Riviste scientifiche

[Comment] COMPARE trial: new hope for organ preservation

The Lancet - Sa, 21/11/2020 - 00:00
Kidney transplantation is the optimal treatment for most people with kidney failure. Initially done in identical twins more than 60 years ago, kidney transplantation has become a highly efficacious, widely accepted, and routine procedure. Efforts to address the worldwide shortage of organ donors have included extending donor criteria—eg, by accepting donation after donor circulatory death, which now represents the fastest growing source of deceased donor kidneys. However, these donors carry an increased risk of delayed graft function, acute rejection, and premature graft failure.

[Comment] Offline: Holocaust education—a medical imperative

The Lancet - Sa, 21/11/2020 - 00:00
As school students in England in the 1970s, we were taught the bare facts of the Holocaust. And that is where we left it. A fact of history, a fact certainly to be remembered, yet a fact that seemed very distant from contemporary times. But last week, the Ontario Medical Association, together with Doctors Against Racism and Anti-Semitism, held a webinar to discuss the case for teaching the Holocaust in medical schools. The meeting was led by Dr Frank Sommers, a professor of psychiatry at the University of Toronto.

[Comment] Notice of addendum to Article reporting Oxford trial of ChAdOx1 nCoV-19 vaccine

The Lancet - Sa, 21/11/2020 - 00:00
On request, and to aid others doing similar trials, we are publishing the full standard operating procedures (SOPs) for the Oxford University-sponsored trials of the ChAdOx1 nCoV-19 vaccine. Operational details about running clinical trials of COVID-19 vaccines in a pandemic are not generally available as they are contained in SOPs held at trial sites. These SOPs can provide additional insight into study conduct that assist with interpretation of the data. We have provided an additional appendix to our Article reporting the phase 1/2 findings1 to provide this information about the key processes guiding the Oxford University-sponsored trials of the ChAdOx1 nCoV-19 vaccine.

[World Report] US Supreme Court poised to keep the Affordable Care Act

The Lancet - Sa, 21/11/2020 - 00:00
A lawsuit to overturn the Affordable Care Act may be floundering after Supreme Court justices questioned why the law should be dismantled. Susan Jaffe reports from Washington, DC.

[World Report] Violence leads to health emergencies in Mozambique

The Lancet - Sa, 21/11/2020 - 00:00
Displaced by war, thousands of people in Mozambique are at risk of infectious disease. Munyaradzi Makoni reports.

[World Report] China's fertility treatment boom

The Lancet - Sa, 21/11/2020 - 00:00
The end of the one-child policy and social shifts have increased demand for fertility treatments. Many patients are turning to medical tourism. Megan Tatum reports.

[Perspectives] The banality of the patriarchy

The Lancet - Sa, 21/11/2020 - 00:00
When German–American philosopher Hannah Arendt covered the 1961 trial of the Nazi Adolf Eichmann for The New Yorker magazine—her reports led to her book of 1963, Eichmann in Jerusalem: A Report on the Banality of Evil—she was struck by the concept of banality. Arendt wrote that Eichmann, this bureaucrat who was “medium-sized, slender, middle-aged, with receding hair, ill-fitting teeth, and nearsighted eyes” was responsible for participation in one of the greatest crimes in history. The banality to which Arendt referred, however, was not Eichmann's unexceptional physical appearance, but “an inability to think; that is, to think from the standpoint of somebody else”.

[Perspectives] New narratives of life

The Lancet - Sa, 21/11/2020 - 00:00
To take on the question of this book's title, you probably have to be foolhardy or a Nobel laureate. Those aren't, of course, mutually exclusive categories, but fortunately Paul Nurse belongs to just one of them. This smart little book, What is Life?, has many of the qualities that Nurse has displayed as a public spokesperson for science, and a former president of the UK's Royal Society. It is concise, clear, careful, and considered. If there's one alliterative quality it lacks, it is completeness.

[Perspectives] Will global health survive its decolonisation?

The Lancet - Sa, 21/11/2020 - 00:00
There are growing calls to decolonise global health. This process is only just beginning. But what would success look like? Will global health survive its decolonisation? This is a question that fills us with imagination. It is a question that makes us reflect on what Martin Luther King Jr saw when he said in 1968, in the last speech he gave before he was killed, that “I've been to the mountaintop…and I've seen the Promised Land.” If what he saw was an equal, inclusive, and diverse world without a hint of supremacy, then, that world is still elusive.

[Obituary] Frank von Sonnenburg

The Lancet - Sa, 21/11/2020 - 00:00
Specialist in infectious diseases and travel medicine. He was born on May 8, 1946, in Munich, Germany, and died there of brain cancer on Aug 21, 2020, aged 74 years.

[Articles] Oxygenated versus standard cold perfusion preservation in kidney transplantation (COMPARE): a randomised, double-blind, paired, phase 3 trial

The Lancet - Sa, 21/11/2020 - 00:00
HMPO2 of kidneys donated after circulatory death is safe and reduces post-transplant complications (grade IIIb or more). The 12-month difference in eGFR between the HMPO2 and HMP groups was not significant when both kidneys from the same donor were still functioning 1-year post-transplant, but potential beneficial effects of HMPO2 were suggested by analysis of secondary outcomes.

[Clinical Picture] A painful lump on a teenager's toe is a benign enchondroma

The Lancet - Sa, 21/11/2020 - 00:00
A 16-year-old girl attended our outpatient clinic complaining about a hard lump on the second toe of her left foot. She said it had been present for 6 years, but that in the past 3 months it had become moderately painful and that the pain was aggravated by walking. She said that the lump had not increased in size. She reported no history of trauma and no relevant medical history.

The impact of voluntary front-of-pack nutrition labelling on packaged food reformulation: A difference-in-differences analysis of the Australasian Health Star Rating scheme

PLoS Medicine - Ve, 20/11/2020 - 23:00

by Laxman Bablani, Cliona Ni Mhurchu, Bruce Neal, Christopher L. Skeels, Kevin E. Staub, Tony Blakely

Background

Front-of-pack nutrition labelling (FoPL) of packaged foods can promote healthier diets. Australia and New Zealand (NZ) adopted the voluntary Health Star Rating (HSR) scheme in 2014. We studied the impact of voluntary adoption of HSR on food reformulation relative to unlabelled foods and examined differential impacts for more-versus-less healthy foods.

Methods and findings

Annual nutrition information panel data were collected for nonseasonal packaged foods sold in major supermarkets in Auckland from 2013 to 2019 and in Sydney from 2014 to 2018. The analysis sample covered 58,905 unique products over 14 major food groups. We used a difference-in-differences design to estimate reformulation associated with HSR adoption.Healthier products adopted HSR more than unhealthy products: >35% of products that achieved 4 or more stars displayed the label compared to <15% of products that achieved 2 stars or less. Products that adopted HSR were 6.5% and 10.7% more likely to increase their rating by ≥0.5 stars in Australia and NZ, respectively. Labelled products showed a −4.0% [95% confidence interval (CI): −6.4% to −1.7%, p = 0.001] relative decline in sodium content in NZ, and there was a −1.4% [95% CI: −2.7% to −0.0%, p = 0.045] sodium change in Australia. HSR adoption was associated with a −2.3% [−3.7% to −0.9%, p = 0.001] change in sugar content in NZ and a statistically insignificant −1.1% [−2.3% to 0.1%, p = 0.061] difference in Australia. Initially unhealthy products showed larger reformulation effects when adopting HSR than healthier products. No evidence of a change in protein or saturated fat content was observed.A limitation of our study is that results are not sales weighted. Thus, it is not able to assess changes in overall nutrient consumption that occur because of HSR-caused reformulation. Also, participation into labelling and reformulation is jointly determined by producers in this observational study, impacting its generalisability to settings with mandatory labelling.

Conclusions

In this study, we observed that reformulation changes following voluntary HSR labelling are small, but greater for initially unhealthy products. Initially unhealthy foods were, however, less likely to adopt HSR. Our results, therefore, suggest that mandatory labelling has the greatest potential for improving the healthiness of packaged foods.

What are the odds of dying if you're infected by the coronavirus?

New Scientist - Ve, 20/11/2020 - 20:05
During the first wave of the coronavirus pandemic, the infection fatality rate – how many infected people die – may have been 1 per cent for high-income countries with older populations

Covid-19 news: NHS drafts plan to vaccinate adults in England by April

New Scientist - Ve, 20/11/2020 - 18:37
The latest coronavirus news updated every day including coronavirus cases, the latest news, features and interviews from New Scientist and essential information about the covid-19 pandemic

Microplastic pollution discovered near the top of Mount Everest

New Scientist - Ve, 20/11/2020 - 17:00
Tiny pieces of plastic called microplastics have have been found on Mount Everest. They have previously been detected in the Mariana trench so are now present at both the highest and deepest points on Earth

Plate tectonics may have begun a billion years earlier than thought

New Scientist - Ve, 20/11/2020 - 12:02
Plate tectonics may have begun 4 billion years ago, almost a billion years earlier than we thought, according to a new analysis of ancient rocks

Computer vision can estimate calorie content of food at a glance

New Scientist - Ve, 20/11/2020 - 09:00
A neural network fed with 300,000 photographs of meals and information from 70,000 recipes can now estimate the calorie content of food from a photo

Ancient parasites in a titanosaur’s bones made it look like a zombie

New Scientist - Ve, 20/11/2020 - 08:00
The first discovery of parasites in a dinosaur bone reveals some of the oldest evidence of bone disease, which left a titanosaur with open wounds

[Comment] Data for action on early childhood development

The Lancet - Ve, 20/11/2020 - 00:30
Early childhood development (ECD) in the first few years of life lays the foundation for a lifetime's mental and physical health, education, labour market productivity, and wellbeing.1 ECD is receiving increasing attention and is included in the Sustainable Development Goals (SDGs). Expanded 2020 ECD Countdown to 2030 country profiles2 will be launched by UNICEF and Countdown to 2030 on Nov 23, 2020, shortly after Universal Children's Day on Nov 20, 2020. The updated profiles cover 42 ECD indicators and 197 countries, including 60 high-income countries (HICs), that encompass 99·8% of the world's children younger than 5 years (figure).
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