The UA Magazine delivers news articles, opinion pieces, and long-features on some of the major scientific developments. We cover topics in the field of life sciences, technology, history, social sciences, and many others.
Elephant hunting will be permitted again in Botswana. The hunting ban had been introduced in the country in 2014, after years of decline of wildlife species, in particular elephants and impalas. Since then, hunting licenses were suspended except for birds and the so-called “game animals” confined in appropriate fences.
Now, the Ministry of Environment claims that there is a “negative impact of the hunting suspension on livelihood”, citing high levels of human-elephant conflicts and an increasing number of predators around communities, thus announcing that the hunting ban will be lifted in the country. According to a press release, the Ministry will limit hunting suspensions to 400 per year and “an effective hunting quota allocation system shall be developed based on science”. Scientists called the measure a “disappointing decision” (Pro Wildlife) and “damaging to the image of Botswana” (Dr Paula Kahumbu).
Earlier this month, Zimbabwe and Namibia joined Botswana in the decision to call for an end of ivory ban. The pledge will be presented on this year’s Convention on International Trade in Endangered Species (CITES), on Sri Lanka. The South African countries stress that lifting the ban will allow them to sell stocks of ivory and boost funds for conservation. The three countries are home to more than half of the elephants’ population in Africa.
Larkana, a small Pakistan town, is experiencing, once again, a major HIV outbreak. The latest report estimates that 410 children and 115 adults have tested positive for the virus.
The fact that the parents of the HIV-positive children tested negative for the virus led authorities to investigate a possible source of the outbreak: a clinic where many of the infected children had been treated before. The clinic was run by a doctor who tested positive for the virus and who has been arrested on suspicions of intentionally infecting people with syringes, according to reports by BBC.
Nucleic acids, like DNA and RNA, are made of small organic molecules, called nucleotides. Four different nucleotides exist for each nucleic acid (A, G, C, T for DNA and A, C, G, U for RNA). Put three nucleotides together and you have a codon (fig.1).
In a way, codons are the bridge between the DNA molecule and amino acids (the building blocks of proteins); the genetic code tells the cell where the bridge should lead to, that is, which triplet codon corresponds to which amino acid. The codon GAC, for instance, originates the amino acid aspartate, whereas the codon GAG translates into glutamine.
Figure 1: Protein Synthesis: from DNA to RNA and amino acids.
There are 64 different codons – the number of possible arrangements of 4 nucleotides in sequences of three – but only 20 amino acids, so some amino acids can be encoded by more than one codon (fig.2). What do these synonymous codons do in the cell, if their function is redundant? Researchers at the University of Cambridge tried to answer this question. They figured that if they reduced the number of codons in the genome of an organism, they would know whether the deleted triplets are necessary for the cell’s normal cell functioning.
Figure 2: The Genetic Code. Correspondence between codons and amino acids
The first step was to build a synthetic genome, one where some redundant codons were replaced by their synonymous. The E. coli was the chosen organism to test whether these changes in DNA redundancies would cause damages to the cell’s machinery. Thus, the Syn61 was created, an E. coli with 61 codons in its genome, instead of the regular 64.
Apart from an initial delay in the Syn61’s growth, compared to the regular E. coli, the researchers report that the organism survives with normal cell functioning. One benefit of such discovery has to do with the study of viral infections: if the bacteria’s genome is different, it will be more difficult for viruses to invade them and replicate themselves within the organism. The discovery can also be important in the synthesis of new drugs with E. coli.
Article: Fredens, J., Wang, K., de la Torre, D., Funke, L., Robertson, W., Christova, Y., Chia, T., Schmied, W., Dunkelmann, D., Beránek, V., Uttamapinant, C., Llamazares, A., Elliott, T. and Chin, J. (2019). Total synthesis of Escherichia coli with a recoded genome. Nature. [CLOSED ACCESS]
A few days after giving birth at her home in southeast Australia, Emily Burns sat in her yard and watched as her husband and 2-year-old son dug a hole. In her arms, she cradled her sleeping newborn; beside her was a small container holding her placenta. It was a beautiful October day in 2008.
When the hole was big enough, Burns gently laid her still-sleeping baby onto the soft grass beside her to pick up the container. She walked over to the hole and placed the placenta inside. She then paused, resting her hand on the earth, and silently acknowledged what the placenta had given her. “I felt emotional, bestowing the thanks for my beautiful healthy baby on this organ that had been grown just for that purpose,” she recounts.
When it was time to plant the peach tree atop the placenta, Burns hesitated, feeling as if she was “saying goodbye to something very special that would not return.” The trio then packed handfuls of earth in the hole around the tree until it was filled. Finally, she gave her baby a kiss.
Burns’ ritual was much more ceremony than is afforded to a placenta in most Western cultures. In countries where the childbirth process is highly medicalized, the placenta is typically whisked away to the incinerator. Recently, however, there has been some pushback: Maternal placentophagy—a mother’s consumption of the placenta after giving birth—has become an increasingly popular practice in wealthy, developed nations. Proponents, including celebrities and social media influencers, insist—based on anecdotal evidence—that it can boost new moms’ milk supply and mood levels, even going so far as to say it can fend off postpartum depression.
Thus far, researchers have been unsuccessful in validating these claims in large-scale studies—but this newfound Western interest in placentas has helped propel investigations into the varied cultural practices surrounding the placenta. Anthropologists are uncovering myriad practices for handling this organ. Because traditional cultures have long recognized and revered its power, the placenta is treated with great respect throughout much of the world, often disposed of in solemn ceremonies. Inspired by those rituals, more mothers in the West, like Burns, are finding ways to appreciate an entity that modern medicine has dismissed as medical waste.
A magical organ
The placenta is a magical organ. It’s a 1-pound frisbee-like mass of tissue that, together with the umbilical cord, brokers the sharing of resources between mother and fetus, maintains the uterine environment, filters out toxins, and disposes of waste. It’s the body’s only temporary organ, conjured by an embryo and expelled when its job is complete. Blood vessels spread across its surface like the wide, billowing branches of a tree.
In 2010, medical anthropologists Daniel Benyshek and Sharon Young, both at the University of Nevada, Las Vegas, set about analyzing the traditions of 179 cultures for handling of the placenta. They found that among the 109 communities that define culturally appropriate placenta rituals, there were 169 disposal methods, including burial, incineration, intentional placement in a specific location, or hanging in a tree or structure. When Burns chose to bury her child’s placenta under a tree, she participated in one of the most common disposal methods. In many cultures, the tree is thought to act as a protector of the child; alternatively, the tree’s health could foreshadow the child’s well-being and prosperity.
Burns knows that fact well. She is not just a practitioner of placenta ritual. She studies home-birthing and placenta-disposal practices among modern Australians as a researcher at Western Sydney University’s School of Social Sciences and Psychology. Becoming a mother sparked Burns’ fascination with placenta rituals and other elements of spirituality in childbirth.
“Around the world, various traditions, customs, rituals, and beliefs surround the placenta,” Burns wrote in a 2014 paper in The Journal of Perinatal Education. She noted that scholars believe these practices may release some of the anxiety that often accompanies labor, birth, and new motherhood.
Click on the red dots to explore a sampling of placenta rituals from around the world.
Placenta: a living being, a guardian angel
The placenta is commonly believed to be a child’s living relative: several cultures refer to it as a mother, sibling, or grandmother. “Across the Americas, the placenta is treated reverentially,” wrote Patrisia Gonzales, an assistant professor of Mexican American studies at the University of Arizona, in her book Red Medicine: Traditional Indigenous Rites of Birthing and Healing. “For many Indigenous cultures, the placenta is a living being.” Some other cultures believe in a sort of twinning of child and placenta. In Ancient Egypt, the placenta was considered by many to be a child’s secret helper. Some Icelandic and Balinese cultures see the placenta as a child’s guardian angel.
In many traditions, people believe that improper handling of the placenta will affect the fate of the mother and/or child—or that the placenta’s condition is an omen for the child’s abilities or health. Rituals must therefore be performed exactly and can be quite involved, requiring that the placenta be washed in special liquid, wrapped in certain fabrics or plants, placed in a specific vessel, and buried or set in an appropriate location.
But of the many rituals investigated by anthropologists and social scientists more broadly, one is notably absent from the list: the increasingly trendy practice among Western women of eating the placenta.
Eating the placenta
Benyshek’s interest in placentas was piqued in 2008 at a departmental brown-bag lunch presentation at the University of Nevada, Las Vegas. There, a prominent local placenta encapsulation specialist described how she prepares placenta for a mother’s consumption. The organ, she explained, is typically steamed, dehydrated, ground, and placed into capsules.
Curious about academic research on the practice’s history, Benyshek approached the speaker after the presentation. What he learned next about placentophagy surprised him. “I asked her what research was being done into it and she said none. I couldn’t believe it. There was no look at traditional cultures,” he says.
That absence inspired Benyshek and Young’s 2010 cultural analysis, which examined a range of rituals but found virtually no evidence of mothers regularly consuming their own placenta. Granted, they only looked at 179 cultures: “It was a representative sample, but it’s not an exhaustive list,” Benyshek says. But their data suggest that, if anything, many cultures avoid eating the placenta. (Indeed, some communities believe that the mother or child will be harmed if an animal, for instance, consumes the placenta.)
Although a few cultures do have long-standing beliefs that the placenta can be an edible remedy, the practices rarely resemble modern maternal placentophagy. For example, in some, pieces of the umbilical cord or placenta are dried and later fed to the child as a treatment for illness. And in traditional Chinese medicine, which placentophagy practitioners point to as the source of their practice, “it is not a mother ingesting her own placenta, it’s always another person’s placenta,” explains Benyshek. “Also, it’s not prescribed right after birth, though it is said to treat low milk supply,” he adds. In addition, traditional Chinese medicine sometimes prescribes dried placenta for chronic cough, liver problems, and male impotence.
There is perhaps just one line of logic that suggests the practice of a woman eating her own is, in a sense, ancient. Among almost all mammal species on Earth besides humans, birthing mothers eat their own placenta. It’s possible, then, that early humans had, at some point, an animalistic impulse to devour the placenta—fresh and raw—just after giving birth.
Benyshek believes that tendency would have ended after our species discovered fire, an innovation that would have regularly exposed humans to toxic smoke and ash. Since the placenta acts as a filter, wherein toxins accumulate, the organ was an increasingly poor choice of nutrients.
A risky endeavor
Today, in fact, ingesting one’s placenta remains a potentially risky endeavor. “Placentas are often colonized with bacteria. Many are infected. As a general rule it’s best not to eat something that is potentially teeming with bacteria, many of which may be pathogenic,” wrote Jen Gunter, an OB-GYN at the San Francisco Medical Center, in an opinion article in The New York Times last year. Gunter, who has fielded requests by mothers who want to keep their placenta, noted that the organ can carry traces of arsenic, mercury, and lead. She also worries about how the reproductive hormones in placentas could affect new moms.
In 2017, the U.S. Centers for Disease Control and Prevention warned against the practice of ingesting encapsulated placenta after an infant developed a life-threatening infection. The baby’s mother consumed her own encapsulated placenta, not realizing that it contained group B streptococcus bacteria. The baby then contracted a strep infection that developed into sepsis.
Consuming the placenta may not be advisable—nor may it have the deep cultural roots that some adherents describe—but studying the treatment of the placenta has led researchers like Burns and Benyshek to question the dismissive handling of this organ in many societies.
A not-so-disposable tool for researchers
Western medicine is only just beginning to recognize the mysterious power of the placenta. For example, scientists are realizing how the expression of different genes in the placenta is linked to a number of pregnancy complications, including preeclampsia, gestational diabetes, miscarriage, premature birth, and low birth weight. In addition, since placentas are mostly made of the baby’s cells packaged inside the mother’s uterus, they are helping scientists to understand how cancer cells can similarly avoid being attacked by the immune system.
Benyshek likens traditional treatments of the placenta to those of a corpse after death; many cultures treat the placenta much like a miscarried fetus or stillborn child. Human remains are powerful—“potentially very dangerous, polluting, contagious,” Benyshek points out. They are therefore handled with attention and solemnity in many traditions. “It’s very striking when you contrast this [care] with how it’s treated in biomedicine: as biological waste.”
This idea of reclaiming the placenta from the status of biohazard or waste is a significant one. In New Zealand, the Maori use the same word for placenta and land: whenua. Traditionally, whenua were placed in hollowed-out gourds, earthen pots, or woven baskets, and then buried in a place of significance to return them to the Earth Mother. Later, British colonists dubbed the practice primitive and unhygienic. They regarded it as superstitious. The Maori began to treat the placenta as their European conquerors did: as medical waste. In the early 1980s, a small group of activists sparked a resurgence in traditional placenta burial, and it is now once again a common practice.
Burns has observed a parallel transition in her in-depth interviews with mothers in Australia who have had home births. “It was clear quite early in the research that the placenta was not an afterthought. … When you take away the medical context for birth, women and families are responsible for making some very specific and deliberate decisions about processes that are otherwise handed over to medical personnel,” Burns says.
Burns believes Western societies could benefit from adopting postpartum practices, such as intentional placenta disposal. There’s something to be said, she argues, for slowing down the transition to parenthood. “We can also learn the value in ritual, in a mourning ritual of burial in particular, as we might find comfort in a ceremony to say farewell to pregnancy as we move into motherhood,” Burns says.
As Burns’ baby grew, she says it felt very special to tell her child “these are your peaches” when they got a great crop from the tree planted over the placenta. When she looked out at the tree, she would feel a twinge of nostalgia for her child’s baby years.
Though Burns and her family have since moved, their old neighbor tells them the tree is still growing strong. Sad to leave it behind, they did try to dig it up and take it along, but it was just too heavy.
Born on Isleworth, England, in 1926, Sir David Attenborough soon showed a passion for nature; in his childhood, he spent most his time collecting rocks, fossils and natural specimens. In 1945, he won a scholarship to study zoology and geology at Clare College, in Cambridge. After his graduation, Attenborough spent two years in the Royal Navy as a navigational officer.
The Zoo Quest
After a short passage in an educational publishing house, revising children’s textbooks, the entertainment business crossed Attenborough’s path. In 1952, he became a full-time TV producer at BBC, a career marked by innovative programs. Zoo Quest helped launch his name to the wide audience. First aired in 1954, the show was a collaboration between Attenborough and Jack Lester, the curator of the reptile house in the London Zoo at the time. The documentary series featured both studio and wildlife footages, often in locations which have never been seen on television before. Zoo Quest stayed on air at BBC until 1963 and became the most popular nature program at its time in Britain. For most viewers, each one of the forty-two episodes showed them terrifying and spectacular footages of animals they had never seen before.
Attenborough Catches a Komodo Dragon | Zoo Quest for a Dragon | BBC - YouTube
A young David Attenborough has gone to Indonesia in search of the fearsome Komodo dragon. Credit: BBC Earth
After the series’ success, Attenborough was promoted to director of the recently created BBC Two, where he commissioned diverse programs, such as the Monty Python’s Flying Circus, Man Alive, and Civilization.
Life on Earth
In 1972, he resigned from BBC and focused on writing documentaries. The Life on Earth, broadcasted by BBC in association with Warner Bros in 1979 and with Christopher Parsons as executive director, overwhelmed the audience. The show was sold to more than one hundred territories and won the Broadcasting Press Guild award for Best Documentary Series.
On one of the most famous episodes of the show, Attenborough sees himself face to face with an adult mountain gorilla. When he turns to the camera, he whispers: “There is more meaning and mutual understanding in exchanging a glance with a gorilla than with any other animal I know. Their sight, their hearing, their sense of smell are so similar to ours that they see the world in much the same way as we do. ”
David Attenborough plays with cute baby gorillas | BBC - YouTube
In 1984, Attenborough wrote and presented The Living Planet, a follow-up of the Life on Earth series. This series focused on the mechanisms by which plants and animals adapt to their surroundings. Like its predecessor, The Living Planet gained major critical acclamation. A year later, Attenborough received his knighthood from Queen Elizabeth II, in recognition of his services to television. Later, in 2005, the monarch awarded him an Order of Merit.
Throughout the following years, Sir David Attenborough cemented his role as one of the most prestigious TV broadcasters, with dozens of documentaries produced and narrated by him, as well an environmental activist, calling out for the tremendous impact of human activities on the environment. In the recent protests against climate change in England, he supported school climate strikers, claiming that their decision to strike over the lack of political action concerning climate change was “certainly justified”. He added that “If we were not making progress with young people, we are done” while admitting that his generation has damaged the planet. “We have done terrible things. (….) We older ones should take notice of what [young strikers] say.”
Our Planet: David Attenborough speech at premiere - YouTube
Sir David Attenborough delivers a speech at the premiere of Our Planet, a Netflix documentary narrated by the iconic environmentalist
Grab a book. Notice its length, width and thickness. They correspond, respectively, to the three dimensions of space and, we reasonably assume, to all objects in the three-dimensional space.
As you flip through the book, you note that its pages have two sides – in fact, all objects around you are two-sided. It may slip your mind that this trivial aspect is a feature of spacetime. And, yet, the spacetime itself is a two-sided surface.
The fact that the world is two-sided is sustained by an important property of two-sided spacetimes: a definite orientation for the arrow of time. Since we experience time as flowing irreversibly from the past to the future, we assume we are living in a two-sided world.
Still, there may be one-sided worlds out there, with one-sided objects in them. For the sake of imagination, picture yourself reading your book in a one-sided spacetime. Hard to believe it, but you would be able to read both sides of the pages at the same time. To see this, I encourage you to cut a sheet from the book (just kidding!) and glue it as in the picture below (fig 1), forming a trivial Mobius strip, the most known one-sided surface.
Fig. 1: Mobius Strip
There is more to the story. In a one-sided world, time has no preferred orientation; it may flow from the past to the future or vice versa.
If we are going to delve into technical details, first we must describe the overall picture, by looking at prior scientific work, which resembles the pieces of a puzzle. Quantum entanglement happens to be the key to solve that puzzle.
Entanglement is the process in which two quantum systems (usually two quantum particles) share the same existence. In a quantum realm, particles that interact can become entangled in such a way that they exist in a single quantum state. In this state, a measurement performed on one of the particles can reveal information about the other particle, no matter how far apart the particles are.
Juan Maldacena’s piece of the puzzle
In 1997, the physicist Juan Maldacena, now at the Institute for Advanced Study in Princeton, announced the birth of the renewed gravity/quantum field correspondence conjecture. According to this conjecture, certain quantum gravitational theories with fixed spacetime asymptotic behavior are equivalent to ordinary quantum field theories.
Maldacena demonstrated in 2001 that by entangling particles on one black hole with particles on another black hole, he could describe the wormhole connection between the black holes in the language of quantum mechanics. Entanglement is thus equivalent to physically tying chunks of spacetime together.
Building up spacetime with quantum entanglement
Van Raamsdonk has shown in 2010 that if the two quantum systems are not correlated, to begin with, they correspond, according to gravity/quantum field duality, to two separate components of spacetime. On the other hand, considering the second Maldacena’s paper, when the quantum systems are initially entangled in a particular state, the two components of the spacetime are classically connected.
Now, Van Raamsdonk wondered, what would happen to this classically-connected spacetime if we removed the entanglement between the two dual quantum systems? He answered that question using a proposal introduced in 2006 by Shinsei Ryu, now at the University of Illinois, and Tadashi Takanagi, now at the Yukawa Institute for Theoretical Physics at Kyoto University. Their equations allowed him to reduce the entanglement and watch the response in the dual spacetime, where he saw spacetime gradually pulling apart. Ultimately, reducing the entanglement to zero would break the spacetime into two disjointed chunks.
Quantum entanglement as geometric glue of spacetime— this was the essence of Van Raamsdonk’s paper.
The thermodynamic arrow of time
The arguments of the initial conditions between two quantum systems were reiterated recently in studies related to thermodynamics arrow of time. The existence of an arrow follows from the second law of thermodynamics. The law states that entropy, or disorder, tends to increase over time, which is why everything around us appears to unfold forward in time. The arrow of time is an arrow of increasing correlations. Sure, the second law assumes there are no initial correlations between particles.
What happens in the presence of initial entanglement between two quantum systems? we may ask. Things change dramatically. Late theoretical work suggests that the quantum entanglement places extra limits on the two systems resulting in the impossibility of entropy to increase further. As a result, the entropy can only decrease which reverses the arrow and makes time flow from the future to the past. In a recent experiment, Micadei and colleagues managed to observe this reversed arrow of time.
A two-sided world
Having all pieces in place, it’s time to assemble them and see the whole picture. We start with two quantum systems initially uncorrelated. As we have seen, these correlate to a spacetime having two disconnected components. Since there are no initial correlations, the time is oriented in the standard thermodynamic direction; from the past to the future. This state of fact is consistent in the dual gravity side with a spacetime having a preferred orientation of time, a time-oriented spacetime so to speak.
Now, let’s consider that the two quantum systems are entangled to begin with. The entanglement constrains the individual entropies to decrease such that there is no opportunity for the dominance of one orientation of time over the other. Thus we end up with a spacetime with no predefined orientation having two connected components; a time-unoriented spacetime, in other words.
With a time-unoriented spacetime at hand, let’s decrease the entanglement to zero, just as Van Raamsdonk has shown us. We move from an entangled state to a pure state, with no correlations, or in the language of geometry, from a time-unoriented spacetime to time-oriented one.
Let’s recall that unoriented spacetimes are one-sided and oriented spacetimes are two-sided. Having this argument in mind, when we reduce the entanglement to zero we translate a one-sided spacetime (in the left) into a two-sided spacetime (on the right). Quantum entanglement builds a connection between the two sides of a two-sided spacetime.
Fig. 2: One-sided spacetime (left) and a two-sided spacetime (right).
Our story could end here, with the stunning conclusion that our universe must have a second side that we do not have access to. We can only contemplate our side of the universe full of the stars in the night, but we will miss the best and, at the same time, the oddest part. On the other side of the universe, time runs backwards. If you would somehow reach the other side of our world you will “grow” younger in respect to the people you left behind.
Still, how do we reach this other side of the universe? We can speculate about it with Maldacena on your side (of the universe).
Entangled black holes
We return to Maldacena’s paper from 2001. Remember that he described the eternal black hole as two black holes united by a wormhole, as a manifestation of entanglement between particles on these two black holes. In other words, the two components of the spacetime in Van Raamsdonk proposal are identified by Maldacena with two black holes.
Since we have seen that the Van Raamsdonk’s two components of spacetime correspond to two sides of the spacetime, we can emphasize that the two black holes in the Maldacena conjecture are situated in different sides of the spacetime; somehow connecting the sides of spacetime.
Now we have completed the puzzle! To sum up, our universe must have a second side where time runs in reverse, from the future to the past, which can be accessed throughout the eternal black hole.
And yes… inside the black hole, you can read both sides of your page of the book at once!
Most people have read at least one story that changed their way of thinking. Researchers at Emory University have found that the impressions a book cause on us can have long-term effects on our biology. After reading parts of a novel, the participants of the study showed a significant increase in the connectivity in the left and right regions of the brain that lasted for several days.
It seems that reading not only strengthens the language processing regions of the brain, but it also promotes “embodied semantics”, a process by which the act of reading invokes bodily sensations.
At a young age, reading is crucial to build vocabulary and learn how to communicate with others. As people get older, picking a book may help them deal with other problems. A study from 2013 has shown that engaging in cognitive activity at an older age is associated with slower late-life cognitive decay.
The researchers studied over 1,000 people, all older than 55 years, as they engaged in stimulating tasks, such as reading and writing. After their deaths, the participant’s brains were examined for signs of dementia and lesions. The participants who had engaged in cognitive tasks, both during early and late life periods, had a 32% slower rate of decline in memory.
The World Book Day is celebrated by the UN on April 23. On this date, in 1616, both Cervantes, Shakespeare and Inca Garcilaso de la Vega died. It is a day to celebrate books, authors, publishers and readers.
Infections have since been reported in a range of countries, but the prevalence of C. auris has likely been underestimated in most places. This is because it’s hard to identify, and surveillance programs, where they exist, may not capture all cases.
The Centres for Disease Control and Prevention in the United States report that 617 cases of C. auris have been detected in the US.
Countries from which Candida auris cases have been reported as of February 2019.
Australia has had very few cases, and the cases we have seen have mainly been acquired overseas.
The Victorian health department notes hospital stays in a number of affected areas such as the UK, India, Pakistan, China, South Africa and parts of the US may pose a risk.
How does it manifest and how is it diagnosed?
C. auris seems to most commonly colonise and infect people who are already sick or have compromised immune systems, such as cancer or transplant patients, or hospitalised patients who are very young or very old.
Risk factors include suppression of the immune system (such as via medication after organ transplants to prevent organ rejection), recent surgery, diabetes, and the presence of an in-dwelling medical device such as a catheter.
The presence of the fungus on the body, called colonisation, doesn’t necessarily cause illness.
But invasive candidiasis (that is, invasive infection with Candida species) can infect the bloodstream (candidemia), central nervous system and internal organs.
When the infection spreads to the bloodstream, it can manifest as sepsis, with symptoms including fever, rapid breathing, muscle pain, and confusion.
Just like serious bacterial infections, C. auris may form abscesses in different parts of the body and may require surgery.
C. auris spreads in hospitals and other health-care settings. From shutterstock.com
It can be difficult to diagnose fungal infections and accurately identify the species that has caused the infection. C. auris is very similar to other common fungi of the Candida genus and can be misidentified.
In most Australian hospitals, we use a blood culture diagnostic test. This is time-consuming and relies on specialists to accurately identify the pathogen.
Alternatives such as molecular diagnostic tests are not routinely used in many hospitals due to their cost, and, even when they are, they may not be able to accurately identify the type of fungus that has caused the infection.
However, these tests are improving and will become more widely available soon.
Outcomes for people who contract C. auris
Patients with weakened immune systems who have candidemia or invasive candidiasis have a 30-60% chance of dying after becoming infected.
But it can be very difficult to tell if these patients die from their infection, or die with their infection, given infection typically occurs when a person is already very sick.
Another problem is that treatment with antifungal drugs is routinely delayed. The time between the taking of a blood sample and the delivery of a test result often extends beyond 48 hours, which can lead to delayed or inappropriate treatment (because the cause of infection is still unknown).
Delaying antifungal therapy is associated with an increased risk of death.
For these reasons, we need better tests to diagnose fungal infections.
Why resistance has developed
C. auris has developed resistance to several different antifungal drugs.
While its resistance profile varies geographically, C. auris is almost universally resistant to fluconazole, a dependable drug in the azole class of antifungal drugs – one of the four main classes of existing antifungal drugs.
For example, in the presence of azole-based pesticides, we’ve seen the emergence of azole-resistant Aspergillus, another genus of fungi. Resistant strains then reproduce in the soil, and infections may be contracted from spores in the air that are inhaled.
Similar processes may also have led to the emergence of resistant C. auris, but we don’t know this for sure.
On April 2017, eight telescopes turned to the sky, pointed to a black hole and photographed it. Those were not ordinary photographies. The Event Horizon Telescopes (EHT) produce the highest resolution pictures ever known, 2000 times more precise than those produced by the Hubble telescope. For four days, the synchronized telescopes gathered petabytes (one petabyte is equivalent to 1,000,000 gigabytes) of raw data which was later analyzed by supercomputers. The weather was clear on the six different places where the eight telescopes were placed: the conditions were just right for a one-of-a-kind set of images. Two years later, the first photograph of a black hole and its shadow was shown to the world.
The supermassive black hole in question lies at the center of the Messier 87 galaxy, in the Virgo galaxy cluster, 55 million light-years away from Earth. Like all black holes, it has an enormous mass, 65 billion times bigger than the Sun’s mass. The images gathered by the international team of over 200 researchers reveal that the M87* looks like a ring with a dark center – the black hole’s shadow. This shadow, astronomers point out, is the closest one can come to an image of a black hole itself. It is a completely dark object, caused by gravitational bending, from which light cannot escape.
The shadow cast by black holes is a relatively small object, which explains why they were never seen before. The M87*’s shadow, because of its large size and proximity to Earth, was the ideal target for making history. “We have achieved something presumed to be impossible just a generation ago”, said EHT project director Sheperd Doeleman, at a press conference announcing the discovery, on April 10.
Under the clear, moonlit sky of Friday, July 13, 2018, Elide Sanchez Rivera steps into her own star—a large, white symbol chalked into the dusty ground. With the sound of the ocean waves crashing nearby, Sanchez stands in front of an altar and waits for the healing to begin.
The work of curanderos
For the last 2,000 years, if residents along the northern coast of Peru were sick, they could seek out a curandero, one of the region’s shamanistic healers. Their treatment would consist of a nightlong diagnosis whereby the curandero and perhaps some family members would gather with them around a symbolic altar known as a mesa. Here, strategically placed power objects such as bottled herbs, sacred images, or magnetic stones would represent opposing forces—good and evil, old and new, masculine and feminine—and be arranged around a central point of harmony. The Andean healer’s mission was, and still is, to restore a patient to balance, allowing them to accept the natural flow of extremes without being swayed in one direction or another.
After the ceremony, the curandero would prescribe a treatment for the weeks or months to come: typically, a mixture of precisely prepared medicinal plants and suggestions for lifestyle changes. Such millennia-old healing rituals are still common in northern Peru today—and now, remarkably, some of these ancient medicines are becoming accessible at national clinics across the country.
In the late 1990s, Peru’s social security health insurance program, EsSalud, developed the National Program of Complementary Medicine and opened three centers in the country’s major urban centers of Lima, Arequipa, and Trujillo. Now 29 such centers exist, offering a range of alternative treatments that include the medicinal plant therapies historically prescribed by curanderos.
This move takes advantage of Peru’s rich diversity of flora and traditions to offer affordable and accessible treatment options to as many people as possible. It’s an innovative approach. But the program has faced multiple hurdles in actualizing its vision. As yet, only a narrow selection of plants is available through the clinics, ensuring a sustainable supply is a challenge, and many potential patients remain suspicious, reticent, or simply unaware of the new treatment options.
Help, however, is coming from an unlikely source: anthropology. For almost two decades, researchers in the U.S. and Peru have joined forces to understand the ethnobotany and medical anthropology of medicinal plant use in urban and rural communities near Trujillo, north of Lima, Peru. They have been tapping into knowledge that was nearly lost due to the persecution of curanderos during Spanish colonization of the New World.
“We are motivated by the chance to improve people’s lives through the direct application of cultural anthropology,” says anthropologist Thomas Love from Linfield College in Oregon. “These plants are the first line of people’s health.”
The studies to date have helped mine the wisdom buried in age-old healing traditions and have also yielded insights into the essence of what constitutes true healing—socially, emotionally, and physically. As such, the investigations are not only uncovering treatments that could benefit modern medicine but are also revealing potential pathways to holistic health in Peru and beyond.
On a July day in 2018, Luis Fernandez Sosaya strolls around EsSalud’s complementary health clinic in downtown Trujillo while giving two anthropologists a tour. Fernandez, a physician, coordinates the clinic and is, himself, a pioneer of the program.
A cacophony of taxi horns, revved engines, and good-natured shouting blares outside, but inside the stately colonial building, an aura of tranquil healing prevails. The burble of water fountains gently mixes with the sound of Mozart, and a light breeze carries the scent of flowers from the clinic’s courtyard garden. “The environment, and natural beauty, is an important part of healing,” Fernandez says.
The men walk from the garden, where many of the medical plants prescribed by EsSalud physicians grow, to the natural pharmacy. There, Fernandez proudly shows the anthropologists where the medicinal parts of plants such as horsetail and cat’s claw are neatly packaged to administer to patients who have a prescription. At present, Peru’s clinics offer medicinal plants—each of which has undergone years of rigorous testing for safety and efficacy—in their pharmacies. Clinicians carefully prepare, store, and stock the plants and their extracts to ensure full effectiveness and a consistent supply for patients.
New challenges for Peru’s Health System
Peru’s innovations in public health began nearly 30 years ago. In 1991, Peruvian physician and scholar Fernando Cabieses, a senator at the time, founded (and later directed) the country’s Institute of Traditional Medicine within the public health system. For the next 10 years, Cabieses pioneered many projects, including the establishment of a network of botanical gardens throughout Peru and a series of scientific papers on the safety, efficacy, and quality control of 200 widely used medicinal plants in the country.
At the same time, Peru’s public health system was encountering new challenges. The country’s citizens—as in many parts of Latin America—were aging and facing the modern epidemics of hypertension, diabetes, and cancer, which strain the health care system. To address the increasing demand on resources, EsSalud was created within the social security system to serve the health-insured working class and their families, focusing on prevention, as well as treatment, of these diseases, which are often lifestyle-linked.
EsSalud also wanted their prevention program to be sustainable and available to as many patients as possible. The clinics needed to find treatments that clients could afford, so they made use of the resources available. “It doesn’t make sense that a country that is as rich in plants as this isn’t using them,” Fernandez says. “And there is a huge body of traditional knowledge and wisdom surrounding the use of the plants.”
Consequently, the EsSalud pioneers chose phytotherapy—the science-based use of plants in medicine—as one of the first clinical treatment modalities to embrace. EsSalud chose the 20 most thoroughly researched plants to use in its clinics at the start of the program, a mere fraction of the number used traditionally by curanderos and the local communities. In 2001, the country collaborated with the World Health Organization to compile a manual summarizing the available scientific literature on 76 medicinal plants and the illnesses they could treat.
An early study comparing the use of complementary medicine with conventional medicine within EsSalud found alternative approaches—such as medicinal plant therapy and acupuncture—scored better in efficiency, patient satisfaction, and reduction of future risks in treating and preventing several disorders, including osteoarthritis, tension, migraine headaches, and obesity. In 95 percent of case studies reviewed, they also proved less expensive. Ongoing annual evaluations by EsSalud show that many patients are able to stop all prior uses of pharmaceutical drugs.
Still, trying to determine which of the wealth of available plants might have medicinal properties proved to be a formidable and complicated task. That is, however, without looking to the substantial body of knowledge passed down through generations of communities that have used medicinal plants for centuries.
In the bleak coastal desert of northern Peru, right next to the ocean and less than a couple of miles from Trujillo, lie the remains of Chan Chan, the ancient capital of the Kingdom of Chimor. Six hundred years ago, this formidable city possessed more than 10,000 adobe structures. Decorated friezes, hundreds of feet long, lined the palaces and temples. Now, the stark, sand-colored walls mark a sharp contrast with the clear, blue sky, and the only inhabitants are clusters of crows. It was here that Sharon’s decadeslong fascination with curanderos began.
In 1957, Sharon dropped out of high school in Canada to join an archaeological explorers’ group in Peru, and in 1965, he ended up at Chan Chan. In the process, he met Eduardo Calderón Palomino, a trained artist in charge of restoring the animals and geometric shapes that adorned the friezes. Calderón was also a curandero; he used rituals, intuition, and herbs to heal his patients.
Curanderos, Sharon learned, practice throughout Peru and specialize in local plant use. In the North, these shamans use the psychoactive San Pedro cactus, whereas in rainforest areas, curanderos are more likely to use a psychoactive brew of ayahuasca. Once respected and well-rewarded for their treatments, curanderos were persecuted by Spanish colonizers beginning in the 1500s. A deep-seated prejudice against curandero practices persisted until recently.
Calderón was an extrovert who took great pride in the services he provided to his community. His attitude and work inspired Sharon, who would go on to pursue a degree in cultural anthropology and become Calderón’s apprentice. In 1978 and 1979, the two men taught a course on traditional medicine to medical students at the University of Trujillo’s School of Medicine. Calderón died in 1996, but Sharon’s network of curanderos expanded: He has studied and worked with 15 curanderos to date.
In 1981, Sharon took the directorship of the San Diego Museum of Man, and his fieldwork on medicinal plants extended to Ecuador in the 1990s. He teamed up with ethnobotanist Rainer Bussmann, who had become the scientific director of Nature and Culture International in Loja, Ecuador; the two researchers studied traditional medicine and the use of medicinal plants in Ecuador and Peru.
When, in 1999, Peru’s EsSalud began to explore the use of medicinal plants, Sharon immediately saw that his research with Bussmann could help the endeavor. “It was a great opportunity—the door was opening and I realized that, hey, a botanist and an anthropologist can do a lot here,” Sharon says.
Sharon and Bussmann started their own program to determine the broad range of medicinal plants used by curanderos over generations. “These people are living libraries of this heritage,” Sharon says.
The two scientists worked with their network of curanderos to build and publish a database of 512 medicinal plant species and 974 botanical mixtures that healers employed to treat various ailments. “When I first started to document medicinal plants with Eduardo Calderón, I thought, We’ll get a few dozen. But late into the afternoon, I had to turn the tape recorder off and continue the next day because he just kept going and going and going,” Sharon says. “And it was all carried around in his head. None of this was written down.”
In their analysis, the researchers found that the curanderos applied the plants catalogued in the database in more than 2,000 different ways. Sometimes, separate parts of the plant would be used topically for certain conditions, orally for others. The curanderos selected more than 40 percent of the plants to treat “nervous system” disorders. They also treated respiratory problems, kidney and urinary tract ailments, cardiac and circulatory disorders, rheumatic and arthritic conditions, and female reproductive system problems. “A lot of treatments from curanderos are for diseases where stress might play a role, such as autoimmune diseases, arthritis, fibromyalgia, irritable bowel, and psoriasis—long-term diseases that Western medicine doesn’t have a good handle on,” Bussmann says.
Bussmann, as a botanist, began to place the information into a scientific framework. In the 1990s, students went out to collect the plants in the field and in local markets, and prepared herbarium specimens. In 2005, U.S. and Peruvian scientists began working in local laboratories to characterize the composition of the plant extracts, verify that the plants used to treat infectious entities had antibacterial properties, and test if the plants were toxic.
The laboratory studies revealed that most of the extracts from 141 plants used to treat infectious disease showed antibacterial activity. Gail Willsky, a biochemist at the University at Buffalo who became involved in the project in 2011, believes that there is the potential for Western medicine to learn from the curanderos’ use of the plants. Fifty years ago, no one knew that bacteria could cause ulcers, but now medicines that kill the bacteria, Helicobacter pylori, are a standard treatment for ulcers. “So it is interesting to see what the curanderos are using to treat conditions we don’t think of as infectious,” Willsky says.
In 2011, when Sharon believed that they had enough verified information to be of value to EsSalud, he approached Fernandez to offer the group’s assistance. The anthropologists have contributed to EsSalud’s efforts ever since. They continue to collect information on medicinal plants, document cultural familiarity with this therapy, and investigate the extensive knowledge and worldview of the curanderos.
It’s a cool, misty morning in Huanchaco, and the fishermen are out in their caballitos de totora, a style of reed boats used in the region for thousands of years. On the hill stands one of the oldest churches in Peru, but, in contrast, modern restaurants and trinket stalls line the seafront, catering to the steady stream of tourists.
Against this eclectic backdrop of ancient traditions and contemporary influences, Love and Sharon’s students have spent weeks knocking on doors to find out householders’ knowledge about, and use of, medicinal plants. They also documented the interviewees’ perceptions and preferences regarding Western and traditional medicine. By early July, each student had conducted 100 interviews in Huanchaco and the nearby town of Huanchaquito.
Sharon started such surveys in clinics in 2002, and Love joined him in these studies in 2009. To date, they have found that northern Peruvians typically have a great deal of knowledge about traditional herbal therapy and continue to use it as an alternative to Western medicine. “The thing that struck me is how basically pragmatic the people are,” Love says. “They are happy to use both medicinal plants and pharmaceuticals.”
Indeed, in the public, private, and herbal clinics in Trujillo and its neighboring communities, people have an almost equal preference for traditional and Western medicine. The students’ recent findings show that convenience, cost, and familiarity factor into a person’s final choice.
“Many people say that they would use either plants or pharmaceuticals, but they would often choose Western medicine because it works faster,” says Kennedi Dean, who is studying in the life sciences at Howard University in Washington, D.C. According to San Diego State University student Francisco Hernandez, the number of pharmacies in Huanchaco makes it more convenient to use pharmaceuticals, despite people’s preference for medicinal plants.
Understanding local knowledge about traditional medicine could update EsSalud’s plant database and help clinics in their outreach efforts. EsSalud wants to help communities understand that the clinic is an additional resource for healthy living and that medicinal plants are a science-backed therapy, not only a cultural tradition passed down through generations.
Sharon and Love’s research teams are also identifying culturally bound social and emotional ailments that many Peruvians claim can only be treated by a curandero. These include conditions such as “fright,” “shame,” and the “evil eye,” a malady brought about due to envy or bad will from someone else. Previous studies have revealed that 90 percent of people interviewed believe in or know about such ailments. For the students, several of whom plan to train as doctors or anthropologists, these ideas highlight how cultural and social factors play into human health.
Many Peruvians appear to value both a mental and physical approach to disease, Love says. “We need to understand the way they think about illness,” he says. “They see it as having psychological and social aspects as well.”
To Elide Sanchez Rivera, these ideas are familiar. Like the others in her cohort, she is American-born, and, like three others in the group, her parents moved to the U.S. from Mexico. Sanchez’s grandmother knew how to treat people with medicinal plants, including how to cleanse people of the “evil eye.” When she and Love and Sharon’s other students were offered the opportunity to participate in a healing ritual with Julia Calderón de Ávila, longtime curandera and daughter of Eduardo Calderón, Sanchez jumped at the chance.
Once Sanchez stood in the white star, the chanting, whistling, and rattle shaking began. Calderón lit incense and began to spray a mixture of cornmeal, clear-colored perfumes, and white flowers over Sanchez in a ceremony designed to root out any negative influences in her life. The curandera’s mission is to help her patients move forward with clarity and confidence in body, mind, and spirit.
Although the scope of EsSalud’s interest has concentrated on curanderos’ knowledge of medicinal plants, Sharon stresses their value doesn’t lie solely in that tradition. Curanderos, he says, “have an acute, intuitive sense about people,” and in Latin America, people call this intuitive capacity to look into a person’s soul el don (the gift). He believes that this talent is the essence of the curanderos’ healing ability.
During the five decades he’s worked in Peru, Sharon has seen some encouraging developments in attitudes toward previously persecuted curanderos. In 2015, the Ministry of Culture began an initiative to acknowledge the curanderismo of the northern coastal region of Peru as “cultural patrimony of the nation.”
“If this comes to fruition, it will be a huge step forward,” Sharon says. Also, EsSalud invited Julia Calderón to the 2018 World Congress on Medicinal Plants and Natural Products Research. “Another small step,” he says.
Sharon believes that the future lies in recognizing the role of curanderos in nurturing public health, a vision that would require a greater recognition of this ancient traditional healing practice. But that need not mean fully integrating traditional medicine and the curanderos into the public health system. Rather, Sharon envisages the curanderos and EsSalud on parallel tracks, each healing the public and, on occasion, collaborating with one another.
Such an arrangement would echo the curanderos’ emphasis on wholeness and completion through weaving together opposites—what Sharon refers to as the “Peruvian yin yang.” Old and new, traditional and modern, would work in harmony to bring each patient, and their health care system, to a point of balanced well-being.
Dr Joanna Bryson is a professor and researcher specialising in the study of natural and artificial intelligence. As well as being an associate professor at the University of Bath, she sits on the ethics board of ‘Mind Fire’ Global – a non-profit examining how the principles of human intelligence can be used to build better AI. She is a member of the British Engineering and Physical Sciences Research Council. One of Joanna’s focuses is on building accountable and transparent AI. I travelled to the University of Oxford to meet with Joanna, to learn more about her work.
What is AI?
Artificial intelligence is intelligence that is artificial. What is intelligence? Intelligence is being able to respond to the environment or context, according to a definition going back to the 19th century. The better you can respond to threats, the more intelligent you are said to be. By that definition, plants and thermostats are intelligent, but some people find that uninteresting. However, if you are really trying to discuss artificial intelligence, it is important to realise there is an enormous range of intelligence.
AI is intelligence in an artefact- something a human has deliberately built. The fact that a human created it is central. People often think intelligence means ‘human-like’, but there is a lot more to ‘humanness’ than intelligence, like art or emotions. If people think saying something is more intelligent is saying it is more human, that is like saying if something is taller than a human it is more human. People have this false, mistaken idea that just making something more intelligent makes it more human-like.
Intelligence is one of our traits, a trait we share with a lot of animals and even plants. One of the things we find important in human intelligence is cognitive ability. Something is cognitive if it can change how it learns. A plant can’t change the way it senses and acts in the way a human can. Humans can categorise and react.
So you are saying intelligence is just one subset of ‘Humanness’?
How has the study of the natural world informed your work around AI?
I am interested in understanding cognition. Why are some species using cognition as a strategy more than other species? Why is there diversity in nature? Why do people use cognitive strategies in different ways? A lot of my current work was originally based in questions on the origins of language.
You can think of language or culture as a public good. For example, “Why am I telling you this stuff?” The culture itself has presented enough context for us to be doing this interview. Our culture is organised in a way that we invest in each other communally, so we get something back in the extent to which we create a sustainable society, and live through the ‘winter’.
I use AI to better understand natural intelligence. When you learn something new and look at our society, e.g. our massively high amounts of communication, what are the consequences of that? Theoretical biology tells us that when you have better ways to communicate you are more likely to invest at the group level rather than the individual level because you are more likely to find cooperative strategies to create coalitions and public goods. That shows us that communication, in general, is giving us ways to create new allegiances very quickly.
Are there parallels between the intelligence we see in nature and AI?
Computation is computation. A paper I published recently demonstrated that AI trained through machine learning and human culture has the same bias that people do. If AI gets all the data from society, it will still have the same bias that society has. Emotions are a means by which animals coordinate behaviour. You can find the same neurotransmitters humans have for basic emotions in species that do not even have neurons. Emotions and drives like loneliness are not things we need to build into AI. If people think all intelligence is the same, then they think their vacuum cleaner is lonely when they leave for vacation.
In terms of phenomenological consciousness, the odds we would ever build a machine that has that feeling are fairly minimal. Cows and rats feel much more like what it is to be human than any robot would ever feel, not because of intelligence but because of nature showing you what is a good or a bad thing in your life via emotions.
To what extent do ethical concerns surround the Intelligence that has no phenomenology – e.g. AI?
My catch line for 20 years has been: we are obliged to build robots we are not obliged to. Part of the design component of robots is to pick their motivations. I think it is unlikely that you would build something like human phenomenology into AI, but whether or not you could; I am saying it is a bad idea. If we did, then we would have all kind of obligations to robots, and we are not even good at taking care of our obligations to other people, let alone robots. Why would you want a robot to have the ability to suffer? That is not an intrinsic part of what a tool needs to do.
Are you saying that ethical obligation begins when a robot has the ability to suffer?
There is a real question in the natural world about which kind of suffering we care about. Most people eat cows, we do all kinds of things to rats, kids suffer when you leave them at a daycare centre- but they would suffer more if they didn’t get an education. There is a process we take when we decide which kind of suffering we allow. However, I have a problem with thinking this weighing up of suffering is all there is to ethics.
I think what ethics is mostly for is keeping societies together: we just describe the set of rules by which we respect each other and create healthy collaborations- and we call that ethics.
If you could design one piece of legislation relating to AI going forward – what would it be?
I have a clear answer except I am not sure we need new legislation for it. At the end of the day, AI is just software. The most important thing we need to do is maintain and communicate human accountability across the AI systems- and there are known ways to do that! A lot of people are hacking around with machine learning and treating it like it’s a kid. AI is not something we ‘hand off’ to like in procreation; it is something we designed.
If you cannot prove why you wrote the software system the way you wrote it, then you are accountable for what it does. If you can show that you followed best practice, then there is no liability on the creator, or the user is accountable. The main point is that humans are always accountable. We should never treat the AI itself as accountable. We don’t need new legislation; we need to communicate this understanding to the public. We need judges who understand, and we may need to set up some new regulatory bodies with expertise in this. It’s really not that different to what people already do to monitor software systems, for example with driverless cars.
What about companies who use machine learning to mine and sell data?
I hope there are serious fines that bring these companies to justice. Some of these companies are so large that you could take them down to a tenth of their current value and they could still recover. You need to do something serious to make people think “alright – that’s an issue!”.