220861 research outputs found
Sort by
A scoping review of disease-modifying antirheumatic drug nonadherence in rheumatoid arthritis: Measurement, prevalence and implications for clinical practice
No full textFirst published: 21 September 2025Aims Adherence to disease-modifying antirheumatic drugs (DMARDs) has been associated with improved treatment outcomes, but how adherence is reported ranges between studies. We therefore aimed to determine how nonadherence to DMARDs used to treat rheumatoid arthritis (RA) has been measured and to report the nonadherence rate with each measure identified. Additionally, we aimed to explore what factors are associated with nonadherence. Methods A scoping review was conducted in the following databases: Embase, Medline, Scopus and Cochrane, searching from 2000 up to 31 August 2022 using search terms related to ‘adherence’; ‘measures’; rheumatoid arthritis'; and ‘medication’. Descriptive analyses were used to analyse and interpret the data according to the stated aims. We included 172 manuscripts that met the inclusion criteria and the median number of participants for each study was 249 (interquartile range 120–767). Measures of adherence included dispensing data, tablet counts, self-report and physician estimates, electronic monitors, questionnaires and blood assays. Results Nonadherence was most commonly reported as a proportion and ranged from 1.5 to 100% for any DMARDs as a class, 0 to 95% for conventional synthetic DMARDs and 3 to 95% for biologic DMARDs. Increased disease activity, younger age and comorbidities were found in several studies to be associated with nonadherence, while there were inconsistent findings for sex, education, disease duration and other patient characteristics. Conclusion Much variability exists in the reported prevalence of nonadherence in RA, in what measures are used to assess nonadherence, how nonadherence is reported and which patient characteristics are associated with nonadherence.Lauren Fraser, Nagham Ailabouni, Lisa Kalisch Ellett, Jiun Ming Tan, Anthea Freeman, Susanna M. Proudman, Emily Reeve, Michael D. Wies
Impact of immobilization system angle, body mass index and breast size on breast radiotherapy accuracy using EPID-only setup
No full textData source: Supplementary data, https://doi.org/10.1016/j.heliyon.2025.e42176This study aims to assess setup errors for patients immobilized on different board inclinations and to evaluate the effect of body mass index (BMI) and breast size on positioning errors. Furthermore, the dosimetric impact of setup errors on target and organs at risk was measured using three different irradiation techniques (3D conformal radiotherapy, intensity modulated and volumetric modulated arc radiotherapy). A cohort of 40 breast cancer patients was split into two groups as a function of immobilization board inclination: 20 patients immobilized on 7.5° inclination (group A) and 20 on 0° (group B). Systematic and random errors were determined with weekly portal and tangential images.
A strong correlation between BMI and both systematic (r = 0.720) and random errors (r = 0.752) was observed in posterior direction for group B, while the correlation between breast size and setup errors showed a moderate association under systematic errors for right (r = −0.507) and left (r = 0.503) directions. The dosimetric impact of setup errors on target volume showed higher contribution from systematic than from random errors. Suboptimal coverage of target volume was more prominent in group A for all planning techniques (46.65Gy 3DCRT, 46.95Gy IMRT, 46.90Gy VMAT). Patients with high BMI could benefit from the inclined immobilization board with a higher frequency of image position verification. When comparing 3DCRT versus modulated techniques the ipsilateral lung is better spared with the latter, while the contralateral lung is more efficiently protected with conformal technique
Geopolitical risks and airlines stock return - Implications to the financial stability of European airlines
No full textThis study utilizes a time-varying Granger causality test to investigate the causal relationship between geopolitical risks and stock return of main carriers in Europe. While the overall estimations from the entire dataset reveal limited evidence supporting causality between these variables, the rolling-window bootstrapping Granger causality test presents a dynamic pattern that a time-varying causality running from geopolitical risks to airline stock returns. However, within this fluctuating analytical framework, airline stock returns fail to reliably predict geopolitical risks. Finally, we offer significant policy implications to the financial stability of European airlines
Amplify as a discourse and what it might mean for teacher education research
No full textYou may have noticed that the word “amplify” is currently everywhere. It is writ large in advertising for the generative AI programme Claude (n.d.): “your ideas, amplified.” It is in an article in The Guardian on Anna Wintour, the fashion doyenne, and her departure as editor-in-chief of American Vogue magazine: “She has amplified the place of fashion in culture beyond all recognition” (Cartner-Morley, 2025). And it is in advertising by academic publisher Springer Nature: “Amplify your book’s visibility with personalized marketing assets.” This is not to mention the premium unleaded and diesel product range called Amplify by petroleum company Ampol and the extensive list of education products called Amplify revealed in a simple internet search. This emergence of amplify/amplification raises questions about what and why now, and of course, what does it mean for teacher education research – our remit as editors of the Asia-Pacific Journal of Teacher Education (APJTE)
Identifying abnormal exertional breathlessness in COPD: comparing modified Medical Research Council and COPD assessment test with cardiopulmonary exercise testing
No full textData source: supplementary data, https://doi.org/10.1016/j.chest.2024.10.027Background: COPD management is guided by the respiratory symptom burden, assessed using the modified Medical Research Council (mMRC) scale, the COPD Assessment Test (CAT), or both.
Research Question: What are the abilities of mMRC and CAT to detect abnormally high exertional breathlessness on incremental cardiopulmonary cycle exercise testing (CPET) in people with COPD?
Study Design and Methods: Analysis of people ≥ 40 years of age with FEV1 to FVC ratio of < 0.70 after bronchodilator administration and ≥ 10 pack-years of smoking from the Canadian Cohort Obstructive Lung Disease study. Abnormal exertional breathlessness was defined as a breathlessness (Borg scale 0-10) intensity rating more than the upper limit of normal at the symptom-limited peak of CPET using normative reference equations.
Results: We included 318 people with COPD (40% women) with a mean (SD) age of 66.5 (9.3) years and FEV1 of 79.5% predicted (19.0% predicted); 26% showed abnormally low exercise capacity (peak oxygen uptake less than the lower limit of normal). Abnormally high exertional breathlessness was present in 24%, including 9% and 11% of people with mMRC score of 0 and CAT score of < 10, respectively. An mMRC score of ≥ 2 and CAT score of ≥ 10 was most specific (95%) to detect abnormal exertional breathlessness, but showed low sensitivity of only 12%. Accuracy for all scale cutoffs or combinations was < 65%. Compared with people with true-negatives findings, people with abnormal exertional breathlessness but low mMRC score, low CAT scores (false-negatives findings), or both showed worse self-reported and physiologic outcomes during CPET, were more likely to have physician-diagnosed COPD, but were not more likely to be taking any respiratory medication (37% vs 30%; mean difference, 6.1%; 95% CI, –7.2 to 19.4; P= .36).
Interpretation: In COPD, mMRC and CAT show low concordance with CPET and fail to identify many people with abnormally high exertional breathlessness.
Clinical Trial Registry: ClinicalTrials.gov; No.: NCT00920348; URL: www.clinicaltrials.go
Spider silk-inspired hyaluronic acid-based hydrogels with superior self-healing capability and enhanced strength
No full textData source: Supporting information, https://doi.org/10.1002/cssc.202400769Hyaluronic acid hydrogels are promising materials for diverse applications, yet their potential is hampered by limitations such as low self-healing efficiency and insufficient mechanical strength. Inspired by the heterogeneous structures of spider silk, we introduce a novel dual dynamically crosslinked network hydrogel. This hydrogel comprises an acylhydrazone-crosslinked network, utilizing aldehyde hyaluronic acid (AHA) and 3,3′-dithiobis (propionohydrazide) (DTP) as a first network, and a secondary network formed by hydrogen bonds-crosslinked network between tannic acid (TA) and silk fibroin (SF) with β-sheet formation. The hydrogel exhibits exceptional self-healing ability due to the dynamic and reversible nature of Schiff base bonds, disulfide bonds, and hydrogen bonds, achieving complete healing within 5 minutes. Additionally, the spider silk-inspired heterogeneous structures enhance mechanical properties. Furthermore, the incorporation of TA provides enhances adhesion, as well as remarkable antibacterial and antioxidant properties. This innovative hyaluronic acid-based hydrogel, inspired by spider silk, offers a promising avenue to fortify both the mechanical strength and self-healing capabilities of hydrogels, thus expanding opportunities for applications in tissue engineering and biomedicine
Buy Now, Pay Later technologies and the gamification of debt in the financial lives of young people
No full textIn many countries Buy-Now-Pay-Later (BNPL) services have rapidly become a pervasive option to pay for consumer products both online and instore. Under-regulated and specifically marketed at young people, BNPL services use gamified and social media-like features to create frictionless user interfaces that supposedly resonate with the way young people engage online and in digital spaces, producing specific financialised subjectivities. In this article, we draw upon Sianne Ngai’s theory of the gimmick to analyse young people’s experiences with these products within an Australian context. Importantly, we emphasise how engagement with BNPL services feels and the many ambivalences and antinomies this surfaces around the blurry lines between production and consumption, and the precarious economic positions of many young people. We contribute to research on the financialisation of everyday life and the consumption of credit by analysing the everyday practices of young people’s indebted subjectivities within a public discourse that positions youth as financially irresponsible while debt is ubiquitous and unavoidable for all but the most privileged
Adapting smallholder irrigation systems to extreme events: a case of the transforming irrigation in Southern Africa (TISA) project in Zimbabwe
No full textSmallholder irrigation schemes are vulnerable to increased climate variability and change, particularly increased water stress. This paper explores whether the introduction of Agricultural Innovation Platforms and soil monitoring tools in smallholder irrigation schemes can improve the adaptive capacity of farmers and schemes in the Insiza District. Drawing on household survey and qualitative data, collected through the Transforming Irrigation in Southern Africa project, we analyse a comprehensive set of measures across four domains: field, household, community and markets. We find that social capacity and increased climate adaptation can be built with modest cost through combined social and technological interventions
Iron oxide nano-adsorbent doped with nickel and palladium for phosphorus removal from water
No full textData source: Supplementary information, https://doi.org/10.1039/D5RA02256HExcessive phosphorus (P) in surface and ground water can cause serious environmental issues. This study aims to synthesize and characterize novel iron oxides (FexOy) nanoparticles (NPs) with and without Ni and Ni–Pd doping and unravel the NPs' performance and mechanism for P removal from water. X-ray diffraction, energy dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy results confirmed successful doping of Ni and Ni–Pd on FexOy NPs. FexOy–Ni NPs exhibited a higher specific surface area and isoelectric point than FexOy and FexOy–Ni–Pd NPs.
The kinetic data for P adsorption on FexOy NPs fitted to the pseudo-first order model and FexOy–Ni and FexOy–Ni–Pd NPs fitted to the pseudo-second order model. Adsorption isotherm data for FexOy NPs fitted to the Freundlich model and FexOy–Ni and FexOy–Ni–Pd NPs fitted to the Langmuir model. The maximum P adsorption capacity was the highest for FexOy–Ni (35.66 mg g−1) followed by FexOy–Ni–Pd (30.73 mg g−1) and FexOy NPs (21.97 mg g−1), which was opposite to the P desorption order of these adsorbents. The adsorption and characterization analysis suggested that inner-sphere complexes and co-precipitation were the key mechanisms for P adsorption on FexOy–Ni and FexOy–Ni–Pd NPs. Therefore, FexOy–Ni NPs were a highly effective adsorbent for removing P from water
Evaluating the readability and quality of AI-generated scoliosis education materials: a comparative analysis of five language models
No full textData source: supplementary information, https://doi.org/10.1038/s41598-025-19370-3The complexity of scoliosis-related terminology and treatment options often hinders patients and caregivers from understanding their choices, making it difficult to make informed decisions. As a result, many patients seek guidance from artificial intelligence (AI) tools. However, AI-generated health content may suffer from low readability, inconsistency, and questionable quality, posing risks of misinformation. This study evaluates the readability and informational quality of scoliosis-related content produced by AI. We evaluated five AI models-ChatGPT-4o, ChatGPT-o1, ChatGPT-o3 mini-high, DeepSeek-V3, and DeepSeek-R1-by querying each on three types of scoliosis: congenital, adolescent idiopathic, and neuromuscular. Readability was assessed using the Flesch-Kincaid Grade Level (FKGL) and FleschKincaid Reading Ease (FKRE), while content quality was evaluated using the DISCERN score. Statistical analyses were performed in R-Studio. Inter-rater reliability was calculated using the Intraclass Correlation Coefficient (ICC). DeepSeek-R1 achieved the lowest FKGL (6.2) and the highest FKRE (64.5), indicating superior readability. In contrast, ChatGPT-o1 and ChatGPT-o3 mini-high scored above FKGL 12.0, requiring college-level reading skills. Despite readability differences, DISCERN scores remained stable across models (similar to 50.5/80) with high inter-rater agreement (ICC = 0.85-0.87), suggesting a fair level quality. However, all responses lacked citations, limiting reliability. AI-generated scoliosis education materials vary significantly in readability, with DeepSeek-R1 being the most accessible. Future AI models should enhance readability without compromising information accuracy and integrate real-time citation mechanisms for improved trustworthiness