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Public Health
21st Nov, 2025
The Lancet
Our recent Article on daily step counts and health outcomes1 has received considerable public interest, given its suggestion of a 7000-step target per day for clinically meaningful health benefits. Although the appeal of a clear, prescriptive number is understandable, we emphasise that scientific evidence rarely offers such definitive conclusions. The aim of our work was never to establish a single magic number, but to synthesise the best available evidence and present a nuanced overview of current knowledge.
As researchers and epidemiologists working in physical activity surveillance, we read with great interest the Article by Ding Ding and colleagues.1 Their work has direct implications for informing how surveillance systems interpret steps-based data and informing the development of public health messaging to promote physical activity. Steps are a practical measure of physical activity: they are easy to understand, inclusive of all intensities, and increasingly measured and understood by individuals given the ubiquity of smartwatches capturing steps.
Physical activity is a powerful tool for improving physical and mental health, preventing chronic diseases, and enhancing wellbeing.1 Despite these established benefits, the global age-standardised prevalence of insufficient physical activity in 2022 was 31·3%.2 Several barriers hinder participation in physical activity, including insufficient time, financial constraints, poor health, and urban violence.3 However, an often overlooked factor is the impact of gender-based violence on women's ability to engage in safe and consistent exercise routines.
Long before the emergence of COVID-19, cardiovascular diseases (CVD) had already established themselves as the leading cause of morbidity and mortality worldwide.1 Notably, the pandemic added a new dimension to this crisis, disrupting care pathways, delaying diagnoses, and exacerbating chronic conditions.2 The global focus on infection control often overshadowed these secondary effects.
Alcohol-use disorders (AUDs) result from a complex interplay of genetic, psychological, social, and environmental factors, and their onset and persistence can drastically affect an individual's life trajectory. By mapping the natural history of AUD from initiation to risky use, dependence, remission, and relapse, we can identify crucial developmental windows during which individuals are more susceptible to developing, overcoming, and re-experiencing alcohol-related issues and thus identify important intervention opportunities when preventive or therapeutic efforts might be most effective.
More than 1 billion people worldwide live with a mental health condition. One in seven young people. Despite these alarming numbers, the public health response is woefully inadequate. In the words of Dr Tedros, WHO Director General, “Mental health remains one of the most neglected areas of public health and health services delivery”. Indeed, the WHO report World Mental Health Today, published in September, paints a sobering picture with rising incidence rates, persistent service gaps, and a glaring neglect of youth-specific mental health needs.
Neurology
5th Nov, 2025
The global burden of Parkinson's disease is rising. Large-scale genetic studies have confirmed that extrinsic or environmental factors, rather than genetic predisposition, play a dominant role in its cause. Increasing evidence implicates three classes of toxicants—certain pesticides, the dry-cleaning chemicals trichloroethylene and perchloroethylene, and air pollution—in the development of Parkinson's disease. These toxicants are widely prevalent, impair mitochondrial or lysosomal function, or both, and contribute to, if not cause, the disease.
Genetics research in Parkinson's disease has identified over 100 risk loci, yet translating these findings into understanding of disease mechanisms, clinical and pathological heterogeneity, and disease progression remains a challenge. This task requires exploring how genetic risk factors operate over time, interact with environmental factors, and contribute to the diverse ways in which disease manifests. The development of α-synuclein seeding amplification assays (SAAs) offers the opportunity to understand Parkinson's disease pathogenesis and heterogeneity, and drive the development of new disease-modifying and prevention interventions.
The clinical evaluation and decision making associated with the management of unruptured intracranial aneurysms are complex. In the past 5 years, studies have evaluated the benefits of screening in people at high-risk, such as those with a family history of aneurysmal subarachnoid haemorrhage or unruptured intracranial aneurysms, people with genetic or other disorders associated with intracranial aneurysms, and people who smoke and have hypertension. If an aneurysm is detected during screening or incidentally, prediction models now allow for estimating the risk of complications from preventive aneurysm occlusion.
About 3% of adults have an unruptured intracranial aneurysm and this prevalence can increase to 10% in high-risk groups. Aneurysms are not congenital, but develop throughout life. New evidence has established that genetic, anatomical, inflammatory, and modifiable risk factors interact in the formation, growth, and rupture of aneurysms. Genome-wide association studies have found an association with genetic risk variants in 17 loci. Furthermore, circle of Willis variations predispose to aneurysm formation and cluster within families.
Intravenous alteplase administered within 4·5 h of CRAO onset was not associated with a significant improvement in visual acuity compared with aspirin, despite a higher rate of improvement in the alteplase group. However, the study was likely underpowered to detect a statistical difference. Although no safety concerns related to alteplase were identified, the overall modest recovery rates underscore the need for individual patient-level data meta-analyses with forthcoming randomised controlled trials to clarify the potential benefit of thrombolysis or aspirin in patients with acute CRAO.
“I’m quite happy to talk about it—I would prefer for people to know that I have Alzheimer's disease,” explained Gerry King, one of the founders of Striving Towards A New Day (STAND), a charity that supports people living with dementia in Fife, UK. King was diagnosed with young-onset Alzheimer's disease at the age of 55 years. “It gets me down when people say, I’m really sorry, I think that's terrible, it's awful. It's not awful, it's opened up a whole new world for me, meeting other people with young-onset dementia, meeting older people with dementia, and showing that people with dementia can actually do things.” King's comments were among the many stark statements that were digested by the audience at Alzheimer's: To Test or Not to Test?, a discussion held on April 9, 2025, at the National Museum of Scotland in Edinburgh, UK, as part of the Edinburgh Science Festival.
Dementia is one of the most pressing challenges for health and social care globally, with an estimated annual economic burden of £42 billion in the UK alone. The specific toll on individuals and their families is more difficult to quantify, yet often profound, with dementia now the most feared health condition among UK adults. The assessment of health-related quality of life in dementia has assumed increasing importance, particularly in evaluating whether the benefits of disease-modifying therapies for Alzheimer's disease newly approved in the UK justify their cost.
Maximilian U Friedrich is a neurologist and incoming research group leader at the Department of Neurology, University Hospital Ulm, Germany. Previously, he worked as a postdoc with Michael D Fox at the Center for Brain Circuit Therapeutics, Harvard Medical School, Boston, USA. His research bridges clinical neurology, computer vision, and neuroimaging, with the goal of translating pixels and voxels into clinically meaningful outcomes, for both doctors and patients.
History can be put to any number of uses. One of the more common of these is the construction of a story that links present day developments to events in the past, seeking legitimacy for the present by enrolling historical figures in an ancestral lineage that inexorably, and inevitably, leads to the present. This storytelling is often achieved by picking out statements from past writings that seem, in some way, to be ahead of their time or otherwise prescient.
What's New: Drugs
15th Jan, 2026
FDA
Medical Journal
Wiley
Medical News
phys.org
Regional Health – Americas
