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[Department of Error] Department of Error

Sáb, 07/04/2018 - 00:00
Khanna D, Denton CP, Angelika Jahreis A, et al. Safety and efficacy of subcutaneous tocilizumab in adults with systemic sclerosis (faSScinate): a phase 2, randomised, controlled trial. Lancet 2016; 387: 2630–40—In table 3 of this Article (published online first on May 5, 2016), the p value (placebo vs tocilizumab) for a decrease of 4·7 units or more at 48 weeks should have been 0·25. The interpretation of these data remains unchanged. This correction has been made online as of April 5, 2018.

[Editorial] Dementia in the UK: preparing the NHS for new treatments

Sáb, 31/03/2018 - 00:00
Dementia is a devastating disease that brings fear, confusion, and loneliness to the lives of patients and their families. Today, around 850?000 people in the UK are living with dementia, costing the National Health Service (NHS) and UK society more than £26 million annually. By 2025, it is estimated that over 1 million people in the UK will be affected, with the prevalence and costs of care for these patients expected to double by 2050. These are worrisome figures given the absence of any safe, clinically effective, disease-modifying therapy for Alzheimer's disease or other forms of dementia.

[Editorial] Good news for the world's newest nation

Sáb, 31/03/2018 - 00:00
Despite South Sudan's crippling civil war, the country has interrupted the transmission of Guinea worm disease, announced the Carter Center on March 21. This disease is now on the edge of eradication, with only six countries reporting low rates of infection.

[Editorial] Cybersecurity and patient protection

Sáb, 31/03/2018 - 00:00
Network-connected devices and data are vulnerable to attack, exploitation, and unintended loss. The alleged harvesting of profiles from 50 million people by Cambridge Analytica through friend networks on Facebook is the most recent and egregious example. In May, 2017, the WannaCry ransomware that infected more than 200?000 computers across 100 countries also infiltrated a third of National Health Service trusts, and brought some services to a standstill. Yet, despite agreement on the need for better cyber hygiene (risk management and online health), there is no consensus on what form it should take.

[Comment] Transparency of retracting and replacing articles

Sáb, 31/03/2018 - 00:00
Journal editors are responsible for the integrity of the published record and must correct it when necessary. They are getting better at this job, as evidenced by journal retraction policies1 and numbers of article retractions.2 Most retractions are due to misconduct, but about 20% are retracted because of an unintentional error or methodological flaw.2 To credit the correction of an honest error and avoid stigmatisation of authors, journals have begun a practice of retraction with republication of a corrected article.

[Comment] Offline: The Palestinian health predicament worsens

Sáb, 31/03/2018 - 00:00
The United Nations Relief and Works Agency (UNRWA), which administers health services to 5·3 million Palestinian refugees through 143 primary health facilities, is in acute crisis. After President Trump cut almost US$300 million from UNRWA's 2018 budget, services will run out of money by the end of May. Irrespective of one's views about the complex politics of the Middle East, America's decision to threaten the provision of basic health care to millions of dependent people seems utterly cruel. This emergency was a major theme of last week's annual Lancet Palestinian Health Alliance (LPHA) scientific meeting, held in Beirut, Lebanon.

[World Report] Gairdner Awards 2018 honour GBD studies

Sáb, 31/03/2018 - 00:00
Creators of the GBD studies look back at almost two decades since the first iteration. Other awards recognised the fields of optogenetics, epigenetics, and lung cancer research. Brian Owens reports.

[World Report] What does the GDPR mean for the medical community?

Sáb, 31/03/2018 - 00:00
The General Data Protection Regulation will start in May across the European Union, but doubts are being cast on how prepared researchers and clinicians are. Becky McCall reports.

[Perspectives] Jan Egeland: humanitarian who gives a voice to the displaced

Sáb, 31/03/2018 - 00:00
“The major challenge of our time is to fight social injustice, and to promote human rights and humanitarian principles through action and not just words”, says Jan Egeland. “We must stand up for our values, even in extraordinary times.” As Secretary-General of the Norwegian Refugee Council (NRC) and Special Adviser to the UN Special Envoy for Syria, he speaks forcefully about the crises in Syria, Yemen, Nigeria, and elsewhere, “where millions of civilians are displaced and attacked, and there is no protection at all”.

[Perspectives] Rethinking cures in Jesse Ball's A Cure for Suicide

Sáb, 31/03/2018 - 00:00
In January, 2018, UK Prime Minister Theresa May appointed a ministerial lead on loneliness “to address the loneliness endured by the elderly, by carers, by those who have lost loved ones—people who have no one to talk to or share their thoughts and experiences with”. Social psychologist Jean Twenge offers a different perspective on modern loneliness for a generation that has grown up staring at digital screens. This generation, she argues, is “on the brink of the worst mental-health crisis in decades [and] much of this deterioration can be traced to their phones”.

[Perspectives] Moments on the margins

Sáb, 31/03/2018 - 00:00
Once upon a time it must have seemed exciting to be photographed, as if you were going to become part of history. Now that everyone with a smartphone can post selfies all day, what does it really mean to make images of someone else? Photographers who are trying to capture marginalised or misunderstood cultures are in an increasingly difficult position if they are not from the same background or culture as their subjects. They risk being accused of objectification in the name of art at best, and exploitation at worst.

[Perspectives] Bridging magic and medicine

Sáb, 31/03/2018 - 00:00
12-year-old Tommy lay listlessly in his hospital bed. I noticed, however, that his eyes were becoming a bit brighter since I had bounded into the room a moment earlier with my satchel of magic paraphernalia and made three red foam balls disappear into thin air.

[Perspectives] The girl who died in the fire

Sáb, 31/03/2018 - 00:00
A warm light suffuses an empty stage surrounded by nine pianos. A young woman walks to the front and she is caught by a panic attack. Thus the new production of Tennessee Williams' Summer and Smoke, directed by Rebecca Frecknall at London's Almeida Theatre, begins. Written in 1948, just after the success of A Streetcar Named Desire, the play, in its deceptive simplicity, touches some of the key themes of Williams' early works: the marginalisation of women in the southern states of the USA, the dichotomy between spirituality and carnality, and the lability of mental health.

[Perspectives] Newmanopolis

Sáb, 31/03/2018 - 00:00
Comedian Robert Newman first came to prominence in the UK during the 1990s and readers of a certain age will remember how classrooms across the UK once abounded with his catchphrases. Newman subsequently largely rejected fame and reinvented himself as iconoclastic stand-up tackling complex subjects with wit and erudition. Whilst one of his early sketches—“History Today”—mocks scholars by having two elderly professors tirelessly trading playground insults, Newman has now graduated to challenging academics directly.

[Obituary] Sir Roger Gilbert Bannister

Sáb, 31/03/2018 - 00:00
Neurologist and athletic record-breaker. He was born in Harrow, UK, on March 23, 1929, and died in Oxford, UK, on March 3, 2018, aged 88 years.

[Correspondence] Quantification of the effect of terrorism on the HIV response in Nigeria

Sáb, 31/03/2018 - 00:00
The insurgency by the Boko Haram terrorist group in northeast Nigeria has had devastating effects on the region including thousands of deaths, internal displacement, destruction of private and public properties, and considerable economic ruin. The violent conflict perpetuated by the group also has public health implications and has affected the spread and management of HIV, which remains a huge public health issue in Nigeria.

[Correspondence] Liver disease mortality trends: a response to the editor

Sáb, 31/03/2018 - 00:00
We read the Offline Comment by Richard Horton (Jan 13, p 106)1 that summarised the evidence and current policy debate in England around minimum unit pricing for alcohol with interest. Unfortunately, the Comment contained an important error, which has already been repeated in UK parliamentary hearings and that we would like to correct to avoid it being repeated elsewhere. This error is the statement that “liver disease is on a trajectory to become the biggest cause of death in England and Wales”.

[Correspondence] Did Cro-Magnon 1 have neurofibromatosis type 1?

Sáb, 31/03/2018 - 00:00
The Cro-Magnon 1 skeleton corresponds to a 28?000 BCE Homo sapiens male individual that was discovered in 1868 in a rock shelter in Les Eyzies, France.1 Since its discovery, various diagnoses have been proposed with regards to a round polycyclic osteolytic lesion on the right frontal bone, measuring 37 mm?x?27 mm (appendix): post-mortem alteration due to the soil,2 rickets,3 actinomycosis,4 and Langerhans cell histiocytosis.5

[Correspondence] Artificial intelligence in health care: enabling informed care

Sáb, 31/03/2018 - 00:00
We read with interest the Lancet Editorial on artificial intelligence (AI) in health care (Dec 23, 2017, p 2739).1 Deep learning as a form of AI risks being overhyped. Deep neural networks contain multiple layers of nodes connected by adjustable weights. Learning occurs by adjusting these weights until the desired input-to-output function is achieved.2 With many millions of weights, huge amounts of data are required for learning, a process facilitated by recent increases in computational power. However, the learning algorithm, known as the error back-propagation algorithm, was invented in the 1980s and has been used to train neural networks ever since.

[Correspondence] In support of UNRWA appeal for health and dignity of Palestinian refugees

Sáb, 31/03/2018 - 00:00
Our research into the UN Relief and Works Agency (UNRWA)'s delivery of health services to Palestinian refugees during the Syria crisis1 puts us in a unique position to anticipate the challenges of the organisation's current funding crisis.2 We have conducted over 90 interviews with health workers and managers, a series of systems modelling sessions, and rigorous analysis of UNRWA health data from 2007–16, and conclude the following.

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