Lancet Regional Health-Europe最新文献

{"title":"Artificial intelligence in the EU Safe Hearts Plan: prediction alone is not enough","authors":"Hannah van Kolfschooten,&nbsp;Georges Hattab,&nbsp;Franziska Bächler,&nbsp;Giulio Stefanini","doi":"10.1016/j.lanepe.2026.101784","DOIUrl":"10.1016/j.lanepe.2026.101784","url":null,"abstract":"<div><div>The European Commission's Safe Hearts Plan positions AI as a key tool for enhancing the prevention, diagnosis, and care of cardiovascular disease. Although AI presents significant opportunities, the Safe Hearts Plan may be overstating its impact by prioritising technological capacity over implementation readiness. This Viewpoint examines the role assigned to AI within the Safe Hearts Plan through a policy and legal analysis, drawing on EU policy documents, WHO/Europe reports, and literature on AI governance and cardiovascular care. It argues that a persistent “benefits gap” exists between AI's technical performance and its real-world clinical impact, reflecting institutional, operational, and legal barriers to implementation. The Viewpoint further analyses how legal uncertainty surrounding regulation, liability, and patients' rights may hinder the responsible integration of AI into cardiovascular care. It concludes that AI should be embedded within robust legal, institutional, and operational frameworks to improve cardiovascular outcomes rather than simply generate more accurate predictions.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"67 ","pages":"Article 101784"},"PeriodicalIF":15.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148657131","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":"Automated cardiac arrest detection using wrist-derived photoplethysmography during withdrawal of life-sustaining treatment: a prospective clinical validation study","authors":"Roos Edgar,&nbsp;Catharina E. Jansen,&nbsp;Lente R. Pol,&nbsp;Kambiz Ebrahimkheil,&nbsp;Ruud C. van Kaam,&nbsp;Eelko Ronner,&nbsp;Marc A. Brouwer,&nbsp;Rypko J. Beukema,&nbsp;Aysun Cetinyurek-Yavuz,&nbsp;Peter C. Stas,&nbsp;Eric Boersma,&nbsp;Cornelia W.E. Hoedemaekers,&nbsp;Niels van Royen,&nbsp;Judith L. Bonnes","doi":"10.1016/j.lanepe.2026.101791","DOIUrl":"10.1016/j.lanepe.2026.101791","url":null,"abstract":"<div><h3>Background</h3><div>Automated cardiac arrest detection and alerting using wearable technology has the potential to shorten recognition delays for unwitnessed out-of-hospital cardiac arrest. In DETECT-1A and -1B, a photoplethysmography-based detection model was developed and validated in patients with induced cardiac arrest. This study evaluates model performance in true cardiac arrests following withdrawal of life-sustaining treatment.</div></div><div><h3>Methods</h3><div>Prospective, single-center study in adult ICU patients with planned withdrawal of life-sustaining treatment. Patients wore a photoplethysmography-wristband (CardioWatch) until death. Continuous ECG and invasive arterial pressure served as reference standards. The previously developed rule-based algorithm was refined using two training cohorts and evaluated in a separate test cohort. Endpoints were sensitivity for cardiac arrest detection and false positive alerts.</div></div><div><h3>Findings</h3><div>Forty-four patients were included (training 1: n = 10; training 2: n = 11; test: n = 23), median age 65 years; 75% male, all with non-shockable cardiac arrest. Sensitivity for cardiac arrest detection was 100% (10/10; 95% confidence interval [CI] 66–100%) and 90% (9/10; 95% CI 54–99%), in training 1 and 2, respectively. In the test set, sensitivity was 100% (23/23; 95% CI 82–100%), with one false positive alert. Cardiac arrest was detected at a mean arterial pressure of 30 mmHg (IQR 24–35) and pulse pressure of 13 mmHg (IQR 11–19).</div></div><div><h3>Interpretation</h3><div>Cardiac arrest can be detected with high sensitivity using wrist-derived photoplethysmography, providing first evidence on model performance in true cardiac arrest, specifically in non-shockable cases. Findings support further development of wearable-based cardiac arrest detection technologies to enable earlier recognition for unwitnessed cardiac arrest.</div></div><div><h3>Funding</h3><div>Dutch Heart Foundation, Radboudumc.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"67 ","pages":"Article 101791"},"PeriodicalIF":15.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655114","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":"Trends in type 2 diabetes incidence and BMI at diagnosis by age, sex, and ethnicity, 2011–2024: a population-based analysis of the English National Diabetes Audit","authors":"Naomi Holman,&nbsp;Jackie O’Keefe,&nbsp;Edward Gregg,&nbsp;Garry Daniel Tan,&nbsp;Kamlesh Khunti,&nbsp;Jonathan Valabhji,&nbsp;Chirag Bakhai,&nbsp;Clare Hambling,&nbsp;Bob Young,&nbsp;Shivani Misra","doi":"10.1016/j.lanepe.2026.101764","DOIUrl":"10.1016/j.lanepe.2026.101764","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset type 2 diabetes is associated with aggressive disease progression, long-term health burden and reduced life expectancy. Trends in incidence have not been comprehensively described.</div></div><div><h3>Methods</h3><div>Using data from the English National Diabetes Audit, age-standardised incidence rates for adults with type 2 diabetes were calculated by age, sex, and ethnicity between 2011 and 2024. Poisson regression models were created to study incidence over time. Annual change in median BMI within 26 weeks of diagnosis were calculated.</div></div><div><h3>Findings</h3><div>Age-standardised incidence increased among adults aged 20–29 years (RR 1.021 [95% CI 1.017–1.026] per year in males, 1.030 [1.026–1.034] in females) and 30–39 years (1.013 [1.012–1.015] in males, 1.03 [1.028–1.032] in females). Incidence increased minimally in males aged 40–59 years (1.006 [1.005–1.006]), was rising in females (1.018 [1.017–1.019]) and declined in males and females aged 60–79 years (0.983 [0.983–0.984] in males, 0.985 in females 0.985 [0.984–0.985]). Increasing incidence in young adults were observed in all sex and ethnicity subgroups except Asian males (20–39-years) but highest rates were in White females (30–39-years) and Black females (20–29). BMI at diagnosis increased in all subgroups over time but was highest in younger adults and higher in females than males. The annual change in younger adults was double that of older (20–29 year-old-males +0.17 kg/m²/year [0.08–0.26] and females +0.17 [0.09–0.26]; 30–39-year-old males +0.21 [0.18–0.24] and females +0.20 [0.16–0.24]; 40–59 year-old-males +0.06 [0.04–0.07] and females +0.09 [0.06–0.12]; 60–79 year old males +0.08 [0.06–0.09] and females +0.11 [0.08–0.13]).</div></div><div><h3>Interpretation</h3><div>Since 2011, incidence of type 2 diabetes has risen significantly in young adults across most ethnicity and sex subgroups (especially females) despite minimal changes or declining rates at older ages. This trend parallels greater increases in BMI-at-diagnosis in young people, highlighting a shift in disease burden and the urgent need for earlier prevention, and focused obesity interventions in early-life.</div></div><div><h3>Funding</h3><div>Wellcome Trust.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"67 ","pages":"Article 101764"},"PeriodicalIF":15.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708544","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":"A call to action on antimicrobial stewardship in tuberculosis: safeguarding effective tuberculosis treatment for future generations","authors":"Thomas Theo Brehm,&nbsp;Askar Yedilbayev,&nbsp;Ihor Perehinets,&nbsp;Diane Ashiru-Oredope,&nbsp;Dumitru Chesov,&nbsp;Christoph Lange","doi":"10.1016/j.lanepe.2026.101797","DOIUrl":"10.1016/j.lanepe.2026.101797","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"67 ","pages":"Article 101797"},"PeriodicalIF":15.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148657130","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":"Real-World Psilocybin Therapy for Treatment-Resistant Depression: A Retrospective Observational Study","authors":"Johannes Jungwirth,&nbsp;Samuel Westenhöfer,&nbsp;Helena D. Aicher,&nbsp;Barbora Provaznikova,&nbsp;Golo Kronenberg,&nbsp;Erich Seifritz,&nbsp;Susanne Prinz,&nbsp;Sebastian Olbrich","doi":"10.1016/j.lanepe.2026.101719","DOIUrl":"10.1016/j.lanepe.2026.101719","url":null,"abstract":"<div><h3>Background</h3><div>Psilocybin has demonstrated promising antidepressant effects in depression and treatment-resistant depression (TRD) in controlled clinical trials. However, its effectiveness and safety in real-world therapeutic settings remain largely unknown. Although psilocybin is not yet approved as an antidepressant treatment, Switzerland's unique legal framework allows its limited medical use for TRD. We aimed to examine antidepressant outcomes, safety, and feasibility of real-world psilocybin therapy for TRD, including repeated dosing sessions.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of medical records from 19 TRD patients treated with psilocybin (20–35 mg) across one to four dosing sessions at the Psychiatric University Hospital Zurich. Depression severity was assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS) and the Beck Depression Inventory II (BDI). Changes from baseline to interim and post-treatment were analysed, including response and remission.</div></div><div><h3>Findings</h3><div>MADRS scores decreased from baseline (M = 30.78) to post-treatment (M = 19.89), with a large effect size (Hedges' g = 1.37, 95% CI [0.90, 1.84]). BDI scores also decreased (M = 32.33–M = 23.28), with a medium-to-large effect (Hedges’ g = .77, 95% CI [0.46, 1.09]). Response and remission rates were 33.3% and 22.2% (MADRS), and 27.8% and 27.8% (BDI). No serious adverse events were documented.</div></div><div><h3>Interpretation</h3><div>This study provides some of the first evidence on psilocybin outside controlled trials. Psilocybin was associated with a clinically meaningful reduction in depressive symptoms, with response and remission rates below those reported in previous trials. Findings suggest feasibility of psilocybin in real-world TRD care and should be interpreted within the limitations of small sample size, retrospective uncontrolled design, heterogeneous treatment conditions, and concomitant psychopharmacology.</div></div><div><h3>Funding</h3><div>This research did not receive any funding.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"67 ","pages":"Article 101719"},"PeriodicalIF":15.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708556","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 case for primary prevention of obesity in the era of GLP-1 therapies","authors":"Søren Holm,&nbsp;Manuel Tena-Sempere,&nbsp;Dimitrios Koutsouris,&nbsp;George V. Dedoussis,&nbsp;Karl-Heinz Wagner,&nbsp;Sara Arranz,&nbsp;Philippe Froguel,&nbsp;Torsten Bohn,&nbsp;Paulo J. Oliveira,&nbsp;Jeroen Lakerveld","doi":"10.1016/j.lanepe.2026.101679","DOIUrl":"10.1016/j.lanepe.2026.101679","url":null,"abstract":"<div><div>Obesity rates continue to rise across Europe, driven by obesogenic environments shaped by food systems, urban design, socioeconomic inequalities, and commercial forces. The introduction of incretin-based pharmacotherapies like GLP-1 receptor agonists has transformed treatment, leading to significant weight loss and metabolic benefits for many. This progress has shifted public and policy discourse, with some suggesting that effective treatment reduces the urgency of prevention. However, this position paper argues that the growing availability of medications actually reinforces the need to prioritize primary prevention. While pharmacotherapy can improve individual outcomes, it cannot lower population-level risk or deliver the wider societal, environmental, and economic benefits of prevention. The paper also outlines key policy implications to reaffirm prevention as a cornerstone of public health across Europe.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"66 ","pages":"Article 101679"},"PeriodicalIF":15.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392488","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":"Early impact of RSV prevention on infant hospitalisations in Denmark","authors":"Caroline Klint Johannesen,&nbsp;Amanda Marie Egeskov-Cavling,&nbsp;Stine Lund,&nbsp;Zitta Barrella Harboe,&nbsp;Thea K. Fischer","doi":"10.1016/j.lanepe.2026.101750","DOIUrl":"10.1016/j.lanepe.2026.101750","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"66 ","pages":"Article 101750"},"PeriodicalIF":15.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363731","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":"Primary Human Papillomavirus Screening Versus Cytology for Detection of Cervical Intraepithelial Neoplasia Grade 2 or Higher in Poland: a Parallel-Group, Randomized Controlled Trial","authors":"Andrzej Nowakowski,&nbsp;Anna Macios,&nbsp;Patrycja Glinska,&nbsp;Aneta Chmielewska,&nbsp;Beata Janik,&nbsp;Ilona Jędrzejewska,&nbsp;Alicja Klimiuk,&nbsp;Ewa Chmielik,&nbsp;Piotr Bobkiewicz,&nbsp;Ewa Kapuśniak,&nbsp;Jacek Podolski,&nbsp;Ewa Prokurat,&nbsp;Marc Arbyn,&nbsp;Michal Filip Kamiński","doi":"10.1016/j.lanepe.2026.101697","DOIUrl":"10.1016/j.lanepe.2026.101697","url":null,"abstract":"<div><h3>Background</h3><div>2025 European guidelines recommended transition from cytology to HPV-based cervical cancer screening. We compared both strategies in a pilot in Poland.</div></div><div><h3>Methods</h3><div>Eligible, consenting women aged 30–59 years underwent centralized 1:1 randomization to HPV-testing or cytology (HPV or cytology arm, respectively) in 30–39, 40–49, and 50–59 years age strata in 27 clinics. Arm assignment was unblinded. HPV positive samples underwent liquid-based cytology (LBC) triage. If normal, another LBC was performed in six months. Abnormal LBC triggered colposcopy. If both LBCs were normal, p16/Ki-67 immunocytochemistry and <em>FAM19A4/miR124-2</em> methylation tests were performed. Either positive triggered referral to colposcopy. In the cytology arm, abnormal results triggered another cytology after six months or colposcopy, according to routine protocols. Cervical intraepithelial neoplasia grade 2 or worse (CIN2+) detection rate in the population intended to treat was the main outcome. <span><span>NCT04111835-Clinicaltrials.gov</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>Between 28 October 2019 and 31 December 2022, 16,795 and 16,707 women underwent primary HPV or cytological testing, respectively. 702/16,795 (4.2%; 95% CI: 3.9%–4.5%) and 499/16,707 women (3.0%; 95% CI: 2.7%–3.3%), were referred for colposcopy in the HPV and cytology arm, respectively (RR = 1.40; 95% CI: 1.25–1.57). CIN2+ was detected in 137 women (0.82%; 95% CI: 0.69–0.96%) and in 71 women (0.42%; 95% CI: 0.34–0.54%; OR = 1.93; 95% CI: 1.34–2.77), while CIN grade 3 or worse (CIN3+) was detected in 69 women (0.41%; 95% CI: 0.32%–0.52%) and in 35 women (0.21%; 95% CI: 0.15%–0.29%; OR = 1.99; 95% CI: 1.16–3.42) in the HPV and cytology arm, respectively. In HPV positive women with two normal LBCs immunocytochemistry and methylation detected 4/9 (44.4%) and 7/9 (77.8%) CIN2+ cases, respectively.</div></div><div><h3>Interpretation</h3><div>HPV-based screening may almost double CIN2+ detection compared to cytology. It however yields more positive screening results and colposcopies. Smooth transition from cytology to HPV-based screening requires proper triage strategies and additional colposcopy services. Methylation seems to detect more CIN2+ than immunocytochemistry in HPV positive women with two normal LBCs.</div></div><div><h3>Funding</h3><div><span>Polish Ministry of Health</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"66 ","pages":"Article 101697"},"PeriodicalIF":15.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392485","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 Association for the Study of the Liver (EASL) Congress 2026","authors":"Ivana Nedic,&nbsp;Larissa Otero","doi":"10.1016/j.lanepe.2026.101759","DOIUrl":"10.1016/j.lanepe.2026.101759","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"66 ","pages":"Article 101759"},"PeriodicalIF":15.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554013","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":"Preparing for the next pandemic requires more than commitments","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2026.101771","DOIUrl":"10.1016/j.lanepe.2026.101771","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"66 ","pages":"Article 101771"},"PeriodicalIF":15.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554014","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}