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Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021 1990-2021 年全球、地区和国家成人超重和肥胖流行率,以及到 2050 年的预测:2021 年全球疾病负担研究的预测研究
Pub Date : 2025-03-03 DOI: 10.1016/s0140-6736(25)00355-1
<h3>Background</h3>Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050.<h3>Methods</h3>Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends.<h3>Findings</h3>Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, th
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引用次数: 0
Forecasting the global obesity epidemic through 2050
Pub Date : 2025-03-03 DOI: 10.1016/s0140-6736(25)00260-0
Thorkild I A Sørensen
No Abstract
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引用次数: 0
Atosiban and managing women in preterm labour
Pub Date : 2025-03-03 DOI: 10.1016/s0140-6736(25)00402-7
Maureen Makama, Joshua P Vogel
No Abstract
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引用次数: 0
Atosiban versus placebo for threatened preterm birth (APOSTEL 8): a multicentre, randomised controlled trial 阿托西班与安慰剂治疗早产儿(APOSTEL 8):多中心随机对照试验
Pub Date : 2025-03-03 DOI: 10.1016/s0140-6736(25)00295-8
Larissa I van der Windt, Job Klumper, Ruben G Duijnhoven, Marjolein Kok, Carrie Ris-Stalpers, Marjon A de Boer, Anton H van Kaam, Eva Pajkrt, Ben W Mol, Kate F Walker, Fionnuala M McAuliffe, Joris A van der Post, Carolien Roos, Martijn A Oudijk

Background

Tocolytics are recommended in international guidelines as treatment for threatened preterm birth. Atosiban, an oxytocin receptor antagonist, is a registered tocolytic drug specifically indicated for the treatment of threatened preterm birth. Although tocolytics have been shown to delay birth, benefits on neonatal outcomes have not been demonstrated. In the APOSTEL 8 trial we aimed to assess superiority of tocolysis with atosiban compared with placebo in threatened preterm birth from 30 weeks and 0 days (30+0 weeks) to 33+6 weeks of gestation in improving neonatal morbidity and mortality.

Methods

This was an international, multicentre, randomised, double-blind, superiority trial conducted in 26 hospitals in the Netherlands, England, and Ireland. After written informed consent, women aged 18 years or older with a singleton or twin pregnancy with threatened preterm birth from 30+0 to 33+6 weeks of gestation were randomly assigned (stratified by centre, 1:1 ratio) to intravenous atosiban or placebo. The primary outcome was a composite of perinatal mortality (stillbirth and death until 28 days postpartum) and six severe neonatal morbidities. Analysis was by intention-to-treat. Treatment effect was estimated as relative risk (RR) with 95% CI. This trial was prospectively registered at EudraCT (2017-001007-72) and the Netherlands Trial Registry (NL-OMON54673), and is complete.

Findings

Between Dec 4, 2017, and July 24, 2023, a total of 755 participants were randomly assigned, of whom 752 were included in the intention-to-treat analysis (atosiban n=375, placebo n=377). The primary outcome occurred in 37 (8%) of 449 infants in the atosiban group and 40 (9%) of 435 in the placebo group (RR 0·90 [95% CI 0·58–1·40]). There were three (0·7%) and four (0·9%) infants who died, respectively (RR 0·73 [0·16–3·23]); all deaths were deemed unlikely to be related to the study drug. Maternal adverse events did not differ between groups, and there were no maternal deaths.

Interpretation

We did not demonstrate superiority of atosiban over placebo in improving neonatal outcomes as treatment for threatened preterm birth from 30+0 to 33+6 weeks of gestation. As the primary goal of tocolysis should be improvement of neonatal outcomes, our outcomes question the standardised use of atosiban as treatment for threatened preterm birth from 30+0 to 33+6 weeks of gestation. Our findings should reduce practice variation across countries and will contribute to evidence-based treatment for patients with threatened preterm birth.

Funding

ZonMw.
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引用次数: 0
Efficacy and safety of twice per year depemokimab in chronic rhinosinusitis with nasal polyps (ANCHOR-1 and ANCHOR-2): phase 3, randomised, double-blind, parallel trials 每年两次使用去莫基单抗治疗伴有鼻息肉的慢性鼻窦炎的有效性和安全性(ANCHOR-1 和 ANCHOR-2):第 3 期随机、双盲、平行试验
Pub Date : 2025-03-01 DOI: 10.1016/s0140-6736(25)00197-7
Philippe Gevaert, Martin Desrosiers, Marjolein Cornet, Joaquim Mullol, Eugenio De Corso, Nesil Keles Turel, Jorge Maspero, Shigeharu Fujieda, Luo Zhang, Ana R Sousa, Samantha J Woods, Angela M Davis, Stein Schalkwijk, Dawn Edwards, Prerna Ranganathan, Richard Follows, Carolynne Marshall, Joseph K Han
<h3>Background</h3>Chronic rhinosinusitis with nasal polyps (CRSwNP) symptoms are frequently driven by type 2 inflammation. Depemokimab is the first ultra-long-acting biological drug engineered with enhanced interleukin-5 binding affinity, high potency, and an extended half-life, enabling twice per year dosing and sustained type 2 inflammation inhibition. The ANCHOR-1 and ANCHOR-2 trials investigated the efficacy and safety of depemokimab in people with CRSwNP.<h3>Methods</h3>ANCHOR-1 and ANCHOR-2 were randomised, double-blind, placebo-controlled, parallel-group, replicate phase 3 trials conducted concurrently at 190 centres (hospitals, specialised clinics, and clinical trial sites) in 16 countries (Argentina, Belgium, Canada, China, France, Germany, Italy, Japan, the Netherlands, Poland, Romania, Spain, Sweden, Türkiye, the UK, and the USA). Individuals aged 18 years or older at the time of consent, with inadequately controlled CRSwNP, an endoscopic bilateral nasal polyps score of 5 or more, previous surgery for CRSwNP or previous treatment with or intolerance to systemic corticosteroids, and severe symptoms were stratified by previous CRSwNP surgery and randomly assigned 1:1 to receive either depemokimab (100 mg subcutaneously) or placebo every 26 weeks (with standard of care). Allocation was computer generated. The trial sponsor, site staff, and participants were masked. The coprimary endpoints were change from baseline in total endoscopic nasal polyps score (0–8) at week 52 and mean nasal obstruction score (verbal response scale [0–3]) over weeks 49–52, assessed in the full analysis set. Integrated analyses were conducted. Adverse events on treatment and after treatment were monitored. The trials are complete and are registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span> (<span><span>NCT05274750</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span> and <span><span>NCT05281523</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>).<h3>Findings</h3>Between April 18, 2022, and Aug 7, 2023, 540 individuals were randomly assigned across ANCHOR-1 and ANCHOR-2; 528 participants comprised the full analysis set (depemokimab, n=272; placebo, n=256). Depemokimab had statistically significant improvements from baseline versus placebo in the coprimary endpoints of total nasal polyps score (treatment difference: ANCHOR-1, –0·7, 95% CI –1·1 to –0·3; p<0·001; ANCHOR-2, –0·6, –1·0 to –0·2; p=0·004; integrated, –0·7, –0·9 to –0·4) and mean nasal o
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引用次数: 0
Ultra-long-acting biological therapy for chronic rhinosinusitis with nasal polyps 治疗伴有鼻息肉的慢性鼻窦炎的超长效生物疗法
Pub Date : 2025-03-01 DOI: 10.1016/s0140-6736(25)00367-8
Sathish Paramasivan, Peter-John Wormald
No Abstract
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引用次数: 0
Rebuilding trust and equity in Syria's health system: a governance-driven transition
Pub Date : 2025-02-28 DOI: 10.1016/s0140-6736(25)00406-4
Munzer Alkhalil, Aula Abbara, Mayssoon Dashash, Richard Sullivan, Maher Aboumayaleh, Abdulkarim Ekzayez, Zuhair Kharrat, Reem Hasan Obaydo, Zeidoun Alzoubi, Majd Alghatrif, Fouad M Fouad
No Abstract
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引用次数: 0
Glenn Bowes
Pub Date : 2025-02-27 DOI: 10.1016/s0140-6736(25)00350-2
Jacqui Thornton
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引用次数: 0
Mechanical circulatory support for cardiogenic shock
Pub Date : 2025-02-27 DOI: 10.1016/s0140-6736(24)02854-x
Christophe Giacardi, Gildas Gueret, Baptiste Quilly
No Abstract
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引用次数: 0
Legacies of ableism and the pursuit of disability justice in medicine
Pub Date : 2025-02-27 DOI: 10.1016/s0140-6736(25)00349-6
Ananya Tina Banerjee
No Abstract
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引用次数: 0
期刊
The Lancet
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