Insights, Perspectives & Ideas
PEPFAR at 20 — A Game-Changing Impact on HIV in Africa The New England Journal of Medicine, July 2023 In 2003, antiretroviral therapy ( ART ) transformed AIDS into a chronic condition in industrialized countries. However, in sub- Saharan Africa, fewer than 50,000 of the 27 million people living with HIV had access to it. President George W. Bush launched the President ’ s Emergency Plan for AIDS Relief ( PEPFAR ) in 2003 in 15 countries with high HIV burdens. As of 2022, PEPFAR-supported programs have resulted in around 20 million people receiving ART, 25 million lives saved and several countries nearing or achieving new treatment targets. PEPFAR is a great example of a bold, data-driven international initiative that was able to succeed by sustaining local ownership and participation.
Why Cancer Treatments Might Not Work Very Well for Older Adults Undark, June 2023 Older people are more likely to be diagnosed with cancer than younger ones. Clinical drug trials, however, exclude older participants for a variety of reasons. Yet, cancer treatments effective in younger people can be toxic in older individuals. Jyoti Madhusoodanan explains that physicians treating geriatric cancer patients often tweak the dose or duration to limit side effects. Dr. Supriya Mohile, a geriatric oncologist at the University of Rochester thinks that the geriatric assessment, a tool to determine a person ’ s biological age, “ needs to be implemented until we have better clinical trial data. ” This may help mitigate under-treatment of those who might benefit from chemotherapy and over-treatment of those at risk of serious side effects.
Brain Waves Synchronize When People Interact Scientific American, July 2023 Collective neuroscience, or the study of how brains work together, is a rapidly growing field of research. When people converse or share an experience, they exhibit high degrees of brain synchrony. Researchers are mapping its choreography ( rhythm, timing and undulations ) to better understand its benefits. Lydia Denworth explains: “ Without synchrony and the deeper forms of connection that lie beyond it, we may be at greater risk for mental instability and poor physical health. With synchrony and other levels of neural interaction, humans teach and learn, forge friendships and romances, and cooperate and converse. We are driven to connect, and synchrony is one way our brains help us do it. ”
AI & Machine Learning in Medicine NEJM AI, July 2023 The NEJM AI journal editors curated a collection of articles from NEJM Group publications exploring the rapid impact and ethical considerations of artificial intelligence ( AI ) in medicine. The articles cover AI use in clinical applications, imaging interpretation, infectious-disease surveillance, collaborative workflows and real-time diagnostics. The NEJM AI journal, set to launch in early 2024, aims to provide a platform for rigorous evidence, resource sharing and thoughtful discussions on AI integration in medicine.
How Plastics Are Poisoning Us The New Yorker, June 2023
The Retrievals Serial Productions and The New York Times, June-July 2023 A five-part podcast narrative series by Susan Burton explores the events unfolding at the Yale Fertility Center where patients experienced excruciating pain during and after a surgical procedure called egg retrieval to be used for in vitro fertilization. The staff members were unaware of the real cause: a nurse stealing fentanyl and replacing it with saline. This series tells the stories told about women ’ s pain, as well as how it is tolerated and interpreted, including the ways in which it may be minimized or dismissed.
To preserve elephants, tortoises and coral, celluloid ( plastic ) was invented in 1865. Now, these same creatures as well as others are threatened by plastic waste. Large pieces pose hazards such as choking and intestinal tract perforation. When plastic degrades, microplastics, smaller than five millimeters, are formed and can both leach and attract chemical carcinogens. Plastic waste is found floating in the Great Pacific Garbage Patch, the Mariana Trench and human placentas. Matt Simon, author of A Poison Like No Other: How Microplastics Corrupted Our Planet and Our Bodies says, “ So long as we ’ re churning out single- use plastic … we ’ re trying to drain the tub without turning off the tap. We ’ ve got to cut it out. ”
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