Thomas Cox

The MCU has always claimed that the X-Men will make a comeback in their shared universe, but an insider has revealed that the mutants will carry significant moral baggage.

Introduction: While the musculoskeletal symptoms of axial spondyloarthritis (axSpA) are well appreciated, emerging evidence demonstrates that patients newly diagnosed with axSpA experience a substantial mental health burden. There is increasing awareness of the need for mental health screening and integrated psychological support as part of comprehensive axSpA management. The primary aims of our study were to assess the prevalence of depression and anxiety in patients with a new diagnosis of axSpA within the past 24 months and to establish the relationship between axSpA disease activity and the severity of anxiety or depression symptoms. The secondary exploratory analysis was to assess the relationship between interventions received (none, biologics, physiotherapy, and patient support groups) and the severity of anxiety or depression symptoms.Methods: We conducted a single-centre cross-sectional observational study in a tertiary axSpA rheumatology clinic. Of the 95 eligible patients, 66 patients (response rate 69.5%) completed a comprehensive questionnaire assessing patient demographics, disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), quality of life using the Ankylosing Spondylitis Quality of Life (ASQoL) score, and depressive and anxiety symptoms using standardised screening tools, Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7), respectively. Linear regression analysis was performed to assess the correlation between BASDAI and PHQ-9, as well as GAD-7.Results: Based on the PHQ-9 scores, 81.8% (54/66) of patients had a score of 5 or more, which is equivalent to having symptoms of mild depression. Of these, 57.4% (n = 31/54) reported moderate-severe symptoms of depression (PHQ-9 ≥10). Similarly, 65.2% (n = 43/66) reported anxiety symptoms, with 53.3% (n = 23/43) experiencing moderate-severe symptoms of anxiety (GAD-7 ≥10). Linear regression analysis demonstrated a strong positive correlation between disease activity (BASDAI) and depression (coefficient = 1.77, 95% CI 1.30-2.23, R² = 0.473, p < 0.0001) and between disease activity and anxiety (coefficient = 1.32, 95% CI 0.79-1.85, R² = 0.279, p < 0.0001). Multivariate analysis demonstrated that disease activity independently predicted both depressive (coefficient 1.79, p value < 0.0001) and anxiety symptoms (coefficient 1.33, p value < 0.0001), even after adjusting for age, gender, employment status, diagnostic delay, and quality of life.Conclusion: This study demonstrates a high prevalence of undiagnosed depression and anxiety in newly diagnosed axSpA patients, with disease activity as an independent predictor of mental health burden. These findings support the urgent need for routine mental health screening at diagnosis and the integration of psychological care within holistic axSpA management. Further prospective research is required to evaluate optimal screening strategies and psychological intervention models to address this substantial treatment gap.

Why does Lean fail to stick so often? Thomas Cox and Andre DeMerchant join me on Episode 547 to make the case that the missing precondition is psychological safety, and that it has to exist at the top before any…

The US administration has finalised a decision to eliminate habitat protections for wildlife against activities such as mining by changing definitions under its cornerstone Endangered Species Act (ESA).

France has around 40 voluntary and mandatory biodiversity credit projects in the pipeline under the government's rebranded scheme, an official has said.

An Austria-based non-profit has published a tool in collaboration with an EU Horizon-funded wetlands project to help restoration practitioners assess whether biodiversity credits are a suitable financing option.

Albania's path to becoming an EU member is at risk due to the government's failure to protect natural areas, a Dutch MEP has told local media.

The monitoring of nature-based solutions in cities should be reframed as a learning process built on community involvement rather than using only standardised frameworks, a paper has argued.

Australia has protected a quarter of its land – over 196 million hectares – following the establishment of another Indigenous Protected Area (IPA), the government said on Thursday.

The Kumamoto Declaration, setting out ambition towards a nature-positive future, was released at a global summit in Japan with 85 signatories from across the public, private, and non-profit sectors.