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[Editorial] Measuring the future of humanity for health

Sa, 16/07/2022 - 00:00
Estimating the future is fraught with uncertainty. Time makes fools of all prophets. But the broad contours of humanity's destiny can be sketched, at least tentatively. The latest World Population Prospects 2022, published by the UN, provides provocative insights into what we might expect over the present century. The headline finding is that the world's population will reach a peak of 10·4 billion people by the 2080s, before stabilising at that level until 2100. In the short term, 8 billion people will populate the planet by November, 2022.

[Comment] What is the right drug for insomnia disorder?

Sa, 16/07/2022 - 00:00
Cognitive behavioural therapy (CBT) is considered a first-line treatment for chronic insomnia disorder;1 nevertheless, few clinicians are trained to deliver this treatment, and exploring other options seems imperative. In The Lancet, Franco De Crescenzo and colleagues2 report a large and comprehensive data synthesis on pharmacological treatments for insomnia disorder in which they assessed 154 double-blind trials of 30 different drugs or placebo with 44 089 adult participants (mean age 51·7 [SD 12·2] years, 62·8% women), conducted across a range of international settings.

[Comment] Complex relationship between health and moderate alcohol use

Sa, 16/07/2022 - 00:00
In The Lancet, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 Alcohol Collaborators1 provide a further study to systematically determine thresholds for low-risk alcohol consumption while considering background rates of disease. Overall, the authors estimated the amount of alcohol that minimises health risks to be between 0 (95% uncertainty interval 0–0) and 1·87 (0·50–3·30) standard drinks per day. Levels of zero, or very close to zero, were observed among individuals aged 15–39 years (ranging from 0 to 0·603 standard drinks per day), but higher levels were reported for individuals aged 40 years and older (ranging from 0·114 to 1·87 standard drinks per day).

[World Report] The UN reports global asymmetries in population growth

Sa, 16/07/2022 - 00:00
A UN study highlights the rapid population growth in some countries versus the growing ageing populations and challenges ahead. John Zarocostas reports from Geneva.

[World Report] New HIV law welcomed in Argentina

Sa, 16/07/2022 - 00:00
The legislation also makes provisions for patients with viral hepatitis, tuberculosis, and sexually transmitted infections. Amy Booth reports from Buenos Aires.

[World Report] Climate change driving east Africa towards famine

Sa, 16/07/2022 - 00:00
Consecutive years of drought caused by climate change and La Niña have led to food insecurity in many parts of east Africa. Sharmila Devi reports.

[Perspectives] Mariana Mazzucato: leading a new type of economics

Sa, 16/07/2022 - 00:00
Mariana Mazzucato is a firebrand economist. In 2020, she became Chair of the WHO Council on the Economics of Health For All. “The idea was instead of doing the usual of saying invest in health because it's good for the economy, what if you said invest in health for all and backtrack to design an economic system to deliver on that, meaning design a different form of budgeting, a different form of procurement, a different form of intellectual property, a different form of public–private ways of working together on projects”, she explains.

[Perspectives] The search for a sea of tranquility

Sa, 16/07/2022 - 00:00
Emily St John Mandel's best-selling novel, Station Eleven (2014), begins when an actor, playing King Lear onstage, collapses and dies. This premature death signals the arrival of a new virus that will spread with incomprehensible speed, killing most of the earth's population. Mandel's book is often referred to as a pandemic novel, but plague is not really her subject. The virus in Station Eleven serves as the event that puts the plot in motion. Mandel's primary interest is how an itinerant theatre group rediscovers that, after catastrophe, the arts and culture help us to make sense of our lives.

[Perspectives] Navigating recovery: the healing power of patients' narratives

Sa, 16/07/2022 - 00:00
The Miskito are Indigenous people of Nicaragua. They come from the Mosquito coast where remote villages nestle between the Caribbean Sea and lush jungle. Their communities are affected by a disorder called grisi siknis that manifests as highly contagious convulsions. It predominantly affects young women and sweeps through villages in sporadic outbreaks. The Miskito believe that grisi siknis is caused by a spirit called the duende. Traditional healers cure it with ritual and herbal potions. Krasnogorsk, a small town in Kazakhstan's vast northern steppe that is now nearly deserted, is another place said to have a unique illness.

[Obituary] Michael Sela

Sa, 16/07/2022 - 00:00
Chemical immunologist and President of the Weizmann Institute of Science. He was born in Tomaszów Mazowiecki, Poland, on March 2, 1924 and died in Rehovot, Israel, on May 27, 2022 aged 98 years.

[Correspondence] Ad-hoc medical mission for refugees in the Ukraine–Russia war: from vision to practice

Sa, 16/07/2022 - 00:00
On Feb 24, 2022, Russia invaded Ukraine, and the humanitarian crisis that resulted is ongoing. As of June 29, 2022, the UN Refugee Agency (UNRA) has recorded nearly 5·5 million refugees across Europe who have fled the combat zones in Ukraine. As men are not allowed to leave Ukraine, refugees are primarily women, children, and older people. Refugees are medically vulnerable, often suffering from numerous physical and psychological conditions.1 Unmanaged chronic disorders, infectious diseases, and mental illness are common, exacerbated by the arduous journey, stress, weather conditions, and limited access to health care.

[Correspondence] The prohibition of nuclear weapons: a public health priority

Sa, 16/07/2022 - 00:00
The ongoing conflict in Ukraine confirms how wars and armed conflicts are a serious threat to public health and environmental integrity. The crisis has made clear that nuclear war is closer than ever.

[Correspondence] Payment and progress in peer review

Sa, 16/07/2022 - 00:00
Phaik Y Cheah and Jan Piasecki1 raise important issues about the peer review process arising from the assessment of Aczel and colleagues,2 including the under-representation of female reviewers and reviewers from low-income countries, and they suggest that payment for reviews should be trialled to address these issues. Traditionally, agreeing to review manuscripts and grant applications has been largely motivated by philanthropic motives to contribute to a key aspect of biomedical research and the pursuit of knowledge, ultimately offering a potential public benefit.

[Correspondence] Academic exploitation

Sa, 16/07/2022 - 00:00
We are delighted to see payment for peer reviewers proposed by Phaik Y Cheah and Jan Piasecki.1 This proposal reflects a broader problem in academia: exploitation of, and even mandating, free labour for career advancement. Publishing is only one example, extending beyond the peer review process. Of course, reviewers should be paid for their expertise, as should authors. No journals pay authors for creating the product they sell. Book publishing is similarly exploitative: royalties are trivial and typically only paid after publishers recover their costs, a process hindered by publishers' unwillingness to market books.

[Correspondence] A fair day's wage for a fair day's work

Sa, 16/07/2022 - 00:00
We read with interest the discussion about compensation for scientific peer review.1 Voluntary peer review used to be the foundation of high-quality science. Peer review was based on an honour system, by which scientists would review the work of their peers for free, as part of their scientific duty, with the implicit assumption that someone else would do the same for them in the future. Although the system had flaws, including a limited number of scientific journals and insufficient access to science outside of academic circles, a certain balance was possible.

[Correspondence] No to paid peer review

Sa, 16/07/2022 - 00:00
Peer review can last months or years in some cases. Paying peer reviewers can speed up the process and motivate reviewers to evaluate manuscripts more efficiently.1 However, using money to lure reviewers in a publishing system that is already fraught with inherent and structural biases will exacerbate these shortcomings and create new challenges.

[Department of Error] Department of Error

Sa, 16/07/2022 - 00:00
Kamdar M, Solomon SR, Arnason J, et al. Lisocabtagene maraleucel versus standard of care with salvage chemotherapy followed by autologous stem cell transplantation as second-line treatment in patients with relapsed or refractory large B-cell lymphoma (TRANSFORM): results from an interim analysis of an open-label, randomised, phase 3 trial. Lancet 2022; 399: 2294–308—In this Article, in figure 3B, the number of censored patients in the liso-cel group at 4 months after randomisation should have been 14; the eighth sentence of the Discussion should read “Prolonged cytopenia occurred in 43% of patients in the liso-cel group'; and figure 1 has been updated.

[Articles] Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis

Sa, 16/07/2022 - 00:00
Overall, eszopiclone and lemborexant had a favorable profile, but eszopiclone might cause substantial adverse events and safety data on lemborexant were inconclusive. Doxepin, seltorexant, and zaleplon were well tolerated, but data on efficacy and other important outcomes were scarce and do not allow firm conclusions. Many licensed drugs (including benzodiazepines, daridorexant, suvorexant, and trazodone) can be effective in the acute treatment of insomnia but are associated with poor tolerability, or information about long-term effects is not available.

[Articles] Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Sa, 16/07/2022 - 00:00
There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol.

[Clinical Picture] Facial lymphoedema, viral warts, and myelodysplastic syndrome: the protean condition of GATA2 deficiency

Sa, 16/07/2022 - 00:00
A 17-year-old man reporting a 3-year history of an acneiform eruption and a 4-month history of worsening swelling of his face, was referred to our specialist joint haematology-dermatology clinic. The patient had been found to have a monocytopenia of 0·2 × 109 per L (normal 0·2–1·0); he had no other past medical problems.