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[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.

[Correspondence] Type 2 diabetes

Sáb, 31/03/2018 - 00:00
We read with great interest the Seminar (Feb 9, 2017, p 2239)1 on type 2 diabetes by Sudesna Chatterjee and colleagues. However, we were surprised by the articles selected and believe that detailed selection criteria with the level of evidence of reported studies would have been useful to the reader. According to the research method described, we would expect other papers to be cited, including meta-analyses of randomised controlled trials that could have balanced the authors' outlook.2–6 For example, intensive glycaemic control probably has some beneficial effect on diabetic complications, such as non-fatal myocardial infarctions3–5 or retinopathy assessed with the Early Treatment Diabetic Retinopathy Study scale.

[Correspondence] Type 2 diabetes

Sáb, 31/03/2018 - 00:00
In the summary of their Seminar,1 Sudesna Chatterjee and colleagues state that the incidence of type 2 diabetes “continues to rise globally”. There is no evidence to support this claim and most recent literature suggests that, in developed countries, incidence peaked sometime in the last decade and then levelled off or slightly decreased.2–5

[Correspondence] Type 2 diabetes – Authors' reply

Sáb, 31/03/2018 - 00:00
We thank A Rosemary Tate for her insightful comments on our Seminar.1 Tate indicates that there is no evidence to support the rise in global incidence of type 2 diabetes mentioned in the summary by citing a number of references published between 2014 and 2017 in the USA and UK.

[Comment] Widening the options for recurrent malaria

Vie, 30/03/2018 - 00:30
The global need for new antimalarial drugs and new combinations is enormous and urgent,1,2 but their successful delivery needs resilience to overcome the barriers imposed by expensive and lengthy clinical development plans. Attention is often directed to areas such as southeast Asia, where some antimalarial combinations are failing but transmission intensities are much lower than in sub-Saharan African countries. Children in Africa have frequent and life-threatening malaria infections as they grow up, and these need to be treated safely.

[Articles] Pyronaridine–artesunate or dihydroartemisinin–piperaquine versus current first-line therapies for repeated treatment of uncomplicated malaria: a randomised, multicentre, open-label, longitudinal, controlled, phase 3b/4 trial

Vie, 30/03/2018 - 00:30
Pyronaridine–artesunate and dihydroartemisinin–piperaquine treatment and retreatment of malaria were well tolerated with efficacy that was non-inferior to first-line ACTs. Greater access to these efficacious treatments in west Africa is justified.

[Comment] Skeletal muscle channelopathy: a new risk for sudden infant death syndrome

Jue, 29/03/2018 - 00:30
Sudden infant death syndrome (SIDS) remains a leading cause of infant mortality, despite a steadily decreasing incidence since the 1990s.1 The reasons for this decline are debated, but it could be due to methodological reasons (eg, changes in reporting or advances in diagnosis of specific diseases) or a reduction of risks, such as an increase in supine sleeping position for infants, as advocated by the Back to Sleep campaign.2 A better understanding of the causes of SIDS is needed to identify infants at high risk and to develop interventions and guidelines that will prevent SIDS for all infants.

[Articles] Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome: a case-control study

Jue, 29/03/2018 - 00:30
Rare SCN4A variants that directly alter NaV1.4 function occur in infants who had died from SIDS. These variants are predicted to significantly alter muscle membrane excitability and compromise respiratory and laryngeal function. These findings indicate that dysfunction of muscle sodium channels is a potentially modifiable risk factor in a subset of infant sudden deaths.