Knowledge of Tuberculosis, Services of TB Control Programme and Associated Socio-Demographic Inequity among Rural Participants of Jaipur, Rajasthan, India: A Cross Sectional Study

Background: Tuberculosis (TB) is one of the top 10 causes of death worldwide. India is still the highest TB burden country. There is a scarcity of data on TB knowledge from Rajasthan state of India. Objective: The objective of this study was to estimate the prevalence of knowledge about TB and services of TB control programme and to determine its correlates among rural population of Jaipur, Rajasthan. Methods: Cross-sectional community based study was carried out at Model Rural Health Research Unit, Jaipur, a unit of Department of Health Research, Ministry of Health & Family Welfare, Government of India. Results: Study reports the result from 1993 adult participants from 10 villages of 2 sub-districts of district Jaipur. About 88.9% of studied participants knew that TB is an infectious disease and it spreads from TB patient to healthy person in close contact. Only 22.3% of participants knew “DOTS is the treatment for TB”. While, only 58.9% knew “sputum is used for diagnosis of TB” at health centers. Scheduled castes, scheduled tribes and backward classes social groups knew less than the mainstream “General” social group. The observed difference was statistically significant (p 0.05). Logistic regression analysis estimated the relative contribution to knowledge status. Conclusion: The knowledge of study participants on transmission of tuberculosis was similar to knowledge of population in country wide study. They poorly knew sputum is used for diagnosing tuberculosis disease;socio-demographic inequity exists in this knowledge too. People from older age groups, underprivileged social groups and minority need extra educational activities.

Inequity in the global distribution of monkeypox vaccines

Monkeypox(mpox)has been a public health emergency of international concern that emerged in mid-2022 and has spread to 110 countries.The clinical findings of the disease vary according to the seriousness of the cases.Although its case fatality risk has not been high,a significant percentage of patients require hospitalization.In this context,local initiatives were taken to extend the limited supply of vaccines against the disease;however,such measures have not been sufficient to contain the spread of cases and ensure an equitable distribution of health resources.As a result,endemic regions of low-income countries continue to have insufficient access to mpox vaccination.Despite this and considering the global scope of the disease,there is still little discussion in the literature about the difficulties in achieving adequate vaccination coverage rates for the target population of interest.In this article,we briefly discussed general aspects of the disease,including its surveillance,the current global context of challenges for mpox vaccination,and issues on global allocation of health resources as well as proposed related recommendations.

Confronting Inequity in Nigerian Social Milieu： Apprehending Class Stratification in Festus Iyayi＇s Violence

This paper is preoccupied with the delineation of the dialectic of poverty and wealth in Festus Iyayi＇s Violence. The unbridled struggle between the bourgeois and the proletariat in the novel constitutes the onus of the dialectical materialism which underlies an axiomatic focus of societal superstructure. An application of Kenneth Boulding＇s theory of protest to the Nigerian social milieu, poignantly reveals that there is a potent foregrounding of the class stratification between the rich and the poor. The paper will further examine how this dichotomy between the highly placed and the down trodden in the novel has graphically accentuated the poverty index in contemporary Nigeria.

Rethinking Strategies to Address Inequity in Immunization Services towards Achieving Universal Immunization Coverage (UIC) in Karachi, Pakistan

Karachi, the largest city in Pakistan, having high population growth and a complex health care environment, has highest density of unimmunized (zero dose) and under-immunized children. The main reasons of low immunization coverage in Karachi were lack of governance and accountability in a duplicative and fragmented health management structure, weak and inequitable immunization services, and lack of demand and trust among people for immunization services. The Expanded Programme on Immunization (EPI), Ministry of Health (MOH) in Sindh Province spearheaded a structured and collaborative process to develop strategies for addressing inequity in immunization services towards achieving Universal Immunization Coverage (UIC) in Karachi. The process included a situation analysis with gathering quantitative and qualitative information on the root causes of zero-dose and inequity of the immunization services. The strategies and interventions were developed with multi-layer input and feedback of the stakeholders and partners, and focusing primarily to address gaps in three program areas: governance, leadership and accountability;immunization service delivery;and building demand and trust among the people. The interventions were further prioritized for high-risk areas;identified based on maximum number zero-dose children, presence of large slum areas, measles outbreak and on-going circulation of wild poliovirus. Finally, costing for the Roadmap activities was done through consultation with partners and aligning domestic and external (donor) resources. In this paper, we have highlighted the unique process the Sindh Government undertook in collaboration with the stakeholders and partners to develop strategies and interventions for addressing inequity in urban immunization services in Karachi towards achieving Universal Immunization Coverage (UIC). Similar processes can be adapted, as a potential model, for developing strategies to achieve universal health coverage in the cities of Pakistan and in other countries.

Empirical Analysis on Inequity of Rural Tax and Fee Burden Distribution： A Case from Rural Households of China from 1986 to 2000

This paper analyzes the distribution of rural in the eastern, mid and western China and in five income tax and fee burden and income of the rural households groups from the lowest income group to the highest group from 1986 to 1999. After the analyses, the paper thinks that the distribution of tax and fee between the rural households is inequitable whatsoever it is in the different income groups or in the different regions. The higher the income of the rural household is, the lighter the rural tax and fee burden is. The poorer the rural household is, the heavier the tax and fee burden of the rural household is. The more developed the economy of the region is, the less the rural tax and fee burden of rural household is. In the region that the agriculture is the leading industry, the rural tax and fee burden of the rural household is heavier than that in the region that the agriculture is not dominant. All mentioned above show the regressive characters of the agricultural taxation in rural China. At present the distribution of rural tax and fee burden between the rural household is inequitable.

Educational Opportunities and Dimensions in Rich and Poor Nations＂ Rethinking Global Access and the Inequity Question

This paper presents some important facts about educational opportunities and students＇ access worldwide. Specific facts and scenarios are exhibited and provided to compare education opportunities in rich and poor areas in developed and developing countries. Particularly, this paper surveys and compares forces on educational happening in Nigeria and United States. It argues that despite the much acclaimed democratization of access to education, glaring inequalities can be identified in the way educators and how our students are treated. In regards to quantities and quality of educational resources, education is not equally accessed by all students in our today＇s world. This paper, therefore, recommends that human beings should be given equal access and opportunities to education at all levels; and should be treated with respect and dignity in spite of color, religion, or race wherever they find themselves. This becomes an imperative if mankind is to achieve success in the task of propelling students and Educators to greater achievements. As well, this paper recommends that cultural, institutional, and political powers should be deployed to bring about a more equitable world order.

Quantifying the contribution of activity patterns to PM_(2.5)exposure inequity between urban and rural residents by a novel method

PM_(2.5)pollution variations in different microenvironments would result in PM_(2.5)exposure inequity between rural and urban residents.In this study,the real-time PM_(2.5)exposure of urban and rural residents in China was examined based on portable PM_(2.5)sensors together with activity patterns derived from questionnaire surveys,with a focus on students and senior citizens who are sensitive to air pollution.The results showed that PM_(2.5)exposure varied significantly among different resident groups,with higher PM_(2.5)exposure of rural residents than those of urban residents.PM_(2.5)exposure peaks mostly occurred during(Accompanied)cooking activities owing to strong emissions.Sleeping and resting were the main activities that affected PM_(2.5)exposures of different resident groups,accounting for 60.7%-94.5%of total daily exposures.Furthermore,the long duration of sleeping makes it the predominant activity contributing to PM 25 exposure inequity.It is necessary to obtain point-to-point respiratory volume(respiratory rate)data when measuring real-time PM_(2.5)exposure data and incorporate respiratory volume(respiratory rate)into the analysis of PM_(2.5)exposure.For the first time,this study quantified the PM_(2.5)exposure inequality based on a novel method and can provide useful information for further studies on the exposure inequity.

Community-Based Hepatitis B Campaign in Asian Americans

Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in the US, 60% are Asian American. Many are unaware of their status and lack access to proper clinical care, with less than ten percent receiving necessary antiviral treatment. Barriers to screening and care include lack of disease awareness, language and cultural barriers, and financial constraints. Additionally, healthcare providers and systems in the US often overlook the importance of CHB, leading to inadequate care. In response, the Center for Viral Hepatitis (CVH) has implemented a community-based outreach program over the past sixteen years, employing a multifaceted approach involving all sectors of society and various organizations to combat health disparities in CHB. This grassroots campaign has proven highly effective, leveraging CVH’s leadership in spearheading numerous collaborative activities with community members, healthcare professionals, and policymakers. We have summarized the key points of CVH's efforts and their significance in combating CHB-related health disparities. The CHB Screening and Awareness Campaign, tailored to the Asian American community, serves as a successful model for increasing CHB screening, linkage-to-care, and addressing socio-cultural barriers and health literacy. Insights from these outreach programs have guided the development of culturally relevant resources and education initiatives. These findings suggest that such community-driven approaches are essential for addressing health disparities. The strategies and outcomes of CVH’s efforts can inform future health initiatives for other minority communities in the US and globally.

Mapping and measuring urban-rural inequalities in accessibility to social infrastructures

Equal access to social infrastructures is a fundamental prerequisite for sustainable development,but has long been a great challenge worldwide.Previous studies have primarily focused on the accessibility to social infras-tructures in urban areas across various scales,with less attention to rural areas,where inequality can be more severe.Particularly,few have investigated the disparities of accessibility to social infrastructures between urban and rural areas.Here,using the Changsha-Zhuzhou-Xiangtan urban agglomeration,China,as an example,we investigated the inequality of accessibility in both urban and rural areas,and further compared the urban-rural difference.Accessibility was measured by travel time of residents to infrastructures.We selected four types of social infrastructures including supermarkets,bus stops,primary schools,and health care,which were funda-mentally important to both urban and rural residents.We found large disparities in accessibility between urban and rural areas,ranging from 20 min to 2 h.Rural residents had to spend one to two more hours to bus stops than urban residents,and 20 min more to the other three types of infrastructures.Furthermore,accessibility to multiple infrastructures showed greater urban-rural differences.Rural residents in more than half of the towns had no access to any infrastructure within 15 min,while more than 60%of the urban residents could access to all infrastructures within 15 min.Our results revealed quantitative accessibility gap between urban and rural areas and underscored the necessity of social infrastructures planning to address such disparities.

Does digitalization mitigate regional inequalities?Evidence from China

Regional inequality significantly influences sustainable development and human well-being.In China,there exists pronounced regional disparities in economic and digital advancements;however,scant research delves into the interplay between them.By analyzing the economic development and digitalization gaps at regional and city levels in China,extending the original Cobb-Douglas production function,this study aims to evaluate the impact of digitalization on China's regional inequality using seemingly unrelated regression.The results indicate a greater emphasis on digital inequality compared to economic disparity,with variable coefficients of 0.59 for GDP per capita and 0.92 for the digitalization index over the past four years.However,GDP per capita demonstrates higher spatial concentration than digitalization.Notably,both disparities have shown a gradual reduction in recent years.The southeastern region of the Hu Huanyong Line exhibits superior levels and rates of economic and digital advancement in contrast to the northwestern region.While digitalization propels economic growth,it yields a nuanced impact on achieving balanced regional development,encompassing both positive and negative facets.Our study highlights that the marginal utility of advancing digitalization is more pronounced in less developed regions,but only if the government invests in the digital infrastructure and education in these areas.This study's methodology can be utilized for subsequent research,and our findings hold the potential to the government's regional investment and policy-making.

Is it possible to run after positive affective experiences instead of health benefits without tackling social inequalities?

We recently read the opinion piece titled“Why people should run after positive affective experiences instead of health benefits”,which was carried out by Maltagliati et al.^(1)and published in the Journal of Sport and Health Science.The article started an important discussion about a physical activity(PA)promotion approach that encourages the use of affective experience to PA activity.Although we agree with the authors’point of view and believe that its message can generate an important insight for PA promotion,the authors presented a scenario where behavior change seems to be exclusively dependent on the individual.Recognizing the existence of other barriers to an active lifestyle(e.g.,social inequalities)could enhance the authors’suggested approach because many people live in conditions that reduce their opportunities to engage in affective experiences related to PA;furthermore,affective experiences can vary depending on individual context.

Entanglement polygon inequalities for a class of mixed states

The study on the entanglement polygon inequality of multipartite systems has attracted much attention.However,most of the results are on pure states.Here we consider the property for a class of mixed states,which are the reduced density matrices of generalizedW-class states in multipartite higher dimensional systems.First we show the class of mixed states satisfies the entanglement polygon inequalities in terms of Tsallis-q entanglement,then we propose a class of tighter inequalities for mixed states in terms of Tsallis-q entanglement.At last,we get an inequality for the mixed states,which can be regarded as a relation for bipartite entanglement.

Synchronization of Drive-Response Networks With Delays on Time Scales

Dear Editor,This letter deals with the synchronization in drive-response networks with discrete and distributed delays on time scales.Based on the theory of calculus on time scales,Lyapunov functional method and inequality technique,we obtain new sufficient conditions to ensure synchronization criteria which are dependent on boundedness of grainness but independent of the types of delays.Numerical simulations are given to illustrate the effectiveness of our new results.

TOEPLITZ DETERMINANTS IN ONE AND HIGHER DIMENSIONS

In this study,we derive the sharp bounds of certain Toeplitz determinants whose entries are the coefficients of holomorphic functions belonging to a class defined on the unit disk U.Furthermore,these results are extended to a class of holomorphic functions on the unit ball in a complex Banach space and on the unit polydisc in C^(n).The obtained results provide the bounds of Toeplitz determinants in higher dimensions for various subclasses of normalized univalent functions.

STRONGLY CONVERGENT INERTIAL FORWARD-BACKWARD-FORWARD ALGORITHM WITHOUT ON-LINE RULE FOR VARIATIONAL INEQUALITIES

This paper studies a strongly convergent inertial forward-backward-forward algorithm for the variational inequality problem in Hilbert spaces.In our convergence analysis,we do not assume the on-line rule of the inertial parameters and the iterates,which have been assumed by several authors whenever a strongly convergent algorithm with an inertial extrapolation step is proposed for a variational inequality problem.Consequently,our proof arguments are different from what is obtainable in the relevant literature.Finally,we give numerical tests to confirm the theoretical analysis and show that our proposed algorithm is superior to related ones in the literature.

Global prevalence and gender inequalities in at least 60 min of self-reported moderate-to-vigorous physical activity 1 or more days per week:An analysis with 707,616 adolescents

Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.

Understanding the educational inequalities in suicide attempts and their mediators:a Mendelian randomisation study

Background Educational inequalities in suicide have become increasingly prominent over the past decade.Elucidating modifiable risk factors that serve as intermediaries in the impact of low educational attainment on suicide has the potential to reduce health disparities.Aims To examine the risk factors that mediate the relationship between educational attainment and suicide attempts and quantify their contributions to the mediation effect.Methods We conducted a two-sample Mendelian randomisation(MR)analysis to estimate the causal effect of educational attainment on suicide attempts,utilising genome-wide association study summary statistics from the Integrative Psychiatric Research(iPSYCH;6024 cases and 44240 controls)and FinnGen(8978 cases and 368299 controls).We systematically evaluated 42 putative mediators within the causal pathway connecting reduced educational attainment to suicide attempts and employed two-step and multivariable MR to quantify the proportion of the mediated effect.Results In the combined analysis of iPSYCH and FinnGen,each standard deviation(SD)decrease in genetically predicted educational attainment(equating to 3.4 years of education)was associated with a 105%higher risk of suicide attempts(odds ratio(OR):2.05;95%confidence interval(Cl):1.81 to 2.31).0f the 42 risk factors analysed,the two-step MR identified five factors that mediated the association between educational attainment and suicide attempts.The respective proportions of mediation were 47%(95%Cl:29%to 66%)for smoking behaviour,36%(95%Cl:0%to 84%)for chronic pain,49%(95%Cl:36%to 61%)for depression,35%(95%Cl:12%to 59%)for anxiety and 26%(95%Cl:18%to 34%)for insomnia.Multivariable MR implicated these five mediators collectively,accounting for 68%(95%Cl:40%to 96%)of the total effect.Conclusions This study identified smoking,chronic pain and mental disorders as primary intervention targets for attenuating suicide risk attributable to lower educational levels in the European population.

THE WEIGHTED KATO SQUARE ROOT PROBLEMOF ELLIPTIC OPERATORS HAVING A BMOANTI-SYMMETRICPART

Let n≥2 and let L be a second-order elliptic operator of divergence form with coefficients consisting of both an elliptic symmetric part and a BMO anti-symmetric part in ℝ^(n).In this article,we consider the weighted Kato square root problem for L.More precisely,we prove that the square root L^(1/2)satisfies the weighted L^(p)estimates||L^(1/2)(f)||L_(ω)^p(R^(n))≤C||■f||L_(ω)^p(R^(n);R^(n))for any p∈(1,∞)andω∈Ap(ℝ^(n))(the class of Muckenhoupt weights),and that||■f||L_(ω)^p(R^(n);R^(n))≤C||L^(1/2)(f)||L_(ω)^p(R^(n))for any p∈(1,2+ε)andω∈Ap(ℝ^(n))∩RH_(2+ε/p),(R^(n))(the class of reverse Hölder weights),whereε∈(0,∞)is a constant depending only on n and the operator L,and where(2+ε/p)'denotes the Hölder conjugate exponent of 2+ε/p.Moreover,for any given q∈(2,∞),we give a sufficient condition to obtain that||■f||L_(ω)^p(R^(n);R^(n))≤C||L^(1/2)(f)||L_(ω)^p(R^(n))for any p∈(1,q)andω∈A_(p)(R^(n))∩pRH_(q/p),(R^(n)).As an application,we prove that when the coefficient matrix A that appears in L satisfies the small BMO condition,the Riesz transform∇L^(−1/2)is bounded on L_(ω)^(p)(ℝ^(n))for any given p∈(1,∞)andω∈Ap(ℝ^(n)).Furthermore,applications to the weighted L^(2)-regularity problem with the Dirichlet or the Neumann boundary condition are also given.

Existence and numerical approximation of a solution to frictional contact problem for electro-elastic materials

In this paper,a frictional contact problem between an electro-elastic body and an electrically conductive foundation is studied.The contact is modeled by normal compliance with finite penetration and a version of Coulomb’s law of dry friction in which the coefficient of friction depends on the slip.In addition,the effects of the electrical conductivity of the foundation are taken into account.This model leads to a coupled system of the quasi-variational inequality of the elliptic type for the displacement and the nonlinear variational equation for the electric potential.The existence of a weak solution is proved by using an abstract result for elliptic variational inequalities and a fixed point argument.Then,a finite element approximation of the problem is presented.Under some regularity conditions,an optimal order error estimate of the approximate solution is derived.Finally,a successive iteration technique is used to solve the problem numerically and a convergence result is established.

THE LOGARITHMIC SOBOLEV INEQUALITY FOR A SUBMANIFOLD IN MANIFOLDS WITH ASYMPTOTICALLY NONNEGATIVE SECTIONAL CURVATURE

In this note,we prove a logarithmic Sobolev inequality which holds for compact submanifolds without a boundary in manifolds with asymptotically nonnegative sectional curvature.Like the Michale-Simon Sobolev inequality,this inequality contains a term involving the mean curvature.