Title: Pregnancy Guidelines During COVID-19 Pandemic
Category: Health News
Created: 4/2/2020 12:00:00 AM
Last Editorial Review: 4/2/2020 12:00:00 AM

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Category: Health News
Created: 3/14/2020 12:00:00 AM
Last Editorial Review: 3/16/2020 12:00:00 AM

Title: A Woman's Guide to Skin Care During and After Menopause
Category: Health News
Created: 2/23/2020 12:00:00 AM
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Title: AI May Help Guide Patients to Most Effective Antidepressant
Category: Health News
Created: 2/10/2020 12:00:00 AM
Last Editorial Review: 2/11/2020 12:00:00 AM

ABSTRACT

Hepatitis C virus (HCV) infects millions of people worldwide, causing chronic liver disease that can lead to cirrhosis, hepatocellular carcinoma, and liver transplant. In the last several years, the advent of direct-acting antivirals, including NS3/4A protease inhibitors (PIs), has remarkably improved treatment outcomes of HCV-infected patients. However, selection of resistance-associated substitutions and polymorphisms among genotypes can lead to drug resistance and in some cases treatment failure. A proactive strategy to combat resistance is to constrain PIs within evolutionarily conserved regions in the protease active site. Designing PIs using the substrate envelope is a rational strategy to decrease the susceptibility to resistance by using the constraints of substrate recognition. We successfully designed two series of HCV NS3/4A PIs to leverage unexploited areas in the substrate envelope to improve potency, specifically against resistance-associated substitutions at D168. Our design strategy achieved better resistance profiles over both the FDA-approved NS3/4A PI grazoprevir and the parent compound against the clinically relevant D168A substitution. Crystallographic structural analysis and inhibition assays confirmed that optimally filling the substrate envelope is critical to improve inhibitor potency while avoiding resistance. Specifically, inhibitors that enhanced hydrophobic packing in the S4 pocket and avoided an energetically frustrated pocket performed the best. Thus, the HCV substrate envelope proved to be a powerful tool to design robust PIs, offering a strategy that can be translated to other targets for rational design of inhibitors with improved potency and resistance profiles.

IMPORTANCE Despite significant progress, hepatitis C virus (HCV) continues to be a major health problem with millions of people infected worldwide and thousands dying annually due to resulting complications. Recent antiviral combinations can achieve >95% cure, but late diagnosis, low access to treatment, and treatment failure due to drug resistance continue to be roadblocks against eradication of the virus. We report the rational design of two series of HCV NS3/4A protease inhibitors with improved resistance profiles by exploiting evolutionarily constrained regions of the active site using the substrate envelope model. Optimally filling the S4 pocket is critical to avoid resistance and improve potency. Our results provide drug design strategies to avoid resistance that are applicable to other quickly evolving viral drug targets.

BACKGROUND AND OBJECTIVES:

Early diagnosis of cerebral palsy (CP) is critical in obtaining evidence-based interventions when plasticity is greatest. In 2017, international guidelines for early detection of CP were published on the basis of a systematic review of evidence. Our study aim was to reduce the age at CP diagnosis throughout a network of 5 diverse US high-risk infant follow-up programs through consistent implementation of these guidelines.

METHODS:

The study leveraged plan-do-study-act and Lean methodologies. The primary outcome was age at CP diagnosis. Data were acquired during the corresponding 9-month baseline and quarterly throughout study. Balancing measures were clinic no-show rates and parent perception of the diagnosis visit. Clinic teams conducted strengths, weaknesses, opportunities, and threats analyses, process flow evaluations, standardized assessments training, and parent questionnaires. Performance of a 3- to 4-month clinic visit was a critical process step because it included a Hammersmith Infant Neurologic Examination, a General Movements Assessment, and standardized assessments of motor function.

RESULTS:

The age at CP diagnosis decreased from a weighted average of 19.5 (95% confidence interval 16.2 to 22.8) to 9.5 months (95% confidence interval 4.5 to 14.6), with P = .008; 3- to 4-month visits per site increased from the median (interquartile range) 14 (5.2–73.7) to 54 (34.5–152.0), with P < .001; and no-show rates were not different. Parent questionnaires revealed positive provider perception with improvement opportunities for information content and understandability.

CONCLUSIONS:

Large-scale implementation of international guidelines for early detection of CP is feasible in diverse high-risk infant follow-up clinics. The initiative was received positively by families and without adversely affecting clinic operational flow. Additional parent support and education are necessary.

Cervical spondylotic myelopathy (CSM) is a neurologic condition that develops insidiously over time as degenerative changes of the spine result in compression of the cord and nearby structures. It is the most common form of spinal cord injury in adults; yet, its diagnosis is often delayed. The purpose of this article is to review the pathophysiology, natural history, diagnosis, and management of CSM with a focus on the recommended timeline for physicians suspecting CSM to refer patients to a spine surgeon. Various processes underlie spondylotic changes of the canal and are separated into static and dynamic factors. Not all patients with evidence of cord compression will present with symptoms, and the progression of disease varies by patient. The hallmark symptoms of CSM include decreased hand dexterity and gait instability as well as sensory and motor dysfunction. magnetic resonance imaging is the imaging modality of choice in patients with suspected CSM, but computed tomography myelography may be used in patients with contraindications. Patients with mild CSM may be treated surgically or nonoperatively, whereas those with moderate-severe disease are treated operatively. Due to the long-term disability that may result from a delay in diagnosis and management, prompt referral to a spine surgeon is recommended for any patient suspected of having CSM. This review provides information and guidelines for practitioners to develop an actionable awareness of CSM.

Background:

Despite widespread recognition that adherence to clinical preventive guidelines improves patient outcomes, clinicians struggle to implement guideline changes in a timely manner. Multiple factors influence guideline adoption and effective implementation. However, few studies evaluate their collective and inter-related effects. This qualitative study provides a comprehensive picture of the interplay between multiple factors on uptake of new or changed preventive guidelines.

Methods:

Semistructured interviews conducted in 2018 with a diverse sample of clinicians and practice leaders sought to understand patient, clinician, practice, health system, environment, and guideline factors of influence. An immersion-crystallization approach was used to identify emergent themes.

Results:

Interviewees expressed motivation to adhere to guidelines but also valued sharing decisions with patients. Personal biases and fears affected both clinician and patient guideline adoption. Practices facilitated implementation through workflow optimization and encouraging a culture of evidence-based practice while a key health system function was to maintain electronic health record alerts. More traditional environmental factors, such as insurance coverage or transportation, were less of a barrier to guideline adoption and implementation than the influence of media and specialists. Various specific guideline characteristics also affected ease of adoption and implementation. Different settings expressed greater health system, practice, or clinician-centric approaches to guideline implementation.

Conclusions:

Guideline uptake is influenced by a complex interplay of multiple levels of factors including the patient, clinician, practice, health system, environment, and guideline levels. Comprehensively understanding all levels of influence for each specific clinical setting may help to determine the optimal intervention(s) for improving uptake of evidence-based guidelines.

Site-specific recombinases, such as Cre, are a widely used tool for genetic lineage tracing in the fields of developmental biology, neural science, stem cell biology, and regenerative medicine. However, nonspecific cell labeling by some genetic Cre tools remains a technical limitation of this recombination system, which has resulted in data misinterpretation and led to many controversies in the scientific community. In the past decade, to enhance the specificity and precision of genetic targeting, researchers have used two or more orthogonal recombinases simultaneously for labeling cell lineages. Here, we review the history of cell-tracing strategies and then elaborate on the working principle and application of a recently developed dual genetic lineage-tracing approach for cell fate studies. We place an emphasis on discussing the technical strengths and caveats of different methods, with the goal to develop more specific and efficient tracing technologies for cell fate mapping. Our review also provides several examples for how to use different types of DNA recombinase–mediated lineage-tracing strategies to improve the resolution of the cell fate mapping in order to probe and explore cell fate–related biological phenomena in the life sciences.

Negative circumferential resection margins (CRM) are the cornerstone for the curative treatment of locally advanced rectal cancer (LARC). However, in up to 18.6% of patients, tumor-positive resection margins are detected on histopathology. In this proof-of-concept study, we investigated the feasibility of optical molecular imaging as a tool for evaluating the CRM directly after surgical resection to improve tumor-negative CRM rates. Methods: LARC patients treated with neoadjuvant chemoradiotherapy received an intravenous bolus injection of 4.5 mg of bevacizumab-800CW, a fluorescent tracer targeting vascular endothelial growth factor A, 2–3 d before surgery (ClinicalTrials.gov identifier: NCT01972373). First, for evaluation of the CRM status, back-table fluorescence-guided imaging (FGI) of the fresh surgical resection specimens (n = 8) was performed. These results were correlated with histopathology results. Second, for determination of the sensitivity and specificity of bevacizumab-800CW for tumor detection, a mean fluorescence intensity cutoff value was determined from the formalin-fixed tissue slices (n = 42; 17 patients). Local bevacizumab-800CW accumulation was evaluated by fluorescence microscopy. Results: Back-table FGI correctly identified a tumor-positive CRM by high fluorescence intensities in 1 of 2 patients (50%) with a tumor-positive CRM. For the other patient, low fluorescence intensities were shown, although (sub)millimeter tumor deposits were present less than 1 mm from the CRM. FGI correctly identified 5 of 6 tumor-negative CRM (83%). The 1 patient with false-positive findings had a marginal negative CRM of only 1.4 mm. Receiver operating characteristic curve analysis of the fluorescence intensities of formalin-fixed tissue slices yielded an optimal mean fluorescence intensity cutoff value for tumor detection of 5,775 (sensitivity of 96.19% and specificity of 80.39%). Bevacizumab-800CW enabled a clear differentiation between tumor and normal tissue up to a microscopic level, with a tumor-to-background ratio of 4.7 ± 2.5 (mean ± SD). Conclusion: In this proof-of-concept study, we showed the potential of back-table FGI for evaluating the CRM status in LARC patients. Optimization of this technique with adaptation of standard operating procedures could change perioperative decision making with regard to extending resections or applying intraoperative radiation therapy in the case of positive CRM.

Objective

We aimed to assess adherence to the Australian national guideline (COPD-X) against audited practice, and to document the outcomes of patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (COPD) at discharge and 28 days after.

Methods

A prospective clinical audit of COPD hospital admission from five tertiary care hospitals in five states of Australia was conducted. Post-discharge follow-up was conducted via telephone to assess for readmission and health status.

Results

There were 207 admissions for acute exacerbation (171 patients; mean 70.2 years old; 50.3% males). Readmission rates at 28 days were 25.4%, with one (0.6%) death during admission and eight (6.1%) post-discharge within 28 days. Concordance to the COPD-X guidance was variable; 22.7% performed spirometry, 81.1% had blood gases collected when forced expiratory volume in 1 s was <1 L, 99.5% had chest radiography performed, 95.1% were prescribed systemic corticosteroids and 95% were prescribed antibiotic therapy. There were 89.1% given oxygen therapy and 92.6% when arterial oxygen tension was <80 mmHg; 65.6% were given ventilatory assistance when pH was <7.35. Only 32.4% were referred to pulmonary rehabilitation but 76.8% had general practitioner follow-up arranged.

Conclusion

When compared against clinical practice guidelines, we found important gaps in management of patients admitted with COPD throughout tertiary care centres in Australia. Strategies to improve guideline uptake are needed to optimise care.

Background and objectives

Bioelectrical impedance analysis (BIA) devices can help assess volume overload in patients receiving maintenance peritoneal dialysis. However, the effects of BIA on the short-term hard end points of peritoneal dialysis lack consistency. This study aimed to test whether BIA-guided fluid management could improve short-term outcomes in patients on peritoneal dialysis.

Design, setting, participants, & measurements

A single-center, open-labeled, randomized, controlled trial was conducted. Patients on prevalent peritoneal dialysis with volume overload were recruited from July 1, 2013 to March 30, 2014 and followed for 1 year in the initial protocol. All participants with volume overload were 1:1 randomized to the BIA-guided arm (BIA and traditional clinical methods) and control arm (only traditional clinical methods). The primary end point was all-cause mortality and secondary end points were cardiovascular disease mortality and technique survival.

Results

A total of 240 patients (mean age, 49 years; men, 51%; diabetic, 21%, 120 per group) were enrolled. After 1-year follow-up, 11(5%) patients died (three in BIA versus eight in control) and 21 patients were permanently transferred to hemodialysis (eight in BIA versus 13 in control). The rate of extracellular water/total body water decline in the BIA group was significantly higher than that in the control group. The 1-year patient survival rates were 96% and 92% in BIA and control groups, respectively. No significant statistical differences were found between patients randomized to the BIA-guided or control arm in terms of patient survival, cardiovascular disease mortality, and technique survival (P>0.05).

Conclusions

Although BIA-guided fluid management improved the fluid overload status better than the traditional clinical method, no significant effect was found on 1-year patient survival and technique survival in patients on peritoneal dialysis.

The amended 2014 Housing Law, which took effect from July 1, 2015, allows foreign individuals and organizations to own property in Vietnam. The more "open" regulations of the Law have created new demand and momentum for the local real estate market. Here are the latest updates on Vietnam property foreign ownership that you need to know.

Tip 1: Bring your paperwork. The best way to win over a prospective landlord is to be prepared. To get a competitive edge over other applicants, bring the following when you meet the landlord: a completed rental application; written references from landlords, employers, and colleagues; and a current copy of your credit report.

One of the most notable changes introduced by Vietnam’s new 2014 property law and its regulations is the revision of the right for overseas Vietnamese, foreign individuals and organizations to own residential houses.

Many people see buy-to-rent as an attractive income investment in a time of low rates and stock market volatility. But if you are considering investing in property - or improving your returns on a buy-to-rent you already own - it's important to do things right.

As with other types of investment, real estate investors need a good vision and smart strategies to make it profitable. Here are 6 important guides for investors to avoid loss and gain profit from their real estate investment.

There’s the technical definition of personalized marketing: the collection and analysis of prospect data to implement an enterprise marketing strategy for custom segments And then […]

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The White House is making "contingency plans" for a second wave of coronavirus after emails reportedly contradict their claims that Centers for Disease Control and Prevention guidelines to safely reopen the economy were set aside because medical experts did not approve of them.

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America can take its next steps toward reopening by placing an emphasis on emerging health data and closely examining how early states are performing, Housing and Urban Development Secretary Dr. Ben Carson asserted Saturday.

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When writing an email, we often think that closing is the easiest part. Whether we end our messages with “Kind regards,” “Sincerely,” “ Thank you in advance,” or “Take care,” it only takes a second, and we probably don’t give it too much thought. But do email sign-offs even matter? And if so, is “best” […]

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The files also show that after reports that the guidance document had been buried, the Trump administration ordered key parts of it to be fast-tracked for approval.

Confession: we are all about that Pogue life this summer. Wait, you don't know what that means? Gosh, you are a total Kook. In case you are the proverbial nerd that fell asleep first...

Plants are intelligent beings with profound wisdom to impart—if only we know how to listen. And Monica Gagliano knows how to listen. The evolutionary ecologist has done groundbreaking experiments suggesting plants have the capacity to learn, remember, and make choices. That’s not all. Gagliano, a senior research fellow at the University of Sydney in Australia, talks to plants. And they talk back. Plants summon her with instructions on how to live and work. Some of Gagliano’s conversations happened in prophetic dreams, which led her to study with a shaman in Peru while tripping on psychoactive plants.

Along with forest scientists like Suzanne Simard and Peter Wohlleben, Gagliano raises profound scientific and philosophical questions about the nature of intelligence and the possibility of “vegetal consciousness.” But what’s unusual about Gagliano is her willingness to talk about her experiences with shamans and traditional healers, along with her use of psychedelics. For someone who’d already received fierce pushback from other scientists, it was hardly a safe career move to reveal her personal experiences in otherworldly realms.

Gagliano considers her explorations in non-Western ways of seeing the world to be part of her scientific work. “Those are important doors that you need to open and you either walk through or you don’t,” she told me. “I simply decided to walk through.” Sometimes, she said, certain plants have given her precise directions on how to conduct her experiments, even telling her which plant to study. But it hasn’t been easy. “Like Alice, [I] found myself tumbling down a rather strange rabbit hole,” she wrote in a 2018 memoir, Thus Spoke the Plant. “I did doubt my own sanity many times, especially when all these odd occurrences started—and yet I know I do not suffer from psychoses.”

Shortly before the COVID-19 lockdown, I talked with Gagliano at Dartmouth College, where she was a visiting scholar. We spoke about her experiments, the new field of plant intelligence, and her own experiences of talking with plants.

PAVLOV’S PEAS: Monica Gagliano sketches a pea plant in her lab at the University of Sydney (above). She conducted experiments with pea plants to determine if, like Pavlov’s famous dogs, the plants learned to anticipate food. They did. “Although they do not salivate,” Gagliano says.Scene from the upcoming documentary, AWARE ©umbrellafilms.org

You are best known for an experiment with Mimosa pudica, commonly known as the “sensitive plant,” which instantly closes its leaves when it’s touched. Can you describe your experiment?

I built a little contraption that allowed me to drop the plants from a height of maybe 15 centimeters. So it’s not too high. When they fall, they land in a softly padded base. This plant closes its leaves when disturbed, especially if the disturbance is a potential predator. When the leaves are closed, big, spiny, pointy things stick out, so they might deter a predator. In fact, they not only close the leaf, but literally droop, like, “Look, I’m dead. No juice for you here.”

You did this over and over, dropping the plants repeatedly.

Exactly. It makes no sense for a plant or animal to repeat a behavior that is actually useless, so we learn pretty quick that whatever is useless, you don’t do anymore. You’re wasting a lot of energy trying to do something that doesn’t actually help. So, can the plant—in this case, Mimosa—learn not to close the leaves when the potential predator is not real and there are no bad consequences afterward?

After how many drops did they stop closing their leaves?

The test is for a specific type of learning that is called habituation. I decided they would be dropped continuously for 60 times. Then there was a big pause to let them rest and I did it again. But the plants were already re-opening their leaves after the first three to six drops. So within a few minutes, they knew exactly what was going on—like, “Oh my god, this is really annoying but it doesn’t mean anything, so I’m just not going to bother closing. Because when my leaves are open, I can eat light.” So there is a tradeoff between protecting yourself when the threat is real and continuing to feed and grow. I left the plants undisturbed for a month and then came back and repeated the same experiment on those individuals. And they showed they knew exactly what was going on. They were trained.

This is who I am. And nobody has the right to tell me that it’s not real.

You say these plants “understand” and “learn” that there’s no longer a threat. And you’re suggesting they “remember.” You’re not using these words metaphorically. You mean this literally?

Yes, that’s what they’re doing. This is definitely memory. It’s the same kind of experiment we do with a bee or a mouse. So using the words “memory” and “learning” feels totally appropriate. I know that some of my colleagues accuse me of anthropomorphizing, but there is nothing anthropomorphic about this. These are terms that refer to certain processes. Memory and learning are not two separate processes. You can’t learn unless you remember. So if a plant is ticking all the boxes and doing what you would expect a rat or a mouse or a bee to do, then the test is being passed.

Do you think these plants are actually making decisions about whether or not to close their leaves?

This experiment with Mimosa wasn’t designed to test that specific question. But later, I did experiments with other plants, with peas in particular, and yes, there is no doubt the plants make choices in real decision-making. This was tested in the context of a maze, where the test is actually to make a choice between left and right. The choice is based on what you might gain if you choose one side or the other. I did one study with peas that showed the plants can choose the right arm in a maze based on where the sound of water is coming from. Of course, they want water. So they will use the signal to follow that arm of the maze as they try to find the source of water.

So plants can hear water?

Oh, yeah, of course. And I’m not talking about electrical signals. We have also discovered that plants emit their own sounds. The acoustic signal comes out of the plant.

What kind of sounds do they make?

We call them clicks, but this is where language might fail because we are trying to describe something we’re not familiar enough with to create the language that really describes the picture. We worked out that, yes, plants not only produce their own sound, which is amazing, but they are listening to sounds. We are surrounded by sound, so there are studies, like my own study, of plants moving toward certain frequencies and then responding to sounds of potential predators chewing on leaves, which other plants that are not yet threatened can hear. “Oh, that’s a predator chewing on my neighbor’s leaves. I better put my defenses up.” And more recently, there was some work done in Israel on the sound of bees and how flowers prepared themselves and become very nice and sweet, literally, to be more attractive to the bee. So the level of sugars gets increased as a bee passes by.

SECRET LIFE OF PLANTS: Monica Gagliano says her experiences with indigenous people, such as the Huichol in Mexico (above), informed her view that plants have a range of feelings. “I don’t know if they would use those words to describe joy or sadness, but they are feeling bodies,” she says.Scene from the upcoming documentary, AWARE ©umbrellafilms.org

You are describing a surprising level of sophistication in these plants. Do you have a working definition of “intelligence?”

That’s one of those touchy subjects. I use the Latin etymology of the word and “intelligere” literally means something like “choosing between.” So intelligence really underscores decision-making, learning, memory, choice. As you can imagine, all those words are also loaded. They belong in the cognitive realm. That’s why I define all of this work as “cognitive ecology.”

Do you see parallels between this kind of intelligence in plants and the collective intelligence that we associate with social insects in ant colonies or beehives?

That kind of intelligence might be referred to as “distributed intelligence” or “collective intelligence.” We are testing those questions right now. Plants don’t have neurons. They don’t have a brain, which is often what we assume is the base for all of these behaviors. But like slime molds and other basal animals that don’t have neural systems, they seem to be doing the same things. So the short answer is yes.

What you’re saying is very controversial among scientists. The common criticism of your views is that an organism needs a brain or at least a nervous system to be able to learn or remember. Are you saying neurons are not required for intelligence?

Science is full of assumptions and presuppositions that we don’t question. But who said the brain and the neurons are essential for any form of intelligence or learning or cognition? Who decided that? And when I say neurons and brains are not required, it’s not to say they’re not important. For those organisms like ourselves and many animals who do have neurons and brains, it’s amazing. But if we look at the base of the animal kingdom, sponges don’t have neurons. They look like plants because when they’re adults, they settle on the bottom of the ocean and pretty much just sit there forever. Yet if you look at the sponge’s genome, they have the genetic code for the neural system. It’s almost like from an evolutionary perspective, they simply decided that developing a neural system was not useful. So they went a different way. Why would you invest that energy if you don’t need it? You can achieve the same task in different ways.

Your food is psychedelic. It changes your brain chemistry all the time.

Your critics say these are just automatic adaptive responses. This is not really learning.

You know, they just say plants do not learn and do not remember. Then you do this study and stumble on something that actually shows you otherwise. It’s the job of science to be humble enough to realize that we actually make mistakes in our thinking, but we can correct that. Science grows by correcting and modifying and adjusting what we once thought was the fact. I went and asked, can plants do Pavlovian learning? This is a higher kind of learning, which Pavlov did with his dogs salivating, expecting dinner. Well, it turns out plants actually can do it, but in a plant way. So plants do not salivate and dinner is a different kind of dinner. Can you as a scientist create the space for these other organisms to express their own, in this case, “plantness,” instead of expecting them to become more like you?

There’s an emerging field of what’s called “vegetal consciousness.” Do you think plants have minds?

What is the mind? [Laughs] You see, language is very inadequate at the moment in describing this field. I could ask you the same question in referring to humans. Do you think humans have a mind? And I could answer again, what is the mind? Of course, I have written a paper with the title “The Mind of Plants” and there is a book coming called The Mind of Plants. In this context, language is used to capture aspects of how plants can change their mind, and also whether they have agency. Is there a “person” there? These questions are relevant beyond science because they have ethical repercussions. They demand a change in our social attitude toward the environment. But I already have a problem with the language we are using because the question formulated in that way demands a yes or no answer. And what if the answer cannot be yes or no?

Let me ask the question a different way. Do you think plants have emotional lives? Can they feel pain or joy?

It’s the same question. Where do feelings arise from, and what are feelings? These are yes or no questions, usually. But to me, they are yes and no. It depends on what you mean by “feeling” and “joy.” It also depends on where you are expecting the plant to feel those things, if they do, and how you recognize them in a human way. I mean, plants might have more joy than we do. It’s just that we don’t know because we’re not plants.

We have only talked about this from the scientific perspective, which is the Western view of the world. But I’ve also had a close relationship with plants from a very different perspective, the indigenous world view. Why is that less valuable? And when you actually do explore those perspectives, they require your experience. You can’t just understand them by thinking about them. My own personal experience tells me that plants definitely feel many things. I don’t know if they would use those words to describe joy or sadness, but they are feeling bodies. We are feeling bodies.

Science is full of assumptions and presuppositions that we don’t question.

You’ve studied with shamans in indigenous cultures and you’ve taken ayahuasca and other psychoactive plants. Why did you seek out those experiences?

I didn’t. They sought me. So I just followed. They just arrived in my life. You know, those are important doors that you need to open and you either walk through or you don’t. I simply decided to walk through. I had this weird series of three dreams while I was in Australia doing my normal life. By the time the third dream came, it was very clear that the people that I was dreaming of were real people. They were waiting somewhere in this reality, in this world. And the next thing, I’m buying a ticket and going to Peru and my partner at the time is looking at me like, “What are you doing?” [laughs] I have no idea, but I need to go. As a scientist, I find this is the most scientific approach that I’ve ever had. It’s like there is something asking a question and is calling you to meet the answer. The answer is already there and is waiting for you, if you are prepared to open the door and cross through. And I did.

What did you do in Peru?

The first time I went, I found this place that was in my dream. It was just exactly the same as what I saw in my dream. It was the same man I saw in my dream, grinning in the same way as he was in my dream. So I just worked with him, trying to learn as much as I could about myself with his support.

This was a local shaman whom you identify as Don M. And there was a particular plant substance, a hallucinogen, that you took.

I did what they call a “dieta,” which is basically a quiet, intense time in isolation that you do on your own in a little hut. You are just relating with the plant that the elder is deciding on. So for me, the plant that I worked with wasn’t by itself a psychedelic in the normal way of thinking about it. But of course, all plants are psychedelic. Even your food is psychedelic because it changes your brain chemistry and your neurobiology all the time you eat. Sugars, almonds, all sorts of neurotransmitters are flying everywhere. So, again, even the idea of what a psychedelic experience is needs to be revised, because a lot of people might think that it’s only about certain plants that they have a very strong, powerful transformation. And I find that all plants are psychedelic. I can sit in my garden. I don’t have to ingest anything and I can feel very altered by that experience.

You’ve said the plant talked to you. Did you actually hear words?

When you’re trying to describe this to people haven’t had the experience, it probably doesn’t make much sense because this kind of knowledge requires your participation. I don’t hear someone talking to me as if from the outside, talking to me in words and sound. But even that is not correct because inside my head it does sound exactly like a conversation. Not only that, but I know it’s not me. There is no way that I would know about some of the information that’s been shared with me.

Are you saying these plants had specific information to tell you about your life and your work?

Yeah, I mean, some of the plants tell me exactly how wrong I was in thinking about my experiments and how I should be doing them to get them to work. And I’m like, “Really?” I’m scribbling down without really understanding. Then I go in the lab and try what they say. And even then, there is a part of me that doesn’t really believe it. For one experiment, the one on the Pavlovian pea, I was trying to address that question the year before with a different plant. I was using sunflowers. And while I was doing my dieta with a different tree back in Peru, the plant just turned up and said, “By the way, not sunflowers, peas.” And I’m like, “what?” People always think that when you have these experiences, you’re supposed to understand the secrets of the universe. No, my plants are usually quite practical. [laughs] And they were right.

Do you think you are really encountering the consciousness of that plant? Maybe your imagination has opened up to see the world in new ways, but it’s all just a projection of your own mind. How do you know you are actually encountering another intelligence?

If you had this experience of connecting with plants the way I have described—and there are plenty of people who have—the experience is so clear that you know that it’s not you; it’s someone else talking. If you haven’t had that experience, then I can totally see it’s like, “No way, it must be your mind that makes it up.” But all I can say is that I have had exchanges with plants who have shared things about topics and asked me to do things that I have really no idea about.

What have plants asked you to do?

I’m not a medical scientist, but I’ve been given information by plants about their medical properties. And these are very specific bits of information. I wrote them in my diary. I would later check and I did find them in the medical literature: “This plant is for this and we know this.” I just didn’t know. So maybe I’m tapping into the collective consciousness.

What do you do with these kinds of personal experiences? You are a scientist who’s been trained to observe and study and measure the physical world. But this is an entirely different kind of reality. Can you reconcile these two different realities?

I think there are some presuppositions that a scientist should just explore the consensus reality that most of us experience in more or less the same way. But I don’t really have a conflict because I find this is just part of experimenting and exploring. If anything, I found that it has enriched and expanded the science I do. This is a work in progress, obviously, but I think I’m getting better at it. And in the writing of my book, which for a scientist was a very scary process because it was laying bare some parts of me that I knew would likely compromise my career forever, it also became liberating because once it was written, now the world knows. And it’s my truth. This is how I operate. This is who I am. And nobody has the right or the authority to tell me that it’s not real.

Steve Paulson is the executive producer of Wisconsin Public Radio’s nationally syndicated show “To the Best of Our Knowledge.” He’s the author of Atoms and Eden: Conversations on Religion and Science. You can subscribe to TTBOOK’s podcast here.

Lead image: kmeds7 / Shutterstock

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