For David Walden, a Southern Californian, surfing is a lifestyle, not a hobby. The 38-year-old works nights at a seafood restaurant to leave his mornings free for surfing.
While the surfers are doing what they love, they are also collecting information that is helping scientists better understand the ocean.
"Once you fall in love with the ocean, you need it like a daily cleanse or refresher," he says. "The positive mental and physical effects of the ocean, the endorphins and dopamine, keep you addicted in a good way."
Given his dedication to surfing, Walden was delighted when he became one of more than 200 surfers last year to test Smartfin, a 5-1/2-inch surfboard fin that contains a circuit board, a rechargeable battery, a GPS device, a sensor that captures temperature to one-hundredth of a degree, and a motion sensor that tracks the movement of the waves. While Walden and his fellow surfers are doing what they love, they are also collecting information that is helping scientists better understand the health of the near-shore ocean and how its chemistry is shifting due to climate change.
"I'm excited to be a part of it," Walden says. "I like to tell people I surf for science."
Back on shore, the surfers download the Smartfin data via a smartphone app so they can be accessed by scientists and other interested parties. (You can see where Smartfin surfers go at this interactive map.)
By putting sensors directly onto surfboards, oceanographers can collect data to help them better understand the global-warming related changes occurring in coastal oceans in temperature, salinity, and pH, all properties that have huge implications for the species that live in near-shore ecosystems.
There is much unknown about coastal waters because it's so difficult to obtain meaningful measurements. Traditional methods to monitor the close shore, such as bottle samples and buoys, are time consuming and expensive and tend to get damaged by the surf.
The Smartfin is the brainchild of Dr. Andy Stern, a retired neurologist. He and his brother-in-law, sculptor and filmmaker Todd McGrain, run The Lost Bird Project, a nonprofit devoted to raising awareness about climate change and other environmental issues. Stern brought his super fin idea to engineer Benjamin Thompson, who spent several years creating a prototype in his garage workshop. Smartfin was further developed by scientists at the Scripps Institution of Oceanography at the University of California at San Diego.
"The big challenge was to make a sensor small enough to fit in the fin but still produce good measurements," says Andreas Andersson, an associate professor of geoscience research at Scripps.
The Surfrider Foundation, a surfer-led nonprofit environmental organization, came aboard two years ago to distribute the Smartfin to its San Diego members.
Smartfin has also made a splash with scientists at the University of the Sunshine Coast in Queensland on the eastern coast of Australia. They are using the fin's temperature sensor to better understand how climate change is affecting the movement and distribution of marine life. And at the Plymouth Marine Laboratory in Plymouth, United Kingdom, the Smartfin's precise temperature readings of the near-shore ocean's surface are being used to improve the accuracy of satellites that monitor the ocean from hundreds of miles away.
"It's hard to talk about climate change in a way that's not boring or gloomy, but there's nothing gloomy or depressing about surfers and Smartfin."
"The hope is that Smartfin will improve the satellite measurements, which could improve the retrieval of temperature data around the world," says Dr. Phil Bresnahan, Smartfin's lead engineer at Scripps. In the future, the fin will include sensors to measure pH, chlorophyll (algae), dissolved oxygen, and turbidity (water clarity).
Stern envisions a time when thousands of surfers, paddle boarders, and other water enthusiasts worldwide will have Smartfins and be downloading data for scientists and environmentalists. Right now, there are approximately 70 surfers in the San Diego area using Smartfin and an additional 30 globally.
Scientists have plenty of evidence that global warming is largely caused by humans. Now they are trying to figure out what the long-term effects of climate change may be. For example, scientists are trying to predict which sections of coral reef, which house 25 percent of marine species, are most vulnerable so interventions can be developed to save them. Because of its small size, Smartfin is ideal to measure temperature changes in coral reefs.
Smartfin was also intended to be an educational tool. "It's a great way to start a different conversation about climate change," says Stern. "It's hard to talk about climate change in a way that's not boring or gloomy, but there's nothing gloomy or depressing about surfers and Smartfin. People want to hear more."
Turning surfers into citizen scientists makes perfect sense, says David Pasquini, 35, a longtime surfer who works for the British Consulate General's office in Oceanside, Calif. "Anyone who spends a lot of time in the ocean is aware of the changes happening in the ecosystem, the climate," says Pasquini. "Everyone asks, 'What can I do?'" Surfing with Smartfin, Pasquini feels like he is giving back.
"I know the data will be analyzed and eventually used to make a policy that helps with climate change. That's a great feeling--just by surfing, doing something you love, you're contributing."
The Friday Five covers five stories in research that you may have missed this week. There are plenty of controversies and troubling ethical issues in science – and we get into many of them in our online magazine – but this news roundup focuses on scientific creativity and progress to give you a therapeutic dose of inspiration headed into the weekend.
Here are the promising studies covered in this week's Friday Five:
- Research on a "smart" bandage for wounds
- A breakthrough in fighting inflammation
- The pros and cons of a new drug for Alzheimer's
- Benefits of the Mediterranean diet - with a twist
- How to recycle a plastic that was un-recyclable
Sexually transmitted infections (STIs) are surging across the U.S. to 2.5 million cases in 2021 according to preliminary data from the CDC. A new prevention and treatment strategy now in clinical trials may provide a way to get a handle on them.
It's easy to overlook the soaring rates of gonorrhea, chlamydia, and syphilis because most of those infections have few or no symptoms and can be identified only through testing. But left untreated, they can lead to serious damage to nerves and tissue, resulting in infertility, blindness, and dementia. Infants developing in utero are particularly vulnerable.
Covid-19 played havoc with regular medical treatment and preventive care for many health problems, including STIs. After formal lockdowns ended, many people gradually became more socially engaged, with increases in sexual activity, and may have prioritized these activities over getting back in touch with their doctors.
A second blow to controlling STIs is that family planning clinics are closing left and right because of the Dobbs decision and legislation in many states that curtailed access to an abortion. Discussion has focused on abortion, but those same clinics also play a vital role in the diagnosis and treatment of STIs.
Routine public health is the neglected stepchild of medicine. It is called upon in times of crisis but as that crisis resolves, funding dries up. Labs have atrophied and personnel have been redirected to Covid, “so access to routine screening for STIs has been decimated,” says Jennifer Mahn, director of sexual and clinical health with the National Coalition of STD Directors.
A preview of what we likely are facing comes from Iowa. In 2017, the state legislature restricted funding to family health clinics in four counties, which closed their doors. A year later the statewide rate of gonorrhea skyrocketed from 83 to 153.7 cases per 100,000 people. “Iowa counties with clinic closures had a significantly larger increase,” according to a study published in JAMA. That scenario likely is playing out in countless other regions where access to sexual health care is shrinking; it will be many months before we have the data to know for sure.
A decades-old antibiotic finds a new purpose
Using drugs to protect against HIV, either as post exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP), has proven to be quite successful. Researchers wondered if the same approach might be applied to other STIs. They focused on doxycycline, or doxy for short. One of the most commonly prescribed antibiotics in the U.S., it’s a member of the tetracycline family that has been on the market since 1967. It is so safe that it’s used to treat acne.
Two small studies using doxy suggested that it could work to prevent STIs. A handful of clinical trials by different researchers and funding sources set out to generate the additional evidence needed to prove their hypothesis and change the standard of care.
Senior researcher Victor Omollo, with the Kenya Medical Research Institute, noted, “These are prevention interventions that women can control on their own without having to seek or get consent from another person,” as is the case with condom use.
The first with results is the DoxyPEP study, conducted at two sexual health clinics in San Francisco and Seattle. It drew from a mix of transgender women and men who have sex with men, who had at least one diagnosed STI over the last year. The researchers divided the participants into two groups: one with people who were already HIV-positive and engaged in care, while the other group consisted of people who were on PrEP to prevent infection with HIV. For the active part of the study, a subset of the participants received doxy, and the rest of the participants did not.
The researchers intentionally chose to do the study in a population at the highest risk of having STIs, who were very health oriented, and “who were getting screened every three months or so as part of their PrEP program or their HIV care program,” says Connie Celum, a senior researcher at the University of Washington on the study.
Each member of the active group was given a supply of doxy and asked to take two pills within 72 hours of having sex where a condom was not used. The study was supposed to run for two years but, in May, it stopped halfway through, when a safety monitoring board looked at the data and recommended that it would be unethical to continue depriving the control group of the drug’s benefits.
Celum presented these preliminary results from the DoxyPEP study in July at the International AIDS Conference in Montreal. “We saw about a 56 percent reduction in gonorrhea, about 80 percent reduction in chlamydia and syphilis, so very significant reductions, and this is on a per quarter basis,” she told a later webinar.
In Kenya, another study is following a group of cisgender women who are taking the same two-pill regimen to prevent HIV, and the data from this research should become available in 2023. Senior researcher Victor Omollo, with the Kenya Medical Research Institute, noted that “these are prevention interventions that women can control on their own without having to seek or get consent from another person,” as is the case with condom use, another effective prevention tool.
Antibiotic resistance is a potentially big concern. About 25 percent of gonorrhea strains circulating in the U.S. are resistant to the tetracycline class of drugs, including doxy; rates are higher elsewhere. But resistance often is a matter of degree and can be overcome with a larger or longer dose of the drug, or perhaps with a switch to another drug or a two-drug combination.
Research has shown that an established bacterial infection is more difficult to treat because it is part of a biofilm, which can leave only a small portion or perhaps none of the cell surface exposed to a drug. But a new infection, even one where the bacteria is resistant to a drug, might still be vulnerable to that drug if it's used before the bacterial biofilm can be established. Preliminary data suggests that may be the case with doxyPEP and drug resistant gonorrhea; some but not all new drug resistant infections might be thwarted if they’re treated early enough.
“There are some tradeoffs” to these interventions, Celum says, and people may disagree on the cost of increased resistance balanced against the benefits of treating the STIs and reducing their spread within the community.
Resistance does not seem to be an issue yet for chlamydia and syphilis even though doxy has been a recommended treatment for decades, but a remaining question is whether broader use of doxy will directly worsen antibiotic resistance in gonorrhea, or promote it in other STIs. And how will it affect the gut microbiome?
In addition, Celum notes that we need to understand whether doxy will generate mutations in other bacteria that might contribute to drug resistance for gonorrhea, chlamydia or syphilis. The studies underway aim to provide data to answer these questions.
“There are some tradeoffs” to these interventions, Celum says, and people may disagree on the cost of increased resistance balanced against the benefits of treating the STIs and reducing their spread within the community. That might affect doctors' willingness to prescribe the drug.
Turning research into action
The CDC makes policy recommendations for prevention services such as taking doxy, requiring some and leaving others optional. Celum says the CDC will be reviewing information from her trial at a meeting in December, but probably will wait until that study is published before making recommendations, likely in 2023. The San Francisco Department of Public Health issued its own guidance on October 20th and anecdotally, some doctors around the country are beginning to issue prescriptions for doxy to select patients.
About half of new STIs occur in young people ages 15 to 24, a group that is least likely to regularly see a doctor. And sexual health remains a great taboo for many people who don't want such information on their health record for prying parents, employers or neighbors to find out.
“People will go out of their way and travel extensive distances just to avoid that,” says Mahn, the National Coalition director. “People identify locations where they feel safe, where they feel welcome, where they don't feel judged,” Mahn explains, such as community and family planning clinics. They understand those issues and have fees that vary depending on a person’s ability to pay.
Given that these clinics already are understaffed and underfunded, they will be hard pressed to expand services covering the labor intensive testing and monitoring of a doxyPEP regimen. Sexual health clinics don't even have a separate line item in the federal budget for health. That is something the National Association of STI Directors is pushing for in D.C.
DoxyPEP isn't a panacea, and it isn't for everyone. “We really want to try to reach that population who is most likely going to have an STI in the next year,” says Celum, “Because that's where you are going to have the biggest impact.”