Lancet

In May, 2024, Brazilian Federal Deputy Sóstenes Cavalcante presented Bill 1904/24, which equates abortions done after 22 weeks with homicide. The bill reflects the rise of Brazil's far right after the 2018 presidential election of Jair Bolsonaro. Even with the 2022 election of Luiz Inácio Lula da Silva, Bill 1904/24 symbolises the Brazilian far right's continued relevance and the history of abortion law as a key moral battleground.

Afghanistan's de facto authorities have made the alarming decision to ban women from studying nursing and midwifery.1 This policy, along with the broader ban on girls completing education beyond grade six, has severe social and economic consequences.1 According to UNICEF, the ban on secondary education for girls alone cost the Afghan economy at least US$500 million in 2022. Allowing the 3 million girls from that year's cohort to complete secondary education could have contributed $5·4 billion to the economy.

Medical students and residents have been protesting for months against the South Korean governmental policy of increasing the number of physicians.1,2 In the Correspondence from Dongju Shin and Dong-Jin Shin written in support of the protest,1 the important realities of the South Korean health-care system have been obscured.

We read with great interest the Correspondence from Saad Javed and colleagues1 on the mpox threat in Pakistan, which raised concerns about Pakistan's preparedness for an mpox outbreak. Although the authors highlight important points, we would like to clarify Pakistan's substantial efforts to address this public health threat.

Health education is not only about teaching students how to practise health care; it is mostly about teaching them how to become health-care professionals. One cannot become a health-care professional in the present day without remembering the past. Unfortunately, humanity's shared past is stained by atrocities. Although much is known about the Nazi experiments,1 little is known about the concurrent human experiments done by the Japanese in the Pacific Theatre.

Kudo M, Ren Z, Guo Y, et al. Transarterial chemoembolisation combined with lenvatinib plus pembrolizumab versus dual placebo for unresectable, non-metastatic hepatocellular carcinoma (LEAP-012): a multicentre, randomised, double-blind, phase 3 study. Lancet 2025; 405: 203–15. The appendix of this Article has been corrected as of Feb 6, 2025.

St Peter SD, Noel-MacDonnell JR, Hall NJ, et al. Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children: an open-label, international, multicentre, randomised, non-inferiority trial. Lancet 2025; 405: 233–40—In this Article, Prof Simon Eaton's affiliation should have been “UCL Great Ormond Street Institute of Child Health, London, UK”. This correction has been made to the online version as of Feb 6, 2025.

McCormack M, Eminowicz G, Gallardo D, et al. Induction chemotherapy followed by standard chemoradiotherapy versus standard chemoradiotherapy alone in patients with locally advanced cervical cancer (GCIG INTERLACE): an international, multicentre, randomised phase 3 trial. Lancet 2024; 404: 1525–35—The appendix of this Article has been corrected as of Feb 6, 2025.

Vanden Driessche K, Dermauw V, Schoonjans A-S, Gabriël S, Theeten H, Cysticercosis Outbreak Team. Neurocysticercosis school outbreak in Belgium. Lancet 2024; 404: 2415–16—The author list of this Correspondence has been supplied for indexing on PubMed. This correction has been made to the online version as of Feb 6, 2025.

Jamaluddine Z, Abukmail H, Aly S, Campbell OMR, Checchi F. Traumatic injury mortality in the Gaza Strip from Oct 7, 2023, to June 30, 2024: a capture–recapture analysis. Lancet 2025; 405: 469–77—The appendix of this Article has been corrected to fix labelling discrepancies. This correction has been made as of Feb 6, 2025.

In patients with acute ischaemic stroke caused by large-vessel occlusion in the anterior circulation who were candidates for endovascular treatment, normobaric hyperoxia yielded superior functional outcomes at 90 days compared with the sham normobaric hyperoxia, without raising safety concerns.

Some of the physiological changes that occur in pregnancy manifest in the liver. These alterations might exacerbate or improve some pre-existent liver diseases, while many conditions remain unaffected. Some hepatic manifestations during pregnancy are secondary to disorders unique to pregnancy. Due to improved management of chronic conditions and assisted conception methods, pregnancies in people with cirrhosis or after liver transplantation are increasingly common. With pregnancy also becoming more common in older people and with the rising prevalence of comorbidities, such as obesity, diabetes, and metabolic syndrome, hypertensive disorders of pregnancy and gestational diabetes are increasing in prevalance.

An oft-repeated message is that primary aldosteronism is not rare; it is quite common. An equally urgent message is that primary aldosteronism, when left untreated, is extremely dangerous. Strong evidence shows that patients with primary aldosteronism have a higher risk of heart disease, arrythmias, heart failure, stroke, and progressive renal injury compared with patients who have other forms of hypertension, even after adjustment for blood pressure.1 Primary aldosteronism is not just a risk factor, it is a distinct endocrinopathy, for which there are targeted therapeutic options: medical (mineralocorticoid receptor antagonists [MRAs]) and surgical (unilateral adrenalectomy).

We write to alert Lancet readers that, as of Feb 1, 2025, all US research and websites published by federal scientists and agencies are now subject to new edicts issued by the Trump administration1,2 that are contrary to established norms, and contradict the guidelines of The Lancet3 and the International Committee of Medical Journal Editors (ICMJE).4

EUS-RFA appears a safe alternative to total adrenalectomy for the treatment of left-sided APAs and has the potential to completely cure primary aldosteronism and hypertension when most of the APA is ablated. These findings have informed the design of a pivotal study of thermal ablation versus surgery, which will determine the full benefits of EUS-RFA.

The US President's Emergency Plan for AIDS Relief (PEPFAR) faces a pivotal moment, confronting one of its most challenging periods since its launch in 2003. The new policy priorities of the administration of US President Donald Trump, along with reports of 21 abortion services performed under PEPFAR-funded service providers in Mozambique, has intensified discussions about PEPFAR's future.1 With PEPFAR's authorisation set to expire on March 25, 2025, and a US State Department-mandated 90-day review of foreign aid underway,2 HIV and global health stakeholders have a short time to pursue urgent reforms to safeguard the future of this vital programme.

Angola's Ministry of Health has released alarming statistics regarding the ongoing cholera outbreak,1,2 highlighting a severe public health crisis that warrants immediate international attention. By Feb 3, 2025, Angola had recorded 1888 cases and 65 fatalities since the outbreak began. Over the past 24 h alone, 178 new cases were reported across multiple provinces, with a concentration in Luanda. Epidemiologically, children aged 2–9 years are the most affected, with 294 cases and ten fatalities, followed by those aged 10–14 years, with 250 cases and five deaths.

The increasing frequency and severity of environmental disasters necessitate robust health-care system adaptation strategies. Recent wildfire events in and around Los Angeles County, CA, USA, are reported to be the most destructive in regional history, burning more than 50 000 acres, destroying over 15 000 structures, and resulting in 29 fatalities, as of Feb 4, 2025.1,2 We used critical observations and recommendations derived from this experience to examine institutional resilience and response mechanisms within a complex metropolitan health-care network.

Our findings suggest that exenatide is safe and well tolerated. We found no evidence to support exenatide as a disease-modifying treatment for people with Parkinson's disease. Studies with agents that show better target engagement or in specific subgroups of patients are needed to establish whether there is any support for the use of GLP-1 receptor agonists for Parkinson's disease.

The discovery and development of GLP-1 receptor agonists for type 2 diabetes and obesity is a bench-to-bedside success story.1 Multiple GLP-1 receptor agonists are now in clinical use, such as exenatide, lixisenatide, and, most recently, semaglutide, with new agents in the pipeline. Their clinical indications are quickly expanding to include conditions related to type 2 diabetes and obesity, from cardiovascular disease to obstructive sleep apnoea to knee osteoarthritis. In the phase 3 trial by Nirosen Vijiaratnam and colleagues2 in The Lancet, a more high-risk indication was investigated: exenatide as a disease-modifying therapy for Parkinson's disease.