The Lancet最新文献

{"title":"Surgical health policy 2025–35: strengthening essential services for tomorrow's needs","authors":"Dmitri Nepogodiev, Maria Picciochi, Adesoji Ademuyiwa, Adewale Adisa, Anita E Agbeko, Maria-Lorena Aguilera, Fareeda Agyei, Philip Alexander, Jaymie Henry, Theophilus T K Anyomih, Alazar B Aregawi, Rifat Atun, Bruce Biccard, Mumba Chalwe, Kathryn Chu, Arri Coomarasamy, Richard Crawford, Ara Darzi, Justine Davies, Zipporah Gathuya, Aneel Bhangu","doi":"10.1016/s0140-6736(25)00985-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00985-7","url":null,"abstract":"Progress towards The <em>Lancet Commission on Global Surgery</em>'s 2030 targets has been too slow and too patchy, particularly in low-income and middle-income countries. The unmet need for surgery has continued to grow, reaching at least 160 million operations per year. Ensuring high-quality surgical care remains a crucial global challenge, with 3·5 million adults dying after surgery each year. The COVID-19 pandemic exposed the fragility of surgical services long undermined by chronic underfunding, workforce shortages, and under-resourced infrastructure. However, The <em>Lancet Commission on Global Surgery</em> inspired a new generation of surgeons to engage with policy, and several countries have developed national surgical plans, although most remain unfunded. Advancements in surgical data science have allowed health systems to identify priorities for improvement. Preserving this infrastructure is important, especially during periods of uncertain global health funding. The next decade requires urgent change to prevent economic instability and armed conflict from forcing surgery down the global health agenda. Reframing surgery as an essential service that saves lives, strengthens health systems, and fosters economic productivity could unlock much needed investment. Sustained progress requires integration of funding both within hospital infrastructure and across care pathways. Such holistic approaches would reinforce entire hospital systems, which are essential to national security and wellbeing.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting to zero: when can we guarantee vertical transmission of HIV will not occur?","authors":"Grace John-Stewart, Irene Njuguna","doi":"10.1016/s0140-6736(25)01282-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01282-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the effect of maternal viral load on perinatal and postnatal HIV transmission: a systematic review and meta-analysis","authors":"Caitlin M Dugdale, Ogochukwu Ufio, John Giardina, Fatma Shebl, Elif Coskun, Eden Pletner, Pamela R Torola, Duru Cosar, Roger Shapiro, Maria Kim, Lynne Mofenson, Andrea L Ciaranello","doi":"10.1016/s0140-6736(25)00765-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00765-2","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Although a growing body of evidence supports zero risk of sexual HIV transmission from a person with sustained virological suppression, known as U=U (undetectable equals untransmittable), data have been insufficient to determine whether this is also true for vertical HIV transmission. We conducted a systematic review and meta-analysis to quantify vertical transmission risk by maternal HIV viral load (mHVL) and to evaluate the applicability of U=U to perinatal and postnatal HIV transmission.&lt;h3&gt;Methods&lt;/h3&gt;In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature, the WHO Global Health Library, and abstracts from the International AIDS Society Conference and the Conference on Retroviruses and Opportunistic Infections (2016–24) for studies published from Jan 1, 1989, to Dec 31, 2024, reporting the relationship between mHVL near birth (to estimate perinatal transmission risk by 6 weeks) or during breastfeeding (to estimate monthly postnatal transmission risk by mHVL within the past 6 months) and vertical transmission. We pooled risks of perinatal and postnatal transmission across prespecified mHVL categories. We also conducted comparative analyses to determine the adjusted relative risk (aRR) of transmission by mHVL using Poisson meta-regression. The protocol for this analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42019146768).&lt;h3&gt;Findings&lt;/h3&gt;147 studies were included in the analysis; 138 studies contributed to perinatal analyses and 13 studies contributed to postnatal analyses. Data on 82 723 mother–child pairs were included across all analyses. Pooled perinatal transmission risks were 0·2% (95% CI 0·2–0·3) with a mHVL of &lt;50 copies per mL, 1·3% (1·0–1·7) with 50–999 copies per mL, and 5·1% (2·6–7·9) with ≥1000 copies per mL. aRRs of perinatal transmission were 6·3 (3·9–10·3) with a mHVL of 50–999 copies per mL and 22·5 (13·9–36·5) with ≥1000 copies per mL versus &lt;50 copies per mL. In subgroup analyses, in five studies reporting on 4675 women receiving pre-conception antiretroviral therapy (ART) with a mHVL of &lt;50 copies per mL near birth, there were zero (0%, 0·0–0·1) perinatal transmissions. Monthly postnatal transmission risks were 0·1% (0·0–0·4) with recent mHVL &lt;50 copies per mL and 0·5% (0·1–1·8) with a mHVL of ≥50 copies per mL.&lt;h3&gt;Interpretation&lt;/h3&gt;Perinatal transmission with a mHVL of &lt;50 copies per mL is ≤0·2% overall. Zero transmissions were observed among women receiving ART before pregnancy with a mHVL of &lt;50 copies per mL near birth, supporting U=U in pregnancy and birth. Postnatal transmission was very low—but not zero—among women with a recent mHVL of &lt;50 copies per mL. Current data, largely from studies lacking frequent mHVL monitoring or modern first-line ART regimens, are insufficient to assess U=U during breastfeeding.&lt;h3&gt;Funding&lt;","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Error","authors":"","doi":"10.1016/s0140-6736(25)01396-0","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01396-0","url":null,"abstract":"<em>Versijpt J, Paemeleire K, Reuter U, MaassenVanDenBrink A. Calcitonin gene-related peptide-targeted therapy in migraine: current role and future perspectives.</em> Lancet <em>2025; <strong>405:</strong> 1014–26</em>—In this paper, the grey circle indicating an area of blockade of CGRP receptor in figure 2 has been adjusted. This correction has been made to the online version as of July 10, 2025.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of once-weekly insulins for type 1 diabetes – Author's reply","authors":"Kaitlin M Love, Alan C Kinlaw, Sue A Brown","doi":"10.1016/s0140-6736(25)00759-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00759-7","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From emergency multilateralism to resilient health diplomacy","authors":"Brian Li Han Wong, Esperanza Martinez, Garry Aslanyan, Katherine Urbáez, Yik-Ying Teo, Ilona Kickbusch","doi":"10.1016/s0140-6736(25)01205-x","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01205-x","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"River of life","authors":"Philip Ball","doi":"10.1016/s0140-6736(25)01392-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01392-3","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Error","authors":"","doi":"10.1016/s0140-6736(25)01397-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01397-2","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"197 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worldwide trends in diabetes prevalence: the NCD-RisC study","authors":"Edward J Boyko, Kanyin Liane Ong, Bruce B Duncan","doi":"10.1016/s0140-6736(25)01079-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01079-7","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worldwide trends in diabetes prevalence: the NCD-RisC study","authors":"Lorraine Lipscombe, Kaberi Dasgupta, Baiju Shah","doi":"10.1016/s0140-6736(25)01080-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01080-3","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"694 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}