[Correspondence] Junior hospital doctors —time to rethink the terminology
The moment to abandon the terms junior and trainee, as applied to hospital doctors in the National Health Service (NHS), has surely come. The labels are discriminatory, belittling, untruthful in their application, and harmful to morale. Junior is misunderstood by the public and detrimental to confidence in the service, and trainee is demeaning and suggestive of incompetence and inferiority of status. We need appropriate terms to reflect the seniority and skills of this valued cadre of doctors. (Source: LANCET)
Source: LANCET - October 19, 2017 Category: General Medicine Authors: David R Matthews Tags: Correspondence Source Type: research

[Public Health] Evidence-based guidelines for supportive care of patients with Ebola virus disease
The 2013 –16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and E valuation (GRADE...
Source: LANCET - October 17, 2017 Category: General Medicine Authors: Fran çois Lamontagne, Robert A Fowler, Neill K Adhikari, Srinivas Murthy, David M Brett-Major, Michael Jacobs, Timothy M Uyeki, Constanza Vallenas, Susan L Norris, William A Fischer, Thomas E Fletcher, Adam C Levine, Paul Reed, Daniel G Bausch, Sandy Gov Tags: Public Health Source Type: research

[Articles] Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies
At the turn of the 21st century, inflammatory bowel disease has become a global disease with accelerating incidence in newly industrialised countries whose societies have become more westernised. Although incidence is stabilising in western countries, burden remains high as prevalence surpasses 0 ·3%. These data highlight the need for research into prevention of inflammatory bowel disease and innovations in health-care systems to manage this complex and costly disease. (Source: LANCET)
Source: LANCET - October 16, 2017 Category: General Medicine Authors: Siew C Ng, Hai Yun Shi, Nima Hamidi, Fox E Underwood, Whitney Tang, Eric I Benchimol, Remo Panaccione, Subrata Ghosh, Justin C Y Wu, Francis K L Chan, Joseph J Y Sung, Gilaad G Kaplan Tags: Articles Source Type: research

[Comment] Rapid changes in epidemiology of inflammatory bowel disease
The prevalence of inflammatory bowel disease, that is Crohn's disease and ulcerative colitis, has increased over two to three generations in high-income countries, but in only one generation (the past 25 years) in much of the newly industrialised and “developing” world. In China, for example, these conditions have changed from being rare to common and now account for the use of as much as a quarter of gastroenterological and colorectal surgical hospital beds.1 These diseases are not necessarily less severe initially; in developing countries inflammatory bowel disease has as severe a phenotype, with the same com...
Source: LANCET - October 16, 2017 Category: General Medicine Authors: Michael A Kamm Tags: Comment Source Type: research

[Comment] A global coalition for the fight against heart disease and stroke
As political leaders prepare for the third UN High-level Meeting on Non-communicable Diseases (NCDs) in 2018, the World Heart Federation (WHF) is bringing together a global coalition of international, regional, and national stakeholders in cardiovascular diseases (CVDs) to drive the urgent action needed to combat heart disease and stroke. (Source: LANCET)
Source: LANCET - October 16, 2017 Category: General Medicine Authors: David Wood, Jean-Luc Eisel é Tags: Comment Source Type: research

[Correspondence] Rohingya in Bangladesh: an unfolding public health emergency
I am writing from Cox's Bazar, Bangladesh, where a large number of Rohingya have taken refuge and where our organisation, M édecins Sans Frontières, has been providing emergency medical assistance. I am working as the medical emergency manager in Kutupolong, a makeshift settlement in the Cox's Bazar district, which borders Myanmar. Of the estimated 1·2 million people in the peninsula that connects with Myanmar, only 2 50 000 of them are local Bangladeshi. The rest are forcibly displaced Myanmar nationals, and refugees from prior to 1992, who have been fleeing here since the 1990s. (Source: LANCET)
Source: LANCET - October 16, 2017 Category: General Medicine Authors: Kate White Tags: Correspondence Source Type: research

[Viewpoint] Foundation for a smoke-free world
The current and future health effects of smoking are well described. More than 7 million deaths per year are attributable to smoking, and projections suggest 1 billion deaths this century.1 Over a decade ago, in my role to facilitate the establishment of WHO's Framework Convention on Tobacco Control (FCTC), I warned about the potential for complacency in the years following the FCTC's adoption.2 We knew that implementation of the FCTC would take decades, and that it would be challenged from the outset by constrained funding, shifting priorities and political will, weak human and institutional capacity, and continuing oppos...
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Derek Yach Tags: Viewpoint Source Type: research

[Review] Transport and public health in China: the road to a healthy future
Transportation-related risk factors are a major source of morbidity and mortality in China, where the expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside increased use of motorised transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect on air quality, but persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet ...
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Baoguo Jiang, Song Liang, Zhong-Ren Peng, Haozhe Cong, Morgan Levy, Qu Cheng, Tianbing Wang, Justin V Remais Tags: Review Source Type: research

[Department of Error] Department of Error
Bhangu A, S øreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 2015; 386: 1278–87—In this Article, the units for C-reactive protein concentration have been corrected to mg/L in the second sentence of the “Differentia tion of simple from complex disease” section and in figure 2. The body temperature signs, low-risk Alvarado score, and high-risk AIR score have also been corrected in figure 2. These corrections have been made online as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Medical education: what about the barefoot doctors?
Medical education aims to cultivate effective and essential medical human resources for protecting people's health and the nation's sustainable development. On July 11, the State Council of China introduced bold plans to deepen the reform and development of medical education, which were summarised in The Lancet (July 22, p 334).1 Facing the increasing needs of health care and medical education, the Chinese Government is struggling to change the current situation and improve educational programmes, financial welfare, career promotion mechanisms, and ethical decision-making. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Le Yang, Hongman Wang Tags: Correspondence Source Type: research

[Correspondence] HPV vaccination in China needs to be more cost-effective
Almost all cases of cervical cancer are caused by human papillomavirus (HPV). China accounts for about a third of the global burden of cervical cancer, with about 98 900 new cases of cervical cancer in China in 2015.1 After 10 years of the HPV vaccine being available in developed countries, HPV vaccines were finally approved in mainland China in 2016. On July 31, 2017, it was announced that HPV vaccines will gradually be made available in community health centres across 17 provinces.2 (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Yue Yin Tags: Correspondence Source Type: research

[Correspondence] Severity of illness and the weekend effect – Authors' reply
In their letter, William J Kostis and Abel E Moreyra suggest that the poor availability of detailed data cannot explain all differences in outcomes between patients admitted at weekends and on weekdays. There is no intrinsic causal mechanism for a named day to lead to higher mortality risk and, therefore, some data clearly must exist that explain how the higher risk arises. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: A Sarah Walker, Peter Watkinson, Martin Llewelyn, Nicole Stoesser, Tim Peto Tags: Correspondence Source Type: research

[Correspondence] Severity of illness and the weekend effect
In their Article (July 1, p 62),1 A Sarah Walker and colleagues reported that part of the so-called weekend effect can be explained using detailed biochemical, haematological, and other tests, which were absent in previous studies based on administrative databases. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: William J Kostis, Abel E Moreyra Tags: Correspondence Source Type: research

[Correspondence] Charlie Gard and the limits of medicine
The coverage of the Charlie Gard case in The Lancet (Aug 5, p 531)1 was excellent. As Dominic Wilkinson and Julian Savulescu wrote in their Comment,2 “we need a fair, expedient way of resolving disputes between families and clinicians”. But first, we need to acknowledge how rare such disputes are or, rather, how rarely they are not resolved at local level. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Brendan D Kelly Tags: Correspondence Source Type: research

[Correspondence] Nuclear war and public health: rebalancing priorities and global health leadership
Recently, the North Korean nuclear and missile crisis has gripped international media headlines.1 In the streets of Seoul, the vast majority of civilians remain remarkably calm, confident that this threat will pass like those of the past. Yet, complacency would not serve an excuse in the face of war by either intention or tragic miscalculation. By then, the silence of the global health community will likely be seen as an opportunity missed. Why does it remain silent? Perhaps the community feels out of its depth in an area of competence of the UN Security Council —surely they must know what they are doing? (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: John Jungpa Park, Kee B Park, Nagi Shafik Tags: Correspondence Source Type: research

[Correspondence] Condemning industry attempts to subvert public policy for a tobacco-free world
The World Heart Federation, alongside its partners in the Global Coalition for Circulatory Health, condemns outright the launch of the Foundation for a Smoke-Free World,1 which is a vehicle for the tobacco industry. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: David Wood, Jean-Luc Eisel é, Global Coalition for Circulatory Health (appendix) Tags: Correspondence Source Type: research

[Obituary] Sir David Todd
Haematologist who transformed medical education and training in Hong Kong. He was born in Guangzhou, China, on Nov 17, 1928, and he died from pneumonia in Hong Kong on Aug 16, 2017, age 88 years. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Alison Snyder Tags: Obituary Source Type: research

[Perspectives] Doubt
“You're sure?” she asks me. This is about the nasogastric tube, whether to remove it. Or—someone else, another day—if the biopsy's finally conclusive. Or the operation, to have it now or wait. Or CPR, whether to receive it. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Sam Guglani Tags: Perspectives Source Type: research

[Perspectives] Spatial awareness
How is your Klingon? The first scene of Star Trek: Discovery begins with a heated speech in the alien warriors' language. The Klingons are increasingly concerned about the incursion of Starfleet —the 23rd-century space exploration and defence service of the United Federation of Planets—into deep space. They don't like this human-heavy coalition, and they certainly don't trust it. The only words in English come at the climax of the scene, as the speaker quotes the distrusted “fatal gre eting” of the enemy: “We come in peace.” (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Niall Boyce Tags: Perspectives Source Type: research

[Perspectives] Jiang Baoguo: one, two, three against trauma in China
To those who live in nations that count their population in tens rather than hundreds of millions, Chinese health and social statistics can be faintly unnerving. Major trauma, for example, accounts for more than 60 million visits annually to Chinese hospitals, and for 700  000–800 000 deaths. Many of these injuries are due to road traffic accidents—and car ownership in China has soared. One man long familiar with these figures is Professor Jiang Baoguo, President of Peking University People's Hospital and its Chief Physician, who is a co-author of a Review on transport and public health in China in this issue. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Geoff Watts Tags: Perspectives Source Type: research

[World Report] 2017 Roux Prize recipient announced: Samba Sow
This year's Roux Prize was awarded to Samba Sow for using health data to save children's lives through a comprehensive vaccination programme. Andrew Green reports. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Andrew Green Tags: World Report Source Type: research

[World Report] Nobel Prize awarded for discoveries in circadian rhythm
The 2017 Nobel Prize in Physiology or Medicine was awarded to Jeffrey Hall, Michael Rosbash, and Michael Young. Talha Burki reports. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Talha Burki Tags: World Report Source Type: research

[World Report] The ACA after the expiry of the budget reconciliation
After the latest repeal bill was withdrawn and the budget reconciliation has expired, what does the future hold for the ACA? Susan Jaffe, The Lancet's Washington correspondent, reports. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Susan Jaffe Tags: World Report Source Type: research

[Comment] Offline: Jim Kim finds his voice
Jim Kim was an unexpected choice to lead the World Bank in 2012. He is not an economist (Kim is an anthropologist, physician, and health activist), and many Bank watchers were sceptical that he could lead an organisation full of econometricians. Kim's first term as President was tinged with controversy. Bravely —critics said unwisely—he embarked on a huge internal reform and cost-cutting programme. Soon, unhappiness inside the Bank became public, casting a shadow over his hopes for a fresh start at one of the world's most reviled development institutions. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Catastrophic medical insurance in China
China's medical insurance system has changed dramatically in the past two decades. The country's most established programme, the Urban Employee Basic Medical Insurance, dates back to the mid-1990s and initially covered only 109 million employees of state-owned and collective enterprises.1 In the early 2000s, the Chinese Government established two additional insurance programmes, the New Cooperative Medical Scheme (NCMS) for rural residents and the Urban Resident Medical Insurance (URMI) programme for self-employed and unemployed urban residents. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Hongmei Li, Lixin Jiang Tags: Comment Source Type: research

[Comment] Towards a smoke-free world? Philip Morris International's new Foundation is not credible
Smoking causes more than 7 million deaths each year1 and tobacco companies have known, since at least 1950, that their products are lethal and addictive. Now Philip Morris International (PMI) is committing nearly US$1 billion over 12 years to the Philip Morris Foundation for a Smoke-Free World that will “fund scientific research designed to eliminate the use of smoked tobacco around the globe”.2 In a Lancet Viewpoint in this issue, the Foundation's President Derek Yach argues it will support “an unswerving focus…to improve public health and human wellbeing”. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Mike Daube, Rob Moodie, Martin McKee Tags: Comment Source Type: research

[Editorial] The link between cancer and obesity
The US Centers for Disease Control and Prevention released a new report on cancer and obesity last week, highlighting that cancers associated with overweight and obesity, including thyroid, liver, kidney, and ovarian cancer, constitute 40% of cancers diagnosed in the USA, with over 630 000 diagnoses in 2014 alone. The study looked at data from the United States Cancer Statistics for 2005-2014. Disparities between sexes in the rates of cancers associated with obesity are especially stark, with 55% of all cancers diagnosed in women being associated with overweight and obesity, compared with only 24% of cancers in men. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] WHO launches new leadership, new priorities
WHO's Director-General, Dr Tedros, last week launched his new cabinet to widespread acclaim. His mix of deputy and assistant director-generals is made up of nine women (two-thirds of his leadership team) with a geographical spread across 14 countries. India, Brazil, Saudi Arabia, South Africa, and Barbados are all newly represented. The announcement also translated Tedros's verbal promises into structural commitments. New priorities include Universal Health Coverage, climate change, and access to medicines. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Tobacco control: a Foundation too far?
Tobacco smoking is the leading cause of preventable mortality worldwide and is responsible for more than 7 million deaths each year. In today's issue of The Lancet, we publish a Viewpoint describing the mission and goals of the recently established Foundation for a Smoke-Free World, funded by tobacco giant Philip Morris International. Led by former WHO executive director Derek Yach, the Foundation, whose aim is “to eliminate cigarette smoking worldwide”, will receive US$1 billion in funding over the next 12 years. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Comment] Can the Antimicrobial Resistance Benchmark blaze a new trail?
A year has passed since the landmark declaration at the UN General Assembly on antimicrobial resistance (AMR), acknowledging the threat to people, animals, agriculture, and the environment.1 On Oct 12 –13, 2017, a conference organised by the Wellcome Trust in partnership with the UK, Ghanaian, and Thai governments and the UN Foundation, in support of the work of the Antimicrobial Resistance Inter-Agency Coordination Group (IACG), aimed to accelerate efforts to tackle rising drug-resistant infec tions. (Source: LANCET)
Source: LANCET - October 13, 2017 Category: General Medicine Authors: Jayasree K Iyer, Marc Mendelson Tags: Comment Source Type: research

[The Lancet Commissions] Alleviating the access abyss in palliative care and pain relief —an imperative of universal health coverage: the Lancet Commission report
In agonising, crippling pain from lung cancer, Mr S came to the palliative care service in Calicut, Kerala, from an adjoining district a couple of hours away by bus. His body language revealed the depth of the suffering.We put Mr S on morphine, among other things. A couple of hours later, he surveyed himself with disbelief. He had neither hoped nor conceived of the possibility that this kind of relief was possible.Mr S returned the next month. Yet, common tragedy befell patient and caregivers in the form of a stock-out of morphine. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Authors: Felicia Marie Knaul, Paul E Farmer, Eric L Krakauer, Liliana De Lima, Afsan Bhadelia, Xiaoxiao Jiang Kwete, H éctor Arreola-Ornelas, Octavio Gómez-Dantés, Natalia M Rodriguez, George A O Alleyne, Stephen R Connor, David J Hunter, Diederik Lohman, Lukas Tags: The Lancet Commissions Source Type: research

[Perspectives] Felicia Marie Knaul: advocate for better pain relief and palliative care
The time before her father died of stomach cancer in 1984 had a lasting impact on Felicia Knaul. “Each day brought new and ever-more challenging horrors—bone metastases popping up throughout his body…lungs filling with fluid and agonising, rattling breathing for which for several days I could do little other than keep his head elevated to stop him from drowning”, recalls Knaul, who was just 18 years old at the time. Eventually, he was given sufficient opioids to make him more comfortable. Since then, Knaul, a health economist, has devoted herself to tackling neglected aspects of health care and soc...
Source: LANCET - October 12, 2017 Category: General Medicine Authors: Rachael Davies Tags: Perspectives Source Type: research

[Comment] A milestone for palliative care and pain relief
Universal health coverage (UHC) has assumed an iconic place in work to achieve the Sustainable Development Goals (SDGs). Its central importance for achieving SDG 3 —ensuring healthy lives for all—is proven by the increasingly sophisticated efforts to measure UHC and to estimate to what extent UHC can be achieved by 2030. An example is the Global Burden of Disease (GBD).1 The GBD team constructed a UHC Index by beginning with the idea of access to quality e ssential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Department of Error] Department of Error
GBD 2016 SDG Collaborators. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet 2017; 390: 1423 –59—The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This correction has been made to the online version as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990 –2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1345–1422—The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This corr ection has been made to the online version as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990 –2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1260–1344. The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This corre ction has been made to the online version as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1211 –59—The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This correction has been made to the online version as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980 –2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1151–1210—The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This corr ection has been made to the online version as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
GBD 2016 Mortality Collaborators. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970 –2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1084–150. The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This correc tion has been made to the online version as of Oct 12, 2017. (Source: LANCET)
Source: LANCET - October 12, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Clinical Picture] Xanthoma disseminatum
A 20-year-old man presented to the dermatology department of our hospital in November, 2012, with a 5-year history of multiple brownish-yellow xanthoma-like papules and nodules affecting the face, flexures of the trunk, and limbs, with no systemic symptoms. The lesions had initially appeared as discrete or grouped papules, which then coalesced into plaques and nodules, especially in the axillae, over a period of 2 years. They were painless and asymptomatic, and the patient sought medical help only for cosmetic resions, particularly regarding the lesions on his face. (Source: LANCET)
Source: LANCET - October 11, 2017 Category: General Medicine Authors: Hui Zi Gong, He Yi Zheng, Jun Li Tags: Clinical Picture Source Type: research

[Articles] Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis
Our analysis provides a unified assessment of potential epidemic trajectories, with the aim of allowing national and international agencies to pre-emptively evaluate needs and target resources. Within each country, our framework identifies at-risk subnational locations in which to improve surveillance, diagnostic capabilities, and health systems in parallel with the design of policies for optimal responses at each stage. In conjunction with pandemic preparedness activities, assessments such as ours can identify regions where needs and provisions do not align, and thus should be targeted for future strengthening and support. (Source: LANCET)
Source: LANCET - October 11, 2017 Category: General Medicine Authors: David M Pigott, Aniruddha Deshpande, Ian Letourneau, Chloe Morozoff, Robert C Reiner, Moritz U G Kraemer, Shannon E Brent, Isaac I Bogoch, Kamran Khan, Molly H Biehl, Roy Burstein, Lucas Earl, Nancy Fullman, Jane P Messina, Adrian Q N Mylne, Catherine L M Tags: Articles Source Type: research

[Comment] Tackling viral haemorrhagic fever in Africa
Outbreaks of viral haemorrhagic fevers, such as the Ebola virus disease epidemic in west Africa, have caught the attention of the global health community because of perceived and real threats to local, national, and global health security and their economic impact.1 Although viral haemorrhagic fever outbreaks primarily affect settings in which pathogens emerge from animal hosts, they also have the potential to spread worldwide. Consequently, models that accurately predict the emergence and spread of viruses that cause viral haemorrhagic fevers are needed. (Source: LANCET)
Source: LANCET - October 11, 2017 Category: General Medicine Authors: Chikwe Ihekweazu, Ibrahim Abubakar Tags: Comment Source Type: research

[Department of Error] Department of Error
Fouad FM, Sparrow A, Tarakji A, et al. Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet –American University of Beirut Commission on Syria. Lancet 2017; 390: 2516–26—In figure 1 of this Health Policy (published online first on March 14, 2017), the positions of the map of Syria and the labels of the surrounding countries have been corrected. These changes have been made to the onl ine version as of Oct 11, 2017, and the printed Health Policy is correct. (Source: LANCET)
Source: LANCET - October 11, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Articles] Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128 ·9 million children, adolescents, and adults
The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Authors: NCD Risk Factor Collaboration (NCD-RisC) Tags: Articles Source Type: research

[Comment] Double-duty solutions for the double burden of malnutrition
In The Lancet, the NCD Risk Factor Collaboration1 describe trends in body-mass index (BMI), underweight, overweight, and obesity in almost 130 million children, adolescents, and adults from 200 countries worldwide. Findings of the study provide grounds for both optimism and concern. The good news is that from 1975 to 2016, the prevalence of undernutrition in children aged 5 years and older decreased, and obesity in some regions had slowed. The bad news is that the prevalence of overweight and obesity in adults (aged ≥20 years) and children and adolescents (5–19 years) in other regions of the world was increasing. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Authors: William H Dietz Tags: Comment Source Type: research

[Articles] Clemastine fumarate as a remyelinating therapy for multiple sclerosis (ReBUILD): a randomised, controlled, double-blind, crossover trial
To our knowledge, this is the first randomised controlled trial to document efficacy of a remyelinating drug for the treatment of chronic demyelinating injury in multiple sclerosis. Our findings suggest that myelin repair can be achieved even following prolonged damage. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Authors: Ari J Green, Jeffrey M Gelfand, Bruce A Cree, Carolyn Bevan, W John Boscardin, Feng Mei, Justin Inman, Sam Arnow, Michael Devereux, Aya Abounasr, Hiroko Nobuta, Alyssa Zhu, Matt Friessen, Roy Gerona, Hans Christian von B üdingen, Roland G Henry, Stephen Tags: Articles Source Type: research

[Comment] Clemastine fumarate for promotion of optic nerve remyelination
The regulatory approval of 15 disease-modifying medications to reduce inflammatory lesion activity in relapsing multiple sclerosis illustrates the dramatic progress made in the treatment of this frequently disabling condition. None of these medications, however, directly promotes repair of the damaged CNS. As a result, therapies to prevent accumulation of permanent disability and, especially, to reverse pre-existing disability represent major unmet needs. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Authors: Jeffrey A Cohen, Paul J Tesar Tags: Comment Source Type: research

[Department of Error] Department of Error
Kirchhof P. The future of atrial fibrillation management: intergrated care and stratified therapy. Lancet 2017; 390: 1873 –87—In table 4 of this Seminar (published online first on April 28), the dose of edoxaban should be 60 mg once daily. This correction has been made to the online version as of Oct 10, 2017, and the printed Seminar is correct. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Discussion “Although eastern Asia appeared to be similar to developed regions, fewer than one in two abortions elsewhere in Asia, and ab out one in four abortions in Africa, were safe” should be “Although eastern Asia was similar to developed regions, fewer than one in two abortions in south-central Asia and about one in four abortions in Africa were safe”. (Source: LANCET)
Source: LANCET - October 9, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Comment] Treaty to prohibit nuclear weapons: towards safeguarding humanity
Escalating tensions around nuclear weapons in North Korea remind us that humanity remains vulnerable to their use by design, miscalculation, or accident. About 15  000 warheads exist today, of which nearly 1800 warheads are on alert and ready for use at short notice.1 (Source: LANCET)
Source: LANCET - October 9, 2017 Category: General Medicine Authors: Andy Haines, Ira Helfand Tags: Comment Source Type: research