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A new large‑scale randomized trial presented at the European Congress on Obesity in Istanbul indicates that the oral GLP‑1 antagonist orforglipron can help patients retain the majority of weight lost with injectable therapies such as tirzepatide (Mounjaro) and semaglutide (Wegovy).Trial Shows Oral Orforglipron Preserves Most Weight After Switching from InjectablesThe study, funded by Eli Lilly, followed 376 US patients who had been on tirzepatide or semaglutide injections for 72 weeks and then randomized them to a daily orforglipron tablet or placebo for an additional year.Participants were previously on weekly GLP‑1 jabs that typically produce 15‑20% body‑weight loss.After the injection phase, subjects were switched to oral therapy or placebo for 12 months.Primary endpoint: proportion of weight loss retained at 12 months.Quantitative Outcomes: 75% vs 49% Retention for Tirzepatide Users, 80% vs 38% for Semaglutide UsersWeight‑loss maintenance differed markedly between the pill and placebo groups:Tirzepatide cohort: 75% of lost weight retained with orforglipron vs 49% with placebo.Semaglutide cohort: 80% retained with the pill vs 38% with placebo.Secondary benefits—blood pressure, cholesterol, and glycaemic control—were also sustained in the pill arm.Implications for Obesity Management and Healthcare CostsExperts highlighted the broader significance:Dr Louis Aronne (Weill Cornell Medicine) emphasized that treating obesity directly can simultaneously improve glucose, lipid, and blood‑pressure metrics.Dr Marie Spreckley (University of Cambridge) noted patient preference for oral therapy due to convenience, storage, and lower cost.Dr Simon Cork (Anglia Ruskin University) warned that injectable GLP‑1 drugs, while highly effective, are expensive and limit long‑term accessibility for both private payers and the NHS.The findings suggest a potential shift toward oral agents that maintain efficacy while reducing financial and logistical burdens.Future Outlook: Oral GLP‑1 Therapies Could Redefine Chronic Obesity CareIf further trials confirm these results, orforglipron could become a cornerstone of chronic obesity management, enabling earlier intervention (BMI 25‑27) and possibly preventing progression to severe obesity.Regulators and payers will likely scrutinize cost‑effectiveness models, but the prospect of a cheap, daily tablet that sustains weight loss may reshape treatment algorithms worldwide.

The World's Longest Football DerbyCarlisle and Barrow will play each other next season in the Cumbrian derby in the National League. The clubs are located at opposite ends of Cumbria and the distance between the two grounds is some 78 miles by car. But this is not the greatest distance between two teams involved in a 'derby'.When considering derbies, we are looking for matches between teams that are linked based upon their proximity or geography, rather than simply historical rivalries like the 'clásico' between Real Madrid and Barcelona.UK Derbies: The Cumbrian ContenderWithin the UK, the Cumbrian derby certainly looks the furthest derby by distance. If we are staying in England, the closest we can get to 78 miles is the A49 derby between Shrewsbury Town and Hereford United, separated by 51 miles, although it should be said that the two teams have not met since the latter was dissolved in 2014.In England, thoughts immediately go to Crystal Palace and Brighton, dubbed the M23 derby, but a quick search reveals that Selhurst Park is a mere 46 miles from the Amex Stadium. It is also 46 miles that separate the stadiums of Plymouth Argyle and Exeter City, the Devon derby. Just behind are Ipswich and Norwich – the East Anglian derby (AKA El Tractico or the Old Farm) – with Portman Road and Carrow Road 45 miles apart.International Long-Distance DerbiesFarther afield, we must mention the derby between Persib Bandung and Persija Jakarta, who take part in the Indonesia derby, or Laga Klasikal as it is locally known, with Persib's Gelora Bandung Lautan Api Stadium lying 108 miles away from Persija's Jakarta International Stadium in Indonesia's capital.Italy is fertile ground for a host of famous derbies, and it is here that we find some of the longest-distance derbies. Of course there is the Derby d'Italia between Milan and Juventus, with 85 miles separating San Siro and Juve's Allianz Arena in Italy's north-west. The Derby di Sicilia between Palermo and Catania spans a whopping 134 miles across the breadth of Sicily, while the Derby delle Isole (Derby of the Islands) between Palermo and Sardinian club Cagliari goes even further – a full 250 miles across the Tyrrhenian Sea.The Champion: New Zealand's 386-Mile DerbyOur winner, though, comes from New Zealand's North Island. With Auckland FC only entering the A-League Men in 2024-25, the New Zealand derby between themselves and Wellington Phoenix is still very much in its infancy but has already blossomed into something substantial. In February, just the sixth edition of the derby, a comical own goal from Wellington goalkeeper Josh Oluwayemi sparked a 5-0 thrashing by Auckland, prompting Phoenix coach Giancarlo Italiano to resign immediately after the defeat. With 386 miles between the two grounds, the NZD is our clear winner.The Evolution of Geographic DerbiesThe existence of such long-distance derbies challenges our traditional understanding of what constitutes a local rivalry. In an era where football has become increasingly globalized, these geographic matchups represent unique connections between communities separated by vast distances. The New Zealand derby, in particular, showcases how even in a country with a relatively small population, football can create intense rivalries across significant geographical divides.The Future of Long-Distance DerbiesAs football continues to evolve, we may see more long-distance derbies emerge, particularly in regions with expanding leagues or where new clubs are formed to serve underserved areas. The New Zealand derby between Auckland and Wellington Phoenix is a prime example of how modern football infrastructure and scheduling can create meaningful rivalries regardless of distance. With the increasing popularity of travel and fan engagement, these long-distance derbies may become even more significant in the future of football culture.Double Winners in FootballDeji Elerewe has won the title with both Bromley (League Two) and Lincoln (League One) this season. Has any other player managed the same feat?We covered this answer 10 years ago in a previous Knowledge, but regular contributor Dirk Maas has come in clutch with some additions, although he does clarify that he has limited his search to the top five leagues in Europe in this century.There are several examples of players winning titles with different teams in the same season, including:Jonas Urbig with Köln (2. Bundesliga) and Bayern Munich (Bundesliga) in 2024-25Leigh Griffiths with Celtic (Scottish Premiership) and Wolverhampton (League One) in 2013-14Urby Emanuelson with Ajax and Milan in 2010-11Daniel Amartey with Leicester City and FC Copenhagen in 2015-16Timothy Weah with Paris Saint-Germain and Celtic in 2018-19Khvicha Kvaratskhelia with Napoli and PSG in 2024-25There are also alternative cases where seasons happen at different times of year, such as David Beckham achieving this by picking up an MLS winner's medal with LA Galaxy and a Ligue 1 winner's medal with Paris Saint-Germain in 2012-13.

The Lead A draft United Nations Security Council resolution calling for freedom of navigation through the Strait of Hormuz has gained 112 co-sponsors, according to diplomatic sources. This development underscores the breadth of global concern over the closure of one of the world’s most critical shipping lanes. The Event Details The resolution, tabled by Bahrain and the United States, seeks to protect international waterways, commercial shipping and energy supplies, and to ensure the safety of seafarers. It also calls for an end to Iranian attacks on its Gulf neighbours. Qatar, Saudi Arabia and Kuwait have joined Manama and Washington as principal sponsors, while India, Japan, South Korea, Kenya, Argentina and most member states of the European Union have also signed on. The Data Analysis “The list takes up three full pages,” said Al Jazeera’s correspondent in New York, Gabriel Elizondo. “It’s essentially being co-sponsored by two-thirds of all 193 UN member states.” This level of support indicates a significant international consensus on the need to maintain freedom of navigation through the Strait of Hormuz. The Impact Analysis The diplomatic push comes as peace negotiations between Iran and the US remain deadlocked. The US is demanding that Iran dismantle its nuclear programme and lift its restrictions on the strait. Iran has countered with calls for war reparations, an end to the US naval blockade of its ports and a ceasefire on all fronts, including in Lebanon, where US ally Israel is fighting Iranian-backed Hezbollah. The Prediction No date has been set for a vote on the resolution. However, with 112 co-sponsors, it is clear that there is significant international pressure on Iran to reconsider its stance on the Strait of Hormuz. The outcome of the vote will depend on the positions of key players such as China and Russia, which have voiced reservations about the draft but have not yet indicated whether they will veto it.

Ukraine's Long-Range Retaliation Strikes Russian Gas InfrastructurePresident Volodymyr Zelenskyy confirmed that Ukraine has targeted gas facilities in Russia's Orenburg region, located more than 1,500km (932 miles) from the Ukrainian border. The attack represents a significant escalation in the conflict, demonstrating Ukraine's capability to strike deep within Russian territory.Zelenskyy framed the operation as symmetrical retaliation, stating: "Ukraine has said that we will act symmetrically in response to Russia." The Orenburg region is home to one of the world's largest gasfields and contains industrial infrastructure considered vital to Russia's military and economy.Russian Governor Evgeny Solntsev claimed that nine Ukrainian drones were repelled over the region, though fragments from the downed drones damaged a residential building, a school, and a kindergarten, without causing any injuries.Escalation After Failed Ceasefire: Six Dead in Russian AttacksUkraine's latest attacks on Russia came hours after Moscow launched a series of overnight assaults on Ukrainian territory, killing six people in the Dnipropetrovsk region. The violence occurred as the three-day ceasefire brokered by US President Donald Trump came to an end.The pause in hostilities had coincided with Russia's Victory Day celebrations, marking the Soviet defeat of Nazi Germany in World War II. Ukrainian Foreign Minister Andrii Sybiha revealed that Kyiv had offered to extend the ceasefire, but Moscow refused.Zelenskyy reported that Ukraine had been attacked by more than 200 drones, which damaged energy facilities, apartment buildings, a kindergarten, and a civilian train. He added that drones had been intercepted across six regions.Geopolitical Shifts: Russia's Nuclear Posturing and Peace Talk DevelopmentsOn Tuesday, Russia tested its new nuclear-capable intercontinental missile, which President Vladimir Putin described as the "most powerful" nuclear missile in the world, capable of traveling more than 25,000 kilometres (15,534 miles). Putin claimed the weapon "has the ability to penetrate all existing and future anti-missile defence systems." Analysts have previously accused Putin of exaggerating Russia's military capabilities.The Kremlin has suggested the war in Ukraine, which began more than four years ago, is nearing its end. Spokesperson Dmitry Peskov stated: "This accumulated groundwork in terms of the peace process allows us to say that the completion is indeed approaching." However, Zelenskyy disagreed, warning that Ukraine was preparing for further attacks: "Russia has no intention of ending this war. And we are, unfortunately, preparing for new attacks."European Union foreign policy chief Kaja Kallas interpreted Putin's comments as a sign of weakness: "What his statement really shows is that he's not in a strong position. So, I think there's an opportunity for ending this war."Future Outlook: Stalemate or Breakthrough in the Conflict?Talks aimed at ending the conflict have so far failed to achieve significant breakthroughs, stalling in recent months. US President Donald Trump made ending what has become a war of attrition a key pledge during his 2024 election campaign. As he left for a trip to China, Trump told reporters: "The end of the war in Ukraine, I really think it's getting very close."The Kyiv Independent newspaper reported that Washington was attempting to negotiate another temporary ceasefire that would include sanctions relief for Russia. Ukrainian officials are reportedly concerned that the proposed agreement does not include security guarantees, which Kyiv views as essential to deterring future aggression from Moscow.

French President Emmanuel Macron unveiled a €27 billion ($27 billion) investment initiative for Africa, urging a strategic reset of relations between the continent and the European Union. The package, presented at a summit in Paris on 12 May 2026, seeks to boost economic growth, deepen political cooperation, and position Europe as a leading partner in Africa’s development agenda. Macron Announces €27 Billion Multi‑Sector Investment Package for Africa The announcement covered four priority pillars: Infrastructure: €8 billion for transport corridors, ports and cross‑border rail links. Digital & Innovation: €5 billion to expand broadband, support tech hubs and foster AI research collaborations. Renewable Energy: €7 billion for solar, wind and green‑hydrogen projects across 15 African nations. Youth & Skills: €4 billion for vocational training, entrepreneurship incubators and job‑creation programmes. Macron framed the initiative as a “reset” of the EU‑Africa partnership, emphasizing mutual benefits and shared responsibility for climate goals. Financial Scale and Allocation of the €27 Billion Commitment The €27 billion commitment translates to an average of €1.8 billion per pillar, with a projected annual disbursement of €2.5 billion over the next ten years. Funding will be sourced from a mix of French state budgets, EU development funds, and private‑sector co‑investment mechanisms, including a newly created “Euro‑Africa Investment Fund”. Implications for EU‑Africa Partnership and Regional Development Analysts see three immediate effects: Strengthening of France’s geopolitical influence in key African markets, particularly in West and Central Africa. Acceleration of the EU’s strategic autonomy agenda by reducing reliance on non‑European supply chains for critical minerals and digital services. Potential boost to African GDP growth rates by 0.3‑0.5 percentage points annually, according to IMF scenario modelling. The initiative also signals a shift from aid‑centric models toward investment‑driven cooperation, aligning with the EU’s “Strategic Partnerships” framework. What the Next Five Years Could Hold for Franco‑African Cooperation Looking ahead, the following trends are likely: Increased joint ventures between French multinationals and African startups, especially in renewable energy and fintech. Enhanced regulatory harmonisation, with pilot “digital trade corridors” facilitating cross‑border data flows. Potential political friction if project implementation stalls, prompting the EU to establish a monitoring body to ensure transparency and accountability. If the rollout stays on schedule, the €27 billion package could become a benchmark for future EU‑Africa investment strategies, reshaping the continent’s development trajectory and Europe’s role as a partner rather than a donor.

Chelsea's Coaching Conundrum Chelsea FC is optimistic about luring Xabi Alonso as their new head coach, but they are also eyeing Andoni Iraola as an alternative option. The club has held encouraging discussions with Alonso's camp and is closely monitoring Iraola's situation. The Alonso Factor The 44-year-old Alonso, who announced himself as one of the best young managers in Europe when he won the Bundesliga with Bayer Leverkusen in 2024, has been out of work since leaving Real Madrid earlier this season and has been on Chelsea's radar for at least three years. There is a feeling inside Chelsea that Alonso's style of play would make him suited to their young squad. Iraola as an Alternative Chelsea have also met with Iraola to talk to him about the role. There is respect for the Spaniard's work with Bournemouth and a sense that he is more than capable of taking on a big job. Iraola has responded to Bournemouth losing a number of key players in defence and attack during the past year by putting them in contention for Champions League qualification. Chelsea's Coaching Search Chelsea, who made Calum McFarlane interim head coach until the end of the season after firing Liam Rosenior last month, have also looked at Fulham's Marco Silva, Crystal Palace's Olivier Glasner and the former Flamengo manager Filipe Luís. Silva is out of contract at the end of the season and Glasner will leave Palace after the Conference League final later this month.

The Historic CooperationSerbia and NATO have launched their first-ever joint military exercise, a landmark cooperation between the Balkan country and the alliance that bombed its capital less than 30 years ago. The two-week-long drills, which began on May 12 and run until May 23, involve about 600 troops from Serbia, Italy, Romania and Turkiye. Military planners and observers from France, Germany, Italy, Montenegro, Romania, Serbia, Turkiye, the United Kingdom and the United States are also participating.Photographs released on Tuesday showed Serbian and NATO soldiers standing side by side at a military training ground near Bujanovac in southern Serbia, alongside armoured vehicles from both forces. "The cooperation is aimed at preserving peace and stability in the region," Serbia's Ministry of Defence said.The Regional ImplicationsThe tactical exercise falls under NATO's Partnership for Peace programme, which Serbia has been part of for nearly 20 years. The country regularly participates in drills with NATO members, though this marks the first exercise conducted directly with the alliance. This development comes at a time when the Balkans remain a sensitive region with unresolved territorial disputes, particularly regarding Kosovo, which declared independence in 2008 and is not recognized by Serbia.A NATO-led peacekeeping force has been stationed in Kosovo since the 1999 war ended, and Serbia has never recognised its former province's declaration of independence. The exercise takes place against this backdrop of historical tensions but signals a new chapter in regional security cooperation.The Balancing ActSerbia remains one of the few Balkan countries not in the alliance, maintaining a policy of neutrality while balancing close ties with both NATO and Russia. The country has significantly bolstered its military capabilities over the past 10 years, buying arms from NATO member countries alongside purchases from Russia and China."The planning of this exercise has been an important part of this joint endeavour. Both NATO and the Serbian Armed Forces have a long track record of major international exercise planning, so the teams were able to collaborate and deliver in a seamless way, sharing ideas and experience," Royal Navy Commander Ian Kewley said in the news release.The Future OutlookA NATO official told the AFP news agency that the exercise is conducted "in full respect of Serbia's stated policy of military neutrality." This statement underscores the delicate nature of the cooperation and suggests that while Serbia is engaging with NATO, it has no immediate plans to join the alliance.This historic joint exercise could pave the way for increased security cooperation in the region while respecting Serbia's neutral status. As geopolitical tensions continue to evolve, particularly with Russia's influence in the Balkans, Serbia's relationship with NATO may continue to develop, potentially reshaping security dynamics in Southeastern Europe.

Arsenal confirmed that defender Ben White will miss the remainder of the season following a serious knee injury sustained in the 1‑0 win over West Ham, effectively ending his chances of playing for England at the upcoming World Cup. Ben White's Knee Injury Halts Arsenal Campaign Injury type: Significant medial ligament damage Age: 28‑year‑old Match: West Ham vs Arsenal, 10 May 2026 Outcome: White forced off in the first half, left the stadium in a brace Recovery plan: Medical team focusing on rehabilitation for pre‑season Title Race Numbers: What the Loss Means for Arsenal's League Lead Current standing: Premier League leaders Fixtures remaining: Three league games + Champions League final on 30 May 2026 Defensive depth: White had started the last five matches, covering for Jurriën Timber who is also sidelined The absence of a regular centre‑back reduces Arsenal’s defensive options at a crucial stage, potentially narrowing the points gap with rivals as the title race tightens. Broader Implications for Arsenal's Title and Champions League Ambitions Arteta now faces a tactical dilemma ahead of decisive fixtures against Burnley and Crystal Palace, while also preparing a squad for the Champions League final against Paris Saint‑Germain in Budapest. The injury highlights the squad’s vulnerability to depth issues and may force Arteta to reshuffle the back line, possibly promoting younger players or altering formation. Future Outlook: Recovery Timeline and England Squad Prospects Projected return: Medical team aims for readiness at the start of pre‑season (summer) England World Cup squad: White’s injury likely removes him from Thomas Tuchel's 26‑man roster Long‑term impact: Arsenal must reinforce defensively in the upcoming transfer window to mitigate similar setbacks While Arsenal can still clinch the league and contest the Champions League final, the loss of White adds uncertainty to both domestic and European objectives, and it removes a versatile option from England’s World Cup plans.

The LeadRobert Smith, a distinguished pharmacologist and professor at St Mary's medical school in London (now part of Imperial College), has died aged 92. His groundbreaking work on how genetic variations affect drug responses helped shape the field of personalized medicine.The Discovery of Debrisoquine PolymorphismBob became well known for his role in the discovery of "debrisoquine polymorphism." In 1975, as one of five volunteer researchers who took debrisoquine, a blood pressure medication, he was the only one to suffer adverse effects (hypotension) and collapse. This led to the discovery of a genetic polymorphism where certain individuals cannot break down specific drugs efficiently. While Bob described this as an "accident waiting to happen," it positioned him at the forefront of pharmacogenetics.Awards and RecognitionSmith's contributions to pharmacology were formally recognized when he became the first recipient of the Paton prize in 1998 for his work in understanding how genes affect drug response. His academic achievements included becoming professor of pharmacology in 1978 and serving as deputy dean of the medical school from 1980-88.Impact on Medicine and SportsSmith's research fundamentally changed how medical professionals understand drug responses, paving the way for personalized medicine approaches. Beyond human medicine, he applied these principles to horse racing, chairing the UK Horserace Scientific Advisory Committee (1979-99) and its pan-European equivalent (1992-2005). He also served as a director of the Horseracing Forensic Laboratory in Newmarket during the 1990s, helping shape anti-doping protocols.Enduring LegacySmith never fully retired, continuing his research as emeritus professor until publishing his last paper in 2020. His legacy extends beyond scientific contributions to include the principles, warmth, kindness and generosity he embodied throughout his career. His work continues to influence pharmacology and personalized medicine, ensuring his impact will be felt for generations to come.