Removing their white winter coat once kept snowshoe hares hidden in spring, but as the snows melt earlier, they are increasingly exposed. Can they fight back? (full text available to subscribers)
It's the ultimate speed limit – but in some places, it seems the cosmic traffic cops are letting things slip (full text available to subscribers)
Without the Pauli exclusion principle, matter as we know it would not exist. But at low, low temperatures, even this quantum law gives way (full text available to subscribers)
A survey by the Royal College of Radiologists (RCR) has revealed that more than 300 000 patients in England wait longer than a month for radiograph results or scan interpretations. This long wait could delay diagnosis and cause patient distress. The RCR calls for a revision of radiology services and commitment to train more radiologists in the UK.
The notion of air pollution can conjure up the murky haze that clings to urban skylines, but air pollution is often a much more intimate threat, emanating from hearth and home. WHO estimates have placed a global tally of more than 7 million deaths caused annually by air pollution; of this number, 4·3 million deaths are attributed to household air pollution created by stoves that use biomass, such as crop waste and animal dung, or coal as fuel. To address the threat of indoor air pollution in low-income and middle-income countries, WHO released new guidelines for indoor air quality and household fuel combustion on Nov 12.
Drowning kills 372 000 people each year. It is in the top ten causes of deaths in children and young people: half of those who drown are younger than 25 years, and those younger than 5 years are the most vulnerable. 91% of these deaths occur in low-income and middle-income countries, where water is often entwined culturally with work and transport. On Nov 18, WHO published the Global report on drowning. The report's figures do not include natural flood disasters, transport-related incidents, drowning as suicide, and non-fatal drowning; thus, their already stark figures could be an underestimate.
The USA has the third highest burden of diabetes in the world. 29·1 million people (9·3% of the population) have the disorder, including 8·1 million who are undiagnosed. Of the US adults who have a confirmed diagnosis of diabetes, 90–95% have type 2 diabetes. Reflecting this burden, several US societies, associations, and federal agencies provide advice and (sometimes conflicting) clinical practice guidelines for type 2 diabetes, which can be confusing for practitioners. Which should be followed?
Pacific Island countries offer a litmus test for how small island developing states and the global community respond to the crisis in non-communicable diseases (NCDs). The Pacific NCD epidemic has been growing for decades, and by 2010 eight out of ten deaths in the region were caused by NCDs. Although life expectancy is increasing across the developing world, it is stagnating in several Pacific Island countries and at fairly low levels. Given declines in infant and child mortality, these patterns reflect premature adult mortality from NCDs.
In The Lancet, investigators from Liverpool, UK, report a randomised trial that has generated more debate over its design and results than any in recent memory. While the trial's ethics are discussed in an accompanying Comment, we assess how its results might affect clinical practice.
In The Lancet, Adeel Shahzad and colleagues report the results of their groundbreaking How Effective are Antithrombotic Therapies in Primary Percutaneous Coronary Intervention (HEAT-PPCI) trial. In 1829 patients with suspected ST segment elevation myocardial infarction, percutaneous coronary intervention was attempted in 1491 (82%), and the trial's primary efficacy outcome (a composite of all-cause mortality, cerebrovascular accident, reinfarction, or unplanned target lesion revascularisation) occurred in 79 (9%) of 905 patients randomised to receive bivalirudin as compared with 52 (6%) of 907 receiving heparin (relative risk 1·52, 95% CI 1·09–2·13).
Primary care doctors worldwide could be forgiven for feeling stuck in the middle of a supply and demand crisis, with the need to balance increasingly complex care for patients with provision of same-day access for all. Optimisation of workflow within primary care is essential to maintain this balance, so that the entire primary care team can be used effectively, while providing safe, cost-effective care that satisfies patient demands. Demonstrations of access to primary care are often viewed by policy makers as a measure of overall success (or failure) of care.
In 1972, Liggins and Howie reported results of their landmark randomised controlled trial of antenatal corticosteroids for the prevention of respiratory distress syndrome associated with preterm birth. That trial provided clear evidence for the drug's efficacy to reduce respiratory distress syndrome and mortality in the 1218 infants enrolled. However, it was not until the publication of a consensus statement by the US National Institutes of Health (22 years and 12 trials later, involving an additional 2138 infants), that this simple and cost-effective treatment was widely adopted.
In 2015, The Lancet will again devote an issue of the journal to health care and clinical research in China—our sixth such themed issue. All Lancet titles welcome submissions from China throughout the year, and we would now like to invite submissions of high-quality research from China, or from research teams working on health in China, specifically for this forthcoming issue of The Lancet.
The Office of the High Commissioner for Human Rights (OHCHR) is bankrupt. The High Commissioner's Office isn't an office, of course. It is the UN's chief human rights body, employing over 1000 people. Its mandate is to promote and protect all human rights, including the right to health. But OHCHR is alleged to be $20 million in the red, facing the prospect of cutting jobs and programmes. OHCHR receives only 3% of the UN's total budget, a pitifully small amount (the figure for 2014–15 is $174 million, several million dollars less than it was in 2012–13).
Three experimental treatments for Ebola are being fast-tracked into human trials in west Africa with recruitment due to start next month. Dara Mohammadi reports.
Brian Owens examines the rise of academic social networking websites, such as Academia.edu and ResearchGate, and asks researchers how these sites are shaping their careers.
A decade ago, an initiative was launched to strengthen Africa's science academies. Now, as the programme comes to an end, those involved review its achievements. Andrew Green reports.
Mike Leigh's Mr Turner catalogues unflinchingly the aches and afflictions of old age. Near the beginning of this absorbing bio-flick, which covers the last 25 years of the Romantic artist's life, Turner's elderly “Dadda” coughs up the contents of his lungs into a pot. Soon after we see him nailed to his deathbed by consumption, babbling about the madness that darkened the twilight years of Turner's mother.
“Rest in peace”: our organism's final state. Rest, though, is not usually invoked as a state without end, but as that which variously punctuates the ordinary course of things. It is repose, recuperation, stillness, respite, lying fallow. Rest can be applied to different kinds of entity at different scales—to physiologies (cells, brains, and organisms have “resting states”), to bodies, to minds, to landscapes. Rest, for many of us today, seems increasingly hard to find, whether in relation to an exhausted body, a racing mind, or a hectic city.
The plethora of comment and reflection on the First World War has overlooked the importance of that war for drug and alcohol control. Yet this war was crucial in the establishment of a system of international control for drugs that still endures today. It instituted models of control for alcohol that also had a lengthy life. In 2014, the First World War is still a potent presence so far as drugs and alcohol are concerned.