Lancet Regional Health-Europe最新文献

{"title":"Public trust and evidence: decisions on vaccines must be anchored in science","authors":"Marco Cavaleri","doi":"10.1016/j.lanepe.2026.101844","DOIUrl":"10.1016/j.lanepe.2026.101844","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"69 ","pages":"Article 101844"},"PeriodicalIF":15.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149154471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can Europe increase uptake of maternal vaccines?","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2026.101891","DOIUrl":"10.1016/j.lanepe.2026.101891","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"69 ","pages":"Article 101891"},"PeriodicalIF":15.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hidden consequences of marine heatwaves: rising Vibrio risk in European coastal waters","authors":"Jan C. Semenza, Joaquin A. Trinanes, Jaime Martinez-Urtaza","doi":"10.1016/j.lanepe.2026.101838","DOIUrl":"10.1016/j.lanepe.2026.101838","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"69 ","pages":"Article 101838"},"PeriodicalIF":15.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149154470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If the EU is serious about One Health, it must ban fur farming","authors":"Joanna Swabe, Chris Walzer, Benjamin Roche, Arnaud Fontanet, Thijs Kuiken, Manon Lounnas, Andrea S. Winkler, Sarah Cleaveland, Dirk U. Pfeiffer, Latiffah Hassan, Raina K. Plowright, Neil M. Vora","doi":"10.1016/j.lanepe.2026.101848","DOIUrl":"10.1016/j.lanepe.2026.101848","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"69 ","pages":"Article 101848"},"PeriodicalIF":15.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149154472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ménière's disease: the treatment evidence we still do not have","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2026.101853","DOIUrl":"10.1016/j.lanepe.2026.101853","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"68 ","pages":"Article 101853"},"PeriodicalIF":15.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient characteristics, treatment patterns, and survival across estrogen receptor expression subgroups in HER2-negative breast cancer: a population-based cohort study","authors":"Qiao Yang, Ceren Boyaci, Ioannis Zerdes, Irma Fredriksson, Xinsong Chen, Johan Hartman, Balazs Acs","doi":"10.1016/j.lanepe.2026.101826","DOIUrl":"10.1016/j.lanepe.2026.101826","url":null,"abstract":"<div><h3>Background</h3><div>Estrogen receptor (ER) low (1–9%) breast cancer (BC) often behaves like triple-negative BC, while ERhigh (≥60%) disease has a more favorable prognosis. However, tumors with ER expressing 10–59% represent a poorly defined patient population. In this nationwide cohort study, we aimed to describe real-world patient characteristics, treatment patterns and survival across the entire ER spectrum in Human Epidermal growth factor Receptor 2 (HER2)-negative BC.</div></div><div>Estrogen receptor (ER) low (1–9%) breast cancer (BC) often behaves like triple-negative BC, while ERhigh (≥60%) disease has a more favorable prognosis. However, tumors with ER expressing 10–59% represent a poorly defined patient population. In this nationwide cohort study, we aimed to describe real-world patient characteristics, treatment patterns and survival across the entire ER spectrum in Human Epidermal growth factor Receptor 2 (HER2)-negative BC.</div><div><h3>Methods</h3><div>We conducted a population-based cohort study of all women diagnosed with HER2-negative BC in Sweden (2007–2023), based on prospectively collected data. Tumors were stratified into five ER subgroups: ER<sup>0%</sup> (ERzero), ER<sup>1–9%</sup> (ERlow), ER<sup>10–29%</sup> (ERmild), ER<sup>30–59%</sup> (ERmod), and ER<sup>60–100%</sup> (ERhigh). We evaluated overall survival (OS) by ER subgroups and treatment (chemotherapy [CT] and endocrine therapy [ET]) using Kaplan–Meier analysis and multivariable Cox regression.</div></div><div>We conducted a population-based cohort study of all women diagnosed with HER2-negative BC in Sweden (2007–2023), based on prospectively collected data. Tumors were stratified into five ER subgroups: ER<sup>0%</sup> (ERzero), ER<sup>1–9%</sup> (ERlow), ER<sup>10–29%</sup> (ERmild), ER<sup>30–59%</sup> (ERmod), and ER<sup>60–100%</sup> (ERhigh). We evaluated overall survival (OS) by ER subgroups and treatment (chemotherapy [CT] and endocrine therapy [ET]) using Kaplan–Meier analysis and multivariable Cox regression.</div><div><h3>Findings</h3><div>We included 75,211 patients. Compared to the ERhigh subgroup, both the ERmild (adjusted HR [aHR] = 1.59, 95% confidence interval [CI]: 1.31–1.93) and ERmod (aHR = 1.31, 95% CI: 1.17–1.47) subgroups had significantly worse survival (both adjusted P [aP] < 0.001). Notably, ERmild patients had survival outcomes and molecular characteristics similar to those of ERlow and ERzero patients. Patients with ERmild (aHR = 0.46, 95% CI: 0.23–0.94, aP = 0.033) and ERmod (aHR = 0.60, 95% CI: 0.42–0.85, aP = 0.0046) tumors, CT + ET was associated with a lower risk of death than ETonly.</div></div><div>We included 75,211 patients. Compared to the ERhigh subgroup, both the ERmild (adjusted HR [aHR] = 1.59, 95% confidence interval [CI]: 1.31–1.93) and ERmod (aHR = 1.31, 95% CI: 1.17–1.47) subgroups had significantly worse survival (both adjusted P [aP] < 0.001). Notably, ERmild patients had survival outcomes and molecula","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"68 ","pages":"Article 101826"},"PeriodicalIF":15.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Medicines Agency multi-stakeholder workshop on innovation in cardiovascular medicines and medical devices in the EU","authors":"Steffen Thirstrup, Bruno Sepodes, Iana Simova, Daniel Prieto-Alhambra, Patrice Verpillat, Luis Pinheiro, Mattias Van Heetvelde, Patrick Vrijlandt, Alar Irs, Silvy da Rocha Dias, Miguel Antunes, Nacho Mbaeliachi, Anna Baczynska, Pooja Jha","doi":"10.1016/j.lanepe.2026.101799","DOIUrl":"10.1016/j.lanepe.2026.101799","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"68 ","pages":"Article 101799"},"PeriodicalIF":15.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148958468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, temporal trends, and fibrosis risk stratification in metabolic dysfunction-associated steatotic liver disease in UK primary care: a population-based cohort and nested case–control study","authors":"Huei-Tyng Huang, Michael Hewitt, Wenhao Li, Laura Temperley, Naveed Sattar, William Alazawi","doi":"10.1016/j.lanepe.2026.101808","DOIUrl":"10.1016/j.lanepe.2026.101808","url":null,"abstract":"<div><h3>Background</h3><div>We sought to determine the changing prevalence, incidence, and temporal trends in real-world, recorded diagnoses of metabolic dysfunction-associated steatotic liver disease (MASLD) and assess availability of fibrosis risk stratification following awareness campaigns and guideline updates over the last decade.</div></div><div>We sought to determine the changing prevalence, incidence, and temporal trends in real-world, recorded diagnoses of metabolic dysfunction-associated steatotic liver disease (MASLD) and assess availability of fibrosis risk stratification following awareness campaigns and guideline updates over the last decade.</div><div><h3>Methods</h3><div>This population-based cohort study identified MASLD diagnoses made between 2003 and 2022 in the UK primary-care Clinical Practice Research Datalink (CPRD) to estimate prevalence and incidence. A nested case–control analysis, utilising 1:4 age-, sex-, and general practice-matched controls, assessed clinical characteristics, availability of Fibrosis-4 (Fib-4) components, and its temporal trend pre- and post-2015.</div></div><div>This population-based cohort study identified MASLD diagnoses made between 2003 and 2022 in the UK primary-care Clinical Practice Research Datalink (CPRD) to estimate prevalence and incidence. A nested case–control analysis, utilising 1:4 age-, sex-, and general practice-matched controls, assessed clinical characteristics, availability of Fibrosis-4 (Fib-4) components, and its temporal trend pre- and post-2015.</div><div><h3>Findings</h3><div>11.7 million individuals were active in CPRD in 2022. 365,797 comprised the study cohort of people with a MASLD diagnosis (matched to 1,460,288 controls). From 2012 to 2022, recorded MASLD prevalence rose from 0.52% [N = 51,028] to 2.42% [N = 283,762] (p < 0.001); recorded incidence doubled from 1.60 to 3.31 per 1000 person-years (p < 0.001). People with MASLD diagnosis had a higher prevalence of type 2 diabetes (21.0% [N = 76,640] vs 7.7% [N = 112,812]) and hypertension (35.3% [N = 129,156] vs 18.7% [N = 273,502]). People of South Asian ethnicity were overrepresented in MASLD cohort but had the lowest availability of Fib-4 components (14.6% [N = 4467]; adjusted odds ratio 0.67, 95% CI: 0.65–0.70, vs White). Overall, Fib-4 availability increased pre-to post-2015 (4.3% [N = 4945] to 22.8% [N = 56,634]). Among those with a calculable score, fewer South Asian individuals had indeterminate/high risk (18.6% [N = 833] vs 35.3% [N = 15,115] in White individuals, p < 0.001).</div></div><div>11.7 million individuals were active in CPRD in 2022. 365,797 comprised the study cohort of people with a MASLD diagnosis (matched to 1,460,288 controls). From 2012 to 2022, recorded MASLD prevalence rose from 0.52% [N = 51,028] to 2.42% [N = 283,762] (p < 0.001); recorded incidence doubled from 1.60 to 3.31 per 1000 person-years (p < 0.001). People with MASLD diagnosis had a higher prevalence of type 2 diab","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"68 ","pages":"Article 101808"},"PeriodicalIF":15.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal and socioeconomic trends in hospital admissions for miscarriage and ectopic pregnancy in England, 2004–2024: a nationwide study","authors":"Sindhu Sekar, Joshua Odendaal, Siobhan Quenby, Nicola Tempest","doi":"10.1016/j.lanepe.2026.101777","DOIUrl":"10.1016/j.lanepe.2026.101777","url":null,"abstract":"<div><h3>Background</h3><div>Miscarriage and ectopic pregnancy are among the most common early pregnancy complications, yet contemporary national trends and associated inequalities in England remain poorly characterised. This study examined 20-year temporal patterns in hospital admissions for miscarriage and ectopic pregnancy, with additional stratification by socioeconomic deprivation and age.</div></div><div>Miscarriage and ectopic pregnancy are among the most common early pregnancy complications, yet contemporary national trends and associated inequalities in England remain poorly characterised. This study examined 20-year temporal patterns in hospital admissions for miscarriage and ectopic pregnancy, with additional stratification by socioeconomic deprivation and age.</div><div><h3>Methods</h3><div>National admissions data from 2004 to 2024, curated by NHS England, were extracted from Hospital Episode Statistics and the Maternity Services Data Set. Annual counts of miscarriage (ICD-10 O02–O03) and ectopic pregnancy (ICD-10 O00), deliveries, deprivation deciles, and age groups were analysed. Joinpoint regression (version 5.0) was used to identify significant changes in trends, calculating Annual Percent Change (APC) and Average Annual Percent Change (AAPC).</div></div><div>National admissions data from 2004 to 2024, curated by NHS England, were extracted from Hospital Episode Statistics and the Maternity Services Data Set. Annual counts of miscarriage (ICD-10 O02–O03) and ectopic pregnancy (ICD-10 O00), deliveries, deprivation deciles, and age groups were analysed. Joinpoint regression (version 5.0) was used to identify significant changes in trends, calculating Annual Percent Change (APC) and Average Annual Percent Change (AAPC).</div><div><h3>Findings</h3><div>Miscarriage admissions declined significantly between 2018 and 2021 (APC = −4.44∗%; 95% CI: −7.4218 to −0.7135; <em>p</em> = 0.03), followed by a modest rise after 2021 (APC = +2.823%; 95% CI: −1.8311 to 8.8970; <em>p</em> = 0.13). Ectopic pregnancy admissions increased significantly up to 2012 (APC +2.82%; 95% CI: 1.3845–3.8309; <em>p</em> = 0.007), declined with the introduction of conservative management guidelines (APC = −2.97%; 95% CI: −3.9393 to 3.827; <em>p</em> = 0.15) and rose again after 2021 (APC = +4.23∗% (95% CI: 2.1194–7.1943; <em>p</em> < 0.001). A persistent deprivation gradient was observed, with the most deprived deciles consistently experiencing the highest admissions (around two-fold difference). The proportion of admissions among women aged 25–34 years increased (approximately 40–50%) for both outcomes.</div></div><div>Miscarriage admissions declined significantly between 2018 and 2021 (APC = −4.44∗%; 95% CI: −7.4218 to −0.7135; <em>p</em> = 0.03), followed by a modest rise after 2021 (APC = +2.823%; 95% CI: −1.8311 to 8.8970; <em>p</em> = 0.13). Ectopic pregnancy admissions increased significantly up to 2012 (APC +2.82%; 95% CI: 1.3845–3.8309; <em>p</em> = 0.00","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"68 ","pages":"Article 101777"},"PeriodicalIF":15.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the hope groups intervention on mental health, parenting practices, and violence against children among Ukrainian parents and caregivers affected by war and displacement: a cluster randomised controlled trial","authors":"Sydney Tucker, Nicole Baldonado, Olha H. Ruina, G.J. Melendez-Torres, Seth Flaxman, Lyudmila Bryn, Laura Rawlings, Philip Goldman, Kateryna Louchnikov, Joshua Baldonado, Tetiana Machabeli","doi":"10.1016/j.lanepe.2026.101783","DOIUrl":"10.1016/j.lanepe.2026.101783","url":null,"abstract":"<div><h3>Background</h3><div>Almost two-thirds of the world’s children live in conflict-affected countries, including Ukraine, where two-thirds of children were displaced after Russia’s 2022 invasion. To address the urgent need for effective approaches to support parents and protect children in war, we designed Hope Groups—a group-based mental health, parenting, and violence prevention intervention—and used a cluster randomised controlled trial (cRCT) to evaluate its effectiveness.</div></div><div>Almost two-thirds of the world’s children live in conflict-affected countries, including Ukraine, where two-thirds of children were displaced after Russia’s 2022 invasion. To address the urgent need for effective approaches to support parents and protect children in war, we designed Hope Groups—a group-based mental health, parenting, and violence prevention intervention—and used a cluster randomised controlled trial (cRCT) to evaluate its effectiveness.</div><div><h3>Methods</h3><div>We conducted a two-arm, parallel cRCT comprising K = 90 clusters and N = 510 parents/caregivers, who were internally displaced, externally displaced, or at home in war-affected Ukraine. Primary outcomes, assessed at baseline and after completing the 12-session intervention (endline), included caregiver mental health, parenting practices, and violence against children. Clusters were randomly assigned to immediate Hope Groups intervention (K = 45; N = 255) or waitlist control (K = 45; N = 255). Interim analyses were conducted after the first 20 clusters reached trial endline. The trial was prospectively registered with Open Science Framework (<span><span>https://osf.io/uvj67</span><svg><path></path></svg></span>) and subsequently registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> to align with ICMJE guidance (NCT07470333).</div></div><div>We conducted a two-arm, parallel cRCT comprising K = 90 clusters and N = 510 parents/caregivers, who were internally displaced, externally displaced, or at home in war-affected Ukraine. Primary outcomes, assessed at baseline and after completing the 12-session intervention (endline), included caregiver mental health, parenting practices, and violence against children. Clusters were randomly assigned to immediate Hope Groups intervention (K = 45; N = 255) or waitlist control (K = 45; N = 255). Interim analyses were conducted after the first 20 clusters reached trial endline. The trial was prospectively registered with Open Science Framework (<span><span>https://osf.io/uvj67</span><svg><path></path></svg></span>) and subsequently registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> to align with ICMJE guidance (NCT07470333).</div><div><h3>Findings</h3><div>After completion of the 12-session intervention, the Hope Groups intervention demonstrated medium-to-large effects across all measured primary outcomes compared with the control arm. Caregivers in the intervention arm reported 57.","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"68 ","pages":"Article 101783"},"PeriodicalIF":15.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}