The Lancet最新文献

{"title":"Maurice Henry King","authors":"Andrew Green","doi":"10.1016/s0140-6736(25)00158-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00158-8","url":null,"abstract":"<span><figure><span><img alt=\"\" height=\"472\" src=\"https://ars.els-cdn.com/content/image/1-s2.0-S0140673625001588-fx1.jpg\"/><ol><li><span><span>Download: <span>Download high-res image (553KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span>","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071619","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":"Psychedelics for health","authors":"Talha Burki","doi":"10.1016/s0140-6736(25)00188-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00188-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071629","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":"Annual versus less frequent mammographic surveillance in people with breast cancer aged 50 years and older in the UK (Mammo-50): a multicentre, randomised, phase 3, non-inferiority trial","authors":"Janet A Dunn, Peter Donnelly, Nada Elbeltagi, Andrea Marshall, Amy Hopkins, Alastair M Thompson, Riccardo Audisio, Sarah E Pinder, David A Cameron, Sue Hartup, Lesley Turner, Annie Young, Helen Higgins, Eila K Watson, Sophie Gasson, Peter J Barrett-Lee, Claire Hulme, Bethany Shinkins, Peter S Hall, Andrew Evans","doi":"10.1016/s0140-6736(24)02715-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02715-6","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;The frequency of mammographic surveillance for women after diagnosis of breast cancer varies globally. The aim of this study was to evaluate whether less than annual mammography was non-inferior in terms of breast cancer-specific survival in women aged 50 years or older.&lt;h3&gt;Methods&lt;/h3&gt;Mammo-50 was a multicentre, randomised, phase 3 trial of annual versus less frequent mammography (2-yearly after conservation surgery; 3-yearly after a mastectomy) for women aged 50 years or older at initial diagnosis of invasive or non-invasive breast cancer and who were recurrence free 3 years post curative surgery. The trial was conducted at 114 National Health Service hospitals in the UK. Participants were randomly assigned (1:1) to annual or less frequent mammograms at 3 years post curative surgery and were followed up for 6 years. The co-primary outcomes were breast cancer-specific survival and cost-effectiveness. The cost-effectiveness analysis will be reported elsewhere. Breast cancer-specific survival was assessed in the intention-to-treat population. Secondary outcomes were recurrence-free interval, overall survival, and referrals back to the hospital system. 5000 women provided 90% power to detect a 3% absolute non-inferiority margin for breast cancer-specific survival with 2·5% one-sided significance. The trial was registered with the ISRCTN registry, ISRCTN48534559; recruitment is complete but longer-term follow-up is ongoing.&lt;h3&gt;Findings&lt;/h3&gt;Between April 22, 2014, and Sept 28, 2018, 5235 women were randomly assigned to annual mammography (n=2618) or less frequent mammography (n=2617). 3858 (73·6%) women were aged 60 years or older, 4202 (80·3%) had undergone conservation surgery, 4576 (87·4%) had invasive disease, 1159 (22·1%) had node positive disease, and 4330 (82·7%) had oestrogen receptor-positive tumours. With a median of 5·7 years follow-up (IQR 5·0–6·0; 8·7 years post curative surgery), 343 women died, including 116 who died of breast cancer (61 in the annual mammography group and 55 in the less frequent mammography group). 5-year breast cancer-specific survival was 98·1% (95% CI 97·5–98·6) in the annual mammography group and 98·3% (97·8–98·8) in the less frequent mammography group (hazard ratio 0·92, 95% CI 0·64–1·32), demonstrating non-inferiority of less frequent mammography at the pre-specified 3% margin (non-inferiority p&lt;0·0001). 5-year recurrence-free interval was 94·1% (95% CI 93·1–94·9) in the annual mammography group and 94·5% (93·5–95·3) in the less frequent mammography group. Overall survival at 5 years was 94·7% (95% CI 93·8–95·5%) and 94·5% (93·5–95·3), respectively. 224 (64·9%) of 345 breast cancer events were detected from emergency admissions or symptomatic referrals back to the hospital system, including 108 (61·7%) of 175 in the annual mammography group and 116 (68·2%) of 170 in the less frequent mammography group.&lt;h3&gt;Interpretation&lt;/h3&gt;For patients aged 50 years or older and at 3 years post diagnosis, ","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071633","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":"Challenges in containing the global spread of mpox clade Ib","authors":"Boghuma K Titanji, Jason Zucker","doi":"10.1016/s0140-6736(25)00139-4","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00139-4","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"28 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056209","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":"Epidemiological and clinical features of mpox during the clade Ib outbreak in South Kivu, Democratic Republic of the Congo: a prospective cohort study","authors":"Isabel Brosius, Emmanuel Hasivirwe Vakaniaki, Guy Mukari, Papy Munganga, Jean Claude Tshomba, Elise De Vos, Eugene Bangwen, Yves Mujula, Achilleas Tsoumanis, Christophe Van Dijck, Aimé Alengo, Léandre Mutimbwa-Mambo, Franklin Mweshi Kumbana, Jenestin Babingwa Munga, Divin Mazambi Mambo, James Wakilongo Zangilwa, Steeven Bilembo Kitwanda, Sarah Houben, Nicole A Hoff, Jean-Claude Makangara-Cigolo, Placide Mbala-Kingebeni","doi":"10.1016/s0140-6736(25)00047-9","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00047-9","url":null,"abstract":"<h3>Background</h3>Clade Ib, a new strain of clade I monkeypox virus, emerged in eastern DR Congo, sparking an international outbreak. Comprehensive studies are needed to assess its transmission dynamics and clinical presentation.<h3>Methods</h3>We did a prospective observational cohort study at Kamituga General Hospital in South Kivu, DR Congo, between May 2 and Oct 9, 2024. Sociodemographic, exposure, and clinical data were collected from mpox-suspected cases. Cases were confirmed by Xpert Mpox PCR and followed through hospitalisation and on days 29 and 59 after diagnosis.<h3>Findings</h3>Of the 510 suspected cases included, 407 (80%) tested positive via PCR. Among the 407 confirmed cases, 196 (48%) were women. Age distribution was bimodal, with 58 (14%) children younger than 5 years, and 267 (66%) individuals aged 15–34 years. Most cases (237 [58%] of 406) reported contact with a suspected or confirmed mpox case; primarily colleagues, spouses or sexual partners in adults, and parents or siblings in children. Self-reported comorbidities were rare (18 [5%] of 400), including 6 (2%) people infected with HIV. Prodromal symptoms were present in 331 (88%) of 375 patients, active skin lesions in 394 (97%) of 407 patients, mucosal lesions in 324 (82%) of 394 patients, and lymphadenopathy in 288 (73%) of 394 patients. In adults, 280 (89%) of 314 had genital skin lesions and mean lesion density was highest in the genital area. In contrast, only 35 (42%) of 84 children had genital lesions, as part of a more uniform rash. Among 403 hospitalised patients, two (&lt;1%) deaths occurred. Among 296 patients with detailed hospital follow-up, complications were primarily genito-urinary (169 [57%]) or cutaneous (121 [41%]). Four (67%) of six pregnant women with recorded outcome had adverse pregnancy outcomes. On days 29 and 59, few sequelae were reported other than scars.<h3>Interpretation</h3>Clade Ib infections in Kamituga showed distinct clinical patterns compared with clade Ia outbreaks elsewhere in the country and the global clade IIb outbreak. In adults, the disease primarily affected the genito-urinary system, compatible with sexual transmission, whereas children mostly manifested extragenital lesions. These findings highlight the need for updated case definitions and targeted public health interventions to address evolving transmission dynamics and mitigate risks for vulnerable groups, including pregnant women and young children.<h3>Funding</h3>European &amp; Developing Countries Clinical Trials Partnership (EDCTP2 and EDCTP3); Belgian Directorate-General Development Cooperation and Humanitarian Aid; Research Foundation–Flanders.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056210","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":"Global health partnerships for a post-2030 agenda","authors":"Antoine de Bengy Puyvallée, Sophie Harman, Simon Rushton, Katerini T Storeng","doi":"10.1016/s0140-6736(24)02816-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02816-2","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Contributors</h2>All authors contributed equally to the conceptualisation, development, and writing of the manuscript. All authors have had access to the data, research, and analysis used in the preparation of this Viewpoint and jointly accept responsibility for its publication.</section></section><section><section><h2>Declaration of interests</h2>AdBP and KTS declare a research grant from the Norwegian Research Council (number 01929). SH and SR declare no competing interests.</section></section><section><section><h2>Acknowledgments</h2>This Viewpoint represents the views of the authors only, and not the views of their institutions or funders, who had no role in preparation of the manuscript or decision to publish.</section></section>","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055302","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":"US exit from WHO: it is about much more than WHO","authors":"Ilona Kickbusch","doi":"10.1016/s0140-6736(25)00163-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00163-1","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050036","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":"An imminent hazard: Dhaka's unbreathable air","authors":"Protyoi Chakraborty","doi":"10.1016/s0140-6736(25)00091-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00091-1","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050038","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":"Announcing the Lancet Commission on US Societal Resilience in a Global Pandemic Age: Lessons for the Present from the Future","authors":"Eliah Aronoff-Spencer, Richard M Carpiano, Lara Vojnov","doi":"10.1016/s0140-6736(24)02721-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02721-1","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050037","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":"Dual checkpoint blockade for microsatellite instability-high colorectal cancer","authors":"S Daniel Haldar, Scott Kopetz","doi":"10.1016/s0140-6736(25)00144-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00144-8","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035021","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}