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MDEL Bulletin, June 24 2021, from the Medical Devices Compliance Program On this page Fees for Medical go to my blog Device Establishment Licences (MDELs) We issue levitra online Medical Device Establishment Licences (MDELs) to. class I manufacturers importers or distributors of all device classes for human use in Canada The MDEL fee is a flat fee, regardless of when we receive your initial application. The same levitra online fee applies to applications for. a new MDEL the reinstatement of a suspended MDEL the annual licence review (ALR) of an MDEL If you submit any of these applications, you must pay the MDEL fee when you receive an invoice.

See Part 3, Division 2 of the Fees in Respect of Drugs and Medical Devices Order. Normally, we collect the MDEL fee before levitra online we review an application. However, to help meet the demand for medical devices during the erectile dysfunction treatment levitra, we have been reviewing and processing MDEL applications before collecting the fees. As a result, some MDEL holders still haven't paid the fees for levitra online their 2020 initial MDEL application, despite multiple reminders.

Authority to withhold services in case of non-payment As stated in the Food and Drug Act, Health Canada has the authority to withhold services, approvals, rights and/or privileges, if the fee for an MDEL application is not paid. Non-payment of fees 30.64. The Minister may withdraw or withhold a service, the use of a facility, a regulatory process or approval or a product, right or privilege under levitra online this Act from any person who fails to pay the fee fixed for it under subsection 30.61(1). For more information, please refer to.

Cancellation of existing MDELs We will cancel MDELs for existing MDEL holders with outstanding fees for. initial applications or annual licence review applications If your establishment licence is cancelled, you are no longer authorized levitra online to conduct licensable activities (such as manufacturing, distributing or importing medical devices). You must stop licensable activities as soon as you receive your cancellation notice. Resuming activities after MDEL cancellation levitra online To resume licensable activities, you must re-apply for a new establishment licence and pay the MDEL fee.

See section 45 of the Medical Device Regulations. To find out how to re-apply for a MDEL, please refer to our Guidance on medical device establishment licensing (GUI-0016). In line with the Compliance and Enforcement Policy (POL-0001), Health Canada monitors activities for levitra online compliance. If your MDEL has been cancelled, you may be subject to compliance and enforcement actions if you conduct non-compliant activities.

If you levitra online have questions about a MDEL or the application process, please contact the Medical Device Establishment Licensing Unit at hc.mdel.questions.leim.sc@canada.ca. If you have questions about invoicing and fees for an MDEL application, please contact the Cost Recovery Invoicing Unit at hc.criu-ufrc.sc@canada.ca. Related linksMDEL Bulletin, June 15, 2021, from the Medical Devices Compliance Program On this page Rapid antigen tests and the workplace screening initiative There are currently various technologies to detect SARS CoV-2, the levitra that causes erectile dysfunction treatment. Antigen-based testing devices detect specific proteins on the surface of the levitra and typically provide results levitra online in less than 1 hour.

While some rapid antigen detection tests (RADTs) have been approved for people without symptoms, most RADTs are indicated for use on people with symptoms and are to be conducted by laboratory personnel, healthcare professionals or trained operators. Health Canada has authorized several RADTs under two interim orders. The indications and conditions of use of authorized products levitra online may change over time as manufacturers continue to collect data. Screening asymptomatic individuals for SARS CoV-2 is proving to be effective in high-risk settings where social distancing and other measures are not feasible.

Through the workplace screening initiative, Canada is supplying RADTs levitra online to eligible workplaces across the country. The initiative will help companies detect early cases of erectile dysfunction treatment, for people who are asymptomatic. This initiative is being administered in collaboration with the provinces and territories. Interim enforcement approach In the interest of public health, levitra online Health Canada is placing less priority on enforcing off-label distribution of RADTs under the following circumstances.

This enforcement discretion will be in effect until December 31, 2021. The exception levitra online is if. post-market monitoring identifies new risks or there’s no longer a need to apply this discretion based on public health status Related linksWhat is the Notice of Compliance (NOC) Data Extract?. The data extract is a series of compressed ASCII text files of the database.

The uncompressed levitra online size of the files is approximately 20.9 MB. In order to utilize the data, the file must be loaded into an existing database or information system. The typical user is most likely a third party claims adjudicator, provincial formulary, insurance company, etc. A casual user of this levitra online file must be familiar with database structure and capable of setting up queries.

The "Read me" file contains the data structure required to download the zipped files.The NOC extract files have been updated. They contain Health Canada authorization dates for all drugs dating back to 1994 that have received levitra online an NOC. All NOCs issued between 1991 and 1993 can be found in the NOC listings.Please note any Portable Document Format (PDF) files visible on the NOC database are not part of the data extracts.For more information, please go to the Read Me File.Data Extracts - Last updated. 2021-08-06 CopyrightFor information on copyright and who to contact, please visit the Notice of Compliance Online Database Terms and Conditions.From Health Canada Current status.

OpenOpened on August 6, 2021 and levitra online will close to new input onNovember 4, 2021, 2021.Stakeholders are invited to comment on draft revised guidance documents on Post-Notice of Compliance (NOC) Changes - Quality, for pharmaceutical, biologic and radiopharmaceutical drugs for human use. Comments will be considered in finalizing thedocuments. For more information, please see levitra online the accompanying Notice.Join in. How to participateFor copies of draft documents, email hc.bpsip-bpspiconsultation.sc@canada.ca with the subject line "Post NOC changes Quality documents English".

Send us an emailSend an email to E-mail. Hc.policy.bureau.enquiries.sc@canada.ca with your comments Participate by mailSend a levitra online letter with your input to the address in the contact information below. Who is the focus of this consultationWe will engage with. Sponsors of pharmaceutical, biologic or radiopharmaceutical drugsAcademiaKey questions for discussionHealth Canada's Post-Notice of Compliance (NOC) Changes - Quality Guidance released in September 2009 provides comprehensive guidance regarding the conditions for the categorization of common post-authorization changes and recommendations for supporting documentation.

The guidance was levitra online a single document with four (4) appendices specific to different product lines. This document has been updated, and for ease of reference, it has now been split into (4) four separate documents. One each levitra online for human pharmaceuticals, biologics and Schedule C drugs (radiopharmaceuticals) and an overall document which covers aspects common to these three guidance documents. The revised Framework document also provides information relevant to post-Notice of Compliance changes related to safety.

Documents related todrugs for veterinary use will be published separately.Your input is sought on the following draft guidance documents. Post-Notice of levitra online Compliance (NOC) Changes. Framework Document (Pharmaceutical, biologic and radiopharmaceutical drugs for human use only) Post-Notice of Compliance (NOC) Changes. Overall Quality Document Post-Notice of Compliance (NOC) Changes levitra online.

Quality - Guidance for Human Pharmaceuticals Post-Notice of Compliance (NOC) Changes. Quality - Guidance for BiologicsPost-Notice of Compliance (NOC) Changes. Quality - Guidance for Schedule C drugsThe input gathered through levitra online this process will be analysed and considered infinalizing the guidance documents.Contact usBureau of Policy, Science and International ProgramsTherapeutic Products DirectorateHealth Canada1600 Scott StreetHolland Cross, Tower B2nd Floor, Address Locator 3102C1Ottawa, OntarioK1A 0K9Facsimile. 613-941-1812E-mail.

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A Washington Post story said “some cotton cloth masks are about as effective as surgical masks, while thin polyester spandex gaiters may be worse than going maskless.” A Forbes article, referring to neck gaiters, said the study “found that one type of use this link face covering might actually be doing more harm than good.” But the study didn’t active ingredient in levitra show that, nor was it designed to. It was actually a test on how to test masks inexpensively, not to determine which one was most effective. The researchers set up a green laser beam in a dark room.

A masked subject was then active ingredient in levitra asked to speak so that the droplets from the speaker’s mouth showed up in the green beam. The whole process was video recorded on a cell phone, after which researchers calculated the number of droplets that showed up. The process was repeated 10 times for each mask (14 in total, one of which was a neck gaiter) and the setup cost less than $200.

What was meant as a study on the pricing and efficacy of a test turned into, at active ingredient in levitra least in some journalistic circles, a definitive nail-in-the-coffin for gaiters. Days after the initial reports that neck gaiters might not only be useless but maybe even harmful, a new round of new reports came out saying that those initial reports were overblown and misleading. The authors of the study even held a press conference where they emphasized that their study was never meant to test the effectiveness of masks.

They only tested one gaiter-style mask, which active ingredient in levitra says nothing about that style of mask in general. The combination of reporting on the actual findings of the study and the direct comments from the authors seems to have abated the anti-neck gaiter fervor. But all of this this—or most of it, anyway—likely could have been prevented.

You could make active ingredient in levitra the argument that it’s not a scientist’s job to worrying about how their science might be interpreted. It’s their job to do the research and publish it in a scientific manuscript. Leave the communicating for someone else.

But that’s not how the active ingredient in levitra spread of information works. Fewer and fewer newsrooms have staffers with scientific backgrounds, or who are dedicated to scientific reporting. To be clear, journalists don’t need to be scientists to understand science, but reporting on science does require a certain amount of expertise.

When newsrooms ask reporters to cover more and more topic areas and this specialization decreases, an attention to detail is sometimes lost active ingredient in levitra. So, the onus to help journalists (and frankly, all nonscientists) get the facts straight falls to the scientists doing the science. That’s where science communication training comes in.

Science communication, or scicomm as it’s known colloquially, is not a core part of active ingredient in levitra coursework in a majority of degree-granting science programs at the undergraduate and graduate levels. This trend is slowly changing as more institutions incorporate scicomm into their curriculums. Outside of academia, nonprofits and scientific societies are taking up the mantle.

I work for the American Geophysical Union (AGU), a society for Earth and space scientists, in the Sharing Science program, where we teach scientists to communicate with nonscientists through active ingredient in levitra courses, workshops, webinars and other trainings. Aside from the AGU, there is the American Association for the Advancement of Science (AAAS), the Stony Brook–affiliated Alan Alda Center for Communicating Science and the science storytelling organization The Story Collider, to name just to name a few. We teach the so-called “soft skills” that the ivory tower of science has shunned for so long but that are so necessary in effectively communicating.

One thing we stress is “know active ingredient in levitra your audience.” Scientists must think about how their science will be perceived, no matter how relevant or not it might be to the broader public. Science does not exist in a vacuum. It never has.

But especially now, and especially with anything related to erectile dysfunction treatment, scientists much be hypervigilant when communicating results and try, to the best of their abilities, to account for active ingredient in levitra as many interpretations as possible. Yes, it is onerous, especially on top of the multitude of other responsibilities that come with being a scientist, but it is necessary. The traditional ways in which scientists communicate their results (i.e., scientific manuscripts) are not going away anytime soon.

However, and while it may be an unfair ask, scientists must not only be active ingredient in levitra able to communicate their science to their peers. They must always think about nonscience audiences as the lines between science and “the public” continue to blur. Training scientists to effectively communicate to, or at least think about, diverse audiences is a necessary part of science.In 1835 French philosopher Auguste Comte asserted that nobody would ever know what the stars were made of.

€œWe understand active ingredient in levitra the possibility of determining their shapes, their distances, their sizes and their movements,” he wrote, “whereas we would never know how to study by any means their chemical composition, or their mineralogical structure, and, even more so, the nature of any organized beings that might live on their surface.” Comte would be stunned by the discoveries made since then. Today we know that the universe is far bigger and stranger than anyone suspected. Not only does it extend beyond the Milky Way to untold numbers of other galaxies—this would come as a surprise to astronomers of the 19th and early 20th century to whom our galaxy was “the universe”—but it is expanding faster every day.

Now we can confidently trace cosmic history back 13.8 billion years to a moment only a billionth of active ingredient in levitra a second after the big bang. Astronomers have pinned down our universe's expansion rate, the mean density of its main constituents, and other key numbers to a precision of 1 or 2 percent. They have also worked out new laws of physics governing space—general relativity and quantum mechanics—that turn out to be much more outlandish than the classical laws people understood before.

These laws in turn predicted cosmic oddities such as black holes, neutron stars active ingredient in levitra and gravitational waves. The story of how we gained this knowledge is full of accidental discoveries, stunning surprises and dogged scientists pursuing goals others thought unreachable. Our first hint of the true nature of stars came in 1860, when Gustav Kirchhoff recognized that the dark lines in the spectrum of light coming from the sun were caused by different elements absorbing specific wavelengths.

Astronomers analyzed similar features in the light of other bright stars and discovered that they were active ingredient in levitra made of the same materials found on Earth—not of some mysterious “fifth essence” as the ancients had believed. But it took longer to understand what fuel made the stars shine. Lord Kelvin (William Thomson) calculated that if stars derived their power just from gravity, slowly deflating as their radiation leaked out, then the sun's age was 20 million to 40 million years—far less time than Charles Darwin or the geologists of the time inferred had elapsed on Earth.

In his last paper on the subject, in 1908, Kelvin inserted an escape clause stating that he would stick by his estimate “unless there were active ingredient in levitra some other energy source laid up in the storehouse of creation.” That source, it turned out, is nuclear fusion—the process by which atomic nuclei join to create a larger nucleus and release energy. In 1925 astrophysicist Cecilia Payne-Gaposchkin used the light spectra of stars to calculate their chemical abundances and found that, unlike Earth, they were made mainly of hydrogen and helium. She revealed her conclusions in what astronomer Otto Struve described as “the most brilliant Ph.D.

Thesis ever written in astronomy.” A decade later physicist Hans Bethe showed that the fusion of hydrogen nuclei into helium was the main power source active ingredient in levitra in ordinary stars. What is the source of the sun's power?. The answer—fusion—came in 1938.

Credit. SOHO (ESA and NASA) At the same time stars were becoming less mysterious, so, too, was the nature of fuzzy “nebulae” becoming clearer. In a “great debate” held before the National Academy of Sciences in Washington, D.C., on April 26, 1920, Harlow Shapley maintained that our Milky Way was preeminent and that all the nebulae were part of it.

In contrast, Heber Curtis argued that some of the fuzzy objects in the sky were separate galaxies—“island universes”—fully the equal of our Milky Way. The conflict was settled not that night but just a few years later, in 1924, when Edwin Hubble measured the distances to many nebulae and proved they were beyond the reaches of the Milky Way. His evidence came from Cepheids, variable stars in the nebulae that reveal their true brightness, and thus their distance, by their pulsation period—a relation discovered by Henrietta Swan Leavitt.

Soon after Hubble realized that the universe was bigger than many had thought, he found that it was still growing. In 1929 he discovered that spectral features in the starlight from distant galaxies appeared redder—that is, they had longer wavelengths—than the same features in nearby stars. If this effect was interpreted as a Doppler shift—the natural spreading of waves as they recede—it would imply that other galaxies were moving away from one another and from us.

Indeed, the farther away they were, the faster their recession seemed to be. This was the first clue that our cosmos was not static but was expanding all the time. The universe also appeared to contain much that we could not see.

In 1933 Fritz Zwicky estimated the mass of all the stars in the Coma cluster of galaxies and found that they make up only about 1 percent of the mass necessary to keep the cluster from flying apart. The discrepancy was dubbed “the missing mass problem,” but many scientists at the time doubted Zwicky's suggestion that hidden matter might be to blame. The question remained divisive until the 1970s, when work by Vera Rubin and W.

Kent Ford (observing stars) and by Morton Roberts and Robert Whitehurst (making radio observations) showed that the outer parts of galactic disks would also fly apart unless they were subject to a stronger gravitational pull than stars and gas alone could provide. Finally, most astronomers were compelled to accept that some kind of “dark matter” must be present. €œWe have peered into a new world,” Rubin wrote, “and have seen that it is more mysterious and more complex than we had imagined.” Scientists now believe that dark matter outnumbers visible matter by about a factor of five, yet we are hardly closer than we were in the 1930s to figuring out what it is.

Gravity, the force that revealed all that dark matter, has proved to be nearly as baffling. A pivotal moment came in 1915 when Albert Einstein published his general theory of relativity, which transcended Isaac Newton's mechanics and revealed that gravity is actually the deformation of the fabric of space and time. This new theory was slow to take hold.

Even after it was shown to be correct by observations of a 1919 solar eclipse, many dismissed the theory as an interesting quirk—after all, Newton's laws were still good enough for calculating most things. €œThe discoveries, while very important, did not, however, affect anything on this earth,” astronomer W.J.S. Lockyer told the New York Times after the eclipse.

For almost half a century after it was proposed, general relativity was sidelined from the mainstream of physics. Then, beginning in the 1960s, astronomers started discovering new and extreme phenomena that only Einstein's ideas could explain. One example lurks in the Crab Nebula, one of the best-known objects in the sky, which is composed of the expanding debris from a supernova witnessed by Chinese astronomers in a.d.

1054. Since it appeared, the nebula has kept on shining blue and bright—but how?. Its light source was a longtime puzzle, but the answer came in 1968, when the dim star at its center was revealed to be anything but normal.

It was actually an ultracompact neutron star, heavier than the sun but only a few miles in radius and spinning at 30 revolutions per second. €œThis was a totally unexpected, totally new kind of object behaving in a way that astronomers had never expected, never dreamt of,” said Jocelyn Bell Burnell, one of the discoverers of the phenomenon. The star's excessive spin sends out a wind of fast electrons that generate the blue light.

The gravitational force at the surface of such an incredibly dense object falls way outside of Newton's purview—a rocket would need to be fired at half the speed of light to escape its pull. Here the relativistic effects predicted by Einstein must be taken into account. Thousands of such spinning neutron stars—called pulsars—have been discovered.

All are believed to be remnants of the cores of stars that exploded as supernovae, offering an ideal laboratory for studying the laws of nature under extreme conditions. The most exotic result of Einstein's theory was the concept of black holes—objects that have collapsed so far that not even light can escape their gravitational pull. For decades these were only conjecture, and Einstein wrote in 1939 that they “do not exist in physical reality.” But in 1963 astronomers discovered quasars.

Mysterious, hyperluminous beacons in the centers of some galaxies. More than a decade passed before a consensus emerged that this intense brightness was generated by gas swirling into huge black holes lurking in the galaxies' cores. It was the strongest evidence yet that these bizarre predictions of general relativity actually exist.

When did the universe begin?. Did it even have a beginning?. Astronomers had long debated these questions when, in the middle of the 20th century, two competing theories proposed very different answers.

The “hot big bang” model said the cosmos began extremely small, hot and dense and then cooled and spread out over time. The “steady state” hypothesis held that the universe had essentially existed in the same form forever. The contest was settled by a serendipitous discovery.

In 1965 radio astronomers Arno Penzias and Robert Wilson were trying to calibrate a new antenna at Bell Labs in New Jersey. They had a problem. No matter what they did to reduce background interference, they measured a consistent level of noise in every direction.

They even evicted a family of pigeons that had been nesting in the antenna in the hope that they were the source of the problem. But the signal persisted. They had discovered that intergalactic space is not completely cold.

Instead it is warmed to nearly three kelvins (just above absolute zero) by weak microwaves. Penzias and Wilson had accidentally uncovered the “afterglow of creation”—the cooled and diluted relic of an era when everything in the universe was squeezed until it was hot and dense. The finding tipped the balance firmly in favor of the big bang picture of cosmology.

According to the model, during the earliest, hottest epochs of time, the universe was opaque, rather like the inside of a star, and light was repeatedly scattered by electrons. When the temperature fell to 3,000 kelvins, however, the electrons slowed down enough to be captured by protons and created neutral atoms. Thereafter light could travel freely.

The Bell Labs signal was this ancient light, first released about 300,000 years after the birth of the universe and still pervading the cosmos—what we call the cosmic microwave background. It took a while for the magnitude of the discovery to sink in for the scientists who made it. €œWe were very pleased to have a possible explanation [for the antenna noise], but I don't think either of us really took the cosmology very seriously at first,” Wilson says.

€œWalter Sullivan wrote a first-page article in the New York Times about it, and I began to think at that point that, you know, maybe I better start taking this cosmology seriously.” Measurements of this radiation have since enabled scientists to understand how galaxies emerged. Precise observations of the microwaves reveal that they are not completely uniform over the sky. Some patches are slightly hotter, others slightly cooler.

The amplitude of these fluctuations is only one part in 100,000, but they are the seeds of today's cosmic structure. Any region of the expanding universe that started off slightly denser than average expanded less because it was subjected to extra gravity. Its growth lagged further and further, the contrast between its density and that of its surroundings becoming greater and greater.

Eventually these clumps were dense enough that gas was pulled in and compressed into stars, forming galaxies. The crucial point is this. Computer models that simulate this process are fed the initial fluctuations measured in the cosmic microwave background, which represent the universe when it was 300,000 years old.

The output after 13.8 billion years of virtual time have elapsed is a cosmos where galaxies resemble those we see, clustered as they are in the actual universe. This is a real triumph. We understand, at least in outline, 99.998 percent of cosmic history.

It is not only the big cosmic picture that we have come to understand. A series of discoveries has also revealed the history of the elemental building blocks that make up stars, planets and even our own bodies. Starting in the 1950s, progress in atomic physics led to accurate modeling of stars' surface layers.

Simultaneously, detailed knowledge of the nuclei not just of hydrogen and helium atoms but also of the rest of the elements allowed scientists to calculate which nuclear reactions dominate at different stages in a star's life. Astronomers came to understand how nuclear fusion creates an onion-skin structure in massive stars as atoms successively fuse to build heavier and heavier elements, ending with iron in the innermost, hottest layer. Inside the Crab Nebula is a neutron star.

Classical physics fails, and relativity applies. Credit. NASA, ESA and Hubble Heritage Team (STSCI and AURA) Astronomers also learned how stars die when they exhaust their hydrogen fuel and blow off their outer gaseous layers.

Lighter stars then settle down to a quiet demise as dense, dim objects called white dwarfs, but heavier stars shed more of their mass, either in winds during their lives or in an explosive death via supernova. This expelled mass turns out to be crucial to our own existence. It mixes into the interstellar medium and recondenses into new stars orbited by planets such as Earth.

The concept was conceived by Fred Hoyle, who developed it during the 1950s along with two other British astronomers, Margaret Burbidge and Geoffrey Burbidge, and American nuclear physicist William Fowler. In their classic 1957 paper in Reviews of Modern Physics (known by the initials of its authors as BBFH), they analyzed the networks of the nuclear reactions involved and discovered how most atoms in the periodic table came to exist. They calculated why oxygen and carbon, for instance, are common, whereas gold and uranium are rare.

Our galaxy, it turns out, is a huge ecological system where gas is being recycled through successive generations of stars. Each of us contains atoms forged in dozens of different stars spread across the Milky Way that lived and died more than 4.5 billion years ago. Scientists long assumed this process was seeding planets—and possibly even life—around stars other than our own sun.

But we did not know for sure whether planets existed outside our solar system until the 1990s, when astronomers developed clever methods for identifying worlds that are too dim for us to see directly. One technique looks for tiny periodic changes in a star's movement caused by the gravitational pull of a planet orbiting it. In 1995 Michel Mayor and Didier Queloz used this strategy to detect 51 Pegasi b, the first known exoplanet orbiting a sunlike star.

The technique can reveal a planet's mass, the length of its “year” and the shape of its orbit. So far more than 800 exoplanets have been found this way. A second technique works better for smaller planets.

A star dims slightly when a planet transits in front of it. An Earth-like planet passing a sunlike star can cause a dimming of about one part in 10,000 once per orbit. The Kepler spacecraft launched in 2009 found more than 2,000 planets this way, many no bigger than Earth.

A big surprise to come from astronomers' success in planet hunting was the variety of different planets out there—many much larger and closer to their stars than the bodies in our solar system—suggesting that our cosmic neighborhood may be somewhat special. By this point scientists understood where almost all the elements that form planets, stars and galaxies originated. The final piece in this puzzle, however, arrived very recently and from a seemingly unrelated inquiry.

General relativity had predicted a phenomenon called gravitational waves—ripples in spacetime produced by the movement of massive objects. Despite decades of searching for them, however, no waves were seen—until September 2015. That was when the Laser Interferometer Gravitational-wave Observatory (LIGO) detected the first evidence of gravitational waves in the form of a “chirp”—a minute shaking of spacetime that speeds up and then dies away.

In this case, it was caused by two black holes in a binary system that had started out orbiting each other but gradually spiraled together and eventually converged into a single massive hole. The crash occurred more than a billion light-years away. LIGO's detectors consist of mirrors four kilometers apart whose separation is measured by laser beams that reflect light back and forth between them.

A passing gravitational wave causes the space between the two mirrors to jitter by an amount millions of times as small as the diameter of a single atom—LIGO is indeed an amazing feat of precision engineering and perseverance. Since that first find, more than a dozen similar events have been detected, opening up a new field that probes the dynamics of space itself. One event was of special astrophysical interest because it signaled the merger of two pulsars.

Unlike black hole mergers, this kind of collision, a splat between two ultradense stars, yields a pulse of optical light, x-rays and gamma rays. The discovery filled a gap in the classic work of BBFH. The authors had explained the genesis of many of the elements in space but were flummoxed by the forging of gold.

In the 1970s David N. Schramm and his colleagues had speculated that the exotic nuclear processes involved in hypothetical mergers of pulsar stars might do the job—a theory that has since been validated. Despite the incredible progress in astronomy over the past 175 years, we have perhaps more questions now than we did back then.

Take dark matter. I am on record as having said more than 20 years ago that we would know dark matter's nature long before today. Although that prediction has proved wrong, I have not given up hope.

Dark energy, however, is a different story. Dark energy entered the picture in 1998, when researchers measuring the distances and speeds of supernovae found that the expansion of the universe was actually accelerating. Gravitational attraction pulling galaxies toward one another seemed to be overwhelmed by a mysterious new force latent in empty space that pushes galaxies apart—a force that came to be known as dark energy.

The mystery of dark energy has lingered—we still do not know what causes it or why it has the particular strength it does—and we probably will not understand it until we have a model for the graininess of space on a scale a billion billion times smaller than an atomic nucleus. Theorists working on string theory or loop quantum gravity are tackling this challenge, but the phenomenon seems so far from being accessible by any experiment that I am not expecting answers anytime soon. The upside, however, is that a theory that could account for the energy in the vacuum of space might also yield insights into the very beginning of our universe, when everything was so compressed and dense that quantum fluctuations could shake the entire cosmos.

Which brings us to another major question facing us now. How did it all begin?. What exactly set off the big bang that started our universe?.

Did space undergo a period of extremely rapid early expansion called inflation, as many theorists believe?. And there is something else. Some models, such as eternal inflation, suggest that “our” big bang could be just one island of spacetime in a vast archipelago—one big bang among many.

If this hypothesis is true, different big bangs may cool down differently, leading to unique laws of physics in each case—a “multiverse” rather than a universe. Some physicists hate the multiverse concept because it means that we will never have neat explanations for the fundamental numbers that govern our physical laws, which may in this grander perspective be just environmental accidents. But our preferences are irrelevant to nature.

About 10 years ago I was on a panel at Stanford University where we were asked by someone in the audience how much we would bet on the multiverse concept. I said that on a scale of betting my goldfish, my dog or my life, I was nearly at the dog level. Andrei Linde, who had spent 25 years promoting eternal inflation, said he would almost bet his life.

Later, on being told this, physicist Steven Weinberg said he would happily bet my dog and Linde's life. Linde, my dog and I will all be dead before the question is settled. But none of this should be dismissed as metaphysics.

It is speculative science—exciting science. And it may be true. And what will happen to this universe—or multiverse—of ours?.

Long-range forecasts are seldom reliable, but the best and most conservative bet is that we have almost an eternity ahead with an ever colder and ever emptier cosmos. Galaxies will accelerate away and disappear. All that will be left from our vantage point will be the remnants of the Milky Way, Andromeda and smaller neighbors.

Protons may decay, dark matter particles may be annihilated, there may be occasional flashes when black holes evaporate—and then silence. This possible future is based on the assumption that the dark energy stays constant. If it decays, however, there could be a “big crunch” with the universe contracting in on itself.

Or if dark energy strengthens, there would be a “big rip” when galaxies, stars and even atoms are torn apart. Other questions closer to home tantalize us. Could there be life on any of these new planets we are discovering?.

Here we are still in the realm of speculation. But unless the origin of life on Earth involved a rare fluke, I expect evidence of a biosphere on an exoplanet within 20 years. I will not hold my breath for the discovery of aliens, but I think the search for extraterrestrial intelligence is a worthwhile gamble.

Success in the search would carry the momentous message that concepts of logic and physics are not limited to the hardware in human skulls. Until now, progress in cosmology and astrophysics has owed 95 percent to advancing instruments and technology and less than 5 percent to armchair theory. I expect that balance to persist.

What Hubble wrote in the 1930s remains a good maxim today. €œNot until the empirical resources are exhausted, need we pass on to the dreamy realms of speculation.” There have been many particularly exhilarating eras in the past 175 years—the 1920s and 1930s, when we realized the universe was not limited to the Milky Way, and the 1960s and 1970s, when we discovered objects that defy classical physics, such as neutron stars and quasars, and clues about the beginning of time from the cosmic microwave background. Since then, the pace of advancement has crescendoed rather than slackened.

When the history of science gets written, this amazing progress will be acclaimed as one of its greatest triumphs—up there with plate tectonics, the genome and the Standard Model of particle physics. And some major fields in astronomy are just getting going. Exoplanet research is only 25 years old, and serious work in astrobiology is really only starting.

Some exoplanets may have life—they may even harbor aliens who know all the answers already. I find that encouraging. Credit.

Moritz Stefaner and Christian LässerFor more context, see “Visualizing 175 Years of Words in Scientific American”Fully functional quantum computers and a new quantum industry may appear much sooner than many have anticipated—thanks to five new National Quantum Information Science Research centers just announced by the U.S. Department of Energy. This latest development in the recently launched National Quantum Initiative Act, signed into law in December 2018, comes with $625 million in funding over five years.

It’s a huge deal. For the first time, researchers from academia, U.S. National labs and industry will be working side by side aiming to speed up the fundamental quantum information science research.

And more research should bring us closer to advanced quantum technologies and the grandest goal of quantum information science, creating a fault-tolerant quantum computer that can indefinitely compute without errors. Why do we need quantum computers?. We need them to speed up the process of scientific discovery so that we can address some our greatest global challenges, from designing new materials for more efficient carbon capture plants and batteries to better drugs and treatments.

Traditionally, material design has depended a lot on either happy accidents or a long and tedious iterative process of experimentation. Over the past half a century, classical computers have greatly accelerated this process by performing molecular simulations. Still, classical computers can’t simulate complex molecules with enough accuracy, and that’s where quantum computing will be able to help.

Quantum computers rely on the same physical rules as atoms to manipulate information. Just like traditional, classical, computers execute logical circuits to run software programs, quantum computers use the physics phenomena of superposition, entanglement and interference to execute quantum circuits. One day soon, they should be able to perform mathematical calculations out of the reach of the most advanced current and future classical supercomputers.

But to get there, we will need to build quantum machines that compute without errors. Quantum computers rely on fragile qubits, short for quantum bits, which are only of use when they are in a delicate quantum state. Any external disturbances or “noise,” such as heat, light or vibrations, inevitably yanks these qubits out of their quantum state and turns them into regular bits.

Overcoming this hurdle is beyond the limits of a single team, and we need scores of scientists from academia, the national labs and industry to get us there. This is where the new centers come in. At last, they will get the talent from all our R&D sectors to work together on quantum-related issues.

Take the problem of building a quantum system that would compute without errors. Our best theories estimate that to get there, we should build machines with tens of millions of qubits on a single cooled-down chip. But we don’t want to cool down quantum chips the size of football fields.

To avoid it, we need many breakthroughs—meaning we have to invest in research at scale. Luckily, some of the latest results show that it’s possible to reduce the number of qubits we need to implement error-correcting codes. But even if we achieve this, we will have to overcome another hurdle.

Linking quantum processors, just like we connect today’s computer chips inside data centers using intranets. This requires quantum interconnects that transfer the fragile quantum information stored in the processor’s qubits into a different quantum format (say, photons) that “communicate” the data to another processor. Advances in this space must unite disparate technologies like superconducting qubits and fiber optics, while solving outstanding challenges in materials science and quantum communications.

Research teams could probably solve these problems, and many other challenges the quantum information science community is tackling, individually. But it would take decades, and we can’t afford to wait this long. Partnerships and collaboration, through the new centers, will offer us the chance of making the quantum leap we need.

With a long-term vision of establishing a robust national quantum ecosystem, academia, national labs and industry partners at last have a quantum roadmap. Now it’s up to all the partners in this joint effort to create a quantum ecosystem and industry. We’ll need plenty of the wit, talent, creativity and enthusiasm of a skilled and diverse quantum workforce to make it happen..

In early August, there was a lot of hubbub around a study that purportedly showed that wearing a neck gaiter, the sleeve-like face covering popular especially among runners, might be worse at stemming the spread of erectile dysfunction treatment than not wearing a mask at all levitra online. Headlines popped up spreading the news, sparking conversations far and wide and forcing many to reconsider their preferred style of face mask. A Washington Post story said “some cotton cloth masks are about as effective as surgical masks, while thin polyester spandex gaiters may be worse than going maskless.” A Forbes article, referring to neck gaiters, said the study “found that one type of face covering might actually be doing more harm than good.” But the study didn’t show that, nor was it designed to.

It was actually a test on how to levitra online test masks inexpensively, not to determine which one was most effective. The researchers set up a green laser beam in a dark room. A masked subject was then asked to speak so that the droplets from the speaker’s mouth showed up in the green beam.

The whole process was video recorded on a cell phone, after which researchers calculated the number of droplets that showed up levitra online. The process was repeated 10 times for each mask (14 in total, one of which was a neck gaiter) and the setup cost less than $200. What was meant as a study on the pricing and efficacy of a test turned into, at least in some journalistic circles, a definitive nail-in-the-coffin for gaiters.

Days after the initial reports that neck gaiters might not only be useless but maybe even harmful, a new round of new reports came out saying that those initial reports levitra online were overblown and misleading. The authors of the study even held a press conference where they emphasized that their study was never meant to test the effectiveness of masks. They only tested one gaiter-style mask, which says nothing about that style of mask in general.

The combination of reporting on the actual findings levitra online of the study and the direct comments from the authors seems to have abated the anti-neck gaiter fervor. But all of this this—or most of it, anyway—likely could have been prevented. You could make the argument that it’s not a scientist’s job to worrying about how their science might be interpreted.

It’s their levitra online job to do the research and publish it in a scientific manuscript. Leave the communicating for someone else. But that’s not how the spread of information works.

Fewer and fewer newsrooms have staffers with scientific backgrounds, levitra online or who are dedicated to scientific reporting. To be clear, journalists don’t need to be scientists to understand science, but reporting on science does require a certain amount of expertise. When newsrooms ask reporters to cover more and more topic areas and this specialization decreases, an attention to detail is sometimes lost.

So, the onus to help journalists (and frankly, all nonscientists) get the facts straight falls levitra online to the scientists doing the science. That’s where science communication training comes in. Science communication, or scicomm as it’s known colloquially, is not a core part of coursework in a majority of degree-granting science programs at the undergraduate and graduate levels.

This trend is slowly changing as levitra online more institutions incorporate scicomm into their curriculums. Outside of academia, nonprofits and scientific societies are taking up the mantle. I work for the American Geophysical Union (AGU), a society for Earth and space scientists, in the Sharing Science program, where we teach scientists to communicate with nonscientists through courses, workshops, webinars and other trainings.

Aside from the AGU, there is levitra online the American Association for the Advancement of Science (AAAS), the Stony Brook–affiliated Alan Alda Center for Communicating Science and the science storytelling organization The Story Collider, to name just to name a few. We teach the so-called “soft skills” that the ivory tower of science has shunned for so long but that are so necessary in effectively communicating. One thing we stress is “know your audience.” Scientists must think about how their science will be perceived, no matter how relevant or not it might be to the broader public.

Science does not levitra online exist in a vacuum. It never has. But especially now, and especially with anything related to erectile dysfunction treatment, scientists much be hypervigilant when communicating results and try, to the best of their abilities, to account for as many interpretations as possible.

Yes, it is onerous, especially on top of the multitude of other levitra online responsibilities that come with being a scientist, but it is necessary. The traditional ways in which scientists communicate their results (i.e., scientific manuscripts) are not going away anytime soon. However, and while it may be an unfair ask, scientists must not only be able to communicate their science to their peers.

They must always think about nonscience audiences as the lines between science and “the public” continue to blur levitra online. Training scientists to effectively communicate to, or at least think about, diverse audiences is a necessary part of science.In 1835 French philosopher Auguste Comte asserted that nobody would ever know what the stars were made of. €œWe understand the possibility of determining their shapes, their distances, their sizes and their movements,” he wrote, “whereas we would never know how to study by any means their chemical composition, or their mineralogical structure, and, even more so, the nature of any organized beings that might live on their surface.” Comte would be stunned by the discoveries made since then.

Today we know that the universe levitra online is far bigger and stranger than anyone suspected. Not only does it extend beyond the Milky Way to untold numbers of other galaxies—this would come as a surprise to astronomers of the 19th and early 20th century to whom our galaxy was “the universe”—but it is expanding faster every day. Now we can confidently trace cosmic history back 13.8 billion years to a moment only a billionth of a second after the big bang.

Astronomers have pinned down our universe's expansion rate, the mean levitra online density of its main constituents, and other key numbers to a precision of 1 or 2 percent. They have also worked out new laws of physics governing space—general relativity and quantum mechanics—that turn out to be much more outlandish than the classical laws people understood before. These laws in turn predicted cosmic oddities such as black holes, neutron stars and gravitational waves.

The story of how we gained this knowledge is full of accidental discoveries, stunning surprises and levitra online dogged scientists pursuing goals others thought unreachable. Our first hint of the true nature of stars came in 1860, when Gustav Kirchhoff recognized that the dark lines in the spectrum of light coming from the sun were caused by different elements absorbing specific wavelengths. Astronomers analyzed similar features in the light of other bright stars and discovered that they were made of the same materials found on Earth—not of some mysterious “fifth essence” as the ancients had believed.

But it took longer to understand what levitra online fuel made the stars shine. Lord Kelvin (William Thomson) calculated that if stars derived their power just from gravity, slowly deflating as their radiation leaked out, then the sun's age was 20 million to 40 million years—far less time than Charles Darwin or the geologists of the time inferred had elapsed on Earth. In his last paper on the subject, in 1908, Kelvin inserted an escape clause stating that he would stick by his estimate “unless there were some other energy source laid up in the storehouse of creation.” That source, it turned out, is nuclear fusion—the process by which atomic nuclei join to create a larger nucleus and release energy.

In 1925 astrophysicist Cecilia Payne-Gaposchkin used the light spectra of levitra online stars to calculate their chemical abundances and found that, unlike Earth, they were made mainly of hydrogen and helium. She revealed her conclusions in what astronomer Otto Struve described as “the most brilliant Ph.D. Thesis ever written in astronomy.” A decade later physicist Hans Bethe showed that the fusion of hydrogen nuclei into helium was the main power source in ordinary stars.

What is the source levitra online of the sun's power?. The answer—fusion—came in 1938. Credit.

SOHO (ESA and NASA) At the same time stars were becoming less levitra online mysterious, so, too, was the nature of fuzzy “nebulae” becoming clearer. In a “great debate” held before the National Academy of Sciences in Washington, D.C., on April 26, 1920, Harlow Shapley maintained that our Milky Way was preeminent and that all the nebulae were part of it. In contrast, Heber Curtis argued that some of the fuzzy objects in the sky were separate galaxies—“island universes”—fully the equal of our Milky Way.

The conflict was settled not that night but just a few years later, in 1924, when Edwin levitra online Hubble measured the distances to many nebulae and proved they were beyond the reaches of the Milky Way. His evidence came from Cepheids, variable stars in the nebulae that reveal their true brightness, and thus their distance, by their pulsation period—a relation discovered by Henrietta Swan Leavitt. Soon after Hubble realized that the universe was bigger than many had thought, he found that it was still growing.

In 1929 he discovered that spectral features in the starlight from distant galaxies appeared levitra online redder—that is, they had longer wavelengths—than the same features in nearby stars. If this effect was interpreted as a Doppler shift—the natural spreading of waves as they recede—it would imply that other galaxies were moving away from one another and from us. Indeed, the farther away they were, the faster their recession seemed to be.

This was the first clue that our cosmos was not static but was levitra online expanding all the time. The universe also appeared to contain much that we could not see. In 1933 Fritz Zwicky estimated the mass of all the stars in the Coma cluster of galaxies and found that they make up only about 1 percent of the mass necessary to keep the cluster from flying apart.

The discrepancy was dubbed levitra online “the missing mass problem,” but many scientists at the time doubted Zwicky's suggestion that hidden matter might be to blame. The question remained divisive until the 1970s, when work by Vera Rubin and W. Kent Ford (observing stars) and by Morton Roberts and Robert Whitehurst (making radio observations) showed that the outer parts of galactic disks would also fly apart unless they were subject to a stronger gravitational pull than stars and gas alone could provide.

Finally, most astronomers were compelled to accept that some kind levitra online of “dark matter” must be present. €œWe have peered into a new world,” Rubin wrote, “and have seen that it is more mysterious and more complex than we had imagined.” Scientists now believe that dark matter outnumbers visible matter by about a factor of five, yet we are hardly closer than we were in the 1930s to figuring out what it is. Gravity, the force that revealed all that dark matter, has proved to be nearly as baffling.

A pivotal moment came in 1915 when Albert Einstein published his general theory of relativity, which transcended Isaac Newton's mechanics and revealed that gravity is actually levitra online the deformation of the fabric of space and time. This new theory was slow to take hold. Even after it was shown to be correct by observations of a 1919 solar eclipse, many dismissed the theory as an interesting quirk—after all, Newton's laws were still good enough for calculating most things.

€œThe discoveries, while very important, did not, however, affect anything on this earth,” astronomer W.J.S levitra online. Lockyer told the New York Times after the eclipse. For almost half a century after it was proposed, general relativity was sidelined from the mainstream of physics.

Then, beginning levitra online in the 1960s, astronomers started discovering new and extreme phenomena that only Einstein's ideas could explain. One example lurks in the Crab Nebula, one of the best-known objects in the sky, which is composed of the expanding debris from a supernova witnessed by Chinese astronomers in a.d. 1054.

Since it appeared, the nebula has kept on shining blue levitra online and bright—but how?. Its light source was a longtime puzzle, but the answer came in 1968, when the dim star at its center was revealed to be anything but normal. It was actually an ultracompact neutron star, heavier than the sun but only a few miles in radius and spinning at 30 revolutions per second.

€œThis was a totally unexpected, totally new kind levitra online of object behaving in a way that astronomers had never expected, never dreamt of,” said Jocelyn Bell Burnell, one of the discoverers of the phenomenon. The star's excessive spin sends out a wind of fast electrons that generate the blue light. The gravitational force at the surface of such an incredibly dense object falls way outside of Newton's purview—a rocket would need to be fired at half the speed of light to escape its pull.

Here the relativistic effects levitra online predicted by Einstein must be taken into account. Thousands of such spinning neutron stars—called pulsars—have been discovered. All are believed to be remnants of the cores of stars that exploded as supernovae, offering an ideal laboratory for studying the laws of nature under extreme conditions.

The most exotic result of Einstein's theory was the concept of black holes—objects that have collapsed so far that not even levitra online light can escape their gravitational pull. For decades these were only conjecture, and Einstein wrote in 1939 that they “do not exist in physical reality.” But in 1963 astronomers discovered quasars. Mysterious, hyperluminous beacons in the centers of some galaxies.

More than a decade passed before a consensus emerged that this intense brightness was generated by gas swirling into huge levitra online black holes lurking in the galaxies' cores. It was the strongest evidence yet that these bizarre predictions of general relativity actually exist. When did the universe begin?.

Did it levitra online even have a beginning?. Astronomers had long debated these questions when, in the middle of the 20th century, two competing theories proposed very different answers. The “hot big bang” model said the cosmos began extremely small, hot and dense and then cooled and spread out over time.

The “steady state” hypothesis held that the universe had essentially existed levitra online in the same form forever. The contest was settled by a serendipitous discovery. In 1965 radio astronomers Arno Penzias and Robert Wilson were trying to calibrate a new antenna at Bell Labs in New Jersey.

They had levitra online a problem. No matter what they did to reduce background interference, they measured a consistent level of noise in every direction. They even evicted a family of pigeons that had been nesting in the antenna in the hope that they were the source of the problem.

But the signal persisted levitra online. They had discovered that intergalactic space is not completely cold. Instead it is warmed to nearly three kelvins (just above absolute zero) by weak microwaves.

Penzias and Wilson had levitra online accidentally uncovered the “afterglow of creation”—the cooled and diluted relic of an era when everything in the universe was squeezed until it was hot and dense. The finding tipped the balance firmly in favor of the big bang picture of cosmology. According to the model, during the earliest, hottest epochs of time, the universe was opaque, rather like the inside of a star, and light was repeatedly scattered by electrons.

When the temperature fell to 3,000 kelvins, however, the electrons slowed down enough to be captured by protons levitra online and created neutral atoms. Thereafter light could travel freely. The Bell Labs signal was this ancient light, first released about 300,000 years after the birth of the universe and still pervading the cosmos—what we call the cosmic microwave background.

It took a while for the levitra online magnitude of the discovery to sink in for the scientists who made it. €œWe were very pleased to have a possible explanation [for the antenna noise], but I don't think either of us really took the cosmology very seriously at first,” Wilson says. €œWalter Sullivan wrote a first-page article in the New York Times about it, and I began to think at that point that, you know, maybe I better start taking this cosmology seriously.” Measurements of this radiation have since enabled scientists to understand how galaxies emerged.

Precise observations of the microwaves reveal that they are not completely uniform over levitra online the sky. Some patches are slightly hotter, others slightly cooler. The amplitude of these fluctuations is only one part in 100,000, but they are the seeds of today's cosmic structure.

Any region of the expanding universe that started off slightly denser than average expanded less because it was subjected to levitra online extra gravity. Its growth lagged further and further, the contrast between its density and that of its surroundings becoming greater and greater. Eventually these clumps were dense enough that gas was pulled in and compressed into stars, forming galaxies.

The crucial point is this levitra online. Computer models that simulate this process are fed the initial fluctuations measured in the cosmic microwave background, which represent the universe when it was 300,000 years old. The output after 13.8 billion years of virtual time have elapsed is a cosmos where galaxies resemble those we see, clustered as they are in the actual universe.

This is a real triumph levitra online. We understand, at least in outline, 99.998 percent of cosmic history. It is not only the big cosmic picture that we have come to understand.

A series of discoveries has also revealed the history of the elemental levitra online building blocks that make up stars, planets and even our own bodies. Starting in the 1950s, progress in atomic physics led to accurate modeling of stars' surface layers. Simultaneously, detailed knowledge of the nuclei not just of hydrogen and helium atoms but also of the rest of the elements allowed scientists to calculate which nuclear reactions dominate at different stages in a star's life.

Astronomers came to levitra online understand how nuclear fusion creates an onion-skin structure in massive stars as atoms successively fuse to build heavier and heavier elements, ending with iron in the innermost, hottest layer. Inside the Crab Nebula is a neutron star. Classical physics fails, and relativity applies.

Credit. NASA, ESA and Hubble Heritage Team (STSCI and AURA) Astronomers also learned how stars die when they exhaust their hydrogen fuel and blow off their outer gaseous layers. Lighter stars then settle down to a quiet demise as dense, dim objects called white dwarfs, but heavier stars shed more of their mass, either in winds during their lives or in an explosive death via supernova.

This expelled mass turns out to be crucial to our own existence. It mixes into the interstellar medium and recondenses into new stars orbited by planets such as Earth. The concept was conceived by Fred Hoyle, who developed it during the 1950s along with two other British astronomers, Margaret Burbidge and Geoffrey Burbidge, and American nuclear physicist William Fowler.

In their classic 1957 paper in Reviews of Modern Physics (known by the initials of its authors as BBFH), they analyzed the networks of the nuclear reactions involved and discovered how most atoms in the periodic table came to exist. They calculated why oxygen and carbon, for instance, are common, whereas gold and uranium are rare. Our galaxy, it turns out, is a huge ecological system where gas is being recycled through successive generations of stars.

Each of us contains atoms forged in dozens of different stars spread across the Milky Way that lived and died more than 4.5 billion years ago. Scientists long assumed this process was seeding planets—and possibly even life—around stars other than our own sun. But we did not know for sure whether planets existed outside our solar system until the 1990s, when astronomers developed clever methods for identifying worlds that are too dim for us to see directly.

One technique looks for tiny periodic changes in a star's movement caused by the gravitational pull of a planet orbiting it. In 1995 Michel Mayor and Didier Queloz used this strategy to detect 51 Pegasi b, the first known exoplanet orbiting a sunlike star. The technique can reveal a planet's mass, the length of its “year” and the shape of its orbit.

So far more than 800 exoplanets have been found this way. A second technique works better for smaller planets. A star dims slightly when a planet transits in front of it.

An Earth-like planet passing a sunlike star can cause a dimming of about one part in 10,000 once per orbit. The Kepler spacecraft launched in 2009 found more than 2,000 planets this way, many no bigger than Earth. A big surprise to come from astronomers' success in planet hunting was the variety of different planets out there—many much larger and closer to their stars than the bodies in our solar system—suggesting that our cosmic neighborhood may be somewhat special.

By this point scientists understood where almost all the elements that form planets, stars and galaxies originated. The final piece in this puzzle, however, arrived very recently and from a seemingly unrelated inquiry. General relativity had predicted a phenomenon called gravitational waves—ripples in spacetime produced by the movement of massive objects.

Despite decades of searching for them, however, no waves were seen—until September 2015. That was when the Laser Interferometer Gravitational-wave Observatory (LIGO) detected the first evidence of gravitational waves in the form of a “chirp”—a minute shaking of spacetime that speeds up and then dies away. In this case, it was caused by two black holes in a binary system that had started out orbiting each other but gradually spiraled together and eventually converged into a single massive hole.

The crash occurred more than a billion light-years away. LIGO's detectors consist of mirrors four kilometers apart whose separation is measured by laser beams that reflect light back and forth between them. A passing gravitational wave causes the space between the two mirrors to jitter by an amount millions of times as small as the diameter of a single atom—LIGO is indeed an amazing feat of precision engineering and perseverance.

Since that first find, more than a dozen similar events have been detected, opening up a new field that probes the dynamics of space itself. One event was of special astrophysical interest because it signaled the merger of two pulsars. Unlike black hole mergers, this kind of collision, a splat between two ultradense stars, yields a pulse of optical light, x-rays and gamma rays.

The discovery filled a gap in the classic work of BBFH. The authors had explained the genesis of many of the elements in space but were flummoxed by the forging of gold. In the 1970s David N.

Schramm and his colleagues had speculated that the exotic nuclear processes involved in hypothetical mergers of pulsar stars might do the job—a theory that has since been validated. Despite the incredible progress in astronomy over the past 175 years, we have perhaps more questions now than we did back then. Take dark matter.

I am on record as having said more than 20 years ago that we would know dark matter's nature long before today. Although that prediction has proved wrong, I have not given up hope. Dark energy, however, is a different story.

Dark energy entered the picture in 1998, when researchers measuring the distances and speeds of supernovae found that the expansion of the universe was actually accelerating. Gravitational attraction pulling galaxies toward one another seemed to be overwhelmed by a mysterious new force latent in empty space that pushes galaxies apart—a force that came to be known as dark energy. The mystery of dark energy has lingered—we still do not know what causes it or why it has the particular strength it does—and we probably will not understand it until we have a model for the graininess of space on a scale a billion billion times smaller than an atomic nucleus.

Theorists working on string theory or loop quantum gravity are tackling this challenge, but the phenomenon seems so far from being accessible by any experiment that I am not expecting answers anytime soon. The upside, however, is that a theory that could account for the energy in the vacuum of space might also yield insights into the very beginning of our universe, when everything was so compressed and dense that quantum fluctuations could shake the entire cosmos. Which brings us to another major question facing us now.

How did it all begin?. What exactly set off the big bang that started our universe?. Did space undergo a period of extremely rapid early expansion called inflation, as many theorists believe?.

And there is something else. Some models, such as eternal inflation, suggest that “our” big bang could be just one island of spacetime in a vast archipelago—one big bang among many. If this hypothesis is true, different big bangs may cool down differently, leading to unique laws of physics in each case—a “multiverse” rather than a universe.

Some physicists hate the multiverse concept because it means that we will never have neat explanations for the fundamental numbers that govern our physical laws, which may in this grander perspective be just environmental accidents. But our preferences are irrelevant to nature. About 10 years ago I was on a panel at Stanford University where we were asked by someone in the audience how much we would bet on the multiverse concept.

I said that on a scale of betting my goldfish, my dog or my life, I was nearly at the dog level. Andrei Linde, who had spent 25 years promoting eternal inflation, said he would almost bet his life. Later, on being told this, physicist Steven Weinberg said he would happily bet my dog and Linde's life.

Linde, my dog and I will all be dead before the question is settled. But none of this should be dismissed as metaphysics. It is speculative science—exciting science.

And it may be true. And what will happen to this universe—or multiverse—of ours?. Long-range forecasts are seldom reliable, but the best and most conservative bet is that we have almost an eternity ahead with an ever colder and ever emptier cosmos.

Galaxies will accelerate away and disappear. All that will be left from our vantage point will be the remnants of the Milky Way, Andromeda and smaller neighbors. Protons may decay, dark matter particles may be annihilated, there may be occasional flashes when black holes evaporate—and then silence.

This possible future is based on the assumption that the dark energy stays constant. If it decays, however, there could be a “big crunch” with the universe contracting in on itself. Or if dark energy strengthens, there would be a “big rip” when galaxies, stars and even atoms are torn apart.

Other questions closer to home tantalize us. Could there be life on any of these new planets we are discovering?. Here we are still in the realm of speculation.

But unless the origin of life on Earth involved a rare fluke, I expect evidence of a biosphere on an exoplanet within 20 years. I will not hold my breath for the discovery of aliens, but I think the search for extraterrestrial intelligence is a worthwhile gamble. Success in the search would carry the momentous message that concepts of logic and physics are not limited to the hardware in human skulls.

Until now, progress in cosmology and astrophysics has owed 95 percent to advancing instruments and technology and less than 5 percent to armchair theory. I expect that balance to persist. What Hubble wrote in the 1930s remains a good maxim today.

€œNot until the empirical resources are exhausted, need we pass on to the dreamy realms of speculation.” There have been many particularly exhilarating eras in the past 175 years—the 1920s and 1930s, when we realized the universe was not limited to the Milky Way, and the 1960s and 1970s, when we discovered objects that defy classical physics, such as neutron stars and quasars, and clues about the beginning of time from the cosmic microwave background. Since then, the pace of advancement has crescendoed rather than slackened. When the history of science gets written, this amazing progress will be acclaimed as one of its greatest triumphs—up there with plate tectonics, the genome and the Standard Model of particle physics.

And some major fields in astronomy are just getting going. Exoplanet research is only 25 years old, and serious work in astrobiology is really only starting. Some exoplanets may have life—they may even harbor aliens who know all the answers already.

I find that encouraging. Credit. Moritz Stefaner and Christian LässerFor more context, see “Visualizing 175 Years of Words in Scientific American”Fully functional quantum computers and a new quantum industry may appear much sooner than many have anticipated—thanks to five new National Quantum Information Science Research centers just announced by the U.S.

Department of Energy. This latest development in the recently launched National Quantum Initiative Act, signed into law in December 2018, comes with $625 million in funding over five years. It’s a huge deal.

For the first time, researchers from academia, U.S. National labs and industry will be working side by side aiming to speed up the fundamental quantum information science research. And more research should bring us closer to advanced quantum technologies and the grandest goal of quantum information science, creating a fault-tolerant quantum computer that can indefinitely compute without errors.

Why do we need quantum computers?. We need them to speed up the process of scientific discovery so that we can address some our greatest global challenges, from designing new materials for more efficient carbon capture plants and batteries to better drugs and treatments. Traditionally, material design has depended a lot on either happy accidents or a long and tedious iterative process of experimentation.

Over the past half a century, classical computers have greatly accelerated this process by performing molecular simulations. Still, classical computers can’t simulate complex molecules with enough accuracy, and that’s where quantum computing will be able to help. Quantum computers rely on the same physical rules as atoms to manipulate information.

Just like traditional, classical, computers execute logical circuits to run software programs, quantum computers use the physics phenomena of superposition, entanglement and interference to execute quantum circuits. One day soon, they should be able to perform mathematical calculations out of the reach of the most advanced current and future classical supercomputers. But to get there, we will need to build quantum machines that compute without errors.

Quantum computers rely on fragile qubits, short for quantum bits, which are only of use when they are in a delicate quantum state. Any external disturbances or “noise,” such as heat, light or vibrations, inevitably yanks these qubits out of their quantum state and turns them into regular bits. Overcoming this hurdle is beyond the limits of a single team, and we need scores of scientists from academia, the national labs and industry to get us there.

This is where the new centers come in. At last, they will get the talent from all our R&D sectors to work together on quantum-related issues. Take the problem of building a quantum system that would compute without errors.

Our best theories estimate that to get there, we should build machines with tens of millions of qubits on a single cooled-down chip. But we don’t want to cool down quantum chips the size of football fields. To avoid it, we need many breakthroughs—meaning we have to invest in research at scale.

Luckily, some of the latest results show that it’s possible to reduce the number of qubits we need to implement error-correcting codes. But even if we achieve this, we will have to overcome another hurdle. Linking quantum processors, just like we connect today’s computer chips inside data centers using intranets.

This requires quantum interconnects that transfer the fragile quantum information stored in the processor’s qubits into a different quantum format (say, photons) that “communicate” the data to another processor. Advances in this space must unite disparate technologies like superconducting qubits and fiber optics, while solving outstanding challenges in materials science and quantum communications. Research teams could probably solve these problems, and many other challenges the quantum information science community is tackling, individually.

But it would take decades, and we can’t afford to wait this long. Partnerships and collaboration, through the new centers, will offer us the chance of making the quantum leap we need. With a long-term vision of establishing a robust national quantum ecosystem, academia, national labs and industry partners at last have a quantum roadmap.

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KNOW YOUR RIGHTS - FACT SHEET on THREE ways to Reduce how much does levitra cost per pill Spend-down, including this Special Income Standard. September 2018 NEWS -- Those already enrolled in MLTC plans before they are admitted to a nursing home or adult home may obtain this budgeting upon discharge, if they meet the other criteria below. "How nursing home administrators, adult home operators and MLTC plans should identify individuals who are eligible for the special income standard" and explains their duties to identify eligible individuals, and the MLTC plan must notify the local DSS that the individual may qualify. "Nursing home administrators, nursing home discharge planning staff, adult home operators and MLTC health plans are encouraged to identify individuals who may qualify for the special income standard, if they can be safely discharged back to the community how much does levitra cost per pill from a nursing home and enroll in, or remain enrolled in, an MLTC plan. Once an individual has been accepted into an MLTC plan, the MLTC plan must notify the individual's local district of social services that the transition has occurred and that the individual may qualify for the special income standard.

The special income standard will be effective upon enrollment into the MLTC plan, or, for nursing home residents already enrolled in an MLTC plan, the month of discharge to the community. Questions regarding the special how much does levitra cost per pill income standard may be directed to DOH at 518-474-8887. Who is eligible for this special income standard?. must be age 18+, must have been in a nursing home or an adult home for 30 days or more, must have had Medicaid pay toward the nursing home care, and must enroll in or REMAIN ENROLLED IN a Managed Long Term Care (MLTC) plan or FIDA plan upon leaving the nursing home or adult home must have a housing expense if married, spouse may not receive a "spousal impoverishment" allowance once the individual is enrolled in MLTC. How how much does levitra cost per pill much is the allowance?.

The rates vary by region and change yearly. Region Counties Deduction (2021) Central Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins $450 Long Island Nassau, Suffolk $1,393 NYC Bronx, Kings, Manhattan, Queens, Richmond $1,535 (up from 1,451 in 2020) Northeastern Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington $524 North Metropolitan Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester $1,075 Rochester Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates $469 Western Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming $413 Past rates published as follows, available on DOH website 2021 rates published in Attachment I to GIS 20 MA/13 -- 2021 Medicaid Levels and Other Updates 2020 rates published in Attachment I to GIS 19 MA/12 – 2020 Medicaid Levels how much does levitra cost per pill and Other Updates 2019 rates published in Attachment 1 to GIS 18/MA015 - 2019 Medicaid Levels and Other Updates 2018 rates published in GIS 17 MA/020 - 2018 Medicaid Levels and Other Updates. The guidance on how the standardized amount of the disregard is calculated is found in NYS DOH 12- ADM-05. 2017 rate -- GIS 16 MA/018 - 2016 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards Attachment 12016 rate -- GIS 15-MA/0212015 rate -- Were not posted by DOH but were updated in WMS.

2015 Central $382 Long how much does levitra cost per pill Island $1,147 NYC $1,001 Northeastern $440 N. Metropolitan $791 Rochester $388 Western $336 2014 rate -- GIS-14-MA/017 HOW DOES IT WORK?. Here is a sample budget for a single person in NYC with Social Security income of $2,386/month paying a Medigap premium of $261/mo. Gross monthly income $2,575.50 DEDUCT Health insurance premiums (Medicare Part B) - 135.50 (Medigap) - 261.00 DEDUCT Unearned income disregard - 20 DEDUCT Shelter deduction (NYC—2019) - 1,300 DEDUCT Income limit for single (2019) - 859 Excess income or Spend-down $0 WITH NO SPEND-DOWN, May NOT NEED POOLED TRUST!. HOW TO OBTAIN THE HOUSING DISREGARD.

When you are ready to leave the nursing home or adult home, or soon after you leave, you or your MLTC plan must request that your local Medicaid program change your Medicaid budget to give you the Housing Disregard. See September 2018 NYS DOH Medicaid Update that requires MLTC plan to help you ask for it. The procedures in NYC are explained in this Troubleshooting guide. In NYC, submit the application with the MAP-751W (check off "Budgeting Changes" and "Special Housing Standard"). (The MAP-751W is also posted in languages other than English in this link.

(Updated 3-15-2021.)) NYC Medicaid program prefers that your MLTC plan file the request, using Form MAP-3057E - Special income housing Expenses NH-MLTC.pdf and Form MAP-3047B - MLTC/NHED Cover Sheet Form MAP-259f (revised 7-31-18)(page 7 of PDF)(DIscharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GOVERNMENT DIRECTIVES (beginning with oldest). NYS DOH 12- ADM-05 - Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility who Enroll into the Managed Long Term Care (MLTC) Program Attachment II - OHIP-0057 - Notice of Intent to Change Medicaid Coverage, (Recipient Discharged from a Skilled Nursing Facility and Enrolled in a Managed Long Term Care Plan) Attachment III - Attachment III – OHIP-0058 - Notice of Intent to Change Medicaid Coverage, (Recipient Disenrolled from a Managed Long Term Care Plan, No Special Income Standard) MLTC Policy 13.02. MLTC Housing Disregard NYC HRA Medicaid Alert Special Income Standard for housing expenses NH-MLTC 2-9-2013.pdf 2018-07-28 HRA MICSA ALERT Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility and who Enroll into the MLTC Program - update on previous policy. References Form MAP-259f (revised 7-31-18)(page 7 of PDF)(Discharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard.

GIS 18 MA/012 - Special Income Standard for Housing Expenses for Certain Managed Long-Term Care Enrollees Who are Discharged from a Nursing Home issued Sept. 28, 2018 - this finally implements the most recent Special Terms &. Conditions of the CMS 1115 Waiver that governs the MLTC program, dated Jan. 19, 2017. The section on this income standard is at pages 26-27.

In these revised ST&C, this special income standard applies to people who were in a NH or adult home paid by Medicaid and "who enroll into or remain enrolled in the MLTC program in order to receive community based long term services and supports" and to those in a NH who were required to enroll into MLTC because of "...the mandatory Nursing Facility transition, and subsequently able to be discharged to the community from the nursing facility, with the services of MLTC program in place." September 2018 DOH Medicaid Update - explains this benefit to medical providers (nursing homes, MLTC plans, home care agencies, adult home operators, and requires them to identify potential individuals who could benefit and help them apply - described here..

A huge barrier to people returning to the community from nursing homes is the levitra online high cost of housing he has a good point. One way New York State is trying to address that barrier is with the Special Housing Disregard that allows certain members of Managed Long Term Care or FIDA plans to keep more of their income to pay for rent or other shelter costs, rather than having to "spend down" their "excess income" or spend-down on the cost of Medicaid home care. The special levitra online income standard for housing expenses helps pay for housing expenses to help certain nursing home or adult home residents to safely transition back to the community with MLTC.

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September 2018 NEWS -- Those already enrolled in MLTC plans before they are admitted to a nursing home or adult home may obtain this budgeting upon discharge, if they meet the other criteria below. "How nursing home administrators, adult home operators and MLTC plans should identify individuals who are eligible for the special income standard" and explains their duties to identify eligible individuals, and the MLTC plan must notify the local DSS that the individual may qualify. "Nursing home administrators, nursing home discharge planning staff, adult home operators and MLTC health plans are encouraged to identify individuals who may qualify for the special income standard, if they can be safely levitra online discharged back to the community from a nursing home and enroll in, or remain enrolled in, an MLTC plan.

Once an individual has been accepted into an MLTC plan, the MLTC plan must notify the individual's local district of social services that the transition has occurred and that the individual may qualify for the special income standard. The special income standard will be effective upon enrollment into the MLTC plan, or, for nursing home residents already enrolled in an MLTC plan, the month of discharge to the community. Questions regarding the special income standard may be directed to DOH at 518-474-8887 levitra online.

Who is eligible for this special income standard?. must be age 18+, must have been in a nursing home or an adult home for 30 days or more, must have had Medicaid pay toward the nursing home care, and must enroll in or REMAIN ENROLLED IN a Managed Long Term Care (MLTC) plan or FIDA plan upon leaving the nursing home or adult home must have a housing expense if married, spouse may not receive a "spousal impoverishment" allowance once the individual is enrolled in MLTC. How much levitra online is the allowance?.

The rates vary by region and change yearly. Region Counties Deduction (2021) Central Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins $450 Long Island Nassau, Suffolk $1,393 NYC Bronx, Kings, Manhattan, Queens, Richmond $1,535 (up from 1,451 in 2020) Northeastern Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington $524 North Metropolitan Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester $1,075 levitra online Rochester Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates $469 Western Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming $413 Past rates published as follows, available on DOH website 2021 rates published in Attachment I to GIS 20 MA/13 -- 2021 Medicaid Levels and Other Updates 2020 rates published in Attachment I to GIS 19 MA/12 – 2020 Medicaid Levels and Other Updates 2019 rates published in Attachment 1 to GIS 18/MA015 - 2019 Medicaid Levels and Other Updates 2018 rates published in GIS 17 MA/020 - 2018 Medicaid Levels and Other Updates.

The guidance on how the standardized amount of the disregard is calculated is found in NYS DOH 12- ADM-05. 2017 rate -- GIS 16 MA/018 - 2016 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards Attachment 12016 rate -- GIS 15-MA/0212015 rate -- Were not posted by DOH but were updated in WMS. 2015 Central $382 Long Island $1,147 NYC $1,001 Northeastern levitra online $440 N.

Metropolitan $791 Rochester $388 Western $336 2014 rate -- GIS-14-MA/017 HOW DOES IT WORK?. Here is a sample budget for a single person in NYC with Social Security income of $2,386/month paying a Medigap premium of $261/mo. Gross monthly income $2,575.50 DEDUCT Health insurance premiums (Medicare levitra online Part B) - 135.50 (Medigap) - 261.00 DEDUCT Unearned income disregard - 20 DEDUCT Shelter deduction (NYC—2019) - 1,300 DEDUCT Income limit for single (2019) - 859 Excess income or Spend-down $0 WITH NO SPEND-DOWN, May NOT NEED POOLED TRUST!.

HOW TO OBTAIN THE HOUSING DISREGARD. When you are ready to leave the nursing home or adult home, or soon after you leave, you or your MLTC plan must request that your local Medicaid program change your Medicaid budget to give you the Housing Disregard. See September 2018 NYS DOH Medicaid Update that requires MLTC plan to help you ask for it.

The procedures in NYC are explained in this Troubleshooting guide. In NYC, submit the application with the MAP-751W (check off "Budgeting Changes" and "Special Housing Standard"). (The MAP-751W is also posted in languages other than English in this link.

(Updated 3-15-2021.)) NYC Medicaid program prefers that your MLTC plan file the request, using Form MAP-3057E - Special income housing Expenses NH-MLTC.pdf and Form MAP-3047B - MLTC/NHED Cover Sheet Form MAP-259f (revised 7-31-18)(page 7 of PDF)(DIscharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GOVERNMENT DIRECTIVES (beginning with oldest). NYS DOH 12- ADM-05 - Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility who Enroll into the Managed Long Term Care (MLTC) Program Attachment II - OHIP-0057 - Notice of Intent to Change Medicaid Coverage, (Recipient Discharged from a Skilled Nursing Facility and Enrolled in a Managed Long Term Care Plan) Attachment III - Attachment III – OHIP-0058 - Notice of Intent to Change Medicaid Coverage, (Recipient Disenrolled from a Managed Long Term Care Plan, No Special Income Standard) MLTC Policy 13.02.

MLTC Housing Disregard NYC HRA Medicaid Alert Special Income Standard for housing expenses NH-MLTC 2-9-2013.pdf 2018-07-28 HRA MICSA ALERT Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility and who Enroll into the MLTC Program - update on previous policy. References Form MAP-259f (revised 7-31-18)(page 7 of PDF)(Discharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GIS 18 MA/012 - Special Income Standard for Housing Expenses for Certain Managed Long-Term Care Enrollees Who are Discharged from a Nursing Home issued Sept.

28, 2018 - this finally implements the most recent Special Terms &. Conditions of the CMS 1115 Waiver that governs the MLTC program, dated Jan. 19, 2017.

The section on this income standard is at pages 26-27. In these revised ST&C, this special income standard applies to people who were in a NH or adult home paid by Medicaid and "who enroll into or remain enrolled in the MLTC program in order to receive community based long term services and supports" and to those in a NH who were required to enroll into MLTC because of "...the mandatory Nursing Facility transition, and subsequently able to be discharged to the community from the nursing facility, with the services of MLTC program in place." September 2018 DOH Medicaid Update - explains this benefit to medical providers (nursing homes, MLTC plans, home care agencies, adult home operators, and requires them to identify potential individuals who could benefit and help them apply - described here..

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Can’t see levitra online the audio player?. Click here to listen on SoundCloud. The death of Supreme Court Justice Ruth Bader Ginsburg — and the insistence of President Donald Trump levitra online and the GOP-led Senate to fill that vacancy this year — could have major implications for health care.

The high court will hear yet another case challenging the constitutionality of the Affordable Care Act the week after the November election, and a long list of cases involving women’s reproductive rights, including both abortion and birth control, are working their way through lower federal courts.Meanwhile, scandals at the Department of Health and Human Services continue to surface, such as the case of a media spokesperson for the National Institutes of Health who criticized his boss’s handling of the levitra via a conservative website. And the Centers for Disease Control and Prevention continues to struggle with its credibility, after posting and then taking down another set of guidelines, this one levitra online concerning whether the erectile dysfunction treatment levitra is spread through aerosol particles.This week’s panelists are Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Kimberly Leonard of Business Insider and Mary Ellen McIntire of CQ Roll Call.Among the takeaways from this week’s podcast:The Supreme Court’s upcoming ACA case was brought by Republican state officials seeking to invalidate the law based Congress’ elimination of the penalty for not having insurance, a provision that the court once used to uphold the law because it was considered part of Congress’ right to impose taxes.Many legal experts believe that even if the high court were to decide that the loss of the penalty invalidates the individual mandate to get insurance, other parts of the law should be able to stand. But it’s not clear conservatives on the court will agree.With so much emphasis on the ACA’s insurance marketplace, the expansion of the Medicaid program for low-income people and protections for people with preexisting conditions, many consumers don’t realize that the law touches nearly all aspects of health care, including guarantees of preventive services, insurance practices and even requirements for calorie counts on restaurant menus.Ginsburg’s death could also influence efforts to undermine abortion rights.

Two cases are already before the court, one involving the ability of doctors to remotely prescribe drugs that can end a pregnancy and a Mississippi ban on abortions after the 15th week of pregnancy.As the nation marks more than 200,000 deaths from the erectile dysfunction, the “What the Health?. € panel looks at problems in the levitra online U.S. Effort to fight erectile dysfunction treatment, including flip-flops on the need for masks, inconsistent messaging from different parts of government and the politicization of science.The Centers for Disease Control and Prevention’s decision to remove guidance on the erectile dysfunction’s ability to spread through the air created more concerns about the politicization of the federal government’s scientific studies.

The controversy over the agency’s work is a stark change from the past, when the CDC was considered among the least politicized parts of the government.It may take years after these erectile dysfunction controversies for the CDC to restore its credibility with the public, no matter who is elected president.Trump has touted his efforts to lower prescription drug prices, and last levitra online week The New York Times reported that the administration tried unsuccessfully to get drugmakers to send a $100 gift card to all seniors to help cover the costs of their medicines. The companies objected because, among other reasons, they were worried the move could be seen as an effort to help the Trump campaign.This week, Rovner also interviews KHN’s Sarah Jane Tribble, whose new podcast, “Where It Hurts,” drops Sept. 29.

The podcast chronicles what happens to a small rural community in Kansas after its local hospital closes.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner. KHN’s “Battle Rages Inside Hospitals Over How erectile dysfunction treatment Strikes and Kills,” by Robert Lewis and Christina JewettAnna Edney. The New Yorker’s “A Young Kennedy, in Kushnerland, Turned Whistle-Blower,” by Jane MayerKimberly Leonard.

The Wall Street Journal’s “Medicare Wouldn’t Cover Costs of Administering erectile dysfunction treatment Approved Under Emergency-Use Authorization,” by Stephanie ArmourMary Ellen McIntire. The New York Times’ “Many Hospitals Charge More Than Twice What Medicare Pays for the Same Care,” by Reed AbelsonOther stories discussed by the panelists this week:The New York Times’ “A Deal on Drug Prices Undone by White House Insistence on ‘Trump Cards,’” by Jonathan Martin and Maggie HabermanThe Daily Beast’s “A Notorious erectile dysfunction treatment Troll Actually Works for Dr. Fauci’s Agency,” by Lachlan MarkayPolitico’s “Trump Administration Shakes Up HHS Personal Office After Tumultuous Hires,” by Dan DiamondThe Washington Post’s “Pentagon Used Taxpayer Money Meant for Masks and Swabs to Make Jet Engine Parts and Body Armor,” by Aaron Gregg and Yeganeh TorbatiTo hear all our podcasts, click here.And subscribe to What the Health?.

on iTunes, Stitcher, Google Play, Spotify or Pocket Casts. Related Topics Courts Elections Health Care Costs Insurance Multimedia Pharmaceuticals The Health Law Abortion erectile dysfunction treatment Drug Costs HHS KHN's 'What The Health?. ' Podcasts Prescription Drugs Trump Administration.

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Restrictions for religious gatherings and gyms will be eased under relaxed erectile dysfunction treatment safety rules announced levitra troche today. From Friday levitra troche 23 October. Religious gatherings/places of worship (excluding weddings and funerals) can have up to 300 people, subject to a erectile dysfunction treatment safety plan gyms will only be required to have a erectile dysfunction treatment safety marshal if there are more than 20 people in the gym at one time.Treasurer Dominic Perrottet said as the NSW Government eases restrictions the community should continue to be erectile dysfunction treatment Safe.“Our aim is to provide as many opportunities as we can for organisations and the community to carry on with their work and lives as much as possible,” Mr Perrottet said.“We want to keep moving forward but for that strategy to be successful we need everyone to follow the erectile dysfunction treatment Safety Plans.”Minister for Health Brad Hazzard thanked religious leaders and the community for their ongoing support of the efforts to control erectile dysfunction treatment.

€œThe impact of erectile dysfunction treatment is being felt right across the community but the further easing of restrictions to levitra troche allow 300 people at religious gatherings is another cautious step towards a ‘erectile dysfunction treatment-normal’ life,” Mr Hazzard said.“erectile dysfunction treatment is still lurking amongst us so I urge all leaders to continue encouraging everyone at their religious gatherings and places of worship to comply with the health advice to keep themselves and others safe.”Religious gatherings exclude weddings and funerals. However, from 1 December, the number of people who can attend weddings will levitra troche be lifted to 300 people subject to the four square metre rule indoors and two square metre rule outdoors. People attending a religious service will be required to provide their name and contact details when they enter so they can be used for contact tracing.

They are also being urged to wear a mask when attending places of worship.NSW Health Chief Health Officer Dr Kerry Chant said NSW Health continues to work closely with the levitra troche gym sector to develop further guidance to ensure every measure is taken to keep people safe when they visit the gym.“People can help stop the spread of erectile dysfunction treatment in gyms by visiting at less busy times, practising good hand hygiene before, during and after workouts, maintaining physical distancing especially when working out, and wiping down equipment with detergent and disinfectant each time it is used,” Dr Chant said. Each gym facility is required to have a erectile dysfunction treatment Safe plan.NSW Health is providing a $1 million boost to a new cancer levitra troche and wellness centre in Echuca to help deliver chemotherapy and dialysis to cross-border communities.The Echuca Cancer and Wellness Centre will be part of Echuca Regional Health, which services about 44,000 people in Murray River Council and the shires of Hay, Deniliquin, Moama, Balranald in NSW, and Campaspe Shire in Victoria. Health Minister Brad Hazzard said the NSW Government invests millions of dollars in services and infrastructure across the state to ensure regional communities can access the best health care possible.“Echuca, on the Victorian side of the border, and Moama, on the NSW side, are in a similar situation to Albury-Wodonga.

These border towns identify as single communities, with residents crossing the border daily to access services,” Mr Hazzard said.“This new centre will provide patients in cross-border communities with world-class, critical cancer services and treatments right on their doorstep.”Echuca Regional Health Chief Executive Nick Bush thanked the NSW Government for its levitra troche $1 million commitment. €œWe appreciate the support of levitra troche the NSW Government of the Echuca-Moama and surrounding community. It is very exciting to see the project progressing.

The purpose-built facility will give patients the best care in a wonderful, new centre in our community.”NSW and Victoria have a long-standing agreement levitra troche for cross-border health care. In 2020/2021, NSW will reimburse about $63 million to Victoria, on top of the $120 million NSW Health provides to Albury-Wodonga Health for NSW residents.Planning is underway for the centre, which will provide access to haematologists, medical oncologists, nephrologists and levitra troche radiation oncologists for more than 1,200 patients each year. Murrumbidgee Local Health District provides a cancer diagnosis service at Deniliquin Hospital, and there are plans to recruit and train staff in oncology.​.

Restrictions for religious http://joehuser.com/can-you-buy-levitra-over-the-counter/ gatherings and gyms will levitra online be eased under relaxed erectile dysfunction treatment safety rules announced today. From Friday levitra online 23 October. Religious gatherings/places of worship (excluding weddings and funerals) can have up to 300 people, subject to a erectile dysfunction treatment safety plan gyms will only be required to have a erectile dysfunction treatment safety marshal if there are more than 20 people in the gym at one time.Treasurer Dominic Perrottet said as the NSW Government eases restrictions the community should continue to be erectile dysfunction treatment Safe.“Our aim is to provide as many opportunities as we can for organisations and the community to carry on with their work and lives as much as possible,” Mr Perrottet said.“We want to keep moving forward but for that strategy to be successful we need everyone to follow the erectile dysfunction treatment Safety Plans.”Minister for Health Brad Hazzard thanked religious leaders and the community for their ongoing support of the efforts to control erectile dysfunction treatment.

€œThe impact of erectile dysfunction treatment is being felt right across the community but the further easing of restrictions to allow 300 people at religious gatherings is another cautious step towards a ‘erectile dysfunction treatment-normal’ life,” Mr Hazzard said.“erectile dysfunction treatment is still lurking amongst us so I urge all leaders to continue encouraging everyone at their religious gatherings and places of worship to levitra online comply with the health advice to keep themselves and others safe.”Religious gatherings exclude weddings and funerals. However, from 1 December, the number of people who can attend weddings will be lifted to 300 people subject to the four square metre rule indoors and levitra online two square metre rule outdoors. People attending a religious service will be required to provide their name and contact details when they enter so they can be used for contact tracing.

They are also being urged to wear levitra online a mask when attending places of worship.NSW Health Chief Health Officer Dr Kerry Chant said NSW Health continues to work closely with the gym sector to develop further guidance to ensure every measure is taken to keep people safe when they visit the gym.“People can help stop the spread of erectile dysfunction treatment in gyms by visiting at less busy times, practising good hand hygiene before, during and after workouts, maintaining physical distancing especially when working out, and wiping down equipment with detergent and disinfectant each time it is used,” Dr Chant said. Each gym facility is required to have a erectile dysfunction treatment Safe plan.NSW Health is providing a $1 million boost to a new cancer levitra online and wellness centre in Echuca to help deliver chemotherapy and dialysis to cross-border communities.The Echuca Cancer and Wellness Centre will be part of Echuca Regional Health, which services about 44,000 people in Murray River Council and the shires of Hay, Deniliquin, Moama, Balranald in NSW, and Campaspe Shire in Victoria. Health Minister Brad Hazzard said the NSW Government invests millions of dollars in services and infrastructure across the state to ensure regional communities can access the best health care possible.“Echuca, on the Victorian side of the border, and Moama, on the NSW side, are in a similar situation to Albury-Wodonga.

These border towns identify as single communities, with residents crossing the border daily levitra online to access services,” Mr Hazzard said.“This new centre will provide patients in cross-border communities with world-class, critical cancer services and treatments right on their doorstep.”Echuca Regional Health Chief Executive Nick Bush thanked the NSW Government for its $1 million commitment. €œWe appreciate the support of levitra online the NSW Government of the Echuca-Moama and surrounding community. It is very exciting to see the project progressing.

The purpose-built facility will give patients the best care in a wonderful, new centre in our community.”NSW and Victoria have levitra online a long-standing agreement for cross-border health care. In 2020/2021, NSW will reimburse about $63 million to Victoria, on top of the $120 million NSW Health provides to levitra online Albury-Wodonga Health for NSW residents.Planning is underway for the centre, which will provide access to haematologists, medical oncologists, nephrologists and radiation oncologists for more than 1,200 patients each year. Murrumbidgee Local Health District provides a cancer diagnosis service at Deniliquin Hospital, and there are plans to recruit and train staff in oncology.​.