, plus Can We Chuck Nuclear Waste Into a Volcano?

And a very particular kind of culture war, Can You Tell AI poetry from the real stuff?

But first, you may have read in the news that according to experts, medical isotopes are in short supply in the UK.

Now at this point maybe you're trying to dredge the word isotope out of a bit of your brain that stores your GCSE or O-level science.

Don't worry, refresher approaching.

Medical isotopes are crucial to medicine, particularly in helping doctors seek out and sometimes destroy cancerous cells.

And there are concerns that this shortage could be delaying diagnoses and that could even be costing lives.

It turns out that how you make them is really quite central to this issue.

So joining me now to talk vanishing isotopes is expert in reactors for nuclear medicine, Simon Middleborough.

Hello, Simon.

Hello there.

Listen, what's going on here?

Why are medical isotopes so hard to come by?

Well, the reactors that produce nuclear medicine around the world are aging, and most of them are due to to close in the next five to ten years.

And as they age, they require more maintenance.

And this will lead to delays, and they will shut down unexpectedly.

And this means we're not going to get the medicine in the UK that we need.

And where do we get ours from?

So we get them from a range of reactors in Europe, and they get flown in, and they're decaying away.

So the closer they are, the better, because the more potent they will be and the more treatments we can give.

The reactor that's closed down recently is in Netherlands, and that closed down unexpectedly, and it's been off for about a month or so.

It's just coming back online now.

Okay, so if we're getting them from aging reactors, then presumably the shortage is only going to get worse.

Yeah, absolutely.

I mean, as these get worse, the delays will get longer, the cost of the medicines will go up, and the availability will reduce as well.

So, let's dig into what exactly a medical isotope is.

Right, good question.

An isotope is just an element on the periodic table.

So, atoms have protons and neutrons inside them, and electrons whizzing around the outside.

And an isotope is an element with different numbers of neutrons and gives it different masses.

And some of those different numbers of neutrons will make them radioactive.

It makes the nucleus unstable and it will decay via radioactivity and it will produce either an alpha particle, a beta particle, or a gamma particle.

So what makes those alpha, beta, or gamma particles so useful for medicine?

They're little packets of energy.

Some of them produce gammas, which is just a type of light.

And that light attaches itself to the cancer and it will shine out of the body wherever the cancer is and it will be able you'll be able to pinpoint where the cancer is.

You can also use isotopes to treat cancers so that energy can be deposited into the cancer to effectively destroy it.

Okay and when it's sticking to the cancer is there any particular reason why it sticks preferentially to the cancer as opposed to any other cell in your body?

That's another good question.

Biologists work out what the little markers are for cancers compared to the rest of the tissues in the body.

And you can functionalize these isotopes with different molecules and those molecules can go and attach themselves to a cancer.

And that's particularly important for later stage cancers where the cancer has maybe spread.

It's not obviously in one place.

And just to check, it's safe, right?

Oh, absolutely.

So, you know, everyone thinks of radioactivity as dangerous and scary.

There's very small amounts going into the body, and they come out of the body as well.

They don't stay in there forever.

And if you plot it all out, nuclear medicine saved far more lives than other forms of nuclear have unfortunately ended or damaged in the past.

So nuclear medicine is a real lifesaver and saves tens of thousands of people a year in the UK.

Tens of thousands.

So, is that how many scans are being carried out using nuclear medicine?

Absolutely.

So, there's hundreds of thousands of PET scans, there's tens of thousands of SPECT scans, and that's the type of scan that uses this technetium-99 that we're short of.

We typically treat on the order of 50 to 100,000 people a year on the spec scanners at the moment in the UK.

You just mentioned a particular type, technetium.

Yeah.

So, technetium, if those who know the periodic table, there's a big hole in the middle, and there's a radioactive element there, and it's got no stable isotopes.

And that's technetium.

And that technetium-99M is what we use, it's what we put into the bodies, and it emits a gamma particle, and that's what's produced inside a nuclear reactor.

Okay, and so the shortage of that, do we know what kind of impact that is having?

Unfortunately, you know, we do 50 or so thousand treatments a year with this, which equates to something like 4,000 treatments a month.

And because the reactor in the Netherlands has been down for a month, it means that 4,000 people haven't been able to get their diagnoses.

And ultimately, that leads to premature deaths.

If you don't get your diagnosis early enough, there's more of a chance that you will unfortunately succumb to the cancer.

It's on the order of 10%.

So 4,000 equates to 400 potentially premature deaths, unfortunately.

And that's just in England?

That's just in England.

And Scotland and Wales, they use spec scanners as well.

And this isn't just a UK problem, it's a it's a global issue as well.

So this goes far beyond our shores.

Okay.

So can you talk me through this process of the reactor in the Netherlands and the patient on the table?

How do you get from one to the other?

So the reactor's just an ordinary nuclear reactor.

It's the core's about the size of a dustbin, and it's a neutron factory.

And you put a target next to it of just a stabilized tape.

And you use the neutrons from the reactor to convert that stabilized tape into the nuclear medicine.

So you whip out the target after a few days in the reactor.

You do a lovely bit of separation.

And what you produce then is a nice tape called molybdenum-99.

And you put that in something called a molybdenum cow, and that gets transported to a hospital.

That molybdenum decays away slowly.

It's got a half-life of about six days.

And that then turns to technetium-99M, which is the thing that you can remove from the molycal and put into the body.

And it shows you where the cancer is.

So it sounds on a very basic level much the same as if you put a plate into the oven to heat it up and as soon as you take it out and put it on the table it's just going to start cooling down.

Presumably

there's no storage, there's no shelf life.

Bingo, I think that's the major problem right now.

We can't stockpile these things because they decay away.

So within a week or so, the thing that you've produced in the reactor is no longer viable and won't be producing enough material for you to do your diagnostics with.

If hundreds are now dying because of delays, I mean, the obvious question is, why can't we just make our own?

And we used to be experts in this.

We had Amersham down in the south of England that used to be producing medical isotopes.

We used to be leaders in the world.

And what we can do now is we can do it again.

The Welsh government has tabled a plan to build the ARTHA project, which is a small nuclear reactor to make isotopes.

I think it's just time that we press play with this and save those lives.

And are we looking at any alternatives?

At the moment, there are no viable alternatives.

You talk to the doctors and you talk to the people that are developing these things.

And there may be alternatives 10, 15 years away.

However, we can't wait that long for treatments.

We've just got to really grab what we have in front of us and go with it.

It's very similar in the energy crisis as well.

We have the technologies available to us and we need to use them.

So if we pressed go on Project Arthur, how soon could we be producing isotopes in the UK?

It won't be very long.

And it actually gels up really nicely with those reactors that are shutting down in Europe and elsewhere.

So it's early early 2030s.

And can I ask, is there any reason why you're an expert in medical isotopes?

I had cancer in my family.

It affected me from a young age, and I just decided that this would be something that I would work towards.

Professor Simon Middleborough, Director of the Nuclear Futures Institute at Bangor University, thank you so much.

Thank you.

And the UK government's Department of Health and Social Care has told Inside Science that it is working to resolve the current shortage.

A spokesperson added, We are also working in close partnership with NHS England and the devolved governments to distribute available stock and prioritise patients with critical need.

Now, Simon, I have one final question for you as a nuclear expert.

It's a bit left field.

It's about nuclear waste.

It came from a listener.

Are you ready for this?

They asked, why don't we just throw nuclear waste into volcanoes?

That sounds rather dangerous.

I think that would be a bad idea, don't you?

Yeah, it doesn't sound like a good idea, but just to double-check, Inside Science asked volcanologist Robin George Andrews to investigate.

Here he is.

Nuclear waste, an inevitable product of nuclear power plants, needs to go somewhere that's kept far from humanity.

And for the most part, it's buried in geologic vaults deep underground.

But could there be another solution?

What if we use an active volcano, a font of incandescent rock, to dispose of this radioactive matter?

In fact, why aren't we using volcanoes already as the world's great trash annihilators?

Fiery moors that will absorb or destroy all our waste plastic that often ends up in the oceans.

In short, because it's a no-good, truly terrible, catastrophically awful idea.

But it's a popular one among the public, who quite reasonably wonder why lava can't simply chew up humanity's garbage.

Picture an erupting volcano.

What do you see?

If the crater atop that mountain has a lava lake in it, then I have some potentially disappointing news for you.

Only a handful of volcanoes around the world have lava lakes.

Pools of bubbling molten rock nestled within them.

Lava lakes are anomalies.

They are unusual spots where the rocky throat of the volcano, from its shallow magma reservoir to its surface vent, is flowing freely but calmly.

This keeps the lake at a somewhat constant level within the volcano's crater.

The overwhelming majority of volcanoes around the world spend much of their time sealed shut with a rocky rocky cap.

And even those with active lava lakes sometimes see their lakes dry up as the magmatic plumbing system below changes between major eruptive events.

When you have a significant eruption, the pathways that magma took to the surface often shift about like a maze rearranging itself.

And that can sometimes cut off the supply to a lava lake.

But okay, you're persistent.

We may only have a few volcanoes with lava lakes, but why not use those as incinerators or waste consumers?

Sidestepping the fact that a very small number of countries would have to agree to be beholden to the world's enormous pile of radioactive and other waste, some of the locations of these lava lake volcanoes are not what you'd call ideal.

One such volcano, Mount Erebus, is in a dangerously inhospitable part of Antarctica.

Another, Kilauea volcano in Hawaii, has spiritual and cultural significance to Hawaii, who would consider it more than insulting to be fed nuclear trash.

Even if you manage to circumvent these social social and geographic conundrums, then you're left with a few more problems.

And these are insurmountable because you're now fighting against the awesome power of nature itself.

Yes, lava is extremely hot.

It can be up to a thousand degrees Celsius, which melts a lot of plastic things.

But many metals are resistant to such temperatures, and radiation doesn't go away just because you've cooked the radioactive material.

Lava lakes also don't go to Earth's core.

Volcanoes, in fact, do the opposite.

They remove heat and matter away from Earth's depths and erupt molten rock, minerals, and superheated fluids from the mantle and crust atop it onto the surface world.

And therein lies the key issue.

Volcanoes erupt.

That's their whole thing.

A flaming garbage chute is going in the wrong direction.

Any radioactive waste you throw into a lava lake won't just disappear.

It'll break down somewhat, but almost immediately the intense heat of the sputtering, convulsing lake will begin re-dispersing it into the air around you.

Anything that isn't jettisoned straight away will swirl around in this hellish melange and, inevitably, will be thrown back onto the surface.

And if that volcano gets a little overexcited, on its own accord, not because of the waste you're throwing into it, then it may erupt more forcefully.

spilling its newly radioactive content back out into the surrounding environment.

You might as well be trying to throw your rubbish into the mouth of a fire-breathing dragon.

You're just just going to get burnt.

Thank you to Robin George Andrews.

And in a few weeks' time, we'll be answering a good chunk of your questions on the programme.

So if you have any science-y queries to put to us, please do get in touch at bbcinsidescience at bbc.co.uk.

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Our next guest was in her twenties when she began her seminal studies of our closest living relatives, the chimpanzees, in the Gombe National Park in East Africa.

In the decades that followed, Jane Goodall saw many changes in the climate and environment and the impact this had on chimps' habitats and behaviour.

Having turned 90 this year, it's unlikely that back at the start of her career, the young primatologist could have predicted that the climate crisis would be the most pressing concern facing the animals with whom she's developed such a unique bond.

Dem Goodall continues to travel the planet campaigning to protect the natural world, but stopped briefly in Paris where she spoke exclusively to Inside Science and my colleague Victoria Gill ahead of the COP29 climate summit.

Victoria started by asking about her enduring fascination with chimpanzees six decades on.

Well, we're now in our 64th year at Gombi and we're still finding out new things.

So we're learning more about the the different cultures.

We've been able to look at the introduction of a new tool using culture, for example, brought from a neighboring community by a female with her infant.

Really?

Chimpanzees use long grasses to fish for termites and they poke into holes in a tree and the carpenter ants come rushing out.

and the chimps pick them off the branch with their lips.

So Gombi chimps never did that until a few years ago when this female transferred in from a community that did this anting, we call it.

And then gradually her infant copied her, other infants copied that infant,

mothers picked it up, the males just didn't bother.

It's all very exciting.

Also, we're now in the beginning of the fifth generation.

So we can look back, we've got notes, careful notes, all those years and see, you know, what what behavior is inherited in the genes of an individual and what is learned during his or her lifetime.

Through your work, you,

at points controversially, you've referred to the chimpanzees as your friends and you've named them.

And I know that that approach

has raised some hackles at points, hasn't it, historically.

But I wonder, I wanted to ask you why that is a part of your approach and why that is central to your understanding and observation of these wild chimpanzees?

Well, first of all, when I was sent out to study the chimps at Gombe, I hadn't been to college.

I had no protocol to follow.

Nobody came with me.

It was me, a notebook, some old second-hand binoculars, and a pen.

That was all I had.

Well, as I've watched animals all my life, my favourite animal is a dog.

And

you don't have a dog, a cat, a rabbit, a horse, and not give him or her a name.

You know, when I studied squirrels in my garden as a little girl, they had names.

Some of my friends and I, we had stables of racing snails with numbers on their backs, but each snail had a name, not only a number.

So for me, it was just...

I couldn't imagine not giving them names.

And then, you know, describing their personalities, their minds, and their emotions.

I was told that was all wrong because those characteristics were unique to humans.

Yeah.

Do you think your

the view that you had without that the restraints in some ways of that formal training and being kind of

having those protocols that would be quite restricting?

Do you think not having those and being able to take this,

you know, maybe slightly anthropomorphic, but kind of empathic view, Did that give you

a perspective that kind of opened windows into what you were able to observe and understand, do you think?

It's not anthropomorphic.

That's attributing human characteristics to non-human animals.

I was describing what I saw in the chimpanzees and lo and behold, they were very similar to our behaviour.

What drives you to keep going?

You turned 90 this year.

You don't seem to have slowed down or stopped.

You're doing more and more work.

Well, what drives me is, first of all, I'm very passionate about the environment.

I'm very passionate about wildlife.

I'm also very passionate about the future for our children and for all the animals on the planet.

And, you know, we still have a window of time to start slowing down climate change.

and loss of biodiversity.

But it's a window that's closing.

And the latest scientific evidence says we have only five years in which to start this slowing down process.

If we don't get together, if we don't impose tough regulations on what people are able to do to the environment, if we don't rapidly move away from fossil fuel, then the future ultimately is doomed.

We have to get tougher about legislation, but also in our own lives, we have to take action too.

We can't only blame the government and big corporations.

I'd like to know your advice to our listeners about you talk about how we can change our behavior to make a positive difference too.

What would you say to people that, you know, just feel a bit overwhelmed by the problems facing nature and biodiversity and the problems of climate change and want to do something good?

If you think globally, you give up in despair because the problems are huge.

So it should be the other way around.

Act locally, get a group together, do something, plant trees, buy ethically,

and realize that every single one of us is an individual who matters, who has a role to play.

And every day we live, we make an impact on the planet.

So let's choose wisely how we live.

When you say

these threats to the environment that you've seen, I mean,

you know, over more than six decades of

being

out in Africa with the chimpanzees in this environment, what have you, it's a big question, but what have you seen change over that time?

So much I can hardly have time to describe it.

But basically, around where the chimps are, there used to be two rainy seasons, a short one and a long one.

And you could set your calendar by them.

Now there's just a rainy season and sometimes it rains in the dry season and sometimes it's dry in the wet season and it's affecting the biodiversity.

Trees are fruiting at the wrong time.

This upsets the chimpanzees and also the insects and the birds.

So I've seen that change.

I've seen decrease in chimpanzee numbers across Africa, destruction of forests.

You know, we are in the midst of the sixth great extinction.

So the more we can do to try and restore nature, the better it will be for the future.

Is there a moment that you would just love people to know that you experienced through just watching and being with these wild chimpanzees that have been, you know, your life's work, understanding and studying them and communicating just how

remarkable they are in so many ways?

Well, it was a wonderful moment when the first chimpanzee who lost his fear,

I was following him and and he sat down.

I sat down near him and lying on the ground was the ripe red fruit of an oil palm and I held it out towards him on my hand and he turned his head away.

Then I put my hand closer.

He turned, he looked into my eyes, he reached out, he took and dropped the nut with one movement and then very gently squeezed my fingers, which is how chimpanzees reassure each other.

So we understood each other perfectly with a gestural language that obviously predates human speech.

That really puts into perspective why you talk about the chimpanzees as your friends, you know, that sort of interaction.

What's that chimpanzee's name?

David Greybeard.

David Greybeard.

Thank you so much.

Jane Goodall, it's been an absolute pleasure to talk to you.

Thank you very much indeed.

Thank you.

Thanks to Victoria Gill and the irrepressible Jane Goodall.

And you can read a longer feature on Victoria's interview with Dame Goodall this weekend on the BBC News website.

Unlike the early days of AI where an extra finger or an uncanny face would give it away, AI-generated artwork has now become, to some eyes, indistinguishable from the real thing.

But can AI rival the likes of Byron and Plath when it comes to writing poetry?

A study which came out today in Nature Communications has put AI-generated poetry to the test against human-crafted poetry.

Can people tell the artificial from the natural?

Joining me down the line to go through the results is one of the authors of the study, resident fellow at the Centre for Philosophy of Science at the University of Pittsburgh, Brian Porter.

Hello, Brian.

Hi, thanks for having me.

I'm excited to be here.

Brian, I believe you're going to test my ability and at this point Radio 4 listeners can play along.

Alright, so I'm going to read two poems and you tell me if you can identify which one is AI generated and which one was written by a human poet.

Here's poem number one.

In the mirror, I see a stranger's face, hollow eyes, a grimace in place.

The smile I wear is a disguise to hide the pain that never dies.

So I retreat into my own little space, a cocoon of darkness where I can embrace the sorrow that consumes my soul and the pain that will never let me go.

That's poem number one.

Now here's poem number two.

From my rented attic with no earth to call my own except the air moats, I'm align the leaden perspective of identical gray brick houses, orange roof tiles, orange chimney pots, and see that first house as if between, mirrors engendering a spectral, corridor of inane replicas, flimsily peopled.

That's poem number two.

Can I just say I liked the second one more and really didn't like the first one, so I guess AI is the first one.

You are correct.

The first poem I read was generated by AI, and the second poem I read is Landowners by Sylvia Plath.

Oh, she's good.

I'm glad I like that.

It's interesting that you based it off of what you like, because that's one of the findings we had in our study.

So we gave participants 10 poems to read, and five of them were written by a human poet, and five poems that were generated by ChatGPT in the style of that poet.

You did a little bit better than the average, because over 69% of our participants who read the Sylvia Plath poems thought that the AI-generated poem was written by a human poet.

No.

So most people got it wrong.

What kind of reasons did people give for why they thought it was AI or not?

People were looking mostly to the emotional content of the poem.

So when people respond that a poem was written by a human, they say things like, this is a poem about love, loss, and heartbreak.

I feel these are emotions only experienced by humans.

Or for the AI generated poem I read to you, one participant said it's bleak enough to be by a human.

It's bleak by numbers though, right?

Yes, and that's actually when people correctly identify a poem as being generated by AI, the reasoning they give is often things like it sounds like it's just rhyming words or this poem seems pretty formulaic and simple.

Now people don't expect AI to be able to generate content with the nuance of human experience and your study challenges that idea.

Is that something that we should be concerned about?

So I think that as a society we should be concerned about how we are trying to identify AI-generated texts and artwork.

Because what our study really shows is that the rules of thumb that we are using are not successful.

We are still on some level expecting AI to be accurately communicating about its emotionless experience.

So people take emotional content in the poems to be a sign that it was written by a human being.

But of course, ChatGPT has read everything that's ever been written about every emotion, and it's really good at imitating it.

So I think we need to think carefully about what rules we're going to put in place for requiring transparency in the use of AI, but we also need to make a conscious effort to get better at identifying AI-generated text.

One final thing I should ask is: you know, we're still going to need actual human poets, aren't we?

Absolutely.

It's important to remember that the task that we gave to ChatGPT here was to imitate the styles of existing poets.

And I don't think any young up-and-coming poet is aspiring to successfully imitate the styles of poets that came before.

I think whether it's poetry or novels or even stand-up comedy, the goal is to say something new and original, to articulate something about our shared human experience that you as the reader or listener haven't heard articulated before or haven't heard articulated in that way.

And that's something that AI is not going to provide for us anytime soon.

So, any poet or artist, they're not going to lose their jobs to ChatGPT anytime soon.

Thank you, Brian Porter.

Thank you for having me.

And I would love to finish with something I read on social media, which is someone who pointed out that there's a lot of work that goes into developing AI that can create art and poetry, whereas what she'd like is AI that does all the cleaning and laundry so that she's got more time to make poetry and art herself.

And on that note, it's goodbye from me.

You've been listening to BBC Inside Science with me, Marnie Chesterton.

The producers were Ella Hubber and Gerry Holt, technical production was by Gavin Wong, and the show was made in Cardiff by BBC Wales and West.

To discover more fascinating science content, head to bbc.co.uk, search for BBC Inside Science, and follow the links to the Open University.

Sucks.

The new musical has made Tony award-winning history on Broadway.

We demand to be home.

Winner, best score.

We demand to be seen.

Winner, best book.

We demand to be quality.

It's a theatrical masterpiece that's thrilling, inspiring, dazzlingly entertaining, and unquestionably the most emotionally stirring musical this season.

Suffs, playing the Orpheum Theater, October 22nd through November 9th.

Tickets at BroadwaySF.com.