bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating inequalities in HIV testing in sub-Saharan Africa: spatial analysis of cross-sectional population-based surveys in 25 countries
Authors: Ante-Testard Pearl Anne , Carrasco-Escobar Gabriel , Benmarhnia Tarik , Temime Laura , Jean Kévin 
Published: December 2023

ObjectivesWe aim to explore spatial variations in socioeconomic inequalities in HIV testing uptake in sub-Saharan Africa (SSA) at different geographical scales to identify potential geographical hotspots of inequalities. Additionally, to evaluate the potential benefits of HIV testing programmes, we assess whether local levels of HIV testing match the local levels of HIV prevalence.DesignA multi-country analysis of population-based cross-sectional surveys in SSA.SettingWe analysed data from 25 SSA countries with Demographic and Health Surveys between 2011 and 2019.ParticipantsCountry-level analysis included 473 775 participants (312 104 women and 161 671 men) and cluster-level analysis included 328 283 individuals (241 084 women and 87 199 men). Women aged 15–49 years and men aged 15–54/59 years in selected households who were tested for HIV in the last 12 months were eligible. We quantified inequalities in self-reported recent HIV testing with the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) across geographical scales to capture sex-specific within-country spatial variations. We also conducted local Getis-Ord Gi* statistics to consider the autocorrelation in fine-scale SII and RII across countries. To assess the efficiency of HIV testing programmes, we measured the correlation between recent HIV testing and HIV prevalence through Spearman correlation across geographical scales.ResultsWe observed varying inequalities in recent HIV testing in magnitude and spatial distribution on both absolute and relative scales in many countries for both sexes at national and subnational levels. Hotspots of absolute and relative inequalities were mostly observed in Western and Central Africa with a few regions in Eastern and Southern Africa. Despite significant sex-specific correlations between testing and prevalence in all countries when assessed at the national level, we report an absence of such a correlation at fine scale in 17 of 50 sex-country combinations.ConclusionsWe highlight the importance of investigating the spatial variability of various HIV indicators and related inequalities across different geographical levels. Results may help inform an equitable distribution of HIV testing services.
Estimated effect of age of marriage on utilisation of India’s Integrated Child Development Service programme
Authors: Rai Rajesh Kumar , Bromage Sabri 
Published: December 2023

BackgroundAge of marriage among women is considered an important indicator of their readiness for familial integration and parenting. This study estimated the effect of age of marriage of young mothers (aged 15–24 years) on utilisation of various services for their children, provided under the Integrated Child Development Service (ICDS) programme in India.MethodsData from the nationally representative 2019–2021 National Family Health Survey of India were analysed. Mothers’ age of menarche was used as an instrumental variable to isolate the effect of age of marriage on whether their children received (1) food, (2) health check-up, (3) immunisation, (4) early childhood care or preschooling or (5) weight measurement services from ICDS.ResultsNationally, 67.9% (95% CI 67.6%, 68.3%) of children received food (sample: 60 578), 61.8% (95% CI 61.4%, 62.1%) received a health check-up (sample: 60 316), 60.0% (95% CI 59.6%, 60.4%) received immunisation services (sample: 60 537), 52.0% (95% CI 51.6%, 52.4%) received early childhood care or preschooling (sample: 60 458) and 62.9% (95% CI 62.5%, 63.3%) received weight measurement services (sample: 60 278). Findings from instrumental variable analysis suggest that a 1-year increase in age of marriage could yield a 9 percentage point increase (95% CI 4%–13%; p<0.001) in utilisation of immunisation services. Although postponement of marriage positively affected utilisation of each of the other four ICDS components, these effects were not statistically significant.ConclusionPostponing age of marriage among young women is an effective intervention for promoting uptake of child immunisation services. Our findings support the Government of India’s 2021 Bill to raise legal age of marriage of women.
Implementation of a novel thoracostomy tube trainer with real-time feedback
Authors: Hegde Shruti , Hofman Emily , Dubagunta Sruthi , Awad Daniel , Khan Omar , Eisaman Kraigen , Hossain Ifti , Walker James , Sherman Bradley , Kadakia Yash , Najjar Alex , Park Caroline 
Published: December 2023

ObjectivesSimulation-based training leads to improved clinical performance but may be influenced by quality and frequency of training. Within simulation training, chest tube insertion remains a challenge as one of the main pitfalls of insertion is a controlled pleural entry. This study evaluates the efficacy of a novel training model with real-time pressure monitoring, the average force to pleural entry in a model and the utility of audio and visual feedback.MethodsThis proprietary training model comprised a modified Kelly clamp device with three force sensors at the index finger (sensor 1) and two finger loops (sensors 2 and 3), and a manikin with a replaceable chest wall pad. Standard force values (Newtons (N)) were obtained by experts; expert data revealed that 3–5 s was an acceptable time range to complete the chest tube insertion. Participant level ranged from Post-graduate Year (PGY)-1 to PGY-6 with 13 total participants. Each individual was provided an introduction to the procedure and chest tube trainer. Force (N) and time (ms) measurements were obtained from entry through dermis to pleural space puncture. A significant pressure drop suggested puncturing through the chest wall (completion of the procedure).ResultsForce data were captured during each phase of the procedure—linear, plateau, and drop. Linear phase (~3000 ms) was from start of procedure to point of maximum force (<30 N). Plateau phase was from maximum force to just before a drop in pressure. Drop phase was a drop in pressure by 5+ N in a span of 150 ms signaling completion of procedure. All participants were able to complete the task successfully. Force for pleural entry ranged from 17 N to 30 N; time to pleural entry ranged from 7500 to 15 000 ms. There was variability in use of all three sensors. All participants used the index sensor, however there was variability in the use of the loop sensors depending on the handedness of the participant. Left-handed users relied more on sensors 1 and 3 while right-handed users relied more on sensors 1 and 2. Given this variability, only force measurements from sensor 1 were used for assessment.ConclusionsThis novel force-sensing chest tube trainer with continuous pressuring monitoring has a wide range of applications in simulation-based training of emergency surgical tasks. Next steps include evaluating its impact on accuracy and efficiency. Applications of real-time feedback measuring force are broad, including vascular access, trocar placement and other common procedures.Level of evidenceLevel IV, prospective study.
Field test on cross-sectional behaviors of a retaining energy pile subjected to horizontal loads
Authors: Zhou Yang , Kong Gangqiang , Li Junjie 
Published: December 2023

Energy piles may be utilized for retaining structures, embankment reinforcements, and building foundations on a slope. In this study, a field test of a retaining energy pile subjected to horizontal loads has been carried out. The pile was subjected to thermal and thermo-mechanical loads before and after a pit excavation of 6 m deep, respectively. The non-uniform thermal and mechanical response at the cross-section due to heating and horizontal-load-induced bending has been recorded. A simplified mechanism of the normal strain and stress at the pile cross-section was introduced to infer the thermo-mechanical behavior of the energy pile. The results show that the restraint of the retaining pile markedly decreased at the depth of 1.5 and 4.0 m under the thermo-mechanical loads, compared to the case subjected to thermal load only. The bending behaviors (bending moment and horizontal displacement) indicate that there is a 10%–15% increase in bending moment when the energy pile was heated after the pit excavation. This effect needs to be considered at the most unfavorable section position. A possible positive effect is that heating up is beneficial for reducing the risk of tensile crack at the pile section due to the thermal compressive stress.
Lifetime measurement of excited states in $$^{116}$$Xe
Authors: Lakenbrink Casper-David , Beckers Marcel , Blazhev Andrey , Dewald Alfred , Dunkel Felix , Esmaylzadeh Arwin , Fransen Christoph , Jolie Jan , Knafla Lukas , Müller-Gatermann Claus , von Spee Franziskus , Zell Karl-Oskar 
Published: December 2023

AbstractLifetimes of excited states in $$^{116}$$

116

Xe were measured using the recoil-distance Doppler-shift technique. Excited $$^{116}$$

116

Xe nuclei were populated in the fusion-evaporation reaction $$^{102}$$

102

Pd($$^{16}$$

16

O,2n)$$^{116}$$

116

Xe. Lifetimes of the 2$$^+_1$$

1
+

and 4$$^+_1$$

1
+

states were evaluated using the differential decay-curve method with $$\gamma $$
γ
-$$\gamma $$
γ
-coincidence data as well as lifetimes of the 6$$^+_1$$

1
+

and 7$$^-_1$$

1
-

states using simulations of spectra considering Doppler-shift attenuation effects.
Teleparallel bigravity
Authors: Blixt Daniel , Hohmann Manuel , Koivisto Tomi , Marzola Luca 
Published: December 2023

AbstractWe write down the teleparallel equivalent to Hassan–Rosen bigravity, which is written using a torsionful but curvature-free connection. The theories only differ by a boundary term. The equivalence was proven, both by using perturbation theory and Hamiltonian analysis. It is further shown how one can construct novel bigravity theories within the teleparallel framework. Some of those are analyzed through perturbation theory, and it is found that all of the considered novel bigravity theories suffer from pathologies. In particular, it is found that a construction with two copies of new general relativity leads to ghostly degrees of freedom which are not present in the single tetrad teleparallel corresponding theory. We demonstrate how the teleparallel framework allows to easily create theories with derivative interaction. However, it is shown through perturbation theory that the simplest model is not viable. Furthermore, we demonstrate some steps in the Hamiltonian analysis of teleparallel bigravity with two copies of new general relativity and some toy models. The results rule out some of the novel teleparallel bigravity theories, but also demonstrate techniques in perturbation theory and Hamiltonian analysis which could be further used for more profound theories in the future.
Multiple gravity laws for human mobility within cities
Authors: Kwon Oh-Hyun , Hong Inho , Jung Woo-Sung , Jo Hang-Hyun 
Published: December 2023

AbstractThe gravity model of human mobility has successfully described the deterrence of travels with distance in urban mobility patterns. While a broad spectrum of deterrence was found across different cities, yet it is not empirically clear if movement patterns in a single city could also have a spectrum of distance exponents denoting a varying deterrence depending on the origin and destination regions in the city. By analyzing the travel data in the twelve most populated cities of the United States of America, we empirically find that the distance exponent governing the deterrence of travels significantly varies within a city depending on the traffic volumes of the origin and destination regions. Despite the diverse traffic landscape of the cities analyzed, a common pattern is observed for the distance exponents; the exponent value tends to be higher between regions with larger traffic volumes, while it tends to be lower between regions with smaller traffic volumes. This indicates that our method indeed reveals the hidden diversity of gravity laws that would be overlooked otherwise.
Blood Pressure Trajectories Through the First Year Postpartum in Overweight or Obese Individuals Following a Hypertensive Disorder of Pregnancy
Authors: Hauspurg Alisse , Bryan Samantha , Jeyabalan Arun , Davis Esa M. , Hart Renee , Shirriel Jada , Muldoon Matthew F. , Catov Janet M. 
Published: December 2023

BACKGROUND:
Hypertensive disorders of pregnancy are associated with cardiovascular disease; however, patterns of blood pressure (BP) recovery are understudied. We compared pregnancy and postpartum BP trajectories among individuals with hypertensive disorders of pregnancy who developed persistent hypertension at 1-year postpartum compared with individuals with normalization of BP.

METHODS:
We used data from a randomized clinical trial of individuals with overweight, obesity, and hypertensive disorders of pregnancy conducted in the first year after delivery. Pregnancy BPs were obtained during prenatal visits; postpartum BPs were prospectively obtained through home monitoring. Demographic characteristics and trajectories were compared by hypertensive status (systolic BP ≥130 mm Hg, diastolic BP ≥80 mm Hg, or use of antihypertensive medications) at 1 year. We used repeated BP measures to fit separate mixed-effects linear regression models for pregnancy and postpartum using restricted cubic splines.

RESULTS:

We included 129 individuals; 75 (58%) individuals progressed to hypertension by 1-year postpartum. Individuals with hypertension were older, delivered at earlier gestational ages, and had higher body mass index at 1-year postpartum compared with those with normalization. Individuals with hypertension had similar BP trajectories during pregnancy to those with BP normalization but a significantly different BP trajectory (
P
<0.01 for systolic and diastolic BPs) in the first year postpartum. These differences persisted in multivariable models after adjustment for early pregnancy body mass index, age, and severity of hypertensive disorder of pregnancy (
P
<0.01 for systolic and diastolic BPs).

CONCLUSIONS:
BP trajectories in the first year postpartum, but not during pregnancy, may provide important information for risk stratification after a hypertensive disorder of pregnancy.

REGISTRATION:

URL:
https://clinicaltrials.gov
; Unique identifier: NCT03749746.
Health System Integration and Cancer Center Access for Rural Hospitals
Authors: Amu-Nnadi Chimaraije N. , Ross Elizabeth S. , Garcia Natalie H. , Duncan Zoey N. , Correya Tanya A. , Montgomery Kelsey B. , Broman Kristy K. 
Published: December 2023

Background Cancer centers provide superior care but are less accessible to rural populations. Health systems that integrate a cancer center may provide broader access to quality surgical care, but penetration to rural hospitals is unknown. Methods Cancer center data were linked to health system data to describe health systems based on whether they included at least one accredited cancer center. Health systems with and without cancer centers were compared based on rural hospital presence. Bivariate tests and multivariable logistic regression were used with results reported as P-values and odds ratios (OR) with 95% confidence intervals (CIs). Results Ninety percent of cancer centers are in a health system, and 72% of health systems (434/607) have a cancer center. Larger health systems ( P = .03) with more trainees ( P = .03) more often have cancer centers but are no more likely to include rural hospitals (11% vs 6%, P = .43; adjusted OR .69, 95% CI .28-1.70). The minority of cancer centers not in health systems (N = 95) more often serve low complexity patient populations ( P = .02) in non-metropolitan areas ( P = .03). Discussion Health systems with rural hospitals are no more likely to have a cancer center. Ongoing health system integration will not necessarily expand rural patients’ access to surgical care under existing health policy infrastructure and incentives.
Poverty Changes Among Regions of Uttar Pradesh: A Decomposition Exercise During the 2000s
Authors: Sahoo Priyabrata , Singh Manish Kumar , Pathak D. C. 
Published: December 2023

This article examines the disparities in poverty among the regions of Uttar Pradesh during the 2000s through a poverty decomposition exercise. While the poverty reduction from 2004–2005 to 2011–2012 is faster in the northern and southern upper Ganga plain, the reduction is slower in the eastern and southern regions. The poverty headcount ratio increases for the central region. While eastern and southern regions have higher real Monthly Per Capita Expenditure (MPCE) growth than the state average, the lower poverty elasticity in these regions caused slower poverty reduction. The southern and northern upper Ganga plain have high poverty elasticity causing a faster poverty reduction. This study finds that Uttar Pradesh’s central region faces a critical problem with increased Head-Count Ratio and declining MPCE. The differential change in poverty among the regions has also been analysed using the occupational pattern and landholding distribution among regions, both rural and urban areas. JEL Codes: R32, R11, R12
Identifying the Risk Factors of Suicidal Ideation in Patients With Hematologic Malignancies Using a Multidimensional Approach
Authors: Kim Junglyun , Gang Moonhee 
Published: December 2023

Background: Patients with hematologic malignancies have a 3.5-fold higher rate of suicide completion than the noncancer population, and the Hodgkin lymphoma has the highest suicide rate among all cancers. Although the risk factors for suicidal ideation among the cancer population are well-known, the specific risk factors contributing to the high suicide rate among patients with hematologic malignancies are elusive. Objective: This study aimed to identify the risk factors for suicidal ideation among patients with hematologic malignancies using a multidimensional approach. Methods: This was a cross-sectional, observational study. A total of 163 patients were recruited from the oncology department of a university hospital. We collected data on psychological and physical symptoms, social support, and suicidal ideation using the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, and the Suicidal Ideation Scale. Multiple regression analysis was performed using SPSS (version 26.0) to analyze the clinical data. Results: Among the 163 participants, 96 (58.9%) were male, 57 (35%) were diagnosed with acute leukemia, and 97 (59.5%) received chemotherapy. The mean age was 55.26 ± 15.75. Physical symptoms, psychological symptoms, and willingness to use mental health services accounted for 39.5% of suicidal ideation cases. Conclusions: Assessment of psychological conditions at the beginning of diagnosis, provision of appropriate interventions throughout treatment, and follow-up care to relieve psychological symptoms should be initiated in patients with hematologic malignancies to prevent suicide.
Pleurodesis using OK-432 for persistent pleural effusion after cardiac surgery in the neonatal period or early infancy
Authors: Nakata Tomohiro , Tachi Maiko , Yasuda Kenji , Nakashima Shigeki , Ikeda Tadashi , Minatoya Kenji , Oda Teiji 
Published: December 2023

Objective To evaluate the efficacy of pleurodesis using OK-432 after cardiac surgery in the neonatal period or early infancy. Methods We retrospectively reviewed the data of 11 consecutive patients who underwent cardiac surgery in the neonatal period or early infancy and pleurodesis using OK-432 for persistent postoperative pleural effusion in two institutions. Results The median age at surgery was 8 days (interquartile range [IR], 2–18) with a body weight of 2.84 kg (IR, 2.30–3.07). The maximum amount of pleural drainage before pleurodesis was 94.7 (IR, 60.2–107.7) ml/kg/day. Pleurodesis was initiated at postoperative day 20 (IR, 17–22) and performed in bilateral pleural spaces in seven patients and unilateral in four. The median numbers of injection were 4 (IR, 3–6) times per patient and 3 (IR, 2–3) times per pleural space. In 10 patients, pleural effusion was decreased effectively, and drainage tubes were removed without reaccumulation within 15 (IR, 12–28) days after initial pleurodesis. However, in one patient, with severe lymphedema, pleural effusion was uncontrollable, resulting in death due to sepsis. Adverse events were observed in nine patients; temporal deterioration of lung compliance and arterial blood gas occurred in two, insufficient drainage requiring new chest tube(s) in five, temporal atrial tachyarrhythmia in one, and lymphedema in four. Conclusions Pleurodesis using OK-432 is effective and reliable for persistent postoperative pleural effusion in neonates and early infants. Most of the complications, which derived from inflammatory reactions, were temporary and controllable. However, severe lymphedema is difficult to control.
Impaired serotonin synthesis in hippocampus of murine lupus represents an early neuropsychiatric event
Authors: Nikolopoulos Dionysis , Nakos-Bimpos Modestos , Manolakou Theodora , Polissidis Alexia , Boumpas Dimitrios T 
Published: December 2023

Background Despite significant progress in understanding the mechanisms underlying hippocampal involvement in neuropsychiatric systemic lupus erythematosus (NPSLE), our understanding of how neuroinflammation affects the brain neurotransmitter systems is limited. To date, few studies have investigated the role of neurotransmitters in pathogenesis of NPSLE with contradictory results. Methods Hippocampal tissue from NZB/W-F1 lupus-prone mice and age-matched control strains were dissected in both pre-nephritic (3-month-old) and nephritic (6-month-old) stages. High-Performance Liquid Chromatography (HPLC) was used to evaluate the level of serotonin (5-HT), dopamine (DA), and their metabolites 5-HIAA and DOPAC, respectively, in mouse hippocampi. Results Lupus mice exhibit decreased levels of serotonin at the early stages of the disease, along with intact levels of its metabolite 5-HIAA. The 5-HT turnover ratio (5-HIAA/5-HT ratio) was increased in the hippocampus of lupus mice at pre-nephritic stage suggesting that low hippocampal serotonin levels in lupus are attributed to decreased serotonin synthesis. Both DA and DOPAC levels remained unaffected in lupus hippocampus at both early and late stages. Conclusion Impaired hippocampal serotonin synthesis in the hippocampus of lupus-prone mice represents an early neuropsychiatric event. These findings may have important implications for the use of symptomatic therapy in diffuse NPSLE.