Hasta La Gadget!

After 38 years as the head of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci announced on Monday that he will be stepping down from his role in December. Appointed to the position in 1984 by then-president Ronald Reagan, Fauci has personally overseen the federal government’s response to some of the 20th century’s deadliest infectious diseases — from tuberculosis and COVID to SARS and MERS.

But, as he told The Guardian in 2020, “my career and my identity has really been defined by HIV.” The prevention and treatment of HIV has been a prioritized area of research for the NIAID since 1986, and one that Dr. Fauci has devoted much of his public service to. The current state of AIDS research and response in America is thanks in no small part to his continued efforts in the field.

The NIAID is one of 27 specialized institutes and centers that make up the National Institutes of Health (NIH), which in turn reports to the Department of Health and Human Services. The NIH overall serves as the federal government’s premiere health research program. The NIAID operates within that bureaucratic framework, conducting and supporting “basic and applied research to better understand, treat, and ultimately prevent infectious, immunologic, and allergic diseases,” per its mission statement. That includes everything from working to mitigate effects of the annual influenza strain and alleviate asthma in urban youth to leading the development of an effective vaccine against COVID-19. The technology behind that vaccine is now being adapted for use against HIV and malaria as well.

Working at the forefront of immunoregulation research in the early 1980s, Fauci developed treatments for a class of otherwise-fatal inflammatory diseases including polyarteritis nodosa, granulomatosis with polyangiitis (formerly Wegener’s granulomatosis) and lymphomatoid granulomatosis. The results of those studies helped lay the groundwork for today’s research by the NIAID’s Laboratory of Immunoregulation. That research includes cellular and molecular mechanisms of HIV immunopathogenesis and the treatment of immune-mediated diseases. Combining the institute’s nearly four decades of HIV/AIDS research with cutting edge genomic technology has brought us not one, but three potentially viable AIDS vaccines, all of which are currently in clinical trials.

“Finding an HIV vaccine has proven to be a daunting scientific challenge,” Dr. Fauci said in a March NIAID release. “With the success of safe and highly effective COVID-19 vaccines, we have an exciting opportunity to learn whether mRNA technology can achieve similar results against HIV infection.”

The active, hands-on approach we see in response to the AIDS epidemic today is a far cry from that of the Reagan administration at the start of the crisis in 1983, which initially met the issue with silence. That is, outside of the time Larry Speakes, Reagan’s press secretary, called it “the gay plague.”

Fauci’s initial efforts during the AIDS epidemic did more harm than good. In 1983, he published The Acquired Immune Deficiency Syndrome: The Ever-Broadening Clinical Spectrum in which he warned of “the possibility that routine close contact, as within a family household, can spread the disease.” We know now that this is not at all how HIV works, but at the time — despite the study urging caution until more evidence was gathered — it set off a moral panic in the media. The study was subsequently picked up by right-wing organizations and used as a political cudgel blaming the LGBTQIA+ community for the disease.

Reagan himself didn’t publicly mention the crisis until 1985, three years after it was officially identified by the CDC (and, coincidentally, a month after he admitted his involvement in the Iran-Contra Scandal). Social stigma around the disease made funding for basic health research nearly impossible to acquire, and was exacerbated by Reagan’s repeated budget cuts to the NIH and CDC.

“The inadequate funding to date has seriously restricted our work and has presumably deepened the invasion of this disease into the American population,” a CDC staffer wrote in an April, 1983 memo to then-Assistant Director, Dr. Walter Dowdle. “In addition, the time wasted pursuing money from Washington has cast an air of despair over AIDS workers throughout the country.”

Even after his appointment as Chief Medical Officer — one who was determined to treat the AIDS crisis with its deserved gravity — Fauci faced pushback from the LGBTQIA+ community, who demanded greater action from the government in response to the crisis and sought to accelerate the glacial pace of drug trials at the time.

By 1990, the community’s patience had reached a breaking point, resulting in ACT UP’s (AIDS Coalition to Unleash Power) attempt to storm the NIH in protest. “One of the things that people in ACT UP said is that we are the people who are experiencing this novel disease, and we are the experts, not just the scientists and doctors,” Garance Ruta, executive director of GEN magazine and an ACT UP member at the protest, told The Washington Post in 2020.

“I was trying to get them into all the planning meetings for the clinical trials,” Fauci told WaPo, in response. “I felt very strongly that we needed to get them into the planning process because they weren’t always right, but they had very, very good input.”

Over the last 30 years, the NIH has helped lead development of numerous antiretroviral therapies. Azidothymidine (AZT), the first drug discovered to inhibit HIV’s replication without damaging cells, was initially developed by the NIH as an anti-cancer drug in the 1960s. Its use as an antiretroviral, approved by the FDA in 1987, helped to establish the AIDS Clinical Trials Group (ACTG), which further accelerated research into nucleoside reverse transcriptase inhibitors (NRTIs, the class of drug to which AZT belongs). NIAID-funded studies in the 1990s helped establish combination therapies, which combine multiple medications for a synergistic effect, and explored a newly-identified class of drug, non-nucleoside reverse transcriptase inhibitors or NNRTIs.

NIAID

Today, nearly three dozen antiretroviral drugs are available, many of them combined into fixed-dose tablets. In the 1990s, people living with AIDS would be expected to take up to 20 individual pills at set schedules throughout the day. The average lifespan for someone infected with the disease was roughly a year. Today, assuming you’re lucky enough to live in the developed world, AIDS has become a chronic condition to be controlled with a single daily pill. For the 20 million people living with AIDS but without access to modern treatment, it remains a death sentence.

The state of medical research technology has also evolved, even if the nation’s prevailing notions of fairness and equality haven’t improved much in the intervening years since Reagan held power. Advances in laboratory standardization and automation have rapidly reduced development cycles and the occurrence of outlier results. The monotonous tasks that were once performed by lab assistants are now handled by robotic arms equipped with pipette arrays.

Disease prevention and diagnosis efforts have been augmented in recent years with artificial intelligence and machine learning algorithms. They’ve also found use in helping to stem the spread of HIV and improve access to both retrovirals and PReP with applications including, “ML with smartphone-collected and social media data to promote real-time HIV risk reduction, virtual reality tools to facilitate HIV serostatus disclosure, and chatbots for HIV education,” argue Drs. Julia Marcus and Whitney Sewell, of Harvard and UMass Amherst, respectively.

And just as Dr Fauci is, quite specifically, not retiring — “I want to use what I have learned as NIAID Director to continue to advance science and public health and to inspire and mentor the next generation of scientific leaders as they help prepare the world to face future infectious disease threats,” he noted in Monday’s announcement — the work of the NIAID is far from complete. Even as we slowly conquer existing scourges like COVID and HIV, re-emerging threats like Monkeypox (not to mention ancient killers like Polio) will continue to appear on our quickly warming planet.

Twitter is making a major change to its organization after former security head Peiter “Mudge” Zatko accused the company of having lax security and bot problems. According to Reuters, Twitter is merging its health experience team, which is in charge of clamping down on misinformation and harmful content on the website, with its service team. The latter reviews profiles when they’re reported and takes down spam accounts. Together, the combined group will be called Health Products and Services (HPS). 

The group will be led by Ella Irwin, who joined the company in June and had previously worked for Amazon and Google. Reuters says Irwin sent a memo to staff members, telling them that HPS with “ruthlessly prioritize” its projects. “We need teams to focus on specific problems, working together as one team and no longer operating in silos,” Irwin reportedly wrote. 

In a statement sent to Reuters, a Twitter spokesperson said the reshuffling “reflects [the company’s] continued commitment to prioritize, and focus [its] teams in pursuit of [its] goals.” A source also told the news organization that the teams dealing with harmful and toxic content have had major staff departures recently. Merging these two teams may be the best way to ensure that all important roles are filled going forward. 

This news comes on the heels of the revelation that Zatko filed a whistleblower complaint against his former employer. In it, he said Twitter has “extreme, egregious deficiencies” when it comes to security and that it prioritizes user growth over cleaning up spam. Shortly after The Washington Post reported on Zatko’s complaint, which also raises concerns about national security, lawmakers from both sides of the aisle announced that they’re looking into his claims. 

In an email to employees, Twitter CEO Parag Agrawal defended the company and echoed its spokesperson’s statement that Zatko’s complaint is a “false narrative that is riddled with inconsistencies and inaccuracies.” You can read the whole memo, obtained by Bloomberg, below:

“Team,

There are news reports outlining claims about Twitter’s privacy, security, and data protection practices that were made by Mudge Zatko, a former Twitter executive who was terminated in January 2022 for ineffective leadership and poor performance. We are reviewing the redacted claims that have been published, but what we’ve seen so far is a false narrative that is riddled with inconsistencies and inaccuracies, and presented without important context.

I know this is frustrating and confusing to read, given Mudge was accountable for many aspects of this work he is now inaccurately portraying more than six months after his termination. But none of this takes away from the important work you have done and continue to do to safeguard the privacy and security of our customers and their data. This year alone, we have meaningfully accelerated our progress through increased focus and incredible leadership from Lea Kissner, Damien Kieran, and Nick Caldwell. This work continues to be an important priority for us, and if you want to read more about our approach, you can find a summary here.

Given the spotlight on Twitter at the moment, we can assume that we will continue to see more headlines in the coming days – this will only make our work harder. I know that all of you take a lot of pride in the work we do together and in the values that guide us. We will pursue all paths to defend our integrity as a company and set the record straight.

See you all at #OneTeam tomorrow,

Parag”

With iPadOS 16, it’s clear that Apple is transforming the iPad into something beyond a mere tablet, but the process will include a slight delay.

Sometimes, a game trailer just catches your eye. Phantom Hellcat is the first title in an original hack-and-slash universe from Ironbird Creations, a new studio under Ghostrunner and Chernobylite publisher All in! Games. Phantom Hellcat is a perspective-shifting action game that blends fantasy and pop culture, starring a young woman named Jolene on a mission to save the world from an encroaching evil force. You know, classic action fare.

The interesting bit of Phantom Hellcat is its shifting perspective, which transitions from 2D platforming to 3D close-quarters battling. The game has a skill tree, upgradeable masks with varying abilities and secrets to find in each level. Developers at Ironbird drew inspiration from the Nier series, which is a fantastic starting point for this type of experience.

Phantom Hellcat is coming to PlayStation 4, PS5, Xbox One, Xbox Series X/S and PC at some point — there’s no solid release date yet, but it’s available to wishlist on Steam.

Gotham Knights, the DC-soaked open-world title from Warner Bros Games, is due to hit PlayStation 5, Xbox Series X/S and PC on October 21st. Yes, you read that correctly — the game was previously due to come out on October 25th, but it’s now set to land four days earlier. Warner Bros didn’t provide a reason for the rush, aside from saying it will allow “players to jump into the action four days early.” Which, yeah.

The new release date follows delays and platform changes for Gotham Knights. The game was originally set to come out in 2021, but it was pushed back to 2022 less than a year after its announcement. It was also supposed to hit PlayStation 4 and Xbox One, but it’s no longer coming to those consoles.

The updated release timing was revealed during Gamescom’s Opening Night Live, at the end of a new trailer for Gotham Knights. The trailer focuses on the villains, showcasing Harley Quinn and Clayface. The game also features Mr. Freeze and the Court of Owls, but notably not Batman. Instead, players step into the boots of Batgirl, Nightwing, Red Hood and Robin.