Lancet Regional Health-Europe最新文献

{"title":"Enterovirus circulation in the WHO European region, 2015–2022: a comparison of data from WHO's three core poliovirus surveillance systems and the European Non-Polio Enterovirus Network (ENPEN)","authors":"Heli Harvala ,&nbsp;Caroline K. Johannesen ,&nbsp;Kimberley S.M. Benschop ,&nbsp;Eugene V. Saxentoff ,&nbsp;Shahin Huseynov ,&nbsp;José E. Hagan ,&nbsp;Thea K. Fischer","doi":"10.1016/j.lanepe.2025.101292","DOIUrl":"10.1016/j.lanepe.2025.101292","url":null,"abstract":"<div><h3>Background</h3><div>While the association of polioviruses with paralytic disease is well-documented and closely monitored via the Global Polio Eradication initiative, monitoring of the circulation and role of other non-polio enteroviruses in paralytic and non-paralytic disease has not received the same priority. We have assessed assess the role and potential effectiveness of the current enterovirus surveillance systems in the final stages of polio eradication.</div></div><div><h3>Methods</h3><div>We compared data on enterovirus circulation and clinical associations reported to the World Health Organization (WHO) Regional Office for Europe via the acute flaccid paralysis (AFP), clinical enterovirus, and environmental surveillance systems along with that collected by the European Non-Polio Enterovirus Network (ENPEN), 2015–2022.</div></div><div><h3>Findings</h3><div>This 8-year study analysed data from 63,659 samples from diagnosed enterovirus infections reported by 48 European countries, of which 27,699 were successfully typed (43.5%). This revealed the circulation of 67 individual enterovirus types primarily reported via ENPEN (85%; 19,712/23,220), whereas most poliovirus infections were reported via WHO (99.9%; 4484/4489). Only 20% of non-polio enterovirus positive AFP cases reported to WHO were successfully typed (105/544). Clinical data linked to these cases underscored the severity of paralytic non-polio enterovirus infections with 12 deaths compared to three deaths caused by poliovirus infections during the same study period.</div></div><div><h3>Interpretation</h3><div>The study documents non-polio enterovirus infections as a frequent cause of paralysis in Europe. Implementation of standardized monitoring and reporting of all enteroviruses identified from severely ill patients, including those with paralysis, would enhance our understanding of the burden of non-polio enterovirus infections without compromising poliovirus surveillance.</div></div><div><h3>Funding</h3><div>This study was funded by <span>WHO</span> Regional Office for Europe and received financial support from the <span>Bill and Melinda Gates Foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101292"},"PeriodicalIF":13.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817750","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":"Systematic screening for atrial fibrillation with non-invasive devices: a systematic review and meta-analysis","authors":"Ali Wahab ,&nbsp;Ramesh Nadarajah ,&nbsp;Harriet Larvin ,&nbsp;Maryum Farooq ,&nbsp;Keerthenan Raveendra ,&nbsp;Mohammad Haris ,&nbsp;Umbreen Nadeem ,&nbsp;Tobin Joseph ,&nbsp;Asad Bhatty ,&nbsp;Chris Wilkinson ,&nbsp;Kamlesh Khunti ,&nbsp;Rajesh Vedanthan ,&nbsp;A John Camm ,&nbsp;Emma Svennberg ,&nbsp;Gregory YH. Lip ,&nbsp;Ben Freedman ,&nbsp;Jianhua Wu ,&nbsp;Chris P. Gale","doi":"10.1016/j.lanepe.2025.101298","DOIUrl":"10.1016/j.lanepe.2025.101298","url":null,"abstract":"<div><h3>Background</h3><div>Systematic screening individuals with non-invasive devices may improve diagnosis of atrial fibrillation (AF) and reduce adverse clinical events. We systematically reviewed the existing literature to determine the yield of new AF diagnosis associated with systematic AF screening, the relative increase in yield of new AF diagnosis with systematic screening compared to usual care, and the effect of systematic AF screening on clinical outcomes compared with usual care.</div></div><div><h3>Methods</h3><div>The Medline, Embase, Web of Science and Cochrane Library databases were searched from inception through 1st February 2025 for prospective cohort studies or randomised clinical trials (RCTs) of systematic AF screening with the outcome of incidence of previously undiagnosed AF from screening. Incidence rates (IR) and relative risks were calculated and random effects meta-analysis performed to synthesise rates of AF in prospective cohort studies and RCTs, as well as outcomes in RCTs.</div></div><div><h3>Findings</h3><div>From 3806 unique records we included 32 studies representing 735,542 participants from 8 RCTs and 24 prospective cohorts. The diagnosis rate for incident AF in prospective cohorts was 2.75% (95% CI 1.87–3.62), and the pooled relative risk in RCTs was 2.22 (95% CI 1.41–3.50). The use of age and NT-proBNP (IR 4.36%, 95% CI 3.77–5.08) or AF risk score classification (4.79%, 95% CI 3.62–6.29) led to higher new AF diagnosis yields than age alone (0.93%, 95% CI 0.28–2.99). Pooled data from RCTs did not demonstrate an effect of screening on death (RR 1.01, 95% CI 0.97–1.05), cardiovascular hospitalisation (1.00, 95% CI 0.97–1.03), stroke (0.95, 95% CI 0.87–1.04) or bleeding (1.08, 95% CI 0.91–1.29).</div></div><div><h3>Interpretation</h3><div>Systematic screening for AF using non-invasive devices is associated with increased diagnosis of AF, but not reduced adverse clinical events. Screening studies of AF utilising alternative risk stratifications and outcome measures are required.</div></div><div><h3>Funding</h3><div><span>British Heart Foundation</span> (grant reference <span><span>CC/22/250026</span></span>) and <span>National Institute for Health and Care Research</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101298"},"PeriodicalIF":13.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817751","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":"Primary care in Ireland: history explains the system we see today","authors":"Domhnall McGlacken-Byrne","doi":"10.1016/j.lanepe.2025.101300","DOIUrl":"10.1016/j.lanepe.2025.101300","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101300"},"PeriodicalIF":13.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815124","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":"Safety and efficacy of combined portal and hepatic vein embolisation in patients with colorectal liver metastases (DRAGON1): a multicentre, single-arm clinical trial","authors":"Remon Korenblik ,&nbsp;Sinéad James ,&nbsp;Jens Smits ,&nbsp;Rafael Díaz-Nieto ,&nbsp;Rob Davis ,&nbsp;Benjamin K.Y. Chan ,&nbsp;Joris I. Erdmann ,&nbsp;IJsbrand A.J. Zijlstra ,&nbsp;Pieter J.W. Arntz ,&nbsp;Otto Kollmar ,&nbsp;Martin H. Hoffmann ,&nbsp;David G. Vass ,&nbsp;Richard Lindsay ,&nbsp;Matteo Serenari ,&nbsp;Alberto Cappelli ,&nbsp;Paul D. Gobardhan ,&nbsp;Farshad Imani ,&nbsp;Yiliam Fundora Suarez ,&nbsp;Fernando Gómez Muños ,&nbsp;Dirk J. Grünhagen ,&nbsp;R. Young","doi":"10.1016/j.lanepe.2025.101284","DOIUrl":"10.1016/j.lanepe.2025.101284","url":null,"abstract":"<div><h3>Background</h3><div>Major liver resection is often required for complete clearance of colorectal liver metastases (CRLM). Patients with insufficient future liver remnant (FLR) volume/function are at high risk of post-hepatectomy liver failure (PHLF) and require FLR hypertrophy-inducing procedures to enable safe resection. The most recent variant of these procedures is combined portal and hepatic vein embolization (PVE/HVE). The DRAGON 1 trial evaluates the safety and efficacy of PVE/HVE, while assessing recruitment potential for the DRAGON 2 randomized trial.</div></div><div><h3>Methods</h3><div>DRAGON 1 is a prospective, single-arm, international, multicenter trial. Patients with upfront unresectable CRLM due to a small FLR were included. The primary outcome was the ability of centers to recruit three patients and perform PVE/HVE and liver resection without 90-day mortality. Secondary outcomes included recruitment capacity, PVE/HVE technical details, FLR volume changes, complications, and resection rates. The study is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, identifier: <span><span>NCT04272931</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>In total, 102 patients were included from 43 centers. Twenty-four centers (24/43 = 56%) recruited three or more patients, and 20 centers (20/43 = 47%) achieved this without 90-day mortality. Of 96 patients undergoing PVE/HVE, no post-embolization mortality occurred, though major complications were reported in two patients. Resection was completed in 86 patients (86/96 = 90%), with seven patients (7/86 = 8%) dying within 90 days. PHLF grade B/C (International Study Group of Liver Surgery criteria) occurred in 19 patients (19/86 = 22%).</div></div><div><h3>Interpretation</h3><div>DRAGON 1 demonstrates that PVE/HVE is safe, with no embolization-related mortality, low morbidity, and high resection rates in upfront unresectable CRLM.</div></div><div><h3>Funding</h3><div>The <span>Dutch Cancer Society</span>, <span>National Institute for Health and Care Research UK</span>, <span>Maastricht UMC+</span>, <span>Abbott Laboratories and Guerbet</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101284"},"PeriodicalIF":13.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807843","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":"Strengthening health technology assessment for cancer treatments in Europe by integrating causal inference and target trial emulation","authors":"Heiner C. Bucher,&nbsp;Frédérique Chammartin","doi":"10.1016/j.lanepe.2025.101294","DOIUrl":"10.1016/j.lanepe.2025.101294","url":null,"abstract":"<div><div>Health Technology Assessment (HTA) for reimbursement of all new cancer drugs in the European Union (EU) will be evaluated for all member states by a central European HTA starting in 2025. EU HTA guidelines for applicants under these new regulations put the focus on meta-analysis of aggregated randomized trial data and are in contrast with the growing number of cancer drug approvals by drug regulators that are based on single arm studies and the needs in the rapidly evolving field of oncological drug development. We advocate to broaden the methodological approaches for HTA by including observational data based causal inference methodology and target trial emulation into the assessments of comparative effectiveness. Causal inference estimates causal estimands, effect measures that reflect a population level effect in terms of contrasts of counterfactual outcomes in the same patients and are directly measured in the target population by modeling of hypothetical intervention. Target trial emulation allows with the use of causal inference to estimate causal effects by mimicking pragmatic trials that evolve apart from randomization like a trial. We illustrate the potential of causal inference for HTA and provide an introduction into causal inference methodology for health scientists involved in HTA.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101294"},"PeriodicalIF":13.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergenerational ‘transmission’ of intimate partner violence and abuse: interpretations and implications","authors":"Roxanne C. Keynejad,&nbsp;Louise M. Howard","doi":"10.1016/j.lanepe.2025.101299","DOIUrl":"10.1016/j.lanepe.2025.101299","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101299"},"PeriodicalIF":13.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of informal family caregiving in Europe, 2000–2050: a microsimulation modelling study","authors":"Andrea Cattaneo,&nbsp;Andrea Vitali,&nbsp;Daniele Regazzoni,&nbsp;Caterina Rizzi","doi":"10.1016/j.lanepe.2025.101295","DOIUrl":"10.1016/j.lanepe.2025.101295","url":null,"abstract":"<div><h3>Background</h3><div>The demand for informal care in Europe is increasing, with family members often providing essential support. However, the future burden of informal family caregiving remains unclear. This study estimates and projects trends in the burden of family caregiving across 31 European countries from 2000 to 2050.</div></div><div><h3>Methods</h3><div>We developed a demographic microsimulation model to estimate and project family care burden. The model produces virtual populations with realistic kinship networks and health trajectories over time. From these kinship structures, we defined a novel metric – Years Lived Caregiving for older relatives (YLCs). It accounts for care recipients’ disability severity, care dynamics within kinship networks, and national institutional care capacity. Model inputs included demographic data from UN World Population Prospects, marital statistics from Eurostat, disease prevalence from the Global Burden of Disease study, and microdata from the SHARE survey.</div></div><div><h3>Findings</h3><div>From 2000 to 2050, in Europe the overall burden for informal care is projected to increase by +49.7% (95% UI 45–53.6), from 7.98 (7.65–8.28) to 11.9 (11.4–12.5) million YLC. Musculoskeletal disorders are the largest cause of care burden, contributing to 2.3 (2.18–2.42) million YLC in 2050. Burden of informal care is disproportionally higher for women, although the gender gap is in a descending trend.</div></div><div><h3>Interpretation</h3><div>Projections indicate a substantial rise in the informal family care burden across Europe by 2050, with only limited offsetting from institutional care. These findings underscore the need for comprehensive strategies to support both caregivers and care recipients, ensuring sustainable healthcare systems across Europe.</div></div><div><h3>Funding</h3><div>Italian government and the <span>European Union</span>, National Plan for <span>NRRP Complementary Investments</span> (PNC).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101295"},"PeriodicalIF":13.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing existing tumour biobanks in European prospective cohort studies","authors":"Tomotaka Ugai ,&nbsp;Bethany van Guelpen ,&nbsp;Lorelei A. Mucci ,&nbsp;Shuji Ogino","doi":"10.1016/j.lanepe.2025.101293","DOIUrl":"10.1016/j.lanepe.2025.101293","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101293"},"PeriodicalIF":13.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Impact of vaccination with third generation modified vaccinia Ankara and sexual behaviour on mpox incidence in men who have sex with men: analysis among participants of the ANRS-174 DOXYVAC trial” [The Lancet Regional Health—Europe 45, October 2024, 101020]","authors":"Jade Ghosn ,&nbsp;Lambert Assoumou ,&nbsp;Moussa Ouattara ,&nbsp;Emma Rubenstein ,&nbsp;Gilles Pialoux ,&nbsp;Christine Katlama ,&nbsp;Laure Surgers ,&nbsp;Claudine Duvivier ,&nbsp;Juliette Pavie ,&nbsp;Jean-Paul Viard ,&nbsp;Michèle Algarte-Genin ,&nbsp;Severine Gibowski ,&nbsp;Manon Ollivier ,&nbsp;Dominique Costagliola ,&nbsp;Jean-Michel Molina","doi":"10.1016/j.lanepe.2025.101297","DOIUrl":"10.1016/j.lanepe.2025.101297","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101297"},"PeriodicalIF":13.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A balancing ACT: maximizing the benefits of appropriate brain radiation therapy—authors’ reply","authors":"Olav E. Yri ,&nbsp;Stein Kaasa","doi":"10.1016/j.lanepe.2025.101291","DOIUrl":"10.1016/j.lanepe.2025.101291","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101291"},"PeriodicalIF":13.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}