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Journal Cover The Lancet
  [SJR: 14.638]   [H-I: 600]   [1871 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 0140-6736 - ISSN (Online) 1474-547X
   Published by Elsevier Homepage  [3039 journals]
  • Laryngeal mask airways in anaesthetised infants: a paradigm shift?
    • Authors: John Fiadjoe; Ronald Litman
      Pages: 673 - 674
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): John Fiadjoe, Ronald Litman


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30120-4
       
  • Clinical development of hepatitis C virus host-targeting agents
    • Authors: Mirjam B Zeisel; Thomas F Baumert
      Pages: 674 - 675
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Mirjam B Zeisel, Thomas F Baumert


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30043-0
       
  • Living close to heavy traffic roads, air pollution, and dementia
    • Authors: Lilian Calderón-Garcidueñas; Rodolfo Villarreal-Ríos
      Pages: 675 - 677
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Lilian Calderón-Garcidueñas, Rodolfo Villarreal-Ríos


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)32596-x
       
  • Sense and sensitivity: incompatible patients and their donors in kidney
           transplantation
    • Authors: Peter P Reese; Sumit Mohan
      Pages: 677 - 678
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Peter P Reese, Sumit Mohan


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)32053-0
       
  • Offline: Turning fear into resistance
    • Authors: Richard Horton
      First page: 683
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Richard Horton


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30399-9
       
  • New era for health in The Gambia?
    • Authors: Andrew Green
      First page: 684
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Andrew Green


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30395-1
       
  • India plans to expand access to new tuberculosis drug
    • Authors: Dinesh C Sharma
      First page: 685
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Dinesh C Sharma


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30394-x
       
  • Troubling times for health and human rights in Egypt
    • Authors: Sharmila Devi
      Pages: 686 - 687
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Sharmila Devi


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30393-8
       
  • Diffuse reflection
    • Authors: Stephen Ginn
      Pages: 688 - 689
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Stephen Ginn


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30346-x
       
  • The mesmerist will see you now
    • Authors: Wendy Moore
      Pages: 689 - 690
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Wendy Moore


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30347-1
       
  • The mathematics of life, death, and beauty
    • Authors: Andrew Robinson
      Pages: 690 - 691
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Andrew Robinson


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30348-3
       
  • Cynicism as a strategic virtue
    • Authors: Arthur Rose; Robbie Duschinsky; Jane Macnaughton
      Pages: 692 - 693
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Arthur Rose, Robbie Duschinsky, Jane Macnaughton


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30349-5
       
  • Hans Rosling
    • Authors: Geoff Watts
      First page: 694
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Geoff Watts


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30392-6
       
  • Early goal-directed mobilisation after surgery
    • Authors: Ayako Tada; Akihiko Ozaki; Katsuhisa Kuwano; Tomohiro Morita; Tetsuya Tanimoto
      First page: 695
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Ayako Tada, Akihiko Ozaki, Katsuhisa Kuwano, Tomohiro Morita, Tetsuya Tanimoto


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30335-5
       
  • Early goal-directed mobilisation after surgery – Authors' reply
    • Authors: Matthias Eikermann; Stefan J Schaller; George Kasotakis; Matthew Anstey; Timothy Houle
      Pages: 695 - 696
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Matthias Eikermann, Stefan J Schaller, George Kasotakis, Matthew Anstey, Timothy Houle


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30334-3
       
  • Setting maternal mortality targets for the SDGs
    • Authors: Amy Boldosser-Boesch; Michel Brun; Liliana Carvajal; Doris Chou; Luc de Bernis; Karen Fogg; Kathleen Hill; Rima Jolivet; Betsy McCallon; Allisyn Moran; Lale Say; Jeffrey Smith; Mary E Stanton; Petra ten Hoope-Bender; Mary N Wegner
      Pages: 696 - 697
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Amy Boldosser-Boesch, Michel Brun, Liliana Carvajal, Doris Chou, Luc de Bernis, Karen Fogg, Kathleen Hill, Rima Jolivet, Betsy McCallon, Allisyn Moran, Lale Say, Jeffrey Smith, Mary E Stanton, Petra ten Hoope-Bender, Mary N Wegner


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30337-9
       
  • Setting maternal mortality targets for the SDGs – Authors' reply
    • Authors: Nicholas J Kassebaum; Rafael Lozano; Stephen S Lim; Christopher J Murray
      Pages: 697 - 698
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Nicholas J Kassebaum, Rafael Lozano, Stephen S Lim, Christopher J Murray


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30339-2
       
  • Minimum obstetric volume in low-income countries
    • Authors: Manuela Straneo; Claudia Hanson; Piera Fogliati; Godfrey M Mbaruku
      First page: 698
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Manuela Straneo, Claudia Hanson, Piera Fogliati, Godfrey M Mbaruku


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30342-2
       
  • Progress and challenges to introduce midwifery education in Nepal
    • Authors: Sophie Goyet; Laxmi Tamang; Valerie Broch Alvarez; Ishwori Devi Shrestha; Kiran Bajracharya
      Pages: 698 - 699
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Sophie Goyet, Laxmi Tamang, Valerie Broch Alvarez, Ishwori Devi Shrestha, Kiran Bajracharya


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30341-0
       
  • Funding agency mechanisms to increase sex and gender analysis
    • Authors: Annie Duchesne; Cara Tannenbaum; Gillian Einstein
      First page: 699
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Annie Duchesne, Cara Tannenbaum, Gillian Einstein


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30343-4
       
  • A declaration to the UN on wars in the Middle East
    • Authors: Frederick M Burkle; Timothy B Erickson; Johan von Schreeb; Anthony D Redmond; Stephanie Kayden; Michael Van Rooyen
      Pages: 699 - 700
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Frederick M Burkle, Timothy B Erickson, Johan von Schreeb, Anthony D Redmond, Stephanie Kayden, Michael Van Rooyen


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30338-0
       
  • Green space is important for health
    • Authors: Mark Nieuwenhuijsen; Haneen Khreis
      First page: 700
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Mark Nieuwenhuijsen, Haneen Khreis


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30340-9
       
  • The effect of endotracheal tubes versus laryngeal mask airways on
           perioperative respiratory adverse events in infants: a randomised
           controlled trial
    • Authors: Thomas F E Drake-Brockman; Anoop Ramgolam; Guicheng Zhang; Graham L Hall; Britta S von Ungern-Sternberg
      Pages: 701 - 708
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
      Background Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. Methods We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0–12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery. We excluded patients contraindicated for LMA or endotracheal tube; who had known cardiac disease or airway or thoracic malformations; who were receiving midazolam premedication; who were undergoing airway, thoracic, or abdomen surgery at the time of participation; and if the parents did not speak English. Written parental or guardian consent was obtained before enrolment. Participants were randomly assigned (1:1), by computer-generated variable block randomisation, to receive an LMA (PRO-Breathe, Well Lead Medical Co Ltd, Panyu, China) or an endotracheal tube (Microcuff, Halyard Health Inc, Atlanta, GA, USA). Sealed randomisation envelopes were used to conceal device assignment. An interim analysis was planned once half the number of infants needed (145) had been recruited. The primary outcome was incidence of PRAE, assessed in the intention-to-treat population. The institutional ethics committee at the Princess Margaret Hospital for Children granted ethical approval (1786/EP). The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12610000250033). Findings The trial began on July 8, 2010, and was ended early on May 7, 2015, after the interim analysis results met the study stopping rules. During this time, 239 infants were assessed and 181 eligible infants were randomly assigned to receive an LMA (n=85) or an endotracheal tube (n=95). Four infants were not included in the analysis (two due to cancelled procedures, one did not meet inclusion criteria, and one with missing dataset). In the intention-to-treat analysis, PRAE occurred in 50 (53%) infants in the endotracheal tube group and in 15 (18%) infants in the LMA group (risk ratio [RR] 2·94, 95% CI 1·79–4·83, p<0·0001). Laryngospasm and bronchospasm (major PRAE) were recorded in 18 (19%) infants in the endotracheal tube group and in three (4%) infants in the LMA group (RR 5·30, 95% CI 1·62–17·35, p=0·002). No deaths were reported. Interpretation In infants undergoing minor elective procedures, LMAs were associated with clinically significantly fewer PRAE and lower occurrence of major PRAE (laryngospasm and bronchospasm) than endotracheal tubes. This difference should be a consideration in airway device selection. Funding Princess Margaret Hospital Foundation, National Health and Australian Medical Research Council, Stan Perron Charitable Trust, and Callahan Estate.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)31719-6
       
  • Safety, tolerability, and antiviral effect of RG-101 in patients with
           chronic hepatitis C: a phase 1B, double-blind, randomised controlled trial
           
    • Authors: Meike H van der Ree; J Marleen de Vree; Femke Stelma; Sophie Willemse; Marc van der Valk; Svend Rietdijk; Richard Molenkamp; Janke Schinkel; Ad C van Nuenen; Ulrich Beuers; Salah Hadi; Marten Harbers; Eva van der Veer; Kai Liu; John Grundy; Amy K Patick; Adam Pavlicek; Jacqueline Blem; Michael Huang; Paul Grint; Steven Neben; Neil W Gibson; Neeltje A Kootstra; Hendrik W Reesink
      Pages: 709 - 717
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Meike H van der Ree, J Marleen de Vree, Femke Stelma, Sophie Willemse, Marc van der Valk, Svend Rietdijk, Richard Molenkamp, Janke Schinkel, Ad C van Nuenen, Ulrich Beuers, Salah Hadi, Marten Harbers, Eva van der Veer, Kai Liu, John Grundy, Amy K Patick, Adam Pavlicek, Jacqueline Blem, Michael Huang, Paul Grint, Steven Neben, Neil W Gibson, Neeltje A Kootstra, Hendrik W Reesink
      Background miR-122 is an important host factor for hepatitis C virus (HCV) replication. The aim of this study was to assess the safety and tolerability, pharmacokinetics, and antiviral effect of a single dose of RG-101, a hepatocyte targeted N-acetylgalactosamine conjugated oligonucleotide that antagonises miR-122, in patients with chronic HCV infection with various genotypes. Methods In this randomised, double-blind, placebo-controlled, multicentre, phase 1B study, patients were randomly assigned to RG-101 or placebo (7:1). We enrolled men and postmenopausal or hysterectomised women (aged 18–65 years) with chronic HCV genotype 1, 3, or 4 infection diagnosed at least 24 weeks before screening who were either treatment naive to or relapsed after interferon-α based therapy. Patients with co-infection (hepatitis B virus or HIV infection), evidence of decompensated liver disease, or a history of hepatocellular carcinoma were excluded. Randomisation was done by an independent, unblinded, statistician using the SAS procedure Proc Plan. The first cohort received one subcutaneous injection of 2 mg/kg RG-101 or placebo; the second cohort received one subcutaneous injection of 4 mg/kg or placebo. Patients were followed up for 8 weeks (all patients) and up to 76 weeks (patients with no viral rebound and excluding those who were randomised to the placebo group) after randomisation. The primary objective was safety and tolerability of RG-101. This trial was registered with EudraCT, number 2013-002978-49. Findings Between June 4, 2014, and Oct 27, 2014, we enrolled 32 patients with chronic HCV genotype 1 (n=16), 3 (n=10), or 4 (n=6) infections. In the first cohort, 14 patients were randomly assigned to receive 2 mg/kg RG-101 and two patients were randomly assigned to receive placebo, and in the second cohort, 14 patients were randomly assigned to receive 4 mg/kg RG-101 and two patients were randomly assigned to receive placebo. Overall, 26 of the 28 patients dosed with RG-101 reported at least one treatment-related adverse event. At week 4, the median viral load reduction from baseline was 4·42 (IQR 3·23–5·00) and 5·07 (4·19–5·35) log10 IU/mL in patients dosed with 2 mg/kg RG-101 or 4 mg/kg RG-101. Three patients had undetectable HCV RNA levels 76 weeks after a single dose of RG-101. Viral rebound at or before week 12 was associated with the appearance of resistance associated substitutions in miR-122 binding regions in the 5′ UTR of the HCV genome. Interpretation This study showed that one administration of 2 mg/kg or 4 mg/kg RG-101, a hepatocyte targeted N-acetylgalactosamine conjugated anti-miR-122 oligonucleotide, was well tolerated and resulted in substantial viral load reduction in all treated patients within 4 weeks, and sustained virological response in three patients for 76 weeks. Funding Regulus Therapeutics, Inc.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)31715-9
       
  • Living near major roads and the incidence of dementia, Parkinson's
           disease, and multiple sclerosis: a population-based cohort study
    • Authors: Hong Chen; Jeffrey C Kwong; Ray Copes; Karen Tu; Paul J Villeneuve; Aaron van Donkelaar; Perry Hystad; Randall V Martin; Brian J Murray; Barry Jessiman; Andrew S Wilton; Alexander Kopp; Richard T Burnett
      Pages: 718 - 726
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Hong Chen, Jeffrey C Kwong, Ray Copes, Karen Tu, Paul J Villeneuve, Aaron van Donkelaar, Perry Hystad, Randall V Martin, Brian J Murray, Barry Jessiman, Andrew S Wilton, Alexander Kopp, Richard T Burnett
      Background Emerging evidence suggests that living near major roads might adversely affect cognition. However, little is known about its relationship with the incidence of dementia, Parkinson's disease, and multiple sclerosis. We aimed to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada. Methods In this population-based cohort study, we assembled two population-based cohorts including all adults aged 20–50 years (about 4·4 million; multiple sclerosis cohort) and all adults aged 55–85 years (about 2·2 million; dementia or Parkinson's disease cohort) who resided in Ontario, Canada on April 1, 2001. Eligible patients were free of these neurological diseases, Ontario residents for 5 years or longer, and Canadian-born. We ascertained the individual's proximity to major roadways based on their residential postal-code address in 1996, 5 years before cohort inception. Incident diagnoses of dementia, Parkinson's disease, and multiple sclerosis were ascertained from provincial health administrative databases with validated algorithms. We assessed the associations between traffic proximity and incident dementia, Parkinson's disease, and multiple sclerosis using Cox proportional hazards models, adjusting for individual and contextual factors such as diabetes, brain injury, and neighbourhood income. We did various sensitivity analyses, such as adjusting for access to neurologists and exposure to selected air pollutants, and restricting to never movers and urban dwellers. Findings Between 2001, and 2012, we identified 243 611 incident cases of dementia, 31 577 cases of Parkinson's disease, and 9247 cases of multiple sclerosis. The adjusted hazard ratio (HR) of incident dementia was 1·07 for people living less than 50 m from a major traffic road (95% CI 1·06–1·08), 1·04 (1·02–1·05) for 50–100 m, 1·02 (1·01–1·03) for 101–200 m, and 1·00 (0·99–1·01) for 201–300 m versus further than 300 m (p for trend=0·0349). The associations were robust to sensitivity analyses and seemed stronger among urban residents, especially those who lived in major cities (HR 1·12, 95% CI 1·10–1·14 for people living <50 m from a major traffic road), and who never moved (1·12, 1·10–1·14 for people living <50 m from a major traffic road). No association was found with Parkinson's disease or multiple sclerosis. Interpretation In this large population-based cohort, living close to heavy traffic was associated with a higher incidence of dementia, but not with Parkinson's disease or multiple sclerosis. Funding Health Canada (MOA-4500314182).

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)32399-6
       
  • Post-listing survival for highly sensitised patients on the UK kidney
           transplant waiting list: a matched cohort analysis
    • Authors: Miriam Manook; Leonardo Koeser; Zubir Ahmed; Matthew Robb; Rachel Johnson; Olivia Shaw; Nicos Kessaris; Anthony Dorling; Nizam Mamode
      Pages: 727 - 734
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Miriam Manook, Leonardo Koeser, Zubir Ahmed, Matthew Robb, Rachel Johnson, Olivia Shaw, Nicos Kessaris, Anthony Dorling, Nizam Mamode
      Background More than 40% of patients awaiting a kidney transplant in the UK are sensitised with human leucocyte antigen (HLA) antibodies. Median time to transplantation for such patients is double that of unsensitised patients at about 74 months. Removing antibody to perform an HLA-incompatible (HLAi) living donor transplantation is perceived to be high risk, although patient survival data are limited. We compared survival of patients opting for an HLAi kidney transplant with that of similarly sensitised patients awaiting a compatible organ. Methods From the UK adult kidney transplant waiting list, we selected crossmatch positive living donor HLAi kidney transplant recipients who received their transplant between Jan 1, 2007, and Dec 31, 2013, and were followed up to Dec 31, 2014 (end of study). These patients were matched in a 1:4 ratio with similarly sensitised patients cases listed for a deceased-donor transplant during that period. Data were censored both at the time of transplantation (listed only), and at the end of the study period (listed or transplant). We used Kaplan-Meier curves to compare patient survival between HLAi and the matched cohort. Findings Of 25 518 patient listings, 213 (1%) underwent HLAi transplantation during the study period. 852 matched controls were identified, of whom 41% (95% CI 32–50) remained without a transplant at 58 months after matching. We noted no difference in survival between patients who were in the HLAi group compared with the listed only group (log rank p=0·446), or listed or transplant group (log rank p=0·984). Interpretation Survival of sensitised patients undergoing HLAi in the UK is comparable with those on dialysis awaiting a compatible organ, many of whom are unlikely to be have a transplant. Choosing a direct HLAi transplant has no detrimental effect on survival, but offers no survival benefit, by contrast with similar patients studied in a North American multicentre cohort. Funding UK National Health Service Blood & Transplant and Guy's & St Thomas' National Institute for Health Research Biomedical Research Centre.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)31595-1
       
  • Spontaneous bacterial peritonitis
    • Authors: Burcin Ekser; Richard S Mangus
      First page: 735
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Burcin Ekser, Richard S Mangus


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)30782-6
       
  • Non-specific low back pain
    • Authors: Chris Maher; Martin Underwood; Rachelle Buchbinder
      Pages: 736 - 747
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Chris Maher, Martin Underwood, Rachelle Buchbinder
      Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)30970-9
       
  • What will Donald Trump's presidency mean for health? A scorecard
    • Authors: Martin McKee; Scott L Greer; David Stuckler
      Pages: 748 - 754
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Martin McKee, Scott L Greer, David Stuckler
      US Presidents make their mark on health, for better or worse. Donald Trump campaigned on a populist platform to “make America great again”. While the actual policies his administration will pursue—and the priority he will place on each of them—remain in many ways uncertain, both his statements and his nominations for key government posts suggest that his presidency could have profound implications for health. His proposal to repeal and replace the Affordable Care Act with a “better reform”, his stance on reproductive rights, and his approaches to other areas, such as science policy and climate change, coupled with his stated intention to put “America first” are creating anxiety and uncertainty about America's domestic health policies and its global leadership role in areas such as security and development. We propose criteria on which the global health community can judge the success or failure of a Trump presidency, based on a selection of the 17 Sustainable Development Goals that apply to health.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30122-8
       
  • Reimagining WHO: leadership and action for a new Director-General
    • Authors: Lawrence O Gostin; Eric A Friedman
      Pages: 755 - 759
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Lawrence O Gostin, Eric A Friedman
      Three candidates to be the next WHO Director-General remain: Tedros Adhanom Ghebreyesus, David Nabarro, and Sania Nishtar. The World Health Assembly's ultimate choice will lead an organisation facing daunting internal and external challenges, from its own funding shortfalls to antimicrobial resistance and immense health inequities. The new Director-General must transform WHO into a 21st century institution guided by the right to health. Topping the incoming Director-General's agenda will be a host of growing threats—risks to global health security, antimicrobial resistance, non-communicable diseases, and climate change—but also the transformative potential of the Sustainable Development Goals, including their universal health coverage target. Throughout, the next Director-General should emphasise equality, including through national health equity strategies and, more boldly still, advancing the Framework Convention on Global Health. Success in these areas will require a reinvigorated WHO, with sustainable financing, greater multisector engagement, enhanced accountability and transparency, and strengthened normative leadership. WHO must also evolve its governance to become far more welcoming of civil society and communities. To create the foundation for these transformative changes, the Director-General will need to focus first on gaining political support. This entails improving accountability and transparency to gain member state trust, and enabling meaningful civil society participation in WHO's governance and standing up for the right to health to gain civil society support. Ultimately, in the face of a global environment marked by heightened nationalism and xenophobia, member states must empower the next Director-General to enable WHO to be a bulwark for health and human rights, serving as an inspiring contra-example to today's destructive politics, demonstrating that the community of nations are indeed stronger together.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30203-9
       
  • Political origins of health inequities: trade and investment agreements
    • Authors: Desmond McNeill; Carolyn Deere Birkbeck; Sakiko Fukuda-Parr; Anand Grover; Ted Schrecker; David Stuckler
      Pages: 760 - 762
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Desmond McNeill, Carolyn Deere Birkbeck, Sakiko Fukuda-Parr, Anand Grover, Ted Schrecker, David Stuckler


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)31013-3
       
  • Optimal duration of trastuzumab for early HER2-positive breast cancer
    • Authors: Jennifer M Specht; Nancy E Davidson
      Abstract: Publication date: Available online 20 February 2017
      Source:The Lancet
      Author(s): Jennifer M Specht, Nancy E Davidson


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30322-7
       
  • Safeguarding the future of human gene editing
    • Authors: Lancet
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): The Lancet


      PubDate: 2017-02-20T17:07:35Z
       
  • Organic food: panacea for health?
    • Authors: Lancet
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): The Lancet


      PubDate: 2017-02-20T17:07:35Z
       
  • Yemen's silent killers
    • Authors: Lancet
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): The Lancet


      PubDate: 2017-02-20T17:07:35Z
       
  • Early goal-directed mobilisation after surgery
    • Authors: Guohui
      Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070
      Author(s): Guohui Li


      PubDate: 2017-02-20T17:07:35Z
       
  • Department of Error
    • Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070


      PubDate: 2017-02-20T17:07:35Z
       
  • Department of Error
    • Abstract: Publication date: 18–24 February 2017
      Source:The Lancet, Volume 389, Issue 10070


      PubDate: 2017-02-20T17:07:35Z
       
  • 11 years' follow-up of trastuzumab after adjuvant chemotherapy in
           HER2-positive early breast cancer: final analysis of the HERceptin
           Adjuvant (HERA) trial
    • Authors: David Cameron; Martine J Piccart-Gebhart; Richard D Gelber; Marion Procter; Aron Goldhirsch; Evandro de Azambuja; Gilberto Castro; Michael Untch; Ian Smith; Luca Gianni; Jose Baselga; Nedal Al-Sakaff; Sabine Lauer; Eleanor McFadden; Brian Leyland-Jones; Richard Bell; Mitch Dowsett; Christian Jackisch
      Abstract: Publication date: Available online 17 February 2017
      Source:The Lancet
      Author(s): David Cameron, Martine J Piccart-Gebhart, Richard D Gelber, Marion Procter, Aron Goldhirsch, Evandro de Azambuja, Gilberto Castro, Michael Untch, Ian Smith, Luca Gianni, Jose Baselga, Nedal Al-Sakaff, Sabine Lauer, Eleanor McFadden, Brian Leyland-Jones, Richard Bell, Mitch Dowsett, Christian Jackisch
      Background Clinical trials have shown that trastuzumab, a recombinant monoclonal antibody against HER2 receptor, significantly improves overall survival and disease-free survival in women with HER2-positive early breast cancer, but long-term follow-up data are needed. We report the results of comparing observation with two durations of trastuzumab treatment at a median follow-up of 11 years, for patients enrolled in the HERA (HERceptin Adjuvant) trial. Methods HERA (BIG 1-01) is an international, multicentre, open-label, phase 3 randomised trial of 5102 women with HER2-positive early breast cancer, who were enrolled from hospitals in 39 countries between Dec 7, 2001, and June 20, 2005. After completion of all primary therapy (including, surgery, chemotherapy, and radiotherapy as indicated), patients were randomly assigned (1:1:1) to receive trastuzumab for 1 year (once at 8 mg/kg of bodyweight intravenously, then 6 mg/kg once every 3 weeks) or for 2 years (with the same dose schedule), or to the observation group. Primary endpoint is disease-free survival, and analyses are in the intention-to-treat population. Hazard ratios (HRs) were estimated from Cox models, and survival curves were estimated by the Kaplan-Meier method. Comparison of 2 years versus 1 year of trastuzumab is based on 366-day landmark analyses. This study is registered with ClinicalTrials.gov (NCT00045032). Findings Of the 5102 women randomly assigned in the HERA trial, three patients had no evidence of having provided written informed consent to participate. We followed up the intention-to-treat population of 5099 patients (1697 in observation, 1702 in 1-year trastuzumab, and 1700 in 2-years trastuzumab groups). After a median follow-up of 11 years (IQR 10·09–11·53), random assignment to 1 year of trastuzumab significantly reduced the risk of a disease-free survival event (HR 0·76, 95% CI 0·68–0·86) and death (0·74, 0·64–0·86) compared with observation. 2 years of adjuvant trastuzumab did not improve disease free-survival outcomes compared with 1 year of this drug (HR 1·02, 95% CI 0·89–1·17). Estimates of 10-year disease-free survival were 63% for observation, 69% for 1 year of trastuzumab, and 69% for 2 years of trastuzumab. 884 (52%) patients assigned to the observation group selectively crossed over to receive trastuzumab. Cardiac toxicity remained low in all groups and occurred mostly during the treatment phase. The incidence of secondary cardiac endpoints was 122 (7·3%) in the 2-years trastuzumab group, 74 (4·4%) in the 1-year trastuzumab group, and 15 (0·9%) in the observation group. Interpretation 1 year of adjuvant trastuzumab after chemotherapy for patients with HER2-positive early breast cancer significantly improves long-term disease-free survival, compared with observation. 2 years of trastuzumab had no additional benefit. Funding F Hoffmann-La Roche (Roche).

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)32616-2
       
  • Generalised nodules in pemphigoid nodularis
    • Authors: Weigang Zhang; Yu Liu; Chunying Li
      Abstract: Publication date: Available online 17 February 2017
      Source:The Lancet
      Author(s): Weigang Zhang, Yu Liu, Chunying Li


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30064-8
       
  • Progress in evidence-based medicine: a quarter century on
    • Authors: Benjamin Djulbegovic; Gordon H Guyatt
      Abstract: Publication date: Available online 17 February 2017
      Source:The Lancet
      Author(s): Benjamin Djulbegovic, Gordon H Guyatt
      In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making. In another progress, EBM incorporated and further developed the science of producing trustworthy clinical practice guidelines pioneered by investigators in the 1980s. EBM's enduring contributions to clinical medicine include placing the practice of medicine on a solid scientific basis, the development of more sophisticated hierarchies of evidence, the recognition of the crucial role of patient values and preferences in clinical decision making, and the development of the methodology for generating trustworthy recommendations.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)31592-6
       
  • Department of Error
    • Abstract: Publication date: Available online 17 February 2017
      Source:The Lancet


      PubDate: 2017-02-20T17:07:35Z
       
  • Is screening for the psychological effects of war useful?
    • Authors: Alexander C McFarlane
      Abstract: Publication date: Available online 17 February 2017
      Source:The Lancet
      Author(s): Alexander C McFarlane


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30073-9
       
  • Post-deployment screening for mental disorders and tailored advice about
           help-seeking in the UK military: a cluster randomised controlled trial
    • Authors: Roberto J Rona; Howard Burdett; Mizanur Khondoker; Melanie Chesnokov; Kevin Green; David Pernet; Norman Jones; Neil Greenberg; Simon Wessely; Nicola T Fear
      Abstract: Publication date: Available online 17 February 2017
      Source:The Lancet
      Author(s): Roberto J Rona, Howard Burdett, Mizanur Khondoker, Melanie Chesnokov, Kevin Green, David Pernet, Norman Jones, Neil Greenberg, Simon Wessely, Nicola T Fear
      Background The effectiveness of post-deployment screening for mental disorders has not been assessed in a randomised controlled trial. We aimed to assess whether post-deployment screening for post-traumatic stress disorder (PTSD), depression, anxiety, or alcohol misuse was effective. We defined screening as the presumptive identification of a previously unrecognised disorder using tests to distinguish those who probably had the disorder from those who probably did not so that those people with a probable disorder could be referred appropriately, and assessed effectiveness and consequences for help-seeking by the odds ratio at follow-up between those receiving tailored help-seeking advice and those who received general mental health advice. Methods We did a cluster randomised controlled trial among Royal Marines and Army personnel in the UK military after deployment to Afghanistan. Platoons were randomly assigned (1:1 initially, then 2:1) by stratified block randomisation with randomly varying block sizes of two and four to the screening group, which received tailored help-seeking advice, or the control group, which received general mental health advice. Initial assessment took place 6–12 weeks after deployment; follow-up assessments were done 10–24 months later. Follow-up measures were the PTSD Checklist–Civilian Version, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 scale, Alcohol Use Disorder Identification Test (AUDIT), and self-reported help-seeking from clinical and welfare providers comparing those receiving tailored advice and those receiving only general advice. All participants and all investigators other than the person who analysed the data were masked to allocation. The primary outcomes were PTSD, depression or generalised anxiety disorder, and alcohol misuse at follow-up. A key secondary outcome was assessment of whether post-deployment screening followed by tailored advice would modify help-seeking behaviour. Comparisons were made between screening and control groups, with primary analyses by intention to treat. This trial is registered with the ISRCTN Registry, number ISRCTN19965528. Findings Between Oct 24, 2011, and Oct 31, 2014, 434 platoons comprising 10 190 personnel were included: 274 (6350 personnel) in the screening group and 160 (3840 personnel) in the control group. 5577 (88%) of 6350 personnel received screening and 3996 (63%) completed follow-up, whereas 3149 (82%) of 3840 received the control questionnaire and 2369 (62%) completed follow-up. 1958 (35%) of 5577 personnel in the screening group declined to see the tailored advice, but those with PTSD (83%) or anxiety or depression (84%) were more likely than non-cases (64%) to view the advice (both p<0·0001). At follow-up, there were no significant differences in prevalence between groups for PTSD (adjusted odds ratio 0·92, 95% CI 0·75–1·14), depression or anxiety (0·91, 0·71–1·16), alcohol misuse (0·88, 0·73–1·06), or seeking support for mental disorders (0·92, 0·78–1·08). Interpretation Post-deployment screening for mental disorders based on tailored advice was not effective at reducing prevalence of mental health disorders nor did it increase help-seeking. Countries that have implemented post-deployment screening programmes for mental disorders should consider monitoring the outcomes of their programmes. Funding The US Congressionally Directed Medical Research Programs.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)32398-4
       
  • Interleukin-6 inhibition for rheumatoid arthritis
    • Authors: Roy Fleischmann
      Abstract: Publication date: Available online 16 February 2017
      Source:The Lancet
      Author(s): Roy Fleischmann


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30405-1
       
  • Efficacy and safety of sirukumab in patients with active rheumatoid
           arthritis refractory to anti-TNF therapy (SIRROUND-T): a randomised,
           double-blind, placebo-controlled, parallel-group, multinational, phase 3
           study
    • Authors: Daniel Aletaha; Clifton O Bingham; Yoshiya Tanaka; Prasheen Agarwal; Regina Kurrasch; Paul P Tak; Sharon Popik
      Abstract: Publication date: Available online 16 February 2017
      Source:The Lancet
      Author(s): Daniel Aletaha, Clifton O Bingham, Yoshiya Tanaka, Prasheen Agarwal, Regina Kurrasch, Paul P Tak, Sharon Popik
      Background Sirukumab, a human monoclonal antibody that selectively binds to the interleukin-6 cytokine with high affinity, is under development for the treatment of rheumatoid arthritis and other diseases. We aimed to assess the efficacy and safety of sirukumab for rheumatoid arthritis in a phase 3 study (SIRROUND-T). Methods We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre study at 183 hospitals and private rheumatology clinics in 20 countries (Argentina, Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, Lithuania, Mexico, Netherlands, Poland, Portugal, Russia, South Korea, Spain, Taiwan, UK, and USA). Eligible participants were patients with active rheumatoid arthritis aged at least 18 years, with four or more of 68 tender joints and four or more of 66 swollen joints, who were refractory or intolerant to previous treatment with at least one anti-TNF drug. We randomly assigned patients (1:1:1) via a central interactive voice or web response system to either placebo every 2 weeks, 50 mg sirukumab every 4 weeks, or 100 mg sirukumab every 2 weeks, all given for 52 weeks or less. We allowed participants to continue using any concomitant disease-modifying antirheumatic drugs (DMARDs). We based the randomisation on a computer-generated, permuted-block schedule stratified by use of methotrexate at baseline (0, >0 to <12·5 mg/week, or ≥12·5 mg/week). Masking was achieved with the use of multipart labels on the study drug containers which contained directions for use and other information, but not the drug's identity. Treatments were administered by subcutaneous injection; patients assigned to 50 mg sirukumab given every 4 weeks also received a placebo injection every 2 weeks to maintain masking. At week 18, placebo-treated patients meeting early escape criteria (<20% improvement in swollen and tender joint counts) were randomly reassigned to either 50 mg or 100 mg of sirukumab. All remaining placebo-treated patients were subsequently randomly reassigned at week 24 to either sirukumab dose (crossover). The primary outcome was the proportion of patients who achieved a response of at least 20% improvement at week 16 according to American College of Rheumatology criteria (ACR20) in the intention-to-treat population (all randomly assigned participants). Safety analyses included all participants who received at least one dose (partial or complete) of study drug. This study is registered at EudraCT (number: 2010-022243-38) and ClinicalTrials.gov (number: NCT01606761). Findings Between July 25, 2012, and Jan 12, 2016, we randomly assigned 878 patients to treatment: 294 to placebo, 292 to 50 mg sirukumab every 4 weeks, and 292 to 100 mg sirukumab every 2 weeks. 523 (60%) of 878 patients had previously received two or more biological treatments including non-TNF drugs, and 166 (19%) of 878 were not taking a DMARD at baseline. The proportions of patients who achieved an ACR20 response at week 16 were 117 (40%) of 292 with 50 mg sirukumab every 4 weeks, and 132 (45%) of 292 with 100 mg sirukumab every 2 weeks versus 71 (24%) of 294 with placebo; differences compared with placebo were 0·16 (95% CI 0·09–0·23) for 50 mg sirukumab every 4 weeks and 0·21 (0·14–0·29) for 100 mg sirukumab every 2 weeks (both p<0·0001). Adverse event incidences in the 24-week placebo-controlled period were similar across groups (at least one event occurred for 182 patients assigned to placebo [62%, including early escape patients switched to sirukumab at week 18] of 294; 194 [66%] of 292 with 50 mg sirukumab every 4 weeks; and 207 [71%] of 292 with 100 mg sirukumab every 2 weeks). The most common adverse events in this period were injection-site erythema (four [1%] with placebo, 22 [8%] with 50 mg sirukumab every 4 weeks, and 41 [14%] with 100 mg sirukumab every 2 weeks). At week 52, of all patients receiving sirukumab including those reassigned from placebo, the most common adverse events were again injection-site erythema (33 [8%] of 416 with 50 mg sirukumab every 4 weeks and 66 [16%] of 418 with 100 mg sirukumab every 2 weeks). Interpretation In patients with active rheumatoid arthritis who were refractory or intolerant to anti-TNF drugs and other biological treatments, both dosing regimens of sirukumab were well tolerated and significantly improved signs and symptoms of the disease, compared wit...
      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30401-4
       
  • Educating religious leaders to promote uptake of male circumcision in
           Tanzania: a cluster randomised trial
    • Authors: Jennifer A Downs; Agrey H Mwakisole; Alphonce B Chandika; Shibide Lugoba; Rehema Kassim; Evarist Laizer; Kinanga A Magambo; Myung Hee Lee; Samuel E Kalluvya; David J Downs; Daniel W Fitzgerald
      Abstract: Publication date: Available online 15 February 2017
      Source:The Lancet
      Author(s): Jennifer A Downs, Agrey H Mwakisole, Alphonce B Chandika, Shibide Lugoba, Rehema Kassim, Evarist Laizer, Kinanga A Magambo, Myung Hee Lee, Samuel E Kalluvya, David J Downs, Daniel W Fitzgerald
      Background Male circumcision is being widely deployed as an HIV prevention strategy in countries with high HIV incidence, but its uptake in sub-Saharan Africa has been below targets. We did a study to establish whether educating religious leaders about male circumcision would increase uptake in their village. Methods In this cluster randomised trial in northwest Tanzania, eligible villages were paired by proximity (<60 km) and the time that a free male circumcision outreach campaign from the Tanzanian Ministry of Health became available in their village. All villages received the standard male circumcision outreach activities provided by the Ministry of Health. Within the village pairs, villages were randomly assigned by coin toss to receive either additional education for Christian church leaders on scientific, religious, and cultural aspects of male circumcision (intervention group), or standard outreach only (control group). Church leaders or their congregations were not masked to random assignment. The educational intervention consisted of a 1-day seminar co-taught by a Tanzanian pastor and a Tanzanian clinician who worked with the Ministry of Health, and meetings with the study team every 2 weeks thereafter, for the duration of the circumcision campaign. The primary outcome was the proportion of male individuals in a village who were circumcised during the campaign, using an intention-to-treat analysis that included all men in the village. This trial is registered with ClinicalTrials.gov, number NCT 02167776. Findings Between June 15, 2014, and Dec 10, 2015, we provided education for church leaders in eight intervention villages and compared the outcomes with those in eight control villages. In the intervention villages, 52·8% (30 889 of 58 536) of men were circumcised compared with 29·5% (25 484 of 86 492) of men in the eight control villages (odds ratio 3·2 [95% CI, 1·4–7·3]; p=0·006). Interpretation Education of religious leaders had a substantial effect on uptake of male circumcision, and should be considered as part of male circumcision programmes in other sub-Saharan African countries. This study was conducted in one region in Tanzania; however, we believe that our intervention is generalisable. We equipped church leaders with knowledge and tools, and ultimately each leader established the most culturally-appropriate way to promote male circumcision. Therefore, we think that the process of working through religious leaders can serve as an innovative model to promote healthy behaviour, leading to HIV prevention and other clinically relevant outcomes, in a variety of settings. Funding Bill & Melinda Gates Foundation, National Institutes of Health, and the Mulago Foundation.

      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(16)32055-4
       
  • Educating religious leaders to create demand for medical male circumcision
    • Authors: Nelson K Sewankambo; David K Mafigiri
      Abstract: Publication date: Available online 15 February 2017
      Source:The Lancet
      Author(s): Nelson K Sewankambo, David K Mafigiri


      PubDate: 2017-02-20T17:07:35Z
      DOI: 10.1016/s0140-6736(17)30318-5
       
  • The academic case for repealing Trump's refugee and travel ban
    • Authors: Paul Spiegel; Leonard Rubenstein
      Abstract: Publication date: Available online 9 February 2017
      Source:The Lancet
      Author(s): Paul Spiegel, Leonard Rubenstein


      PubDate: 2017-02-13T11:45:54Z
      DOI: 10.1016/s0140-6736(17)30332-x
       
  • Accounting for the future of health in India
    • Authors: Aarathi Prasad; Monica Lakhanpaul; Surina Narula; Vikram Patel; Peter Piot; Sridhar Venkatapuram
      Abstract: Publication date: Available online 8 February 2017
      Source:The Lancet
      Author(s): Aarathi Prasad, Monica Lakhanpaul, Surina Narula, Vikram Patel, Peter Piot, Sridhar Venkatapuram


      PubDate: 2017-02-13T11:45:54Z
      DOI: 10.1016/s0140-6736(17)30324-0
       
 
 
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