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Biosimilars are biological medicines highly similar to an authorized reference medicine, offering substantial cost savings and increased treatment access. Despite the regulatory framework in the UK and EU facilitating their approval, the biosimilar landscape remains small compared to small-molecule drugs. This study provides a horizon scanning overview of the current biosimilar landscape, procured through horizon scanning activities.
Methods
Data were sourced from ClinicalTrials.gov and the EU Clinical Trials Register, scanned monthly to identify innovative medicines in clinical development. We included biosimilars identified through horizon scanning from April 2017 to February 2025. Supplementary data were collected from the European Medicines Agency to ascertain approval status, and additional clinical trial information was manually extracted from relevant registries.
Results
We identified 156 unique biosimilars developed across 174 clinical trials, with sixty-four approved by the MHRA and seventy-eight by the European Medicines Agency. Adalimumab, bevacizumab, and denosumab were the reference products with the most biosimilars in development. Most biosimilar trials were at phase III. There are seventy-one biosimilars in active development.
Conclusions
The development landscape of biosimilars in the UK and EU show high activity levels. Continuous improvements in horizon scanning methods and regulatory frameworks are essential to support the timely adoption of biosimilars, maximizing their benefits for healthcare systems.
Achieving a Better Life Experience (ABLE) accounts can help build financial capacity for people with disabilities as tax-advantaged savings vehicles designed for disability-related expenses. ABLE accounts might be particularly beneficial for low-income individuals with severe disabilities who receive Supplemental Security Income (SSI) from the Social Security Administration (SSA), because funds deposited in ABLE accounts do not count toward the asset limits required to maintain monthly SSI benefits and access to healthcare. This paper investigates the potential savings and financial capacity of eligible individuals with disabilities who may benefit from the expansion of ABLE accounts. Utilizing the 2014–2017 Survey of Income and Program Participation merged with the 2014 Social Security Supplement, this study examines different levels of access to savings and financial assets – factors that may influence ABLE participation – among people with disabilities, particularly SSI recipients. Financial capacity is analyzed across three disability onset age groups: before age 26, ages 26 through 45, and age 46 and older, with particular attention to individuals in the second group, who will become eligible for ABLE in January 2026 when the onset-age threshold increases from age 26 to age 46. Findings from logistic and OLS regression analyses indicate that financial capacity is particularly weak among SSI recipients who are newly eligible for ABLE accounts, suggesting limited financial resources to open or contribute to ABLE accounts. Directions for further research on ABLE participation are discussed.
Spectral turbulence models commonly used in the design and certification of wind turbines have only been validated at heights up to 70 m in the atmosphere, but many offshore wind turbines now operate at heights above 150 m. Moreover, there is a lack of measurement data on the spatial structure of turbulence at such heights in the marine atmospheric boundary layer (MBL). Consequently, it is uncertain whether these turbulence models are valid for the design of tall offshore wind turbines. To fill this gap, we present measurements of one-point auto-spectra and two-point spectral coherence at heights of 150–250 m and lateral separations up to 241 m providing lateral coherence of turbulence in the MBL that has never been measured before for these heights and separations. Five light detection and ranging (lidar) instruments were deployed on the west coast of Denmark, and we reconstructed the along-wind and cross-wind components at the lidar beam intersection points. The measurements were compared with the theoretical predictions of auto-spectra and lateral coherence from the Mann model and its extension, the Syed–Mann model. The latter models turbulence down to frequencies of 1 h$^{-1}$ through the $-5/3$ scaling observed in the mesoscale range. The results show that the Mann model did not compare well with the measurements under stable and near-neutral conditions. On the other hand, the Syed–Mann model predicted the lateral coherence for a range of different conditions. However, the lateral coherence was under predicted in about $8\,\%$ of the data, possibly due to gravity waves. We believe that the high coherence from mesoscale turbulence at these heights can influence the loads on floating wind turbines and large offshore wind farms.
The interaction of an object with an unsteady flow is non-trivial and is still far from being fully understood. When an aerofoil or hydrofoil, for example, undergoes time-dependent motion, nonlinear flow phenomena such as dynamic stall can emerge. The present work experimentally investigates the interaction between a hydrofoil and surface gravity waves. The waves impose periodic fluctuations of the velocity magnitude and orientation, causing a steadily translating hydrofoil to be susceptible to dynamic stall at large wave forcing amplitudes. Simultaneous measurement of both the forces acting on the hydrofoil and the flow around it by means of particle image velocimetry (PIV) are performed, to properly characterise the hydrofoil–wave interaction. In an attempt at alleviating the impact of the flow unsteadiness via passive flow control, a bio-inspired tubercle geometry is applied along the hydrofoil leading edge. This geometry is known to delay stall in steady cases but has scarcely been studied in unsteady flow conditions. The vortex structures associated with dynamic stall are identified, and their trajectories, dimension and strength characterised. This analysis is performed for both straight- and tubercled-leading-edge geometries, with tubercles found to qualitatively modify the flow behaviour during dynamic stall. In contrast to previous studies, direct measurements of lift do not evidence any strong modification by tubercles. Drag-driven horizontal force fluctuations, however, which have not previously been measured in this context, are found to be strongly attenuated. This decrease is quantified and a physical model based on the flow observations is finally proposed.
Inspired by the theory of hyperbolic polynomials and Hodge theory, we develop the theory of Lorentzian polynomials on cones. This notion captures the Hodge-Riemann relations of degree zero and one. Motivated by fundamental properties of volume polynomials of Chow rings of simplicial fans, we define a class of multivariate polynomials which we call hereditary polynomials. We give a complete and easily checkable characterization of hereditary Lorentzian polynomials. This characterization is used to give elementary and simple proofs of the Heron-Rota-Welsh conjecture for the characteristic polynomial of a matroid, and the Alexandrov-Fenchel inequalities for convex bodies.
We then characterize Chow rings of simplicial fans which satisfy the Hodge-Riemann relations of degree zero and one, and we prove that this property only depends on the support of the fan.
Several different characterizations of Lorentzian polynomials on cones are provided.
The present study has set up a pilot experiment to optimise the most promising assays for investigating the survival of Antarctic microbial cryptoendolithic communities – a natural astrobiological benchmark – when subjected to lethal/sub-lethal stresses testing viability, cell integrity and metabolic activity. Namely, the viability tests for culturable species are based on cultivation on a solid medium, while qPCR coupled to propidium monoazide (PMA) provides information of both culturable and non-culturable microorganisms. The fluorescein diacetate (FDA) and Adenosine 5’-TriPhosphate (ATP) assays, here optimised, consent to highlight the presence of metabolically active cells. The results revealed significant differences between the treated and untreated samples, proving the suitability of the selected tests for investigating the resilience of these astrobiological models.
Marsupials have been the subject of experimental and natural parasitological studies on helminths in the Americas. Brazil has a significant proportion of the American marsupial fauna, with approximately 15 genera and 69 species out of 95 extant. Helminths have been reported for approximately one-third of the Brazilian marsupial species. Consequently, an update of this information is necessary to ensure the correct identification of the species. This work represents the first comprehensive review of the helminths of the Brazilian marsupials, including taxonomic information on both parasites and hosts. The data were extracted and compiled from references published from 1819 to 2023 and organised according to the classification of the helminths by the host name of the original description, followed by the updated host species nomenclature, geographical distribution, site of infection, and references. In total, 1,047 records of helminths parasitising 22 marsupial species in Brazil were compiled. The list included 93 identified species, including five of the phylum Acanthocephala, 58 of the phylum Nematoda, and 30 of the phylum Platyhelminthes. In addition, 51 other morphospecies were reported. This work may serve as a reference for future studies.
This study aims to understand if the American public supports five policies related to the involvement of healthcare providers in immigration enforcement efforts such as documenting legal status in medical charts to actively assisting immigration enforcement. We also seek to establish whether public attitudes are stable on this issue using an experiment highlighting the implications of these policies for immigrants, communities, and the broader public. To assess public attitudes, we fielded a survey (N = 6049) from 7 March to 26 March 2025. We randomly assigned respondents to one of six treatments highlighting various implications of these policies for immigrants and communities. We found a divided public on the topic, with a substantial number of Americans willing to blur the lines between immigration policy and the provision of healthcare. Respondents were most receptive to tracking the number of undocumented patients served and least supportive of assisting in detaining patients. We found substantial differences based on party affiliation and presidential vote choice but not personal connections or residence inside or outside of border states. Our findings suggest that a majority of Americans support some level of immigration enforcement in healthcare settings while public opinion on this issue is hard to move.
Infectious disease (ID) care involves a diverse range of professionals, yet the shortage and geographical disparity of ID physicians, among other professionals, remain underexplored. This cross-sectional descriptive study aimed to elucidate the distribution of ID physicians, infection control (IC) pharmacists, and IC nurses in Japan, focusing on the interrelations among the ID workforce within medically relevant geographical units.
Methods:
Publicly available data from 335 secondary medical areas (SMAs) in Japan, with a population of 125 million, were analyzed. Workforce distribution was assessed using the Gini index to quantify inequalities and spatial clustering across the SMAs per capita, per hospital bed, and per unit area. χ2 test was used to assess the association of hospital characteristics with the presence of each professional.
Findings:
The research subjects were 1,729 ID physicians, 1,371 IC pharmacists, and 2,657 IC nurses, whose workplace data were available in Japan as of 2023. The Gini coefficients for the densities of ID physicians, IC pharmacists, and IC nurses per 100,000 people were 0.46, 0.34, and 0.28, respectively. The density of the ID workforce per unit area (1,000 km2) showed a positive correlation ( > 0.8) with any combination of ID physicians, IC pharmacists, and IC nurses. A total of 186 SMAs (56%) had at least one member from each professional group and 13 (3.9%) lacked staff from all three.
Conclusions:
The substantial variation in ID workforce composition across SMAs suggests opportunities for both regional and national policy and identifies new avenues for improving access to ID care.
Over the history of Maya studies, archaeologists have proposed various models for the structure of Maya settlements and their use of the landscape. The introduction of lidar to Maya studies, and the wealth of data this technology yielded, has many of these ideas coming under renewed study. Some of the most prominent models discussed in the last two decades have centered on low-density agrarian urbanism and forest gardens. Using settlement studies, lidar data, and hydrological analysis, this article discusses the applicability of these models for the ancient Maya at Lamanai and Ka’kabish, and more generally, Northern Belize. The Maya in the periphery at Lamanai developed wetland management strategies by capitalizing on natural drainage next to seasonally inundated swamps, or bajos. Evidence suggests that the Maya sustained large populations by using channels at the edge of bajos for field systems. These systems may be key to understanding their sustainability in the past.
Professional burnout syndrome represents a significant occupational hazard within European primary care physicians, impacting their well-being, quality of care, and the sustainability of healthcare systems. This joint European Psychiatric Association (EPA) and the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians- Europe Region (WONCA Europe) viewpoint focuses specifically on primary care physicians, contrasts their risk profile with other specialties, and outlines actionable, system-level recommendations for policymakers, provider organizations, and professional associations. Evidence indicates a wide range in professional burnout syndrome prevalence, influenced by assessment methodologies and specific national contexts. The syndrome manifests through emotional exhaustion, depersonalization, and reduced personal accomplishment, often accompanied by secondary psychological and physical symptoms. A multitude of interacting risk factors at the individual, interpersonal, and organizational levels contribute to its development. Effective mitigation strategies necessitate a multi-pronged approach encompassing individual coping mechanisms and systemic organizational changes aimed at alleviating workload, enhancing autonomy, and fostering supportive work environments.
This article explores how the five major rebellions which took place in Devon and Cornwall between 1485 and 1603 were subsequently remembered by the region’s inhabitants. It begins by demonstrating that – although early modern elites generally preferred to say as little as possible about episodes of popular protest once they had been safely suppressed – the revolts which had occurred under the Tudor monarchs went on to be officially memorialised in several South Western communities. The article then moves on to discuss how local gentlefolk looked back on the rebellions, and argues that such individuals tended, in their retrospective accounts, to exaggerate the degree of social radicalism which had been exhibited by the insurgents. Next, the article considers the few scraps of evidence which have survived about popular memories of the protests, and suggests that, while the specific grievances which had motivated the rebels may well have been quite quickly forgotten, the desperate courage with which they had fought – particularly during the Western Rising of 1549 – had continued to be remembered by the ordinary people of the region for decades to come. The fourth and last part of the article looks at ‘modern’ commemoration of the revolts and draws out some general conclusions.
Triply periodic minimal surfaces (TPMS)-based media (a type of metamaterial) are defined by mathematical expressions, which are amenable to additive manufacturing, and are finding increasing practical applications owing to their porous nature. We present experimental pressure drop measurements for a range of velocities spanning laminar to turbulent regimes for three TPMS geometries – gyroid, primitive and body-centred cubic (BCC) – with different porosity, unit cell length and surface finish. Dimensional Darcy and Forchheimer permeabilities are estimated via quadratic fitting for the gyroid geometry, which closely resembles random packed porous media. Subsequently, the non-dimensional drag (${\kern-0.5pt}f$) is plotted against Reynolds number ($Re$) yielding distinct curves for each case. The lack of collapse stems from varying definitions of pore diameter, complicating comparisons across porous media (not just TPMS). Therefore, a method is developed to estimate an equivalent hydraulic diameter $d_{{H\hbox{-}\textit{equ}}}$ from pressure drop data by matching the laminar drag $f$ of packed spheres via the Ergun equation, allowing the collapse of all porous media $f-Re$ curves in the laminar regime. The value of $d_{ {H\hbox{-}\textit{equ}}}$ is related to the ‘true’ Darcy permeability defined strictly in the linear regime (unlike permeability from quadratic fitting). We observe an approximate linear relationship between the $d_{ {H\hbox{-}\textit{equ}}}$ and the hydraulic diameter for self-similar TPMS configurations. The common basis of $d_{ {H\hbox{-}\textit{equ}}}$ allows intercomparison of TPMS geometries, and shows that BCC achieves significant drag reduction compared with packed spheres in the turbulent regime partially because of their open tube-like structure, whereas some configurations show drag increase. Although gyroid can be represented using the traditional quadratic drag law, primitive and BCC show an increase in $f$ with increasing $Re$ immediately before transitioning to fully turbulent regime – akin to rough-wall pipe flows, likely owing to their periodic streamwise elongated open structures.
This paper considers how issue salience environments affect long-term patterns of political choice via processes of political socialization. Drawing on the well-known ‘impressionable years’ hypothesis, we theorize that voters who grew up in high-immigration salience contexts subsequently exhibit higher levels of voter-party agreement on immigration (issue congruence). We find support for this hypothesis from two studies, which leverage cross-sectional variation within cohorts in exposure to immigration salience in voters’ formative years. The first employs congruence data from a survey of 10 European countries, linked to historical salience data from the Comparative Manifesto Project. The second is a within-country study, measuring salience and congruence from two long-running German public opinion survey series. The analysis suggests that growing up at times when immigration is high on the political agenda can have long-term consequences for the relationship between voters’ preferences on that issue and their political choices, shedding light on the mechanism behind ‘generational realignment’.
The discourse on decolonising environmental education necessitates a critical engagement with Indigenous epistemologies and narratives that challenge dominant, Eurocentric paradigms of ecological knowledge. Sheela Tomy’s Valli (2022) offers a compelling literary intervention in this context, concentrating forest narratives and subverting colonial legacies of environmental exploitation. The analysis positions Valli as a narrative intervention that centres the Adivasi communities of Kerala’s Wayanad district. The fiction portrays the forest as a sentient, sovereign entity, challenging colonial and post-colonial forest policies that commodified nature through timber extraction and plantations, leading to ecological ruin and displacement. Guided by the insights of decolonial theorists such as Walter Mignolo, Arturo Escobar and Vandana Shiva, the article demonstrates how the fiction leverages folklore and testimony to validate oral histories, presenting them as crucial for understanding ecological crises. Valli enacts a pedagogical project that recentres Indigenous knowledge, aligning with environmental justice movements. The article concludes that decolonising environmental education requires fundamental ontological shift from human domination to coexistence. It advocates for a pedagogical model, exemplified by the fictional Kadoram school, which integrates Indigenous knowledge, advances multispecies empathy and recognises the land as a co-instructor. This approach thereby fosters pluriversality and a sustainable environmental ethic.
As the volume of meteorological observations continues to grow, automating the quality control (QC) process is essential for timely data delivery. This study evaluates the performance of three machine learning algorithms—autoencoder, variational autoencoder, and long short-term memory (LSTM) autoencoder—for detecting anomalies in air temperature data. Using expert-quality-controlled data as ground truth, all models demonstrated anomaly detection capability, with the LSTM outperforming others due to its ability to capture temporal patterns and minimize false positives. When applied to raw data, the LSTM achieved 99.6% accuracy in identifying valid observations and replicated 79% of manual flags, with only five false negatives and six false positives over a full year. Its sensitivity to subtle meteorological changes, such as those caused by rainfall or cloud cover, highlights its robustness. The LSTM’s performance using a three-day timestep, combined with basic QC checks in SaQC (System for Automated Quality Control), suggests a scalable and effective solution for automated QC at Met Éireann, with potential for expansion to include additional variables and multi-station generalization.
We examined the diagnostic utility of urinalyses (UAs) in psychiatric admissions. Admission UAs led to diagnosis of clinical urinary tract infections in 1.7% of cases. Among those treated with antibiotics, inappropriate prescriptions occurred in 71.3% of cases, with increased odds in older age, female sex, positive cultures, and certain psychiatric diagnoses.
COVID-19 led to a pandemic in 2020, which officially arrived in Colombia on 6 March 2020. As in other parts of the world, the spread of the virus was underestimated due to the lack of diagnostic tests and follow-up protocols. The present study estimates the number of daily cases of COVID-19 infection compatible with theoretical knowledge of the disease, seroprevalence studies, and records of daily deaths due to the disease. To this end, the REMEDID (Retrospective Methodology to Estimate Daily Infections from Deaths) algorithm was applied in nine Colombian cities. On average, official records detected only around 13% of the maximum number of infected persons in the first wave, which they dated with a delay of 25 days. In addition, there was an average delay of 30 days in detecting the first cases. In particular, in Bogotá, the city with the highest number of infections in Colombia, it was observed that (1) the first infected person arrived on 26 January 2020, 40 days before the official registration; (2) the maximum peak of infections was around 6 times higher than that recorded in the official statistics; and (3) this peak was reached on 08 July 2020, 39 days before the official registration date.
The article argues that, contrary to what is often held in academic literature, traditional fishermen had solid empirical knowledge about underwater topography long before acoustic sounding. To substantiate the argument, a large mid twentieth-century collection of place names and terms collected among coastal fishermen in Norway is explored, with the aim to demonstrate that this vocabulary reflects a detailed knowledge about underwater geography as well as advanced navigational skills. The second aim of the article is to investigate the reformatting of this knowledge when it was first transferred to national fisheries maps and secondly when it entered the International Court of Justice as part of the Norwegian fisheries case against the UK in 1951. Reformatting represents more than a new context: It shapes and changes knowledge. The present article applies this more general principle of knowledge transformation to the study of the human–ocean relationship and explores how reformatting has decisively impacted activities at sea, influenced parameters for ocean use, and been constitutive to shaping the ocean as an object of knowledge.
Deposits of thick volcanic and volcaniclastic series can be interpreted as either related to regional tectonics (commonly extensional or transtensional tectonics) or local volcanic mechanisms (caldera collapse). In order to distinguish between these two end-member mechanisms, we propose the use of magnetic techniques, namely analysis of Anisotropy of Magnetic Susceptibility (AMS) and paleomagnetism, and analysis of geological structures. These techniques have been applied to the Estac Basin (Central Pyrenees), an inverted Late Carboniferous–Permian basin now involved in the antiformal stack of the Pyrenean belt. AMS data provide directions of flow of volcanic rocks that can be interpreted in terms of palaeo-slopes and therefore can be related to structures contemporary with deposition and Late Carboniferous–Permian volcanic activity. The maximum of the magnetic lineation (i.e. volcanic paleoflow) direction is bimodal, with (i) an absolute maximum (as occurring in most South-Pyrenean Late Carboniferous–Permian basins) along a WNW–ESE direction and (ii) a secondary magnetic lineation along an N–S direction. Paleomagnetic data obtained from the volcanic products show a primary magnetization or early remagnetization compatible with the Late Carboniferous–Permian paleomagnetic reference direction and allow us to reconstruct an early folding probably related to the warping of the basin. The magnetic and structural data can be interpreted according to a volcano-tectonic subsidence model in which E–W faults played a major role and caldera collapse contributed to the important thickness of the volcaniclastic deposits.