bluuebunny/crossref_metadata_2025 huggingface dataset:
The global health and economic value of COVID-19 vaccination
Authors: Sevilla JP , Burnes Daria , Knee Joseph S , Di Fusco Manuela , Kyaw Moe H , Yang Jingyan , Nguyen Jennifer L , Bloom David E
Published: September 2024

Introduction

The COVID-19 pandemic triggered one of the largest global health and economic crises in recent history. COVID-19 vaccination (CV) has been the central tool for global health and macroeconomic recovery, yet estimates of CV’s global health and macroeconomic value remain scarce.

Methods

We used regression analyses to measure the impact of CV on gross domestic product (GDP), infections and deaths. We combined regression estimates of vaccine-averted infections and deaths with estimates of quality-adjusted life years (QALY) losses, and direct and indirect costs, to estimate three broad value components: (i) QALY gains, (ii) direct and indirect costs averted and (iii) GDP impacts. The global value is the sum of components over 148 countries between January 2020 and December 2021 for CV generally and for Pfizer-BioNTech specifically.

Results

CV’s global value was US$5.2 (95% CI US$4.1 to US$6.2) trillion, with Pfizer-BioNTech’s vaccines contributing over US$1.9 (95% CI US$1.5 to US$2.3) trillion. Varying key parameters results in values 10%–20% higher or lower than the base-case value. The largest value component was GDP impacts, followed by QALY gains, then direct and indirect costs averted. CV provided US$740 of value per dose, while Pfizer-BioNTech specifically provided >US$1600 per dose. We estimated conservative benefit-cost ratios of 13.9 and 30.8 for CV and Pfizer-BioNTech, respectively.

Conclusions

We provide the first estimates of the broad value of CV incorporating GDP, QALY and direct and indirect cost impacts. Through December 2021, CV produced significant health and economic value, represented strong value for money and produced significant macroeconomic benefits that should be considered in vaccine evaluation.
Brain reserve and physical disability in secondary progressive multiple sclerosis
Authors: John Nevin , Li Yingtong , De Angelis Floriana , Stutters Jonathan , Prados Carrasco Ferran , Eshaghi Arman , Doshi Anisha , Calvi Alberto , Williams Thomas , Plantone Domenico , Phan Thanh , Barkhof Frederik , Chataway Jeremy
Published: September 2024

Background

The brain reserve hypothesis posits that larger maximal lifetime brain growth (MLBG) may confer protection against physical disability in multiple sclerosis (MS). Larger MLBG as a proxy for brain reserve, has been associated with reduced progression of physical disability in patients with early MS; however, it is unknown whether this association remains once in the secondary progressive phase of MS (SPMS). Our aim was to assess whether larger MLBG is associated with decreased physical disability progression in SPMS.

Methods

We conducted a post hoc analysis of participants in the MS-Secondary Progressive Multi-Arm Randomisation Trial (NCT01910259), a multicentre randomised placebo-controlled trial of the neuroprotective potential of three agents in SPMS. Physical disability was measured by Expanded Disability Status Scale (EDSS), 9-hole peg test (9HPT) and 25-foot timed walk test (T25FW) at baseline, 48 and 96 weeks. MLBG was estimated by baseline intracranial volume (ICV). Multivariable time-varying Cox regression models were used to investigate the association between MLBG and physical disability progression.

Results

383 participants (mean age 54.5 years, 298 female) were followed up over 96 weeks. Median baseline EDSS was 6.0 (range 4.0–6.5). Adjusted for covariates, larger MLBG was associated with a reduced risk of EDSS progression (HR 0.84,95% CI:0.72 to 0.99;p=0.04). MLBG was not independently associated with time to progression as measured by 9HPT or T25FW.

Conclusion

Larger MLBG is independently associated with physical disability progression over 96 weeks as measured by EDSS in SPMS. This suggests that MLBG as a proxy for brain reserve may continue to confer protection against disability when in the secondary progression phase of MS.

Trail registration number

NCT01910259.
Effectiveness and feasibility of continuous renal replacement therapy for acute kidney injury in neonates weighing 3 kg or less: a two-centre, retrospective study
Authors: Sun Yifan , Xu Jinglin , Chu Xiaoyun , Zhang Weifeng , Gong Xiaohui , Chen Dongmei , Cai Cheng
Published: September 2024

Background

Continuous renal replacement therapy (CRRT) is commonly used for the treatment of acute kidney injury (AKI) in critically ill neonates. This study investigated the effectiveness and feasibility of CRRT for AKI in neonates who weigh ≤3 kg.

Methods

Data from 19 neonates with a weight ≤3 kg and AKI who underwent CRRT at two centres between January 2015 and October 2021 were collected retrospectively. Kidney function, circulatory function, complications and clinical outcomes were recorded. Repeated-measures analyses of variance, t-tests and non-parametric tests were conducted.

Results

The median patient age at CRRT initiation was 3 days (IQR: 1–7 days). The median patient weight at CRRT initiation was 2.67 kg (IQR: 2.20–2.85 kg). The median CCRT duration was 46 hours (IQR: 32–72 hours). The serum creatinine and blood urea nitrogen levels decreased significantly, and the mean arterial pressure increased significantly after 12 hours of CRRT and at the end of CRRT. The urinary output was significantly increased at the end of CRRT. 11 patients had thrombocytopaenia, 6 had electrolyte disorders and 3 had blocked tubes. Five patients were discharged, six died after their parents chose to discontinue treatment and eight died after active treatment. Weight at CRRT initiation and urinary output at the end of CRRT were significantly lower among patients who died than among patients who survived.

Conclusions

CRRT is feasible and effective for AKI in neonates who weigh ≤3 kg when accompanied by elaborate supportive care. Lower body weight and persistent oliguria may be correlated with an increased risk of poor clinical outcomes.
Goblet cells: guardians of gut immunity and their role in gastrointestinal diseases
Authors: Raya Tonetti Fernanda , Eguileor Alvaro , Llorente Cristina
Published: September 2024

Goblet cells (GCs) are specialised guardians lining the intestine. They play a critical role in gut defence and immune regulation. GCs continuously secrete mucus creating a physical barrier to protect from pathogens while harbouring symbiotic gut bacteria adapted to live within the mucus. GCs also form specialised GC-associated passages in a dynamic and regulated manner to deliver luminal antigens to immune cells, promoting gut tolerance and preventing inflammation. The composition of gut bacteria directly influences GC function, highlighting the intricate interplay between these components of a healthy gut. Indeed, imbalances in the gut microbiome can disrupt GC function, contributing to various gastrointestinal diseases like colorectal cancer, inflammatory bowel disease, cystic fibrosis, pathogen infections and liver diseases. This review explores the interplay between GCs and the immune system. We delve into the underlying mechanisms by which GC dysfunction contributes to the development and progression of gastrointestinal diseases. Finally, we examine current and potential treatments that target GCs and represent promising avenues for further investigation.
Sphincterotomy for biliary sphincter of Oddi disorder and idiopathic acute recurrent pancreatitis: the RESPOnD longitudinal cohort
Authors: Coté Gregory A , Elmunzer Badih Joseph , Nitchie Haley , Kwon Richard S , Willingham Field , Wani Sachin , Kushnir Vladimir , Chak Amitabh , Singh Vikesh , Papachristou Georgios I , Slivka Adam , Freeman Martin , Gaddam Srinivas , Jamidar Priya , Tarnasky Paul , Varadarajulu Shyam , Foster Lydia D , Cotton Peter
Published: September 2024

Objective

Sphincter of Oddi disorders (SOD) are contentious conditions in patients whose abdominal pain, idiopathic acute pancreatitis (iAP) might arise from pressurisation at the sphincter of Oddi. The present study aimed to measure the benefit of sphincterotomy for suspected SOD.

Design

Prospective cohort conducted at 14 US centres with 12 months follow-up. Patients undergoing first-time endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy for suspected SOD were eligible: pancreatobiliary-type pain with or without iAP. The primary outcome was defined as the composite of improvement by Patient Global Impression of Change (PGIC), no new or increased opioids and no repeat intervention. Missing data were addressed by hierarchal, multiple imputation scheme.

Results

Of 316 screened, 213 were enrolled with 190 (89.2%) of these having a dilated bile duct, abnormal labs, iAP or some combination. By imputation, an average of 122/213 (57.4% (95% CI 50.4% to 64.4%)) improved; response rate was similar for those with complete follow-up (99/161, 61.5% (54.0% to 69.0%)); of these, 118 (73.3%) improved by PGIC alone. Duct size, elevated labs and patient characteristics were not associated with response. AP occurred in 37/213 (17.4%) at a median of 6 months post ERCP and was more likely in those with a history of AP (30.9% vs 2.9%, p<0.0001).

Conclusion

Nearly 60% of patients undergoing ERCP for suspected SOD improve, although the contribution of a placebo response is unknown. Contrary to prevailing belief, duct size and labs are poor response predictors. AP recurrence was common and like observations from prior non-intervention cohorts, suggesting no benefit of sphincterotomy in mitigating future AP episodes.
Who shall go first? A multicriteria approach to patient selection for first clinical trials of cardiac xenotransplantation
Authors: Kögel Johannes , Schmoeckel Michael , Marckmann Georg
Published: September 2024

After achieving sustained graft functioning in animal studies, the next step in the progression of xenotransplantation towards clinical application is the initiation of the first clinical trials. This raises the question according to which criteria patients shall be selected for these trials. While the discussion regarding medical criteria has already commenced, ethical considerations must also be taken into account. This is essential, first, to establish a procedure that is ethically reasonable and justified. Second, it is a prerequisite for a publicly acceptable and comprehensible implementation. This paper outlines a multicriteria approach for the selection of patients in first-in-human clinical trials of cardiac xenotransplantation with four ethical criteria: medical need, capacity to benefit, patient choice and compliance (as an exclusion criterion). Consequently, these criteria identify a primary target group of patients who exhibit a high medical need for cardiac xenotransplantation, face a high risk of morbidity and mortality without an organ replcaement therapy, have a substantial chance of benefiting from xenotransplantation, thereby also enhancing the scientific value of the trial, and qualify for an allotransplant to have a real choice between participating in a first-in-human xenotransplantation trial and waiting for a human organ. A secondary group would include patients for whom only the first two criteria are met, that is, who have a high medical need and a good capacity to benefit from xenotransplantation but who have a restricted choice because they do not qualify for an allotransplant.
Numerical study on slurry-induced fracturing pressure of cohesive soil
Authors: Jin Dalong , Zhu Lin , Wang Teng , Yuan Dajun , Li Fulin
Published: September 2024

The stability of the tunnel face during the slurry shield tunnelling is controlled by the slurry pressure in the slurry chamber, and excessive slurry pressure will cause fracturing on excavation face. To prevent the occurrence of slurry fracturing, it is necessary to conduct a detailed study on the slurry support pressure when the slurry fracturing occurs. In this study, the hydraulic fracturing experiment of cohesive soil samples was carried out by the self-developed hydraulic fracturing device, and the improved extended finite element method (XFEM) was used to simulate the experiment process. The influence of various factors on the fracturing pressure was analyzed, and the accuracy of the numerical simulation method was also verified. In addition, the calculation method of fracturing pressure of soft cohesive soil is obtained by fitting the influence of each factor. The results show that the improved XFEM can accurately simulate the shear failure of soft cohesive soil. The fracturing pressure increases linearly with the increase in the circumferential pressure, indicating that a higher overburden of the tunnel can help resist the initial fracturing induced by shield tunneling. The fracturing pressure increases with an increase in the unconfined compressive strength as well as the slurry viscosity. Based on the regression analysis of the numerical results, an empirical approach was proposed for estimating the slurry-induced fracturing of soil.
Avoiding Dense Pedestrian Regions: A New Rapidly‐Exploring Random Tree (RRT ∗) Algorithm for Shortest Travel Time
Authors: Zhen H. S. , Kang W. A. , Liu X. Y. , Wei Z. L.
Published: September 2024

Currently, regardless of the algorithm used, motion planners for dealing with dynamic obstructions need to rely on high‐precision sensors and high performance processors. The requirements for hardware increase as the density of dynamic obstructions in an area becomes higher. Additionally, motion planners are more prone to errors in complex environments. The Rapidly‐exploring Random Tree (RRT ∗) algorithm only considers static obstructions and cannot effectively avoid densely populated regions of dynamic obstructions. This paper develops an improved RRT ∗algorithm that is capable of avoiding densely populated regions of dynamic obstructions. In this algorithm, the cost function of the traditional RRT ∗algorithm is modified based on the density of dynamic obstructions, allowing the planned path to bypass densely populated regions. The algorithm also introduces reasonable penalty terms to penalize segments that pass through densely populated regions, while maintaining asymptotic optimality of the traditional RRT ∗algorithm. Numerical experiments reveal that the improved RRT ∗algorithm is able to successfully avoid densely populated regions of dynamic obstructions with minimal time cost and exhibits better robustness during the path search process in comparison to the traditional RRT ∗algorithm. Thus, the improved RRT ∗algorithm possesses the ability to adapt to more complex areas for path planning.
Aflatoxin M1 Concentrations, Adulterants, Microbial Loads, and Physicochemical Properties of Raw Milk Collected From Nekemte City, Ethiopia
Authors: Nasir Leila , Gemede Habtamu Fekadu
Published: September 2024

Milk is an essential part of the human diet and is a nutrient‐rich food that improves nutrition and food security. The aim of this study was to determine the presence and concentration of aflatoxin M1 (AFM1), adulterants, microbial loads, and physicochemical properties of raw cow’s milk (CM) in Nekemte City, Ethiopia. A total of 12 samples of fresh CM were purposefully collected from four kebeles in the city (Bake Jama, Burka Jato, Cheleleki, and Bakanisa Kese) based on the potential of each milk production and distributor site. The AFM1 concentration was determined by high‐performance liquid chromatography (HPLC) with a Sigma‐Aldrich standard (St. Louis, MO, USA). The concentrations of AFM1 in Bake Jama, Burka Jato, Cheleleki, and Bakanisa Kese were found to be 0.01–0.03 g/L, 0.31–0.35 g/L, 0.19–0.21 g/L, and 0.04–0.07 g/L, respectively. The concentrations of AFM1 in the present study varied significantly (p < 0.05) and ranged from 0.01 g/L to 0.35 g/L. These results show that of the 12 samples tested, all were positive for AFM1 and contaminated to varying degrees. The results of this study also revealed that the concentration of AFM1 in 7 (58%) of the 12 milk samples was above the European Union’s (EU) maximum tolerance limit (0.05 g/L). The present study also revealed that of the investigated adulterants, only the addition of water had positive effects on three milk samples, while the remaining adulterants were not detected in any of the milk samples. The total bacterial count (TBC) and total coliform count (TCC) were significantly (p < 0.05) different and ranged from 5.53 to 6.82 log10cfumL−1 and from 4.21 to 4.74 log10cfumL−1, respectively. The physicochemical properties of the milk samples in the present study were significantly (p < 0.05) different and ranged from 2.8% to 5.75% fat, 7.03% to 9.75% solid‐not‐fat (SNF), 2.35% to 3.61% protein, 3.33% to 5.15% lactose, 11.54% to 13.69% total solid, 0.16% to 0.18% titratable acid, 26.7 to 32.1°C, 6.35 to 6.55 pH, and 1.027 to 1.030 specific gravity. The physicochemical parameters of the raw milk in the study area met the required quality standards. Hence, further studies are required to determine the extent of the problem and the factors associated with high levels of AFM1 in raw milk in the study areas, including the detection of aflatoxin B1 (AFB1) in animal feed.
Patterns of Resident Activity and Their Impact on Environmental Parameters in Residential Apartments: Case Study and Implications for Design and Management
Authors: Wang Xiaodong , Lv Yang , Luo Wenjian , Duan Xianghao
Published: September 2024

In the quest to optimize residential environments for health and sustainability, understanding the interaction between pedestrian dynamics and environmental parameters is crucial. This study delves into this intersection by conducting a detailed spatial‐temporal analysis within an apartment building. The research reveals pivotal insights about the relationship between pedestrian flow and environmental quality. Key findings reveal distinct patterns in pedestrian traffic, with two main peaks in early morning and late evening, accounting for approximately 24% of daily movement. The study identifies a pronounced preference for upward elevator use, reflecting residents’ lifestyle and floor‐level choices. Importantly, we observed variable correlations between pedestrian flow and environmental pollutants. Pollutants like PM2.5 and carbon monoxide exhibited weak correlations, while noise, TVOC, formaldehyde, and ozone showed stronger associations with human movement. The research uncovered significant spatial differences in pollutant levels across the building, with higher particulate matter and ozone levels in the seventh‐floor elevator room. The data suggest a need for tailored pollution management strategies, especially for noise and hazardous compounds like formaldehyde and ozone, which exceed safety limits in certain areas. Our findings offer critical insights for the design and management of residential environments, emphasizing the importance of considering both pedestrian flow and environmental factors in optimizing living spaces for health and efficiency.
Influence of Frailty Status on the Efficacy of Epidural Steroid Injections in Elderly Patients With Degenerative Lumbar Spinal Disease
Authors: Kim Hee Jung , Nam Ho Jae , Kim Shin Hyung
Published: September 2024

Background: The global increase in the elderly population has led to a higher prevalence of degenerative lumbar spinal diseases. Epidural steroid injection (ESI) is a widely used procedure for managing lower back pain. This study investigated the association of preprocedural frailty status with the efficacy of ESI in elderly patients diagnosed with degenerative lumbar spinal diseases.

Methods: This retrospective observational study included patients aged 65 years and older who underwent lumbar ESI. Frailty status (robust, prefrail, and frail) assessed via the Frailty Phenotype Questionnaire was collected along with demographic and clinical parameters. Good analgesia was defined as a ≥ 50% reduction in pain score at 4‐week follow‐up evaluation. Multivariable logistic regression analyses were performed to identify factors associated with poor analgesia.

Results: We included 289 patients in this study. Frailty status correlated with analgesic outcomes, with worsening frailty status correlating with increasingly poor analgesia after the injection (robust = 34.5%, prefrail = 40.8%, and frail = 60.0%, p = 0.003), predominantly in female patients. After adjusting for demographic and clinical factors, frail patients demonstrated much higher odds of poor analgesia than robust individuals (adjusted odds ratio [aOR] = 2.673, 95% confidence interval [CI] = 1.338–5.342, p = 0.005). Conversely, prefrail patients did not show a significant association with analgesic outcome (aOR = 1.293, 95% CI = 0.736–2.272, p = 0.372).

Conclusions: Frailty, but not prefrailty, appeared to be an independent factor associated with poor analgesic efficacy of ESI in elderly patients with symptomatic degenerative lumbar spinal disease receiving conservative care.
Concurrent Eosinophilia Increases the Prevalence of Nail Abnormalities and Severity of Hair Loss in Patients With Alopecia Areata
Authors: Damiani Giovanni , Gironi Laura Cristina , Conic Rosalynn R. Z. , del Fabbro Massimo , Savoia Paola , Fiore Marco , Bergfeld Wilma F.
Published: September 2024

Background: The potential link between alopecia areata (AA) and eosinophilia is unclear, as well as its clinical manifestations in these patients’ subsets.

Methods: This is a monocentric retrospective observational study in which clinical and laboratory data were summarized and evaluated the AA subset with concurrent eosinophilia.

Results: In a sample of 205 AA patients, 38 (18.5%) were classified as AA with eosinophilia. Interestingly, this subset of patients had a statistically higher prevalence of atopia and nail abnormalities (p < 0.05) than AA without eosinophilia. AA patients with eosinophilia had a 3.70 higher odds of more severe hair loss versus age‐ and gender‐matched AA without eosinophilia.

Conclusions: AA patients with eosinophilia had distinctive clinical and laboratory characteristics, so future studies may potentially explore the use of IL‐5 inhibitors.
Neonatal Outcomes of Multiple Congenital Thoracic Lesions
Authors: di Natale Anthony , Flohr Sabrina , Mathew Leny , Katterman Cara , Gallagher Colby , Reynolds Thomas A. , Gebb Juliana S. , Panitch Howard B. , Oliver Edward R. , Rintoul Natalie E. , Peranteau William H. , Flake Alan W. , Adzick N. Scott , Hedrick Holly L.
Published: September 2024

Introduction: Congenital pulmonary airway malformations (CPAM), intra- and extralobar bronchopulmonary sequestrations (iBPS/eBPS), CPAM-BPS hybrid lesions (HL), congenital lobar emphysema (CLE), bronchial atresia (BA), and foregut duplication cysts (FDC), collectively referred to as congenital thoracic lesions (CTL), are mostly solitary. Patients with multiple CTL are rare, and reports on such cases are scarce. To address this dearth, we analyzed a large multifocal CTL patient cohort. Methods: Retrospective chart review of patients born between September 1, 2013, and March 31, 2023, who underwent surgery for a CTL at our tertiary center. Patients with radiological and surgical diagnosis of multifocal CTL, defined as ≥2 CTL present in more than one lobe were included to record pre-, peri-, and postnatal patient characteristics. Results: Among 701 CTL patients, 74 (10.5%) had multiple CTL. CTL multifocality was prenatally recognized correctly in 8 (12.9%) patients. Most multiple CTL were right-sided, unilateral multilobar lesions (n = 33, 44%). Bilateral CTL were found in 9 (12.1%) patients. CPAM-CPAM lesions were the most prevalent CTL types (n = 36, 49%). Genetic syndromes were confirmed in 3 (4%) and additional congenital anomalies in 9 (12.9%) patients, 5 of those had multiple congenital anomalies. Of 49 (65%) patients with multilobar CTL, 25 (51%) underwent bilobectomy and 24 (49%) lung-sparing surgery. Length of stay was similar. Mortality was 5.4%. Conclusion: We report on the largest patient cohort with multiple CTL to date. Multiple CTL occurred in 1/10 patients with CTL, and only 12.9% were recognized prenatally. Lung-sparing surgery can be considered. Multiple additional congenital anomalies and genetic syndromes may be more common and genetic testing should be considered. Overall, outcomes in this patient population are favorable.
Understanding the Dynamics of the South Africa – Russia Relations through the Constructivist Concept of ‘State’s Identity’
Authors: Belousova Tatiana
Published: September 2024

The paper analyses the Russia-South Africa bilateral relations, using the constructivist framework of states’ identities. This approach posits that states may have multiple identities, and thus, cannot be strictly categorized in international politics. In other words, the same state can be perceived as a friendly and coercive power, simultaneously. This article explores the important nuances of the Russia-South Africa bilateral ties, since 1990s, when two countries re-established their diplomatic relations. Their strong bilateral ties have successfully navigated through the past and present complexities of the international system. In recent years, they conducted several joint military exercises, and, on many occasions, their leaders expressed similar worldviews and shared stances towards the increasing global tensions.
This Is Why I Leave: Race and Voluntary Departure
Authors: Sterling Adina D.
Published: September 2024

Despite continued research on workers’ quit behavior, questions remain on how race influences voluntary departure. To make progress on this topic, in this study I treat race as a structural position with respect to resources in order to develop a theoretical frame on why members of racial groups leave jobs. I argue that Black workers are more apt than White workers to voluntarily depart for reasons related to a lack of resources, such as a lack of health or transportation, whereas White workers are more likely than Black workers to depart for reasons that require resources, such as to start a new business or to take a new job. Using a nationally representative cohort sample spanning a period of two decades, I find support for my theory. The results indicate that Black workers are more likely than White workers to voluntarily depart their jobs due to resource constraints, and White workers are more likely than Black workers to voluntarily depart their jobs for reasons that require resources. This study suggests ways to reconceptualize the constraints and opportunities underlying voluntary departure and why such departure varies across racial groups.
Evaluating the Effects of the 2021 Expansion of the Child Tax Credit: The International Comparative Context
Authors: Koebel Kourtney , Stabile Mark
Published: September 2024

We provide an overview of child benefit programs in high-income countries, particularly in comparison to the 2019 and expanded 2021 U.S. Child Tax Credit (CTC). Most countries included in our review provide child benefits that are more generous than the 2019 (and current) U.S. CTC, aligning more closely to the parameters of the now-expired 2021 expanded CTC. We show that while the expanded U.S. CTC was in effect, the U.S. significantly improved its ranking within the Organisation for Economic Co-operation and Development (OECD) in terms of lowering child poverty rates and the effectiveness of its redistribution system on poverty alleviation. Our cross-country analysis further reveals that the refundable and monthly payment structure of the expanded 2021 CTC was in keeping with prevailing models of child benefits internationally.
Implementing the Expanded Child Tax Credit: What Worked, What Didn’t, and How to Move Forward
Authors: Herd Pamela , Moynihan Donald
Published: September 2024

The Child Tax Credit (CTC) expansion was an extraordinary experiment not just in policy design but also in policy implementation. As such, it cast light on the possibilities and blind spots of using the tax system to deliver safety-net benefits. The rapid and widespread take-up of the benefit reflected the use of a specific implementation tool that reduced administrative burden for the public: auto-enrollment via the tax system. But use of this tool also excluded families who could benefit from the program but were disconnected from the tax system. These tended to be families with the lowest incomes. Thus, while the CTC expansion offered a classic example of “targeting within universalism” by broadening a policy’s beneficiaries while making it more redistributive, its implementation revealed that a different sort of targeting is needed to reach those with the lowest incomes and to achieve the hoped-for redistributive impact.
The Effects of the 2021 Child Tax Credit on Food Insecurity and Financial Hardship
Authors: Moellman Nicholas , Vaughn Cody N. , Ziliak James P.
Published: September 2024

We review the literature on the expansion of the Child Tax Credit in 2021, as it relates to food and financial hardship among households with children in the U.S. Extant scholarship consistently finds that receipt of the expanded tax credit is associated with an increase in food purchases and declines in food insufficiency and food insecurity. The effects of the tax credit expansion also vary by the socioeconomic characteristics of families. There are important differences, though, in effect sizes across studies, indicating that data sources, timeframe of analysis, and the way in which food hardship is measured all matter to the accurate estimation of effects. The effect of the credit on financial hardship is less conclusive, with the literature finding generally insignificant effects on measures such as difficulty paying rent or bills.
The Effects of the 2021 Child Tax Credit on Parents’ Psychological Well-Being
Authors: Gennetian Lisa A. , Gassman-Pines Anna
Published: September 2024

Improving the psychological well-being of parents who received the 2021 expanded Child Tax Credit (CTC) was not an explicit focus of that benefit program, but psychological effects may have been felt, given the positive income shocks generated by the credit. This article reviews academic research that is available on the CTC’s effect on parents’ psychological well-being. Some studies have found that the CTC led to reductions in reported levels of clinical depression and anxiety among parents and in their subclinical depressive and anxiety symptoms. Other studies that have used similar methods find no effects on those outcomes. Importantly, the evidence does not point to the CTC worsening psychological well-being. Overall, evidence on this topic is thin and mixed, even when comparable studies on the impact of income support are also included in the review. We argue that building a more conclusive evidence base would require tighter alignment of policy objectives to measurement approaches.
Implications of Alternative Designs of the Child Tax Credit
Authors: Maag Elaine , Airi Nikhita , Collyer Sophie
Published: September 2024

The Child Tax Credit (CTC) delivers more economic benefits to children than any other federal program. Under its current design, the CTC provides a benefit of up to $2,000 per child under age 17: almost 90 percent of families with children receive at least some benefits, and families with the lowest incomes receive the least. In 2021, a temporary expansion of the program increased the maximum benefit, delivered up to half the credit as a monthly payment, and allowed families with the lowest incomes to receive the full benefit: millions of families that typically received a partial benefit saw greater economic returns, and the nation saw substantial drops in poverty and hardship. Even in a highly polarized political climate, policymakers continue to consider changes to the CTC that could reclaim some of the benefits that were observed in 2021. This article describes reform options and who would benefit most from various reform approaches.
Development and validation of interpretable machine learning models to predict glomerular filtration rate in chronic kidney disease Colombian patients
Authors: Rojas Luis H , Pereira-Morales Angela J , Amador William , Montenegro Albert , Buelvas Walberto , de la Espriella Víctor
Published: September 2024

Background

ML predictive models have shown their capability to improve risk prediction and assist medical decision‐making, nevertheless, there is a lack of accuracy systems to early identify future rapid CKD progressors in Colombia and even in South America.

Objective

The purpose of this study was to develop a series of interpretable machine learning models that predict GFR at 6-months, 9-months, and 12-months.

Study Design and Setting

Over 29,000 CKD patients stage 1 to 3b (estimated GFR, <60 mL/min/1.73 m2) with an average of 3-year follow-up data were included. We used the machine learning extreme gradient boosting (XGBoost) to build three models to predict the next eGFR. Models were internally and externally validated. In addition, we included SHapley Additive exPlanation (SHAP) values to offer interpretable global and local prediction models.

Results

All models showed a good performance in development and external validation. However, the 6-months XGBoost prediction model showed the best performance in internal (MAE average = 6.07; RSME = 78.87), and in external validation (MAE average = 6.45, RSME = 18.94). The top 3 most influential features that pushed the predicted eGFR value to lower values were the interpolated values for eGFR and creatinine, and eGFR at baseline.

Conclusion

In the current study we have developed and validated machine learning models to predict the next eGFR value at different intervals. Furthermore, we attempted to approach the need for prediction explanation by offering transparent predictions.
Toward Equity and Transparency: A Content Analysis of Florida Elementary Acceleration Policies
Authors: Guilbault Keri M. , Meyer Melanie S.
Published: September 2024

In 2012, Florida adopted the Academically Challenging Curriculum to Enhance Learning (ACCEL) statute establishing minimum requirements for local education agencies to provide access to accelerated learning options for eligible K–12 public school students. This study examined Florida public school district acceleration policies for elementary students one decade after the enactment of the statute. We analyzed Student Progression Plans, school board policies, and district websites to explore the status of acceleration policy in the state, compare the accessibility of acceleration information across districts, and identify policy elements that support equity and those that create potential barriers for elementary students with advanced learning needs who could benefit from acceleration. The findings of this study indicated several areas for improvement, including the accessibility of acceleration information, the service options available to K–5 students, the protocols districts use, criteria for decision-making, and the implementation of acceleration. In addition, we discuss implications for school districts developing or revising acceleration policies and several avenues for future research. The preregistration and open-access materials for this study are available at https://osf.io/yc3xd/ .
Enhanced mechanical, tribological and corrosion properties of graphite and carbon nanotube-reinforced copper-based hybrid composites
Authors: Kara Gamze Ispirlioglu , Sezek Sinan , Aksakal Bunyamin
Published: September 2024

Copper (Cu)-based hybrid composites were fabricated by powder metallurgy, incorporating Graphite (Gr) and Carbon nanotube (CNT) reinforcements at various fractions. The composites were formed using a cold pressing technique and subsequently sintered at various temperatures. The structural properties of the hybrid composites were evaluated using Scanning Electron Microscopy (SEM), Energy Dispersion Spectrum (EDX) and X-ray diffraction (XRD). Hardness, compression, wear and corrosion tests were performed to show the effect of the reinforcements. It was shown that the hardness of Gr and CNT reinforcements have significantly improved the properties of pure Cu. The Cu-Gr-2CNT hybrid composite, which was subjected to sintering at a temperature of 850°C, exhibited the highest level of hardness, showing a significant increase of 51.4% in comparison to the pure Cu sample. While the compressive stresses increased in the Cu matrix with the addition of Cu-Gr, it increased to 350 MPa with the addition of 2 wt% CNT. The hardness value exhibited a similar increase and was measured to be 122 HV in Cu-Gr-2CNT. During the wear tests, the coefficient of friction values fell by 9.2% for Cu-2CNT, by 3.88% for Cu-CNT, by 3.92% for Cu-Gr-2CNT, and by 5.27% for Cu-Gr-CNT, as compared to pure Cu. The comprehensive findings demonstrated that the tests and analyses yielded consistent results, and the utilization of various combinations of Gr and CNT reinforcements enhanced the mechanical, tribological, and corrosion resistance properties of the fabricated hybrid composites. Nevertheless, the combination of Cu-Gr-2CNT yielded the most advantageous outcomes.
The Uterus Keeps the Score: Black Women Academics’ Insights and Coping with Uterine Fibroids
Authors: Goosby Bridget J. , Winkle-Wagner Rachelle , Zhang Amy
Published: September 2024

Few studies examine how high-achieving Black women navigate chronic reproductive health morbidities. Black women are disproportionately more likely to experience uterine fibroids, with earlier onset and more severe symptoms. This study leverages a national mixed-methods data set of Black women academics to examine how they describe symptomatic fibroids impacting their careers and lives. We find that participants (1) actively coped by engaging in superwoman schema, (2) postponed treatment due to the demands of their tenure-track position, and (3) normalized pain. Our findings suggest a potentially high prevalence of uterine fibroids among Black women faculty, that symptomatic fibroids were an impediment to some women’s careers, and that women with symptomatic fibroids often identified expectations of their careers as an impediment to seeking timely treatment. We provide insights for how highly educated, successful Black women cope and navigate career stress coupled with challenges resulting from chronic reproductive health morbidities.
Ongoing Teacher Support for Data-Based Individualization: A Meta-Analysis and Synthesis
Authors: Shanahan Emma , Choi Seohyeon , An Jechun , Casey-Wilke Bess , Birinci Seyma , Roberts Caroline , Reno Emily
Published: September 2024

Although data-based individualization (DBI) has positive effects on learning outcomes for students with learning difficulties, this framework can be difficult for teachers to implement due to its complexity and contextual barriers. The first aim of this synthesis was to investigate the effects of ongoing professional development (PD) support for DBI on teachers’ DBI knowledge, skills, beliefs, and fidelity and the achievement of preschool to Grade 12 students with academic difficulties. The second aim was to report on characteristics of this support and explore whether features were associated with effects. We identified 26 studies, 16 and 22 of which examined teacher and student outcomes, respectively. Meta-analyses indicated that the weighted mean effect size for DBI with ongoing support for teachers was g = 0.86 (95% confidence interval [CI] = [0.43, 1.28], p < .001, I2 = 83.74%, k = 46) and g = 0.31 for students (95% CI = [0.19, 0.42], p < .001, I2 = 61.38%, k = 103). We did not identify moderators of treatment effects. However, subset effects were descriptively larger for ongoing support that targeted data-based instructional changes or included collaborative problem-solving. Researchers may improve future DBI PD by focusing on support for teachers’ instructional changes, describing support practices in greater detail, and advancing technological supports.
Effects of Orthographic Input and Inhibitory Control on Second-Language Speech Production
Authors: Han Jeong-Im , Kim Song Yi , Kim Joo-Yeon
Published: September 2024

The present study extends previous research reporting that orthographic forms, such as the use of a single letter or two letters to indicate the same sound, affect sound duration in second-language (L2) production. Native-language (L1) Korean L2 English sequential bilinguals performed a delayed repetition task for word pairs containing the same consonant or vowel spelled with one or two letters. Korean provided an interesting case because (1) it has an alphabetic orthographic system but not a Roman alphabet and thus, there may be no interorthographic interference and (2) it has no phonemic length contrast for vowels, whereas there is some disagreement on the contrastiveness of the consonant length, which can lead to an asymmetry in the grapheme-to-phoneme correspondence between vowels and consonants. The results showed that Korean learners produced the same English vowel with a short duration when spelled with a single letter and with a long duration when spelled with double letters or digraphs composed of two different letters; this variation in duration did not appear when producing English consonants spelled with a single or two letters. This study further examined whether individual differences in inhibitory control influenced the magnitude of orthographic effects in the production of English vowels by Korean learners. Individual differences in inhibitory control were not strongly related to the influence of orthography on vowel production.
“Death Bouncers” and “Spiritual Guides”: How End-of-Life Doulas Provide, Frame, and Navigate Spirituality and Spiritual Care
Authors: Donley Sarah , Fannin Casey
Published: September 2024

The medicalization of death has left gaps in the spiritual and psychosocial well-being of the dying. Factors like professional and caregiver burnout, lack of training, overburdened caseloads and rigid schedules, and other organizational constraints lead to holistic, humane care falling through the cracks. Consequently, the dying and their families are opting to rely on individuals who can bridge these gaps—end-of-life (EOL) doulas. EOL doulas employ a variety of non-medical practices from touch therapies to legacy projects to religious rites that provide support covering the emotional, spiritual, and practical aspects of dying. Utilizing qualitative interviews with 23 EOL doulas located and working in the United States, this research offers insights into doulas’ provisions of spiritual care, how death doulas’ understanding of the death transition inform spiritual care provisions, as well as how death doulas navigate differences in spiritual and religious belief systems between themselves and their clients. The study emphasizes the critical role of EOL doulas in bridging gaps in end-of-life care, providing personalized, compassionate support sometimes missing in institutional settings.
The production of extended local territory: Topology and the spatial politics of city-region making in China
Authors: Wang Xuan , Zhao Yimin
Published: September 2024

A new trend has been emerging in China’s urban and regional politics, as it is becoming prevalent to extend one municipal authority to another, transcending boundaries, often through the establishment of joint development zones. These newly produced subnational territories are worth further attention to clarify the underlying political dynamics of China’s changing state space. This paper examines the Shenzhen–Shanwei Special Cooperation Zone in Guangdong and analyses the political–spatial processes through which a certain area of Shanwei has been transformed into the ‘Eastern frontier of Shenzhen’. Looking into the relational power nexus that has also been inflected by trans-scalar and cross-boundary dynamics, as well as its manifestations in urban landscapes, we propose extended local territory as a key analytical concept to explore how and how far the rise of extensive territoriality has been articulated with intensive localities. Empirically, we elaborate on the ways in which the territorial ambition and authority of Shenzhen have been managing to traverse boundaries, while also recognising that Shenzhen’s aspiration of materialising its extensive territoriality is challenged by both scalar constraints and the grassroots politics rooted in local history and geography. Addressing the dialectics between the extensive territoriality and intensive locality, we attend to the inter-topological effects and trace the patterns of correlation that are involved in this process, which also turns out to be a critical approach to better understanding changing state spaces in and beyond China.
Effects of Anxiety, Stress and Perceived Social Support on Depression and Loneliness Among Older People During the COVID-19 Pandemic: A Cross-Sectional Path Analysis
Authors: Farhang Maryam , Álvarez-Aguado Izaskun , Celis Correa Javier , Toffoletto Maria Cecilia , Rosello-Peñaloza Miguel , Miranda-Castillo Claudia
Published: September 2024

During the COVID-19 pandemic, older people were exposed to high levels of anxiety and stress leading to loneliness and depressive disorders. The purpose of the present study was to investigate the effects of anxiety, positive coping, perceived social support, and perceived stress on depression and loneliness among older people during the COVID-19 pandemic. This was a cross-sectional online/telephone survey. A non-probability convenience sampling method was used. Participants were 112 people aged 60 years and above, without cognitive impairment, who experienced confinement (from March 2020 onward) and had access to the internet or telephone. A path analysis model showed a direct significant effect of anxiety on both, depression (β = .68, P < .001) and perceived stress (β = .65, P < .001), as well as an indirect effect of anxiety on loneliness via perceived stress (β = .65) * (β = .40); and social support (β = −.21) * (β = −.20). The model showed adequate fit χ2(df = 4) =5.972, P = .201; RMSEA = 0.066 (0.000, 0.169), CFI = 0.992; TLI = 0.970. Anxiety had a significant effect on depressive symptoms as well as on loneliness via perceived social support and perceived stress. According to our findings, in order to reduce depressive symptoms and perceived loneliness, it is essential to develop timely interventions that decrease levels of anxiety and stress and increase levels of perceived social support in older people, particularly when there are any restrictions, physical or contextual, that prevent face-to-face contact. This can be achieved by implementing preventive community-based programs, enhancing accessibility to mental health services, and collaborating with local support groups, among others.