"On this week's show, Liz investigates why we're running out of antibiotics." "I think we could have a very serious problem of infectious disease." "I'm not talking about the developing world, I'm talking about the developed world too." "Dr Yan is experimenting on Members of Parliament." "I have a quick hypothetical question." "I don't do hypotheticals, Yan." " Not at all, as an MP?" "And Jem is back to his old tricks." "All in the name of science." "The energy that you see in that explosion is exactly the same energy that you produce in your body, chemically, from a packet of these." "That's Bang Goes The Theory revealing your world with a bang." "Hello." "We're surrounded by scientific terms we use every day but rarely give a second thought to." "Like these, a little number on a packet does no justice to the huge world of the calorie." "So what is a calorie?" "Well simply, it's a measure of energy." "Like we measure length in metres and mass in kilos, we measure energy in all its many forms in calories." "But what does one calorie look like?" "I know what a metre looks like, and I can estimate a kilo of weight, but what would I need to do to experience a calorie?" "The scientific definition is the amount of energy needed to heat 1g of water by one degree Oelsius." "But how about one scientific calorie in another form of energy?" "For example, a calorie of kinetic energy, that's the amount of energy a moving thing has." "What would that feel like?" "That's one calorie of kinetic energy." "What about heat energy?" "That's all around us, I've worked out that it's this piece of steel heated by 300 degrees." "That's about 300." "Ooh!" "This is a capacitor." "It's like a fast-acting battery and in it, I've stored exactly one calorie of electrical energy and to show it in its full glory, I'll release it all straight away." "There we go!" "One calorie of electrical energy." "Mildly shocking." "Gravity gives things potential energy too." "That's the energy you put into something when you use effort to lift it." "That energy stays stored until it drops, then it comes back out." "Ow!" "Right, I've now had enough of calories." "Well, enough of those calories." "I want to get to food calories." "There's big news here." "Where it says 83 calories on the front of that, it's 83 food calories but that's 83,000 scientific calories." "It admits to this in the small print on the back." "It says 83 kcal, that's 83,000 calories." "What it's saying is in here, there's 83,000 times more chemical potential energy than there is in that falling cricket ball." "Seems astonishing?" "I'd like to prove it." "I've come to a secret laboratory to meet explosives expert," "Dr Sidney Alford." "I've bought him a box of breakfast cereal and after grinding it all up, we've put it safely in the corner of Sidney's quarry." "If food really contains so many calories, he's the man to help me unleash them." "Us human beings, we get the energy out of our food by reacting it with the oxygen in the air we breathe." "But that takes quite a long time and we can't see it." "So Sidney here... has agreed to mix our flakes directly with oxygen to speed up the process a bit." "Now, this has never been done before so I'm more than a little intrigued as to the result." "Remember, Sidney's using nothing except breakfast cereal, oxygen and a little detonator to start the reaction." "Firing..." "Four, three, two, one..." "The energy that you see in that explosion is exactly the same energy that you produce in your body, chemically, from a packet of these." "And to know there's that going off in my body between breakfast and lunch is almost concerning." "I might cut down." "Not only did those explosions blow holes in the metal plates they were stood on..." "But the whole energy of the explosion just came from one mini-pack of cereal." "That's why I don't eat breakfast!" "How many calories are we talking about again?" "You're talking about 100 food calories which is 100,000 scientific calories." "Nutritionists drop the thousand." " Did they drop the thousand just to be nice?" "Just to make us feel better about what we're consuming?" "Yeah." "So 83 calories in a packet of crisps is 83,000 scientific calories?" "Yeah." "I ain't ever eating crisps again." " l'm never eating again!" "But you need that, you need 25 times the energy of that explosion in order to get you through the day." "And it's down to the definition of a calorie, which is the amount of energy required to warm just one gram of water by one degree." "And if you think, I'm essentially a sack containing 70,000 grams of water." "You're looking a bit like a sack of water." " That's because I borrowed Dallas's shirt." "Beautifully ironed as well, I'll have you know, you look very smart today." "So that's it." "To keep me warm requires all those calories." "OK, so to keep your internal body temperature 37 degrees O would need, what, millions of scientific calories then?" "Yes, or thousands of food calories depending on whether you're a nutritionist or a scientist." "It makes you wonder if there's any calories left to do anything like run for a bus or work out something because you burn calories mentally as well." "Yes, there are indeed calories left." "That's what we'll look at later on." "Looking forward to that." "Next up, antibiotics, guys." "I'm on them now." " Are you?" "I've got sinusitis." " You need to watch this then." "It's why I sound a bit funny." " You always sound like that." "Since the 1800s, scientists like Louis Pasteur have helped our understanding of where they come from, how they work and in 1928, Alexander Fleming discovered penicillin." "Since then, antibiotics have gone on to save countless lives but it now looks like we're running out of them and if we are, our fight against bacterial infections could get very nasty indeed." "Surgeons behind me are carrying out a routine hernia operation and it's more than likely that this patient will have a full recovery with no complications." "But it's easy to forget that less than 100 years ago, this kind of surgery would quite literally be a matter of life and death." "In abdominal surgery, the risk is especially high as the release of bacteria from the gut into the body is almost impossible to avoid." "But thankfully, the development of antibiotics gave us the upper hand in the battle against bacterial infection and the risk to life from something as routine as a hernia operation has been almost completely eliminated." "Antibiotics kill bacteria either by damaging their cell membranes or by interfering with their reproduction." "To obtain them, we've simply harnessed natural defensive substances released by fungi or bacteria themselves as they fight to out-compete other micro-organisms." "But it's a never-ending war, and the trouble is that right now, antibiotics seem to be on the losing side." "Bacteria seem to always be one step ahead." "Antibiotics will work for a limited time before the bacteria they're targeting become resistant and then we have to go all the way back to the drawing board to find new, effective antibiotics." "A single bacterium can multiply 200 trillion times in one day and they mutate at a very high rate so resistance can evolve incredibly fast and some scientists predict we'll run out of antibiotics in ten years." "Tony Maxwell is at the front line of the battle against bacteria." "The more you use antibiotics, the more resistance you're going to get." "The more you're forcing them to evolve?" " Yes." "And one of the worst things you can do is take a low dose or a small dose of antibiotics because the bacteria, more bacteria can then survive, you'll get more mutations and more resistant individuals so it's very important that one uses antibiotics at exactly the right dose" "and, as a doctor says, to finish the course." "So, Tony, paint a picture for me." "The world without antibiotics." "What would it be like?" "Right now, antibiotics are our best defence against bacteria." "And we'd have the spectre of old diseases, for example like tuberculosis, coming back." "I think we could have a very serious problem of infectious disease." "I'm not talking about the developing world, I'm talking about the developed world too." "So if we face a future without antibiotics, what alternatives do we have?" "I've come to Oambridge where Dr Heather Fairhead has taken on one of our biggest threats, MRSA." "And resistance won't be an issue with her solution, to attack the DNA of the bacteria using one of their natural enemies, a virus." "We use these bacterial viruses or phages, as they're called, we use them simply as couriers, a sort of postman to deliver an anti-bacterial agent to the bacteria." "So our anti-bacterial agent actually kills the bacteria from inside." "Here we have a culture of MRSA cells." " That's MRSA in there?" "It is, yes." "That's been grown overnight at 37 degrees." "The perfect body temperature for them all to grow like the clappers." " Exactly." "By the morning you can see this looks really cloudy and that's due to all the MRSA bugs in there." "So what do you do with that, then?" "To this we then add a small amount of antibiotic agent and after overnight, if you come back, the culture will have gone from that, which is just MRSA, to that which has been treated." "That shows that all the bugs are dead, then?" " Basically." "And on a Petri dish, - without the agent." "That's spectacular." "What an amazing result." "What we can get, say if that was 100,000 bacteria on there, we could get to that number within five to ten minutes." "It sounds hugely effective." "Results like this are pretty impressive, but there's still a few years of clinical trials ahead before it's safe for public release." "But it's not the only strategy, at Nottingham University they're taking a very different approach." "They're not trying to kill the bacteria, but confuse them." "For many years we thought bacterial cells behaved as individuals." "Now we know, in fact, they are very good at co-operating and causing trouble as a group, rather than as individuals." "How on earth do they co-operate together?" "Would you believe it, bacteria are basically able to communicate with each other." "The term we use to describe bacterial co-ordination is quorum sensing." "Here we have an image that's been taken over 24 hours with time lapse photography." "So each of the little bacteria, in that spot, are talking to each other." "They're starting to grow and then suddenly bang let's migrate all over the tissue." "There's this massive growth outwards and then another wave." "That second wave of activity is all the toxins that the bacteria produce that help kill immune cells, white blood cells." "How are you using this knowledge of bacterial communication to combat infection?" "Now what does an army need when it goes into battle?" "Well, it needs to have strength in numbers, it needs to have good lines of communication so it knows when it's the best time to deploy your weapons." "If you deploy them too soon then you get wiped out by the enemy." "So each cell releases a small single molecule and it can be heard by a receptor, receiver on the neighbouring cells." "We're designing molecules that look just like the single molecule but are sufficiently different to stop the signalling happening." "It's making it deaf - not killing the organism but reforming it, stopping it doing the bad things that lead to all the tissue damage." "How soon do you think we will have a very real drug to take to combat bacterial infections?" "Well, we have the molecules that work in the lab." "We need to refine their structures." "It's probably still going to be of the order of five to ten years." "You know that surgeons have been carrying out trials to figure out which ops really need them and which ops don't, to minimise the over-use of antibiotics and what they've found with keyhole surgery and improved hygiene in operating theatres," "they don't need to use them as much, which is really good - they're doing their bit in that battle against the resistance issue." "Absolutely, we all have to do our bit." "If we look at the big picture we can't just use antibiotics willy-nilly, we have to understand when it's appropriate to use them and we have to use them properly." "We can't expect us to use them and there be no consequences for misuse." "It's really important and the thing that Jem was saying earlier that how us as individuals use the antibiotics affects everybody." "And you need to finish your course." "I promise I'll finish my course." "I promise I will do that." "As a biochemist I am so amazed at the incredibly sophisticated method of infection that bacteria use." "That communication thing just blew me away when I found out about it." "And, the quorum-sensing technology is amazing because not only can it stop the receptor from receiving the signal, it can also target it from the making of the signal point of view, and also destroy the signal as it's moving towards the receptor." "So the scientists have three lines of attack from which to work and stop all this communication going on between the bacteria." "It's amazing." "What blew me away about the film is that as a species somehow we've attained enough knowledge that there are people out there able to manufacture bespoke molecules that will confuse a bacteria." "I can't quite get over that." "It's beautiful, it's the best bit of research I've seen in a long time." "With new technologies like quorum sensing and the bacteria phage technology, it doesn't really matter how much the bacterium you take because you're attacking bacteria from a different angle." "So that's a really cool thing." "Yeah, I'm always concerned about this kind of it'll never happen again scene." "I can imagine scenarios where bacteria will mutate to develop a different communication system." "They're going to want to survive." "We're not saying categorically this is the answer of all answers but, as always, scientists will be on top of that as well." "Good." "But there are no full stops in science." " No, there are not." "That's the beauty of it." "Time, ladies and gentlemen is against us." "But, luckily for us, it's time for Doctor Yan, he's on his travels again." "This week he's gone to Westminster to talk to MPs about risk." "Today I'm at the Houses of Parliament, but I'm not interested in any particular policy or the Budget." "Instead I'm looking at the risky business of decision-making and that's something really important that MPs have to do all the time." "They've been some cool psychology studies that's shown how you can influence someone else's decision simply by phrasing a question in a certain way." "I'm going to ask MPs to make a hypothetical decision." "They'll have two choices A or B and I'm going to try to steer them towards one answer just by wording the options carefully." "I've just got a quick hypothetical question for you." "OK." "Imagine that the UK is preparing for the outbreak of a new epidemic." "OK." "And it's predicted that 60,000 people are doing to die." "Not great." "Now you have to decide between two programmes, A or B, to combat the disease." "I've got a little visual aid there." "So, with programme A, 20,000 people will be saved." "With programme B, there's a 33% chance that all 60,000 will be saved, and a 66% chance that none of them will be saved." "Gut reaction which would you go for?" " Gut reaction, Programme A." "I'd go for option A." " Programme A. Programme A." "So, why was it you went for A?" "Because the chances of everybody, the full 60,000, not being saved seem too high." "So option A is clear favourite, but what happens if I ask the same question but instead of counting lives saved I count the deaths?" "Imagine the UK is preparing for the outbreak of a new epidemic." "And it's predicted to kill 60,000 people." " Yes." "Which is not great." " No." "You have to decide between two programmes, A or B, to combat the disease." "With programme A, 40,000 people will die." " Right." "With programme B, there is a 33 % chance that nobody will die, none of them, and a 66 % chance that all of them will die." "So, gut reaction, what would you go for?" "Well, the sums are the same, but I'd probably go for B." "B." " B?" "Instinctively, I would go for B." "To be honest, my instinct says, "Let's go with B,"" "because at least there's a chance that you're going to save everybody, whereas you're not going to save everybody on A." " Yeah." "Now, the interesting thing is that I asked your colleagues here exactly the same question but with slightly different options, basically." "Now, both programme As have the same result." "40,000 people die, no matter what." "And both programme Bs are the same gamble." "There's a 33% chance that none of them will die and a 66% chance that all of them will die." "But what is it that makes people go for the certainty of A in the first case but gamble on B in the second case?" "See, I find that so interesting." "All the subtle things that influence how you live your life, basically." "I think that is a really important film." "Forget about MPs for the minute." "It's important for us, I think, just to understand how we process information, how we sell ideas and, even more importantly, how ideas are sold back to us." "Oontext is king." " And wording is queen." "If you're given a choice of a fixed number of people dying, or a gamble to save people, you're going to go for the gamble every time." "Let's just look at Yan's thing again, so we can be really clear." "So here are the two options side-by-side." "The thing is, the maths is exactly the same for both." "40,000 out of 60,000 are going to die anyway, but in this option, you're being given the choice of a gain." "You're being given the choice to save 20,000 people - you're given the choice to gamble on how many can be saved, how many won't be saved." "You're going to go for the fixed option." "The gamble is perceived as negative against that beautiful word "saved"" "with the nice green man flashing... lt's positive." "Whereas here, same maths - 40,000 people are going to die anyway but you're given the choice of a loss." "40,000 people die or you can gamble that none die, and some die." "You're going to go for the gamble." "You're not going to go for that." "It's really subtle but big decisions are based on things like this." "That's why understanding how that works, I think, is vital." "Absolutely." "Absolutely." "Now back to calories, and to get a clearer picture of just how much physical work we can get out of what we eat." "People often associate calories with gaining weight, but they're vital and useful, and to investigate just how much use we can get out of them, the Bang team have come down to the banks of the River Thames." "We're going to attempt the famous Oxford and Oambridge Boat Race, fuelled by a slap-up take-out." "That's good." "But first, a crash-course in rowing, from the junior Team GB coach." "People think that rowing is all about the arms, and it really isn't." "It's about your legs and your glutes and your arms just drift in and out and finish the stroke off." "Ah." "My arms are tired." "I've done a whopping 600m and already I'm starting to flag." "Now, I ought to point out that in seven minutes," "Dallas has almost put out as much energy as that massive explosion that drove a hole through a steel plate." "Look at the man!" "Urgggghhhh!" "Then to the indoor pool to test out our strokes." "Think about rotating around the pin." "Remember, it's your glutes and your quads doing the work." "You're leaning back straight away." "Push your glutes away." "Now think about rowing half the stroke, so start bending your legs." "Take a break." " OK, so if we go back out..." "OK, now we're lean, mean, keen rowing machines." "Time to fuel up for our big challenge." "I've been reliably informed that the food I've got on that plate is what I need to complete the Oxford and Oambridge Boat Race." "Tuck in, guys." "Liz has got a Ohinese takeaway," "Yan's got a pizza and Dallas has got a lamb jalfrezi." "We reckon each meal's well over 1 ,000 food calories." "That's over a million scientific calories, but how far will that get us down the River Thames?" "Ooh." "There's no escaping that we're rowing novices." "Other way." " Sorry." "So we've got four serious rowers to guide us on the water." "Remember, the only race here is against our lunch." "OK, let's roll it over." "Ah, look at that." "Textbook." "I'm going to wear a mobile respiratory unit to monitor the oxygen I breathe in and out." "It's a really new piece of kit that'll give me an actual measure of the calories I'm using." "Our glorious leader." " OK" "Put them flat on the water. lf one and three can take a tap, please." "Keep down, middle four." "The University boat race starts at Putney Bridge... ..and powers up the river... for four and a half miles." "A mile and a half in, my monitor shows I've only needed to use up a handful of chips." "People can get a lot of work out of 150 calories." "Oome on!" "That's just a few mouthfuls of Dallas's jalfrezi." "And not even one slice of Yan's pizza." "My monitor shows I'm burning just over 800 food calories an hour." "So those fish and chips should keep me going for a good hour and a half." "After almost 30 minutes of back-breaking, leg-jarring work... ..the end of the course is in sight." "How much of those great British takeaways have we really needed?" "Let's bring it home!" " Oome on, lamb jalfrezi!" "Oome on, pizza!" "The monitor shows I used just 41 4 food calories to get me through that demanding course." "Astonishingly, that's barely a quarter of my greasy dinner." "Liz required less than half of her Ohinese meal." "Yan, just a slice and a half of greasy pizza." "And Dallas, possibly only a third of his Indian." "Definitely no poppadoms." "We'll still burn up and use those remaining calories just staying warm and getting through everyday life but if we go on routinely consuming more calories than we need on a daily basis the excess energy will eventually get stored as fat for us to use at a later date." "If you ever catch me in a boat again, I give you permission to shoot me." "Three cheers for Bang Goes The Theory." "Hip hip." "Hooray!" "Hip hip." "Hooray!" "Hip hip." "Hooray!" "What you say we head back down to the start - 1 4 minutes, double the calories?" "Let's do it!" "OK." "We'll see you soon!" "Bye!" "Ready, go!" "A-a-ah!"