Pub Date : 2026-01-01DOI: 10.1016/j.lana.2025.101364
The Lancet Regional Health – Americas
{"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}
Pub Date : 2025-12-31DOI: 10.1016/j.lana.2025.101347
Abelardo Q.C. Araujo , Marcus Tulius T. Silva
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.
{"title":"Expanding the neurological spectrum of HTLV-1 beyond HAM/TSP: a contemporary perspective","authors":"Abelardo Q.C. Araujo , 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}
Pub Date : 2025-12-30DOI: 10.1016/j.lana.2025.101355
Garrett Keim , Paula Magee , Cody Gathers , Anireddy R. Reddy , Charlotte Z. Woods-Hill , Nadir Yehya
Background
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.
Methods
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.
Findings
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.
Interpretation
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.
Funding
This work was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health (Award K23HL177271, PI: Keim).
背景：儿童重症监护结果的差异是公认的，但描述儿童急性呼吸窘迫综合征（PARDS）患病率、死亡率和时间趋势的国家数据是有限的。我们描述了2016年至2022年美国儿童中算法定义的ARDS （PARDS的替代方法）的患病率、地区和种族/民族死亡率差异。方法采用2016年、2019年和2022年儿童住院患者数据库（KID）进行回顾性队列研究。通过ICD-10方法确定算法定义的ARDS，要求肺部、败血症或休克病因引起的急性呼吸衰竭需要有创机械通气≥24小时。主要结局是院内死亡率。暴露是美国地区和种族/民族，单独和联合建模。混合效应logistic回归模型，调整了收入四分位数、疾病的APR-DRG严重程度、医院类型和复杂慢性病，估计了调整后的死亡率和风险差异。算法定义的ARDS发生在每年约42,000例住院患者中，患病率从2016年的0.68% （95% CI 0.67-0.69）增加到2022年的0.75%（0.74-0.75）。2016年总死亡率为12.9%(12.5-13.3)，2019年为12.5%(12.1-12.9)，2022年为13.7%（13.3-14.1）。在联合模型中，相对于东北部白人儿童（预测10.9%,95% CI 9.72-12.1），南部黑人儿童（预测14.2%,ARD 3.27%, 1.74-4.79）和西部黑人儿童（14.6%,ARD 3.69%, 1.39-6.00）的风险更高；西部的西班牙裔儿童（12.6%,ARD 1.70%, 0.09-3.31），南部（16.5%,ARD 5.57%, 3.14-7.99）和西部（14.0%,ARD 3.11%, 0.96-5.25）的其他种族/族裔儿童。从2016年到2019年，差距没有显著变化，而死亡率从2019年到2022年有所上升。解释算法定义的急性呼吸窘迫综合征在美国住院儿童中仍然很常见且高度致命。持续存在的区域和种族/族裔差异突出了不平等的系统性驱动因素和有针对性干预措施的必要性。本研究得到了美国国立卫生研究院国家心肺血液研究所的支持（编号：K23HL177271， PI: Keim）。
{"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 , Paula Magee , Cody Gathers , Anireddy R. Reddy , Charlotte Z. Woods-Hill , 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}
Pub Date : 2025-12-29DOI: 10.1016/j.lana.2025.101360
Thiago Cerqueira-Silva , Felipe Argolo , Gabriel Gonçalves da Costa , Felipe Nogueira Barbara , Pedro Hallal , Bruno Gualano
{"title":"Uncovering the biases: why the claimed mask–excess mortality link fails to hold","authors":"Thiago Cerqueira-Silva , Felipe Argolo , Gabriel Gonçalves da Costa , Felipe Nogueira Barbara , Pedro Hallal , 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}
Pub Date : 2025-12-29DOI: 10.1016/j.lana.2025.101352
Caineng Cao , Teeradon Treechairusame , Amir H. Safavi , Yingzhi Wu , Zhigang Zhang , Achraf Shamseddine , Yao Yu , Nadeem Riaz , Daphna Y. Gelblum , Sean M. McBride , Alan L. Ho , Winston Wong , Lara A. Dunn , Loren Scott Michel , Eric J. Sherman , Nancy Y. Lee
Background
Intensity-modulated proton therapy (IMPT) is associated with fewer acute toxicities compared with intensity-modulated radiotherapy (IMRT) in definitive treatment of nonmetastatic nasopharyngeal carcinoma (NPC). Longer term efficacy and safety data are warranted to appraise the comparative benefit of IMPT for this population. The aim of this study was to evaluate the long-term toxicity and survival outcomes of NPC treated with IMPT vs IMRT at a tertiary academic cancer center during 2016–2022.
Methods
Sixty-seven (42.1%) cases treated by IMPT, and 92 (57.9%) controls treated by IMRT were included.
Findings
The median follow-up time was 55.4 months (interquartile range [IQR], 32.1–73.8 months). The incidence of any grade 2+ acute toxicity was lower with IMPT than IMRT (86.6% vs 97.8%, p = 0.009). Based on the logistic regression analysis, radiotherapy modality (IMRT vs IMPT) was significantly associated with developing any grade 2+ acute toxicity (odds ratio, 0.177; 95% confidence interval 0.035–0.886; p = 0.035). The incidence of grade 2+ late toxicity was not significantly different (p > 0.05) following IMPT (40.3%) and IMRT (52.7%). There were no statistically significant differences following IMRT and IMPT in 5-year cumulative incidence of local or regional failures [16.4% (9.1–25.6) vs 14.1% (6.5–24.7)], progression free survival and overall survival.
Interpretation
Although there were no statistically significant differences in incidence of late toxicities or oncologic outcomes, IMPT was associated with lower incidence of acute toxicity in comparison with IMRT.
Funding
This research was funded in part through the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748.
背景：在非转移性鼻咽癌（NPC）的最终治疗中，与调强放疗（IMRT）相比，调强质子治疗（IMPT）的急性毒性更小。需要长期疗效和安全性数据来评估IMPT对这一人群的相对获益。本研究的目的是评估2016-2022年在三级学术癌症中心接受IMPT与IMRT治疗的鼻咽癌的长期毒性和生存结果。方法采用IMPT治疗67例（42.1%），对照组92例（57.9%）。中位随访时间为55.4个月（四分位数间距32.1-73.8个月）。IMPT组任何2+级急性毒性发生率均低于IMRT组（86.6% vs 97.8%, p = 0.009）。根据logistic回归分析，放疗方式（IMRT vs IMPT）与发生任何2+级急性毒性显著相关（优势比0.177；95%可信区间0.035 - 0.886;p = 0.035）。IMPT组（40.3%）和IMRT组（52.7%）2+级晚期毒性发生率无显著差异（p > 0.05）。IMRT和IMPT在5年累积局部或区域失败发生率[16.4% (9.1-25.6)vs 14.1%(6.5-24.7)]、无进展生存期和总生存期方面无统计学差异。尽管在晚期毒性发生率或肿瘤预后方面没有统计学上的显著差异，但与IMRT相比，IMPT的急性毒性发生率较低。本研究部分由美国国立卫生研究院/国家癌症研究所癌症中心支持基金P30 CA008748资助。
{"title":"Intensity-modulated proton therapy vs intensity-modulated radiotherapy in nasopharyngeal carcinoma: a case–control study","authors":"Caineng Cao , Teeradon Treechairusame , Amir H. Safavi , Yingzhi Wu , Zhigang Zhang , Achraf Shamseddine , Yao Yu , Nadeem Riaz , Daphna Y. Gelblum , Sean M. McBride , Alan L. Ho , Winston Wong , Lara A. Dunn , Loren Scott Michel , Eric J. Sherman , Nancy Y. Lee","doi":"10.1016/j.lana.2025.101352","DOIUrl":"10.1016/j.lana.2025.101352","url":null,"abstract":"<div><h3>Background</h3><div>Intensity-modulated proton therapy (IMPT) is associated with fewer acute toxicities compared with intensity-modulated radiotherapy (IMRT) in definitive treatment of nonmetastatic nasopharyngeal carcinoma (NPC). Longer term efficacy and safety data are warranted to appraise the comparative benefit of IMPT for this population. The aim of this study was to evaluate the long-term toxicity and survival outcomes of NPC treated with IMPT vs IMRT at a tertiary academic cancer center during 2016–2022.</div></div><div><h3>Methods</h3><div>Sixty-seven (42.1%) cases treated by IMPT, and 92 (57.9%) controls treated by IMRT were included.</div></div><div><h3>Findings</h3><div>The median follow-up time was 55.4 months (interquartile range [IQR], 32.1–73.8 months). The incidence of any grade 2+ acute toxicity was lower with IMPT than IMRT (86.6% vs 97.8%, p = 0.009). Based on the logistic regression analysis, radiotherapy modality (IMRT vs IMPT) was significantly associated with developing any grade 2+ acute toxicity (odds ratio, 0.177; 95% confidence interval 0.035–0.886; p = 0.035). The incidence of grade 2+ late toxicity was not significantly different (p > 0.05) following IMPT (40.3%) and IMRT (52.7%). There were no statistically significant differences following IMRT and IMPT in 5-year cumulative incidence of local or regional failures [16.4% (9.1–25.6) vs 14.1% (6.5–24.7)], progression free survival and overall survival.</div></div><div><h3>Interpretation</h3><div>Although there were no statistically significant differences in incidence of late toxicities or oncologic outcomes, IMPT was associated with lower incidence of acute toxicity in comparison with IMRT.</div></div><div><h3>Funding</h3><div>This research was funded in part through the <span>National Institutes of Health</span>/<span>National Cancer Institute Cancer Center</span> Support Grant <span><span>P30 CA008748</span></span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101352"},"PeriodicalIF":7.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884385","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}
Pub Date : 2025-12-29DOI: 10.1016/j.lana.2025.101354
Lawrence A. Haber , Katherine LeMasters , Justin Berk
{"title":"Inclusion of incarcerated individuals in wildfire exposure registries","authors":"Lawrence A. Haber , Katherine LeMasters , Justin Berk","doi":"10.1016/j.lana.2025.101354","DOIUrl":"10.1016/j.lana.2025.101354","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"55 ","pages":"Article 101354"},"PeriodicalIF":7.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885803","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}
Pub Date : 2025-12-27DOI: 10.1016/j.lana.2025.101350
Amos Grünebaum , Ruth Landau , Frank A. Chervenak
Background
The safety of out-of-hospital birth in the United States remains contested. A neglected methodological issue is the selective nonreporting of 5-min Apgar scores, which may conceal adverse outcomes and bias safety comparisons. This study examined whether Apgar score missingness differs systematically by birth setting and whether such “informative missingness” alters risk estimates.
Methods
We conducted a population-based analysis of 3,066,021 term, normal-birthweight, midwife-attended singleton births in the United States (2016–2023). Birth settings included hospitals, freestanding birth centers, and planned home births. Missing 5-min Apgar scores were quantified, and deterministic sensitivity analyses modeled the impact of varying assumptions about unrecorded low scores (<4 and <7). Hospital births served as the reference group.
Findings
Five-minute Apgar scores were missing in 0.13% of hospital, 1.9% of birth-center, and 3.1% of home births. Severe compromise (Apgar <4) occurred in 0.17%, 0.20%, and 0.26%, respectively. When half of missing scores were imputed as <4, adjusted odds of severe compromise increased to 7.7 for home and 4.9 for birth-center births vs. hospitals.
Interpretation
This study evaluates documentation integrity of US births. Selective nonreporting of 5-min Apgar scores at out-of-hospital births introduces major bias, distorting apparent safety of out-of-hospital births. Complete and enforceable outcome reporting is essential for scientific validity and ethically sound informed consent.
{"title":"Selective nonreporting of 5-min Apgar scores and its safety assessment of out-of-hospital births: a population-based study of United States’ birth data, 2016–2023 a population based study","authors":"Amos Grünebaum , Ruth Landau , Frank A. Chervenak","doi":"10.1016/j.lana.2025.101350","DOIUrl":"10.1016/j.lana.2025.101350","url":null,"abstract":"<div><h3>Background</h3><div>The safety of out-of-hospital birth in the United States remains contested. A neglected methodological issue is the selective nonreporting of 5-min Apgar scores, which may conceal adverse outcomes and bias safety comparisons. This study examined whether Apgar score missingness differs systematically by birth setting and whether such “informative missingness” alters risk estimates.</div></div><div><h3>Methods</h3><div>We conducted a population-based analysis of 3,066,021 term, normal-birthweight, midwife-attended singleton births in the United States (2016–2023). Birth settings included hospitals, freestanding birth centers, and planned home births. Missing 5-min Apgar scores were quantified, and deterministic sensitivity analyses modeled the impact of varying assumptions about unrecorded low scores (<4 and <7). Hospital births served as the reference group.</div></div><div><h3>Findings</h3><div>Five-minute Apgar scores were missing in 0.13% of hospital, 1.9% of birth-center, and 3.1% of home births. Severe compromise (Apgar <4) occurred in 0.17%, 0.20%, and 0.26%, respectively. When half of missing scores were imputed as <4, adjusted odds of severe compromise increased to 7.7 for home and 4.9 for birth-center births vs. hospitals.</div></div><div><h3>Interpretation</h3><div>This study evaluates documentation integrity of US births. Selective nonreporting of 5-min Apgar scores at out-of-hospital births introduces major bias, distorting apparent safety of out-of-hospital births. Complete and enforceable outcome reporting is essential for scientific validity and ethically sound informed consent.</div></div><div><h3>Funding</h3><div>None declared.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101350"},"PeriodicalIF":7.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840622","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号