Lancet Regional Health-Europe最新文献

{"title":"In-hospital mortality, comorbidities, and costs of one million mechanically ventilated patients in Germany: a nationwide observational study before, during, and after the COVID-19 pandemic","authors":"Christian Karagiannidis ,&nbsp;Franz Krause ,&nbsp;Claas Bentlage ,&nbsp;Johannes Wolff ,&nbsp;Thomas Bein ,&nbsp;Wolfram Windisch ,&nbsp;Reinhard Busse","doi":"10.1016/j.lanepe.2024.100954","DOIUrl":"10.1016/j.lanepe.2024.100954","url":null,"abstract":"<div><h3>Background</h3><p>Even more than hospital care in general, intensive care and mechanical ventilation capacities and its utilization in terms of rates, indications, ventilation types and outcomes vary largely among countries. We analyzed complete and nationwide data for Germany, a country with a large intensive care sector, before, during and after the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>Analysis of administrative claims data, provided by the German health insurance, from all hospitals for all individual patients who were mechanically ventilated between 2019 and 2022. The data included age, sex, diagnoses, length of stay, procedures (e.g., form and duration of mechanical ventilation), outcome (dead vs. alive) and costs. We included all patients who were at least 18 years old at the time of discharge from January 1st, 2019 to December 31st, 2022. Patients were grouped according to year, age group and the form of mechanical ventilation. We further analyzed subgroups of patients being resuscitated and those being COVID-19 positive (vs. negative).</p></div><div><h3>Findings</h3><p>During the four years, 1,003,882 patients were mechanically ventilated in 1395 hospitals. Rates per 100,000 inhabitants varied across age groups from 110 to 123 (18–59 years) to 1101–1275 (&gt;80 years). The top main diagnoses were other forms of heart diseases, pneumonia, chronic obstructive pulmonary disease (COPD), ischemic heart diseases and cerebrovascular diseases. 43.3% (437,031/1,003,882) of all mechanically ventilated patients died in hospital with a remarkable increase in mortality with age and from 2019 to 2022 by almost 5%-points. The in-hospital mortality of ventilated COVID-19 patients was 53.7% (46,553/86,729), while it was 42.6% (390,478/917,153) in non-COVID patients. In-hospital mortality varied from 27.0% in non-invasive mechanical ventilation (NIV) only to 53.4% in invasive mechanical ventilation only cases, 59.4% with early NIV failure, 68.6% with late NIV failure, to 74.0% in patients receiving VV-ECMO and 80.0% in VA-ECMO. 17.5% of mechanically ventilated patients had been resuscitated before, of whom 78.2% (153,762/196,750) died. Total expenditure was around 6 billion Euros per year, i.e. 0.17% of the German GDP.</p></div><div><h3>Interpretation</h3><p>Mechanical ventilation was widely used, before, during and after the COVID-19 pandemic in Germany, reaching more than 1000 patients per 100,000 inhabitants per year in the age over 80 years. In-hospital mortality rates in this nationwide and complete cohort exceeded most of the data known by far.</p></div><div><h3>Funding</h3><p>This research did not receive any dedicated funding.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001212/pdfft?md5=6c4f99a3fe6499bf043569f2bba9511e&pid=1-s2.0-S2666776224001212-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403221","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":"Lanreotide versus placebo for tumour reduction in patients with a 68Ga-DOTATATE PET-positive, clinically non-functioning pituitary macroadenoma (GALANT study): a randomised, multicentre, phase 3 trial with blinded outcome assessment","authors":"Tessel M. Boertien ,&nbsp;Madeleine L. Drent ,&nbsp;Jan Booij ,&nbsp;Charles B.L.M. Majoie ,&nbsp;Marcel P.M. Stokkel ,&nbsp;Jantien Hoogmoed ,&nbsp;Alberto M. Pereira ,&nbsp;Nienke R. Biermasz ,&nbsp;Suat Simsek ,&nbsp;Ronald Groote Veldman ,&nbsp;Annick J. Weterings ,&nbsp;Juan M. Vink ,&nbsp;Michael W.T. Tanck ,&nbsp;Eric Fliers ,&nbsp;Peter H. Bisschop","doi":"10.1016/j.lanepe.2024.100923","DOIUrl":"10.1016/j.lanepe.2024.100923","url":null,"abstract":"<div><h3>Background</h3><p>No established medical treatment options currently exist for patients with non-functioning pituitary macroadenoma (NFPMA). Somatostatin analogues may prevent tumour growth, but randomised controlled trials are lacking. <em>In vivo</em> somatostatin receptor assessment with ⁶⁸Ga-DOTATATE PET could help in selecting patients for treatment. We aimed to determine the effect of the somatostatin analogue lanreotide on tumour size in patients with a ⁶⁸Ga-DOTATATE PET-positive NFPMA.</p></div><div><h3>Methods</h3><p>The GALANT study was an investigator-initiated, multicentre, randomised, double-blind, placebo-controlled, parallel-group, phase 3 trial with recruitment at three academic hospitals in the Netherlands. Adult patients with a suprasellar extending NFPMA, either surgery-naïve or postoperative remnant ≥10 mm, were eligible for inclusion. Important exclusion criteria were previous sellar radiotherapy and use of dopamine receptor agonists. Somatostatin receptor expression in the NFPMA was determined through ⁶⁸Ga-DOTATATE PET/CT, co-registered with MRI. A predefined sample of 44 patients with PET-positive NFPMA were randomly assigned (1:1) to lanreotide acetate 120 mg or placebo, both administered as deep subcutaneous injections every 28 days for 72 weeks. Primary outcome was the change in cranio-caudal tumour diameter measured on pituitary MRI from baseline to end-of-treatment in the intention-to-treat population. Participants, investigators and outcome assessors were masked to treatment allocation. The trial is registered with the Netherlands Trial Registry, NL5136, and EudraCT, 2015-001234-22.</p></div><div><h3>Findings</h3><p>Between Nov 3, 2015, and Dec 10, 2019, 49 patients were included in the study. Forty-four patients with a ⁶⁸Ga-DOTATATE PET-positive NFPMA were randomly assigned to lanreotide (22 [50%]) or placebo (22 [50%]). Study treatment was completed in 13 (59%) lanreotide and 19 (86%) placebo participants. The mean (SD) change from baseline in cranio-caudal tumour diameter after treatment was +1·2 (2·5) mm with lanreotide and +1·3 (1·5) mm with placebo; adjusted mean difference versus placebo −0·1 mm (95% CI −1·3 to 1·2, p = 0·93). Adverse events occurred in 22 (100%, 147 events) lanreotide and 21 (95%, 94 events) placebo participants. Gastrointestinal complaints were most common, reported by 18 (82%) lanreotide and 8 (36%) placebo participants. There were no treatment-related serious adverse events.</p></div><div><h3>Interpretation</h3><p>Compared with placebo, lanreotide treatment did not reduce tumour size or growth in patients with ⁶⁸Ga-DOTATATE PET-positive NFPMA.</p></div><div><h3>Funding</h3><p><span>Ipsen Farmaceutica BV</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224000905/pdfft?md5=726f3b94bca503501b5551c46ffa6e00&pid=1-s2.0-S2666776224000905-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141036450","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":"Corrigendum to “Comparison of baseline patient characteristics in Italian oncology drug monitoring registries and clinical trials: a real-world cross-sectional study” [The Lancet Regional Health – Europe 41 (2024) 100912]","authors":"Maria Lucia Iacovino ,&nbsp;Simone Celant ,&nbsp;Luca Tomassini ,&nbsp;Laura Arenare ,&nbsp;Andrea Caglio ,&nbsp;Andrea Canciello ,&nbsp;Flavio Salerno ,&nbsp;Pier Paolo Olimpieri ,&nbsp;Susanna Di Segni ,&nbsp;Antonella Sferrazza ,&nbsp;Maria Carmela Piccirillo ,&nbsp;Giordano Domenico Beretta ,&nbsp;Carmine Pinto ,&nbsp;Livio Blasi ,&nbsp;Saverio Cinieri ,&nbsp;Luigi Cavanna ,&nbsp;Massimo Di Maio ,&nbsp;Pierluigi Russo ,&nbsp;Francesco Perrone","doi":"10.1016/j.lanepe.2024.100973","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.100973","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001406/pdfft?md5=4ad9465db813e47bf6d38ceae5fd94b1&pid=1-s2.0-S2666776224001406-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483428","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 vaping and smoking following the rise of disposable e-cigarettes: a repeat cross-sectional study in England between 2016 and 2023","authors":"Harry Tattan-Birch ,&nbsp;Jamie Brown ,&nbsp;Lion Shahab ,&nbsp;Emma Beard ,&nbsp;Sarah E. Jackson","doi":"10.1016/j.lanepe.2024.100924","DOIUrl":"10.1016/j.lanepe.2024.100924","url":null,"abstract":"<div><h3>Background</h3><p>There has been a rapid rise in disposable (single-use) e-cigarette vaping among young adults in England since June 2021 (leading to a planned ban on these products). We examined how this has affected population trends in current (i) vaping, (ii) tobacco smoking, and (iii) inhaled nicotine use.</p></div><div><h3>Methods</h3><p>We used data from a nationally-representative monthly repeat cross-sectional survey of adults (≥18) in England (n = 132,252; July-2016–May-2023). Using interrupted time-series analyses (segmented logistic regression), we estimated yearly trends in current tobacco smoking, vaping, and inhaled nicotine use (smoking and/or vaping) before (‘pre-disposables’) and after June-2021 (‘post-disposables’), stratified by age group (18 to 24, 25 to 44, 45 and over). We also examined trends in daily use and in vaping among never-smokers.</p></div><div><h3>Findings</h3><p>Pre-disposables, vaping and smoking prevalence had been stable or declining across all age groups. However, post-disposables, the odds of current vaping increased by 99% per year among 18 to 24-year-olds (odds ratio [OR] = 1.99; 95% confidence interval [CI] = 1.71 to 2.31), compared with 39% (OR = 1.39; 95% CI = 1.26 to 1.52) in 25 to 44-year-olds and 23% (OR = 1.23; 95% CI = 1.12 to 1.35) in those aged 45 or older. Smoking rates continued to decline — albeit modestly — in 18 to 24-year-olds (OR = 0.88, 95% CI = 0.77 to 1.00) and 25 to 44-year-olds (OR = 0.93, 95% CI = 0.86 to 1.00), but increased among those aged 45 or older (OR = 1.12, 95% CI = 1.05 to 1.20). As a result, post-disposables, the overall prevalence of inhaled nicotine use increased across all age groups. Trends were similar for daily use, but post-disposables increases in vaping were greatest among people who had never regularly smoked (e.g., 18 to 24-year-olds: OR = 2.50, 95% CI = 1.82 to 3.43).</p></div><div><h3>Interpretation</h3><p>Since disposable vapes started becoming popular in England, historic declines in nicotine use have reversed. Now, nicotine use appears to be rising, driven primarily by sharp increases in vaping among young people. Smoking declines have been most pronounced in age groups with the largest increases in vaping.</p></div><div><h3>Funding</h3><p><span>Cancer Research UK</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224000917/pdfft?md5=d5526f94f8312330967a20363de8c06a&pid=1-s2.0-S2666776224000917-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141144636","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":"Addressing burnout in the healthcare workforce: current realities and mitigation strategies","authors":"David Sipos ,&nbsp;Rahul Goyal ,&nbsp;Tomas Zapata","doi":"10.1016/j.lanepe.2024.100961","DOIUrl":"10.1016/j.lanepe.2024.100961","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001285/pdfft?md5=bf90f366d55bd6233c6f4f7752087af0&pid=1-s2.0-S2666776224001285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405834","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":"Utility of ultrasound in the diagnostic work-up of suspected pulmonary embolism: an open-label multicentre randomized controlled trial (the PRIME study)","authors":"Casper Falster ,&nbsp;Mads Damgaard Mørkenborg ,&nbsp;Mikkel Thrane ,&nbsp;Jesper Clausen ,&nbsp;Michael Arvig ,&nbsp;Kristoffer Brockhattingen ,&nbsp;Peter Biesenbach ,&nbsp;Lasse Paludan ,&nbsp;Rune Wiig Nielsen ,&nbsp;Thi Anh Nhi Huynh ,&nbsp;Mikael K. Poulsen ,&nbsp;Mikkel Brabrand ,&nbsp;Jacob E. Møller ,&nbsp;Stefan Posth ,&nbsp;Christian B. Laursen","doi":"10.1016/j.lanepe.2024.100941","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.100941","url":null,"abstract":"<div><h3>Background</h3><p>Prevalence of pulmonary embolism (PE) in patients referred to diagnostic imaging is decreasing, indicating a need for improving patient selection. The aim of this study was to assess reduction in referral to diagnostic imaging by integrating a bespoke ultrasound protocol and describe associated failure rate and adverse events in patients with suspected PE.</p></div><div><h3>Methods</h3><p>In a randomized open-label multicentre trial spanning June 18, 2021, through Feb 1, 2023, adult patients with suspected PE and 1) a Wells score of 0–6 and elevated age-adjusted D-dimer or 2) Wells score &gt;6 were randomly assigned 1:1 to direct diagnostic imaging (controls) or focused lung, cardiac, and deep venous ultrasound by unblinded investigators. Ultrasound could: 1) dismiss PE if no signs of PE and low clinical suspicion or an alternate diagnosis, 2) confirm PE in case of visible venous thrombus, ≥2 subpleural infarctions, McConnell's, or D-sign, or 3) refer to diagnostic imaging if neither category was fulfilled or a patient with confirmed PE by ultrasound required admission. Primary endpoint was proportion of patients referred to diagnostic imaging. Outcome assessors were not blinded to group assignment. All included participants were included in safety analyses. The trial was registered at <span>clinicaltrials.gov</span><svg><path></path></svg> (<span>NCT04882579</span><svg><path></path></svg>).</p></div><div><h3>Findings</h3><p>A total of 150 patients were recruited, of whom 73 were randomized to ultrasound. Among 77 controls referred to diagnostic imaging, 26 patients had PE confirmed. In the ultrasound group, 40 patients were referred to diagnostic imaging of whom 20 had PE, reducing referral for diagnostic imaging by 45.2% (95% CI: 34.3–56.6, p &lt; 0.0001). Three further PEs were diagnosed by presence of a DVT. During 3-month follow-up, the number of patients who did not receive anticoagulation but was diagnosed with PE was two (4%; 95% CI: 1.1–13.5) and none (0%; 95% CI: 0.0–7.0) in the ultrasound and control group, respectively.</p></div><div><h3>Interpretation</h3><p>Ultrasound substantially reduced referral to diagnostic imaging in suspected PE. Albeit with an unacceptable failure rate.</p></div><div><h3>Funding</h3><p><span>University of Southern Denmark</span>, <span>Odense University Hospital</span>, <span>Master Carpenter Sophus Jacobsen and wife’s foundation</span>, <span>Engineer K. A. Rhode and wife foundation</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266677622400108X/pdfft?md5=b18fd4a2a34a88c2e5c80dab2d185ba2&pid=1-s2.0-S266677622400108X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483429","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":"Quality of life in patients with statin intolerance: a multicentre prospective registry study","authors":"Paulina E. Stürzebecher ,&nbsp;Ioanna Gouni-Berthold ,&nbsp;Christina Mateev ,&nbsp;Ole Frenzel ,&nbsp;Stephan Erbe ,&nbsp;Jes-Niels Boeckel ,&nbsp;Markus Scholz ,&nbsp;Ulrike Schatz ,&nbsp;Oliver Weingärtner ,&nbsp;Ursula Kassner ,&nbsp;Ulrich Laufs","doi":"10.1016/j.lanepe.2024.100981","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.100981","url":null,"abstract":"<div><h3>Background</h3><p>Statin intolerance is associated with increased cardiovascular risk. Symptoms and patients’ characteristics are incompletely known. We aimed to analyse the health-related quality of life (QOL) associated with statin intolerance.</p></div><div><h3>Methods</h3><p>The Statin Intolerance Registry (SIR) is an observational, prospective, multicentre study that included 1111 patients, with intolerance to at least two different statins, between 2021 and 2023 in Germany. SIR baseline data were compared to individuals with and without statin therapy of the population-based LIFE-Adult Study (n = 9983).</p></div><div><h3>Findings</h3><p>The mean age in SIR was 66.1 years (standard deviation (SD) 9.9). The cohort was characterized by a higher proportion of women compared to patients on statins in LIFE-Adult (57.7% vs. 38.2%). SIR patients had impaired QOL (mean EQ VAS score of 64.9 (SD 18.1)) as measured by EuroQol (EQ-5D-5L)), which further deteriorated with age. Muscle symptoms were frequent (95.8%) and were associated with severe pain in 43.2% and intake of pain medication in 32.3% of statin intolerant patients. 10.3% had a diagnosis of depression. Women reported more pronounced symptoms than men. A data-driven k-means analysis, based on variables predicting severity of pain while on statin therapy, identified five clusters of SIR patients. The clusters differed in sex, prevalence of depression, QOL, comorbidities, and expectations to tolerate statin therapy.</p></div><div><h3>Interpretation</h3><p>Statin intolerance is associated with impaired QOL. Women are more frequently and severely affected. The identified clusters may help to identify patients at risk and to develop individualized strategies to improve patient trajectories and outcomes.</p></div><div><h3>Funding</h3><p><span>Leipzig University</span>, research grants from <span>Daiichi Sankyo, Novartis, and Amgen</span> to <span>Leipzig University</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001480/pdfft?md5=322f178c1993002151f3717742ab0b6c&pid=1-s2.0-S2666776224001480-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480559","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":"Personal light exposure patterns and incidence of type 2 diabetes: analysis of 13 million hours of light sensor data and 670,000 person-years of prospective observation","authors":"Daniel P. Windred ,&nbsp;Angus C. Burns ,&nbsp;Martin K. Rutter ,&nbsp;Chris Ho Ching Yeung ,&nbsp;Jacqueline M. Lane ,&nbsp;Qian Xiao ,&nbsp;Richa Saxena ,&nbsp;Sean W. Cain ,&nbsp;Andrew J.K. Phillips","doi":"10.1016/j.lanepe.2024.100943","DOIUrl":"10.1016/j.lanepe.2024.100943","url":null,"abstract":"<div><h3>Background</h3><p>Light at night disrupts circadian rhythms, and circadian disruption is a risk factor for type 2 diabetes. Whether personal light exposure predicts diabetes risk has not been demonstrated in a large prospective cohort. We therefore assessed whether personal light exposure patterns predicted risk of incident type 2 diabetes in UK Biobank participants, using ∼13 million hours of light sensor data.</p></div><div><h3>Methods</h3><p>Participants (N = 84,790, age (M ± SD) = 62.3 ± 7.9 years, 58% female) wore light sensors for one week, recording day and night light exposure. Circadian amplitude and phase were modeled from weekly light data. Incident type 2 diabetes was recorded (1997 cases; 7.9 ± 1.2 years follow-up; excluding diabetes cases prior to light-tracking). Risk of incident type 2 diabetes was assessed as a function of day and night light, circadian phase, and circadian amplitude, adjusting for age, sex, ethnicity, socioeconomic and lifestyle factors, and polygenic risk.</p></div><div><h3>Findings</h3><p>Compared to people with dark nights (0–50th percentiles), diabetes risk was incrementally higher across brighter night light exposure percentiles (50–70th: multivariable-adjusted HR = 1.29 [1.14–1.46]; 70–90th: 1.39 [1.24–1.57]; and 90–100th: 1.53 [1.32–1.77]). Diabetes risk was higher in people with lower modeled circadian amplitude (aHR = 1.07 [1.03–1.10] per SD), and with early or late circadian phase (aHR range: 1.06–1.26). Night light and polygenic risk independently predicted higher diabetes risk. The difference in diabetes risk between people with bright and dark nights was similar to the difference between people with low and moderate genetic risk.</p></div><div><h3>Interpretation</h3><p>Type 2 diabetes risk was higher in people exposed to brighter night light, and in people exposed to light patterns that may disrupt circadian rhythms. Avoidance of light at night could be a simple and cost-effective recommendation that mitigates risk of diabetes, even in those with high genetic risk.</p></div><div><h3>Funding</h3><p><span>Australian Government Research Training Program</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001108/pdfft?md5=5260c5c06580e719d3b58d4b127def7f&pid=1-s2.0-S2666776224001108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396759","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":"Smoking cessation in lung cancer screening: can a smartphone help?","authors":"Francesco Pistelli,&nbsp;Claudia Meschi,&nbsp;Laura Carrozzi","doi":"10.1016/j.lanepe.2024.100976","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.100976","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001431/pdfft?md5=8f658c39e7bfb2fc2d303a56db36698f&pid=1-s2.0-S2666776224001431-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141482037","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":"Corrigendum to “Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)” [The Lancet Regional Health – Europe 40 (2024) 100892]","authors":"Marianne Leruez-Ville ,&nbsp;Christos Chatzakis ,&nbsp;Daniele Lilleri ,&nbsp;Daniel Blazquez-Gamero ,&nbsp;Ana Alarcon ,&nbsp;Nicolas Bourgon ,&nbsp;Ina Foulon ,&nbsp;Jacques Fourgeaud ,&nbsp;Anna Gonce ,&nbsp;Christine E. Jones ,&nbsp;Paul Klapper ,&nbsp;André Krom ,&nbsp;Tiziana Lazzarotto ,&nbsp;Hermione Lyall ,&nbsp;Paulo Paixao ,&nbsp;Vassiliki Papaevangelou ,&nbsp;Elisabeth Puchhammer ,&nbsp;George Sourvinos ,&nbsp;Pamela Vallely ,&nbsp;Yves Ville ,&nbsp;Ann Vossen","doi":"10.1016/j.lanepe.2024.100974","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.100974","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001418/pdfft?md5=68ec857dec2b409a4b36eb6a2f04557a&pid=1-s2.0-S2666776224001418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483514","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}