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[Editorial] Theranos and the scientific community: at the bleeding edge

Sa, 15/01/2022 - 00:00
The Theranos story is reaching its conclusion. Elizabeth Holmes, the company's founder and former CEO, once the world's youngest self-made female billionaire, was last week found guilty of four of 11 charges of fraud related to her actions at the now defunct blood testing company. COO Ramesh Balwani will face similar charges in a trial later this year. The sensational rise and fall of Theranos has spawned books, documentaries, and podcasts. Yet, for all the attention, questions remain: where was the scientific community in exposing the absence of evidence backing the claims of Theranos? Why did it take the Wall Street Journal to uncover the scandal, and not the supposedly self-correcting culture of science?

[Comment] Offline: The incontestable moral value of health

Sa, 15/01/2022 - 00:00
In March, 2020, chief science advisers from 12 countries, including the US, the UK, and Germany, issued a call to scholarly publishers “to voluntarily agree to make their COVID-19 and coronavirus-related publications, and the available data supporting them, immediately accessible in PubMed Central and other appropriate public repositories.” That same month, over 30 publishers, including The Lancet, signed up to this request. The call reflected the urgency of the pandemic and “the associated global health crisis.” We have made all of our coronavirus-related content freely available through a COVID-19 Resource Centre.

[World Report] Holmes verdicts prompt questions over justice for patients

Sa, 15/01/2022 - 00:00
The founder of Theranos was found guilty of defrauding some investors, but cleared of charges that she misled patients. Susan Jaffe reports.

[World Report] Disrupted care in Papua New Guinea: the harms of COVID-19

Sa, 15/01/2022 - 00:00
The COVID-19 pandemic in Papua New Guinea shows no sign of ending, and its worst legacy might be its effect on other diseases, such as tuberculosis, HIV/AIDS, and malaria. Chris McCall reports.

[Perspectives] From herbs and humours to anatomy

Sa, 15/01/2022 - 00:00
What if you had a second chance? If you could throw off suffocating circumstances, rewrite your narrative, and pursue your drive towards modern advances in understanding? In Ophelia Swam: An Oxford Novel, this chance unfolds for a young woman in mid-16th-century England, drawn towards the huge transformations taking place in medicine. This delicate exploration of trauma, grief, and friendship, deftly navigates the changes in thought and practice in this fascinating period of the history of medicine.

[Perspectives] Physicians in the digital age

Sa, 15/01/2022 - 00:00
Artificial intelligence (AI) is here. We are now in decade of Philip K Dick's dystopian novel Do Androids Dream of Electric Sheep? and AI is already capable of driving our cars. But self-driving cars have harmed pedestrians and AI has been credited with delivering misinformation in curated social media feeds that threaten democracy. AI has also entered medicine, with uses in medical imaging and many other areas. However, there is increasing attention on how some algorithms in health care are racially biased.

[Obituary] Paula Clayton

Sa, 15/01/2022 - 00:00
Psychiatrist who sought to destigmatise mental illness. Born on Dec 1, 1934, in St Louis, MO, USA, she died of complications from a non-COVID-19 viral infection on Sept 4, 2021, in Pasadena, CA, USA, aged 86 years.

[Correspondence] The UK People's Covid Inquiry

Sa, 15/01/2022 - 00:00
The People's Covid Inquiry anticipated that any official public investigation into the COVID-19 pandemic would be much delayed. It was a citizens’ tribunal —ie, part legal proceedings, part theatre, part publicly speaking truth to power—aimed at raising issues to more visible levels than government or the media were prepared to do on their own. The renowned human rights barrister, Michael Mansfield, acted as chair. A final report in December, 2021, set out conclusions and recommendations on the basis of the evidence collected.

[Department of Error] Department of Error

Sa, 15/01/2022 - 00:00
Halperin SA, Ye L, MacKinnon-Cameron D, et al. Final efficacy analysis, interim safety analysis, and immunogenicity of a single dose of recombinant novel coronavirus vaccine (adenovirus type 5 vector) in adults 18 years and older: an international, multicentre, randomised, double-blinded, placebo-controlled phase 3 trial. Lancet 2021; 399: 237–48—In this Article, the third section of the Procedures section should have stated “A single 0·5 mL dose of either the Ad5-nCoV vaccine or placebo was administered to each participant in the deltoid muscle of the non-dominant arm.” This correction has been made to the online version as of Jan 13, 2022, and the printed version is correct.

[Clinical Picture] Ground glass opacities are not always COVID-19: a case of acute eosinophilic pneumonitis caused by daptomycin

Sa, 15/01/2022 - 00:00
An 83-year-old man was admitted to our hospital reporting a 3-week history of cough and exertional dyspnoea. At the time of admission, the patient was 4 weeks into a 6-week course of daptomycin and rifampicin because he had an infected prosthetic knee joint; he also had a history of pituitary hypoplasia and had not been vaccinated against SARS-CoV-2.

[Editorial] Children and adolescents deserve a better future

Sa, 08/01/2022 - 00:00
In January, 2020, we announced a Lancet campaign on child and adolescent health. Our intention was to refocus on child mortality, and on the recognition that adolescents matter in global health, at a time when progress had stalled or in some cases reversed amid changing political and environmental circumstances. Little did we know then what the next 2 years would bring.

[Comment] Offline: The origins story—towards a Deep Ecology

Sa, 08/01/2022 - 00:00
Whatever the precise origins of SARS-CoV-2, one doesn’t have to wait for the definitive source of COVID-19 to be identified before important lessons are learned—lessons that the global health community presently seems to be ignoring. There are four immediate priorities. First, countries must strengthen public health surveillance to deliver a globally robust early warning system for pneumonias of unknown aetiology. The Independent Panel for Pandemic Preparedness and Response, chaired by Helen Clark and Ellen Johnson Sirleaf, made this recommendation in their May, 2021 report to the World Health Assembly.

[World Report] Challenges ahead for new UNICEF leader

Sa, 08/01/2022 - 00:00
Catherine Russell replaces Henrietta Fore as UNICEF's executive director. Udani Samarasekera assesses Fore's legacy and the future of the organisation.

[World Report] Humanitarian need in 2022

Sa, 08/01/2022 - 00:00
An estimated 1 in 29 people worldwide will need humanitarian assistance in 2022. Sharmila Devi looks ahead to the major hotspots and issues in the coming year.

[Perspectives] Simukai Chigudu: elucidating the politics of global health

Sa, 08/01/2022 - 00:00
In 2003, aged 16 years, Simukai Chigudu came to the UK as a student from Zimbabwe, a country in political upheaval as opposition to the then President Robert Mugabe grew. A year later, Chigudu began a medical degree at Newcastle University. It was, he recalls, an unsettling time: “I felt this sense of being caught between worlds, where I was really struggling to be at one with my new setting in Newcastle, and yet I could never feel disencumbered of home. The more that things in Zimbabwe had deteriorated, the more powerless I felt…It was as if my own sense of identity was being fragmented as much as the country was being fragmented.

[Perspectives] The fall of a poisoned empire

Sa, 08/01/2022 - 00:00
Arthur M Sackler (1913–87) was a psychiatrist, researcher, and the owner of a boutique marketing agency. When he was inducted into the Medical Advertising Hall of Fame in 1997, his citation was: “No single individual did more to shape the character of medical advertising than the multi-talented Dr Arthur Sackler”. The US Centers for Disease Control and Prevention says that between 1999 and 2019, nearly 500 000 people in the USA died from an opioid overdose, including prescription and illicit opioids.

[Perspectives] The wall

Sa, 08/01/2022 - 00:00
If she likes you, you go on the wall. Queen Fairy who sat with her during her chemotherapy. Her first carer who was the best of the rest. Wonder Woman from the local council who calls every week and the Joker who stands in when Wonder Woman is away. Butterfly, the first of the befriender volunteers, and the others who came after. Darling Postman who delivers all the online purchases she uses to make her world of stickers, poems, and dreamcatchers. Scarlett Pimpernel from Age UK who always gets back to her, but does not stop by as often as she would like.

[Correspondence] Racialised people in clinical guideline panels

Sa, 08/01/2022 - 00:00
Clinical practice guidelines can include recommendations with important implications for health equity; therefore, guideline panels should comprise individuals positioned to make relevant recommendations, including those that reflect the diversity of the priority population.1 Women are under-represented in guideline panels, and, although the inclusion of racialised people in guideline panels has received less attention, racialised clinicians are discriminated against in training and hiring.2–4 We determined the extent to which guideline panels included racialised people and women.

[Correspondence] Strengthening the reporting of stillbirths globally

Sa, 08/01/2022 - 00:00
The UN recommends the continu-ous, permanent, universal, and compulsory registration of ten vital events, including stillbirths.1 Yet, civil registration and vital statistics (CRVS) improvement efforts have focused almost exclusively on birth and death registration, resulting in gains in those areas in recent decades.2 It is time to increase the completeness of stillbirth registration through its inclusion in CRVS strengthening efforts.

[Correspondence] Strengthening the reporting of stillbirths globally

Sa, 08/01/2022 - 00:00
In their excellent Article, Lucia Hug and colleagues1 systematically assessed about two decades of stillbirth estimates acquired from national administrative records of 195 countries and report an alarming trend that demands expeditious action, if the Every Newborn Action Plan target of reducing stillbirths to fewer than 12 per 1000 is to be achieved by 2030.2