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Launching a plan for the Cancer Moonshot.

Lancet. 2016 Sep 17;388(10050):1130

Authors: The Lancet

PMID: 27650078 [PubMed - indexed for MEDLINE]

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An unusual extranodal T-cell non-Hodgkin lymphoma.

Lancet. 2016 Sep 10;388(10049):1127-8

Authors: Coats JT, Mackie AD, Kernohan NM, Ramkumar PG, McMahon LM, Goodlad JR, Tauro S

PMID: 27628520 [PubMed - indexed for MEDLINE]

Related Articles

Oil dependence and terrorism in Europe.

Lancet. 2016 Sep 10;388(10049):1055

Authors: Guerrier G

PMID: 27628518 [PubMed - indexed for MEDLINE]

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Routine molecular profiling of patients with NSCLC.

Lancet. 2016 Sep 10;388(10049):1054

Authors: Schildgen V, Schildgen O

PMID: 27628517 [PubMed - indexed for MEDLINE]

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Hepatitis C: the path towards effective universal therapy.

Lancet. 2016 Sep 10;388(10049):1051-2

Authors: Piroth L, Rabaud C, Rey D, Schmit JL, Chirouze C, Beck-Wirth G, Robineau O, Bani-Sadr F, ICONE Study Group

PMID: 27628513 [PubMed - indexed for MEDLINE]

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Inuit take action towards suicide prevention.

Lancet. 2016 Sep 10;388(10049):1036-8

Authors: Crawford A

PMID: 27628510 [PubMed - indexed for MEDLINE]

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Zika's emerging threat for the Asia-Pacific region.

Lancet. 2016 Sep 10;388(10049):1026

Authors: The Lancet

PMID: 27628509 [PubMed - indexed for MEDLINE]

Related Articles

Robotic surgery evaluation: 10 years too late.

Lancet. 2016 Sep 10;388(10049):1026

Authors: The Lancet

PMID: 27628508 [PubMed - indexed for MEDLINE]

Related Articles

The 2016 US Election: a platform for improving health.

Lancet. 2016 Sep 10;388(10049):1025

Authors: The Lancet

PMID: 27628507 [PubMed - indexed for MEDLINE]

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Against the odds, Sri Lanka eliminates malaria.

Lancet. 2016 Sep 10;388(10049):1038-9

Authors: Senaratne R, Singh PK

PMID: 27613520 [PubMed - indexed for MEDLINE]

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Profile: Istituto Superiore di Sanità, Rome, Italy.

Lancet. 2016 Sep 10;388(10049):1044

Authors: Paterleni M

PMID: 27590219 [PubMed - indexed for MEDLINE]

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Protect Syria's doctors: an open letter to world leaders.

Lancet. 2016 Sep 10;388(10049):1056

Authors: Ghaleb S, Mukwege DM, Roberts R, Sulkowicz KJ, Vlassov VV, 23 signatories, a full list of signatories is available in the appendix

PMID: 27581530 [PubMed - indexed for MEDLINE]

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Improving outcomes in dialysis fistulae.

Lancet. 2016 Sep 10;388(10049):1029-30

Authors: Mamode N, Calder F

PMID: 27492882 [PubMed - indexed for MEDLINE]

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Innovation and surgical clinical trials.

Lancet. 2016 Sep 10;388(10049):1027-8

Authors: Mayer E, Darzi A

PMID: 27474377 [PubMed - indexed for MEDLINE]

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Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study.

Lancet. 2016 Sep 10;388(10049):1057-66

Authors: Yaxley JW, Coughlin GD, Chambers SK, Occhipinti S, Samaratunga H, Zajdlewicz L, Dunglison N, Carter R, Williams S, Payton DJ, Perry-Keene J, Lavin MF, Gardiner RA

Abstract
BACKGROUND: The absence of trial data comparing robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy is a crucial knowledge gap in uro-oncology. We aimed to compare these two approaches in terms of functional and oncological outcomes and report the early postoperative outcomes at 12 weeks.
METHOD: In this randomised controlled phase 3 study, men who had newly diagnosed clinically localised prostate cancer and who had chosen surgery as their treatment approach, were able to read and speak English, had no previous history of head injury, dementia, or psychiatric illness or no other concurrent cancer, had an estimated life expectancy of 10 years or more, and were aged between 35 years and 70 years were eligible and recruited from the Royal Brisbane and Women's Hospital (Brisbane, QLD). Participants were randomly assigned (1:1) to receive either robot-assisted laparoscopic prostatectomy or radical retropubic prostatectomy. Randomisation was computer generated and occurred in blocks of ten. This was an open trial; however, study investigators involved in data analysis were masked to each patient's condition. Further, a masked central pathologist reviewed the biopsy and radical prostatectomy specimens. Primary outcomes were urinary function (urinary domain of EPIC) and sexual function (sexual domain of EPIC and IIEF) at 6 weeks, 12 weeks, and 24 months and oncological outcome (positive surgical margin status and biochemical and imaging evidence of progression at 24 months). The trial was powered to assess health-related and domain-specific quality of life outcomes over 24 months. We report here the early outcomes at 6 weeks and 12 weeks. The per-protocol populations were included in the primary and safety analyses. This trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12611000661976.
FINDINGS: Between Aug 23, 2010, and Nov 25, 2014, 326 men were enrolled, of whom 163 were randomly assigned to radical retropubic prostatectomy and 163 to robot-assisted laparoscopic prostatectomy. 18 withdrew (12 assigned to radical retropubic prostatectomy and six assigned to robot-assisted laparoscopic prostatectomy); thus, 151 in the radical retropubic prostatectomy group proceeded to surgery and 157 in the robot-assisted laparoscopic prostatectomy group. 121 assigned to radical retropubic prostatectomy completed the 12 week questionnaire versus 131 assigned to robot-assisted laparoscopic prostatectomy. Urinary function scores did not differ significantly between the radical retropubic prostatectomy group and robot-assisted laparoscopic prostatectomy group at 6 weeks post-surgery (74·50 vs 71·10; p=0·09) or 12 weeks post-surgery (83·80 vs 82·50; p=0·48). Sexual function scores did not differ significantly between the radical retropubic prostatectomy group and robot-assisted laparoscopic prostatectomy group at 6 weeks post-surgery (30·70 vs 32·70; p=0·45) or 12 weeks post-surgery (35·00 vs 38·90; p=0·18). Equivalence testing on the difference between the proportion of positive surgical margins between the two groups (15 [10%] in the radical retropubic prostatectomy group vs 23 [15%] in the robot-assisted laparoscopic prostatectomy group) showed that equality between the two techniques could not be established based on a 90% CI with a Δ of 10%. However, a superiority test showed that the two proportions were not significantly different (p=0·21). 14 patients (9%) in the radical retropubic prostatectomy group versus six (4%) in the robot-assisted laparoscopic prostatectomy group had postoperative complications (p=0·052). 12 (8%) men receiving radical retropubic prostatectomy and three (2%) men receiving robot-assisted laparoscopic prostatectomy experienced intraoperative adverse events.
INTERPRETATION: These two techniques yield similar functional outcomes at 12 weeks. Longer term follow-up is needed. In the interim, we encourage patients to choose an experienced surgeon they trust and with whom they have rapport, rather than a specific surgical approach.
FUNDING: Cancer Council Queensland.

PMID: 27474375 [PubMed - indexed for MEDLINE]

Related Articles

US prisons missing opportunities to tackle HIV in inmates.

Lancet. 2016 Sep 10;388(10049):1041-2

Authors: Rubin R

PMID: 27427458 [PubMed - indexed for MEDLINE]

Related Articles

Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees.

Lancet. 2016 Sep 10;388(10049):1089-102

Authors: Dolan K, Wirtz AL, Moazen B, Ndeffo-Mbah M, Galvani A, Kinner SA, Courtney R, McKee M, Amon JJ, Maher L, Hellard M, Beyrer C, Altice FL

Abstract
The prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV, viral hepatitis, and tuberculosis. We did a comprehensive literature search of data published between 2005 and 2015 to understand the global epidemiology of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and tuberculosis in prisoners. We further modelled the contribution of imprisonment and the potential impact of prevention interventions on HIV transmission in this population. Of the estimated 10·2 million people incarcerated worldwide on any given day in 2014, we estimated that 3·8% have HIV (389 000 living with HIV), 15·1% have HCV (1 546 500), 4·8% have chronic HBV (491 500), and 2·8% have active tuberculosis (286 000). The few studies on incidence suggest that intraprison transmission is generally low, except for large-scale outbreaks. Our model indicates that decreasing the incarceration rate in people who inject drugs and providing opioid agonist therapy could reduce the burden of HIV in this population. The prevalence of HIV, HCV, HBV, and tuberculosis is higher in prison populations than in the general population, mainly because of the criminalisation of drug use and the detention of people who use drugs. The most effective way of controlling these infections in prisoners and the broader community is to reduce the incarceration of people who inject drugs.

PMID: 27427453 [PubMed - indexed for MEDLINE]

Related Articles

On both sides of the prison walls-prisoners and HIV.

Lancet. 2016 Sep 10;388(10049):1032-3

Authors: Das P, Horton R

PMID: 27427449 [PubMed - indexed for MEDLINE]

Related Articles

Prisoners, prisons, and HIV: time for reform.

Lancet. 2016 Sep 10;388(10049):1033-5

Authors: Beyrer C, Kamarulzaman A, McKee M, Lancet HIV in Prisoners Group

PMID: 27427447 [PubMed - indexed for MEDLINE]

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Current approaches to dealing with burnouts in doctors on an individual case-by-case basis is not effective and the issue should instead be tackled with organization-wide initiatives, according to researchers.
Repeated dieting may lead to weight gain because the brain interprets the diets as short famines and urges the person to store more fat for future shortages, new research suggests.
Aging is a key risk factor for a variety of devastating, chronic diseases, yet the biological factors that influence when and how rapidly cells deteriorate over time remain largely unknown. Now, for the first time, a research team has linked the function of a core component of cells' machinery -- which cuts and rejoins RNA molecules in a process known as "RNA splicing" -- with longevity in the roundworm. The finding sheds light on the biological role of splicing in lifespan and suggests that manipulating specific splicing factors in humans might help promote healthy aging.
Low-intensity smokers who puff on 10 or less cigarettes per day over their lifetime still have higher risks of death than individuals who never smoke, providing further evidence that there is no safe level of cigarette smoking, according to a study.
The ancient Japanese art of flower arranging was the inspiration for a groundbreaking technique to create tiny “artificial brains” that could be used to develop personalized cancer treatments.
Two studies define how key genetic factors affect blood-forming stem cells by either accelerating or hindering the cells’ regenerative properties. The findings could one day lead to improved treatments for people undergoing common therapies for cancer such as chemotherapy and radiation, say researchers.
Fear of confronting the tensions and conflicts brought on by existential concerns—the “big questions” of life—is linked with poorer mental health, including higher levels of depression, anxiety and difficulty regulating emotions, according to a new study.
Immune cellular therapy is a promising new area of cancer treatment. Anti-cancer therapeutics, such as chimeric antigen receptor (CAR) modified T cells, can be engineered to target tumor-associated antigens to attack and kill cancer cells. This allows for an improved precision medicine approach to treating cancer.
A long-sought-after mechanism has been found in human cells that creates immunity to influenza A virus, which causes annual seasonal epidemics and occasional pandemics.
Over the last few decades, an age-old infectious disease has been re-emerging globally: syphilis. Using techniques to analyze low levels of DNA, an international research team has now shown that all syphilis strains from modern patient samples share a common ancestor from the 1700s. Furthermore, their research demonstrates that strains dominating infections today originate from a pandemic cluster that emerged after 1950, and these strains share a worrying trait: resistance to the second-line antibiotic azithromycin.
Labor induction is one of the most common medical procedures in the world, with nearly one-quarter of women who deliver in the U.S. undergoing the procedure each year (totaling roughly 1 million). Despite its widespread use, labor induction is costly and still has no widely accepted “best practice.” Now, new research is showing what may be the best available method for inducing labor, which may be necessary under circumstances including medical conditions such as preeclampsia, gestational diabetes or other health risks to the mom or baby.
Combination drug treatments have become successful at long-term control of HIV infection, but the goal of totally wiping out the virus and curing patients has so far been stymied by HIV's ability to hide out in cells and become dormant for long periods of time. One of the proposed curative strategies for HIV, known as "shock and kill," may be harmful to patients' brains, warn researchers.
In a Phase I study, 8 out of 12 patients with relapsed and/or chemotherapy refractory blood cancers responded to a combination of the chemotherapy drugs thioguanine and decitabine; some of the responders had relapsed after treatment with decitabine alone, report researchers.
What are the psychological demands commonly faced by endurance athletes? New research has identified psychological stressors common to endurance athletes across different sports at different performance levels. A new article underscores where researchers can make effective recommendations to athletes of all abilities in helping them cope with pervasive psychological difficulties. The new research is therefore an important set of findings for anyone interested in improving performance in endurance sports.
Researchers have elucidated a mechanism that recycles bacterial ribosomes stalled on messenger RNAs that lack termination codons. The protein involved provides a potential target for future antibiotics.
A portable sensor has been developed that can assess the clotting ability of a person’s blood 95 times faster than current methods—using only a single drop of blood.
There is a common misperception that widespread marijuana use is limited to younger generations. However, the Baby Boomer generation has reported higher rates of substance use than any preceding generation.
A large analysis of current research shows that people who eat at least 20g of nuts a day have a lower risk of heart disease, cancer and other diseases.
A chemist has designed and synthesized a catalyst that flexibly molds the handedness of the reaction products with which it interacts.
A research team has investigated the expression of ribosomal proteins in a wide range of human tissues including tumors and discovered a cancer type specific signature. This “cancer signature” could potentially be used to predict the progression of the disease.
Researchers show modification of a gene product results in greater physical activity and reduced body weight in mice, thus boosting understanding of how physical activity is regulated at the cellular level in the nervous system.
How do you remember what happened today in the weeks and months that follow? Researchers have answered a piece of that question in a recent study.
Increased stigma and discrimination can affect circadian HPA-axis functioning, say researchers. The majority of previous studies have been conducted among white heterosexuals, with very little research examining HPA-axis functioning between different minorities. Individuals who identify as both sexual and racial minorities may experience increased stigma and discrimination that can affect this HPA-axis functioning. Now, researchers have examined differences in diurnal cortisol rhythm between young, self-identified, white gay men and black gay men.
A researcher wants to scrap the traditional electronic and paper survey approaches to gathering marketing and information systems data in favor of scanning your brainwaves.
Patients successfully treated for breast, colon and other cancers can go on to develop an often-fatal form of leukemia, sometimes years after completion of treatment, due to a genetic mutation leading to secondary malignancies known as therapy-related myeloid neoplasms (t-MNs).
Researchers are reporting the highest and most sustained levels to date of an essential blood-clotting factor IX in patients with the inherited bleeding disorder hemophilia B. After receiving a single dose of an experimental gene therapy in a clinical trial, patients with hemophilia produced near-normal levels of clotting factor IX, allowing them to stop clotting factor infusions and to pursue normal activities of daily life without disabling bleeding episodes.
In a small, early phase trial, a high percentage of patients who had exhausted most traditional treatments for chronic lymphocytic leukemia saw their tumors shrink or even disappear after an infusion of a highly targeted, experimental CAR T-cell immunotherapy.
People with schizophrenia who have difficulty hearing subtle changes in pitch may be helped with auditory training exercises and a drug that targets NMDA receptors in the brain, report researchers.
As the Zika epidemic spreads to the United States, the potential for contracting the disease via blood transfusion has emerged as a serious concern. The problem of transfusion-related Zika virus transmission—and recommended strategies to reduce that risk—are outlined in a new article.
Epilepsy patients who want to learn how to manage their own unique symptoms can now get individualized information via tablet computer through a new research project.
A novel route for non-covalent protein modification has now been tested, and results reveal a new way to improve the stability of common protein drugs and extend shelf-life.
What are the characteristics of the way you say, “hello,” (or anything else for that matter) that makes you recognizable over the phone? Despite the increasing amount of literature on personal voice quality, very little is actually known about how to characterize the sound of an individual speaker.
Researchers have developed a chemical tool to control inflammation that is activated by ultraviolet (UV) light.
Sodium thiosulfate prevents cisplatin-induced hearing loss in children and adolescents with cancer, investigators have determined.
Pregnant women who take a specific type of antidepressant in early pregnancy have a small but significantly greater risk of having babies with major congenital anomalies (sometimes referred to as birth defects) or stillbirths compared with those who did not take these antidepressants, suggests a dose-response analysis.
When we are in a deep slumber our brain's activity ebbs and flows in big, obvious waves, like watching a tide of human bodies rise up and sit down around a sports stadium. It's hard to miss. Now, researchers have found, those same cycles exist in wake as in sleep, but with only small sections sitting and standing in unison rather than the entire stadium. It's as if tiny portions of the brain are independently falling asleep and waking back up all the time.
A new device that could revolutionize the delivery of medicine to treat cancer as well as a host of other diseases and ailments has been outlined in a new report.
Hospitals in which the administration of epinephrine to patients whose hearts have stopped is delayed beyond five minutes have significantly lower survival rates of those patients, a new study.
New findings showed associations between psychological well-being and physical activity in adults ages 50 and older.
Too little sleep takes a toll on your heart, according to a new study.
Scientists hoping to get a glimpse of molecules that control brain activity have devised a new probe that allows them to image these molecules without using any chemical or radioactive labels.
Working with human immune cells in the laboratory, researchers report they have identified a critical cellular "off" switch for the inflammatory immune response that contributes to lung-constricting asthma attacks. The switch, they say, is composed of regulatory proteins that control an immune signaling pathway in cells.
Two recently discovered genetic differences between brain cancer cells and normal tissue cells — an altered gene and a snippet of noncoding genetic material — could offer clues to tumor behavior and potential new targets for therapy, scientists report.
For the two-thirds of kidney stone patients who need more than just extra hydration to pass their stones, physicians are eager to find non-surgical ways to help. Now, a new review of the medical literature suggests alpha blockers may be useful in some cases.
A new diet intervention study raises questions regarding the validity of a diet hypothesis that has dominated for more than half a century: that dietary fat and particularly saturated fat is unhealthy for most people.
A novel method of treating phantom limb pain has been developed using machine learning and augmented reality. This approach has been tested on over a dozen of amputees with chronic phantom limb pain who found no relief by other clinically available methods before. The new treatment reduced their pain by approximately 50 per cent, reports a clinical study.
A new anti-cancer drug that inhibits a key cell signalling process involved in many different cancers has shown that it is capable of stopping the progression of cancer and shrinking tumors. Importantly, it has been able to do this in rare cancers that are less well-studied such as adenoid cystic carcinoma.
Researchers working to find effective treatments for soft tissue sarcomas have discovered that combining a new anti-cancer drug with an existing one kills cancer cells not only in the laboratory but also in the first two patients treated with it, leading to unusually long-lasting periods without the disease progressing.
An important molecular link between a rare childhood genetic disease and a major cancer gene has been uncovered by scientists. The discovery could lead to improved treatment outcomes for some cancer patients, they say.
Even if they don't understand the words, infants react to the way their mother speaks and the emotions conveyed through speech. What exactly they react to and how has yet to be fully deciphered, but could have significant impact on a child's development. Researchers in acoustics and psychology teamed up to better define and study this impact.
Scientists have observed the influence of social and financial contextual information on the pleasures of art. The focus was on the question whether the purchase price, the prestige of a gallery or the socioeconomic status and educational status of other persons have an influence on the personal taste.
By genetically tweaking the constituent live virus, scientists have created a vaccine against influenza in which the virus is capable of activating the immune system but cannot replicate in healthy cells -- an approach that may become more widely used for generating live virus vaccines adapted to other viruses.
Researchers have compared prevalence of aquaporin-4 in the brains of those who had Alzheimer's to those who didn't have the disease, and report that they may have found a new target for treating and preventing the disease.
Researchers have developed a new computational model of the human brain's face-recognition mechanism that seems to capture aspects of human neurology that previous models have missed.
More whites died than were born in a record high 17 states in 2014 compared to just four in 2004, according to new research. Some 121 million people representing 38 percent of the U.S. population reside in these states: California, Pennsylvania, Florida, Arizona, Massachusetts, New Jersey, New Hampshire, Mississippi, Arkansas, Delaware, Nevada, Maine, Alabama, Connecticut, New Mexico, West Virginia and Rhode Island.
An existing drug known as a JAK inhibitor may help patients who don't respond to the so-called checkpoint inhibitor immunotherapy drugs overcome that resistance, suggests a new preclinical study. Importantly, the results demonstrate that shutting down the interferon pathway, shown here to be critical to a tumor's resistance to immunotherapy, with a JAK inhibitor may improve checkpoint inhibitor drugs and even bypass the need for combinations of these drugs, which often come with serious side effects.
The number of shoulder replacement surgeries has skyrocketed across the United States as technology improves and aging Baby Boomers seek to relieve pain and restore function to arthritic shoulders.
Researchers have identified unique genomic changes that may be integral to testicular cancer development and explain why the great majority are highly curable with chemotherapy – unlike most solid tumors.
Open office plans are becoming increasingly common in the workplace -- offering a way to optimize available space and encourage dialogue, interaction and collaboration among employees. However, a new study suggests that productive work-related conversations might actually decrease the performance of other employees within earshot -- more so than other random, meaningless noises.
A large international survey of women with a common condition called polycystic ovary syndrome (PCOS), which is characterized by reproductive and metabolic problems, found nearly two in three were dissatisfied with the length of time they waited and the number of healthcare professionals they had to see before they received a diagnosis, according to a new study.

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