Search Medical Journals & Research Articles

[Articles] Physical effort during labour and behavioural adaptations in response to heat stress among subsistence farmers in Burkina Faso: a gender-specific longitudinal observational study

Heat stress significantly reduces the physical effort during labour. Self-employed subsistence farmers appear to adapt to heat stress by lowering labour intensity, redistributing tasks throughout the day, and shifting work to cooler months. As climate change worsens, these adaptations could become inadequate. Women, who often balance household chores and fieldwork, have limited pacing strategies, heightening their vulnerability to increasing heat stress. Our findings highlight the urgent need for targeted adaptation strategies to sustain physical effort during labour and protect vulnerable groups, especially women, from escalating heat stress.

[Comment] Reframing the climate anxiety focus ahead of COP30: the imperative of addressing the policy-action gap

In November, 2025, government and experts will meet in Brazil for the 30th meeting of the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP30). In preparation, WHO and the Brazilian Government jointly convened the Fifth Global Conference on Climate and Health in July, 2025. The resulting Belém Health Action Plan for the Adaptation of the Health Sector to Climate Change is multifaceted and includes core climate–health targets: equity, justice, and capacity building.

[Comment] A call to action: climate leadership at the World Health Assembly

The past decade was officially the hottest on record,1 highlighting humanity's failure to curb greenhouse gas emissions and the urgent need for decisive climate action. The scientific community and civil society demand prioritising human health in this agenda, supported by evidence on greater societal engagement and by the archetype of reliability, ethics, and responsibility embodied by health professionals.2,3 Although there is a growing awareness among health professionals and health institutions regarding the causal relationship between climate change and disease, this sector still lacks political will, funding, and infrastructure to lead ambitious and equitable response policies.

[Comment] Different futures ahead: why does 1·5°C matter?

Climate change is threatening the health and wellbeing of billions.1 To avert most severe risks of climate change and ensure a safe and liveable planet, global warming must be constrained as much as possible. The core aim of the Paris Agreement is to limit global average temperature increase to ‘well below 2oC’ and pursue efforts to limit warming to 1·5oC above pre-industrial levels.2 The UN, many international agencies, non-government organisations, and climate action groups have focused on achieving this goal (figure).

[Comment] Healthy Islands at 30: revitalising an ecological framework for planetary health

In 1995, health ministers from the Pacific Islands gathered on Yanuca Island, Fiji, to declare a visionary Healthy Islands idea, a holistic framework linking human wellbeing with environmental stewardship. The ministers imagined island communities where children thrive, people live and age with dignity, and “ecological balance is a source of pride and the ocean which sustains us is protected”.1 This Healthy Islands vision anticipated by decades the core principles of the current planetary health movement.

[Comment] Beyond the narrow lens: the power of an interdisciplinary approach to climate and health research and training

Over the past 15 years, there has been an increasing commitment to educate and develop the health workforce on the impacts of climate change, integrating key competencies related to climate into medical education and training.1–3 Modifications in medical training include the introduction of new core competencies such as climate change into global health curriculum.4

[Comment] Northward expansion of Aedes albopictus-associated arbovirus transmission risk in Europe

Since 2007, outbreaks of chikungunya and dengue have become increasingly frequent and large scale in Europe. The frequency and size of these episodes suggest a concerning trend. In 2025 alone, there have been an unprecedented 81 locally acquired chikungunya outbreaks, with a total of 1124 cases to date.1 Another particularly concerning event occurred in October, 2024, when Italy had the largest recorded dengue outbreak in Europe, with more than 200 confirmed autochthonous cases.2 Although this number might seem small compared to outbreaks in endemic regions such as southeast Asia or Latin America, in the European context, it represents an unprecedented scale with epidemic potential.

[Editorial] In desperate need of systems change

It is customary at the end of each year for The Lancet Planetary Health editorial to summarise global environmental change progress and developments. But as 2025 draws to a close, it seems that we could, with minimal editing, simply copy and paste editorial summaries from previous years. That is a facetious statement; of course, there have been positive developments, grinding progress, and wins on some key issues, for example the acceleration in green electricity capacity, the inclusion of health in key climate negotiations, and success in climate change litigation.

[Clinical Picture] High-output cardiac failure from a synovial sarcoma mimicking arteriovenous fistula

A 30-year-old woman presented to the Vascular Anomalies Centre at Shanghai Ninth People's Hospital in February, 2021, for a worsening and painful left inguinal arteriovenous fistula, which had been diagnosis 7 years previously following a strain 10 years ago. Initial endovascular embolisation in 2014 provided only transient relief, with subsequent symptom recurrence, progressive deep vein thrombosis, limb oedema, and claudication. By 2018, she had developed orthopnoea indicative of cardiac failure and required continuous diuretics, having received only symptomatic care until her presentation.

[Review] Development of a core outcome set for adolescents and young adults with cancer

Adolescents and young adults aged 15–39 years diagnosed with cancer are faced with unique challenges, which affect key developmental milestones and can create complex care needs. The aim of this study was to reach international consensus on the minimum set of outcomes to measure through the development of a core outcome set (COS). The COS development followed published methodological standards. A literature review and interviews with adolescents and young adults with cancer and health-care professionals generated a comprehensive list of 129 outcomes, spanning clinical and patient-reported outcomes relevant to adolescents and young adults with cancer.

[Policy Review] International consensus recommendations and alignment of terminology for the histopathological diagnosis of extranodal extension in head and neck squamous cell carcinoma: an HN-CLEAR initiative

Histopathologically detected extranodal extension leads to upstaging and treatment escalation in head and neck squamous cell carcinoma. There is considerable variation in the prevalence of histopathologically detected extranodal extension in comparable studies. The Head and Neck Cancer International Group, which includes 23 organisations managing patients with head and neck cancer, identified several challenges in evaluating histopathologically detected extranodal extension. Thus, the Head and Neck Consensus Language for Ease and Reproducibility (HN-CLEAR) and its global stakeholders prioritised developing diagnostic criteria and uniform terminology for histopathologically detected extranodal extension.

[Policy Review] A comprehensive framework for glioma surgery by the PIONEER Consortium and RANO resect group, part 2: perioperative recommendations for neurological, language, functional, and quality-of-life assessment

Historically, the assessment of surgical outcomes in patients with glioma has been focused on technical outcomes, such as volumetric analysis of the residual tumour, progression-free survival, and overall survival. Other outcomes, such as neurological deficits, can be challenging to assess in an objective, quantifiable, and comprehensive manner. As a result, no consensus is available on methods to systematically evaluate perioperative neurological, language, cognitive, and functional outcomes in patients with glioma.

[Policy Review] A comprehensive framework for glioma surgery by the PIONEER Consortium and RANO resect group, part 1: intraoperative recommendations for mapping, monitoring, and decision making

In adult patients with newly diagnosed or recurrent diffuse glioma, more extensive resection is associated with longer progression-free and overall survival. Intraoperative mapping techniques are used to safely increase the extent of resection by locating, monitoring, and preserving the function of potentially infiltrated brain during surgery. However, there is no consensus on the indications for intraoperative mapping, the optimal functional tests to be used intraoperatively, or intraoperative decision making.

[Articles] Tiragolumab plus atezolizumab and chemotherapy as first-line treatment for patients with unresectable oesophageal squamous cell carcinoma (SKYSCRAPER-08): a randomised, double-blind, placebo-controlled, phase 3 trial

Independent review facility-assessed progression-free survival and overall survival were significantly better in the tiragolumab plus atezolizumab and chemotherapy group compared with chemotherapy alone for unresectable locally advanced, unresectable recurrent, or metastatic oesophageal squamous cell carcinoma. These data support the rationale for exploring dual checkpoint inhibition added to chemotherapy for this group of patients with a high unmet need.

[Perspectives] Current landscape, successes, and key challenges in cancer vaccine clinical trials across the UK

Cancer vaccines represent a transformative frontier in oncology, offering the potential to elicit durable and specific immune responses against tumour-associated or tumour-specific antigens. This technology has the potential to treat established malignancy, reduce tumour relapse, and even prevent cancer formation—improving survival outcomes. Advances in neoantigen discovery, mRNA vaccine platforms, and personalised immunotherapy have substantially enhanced the feasibility and efficacy of cancer vaccines across various malignancies.