Medical Journal News

As Justin Trudeau steps down after a decade as leader of Canada's ruling Liberal Party, Canadians face a pivotal moment. Although attention is focused on trade tariffs and souring relations with the USA, there are important health dimensions to Canada's political transition. Trudeau leaves behind a legacy of initiatives, including the Canada Child Benefit, climate change initiatives through the Pan-Canadian Framework, a National Housing Strategy, legalisation of cannabis, the Early Learning and Child Care plan, and the Canadian Dental Care Plan—which has already benefited 1·5 million Canadians—and passed a universal pharmacare plan to institute publicly funded coverage for medications.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 on oral conditions represents a landmark moment for the community.1 For the first time, a comprehensive analysis of the global, regional, and national burden of oral diseases has been published in The Lancet. Previously confined to dental research journals, this broader platform underscores the increasing significance of oral diseases in global health.

President Subianto's ambitious plan of health checks for all is one of Indonesia's biggest ever health initiatives, but not everyone is convinced it will have the desired effect. Chris McCall reports.

Many Indians are exposed to silica dust, but experts and patients lament the lack of information and health services related to silicosis. Sophie Cousins reports from West Bengal.

Shirin Heidari, the Executive Director of GENDRO and Senior Researcher at the Gender Centre, Geneva Graduate Institute in Switzerland, was born in Tehran 6 years before the 1979 Iranian revolution. Coming from a family with “many strong women as role models, and always a sense of activism”, the revolution, which “resulted in a regime oppressing women, men, as well as any dissidents, followed by political oppression and war”, left her with “a very strong distaste for injustice”, and a profound awareness, “very early on”, of the devastating impacts of “a lack of rights, and the lack of a justice system”.

As a clinician, educator, and emotion researcher, I have long believed that our efforts to optimise the wellbeing of health-care professionals are doomed if we cannot talk openly about the emotional and psychological experience of practising medicine. Hidden behind the more observable forms of distress we can measure, such as burnout, are unpleasant, complex, and entirely human experiences, such as feeling insecure or unlikeable, needing validation, experiencing shame or self-doubt, and wanting to feel loved and accepted.

The Sainsbury Centre is an art museum situated on the University of East Anglia campus near Norwich, UK. Its Living Area—a calm, expansive exhibition space in a hanger-like, purpose-built, Norman Foster designed building—hosts a diverse permanent art collection, including works by modern artists such as Francis Bacon and Henry Moore, alongside historical objects from across the globe. This impressive core collection was donated by British businessman, philanthropist, and supermarket heir Sir Robert Sainsbury and his wife Lady Lisa Sainsbury.

Science editor, journalist, author, and mentor. Born on Oct 9, 1940, in Rawene, New Zealand, he died in Eastbourne, UK, on Feb 10, 2025, aged 84 years.

Africa accounts for only 3% of all medicine production globally, and more than 90% of drugs and 99% of vaccines consumed are imported.1 The continent has not been well positioned to address these gaps due to capacity challenges related to limited research and development (R&D) infrastructure and skilled researchers, the absence of a well defined continental health research governance framework, and scarcity of sustainable financing for R&D.2 Moreover, there is inadequate local funding, and most research conducted on the continent is donor-driven and often not informed by national or regional priorities, underscoring the urgent need for research prioritisation, coordination, and governance.

Canada has joined the world's largest research and innovation programme (Horizon Europe), with its strong life science and technology focus and the launch of a policy dialogue to advance health priorities. Canada and the EU have taken steps towards transnational collaboration, which is paramount to successfully take on global challenges, such as cancer, antimicrobial resistance, health security, rare diseases, and non-communicable diseases.1,2 However, the proposed dialogue does not directly reference the crucial importance of health data access and exchange.

In an Offline piece,1 Richard Horton commented on several issues regarding human rights and remembrance in Argentina.

We enjoyed the Viewpoint by Jeremy W Jacobs and colleagues and agree with their major observations.1 Defining the true need for blood is an essential challenge. The authors rightly noted that the annual blood donation to population ratio threshold cannot define true blood need. This definition should be specific to geographical scale and depend on disease burden, geographical heterogeneity and the isolation of communities in resource and disease distributions, and access to blood and blood products within the context of health-care access, among other factors.

In their open-label, multicentre, randomised, non-inferiority trial of home-based ovulation monitoring in the management of frozen-thawed embryo transfers (FETs), Tjitske Zaat and colleagues showed their ability to organise national collaborative research efforts involving multiple fertility centres.1 In the accompanying Comment,2 Shari Mackens and Christophe Blockeel state that there is little in Zaat and colleagues’ study that warrants the consideration of home-based ovulation monitoring as a new gold standard.

In Tjitske Zaat and colleagues’ study,1 fewer than 3% of patients in natural menstrual cycles were administered exogenous progesterone for luteal phase support. In their Comment,2 Shari Mackens and Christophe Blockeel suggest that, with more evidence, progesterone supplementation could become part of the prescribed natural cycle frozen-thawed embryo transfer (FET) protocol. This change could simplify monitoring and reduce the number of hospital visits.

In the CASTING study,1 the TRiP(cast) score was utilised to identify patients at low risk of venous thromboembolism. The cumulative incidence of venous thromboembolism was estimated to be 2·0%, indicating that most patients, approximately 98%, were at low risk and did not require anticoagulation. Therefore, it was inappropriate to identify low-risk subgroups from a population already consisting mostly of individuals at low risk of developing the condition. In contrast, there was no significant difference in the incidence of venous thromboembolism (1·1% vs 1·0%) between the intervention phase, guided by the TRiP(cast), and the control phase, during which 16% of patients would be classified as high risk but did not receive anticoagulation.

We would like to congratulate Douillet and colleagues1 on their CASTING study, which showed a relevant reduction in prophylactic anticoagulation by using the TRIP(cast) score without an increase in the risk of venous thromboembolism. However, we were surprised by the inclusion of male sex as a risk factor in the TRIP(cast) score. The TRIP(cast) score was developed on the basis of two prior scores. One score was based on expert consensus (TIP score) that did not include male sex as a risk factor.

I read with great interest the CASTING study by Douillet and colleagues.1 I appreciate the authors’ contribution; however, there are several issues I would like to discuss.

We thank Liang V Tang and colleagues, Perrine Truong and Francois-Xavier Ageron, and Wei Xiong for their interest in our CASTING study and their comments.