Riviste scientifiche

[Comment] Breast radiotherapy for ductal carcinoma in situ: could less be more?

The Lancet - Sa, 06/08/2022 - 00:00
We congratulate Boon H Chua and colleagues1 on their high-quality randomised, unmasked, phase 3 trial addressing tumour bed boost and dose fractionation in non-low-risk ductal carcinoma in situ (DCIS) in the breast (BIG 3–07/TROG 07.01). They recruited 1608 women from 136 participating centres in 11 countries and report results with a median follow-up of 6·6 years. The primary endpoint was the 5-year free-from-local-recurrence rate. The rationale for the study was that, despite mounting evidence for moderately hypofractionated whole-breast radiotherapy (~2·7 Gy in 15–16 fractions) and a tumour bed boost for invasive breast cancer, few data exist for DCIS.

[Comment] Long COVID: which symptoms can be attributed to SARS-CoV-2 infection?

The Lancet - Sa, 06/08/2022 - 00:00
Mortality rates following SARS-CoV-2 infection have decreased as a consequence of public health policies, vaccination, and acute antiviral and anti-inflammatory therapies.1 However, in the wake of the pandemic, post-acute sequelae of COVID-19, or long COVID, has emerged: a chronic illness in people who have ongoing multidimensional symptomatology and disability weeks to years after the initial infection.2 Early reports of long COVID prevalence, summarised in a systematic review examining the frequency and variety of persistent symptoms after COVID-19, found that the median proportion of people who had at least one persistent symptom 60 days or more after diagnosis or at least 30 days after recovery from COVID-19 infection was 73%.

[World Report] Health at stake in Kenya elections

The Lancet - Sa, 06/08/2022 - 00:00
On Aug 9, Kenya will go to the polls in a general election. Munyaradzi Makoni reports on the parties’ pledges on health.

[World Report] Rights groups warn over new Tunisian constitution

The Lancet - Sa, 06/08/2022 - 00:00
The judiciary's independence is being undermined as the country faces a cost-of-living crisis and health-care challenges. Sharmila Devi reports.

[World Report] Research focus: the NHS Race & Health Observatory

The Lancet - Sa, 06/08/2022 - 00:00
1 year after its founding, the Observatory is shining light onto issues policy makers may want to avoid. Talha Burki reports.

[Perspectives] Tulio de Oliveira: collaborating to boost science in Africa

The Lancet - Sa, 06/08/2022 - 00:00
Bioinformatician Tulio de Oliveira's philosophy has been to do “science not for journal publications or the academic career but science that can go back to the community and to the managing physicians and nurses of patients”, he says. In South Africa, as founder and Director of the KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP) at the University of KwaZulu-Natal (UKZN) in Durban and the Centre for Epidemic Response and Innovation (CERI) at Stellenbosch University, his work focuses on genomic surveillance and analysis in the COVID-19 pandemic and for viral and bacterial epidemics, including HIV and tuberculosis in South Africa and arboviruses in Brazil.

[Perspectives] A reckoning on how we live with pain

The Lancet - Sa, 06/08/2022 - 00:00
There are few experiences more quintessential to our shared humanity than that of pain. Our ability to experience the fullness of life is inextricably linked to our ability to experience, and ideally learn from, our discomfort. Yet our relationship to pain and the potential for suffering has fundamentally shifted in ways that adversely impact us personally, socially, and economically. Chronic pain is estimated to affect one in five adults worldwide and is one of the leading causes of disability in the USA.

[Obituary] Deborah James

The Lancet - Sa, 06/08/2022 - 00:00
Cancer campaigner, podcaster, and teacher. Born Oct 1, 1981 in London, UK, she died of bowel cancer on June 28, 2022 in Woking, UK, aged 40 years.

[Correspondence] Troubling assumptions behind GBD 2019 on the health risks of red meat

The Lancet - Sa, 06/08/2022 - 00:00
We echo the compliments of Alice Stanton and colleagues1 to the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. We also support Stanton and colleagues’ call for further clarification, justification, or reconsideration of the theoretical minimum risk exposure level of zero for unprocessed red meat selected by GBD in their latest estimates. Not only does the increase in the estimated burden appear implausible, but the lack of transparency in the assumptions underlying the calculations undermines the authority of the GBD estimates.

[Correspondence] COVID-19 and microbiome diversity in sub-Saharan Africa

The Lancet - Sa, 06/08/2022 - 00:00
We read with interest the COVID-19 Forecasting Team's description of the variation in COVID-19 infection–fatality ratio,1 confirming that differences in COVID-19 mortality between geographies are largely explained by the age structures of their populations. However, we fear that the lower than anticipated burden of severe COVID-19 in most of sub-Saharan Africa gets lost in estimations from models based on data from the few African countries that have reliable excess mortality data but are not representative of sub-Saharan Africa.

[Correspondence] COVID-19 and microbiome diversity in sub-Saharan Africa – Author's reply

The Lancet - Sa, 06/08/2022 - 00:00
We thank Wim Van Damme and colleagues for their interest in our work and their Correspondence. Their comments highlight unique aspects of how the COVID-19 pandemic has unfolded in sub-Saharan Africa. These include the difficulty of estimating the true number of deaths for countries without excess mortality data, the effects of comorbidities on COVID-19 disease severity, and the distinctive immunological profile of populations in sub-Saharan Africa. We agree with the main thrust of their Correspondence and believe that clarifying some details about the scope and implementation of our analysis could be helpful.

[Correspondence] Funding to treat malnutrition: a need for greater transparency

The Lancet - Sa, 06/08/2022 - 00:00
The Editors1 highlight the gap between the humanitarian need to treat millions of children with severe acute malnutrition and the amount of funding available. However, I fear that focusing solely on supply-side issues misses a major problem in the cost-effective use of funding. An example is the UN's adherence to the non-evidence-based stipulation that ready-to-use therapeutic food (RUTF) must contain at least 50% of its protein from dairy. This 2007 stipulation corresponded to the only recipe available at the time.

[Articles] Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3–07/TROG 07.01): a randomised, factorial, multicentre, open-label, phase 3 study

The Lancet - Sa, 06/08/2022 - 00:00
In patients with resected non-low-risk DCIS, a tumour bed boost after WBI reduced local recurrence with an increase in grade 2 or greater toxicity. The results provide the first randomised trial data to support the use of boost radiation after postoperative WBI in these patients to improve local control. The international scale of the study supports the generalisability of the results.

[Articles] Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study

The Lancet - Sa, 06/08/2022 - 00:00
To our knowledge, this is the first study to report the nature and prevalence of post-COVID-19 condition, while correcting for individual symptoms present before COVID-19 and the symptom dynamics in the population without SARS-CoV-2 infection during the pandemic. Further research that distinguishes potential mechanisms driving post-COVID-19-related symptomatology is required.

[Clinical Picture] Immune tolerance induction through haematopoietic chimerism after kidney donation

The Lancet - Sa, 06/08/2022 - 00:00
A 57-year-old man with end-stage kidney disease from type 2 diabetes was assessed at our specialist unit for a kidney transplant to be donated by his brother. The patient was unsensitised and blood group O; his 59-year-old brother was the same blood type and two-haplotype HLA-matched. Both the patient and his brother were enrolled into our immunological tolerance protocol, which combines a haematopoietic stem-cell transplant with a kidney transplant with the goal of inducing sustained mixed chimerism—a state where the recipient's haematopoietic system has a mixture of both host and donor cells.

Artificial finger can identify what common material things are made of

New Scientist - Ve, 05/08/2022 - 21:00
Smart finger uses sensors to detect substances such as glass, silicon and wood with more than 90 per cent accuracy, which could be useful for robotic manufacturing tasks

What does the Inflation Reduction Act mean for US carbon emissions?

New Scientist - Ve, 05/08/2022 - 20:57
The US senate just passed the Inflation Reduction Act of 2022, which includes the largest climate spending package in US history. How big of an effect will it have?

What will the Inflation Reduction Act mean for US carbon emissions?

New Scientist - Ve, 05/08/2022 - 20:57
The US senate is set to pass the Inflation Reduction Act of 2022, which would include the largest climate spending package in US history. How big of an effect could it have?

If cryptocurrencies are unhackable, how do they keep getting stolen?

New Scientist - Ve, 05/08/2022 - 18:50
News of a $190 million cryptocurrency theft emerged this week, despite cryptocurrencies being designed to be unhackable. Here's the low-down on what is going on and how safe bitcoin or other cryptocurrencies are

Hummingbird that was feared extinct is spotted in Colombian mountains

New Scientist - Ve, 05/08/2022 - 14:56
The Santa Marta sabrewing, an emerald green hummingbird, has been officially documented for only the second time since it was discovered in 1946
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