bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring communication and implementation challenges of the HIV/AIDS policy change to test-and-treat-all in selected public health facilities in Lusaka District, Zambia
Authors: Simooya Constance , Silumbwe Adam , Halwindi Hikabasa , Zulu Joseph Mumba , Nzala Selestine 
Published: May 2023

Abstract
Background
The World Health Organization has promoted a shift towards the test-and-treat-all strategy to accelerate the elimination of HIV/AIDS. Zambia was one of the early African countries to adopt this strategy as the policy change was officially announced on national television by the republican president on 15th August 2017. This study explored the communication and implementation challenges of the HIV/AIDS policy change to test-and-treat-all in selected public health facilities in Lusaka District, Zambia.

Methods
A qualitative case study design was employed with a purposeful sample of policy makers, international partners, National AIDS Council representatives, health facility managers, and frontline health providers in selected tertiary, secondary and primary health facilities in the Lusaka District, Zambia. Thematic data analysis was performed using NVivo 12 Pro software.

Results
In total, 22 key informant interviews and 3 focus group discussions were conducted. The government relied on formal and informal channels to communicate the test-and-treat-all policy change to health providers. Whilst HIV policy changes were reflected in the National HIV/AIDS Strategic Framework, there was little awareness of this policy by the frontline providers. The use of informal communication channels such as verbal and text instructions affected health providers’ implementation of the test-and-treat-all. Electronic and print media were ineffective in communicating the test-and-treat-all policy change to some sections of the public. Top-down stakeholder engagement, limited health worker training, and poor financing negatively affected the implementation of the test-and-treat-all policy change. Acceptability of the test-and-treat-all policy change was shaped by positive provider perceptions of its benefits, limited sense of policy ownership, and resistance by the non-treatment-ready patients. Furthermore, unintended consequences of the test-and-treat-all policy change on human resources for health and facility infrastructure were reported.

Conclusion
Effective test-and-treat-all policy change communication is vital for successful policy implementation as it enhances interpretation and adoption among health providers and patients. There is a need to enhance collaboration among policy makers, implementers and the public to develop and apply communication strategies that facilitate the adoption of the test-and-treat-all policy changes to sustain gains in the fight against HIV/AIDS.
A heuristic model to evaluate the dielectric properties of human tissues at microwave band based on water and solid content
Authors: Tannino Marco , Mangini Fabio , Dinia Lorenzo , Frezza Fabrizio 
Published: May 2023

AbstractAt the molecular level, the body is composed, on average, of water for 62%, fat for 15%, 17% of protein, and 6% of minerals. In this work, we propose a heuristic methodology using hydration models as a base to realize an automatic and noninvasive procedure to estimate an ad hoc map of the complex dielectric permittivity of a generic human tissue in the frequency range of microwaves based on their solid and water content.
COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms
Authors: Vakani Krupa , Ratto Martina , Sandford-James Anna , Antonova Elena , Kumari Veena 
Published: May 2023

Abstract

Background
There is increasing evidence for cognitive function to be negatively impacted by COVID-19. There is, however, limited research evaluating cognitive function pre- and post-COVID-19 using objective measures.

Methods
We examined processing speed, attention, working memory, executive function and memory in adults (≤69 years) with a history of COVID-19 (n = 129, none acutely unwell), compared to those with no known history of COVID-19 (n = 93). We also examined cognitive changes in a sub-group of COVID (n = 30) and non-COVID (n = 33) participants, compared to their pre-COVID-19 pandemic level.

Results
Cross-sectionally, the COVID group showed significantly larger intra-individual variability in processing speed, compared to the non-COVID group. The COVID sub-group also showed significantly larger intra-individual variability in processing speed, compared to their pre-COVID level; no significant change occurred in non-COVID participants over the same time scale. Other cognitive indices were not significantly impacted in the cross-sectional or within-subjects investigations, but participants (n = 20) who had needed hospitalisation due to COVID-19 showed poor attention and executive function relative to those who had not required hospitalisation (n = 109). Poor health and long-COVID symptoms correlated with poor cognitive function across domains in the COVID group.

Conclusions
The findings indicate a limited cognitive impact of COVID-19 with only intra-individual variability in processing speed being significantly impacted in an adult UK sample. However, those who required hospitalisation due to COVID-19 severity and/or experience long-COVID symptoms display multifaceted cognitive impairment and may benefit from repeated cognitive assessments and remediation efforts.
Two Bigamists in Tehuantepec: Global(ized) Itineraries in Southern Mesoamerica, circa 1600
Authors: Matthew Laura 
Published: May 2023

AbstractThis article compares the itineraries of two men—one European, one Mesoamerican—accused of bigamy at the turn of the seventeenth century. While the European repeatedly remade his life in new locales, the Mesoamerican returned to the same places time and again, revealing a pattern of circular migration by multilingual Oaxacans along the southern Pacific coast. The European's travels enabled his manipulation of the Spanish Inquisition, while the Mesoamerican's expanding social geography became his undoing. Reading these two cases in tandem pushes us beyond their apparent similarities, a product of their framing by the Spanish Catholic legal system, and toward their profound incommensurability despite overlaps of time, place, and circumstance.
“Betwixt Ye Two Rivers”: Trafficking and Colonization in Early Seventeenth-Century Saint Christopher
Authors: Schmitt Casey 
Published: May 2023

Abstract
Starting in the mid-sixteenth century, European traffickers frequented the Caribbean in search of ships to plunder and gained access to Spanish America's closed markets by seizing captives and smuggling them into underserved ports. For traffickers, these activities depended on alliances with Kalinago populations in the Lesser Antilles, who allowed traffickers to refit their vessels and trade for food, wood, and water. By the 1620s, this political economy of raiding and smuggling led to the establishment of English and French colonies in the Lesser Antilles, which created new markets for bound captives and deepened regional and intercolonial commercial networks. The Lesser Antilles developed into sites of colonization because of their centrality to networks of raiding and informal trade in the Spanish Caribbean.
Short Circuits and Seizures
Authors: Birla Ritu 
Published: May 2023

Abstract
This essay explores the financialization of liberal governmentality through questions posed by cryptocurrency, especially in its relationship with the monetary coding of the globe since Bretton Woods. Contemporary Global South deployments of crypto foreground political performatives that can be characterized as attempts to short-circuit established global configurations. This modality of speedy bypassing, enabling volatility and seizure, fuels processes of financialization more broadly, which accelerate and shorten circuits of profit making and, in tandem, short-circuit democratic political representation. Crypto magnifies the tension between the semiotics of the social contract among nations moored in rights, and that of currency as a global language. Digital-speculative monetization warns that the social contract, a futures contract for a secure and stable future, may approach the aleatory contract of the futures trade.
Animating Irony
Authors: Samanani Farhan , Crockford Susannah , Knight Daniel M. , Stensrud Craig , Daswani Girish , Tuters Marc , Chaviara Io 
Published: May 2023

AbstractContemporary politics seems to be saturated with irony. In the context of social movements, this creates a perplexing mix of sincerity and insincerity, in which ambivalence and irreverence are coupled with deep conviction and (sometimes deadly) serious action. Writing as a multidisciplinary collective, the authors have witnessed irony playing a crucial role in diverse social movements — from BlackLivesMatter activists in Ghana, to post-crash political imaginaries in Greece, to the Boogaloo Bois in the United States. Across these cases, the authors argue that irony becomes an important means of gathering, orienting, and animating political collectives, in two ways. First, within contexts of deep uncertainty or instability, where it can be extremely hard to trace political cause and effect and to know how to act effectively, irony provides a useful interpretative tool. Irony allows actors to position themselves between competing values, and attend to contradictions, enabling them to imagine common cause and possible futures within a radically unsteady world. Second, irony generates intensities in excess of understanding. Irony can generate surpluses of meaning, cultivate spaces of play and freedom from responsibility, and amplify the felt potentiality of ideas through memetic repetition. Such intensities have the capacity to spill over into decisive action. The authors conclude by unpacking the implications of these ironic forces for engaging in politics today.
Running and Reading RemnantDanweiWalls in China's Postsocialist City
Authors: Wielander Gerda 
Published: May 2023

AbstractBuilt on visual and running/walking ethnography, this article analyzes visual traces left on remnant danwei walls in postsocialist China. The article considers danwei walls as yiji (remnant traces) that serve as loci of political memory and as a medium to host other visual traces by a variety of different actors. Drawing on a range of concepts from cultural studies and visual ethnography, the article provides a close reading of these traces, treating them as important historical documents and examples of how human actors interact with the built environment during China's postsocialist transformation. The article is built around three case studies, each of which captures different stages of the physical decay of the danwei as represented in the materiality of the walls in varying states of (dis)repair and the different nature of the visual traces local actors have left on them. The analysis of traces—understood as signs on the walls as well as the walls themselves—reveals a story of the ways in which humans interact with a very specific part of China's built environment at a moment of transition and of how relationships between these human actors change in the process. The article provides a reading of visual social phenomena, contributing to the understanding of signifying practices in postsocialist urban China.
“Little Tibet”
Authors: Williams-Oerberg Elizabeth 
Published: May 2023

AbstractWith the Chinese invasion of Tibet, exile-Tibetan Buddhist leaders have found new bases for their monastic endeavors in the Himalayan regions of India and Nepal. This article highlights how the northwest Himalayan region of Ladakh has become a homeland for Tibetan-led Buddhism in India. While previously an independent kingdom, Ladakh has been dubbed “Little Tibet” because of its close geographical, political, cultural, and religious association with the central Tibetan empire. Ladakhis themselves promote the region as “Little Tibet” and the “last Shangri-la” to emphasize the identity of the region as Buddhist. In this way, Ladakhis utilize the moral economy of “Tibetanness” as a means for cultural survival, but also to promote tourism and gain the economic benefits of being “Little Tibet.” By highlighting multiple and ongoing processes of Tibetanization, such as historical/political, cultural/religious, and imagined, this article illuminates the complex Ladakhi-Tibetan relations within projects of cultural preservation in India. Ladakhis are not passive recipients of the cultural domination of Tibetan religious leaders in the area; instead they adopt selective processes of Tibetanization to help safeguard their distinct religious and cultural identity as a religious and ethnic minority in India.
Beyond the Lungs: O2 Supplementation Improves Cerebral Oxygenation and Fatigue during Exercise in Interstitial Lung Disease
Authors: MARILLIER MATHIEU , GRUET MATHIEU , BERNARD ANNE-CATHERINE , CHAMPIGNEULLE BENOIT , VERGES SAMUEL , MORAN-MENDOZA ONOFRE , NEDER J. ALBERTO 
Published: May 2023

ABSTRACT

Purpose
Cerebral hypoxia may exacerbate the perception of fatigue. We previously demonstrated that exercise-related hypoxemia, a hallmark of fibrotic interstitial lung disease (f-ILD), dose dependently impairs cerebral oxygenation in these patients. It is unknown whether normalizing cerebral oxygenation with O2 supplementation would be associated with positive changes in a relevant patient-centered outcome during exercise in f-ILD, such as improved perceived fatigue.

Methods
Fourteen patients (12 males, 72 ± 8 yr, 8 with idiopathic pulmonary fibrosis, lung diffusing capacity for carbon monoxide = 44% ± 13% predicted) performed a constant-load (60% peak work rate) cycle test to symptom limitation (Tlim) breathing medical air. Fourteen controls cycled up to Tlim of an age- and sex-matched patient. Patients repeated the test on supplemental O2 (fraction of inspired O2 = 0.41 ± 0.08) for the same duration. Near-infrared spectroscopy and the rating-of-fatigue (ROF) scale assessed prefrontal cortex oxygenation and perceived fatigue, respectively.

Results
Patients showed severe exertional hypoxemia (Tlim O2 saturation by pulse oximetry = 80% ± 8%); they had poorer cerebral oxygenation (e.g., oxy-deoxyhemoglobin difference [HbDiff] = −3.5 ± 4.7 [range = −17.6 to +1.9] vs +1.9 ± 1.7 μmol from rest) and greater fatigue (ROF = 6.2 ± 2.0 vs 2.6 ± 2.3) versus controls under air (P < 0.001). Reversal of exertional hypoxemia with supplemental O2 led to improved HbDiff (+1.7 ± 2.4 μmol from rest; no longer differing from controls) and lower ROF scores (3.7 ± 1.2, P < 0.001 vs air) in patients. There was a significant correlation between O2-induced changes in HbDiff and ROF scores throughout exercise in f-ILD (r
repeated-measures correlation = −0.51, P < 0.001).

Conclusions
Supplemental O2 improved cerebral oxygenation during exercise in f-ILD, which was moderately associated with lower ratings of perceived fatigue. Reversing cerebral hypoxia with O2 supplementation may thus have positive effects on patients’ disablement beyond those expected from lower ventilation and dyspnea in this patient population.
Implementation of vacuum-assisted excision as a management option for benign and high-risk breast lesions
Authors: van de Voort Elles MF , Struik Gerson M. , Birnie Erwin , Sinke Renata HJA , Verver Daniëlle , van Streun Sophie P. , Macco Maura , Verhoef C. , Klem Taco MAL 
Published: May 2023

Objective: Previous studies have shown that vacuum-assisted excision (VAE) is a safe and effective alternative for surgical excision (SE) of benign breast lesions. However, the use of VAE in high-risk lesions is controversial and guidelines are ambiguous. This study describes the impact of the implementation of VAE in terms of management and outcomes compared to a cohort before implementation. Methods: A single centre retrospective study with two cohorts: ‘before’ and ‘after’ implementation of VAE was performed. All patients with a benign or high-risk lesion treated by VAE or SE between 2016 and 2019 were included. Excision, complication, and upgrade rates were compared between both cohorts. Cox regression was used for the evaluation of recurrences and re-excisions. Results: The overall excision rate of all benign and high-risk lesions was comparable in both cohorts (17% vs 16%, p = 0.700). After implementation, benign lesions were significantly more often managed by VAE (101/151, 67%, p < 0.001). Re-excision, recurrence, and complication rates were low and comparable between cohorts (4.3% vs 3.9%, p > 0.999; 3.0 vs 2.0%, p = 0.683; 3.4 vs 6.6%, p = 0.289, respectively). Conclusion: SE could safely be replaced by VAE in 58% of patients treated for a benign or high-risk lesion. With this shift in management, the use of operating rooms and general anaesthesia can safely be omitted in this patient group. Further research on high-risk lesions is warranted since our data are exploratory. Advances in knowledge: This study provides supportive data for the use of VAE as a management option for both benign (up to 5 cm) and high-risk lesions. Outcomes on re-excision, recurrence should be confirmed in prospective studies especially in high-risk lesions.
Factors affecting students’ entrepreneurial intentions and their differences based on gender, tribe, and parents’ occupation: a cross-sectional study
Authors: Hutasuhut Saidun , Thamrin Thamrin , Aditia Reza 
Published: May 2023

Background: This study examines the effect of entrepreneurial knowledge and self-efficacy in increasing entrepreneurial intentions and whether self-efficacy moderates entrepreneurial knowledge's effect on entrepreneurial intentions. Analysis of differences in entrepreneurial intentions based on gender, ethnicity, and parent's occupation. Methods: The data used in this study were collected from a survey conducted by distributing questionnaires electronically to students of the Economics education Study Program, Faculty of Economics, Medan State University semesters 3,5, and 7, totaling 307 and 260 willing to fill in. The analytical test used is the PLS-SEM test, as well as Mann-Whitney and Kruskal Wallis (non-parametric test. This study examines the effect of entrepreneurial knowledge and self-efficacy in increasing entrepreneurial intentions and whether self-efficacy moderates entrepreneurial knowledge's effect on entrepreneurial intentions. Analysis of differences in entrepreneurial intentions based on gender, ethnicity, and parent's occupation. Results: Entrepreneurial knowledge and self-efficacy positively and significantly increased entrepreneurial intentions. Self-efficacy was not proven to act as a moderating variable, and there was no difference in entrepreneurial intentions between genders, tribes and parents’ occupations. Conclusions: This research implies that it is necessary to organize entrepreneurship education with an innovative active approach to increase women's entrepreneurial intentions and reduce gender inequiality in entrepreneurial activities. Further research is needed on the role of culture-based families in preparing their sons and daughters to become entrepreneurs.
Using models and maps to inform Target Product Profiles and Preferred Product Characteristics: the example of Wolbachia replacement
Authors: Tiley Katie , Entwistle Julian , Thomas Bruce , Yakob Laith , Brady Oliver 
Published: May 2023

Background The global prevalence of diseases transmitted by Aedes aegypti mosquitoes, such as dengue, Zika and Yellow Fever, is increasing, but development of promising new mosquito control technologies could reverse this trend. Target Product Profiles (TPPs) and Preferred Product Characteristics (PPCs) documents issued by the World Health Organization can guide the research and development pathways of new products and product combinations transitioning from proof of concept to operational use. Methods We used high resolution global maps of the case and economic burden of dengue to derive programmatic cost targets to support a TPP for Wolbachia replacement. A compartmental entomological model was used to explore how release size, spacing and timing affect replacement speed and acceptability. To support a PPC for a hybrid suppress-then-replace approach we tested whether Wolbachia replacement could be achieved faster, more acceptably or at a lower cost if preceded by a mosquito suppression programme. Results We show how models can reveal trade-offs, identify quantitative thresholds and prioritise areas and intervention strategies for further development. We estimate that for Wolbachia replacement to be deployable in enough areas to make major contributions to reducing global dengue burden by 25% (in line with 2030 WHO targets), cost must ultimately be reduced to between $7.63 and $0.24 (USD) per person protected or less. Suppression, particularly interventions that induce mosquito sterility, can reduce the number of Wolbachia mosquitoes necessary to achieve fixation by up to 80%. A hybrid approach can also achieve fixation faster and potentially improve acceptability, but may not justify their cost if they require major new investments in suppression technologies. Conclusions Here we demonstrate the value dedicated modelling can provide for interdisciplinary groups of experts when developing TPPs and PPCs. These models could be used by product developers to prioritise and shape development decisions for new Wolbachia replacement products.
Tranexamic acid for the prevention of postpartum bleeding in women with anaemia: Statistical analysis plan for the WOMAN-2 trial: an international, randomised, placebo-controlled trial
Authors: Collier Tim , Shakur-Still Haleema , Roberts Ian , Balogun Eni , Olayemi Oladapo , Bello Folasade Adenike , Chaudhri Rizwana , Muganyizi Projestine ,   WOMAN-2 Trial Collaborators
Published: May 2023

Background: Postpartum haemorrhage (PPH) is responsible for over 50,000 maternal deaths every year. Most of these deaths are in low- and middle-income countries. Tranexamic acid (TXA) reduces bleeding by inhibiting the enzymatic breakdown of fibrin blood clots. TXA decreases surgical bleeding and reduces deaths from bleeding after traumatic injury. When given within three hours of birth, TXA reduces deaths from bleeding in women with PPH. However, for many women, treatment of PPH is too late to prevent death. World-wide, over one-third of pregnant women are anaemic and many are severely anaemic. These women have an increased risk of PPH and are more likely to die if PPH occurs. There is an urgent need to identify ways to prevent severe postpartum bleeding in anaemic women. The WOMAN-2 trial will quantify the effects of TXA on postpartum bleeding in women with anaemia. Results: This statistical analysis plan (version 1.0; dated 22 February 2023) has been written based on information in the WOMAN-2 Trial protocol version 2.0, dated 30 June 2022. The primary outcome of the WOMAN-2 trial is the proportion of women with a clinical diagnosis of primary PPH. Secondary outcomes are maternal blood loss and its consequences (estimated blood loss, haemoglobin, haemodynamic instability, blood transfusion, signs of shock, use of interventions to control bleeding); maternal health and wellbeing (fatigue, headache, dizziness, palpitations, breathlessness, exercise tolerance, ability to care for her baby, health related quality of life, breastfeeding); and other health outcomes (deaths, vascular occlusive events, organ dysfunction, sepsis, side effects, time spent in higher level facility, length of hospital stay, and status of the baby). Conclusions: WOMAN-2 will provide reliable evidence about the effects of TXA in women with anaemia. Registration: WOMAN-2 was prospectively registered at the International Standard Randomised Controlled Trials registry (ISRCTN62396133) on 07/12/2017 and ClinicalTrials.gov on 23/03/2018 (NCT03475342).