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Lancet 11/15/2019 06:18
In September, at the first UN General Assembly focused on universal health coverage (UHC), member states were urged to progress faster on health-related Sustainable Development Goals (SDGs) to achieve UHC by 2030—“leaving no one behind”. Despite major health gains over the past few decades, progress has been uneven when analysed by subgroups and specifically by gender, which is a powerful determinant of health outcomes. The World Health Statistics 2019 report from WHO made a first attempt to disaggregate all indicators by sex, and revealed that, globally, boys born in 2018 could expect to live 68·6 years and girls 73·1 years, a difference of 4·5 years.
Lancet 11/15/2019 05:20
A new report paints a bleak picture of the health of the largest cohort of Americans, Millennials (born 1981–96). The report shows a troubling decline in the health of Millennials compared with the previous cohort, Generation X (born 1965–80). The Economic Consequences of Millennial Health, released on Nov 6, builds on health claims data from more than 41 million people insured by Blue Cross Blue Shield. Although the prevalence of physical conditions such as high cholesterol and hypertension are considerably higher for Millennials than for Generation X at the same age, behavioural health conditions, such as depression, alcohol, and substance use are major drivers of the current health crisis, especially among men.
Lancet 11/15/2019 04:19
As the 2019 UN Climate Action Summit was underway, one of us arrived home after attending scientific meetings abroad, somewhat jaded from two overnight flights in less than a week. This type of travel is common for many involved in global health projects. Yet air travel presents a conundrum for work intended to support improved human health and development.
Lancet 11/15/2019 03:20
The past 12 months have brought an unprecedented surge in awareness of and engagement with the climate emergency. Last week, Collins Dictionary named “climate strike” as their 2019 Word of the Year, after recording a 100-fold increase in usage this year. This endorsement reflects the momentum of school climate strikes and the Extinction Rebellion protests that are applying pressure to governments and the private sector to act on the climate crisis. Furthermore, against the backdrop of political choices faced by the UK, The Guardian newspaper reported last week that two-thirds of people in the UK now consider the climate emergency to be the biggest issue facing humankind.
Lancet 11/15/2019 00:18
In George Eliot's Middlemarch (1871–72), 19-year-old Dorothea Brooke, newly married to Edward Casaubon, a scholarly clergyman in his mid-forties, is found weeping in her hotel room in Rome. She is on her honeymoon and finds that her idea of marriage—she had hoped that her learned husband would fill in the gaps in her education—requires some painful adjustment. As she tells Casaubon's young cousin, the dilettante Will Ladislaw, her husband spends all day, every day, reading in the library of the Vatican.
Lancet 11/14/2019 22:17
Skin conditions, especially different types of cancer, are common. Yet the number of dermatologists is fairly low. Dermatology is a specialty suited for artificial intelligence (AI) research and potential incorporation in clinical practice. AI has the potential to decrease dermatologist workloads, eliminate repetitive and routine tasks, and improve access to dermatological care.
Lancet 11/14/2019 21:18
Imagine if the entire edifice of knowledge in medicine was built upon a falsehood. Systematic reviews are said to be the highest standard of evidence-based health care. Regularly updated to ensure that treatment decisions are built on the most up-to-date and reliable science, systematic reviews and meta-analyses are widely used to inform clinical guidelines and decision making. Powerful organisations have emerged to construct a knowledge base in medicine underpinned by the results of systematic reviews.
Lancet 11/14/2019 20:18
Antimicrobials are needed to treat deadly infections, enable life-saving medical procedures, and manage disease in food production. But antimicrobials come with a trade-off: their use accelerates antimicrobial resistance (AMR), which diminishes the future effectiveness of these medicines. This trade-off makes “antimicrobial effectiveness” a precious global common-pool resource that must be collectively protected.1 Yet antimicrobials have been used inappropriately for decades. In too many circumstances, antimicrobials are deployed to compensate for inadequate infection prevention and control (IPC) in both human health and food production, instead of implementing water, sanitation, and hygiene (WASH) and IPC measures such as preventing hospit.
Lancet 11/14/2019 19:17
This comprehensive framework introduces a new way of doing observational health-care science at scale. The approach supports equivalence between drug classes for initiating monotherapy for hypertension—in keeping with current guidelines, with the exception of thiazide or thiazide-like diuretics superiority to angiotensin-converting enzyme inhibitors and the inferiority of non-dihydropyridine calcium channel blockers.
Lancet 11/14/2019 19:17
Mental disorders are associated with premature mortality. We provide a comprehensive analysis of mortality by different types of disorders, presenting both MRRs and premature mortality based on LYLs, displayed by age, sex, and cause of death. By providing accurate estimates of premature mortality, we reveal previously underappreciated features related to competing risks and specific causes of death.
Lancet 11/14/2019 19:17
Ty Beal and colleagues noted that evidence from observational studies was used to assess the causal relationship between individual dietary factors and non-communicable diseases (NCDs) in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017.1 We acknowledge the limitations of observational studies in making causal inferences.
Lancet 11/14/2019 19:17
On May 13, 2019, the Department of Anatomy, Berlin Charité University Hospital, Berlin, Germany, buried more than 300 microscopic slides discovered on a property that formerly belonged to anatomist Hermann Stieve.1 Although not stated,1 the slides are presumed to derive from Stieve's research at the Anatomical Institute, Berlin University, Berlin, Germany, during World War 2, on the effects of stress on female reproductive organs.
Lancet 11/14/2019 19:17
We thank Dimitrios Moris and Theodore Pappas for their comments and suggestions to further optimise the selection criteria for laparoscopic cholecystectomy in patients with abdominal pain and gallstones. We accept the concerns about the protocol violations. The SECURE trial1 was designed to better select patients for cholecystectomy, but it stops short of answering the question of how to treat patients with abdominal symptoms and gallstones.

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