Breakthrough womb surgery, and the SpaceX Moon crash

0:00Your team just added its 67th AI tool and also your 67th security blind spot. The good news? The Vanta agent works like a GRC engineer in the background, finding every app your team uses, scoring the risk, and drafting fixes for you. Vanta is the platform used by over 16 ,000 fast-moving companies like Ramp, Cursor, and Harvey, who are shaping the future with AI and staying ahead of AI risk. Get started at Vanta.com.

0:31All engine running. Absolute genius. Get this. Welcome. Welcome. This is the show where we bring you science. What that essentially means is... Discovery is the... Advances. Questions. Research. Technology. Unbelievable. Without further ado, this is The Naked Scientist. Hello, welcome to The Naked Scientist podcast, the programme that brings you the biggest breakthroughs and talks to the major movers and shakers in the worlds of science, technology and medicine with me, Chris Smith. On the way, doctors operate to fix a developing baby still inside the womb. So how did they do it? Also, the crafty tricks that gambling machines use to take the sting out of losing and make you bet big.

1:10And lunar littering or a fortuitous space crash. Why a chunk of SpaceX rockets slamming into the moon might actually help to unlock the history of previous impacts and craters.

1:30first this week a team of doctors have used groundbreaking surgery on an unborn baby to successfully correct a birth defect called gastroskisis while he was still inside the womb the baby's mum Maisie Savage who's from London was operated on by doctors in the US while she was 26 weeks pregnant. Sandeep Kaswani and his team at Texas Children's Hospital performed the operation. Gastroschisis is the most common congenital abdominal wall abnormality. It's when babies are born with their intestines outside of their body. It's actually a normal part of development and it just doesn't happen in these kids where the intestines and say you and I were outside and now they don't go back in in these kids.

2:10So the abdominal contents would normally develop outside the body. They retreat early on in development. and in this case that closure had not happened so all the intestines and things this is the baby inside mum were still outside and they shouldn't have been that is absolutely right but it's not necessarily that fact the defect because surgeons can close that the problem is is that by the time that the baby is delivered the intestines don't work those babies stay on for three to six months in the NICU they go on to you know feeding difficulties till they're four or five years old And then they also can go on to intestinal transplant and even one in 10 babies die in the US.

2:47So in good children's hospitals, the outcome still isn't great. And how have you sought to intervene? We're trying to get to the baby to the problem before it becomes a real problem. And so in the middle of gestation, around 26 weeks, the goal is to go into the mother using this keyhole surgery and put the bowel back into the baby, basically anatomically correcting it the way we do it postnatally, but doing it in the middle of gestation or during the pregnancy so that the baby can then recover for the next, hopefully, 13 to 14 weeks before the baby is then eventually delivered. How on earth do you do that?

3:21Because if we think about the anatomy, you've got the mum's abdomen and inside her pelvis is her uterus, the womb, and inside there is a bag of fluid made by the baby with a baby inside it. So you've got to operate through the abdominal wall of the mum, the wall of the uterus, the bag of fluid the baby's in, and then into the baby. But when you put it like that, you make it sound so hard. Now, it is to do that, to make it through all of that first, in transparency, we actually open the mother's abdomen so that we can see the uterus. And the uterus at 26 weeks is above the level of the belly button.

3:53So it's there in your plain side of view. But now with the differences and the advances, instead of making a large incision on the uterus to get to the baby, what we do is we use little almost like straws and we put these laparoscopic instrumentation in to then be able to access the baby. we then take out that fluid that you mentioned and we instill air instead so it's carbon dioxide and so we insufflate this uterus and the uterus is relaxed so it becomes like a balloon and it gives you an operative field and now you're looking at the baby and what we do is we slowly and very gently push the intestines back into the where the umbilicus is now the one thing you didn't mention was the umbilical cord because you still need that because that's where all the blood supply comes from the mother to the baby.

4:40So we now have to stitch and close this defect at the same time making sure that we don't hit those or injure those vessels that are critical, essential to this baby's life. And then we close the defect and then we put the amniotic fluid back in, we take our ports out, close the mother, and then hopefully she goes on for the rest of her pregnancy. Is it easy to spot the umbilical cord and tell it apart from the developing intestines? Absolutely. It looks very, very different. It's like the size of a fettuccine and the defect that we're pushing it in is the size of, say, an eraser head. And so you're slowly pushing this very overcooked fettuccine because it's very, very soft.

5:17And the umbilical cord, on the other hand, is almost more like a rope-like structure because it has the two arteries and the vein in it. And so you can clearly see what that is. It has a very different texture, a very different look. How big is a 26-week gestation baby? About 600 grams, usually between 500 and 700 grams. So is that sort of slightly bigger than a human hand? Oh, sorry. Exactly. The size of a human hand. And are those intestines not incredibly fragile? Because I'm just thinking you've got your instruments, these little, you put it very well, there's straws going in there. Is this not like trying to eat a bowl of fettuccine with chopsticks?

5:53How on earth do you manipulate them and get them back in that tiny hole to fix everything? Well, one, I would say there are probably many people listening to this show today that think that they could eat fettuccine with chopsticks. So that comes with practice and it comes with understanding the structure, the biomechanical strength, so to say, of that fettuccine. And so the way we did that is we actually worked with bioengineers and developed 3D printed models of what this was going to look like. And we did biomechanical testing on these polymers that we had made the intestines out of. This is like obviously a practice model before we do it.

6:31So we've gotten some pretty good tactile feedback from our 3D printed models to be able to tell us what we're doing is right. And I will tell you, it's pretty accurate. When I've done it now in humans and in real form, it's very much like the simulator. And when you get the intestines back where they should be, do you close up? Because they're wrapped up inside the individual, aren't they? So do you close that up when you close the baby's abdominal wall up then? And then are they destined to work properly thereafter if you do this? One of the features of gastroschisis is there is no sac. When there is a sac, it's called an omphalocele.

7:07That is a much larger defect and probably not amenable to a surgery like this, at least not yet. However, when you do put the bowels back in, there is the peritoneum in the skin, which the peritoneum is that inner lining of the abdominal cavity. We just close the skin itself and bring it together. I think the question, the last question that you asked is really the important one. Is this going to work? And no matter how much modeling over the last 10 years that we had done, you never were going to know until you actually did it. Because there is no animal model. There's no 3D printed model. There's no clinical experiment that you could do to actually tell you that this was going to restore intestinal function.

7:48And when we took this to the U.S. government, the FDA that's approved this study, they agreed with that. They said there's just nothing else you can do until you now do it in humans. And that's where we are. And what we've seen in the three patients that we've done is that indeed it does. Indeed it does. It causes the intestines to function normally at birth, at least has that potential. And certainly in this last patient that we did, the last two that we've done, the babies come out of the womb and they start feeding right away, just like a normal baby. They're on goal feeds by two days. and they're going home at three or four days just like any other normal baby with their intestines working it's a great story isn't it although i shall never look at a bowl of fettuccine in the same way again that was surgeon sandeep kaswani at the texas children's hospital astronomers have warned about the long-term effects of space debris after a huge abandoned rocket part hit the moon this week spacex's falcon 9 rocket was launched last year its upper section which weighs 4 ,000 kilograms, was shed into space as planned but deviated onto an accidental collision course with the lunar surface.

8:54Thankfully, it didn't wipe out Neil Armstrong's iconic footprints but an impact of the future might and that is why we need to be careful what we do up there. Nevertheless, impacts like this do have a silver lining because it can help to unpick the anatomy of previous natural collisions and what caused them. Here's space scientist Megan Argo with the intel. So this is a rocket body that's been in a high orbit around, an elliptical high orbit around the Earth and the Moon since early 2025. Its original aim was as part of a mission to take two lander spacecraft to the Moon. So this was a SpaceX Falcon 9 rocket that took off in January 2025.

9:38it's a two-stage rocket so the the lower stage of the rocket the the main core stage of the rocket is the bit that gets you from the launch pad into low earth orbit and that part of the rocket is reusable so that stage once it had done its job and taken the upper stage and the landers into low earth orbit it returned to the ground landers on one of spacex's barges and has been refurbished for reuse the upper stage of the rocket is the bit that takes the spacecraft off to the moon that requires an extra injection of energy to get you out of Earth's orbit and off towards the Moon. Once it had done its job, which it did successfully, then it was no longer useful.

10:15So it separated from the spacecraft, sent them on their way, they went off and landed on the Moon's surface, and it was left basically just in whatever orbit it was in at the time when it separated from the spacecraft. Now, ever since, it's been in this elliptical orbit, and the combined effects of the gravitational pull from the earth the gravitational pull from the moon and a slight pressure the less slight radiation pressure that you get from sunlight has conspired to alter the orbit of this rocket body until yesterday morning it hit the moon surface and created a brand new crater how fast was it going and how much does it weigh so in other words how much energy would it have had when it slammed into the moon so it weighed we think about 4 000 kilograms um its exact mass is not 100 known because we don't know exactly how much unspent fuel was left on board so that will have affected its mass and its dynamics slightly um in terms of its velocity it would have been traveling um a couple of kilometers per second which sounds fast but compared to the rocks that normally hit the moon's surface that's actually a pretty slow collision is that about five six thousand miles an hour something like that yeah that that kind of order of magnitude yes um so it's yeah fast by everyday standards but still slow compared to most of the rocky debris that's floating around the solar system that hits the moon on a daily basis the si unit of how hard things hit things is usually expressed in tons of tnt isn't it so have we got a tnt equivalent for this oh there is but I'm not sure what it is actually.

11:52It must be quite big. But when it slams into the moon's surface then, I mean, is this just littering on a cosmological scale and really naughty? Or does this serve a scientific purpose? Can we actually use this now this has happened to further science? It's space junk, it's debris that in an ideal world would not have accidentally landed on the moon's surface, would have been put in a safe orbit that would have kept it well away from anything important. But as it has impacted on the moon and it was predicted months in advance it was going to impact on the moon surface where it was going to impact and the time it was going to impact there was lots of opportunity for observatories around the world to decide how they were going to observe it and the first data that i've seen from it i haven't yet seen images a lot of people were trying to get images of the impact there was a lot of uncertainty as to whether there would be an impact flash we know impact flashes happen on the moon surface again on a regular basis the artemis 2 astronauts earlier this year they saw impact flashes when they were around the far side of the moon surface and the side of the moon that's in shadow from the sun and these are when rocks that are flying around the solar system at you know much higher velocities impact the moon surface part of that energy is converted into light and you see an impact flash and again from the earth we see those impact flashes as well when the on the parts of the moon surface that are in darkness this would have been a less bright impact anyway but the impact also happened on a part of the moon surface that was in full daylight in fact it was almost noon i think at the position where the the impact occurred so the chances of us actually seeing the impact flash were pretty slim but what did happen was a lot of material was kicked up in this impact so a new crater was formed which we will hopefully get images of from lunar reconnaissance orbiter sometime in the next few days which has got obviously images lots of images of the location taken before the impact because it's been in orbit around the moon since 2009 imaging the surface so we'll get after images hopefully in the next few days where we'll see the exact size of the and shape of the crater that's been formed here but all the material that was kicked up from the surface lots of rocky debris um were sent some of it many kilometers into space from the moon's surface and that plume of material was also being imaged from the earth as well so So observatories that were in darkness at the time, so places in the Americas had darkness at times.

14:13They were in the best position to try and image this plume. And the first data that we've seen comes from the European Southern Observatory. So one of their telescopes at Paranal actually took spectra of the moon before and during the collision and just after the collision. And what they've seen in their spectra is evidence of sodium and lithium lines, emission lines that were not there prior to the impact. So what they think is that the sodium was from the lunar debris itself, from the material, from the rocks that were kicked up in the explosion. And the lithium is from the rocket body itself.

14:46So lithium is a common constituent of batteries, for example. So plenty of heavy metals involved in that rocket body. So that's the first data that I've seen. And the interesting thing about all of this information is, the images and the spectra, is it helps us understand these impacts on the moon's surface. we know that rock hits the moon's surface on a daily basis but what we don't know in advance is the size and velocity of those rocks doing the impacting so we can see the craters that performed but we don't know much about the impactors that cause them here we know the properties of the rocket to a high degree of precision so we know its size its shape its mass to within you know a few hundred kilograms and we know its trajectory so we know its velocity and we know that it was tumbling as well so we know the impact parameters so by comparing the properties of the crater that we see with the properties of the impactor here we can use that to help us understand better some of the other impacts that we see on the moon surface so you can sort of post-mortem the other craters and backtrack on their history what what must have caused them and if we know roughly how old they are that tells us what sorts of things must have been floating around on a moon impacting course at that point in history.

15:58Yes exactly it helps us validate some of those models so that we have seismometers on the moon so this was a common thing during the Apollo days as well Apollo missions that landed left behind seismometers that were active on the moon surface for many years after the Apollo missions ended and they were registering moon quakes from the regular impacts that happened in fact some of the Apollo rocket bodies also impacted the moon deliberately to to provide data on those seismometers as well um so a lot of modeling has been done about impacts on the lunar surface and the differences between impacts that land in rocky regions where you're actually landing on bedrock and other regions where you're landing in deep regolith that lunar soil that that fine dust which can be many many meters deep in places but validating those models requires us to have impacts like this one when we know what the properties of the impactor are in the first place and can compare that data with what we see on the ground.

16:53It's amazing what you can learn from a clapped out lump of old rocket, isn't it? That was Megan Argo there.

17:01Your team just added its 67th AI tool and also your 67th security blind spot. The good news? The Vanta agent works like a GRC engineer in the background, finding every app your team uses, scoring the risk and drafting fixes for you. Vanta is the platform used by over 16 ,000 fast moving companies like Ramp, Cursor and Harvey, who are shaping the future with AI and staying ahead of AI risk. Get started at Vanta.com.

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17:50This is the Naked Scientist podcast with me, Chris Smith. Now, we're halfway through today's programme, so I wanted to share some of the other great content that we publish each month, like our Naked Astronomy podcast strand, which is put together by the fantastic Space Boffins. If you're interested in space science stories, then do give that a look and listen. It's at nakedscientist.com forward slash astronomy, or just look up Naked Astronomy wherever you get your podcasts. Now, anyone who's ever been to a slot machine arcade knows that these places are an audio-visual extravaganza. There's lots of bright, colourful, flashing and blinking lights, coupled with exciting sounds and usually a thudding, drumbeat-led music.

18:31Now, this is all designed to draw you in and persuade you to part with your money. And in that, it seems to be a very successful strategy. Brett Hathaway at NIH has found that rats can be encouraged to make much riskier high-stakes, but ultimately higher loss rate decisions when the wins are associated with rich light and sound stimuli. But it isn't that the sounds and lights reinforce the winning. Surprisingly, the effect seems to be working by making the losses less painful. We were really interested in understanding cognitive processes that underlie a key effect that we found that adding salient lights and sounds to a risky decision-making task in rats increases their risky choice.

19:17I mean, adding sound and light, Brett, I mean, it makes it sound like gambling machines. Yes, that's exactly correct. We know from the human research that there's something about these electronic gaming machines or slot machines that really increase the state of immersion and can be particularly challenging for those with gambling disorder. So we're really trying to understand, you know, what is the effect? Of course, you know, we all know that these machines have tons of sensory stimulation going on. So what exactly is the effect of that on the decision making process? How did you test it? What did you do with the rats?

19:49We use six different variants of this rat gambling test. So on this test, there's four different options they can choose from. Two of them are low risk, low reward. So they actually maximize the ability to earn sugar pellets over time versus the two other options are high risk, high reward. So they win more on a single trial, but they're more likely to lose. And when they lose, they go into this long timeout penalty. So they actually lose out on the maximum number of sugar pellets that they can earn. And if you compare all of those tasks side by side, you're saying that the low risk ones actually, if played consistently, would lead to a bigger reward than if you take the higher risk.

20:27Although you're occasionally going to get more lucky, overall, you're less lucky because the reward total is lower. That's exactly right. And so for a gambler with a gambling problem or a company running a gambling arcade, they want the gambler to take the high risk option, low reward for them, high reward for the person running the gambling machine. The gambler's ideal choice would be the lower risk option. Yeah. So the designers of these machines are trying to obviously maximize their own wins. So they want people to getting that balance between keeping people engaged and essentially thinking they're winning.

21:01Whereas in reality, it's the slot machine companies that are winning out overall. So just played normally then, what do the rats do? Without any win associated cues in the task, they actually are able to determine that these low risk, low reward options are better and they maximize their choice of those options. they'll still sample the other ones a little bit, but overall, the majority of the time, they're going to choose these low risk, low reward options. They don't have much trouble figuring that out in the unqueued version of the task. So then what did you change? We have a version of the task where we add win associated cues.

21:35So this is across all four options, any trial that they have a winning outcome and get those sugar pellets, there's a light and sound compound cue that is going to be played. In the standard version, these cues scale in length and complexity with reward size. So the low risk, low reward options have just, you know, one or two tones and one or two lights that flash, whereas the high risk options, when they get that bigger reward, there's sort of a seven to eight tone that varies in complexity across trials that will play. And so we know that that version can result in a higher number of rats going for those risky options.

22:08When you make the rats get a really rich win like that with lots of stimulation, all those sounds and lights, and it's very dense and complex, that reinforces the choice they made. So if it was a high risk choice, and they got a massive great win, it pushes them towards doing that again. That was kind of the hypothesis that we had before we did this current study that because the cues are on the wins, it must be something about getting this really rich sensory information on the wins is going to, you know, overemphasize those. And that results in repeating that choice. But actually, from this study, it looks like it somehow changes the processes of the losses, they actually aren't able to integrate that information into the sort of value of that option.

22:53And so that is what's driving them to repeat that choice. That's really interesting, isn't it? Because we've all thought that it's the dopamine and adrenaline rush of the win. But you're saying it blunts the sting of the loss. yes exactly um and that's true so in this study we also included a version in which we cued both the losses and the wins and we still got the risk inducing effect and we still saw that effect where they aren't attending to or able to integrate those losses yeah what led you to that conclusion because i can see how the experiment leads you to the conclusion where we reinforce a risky decision with all these extra stimulations when they win and that would encourage them to do it more but i don't see how you were led to conclude that the losses are less painful.

23:37We used a method called computational modeling to basically come up with algorithms that should somehow represent the underlying cognitive process that the rats are using to come to these decisions. And we were able to use this technique to show that we can produce data just from that model that matches what the rats do. And we were able to see that we had two different learning rates. So we had a learning rate for rewards was essentially when you get a winning outcome, how much is that going to update, how much you value that option. And so we split out that learning rate for rewards and punishments.

24:10And we found that across these different tasks, having any version of a task where wins are associated with cues, that seems to decrease punishment learning rates. So they're not learning as much from those losses. Does the same apply in humans? So if you look at our behaviour when we're addicted to gambling or we tend to go into a gambling situation? Do humans seem to do what the rats do? And therefore, do you think the same cognitive mechanism is at play? So we have a couple of lines of evidence that suggest that is the case. Someone else in the lab translated this task into humans and looked at the effect of when associated cues.

24:46And we actually did replicate the effect in humans. I think the most sort of direct application of this to what goes on in a slot machine is this idea of losses disguised as wins, which is essentially where they play a win-associated cue. You've won some amount of money, but you haven't won as much as you bid in the first place. So it's actually a loss, but they play these sounds and lights as if you've actually won. And that seems to be a real driver of both gambling disorder and increasing the length of play and actually alters your perception of how much you think you've won and lost. So I think that's some indication that these same processes are going on in humans and particularly in gambling disorder.

25:24Really interesting that isn't it? Brett Hathaway from our eLife series of podcasts you can get more from that at nakedscientist.com forward slash eLife or look up the eLife podcast wherever you get your podcasts. Holiday makers in the US and Europe have been warned about recent surge in cases of a foodborne intestinal parasitic infection called cyclosporiasis which causes extremely unpleasant prolonged bouts of explosive diarrhea. apologies to anyone eating right now an outbreak in the United States has infected tens of thousands of people across most of the country's states and two people with underlying health conditions have also died from it the culprit appears to be Mexican lettuce which has somehow become contaminated with the parasite presumably from a sewage source Lisa Kachara is a biomedical scientist at Quinnipiac University and she's just penned a piece about the outbreak for the conversation So this particular agent is a parasite and it is something that is spread only through human feces.

26:28It is something because somehow or another somebody probably did not wash their hands and has gotten into our food processing system. The only host then is a human. Correct. And where are we having problems with it at the moment? So we're seeing cases of this particular cyclospora parasite in the UK, in over 35 states in the United States. So it is indicating that there is something that is of a global scale. What do we think the source is? As in when scientists and medical epidemiologists see this kind of thing happening, they usually go after the source. So what do we think that might be? So going after the source seems easy, right?

27:10Like we just track something back. But what did you eat three weeks ago? It becomes something that becomes a little harder to be able to kind of pinpoint the exact source. For this particular outbreak, the source has been linked to lettuce, especially lettuce that's kind of more mass produced, going out to restaurants, going out to fast food chains, going out to supermarkets. It's not likely your local produce because that is something that kind of has an internal level of possibility of contamination. Outbreaks in the past of cyclospora have been lettuce, raspberry, spinach, cilantro, basil. But it's really taken a while for the epidemiologist to kind of figure it out.

27:51It's a very lengthy seven-page questionnaire that you ask somebody that has self-identified with kind of having this explosive diarrhea. and then you're trying to figure out what is the pathogen, what's the germ that's actually causing this, and then what is the commonality of people, what did they actually eat. So it takes a while. Do you remember what you ate three days ago, let alone a week ago or three weeks ago? So it takes a long time in these types of situations to be able to kind of track back the source. Lettuce doesn't catch this parasite, so it must be on the lettuce. So it's sewage getting onto the lettuce.