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Age-specific trends in colorectal, appendiceal, and anal tumour incidence by histological subtype in Australia from 1990 to 2020: a population-based time-series analysis 从1990年到2020年,澳大利亚按组织学亚型划分的结直肠、阑尾和肛门肿瘤发病率的年龄特异性趋势:基于人群的时间序列分析
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101728
Aaron L. Meyers , James G. Dowty , Khalid Mahmood , Finlay A. Macrae , Christophe Rosty , Daniel D. Buchanan , Mark A. Jenkins

Background

Early-onset bowel cancer incidence (age <50 years) has increased worldwide and is highest in Australia, but how trends vary across age, histology, and anatomical site remains unclear. We investigated appendiceal, proximal colon, distal colon, rectal, and anal cancer incidence trends by age and histology in Australia.

Methods

Cancer incidence rate data were obtained from nation-wide cancer registries (1990–2020). Birth cohort-specific incidence rate ratios (IRRs) and annual percentage change were estimated using age-period-cohort modelling and joinpoint regression.

Findings

Combining all malignant tumour histologies, early-onset incidence rose 5–9% annually, yielding 4072 excess cases (1·5 per 100,000 person-years; 15% appendix, 28% colon, 48% rectum, 9% anus). Trends varied by site, period, and age: appendiceal cancer rose from 1990 to 2020 in 30–49-year-olds; colorectal cancers rose from around 1990–2010 in 20–29-year-olds and from 2010 to 2020 in 30–39-year-olds; anal cancer rose from 1990 to 2009 in 40–49-year-olds. Across sites, IRRs increased with successive birth cohorts since 1960. Adenocarcinoma incidence in the 1990s versus 1950s cohort was 2–3-fold for colorectum and 7-fold for appendix. The greatest subtype-specific increases occurred for appendiceal mucinous adenocarcinoma, colorectal non-mucinous adenocarcinoma, and anal squamous cell carcinoma. Colorectal neuroendocrine neoplasms, squamous cell carcinomas, and signet ring cell carcinomas rose across early-onset and later-onset strata.

Interpretation

Appendiceal, colorectal, and anal cancer incidence is rising in Australia, with variation across age and histology. These generational shifts suggest evolving risk factor profiles and early-life exposures, highlighting the need to identify drivers of this growing burden.

Funding

Australian Government.
早发性肠癌发病率(年龄50岁)在世界范围内呈上升趋势,澳大利亚发病率最高,但不同年龄、组织学和解剖部位的趋势如何变化尚不清楚。我们调查了澳大利亚按年龄和组织学划分的阑尾、近端结肠、远端结肠、直肠和肛门癌的发病率趋势。方法癌症发病率数据来自全国癌症登记处(1990-2020年)。使用年龄-时期-队列模型和联结点回归估计出生队列特定发病率比(IRRs)和年百分比变化。结合所有恶性肿瘤组织学,早发发病率每年上升5 - 9%,超额4072例(每10万人年1.5例;阑尾15%,结肠28%,直肠48%,肛门9%)。趋势因地点、时期和年龄而异:从1990年到2020年,30 - 49岁的阑尾癌发病率上升;从1990年到2010年,20 - 29岁人群的结直肠癌发病率上升,从2010年到2020年,30 - 39岁人群的结直肠癌发病率上升;从1990年到2009年,肛门癌在40 - 49岁的人群中有所上升。从各个地点来看,自1960年以来,irr随着连续出生队列的增加而增加。在20世纪90年代和50年代的队列中,结直肠的腺癌发病率是2 - 3倍,阑尾是7倍。最大的亚型特异性增加发生在阑尾黏液性腺癌、结直肠非黏液性腺癌和肛门鳞状细胞癌。结直肠神经内分泌肿瘤、鳞状细胞癌和印戒细胞癌在早发和晚发人群中呈上升趋势。阑尾癌、结直肠癌和肛门癌的发病率在澳大利亚呈上升趋势,且随年龄和组织学的变化而变化。这些代际变化表明不断变化的风险因素概况和早期生活暴露,突出表明需要确定这一日益增长的负担的驱动因素。FundingAustralian政府。
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引用次数: 0
Prevalence and incidence of chronic kidney diseases in Hong Kong: a 12-year territory-wide retrospective cohort study 香港慢性肾脏疾病的患病率和发病率:一项为期12年的全港回顾性队列研究
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101726
Noel C. Yue , Shun-Cheong Ho , Jonathan K.L. Mak , Franco W.T. Cheng , Edward Y.W. Tam , Wallis C.Y. Lau , Ruby L.C. Hoo , Kathryn C.B. Tan , Desmond Y.H. Yap , Ching-Lung Cheung

Background

Over the past decades, epidemiology studies on chronic kidney disease (CKD) have been widely conducted globally, but research on its prevalence and incidence in Chinese population remain scarce. This retrospective cohort study utilized all creatinine and urine albumin-to-creatinine ratio data obtained from the Clinical Data Analysis and Reporting System (CDARS), a territory-wide electronic medical database in Hong Kong, to provide the most up-to-date and largest Chinese cohort with long-term follow-up for comprehensive analysis of the trends in CKD prevalence and incidence.

Methods

Patients diagnosed with CKD between 2010 and 2021 were identified from CDARS. Prevalence, crude incidence, and age-standardized incidence using the United Nations population in 2018 as a reference were estimated. Subgroups of age and sex were also estimated accordingly. Joinpoint regression was used to estimate the annual percent change (APC) and average annual percent change (AAPC).

Findings

A total of 496,796 CKD patients between 2010 and 2021 were identified from CDARS. The prevalence of CKD (per 100,000 persons) increased from 3065.76 (95% confidence interval, CI: 3051.68–3079.88) to 6296.38 (95% CI: 6277.02–6315.78) between 2010 and 2021, with males generally having higher prevalence. The overall prevalence AAPC was 6.69% (95% CI: 6.45–7.03; p < 0.001), with the APC trend decelerating from 13.82% (95% CI: 11.17–16.10; p < 0.001) in 2012 to 4.06% (95% CI: 3.30–4.52; p < 0.001) in 2021. Both crude and age-standardized incidence (per 100,000 persons) showed a decreasing trend, in which the age-standardized incidence decreased from 533.61 (95% CI: 528.4–538.86) to 391.14 (95% CI: 387.2–395.11) between 2010 and 2021, with an AAPC of −3.74% (95% CI: −5.04 to −2.50; p < 0.001). Disparity in trends was observed among sex and age groups.

Interpretation

The deceleration in CKD prevalence growth after 2012, along with the declining incidence trends may reflect the impact of the strategic framework launched by the Hong Kong government to prevent and control chronic diseases. Meanwhile, the sex differences in CKD trends support evidence that Asian males generally have a higher prevalence than females, differing from patterns observed in other regions. Further studies in diverse Asian populations are needed to reduce geographical bias and enhance understanding of CKD.

Funding

None.
在过去的几十年里,慢性肾脏疾病(CKD)的流行病学研究已经在全球范围内广泛开展,但关于其在中国人群中的患病率和发病率的研究仍然很少。这项回顾性队列研究利用了香港临床数据分析和报告系统(CDARS)的所有肌酐和尿白蛋白与肌酐比值数据,该系统是一个覆盖全港的电子医疗数据库,为全面分析CKD患病率和发病率的趋势提供了最新和最大的长期随访的中国队列。方法2010年至2021年间诊断为CKD的患者通过CDARS进行识别。以2018年联合国人口为参考,估计了患病率、粗发病率和年龄标准化发病率。对年龄和性别的亚组也进行了相应的估计。采用联合点回归方法估计年变化百分数(APC)和平均年变化百分数(AAPC)。2010年至2021年间,共有496,796名CKD患者从CDARS中被确定。2010年至2021年间,CKD患病率(每10万人)从3065.76(95%置信区间,CI: 3051.68-3079.88)上升至6296.38 (95% CI: 6277.02-6315.78),男性患病率普遍较高。AAPC总体患病率为6.69% (95% CI: 6.45-7.03; p < 0.001), APC趋势从2012年的13.82% (95% CI: 11.17-16.10; p < 0.001)降至2021年的4.06% (95% CI: 3.30-4.52; p < 0.001)。粗发病率和年龄标准化发病率(每10万人)均呈下降趋势,其中年龄标准化发病率在2010 - 2021年间从533.61 (95% CI: 528.4-538.86)下降到391.14 (95% CI: 387.2-395.11), AAPC为- 3.74% (95% CI: - 5.04 - - 2.50; p < 0.001)。在性别和年龄组之间观察到趋势的差异。2012年后CKD患病率增速放缓,发病率呈下降趋势,可能反映了香港政府推出的慢性病防治战略框架的影响。同时,CKD趋势的性别差异支持亚洲男性普遍比女性患病率高的证据,这与其他地区观察到的模式不同。需要在不同的亚洲人群中进行进一步的研究,以减少地域偏见并增强对ckd的理解。
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引用次数: 0
Leveraging malaria microscopy infrastructure to diagnose common and neglected skin diseases using direct microscopy in Sumba, Indonesia 利用疟疾显微镜基础设施,在印度尼西亚松巴利用直接显微镜诊断常见和被忽视的皮肤病
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101739
Gladys O. Siregar , Maria Harianja , Dallas J. Smith , Messe R. Ataupah , Ruth D. Laiskodat , Claus Bøgh , Hardyanto Soebono , Marlous L. Grijsen
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引用次数: 0
Sustainable age-friendly cities and communities in China: a scoping review and narrative assessment of national policies 中国可持续的老年人友好型城市和社区:国家政策的范围审查和叙事评估
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101723
Yanhui Jia , Siwon Lee , Mikiko Kanda , Pankyu Park , Sally J. Edwards , Jiuxuan Gao , Weiju Zhou , John S. Ji

Background

Climate change, aging populations, and rapid urbanization intersect to pose public health challenges in China, impacting the livelihoods of older adults. This review maps China's national policies shaping Sustainable Age-Friendly Cities and Communities (AFCC), highlights supporting sub-national innovations, and identifies potential policy gaps and opportunities.

Methods

We searched 26 national government websites for policy documents published from January 1, 2020, to December 20, 2024, screening 35,809 records and including 125 that met criteria.

Findings

National frameworks (National Strategy for Climate Change Adaptation 2035, Healthy China 2030, Healthy Cities) have parallel efforts linking climate resilience and healthy aging. However, policy domains are siloed: age-friendly policies focus on healthcare accessibility, whereas sustainability policies target ecological restoration. Sub-national innovations, such as 15-min life circles, sponge cities for flood, “one old, one young” inter-generational hubs, advance climate adaptation. The large-scale Three-North Shelter Forest Program indirectly benefits older adults respiratory risk by controlling dust and desertification. However, these initiatives run in parallel, with limited shared targets, data systems, and co-financing. Institutional fragmentation and regional disparities in geographic, economic, and administrative capacities impede uniform implementation, risking inefficient spending and missed synergies.

Interpretation

Effective action on concurrent aging and climate risks hinges on policy-and-practice integration of AFCC and sustainability agendas. Age-friendly plans should include sustainability and vice versa. China's administrative grid and large-scale ecological programs provide infrastructure for delivery of dual-benefits.

Funding

This work is supported by the World Health Organization (WPRO/2024-02/AGE-DHP/22552 4), the National Natural Science Foundation of China (82422064, 82250610230, 42307535, 42577488), the Natural Science Foundation of Beijing (IS23105), and the National Bureau for Disease Control and Prevention (20241660047).
气候变化、人口老龄化和快速城市化共同构成了中国的公共卫生挑战,影响了老年人的生计。本综述描绘了中国塑造可持续老年友好型城市和社区(AFCC)的国家政策,强调了对地方创新的支持,并确定了潜在的政策差距和机遇。方法检索26个国家政府网站,检索2020年1月1日至2024年12月20日发布的政策文件,筛选35809条记录,其中符合标准的125条。国家框架(《国家适应气候变化战略2035》、《健康中国2030》、《健康城市》)将气候适应能力与健康老龄化联系起来。然而,政策领域是孤立的:老年人友好型政策侧重于医疗保健可及性,而可持续性政策的目标是生态恢复。地方创新,如15分钟生活圈、海绵城市防洪、“一老一少”代际枢纽,促进了气候适应。大规模的三北防护林工程通过控制沙尘和沙漠化间接使老年人的呼吸风险受益。然而,这些行动是并行进行的,只有有限的共同目标、数据系统和共同融资。体制分散和地域、经济和行政能力方面的区域差异阻碍了统一实施,可能导致支出效率低下和错失协同效应。应对老龄化和气候风险的有效行动取决于AFCC和可持续性议程的政策和实践整合。老年人友好型计划应包括可持续性,反之亦然。中国的行政网格和大规模生态规划为实现双重效益提供了基础设施。基金资助:世界卫生组织(WPRO/2024-02/年龄- dhp / 225524),国家自然科学基金(82422064,82250610230,42307535,42577488),北京市自然科学基金(IS23105),国家疾病预防控制局(20241660047)。
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引用次数: 0
Corrigendum to Policies, resource allocation, and interventions for child and adolescent mental health in low- and middle-income countries in the Western Pacific Region: a scoping review [The Lancet Regional Health—Western Pacific, Vol 62 (2025), 101674] 西太平洋区域低收入和中等收入国家儿童和青少年心理健康政策、资源分配和干预措施的勘误表:范围审查[《柳叶刀》区域卫生-西太平洋,第62卷(2025),101674]
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101742
Jiang Long , Stephanie Zhang , Lingjun Chu , Juliet Balkian , Isabel Giovannucci , Cody Mui , Yiqun Luan , Odille Chang , Phetsavanh Chanthavilay , Kartika Goundar , Munkh-Erdene Luvsan , Elissa Kennedy , Dang Nguyen , Picholas Kian Ann Phoa , Caroline Mae Ramirez , Bach Xuan Tran , Siyan Yi , Paula Melizza Valera , Sovanvorleak Tep , Mengieng Ung , Chunling Lu
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引用次数: 0
Epidemiological characteristics of heatstroke in China, 2010–2023: a longitudinal study based on a national heatstroke surveillance system 2010-2023年中国中暑流行病学特征:基于国家中暑监测系统的纵向研究
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101722
Xiaoye Wang , Fan Ding , Xiaoqi Qi , Ziyi Wang , Yingxin Pei , Lijie Zhang , Jinghuan Ren , Yeping Wang , Qing Guo , Biao Zeng , Shiyao Xu , Tian Liu , Rui Wang , Zhifeng Wang , Guoqing Shi

Background

Heatstroke causes numerous pathophysiological changes and can lead to death. Extreme heat events have been increasing in frequency, duration, and intensity worldwide in recent decades and are causing growing public health concern. However, epidemiological studies of heatstroke are limited in number and scope, and have had relatively small sample sizes. To better understand the epidemiological characteristics of heatstroke and advance evidence-based prevention and control strategies, we conducted an observational study of reported heatstroke cases in China.

Methods

Cases included in this study were patients clinically diagnosed with heatstroke during the study period of 2010–2023, reported through a dedicated heatstroke surveillance system established by China CDC. We used descriptive statistical methods to determine the epidemiological characteristics of heatstroke in China.

Findings

There were 86,406 heatstroke cases reported during the study period, with an increasing reporting trend (Spearman correlation coefficient r = 0·79). Annual incidence (Spearman r = 0·77) and proportion of severe cases (Pearson r = 0·67) were positively correlated with the number of nationwide average annual high-temperature days. The overall incidence was 44·83 per 10 million person-years, and the mortality rate was 0·89 per 10 million person-years; 32·02% of cases were severe; the overall case fatality rate (CFR) was 1·98%, and the CFR for severe cases was 6·19%. Most cases and deaths were reported in summer, with peaks in late July. The peaks of incidence, duration, and severity varied by region. The mean age was (50·46 ± 18·73) years, with male cases younger than female cases (49·21 ± 17·41 vs 53·60 ± 21·36; t = −28·73, p < 0·0001). For every five-year increase in age, the risks of severe heatstroke and death increased by 14·64% (95% CI: 1·1415–1·1513) and 25·76% (CI: 1·2400–1·2755), respectively. The male:female ratio was 2·49:1; males exhibited a higher risk of suffering from heatstroke and having greater disease severity than females.

Interpretation

Our study provides a clear profile of heatstroke cases, and highlights differences by population, region, and time of year. Results inform formulation of evidence-based strategies for enhanced heatstroke preparedness and response, such as enhancing public health early warning systems, prioritizing protection for vulnerable groups, and advancing localized interventions for risk communication and clinical management.

Funding

Public Health Talent Program of China’s National Disease Control and Prevention Administration.
中暑会引起许多病理生理变化,并可能导致死亡。近几十年来,全球极端高温事件的频率、持续时间和强度都在增加,并引起越来越多的公共卫生关注。然而,对中暑的流行病学研究在数量和范围上都是有限的,而且样本量相对较小。为了更好地了解中暑的流行病学特征,推进循证防控策略,我们对中国报告的中暑病例进行了观察性研究。方法本研究纳入2010-2023年研究期间临床诊断为中暑的患者,这些患者通过中国疾病预防控制中心建立的中暑专用监测系统报告。我们采用描述性统计方法确定中国中暑的流行病学特征。结果研究期间共报告中暑病例86406例,呈上升趋势(Spearman相关系数r = 0.79)。年发病率(Spearman r = 0.77)和重症比例(Pearson r = 0.67)与全国年平均高温日数呈正相关。总发病率为44.83 / 1000万人-年,死亡率为0.89 / 1000万人-年;重症占32.02%;总病死率(CFR)为1.98%,重症病死率为6.19%。大多数病例和死亡报告发生在夏季,高峰出现在7月下旬。发病率、持续时间和严重程度的高峰因地区而异。平均年龄为(50.46±18.73)岁,男性比女性年轻(49.21±17.41 vs 53.60±21.36;t =−28.73,p < 0.0001)。年龄每增加5年,严重中暑和死亡的风险分别增加14.64% (95% CI: 1.1415 - 1.1513)和25.76% (CI: 1.2400 - 1.2755)。男女比例为2·49:1;与女性相比,男性患中暑的风险更高,疾病严重程度也更高。我们的研究提供了中暑病例的清晰概况,并突出了人口、地区和一年中的时间的差异。研究结果为制定加强中暑防范和应对的循证战略提供了信息,如加强公共卫生预警系统,优先保护弱势群体,推进风险沟通和临床管理的本地化干预措施。国家疾病预防控制局公共卫生人才计划资助项目。
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引用次数: 0
Risk-stratified classification of pulmonary nodule malignancy via a machine learning model integrating imaging and cell-free DNA: a model development and validation study (DECIPHER-NODL) 通过整合成像和无细胞DNA的机器学习模型进行肺结节恶性肿瘤的风险分层分类:模型开发和验证研究(DECIPHER-NODL)
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101730
Huiting Wang , Hairong Huang , Feng Li , Ying Deng , Changyong Wang , Wei Wei , Song Wang , Dongqin Zhu , Hao Xu , Hua Bao , Zheng Li , Wenjun Ye , Yuan Zhang , Caichen Li , Bo Cheng , Xiwen Liu , Liping Liu , Zheng Li , Jing Yang , Wei Chen , Wenhua Liang

Background

Accurate risk stratification of pulmonary nodules is critical for early lung cancer detection. This study aimed to improve malignancy classification and invasiveness prediction using machine learning models integrating low-dose computed tomography (LDCT) radiomics and plasma cell-free DNA (cfDNA) fragmentomics.

Methods

This multicenter study enrolled 1356 participants across discovery (n = 1147) and external validation (n = 209) cohorts. A deep learning-based imaging model processed LDCT scans for automated lung nodule detection and malignancy classification. A parallel cfDNA model analyzed four whole-genome fragmentation features: copy number variation, fragment size ratio, fragment-based methylation, and mutation context and signature. The two models were integrated via a stacked ensemble algorithm. An invasion prediction model evaluated tumor aggressiveness.

Findings

The integrated imaging-cfDNA model outperformed individual models, with an AUC of 0.950 (95% CI: 0.926–0.975) in the internal test set and 0.966 (95% CI: 0.940–0.991) in the external validation. The combined model's specificity increased to 0.60 (95% CI: 0.49–0.71) while maintaining 95% sensitivity, compared to specificities of 0.50 (95% CI: 0.41–0.59) and 0.33 (95% CI: 0.23–0.44) at equivalent sensitivity levels for the imaging and cfDNA models, respectively. The combined model consistently outperformed the other two models across nodule characteristics, with particular improvement for 10–20 mm and pure solid nodules. The invasion prediction model stratified lung cancers with an AUC of 0.884 (internal) and 0.880 (external). Prediction scores increased stepwise with tumor aggressiveness, from adenocarcinoma in situ to minimally invasive adenocarcinoma, and were highest for invasive adenocarcinoma.

Interpretation

This multimodal approach enhances pulmonary nodule risk stratification by integrating radiomic and molecular biomarkers. The model significantly improves diagnostic accuracy, potentially reducing unnecessary procedures while minimizing missed diagnoses, supporting its clinical utility in lung cancer screening.

Funding

Noncommunicable Chronic Diseases-National Science and Technology Major Project, National Key Research & Development Programme, China National Science Foundation, the Science and Technology Planning Project of Guangzhou, and Guangzhou National Laboratory.
背景准确的肺结节风险分层对于早期发现肺癌至关重要。本研究旨在通过结合低剂量计算机断层扫描(LDCT)放射组学和无浆细胞DNA (cfDNA)片段组学的机器学习模型来改善恶性肿瘤的分类和侵袭性预测。方法本多中心研究纳入了1356名参与者,包括发现队列(n = 1147)和外部验证队列(n = 209)。基于深度学习的成像模型处理LDCT扫描,用于自动检测肺结节和恶性肿瘤分类。平行cfDNA模型分析了四个全基因组片段化特征:拷贝数变异、片段大小比、基于片段的甲基化以及突变背景和特征。两个模型通过堆叠集成算法进行集成。侵袭预测模型评估肿瘤侵袭性。结果成像- cfdna集成模型优于单个模型,内部测试集的AUC为0.950 (95% CI: 0.926-0.975),外部验证集的AUC为0.966 (95% CI: 0.940-0.991)。联合模型的特异性增加到0.60 (95% CI: 0.49-0.71),同时保持95%的灵敏度,而在同等灵敏度水平下,成像和cfDNA模型的特异性分别为0.50 (95% CI: 0.41-0.59)和0.33 (95% CI: 0.23-0.44)。组合模型在结节特征方面始终优于其他两种模型,特别是在10-20 mm和纯固体结节方面有明显改善。侵袭预测模型对肺癌分层的AUC分别为0.884(内部)和0.880(外部)。从原位腺癌到微创腺癌,随着肿瘤的侵袭性,预测评分逐渐增加,浸润性腺癌的预测评分最高。这种多模式方法通过整合放射组学和分子生物标志物来增强肺结节风险分层。该模型显著提高了诊断准确性,潜在地减少了不必要的程序,同时最大限度地减少了漏诊,支持其在肺癌筛查中的临床应用。非传染性慢性病国家科技重大专项、国家重点研究发展计划、国家自然科学基金、广州市科技规划项目、广州国家实验室。
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引用次数: 0
Drug-resistant gram-negative bacterial infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data, and key evidence gaps 大洋洲区域儿童中的耐药革兰氏阴性细菌感染:流行病学、抗微生物药物可及性、治疗、临床试验和药代动力学数据以及关键证据差距的审查
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101735
Daniel K. Yeoh , Alison Boast , Sophie CH. Wen , Phoebe CM. Williams , Lesley Voss , Brett Ritchie , Mona Mostaghim , Flora Lutui , Alice Lei , Tony Lai , Adam D. Irwin , Kiera Harwood , Thomas Ewin , Celia Cooper , Emma Best , Sarah Bannister , Amanda Gwee
Gram-negative bacterial infections remain a major cause of morbidity and mortality in children and neonates globally, compounded by the rise of antimicrobial resistance. Barriers to paediatric antibiotic licencing lead to reduced availability of potentially effective agents for treatment. For children and neonates in the Oceania region, specific challenges remain including a paucity of surveillance data on local rates of antimicrobial resistance, and lack of availability of newer, more costly agents. In this review, we summarise available regional epidemiological data on the WHO priority pathogens: extended spectrum B-lactamase (ESBL)-producing Enterobacterales, carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii (CRAB). Paediatric clinical trial and pharmakinetic data for the antimicrobials recommended for treatment of these pathogens are reviewed, and paediatric knowledge gaps identified to inform future collaborative research.
革兰氏阴性细菌感染仍然是全球儿童和新生儿发病和死亡的主要原因,加上抗菌素耐药性的上升。儿科抗生素许可的障碍导致潜在有效治疗药物的可得性减少。对于大洋洲区域的儿童和新生儿来说,具体的挑战仍然存在,包括缺乏当地抗菌素耐药性的监测数据,以及缺乏更新、更昂贵的药物。在这篇综述中,我们总结了世卫组织重点病原体的现有区域流行病学数据:产生扩展谱b -内酰胺酶(ESBL)的肠杆菌、耐碳青霉烯的肠杆菌(CRE)、耐碳青霉烯的铜绿假单胞菌和耐碳青霉烯的鲍曼不动杆菌(CRAB)。审查了推荐用于治疗这些病原体的抗菌素的儿科临床试验和药动学数据,并确定了儿科知识空白,以便为未来的合作研究提供信息。
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引用次数: 0
Diabetes stigma and underdiagnosis: time to change the narrative in the Western Pacific region 糖尿病污名化和诊断不足:是时候改变西太平洋地区的叙事了
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101764
The Lancet Regional Health – Western Pacific
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引用次数: 0
Surveillance epidemiology of heatstroke in China: when numerators are denominators 中国中暑监测流行病学:当分子为分母时
IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-01 DOI: 10.1016/j.lanwpc.2025.101751
John S. Ji
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引用次数: 0
期刊
The Lancet Regional Health: Western Pacific
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