Lancet Regional Health-Americas最新文献

{"title":"US emergency department visits by women due to assault (2018–2021): a retrospective cross-sectional analysis","authors":"Summer Chavez ,&nbsp;Irma Ugalde ,&nbsp;Michael Ulrich ,&nbsp;Omolola Adepoju ,&nbsp;Tonghui Xu ,&nbsp;Winston Liaw","doi":"10.1016/j.lana.2025.101343","DOIUrl":"10.1016/j.lana.2025.101343","url":null,"abstract":"<div><h3>Background</h3><div>Domestic violence has played a key role in linking firearms and homicide amongst female individuals. Combined with the increase of reports of violence against women during the COVID-19 pandemic, a rise in emergency department (ED) visits may be witnessed. Our aim was to estimate the changes in prevalence and risk factors associated with assault and firearm-related emergency department (ED) visits by female patients following the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>We performed a retrospective cross-sectional study of female patients presenting to EDs due to assault from the National Emergency Department Sample (NEDS) from 2018 to 2021. Independent variables included age, race, mortality, ED disposition, primary payer, location, mean total ED chargers, quartile ZIP income, and mechanism and intent of injury. The adjusted association between independent variables and ED visits among patients injured by firearms compared to those injured by other assaults was examined.</div></div><div><h3>Findings</h3><div>The analytic sample represented an estimated 1,575,543 ED weighted records of female assault cases out of a total weighted sample of 537,133,200 observations (0.29%). While year-over-year ED encounters decreased, firearm injuries and the proportion of patients admitted and dying in the hospital increased. Female patients who were injured by firearms had 89 times higher risk of dying in the ED (RR = 88.82; 95% CI 6 = 72.38–97.06) compared to female patients injured by non-firearm injury mechanisms. Racial disparities were prevalent, with Native American women experiencing the greatest risk of being assaulted (RR = 2.81; 95% CI 2.67–2.97). Victims of firearm related assaults had nearly 4.12 times the risk of identifying as Black compared with those assaulted without firearms (95% CI 3.75–4.52). Female patients seeking care for assault had higher risk of being uninsured (95% CI 2.70–2.77).</div></div><div><h3>Interpretation</h3><div>While year-over-year ED encounters due to assault decreased, lockdowns and restrictions associated with the observed COVID-19 pandemic may not fully reflect changes in abuse rates in this time period. The strong connection between firearm presence and female homicide and continuations of assault and firearm-related ED visits among vulnerable demographic groups highlights the need for effective strategies to reduce violence.</div></div><div><h3>Funding</h3><div>Unfunded.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101343"},"PeriodicalIF":7.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazil's health tax at a crossroads: safeguarding the constitutional victory against ultra-processed foods","authors":"Felipe Silva Neves ,&nbsp;Larissa Loures Mendes ,&nbsp;Eduardo Augusto Fernandes Nilson ,&nbsp;Inês Rugani Ribeiro de Castro ,&nbsp;Rafael Moreira Claro ,&nbsp;Daniela Silva Canella ,&nbsp;Ísis Eloah Machado ,&nbsp;Ariene Silva do Carmo ,&nbsp;Mariana Carvalho de Menezes ,&nbsp;Deborah Carvalho Malta","doi":"10.1016/j.lana.2025.101363","DOIUrl":"10.1016/j.lana.2025.101363","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"55 ","pages":"Article 101363"},"PeriodicalIF":7.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond encampments: an evidence-based path to solving Canada's homelessness crisis","authors":"Mohammad Karamouzian ,&nbsp;Stephen W. Hwang ,&nbsp;Dan Werb","doi":"10.1016/j.lana.2025.101362","DOIUrl":"10.1016/j.lana.2025.101362","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"55 ","pages":"Article 101362"},"PeriodicalIF":7.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-cigarettes versus combination nicotine replacement therapy following a recent failed quit attempt: a pragmatic randomized trial through state tobacco quitlines","authors":"Theodore L. Wagener ,&nbsp;Alice Hinton ,&nbsp;Theodore M. Brasky ,&nbsp;Yoo Jin Cho ,&nbsp;Laura A. Beebe ,&nbsp;Michael S. Businelle ,&nbsp;Matthew J. Carpenter ,&nbsp;Jonathan Hart ,&nbsp;Katrina A. Vickerman","doi":"10.1016/j.lana.2025.101351","DOIUrl":"10.1016/j.lana.2025.101351","url":null,"abstract":"<div><h3>Background</h3><div>E-cigarettes have emerged as a potentially more effective and satisfying alternative to nicotine replacement therapy (NRT) for smokers who struggle to quit. Although quitlines are effective platforms for tobacco cessation, they have not incorporated e-cigarettes due to regulatory concerns and limited clinical evidence. We evaluated whether quitline-delivered counseling combined with e-cigarettes was more effective than counseling with NRT among adults who recently failed to quit using standard quitline services.</div></div><div><h3>Methods</h3><div>We conducted a pragmatic, open-label, parallel-group randomised controlled trial with two U.S. state quitlines between October 2020 and January 2023. Adults [N = 350; 212 (61%) female &amp; 248 (72%) white] who were still smoking after a recent quitline enrollment were randomised (1:1) to receive 8 weeks of either JUUL e-cigarettes or a combination of nicotine patch and lozenge, along with three counseling calls. The primary outcome was biochemically verified 7-day point prevalence smoking abstinence (7-day PPA) at 8 weeks. Analyses used an intent-to-treat approach; secondary outcomes included 12-week abstinence, prolonged abstinence, changes in smoking behavior, dependence, and adverse effects.</div></div><div><h3>Findings</h3><div>At 8 weeks, 7-day PPA did not differ significantly between e-cigarette and NRT groups [25 (14.3%) of 175 and 17 (9.7%) of 175, respectively; OR 1.56; 95% CI 0.80–3.04; p = 0.19]. Both groups showed similar reductions in cigarette use and dependence. Adherence to counseling and assigned products was high. Adverse events were generally mild; cough and breathing difficulties were more frequently reported in the e-cigarette group and NRT participants reported more dizziness, sleeplessness, and allergies.</div></div><div><h3>Interpretation</h3><div>Among quitline users with a recent failed quit attempt, e-cigarettes combined with quitline counseling were not more effective than combination NRT in increasing smoking abstinence after 8 weeks’ follow-up.</div></div><div><h3>Funding</h3><div>U.S. <span>National Institute on Drug Abuse</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101351"},"PeriodicalIF":7.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique role of the prospective cohort incident-tumor biobank method in etiological research","authors":"Shuji Ogino ,&nbsp;Alpa V. Patel ,&nbsp;Satoko Ugai ,&nbsp;Marios Giannakis ,&nbsp;Tomotaka Ugai","doi":"10.1016/j.lana.2025.101290","DOIUrl":"10.1016/j.lana.2025.101290","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101290"},"PeriodicalIF":7.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the post-pandemic timing of influenza, RSV, and COVID-19 driving seasonal influenza-like illness in the United States: a retrospective ecological study","authors":"George Dewey ,&nbsp;Austin G. Meyer ,&nbsp;Raul Garrido Garcia ,&nbsp;Mauricio Santillana","doi":"10.1016/j.lana.2025.101359","DOIUrl":"10.1016/j.lana.2025.101359","url":null,"abstract":"<div><h3>Background</h3><div>Influenza and respiratory syncytial virus (RSV) are major contributors to the burden of seasonal influenza-like illnesses (ILI) in the US. The prevention and treatment of ILI varies substantially across age groups and in cost and administration schedule. This study aimed to characterize the timing and ordering of RSV, influenza, and COVID-19 epidemics in the post-pandemic period to inform public health preparedness.</div></div><div><h3>Methods</h3><div>We implemented a series of independent regression models to infer the contribution of each of these diseases to seasonal ILI syndromic indicators. We further implemented anomaly-detection algorithms on data from the US Centers for Disease Control and Prevention National Syndromic Surveillance Program for the 2022–23, 2023–24, and 2024–25 ILI seasons to identify the timing of onsets and peaks of RSV, influenza, and COVID-19.</div></div><div><h3>Findings</h3><div>A total of 148 state-ILI seasons were analyzed. In 114 out of 148 (77.0%) of analyzed seasons, volume of RSV emergency department (ED) visits peaked before influenza ED visits. The median time difference between peaks of RSV and peaks of influenza was +3.0 weeks (95% percentile range: −7.0, +7.0 weeks; interquartile range: 5.0 weeks). The timing of RSV and influenza onsets were found to occur more synchronously in the 2023–2024 and 2024–2025 ILI seasons. The timing of COVID-19 outbreaks did not show a consistent seasonal pattern across the study period.</div></div><div><h3>Interpretation</h3><div>RSV epidemics frequently reach peak volume before influenza epidemics across the US. Healthcare professionals and public health authorities should anticipate increases in RSV cases and hospitalizations at the start of the annual ILI season and establish infrastructure and planning to handle incoming surges of both RSV and influenza appropriately.</div></div><div><h3>Funding</h3><div>CDC <span>Center for Forecasting and Outbreak Analytics</span>; <span>National Institutes of Health</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"55 ","pages":"Article 101359"},"PeriodicalIF":7.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era for RSV: the end in sight?","authors":"The Lancet Regional Health – Americas","doi":"10.1016/j.lana.2025.101364","DOIUrl":"10.1016/j.lana.2025.101364","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101364"},"PeriodicalIF":7.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the neurological spectrum of HTLV-1 beyond HAM/TSP: a contemporary perspective","authors":"Abelardo Q.C. Araujo ,&nbsp;Marcus Tulius T. Silva","doi":"10.1016/j.lana.2025.101347","DOIUrl":"10.1016/j.lana.2025.101347","url":null,"abstract":"<div><div>Human T-lymphotropic virus type 1 (HTLV-1) has long been linked mainly to HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). However, four decades of research show that the virus causes a much broader range of neurological conditions. In Latin America and the Caribbean—regions with high prevalence but limited awareness, diagnostic capacity, and treatment—its burden is especially severe. Misdiagnosis or neglect often delays care, leading to increased disability and emotional distress. This Personal View highlights the expanding neurological spectrum of HTLV-1, which includes rare but well-documented encephalopathy, cognitive decline, peripheral neuropathy, inflammatory myopathy, cerebellar dysfunction, autonomic disorders, motor neuron disease-like syndromes, and seizures. These can happen independently or alongside HAM/TSP. The proposed concept of an “HTLV-1 neurological complex” better represents this multifaceted involvement. Recognising this diversity is essential for accurate diagnosis and better outcomes, particularly in endemic settings. A paradigm shift is needed—one that broadens the clinical focus beyond myelopathy to encompass the full neurological spectrum, thereby improving global care and management.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"55 ","pages":"Article 101347"},"PeriodicalIF":7.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical and racial and/or ethnic disparities in pediatric ARDS mortality in the USA, 2016–2022: a triennial national database retrospective cohort analysis","authors":"Garrett Keim ,&nbsp;Paula Magee ,&nbsp;Cody Gathers ,&nbsp;Anireddy R. Reddy ,&nbsp;Charlotte Z. Woods-Hill ,&nbsp;Nadir Yehya","doi":"10.1016/j.lana.2025.101355","DOIUrl":"10.1016/j.lana.2025.101355","url":null,"abstract":"<div><h3>Background</h3><div>Disparities in pediatric critical care outcomes are recognized, but national data describing Pediatric Acute Respiratory Distress Syndrome (PARDS) prevalence, mortality and temporal trends are limited. We described prevalence, and regional and racial/ethnic mortality disparities for algorithm-defined ARDS, a surrogate for PARDS in US children from 2016 to 2022.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using the 2016, 2019, and 2022 Kids' Inpatient Database (KID). Algorithm-defined ARDS was identified with an ICD-10 approach requiring acute respiratory failure from pulmonary, sepsis, or shock etiologies requiring invasive mechanical ventilation ≥24 h. The primary outcome was in-hospital mortality. Exposures were US region and Race/Ethnicity, modeled individually and jointly. Mixed-effect logistic regression models, adjusting for income quartile, APR-DRG severity of illness, hospital type, and complex chronic conditions, estimated adjusted mortalities and risk differences.</div></div><div><h3>Findings</h3><div>Algorithm-defined ARDS occurred in about 42,000 hospitalizations per year, with prevalence increasing from 0.68% (95% CI 0.67–0.69) in 2016 to 0.75% (0.74–0.75) in 2022. Overall mortality was 12.9% (12.5–13.3) in 2016, 12.5% (12.1–12.9) in 2019, and 13.7% (13.3–14.1) in 2022. In the joint model, relative to Northeastern White children (predicted 10.9%, 95% CI 9.72–12.1), risks were higher for Black children in the South (predicted 14.2%, ARD 3.27%, 1.74–4.79) and West (14.6%, ARD 3.69%, 1.39–6.00); Hispanic children in the West (12.6%, ARD 1.70%, 0.09–3.31), and children of Other race/ethnicity in the South (16.5%, ARD 5.57%, 3.14–7.99) and West (14.0%, ARD 3.11%, 0.96–5.25). Disparities did not meaningfully change from 2016 to 2019, while mortality increased from 2019 to 2022.</div></div><div><h3>Interpretation</h3><div>Algorithm-defined ARDS among hospitalized US children remains common and highly fatal. Persistent regional and racial/ethnic disparities highlight systemic drivers of inequity and the need for targeted interventions.</div></div><div><h3>Funding</h3><div>This work was supported by the <span>National Heart, Lung, and Blood Institute, National Institutes of Health</span> (Award K23HL177271, PI: Keim).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101355"},"PeriodicalIF":7.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the biases: why the claimed mask–excess mortality link fails to hold","authors":"Thiago Cerqueira-Silva ,&nbsp;Felipe Argolo ,&nbsp;Gabriel Gonçalves da Costa ,&nbsp;Felipe Nogueira Barbara ,&nbsp;Pedro Hallal ,&nbsp;Bruno Gualano","doi":"10.1016/j.lana.2025.101360","DOIUrl":"10.1016/j.lana.2025.101360","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"55 ","pages":"Article 101360"},"PeriodicalIF":7.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}