bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Tide Is Turning: More and More Philosophizing Women in Bulgaria
Authors: Gicheva-Gocheva Dimka Ivanova 
Published: November 2023

Abstract
The article uses the method of the historical narrative. The main characteristics and stages in the development of the University of Sofia are sketched. The article focuses on this university because it is the oldest and until recently the biggest in the country, and the participation and inclusion of female scholars is best seen here. Abundant information is provided on the number of women studying and teaching in this university since its establishment and, in the last three decades, elsewhere. The tendencies are positive: more women intellectuals are participating in academic and cultural life, and they are employed and supported at many more institutions than during the previous century.
A deathly silence: why has the number of people found decomposed in England and Wales been rising?
Authors: Hiam Lucinda , Estrin-Serlui Theodore , Dorling Danny , McKee Martin , Minton Jon 
Published: November 2023

Objectives The number of deaths occurring in private homes in England and Wales had been rising for years, increasingly rapidly from 2020. Media stories and research linked decomposing bodies found in private homes with pandemic-related social isolation. We aim to explore whether these incidents are one-offs or part of a wider trend. Design Descriptive analysis of publicly available Office for National Statistics (ONS) data. Setting England and Wales. Participants All residents of England and Wales, 1979 to 2020. Main outcome measures Using data from the Office for National Statistics, we calculate European Age Standardised Rates for deaths coded as R98 (‘unattended death’) and R99 (‘other ill-defined and unknown causes of mortality’) in the 10th version of the International Classification of Diseases (ICD-10), and the corresponding codes in ICD-9, by sex and age group from 1979 (when ICD-9 began) to 2020. These are proxy markers for deaths where decomposition precludes attribution of a specific cause at postmortem. Results While mortality from all other causes decreased from 1979 to 2020, the opposite was seen for deaths from R98 and R99 (or ‘undefined deaths’), with men more affected than women. There was a sharp rise in these deaths in both sexes but in men particularly in the 1990s and 2000s, coinciding with a time when overall mortality was rapidly improving. Conclusions The increase in people found dead from unknown causes suggests wider societal breakdowns of both formal and informal social support networks. They are concerning and warrant urgent further investigation. We call on national and international authorities to consider measures that would make it possible to identify these deaths more easily in routine data.
Accelerating Racial Activism in STEM Higher Education by Institutionalizing Equity Ethics
Authors: McGee Ebony O. , Morton Terrell R. , White Devin T. , Frierson Whitney 
Published: November 2023

Background/Context: The United States invests in STEM education, but this investment is racialized and political. The country wants to maintain global economic domination, but there are also calls to diversify the STEM workforce (Baber, 2015; Basile & Lopez, 2015; Vakil & Ayers, 2019). This context leaves Black and Brown people to navigate racially hostile, toxic, and oppressive STEM learning and working environments (Bullock, 2017; Erete et al., 2020; Wright & Riley, 2021). Purpose/Objective/Research Question/Focus of Study: This conceptual paper offers strategies for institutionalizing equity ethics in STEM higher education. The paper attends to the core components of equity ethics and its possibilities while identifying structural constraints. Equity ethics is an equity-minded perspective that focuses on leveraging the multiple forms of knowledge associated with understanding and engaging the natural world to foster an oppression-free society that specifically enhances the lives of Black and Brown people. We also examine specific cases of STEM education and research scholars and practitioners who are committed to engaging and uplifting racially minoritized communities through the intersection of STEM and justice. Research Design: This conceptual paper takes a qualitative approach. It uses the existing literature to review the current state of diversity in STEM, the major components of an equity ethic, the structural and institutional barriers people of color face in STEM higher education, and how equity ethics may be institutionalized. In particular, we highlight examples of equity ethics in action to provide models for action and policy change. Conclusions/Recommendations: Institutionalized equity ethics at the mid-institutional level (e.g., departments and units) would require all faculty to mentor Black and Brown STEM students through critical transitions. We also recommend revising department- and unit-level policies and practices around access to resources that are critical for STEM achievement and knowledge production. Although expanding and sustaining financial investments in equity-focused endeavors is required, these investments must also come with the power and agency to transform institutional structures around STEM access, learning, and innovation. Transformation of top-level policies and practices could include changes to institutional admissions processes and ensuring that racist gatekeeping mechanisms are removed, while also requiring senior-level administrators to have training in racial justice ideologies and praxes. Building equity ethics into STEM higher education is essential to creating a more just and equitable STEM ecosystem.
Evaluating Risk Prediction with Data Collection Costs: Novel Estimation of Test Tradeoff Curves
Authors: Baker Stuart G. 
Published: November 2023

Background The test tradeoff curve helps investigators decide if collecting data for risk prediction is worthwhile when risk prediction is used for treatment decisions. At a given benefit-cost ratio (the number of false-positive predictions one would trade for a true positive prediction) or risk threshold (the probability of developing disease at indifference between treatment and no treatment), the test tradeoff is the minimum number of data collections per true positive to yield a positive maximum expected utility of risk prediction. For example, a test tradeoff of 3,000 invasive tests per true-positive prediction of cancer may suggest that risk prediction is not worthwhile. A test tradeoff curve plots test tradeoff versus benefit-cost ratio or risk threshold. The test tradeoff curve evaluates risk prediction at the optimal risk score cutpoint for treatment, which is the cutpoint of the risk score (the estimated risk of developing disease) that maximizes the expected utility of risk prediction when the receiver-operating characteristic (ROC) curve is concave. Methods Previous methods for estimating the test tradeoff required grouping risk scores. Using individual risk scores, the new method estimates a concave ROC curve by constructing a concave envelope of ROC points, taking a slope-based moving average, minimizing a sum of squared errors, and connecting successive ROC points with line segments. Results The estimated concave ROC curve yields an estimated test tradeoff curve. Analyses of 2 synthetic data sets illustrate the method. Conclusion Estimating the test tradeoff curve based on individual risk scores is straightforward to implement and more appealing than previous estimation methods that required grouping risk scores. Highlights The test tradeoff curve helps investigators decide if collecting data for risk prediction is worthwhile when risk prediction is used for treatment decisions. At a given benefit-cost ratio or risk threshold, the test tradeoff is the minimum number of data collections per true positive to yield a positive maximum expected utility of risk prediction. Unlike previous estimation methods that grouped risk scores, the method uses individual risk scores to estimate a concave ROC curve, which yields an estimated test tradeoff curve.
On the Relationship between the Money Rate of Interest and Aggregate Investment Spending
Authors: İnal Vedit 
Published: November 2023

Careful observers had already pointed out before the capital theory controversies that an investment demand schedule inversely responsive to the rate of interest is theoretically untenable. This implies that the weak empirical evidence showing the negative relation between aggregate investment spending and the rate of interest cannot be explained via the neoclassical investment theory. Assuming a short-run framework and concentrating on the “Sources and Uses of Funds Account,” it is shown here that the inverse relationship between the two variables derives, not from the investment demand function, but from the ability to finance investment spending. The explanation is valid only in the short run. In the long run, aggregate investment spending may rise, fall, or remain constant in response to a change in the rate of interest. JEL Classification: B51, E11, E22, G31
The Expanded Child Tax Credit: Impacts on Food Insufficiency Across Demographic Subgroups in the United States
Authors: Adrangi Bahram , Barnes William , Berning Derek 
Published: November 2023

We investigate the association of the Child Tax Credit (CTC) program with food insufficiency and related anxieties among families with incomes below $35000. Analyzing the US Census Bureau’s Household Pulse Survey data, our xtprobit specification and estimation reveals the disparate impact of the CTC across demographic and racial divides, a departure from previous work. Subgroup analyses reveal that the final two CTC installments disproportionately benefited Hispanic households and those earning under $25000/year while producing no significant decrease in food insufficiency for black households or those earning $25000–$35000/year. The study indicates that the expanded CTC’s reduction of low-income households’ food insufficiency persisted across the program’s duration. Thus, the expansion achieved its intended purpose by helping to buffer low-income families against the fallout of the disrupted pandemic economy—an important result to keep in mind as policy makers continue to consider modifications to the CTC that improve efficacy and equity. JEL Codes: A12, A13, A14
A Community-Based Study of Cognitive Impairment Caregiving Outcomes Pre- and During the COVID-19 Pandemic
Authors: Khan Noreen , Malingagio Amanda , Briceño Emily M. , Mehdipanah Roshanak , Lewandowski-Romps Lisa , Heeringa Steven G. , Garcia Nelda , Levine Deborah A. , Langa Kenneth M. , Gonzales Xavier F. , Morgenstern Lewis B. 
Published: November 2023

The impact of the COVID-19 pandemic on informal caregiving was examined in a Mexican American (MA) and Non-Hispanic White (NHW) population-based cohort. 395 participants age > 65 years were recruited via door-to-door and phone recruitment as part of the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C) project. Both recipients and caregivers answered questions regarding the recipient’s health and the COVID-19 pandemic. 15% of caregivers saw their caregiving recipient less than before the pandemic and 18% saw their recipient more than before. 55% of caregivers reported a slight to severe impact of the pandemic on their caregiving, and 45% reported no impact. For most caregivers, their caregiving role did not change markedly during the pandemic. MA and NHW caregivers had similar survey responses.
Examination of Maternal Allostatic Load Among Postpartum Women With Distinct Postpartum Symptom Typologies
Authors: Scroggins Jihye Kim , Yang Qing , Dotters-Katz Sarah K. , Brandon Debra , Reuter-Rice Karin 
Published: November 2023

Background An increased allostatic load (cumulative physiologic wear and tear of the body) can lead to adverse health outcomes. Symptom experiences are known to influence allostatic load. Yet, the relationships between postpartum symptom typologies and maternal allostatic load remain unknown. Methods We used Community Child Health Network data and included participants with allostatic load data at 6, 12, or 24 months postpartum. Bivariate and multivariate analyses were conducted to examine associations between postpartum symptom typologies and (a) overall allostatic load, (b) allostatic load subscales for body systems (neuroendocrine, cardiovascular, metabolic, and inflammatory), and (c) individual biomarkers within the subscale. Results Overall allostatic load at 12 months postpartum was different by symptom typologies before ( p = .042) and after adjusting for confounders ( p = .029). Postpartum women in typology 5 ( high overall) had the highest adjusted overall allostatic load (M = 4.18, SE = .27). At 12 months, adjusted allostatic load for the cardiovascular subscale was higher in typologies 3 ( moderate-high sleep symptoms, M = 1.78, SE = .13) and 5 ( high overall, M = 1.80, SE = .17). Within the cardiovascular subscale, those in typology 3 had higher adjusted odds for a clinically significant level of pulse rate (aOR = 2.01, CI = 1.22, 3.31). Conclusion Postpartum women who experienced high symptom severity across all symptoms (typology 5) at 6 months had higher overall allostatic load at 12 months postpartum. Typologies 3 and 5 had the highest symptom severity in sleep-related symptoms and higher cardiovascular subscale scores. Postpartum symptom management should target symptom burden in an effort to reduce allostatic load thereby improving postpartum women’s health outcomes.
Cardioprotection of Water Spinach (Ipomoea aquatica), Wood Apple (Limonia acidissima) and Linseed (Linum usitatissimum L.) on Doxorubicin-Induced Cardiotoxicity and Oxidative Stress in Rat Model
Authors: Mukta Maisha Majid , Hossain Md. Jamal , Akter Mousumi , Banik Badhan , Mithun MD. Mahbub Zaman , Sarwar Sneha , Arefin Md. Saidul , Islam Md. Rabiul , Islam Sheikh Nazrul 
Published: November 2023

Objectives: The aim of this study was to investigate the pharmacological efficacy of 3 functional foods (Water spinach, Wood apple, and Linseed) against doxorubicin-induced cardiotoxicity and oxidative stress in rat models. Methods: Twenty-five Wistar Albino rats (male and female) were equally classified into 5 groups. Except for the normal control (NC) group, the animals received 2.5 mg/kg doxorubicin (DOX) intra-peritoneal injection at 48 hours intervals to create a dose of 15 mg/kg overall for 14 days. Simply a standard diet was given to the NC and DOX groups. In the 3 treatment groups such as water spinach (DOX + WS), wood apple (DOX + WA), and linseed (DOX + LS), rats were given 14 gm/day/rat fried water spinach, mashed wood apple, roasted linseed, respectively mixed with regular rat diet at 1:1 ratio. Blood and heart samples were collected by sacrificing all the rats on the last of the experiment day (the 15th day). LDH (lactate dehydrogenase), CK-MB (creatine kinase myocardial band), MDA (malondialdehyde), and SOD (superoxide dismutase) were analyzed. Additionally, histopathological analysis was conducted for final observation. Results: The functional foods were indicated to lower the serum cardiac biomarkers (LDH and CK-MB) as well as stress marker (MDA) significantly ( P < .05) and improved heart function and oxidative stress. However, the change in serum SOD level was noted as statistically insignificant ( P > .05). The biochemical outcomes of the food intervention groups were supported by the histological findings found in those groups. Conclusion: Consuming the investigated foods containing antioxidant phytochemicals may combat cardiac toxicity and oxidative stress. Nonetheless, thorough investigations and clinical monitoring are required to understand these functional foods’ mechanism of action and dose-response effects in treating cardiotoxicity and oxidative stress.
Increasing the Volume of Outpatient Total Joint Arthroplasty Procedures: An Evaluation of a Novel Rapid Recovery Pathway Program Within an Academic Medical Center
Authors: Gebrelul Aaron , Malhotra Shiv , Sigueza Anna L. , Singer Esme , Ast Michael P. , Sheth Neil P. 
Published: November 2023

Background: There has been a national trend toward shifting joint arthroplasty procedures to the outpatient setting. These cases are often performed in freestanding ambulatory surgery centers (ASCs), which are often not accessible to surgeons within academic practices. Purposes: We sought to investigate a novel rapid recovery program used to transition arthroplasty patients to an outpatient-based care system within an academic medical center. Methods: All patients undergoing hip or knee arthroplasty between November 2019 and April 2021 were retrospectively evaluated for their eligibility for a rapid recovery pathway through the Extended Stay Unit (ESU) based on clinical and social criteria. Once admitted, patients were evaluated for whether they were discharged from the unit or if hospital admission was necessary. Results: Out of the 444 patients deemed candidates for the rapid recovery program, 188 patients were admitted to the ESU (42.3%); 18 (9.6%) required inpatient hospital admission, with the majority of these due to failing physical therapy (16; 88.9%). Of the ESU patients who were successfully discharged home, 55 (32.4%) were discharged on postoperative day (POD) 0 and 115 (67.6%) on POD 1 (<23 hours). Conclusion: As total joint arthroplasties shift toward the outpatient setting, surgeons in academic institutions must employ strategies to increase their volume of patient candidates for outpatient procedures. Our retrospective study of prospectively collected data suggests the feasibility of creating a separate rapid recovery unit within the hospital that can be an effective method by which to eventually transition to the ASC setting.
Cemiplimab combined with chemotherapy versus chemotherapy in advanced non-small cell lung cancer: an updated EMPOWER-Lung 3 trial-based cost-effectiveness analysis
Authors: Zhu Gaofeng , Cai Hongfu , Zheng Zhiwei 
Published: November 2023

Objective: Cemiplimab combined with chemotherapy has emerged as a promising treatment option for advanced non-small cell lung cancer (NSCLC). Accordingly, this study has been conducted to evaluate the cost-effectiveness of this combination therapy in comparison to chemotherapy alone from the perspective of the United States healthcare system. Methods: The present study is based on a partitioned survival model developed from clinical data obtained during the 2-year follow-up of the phase III EMPOWER-Lung 3 part 2 trial. The purpose of this investigation is to estimate the 10-year life expectancy and total healthcare costs of patients with advanced NSCLC by leveraging primary outcomes that evaluated costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER).To establish the willingness-to-pay (WTP) threshold for the analysis, a value of $150,000/QALY was adopted. Sensitivity analysis was performed to determine the impact of varying levels of uncertainty on the results of this study. Results: When compared to chemotherapy alone, the addition of cemiplimab to chemotherapy has been demonstrated to result in an incremental gain of 1.593 QALY at an additional cost of $109351.298. This equates to an incremental cost-effectiveness ratio (ICER) of $68644.883/QALY. One-way sensitivity analyses were conducted on the model, which acknowledged the influence of several parameters, such as subsequent costs, the utility of progressive disease, the cost of best supportive care, the cost of cemiplimab per mg, and the utility of progression-free survival on the outcomes. Nonetheless, none of these parameters yielded an ICER lower than the WTP threshold. Conclusions: From the perspective of the United States healthcare system, the utilization of cemiplimab in combination with chemotherapy as a first-line treatment option for NSCLC appears to be a cost-effective approach as compared to using chemotherapy as a standalone therapy.
Cost-effectiveness analysis of serplulimab in combination with cisplatin plus 5-fluorouracil chemotherapy compared to cisplatin plus 5-fluorouracil chemotherapy as first-line treatment for advanced or metastatic esophageal squamous cell carcinoma in China
Authors: Lin Ying-Tao , Zhou Chong-Chong , Xu Kai , Zhang Meng-Die , Li Xin 
Published: November 2023

Background: This study evaluated the cost-effectiveness of serplulimab plus chemotherapy versus chemotherapy alone in treating advanced/metastatic esophageal squamous cell carcinoma (ESCC) within the Chinese health care system. Methods: A partitioned survival model based on ASTRUM-007 trial patient characteristics was developed. Efficacy, safety, and medical/economic data were obtained from the trial and real-world clinical practice. Costs, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs) were calculated for both treatment strategies. Sensitivity, subgroup, and scenario analyses were performed to assess the uncertainty impact. Results: Serplulimab combined with chemotherapy yielded an ICER of US$ 53,538.27/QALY. Deterministic sensitivity analysis identified patient survival and serplulimab price as influential parameters. Probabilistic sensitivity analysis showed a 47.33% probability of cost-effectiveness at a willingness-to-pay (WTP) threshold of US$ 53,541/QALY and 0.05% at three times China’s GDP per capita. Subgroup analysis revealed that patients with a programmed death-ligand 1 (PD-L1) expression combined positive score (CPS) ⩾10 had a lower hazard ratio (0.59) and ICER (US$ 29,935.23/QALY), with a 95.36% probability of cost-effectiveness. Scenario analysis demonstrated that the drug donation discount policy significantly increased the likelihood of cost-effective serplulimab-chemotherapy combinations in Jiangsu, Fujian, and Guangdong at 99.99%, 99.90%, and 94.16%, respectively. Conclusion: Compared to chemotherapy alone, serplulimab combined with chemotherapy is currently not a cost-effective first-line treatment for advanced/metastatic ESCC in China. However, as serplulimab plus chemotherapy regimens evolve and price competition among programmed death 1 (PD-1) inhibitors intensifies, this combination may become a cost-effective treatment option.