bluuebunny/crossref_metadata_2025 huggingface dataset:
Nematode–citrus plant interactions: host preference, damage rate and molecular characterization of Citrus root nematode Tylenchulus semipenetrans
Authors: Bozbuga R. , Yildiz S. , Yuksel E. , Özer G. , Dababat A. A. , İmren M.
Published: August 2023

Citrus plants are host to several plant parasitic nematodes (PPNs), which are microscopic organisms. Among PPNs, the citrus root nematode, T. semipenetrans (Cobb 1913) (Tylenchida: Tylenchulidae), causes significant damage to citrus plantations worldwide. Understanding citrus nematode populations, precise identification, host preference among citrus species, and damage threshold are crucial to control T. semipenetrans. The minutiae of citrus plant–nematode interactions, nematode density and molecular nematode identification are not well understood. In this study, nematode species and density in citrus orchards, host specialization, molecular and morphological characteristics of nematodes were assessed.

Molecular and morphological methods, host–nematode interactions, host (citrus species) preference, damage economic threshold (ET), and economic injury level (EIL) were determined using laboratory methods and field sampling. Citrus plantations in different provinces in the Mediterranean region of Turkey were investigated.

Nematode species were identified molecularly and morphologically. ITS sequences revealed that samples were infected by citrus root nematode T. semipenetrans. The lowest nematode density was in C. reticulata in Mersin (53 2nd stage juveniles (J2s) 100 g−1 soil), while the highest density was from Hatay in C. sinensis (12173 J2s 100 g−1 soil). Highest citrus nematode population density was on roots of C. reticulata, followed by C. sinensis, C. limon, and C. paradisi.

The citrus nematode is more common than was thought and population fluctuations change according to specific citrus species. Environmental conditions, host and ecological factors, such as temperature, soil pH, and soil nutrients, might influence nematode populations in citrus orchards. Investigating nematode density in diverse soil ecologies and the responses of different resistant/tolerant citrus species and cultivars to nematode populations is essential in future studies.
Evaluating the determinants of support for police militarization among officers
Authors: Welch Ryan M. , Mewhirter Jack , Wright James E. , Oh Jeongmin
Published: August 2023

We evaluate the determinants of officer support for their agency participating in the 1033 Program: a program that facilitates the flow of military hardware to local law enforcement agencies. In doing so, we provide insight into why officers demand such equipment, which, in turn, may partially explain patterns of program participation and equipment usage. We utilize a series of random forest models to examine survey data collected from officers in a large police department, finding that being White and exhibiting animus toward minority communities are highly predictive of officer support across models. Our findings validate long‐held public concerns regarding the distributional patterns and consequences of 1033 transfers: concerns that have led to a number of proposed policy changes at the state and federal levels meant to restrict program usage (e.g., EO‐13688, HR‐1694, MO HB‐330). Policy makers should consider how out‐group animus may drive distributional patterns and usage when considering policy reform.
Turning off the base: Social democracy's neoliberal turn, income inequality, and turnout
Authors: Polacko Matthew
Published: August 2023

Greater party system polarization has recently been shown to influence voter turnout under conditions of higher income inequality. This article builds on these findings by introducing into the framework the policy positions of social democratic parties. It does so through multilevel regression on a sample of 30 advanced democracies in 111 elections, from 1996 to 2019. In doing so, it contributes to the identification of party policy offerings as a mechanism moderating inequality and turnout. It finds that income inequality significantly reduces voter turnout, which is substantially magnified when social democratic parties adopt rightward welfare state positions. It also finds that social democratic parties can largely mitigate the negative effects of inequality on turnout for low‐income individuals by offering leftist welfare state positions. The findings carry important implications for understanding the electoral consequences of both party positioning and rising inequality in advanced democracies.

Related Articles

Simon, Christopher A., and Raymond Tatalovich. 2022. “The Turnout Myth and Referendum Voting in the United States.” Politics & Policy 50(3): 472–86. https://doi.org/10.1111/polp.12483.

Stockemer, Daniel, and Stephanie Parent. 2013. “The Inequality Turnout Nexus: New Evidence from Presidential Elections.” Politics & Policy 42(2): 221–45. https://doi.org/10.1111/polp.12067.

Wilford, Allan M. 2020. “Understanding the Competing Effects of Economic Hardship and Income Inequality on Voter Turnout.” Politics & Policy 48(2): 314–38. https://doi.org/10.1111/polp.12344.
Perceiving as biased but nevertheless persuaded? Effects of fact–checking news delivered by partisan media
Authors: Chae Je Hoon , Lee Sang Yup , Song Hyunjin
Published: August 2023

The effectiveness of and its boundary conditions regarding fact–checking news exposure have significant normative and practical implications. While many of the prior studies have focused on the attitudinal consequences of fact–checking news delivered by neutral third parties such as fact–check organizations, relatively less is known as to the effect of fact–checking news delivered by partisan media. Based on the frameworks of motivated reasoning and the hostile‐media effect, we investigate the possibility of decoupling between attitudinal persuasion and perceptual backfire by fact–checking news by partisan media—that is, exposure to fact–checking news increases bias perception of such news yet nevertheless attitudinally persuades audiences. Based on a series of original experiments conducted in South Korea and in the United States, we find consistent support for our prediction, in that exposure to fact–checking news produces the corrective effects, yet at the same time perceived bias of the fact–checking news systematically varies as a function of the ideological slant of partisan media.
A review on the application of chicken immunoglobulin Y in aquaculture
Authors: Zhang Linpeng , Lin Li , Qin Zhendong
Published: August 2023

The widespread use of antimicrobial drugs in aquaculture has led to antibiotic residues in aquatic animals. Food safety problems caused by the misuse of antibiotics and antibiotic residues have caused widespread global concern. Consequently, there is an urgent need to develop an alternative to antibiotics for use in aquaculture. Immunoglobulin Y (IgY) has attracted significant attention over recent years because it is readily available, simple to prepare, effective in inhibiting pathogenic microorganisms, free from environmental contamination and free from other toxic side effects. In this paper, we review the research progress relating to the basic structure, physicochemical properties and mechanism of action of IgY. We also highlight the applications of IgY in the control of aquatic animal disease, immunological diagnosis and the preservation of aquaculture products, thus providing a reference for future research and the wider application of IgY in aquaculture.
Long‐term desertification process monitoring and driving factors analysis in rare earth mining area
Authors: Li Yingshuang , Li Hengkai , Pan Jiao
Published: August 2023

With the exploitation of rare earth elements (REE) in southern China, desertification has become a serious ecological problem in this region. To accurately understand the desertification process in mining areas and formulate targeted ecological restoration programs, taking the Lingbei mining area in Ganzhou City, Jiangxi Province as the study area, we explored desertification information extraction methods, desertification dynamics monitoring, and desertification drivers in REE mining areas using multisource data from 1986 to 2021. The results show that from the method of extracting desertification information, Random Forest is the prominent (83.33%), followed by Albedo–NDVI (Normalized Difference Vegetation Index) space (74.44%), and thirdly Linear Spectral Mixture Model (65.56%). From 1986 to 2021, the desertification land area in Lingbei mining areas first increased and then decreased, showing a reverse trend, but it has not recovered to the pre‐mining level. The government's ecological reclamation measures are the key factors for the restoration of desertification land. There are still 17.81 km2 areas that have not been restored, of which 2.16 km2 are at the level of severe desertification. Moderate desertification and light desertification have not been completely curbed, which needs continuous attention. Vegetation coverage has the highest explanatory power to the distribution of land desertification in mining areas, followed by land use classification, indicating that human activities have a great influence on the spatial differentiation of land desertification in mining areas, and it is necessary to pay attention to regional balanced and sustainable development in the future.
Reestablishment best practices for Hymenocallis coronaria: a charismatic flowering macrophyte and indicator species for fall line stream restoration in the southeastern U.S.A.
Authors: Grunwald Andrew P. , Hotaling Hagan Althea , Barrett Kyle , Scott Mark C.
Published: August 2023

Charismatic indicator species, which are defined by their sensitivity to ecosystem degradation and attractive traits, are often reintroduced or monitored in restoration projects to evaluate whether desired ecosystem structure and function has been restored and to attract public support for restoration projects. Hymenocallis coronaria is a charismatic and imperiled aquatic plant endemic to southeast U.S. fall line streams. Known for its blooms and sensitivity to flow modification, it provides an opportunity to incorporate the reintroduction of a charismatic indicator species into stream restoration projects. The goal of our research was to provide restoration practitioners with experimentally derived H. coronaria reestablishment best practices by investigating the effects of life stage and outplanting technique on establishment success, with additional considerations given to treatment efficiency. We used binomial generalized linear models to analyze H. coronaria establishment from experimental reestablishment efforts in a free‐flowing segment of Stevens Creek, South Carolina. Model selection showed a strong interaction effect between life stage and outplanting technique and that technique is more important than life stage. Interpretation of our top model indicated that the wedge technique was the most successful and that wedging spring bulbs was significantly more successful than wedging other life stages. However, we recommend that practitioners wedge seedlings or broadcast seeds into existing shoal crevices because of efficiency. Our best practices reflect the need to align reestablishment efforts with H. coronaria's life history to maximize efficiency and suggest that H. coronaria has utility as an indicator species for restored flow regimes of southeast U.S. fall line streams.
Digitalization and outward foreign direct investment of Chinese listed firms
Authors: Fan Linlin , Ou Jinghua , Yang Gongyan , Yao Shujie
Published: August 2023

Digital transformation has given firms new development capability. This paper portrays the overall digital transformation intensity of China's listed firms in 2007–20, and empirically examines the impact of digital transformation on outward foreign direct investment (OFDI) and its transmission mechanisms for the first time. It is found that digital transformation significantly enhances OFDI with two transmission mechanisms: (1) reduced transaction costs and (2) improved production and operation efficiency [Correction added on 25 Aug 2023, after first online publication: The number of transmission mechanisms have been corrected from ‘three’ to ‘two’ in this version.] The impact is more pronounced in the host countries whose economies are more digitalized, in private enterprises, and in the service industries than in their respective counterparts.
Miura transformation for the “good” Boussinesq equation
Authors: Charlier C. , Lenells J.
Published: August 2023

It is well known that each solution of the modified Korteveg–de Vries (mKdV) equation gives rise, via the Miura transformation, to a solution of the Korteveg–de Vries (KdV) equation. In this work, we show that a similar Miura‐type transformation exists also for the “good” Boussinesq equation. This transformation maps solutions of a second‐order equation to solutions of the fourth‐order Boussinesq equation. Just like in the case of mKdV and KdV, the correspondence exists also at the level of the underlying Riemann–Hilbert problems and this is in fact how we construct the new transformation.
Commentary on Catriona Mackenzie's “Autonomous agency, we‐agency, and social oppression”
Authors: Vincent Sarah
Published: August 2023

After a brief summary of Mackenzie's major claims, I offer questions to promote ongoing conversation, most especially regarding they‐ and we‐narratives.
Tobacco usage in India: A meta‐analysis of evidence drawn from regional studies between 2010 and 2022
Authors: Pahari Shubhajit , Barman Diplina , Talukdar Rounik
Published: August 2023

Objectives

To generate a national and zonal pooled estimate of current tobacco usage (CTU) in any form, as well as stratified gender and tobacco type (smokeless and smoke) specific estimates among the Indian population, utilising evidence from 2010 to 2022.

Method

PubMed, Scopus, ScienceDirect, CINAHL and Google Scholar databases were searched for articles on tobacco use among Indian adults published between January 2010 and October 2022. The NIH Quality Assessment Tool was used to assess study quality, and a random‐effects inverse‐variance method was used to attain a pooled estimate of usage. Heterogeneity was estimated through I2 statistics and prediction intervals, and further subgroup analysis and meta‐regression were conducted. A leave‐one‐out analysis was done to establish the sensitivity of the pooled estimate.

Results

CTU prevalence of any form among the adult Indian population was 35.2% [confidence interval (CI) 25.27–45.92, I2 = 99.7, p < 0.001] between 2010 and 2022 with a wide Prediction interval between 3.19 to 78.74. The regionally drawn estimate for the years 2016–2022 was 44.3% (CI 30.57–58.64, I2 = 99.8, p < 0.01). Highest prevalence was found in the East zone (55.4%) followed by the northeast with 51.8% tobacco consumption. Although residual heterogeneity persisted after subgroup analysis, the variability in estimates showed statistical significance when considering disaggregated estimates across administrative zones and gender‐wise consumption. The estimated CTU among males was 54.1%, whereas in females it was 15%. Leave‐one‐out analysis indicated the findings are reliable and are not dependent on any one study.

Conclusion

This review highlights differences in tobacco usage estimates from national‐level surveys and regional studies. More regionally representative surveys of tobacco usage to tailormade prevention efforts alongside increased regional efforts improved community‐level advocacy and more coordinated and stringent tobacco prevention policy implementation at national and state levels are warranted.
An enhancer trap system to track developmental dynamics in Marchantia polymorpha
Authors: Marron Alan O. , Sauret‐Güeto Susanna , Rebmann Marius , Silvestri Linda , Tomaselli Marta , Haseloff Jim
Published: August 2023

A combination of streamlined genetics, experimental tractability and relative morphological simplicity compared to vascular plants makes the liverwort Marchantia polymorpha an ideal model system for studying many aspects of plant biology. Here we describe a transformation vector combining a constitutive fluorescent membrane marker with a nuclear marker that is regulated by nearby enhancer elements and use this to produce a library of enhancer trap lines for Marchantia. Screening gemmae from these lines allowed the identification and characterization of novel marker lines, including markers for rhizoids and oil cells. The library allowed the identification of a margin tissue running around the thallus edge, highlighted during thallus development. The expression of this marker is correlated with auxin levels. We generated multiple markers for the meristematic apical notch region, which have different spatial expression patterns, reappear at different times during meristem regeneration following apical notch excision and have varying responses to auxin supplementation or inhibition. This reveals that there are proximodistal substructures within the apical notch that could not be observed otherwise. We employed our markers to study Marchantia sporeling development, observing meristem emergence as defining the protonema‐to‐prothallus stage transition, and subsequent production of margin tissue during the prothallus stage. Exogenous auxin treatment stalls meristem emergence at the protonema stage but does not inhibit cell division, resulting in callus‐like sporelings with many rhizoids, whereas pharmacologically inhibiting auxin synthesis and transport does not prevent meristem emergence. This enhancer trap system presents a useful resource for the community and will contribute to future Marchantia research.
Social infrastructures and older adults' webs of care: COVID‐19 as spatial breach
Authors: Ho Elaine Lynn‐Ee , Gao Siyao , Lim Samantha S. F.
Published: August 2023

This paper argues that the spatial restrictions and social distancing measures which older adults experienced during COVID‐19 can be interpreted as a spatial breach in their webs of care, impacting their ability to connect socially with others through formal and informal social infrastructures. Drawing on a qualitative study of 50 older adults in Singapore (which is part of a wider mixed‐methods project consisting of 1199 participants), the paper shows how spatial breaches manifest as tension points in the older adults' webs of care. The paper highlights the paradoxical and ageist impacts of vulnerability tropes that emphasise the alleged universal vulnerability of older adults to the coronavirus. It provides further insights on why some tension points in the older adults' webs of care become resolved through adjustments while others remain unresolved. This analysis furthers our understanding of how older adults cope with the social disconnection that may happen during spatial breaches, especially when it is due to the choices of others to withdraw socially. Conceptually, the paper demonstrates how care assemblages and social infrastructures work in tandem to modulate the older adults' webs of care dynamically. The paper situates social infrastructures as key resource components in the webs of care of older adults, functioning as formal or informal platforms through which they access material, financial or emotional resources. Importantly, the paper shows how particular social infrastructures may become prominent or recede in one's webs of care as the person's care assemblages dynamically adjust to personal circumstances and relationships. In doing so, the paper bridges hitherto distinct literatures on how social infrastructures and assemblages are used to understand social life.
A randomized cross‐over study of cryopreserved platelets in prophylactic transfusions of thrombocytopenic patients
Authors: Ang Ai Leen , Gan Linda Seo Hwee , Tuy Tertius Tansloan , Ang Chieh Hwee , Tan Chuen Wen , Tan Hwee Huang , Shu Pei Huey , Zhang Qingxiang , Cao Yang , Moorakonda Rajesh Babu , Pokharkar Yogesh , Lu Jia
Published: August 2023

Background

The short shelf‐life of liquid‐stored platelets (LP) at 20–24°C poses shortage and wastage challenges. Cryopreserved platelets have significantly extended shelf‐life, and were safe and efficacious for therapeutic transfusions of bleeding patients in the Afghanistan conflict and phase 2 randomized studies. Although hematology patients account for half of platelets demand, there is no randomized study on prophylactic cryopreserved platelet transfusions in them.

Methods

We performed a phase 1b/2a randomized cross‐over study comparing the safety and efficacy of cryopreserved buffy coat‐derived pooled platelets (CP) to LP in the prophylactic transfusions of thrombocytopenic hematology patients.

Results

A total of 18 adults were randomly assigned 1:1 to CP and LP for their first thrombocytopenic period (TP) of up to 28‐days. A total of 14 crossed over to the other platelet‐arm for the second TP. Overall, 17 subjects received 51 CP and 15 received 52 LP. CP‐arm had more treatment emergent adverse event (29.4% vs. 13.3% of subjects, 9.8% vs. 3.8% of transfusions) than LP‐arm but all were mild. No thromboembolism was observed. Both arms had similar bleeding rates (23.5% vs. 26.7% of subjects) which were all mild. Subjects in CP‐arm had lower average corrected count increments than LP‐arm (mean [SD] 5.6 [4.20] vs. 22.6 [9.68] ×109/L at 1–4 h, p < .001; 5.3 [4.84] vs. 18.2 [9.52] ×109/L at 18–30 h, p < .001). All TEG parameters at 1–4 h and maximum amplitude (MA) at 18–30 h improved from baseline post‐CP transfusion (p < .05) though improvements in K‐time and MA were lower than LP (p < .05).

Discussion

During shortages, CP may supplement LP in prophylactic transfusions of thrombocytopenic patients.
How do we build a comprehensive Vein‐to‐Vein (V2V) database for conduct of observational studies in transfusion medicine? Demonstrated with the Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric V2V database protocol
Authors: Birch Rebecca Jeffries , Umbel Keith , Karafin Matthew S. , Goel Ruchika , Mathew Sunitha , Pace Wilson ,   for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P)
Published: August 2023

Background

The Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P) is the fourth iteration of the National Heart, Lung, and Blood Institute's REDS program and includes a focus on pediatric populations. The REDS‐IV‐P Vein‐to‐Vein (V2V) database encompasses linked information from blood donors, blood components, and patients to facilitate studies in transfusion medicine.

Study Design and Methods

The V2V database is an Observational Medical Outcomes Partnership Common Data Model database. The study period is April 1, 2019 through December 31, 2023. Data from all donors and donations at participating blood centers, all blood components derived from the donations, and all inpatient visits and selected outpatient visits at participating hospitals are included. The database captures all information within patient data domains not restricting data to a preselected subset of medical records.

Results

The V2V database contains data from 7 blood centers and 22 hospitals. We project the database will have over 2 billion pieces of information from 1.3 million patients with 20.6 million healthcare encounters. The database will include data on approximately 1 million transfused units and 2.3 million donors with approximately 6.8 million donation visits.

Conclusion

The REDS‐IV‐P V2V database is a comprehensive database with data from millions of blood donors, blood components, and patients. A diverse set of data from the encounters are included in the database such that emerging questions can likely be addressed. The Observational Medical Outcomes Partnership Common Data Model is an efficient, flexible, and increasingly used common data model. The final de‐identified database will be publicly available.
Matrix factorizations, Reality and Knörrer periodicity
Authors: Spellmann Jan‐Luca , Young Matthew B.
Published: August 2023

Motivated by periodicity theorems for Real ‐theory and Grothendieck–Witt theory and, separately, work of Hori and Walcher on the physics of Landau–Ginzburg orientifolds, we introduce and study categories of Real matrix factorizations. Our main results are generalizations of Knörrer periodicity to categories of Real matrix factorizations. These generalizations are structurally similar to (1,1)‐periodicity for ‐theory and 4‐periodicity for Grothendieck–Witt theory. We use techniques from Real categorical representation theory, which allow us to incorporate into our main results equivariance for a finite group and discrete torsion twists.
Arithmetic and metric aspects of open de Rham spaces
Authors: Hausel Tamás , Wong Michael Lennox , Wyss Dimitri
Published: August 2023

In this paper, we determine the motivic class — in particular, the weight polynomial and conjecturally the Poincaré polynomial — of the open de Rham space, defined and studied by Boalch, of certain moduli spaces of irregular meromorphic connections on the trivial rank bundle on . The computation is by motivic Fourier transform. We show that the result satisfies the purity conjecture, that is, it agrees with the pure part of the conjectured mixed Hodge polynomial of the corresponding wild character variety. We also identify the open de Rham spaces with quiver varieties with multiplicities of Yamakawa and Geiss–Leclerc–Schröer. We finish with constructing natural complete hyperkähler metrics on them, which in the four‐dimensional cases are expected to be of type ALF.
Primary lung adenocarcinoma mimicking recurrent pneumonia in a young adult
Authors: Joshi Tejas , Rahman Yusuf , Yeung Ho-Man
Published: August 2023

A man in his 20s with a history of tobacco use presented with recurrent shortness of breath. He was hospitalised three times within the past 4 months for similar symptoms despite completing several courses of antibiotic therapy. In this presentation, he was afebrile with rhonchi and decreased breath sounds over the right lung. Chest CT demonstrated large consolidations in the right middle and lower lobes, worsened compared with 4 months prior. Infectious workup including bronchoscopy with bronchoalveolar lavage did not identify a causative organism. Testing for immune disease was negative. Transbronchial biopsy ultimately identified well-differentiated stage 3b lung adenocarcinoma with a KRAS G12C mutation. The patient was referred to oncology for outpatient follow-up and has since initiated chemotherapy. This case highlights diagnostic biases encountered in young patients and the utility of bronchoscopic biopsy for definitive diagnosis in presumed community-acquired pneumonia when the clinical outcome is not improving as expected.
Development of prospective hospital-based venous thromboembolism registry across India: a study protocol
Authors: Tabassum Heena , Aggarwal Sumit , Menon Geetha R , Arora Narendra , Chakraborty Sagnik , Rao M V , Bhargava Balram , Chatterjee Nabendu S
Published: August 2023

Introduction

Indian Council of Medical Research (ICMR), New Delhi has established a nationwide registry ‘Indian Registry for Venous Thromoembolism Disorder (i-RegVeD)’ for real-time analytics of sociodemographic profile of patients, disease patterns, management strategies, treatment choices and outcomes of patients with venous thromboemobolism (VTE). The purpose is to generate evidence on VTE in order to fill the gaps in the knowledge of the disease across various demographic regions.

Methods and analysis

This prospective hospital-based registry will be a continuous data collection process on the occurrence and characteristics of VTE from the 16 hospital sites pan India. This process would include obtaining clinical profiles, risk factors, diagnostic tests, treatment and outcome information of patients collected from medical records through an active method of data abstraction and data capture mechanism guided by an online web-based tool.

Ethics and dissemination

At centralised programme management unit, the study protocol was approved by the Institutional Ethics Committees (IEC) named ICMR-Central Ethics Committee on Human Research and similarly each of the participating site has obtained the ethical approval by their respective IECs. The results from this study will be disseminated publicly on the study website (https://iregved.icmr.org.in) as well as through scientific meetings and publications.
Investigating sustainability challenges for the National Health Insurance Fund in Tanzania: a modelling approach
Authors: Osetinsky Brianna , Fink Günther , Kuwawenaruwa August , Tediosi Fabrizio
Published: August 2023

Objective

This study aimed to model the long-term cost associated with expanding public health insurance coverage in Tanzania.

Design, setting and participants

We analysed the 2016 claims of 2 923 524 beneficiaries of the National Health Insurance Fund in Tanzania. The analysis focused on determining the average cost per beneficiary across 5-year age groups separated by gender, and grouped by broad health condition categories. We then modelled three different insurance coverage scenarios from 2020 to 2050 and we estimated the associated costs.

Outcome measures

Average cost per beneficiary and the projected financing requirements, projected from 2020 to 2050.

Results

The analysis revealed that the average per beneficiary cost for insurance claims was $38.58. Among males over 75 years, the average insurance claims costs were highest, amounting to $125. The total estimated annual cost of claims in 2020 was $151 million. Under the status quo coverage scenario, total claims were projected to increase to $415 million by 2050. Increasing coverage from 7% to 50% would result in an additional financing requirement of $2.27 billion. If coverage would increase by 10% annually, reaching 56% of the population by 2050, the additional financing need would amount to $2.84 billion.

Conclusion

This study highlights the critical importance of assessing the long-term financial viability of health insurance schemes aimed to cover large segments of the population in low-income countries. The findings demonstrate that even without expansion of coverage, financing requirements for insurance will more than triple by 2050. Furthermore, increasing coverage is likely to substantially escalate the cost of claims, potentially requiring significant government or external contributions to finance these additional costs. Policymakers and stakeholders should carefully evaluate the sustainability of insurance schemes to ensure adequate financial support for expanding coverage and improving healthcare access in low-income settings.
Protocol for the feasibility and implementation study of a model of best practice in primary care led postdiagnostic dementia care: PriDem
Authors: Griffiths Sarah , Spencer Emily , Wilcock Jane , Bamford Claire , Wheatley Alison , Brunskill Greta , D'Andrea Federica , Walters Kate R , Lago Natalia , O'Keeffe Aidan , Hunter Rachael , Tuijt Remco , Harrison Dening Karen , Banerjee Sube , Manthorpe Jill , Allan Louise , Robinson Louise , Rait Greta
Published: August 2023

Introduction

Care is often inadequate and poorly integrated after a dementia diagnosis. Research and policy highlight the unaffordability and unsustainability of specialist-led support, and instead suggest a task-shared model, led by primary care. This study is part of the PriDem primary care led postdiagnostic dementia care research programme and will assess delivery of an evidence-informed, primary care based, person-centred intervention. The intervention involves Clinical Dementia Leads (CDLs) working in primary care to develop effective dementia care systems that build workforce capacity and support teams to deliver tailored support to people living with dementia and their carers.

Methods and analysis

This is a 15-month mixed-methods feasibility and implementation study, situated in four National Health Service (NHS) primary care networks in England. The primary outcome is adoption of personalised care planning by participating general practices, assessed through a patient records audit. Feasibility outcomes include recruitment and retention; appropriateness and acceptability of outcome measures; acceptability, feasibility and fidelity of intervention components. People living with dementia (n=80) and carers (n=66) will be recruited through participating general practices and will complete standardised measures of health and well-being. Participant service use data will be extracted from electronic medical records. A process evaluation will explore implementation barriers and facilitators through methods including semistructured interviews with people living with dementia, carers and professionals; observation of CDL engagement with practice staff; and a practice fidelity log. Process evaluation data will be analysed qualitatively using codebook thematic analysis, and quantitatively using descriptive statistics. Economic analysis will determine intervention cost-effectiveness.

Ethics and dissemination

The study has received favourable ethical opinion from Wales REC4. NHS Confidentiality Advisory Group support allows researchers preconsent access to patient data. Results will inform intervention adaptations and a future large-scale evaluation. Dissemination through peer-review journals, engagement with policy-makers and conferences will inform recommendations for dementia services commissioning.

Trial registration number

ISRCTN11677384.
Efficacy and safety of acupuncture in the treatment of urinary incontinence after prostate surgery: protocol for a systematic review and meta-analysis
Authors: Tan Mo-Yao , Mo Chao-Yue , Zhao Qian
Published: August 2023

Background

Urinary incontinence (UI) is a common complication after prostate surgery. Acupuncture treatment (AT) has been proposed as an alternative therapy for this condition. The purpose of this protocol aims to outline a systematic review and meta-analysis that aims to evaluate the effectiveness and safety of AT in patients with postprostate surgery UI.

Methods

We will search for randomised controlled trials (RCTs) in eight databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, SinoMed and VIP database. Additionally, we will search two clinical trial registration platforms, namely the WHO’s International Clinical Trials Registry Platform and the Chinese Clinical Trial Registry. The search will include articles from the inception of these databases until 30 September 2023. The extracted data will then be imported into the Stata V.15.0 software. Two authors will independently review the literature, collect data and use the Grades of Recommendation, Assessment, Development and Evaluation and the Cochrane Risk of Bias 2 tool to evaluate the risk of bias and the quality of the evidence. Outcomes for RCTs will include at least one of the following: International Consultation Incontinence Questionnaire-Urinary Incontinence Short Form, Individualised Care for People with long-term health conditions–Capability measure for Adults, Score of Frequency Incontinence Quality of Life Questionnaire, Patient Global Impression of Improvement, Visual Analogue Scale, Numeric Rating Scale, 1- hour pad test, Self-Rating Anxiety Scale, total efficiency and adverse event. We will use random or fixed effect models to analyse data according to heterogeneity. If significant heterogeneity exists along with sufficient data, we will perform subgroup analyses to identify the source of heterogeneity.

Ethics and dissemination

Ethical approval is not required for this study because the data we will extract are from published articles. The results will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42022382806.
Developing and validating an instrument to assess women’s empowerment in dealing with domestic violence in Iran: a mixed-methods study protocol
Authors: Mataji Amirroud Maryam , Ghaffari Mohtasham , Ramezankhani Ali , Soori Hamid
Published: August 2023

Introduction

Despite the emphasis on empowerment in interventions supporting women against domestic violence and ending spousal abuse, there is still no standard and accurate instrument to evaluate women’s empowerment in this field. This study proposes a protocol to fill this gap by developing and psychometrically testing a standardised instrument for assessing women’s empowerment in dealing with domestic violence (WEDDV).

Methods and analysis

This study will be conducted in Iran in a mixed method with a sequential exploratory design (qualitative–quantitative). In the first phase, qualitative methods will be used to generate items, rank and identify essential items for WEDDV conceptualisation. The data collection method in this phase includes semistructured face-to-face interviews with married women, a review of related literature, and a fuzzy Delphi method with participants with work experience and expertise about violence against women. Qualitative data analysis will be done using a content analysis strategy and MAXQDA 2020 software. In the second phase of the study, the psychometric properties of the instrument, including face, content and construct validity, and the instrument’s reliability will be evaluated. Also, the psychometric features of the COSMIN checklist will be used in the design of this instrument.

Ethics and dissemination

This study protocol has been approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences with code (IR.SBMU.PHNS.REC.1400.011). The findings will be published in prestigious journals and presented at national and international conferences. We hope that these results can provide a practical framework for planning and organising domestic violence interventions for policy-makers, researchers and women’s health and counselling service providers.
Construction and validation of a risk prediction model for perianal infection in patients with haematological malignancies during chemotherapy: a prospective study in a tertiary hospital in China
Authors: Wang Yingli , Luo Yuqin , Leng Yamei , Yang Mei , Liang Taoyun , Niu Ting
Published: August 2023

Objectives

Perianal infection is a serious complication in patients undergoing chemotherapy for haematological malignancies. Therefore, we aimed to develop a predictive model to help medical staff promptly screen patients at a high risk of perianal infection during chemotherapy.

Design

This was a single-centre prospective observational study.

Setting

This study was conducted in a tertiary teaching hospital in Chengdu, China.

Participants

The study sample comprised 850 patients with haematological malignancies who underwent chemotherapy at the department of haematology or our hospital between January 2021 and June 2022.

Interventions

The included patients were randomly divided into training and validation groups in a 7:3 ratio. Based on the discharge diagnosis, patients with perianal infection were selected as the case group and the other patients were selected as the control group.

Outcome measure

The main outcome measure was the occurrence of perianal infections.

Results

A predictive model for perianal infections was established. A history of perianal infection, haemorrhoids, constipation and duration of diarrhoea were independent risk factors. The area under the curve of the The area under the receiver operating characteristic (ROC) curve for the training and validation groups were 0.784 (95% CI 0.727 to 0.841) and 0.789 (95% CI 0.818 to 0.885), respectively. Additionally, the model had good calibration in both the training and validation groups with a non-significant Hosmer-Lemeshow test (p=0.999 and 0.482, respectively).

Conclusions

The risk prediction model, including a history of perianal infection, history of haemorrhoids, constipation and duration of diarrhoea ≥3 days of perianal infection in patients with haematological malignancies during chemotherapy, has good prediction reliability and can be helpful in guiding clinical medical staff in screening and early intervention of high-risk groups.
Feasibility of comparing medical management and surgery (with neurosurgery or stereotactic radiosurgery) with medical management alone in people with symptomatic brain cavernoma – protocol for the Cavernomas: A Randomised Effectiveness (CARE) pilot trial
Authors: Loan James J M , Bacon Andrew , van Beijnum Janneke , Bhatt Pragnesh , Bjornson Anna , Broomes Nicole , Bullen Alistair , Bulters Diederik , Cahill Julian , Chavredakis Emmanuel , Colombo Francesca , Danciut Mihai , Digpal Ronneil , Edwards Richard J , Ferguson Lucie , Forsyth Laura , Fouyas Ioannis , Ganesan Vijeya , Grover Patrick , Gurusinghe Nihal , Hall Peter S , Harkness Kirsty , Harris Lauren S , Hayton Tom , Helmy Adel , Holsgrove Daniel , Hutchinson Peter J , Israni Anil , Kinsella Elaine , Lewis Steff , Majeed Sohail , Mallucci Conor , Mukerji Nitin , Nair Ramesh , Neilson Aileen R , Papadopoulos Marios C , Radatz Matthias , Rossdeutsch Alex , Raza-Knight Saba , Stephen Jacqueline , Stoddart Andrew , Teo Mario , Turner Carole , Wade Julia , Walsh Daniel , White David , White Phil , Wildman Jack , Wroe Wright Oliver , Uff Christopher , Ushewokunze Shungu , Vindlacheruvu Raghu , Kitchen Neil , Al-Shahi Salman Rustam
Published: August 2023

Introduction

The top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was ‘Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people diagnosed with a cavernoma?’ This pilot randomised controlled trial (RCT) aims to determine the feasibility of answering this question in a main phase RCT.

Methods and analysis

We will perform a pilot phase, parallel group, pragmatic RCT involving approximately 60 children or adults with mental capacity, resident in the UK or Ireland, with an unresected symptomatic brain cavernoma. Participants will be randomised by web-based randomisation 1:1 to treatment with medical management and with surgery (neurosurgery or stereotactic radiosurgery) versus medical management alone, stratified by prerandomisation preference for type of surgery. In addition to 13 feasibility outcomes, the primary clinical outcome is symptomatic intracranial haemorrhage or new persistent/progressive focal neurological deficit measured at 6 monthly intervals. An integrated QuinteT Recruitment Intervention (QRI) evaluates screening logs, audio recordings of recruitment discussions, and interviews with recruiters and patients/parents/carers to identify and address barriers to participation. A Patient Advisory Group has codesigned the study and will oversee its progress.

Ethics and dissemination

This study was approved by the Yorkshire and The Humber—Leeds East Research Ethics Committee (21/YH/0046). We will submit manuscripts to peer-reviewed journals, describing the findings of the QRI and the Cavernomas: A Randomised Evaluation (CARE) pilot trial. We will present at national specialty meetings. We will disseminate a plain English summary of the findings of the CARE pilot trial to participants and public audiences with input from, and acknowledgement of, the Patient Advisory Group.

Trial registration number

ISRCTN41647111.
Design of a phase III, double-blind, randomised, placebo-controlled trial of BI 1015550 in patients with idiopathic pulmonary fibrosis (FIBRONEER-IPF)
Authors: Richeldi Luca , Azuma Arata , Cottin Vincent , Kreuter Michael , Maher Toby M , Martinez Fernando J , Oldham Justin M , Valenzuela Claudia , Gordat Maud , Liu Yi , Stowasser Susanne , Zoz Donald F , Wijsenbeek Marlies S
Published: August 2023

Introduction

There is an unmet need for new treatments for idiopathic pulmonary fibrosis (IPF). The oral preferential phosphodiesterase 4B inhibitor, BI 1015550, prevented a decline in forced vital capacity (FVC) in a phase II study in patients with IPF. This study design describes the subsequent pivotal phase III study of BI 1015550 in patients with IPF (FIBRONEER-IPF).

Methods and analysis

In this placebo-controlled, double-blind, phase III trial, patients are being randomised in a 1:1:1 ratio to receive 9 mg or 18 mg of BI 1015550 or placebo two times per day over at least 52 weeks, stratified by use of background antifibrotics (nintedanib/pirfenidone vs neither). The primary endpoint is the absolute change in FVC at week 52. The key secondary endpoint is a composite of time to first acute IPF exacerbation, hospitalisation due to respiratory cause or death over the duration of the trial.

Ethics and dissemination

The trial is being carried out in compliance with the ethical principles of the Declaration of Helsinki, in accordance with the International Council on Harmonisation Guideline for Good Clinical Practice and other local ethics committees. The results of the study will be disseminated at scientific congresses and in peer-reviewed publications.

Trial registration number

NCT05321069.
Inhaled corticosteroids and risk of lower respiratory tract infection withMoraxella catarrhalisin patients with chronic obstructive pulmonary disease
Authors: Johnsen Rikke Helin , Heerfordt Christian Kjer , Boel Jonas Bredtoft , Dessau Ram Benny , Ostergaard Christian , Sivapalan Pradeesh , Eklöf Josefin , Jensen Jens-Ulrik Stæhr
Published: August 2023

Background

Use of inhaled corticosteroids (ICS) is common in patients with chronic obstructive pulmonary disease (COPD) and has been associated with an increased risk of pneumonia.Moraxella catarrhalisis one of the most common bacterial causes of infectious exacerbation in COPD. Currently, to our knowledge, no studies have investigated if ICS increases the risk of lower respiratory tract infection withM. catarrhalisin patients with COPD.

Objective

To investigate if accumulated ICS use in patients with COPD, is associated with a dose-dependent risk of infection withM. catarrhalis.

Methods

This observational cohort study included 18 870 persons with COPD who were registered in The Danish Register of COPD. Linkage to several nationwide registries was performed.

Exposure to ICS was determined by identifying all prescriptions for ICS, redeemed within 365 days prior to study entry. Main outcome was a lower respiratory tract sample positive forM. catarrhalis. For the main analysis, a Cox multivariate regression model was used.

We defined clinical infection as admission to hospital and/or a redeemed prescription for a relevant antibiotic, within 7 days prior to 14 days after the sample was obtained.

Results

We found an increased, dose-dependent, risk of a lower respiratory tract sample withM. catarrhalisamong patients who used ICS, compared with non-users. For low and moderate doses of ICS HR was 1.65 (95% CI 1.19 to 2.30, p=0.003) and 1.82 (95% CI 1.32 to 2.51, p=0.0002), respectively. In the group of patients with highest ICS exposure, the HR ofM. catarrhaliswas 2.80 (95% CI 2.06 to 3.82, p<0.0001). Results remained stable in sensitivity analyses. 87% of patients fulfilled the criteria for clinical infection, and results remained unchanged in this population.

Conclusion

Our study shows a dose-dependent increased risk of infection withM. catarrhalisassociated to ICS exposure.