This story originally appeared on CityLab and is part of the Climate Desk collaboration.

If you want an unusual but punchy telling of the world’s explosion of climate-warping gases, look no further than this visualization of CO₂ levels over the past centuries soaring like skyscrapers into space.

“₂A Brief History of CO₂ Emissions” portrays the cumulative amount of this common greenhouse gas that humans have produced since the mid-1700s. It also projects to the end of the 21st century to show what might happen if the world disregards the Paris Agreement, an ambitious effort to limit warming that 200 countries signed onto in 2015. (President Donald Trump still wants to renege on it.) At this point, the CO₂-plagued atmosphere could see jumps in average temperature as high as 6 to 9 degrees Fahrenheit, the animation’s narrator warns, displaying a model of Earth looking less like planet than porcupine.

“We wanted to show where and when CO₂ was emitted in the last 250 years—and might be emitted in the coming 80 years if no climate action is taken,” emails Boris Mueller, a creator of the viz along with designer Julian Braun and others at Germany’s University of Applied Sciences Potsdam and the Potsdam Institute for Climate Impact Research. “By visualizing the global distribution and the local amount of cumulated CO₂, we were able to create a strong image that demonstrates very clearly the dominant CO₂-emitting regions and time spans.”

The visualization begins with a small, white lump growing on London around 1760—the start of the Industrial Revolution. More white dots quickly appear throughout Europe, rising prominently in Paris and Brussels in the mid-1800s, then throughout Asia and the US, where in the early 1900s emissions skyrocket in the New York region, Chicago, and Southern California.

By the time the present day rolls around, the world looks home to the biggest construction project in existence, with spires that’d put the Burj Khalifa to shame ascending in the US, China, and Europe—currently the worst emitters in terms of volume of CO₂.

For this project, the team pulled historical data from the US Department of Energy-affiliated Carbon Dioxide Information Analysis Center. The “CO₂ emission estimates are deduced from information on the amount and location of fossil-fuel combustion and cement production over time,” says Elmar Kriegler, the viz’s scientific lead. “Therefore, the visualization also tells the history of the Industrial Revolution which started in England, spread across Europe and the United States, and finally across the world.”

Astute observers will notice a couple of troubling things, such as the huge amount of emissions pouring out of urban areas like London, New York, and Tokyo. Cities and the power plants that keep them humming remain the world’s largest source of anthropogenic greenhouse gases. Also notable: the relative absence of emissions in some parts of the planet. That isn’t necessarily a good thing. “Some regions, in particular Africa, still do not show a significant cumulative CO₂-emissions signal,” says Kriegler, “highlighting that they are still in the beginning of industrialization and may increase their emissions rapidly in the future, if they follow the path of Europe, the U.S., Japan, and recently China and Southeast Asia.”

How likely is it the worst-case scenario portrayed in this viz is nearing our doorstep? The viz’s creators argue that some current damage is here to stay. But they have some cause for optimism, too. “Reducing CO₂ emissions to zero in the second half of the century can be achieved with decisive, global-scale emissions-reductions policies and efforts,” Kriegler says. “The Paris Agreement can be an important [catalyst] for this development if embraced fully by the world’s leading emitters and powers. But as we say in the movie, the time to act is now.”

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Huntington’s disease is brutal in its simplicity. The disorder, which slowly bulldozes your ability to control your body, starts with just a single mutation, in the gene for huntingtin protein. That tweak tacks an unwelcome glob of glutamines—extra amino acids—onto the protein, turning it into a destroyer that attacks neurons.

Huntington’s simplicity is exciting, because theoretically, it means you could treat it with a single drug targeted at that errant protein. But in the 24 years since scientists discovered it the gene for huntingtin, the search for suitable drugs has come up empty. This century’s riches of genetic and chemical data seem like it should have sped up research, but so far, the drug pipeline is more faucet than fire hydrant.

Part of the problem is simply that drug design is hard. But many researchers point to the systems of paywalls and patents that lock up data, slowing the flow of information. So a nonprofit called the Structural Genomics Consortium is countering with a strategy of extreme openness. They’re partnering with nine pharmaceutical companies and labs at six universities, including Oxford, the University of Toronto, and UNC Chapel Hill. They’re pledging to share everything with each other—drug wish lists, results in open access journals, and experimental samples—hoping to speed up the long, expensive drug design process for tough diseases like Huntington’s.

Rachel Harding, a postdoc at the University of Toronto arm of the collaboration, joined up to study the Huntington’s protein after she finished her PhD at Oxford. In a recent round of experiments, her lab grew insect cells in stacks of lab flasks fed with pink media. After slipping the cells a DNA vector that directed them to produce huntingtin, Rachel purified and stabilized the protein—and once it hangs out in a deep freezer for a while, she’ll map it with an electron microscope at Oxford.

Harding’s approach deviates from the norm in one major way: She doesn’t wait to publish a paper before sharing her results. After each of her experiments, “we’ll just put that into the public domain so that more people can use our stuff for free,” she says: protocols, the genetic sequences that worked for making proteins, experimental data. She’d even like to share protein samples with interested researchers, as she’s offered on Twitter. All this work is to create a map of huntingtin, “how all the atoms are connected to each other in three-dimensional space,” Harding says, including potential binding sites for drugs.

The next step is to ping that protein structure with thousands of molecules–chemical probes–to see if any bind in a helpful way. That’s what Kilian Huber, a medicinal chemistry researcher at Oxford University’s arm of the Structural Genomics Consortium, spends his days working on. Given a certain protein, he develops a way to measure its activity in cells, and then tests it against chemicals from pharmaceutical companies’ compound libraries, full of thousands of potential drug molecules.

If they score a hit, Huber and his consortium collaborators have pledged not to patent any of these chemicals. To the contrary, they want to share any chemical probe that works so it can quickly get more replication and testing. Many times, at other researchers’ requests, he has “put these compounds in an envelope, and sent them over,” he says. Recipient researchers generally cover shipping costs, and the organization as a whole has shipped off more than 10,000 samples since it started in 2004.

Under the umbrella of the SGC, about 200 scientists like Kilian and Rachel have agreed to never file any patents, and to publish only open access papers. CEO Aled Edwards beams when he talks about the group’s “metastatic openness.” Asking researchers to agree to share their work hasn’t been a problem. “There’s a willingness to be open,” he says, “you just have to show the way.”

Is Sharing Caring?

There are a few challenges to such a high degree of openness. The academic labs are involved in which projects they tackle first—but it’s their funders that ultimately decide which tricky proteins everyone will work on. Each government, pharmaceutical company, or nonprofit that gifts $8 million to the organization can nominate proteins to a master to-do list, which researchers at these companies and affiliate universities tackle together.

That list could be a risk for the pharma companies at the table: While it doesn’t specify which company nominated which protein, the entire group can see that somebody is interested in a Huntington’s strategy, for example. But they’re hedging their bets on a selective reveal of their priorities. For several million dollars—a fraction of most of these companies’ R&D budgets—companies including Pfizer, Novartis, and Bayer buy into the scientific expertise of this group and stand to get results a bit faster. And since no one is patenting any of the genes, protein structures, or experimental chemicals they produce, the companies can still file their own patents for whatever drugs they create as a result of this research.

That might seem like a bum deal for the scientists doing all the work of discovery. But mostly, scientists at the SGC seem thrilled that collaborating can accelerate their research.

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“Rather than trying to do everything yourself, I can just share whatever I'm generating, and give it to the people that I think are experts in that area,” says Huber. “Then they will share the information back with us, and that, to me, is the key, from a personal point of view, on top of hopefully being able to support the development of new medicines,” says Huber. Because all the work is published open access, technically anyone in the world could benefit.

Edwards has pushed the SGC to slowly open up new steps of the drug discovery process. They started out working on genes, which is why they’re named a ‘genomics consortium’, then eked their way to sharing protein structures like the ones Harding works on. Creating and sharing tool compounds like Huber’s is their latest advance. “We’re trying to create a parallel universe where we can invent medicines in the open, where we can share our data,” Edwards says.

He hopes their approach will expand into a wider movement, so that other life science researchers get on board with data sharing, and open-source science improves repeatability and speeds up research findings. The Montreal Neurological Institute stopped filing patents on any of its discoveries last year. And there are other groups, like the Open Source Malaria Project, that have made a point of keeping all of their science in the open.

Sharing data won’t necessarily solve the inflating price of certain drugs. But it could certainly speed up understanding of new compounds, and shore up their chances of getting through clinical trials. The drug-making process is so complicated that if data sharing shaved just a bit of time off each step, it could save people years of waiting. The Huntington’s patients are waiting.

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Every week, two million people across the world will sit for hours, hooked up to a whirring, blinking, blood-cleaning dialysis machine. Their alternatives: Find a kidney transplant or die.

In the US, dialysis is a roughly 40-billion-dollar business keeping 468,000 people with end-stage renal disease alive. The process is far from perfect, but that hasn't hindered the industry's growth. That's thanks to a federally mandated Medicare entitlement that guarantees any American who needs dialysis—regardless of age or financial status—can get it, and get it paid for.

The legally enshrined coverage of dialysis has doubtlessly saved thousands of lives since its enactment 45 years ago, but the procedure’s history of special treatment has also stymied innovation. Today, the US government spends about 50 times more on private dialysis companies than it does on kidney disease research to improve treatments and find new cures. In this funding atmosphere, scientists have made slow progress to come up with something better than the dialysis machine-filled storefronts and strip malls that provide a vital service to so many of the country's sickest people.

Shuvo Roy, UC San Francisco

Now, after more than 20 years of work, one team of doctors and researchers is close to offering patients an implantable artificial kidney, a bionic device that uses the same technology that makes the chips that power your laptop and smartphone. Stacks of carefully designed silicon nanopore filters combine with live kidney cells grown in a bioreactor. The bundle is enclosed in a body-friendly box and connected to a patient’s circulatory system and bladder—no external tubing required.

The device would do more than detach dialysis patients—who experience much higher rates of fatigue, chronic pain, and depression than the average American—from a grueling treatment schedule. It would also address a critical shortfall of organs for transplant that continues despite a recent uptick in donations. For every person who received a kidney last year, 5 more on the waiting list didn’t. And 4,000 of them died.

There are still plenty of regulatory hurdles ahead—human testing is scheduled to begin early next year¹—but this bioartificial kidney is already bringing hope to patients desperate to unhook for good.

Innovation, Interrupted

Kidneys are the body’s bookkeepers. They sort the good from the bad—a process crucial to maintaining a stable balance of bodily chemicals. But sometimes they stop working. Diabetes, high blood pressure, and some forms of cancers can all cause kidney damage and impair the organs' ability to function. Which is why doctors have long been on the lookout for ways to mimic their operations outside the body.

The first successful attempt at a human artificial kidney was a feat of Rube Goldberg-ian ingenuity, necessitated in large part by wartime austerity measures. In the spring of 1940, a young Dutch doctor named Willem Kolff decamped from his university post to wait out the Nazi occupation of the Netherlands in a rural hospital on the IJssel river. There he constructed an unwieldy contraption for treating people dying from kidney failure using some 50 yards of sausage casing, a rotating wooden drum, and a bath of saltwater. The semi-permeable casing filtered out small molecules of toxic kidney waste while keeping larger blood cells and other molecules intact. Kolff's apparatus enabled him to draw blood from his patients, push it through the 150 feet of submerged casings, and return it to them cleansed of deadly impurities.

In some ways, dialysis has advanced quite a bit since 1943. (Vaarwel, sausage casing, hello mass-produced cellulose tubing.) But its basic function has remained unchanged for more than 70 years.

Not because there aren’t plenty of things to improve on. Design and manufacturing flaws make dialysis much less efficient than a real kidney at taking bad stuff out of the body and keeping the good stuff in. Other biological functions it can’t duplicate at all. But any efforts to substantially upgrade (or, heaven forbid, supplant) the technology has been undercut by a political promise made four and a half decades ago with unforeseen economic repercussions.

In the 1960s, when dialysis started gaining traction among doctors treating chronic kidney failure, most patients couldn't afford its $30,000 price tag—and it wasn’t covered by insurance. This led to treatment rationing and the arrival of death panels to the American consciousness. In 1972, Richard Nixon signed a government mandate to pay for dialysis for anyone who needed it. At the time, the moral cost of failing to provide lifesaving care was deemed greater than the financial setback of doing so.

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But the government accountants, unable to see the country’s coming obesity epidemic and all its attendant health problems, greatly underestimated the future need of the nation. In the decades since, the number of patients requiring dialysis has increased fiftyfold. Today the federal government spends as much on treating kidney disease—nearly $31 billion per year—as it does on the entire annual budget for the National Institutes of Health. The NIH devotes $574 million of its funding to kidney disease research to improve therapies and discover cures. It represents just 1.7 percent of the annual total cost of care for the condition.

But Shuvo Roy, a professor in the School of Pharmacy at UC San Francisco, didn’t know any of this back in the late 1990s when he was studying how to apply his electrical engineering chops to medical devices. Fresh off his PhD and starting a new job at the Cleveland Clinic, Roy was a hammer looking for interesting problems to solve. Cardiology and neurosurgery seemed like exciting, well-funded places to do that. So he started working on cardiac ultrasound. But one day, a few months in, an internal medicine resident at nearby Case Western Reserve University named William Fissell came up to Roy and asked: “Have you ever thought about working on the kidney?”

Roy hadn’t. But the more Fissell told him about how stagnant the field of kidney research had been, how ripe dialysis was for a technological overhaul, the more interested he got. And as he familiarized himself with the machines and the engineering behind them, Roy began to realize the extent of dialysis' limitations—and the potential for innovation.

Limitations like the pore-size problem. Dialysis does a decent job cleansing blood of waste products, but it also filters out good stuff: salts, sugars, amino acids. Blame the polymer manufacturing process, which can’t replicate the 7-nanometer precision of nephrons—the kidney's natural filters. Making dialysis membranes involves a process called extrusion, which yields a distribution of pore sizes—most are about 7nm but you also get some portion that are much smaller, some that are much larger, and everything in between. This is a problem because that means some of the bad stuff (like urea and excess salts) can sneak through and some of the good stuff (necessary blood sugars and amino acids) gets trapped. Seven nanometers is the size of albumin—a critical protein that keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body. Taking too much of it out of the bloodstream would be a bad thing. And when it comes to the kidney’s other natural functions, like secreting hormones that regulate blood pressure, dialysis can’t do them at all. Only living cells can.

“We were talking about making a better Bandaid,” Roy says. But as he and Fissell looked around them at the advances being made in live tissue engineering, they started thinking beyond a better, smaller, faster filter. “We thought, if people are growing ears on the backs of mice, why can’t we grow a kidney?”

It turned out, someone had already tried. Sort of.

Dialysis, Disrupted

Back in 1997 when Fissell and Roy were finishing up their advanced training at Case Western, a nephrologist named David Humes at the University of Michigan began working to isolate a particular kind of kidney cell found on the backend of the nephron. Humes figured out how to extract them from cadaver kidneys not suitable for transplant and grow them in his lab. Then he took those cells and coated the inside of hollow fibre-membrane filled tubes similar to the filter cartridge on modern dialysis machines. He had invented an artificial kidney that could live outside the human body on a continuous flow of blood from the patient and do more than just filter.

The results were incredibly encouraging. In clinical trials at the University of Michigan Hospital, it improved the mortality rates for ICU patients with acute renal failure by half. There was just one problem. To work, the patient had to be permanently hooked up to half a hospital room’s worth of tubes and pumps.

The first time Roy saw Humes’ set-up, he immediately recognized its promise—and its limitations. Fissell had convinced him to drive from Cleveland to Ann Arbor in the middle of a snowstorm to check it out. The trip convinced them that the technology worked. It was just way too cumbersome for anyone to actually use it.

In 2000, Fissell joined Humes to do his nephrology fellowship at Michigan. Roy stayed at the Cleveland Clinic to work on cardiac medical devices. But for the next three years, nearly every Thursday afternoon Fissell hopped in his car and drove three hours east on I-90 to spend long weekends in Roy’s lab tackling a quintessentially 21st century engineering problem: miniaturization. They had no money, and no employees. But they were able to ride the wave of advancements in silicon manufacturing that was shrinking screens and battery packs across the electronics industry. “Silicon is the most perfected man-made material on Earth,” Roy says from the entrance to the vacuum-sealed clean room at UCSF, where his grad students produce the filters. If they want to make a slit that’s 7 nanometers wide, they can do that with silicon every time. It has a less than one percent variation rate.

The silicon filters had another advantage, too. Because Roy and Fissell wanted to create a small implantable device, they needed a way to make sure there wasn’t an immune response—similar to transplant rejection. Stacks of silicon filters could act as a screen to keep the body’s immune cells physically separated from Humes’ kidney cells which would be embedded in a microscopic scaffold on the other side. The only thing getting through to them would be the salt and waste-filled water, which the cells would further concentrate into urine and route to the bladder.

By 2007 the three researchers had made enough progress to apply for and receive a 3-year $3 million grant from the NIH to prove the concept of their implantable bioartificial kidney in an animal model. On the line was a second phase of funding, this time for $15 million, enough to take the project through human clinical trials. Roy moved out west to UCSF to be closer to the semiconductor manufacturing expertise in the Bay Area. Fissell worked on the project for a few more years at the Cleveland Clinic before being recruited to Vanderbilt while Humes stayed at the University of Michigan to keep working with his cells. But they didn’t make the cut. And without money, the research began to stall.

By then though, their kidney project had taken on a following of its own. Patients from all over the world wanted to see it succeed. And over the next few years they began donating to the project—some sent in five dollar bills, others signed checks for a million dollars. One six-year-old girl from upstate New York whose brother is on dialysis convinced her mother to let her hold a roadside garden vegetable sale and send in the proceeds. The universities chipped in too, and the scientists started to make more progress. They used 3D printing to test new prototypes and computer models of hydraulic flow to optimize how all the parts would fit together. They began collaborating with the surgeons in their medical schools to figure out the best procedure for implanting the devices. By 2015 the NIH was interested again. They signed on to another $6 million over the next four years. And then the FDA got interested.

That fall the agency selected the Kidney Project to participate in a new expedited regulatory approval plan intended to get medical innovations to patients faster. While Roy and Fissell have continued to tweak their device, helped along by weekly shipments of cryogenically frozen cells from Humes’ lab, FDA officials have shepherded them through two years of preclinical testing, most of which has been done in pigs, and shown good results. In April, they sent 20 agency scientists out to California to advise on their next step: moving into humans.

The plan is to start small—maybe ten patients tops—to test the safety of the silicon filter’s materials. Clotting is the biggest concern, so they’ll surgically implant the device in each participant’s abdomen for a month to make sure that doesn’t happen. If that goes well they will do a follow-up study to make sure it actually filters blood in humans the way it’s supposed to. Only then can they combine the filter with the bioreactor portion of the device, aka Humes’ renal cells, to test the full capacity of the artificial kidney.

The scientists expect to arrive at this final stage of clinical trials, and regulatory approval, by 2020. That may sound fast, but one thing they’ve already got a jump on is patient recruiting. Nearly 9,000 of them have already signed up to the project’s waitlist, ready to be contacted when clinical trials get the green light.

These patients are willing to accept the risk of pioneering a third option, besides transplants, which are too expensive and too hard to get for most people, and the drudgery of dialysis. Joseph Vassalotti, a nephrologist in Manhattan and the Chief Medical Officer for the National Kidney Foundation says “the more choices patients have the better,” even though he’s skeptical the device will become a reality within the next few years. An implantable kidney would dramatically improve their quality of life and be a welcome innovation after so many years of treatment status quo. “During World War II we didn’t think dialysis would be possible,” Vassalotti says. “Now half a million Americans are being treated with it. It’s amazing the progress just a few decades makes.”

¹Correction: 12:50pm ET The Kidney Project is now slated to begin clinical trials in early 2018. A previous version of this article incorrectly stated they would take place later this year. Changes have also been made to correctly identify the size and timing of grants to the Kidney Project.

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Blame the wind, if you want. In Southern California they call it the Santa Ana; in the north, the Diablos. Every autumn, from 4,000 feet up in the Great Basin deserts of Nevada and Utah, air drops down over the mountains and through the canyons. By the time it gets near the coast it’s hot, dry, and can gust as fast as a hurricane.

Or blame lightning, or carelessness, or downed power lines. No one yet knows the cause of the more than a dozen fires ablaze around California, but fires start where humans meet the wild forests, where people build for solitude or space or beauty. Things go wrong in those liminal spaces, at the interface between the wilds and the built.

So blame sprawl, or civilization’s cycling of wilderness into rural into exurban into suburban—urban agglomerations with an ever-expanding wavefront.

Blame all of it. There’s a reason the great Californian writer Raymond Chandler called it the Red Wind—winds “that come down through the mountain passes and curl your hair and make your nerves jump and your skin itch.” Those winds blast down from the mountains and fan small fires into infernos, and sometimes those infernos maim or kill a city. In 1991 it was in the hills of Oakland. And this past weekend it was Napa and Sonoma, and the town of Santa Rosa. At least 15 people are dead. More than 1,500 houses are gone. The skies of the West are full of dust and ash.

Pushed by the wind, fires can throw burning embers a mile and a half ahead. The fire front starts moving faster than anyone can respond, jumping from ridgeline to ridgeline.

A fire’s progress through the forests and wildlands of North America isn’t exactly formulaic, but scientists understand it reasonably well. In the city, though? “Most wildland firefighters are not trained in structural protection, but the urban fire departments are not trained to deal with dozens or hundreds of houses burning at the same time,” says Volker Radeloff, a forestry researcher at the University of Wisconsin. “When these areas with lots of houses burn, the fires become very unpredictable.”

Buildings, the material bits of cities, don’t burn like woodlands. “A wildfire typically doesn’t last in one spot more than a minute or two. In grass it can be like 10 seconds,” says Mark Finney, a US Forest Service researcher at the Missoula Fire Sciences Laboratory. “But structures can burn for a long time. That means they have a long time to be able to spread the fire, to be able to ignite adjacent structures.” They throw off embers as they decompose, and those wide walls emit and transfer heat.

In Southern California, Santa Ana fires push into populated areas more frequently. They kill more people and destroy more buildings. Diablo-powered fires aren't as common in the state's northern half, but they're not unknown.

Fires happen without Santa Anas too, of course, but “they typically don’t grow bigger,” says Yufang Jin, an ecosystem dynamics researcher at UC Davis and lead author on a 2015 paper about the difference. “During summertime in southern California, the typical wind pattern blows from the ocean to inland. The wind speed is usually not that strong, and the relative humidity is usually high.” That can tamp a fire down.

During Santa Ana season, conditions are the opposite. And the particularly bad Diablo winds in the north this year come after the end of a drought that left plenty of fuel. Fire researchers sometimes fight about whether meteorology or fuel conditions are more important to wildfires; this past weekend had both—the perfect firestorm. Cal Fire, the agency responsible for wildfires in the state, has issued another Red Flag Warning for the same conditions later this week. According to a spokesperson, roughly 4,000 firefighters are already deployed.

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California housing policies are more likely to push single-family houses out into the edges of communities than encourage the construction of dense city centers. Climate change makes wet seasons wetter and hot seasons hotter—which builds fuel. “Based on analysis using climate model projections, the frequency of Santa Ana events is uncertain,” Jin says. “But all the models agree that the intensity of Santa Ana events is going to be much stronger.”

Models say the same thing about sea level rise and hurricanes. A continent away from the fires in California, cities along the Gulf of Mexico and in the Caribbean have been battered by tropical cyclones, one after the other. This year, ocean water heated by a warming climate, unusually wet weather, and a lack of the vertical wind shear that can tame a big storm combined to produce an anomalous season. It has already been a fire season and a hurricane season that are, as researchers say, consistent with models of a changing climate.

Cities are not immortal. Economics and wars can kill them, but so can storms and fires. That’s especially true if cities aren’t built to resist—if cities are built in ways that make the change worse instead of fighting it.

So keep thinking about blame as northern California rebuilds—if regulations get brave enough to insist on denser cities, less flammable materials, different ornamental vegetation, underground power lines. The risk of fire will never be zero, but everyone knows what would knock a few points off. Whether anyone will make those changes—well, the red wind makes people do crazy things.

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