bluuebunny/crossref_metadata_2025_split huggingface dataset:
The macroeconomics of establishing a basic income grant in South Africa
Authors: Hollander Hylton , Havemann Roy , Steenkamp Daan 
Published: December 2023

AbstractThis paper quantifies the effect of fiscal transfers on the trade‐off between social relief and debt accumulation and discusses the economic growth and fiscal implications of different combinations of expanded social support and funding choices. Given South Africa's already high level of public debt, the opportunity to fund a basic income grant through higher debt is limited. Using a general equilibrium model, the paper shows that extending the social relief of distress grant could be fiscally feasible provided taxes rise to fund such a programme. Implementing such a policy would, however, have a contractionary impact on the economy. A larger basic income grant (even at the level of the food poverty line) would threaten fiscal sustainability as it would require large tax increases that would crowd‐out consumption and investment. The model results show that sustainably expanding social transfers requires structurally higher growth, which necessitates growth‐enhancing reforms that crowd‐in the private sector through, for example, relieving the energy constraint, increasing government infrastructure investment and expanding employment programmes.
The fatigue after infusion or transfusion pilot trial and feasibility study: A three‐armed randomized pilot trial of intravenous iron and blood transfusion for the treatment of postpartum anemia
Authors: Caljé Esther , Oyston Charlotte , Wang Zeke , Bloomfield Frank , Marriott Joy , Dixon Lesley , Groom Katie 
Published: December 2023

AbstractBackgroundEvidence for the management of moderate‐to‐severe postpartum anemia is limited. A randomized trial is needed; recruitment may be challenging.Study Design and MethodsRandomized pilot trial with feasibility surveys. Inclusion: hemoglobin 65–79 g/L, ≤7 days of birth, hemodynamically stable. Exclusion: ongoing heavy bleeding; already received, or contraindication to intravenous (IV)‐iron or red blood cell transfusion (RBC‐T). Intervention/control: IV‐iron; RBC‐T; or IV‐iron and RBC‐T. Primary outcome: number of recruits; proportion of those approached; proportion considered potentially eligible. Secondary outcomes: fatigue, depression, baby‐feeding, and hemoglobin at 1, 6 and 12 weeks; ferritin at 6 and 12 weeks. Surveys explored attitudes to trial participation.ResultsOver 16 weeks and three sites, 26/34 (76%) women approached consented to trial participation, including eight (31%) Māori women. Of those potentially eligible, 26/167 (15.6%) consented to participate. Key participation enablers were altruism and study relevance. For clinicians and stakeholders the availability of research assistance was the key barrier/enabler. Between‐group rates of fatigue and depression were similar. Although underpowered to address secondary outcomes, IV‐iron and RBC‐T compared with RBC‐T were associated with higher hemoglobin concentrations at 6 (mean difference [MD] 11.7 g/L, 95% confidence interval [CI] 2.7–20.7) and 12 (MD 12.8 g/L, 95% CI 1.5–24.2) weeks, and higher ferritin concentrations at 6 weeks (MD 136.8 mcg/L, 95% CI 76.6–196.9).DiscussionWillingness to participate supports feasibility for a future trial assessing the effectiveness of IV‐iron and RBC‐T for postpartum anemia. Dedicated research assistance will be critical to the success of an appropriately powered trial including women‐centered outcomes.
Dysfunctional iron metabolism in pressure injuries is related to aberrant CD163 and Homx‐1 signal transduction
Authors: Zhang Ju , Shan Hui , Guo Jinglin , Wang Xiaoying , Wang Weiwei 
Published: December 2023

AbstractDysregulation of iron metabolism has been associated with impaired chronic wound healing. However, changes in iron metabolism have yet to be reported in pressure injuries, a type of chronic wound. In this study, we aimed to investigate changes in iron metabolism and associated regulatory mechanisms in pressure injuries. We collected tissue biopsies and data from 20 consenting stage IV‐pressure injuries patients and 5 non‐pressure injuries patients hospitalised at the Affiliated Hospital of Qingdao University between March 2021 and June 2021. In addition, we measured the iron content by inductively coupled plasma mass spectrometry and Prussian blue staining in deep tissue pressure injury mouse models. An Enzyme‐linked immune sorbent assay measured the expression of ferritin, ferroportin‐1 and transferrin. Immunofluorescence staining, high‐throughput transcriptome sequencing, Western blot and RT‐qPCR further analysed the fundamental mechanisms regulating iron metabolism. In this study, we observed numerous inflammatory cells infiltrating the marginal tissues of stage IV pressure injury patients and in deep tissue pressure injury models. The expression levels of pro‐inflammatory factors, such as inducible nitric oxide synthase and interleukin‐6, were significantly increased (p < 0.05). The iron level was proportional to the degree of progression, with the most significant change appearing on the third day in deep tissue pressure injury models (p < 0.05). Enzyme‐linked immune sorbent assay results suggested abnormal gene expression was related to iron metabolism, including a substantial increase in ferritin and a significant decrease in the expression of ferroportin‐1 (p < 0.05). In addition, immunofluorescence staining and Western blot showed that the expression of macrophage membrane receptor CD163 was abnormally elevated (p < 0.05). Both high‐throughput transcriptome sequencing and qRT‐PCR results suggested aberrant expression of the CD163/Homx‐1‐mediated signalling pathway. Dysfunctional iron metabolism was suggested to be related to the aberrant CD163/Homx‐1 signalling pathway in deep tissue pressure injury models.
Evaluating the cost‐effectiveness of diabetic foot ulcer management by wound care specialists in Indonesia
Authors: Jais Suriadi , Oe Makoto , Sanada Hiromi , Sasongko Agung , Haryanto Haryanto 
Published: December 2023

AbstractDiabetic foot ulcers affect quality of life and economically burden patients and the Indonesian healthcare system. The comparative cost‐effectiveness of wound care specialists in private practices (e.g., wound clinics) and wound care nurses in national hospitals remains unknown. Thus, we used a decision tree to compare the cost and healing rates for patients after 12 weeks of wound care. Uncertainty was addressed using one‐way and probabilistic sensitivity analyses. Among 89 participants (42 in the national hospital and 47 in the private practice), no significant differences were observed between the two groups in terms of sex, age, education level, smoking status, duration of diabetes, Wagner wound classification, glycated haemoglobin levels, neuropathy status, ankle‐brachial index, baseline characteristics, quality of life, DMIST (depth, maceration, inflammation/infection, size, tissue type of the wound bed, type of wound edge, and tunnelling/undermining) score and wound location (p > 0.05). However, significant differences were observed for days from first visit/assessment until complete healing, mean quality of life (p ≤ 0.001) and wound size (p = 0.047). Wound care specialists in private practices had a significantly lower cost of 2,804,423.3 Indonesian rupiah compared to 6,483,493.4 Indonesian rupiah for wound care nurses in national hospitals. The incremental cost‐effectiveness ratio was −165,723.9. Therefore, wound care specialists in private practices are more cost‐effective for managing diabetic foot ulcers. Probability sensitivity analysis confirmed that 80%–90% of the scenarios were cost‐effective. These findings may inform healthcare resource allocation in Indonesia. Additionally, evidence‐based cost‐effectiveness measures were strengthened in private practices and national hospitals.
Measurements of Turbulence in Compressible Low-Density Flows at the Inlet of a Transonic Linear Cascade With and Without Unsteady Wakes
Authors: Pastorino Giacomo , Simonassi Loris , Lopes Gustavo , Boufidi Elissavet , Fontaneto Fabrizio , Lavagnoli Sergio 
Published: December 2023

Abstract
In the present work, hot-wire anemometry was employed for the characterization of the turbulent field at the inlet of a high-speed low-pressure turbine cascade, in terms of turbulence intensity and integral length scales. This work addresses two major topics relevant to the turbomachinery field: the application of hot-wire anemometry in transonic and rarefied flow regimes and the decoupling of the deterministic and the stochastic fluctuations when measuring unsteady phenomena. In compressible and rarefied flows, a hot-wire is strongly sensitive to both density and velocity fluctuations, and the commonly used Nusselt–Reynolds correlations are not valid. In this article, a nondimensional calibration methodology, based on Nusselt, Reynolds, and Knudsen numbers, was coupled with a sensitivity analysis and employed to postprocess the experimental dataset, allowing to decouple the fluctuations of density and velocity and to compute the turbulence parameters. In the presence of unsteady wakes generated upstream of the cascade, two different phase-locked averaging techniques were employed to distinguish the wake deterministic fluctuations from the background turbulence intensity.
Microsporidia persistence in host impairs epithelial barriers and increases chances of inflammatory bowel disease
Authors: Jin Jiangyan , Tang Yunlin , Cao Lu , Wang Xue , Chen Yebo , An Guozhen , Zhang Huarui , Pan Guoqing , Bao Jialing , Zhou Zeyang 
Published: December 2023

ABSTRACT

Microsporidia are intracellular fungus-like pathogens and the infection symptoms include recurrent diarrhea and systematic inflammations. The major infection route of microsporidia is the digestive tract. Since microsporidia are hard to fully eliminate, the interactions and persistence of the pathogen within epithelium may modulate host susceptibility to digestive disorders. In this study, both
in vitro
and
in vivo
infection models were applied. The alterations of epithelial barrier integrity, permeability, and tight junction proteins after microsporidia infection were assessed on MDCK/Caco-2 monolayers. The fecal intestinal microbiota and tissue alterations after microsporidia infection were assessed on C57BL/6 mice. Moreover, the susceptibility to develop dextran sulfate sodium (DSS)-induced inflammatory bowel diseases (IBDs) was also analyzed by the murine infection model. The results demonstrated that microsporidia infection increased epithelium permeability, weakened wound healing capability, and destructed tight junction protein zonula occludens-1. Microsporidia infection also dysregulates intestinal microbiota. These impairing effects of microsporidia increased host vulnerability to develop enteritis as shown by the murine model of DSS-induced IBD. Our study is the first to elucidate molecular mechanisms of the damaging effects of microsporidia on host epithelium and pointed out the cryptic threats of latent microsporidia infection to public health as reflected by the increased chances of developing more severe diseases.

IMPORTANCE
Microsporidia are widely present in nature and usually cause latent and persistent infections in hosts. Given the fact that the digestive tract is the major infection route, it is of great importance to explore the consequences of microsporidia infection on the intestinal epithelial barrier and the risks to the host. In this study, we demonstrated the destructing effects of microsporidium infection on epithelial barriers manifested as increased epithelial permeability, weakened wound healing ability, and disrupted tight junctions. Moreover, microsporidia made the host more susceptible to dextran sulfate sodium-induced inflammatory bowel disease. These findings provide new evidence for us to better understand and develop novel strategies for microsporidia prevention and disease control.
Qualitative interview study exploring the perspectives of pregnant women on participating in controlled human infection research in the UK
Authors: Dorey Robert B , Theodosiou Anastasia A , Read Robert C , Vandrevala Tushna , Jones Christine E 
Published: December 2023

IntroductionPregnant women have been historically excluded from interventional research. While recent efforts have been made to improve their involvement, there remains a disparity in the evidence base for treatments available to pregnant women compared with the non-pregnant population. A significant barrier to the enrolment of pregnant women within research is risk perception and a poor understanding of decision-making in this population.ObjectiveAssess the risk perception and influences on decision-making in pregnant women, when considering whether to enrol in a hypothetical interventional research study.DesignSemistructured interviews were undertaken, and thematic analysis was undertaken of participant responses.ParticipantsTwelve pregnant women were enrolled from an antenatal outpatient clinic.ResultsParticipants were unanimously positive about enrolling in the proposed hypothetical interventional study. Risk perception was influenced by potential risks to their fetus and their previous experiences of healthcare and research. Participants found the uncertainty in quantifying risk for new research interventions challenging. They were motivated to enrol in research by altruism and found less invasive research interventions more tolerable.ConclusionIt is vital to understand how pregnant women balance the perceived risks and benefits of interventional research. This may help clinicians and scientists better communicate risk to pregnant women and address the ongoing under-representation of pregnant women in interventional research.
Assessing the feasibility of a randomised controlled trial examining the effect of hearing aids on cognitive decline in elderly individuals: a study protocol
Authors: Fuchten Denise , Smit Adriana L , Huenges Wajer Irene M C , Rhebergen Koen S , Stegeman Inge 
Published: December 2023

IntroductionHearing loss is one of the leading potentially modifiable risk factors for dementia. There is growing evidence suggesting that treating hearing loss with hearing aids could be a relatively low-cost intervention in reducing cognitive decline and the risk of dementia in the long term. However, given the current constraints of the limited evidence, it is premature to draw definitive conclusions about the effect of hearing aids on cognitive functioning. More long-term randomised studies examining this effect would be recommended. Prior to embarking on large-scale lengthy randomised controlled trials (RCTs), it is imperative to determine the viability of such studies. Therefore, the purpose of the current study is to assess the feasibility of a RCT that investigates the effect of hearing aids on cognitive functioning in elderly hearing impaired individuals.Methods and analysisIn this randomised controlled feasibility trial, 24 individuals aged 65 years or older with mild to moderate hearing loss (≥35–<50 dB pure tone average (0.5–4 kHz) unilateral or bilateral) will be included and randomised towards a hearing aid intervention or no intervention. At baseline and at 6-month follow-up, a test battery consisting of cognitive tests and questionnaires will be administered to both groups. The primary outcome of the study is the willingness of hearing impaired individuals to be randomised for hearing amplification in a study regarding cognition. The secondary outcomes are the feasibility of the test battery and the therapy compliance of hearing aid use.Ethics and disseminationThis research protocol was approved by the Institutional Review Board of the University Medical Centre Utrecht (NL80594.041.22, V.3, January 2023). The trial results will be made accessible to the public in a peer-reviewed journal.Trial registration numberISRCTN84550071.
Direct-to-consumer tests advertised online in Australia and their implications for medical overuse: systematic online review and a typology of clinical utility
Authors: Shih Patti , Ding Pauline , Carter Stacy M , Stanaway Fiona , Horvath Andrea R , Langguth Daman , Saad Mirette , St John Andrew , Bell Katy 
Published: December 2023

ObjectivesThe objective of this study is to map the range and variety of direct-to-consumer (DTC) tests advertised online in Australia and analyse their potential clinical utility and implications for medical overuse.DesignSystematic online search of DTC test products in Google and Google Shopping. DTC test advertisements data were collected and analysed to develop a typology of potential clinical utility of the tests at population level, assessing their potential benefits and harms using available evidence, informed by concepts of medical overuse.ResultsWe identified 484 DTC tests (103 unique products), ranging from $A12.99 to $A1947 in cost (mean $A197.83; median $A148.50). Using our typology, we assigned the tests into one of four categories: tests with potential clinical utility (10.7%); tests with limited clinical utility (30.6%); non-evidence-based commercial ‘health checks’ (41.9%); and tests whose methods and/or target conditions are not recognised by the general medical community (16.7%). Of the products identified, 56% did not state that they offered pretest or post-test consultation, and 51% did not report analytical performance of the test or laboratory accreditation.ConclusionsThis first-in-Australia study shows most DTC tests sold online have low potential clinical utility, with healthy consumers constituting the main target market. Harms may be caused by overdiagnosis, high rates of false positives and treatment decisions led by non-evidence-based tests, as well as financial costs of unnecessary and inappropriate testing. Regulatory mechanisms should demand a higher standard of evidence of clinical utility and efficacy for DTC tests. Better transparency and reporting of health outcomes, and the development of decision-support resources for consumers are needed.
External validation of the QCovid 2 and 3 risk prediction algorithms for risk of COVID-19 hospitalisation and mortality in adults: a national cohort study in Scotland
Authors: Kerr Steven , Millington Tristan , Rudan Igor , McCowan Colin , Tibble Holly , Jeffrey Karen , Fagbamigbe Adeniyi Francis , Simpson Colin R , Robertson Chris , Hippisley-Cox Julia , Sheikh Aziz 
Published: December 2023

ObjectiveThe QCovid 2 and 3 algorithms are risk prediction tools developed during the second wave of the COVID-19 pandemic that can be used to predict the risk of COVID-19 hospitalisation and mortality, taking vaccination status into account. In this study, we assess their performance in Scotland.MethodsWe used the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 national data platform consisting of individual-level data for the population of Scotland (5.4 million residents). Primary care data were linked to reverse-transcription PCR virology testing, hospitalisation and mortality data. We assessed the discrimination and calibration of the QCovid 2 and 3 algorithms in predicting COVID-19 hospitalisations and deaths between 8 December 2020 and 15 June 2021.ResultsOur validation dataset comprised 465 058 individuals, aged 19–100. We found the following performance metrics (95% CIs) for QCovid 2 and 3: Harrell’s C 0.84 (0.82 to 0.86) for hospitalisation, and 0.92 (0.90 to 0.94) for death, observed-expected ratio of 0.24 for hospitalisation and 0.26 for death (ie, both the number of hospitalisations and the number of deaths were overestimated), and a Brier score of 0.0009 (0.00084 to 0.00096) for hospitalisation and 0.00036 (0.00032 to 0.0004) for death.ConclusionsWe found good discrimination of the QCovid 2 and 3 algorithms in Scotland, although performance was worse in higher age groups. Both the number of hospitalisations and the number of deaths were overestimated.
Defining anthropometric thresholds (mid-arm circumference and calf circumference) in older adults residing in the community: a cross-sectional analysis using data from the population representative Longitudinal Aging Study in India (LASI DAD)
Authors: Bhagwasia Manjusha , Rao Abhijith Rajaram , Banerjee Joyita , Bajpai Swati , Khobragade Pranali Yogiraj , Raman Aruna V , Talukdar Arunanshu , Jain Arvind , Rajguru Chhaya , Sankhe Lalit , Goswami Debabrata , Shanthi Ganapathy Sankaralingam , Kumar Govind , Varghese Mathew , Dhar Minakshi , Gupta Monica , Koul Parvaiz A , Mohanty Rashmi Ranjan , Chakrabarti Sankha Shubhra , Yadati Sathyanarayana Raju , Dey Sharmistha , Lee Jinkook , Dey Aparajit Ballav 
Published: December 2023

ObjectivesTo identify factors associated with malnutrition (undernutrition and overnutrition) and determine appropriate cut-off values for mid-arm circumference (MAC) and calf circumference (CC) among community-dwelling Indian older adults.DesignData from the first wave of harmonised diagnostic assessment of dementia for Longitudinal Ageing Study in India (LASI-DAD) were used. Various sociodemographic factors, comorbidities, geriatric syndromes, childhood financial and health status were included. Anthropometric measurements included body mass index (BMI), MAC and CC.SettingNationally representative cohort study including 36 Indian states and union territories.Participants4096 older adults aged >60 years from LASI DAD.Outcome measuresThe outcome variable was BMI, categorised as low (<18.5 kg/m2), normal (18.5–22.9 kg/m2) and high (>23 kg/m2). The cut-off values of MAC and CC were derived using ROC curve with BMI as the gold standard.Results902 (weighted percentage 20.55%) had low BMI, 1742 (44.25%) had high BMI. Undernutrition was associated with age, wealth-quintile and impaired cognition, while overnutrition was associated with higher education, urban living and comorbidities such as hypertension, diabetes and chronic heart disease. For CC, the optimal lower and upper cut-offs for males were 28.1 cm and >31.5 cm, respectively, while for females, the corresponding values were 26 cm and >29 cm. Similarly, the optimal lower and upper cut-offs for MAC in males were 23.9 cm and >26.9 cm, and for females, they were 22.5 cm and >25 cm.ConclusionOur study identifies a high BMI prevalence, especially among females, individuals with higher education, urban residents and those with comorbidities. We establish gender-specific MAC and CC cut-off values with significant implications for healthcare, policy and research. Tailored interventions can address undernutrition and overnutrition in older adults, enhancing standardised nutritional assessment and well-being.