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Complementary and Alternative Medicine Market Highlighting Regional Revenue Share Dominance During 2019-2029 – Fusion Science Academy

Posted on January 19, 2020 by Danzig

Global Digital Talent Acquisition Marketwas valued US$ 41.2 Bn in 2018 and is expected to reach US$ 79.6 Bn by 2026, at CAGR of 8.58% during forecast period.

The digital talent acquisition market is projected to be driven by increasing innovations and technological advancements. As the Big Data analytics industry quickly grows to include mainstream customers, technologies like Hadoop and cloud solutions are in demand and they have growth potential. So, it is expected to boost the digital talent acquisition market in the near future. An enormous amount of structured and unstructured data is available in firms owing to increased Internet adoption and they need digitally skilled people to manage the same.

Limited awareness regarding benefits of digital skills is hindering the development of digital talent. Some end-users are still not aware of the importance of digital skills. Despite the evolution of technology, the adoption of tools associated with digital skills still remains challenging. So, it is restraining the growth of the digital talent acquisition market globally.

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Based on skill segment, AI developers are fastest growing sub-segment in the digital talent acquisition market owing to numerous platforms have been created to upscale digital talent skills over the years, like the emergence of AI in talent management. In recent years, organizations are using AI for pre-hiring assessments and to give employees with projects that need their specific skills. Companies are shifting toward AI and machine learning and upscaling their skills to gain a competitive benefit in the digital talent industry.

Region-wise, North America is expected to leading the market for a digital talent acquisition during the forecast period. Growth in data volumes drives analytical skills as well as needs software specialists. Thus, exponential growth in data volumes is expected to drive the digital talent acquisition Industry in the region.

Accenture, IBM, SAP SE, Oracle Corporation are some of the prominent players in the global market for digital talent acquisition. IBM Corporation is an international company that manufactures and markets products like computer hardware, middleware, and software along with hosting and IT consulting services. The company proposals AI-powered talent management solutions with the help of IBM Watson.

A recent development in Global Digital Talent Acquisition Market: In 2017, Accenture PLC acquired data analytics company Search Technologies. Accenture is expected to the association the analytical technologies of Search Technologies with its AI and data analytics capabilities.

The objective of the report is to present a comprehensive assessment of the market and contains thoughtful insights, facts, historical data, industry-validated market data and projections with a suitable set of assumptions and methodology. The report also helps in understanding Global Digital Talent Acquisition Market dynamics, structure by identifying and analyzing the market segments and project the global market size. Further, the report also focuses on the competitive analysis of key players by product, price, financial position, product portfolio, growth strategies, and regional presence. The report also provides PEST analysis, PORTERs analysis, and SWOT analysis to address the question of shareholders to prioritizing the efforts and investment in the near future to the emerging segment in Global Digital Talent Acquisition Market.

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Scope of the Global Digital Talent Acquisition Market

Global Digital Talent Acquisition Market, by Skill

Data Managemento Data Analyticso Big Datao Master Data Management Web Presentationo User Interface Designo App Developmento Web Development AI Developers Cloud Computing & SecurityGlobal Digital Talent Acquisition Market, by Training Type

Internal ExternalGlobal Digital Talent Acquisition Market, by Enterprise Size

Small Enterprises Medium Enterprises Large EnterprisesGlobal Digital Talent Acquisition Market, by End-user

Bankingo Retail Bankingo Wholesale/Corporate Bankingo Investment Bankingo Private Banking Insuranceo Life & Pensiono Property & Casualtyo Healtho Reinsurance Retail IT & Telecom Serviceso Mediao Professional Serviceso Real Estate/Facility Managemento Tourism Government & Defense Manufacturingo Automotive & Discrete Manufacturingo Process Manufacturing LogisticsGlobal Digital Talent Acquisition Market, By Region

North America Europe Asia Pacific Middle East and Africa South AmericaKey players operating in the Global Digital Talent Acquisition Market

Skillsoft Limited Engaging Ideas Pvt. Ltd., The Training Associates Corporation, Hortonworks Inc., Data Science Council of America, BrainStation Inc., Accenture, IBM Corporation, SAP SE Oracle Corporation. Microsoft (Linkendin) Upwork iCIMS Ultimate Software CornerStone Workday ADP

MAJOR TOC OF THE REPORT

Chapter One: Digital Talent Acquisition Market Overview

Chapter Two: Manufacturers Profiles

Chapter Three: Global Digital Talent Acquisition Market Competition, by Players

Chapter Four: Global Digital Talent Acquisition Market Size by Regions

Chapter Five: North America Digital Talent Acquisition Revenue by Countries

Chapter Six: Europe Digital Talent Acquisition Revenue by Countries

Chapter Seven: Asia-Pacific Digital Talent Acquisition Revenue by Countries

Chapter Eight: South America Digital Talent Acquisition Revenue by Countries

Chapter Nine: Middle East and Africa Revenue Digital Talent Acquisition by Countries

Chapter Ten: Global Digital Talent Acquisition Market Segment by Type

Chapter Eleven: Global Digital Talent Acquisition Market Segment by Application

Chapter Twelve: Global Digital Talent Acquisition Market Size Forecast (2019-2026)

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Complementary and Alternative Medicine Market Highlighting Regional Revenue Share Dominance During 2019-2029 - Fusion Science Academy

Complementary and Alternative Medicine Market by Product Type, by Application, by Geography Forecast to 2028 – Fusion Science Academy

Posted on January 19, 2020 by Danzig

Steel Wire Rope Market Trends, In-Depth Research on Market Size, Emerging Growth Factors, Global 2020 Trends and Forecasts 2025

The Steel Wire RopeMarket report is one of the most comprehensive and important dataabout business strategies, qualitative and quantitative analysis of Global Market.It offers detailed research and analysis of key aspects of the Steel Wire Ropemarket. The market analysts authoring this report have provided in-depth information on leading growth drivers, restraints, challenges, trends, and opportunities to offer a complete analysis of the Steel Wire Ropemarket.

The researchers have considered almost all important parameters for company profiling, including market share, recent development, gross margin, future development plans, product portfolio, production, and revenue. The report includes detailed analysis of the vendor landscape and thorough company profiling of leading players of the Steel Wire Rope market.

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Leading players covered in the Steel Wire Rope market report: WireCo World Group, Tokyo Rope, Kiswire, Jiangsu Langshan, Guizhou Wire Rope, Fasten Group, Usha Martin, Bekaert, Xinri Hengli, Bridon, Juli Sling, Jiangsu Shenwang, Shinko, Xianyang Bamco, DSR, Jiangsu Safety, Gustav Wolf, Ansteel Wire Rope, YoungHeung, PFEIFER, Teufelberger, Hubei Fuxing, Redaelli, Haggie, DIEPA, Brugg and More

Product Type Coverage (Market Size & Forecast, Major Company of Product Type etc.):Left Regular LayLeft Lang LayRight Regular LayRight Lang LayAlternate LayApplication Coverage (Market Size & Forecast, Different Demand Market by Region, Main Consumer Profile etc.):Oil & GasFishing & MarineMiningStructuresIndustrial & Crane

The global Steel Wire Rope market is analyzed across key geographies namely: North America, Europe, Asia-Pacific, South America, Middle East and Africa. Each of these regions is analyzed on basis of market findings across major countries in these regions for a macro-level understanding of the market.

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The latest report added by Market Info Reportsdemonstrates that the global Steel Wire Rope market will showcase a steady CAGR in the coming years. The research report includes a thorough analysis of market drivers, restraints, threats, and opportunities. It addresses the lucrative investment options for the players in the coming years. Analysts have offered market estimates at a global and regional level.

Major Points Covered in TOC:

Overview: Along with a broad overview of the global Steel Wire Rope market, this section gives an overview of the report to give an idea about the nature and contents of the research study.

Analysis on Strategies of Leading Players: Market players can use this analysis to gain competitive advantage over their competitors in the Steel Wire Rope market.

Study on Key Market Trends: This section of the report offers deeper analysis of latest and future trends of the Steel Wire Rope market.

Market Forecasts: Buyers of the report will have access to accurate and validated estimates of the total market size in terms of value and volume. The report also provides consumption, production, sales, and other forecasts for the Steel Wire Rope market.

Regional Growth Analysis: All major regions and countries have been covered in the report. The regional analysis will help market players to tap into unexplored regional markets, prepare specific strategies for target regions, and compare the growth of all regional markets.

Segmental Analysis: The report provides accurate and reliable forecasts of the market share of important segments of the Steel Wire Rope market. Market participants can use this analysis to make strategic investments in key growth pockets of the Steel Wire Rope market.

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Complementary and Alternative Medicine Market by Product Type, by Application, by Geography Forecast to 2028 - Fusion Science Academy

NutriDrip, ahead of funding round, sets up aging and hangover treatments at Wynn Hotels, Equinox – CNBC

Posted on January 19, 2020 by Danzig

At Clean Market in Midtown, New Yorkers have a wide menu of healthy offerings to choose from, such as "superfood smoothies" and bowls with a side of a "moon dust of choice."

But if clean food isn't enough, customers can also get a boost from vitamins delivered intravenously at the NutriDrip bar. The service is growing in popularity and attracting customers from fitness and lifestyle companies like Equinox to some major hotel chains.

NutriDrip sells 15 vitamin infusions administered by medical professionals via an IV drip that takes about 30 minutes. The Nutribody drip aims to support fat loss with a combination of l-carnitine, taurine, vitamin C, B complex, among others. There are also the popular hangover remedies Basic Recover, Super Recovery and Mega Recovery which range in price from $119 to $199 depending on how much you're hurting from the night before. The Nutriyouth drip claims the ability to "help stop cellular aging in its tracks" with a mixture of anti-aging enzymes, molecules and vitamins for $599.

Founded five years ago, NutriDrip is looking to expand in 2020 with a Series A funding round in the first half of this year. Executives declined to say how much money they're looking to raise.

"Over the last three years, IV nutrient therapy, specifically NutriDrip, has grown, at like a 60 to 80% year-over-year growth rate, even while opening new stores," said co-founder Asa Kitfield. "So we're really excited to see what sort of saturation the market can see on like a local and national basis."

One of its new corporate clients is Wynn Hotel will be offering NutriDrip IV drips to its guests in Las Vegas in early 2020.

A woman receives a vitamin infusion via intravenous drip.

Carlos Allegri | Reuters

"As many of our guests now expect a more holistic set of wellness options, we have evolved to include broader wellness themes related to functional wellness, physical fitness, and healthy cuisine," said a Wynn spokeswoman, adding "providing IV therapy is one more way to help our guests maintain personal wellness routines while they are traveling."

The Equinox Hotel in Hudson Yards also has been offering the service to guests when it opened last summer. Kitfield also told CNBC, NutriDrip is slowly rolling out the service to other Equinox gym locations in early 2020 as well.

Equinox executives Jeffrey Weinhaus and Harvey Spevak were early investors in NutriDrip parent company Clean Market, along with real estate investor Jack Terzi, Seritage Growth Properties CEO Ben Schall, fashion designer Andrew Rosen and venture capital firm Able Partners.

Celebrities, including Madonna, Rihanna and Simon Cowell, are reportedly fans of IV vitamin treatments, but it's drawn some controversy.

"Anytime you poke a hole in somebody's vein, there is some risk that they'll bleed excessively. There's also some risk that they will clot excessively," said Dr. David Katz, founding director of Yale University's Prevention Research Center. "So the risks are not great. And the risks are not very common, but there are risks, and the only way to justify any risk in medicine is by a greater likely benefit."

He said there is "minimal evidence that there is any meaningful benefit for most people."

Kitfield said NutriDrip doesn't make grand promises about its treatments but said the company and customers clearly believe in its benefits.

"When you look at our business where 50 to 60% of our revenue comes from regulars, and that's why we continue to grow, the proof is kind of in the pudding, Kitfield said.

According to the Global Wellness Institute, a nonprofit that tracks the industry, the global wellness market is a $4.5 trillion industry. While IV therapy and alternative medicine is a small portion of the overall spending, GWI says it's among the fastest-growing sectors.

NutriDrip, ahead of funding round, sets up aging and hangover treatments at Wynn Hotels, Equinox - CNBC

Alternative therapies to cope with workplace stress – The Sunday Guardian

Posted on January 19, 2020 by Danzig

Therapies like yoga, meditation, mindfulness and sound healing programmes can help us manage work-realted stress, which often translates to ill health and low productivity levels.

Increasing job uncertainty, grueling work hours and an abject lack of work-life balance often translates to heavy stress in our professional lives. Rapidly changing nature of jobs, 24/7 connectivity and the resultant pressure of constant deadlines have turned Indian workplaces into pressure cookers where thousands of young professionals struggle to maintain mental balance. Rates of burnout or exhaustion syndrome are high among bright professionals who fail to reach their full potential because stress gets the better of them on their way to success. A survey by insurance company Cigna TTK found that a whopping 89% of people were suffering from stress, with work and finances being the primary causes of stress.

Interestingly, a number of corporate organisations have realised the negative impact stress is having on their employee productivity, and holistic wellness programmes have gained much traction. However, it is important to educate people at individual levels as well to learn to cope with stress on a daily basis. While we cannot change the stressors, we encounter every day, we can most certainly change the way our mind deals with them.

A number of alternative therapies can help individuals achieve better mental health and wellness. These therapies can be adopted as a way of lives as coping mechanisms for the mind. A study published in the BMC Complementary and Alternative Medicine journal concluded that yoga, mindfulness-based cognitive therapy and cognitive behavioural therapy were very effective in promoting overall mental health and preventing burnout due to work-related stress among participants.

Lets take a look at some alternative therapies that can help you cope with professional stress:

Mindfulness:

Mindfulnessis a psychological process through which one tries to maintain complete awareness of the present moment. It trains the mind to prevent distractions of the future or past musings. Achieving a moment-by-moment awareness of our thoughts, feelings, acts, sensations as well as the environment plays a very impactful role in reducing stress. When you are bathing, you are focusing completely on the act of water interacting with your body; when you are eating, you are doing it so mindfully that all your thoughts are focused on your movement from the plate to the palate and beyond. A study published in theJAMA Internal Medicinereview found that a mindfulness-based programme helped reduce anxiety symptoms in people with generalised anxiety disorder. Another study published in the journalBiological Psychiatry found significant changes to the brain on scans after just three days of mindfulness meditation on 35 unemployed people experiencing major stress of a job search.

Mindfulness works by inducing a sense of calmness and improving focus. Mindfulness is even associated with lower levels of inflammation markers.

Yoga:

Yoga and meditation are widely known to induce benefits for mental health including stress management. Yoga combines the physical and mental disciplines to help achieve a peaceful alignment between the body and mind. When combined with meditation, yoga relaxes and soothes the nerves, aligns the mind towards a calm centre and helps an individual become more mindful of the present. Approach has significant benefits for stress and anxiety. Yoga doesnt just help in stress management, it also helps curtail the negative impact of stress on the body and reduces risk factors for chronic diseases, such as heart disease and high blood pressure. Yoga modulates the stress response systems by training the mind to perceive stress and anxiety differently.

Sound Healing:

Sound healing or music therapy is another highly under-utilised therapy that has significant benefits on stress and anxiety healing. It can effectively be termed as vibrational medicine with the use of music, singing, and sound tools that release vibrations to better the mental, emotional and physical state of a person. Sound healing creates a shift in our brainwave state by using entrainment; a bio-musicological sense that refers to the synchronisation (e.g. foot tapping) of humans to an external perceived rhythm such as music and dance. Entrainment creates a stable frequency in the brain. This allows for the mind to go from the normal beta state (normal waking consciousness) to the alpha state (relaxed consciousness). Quite similar to meditation which regulates the breath, sound healing influences the shift in the brain through its frequency.

Sound healing particularly helps in reducing anxiety, stress, and sleep disorders. A study published in the Journal of Evidence-based Integrative Medicine examined the impact of sound meditation, specifically Tibetan singing bowl meditation, on mood, anxiety, pain, and spiritual well-being. It found participants experienced a significant reduction in tension and feeling of spiritual well-being also significantly increased through sound healing.

The author is the director, Poddar Wellness Ltd and managing trustee, Poddar Foundation

Alternative therapies to cope with workplace stress - The Sunday Guardian

Robby Andrews Lyme Disease Recovery | Running With Lyme Disease – Runner’s World

Posted on January 19, 2020 by Danzig

In early June of 2018 elite middle-distance runner Robby Andrews was on fire. Was, unquestionably, at the top of his running game. The then-27-year-old had just run one of his fastest races ever: 3:36 in the 1500 meters at the Oslo Diamond League Meet in Norway, beating out 18-year-old phenom Jakob Ingebrigtsen. Which is why, for Andrewswinner of the 800-meter national outdoor title in high school, holder of a national indoor record in the 800 meters as well as the 1000 meterswhat happened two weeks later was such a shock.

June 21. The USATF Championships in Des Moines, Iowa. Andrews felt confident going into the 1500 meters, but mid-race he completely ran out of steam. He placed a disappointing fifth in his heat, not even qualifying for the finals. I dont know what happened, a confused Andrews told reporters after the race.

Kevin Morris

A few days later he came down with flu-like symptoms. For the next month he battled nasty upper respiratory and sinus infections and 102-degree fevers. Training just sucked, says the Olympian. My paces were nearly 40 seconds slower than theyd been just a few weeks before. Andrews went to his doctor, who ran tests for everything from Lupus to Lyme, but they all came back negative. I was told, There is literally nothing wrong with you, recalls Andrews. But there had to be, he knew. This could not possibly be all in his head.

Still, he had a contract with Adidas to fulfill, so Andrews traveled to Europe, where he clocked disappointing times: 3:44 in the 1500 meters at the Lignano Meeting International in Italy; 1:52 in the 800 meters in Flanders Cup Kortrijk in Belgium. For the remainder of the summer, Andrews felt constantly wiped out. Normally he would be up at 7:30 to train; now, he couldnt pry himself out of bed until 10. The few days a week he forced himself to run, hed get so dizzy and breathless hed have to quit after 20 minutes. Every afternoon, he napped for up to four hours.

He kept thinking how closely his symptoms resembled those of people he knew whod had Lyme, including his older sister Kristin (also a runner who is a 2020 Olympic hopeful) and his former roommate, Donn Cabral (a 2012 and 2016 Olympian in the 3,000-meter steeplechase), so Andrews asked to have his Lyme test re-run in September. It came back positive. The doctor wanted to prescribe antibioticsthe standard treatment for Lymeimmediately, but Andrews was worried about the side effects. Instead, he decided to take the advice of a holistic doctor who had helped his sister during her bout with Lyme in 2016.

Once a week Andrews swallowed eight drops, an hour aparta concentration of herbs such as ashwagandha, rhodiola, turmeric, licorice root, and cordycep mushroomsthat the holistic doctor said would help strengthen his immune system. He soaked his feet in a proprietary blend of herbs that he was told would draw toxins out of his body. He spent more than $1,000 on treatment. He didnt care if anyone thought he was nuts. He just wanted to feel better.

And he did, for a few months. My energy went way up. I could run three miles without having to stop, says Andrews. Then, in February, it all fell apartan almost overnight, dramatic decline in his physical and emotional health. Fatigue weighed down his body. Headaches crackled through his brain. He was sweating so much at night that he had to change the sheets. And perhaps the worst? Really depressive thoughts. It was a dark couple of months, Andrews says. If it wasnt for my girlfriend and family, I would have gone days without talking to anyone or leaving the house. He raced at the U.S. Championships at the end of February on Staten Island, in the 1000 meters. I felt bad from the first step. Something was wrong. He clocked in at 2:26dead last.

Drew Reynolds

Patrick SmithGetty Images

Disillusioned with the holistic protocol, Andrews finally accepted a prescription for antibiotics in March. His doctor told him to take them until his symptoms were relieved for a full month. Andrewss concerns about side effects were valid; the antibiotic gave him severe fatigue and headaches, brain fog and GI issues.

Desperate to make the 2019 world championship team, he ran the 800 meters at the Adrian Martinez Classic in April, only to come in last, again. In June he set his sights on the Princeton Qualifier. I missed my college roommates wedding for it, that is how important this race was for me, he says. Midway through the 1500-meter race, he dropped out, wheezing and depleted.

Andrews felt like he was out of options. And although he didnt know it at the time, he had entered the Lyme Wars, a fiercely contested fight about why some Lyme patients develop chronic, relapsing symptoms even after treatmentand what to do about them.

A stealth pathogen. Thats what some researchers call the corkscrew-shaped bacteriaBorrelia burgdorferithat causes Lyme disease, now one of the fastest growing infectious diseases in America. More than 300,000 new cases are diagnosed every year, according to estimates from the Centers for Disease Control and Prevention (CDC).

Black-legged ticks pick up Borrelia from the birds and small mammals they feed on, then they pass the bacteria into our blood when they feed on us, usually from May to Septemberprime months for logging miles on wooded trails and grassy park paths.

Removing a tick quickly lowers your risk for infectionit takes an estimated 36 to 48 hours for the arthropod to transmit Borrelia. But once the bacteria enters your body, it is a master of evasion. The Borrelia can spread from the skin to other tissues, which can make it more challenging to treat. Your immune system takes days to a few weeks to recognize any infection, including Lyme. Thats why the standard Lyme testwhich checks for antibodies (not the bacteria itself)can more easily give a false negative test early on, like Andrewss did.

When your body finally detects Borrelias presence, it launches an immune response to fight it, which is what can bring on flu-like symptoms such as sluggishness, fatigue, muscle aches, and joint pain. Runnersespecially those who spend hours outside during the summer training for fall marathonscan attribute symptoms to overtraining.

The majority of Lyme cases are easy to treat and cure with a 10- to 28-day course of antibiotics, says Paul Auwaerter, M.D., the president of the Infectious Diseases Society of America (IDSA). Ying Zhang, MD, Ph.D., a leading expert on the Lyme bacteria and a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, disagrees. Lyme can be a really terrible disease and a very complex one. Different patients have different responses, and the disease can manifest in different ways, says Zhang, who believes Lyme can indeed develop into a chronic form that resists the current antibiotic treatment.

Indeed, for around 20 percent of Lyme patients, a dose of antibiotics isnt the end of the story. Not by a long shot. They continue to suffer from a variety of symptoms that can last for months, even years: fatigue, headaches, muscle and joint pain, difficulty concentrating, and sleep disruptions. The frequently used medical term for these persistent problems is Post-Treatment Lyme Disease Syndrome (PTLDS). PTLDS means that we know that a patient has had Lyme, has gotten a course of antibiotics, and doesnt feel like theyve bounced back, says Auwaerter.

PTLDS is often referred to as chronic Lyme, a term Auwaerter disparages as a catchphrase for otherwise unexplained fatigue, pain, and neurologic symptoms in people who dont meet the diagnostic criteria for Lymeusually obtained by medical history, a positive blood test, and physical exam. But diagnosing Lyme can be tricky. In the first three weeks after infection, the test detects Lyme only 29 to 40 percent of the time and some 30 percent of all Lyme patients, like Andrews, dont get the telltale bullseye rash.

Drew Reynolds

What really keeps the controversy alive is this: There isnt yet a sensitive and reliable test that can determine if ongoing symptoms after Lyme treatment are due to an ongoing active infection, says Brian Fallon, MD, director of the Lyme and Tick-Borne Diseases Research Center at Columbia University. Without one, some medical organizations, like the International Lyme and Associated Diseases Society (ILADS), believe chronic symptoms may be due to the persistence of the Lyme bacteria. They suggest that for some patients, the potential risks of treating with antibiotics for longer periods of time outweighs the consequences of an untreated persistent infection. Giving credence to this argument are several recent studies that found Lyme bacteria remained in animals even after they were treated with antibiotics. And in March, Zhang and his colleagues found that a slow-growing form of persister Lyme bacteria not only resisted standard single antibiotic treatment, but also caused more severe arthritis-like symptoms in mice. They found that a cocktail of three antibioticsdaptomycin, doxycycline, and ceftriaxonecompletely killed the bacteria, and they are now planning clinical trials to see if the result is the same in humans.

On the other hand, groups including the IDSA maintain that symptoms that linger after antibiotic therapy are not due to an ongoing active infection of the Lyme bacteria and therefore should not be treated with additional rounds of antibiotics because theyre unlikely to help. Six clinical trials have shown that long-term antibioticsbeyond the recommended 28 dayare not effective, says Auwaerter. Plus, long-term use of antibiotics can lead to serious side effects, such as blood clots and, even, in rare cases, death.

If chronic symptoms are not caused by an active infection, then what? It could be due to an autoimmune reaction, where a prior infection has triggered an immune reaction that is now acting independently, or it could be that the prior infection changed the brain activation patterns, Fallon says. Theres some evidence to support both of these processes.

While researchers debate, patients are left sick, with lots of questions, and no good answers. Its devastating for peoples lives and some are willing to try anything to get better, Fallon says. After his dismal race in Princeton, Andrews was one of them.

This June, after battling symptoms for nearly a year, Andrews visited Mark Sivieri, M.D., a board-certified family practice doctor in Maryland who is also board certified in integrative medicine (which pairs traditional medicine with complementary therapies). Andrewss cousin had been seeing him for her own ongoing Lyme symptoms. There was an instant connection: Sivieri had also been a professional runner; he and Andrews even shared a coach at one point. During the three-and-a-half-hour appointment, Sivieri studied Andrewss previous blood tests. He noticed that, in addition to Lyme, Andrews had tested positive for two other tick-borne infections (Andrews says the doctor who had ordered the test never mentioned them).

Ticks carry and transmit loads of other bacteria, parasites, and viruses beyond Borrelia burgdorferi. A single tick can make a person sick with several diseases at the same time, including Anaplasmosis (a bacterial infection that causes fever, aches, chills, and muscle aches), Babesiosis (a parasitic infection that attacks red blood cells), and Powassan virus (which can cause an infection in the brain and can even be deadly). And not all doctors check for these when they are focused on Lyme; those who do test for them may believe the antibiotics prescribed for Lyme will be enough to wipe out the co-infections. The estimates for co-infection rates with Lyme disease can widely range anywhere from about two to 40 percent. And not only are some, such as Powassan, more dangerous than Lyme, but simultaneous infection, some research suggests, may make Lyme harder to treat or recognize, and might affect how the immune system responds to Burgdorferi.

Sivieri put Andrews on a 60-day course of the two antibiotics hed previously been taking to kill the bacteria for Lyme; he also prescribed a medication to wipe out the co-infections. He said the night sweats and the shortness of breath, thats what the Babesia parasite does, it eats your red blood cells and prevents the oxygen from moving around your body. Thats obviously a big concern for runners. I couldnt breathe well when running, right from the start, says Andrews. And Im a trained athlete.

Sivieris tests showed that Andrews was also sensitive to gluten and dairy; he recommended avoiding them to help take pressure off his immune system. My stereotypical Italian grandma was aghast when I told her no more pasta and chicken parmesan, Andrews says. That was a big transition for me. But if thats whats was going to get me better, I didnt care at all.

Drew Reynolds

Sivieri then turned to natural remedies to help strengthen Andrewss immune system, putting him on adaptogenic herbssaid to help with all types of stresssuch as curcumin which can reduce the inflammatory response caused by Lyme.

Using alternative medicine to nuke hard-to-kill bugs might sound like folklore, but science is starting to back the theory: Zhang recently found that, in laboratory dish tests, 10 oilsincluding from garlic cloves, myrrh trees, thyme leaves, allspice berries, and cumin seedsshowed strong killing activity against the non-growing and slow-growing persister forms of the Lyme bacteria, even better than standard antibiotics. We need to do proper clinical trials, to see how to use them more effectively without being toxic but [in the future, I believe that] the more effective treatment is going to come from a combined approach of antibiotics with essential oils or natural products.

The combination of traditional and alternative medicine helped Andrews. The past year has been brutal, but he finally feels like his old self again. I wake up in the morning and I have energy all day, he says. Im not sweating at night, [there are] no headaches. The depressive thoughts are gone. Im training at full capacity. He plans to run the indoor season in 2020, still in hopes of achieving the Olympic qualifying time.

He stopped taking antibiotics in mid-August, now its complementary treatmentsincluding vitamin C for his adrenals and immune system and curcumin for inflammation. He still avoids gluten and dairy and is content to continue the regimen for the near future. The supplements could be pointless, but hes not going to chance it. It seriously feels like I have my life back, he says. This is me. Im back to me.

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Robby Andrews Lyme Disease Recovery | Running With Lyme Disease - Runner's World

Gwyneth Paltrow’s new Goop Lab is an infomercial for her pseudoscience business – The Conversation CA

Posted on January 19, 2020 by Danzig

Last week, Netflix dropped the trailer for Gwyneth Paltrows new show The Goop Lab. It is a six-episode docuseries launching on Jan. 24 that, according to the trailers, focuses on approaches to wellness that are out there, unregulated and dangerous. (Read: science-free.)

The backlash by health-care professionals and science advocates was immediate and widespread. And for good reason. As noted by my friend, obstetrician and gynecologist Dr. Jen Gunter in Bustle magazine, the trailer is classic Goop: Some fine information presented alongside unscientific, unproven, potentially harmful therapies.

We know the spread of this kind of health misinformation can have a significant and detrimental impact on a range of health behaviours and beliefs. This is the age of misinformation and this show seems likely to add to the noise and public confusion about how to live a healthy lifestyle.

But what has been largely overlooked in the initial wave of critiques is the conflict-of-interest issue. The producers of this show that is, Gwyneth Paltrow and her company Goop benefit directly from not only the show being popular but also from the legitimization of pseudoscience. This show is, basically, an infomercial for the Goop brand, which is built around science-free products and ideas.

To be fair, I have yet to see a full episode. But given the content of the trailer and Goops history of pushing harmful nonsense, there is little reason to be optimistic about the role of science in the series. Regardless, the mere existence of the series will allow Paltrow and Goop to build the brand, which is currently estimated to be worth US$250 million.

The show serves as an opportunity to market the kind of magical thinking and pseudoscience that will help to sell Goops products. It would be like Netflix streaming a show called The Coca-Cola Beverage Lab or the The Starbucks Coffee Adventure.

One of the things that attracts people to the alternative health practices pushed by entities like Goop is frustration with the impact of private industry and the profit motive particularly in the context of the pharmaceutical industry on the conventional health-care system.

This concern about the impact of industry is understandable. There is a vast literature highlighting industry misbehaviour and the adverse consequences of Big Pharmas influence on research, clinical practice and clinical guidelines. Awareness of these issues has contributed to a decrease in trust in the medical profession and even to harmful trends like vaccination hesitancy.

For the advocates of alternative approaches to wellness, conventional medicine is often positioned as irrevocably compromised and corrupt. And many have come to believe even extreme versions of this narrative.

A 2014 survey found 37 per cent of Americans believe (and another 31 per cent think it could be true) that the Food and Drug Administration is deliberately preventing the public from getting natural cures for cancer and other diseases because of pressure from drug companies. Goop has also enabled these kinds of extreme perspectives.

The implication, of course, is that alternative approaches are somehow untainted or, at least, less tainted by vested interests and are, therefore, the better choice. But this clean hands framing is patently false.

First, we need to recognize that alternative medicine is also a huge industry. The worldwide wellness market, which is largely composed of unproven and alternative modalities, has been estimated to be worth over US$4 trillion.

The sale of herbal medicine and supplements are also multi-billion dollar industries. Given the size of these markets, it would be naive to believe that alternative medicine is somehow missing the twisting profit-motive incentives that have created problems for conventional health care.

Second, the alternative health community is also rife with conflicts and biases. To cite just a few examples, naturopaths profit from the in-office sale of products and have partnered with the vitamin industry to expand the reach of their practice.

In addition, alternative medicine research has been influenced by various systemic biases. And we shouldnt forget that many of the most commonly used alternative products, most notably supplements and herbal remedies, are often made by the very pharmaceutical industry that alternative wellness devotees are seeking to avoid.

Third, motivated reasoning plays a big role here. When an individual or a company has built a profession or a business model around a particular worldview, this commitment will have an impact on how the relevant evidence is interpreted, used and presented to the public.

If you are a practising homeopath, for instance, it would be tremendously difficult to accept what the evidence says about the remedies you offer. Indeed, accepting the science would mean you would lose your livelihood and professional identity.

More needs to be done to combat the adverse impact that conflicts of interest issues can have on bio-medical research and clinical practice. But we also need to recognize that profound conflicts of interest exist in the alternative health and wellness domain. We should not give those involved with this industry including Paltrow and Goop a pass.

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Gwyneth Paltrow's new Goop Lab is an infomercial for her pseudoscience business - The Conversation CA

‘How to live and die well’: what I learned from working in an NHS hospice – The Guardian

Posted on January 19, 2020 by Danzig

Shes called Gemma. Shes three years old. She fell into a canal, said a senior nurse. By the time her parents managed to get her out, apparently shed already stopped breathing. Paramedics three minutes away, called another nurse, holding the scarlet phone on which emergencies were called through. With a grace and efficiency akin to choreography, a team of professionals who moments beforehand had been as disparate as atoms, dispersed across the hospital, were poised around an empty resuscitation bed, waiting as one to swing into action.

The consultant quietly confirmed each team members role. The anaesthetist, responsible for airway. The scribe, who would note down, in meticulous detail, the timings, the drugs, the doses, every iota of care which, if we were lucky, might snatch life back from lifelessness. Doctor one, doctor two the roles and responsibilities went on. Then, a moment of silence before the paramedics brute force pushed a trolley through the swing doors and there, tiny, limp and pale, lay a toddler, unmoving beneath the harsh fluorescent lights.

It was impossible to hear the paramedics handover above the screams of Gemmas mother. Save her! she pleaded, over and over. Please, please, save her! Gently, a nurse discussed with her whether she wished to stay or leave the bay for a moment. The crash team worked on, its focus absolute. In moments, the child had been intubated. Tubes and electrodes sprouted everywhere. Tiny, toddler-sized chest compressions continued, interrupted every two minutes to check for the resumption of a heartbeat.

Too inexperienced to help, I hovered on the periphery, trying not to wear my shock visibly. I had never before seen a child this unwell. Unless the crash team managed to restart the heart, I was watching, in effect, a dead little girl. I thought of my own toddler, safe at nursery, and of the magnitude of the horror with which Gemmas mother, sequestered in a relatives room, must now be seized.

On and on the crash team worked. Compressions, adrenalin, electric shocks, compressions. A miniature mannequin, manhandled with conviction. The collective will in the bay for this child to live, to survive, was so strong as to be almost palpable. A forcefield of longing around the bed. Its silent incantation: come on, come on, come on, come on.

Fifteen, 20 minutes must have passed. The resuscitation attempt was going nowhere. In an adult, the risk of brain damage is high, but Gemmas youth gave her body resilience. I bit my lip to keep tears at bay. And then, impossibly, before our disbelieving eyes, the chaotic scrawl of the ECG trace was jolted by the latest shock into something that coalesced into a normal rhythm. Gemmas stunned, battered, fibrillating heart had somehow started to beat again. This bodys submersion in brackish water, these lungs fully flooded with rank green canal despite it all, this little heart had maintained its capacity for life. A resurrection had occurred. Right there, on crumpled NHS cotton, a girl had been brought back from the dead. I wanted to cheer from the rooftops.

Not for one second did the teams concentration dip. The luxury of jubilation was forbidden while her life, her brain, still hung in the balance. ROSC return of spontaneous circulation is only the first step from an arrest back to health, and Gemma was whisked straight to the paediatric intensive care unit.

The smiles after she departed could not have been any broader. Consultant hugged staff nurse hugged student, in a rare moment of shared elation. But what stayed with me, as I walked out of A&E that night, was not this eruption of joy but the preceding ruthless dispassion. That total focus while I, on the sidelines, had fought not to quiver and cry. The crash team, simultaneously human and robotic, crunching through the protocols that maximised a childs chances of life. I wanted to eradicate my human weakness and become, like these doctors, part machine.

The man widely regarded as the father of modern medicine, the Canadian professor William Osler (18491919), famously recognised the unique importance of stories in medicine. Osler insisted that medical students should learn from seeing and, crucially, from talking to their patients. Memorably, he said: Just listen to your patient, he is telling you the diagnosis.

Those words are as true today as they were back then. Storytelling is the bedrock of good medical practice.

The author Philip Pullman goes one step further, stating that: After nourishment, shelter and companionship, stories are the thing we need most in the world. In boldly insisting on stories as imperative for human survival he imbues them with a transformative force in medicine. It is undeniable that the meanings we construct around our afflictions and diseases, the stories we tell ourselves about what is wrong, and where we are heading, can overturn our experience of illness.

You might imagine that storytelling is the last thing on a doctors mind. We are all far too busy doing our jobs, often with time running out. But Pullmans words are nowhere more apt than in a hospital, where what heals is not confined to a doctors drugs or scalpel blades. It is the quieter, smaller things too being held, heard and shown you matter that make patients feel cherished, and hospitals humane.

The NHS hospice where I work today is strikingly beautiful. Natural light streams in from skylights and floor-to-ceiling French windows, allowing patients to look out on gardens, trees and the birds just outside. There are whirlpool baths, massage, art and music therapy, ice-cream and homemade smoothies on tap. We hold weddings here, set up date nights, sneak in pets, break the rules. There is even a drinks trolley, wheeled from room to room twice a day, amply stocked with fine wines and cans. Because what better way, for those who fancy a drink, of remembering normal life back home?

Bird food and beer might not seem revolutionary, but when I arrived here, seven years after starting life as a doctor, they signalled something thrillingly radical. For all the care contained within hospital walls, it would be hard to design a more dehumanising space than your typical busy teaching hospital.

Even after resolving to specialise in palliative medicine, the decision was less a conviction than a leap of faith. Indeed, during my early days in the hospice I felt like a brand-new doctor all over again, learning an alternative medical paradigm, one with people, not diseases, at its heart.

Simon was a man in extremis. He had a cancer of his thyroid that was threatening to suffocate him. Already requiring oxygen, this morning his breathing had taken a turn for the worse and now, we had been told, he was fighting for air.

A former policeman in his 60s, Simon had retired a few months earlier. He was looking forward to having time to while away in the fresh air, walking and jogging. Shortly afterwards, he had noticed a lump in his neck, painless, innocuous and perhaps, he had assumed, related to a recent head cold. But the lump, unlike the cold, persisted and, more unnervingly, continued to grow. Still more curious than concerned, he visited his GP.

The speed of his referral to hospital impressed him, innocent of the fact that he was on a two-week cancer pathway, its celerity commensurate with his doctors worst fears. There was to be no well-earned peace in the countryside for Simon. The scan became a biopsy, and the biopsy a consultant, murmuring cryptically about inoperability, as Simon sat stricken, pinned to his seat, hearing nothing of substance after cancer.

I heard him before I set eyes on him. Specifically, I heard the sound of air being sucked into his lungs through an airway severely compressed by tumour. Stridor the harsh rasp of air with each intake of breath, audible only when the trachea is critically narrowed. Once heard, never forgotten.

When I entered his room, Simon was sitting bolt upright, eyes darting frantically, his shirt ripped off and both hands gripping the bed like his life depended on it. From deep inside his body, from the depths of his spinal cord, he trembled with fear. Beside him stood a woman in her 30s, distraught and dishevelled, saying: Its OK, Dad. Look. Look, the doctors here. Everythings going to be OK now.

Simon stared up at me, beads of sweat on his brow, gulping for air. There was no way he could sustain this work of breathing. At the same time, I observed, the oxygen required was sufficiently low to be delivered not through a mask, but through small tubes in the nose. Although petrified, and with good reason, he was not yet in respiratory failure.

In an A&E department, Simon would have been gowned, cannulated and hooked up to lines and monitoring. I chose instead, you might argue, to gamble. If Simon was about to die, I reasoned, none of this paraphernalia was going to prevent that. But if, as I suspected, panic had exacerbated his airway obstruction, then I knew how to help.

I ascertained from Sophie, Simons daughter, that he had completed radiotherapy to his thyroid a few days earlier. His oncologists hope had been to shrink the tumour, eking out a little more time, perhaps even enabling him to reach his grandsons sixth birthday.

Simon, I am confident we can help you feel better, I began, but Id like to sort out some treatment straight away. Then we can talk. Is that OK? He nodded, mute.

I worked fast. The nurses brought the large dose of steroids that would, I hoped, begin to shrink the swelling in Simons neck. Next, a tiny dose of a fast-acting sedative, just enough to take the edge off his panic.

Would you like me to explain what I think is happening? I asked him, keen to allow the sedative more time to calm his fears. Yes, he said clearly the first word he had been capable of speaking out loud. I spoke evenly, unhurriedly, hoping to instil trust and confidence. I think there are two problems, Simon. First, there is your tumour, pressing on your windpipe, but there is also the radiotherapy, which has damaged the tissues in your throat and caused them to swell. We see this very commonly. The breathing often becomes worse for a few days after radiotherapy, maybe a week or so, before it gets better. Steroids can really help bring down the swelling.

There are moments in medicine when what you say next feels as pregnant with risk as the surgeons first incision

As I talked, Simons eyes never left me. His gasps, I noticed, were beginning to decelerate. How does it feel now? Is the injection we just gave you helping at all? Well, I dont feel quite as bad, he said doubtfully. Out of the corner of my eye I saw that Sophie was crying.

Simon began to describe living alone with his cancer, having been widowed a few years previously. Its all been so quick. Too much to take in. Sophie, if Im honest, is my rock, but she has Timmy, her boy, to look after as well.

Dont be ridiculous, Dad, Sophie interjected, almost angrily. You know looking after you is no problem. We all love being with you, especially Timmy.

Simon could not meet his daughters eye. His chest, damp with sweat, still undulated with muscle, a torso sculpted from lifelong activity, not yet effaced by cancer. I wondered how much it cost him to appear this vulnerable in his daughters eyes, and whether shame was inflaming his distress.

Gently, I kept tweaking the oxygen downwards. Simon, you know this is really encouraging? Youre managing to talk in full sentences. I dropped the oxygen down as low as it will go a good 10 minutes ago. May I try taking it off you?

Youre a sly one, he exclaimed, with the faintest trace of a smile.

The hint of a relationship forged, I broached the topic of the future. He cut me off instantly. Look, Im not stupid, he exclaimed. I dont have one, do I? This is it. I know whats going on. Dad, pleaded Sophie, tears flowing. Shes trying to help. Dont shout at her.

There are moments in medicine when what you say next feels as pregnant with risk as a surgeons first incision. The right words, used wisely, can bridge the airiest expanse between you and your patient but, if misjudged, may blow trust to pieces. In scarcely a month, cancer had snatched from this man of action and authority his health, his future, his strength and his fearlessness. And today, perhaps worse than all of that, his daughter had witnessed him writhing in fear.

Few sensations are more terrifying than that of fighting to breathe. In that moment, every mental sinew you have ever possessed lifelong habits of logic, love, faith and reason are wiped out by a frenzied craving for air. Simon had been fighting for his life, the most powerful and desperate of all human instincts. I needed to give him control, if only over our conversation.

Simon, are you the kind of person who likes to discuss everything frankly, I began, or do you prefer to take things one day at a time, without speculating about the future? I already know Im dying, he responded. What else could you possibly tell me?

Well, people often assume that once you arrive here, you will never leave. But around half of our patients dont die here. They go home again once weve managed to sort out their symptoms. Its not always a one-way ticket.

He blinked. No one said anything for a while, as we listened uncomfortably to the scrape of his stridor. Finally, it was his daughter who spoke: I didnt realise that, Dad. Did you?

Silence. My intuition was that Simon not only feared never leaving the hospice, but was also convinced he was imminently dying. Perhaps the only way to reach him was to confront this head-on. One of the things Ive noticed working here, Simon, is how often patients feel unable to ask about the thing theyre most preoccupied with, which is what its actually going to be like when they die and I wonder whether this is something youd like to talk about?

I saw a flash of horror distort Sophies face; but her father, if anything, looked relieved. Go on, he said cautiously, giving nothing away.

OK. But please stop me at any point if you dont want me to continue. I glanced at Sophie. Simon confirmed that he wanted her to stay. So ... we tend to see the same patterns over and over in people with cancer, or another terminal illness, who are approaching the end of life. One of the first things many patients notice is losing their strength, their energy. Things they used to take in their stride become a real physical and mental effort. Im guessing youre already aware of that?

A dying man had faced his end and found the strength to look towards what mattered more than anything: those he loved

A rueful roll of the eyes. No kidding. I used to run marathons. Cant even get up the stairs now.

That loss of energy gradually worsens. You might find you need a nap most days, more than one, probably. Then, one day, you realise youre sleeping more than youre awake. Its not painful or horrible, its just immensely frustrating. Patients can find it helps to try and plan in advance a bit, saving up their energy for the things that really matter.

Like Timmy, Simon interrupted. I like to know when hes visiting so I can have a sleep beforehand. I didnt realise that, Dad, said Sophie. Well, I want to give him my best, dont I? And I dont want to lose a second with him.

Sophie now turned to me. Timmys dads not around any more, you see. Left when he was two. Dads more like his real father.

I see, I said slowly, computing the layers of loss, more intricate and heftier than I ever imagined.

By now, I noted, Simon had been breathing calmly for half an hour without requiring any additional oxygen. Encouraged, I went on. Often, at the end, there arent any dramatic changes. That sleepiness continues. A patient finds they are sleeping nearly all of the time. You stop feeling hungry and you dont want to eat. You may stop feeling thirsty, too. Then, one day, rather than sleeping, you slip into unconsciousness. Its not a distinction you are even aware of. Your brain is just more deeply unresponsive. Sometimes, I wonder if this is the bodys way of protecting the mind you stop being afraid, youre oblivious to it all.

I paused, trying to gauge Simons reaction. Shall I go on? I asked. The most perfunctory of nods, so I continued. You might be thinking that what youve experienced today is nothing like what Ive just described. Youve felt as though youre suffocating to death and I cant imagine how awful that must be. But what I can promise you is that, if you feel like that again, we will still be able to help you. We can take away that feeling of panic with drugs that work almost instantly. You dont need to feel like that again. We will be right here for you, whatever happens.

Both Simon and Sophie were quietly crying. The sky was darkening outside. We were sitting, I realised, in a small pool of light from the adjustable lamp just above Simons bed. A father, a daughter and a doctor, surrounded by shadow, staring together at the death to come. Weighing it, considering its shape and form, perhaps for the very first time. The hostility with which Simon had been bristling was gone.

How long do you think I have left? he asked me directly.

I have no reason to think you are going to die today, Simon. Im not even certain the blockage in your airway is what will kill you. I do think your time is short weeks, not months, perhaps only very short weeks but I would love to believe we can get you home for a bit, if thats what you would like.

For a while, Simon said nothing. The silence, though thick with emotion, was not strained. Finally, he raised his eyes to mine and smiled. OK. Maybe Ill get to my boys birthday too. Thank you, Rachel I mean it.

So often, soreliably, Iwitness peoplerising totheir best onfacing theworst

My heart, for a beat, threatened to knock me off balance but only later, that night, did I allow myself to feel. A dying man had looked his end in the eye all of it, the worst of it, potential suffocation and yet, in that moment of profound mortal reckoning, with every single thing he loved slipping from his grasp, had found within himself the strength to look outwards, towards what mattered more than anything: the human beings he loved. How, I wondered, could someone be so aghast at their weakness while behaving with such unseen strength?

I cried that night. But not for what we lose. It is who we are that moves me, time and again, in the hospice. When people ask me if my job is depressing, I reply that nothing could be further from the truth. All that is good in human nature courage, compassion, our capacity to love is here in its most distilled form. So often, so reliably, I witness people rising to their best, on facing the worst. I am surrounded by human beings at their finest.

In 2017, my dearest Dad was himself a dying man. He had spent half a year on the chemotherapy carousel. Infusions, blood tests, nausea, fatigue, infusions, damaged nerves, infusions, bleeding skin. Hope, more than anything, kept him coming back for more. Even when the scans showed terminal spread, still he yearned, burned, for more life. He took these monthly batterings of the cytotoxic drugs because they allowed him to imagine a future.

Even as new symptoms revealed themselves, Dad managed to maintain his poise. He was a doctor and, I suppose, his training was useful. None of it came as a surprise to him. Theres something you need to know, he told me later. Over the weeks he had sat down in private and, through the fog of cancer fatigue, written letters to his wife, children and grandchildren. Theyre in a sports bag in my wardrobe, Rachel. Youll find them under my shirts. This was love, painstakingly scrawled and sealed inside envelopes, a legacy of words for his family.

After the funeral, I returned to work a different doctor. I have known the taste and weight of grief. Now, when I enter a patients room, I recognise the sunken eyes and tired frowns of those who cling to the one who would be lost to them. I understand that from the inside out, grief, like love, is non-negotiable, and that the only way to avoid the pain is to opt out of ever loving.

Above all, I have learned from my conversations with my father that being given a terminal diagnosis changes both everything and nothing. Prior to this news, a man of 74, he knew he would die one day, just not when exactly. And after this news, he knew he would die one day, just not when exactly. Everything he had always loved about life was still there to be loved, only more attentively now, more fiercely. All that had changed was the new sense of urgency, the need to savour each day and its sweetness.

Dear Life: A Doctors Story of Love and Loss, by Rachel Clarke, is published by Little, Brown on 30 January. To order a copy go to guardianbookshop.com. Free UK p&p on all online orders over 15.

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'How to live and die well': what I learned from working in an NHS hospice - The Guardian

‘Comfort’ or con? Despite money, education, well-off Filipinos turning to questionable treatments – Coconuts

Posted on January 19, 2020 by Danzig

In 2008, retired finance professional Pablito Bermundo found himself staring up at the surgical lighting hanging over the operating table, feeling both annoyed and amused that he was once again going under the knife.

After his gallbladder was removed in 2006, a massive cyst grew in his liver, one that would need to be surgically drained every six months. After two years of being wheeled in and out of the operating room, he decided that hed had enough.

I have to look for other options, he thought.

In 2009, Bermundo met a man who convinced him to give hilot a shot. Hilot is an ancient Filipino healing method in which ailments are purportedly treated with massages administered by healers known as manghihilot, who supposedly derive their power from God. Though many doctors are skeptical that hilot can cure serious illnesses, Bermundo credits it with saving his life.

With standards of living and education levels on the rise across much of Southeast Asia, including the Philippines, it would stand to reason that traditional healing methods often scientifically dubious, and occasionally accused of making matters worse would have begun to wane outside of remote areas where traditional ways still hold sway. However, Bermundo is one of many middle- and upper-class Filipinos who, despite their means and access to modern treatments, have continued to put their faith in alternative healing methods over Western medicine.

Meanwhile, as access to science-based Western medicine increases, so too does exposure to Western quackery, and questionable new-age healing practices many of which have quasi-Orientalist roots, and have been debunked by science are also beginning to make inroads among well-off Filipinos.

A gift from the gods

Though finding figures on alternative medicine use is next to impossible, medical anthropologist and physician Dr. Gideon Lasco says that the embrace of alternative treatments transcends class.

People just go to different places. For example, our fellow Filipinos in far-flung areas might go to an albularyo [a traditional healer], whereas a millionaire might fly into some Indian [retreat], or see some Korean practitioner.

He said people have different reasons for being wary of modern treatments.

Some people might have previous experience in hospitals or [with] doctors that they didnt enjoy.

In Bermundos case, what pushed him to go for hilot was his unhappiness with the options Western medicine and health professionals were presenting him.

I sought a second, third opinion. One doctor said he could cut off the cysts [because he said the liver] would still regenerate, he said, adding that to him, the treatment sounded too invasive.

But that all changed when he met the late Boy Fajardo, a manghihilot who learned the treatment through apprenticeships with rural healers he met in his travels around the Philippines.

Bermundo felt he had nothing to lose by trusting the healer, and Fajardo put him through regular weekly hilot sessions, and made him drink an herbal concoction containing water spinach and banaba leaves after every meal. After one month under Fajardos care, Bermundo went for an ultrasound and was pleasantly surprised to see that his cyst had shrunk dramatically.

Bermundo recalls his doctor telling him, There are no scientific studies that prove that hilot works, but just continue what youre doing.

Fajardo passed away in 2018, but Bermundo, now 76, still goes for hilot sessions, and remembers the healer as a charming man who was easy to trust.

He was naturally friendly; he wasnt in a hurry. He would answer all of your questions; you can call him anytime.

Fajardos protg Louanne Calipayan told Coconuts Manila that kindness was an especially important requirement for a manghihilot, and not just because it improves their bedside manner.

They have to be good people because what they offer is a service. A healer needs to have this characteristic because [we believe] he channels the energy from a Supreme Being, she said. A healer has to change whats in his heart because thats the energy that he will channel out of himself.

Calipayan said that despite the advancements modern medicine has made, she and her associates are seeing a resurgence in interest in hilot.

We have people flying in from Visayas and Mindanao and all other parts of Luzon. These are not the stereotypical people who go for hilot, who are uneducated or dont have money to pay a doctor, she said. In many cases, these are people who have been to many doctors or have had different treatment options, but they found the relief they were looking for in hilot.

Its not just Filipino patients who are becoming increasingly interested in hilot. As with other Eastern medicinal practices of unproven efficacy like Indias Ayurvedic healing, for instance hilot is attracting attention among Westerners. Calipayan said that not only has their group trained students from all over the country on how to practice hilot, she has also had some from as far away as Canada.

Medical anthropologist Lasco said he was skeptical of the actual medical benefits of hilot, but allowed there was still a lot of things doctors could stand to learn from traditional healers like Fajardo and Calipayan.

Patients dont just go to a doctor to get a diagnosis or treatment. They also go to the doctor to get comfort, to get reassurance, to understand whats happening to their bodies, to be given a chance to discuss choices, he said.

These traditional medicine practitioners offer us a clue of what patients are looking for. These hilot, albularyo what they offer is a personal connection.

He died of sadness

But for every apparent alternative healing success story like Bermundos, theres another like J.B. Bolaos.

A publicist by trade, Bolaos had grown skeptical of Western medicine after he witnessed what it did to his late mother, Lina.

In a recent phone interview, J.B. told Coconuts Manila how he lost both of his parents, starting with Lina, who died of lung cancer in March of 2018 after a grueling course of chemotherapy that ravaged her body. When his father, Melecio, was diagnosed with pancreatic cancer, he looked for another option.

I saw what chemo did to my mom. Every three weeks we would fly to China for cryosurgery, and chemo. She would feel so weak after two days, he recalled. [Thats why I thought] I would not go for conventional therapy for my father.

J.B. explained that based on his research, pancreatic cancer has a very poor prognosis, which further pushed him to try alternative means for his father. Chemo, he believed, would have just made Melecio weaker.

Melecio went through an alternative treatment called Gerson therapy, a dietary regimen devised by the German-American physician Max Gerson, who began touting it as an effective alternative cancer treatment in the 1920s. In Gerson therapy, patients adhere to a strict diet, purportedly to flush out toxins, and are also given coffee enemas, supposedly to spur the production of glutathione, a detoxifying antioxidant.

However, by 1989, the American Cancer Society had already evaluated the treatment and labeled Gerson therapy a sham, finding no evidence that it could effectively treat cancer. Prior to that, the National Cancer Institute in the United States studied 60 patients who used the Gerson therapy between 1947 and 1959, and concluded that the regimen did not benefit those patients.

More recently, an Australian wellness blogger documented her own rejection of more aggressive cancer treatment in favor of Gerson therapy. Despite consuming 10 juices and undergoing five coffee enemas a day as part of the regimen, she died at age 30 in 2015.

Despite the questionable nature of the treatment, J.B. and his father decided to try the method, which proved equally as expensive and taxing as chemotherapy.

Its all about juicing, the right diet, where everything has to be organic, J.B. explained. He had to take around nine juices a day, but theyre organic. All are fresh. You cannot prepare the juice like two hours before [you drink them]; you have to prepare them on the spot.

Because J.B. was busy managing his own company while juggling a teaching career, he had to hire two nurses who worked in shifts to take care of his father. Aside from the organic juices, his father was also infused with high doses of Vitamin C, Vitamin B17, and Chinese herbal medicines, and underwent ozone therapy, an alternative treatment that supposedly increases the amount of oxygen in the body.

Melecio ultimately passed away, but his son still believes that the treatment he received gave him the best quality of life.

Conventional [chemo] therapy would have given him no assurance that he would win the battle against cancer, J.B. said. There were no assurances; in fact, he might have died sooner.

My dad died of heart failure. Normally, if you die of cancer, its multiple organ failure. What he died from was totally unrelated. His heart just stopped. And I know that when someone has pancreatic cancer when you hold that persons hand, they would feel pain. My dad never had that experience, he added.

He died of sadness [from my mothers passing]. I would like to believe that he did not die of cancer.

Lasco, the medical anthropologist, said a belief in alternative treatments is common among those who have been diagnosed with cancer because of the high rate of mortality. Ditching chemotherapy as JB did for his father is understandable given the extreme side effects.

Its natural for us to want to live as long as we can, but for other people, their priority is their quality of life. They would rather have a normal and non-chemotherapy kind of life and think, OK, Ill risk this treatment. If it doesnt work out, thats OK with me, he said.

Still, as a physician, Lasco would not recommend alternative treatments to his own family.

People have their own reasons [for using such treatments]I dont want to debate [against them] because its easy to find someone who died due to chemotherapy, he said.

Whether we like it or not, we are mortals and one way or another, we will all die. So the best thing we can do [as doctors] is to show patients that this kind of treatment, based on a global study, has a recovery rate of this percentage.

Profiting on pain

Lasco, however, remains worried about fraudulent healers who take advantage of patients desperate to find a cure for their terminal illnesses, specifically cancer.

The country is no stranger to such charlatans. In the 1970s, for example, the Philippines became known for its psychic healers and those who claimed to be able to perform surgery with their bare hands. The most famous of them, Ramon Jun Labo, even treated the late comedian Andy Kaufman and then-President Ferdinand Marcos. Labo was later sued for swindling in Moscow by thousands of his former clients.

Another high-profile alternative healer was Antonia Park, who admitted to Rappler in 2014 that she was not a registered physician in the Philippines, despite working as a stem cell doctor for former President Gloria Macapagal Arroyo and the late Quezon City Vice Mayor Charito Planas.

Park was sued by businessman Bernard Tan in 2013 after Park treated his late daughter, Kate Tan, whose cancer recurred in 2012.

According to Bernard, Park said his daughter was just suffering from a hormonal imbalance and promised to treat her within three months through stem cell therapy, Rappler reported. Park also put Kate on a restrictive diet featuring fruit and vegetable juices. But as the months passed, Bernard noticed that his daughter was not getting any better.

Kate ultimately went back to chemotherapy and died in July 2013, with Bernard blaming Park for her death. Park was charged with fraud and reckless imprudence resulting in homicide, and her clinic was shut down by the authorities.

Lasco said that despite peoples understandable motivations for seeing alternative treatments, there is a need to protect patients and their families from healers of questionable backgrounds, without dismissing the legitimate fears and concerns of patients.

We should be vigilant about how peoples desperation [is] being used by these alternative providers. Our regulatory agencies should go after these treatments, Lasco said.

People dont want to give up that easily, and they will avail of treatments, especially these treatments offered by people who offer them hope. Ive seen it happen that theyre taken advantage of, he noted. Theres no way to prove if these treatments work or not because people dont complain because theyre dead.

Read more Coconuts Manila feature stories here.

'Comfort' or con? Despite money, education, well-off Filipinos turning to questionable treatments - Coconuts

Phage therapy: The antibiotics alternative – Sydney Morning Herald

Posted on January 19, 2020 by Danzig

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Just after 10pm on a still Sunday night in March 2016, Jeremy Barr, having cleaned up the dinner dishes in his San Diego apartment, was thinking about bed when his mobile phone buzzed into life with a FaceTime call. Barr instantly recognised the mane of striking salt-and-pepper hair and trimmed beard on the screen. It was his laboratory supervisor at San Diego State University, Professor Forest Rohwer, one of the worlds leading microbial ecologists, and his tone was urgent.

Rohwer, a 47-year-old with a thoughtful demeanour, began quizzing the young scientist from Brisbane about his research into bacteriophage therapy phage therapy, for short which turns viruses into chemical weapons against antibiotic-resistant bacterial infections. Rohwer was curious about how Barr removed toxins from phages, so they were safe to use in humans.

Whats this about Forest? interrupted Barr, whod been working at Forests San Diego lab for four years on a postdoctoral fellowship. Rohwer explained that a local man had contracted a superbug while on holiday in Egypt and the most powerful antibiotics had failed to work. Now on the brink of multi-organ failure, the man would almost certainly die within days unless the infection could be stopped in its tracks. Could bacteria-eating phages be put to work to kill the deadly disease?

Phages, unlike antibiotics, are not drugs. Rather, they are hunt-and-kill viruses.

Both men were aware of the perilous risks of such a procedure. Phages, unlike antibiotics, are not drugs. Rather, they are hunt-and-kill viruses that inject their DNA into bacteria cells, causing the bacteria to burst and die.

The downside is that when the bacteria burst, they also release poisonous impurities and endotoxins, which can kill a person quickly with septic shock. Thats why its vital the phages be scrubbed clean of these endotoxins, without damaging or deactivating the bacteria-zapping viruses.

Could Barr perform this critical task of purifying the phages, sourced from laboratories across the US, within a couple of days, Rohwer enquired. Barr did a quick mental calculation. Yes, he said. I reckon its doable.

But Barr, a tall, slim, fair-haired 30-year-old, was terrified the moment he hung up. Hed never prepared anything for human trial before; his was still an experimental treatment. And this would be the first case in the US of a person receiving intravenous phage therapy for a systemic superbug infection that antibiotics couldnt treat.

About 20 minutes drive away, at Thornton Hospital at UC San Diego Health, the patient in question, a 69-year-old man, a lifelong surfer whod always been super fit, was hooked up to a maze of tubes, including a respirator, in an induced coma.

A. baumannii now shares top billing with two other superbugs listed by the WHO as being the most dangerous to human health.

Tom Pattersons swollen stomach contained a pseudocyst (a pocket of fluid) the size of a football and his body was swimming with a deadly, multi-drug-resistant superbug, the bacterium Acinetobacter baumannii, sometimes dubbed Iraqibacter for its signal talent for striking wounded soldiers during the last Iraq War. (A. baumannii now shares top billing with two other superbugs listed by the World Health Organisation (WHO) as being the most dangerous to human health.)

Patterson had been in a coma for weeks and had lost 45 kilograms from his formerly athletic, strapping 6 feet 5, 100-kilogram-plus frame. Only months earlier, in late November 2015, Patterson and his wife, Steffanie Strathdee, had been holidaying in Egypt.

Just hours after enjoying a romantic moonlit dinner on the top deck of a cruise boat on the Nile, Patterson developed nausea and vomiting, which hed initially dismissed as food poisoning (the intrepid couple had had their share of stomach bugs during their many trips, and routinely packed the antibiotic Cipro). But when he developed severe diarrhoea and a fever, Patterson was rushed by ambulance to a local medical clinic. Within hours the pain was so excruciating the hairs on his head burned.

Pattersons condition worsened over the next few days, to the extent he could no longer even get up to go to the bathroom. Overcome with a growing sense of panic, Strathdee pressured the doctors, who diagnosed pancreatitis.

After two weeks of not responding to treatment, looking deathly pale and losing weight, Patterson was medivaced to Frankfurt Hospital in Germany. Here, doctors discovered a pancreatic cyst teeming with A. baumannii. The only antibiotics that had any braking effect on the microbes lethal spread were the powerful meropenem and tigecycline, and the big gun colistin, a drug of last resort because it can lead to kidney damage.

By the time Patterson was airlifted home to San Diego to the intensive care unit at Thornton Hospital he was delirious, imagining (among other things) that there were hieroglyphics on the walls. He had become resistant to the big three antibiotics administered to him intravenously. Even worse, A. baumannii had migrated through his whole body. He was placed in a medically induced coma.

So much for the dark part of the story; now for the moment of serendipity. Pattersons wife Steffanie Strathdee was an infectious disease epidemiologist at UC San Diego (UCSD), where Patterson was a professor of psychiatry. Refusing to give up on her husband, Strathdee had been researching A. baumannii and treatments to fight it via PubMed, the search engine of the National Library of Medicine, for some weeks.

One night in February, 2016, she researched phage therapy in more detail, compiling a list of US phage researchers. Her mind drifted back to studying phages in virology classes as an undergraduate. Derived from the Greek term phagein, meaning to devour, phages were once medicines great hope, after these bacteria-eating viruses were discovered in England and France during World War I, and later employed with mixed success.

An artists illustration of a phage virus attacking bacteria.Credit:Getty Images

But after the mass production of the more reliable, easier-to-use antibiotic, penicillin, in the mid-1940s, phage research was left behind and eventually forgotten in the West, although it remained popular in the Soviet Union (Stalin was a fan of phage therapy). Its still possible to buy generic phages over the counter in Russia, Poland and Georgia, but they are only effective if they match the specific bacterium causing the infection, so can be unreliable.

The difference between the phage therapy of the past and today is DNA technology, which allows phages to be matched for their specific bacteria-killing properties. Now, with time running out, Strathdee appealed to Dr Robert Chip Schooley, professor of medicine in the division of infectious diseases at UCSD, who, although sceptical at first, helped her locate a selection of phages specifically designed to fight the malevolent invader killing her husband, which sequencing showed was an Egyptian strain of A. baumannii.

Researchers from three US laboratories forwarded the phages and they were granted emergency approval for use from the US Food and Drug Administration.

The tiny bacteriophages, housed in sealed plastic tubes, arrived at Barrs lab in the late afternoon after Rohwers phone call the night before. Dressed in his regulation white lab coat, plastic goggles and rubber gloves, Barr set about stripping the phages of their toxins, a long and painstaking process involving successive washes, cooling and spinning treatments in a centrifuge. What he had to avoid at all costs was damaging or destroying the phages: these were the only batches available.

A phage resembles an alien spacecraft with spindly legs that lock on to the surface of the much bigger bacterial cell.

In the early hours of the following morning, a weary Barr placed the cleaned phages in a speed vacuum to boil away the residual alcohol, a process that would take five hours. Then he went home to grab some sleep.

And wait.

Since his days studying microbiology at the University of Queensland in his 20s, Barr had been fascinated with phages. Under an electron microscope, a phage resembles an alien spacecraft with spindly legs that lock on to the surface of the much bigger bacterial cell. Here it penetrates the bacteriums protective shell and takes over its cellular machinery to produce more phages.

Overwhelmed by the invader, the bacterium dies, releasing a flood of new bacteria-gobbling phages.

When Barr returned to the lab the next morning, everything appeared to have gone smoothly. But the phage testing kit, which compared the results before and after endotoxin removal, repeatedly failed and his heart sank. Another had to be despatched from Germany, which set him back another day.

After 24 hours of intense frustration, Barr faced the moment of truth with the new testing kits colourimetric read-out: bright yellow marked a high and dangerous endotoxin level, clear indicated a low safe level. When it came up clear, Barr almost jumped for joy and immediately buzzed Forest Rohwer, who got in his car and drove the phages, packed in a freezer box with ice packs on the passenger seat, straight over to the hospital.

Dr Schooley pumped the first of five phages directly into Pattersons pseudocyst via catheters, and followed this up with an intravenous injection of the remaining phages.

On the evening of March 19, 2016, Patterson awoke from his coma for the first time in more than two months, turned to his eldest daughter and kissed her on the hand. Even though the bacteria developed resistance to the initial phages, and Patterson slipped into septic shock the following week, Schooleys team fought back the infection with more phages, while Barr kept adjusting the cleaning protocol to keep them safe. After three months and another setback, Pattersons infection was completely under control and, in August, he was discharged.

Illustration of Bacteriophage anatomy.Credit:Getty Images

The case grabbed international headlines when it was announced to the press in early 2017, and since then there have been a number of remarkable victories with phage therapy, including the recovery of a 16-year-old girl with cystic fibrosis in Kent, England, whose life was threatened by a strain of mycobacterium,and a 17-year-old Sydney boy critically ill with a golden staph infection, who suffered a stroke and went into a coma.

Trials in the US, Belgium, the UK and Australia suggest that phage therapy could become an important part of the arsenal against the growing crisis of antibiotic resistance across the globe.

Its a common myth that only those who use antibiotics regularly, or the sick, elderly and infirm, are at risk of developing antibiotic resistance. The unhappy fact is that anyone can get an infection thats resistant to the drugs, no matter how healthy and fit they are.

I should know. When it comes to antibiotic resistance, Im an interested party.

Ding Dong. Its 8pm on a steamy night in mid-January 2019, and Luna, our highly excitable Staffordshire cross, skids across the polished floorboards trying to beat my partner to the front door when the doorbell rings. Im in the kitchen drinking my umpteenth glass of water. I dont feel well.

I ask whether I might eat a bite of dinner first. He hands me the results of the tests and a referral for hospital staff. No, he says.

Its my doctor, a compact man in his 30s with a kind, round face, floppy, jet-black hair, and a taste in bright chinos. Ive been trying to ring you, he says, standing in our living room, to which I splutter something about my phone sitting upstairs being recharged. Youve got to go straight to hospital. Youre very seriously ill. You have highly elevated inflammatory markers.

I ask whether I might eat a bite of dinner first. He hands me the results of the tests and a referral for hospital staff. No, he says gently. You should go now.

I take a deep breath. Since returning from a short work trip to South Africa some weeks earlier, Id been feeling strangely under par, with an overpowering lethargy and body aches classic flu symptoms but with no sore throat or cough. The leeching of my energy levels was disconcertingly out of character, my partners standard simile for me being that Im like a human Eveready battery.

Before departing, Id had a complete physical (passing with flying colours), and all the requisite jabs, including for hepatitis A, malaria and tetanus. On the day before I flew back to Australia, I, along with a small posse of other journalists, was given a tour of a crowded medical clinic in a remote, northern part of the country. Within a day or so of my return, I fell ill. I asked my doc: could I have picked up some unpleasant microbial hitchhiker while I was away, or was this just an unlucky coincidence?

I dont believe in coincidences, he replied, writing me a script for oral antibiotics. Lets see if this knocks it out.

After a few days on them, I felt better, but within a week or two of finishing the script the symptoms returned, only with far, far greater force. These peaked one night in a fitful, feverish sleep in which my eyes were jolted open every couple of hours by unusually vivid dreams. Of my teeth falling out. Of cutting my way through a steamy jungle as thorns and sharp branches ripped the hell out my skin. Each time I awoke I was saturated in a sweat so thick my hands were drenched wiping it off despite a standing fan blasting air on me less than a metre away.

Fevers always seem worse at night, of course, with sensitivities heightened and distractions lowered. The next morning, I went straight back to my doctor, who after taking my temperature (raised) and blood pressure (significantly up) immediately ordered a full battery of blood and urine tests.

Ill mark them urgent, he said, scrolling back through my medical records. The results should be back by late this afternoon. Ill call you.

When I check my medical report I notice more than half the antibiotics administered to me resisted the killing powers of the bug.

So after my doctors visit to my house, here I am sitting in the waiting area of Accident and Emergency at my local hospital, mind in neutral, mystified as to why Ive become enveloped by this mysterious illness, but concerned about the man next to me, who is bent over, wracked in far greater pain than I.

After a couple of hours of waiting, and another series of tests, including blood cultures, Im taken into triage, where the doctor and nurse trade glances and talk about IV antibiotics. He also needs IV fluids, the doc adds.

What you reckon this is? I ask tentatively. Im sure you havent got cancer, the doctor says reassuringly. But you do have a serious infection.

Within a couple of hours of receiving IV antibiotics, my heart rate and blood pressure have settled down, Im feeling a hell of a lot better, and Im discharged the following morning. But when I later check my medical report I notice more than half the antibiotics administered to me resisted the killing powers of the particular bug, from the enterobacteriaceae family, Id been infected with.

Fortunately, the bug was sensitive to three of the drugs so I was soon on the mend. The earlier round of oral antibiotics just hadnt been strong enough to vanquish the bacterium, my doctor later tells me.

Peter Collignon, professor of microbiology at the Australian National University, has been warning about the overuse of antibiotics for more than 30 years.

Weve known about the increasing threat of drug-defying strains of bacteria for decades. In 2014, the World Health Organisation called antibiotic resistance a major global threat and early last year warned that a slew of serious and common complaints, from sexually transmitted diseases such as gonorrhoea and syphilis to respiratory and urinary tract infections, are becoming untreatable, posing a major public-health menace, especially among the very young, the elderly and the seriously ill.

We have reached the point where we should be very worried. An increasing number of infections are becoming harder or almost impossible to treat. Thats Peter Collignon, professor of microbiology at the Australian National University, and director of the infectious diseases unit at Canberra Hospital, whos been warning about the overuse of antibiotics for more than 30 years.

Although Australia has much lower antibiotic-resistance levels than most countries, were facing a tsunami of resistance among our neighbours to our north, in Indonesia, India and China, where levels are two or three times those of 30 years ago, says Collignon. Fifty per cent of common infections in India are untreatable now, he warns. Were virtually back to the 1920s.

We have reached the point where we should be very worried. An increasing number of infections are becoming harder or almost impossible to treat.

Since that day in September 1928 when Alexander Fleming realised the spores growing in his lab were what hed call penicillin, to antibiotics coming into general use in the late 1940s, countless millions of lives have been saved.

But humanity swiftly began to overuse the drugs, especially after it was found in the early 1950s that they helped accelerate growth and weight in chickens, pigs and cattle. By volume, 80 per cent of antibiotics in the world are given as food to animals, although its much lower in Australia, around 50 per cent, says Collignon. Whatever you do with animals comes back to people.

The overuse of antibiotics in livestock produces dangerous drug resistant bacteria that can spread throughout the environment. This prompted the WHO in 2017 to call for a global ban on the use of antibiotics to promote growth in healthy livestock.

China, which produces and consumes the most antibiotics in the world, uses more than 160,000 tonnes of the drugs a year, according to a 2013 study by the Chinese Academy of Sciences. Antibiotic-resistant genes are turning up in river systems, soil and even the air around farming areas in China and the US, say a wave of reports coming out of those countries.

In an eye-opening study early last year, a team of scientists at Perths Murdoch University found that one in five Australian silver gulls were carrying superbugs such as E. coli, resistant to antibiotics. Worryingly, the latest research also shows mutated strains of common bugs are becoming more potent in infecting hosts.

Antibiotic resistance not only makes it more challenging to treat infections, but it may make bacteria more robust, more able to cause infection, notes Collignon. Which means not just more antibiotic-resistant deaths but many more people with urinary tract, sinus and respiratory infections that will become chronic because theyll never be completely cleared up.

Theres no doubt the number of people dying from antibiotic resistance is climbing each year, from about 700,000 currently to an estimated (and conservative) 10 million deaths annually by 2050, according to the WHO. Although no global system for tracking antibiotic use exists, a survey of 76 countries published in the journal Proceedings of the National Academy of Sciences in 2018 found the use of antibiotics in humans increased nearly 40 per cent between 2000 and 2015.

One distinct advantage of phages over antibiotics is that theyre a natural part of the environment, found in air, soil and water in countless trillions upon trillions. Thats because wherever a bacterium set up home, theres a bacteriophage ready to break in.

Even a drop of raw sewage, taken from deep within the bowels of a hospital, could contain the chemical elixir that might fight an antibiotic-resistant infection in a patient languishing in a bed four floors above, as I find to my astonishment when I visit a research facility in western Sydney.

Sydney phage researcher Dr Aleksandra Petrovic Fabijan has worn a hazmat suit to collect samples of raw sewage at the citys Westmead Hospital.Credit:Dominic Lorrimer

Its mid-morning at Sydneys Centre for Infectious Diseases and Microbiology at Westmead Institute for Medical Research, the largest phage research facility in Australia, and Dr Aleksandra Petrovic Fabijan is telling me how she always keeps an eye out for a good spot to take a sample of bacteriophages, whether at placid, bucolic landscapes such as lakes and parks, while out for a picnic with her family, or at less pleasant, germ-filled places such as water treatment facilities.

Petrovic Fabijan and other members of her team have even donned impermeable yellow hazmat suits to venture into the deepest bowels of Westmead Hospital to extract samples of raw sewage to drop into specimen jars (for less hazardous sites of phage collecting, they dont have to swaddle themselves in a hazmat suit). The amount of protection depends on where youre sourcing the phages, she explains.

Dr Carola Venturini, a postdoctoral scientist at the institute, tells me shes even collected stool samples from her 12-year-old cattle dog, Cathy. You have to go where the bacteria are, which is also where youre likely to find a phage against it. From humans, weve taken sputum, faeces and skin scrapings and baby poo.

Dr Carola Venturini, phage researcher at Sydneys Centre for Infectious Diseases and Microbiology. "You have to go where the bacteria are, which is also where youre likely to find a phage against it," she says.Credit:Dominic Lorrimer

For phage therapy to advance, phage biobanks will have to be built into research facilities, explains Venturini, and the institute was recently awarded a research grant for this very purpose. You need to have a wide variety of high-quality phage samples already on hand to deal with any number of antibiotic resistant infections that arise.

The team at Westmead has treated 14 patients with phage therapy since 2017, including people seriously immunocompromised from kidney transplants and infected heart valves. If success is judged by the elimination of superbugs (so-called 28-day mortality, or survival one month after the infection has cleared), then its been a success, with eight patients beating the infection.

Long-term survival is very challenging because of these serious pre-existing and underlying diseases, explains Associate Professor Ruby Lin, project manager of the bacteriophage therapy team. Treatment typically takes about 14 days, with the phages intravenously injected twice a day, in parallel to prescribed antibiotics for the patient.

So far, research at Westmead has shown that phage therapy is safe and tolerable in patients, and only kills bacteria, with no harm to human cells. However, we need more evidence, particularly from randomised controlled trials, before we can offer it in a regular health case setting, says Lin, who as a teenager was driven to study genetics to find a treatment or cure for her older blind brother, who would go on to become the respected New Zealand wine consultant, C.P. Lin.

Phage researcher at Sydneys Centre for Infectious Diseases and Microbiology, Associate Professor Ruby Lin.Credit:Dominic Lorrimer

Lin, Venturini and Petrovic Fabijan are part of the Critical Infection/BARRD Group, a team of microbiologists led by Professor Jon Iredell at the front line of phage therapy in Australia.

Iredell, a youthful-looking 59-year-old who has been working in infectious diseases for more than 30 years, sums up the advantage of phages over antibiotics in three bullet points. First, because phages can be found everywhere on Earth, there are untold trillions available, unlike antibiotics. Second, phages only target bacteria, not the so-called good bugs in the host. Third, once biobanks are established, phages can be administered fairly quickly within 24 hours of a superbug diagnosis, in some cases.

But Iredell concedes phages cant beat the convenience of antibiotics. With antibiotics we know what their structure is and we can administer them to multiple people. With phage therapy, we have to develop phage cocktails for each patient tailored to the infecting bacterium.

Were now able to link the DNA signatures of viruses to the signatures of the bacteria, which accelerates the matching process.

But what Iredell calls the ultimate personalised medicine is also perfectly placed to take advantage of the leaps in todays medical technology, such as DNA testing, mapping the human genome, robotics and artificial intelligence.

These technologies, which werent possible 15 years or so ago, are advancing phage therapy, he says. Were now able to link the DNA signatures of viruses to the signatures of the bacteria, which accelerates the matching process.

Money for phage research worldwide has been slow to pour in, notes Iredell. How do you develop intellectual property around a product that naturally occurs in the environment? he asks. No one knows how to make a dollar out of it. Its not like you need to take a pill every day for the rest of your life, which is how pharmaceutical companies make money. (A similar lack of financial incentive is the reason why research into new antibiotics, also a class of drugs you only take occasionally, has been progressing at a snails pace for decades: most new drugs in the pipeline are only enhancements of existing drugs.)

Phage researcher at Sydneys Centre for Infectious Diseases and Microbiology, Professor JonIredell: "How do you develop intellectual property around a product that naturally occurs in the environment?"Credit:Dominic Lorrimer

Dr Karen Weynberg, of the school of chemistry and molecular biosciences at the University of Queensland, is researching synthetic phages, which in theory would be free of the toxins and risks associated with the natural ones. My goal is to engineer superphages to fight superbugs, she tells me.

Because phage therapy to date has been largely administered on compassionate grounds to elderly people gravely ill with other long-term illnesses that may sooner or later kill them, its success in eliminating a life-threatening infection isnt easy to herald to the media, or even the medical community. Its the miracle recovery stories of the young that grab the headlines.

But sometimes a couple of extra weeks or months of survival can mean the world of difference, not just to sufferers but loved ones, too. Penelope Jackson, a semi-retired resident of the Blue Mountains outside Sydney, had a serious heart condition dating back to a bout of rheumatic fever she suffered as a child growing up in Britain in the 1960s.

Until about 12 years ago, nothing seemed to stop Penny, recalls her husband Russell Jackson, who migrated to Australia with her in 1999, when the couple were in their 40s. Even after Penny had her second heart valve replaced in 2007, she was working hard and keeping busy around the house. Almost until the final months of her life, she was running her dog grooming business from home, he adds, in a thick Mancunian accent.

Russell Jackson is grateful for how phage therapy helped his wife.Credit:Wolter Peeters

One Saturday night in June last year, after suffering breathlessness and chest pain, Penny was taken to the hospitals in Katoomba and later in Nepean, where her condition rapidly deteriorated.

She arrested three times, was intubated, and went into a coma, says Russell, 62. After Penny was transferred to Westmead Hospital, doctors told him that a superbug infection (methicillin-resistant staphylococcus or MRSA) had colonised the tissue around her mechanical heart valves, and antibiotics had failed to quell the infection.

Here it was decided that Penny would be a good candidate for phage therapy, and after two weeks of treatment, the infection cleared up. The antibiotics on their own werent working, but a combination of the phages and the antibiotics saw her recover, says Russell. Another major operation to replace her faulty valves appeared to have been a success.

Even the most fervent advocates for phage therapy concede its unlikely to supplant antibiotics.

Penny returned home and the couple had a blissful two weeks together. So much better did Penny feel that on a Sunday afternoon the pair trudged through car sales yards to check out options for a new car for her. She was due to see her cardiologist on Monday morning.

When Russell went to wake her at about 7am, she had passed from a heart attack. It was of course a terrible shockbut Im so grateful she died at home peacefully, he says.

If phage therapy is a new script for an old plot the one titled humanitys millennia-old battle against infectious disease the obvious question is, will it ever replace antibiotics? Does it represent a stand-alone cure-all?

No, and no. Even the most fervent advocates for phage therapy concede its unlikely to supplant antibiotics because of the latters long-standing success and ease of use. At most, it will be a powerful ally in the battle against infectious disease. For this to happen, phage therapy needs to be shown to be safe, effective and practical on a large scale.

Since her husbands ordeal made medical history, Steffanie Strathdie has written a book about her story, The Perfect Predator, published last year, and set up IPath, a non-profit phage facility at UCSD aimed at ensuring patients suffering from life-threatening superbug infections have a place to turn.

The rest is here:

Phage therapy: The antibiotics alternative - Sydney Morning Herald

Measures to regulate wellness tourism sector in the pipeline – Sunday Observer

Posted on January 19, 2020 by Danzig

The Sri Lanka Export Development Board (EDB), is working to generate more revenue, particularly foreign exchange through ayurvedic services by catering to niche markets which are growing fast. An emphasis on this sector has been placed in the National Export Strategy (NES) where wellness tourism is a major component.

Wellness tourism includes Ayurveda, the Western medical sector, yoga, meditation, spa and relaxation activities. This is a sector where tourists spend four-five folds more and measures are needed to regulate the sector to attract tourists which is a high-end product, Director General, EDB, Jeevani Siriwardena said.

There has been a holistic approach towards the wellness tourism sector by several institutions, including Ayurveda Department, Ministry of Health, EDB, and Foreign Ministry. The country will be geared to meet the growing demand for this kind of services and to this end, required standards and regulatory measures will be taken by the government, she said.

The EDB has identified the export value of the Sri Lankan Ayurveda services in 2013 and facilitated the International Trade Centre (ITC) to carry out a study on the Sri Lankan Health Tourism industry. The study identified the niche capabilities of the Sri Lankan Ayurveda and Wellness sector and the significance of synergy between the main two segments in terms of promotion.

There is an increasing trend in non-communicable diseases (NCDs) in the country and an ayurveda related approach has been the choice of many. This has created a huge demand for the services locally and internationally and it is necessary to improve the service to ensure high standards are maintained, Deputy Director, Technical-Medical, Ministry of Health, Nutrition and Indigenous Medicine, Dr. T. Weerarathna said.

It is necessary to focus on the quality of practitioners, education, products, safety, quality and efficiency. It is encouraging to note that the government has taken steps to provide and pay emphasis on ayurveda education. A university degree up to Masters level has been offered to selected students. This has ensured the high standards of the ayurvedic services. There has been a project to preserve ayurveda knowledge. To this end, a research centre to collect data and identify ayurveda practitioners is in place, he said.

Dr. Weerarathna said that health tourism has two components of medical and wellness tourism. It is necessary to set up regulated healthcare facilities in the country to promote health tourism in a sustainable manner. The concept includes spa, meditation and yoga to ensure well-being and prevent illness. There is a four fold promotion to achieve desired results, he said.

The Department of Ayurveda has drafted regulations to ensure quality, standards and safety. There will be accreditation and guidelines for ayurvedic practitioners. With a view to ensure credibility of service, an Act will be introduced with specific rules and regulations shortly. The EDB is working in collaboration with the Department of Ayurveda to develop National Standards/Regulations for Ayurveda Private Healthcare Institutions to regulate the industry. According to this process, the Department of Ayurveda has now developed the Draft Rules and Regulations on Traditional Medicine (Medical Tourism) Institutions (under Section 10 of the Ayurveda Act, No. 31 of 1961).

A pilot project to set up wellness centres is currently underway to promote the sector in a regulated environment, he said.

Practitioners in the wellness tourism industry have endorsed the formation of the Sri Lanka Wellness Tourism Association (SLWTA).

The EDB has identified the health sector as a prominent export sector, and in 2017, the sector selected as the key focus sector in National Export Strategy (NES). The Wellness Tourism Strategy was developed as part of the NES of Sri Lanka with three main objectives with development and promotional activities in collaboration with the Ayurveda, Western medical and Tourism sector stakeholders.

The first objective concentrates on sector coordination and cohesion. The traditional wellness and the western medicine segments need clusters to organise and improve cooperation among stakeholders.

The second objective focuses on regulation and quality assurance through standardisation, licensing of activities and recognition of traditional healing in target markets and streamlining of institutional procedures. The third objective focuses on gathering more information on the sector through more effective collection of statistics and sharing sector information, to the local population and to foreigners in target markets.

The concept of Wellness Tourism is with a broader spectrum of niche health and medical services inherited by Sri Lanka. However, the ayurveda/indigenous sector remains as the major contributor to this wellness tourism service followed by western medical service and other alternative medicines.

The sector achieved this position within the short time spam considering the contribution to the export growth of the country. Following the National Export Strategy (NES), the EDB formed the Wellness Tourism Advisory Committee comprising leading private sector stakeholders and relevant government officials to drive the sector specific activities.

The EDB identified the wellness tourism mainly Ayurveda and health services as a key sector and initiated this international promotions to increase earnings from the service export sector. The EDB has created a platform for the different service segments to work together towards the economic development of the sector.

By developing these standards, all private sector businesses, including the private healthcare hospitals, clinics and the Wellness centres which are carried out based on Ayurvedic principles will be regulated by the Department of Ayurveda to ensure safe and quality service for the medical travellers.

The rest is here:

Measures to regulate wellness tourism sector in the pipeline - Sunday Observer

More Mysterious Space Blobs Have Been Found Near the Center of the Milky Way – Universe Today

Posted on January 19, 2020 by Danzig

At the center of our galaxy lies a region where roughly 10 million stars are packed into just 1 parsec (3.25 light-years) of space. At the center of this lies the supermassive black hole (SMBH) known as Sagittarius A*, which has a mass of over 4 million Suns. For decades, astronomers have been trying to get a better look at this region in the hopes of understanding the incredible forces at work and how they have affected the evolution of our galaxy.

What theyve found includes a series of stars that orbit very closely to Sagittarius A* (like S1 and S2), which have been used to test Einsteins Theory of General Relativity. And recently, a team from UCLAs Galactic Center Orbits Initiative detected a series of compact objects that also orbit the SMBH. These objects look like clouds of gas but behave like stars, depending on how close they are in their orbits to Sagittarius A*.

The study that describes their findings, which recently appeared in the journal Nature, was led by Dr. Anna Ciurlo of the University of California, Los Angeles (UCLA). As they indicate in their study, these objects orbit our galaxys SMBH with a period of between 100 to 1,000 years. These objects look compact most of the time but stretch out when they are at the closest point in their orbits to the black hole.

Their work builds on about fifteen years of observations that have identified more and more of these objects near the center of our galaxy. The first object (later named G1) was discovered in 2005 by a team led by Andrea Ghez, the Lauren B. Leichtman and Arthur E. Levine Professor of Astrophysics the director of theUCLA Galactic Center Group and a co-author on this study.

This was followed in 2012 when Prof. Ghez and her colleagues found a second object (G2) that made a close approach to Sagittarius A* in 2014. Initially, G1 and G2 were thought to be gas clouds until they made their closest approach to the Sagittarius A*s and were not shredded by the SMBHs gravitational pull (which is what happens normally to gas clouds when approaching a black hole). As Ghez explained:

At the time of closest approach, G2 had a really strange signature. We had seen it before, but it didnt look too peculiar until it got close to the black hole and became elongated, and much of its gas was torn apart. It went from being a pretty innocuous object when it was far from the black hole to one that was really stretched out and distorted at its closest approach and lost its outer shell, and now its getting more compact again.

In 2018, Dr. Cuirlo and an international team of astronomers (which included Prof. Ghez) used twelve years of data gathered by the W.M. Keck Observatory and adaptive optics technology (which Prof. Ghez helped pioneer) to identify three more of these objects (G3, G4, and G5) near the galaxys center. Since that time, a total of six objects have been identified in this region (G1 G6).

In this most recent study, the team led by Dr. Cuirlo used 13 years of near-infrared data obtained by the W.M. Kecks OSIRIS integral field spectrometer to examine the orbits of these six objects. Astronomers are exciting to study these objects because they provide astronomers with an opportunity to test General Relativity something which Prof. Ghez and her colleagues did in the summer of 2019.

And as Mark Morris a UCLA professor of physics and astronomy and a co-author on the study explained, the fate of these objects is something astronomers want to know because it expected to be quite spectacular.

One of the things that has gotten everyone excited about the G objects is that the stuff that gets pulled off of them by tidal forces as they sweep by the central black hole must inevitably fall into the black hole, he said. When that happens, it might be able to produce an impressive fireworks show since the material eaten by the black hole will heat up and emit copious radiation before it disappears across the event horizon.

In the course of observing the Milky Ways central region, the research group has reported the existence of six objects so far. However, they also noticed that while G1 and G2 have very similar orbits, the other four objects differ considerably. This naturally gives rise to the question of whether all six are a similar class of objects, or G1 and G2 are outliers.

Addressing this, Ghez and her colleagues believe that all six objects were binary stars that merged because of the SMBHs strong gravitational force. This process would have taken more than 1 million years to complete and could be an indication that binary star mergers are actually quite common. As Ghez explained:

Black holes may be driving binary stars to merge. Its possible that many of the stars weve been watching and not understanding may be the end product of mergers that are calm now. We are learning how galaxies and black holes evolve. The way binary stars interact with each other and with the black hole is very different from how single stars interact with other single stars and with the black hole.

Another interesting observation, which Ghezs team reported on back in September of 2019, is the fact that Sagittarius A* has been growing brighter in the past 24 years an indication that it is consuming more matter. Similarly, the stretching of G2 that was observed in 2014 appeared to pull gas away from it that may have been recently consumed by the black hole.

This could be an indication that the stellar mergers taking place in its vicinity are feeding Sagittarius A*. The most recent observations also showed that while the gas from G2s outer shell was stretched dramatically, the dust contained inside did not get stretched much. This means that something kept the dust compact, which is compelling evidence that star could be inside G2.

As Ciurlo said, this discovery was made possible thanks to decades worth of observations by the UCLA Galactic Center Group.

The unique dataset that Professor Ghezs group has gathered during more than 20 years is what allowed us to make this discovery. We now have a population of G objects, so it is not a matter of explaining a one-time event like G2.

Meanwhile, the team has already identified a few other candidates that could belong to this new class of objects and are continuing to analyze them. Ultimately, this research will help astronomers to understand what is happening in the majority of galaxies and how interactions between stars and SMBHs in their cores are helping to drive their evolution.

The Earth is in the suburbs compared to the center of the galaxy, which is some 26,000 light-years away, said Ghez. The center of our galaxy has a density of stars 1 billion times higher than our part of the galaxy. The gravitational pull is so much stronger. The magnetic fields are more extreme. The center of the galaxy is where extreme astrophysics occurs the X-sports of astrophysics.

H0LiCOW! Cosmic Magnifying Glasses Yield Independent Measure of Universe’s Expansion That Adds to Troubling Discrepancy – SciTechDaily

Posted on January 19, 2020 by Danzig

Each of these Hubble Space Telescope snapshots reveals four distorted images of a background quasar surrounding the central core of a foreground massive galaxy.The multiple quasar images were produced by the gravity of the foreground galaxy, which is acting like a magnifying glass by warping the quasars light in an effect called gravitational lensing. Quasars are extremely distant cosmic streetlights produced by active black holes.The light rays from each lensed quasar image take a slightly different path through space to reach Earth. The pathways length depends on the amount of matter that is distorting space along the line of sight to the quasar. To trace each pathway, the astronomers monitor the flickering of the quasars light as its black hole gobbles up material. When the light flickers, each lensed image brightens at a different time. This flickering sequence allows researchers to measure the time delays between each image as the lensed light travels along its path to Earth.These time-delay measurements helped astronomers calculate how fast the universe is growing, a value called the Hubble constant.The Hubble images were taken between 2003 and 2004 with the Advanced Camera for Surveys.Credit: NASA, ESA, S.H. Suyu (Max Planck Institute for Astrophysics, Technical University of Munich, and Academia Sinica Institute of Astronomy and Astrophysics), and K.C. Wong (University of Tokyos Kavli Institute for the Physics and Mathematics of the Universe)

People use the phrase Holy Cow to express excitement. Playing with that phrase, researchers from an international collaboration developed an acronymH0LiCOWfor their projects name that expresses the excitement over their Hubble Space Telescope measurements of the universes expansion rate.

Members of the H0LiCOW (H0 Lenses in COSMOGRAILs Wellspring) team used Hubble and a technique that is completely independent of any previous method to measure the universes expansion, a value called the Hubble constant.

This latest value represents the most precise measurement yet using the gravitational lensing method, where the gravity of a foreground galaxy acts like a giant magnifying lens, amplifying and distorting light from background objects. This latest study did not rely on the traditional cosmic distance ladder technique to measure accurate distances to galaxies by using various types of stars as milepost markers. Instead, the researchers employed the exotic physics of gravitational lensing to calculate the universes expansion rate.

The researchers result further strengthens a troubling discrepancy between the expansion rate calculated from measurements of the local universe and the rate as predicted from background radiation in the early universe, a time before galaxies and stars even existed. The new study adds evidence to the idea that new theories may be needed to explain what scientists are finding.

This graphic lists the variety of techniques astronomers have used to measure the expansion rate of the universe, known as the Hubble constant. Knowing the precise value for how fast the universe expands is important for determining the age, size, and fate of the cosmos.One set of observations looked at the very early universe. Based on those measurements, astronomers calculated a Hubble constant value. A second set of observation strategies analyzed the universes expansion in the local universe.The challenge to cosmologists is that these two approaches dont arrive at the same value. Its just as perplexing as two opposite sections of a bridge under construction not lining up. Clearly something is wrong, but what? Astrophysicists may need to rethink their ideas about the physical underpinnings of the observable universe.The top half of the illustration outlines the seven different methods used to measure the expansion in the local universe. The letters corresponding to each technique are plotted on the bridge on the right. The location of each dot on the bridge road represents the measured value of the Hubble constant, while the length of the associated bar shows the estimated amount of uncertainty in the measurements. The seven methods combined yield an average Hubble constant value of 73 kilometers per second per megaparsec.This number is at odds with the combined value of the techniques astronomers used to calculate the universes expansion rate from the early cosmos (shown in the bottom half of the graphic). However, these five techniques are generally more precise because they have lower estimated uncertainties, as shown in the plot on the bridge road. Their combined value for the Hubble constant is 67.4 kilometers per second per megaparsec.Credit: NASA, ESA, and A. James (STScI)

A team of astronomers using NASAs Hubble Space Telescope has measured the universes expansion rate using a technique that is completely independent of any previous method.

Knowing the precise value for how fast the universe expands is important for determining the age, size, and fate of the cosmos. Unraveling this mystery has been one of the greatest challenges in astrophysics in recent years. The new study adds evidence to the idea that new theories may be needed to explain what scientists are finding.

The researchers result further strengthens a troubling discrepancy between the expansion rate, called the Hubble constant, calculated from measurements of the local universe and the rate as predicted from background radiation in the early universe, a time before galaxies and stars even existed.

Annotated Compass Image of Gravitationally Lensed Quasars. Credit: NASA, ESA, S.H. Suyu (Max Planck Institute for Astrophysics, Technical University of Munich, and Academia Sinica Institute of Astronomy and Astrophysics), and K.C. Wong (University of Tokyos Kavli Institute for the Physics and Mathematics of the Universe)

The astronomy team that made the new Hubble constant measurements is dubbed H0LiCOW (H0 Lenses in COSMOGRAILs Wellspring). COSMOGRAIL is the acronym for Cosmological Monitoring of Gravitational Lenses, a large international project whose goal is monitoring gravitational lenses. Wellspring refers to the abundant supply of quasar lensing systems.

The research team derived the H0LiCOW value for the Hubble constant through observing and analysis techniques that have been greatly refined over the past two decades.

H0LiCOW and other recent measurements suggest a faster expansion rate in the local universe than was expected based on observations by the European Space Agencys Planck satellite of how the cosmos behaved more than 13 billion years ago.

The gulf between the two values has important implications for understanding the universes underlying physical parameters and may require new physics to account for the mismatch.

If these results do not agree, it may be a hint that we do not yet fully understand how matter and energy evolved over time, particularly at early times, said H0LiCOW team leader Sherry Suyu of the Max Planck Institute for Astrophysics in Germany, the Technical University of Munich, and the Academia Sinica Institute of Astronomy and Astrophysics in Taipei, Taiwan.

The H0LiCOW team used Hubble to observe the light from six faraway quasars, the brilliant searchlights from gas orbiting supermassive black holes at the centers of galaxies. Quasars are ideal background objects for many reasons; for example, they are bright, extremely distant, and scattered all over the sky. The telescope observed how the light from each quasar was multiplied into four images by the gravity of a massive foreground galaxy. The galaxies studied are 3 billion to 6.5 billion light-years away. The quasars average distance is 5.5 billion light-years from Earth.

The light rays from each lensed quasar image take a slightly different path through space to reach Earth. The pathways length depends on the amount of matter that is distorting space along the line of sight to the quasar. To trace each pathway, the astronomers monitor the flickering of the quasars light as its black hole gobbles up material. When the light flickers, each lensed image brightens at a different time.

This flickering sequence allows researchers to measure the time delays between each image as the lensed light travels along its path to Earth. To fully understand these delays, the team first used Hubble to make accurate maps of the distribution of matter in each lensing galaxy. Astronomers could then reliably deduce the distances from the galaxy to the quasar, and from Earth to the galaxy and to the background quasar. By comparing these distance values, the researchers measured the universes expansion rate.

The length of each time delay indicates how fast the universe is expanding, said team member Kenneth Wong of the University of Tokyos Kavli Institute for the Physics and Mathematics of the Universe, lead author of the H0LiCOW collaborations most recent paper. If the time delays are shorter, then the universe is expanding at a faster rate. If they are longer, then the expansion rate is slower.

The time-delay process is analogous to four trains leaving the same station at exactly the same time and traveling at the same speed to reach the same destination. However, each of the trains arrives at the destination at a different time. Thats because each train takes a different route, and the distance for each route is not the same. Some trains travel over hills. Others go through valleys, and still others chug around mountains. From the varied arrival times, one can infer that each train traveled a different distance to reach the same stop. Similarly, the quasar flickering pattern does not appear at the same time because some of the light is delayed by traveling around bends created by the gravity of dense matter in the intervening galaxy.

The researchers calculated a Hubble constant value of 73 kilometers per second per megaparsec (with 2.4% uncertainty). This means that for every additional 3.3 million light-years away a galaxy is from Earth, it appears to be moving 73 kilometers per second faster, because of the universes expansion.

The teams measurement also is close to the Hubble constant value of 74 calculated by the Supernova H0 for the Equation of State (SH0ES) team, which used the cosmic distance ladder technique. The SH0ES measurement is based on gauging the distances to galaxies near and far from Earth by using Cepheid variable stars and supernovas as measuring sticks to the galaxies.

The SH0ES and H0LiCOW values significantly differ from the Planck number of 67, strengthening the tension between Hubble constant measurements of the modern universe and the predicted value based on observations of the early universe.

One of the challenges we overcame was having dedicated monitoring programs through COSMOGRAIL to get the time delays for several of these quasar lensing systems, said Frdric Courbin of the Ecole Polytechnique Fdrale de Lausanne, leader of the COSMOGRAIL project.

Suyu added: At the same time, new mass modeling techniques were developed to measure a galaxys matter distribution, including models we designed to make use of the high-resolution Hubble imaging. The images enabled us to reconstruct, for example, the quasars host galaxies. These images, along with additional wider-field images taken from ground-based telescopes, also allow us to characterize the environment of the lens system, which affects the bending of light rays. The new mass modeling techniques, in combination with the time delays, help us to measure precise distances to the galaxies.

Begun in 2012, the H0LiCOW team now has Hubble images and time-delay information for 10 lensed quasars and intervening lensing galaxies. The team will continue to search for and follow up on new lensed quasars in collaboration with researchers from two new programs. One program, called STRIDES (STRong-lensing Insights into Dark Energy Survey), is searching for new lensed quasar systems. The second, called SHARP (Strong-lensing at High Angular Resolution Program), uses adaptive optics with the W.M. Keck telescopes to image the lensed systems. The teams goal is to observe 30 more lensed quasar systems to reduce their 2.4% percent uncertainty to 1%.

NASAs upcoming James Webb Space Telescope, expected to launch in 2021, may help them achieve their goal of 1% uncertainty much faster through Webbs ability to map the velocities of stars in a lensing galaxy, which will allow astronomers to develop more precise models of the galaxys distribution of dark matter.

The H0LiCOW teams work also paves the way for studying hundreds of lensed quasars that astronomers are discovering through surveys such as the Dark Energy Survey and PanSTARRS (Panoramic Survey Telescope and Rapid Response System), and the upcoming National Science Foundations Large Synoptic Survey Telescope, which is expected to uncover thousands of additional sources.

In addition, NASAs Wide Field Infrared Survey Telescope (WFIRST) will help astronomers address the disagreement in the Hubble constant value by tracing the expansion history of the universe. The mission will also use multiple techniques, such as sampling thousands of supernovae and other objects at various distances, to help determine whether the discrepancy is a result of measurement errors, observational technique, or whether astronomers need to adjust the theory from which they derive their predictions.

The team will present its results at the 235th meeting of the American Astronomical Society in Honolulu, Hawaii.

The Hubble Space Telescope is a project of international cooperation between the European Space Agency (ESA) and NASA. NASAs Goddard Space Flight Center in Greenbelt, Maryland, manages the telescope. The Space Telescope Science Institute (STScI) in Baltimore, Maryland, conducts Hubble science operations. STScI is operated for NASA by the Association of Universities for Research in Astronomy in Washington, D.C.

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H0LiCOW! Cosmic Magnifying Glasses Yield Independent Measure of Universe's Expansion That Adds to Troubling Discrepancy - SciTechDaily

Space is the place for impossible molecules – The Week Magazine

Posted on January 19, 2020 by Danzig

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Molecules containing noble gases shouldn't exist. By definition, these chemical elements helium, neon, argon, krypton, xenon, and radon are the party poopers of the periodic table, huddling in the rightmost column and refusing to make molecules. Indeed, no one has ever seen any naturally occurring noble gas molecules on Earth. Earlier this decade, though, astronomers accidentally discovered one of these aloof elements in molecules in space.

Then, in 2019, observers reported finding a second kind of noble gas molecule, one they had sought for more than three decades and of a type that was the very first to form after the universe's birth in the big bang. This newly found molecule lends insight into the chemistry of the early universe, before any stars began to shine or any galaxies had formed. The discovery may even help astronomers understand how the first stars arose.

Most chemical elements readily share electrons with other elements to make molecules, but noble gases normally don't. "Noble gases are in some sense happy as they are," says Peter Schilke, an astrophysicist at the University of Cologne in Germany. That's because the outer shell of a noble gas atom already has its fill of electrons, so it won't ordinarily exchange electrons to bond with other atoms and form molecules at least, not here on Earth.

In retrospect, space seems the perfect place to seek noble gas molecules, because these gases abound in the cosmos. Helium is the second most common element in the universe, after hydrogen, and neon ranks fifth or sixth. And in interstellar space, where extreme temperatures and densities are the rule, noble gases do things they would never do on Earth. That includes forming molecules.

In addition to providing insight into the universe's infancy, these exotic molecules tell scientists about the current conditions in the space between the stars the gases that make up the interstellar medium which is of intense interest to astronomers. "The interstellar medium is the place where stars and planetary systems are born," says Maryvonne Gerin, an astrophysicist at the Observatory of Paris and coauthor of a 2016 Annual Review of Astronomy and Astrophysics article on interstellar molecules.

For decades astronomers have pursued one noble gas molecule in particular: helium hydride, or HeH+, made of the two most common elements in the universe and thus a good bet to exist in space. Though naturally occurring helium hydride has never been found on Earth, scientists were able to force the two atoms together in the lab almost a century ago.

So it seemed this combo would be the most likely quarry for astronomers as well. Instead, they were caught off guard by an even stranger molecule.

An interstellar embarrassment

Argon is more than 20 times as common in Earth's atmosphere as carbon dioxide but gets far less press. In fact, it is the third most abundant gas in the air you breathe. Nitrogen and oxygen make up 78 percent and 21 percent of Earth's atmosphere, respectively, while argon accounts for most of the remaining 1 percent.

But nobody was looking for an interstellar molecule containing argon. "It was basically a serendipitous discovery," says University College London astrophysicist Mike Barlow, who led the team that accidentally found ArH+: argonium, which consists of argon and hydrogen.

Another noble gas element helped to make the find possible. In 2009 the Herschel Space Observatory lifted off for space and literally kept its cool during the mission by carrying a tank of frigid liquid helium that lasted four years. This allowed Herschel to observe far-infrared wavelengths from distant objects without the interference its own warmth would have produced. Because many molecules absorb and emit far-infrared light, this spectral range is a good place to seek new space molecules.

Within a year of Herschel's launch, astronomers began noticing that something in interstellar space was absorbing far-infrared light at a wavelength of 485 microns, a spectral line that hadn't been observed before. "Nobody could figure out what it was," says David Neufeld, an astrophysicist at Johns Hopkins University and coauthor of the 2016 Annual Review article (and an acquaintance of the author of this story in graduate school).

Schilke consulted colleagues in his group at Cologne and elsewhere. "We sat in the office at the whiteboard," he says, "and we put all the possible molecules on there, including argonium." No known molecule matched the observed wavelength of 485 microns.

Meanwhile, Barlow's team was using Herschel data to study the Crab Nebula, the remains of a massive star our ancestors saw explode in the year 1054. The celestial fireworks forged argon and other "metals," which astronomers define as all elements heavier than helium.

Another view of the Crab Nebula, the remnants of a supernova explosion witnessed by skywatchers in Japan and China a thousand years ago. Orange filaments reveal the hydrogen that once constituted the star; the blue glow is produced by the neutron star at the nebulas center. Study of the light from the object revealed the presence of argonium. | (NASA / ESA / J. HESTER ARIZONA STATE UNIVERSITY)

In the nebula's argon-rich gas, Barlow and his colleagues spotted two unidentified spectral lines. One was the same mysterious line everyone else had been seeing at 485 microns; the other had exactly half the wavelength the hallmark of a molecule containing two atoms. Barlow identified it as argonium, publishing the discovery in 2013. It was the first noble gas molecule ever found in nature. (Barlow notes that at the last minute the editors of his scientific paper changed "molecule" in the title to "molecular ion.")

The discovery was a shock. "We were just stunned when we heard this," Neufeld says. After all, astronomers had been seeing that same 485-micron spectral line elsewhere. "When I first heard about the detection," Schilke says, "I was extremely embarrassed that we had not spotted this ourselves."

The scientists were the victims of a down-to-earth mix-up. They thought they knew the wavelengths argonium produced, because scientists had created it in the lab decades earlier and measured its spectrum. But these laboratory molecules contained argon-40, which is by far the most common argon isotope on Earth. But that's only because the argon we breathe comes from the radioactive decay of potassium-40 in rocks.

The universe is different. "In the interstellar medium," says Schilke, "argon-36 is by far the most abundant, and we were just too stupid to realize it." Argonium made with argon-36 absorbs and emits light at slightly different wavelengths than it does with argon-40, explaining why the scientists had missed the identification.

Nevertheless, once they recognized the existence of interstellar argonium, Schilke, Neufeld, Gerin, and their colleagues sought to explain its formation. "This is a molecule that doesn't like molecules," Schilke says, just as argon is an atom that doesn't like atoms. This peculiar characteristic is turning out to be useful.

Argonium's cosmic origins

Based on standard calculations of how chemical reactions proceed in space, scientists know the formation of the interstellar argonium molecule requires two steps. First, a cosmic ray a high-speed charged particle strips an electron from an interstellar argon atom, making Ar+. Then that argon ion can steal a hydrogen atom from a hydrogen molecule (H2) to create argonium, ArH+, because the hydrogen atom is more attracted to the argon ion than to its hydrogen mate.

But argonium is fragile, and the same hydrogen molecules it requires for its formation can also destroy it. The noble gas molecule can therefore exist only where there's just enough molecular hydrogen to create argonium but not so much as to tear it apart. This stringent requirement turns out to be handy for identifying which interstellar clouds aren't likely to spawn new stars and planets.

Interstellar gas in our part of the Milky Way comes in two main types: atomic and molecular. The first and more common type consists primarily of individual hydrogen and helium atoms. Because atomic gas is diffuse, it rarely makes new stars. Instead, most stars arise in denser gas where atoms crowd together to create molecules.

It can be difficult to tell apart the interstellar clouds that consist mostly of atomic gas from those that consist mostly of molecular gas, and that's where argonium comes in. "It's a tracer of almost purely atomic gas," Schilke says. In fact, although argonium is a molecule, it exists only in gas that's 99.9 to 99.99 percent atomic.

Because cosmic rays lead to the creation of argonium, its abundance in interstellar space has also helped nail down the number of cosmic rays darting through the galaxy. "There are more cosmic rays than we thought before," Gerin says. That's important not only for future Captain Kirks wishing to minimize their exposure to the destructive radiation as they travel between star systems, but also to scientists studying the chemistry of the interstellar medium, because cosmic rays are the first step in the creation of other molecules as well.

Read the rest of the story at Knowable Magazine.

This article originally appeared in Knowable Magazine, an independent journalistic endeavor from Annual Reviews. Sign up for the newsletter.

NASA Intern Discovered New Planet With Two Suns on Third Day of Placement – Newsweek

Posted on January 19, 2020 by Danzig

A 17-year-old from Scarsdale, New York discovered a new planet on his third day of a two-month internship at NASA Goddard Space Flight Center.

During the internship last year, Wolf Cukier was tasked with examining variations in the brightness of stars within data captured by NASA's Transiting Exoplanet Survey Satellite, or TESS for short.

"I worked with [NASA scientist] Veselin Kostov and with him I worked on finding a circumbinary planet in the TESS data," Cukier told Newsweek. "It was exciting because 1) I was actually able to do research that summer, which is cool, and 2) I was able to work in an area of science that I really enjoy. And 3) I was at NASA, which is just a cool place."

Circumbinary planets are worlds which orbit two starssomething which had never been discovered before in the TESS data. But just three days into the internship, Cukier was able to identify one of these worlds in a star system located around 1,300 light-years away.

"I was pretty excited. Coming into the internship, it would be hard to say that I expected to find a planet. 'Hope' is probably the best word to use there, because there are a total of 12 previously discovered transiting circumbinary planets that were known at the time," Cukier said. "That's 12 I think in 10 years. So they aren't impossible to find but they're not very common to find either. And also tests had yet to find any circumbinary planets. So finding this one was especially cool."

"The TESS data, at the time, was still under a year old," Cukier said. "So finding one just that early in general was fun. And also I don't think [my manager] expected me to find one so early either."

The planetdubbed TOI 1338 bis thought to be around seven times larger than the Earth and it orbits the two stars in almost exactly the same plane, meaning it experiences regular stellar eclipses. The two stars in the system orbit each other every 15 days, according to NASA.

A paper regarding the discoverywhich is co-authored by Cukier, alongside scientists from Goddard and several other institutionshas been submitted for publication in a scientific journal.

On the back of his successful internship at the space agency, Cukier said the next step for him is college.

"My top three choices are Princeton, Stanford and MIT. We shall see what happens in the application process. I intend to study physics or astrophysicsdepends which college I end up going to because some only offer physics and some offer astrophysics in addition."

"Then I will see what happens from there," he said. "Being a research scientist or a professor are appealing options, however, that's a bit in the future for me to predict how my life will turn out."

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NASA Intern Discovered New Planet With Two Suns on Third Day of Placement - Newsweek

Astronomers Detect Radiation Stimulated By Heatwave Of Intense Thermal Energy From A Massive New-born Star – Space in Africa

Posted on January 19, 2020 by Danzig

The Milky Way Galaxy contains billions of massive bright stars. These high-mass stars have masses ranging from tens to hundreds of times the mass of the Sun. Their existence plays a role which is paramount in astrophysics.

They end their lives as supernovae which dramatically influences their environment. Yet, how they form still remains a mystery. The best current theories predict an upper limit of only about eight times the mass of the Sun.

For these stars, this leads to a discrepancy between theory and observation, which resulted in several competing theories emerging to explain this. One prominent emerging theory proposes that high-mass stars achieve their final mass from bursts of episodic accretion onto the protostar to achieve its final mass.

This theory predicts short-lived, intense accretion bursts through which the protostar gains mass from its surrounding accretion-disk, followed by long periods of inactivity, possibly lasting hundreds to thousands of years. In January 2019, astronomers at Ibaraki University in Japan noticed that one such massive protostar, G358-MM1, showed signs of new activity indicative of a potential accretion burst.

In response, a collaboration of astronomers, the Maser Monitoring Organization (M2O), gathered several radio telescopes from Australia, New Zealand and South Africa (HartRAO) to form a telescope array capable of detecting small-scale emission stimulated by the heat of the accreting protostar.

The team, led by Dr Ross Burns (NAOJ and JIVE), compared multiple images over the span of a month which revealed a heat-wave of energy radiating outward from the location of G358-MM1. According to Dr Fanie van den Heever (HartRAO/SARAO, South Africa), the observations made by M2O is the first real-time evidence supporting the episodic accretion theory for high-mass star formation.

The global community of astronomers, astrophysicists and theoreticians are benefiting tremendously from the work done by M2O and the recent results obtained by this group. The paper was published in Nature Astronomy on Monday, 13 January 2020.

About the authors

The work is led by Dr Ross Burns in collaboration with other M2O members. Dr Burns is affiliated to the National Astronomical Observatory of Japan (NAOJ) and the Joint Institute for VLBI in Europe (JIVE).

The South African contributors include:

Credit to Katharina Immer, affiliated with JIVE, for the artists impression.

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Astronomers Detect Radiation Stimulated By Heatwave Of Intense Thermal Energy From A Massive New-born Star - Space in Africa

Massive Black Hole Collisions Illuminated by X-Rays and Gravitational Waves – SciTechDaily

Posted on January 19, 2020 by Danzig

A new study by a group of researchers at the University of Birmingham has found that collisions of supermassive black holes may be simultaneously observable in both gravitational waves and X-rays at the beginning of the next decade.

The European Space Agency (ESA) has recently announced that its two major space observatories of the 2030s will have their launches timed for simultaneous use. These missions, Athena, the next generation X-ray space telescope and LISA, the first space-based gravitational wave observatory, will be coordinated to begin observing within a year of each other and are likely to have at least four years of overlapping science operations.

According to the new study, published this week in Nature Astronomy, ESAs decision will give astronomers an unprecedented opportunity to produce multi-messenger maps of some of the most violent cosmic events in the Universe, which have not been observed so far and which lie at the heart of long-standing mysteries surrounding the evolution of the Universe.

They include the collision of supermassive black holes in the core of galaxies in the distant universe and the swallowing up of stellar compact objects such as neutron stars and black holes by massive black holes harbored in the centers of most galaxies.

The gravitational waves measured by LISA will pinpoint the ripples of space time that the mergers cause while the X-rays observed with Athena reveal the hot and highly energetic physical processes in that environment. Combining these two messengers to observe the same phenomenon in these systems would bring a huge leap in our understanding of how massive black holes and galaxies co-evolve, how massive black holes grow their mass and accrete, and the role of gas around these black holes.

These are some of the big unanswered questions in astrophysics that have puzzled scientists for decades.

Dr. Sean McGee, Lecturer in Astrophysics at the University of Birmingham and a member of both the Athena and LISA consortiums, led the study. He said, The prospect of simultaneous observations of these events is uncharted territory, and could lead to huge advances. This promises to be a revolution in our understanding of supermassive black holes and how they growth within galaxies.

Professor Alberto Vecchio, Director of the Institute for Gravitational Wave Astronomy, University of Birmingham, and a co-author on the study, said: I have worked on LISA for twenty years and the prospect of combining forces with the most powerful X-ray eyes ever designed to look right at the center of galaxies promises to make this long haul even more rewarding. It is difficult to predict exactly what were going to discover: we should just buckle up, because it is going to be quite a ride.

During the life of the missions, there may be as many as 10 mergers of black holes with masses of 100,000 to 10,000,000 times the mass of the sun that have signals strong enough to be observed by both observatories. Although due to our current lack of understanding of the physics occurring during these mergers and how frequently they occur, the observatories could observe many more or many fewer of these events. Indeed, these are questions which will be answered by the observations.

In addition, LISA will detect the early stages of stellar mass black holes mergers which will conclude with the detection in ground based gravitational wave observatories. This early detection will allow Athena to be observing the binary location at the precise moment the merger will occur.

Reference: Linking gravitational waves and X-ray phenomena with joint LISA and Athena observations by Sean McGee, Alberto Sesana and Alberto Vecchio, 6 January 2020, Nature Astronomy.DOI: 10.1038/s41550-019-0969-7

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Massive Black Hole Collisions Illuminated by X-Rays and Gravitational Waves - SciTechDaily

Taking the Temperature of Dark Matter – UC Davis

Posted on January 19, 2020 by Danzig

Warm, cold, just right? Physicists at the University of California, Davis, are taking the temperature of dark matter, the mysterious substance that makes up about a quarter of our universe.

We have very little idea of what dark matter is, and physicists have yet to detect a dark matter particle. But we do know that the gravity of clumps of dark matter can distort light from distant objects. Chris Fassnacht, a physics professor at UC Davis, and colleagues are using this distortion, called gravitational lensing, to learn more about the properties of dark matter.

The standard model for dark matter is that it is cold,meaning that the particles move slowly compared to the speed of light, Fassnacht said. This is also tied to the mass of dark matter particles. The lower the mass of the particle, the warmer it is and the faster it will move.

The model of cold (more massive) dark matter holds at very large scales, Fassnacht said, but doesnt work so well on the scale of individual galaxies. Thats led to other models including warmdark matter with lighter, faster-moving particles. Hot dark matter with particles moving close to the speed of light has been ruled out by observations.

Former UC Davis graduate student Jen-Wei Hsueh, Fassnacht and colleagues used gravitational lensing to put a limit on the warmth and therefore the mass of dark matter. They measured the brightness of seven distant gravitationally lensed quasars to look for changes caused by additional intervening blobs of dark matter and used these results to measure the size of these dark matter lenses.

If dark matter particles are lighter, warmer and more rapidly moving, then they will not form structures below a certain size, Fassnacht said.

Below a certain size, they would just get smeared out, he said.

The results put a lower limit on the mass of a potential dark matter particle while not ruling out cold dark matter, he said. The teams results represent a major improvement over a previous analysis, from 2002, and are comparable to recent results from a team at UCLA.

Fassnacht hopes to continue adding lensed objects to the survey to improve the statistical accuracy.

We need to look at about 50 objects to get a good constraint on how warm dark matter can be, he said.

A paper describing the work is published in the Monthly Notices of the Royal Astronomical Society. Additional co-authors are: W. Enzi, S. Vegetti and G. Despali, Max Planck Institute for Astrophysics, Garching, Germany; M.W. Auger, Institute of Astronomy, University of Cambridge, U.K.; L.V.E. Koopmans,Kapteyn Astronomical Institute, University of Groningen, The Netherlands; and J.P. McKean,Netherlands Institute for Radio Astronomy. The work was supported by the National Science Foundation, the Netherlands Organization for Scientific Research and the Chinese Academy of Sciences.

Taking the Temperature of Dark Matter - UC Davis

Tour the colorful Crab Nebula with this stunning new 3D visualization – Space.com

Posted on January 19, 2020 by Danzig

A new 3D movie highlights the Crab Nebula, beginning with its location in the constellation Taurus and zooming in to show off its dynamic features.

Data from the Hubble Space Telescope, Spitzer Space Telescope and the Chandra X-ray Observatory allowed visualists to piece together the different processes occurring in the beautiful structure.

Viewers of the four-minute video get a glimpse of the pulsing, super-dense stellar corpse within the Crab Nebula. This pulsar, or rapidly-spinning neutron star, blasts out radiation with clockwork precision about 30 times per second, NASA officials said in a statement.

The video was unveiled Jan. 5 at the 235th meeting of the American Astronomical Society in Honolulu, Hawaii.

Video: Crab Nebula visualized using NASA's 'Great Observatories' dataRelated: Amazing views of the famous Crab Nebula

This video isn't just a treat for the eyes it also helps scientists gain a fuller understanding about the Crab Nebula's world.

"Seeing two-dimensional images of an object, especially of a complex structure like the Crab Nebula, doesn't give you a good idea of its three-dimensional nature," said Frank Summers, visualization scientist from the Space Telescope Science Institute (STScI) in Baltimore, Maryland, in the statement. His team developed the movie.

"With this scientific interpretation, we want to help people understand the Crab Nebula's nested and interconnected geometry. The interplay of the multiwavelength observations illuminate all of these structures. Without combining X-ray, infrared and visible light, you don't get the full picture."

"Multiwavelength" means that Hubble, Spitzer and Chandra view different types of activity with their instruments, which are each fine-tuned to different wavelengths on the electromagnetic spectrum, explained NASA.

The pulsar at the center of the Crab Nebula contains certain structures and processes that generate particular wavelengths of light. That's why 3D movies like this one are as helpful as they are fun to watch.

Related: Cosmic Bat Nebula Photographed by ESO's Very Large Telescope

The visualization is from a new generation of products being created by NASA's Universe of Learning Program, an effort to connect scientific work with lay audiences. This particular video aims to highlight the reasons behind observing space through different wavelengths.

The Infrared Processing and Analysis Center (IPAC) at Caltech in Pasadena, California, and the Center for Astrophysics in Cambridge, Massachusetts, also helped produce the video.

Amateur astronomers can get their own good view of the Crab Nebula in January, Hubble officials said. The object was bright enough for 18th century technology to discover it, and astronomer Charles Messier even mistook the nebula for Halley's Comet. That's why the Crab Nebula is also known as Messier 1 (M1).

More importantly, the supernova that created the nebula wowed societies across the planet when it appeared in Earth's skies centuries ago. Chinese astronomers made a record of the "guest star" appearance in 1054. The supernova was visible in the daytime sky for about a month, according to NASA; it wasn't until the 20th century that astronomers realized that both M1 and the historic supernova were the same object.

As unique as this celestial object already is from humanity's perspective, the Crab Nebula is even more peculiar than your run-of-the-mill supernova. Hubble officials shared in the video description that the object is a pulsar-wind nebula.

A traditional nebula has a blast wave that scorches material around it, but the gas and dust in a pulsar wind nebula is heated by radiation to a lower temperature.

The use of many instruments is allowing researchers to wrap their heads around this special stellar corpse.

"It is truly via the multiwavelength structure that you can more cleanly comprehend that it's a pulsar wind nebula," Summers added in the statement. "This is an important learning objective. You can understand the energy from the pulsar at the core moving out to the synchrotron cloud, and then further out to the filaments of the cage."

Follow Doris Elin Urrutia on Twitter @salazar_elin. Follow us on Twitter @Spacedotcom and on Facebook.

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The Week of January 13, 2020 – FYI: Science Policy News

Posted on January 19, 2020 by Danzig

Brookhaven National Lab Picked as Electron-Ion Collider Site

The Department of Energy announced on Jan. 9 that it has selected Brookhaven National Laboratory as the site for the Electron-Ion Collider, a proposed nuclear science facility that the department estimates will cost between $1.6 billion and $2.6 billion. Brookhavens proposal for the collider calls for it to be built as a modification of the labs existing Relativistic Heavy Ion Collider. DOE granted the project initial approval on Dec. 19 and plans will be further developed over a period of years before the final go-ahead is ultimately given to begin construction. Provided Congress appropriates the needed funding, the department estimates the collider will take about a decade to design and build. The project was originally recommended in the 2015 Long Range Plan for Nuclear Science, and a 2018 National Academies report endorsed its scientific value. The only other contender to host the collider was the Thomas Jefferson National Accelerator Facility in Virginia, which would have built it as an extension of its Continuous Electron Beam Accelerator Facility. According to DOE, Jefferson Lab will still be a major partner as the project moves forward.

On Jan. 10, the Department of Energy released its solicitation of proposals for the Quantum Information Science Research Centers called for in the National Quantum Initiative Act. The department states it expects to award up to five centers, which together will receive up to $625 million in funding over a period of five years. Final proposals are due April 10 and are to describe multi-institutional collaborations that employ multi-disciplinary teams and blend together basic research, engineering, and technology development. The National Science Foundation has already initiated its process for awarding a counterpart set of QIS centers.

The Department of Energy announced on Jan. 8 that it is launching an Energy Storage Grand Challenge initiative that aims to accelerate the development, commercialization, and utilization of next-generation energy storage technologies. The effort will comprise R&D funding opportunities, prizes, and partnerships, among other components, with the objective of sustaining American leadership in the field and securing a manufacturing supply chain that is independent of foreign sources of critical materials by 2030. DOE will manage the challenge through the Research and Technology Investment Committee it established early last year and plans to release a request for information to obtain stakeholder feedback on what specific issues the challenge should address.

Last week, the National Academies Space Studies Board released the statement of task for the upcoming planetary science and astrobiology decadal survey, which will set the fields priorities for the years 2023 through 2032. While the survey will follow its predecessors in focusing on robotic missions to other planetary bodies, its additional focus on astrobiology is new and will encompass not only the search for life in the Solar System but also aspects of exoplanet research and the search for technosignatures of extraterrestrial intelligence. In addition, the survey will cover planetary defense, including both the scientific study of near-Earth objects and, for the first time, the hazards they present to Earth. Another new feature of the survey will be its consideration of planetary science opportunities involving crewed space missions, which has become a more important issue in light of NASAs expedited plans to return astronauts to the Moon. The state of the planetary science profession will also be on the agenda, following in the footsteps of the astronomy and astrophysics decadal survey due for release about a year from now. According to the planetary science surveys notional schedule, it will start accepting white papers from the research community next month and its leadership will be announced at the annual Lunar and Planetary Science Conference in March.

Update (1/14/2020): The National Academies has temporarily removed the statement of task from its website pending potential revisions.

The House Science Committee announced on Jan. 9 that Rep. Lizzie Fletcher (D-TX) has taken over as Energy Subcommittee chair from Rep. Conor Lamb (D-PA). Lamb, who remains on the subcommittee, stepped aside after joining the House Transportation and Infrastructure Committee late last year. In turn, Rep. Mikie Sherrill (D-NJ) is taking over Fletchers previous role as chair of the Environment Subcommittee and giving up her job as Investigations and Oversight Subcommittee chair. That spot will be filled by committee member Rep. Bill Foster (D-IL), who was a physicist at Fermilab before joining Congress in 2008.

The House Science Committee approved the Promoting Research and Observations of Space Weather to Improve the Forecasting of Tomorrow (PROSWIFT) Act by voice vote on Jan. 9. The bill, which is sponsored by Reps. Ed Perlmutter (D-CO) and Mo Brooks (R-AL), is similar to the Senates Space Weather Research and Forecasting Act, which the Senate Commerce, Science, and Transportation Committee advanced last April. However, before the committee approved the bill, it adopted an amendment introduced by Ranking Member Frank Lucas (R-OK), which would require the National Oceanic and Atmospheric Administration to establish a pilot program for obtaining space weather data from the commercial sector. Noting the program would expire after four years, Lucas said his amendment balances the need to help ensure there is a market for a commercial space weather data with the existing roles of the federal government and the academic community. A similar provision appeared in a previous version of the legislation that the committee advanced in 2018.

On Jan. 8, Democrats on the House Energy and Commerce Committee released adraft framework for climate legislation that sets an overarching goal of achieving a 100 percent clean economy by 2050, defined as reaching net-zero greenhouse gas emissions. Titled the Climate Leadership and Environmental Action for our Nations (CLEAN) Future Act, the draft bill will include provisions covering the power, building, transportation, and industrial sectors as well as a focus on clean energy workforce development. Beyond setting various renewable power and emissions standards, the bill will feature several R&D-oriented provisions. These include creating an Assistant Secretary for Manufacturing and Industry at DOE who would coordinate the agencys industrial efficiency initiatives, establishing a technology commercialization program for carbon capture and utilization, and creating a prize competition for direct air capture. The draft framework notes the committee plans to add provisions covering climate resilience, community transition, agriculture, financial issues, and international cooperation, among other areas. The committee expectsto release the text of the draft legislation by the end of the month.

Last week, the White House released a draft memorandum with guidance for federal agencies on how to approach the regulation and oversight of technologies that use artificial intelligence. The memorandum is a component of the Trump administrations AI initiative, which has been one of the Office of Science and Technology Policys foremost priorities. It instructs agencies to avoid adopting unnecessarily precautionary approaches and enumerates 10 principles they should consider when weighing the costs and benefits of potential regulations. U.S. Chief Technology Officer Michael Kratsios stated in an op-ed that the principles represent a light-touch approach to regulating AI that also aims to protect privacy and promote civil rights, civil liberties, and American values. The memorandum also provides examples of ways agencies can reduce barriers to the deployment and use of AI, such as increasing public access to federal data and models. Areas that are defined as falling outside the memorandums scope include the governments own use of AI technologies and the regulation of far-afield AI technologies that could approximate human intelligence.

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The Week of January 13, 2020 - FYI: Science Policy News

A Mysterious Burst of Gravitational Waves Came From a Region Near Betelgeuse. But There’s Probably No Connection – Universe Today

Posted on January 19, 2020 by Danzig

Gravitational waves are caused by calamitous events in the Universe. Neutron stars that finally merge after circling each other for a long time can create them, and so can two black holes that collide with each other. But sometimes theres a burst of gravitational waves that doesnt have a clear cause.

One such burst was detected by LIGO/VIRGO on January 14th, and it came from the same region of sky that hosts the star Betelgeuse. Yeah, Betelgeuse, aka Alpha Orionis. The star that has been exhibiting some dimming behaviour recently, and is expected to go supernova at some point in the future. Might the two be connected?

Betelgeuse is a red supergiant star in the constellation Orion. It left the main sequence about one million years ago and has been a red supergiant for about 40,000 years. Eventually, Betelgeuse will have burned enough of its hydrogen that its core will collapse, and it will explode as a supernova.

Recently, Betelgeuse dimmed. That set off all kinds of speculation that it might be getting ready to go supernova. Astrophysicists quickly poured water on that idea. Theres no exact number, but its estimated that Betelgeuse wont go supernova for another 100,000 years. But when a star dims, theres clearly something going on.

Is this new burst of gravitational waves connected to Betelgeuses recent dimming? To its future supernova explosion?

Astronomers understand that Betelgeuse is a variable star, and its brightness can fluctuate. Stars like Betelgeuse arent just static entities. Its a semi-regular variable star that shows both periodic and non-periodic changes in its brightness.

The kind of gravitational waves that LIGO detected are called burst waves. Its possible that a supernova could produce them, but Betelgeuse hasnt gone supernova and wont for a long time.

Some think that the detection of gravitational waves in Betelgeuses direction is unrelated to the star itself. In fact, the detection of the burst waves may not have even been real.

Christopher Berry is an astrophysicist studying gravitational waves at Northwestern Universitys Center for Interdisciplinary Exploration and Research in Astrophysics. On Twitter he spoke up about the gravitational burst waves.

Andy Howell from Las Cumbres Observatory studies supernova and dark energy. He had something to say on Twitter too, and appeared to be having fun with the whole thing. He even walked outside to check up on Betelgeuse after the detection of the burst gravitational waves.

So there you have it. No supernova for now, anyway. The burst gravitational waves may just be a glitch, and Betelgeuses dimming is well-understood and not a threat.

One day Betelgeuse will explode, and our night sky will change forever. But for us here on Earth, that supernova poses no problem.

An exploding star is an awesome event. And it produces a cataclysm of deadly radiation. X-rays, ultraviolet radiation, and even stellar material are ejected with great force. The deadliest radiation is gamma rays, and Betelgeuse likely wont even produce any of those when it blows.

But in any case, were about 700 light years away from Betelgeuse, and thats way too much distance for us to worry.

The biggest fallout is that the Orion constellation will change forever. And therell be a new object to study in the sky: a supernova remnant.

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A Mysterious Burst of Gravitational Waves Came From a Region Near Betelgeuse. But There's Probably No Connection - Universe Today

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