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[Comment] The 2025 Wakley Prize: finding a home in medicine

In the call for submissions for the Wakley Prize earlier this year, we quoted Søren Kierkegaard's notion that life “must be understood backwards; but…it must be lived forwards” and encouraged people to reflect on the change they would like to see in medicine.1 We thank everyone who entered the competition and were impressed by the wide-ranging submissions.

[Comment] US CDC: a public health agency in critical condition

For almost 80 years, the US Centers for Disease Control and Prevention (CDC) has been the nation's immune system, detecting threats early, coordinating rapid responses, and safeguarding population health. Its deep bench of epidemiologists, laboratory expertise, support for health departments, and evidence-based recommendations have fought threats to the public's health. During 2025 that immune system has been compromised, prompting our resignations, following the firing of the US Senate-confirmed CDC Director Susan Monarez on Aug 27, 2025.

[Comment] Exploring CAR NK-cell therapy for refractory lupus

The treatment landscape for systemic lupus erythematosus (SLE) has shifted greatly in recent years, driven by the emergence of cell-based immunotherapies targeting pathogenic B-cell populations. Among these, autologous CD19-directed chimeric antigen receptor (CAR) T-cell therapy has shown promise in inducing remission in patients with severe treatment-refractory SLE.1 This innovation addresses a substantial global burden of disease, with epidemiological data estimating more than 3·4 million individuals affected worldwide;2,3 notably, in an Asia–Pacific cohort study, at least 14% of patients were identified as having severe refractory disease.

[Comment] Methoxyflurane: a promising non-intravenous, non-opioid analgesic

Analgesia in the prehospital setting is a challenging but important priority for first responders. Retrospective military data indicate an association between early analgesia with morphine after injury and lower subsequent risk of long-term sequelae such as post-traumatic stress disorder.1 Yet, data show that the proportion of patients with pain receiving analgesia in the prehospital setting remains low.2,3 This small proportion might reflect difficulty in obtaining intravenous access and concerns regarding haemodynamic side-effects of many analgesic agents such as opioids.

[Comment] Neoadjuvant quadruplet chemotherapy PAXG for pancreatic cancer

Perioperative management of localised pancreatic ductal adenocarcinoma (PDAC) is informed by resectability criteria, which consider anatomy together with biological and clinical factors.1 In patients with resectable PDAC, adjuvant mFOLFIRINOX (modified 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) is a standard of care;2,3 however, many are unable to receive this regimen due to inadequate performance status after surgery. Trials have evaluated various neoadjuvant chemotherapy regimens; notably, two randomised controlled trials did not confirm superiority of mFOLFIRINOX or FOLFIRINOX over gemcitabine–nab-paclitaxel (SWOG 1505)4 and gemcitabine with radiation (PREOPANC-2).

[Comment] Oral small-molecule GLP-1 receptor agonist for type 2 diabetes and obesity

With the rising use of nutrient-stimulating hormone-based therapy for the treatment of obesity, developing oral alternatives could help address the limitations of injectable therapies, including needle phobia, injection site reaction, and storage concerns, and could ultimately improve patient acceptability. Peptide-based oral GLP-1 receptor agonists, such as oral semaglutide, are limited by the need for diet restriction, timing of administration, and low oral bioavailability.1 Peptide-based GLP-1 receptor agonists are also more costly to manufacture and require refrigeration.

[Editorial] 2025: an annus horribilis for health in the USA

The US Advisory Committee on Immunization Practices vote on Dec 5 to no longer recommend the hepatitis B vaccine birth dose, which had ensured that babies exposed to hepatitis B would not later develop hepatitis B-associated liver damage and liver cancer, caps the most disastrous year for US public health policy. Federal funding cuts had occurred under Joe Biden and mistrust in the nation's health leaders has been waning over time, but the goal of the Trump administration now seems to be to tear down the world's premiere scientific infrastructure.

Study shows views of British empire shape voting behavior—but in subtle ways

If you wander through Glasgow Green, you'll encounter the Doulton fountain, a gaudy terracotta tribute to empire that features "native" and colonial figures in national dress holding out the produce of their lands to the imperial center. Like thousands of imperial monuments across Britain, the Doulton Fountain is neither widely celebrated nor widely denounced. It is part of the everyday backdrop.

Mitochondria migrate toward the cell membrane in response to high glucose levels, study shows

Unlike our organs, cell organelles such as mitochondria are not fixed in place, but when, where, how, and why organelles move remain unclear. Research published in the Biophysical Journal shows that when beta cells—the pancreatic cells that produce insulin—are exposed to high levels of glucose, their mitochondria move toward the cell's periphery.

Archaeologists use AI to create prehistoric video game

Archaeologists from the University of Copenhagen and the University of Bergen have used AI and free digital tools to create a dynamic and educational video game about the Stone Age. According to the researchers, the new technology, which does not require strong technical skills, has the potential to revolutionize the digital communication of cultural heritage.

Silicon atom processor links 11 qubits with more than 99% fidelity

In order to scale quantum computers, more qubits must be added and interconnected. However, prior attempts to do this have resulted in a loss of connection quality, or fidelity. But, a new study published in Nature details the design of a new kind of processor that overcomes this problem. The processor, developed by the company Silicon Quantum Computing, uses silicon—the main material used in classical computers—along with phosphorus atoms to link 11 qubits.

Using bent light to map complex planetary architectures

With new technologies comes new discoveries. Or so Spider Man's Uncle Ben might have said if he was an astronomer. Or a scientist more generally—but in astronomy that saying is more true than many other disciplines, as many discoveries are entirely dependent on the technology—the telescope, imager, or processing algorithm—used to collect data on them.

Accelerating next-generation drug discovery with click-based construction of PROTACs

In 2001, chemists K. Barry Sharpless, Hartmuth C. Kolb, and M. G. Finn introduced click chemistry, a concept in which organic molecules can be rapidly and reliably joined to form more complex structures. They recognized that many natural compounds are assembled through efficient carbon–heteroatom (C–X) bond formation, particularly with nitrogen, oxygen, and sulfur, and they sought to replicate this in the laboratory.

Flat-band ultrastrong coupling between phonons and plasmons observed for first time

Researchers from CIC nanoGUNE, in collaboration with the Donostia International Physics Center (DIPC) and the Center for Materials Physics (CFM), have experimentally observed and theoretically verified flat-band ultrastrong coupling between optical phonons and surface plasmon polaritons. Published in Nature Materials, the study reveals a previously unexplored regime of light–matter interaction with potential applications in polariton-driven chemistry, materials science, nanophotonics, and quantum engineering.

A new natural sunscreen: Novel compound discovered in thermophilic cyanobacteria

Natural sunscreens shield the skin from harmful radiation, without triggering allergic reactions. In a recently published study, a group of researchers has discovered a novel compound, β-glucose-bound hydroxy mycosporine-sarcosine, which is produced in thermal cyanobacteria under UV-A/UV-B and salt stress. This compound has a unique biosynthesis pathway which is different from the typical mycosporine-like amino acids (MAAs) biosynthesis mechanism. This discovery aids industrial biotechnology in the production of natural UV-filter compounds.