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.

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.

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.

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.

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.

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.

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.

AGGREGATE SPECIAL FUNCTIONS TO APPROXIMATE PERMUTING TRI-HOMOMORPHISMS AND PERMUTING TRI-DERIVATIONS ASSOCIATED WITH A TRI-ADDITIVEψ-FUNCTIONAL INEQUALITY IN BANACH ALGEBRAS

In this paper,we define a new class of control functions through aggregate special functions.These class of control functions help us to stabilize and approximate a tri-additiveψ-functional inequality to get a better estimation for permuting tri-homomorphisms and permuting tri-derivations in unital C*-algebras and Banach algebras by the vector-valued alternative fixed point theorem.

Weak and Strong Convergence of Self Adaptive Inertial Subgradient Extragradient Algorithms for Solving Variational Inequality Problems

Many solutions of variational inequalities have been proposed,among which the subgradient extragradient method has obvious advantages.Two different algorithms are given for solving variational inequality problem in this paper.The problem we study is defined in a real Hilbert space and has L-Lipschitz and pseudomonotone condition.Two new algorithms adopt inertial technology and non-monotonic step size rule,and their convergence can still be proved when the value of L is not given in advance.Finally,some numerical results are designed to demonstrate the computational efficiency of our two new algorithms.

两类加权空间间的积分算子与离散算子的有界性及算子范数估计

Using the weight coefficient method, we first discuss semi-discrete Hilbert-type inequalities, and then discuss boundedness of integral and discrete operators and operator norm estimates based on Hilbert-type inequalities in weighted Lebesgue space and weighted normed sequence space.

Necessary and Sufficient Conditions for Oscillations of the Generalized Liénard Systems

In this paper, we study the second-order nonlinear differential systems of Liénard-type x˙=1a(x)[ h(y)−F(x) ], y˙=−a(x)g(x). Necessary and sufficient conditions to ensure that all nontrivial solutions are oscillatory are established by using a new nonlinear integral inequality. Our results substantially extend and improve previous results known in the literature.

A Catalyst for Connected World

China’s Belt and Road Initiative serves as an antidote to deglobalisation.During the last 10 years there has been calls for deglobalisation and decoupling as means to curb the so-called unbalanced trade,rein in immigration,and mend inequalities of asset and wealth.Some consider the world to have entered a period of deglobalisation,citing recent events such as Brexit,Trumpism,Russia-Ukraine conflicts,problems with supply chains,global energy crisis and decline in foreign direct investment.

International Students’ Feeling of Shame in the Higher Education: An Intersectional Analysis of Their Racialised, Gendered and Classed Experiences in the UK Universities

The literature on international students’ experiences frequently depicts them within a ‘deficient’ framework, highlighting their perceived lack of essential skills for managing their studies. Moreover, international students’ emotional experiences are often construed as personal and psychological attributes, with their emotions viewed as transient and pathological phases that they will eventually overcome to assimilate into the local context. However, there exists a dearth of literature investigating international students’ experiences from a sociological perspective, particularly concerning their emotional experiences within the broader social and political milieu. Utilizing a longitudinal research design to monitor 25 Chinese international postgraduates from multiple universities in London and Glasgow over the course of one year, this study illuminates the racialised, classed, and gendered dimensions of international students’ experiences in UK higher education through an exploration of their feelings of shame. Drawing on the research findings, it is evident that power relations operate insidiously and covertly to systematically frame international students’ experiences as personal or cultural ‘deficiency’. This process represents a form of misrecognition, which manifests in racialised, gendered, and classed feelings of shame, experienced at the personal level as insecurity, ‘stupidity’, exclusion, and self-doubt. Consequently, social and cultural inequalities within higher education are often situated at the individual level.

Macroeconomic Asymmetries in the Eurozone Countries in the Time of Financial Crisis

This paper seeks to highlight the macroeconomic asymmetries and social impacts among eurozone countries which occurred during the time of the financial crisis,emphasising the urgent need to revise the framework of economic governance.The analysis focuses on the growing macroeconomic and social imbalances on a representative sample of selected eurozone member-states(Euro(€)North and Euro(€)South)which had posed a threat to economic sustainability and social coherence.

Later-Life Marital Dissolution in Italy:An Emerging Phenomenon?

The phenomenon of marital dissolution in later life,also referred to as“gray divorce”,is described on the rise in contemporary Western societies.This article contributes to the study of marriage breakdown in older age,with a specific focus on Italian society.First,the temporal trends of this phenomenon are reconstructed using official statistics.The data reveal that,although still relatively rare,the dissolution of marriage in later life is expanding in Italy.The analysis of the period from 1974 to 2015 indicates a rise in the average age at separation,a higher percentage of spouses over 50 years on the total number of couples obtaining legal separation,and an increase in the proportion of Italian spouses separating after many years of marriage.Furthermore,data from the national survey“Family and Social Subjects”,conducted in 2016 by the Italian National Institute of Statistics,are utilized to explore the relationship between specific traits of those who separated and their tendency to dissolve marriages before or after the age of 50.The data suggest that individuals with characteristics such as lower educational attainment,residence in the South and Islands,and adherence to more traditional family models are more likely to experience separation in later life.