bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allocation of Funds in Bilevel Subsidy Welfare Programs
Authors: Wei Wei , Arora Priyank , Solak Senay 
Published: June 2024

Problem definition: Most subsidy welfare programs operate in a bilevel hierarchical structure, wherein a funding agency allocates funds to multiple service organizations. These service organizations invest in activities within their areas to generate societal impact for beneficiaries by enhancing the quantity and quality of services at local providers. The funds allocation decisions in such programs are complicated by the funding agency’s equity consideration, intricate relationships among contextual factors in societal impact generation, and information asymmetry between different entities about availability of additional funds for an agency. Methodology/results: We propose a model to analyze how the funding agency should allocate funds to generate the most societal impact equitably across areas. We show that the funding agency should direct more funds toward an area with a relatively balanced mix of subsidy-accepting and nonaccepting providers, or with fewer nonaccepting providers, and outreach activity is more likely to yield a higher investment return. Further, comparing the inequity levels and total societal impact under the proposed equity-ensuring method with those under other methods, we find that an efficiency-focused method enhances total societal impact, but can result in greater inequity, especially when there is a large across-area disparity in the size of beneficiaries. A simple formula-based method could achieve greater total societal impact, while not severely sacrificing equity in certain situations. Conversely, the equity-ensuring method always eliminates inequity by not severely sacrificing the total societal impact under a wide range of parameter values. Managerial implications: Given the growing impetus to consider equity within their operations, our equity-ensuring method helps the funding agencies adjust their allocation strategies to generate the greatest equitable impact. Finally, using a case study based on Massachusetts’ child care subsidy program, we illustrate that the proposed method achieves equity while enhancing the overall societal impact by approximately 3% versus the current formula-based method. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0474 .
Comparing the effectiveness of active and reactive mattresses in pressure injury healing: a pilot study
Authors: Rae Katherine E , Barker Judith , Isbel Stephen , Upton Dominic 
Published: June 2024

Objective: A feasibility study to test the proposed methodology for a larger randomised control trial was conducted, investigating the comparative effectiveness of the two types of pressure management support surfaces with regards to healing pressure injuries (PI). A secondary objective was to provide insights into the user acceptability of the two types of pressure management support surfaces. Method: A randomised control feasibility study was conducted in a community health setting in Canberra, Australia. Patients aged ≥65 years with an existing Stage 2 PI who slept in a bed were eligible. Participants were randomised to either the active mattress group or the reactive mattress group for use on their bed. All participants received standard wound care by community nursing staff and were provided an air-flotation cushion for use when not in bed. Photographs were taken and used for blind assessment of wound healing. Secondary information was gathered through a survey regarding user acceptability of the support surfaces and changes in habits regarding PI prevention strategies. Results: In total, five patients were recruited, with one passing away prior to mattress allocation. Results were inconclusive with regards to comparative effectiveness and user acceptability due to the small sample size; however, secondary data indicated an increasing implementation of PI prevention strategies. Conclusion: This study confirmed the need for further high quality research comparing reactive and active pressure mattresses. Trends indicate the importance of including education on PI prevention strategies to promote changes in behaviour. Changes to the proposed methodology will be made to increase recruitment in the primary study.
Fournier's gangrene originating from the perianal region or the urogenital area: does it make a difference?
Authors: Cengiz Fevzi , Gur Emine Ozlem , Atay Yigit Doganay , Kamer Kemal Erdinc , Bozok Yeliz Yilmaz , Bag Halis , Gungor Feyyaz , Haciyanli Mehmet 
Published: June 2024

Objective: Fournier's gangrene (FG) is a rare and serious disorder which is associated with high mortality. In the literature, there is no study evaluating clinician-, patient- and disease-related factors affecting disease outcomes according to aetiological variation in FG. In our study, laboratory results and Uludag Fournier's Gangrene Severity Index (UFGSI) score, clinical characteristics and mortality rates were compared between FG originating from perianal or from urogenital regions. Method: Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) and UFGSI risk scores were calculated in patients with FG at presentation to the emergency department. The patients were assigned to two groups according to FG aetiology. Results: It was observed that the number of debridement interventions and the need for colostomy were significantly greater in the perianal FG group, while the need for flap or reconstruction was significantly (p=0.002) higher in the genitourinary FG group. No significant difference was detected in mortality between groups and the difference in aetiology had no significant effect on the results of the neutrophil-to-lymphocyte ratio, LRINEC or UFGSI scores. Conclusion: Laboratory results and UFGSI score were helpful in assessing disease severity independently from aetiology. The higher number of debridement interventions to protect anal function in the perianal group and the greater need for reconstructive surgery in the urogenital group were identified as factors that prolonged length of hospital stay.
Metabolic profiles of children aged 2–5 years born after frozen and fresh embryo transfer: A Chinese cohort study
Authors: Zhou Wei , Feng Wanbing , Chang Jinli , Hu Jingmei , Li Fuxia , Hu Kuona , Jiao Jiejing , Xue Xinyi , Lan Ting , Wan Wenjing , Chen Zi-Jiang , Cui Linlin 
Published: June 2024

Background
Frozen embryo transfer (FET) has become a widely employed assisted reproductive technology technique. There have historically been concerns regarding the long-term metabolic safety of FET technology in offspring due to pregnancy-induced hypertension and large for gestational age, both of which are well-recognized factors for metabolic dysfunction of children. Therefore, we aimed to compare the metabolic profiles of children born after frozen versus fresh embryo transfer at 2 to 5 years of age.

Methods and findings
This was a prospective cohort study. Using data from the “Assisted Reproductive Technology borned KIDs (ARTKID),” a birth cohort of offspring born from assisted reproductive technology at the Institute of Women, Children and Reproductive Health, Shandong University, China. We included 4,246 singletons born after FET (n = 2,181) and fresh embryo transfer (n = 2,065) enrolled between 2008 and 2019 and assessed the glucose and lipid variables until the age of 2 to 5 years. During a mean follow-up of 3.6 years, no significant differences were observed in fasting blood glucose, fasting insulin, Homeostatic Model Assessment of Insulin Resistance Index, total cholesterol, triglycerides, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol levels between offspring conceived by fresh and frozen embryo transfer in the crude model and adjusted model (adjusted for parental age, parental body mass index, parental education level, paternal smoking, parity, offspring age and sex). These results remained consistent across subgroup analyses considering offspring age, the stage of embryo transfer, and the mode of fertilization. Results from sensitivity analysis on children matched for age within the cohort remains the same. The main limitation of our study is the young age of the offspring.

Conclusions
In this study, the impact of FET on glucose and lipid profiles during early childhood was comparable to fresh embryo transfer. Long-term studies are needed to evaluate the metabolic health of offspring born after FET.
Acceptability and feasibility of tests for infection, serological testing, and photography to define need for interventions against trachoma
Authors: Renneker Kristen K. , Mtuy Tara B. , Kabona George , Mbwambo Stephen Gabriel , Mosha Patrick , Mollel Jeremiah Mepukori , Hooper PJ , Emerson Paul M. , Hollingsworth T. Deirdre , Butcher Robert , Solomon Anthony W. , Harding-Esch Emma M. 
Published: June 2024

Background
Trachoma causes blindness due to repeated conjunctival infection by Chlamydia trachomatis (Ct). Transmission intensity is estimated, for programmatic decision-making, by prevalence of the clinical sign trachomatous inflammation—follicular (TF) in children aged 1–9 years. Research into complementary indicators to field-graded TF includes work on conjunctival photography, tests for ocular Ct infection, and serology. The perceived acceptability and feasibility of these indicators among a variety of stakeholders is unknown.

Methodology
Focus group discussions (FGDs) with community members and in-depth interviews (IDIs) with public health practitioners in Tanzania were conducted. FGDs explored themes including participants’ experience with, and thoughts about, different diagnostic approaches. The framework method for content analysis was used. IDIs yielded lists of perceived strengths of, and barriers to, implementation for programmatic use of each indicator. These were used to form an online quantitative survey on complementary indicators distributed to global stakeholders via meetings, mailing lists, and social media posts.

Results
Sixteen FGDs and 11 IDIs were conducted in October–November 2022. In general, all proposed sample methods were deemed acceptable by community members. Common themes included not wanting undue discomfort and a preference for tests perceived as accurate. Health workers noted the importance of community education for some sample types. The online survey was conducted in April–May 2023 with 98 starting the questionnaire and 81 completing it. Regarding barriers to implementing diagnostics, the highest agreement items related to feasibility, rather than acceptability. No evidence of significant differences was found in responses pertaining to community acceptability based on participant characteristics.

Conclusions
All of the indicators included were generally deemed acceptable by all stakeholders in Tanzania, although community education around the benefits and risks of different sample types, as well as addressing issues around feasibility, will be key to successful, sustainable integration of these indicators into trachoma programs.
Unveiling the nexus between rural population aging, technical efficiency, and carbon emissions in Chinese agriculture
Authors: Song Hongen , Jiang Changyi , Sun Zhaoming 
Published: June 2024

Introduction
According to the seventh national population census in China, the proportion of people aged 65 and above in the population reached 13.5%. The aging trend is more pronounced in rural areas, indicating that China has entered an aging society. This article focuses on agricultural carbon emissions in the context of aging, studying the impact of rural population aging on agricultural carbon emissions.

Study objectives
Under the background of deepening population aging, let us discuss how to maintain the green and sustainable development of agriculture in China.

Methodology
Fixed effects and mediating effects models are used. Technical efficiency is used as a mediating variable to discuss the relationship between rural population ageing, technical efficiency and agricultural carbon emissions.

Results
This paper adopts the classical carbon emission calculation theory of IPCC to measure agricultural carbon emissions from 2010 to 2019, and China’s plantation carbon emissions show an "inverted U-shaped" trend, reaching a high level in 2015 and then starting to decline. In addition, the fixed-effects benchmark regression found that the aging of the rural population promotes agricultural carbon emissions, and the technical efficiency of agriculture suppresses agricultural carbon emissions. Finally, the mediating effect model is applied to explore the relationship between the three. Using technical efficiency as the mediating variable, it is found that under the masking effect, rural population aging will weaken agricultural carbon emissions through technical efficiency, thus achieving the suppression of agricultural carbon emissions.

Policy recommendation
The formulation and modification of agricultural carbon-reducing policy row policies should take full account of the broader context of rural population ageing; increase the interconnectedness and interaction between rural population ageing and agricultural production technology, and actively play a positive role in promoting the efficiency of agricultural technology as a result of rural population ageing; and, in accordance with the actual situation of agricultural research, appropriately increase the strength of financial support for agriculture to improve agricultural technology and promote low-carbon development in agriculture.
Time to death and predictors of mortality among early neonates admitted to neonatal intensive care unit of Addis Ababa public Hospitals, Ethiopia: Institutional-based prospective cohort study
Authors: Malka Erean Shigign , Solomon Tarekegn , Kassa Dejene Hailu , Erega Besfat Berihun , Tufa Derara Girma 
Published: June 2024

Introduction
The largest risk of child mortality occurs within the first week after birth. Early neonatal mortality remains a global public health concern, especially in sub-Saharan African countries. More than 75% of neonatal death occurs within the first seven days of birth, but there are limited prospective follow- up studies to determine time to death, incidence and predictors of death in Ethiopia particularly in the study area. The study aimed to determine incidence and predictors of early neonatal mortality among neonates admitted to the neonatal intensive care unit of Addis Ababa public hospitals, Ethiopia 2021.

Methods
Institutional prospective cohort study was conducted in four public hospitals found in Addis Ababa City, Ethiopia from June 7th, 2021 to July 13th, 2021. All early neonates consecutively admitted to the corresponding neonatal intensive care unit of selected hospitals were included in the study and followed until 7 days-old. Data were coded, cleaned, edited, and entered into Epi data version 3.1 and then exported to STATA software version 14.0 for analysis. The Kaplan Meier survival curve with log- rank test was used to compare survival time between groups. Moreover, both bi-variable and multivariable Cox proportional hazard regression model was used to identify the predictors of early neonatal mortality. All variables having P-value ≤0.2 in the bi-variable analysis model were further fitted to the multivariable model. The assumption of the model was checked graphically and using a global test. The goodness of fit of the model was performed using the Cox-Snell residual test and it was adequate.

Results
A total of 391 early neonates with their mothers were involved in this study. The incidence rate among admitted early neonates was 33.25 per 1000 neonate day’s observation [95% confidence interval (CI): 26.22, 42.17]. Being preterm birth [adjusted hazard ratio (AHR): 6.0 (95% CI 2.02, 17.50)], having low fifth minute Apgar score [AHR: 3.93 (95% CI; 1.5, 6.77)], low temperatures [AHR: 2.67 (95%CI; 1.41, 5.02)] and, resuscitating of early neonate [AHR: 2.80 (95% CI; 1.51,5.10)] were associated with increased hazard of early neonatal death. However, early neonatal crying at birth [AHR: 0.48 (95%CI; 0.26, 0.87)] was associated with reduced hazard of death.

Conclusions
Early neonatal mortality is high in Addis Ababa public Hospitals. Preterm birth, low five-minute Apgar score, hypothermia and crying at birth were found to be independent predictors of early neonatal death. Good care and attention to neonate with low Apgar scores, premature, and hypothermic neonates.
Lifestyle practices and associated factors among adults with hypertension: Conquering Hypertension in Vietnam-solutions at the grassroots level study
Authors: Nguyen Phuong H. , Goldberg Robert J. , Allison Jeroan J. , Nguyen Diep B. , Tran Ha T. , Tran Oanh M. , Ha Duc A. , Nguyen Hieu L. , Tran Brittany A. , Wang Bo , Nguyen Hoa L. 
Published: June 2024

Background
Vietnam is experiencing an increasing prevalence of hypertension in its adult population. In addition to medical therapy, modifying adverse lifestyle practices is important for effective blood pressure control. There are limited data on unhealthy lifestyle practices in patients with chronic diseases, however, particularly among hypertensive patients living in rural Vietnam. Our study objectives were to examine the prevalence of unhealthy lifestyle practices and associated factors among rural Vietnamese adults with uncontrolled hypertension.

Methods
Data from the baseline survey of a cluster randomized trial among hypertensive Vietnamese adults (2017–2022) were utilized. Information on unhealthy lifestyle practices including smoking, excessive alcohol consumption, physical inactivity, and inadequate fruit and vegetable intake was collected from study participants. The primary study outcome was having ≥2 unhealthy lifestyle practices. A multivariable logistic regression model was used to examine factors associated with the primary study outcome.

Results
The mean age of the 671 patients was 67 years and 45.0% were men. Nearly three out of every four participants had one or fewer unhealthy practices, 24.0% had two, and 3.3% had three or all four unhealthy lifestyle practices. Men, individuals who did unpaid work or were unemployed, and individuals with hypertension level III were more likely to have ≥2 unhealthy lifestyle practices, whereas individuals with higher education were less likely to have ≥2 unhealthy lifestyle practices compared with respective comparison groups.

Conclusions
We observed a high prevalence of unhealthy lifestyle practices among rural Vietnamese patients with uncontrolled hypertension. Several demographic factors were associated with a greater number of unhealthy lifestyle practices. Newer interventions and educational programs encouraging lifestyle modification practices are needed to control hypertension among adults living in rural settings of Vietnam.
Potential for high dynamic range Sedia Limiting Antigen antibody assay to support viral load monitoring during antiretroviral therapy
Authors: Sempa Joseph B. , Welte Alex 
Published: June 2024

Introduction
Viral Load (VL) monitoring is a crucial component of patient care during antiretroviral therapy (ART) but is not routinely available in many resource-constrained settings, where millions of patients will require care for decades to come. We hypothesise a serologic ‘recent infection’ test (Sedia LAg assay) which has a high dynamic range for detecting antigen-driven antibody response can provide informative proxies for VL trajectories.

Methods
A retrospective study where we analysed data linked via specimens in a well-described repository for recent infection test benchmarking (CEPHIA collaboration). Patient panels were comprised of 1) observations straddling ART start; 2) observations from a period of stable viral suppression; 3) observations straddling rebound after a period of viral suppression. We analysed an individual’s Sedia LAg ELISA normalised optical density (ODn) trends within these categories. Using groups 2) and 3) we evaluated the specificity and sensitivity of a proposed proxy for “the latest observation is at a time of VL rebound”; proxy was defined as follows: we estimated patient-specific mean-previous-ODn for all observations with at least two preceding virally suppressed observations. We considered various thresholds to define both “VL suppression” and “ODn uptick”.

Results
In regression analysis by category: 1) ODn gradients are statistically significantly negative just after ART-start (p = 0.010); 2) During periods of stable viral suppression, ODn tended to decline, but not statistically significantly, for a range of clinically meaningful “VL suppression” thresholds; 3) comparing ODn values just before, versus at, “VL rebound”, ODn changes were statistically significantly increasing at rebound (p = 0.001). In the analysis comparing groups 2) and 3), at a Z score threshold of 0.8, the proposed proxy for a first viral rebound had an observed specificity and sensitivity both close to 90%.

Conclusion
The high dynamic range of serological tests previously investigated for defining ‘recent infection’ has potential, as demonstrated using the Sedia LAg ELISA, to provide meaningful information about the success of ART, during treatment initiation, at times of stable suppression, and to flag possible viral rebound. It should be investigated how this can be combined with patient management workflows and (clinical and) other data, to provide efficiencies in long-term monitoring viral control in resource-limited settings.
One-year continuation of postpartum intrauterine contraceptive device: Findings from a prospective cohort study in India
Authors: Srivastava Ashish , Sharma Surendra , Lalchandani Kamlesh , Mohanty Nochiketa , Bhatt Deepak Chandra , Usmanova Gulnoza , Sood Bulbul , Kumar Somesh 
Published: June 2024

Objective(s)
To estimate continuation rates for postpartum intrauterine contraceptive device (PPIUD) at 6 weeks, 6 months and 1-year within existing programs in an under-resourced setting, and to identify determinants of discontinuation, removal and expulsion.

Study design
We used a prospective cohort design and enrolled recent PPIUD adopter women across 100 public healthcare facilities in Odisha and Chhattisgarh, India. We collected their socio-demographic information and followed them up telephonically at 6 weeks, 6 months and 1 year for complications and continuation status. We assessed PPIUD continuation rates and factors associated with PPIUD discontinuation, removal, and expulsion using Cox proportional hazards modelling.

Results
We enrolled 916 participants (579 (63.2%) from Odisha and 337 (36.8%) from Chhattisgarh). The continuation rate of PPIUD was 88.7% at 6 weeks, 74.8% at 6 months 60.1% at one year. Once discontinued, chances of not opting for any family planning method was high (up to 81.2%). Participants with education of 6th to 12th class and those experiencing complications (pain abdomen, bleeding and discharge per vaginum) were more likely to remove the IUD with adjusted hazard ratio of 1.82 (95% CI: 1.18–2.79) and 4.39 (95% CI: 3.25–5.93) respectively. For expulsion, we did not find any factor that was statistically significant.

Conclusion(s)
PPIUD continuation rates declined considerably after the initial 6 weeks. Counselling and follow-up services for managing complications must be strengthened, especially in the first 6 weeks of PPIUD insertion, to enhance and sustain programmatic impact.

Implications
Our findings emphasize on the need to strengthen client counseling and follow-up for management of complications, especially in the first 6 weeks of insertion of PPIUDs. Ongoing programs need to address comprehensive capacity building efforts in this regard.