Large Disparities Research Articles

The Role of Ecological Space Structure Optimization in Synergetic Sustainable Development: Evidence from the Guangdong–Hong Kong–Macao Greater Bay Area

Improving carbon sink capacity is critical for meeting energy conservation and emission reduction targets, along with low-carbon development goals. Although many researchers have recognized that urban space can significantly influence the capacity of carbon sinks in urban areas, few studies have quantified the impact of urban landscape patterns, particularly urban green space (UGS) morphology, on carbon sinks. This study quantitatively investigated the impact of UGS morphology on carbon sinks using panel data from nine cities in the Guangdong–Hong Kong–Macao Greater Bay Area (GBA), China, from 2000 to 2017. A series of landscape metrics and land-use data was first selected to quantify the four dimensions of UGS: scale, compactness, type diversity, and shape complexity. Subsequently, the impact of UGS morphology on carbon sinks was estimated using a panel data model. The main findings were as follows. (1) From the carbon sink results, the carbon sink in the GBA was found to be in an evolutionarily stable state, reflecting the relatively limited potential for carbon enhancement in the region. (2) From the landscape metrics results, the AREA_MD was mainly distributed between 0.18 and 0.27. The AI was mainly distributed between 80 and 97, with a concentration at 90. The PAFRAC was mainly distributed between 1.39 and 1.43, with a concentration at 1.41. PR was mainly distributed between 6 and 7. There was a large disparity in the scale of UGS morphology between GBA cities, with an irregular and complex pattern that became more compact over time. (3) From the panel data results, the AI (p < 0.001) had a significant positive impact on carbon sinks, while PR (p < 0.001) had a significant negative impact. The more compact the UGS morphology, the greater the total carbon sink, and the more complex the UGS morphology, the smaller the total carbon sink. The findings highlighted the importance of urban planning and UGS morphological optimization for increasing carbon sink capacity, as well as providing policy makers and urban planners with theoretical references and guidance for achieving climate goals.

The Influence of Racial/Ethnic and Gender Concordance on Care Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus: an Analysis of the Medical Expenditure Panel Survey, 2010-2019.

This study examined associations between patient-provider race/ethnicity concordance and gender concordance on overall healthcare ratings, self-efficacy, and diabetes care monitoring in non-pregnant women of childbearing age with diabetes mellitus before and after adjusting for sociodemographic factors. We analyzed longitudinal data from the 2010-2019 Medical Expenditure Panel Survey. The sample was limited to non-pregnant women of childbearing age (18-45years) diagnosed with diabetes (unweighted n = 327; weighted n = 566,504). Bivariate analysis, logistic regression, and latent variable modeling were performed. Few racially minoritized women reported racial/ethnic and gender concordance with their healthcare provider. Only 2.9% of Hispanic women reported having a Hispanic provider and 12.1% of non-Hispanic Black women reported seeing a non-Hispanic Black provider compared to 81.1% of non-Hispanic White women who reported seeing a non-Hispanic White provider (p < .0001). Among Hispanic women, 15.3% reported seeing a female provider compared to 25.2% of non-Hispanic Black and 53.5% of non-Hispanic White women. Patient-provider race/ethnicity and gender concordance were not statistically significantly associated with overall healthcare ratings, self-efficacy, or diabetes care monitoring. This study revealed a large disparity in race/ethnicity and gender concordance among minority women of reproductive age with diabetes compared to their non-Hispanic White counterparts. There is a need for larger, more robust studies to examine the influence of provider and other healthcare characteristics on diabetes-related outcomes in this understudied population.

Epidemiology of Pertussis After the COVID-19 Pandemic: Analysis of the Factors Involved in the Resurgence of the Disease in High-, Middle-, and Low-Income Countries

Pertussis is a highly contagious bacterial disease of the respiratory tract that can be prevented by vaccination. Before the COVID-19 pandemic, the vaccine coverage rate for the third dose of a DPT-containing vaccine was 86%, with large disparities among countries. Since 2022, many high-income countries have reported a resurgence of pertussis, especially in the European region, but the disease has also caused outbreaks in middle- and low-income countries, despite their less extensive disease surveillance capacities. This paper aims to review the incidence rates (IRs) of pertussis in high-, middle-, and low-income countries following the COVID-19 pandemic and to discuss the most relevant factors associated with the resurgence of the disease. The epidemiology of pertussis is highly variable and is influenced not only by the type of vaccine used but also by the specific characteristics of the disease, vaccine coverage rates, vaccination schedules, and the quality of surveillance. Since the cessation of COVID-19 measures, there have been significant pertussis outbreaks that could have been partially mitigated with higher coverage rates and more comprehensive pertussis vaccination throughout life.

Regional variation in demographics, reproduction, and body mass growth rates of wild pigs: Implications for population control

AbstractWild pigs are a destructive invasive species throughout many regions of the world and have proven difficult to control or eliminate. Their success as an invasive species is, in part, from their high reproductive potential, which can vary based on available resources, ancestry, and other factors. We opportunistically collected data on demographics (i.e., age and sex), reproduction, and body mass on 2,762 wild pigs throughout various research and operation control activities in Texas, Alabama, Hawai'i, Guam (USA), and Queensland (Australia) during 2016–2024. We evaluated these data for differences among study sites that might lead to a better understanding of wild pig ecology and more effective control of their populations. We found that the age structures of wild pigs varied greatly among sites, with areas with more intense control having younger populations. The timing and frequency of birth pulses also varied by site. Large disparities among populations demonstrated the elasticities of wild pigs in invaded ranges; for example, the Alabama study site had a mostly young population with fast body mass growth rates and 2 discernable birth pulses per year, whereas the Guam study site had an older population with slow body mass growth rates and an indistinguishable birth pulse. We hypothesized that intense population control may increase reproduction rates in younger females through increased body mass growth rates and subsequent reproductive maturity. We recommend that managers identify the seasonal birth pulses of wild pigs in their region, and then intensively focus on removing wild pigs during the 115 days (i.e., gestation period) prior to those birth pulses. This may be counterintuitive to managers that focus on trapping after observing a birth pulse, but it increases the probability of simultaneously removing pregnant females and any associated offspring from previous litters that remained with the pregnant female. We also recommend evaluating regional‐specific intensities of removal that might be required for reducing populations with specific emphasis on whether compensatory reproductive behaviors are generated and how to avoid them.

Spatial accessibility and transport inequity in Finland: Open source models and perspectives from planning practice

During the last two decades, accessibility has begun to take a more central role in transport planning and decision making, as its importance has been recognized in many different policy agendas. Although environmental and social sustainability are central in contemporary public policy, the social exclusion effects related to access of opportunities are rarely measured at the national level. In this study, we analyze spatial accessibility to various opportunities in Finland at 1 km resolution and assess accessibility inequalities using the Palma ratio. Furthermore, we test how a web-based tool can be used in stakeholder communication and investigate the usefulness of the accessibility indicators and the tool for planning practice based on focus group discussions with Finnish transport planners. Our results show significant variation in the levels of access to different opportunities across Finnish municipalities. The Palma ratios reveal that the largest disparities are typically located in municipalities surrounding large city regions, where wealthier residents tend to have better access to opportunities compared to low-income populations. Finally, the insights from Finnish planning practitioners reveal that communicating national-level accessibility information via an online tool has high communicative and learning value for various planning and policy processes.

Barriers and facilitators to quality HS biologic care and outcomes for the Medicaid population across US states

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease characterized by painful skin lesions and dermal abscesses.1 US-based patients with HS are often covered by Medicaid (21.6–31.0%)2–5 with substantial state-by-state variations in coverage. Barriers to accessing biologics for HS may delay treatment and worsen patient outcomes. Here, we report differences in Medicaid criteria to access biologic care for HS across all 50 US states. Procedure/study: A qualitative review of the Medicaid Utilization Management (UM) policies for biologic use in HS was conducted. Data were collected from the Medicaid UM policies, Medicaid websites, and Managed Medicaid UM policies of each state in February 2024. All 50 states were analyzed; barriers to access and discrepancies across state Medicaid UM policies were identified, and opportunities to address these discrepancies in the form of an HS coalition were recognized. The analysis stratified the Medicaid UM criteria for each state for treatment with a biologic (adalimumab/secukinumab) into no or low, medium, and high barrier levels. For high barrier level states, comparison with UM criteria for psoriasis was made. Results: Overall, the UM policies varied widely, and burdensome barriers to biologic care were identified in some states. In total, 40 states had no or low barrier criteria; states with low barrier criteria required an HS diagnosis and a prescription, or inadequate responses to ≥1 therapy (steroids/antibiotics). Alabama, Kentucky, Minnesota, Missouri, Ohio, Oregon, Pennsylvania, and Washington had medium barrier criteria and generally required an HS diagnosis and failure with ≥2 therapies. Here, criteria may be reduced to align with low barrier states. Iowa and Oklahoma had high barrier criteria. Both required ≥3 abscesses or inflammatory nodules, an HS diagnosis with Hurley Stage II/III, and failure with ≥2 therapies. In Iowa, eligible requests received three months treatment, with additional authorizations conditional upon ≥50% reduction in abscess and nodule count. The approval criteria of biologics for psoriasis were less stringent than HS in Iowa and Oklahoma, including fewer criteria items and therapy failures: Iowa ≥2 vs ≥3; Oklahoma ≥1 vs ≥2. Conclusion: Substantial state-by-state variations in Medicaid criteria were observed, with ten out of 50 states having medium to high barriers to accessing biologics. Large disparities in criteria for access to biologic care between psoriasis and HS were observed in two states. These barriers and discrepancies represent opportunities for an HS coalition at the state level, to improve access to care and patient outcomes.6

On the Peculiarities of Wire-Feed Electron Beam Additive Manufacturing (WEBAM) of Nickel Alloy–Copper Bimetal Nozzle Samples

In order to gain insight into the unique characteristics of manufacturing large-scale products with intricate geometries, experimental nozzle-shaped samples were created using wire-feed electron beam additive technology. Bimetal samples were fabricated from nickel-based alloy and copper. Two distinct approaches were employed, utilizing varying substrate thicknesses and differing fabrication parameters. The two approaches were the subject of analysis and comparison through the examination of the surface morphology of the samples using optical microscopy, scanning electron microscopy, and X-ray diffraction analysis. It has been demonstrated that the variation in heat flux distributions resulting from varying the substrate thicknesses gives rise to the development of disparate angles of grain boundary orientation relative to the substrate. Furthermore, it is demonstrated that suboptimal choice of the fabrication parameters results in large disparities in the crystallization times, both at the level of sample as a whole and within the same material volume. For example, for the sample manufacturing by Mode I, the macrostructure of the layers is distinguished by the presence of non-uniformity in their geometric dimensions and the presence of unmelted wire fragments. In order to characterize the experimental nozzle-shaped samples, microhardness was measured, uniaxial tensile tests were performed, and thermal diffusivity was determined. The microhardness profiles and the mechanical properties exhibit a higher degree of strength than those observed in pure copper samples and a lower degree of strength than those observed in Inconel 625 samples obtained through the same methodology. The thermal diffusivity values of the samples are sufficiently close to one another and align with the properties of the corresponding materials in their state after casting or rolling. The data discussed above indicate that Mode II yields the optimal mechanical properties of the sample due to the high cooling rate, which influences the structural and phase state of the resulting products. It was thus concluded that the experimental samples grown by Mode II on a thinner substrate exhibited the best formability.

Catalytic Ammonia Synthesis by Supported Molybdenum Nitride: Insight into the Support Effect

AbstractThe influence of the support on the performance of Mo nitrides has been investigated in ammonia synthesis and decomposition. A series of Mo–N catalysts supported on different materials, namely SiO2 (commercial, SBA‐15), Al2O3, and CeO2, were prepared. The results indicated that, despite the high dispersion of Mo species in all catalysts, large disparities in the activity for ammonia synthesis exist. Initial rates of ∼1208, ∼481, and ∼372 µmol gactive phase−1 h−1 are obtained over 10‐Mo–N/SBA‐15, 10‐Mo–N/SiO2, and 10‐Mo–N/Al2O3 respectively. However, no catalytic activity was registered when Mo species were supported on CeO2. Furthermore, 10‐Mo–N/Al2O3 deactivated after few hours of reaction. The surface composition was studied by means of XPS to probe the origin of the catalytic activity differences, and the results indicated that a range of various oxidation states of Mo was detected depending on the support. The difference in catalytic behavior could not be solely explained by the differences in Mo–N species concentrations. In situ EPR analysis exhibited that the mechanism of MoO3 nitridation could differ depending on the support, leading to the formation of different Mo–N species. The effect of support was, however, not as severe in ammonia decomposition as it was the case of ammonia synthesis.

Assessing the Spatial Distribution of Carbon Emissions and Influencing Factors in the Yellow River Basin

The spatial distribution and trend of carbon emissions in the Yellow River Basin—an important ecological barrier and economic belt in China—directly affect the stability of the ecosystem and the sustainable development of the regional economy. Based on the data for carbon emissions in China’s counties from 1997 to 2017, this paper utilizes standard deviation ellipses, Theil index nested decomposition, and geographic detector models to make a comprehensive description of the spatial and temporal distribution and dynamic evolution characteristics of carbon emissions in the Yellow River Basin. Factors influencing carbon emissions are also analyzed from multiple dimensions. According to the findings, (1) carbon emissions at the county level show a clear upward trend without reaching a peak, exhibiting a spatial distribution of higher emissions in the east and lower in the west and higher in the south and lower in the north, with the mid-lower reaches being the center. The junction of the Shandong, Shaanxi, and Gansu provinces further exhibits a significant expansion, forming two core areas of carbon emissions. (2) Carbon emissions at the county level in the Yellow River Basin are influenced by both economic and geographic factors, exhibiting a significant high carbon spillover effect and a low carbon lock-in effect. The gravity center of the distribution has shifted towards the mid-lower reaches, with the upper reaches displaying dispersion tendencies. (3) Intra-regional disparities are the main source of the overall spatial differences in carbon emissions, with the largest disparities being observed in the upper reaches, followed by the middle reaches, and the smallest disparities being observed in the lower reaches. Further analysis shows that the level of economic development is the primary factor influencing the spatial variation of carbon emissions, and the combined effects of population size and industrial agglomeration are the key drivers of the annual growth in carbon emissions.

Lag-WALS approach incorporating ENSO-related quantities for altimetric interannual SLA forecasts in the South China Sea

A novel approach using lag weighted-average least squares (Lag-WALS) is proposed to forecast the interannual sea level anomaly (SLA) in the South China Sea (SCS) using lagged equatorial Pacific El Niño–Southern Oscillation (ENSO)-related quantities. Through empirical orthogonal function (EOF) and wavelet coherence method, we first investigated the relationships between sea surface temperature (SST) and SLA (both steric sea level (SSL) and non-steric sea level (NSSL)) in the equatorial Pacific, and then explored their cross-correlations with the interannual SCS SLA. A robust alignment was found between the first spatiotemporal mode of EOF (i.e. EOF1 and first principal component (PC1)) from SLA/SSL and SST across the equatorial Pacific, both of which exhibited a typical ENSO horseshoe spatial pattern in EOF1. Good consistency between the SCS SLA and the SST/SLA/SSL PC1 was revealed, with the SCS SLA lagging behind the SST, SLA, and SSL by several months at most grid locations. In contrast, the NSSL exhibited large disparities with the SST PC1 or the interannual SCS SLA. The lag-WALS model performed better at the SCS boundaries than in the central region, with an average STD/MAE/Bias (RMSE/MAE/Bias) for internal (external) accuracies of 1.01/0.80/–0.002 cm (1.39/1.13/–0.08 cm), respectively. The altimetric-observed SLA seasonal patterns agreed with the Lag-WALS model-forecasted SLA. A similar situation applies to regionally-averaged SLA time series. These results underscore the ability of the Lag-WALS model to accurately forecast the SCS SLA at the interannual scale, which is crucial for early warning of abnormal sea level changes in the SCS.

The effects of internal migration on regional convergence: Evidence from Serbia

The paper investigates the effects of internal migration flows on regional convergence in Serbia, a country with large regional disparities, during the period 2000–2018. For this purpose, we implement both the net and the gross (in- and out-) migration approaches. We undertake separate analyses for different categories of the migrant population to explore the impact of migrations involving different levels of human capital. The results show that internal migration flows between NUTS3 units in the observed period mainly fostered divergence, thus contradicting the neoclassical theory. This effect is especially pronounced when considering migrations of the active population and prime-age specialists.

Racialized police use of force and maternal health

IntroductionThere are large racial disparities in maternal health that cannot be explained by education, income, or other individual-level risk factors. This cross-sectional study estimated associations between racial inequity in police use of force (PUOF) at the community level and health outcomes of Black and White women. MethodsBirth records were linked to maternal hospital discharge records and municipal police department data for 326,240 births occurring between 1/1/2012 and 12/31/2016 to Black and White women in New Jersey. Outcomes, identified using diagnosis and procedure codes, were substance use (any/tobacco/alcohol/other), mental health disorders (any/depression/anxiety/ other), asthma, obesity, hypertension (preexisting/gestational), diabetes (preexisting/gestational), severe maternal morbidity, other cardiovascular diseases, and preterm labor. Data were analyzed in 2024. ResultsFor Black women, living in a community with 1% greater racially-disproportionate PUOF was associated with higher odds of any mental health disorder [by 0.18%; 95% CI: 0.08-0.28], depression [0.19%; 95% CI: 0.05-0.33], anxiety [0.25%; 95% CI: 0.09-0.41], other mental health disorder [0.17%; 95% CI: 0.07-0.27], any substance use [0.26%; 95% CI: 0.14-0.38], tobacco use [0.31%; 95% CI: 0.16-0.46], other substance use [0.17%; 95% CI: 0.04-0.30], asthma [0.12%; 95% CI: 0.04-0.21], and preterm labor [0.17%; 95% CI: 0.05-0.29] in adjusted models. There were no robust associations with the other outcomes for Black women or with any of the outcomes for White women. ConclusionsRacially-disproportionate PUOF was significantly associated with mental illness, substance use, asthma, and preterm labor of Black women. Results underscore the potential importance of institutionalized racism as a fundamental cause of health disparities.

The Diffusion Tensor of Protons at 1 au: Comparing Simulation, Observation, and Theory

The natural variation in plasma parameters observed at 1 au can lead to a variation in transport parameters, such as diffusion and drift coefficients, for energetic charged particles of solar and galactic origin. Given the importance of these parameters to particle transport studies, this variation is investigated through test particle simulations over a range of energies in the presence of simulated turbulence with properties corresponding to an ensemble of observed turbulence conditions at Earth. The resulting transport coefficients are then compared with observational estimates from the literature, as well as the predictions of several scattering theories. Parallel and perpendicular mean free paths are shown to vary widely, for the former in agreement with prior observational estimates, but not for the latter. Furthermore, a large disparity between the predictions of theory and the simulation results is noted for the perpendicular mean free path. As such, these results indicate that particle transport studies, particularly predictive ones, need to take into account this natural variation in transport coefficients.

Exploratory mediation analysis of the effect of semaglutide on cardiovascular outcomes in people with overweight or obesity in the SELECT randomised trial

Abstract Background Glucagon-like peptide 1 (GLP-1) receptor agonists have been shown to reduce major adverse cardiovascular (CV) events (MACE) in people with diabetes. The SELECT trial investigated weekly subcutaneous semaglutide 2.4 mg versus placebo in people with pre-existing CV disease and body mass index ≥27kg/m², but without diabetes at randomisation. Over a mean duration of follow-up of 39.8 months, risk of MACE was lower in patients treated with semaglutide vs placebo (6.5% vs 8.0%, hazard ratio, 0.80; 95% CI, 0.72, 0.90; P&amp;lt;0.001). There were improvements in several CV risk factors; however, mechanisms underlying the MACE reduction are unclear. Purpose This prespecified analysis explored whether the effects on measured CV risk factors may mediate the 20% reduction in MACE in SELECT. Methods CV risk factors measured during the trial and included as potential mediators in the analysis were: body weight, waist circumference, high-sensitivity C-reactive protein (hsCRP), glycated haemoglobin (HbA1c), lipids, blood pressure, estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR). Mediation analyses were performed using the Vansteelandt repeated regression approach. First, the observed difference in MACE-free survival between semaglutide and placebo at 36 months was estimated as the total effect. The direct effect of semaglutide was then estimated as the difference in MACE-free survival, had the semaglutide arm experienced the values of the mediator observed in the placebo arm during follow-up. The % mediation was then calculated as 100 × (1 – [direct effect] / [total effect]). A reversed counterfactual approach estimating the direct effect as the difference between arms in MACE-free survival, had the placebo arm experienced the mediator values observed in the semaglutide arm, was also conducted. A large disparity between the % mediation from the two approaches can indicate potential treatment–mediator interaction or hidden confounding. Results Statistically significant (P&amp;lt;0.05) improvements in all potential mediators were observed with semaglutide. Table 1 shows the estimated mediation of each potential mediator when evaluated separately. Point estimates for the % mediation were largest for waist circumference (64.0%), hsCRP (42.1%), HbA1c (29.0%) and body weight (19.5%), but with wide 95% CIs. For waist circumference, the estimated mediation was markedly lower using the reversed counterfactual approach, suggesting potential hidden confounding or treatment–mediator interaction (Figure 1). In a multivariable analysis, the estimated joint mediation was 31.4% (−30.1%, 143.6%). Conclusions The results suggest that neither change in body weight nor other measured CV risk factors fully explain the effect of semaglutide on MACE in SELECT. Substantial unmeasured pleiotropic effects of semaglutide on MACE not mediated through these risk factors remain possible.

An analysis into the rise of private healthcare in England by geographical location and time period

Abstract Background Private healthcare is a rapidly growing industry in the UK, particularly for surgical procedures. Across the pandemic period, waiting lists for elective surgical and consultant-led care increased from 4.4 to 7.5 million patients. This study aimed to analyse the trends and geographical variations in privately funded and NHS-funded orthopaedic private procedures across England compared to NHS waiting times. Methods We conducted a longitudinal study using quarterly national data between 2019 and 2023 in England. Descriptive analysis of quarterly orthopaedic surgical volumes per 10,000 people, and quarterly orthopaedic surgery wait times stratified by geographical location and time period was conducted. Results Between 2019 and 2023 there were a total of 1,469,450 procedures across the private sector, comprising 1,030,095 NHS-commissioned private orthopaedic procedures and 439,355 private orthopaedic procedures. The South of England performed a higher total number of private procedures per year compared to the North (63 vs 57/10,000 people); whilst there was almost double the number of privately funded procedures (23 vs 12/10,000), the difference was less amongst NHS-funded procedures (45 vs 40/10,000 respectively). There was a large variation in the number of NHS-funded procedures per 10,000 between regions. The North has consistently shorter waiting times than the South. Conclusions Our findings indicate considerable geographical variation in the use of private healthcare between regions, suggesting a two-tier healthcare system. The founding principles of the NHS, healthcare free at the point of use based on clinical need irrespective of ability to pay, continue to be eroded. Policy makers and politicians urgently need to find solutions to ensure all members of society can access the same high quality health care. Key messages • Private healthcare utilization in the UK for orthopaedic procedures, has increased significantly, contributing to an emerging two-tier healthcare system. • There are large geographical disparities in access to healthcare services, with he South of England performing more private proceeds with longer NHS waiting times compared to the North.

Assessment of Clinical Toxicological Resources in Countries Belonging to the World Health Organization's Regional Office of the Eastern Mediterranean.

Poison Centers are vital to prevent and manage exposures to chemicals, toxins, and ionizing radiation. However, many countries still lack sufficient poison information center services. Within the World Health Organization's Eastern Mediterranean Regional Office (EMRO) region, we were not able to identify a formal assessment of its toxicological resources. We sought to assess the clinical toxicological resources in the EMRO region and the attitudes, needs, andperspective of the workforce in thatregion. METHODS: This was a two part survey study. First, wedeveloped a poison center questionnaire and scoring system based on the World Health Organization's Guidelines for Establishing a Poison Center; thisinstrument wasadministeredby phone to poison center directors and faculty in the EMROregion. Questions assessed for the presence or absence of important poison center capabilities listed in the WHO guidelines, and points were assigned based on response. Secondly, we administered an electronicworkforce survey to clinical toxicology professionals in the region; participanteligibility for the workforce survey was based on themembership roster ofMENATOX. Out of 22 EMRO countries, 16 countries have an established poison center, and 14 of 16 participated in the poison center survey. The results reflected a wide variability in capabilities amongcountries. Areas such as call centers, clinical toxicology units, laboratory services, and data management were relatively lacking while some other areas including toxicovigilance, chemical incidents and emergencies, antidotes/antivenoms, poisoning information sources, and the availability of free services were relatively stronger.Twenty-seven out of 32 workforce respondents were physicians. Results from that survey highlighted a desire for more support from government and better compensation. Our studyidentified areas of need for the EMRO region.The poison center survey results reflect large disparities amongcountries with some areas being stronger than others. The workforce survey highlighted issues such as compensation and government recognition. Overall, a formal assessment of individual poison centers can provide benchmarks to drive improvement of services, but further research is needed to identify and characterize country-specific needs.

Telemedicine as a tool for bridging geographical inequity: insights in geospatial interactions from a study on chronic heart failure patients

IntroductionChronic heart failure patients experience large disparities in quality of and access to treatment, with rural populations receiving lower levels of care. Telemonitoring of patients is increasingly being used as an important tool for improving patient management and care and might reduce geographical inequities in healthcare.MethodsWe investigate the presence and magnitude of a geospatial interaction effect on the health benefit of a supplementary telemedicine intervention, by analyzing the relationship between distance to regular place of treatment and the benefit of telemedicine in a secondary analysis of data from a previously conducted RCT. We use change in EQ5D health status, SF-36 Physical component score and SF-36 Mental component score as the outcomes. In the unadjusted analysis, intervention group and distance group and the interaction term are included as the independent variables, in the adjusted analysis, multiple socioeconomic and health related variables are included to account for potential confounders.ResultsWe find evidence of a significant interaction between the effects of telemedicine and long distance to treatment for change in EQ5D health status (unadjusted: p = 0.016, adjusted p = 0.009) and unadjusted but not adjusted mental component score (unadjusted: p = 0.013, adjusted p = 0.0728), for the change in physical component score the interaction term was not significant (unadjusted: p = 0.118, adjusted p = 0.092).ConclusionIn our study we find that supplementary telemedicine is likely to reduce the health access inequities associated with geographical distance for chronic heart failure patients. However, our sample size was modest and further research is needed to confirm these findings.

Determining Bandgaps in the Layered Group‐10 2D Transition Metal Dichalcogenide PtSe2

AbstractUnlike traditional group‐6 transition metal dichalcogenides (TMDs), group‐10 TMDs such as PtSe2 and PdTe2 possess highly tuneable indirect bandgaps, transitioning from semiconducting in the near‐infrared to semimetal behavior with a number of monolayers (MLs). This opens up the possibility of TMD‐based mid‐infrared and terahertz optoelectronics. Despite this large potential, the optical properties of such materials have shown an extremely large disparity between that predicted and measured. For example, simulations show that a few MLs is required for the semiconductor–semimetal transition, whilst tens of MLs is found experimentally. This is a result of widely used optical extrapolation methods to determine bandgaps, such as the Tauc plot approach, that are not adapted here owing to i) nearby direct transitions, ii) the material dimensionality and iii) large changes in the non‐parabolic bandstructure with MLs. Here, uniquely combining optical ellipsometry to determine the complex permittivity, terahertz time resolved spectroscopy for the complex conductivity and in‐depth density functional theory (DFT) simulations, it is shown that the optical properties and bandstructure can be determined reliably and demonstrate clearly that the semiconductor‐semimetal transition occurs for PtSe2 layers ≈5 MLs. The microscopic origins of the observed transitions and the crucial role of the Coulomb interaction for thin semiconducting layers, and that of interlayer van der Waals forces for multilayer semimetallic samples are also demonstrated. This work of combining complimentary experimental techniques and extensive simulations avoids the application of constrained extrapolation methods to determine the optical properties of group‐10 TMDs, and will be of importance for future mid‐infrared and terahertz applications.

Breaking the Global North Stereotype: A Global South-centric Benchmark Dataset for Auditing and Mitigating Biases in Facial Recognition Systems

Facial Recognition Systems (FRSs) are being developed and deployed all around the world at unprecedented rates. Most platforms are designed in a limited set of countries, but deployed in other regions too, without adequate checkpoints for region-specific requirements. This is especially problematic for Global South countries which lack strong legislation to safeguard persons facing disparate performance of these systems. A combination of unavailability of datasets, lack of understanding of how FRSs function and low-resource bias mitigation measures accentuate the problems at hand. In this work, we propose a self-curated face dataset composed of 6,579 unique male and female sports-persons (cricket players) from eight countries around the world. More than 50% of the dataset is composed of individuals from the Global South countries and is demographically diverse. To aid adversarial audits and robust model training, we curate four adversarial variants of each image in the dataset, leading to more than 40,000 distinct images. We also use this dataset to benchmark five popular facial recognition systems (FRSs), including both commercial and open-source FRSs, for the task of gender prediction (and country prediction for one of the open-source models as an example of red-teaming). Experiments on industrial FRSs reveal accuracies ranging from 98.2% (in case of Azure) to 38.1% (in case of Face++), with a large disparity between males and females in the Global South (max difference of 38.5% in case of Face++). Biases are also observed in all FRSs between females of the Global North and South (max difference of ~50%). A Grad-CAM analysis shows that the nose, forehead and mouth are the regions of interest for one of the open-source FRSs. Based on this crucial observation, we design simple, low-resource bias mitigation solutions using few-shot and novel contrastive learning techniques that demonstrate a significant improvement in accuracy with disparity between males and females reducing from 50% to 1.5% in one of the settings. For the red-teaming experiment using the open-source Deepface model we observe that simple fine-tuning is not very useful while contrastive learning brings steady benefits.

Race, inclusion, and equity: do ESOP jobs deliver for Black workers?

ABSTRACT This paper investigates whether ESOPs closed the wage gap and provided better benefits for millennial workers during the COVID-19 pandemic. The four factors that will be the focus are wages, non-wage benefits, COVID-19 outcomes, and risk of catching COVID-19. The sample size of this study is 4,417, and logit regressions were used to analyse data from Round 20 of the National Longitudinal Study of Youth, collected in 2021. The study found that ESOP jobs provide higher wages and more non-wage benefits than non-ESOP jobs. ESOP workers were less likely to experience a work stoppage during the COVID-19 pandemic. There were no significant differences in the risk of catching COVID-19. Scholarship focuses on ESOPs’ ability to close the wealth gap between Black and White workers. While ESOPs do provide better wages than non- ESOP jobs, there is a large disparity between the wages of Black and White ESOP workers.