ASU Scholarship Showcase

Background: Prior studies have shown that using uterotonics to augment or induce labor before arrival at comprehensive Emergency Obstetric and Neonatal Care (CEmONC) settings (henceforth, “outside uterotonics”) may contribute to perinatal mortality in low- and middle-income countries. We estimate its effect on perinatal mortality in rural Bangladesh.

Methods: Using hospital records (23986 singleton term births, Jan 1, 2009-Dec 31, 2015) from rural Bangladesh, we use a logistic regression model to estimate the increased risk of perinatal death from uterotonics administered outside a CEmONC facility.

Results: Among term births (≥37 weeks gestation), the risk of perinatal death adjusted for key confounders is significantly increased among women reporting uterotonic use outside of CEmONC (OR = 3 · 0, 95 % CI = 2 · 4,3 · 7). This increased risk is particularly high for fresh stillbirths (OR = 4 · 0, 95 % CI = 3 · 0,5 · 3) and intrapartum-related causes of early neonatal deaths (birth asphyxia) (OR = 3 · 1, 95 % CI = 2 · 2,4 · 5).

Conclusions: In this sample, outside uterotonic use was associated with substantially increased risk of fresh stillbirths, deaths due to birth asphyxia, and all perinatal deaths. In settings of high uterotonic use outside of controlled settings, substantial improvement in both stillbirth and early neonatal mortality may be made by reducing such use.

Background: Improving perinatal health is the key to achieving the Millennium Development Goal for child survival. Recently, several reviews suggest that scaling up available effective perinatal interventions in an integrated approach can substantially reduce the stillbirth and neonatal death rates worldwide. We evaluated the effect of packaged interventions given in pregnancy, delivery and post-partum periods through integration of community- and facility-based services on perinatal mortality.

Methods: This study took advantage of an ongoing health and demographic surveillance system (HDSS) and a new Maternal, Neonatal and Child Health (MNCH) Project initiated in 2007 in Matlab, Bangladesh in half (intervention area) of the HDSS area. In the other half, women received usual care through the government health system (comparison area). The MNCH Project strengthened ongoing maternal and child health services as well as added new services. The intervention followed a continuum of care model for pregnancy, intrapartum, and post-natal periods by improving established links between community- and facility-based services. With a separate pre-post samples design, we compared the perinatal mortality rates between two periods--before (2005-2006) and after (2008-2009) implementation of MNCH interventions. We also evaluated the difference-of-differences in perinatal mortality between intervention and comparison areas.

Results: Antenatal coverage, facility delivery and cesarean section rates were significantly higher in the post- intervention period in comparison with the period before intervention. In the intervention area, the odds of perinatal mortality decreased by 36% between the pre-intervention and post-intervention periods (odds ratio: 0.64; 95% confidence intervals: 0.52-0.78). The reduction in the intervention area was also significant relative to the reduction in the comparison area (OR 0.73, 95% CI: 0.56-0.95; P = 0.018).

Conclusion: The continuum of care approach provided through the integration of service delivery modes decreased the perinatal mortality rate within a short period of time. Further testing of this model is warranted within the government health system in Bangladesh and other low-income countries.

Much research has established reliable cross-population differences in motivations to invest in one's in-group. We compare two current historical-evolutionary hypotheses for this variation based on (1) effective large-scale institutions and (2) pathogen threats by analyzing cross-national differences (N = 122) in in-group preferences measured in three ways. We find that the effectiveness of government institutions correlates with favoring in-group members, even when controlling for pathogen stress and world region, assessing reverse causality, and providing a check on endogeneity with an instrumental variable analysis. Conversely, pathogen stress shows inconsistent associations with in-group favoritism when controlling for government effectiveness. Moreover, pathogen stress shows little to no association with in-group favoritism within major world regions whereas government effectiveness does. These results suggest that variation in in-group preferences across contemporary nation-states is more consistent with a generalized response to institutions that meet basic needs rather than an evolved response dedicated to pathogens.

We study the so-called Descent, or [bar over Q], Equation for the null polygonal supersymmetric Wilson loop in the framework of the pentagon operator product expansion. To properly address this problem, one requires to restore the cyclicity of the loop broken by the choice of OPE channels. In the course of the study, we unravel a phenomenon of twist enhancement when passing to a cyclically shifted channel. Currently, we focus on the consistency of the all-order Descent Equation for the particular case relating the NMHV heptagon to MHV hexagon. We find that the equation establishes a relation between contributions of different twists and successfully verify it in perturbation theory making use of available bootstrap predictions for elementary pentagons.

We study event shapes in N = 4SYM describing the angular distribution of energy and R-charge in the final states created by the simplest half-BPS scalar operator. Applying the approach developed in the companion paper arXiv:1309.0769, we compute these observables using the correlation functions of certain components of the N = 4 stress-tensor supermultiplet: the half-BPS operator itself, the R-symmetry current and the stress tensor. We present master formulas for the all-order event shapes as convolutions of the Mellin amplitude defining the correlation function of the half-BPS operators, with a coupling-independent kernel determined by the choice of the observable. We find remarkably simple relations between various event shapes following from N = 4 superconformal symmetry. We perform thorough checks at leading order in the weak coupling expansion and show perfect agreement with the conventional calculations based on amplitude techniques. We extend our results to strong coupling using the correlation function of half-BPS operators obtained from the AdS/CFT correspondence.

We analyze the near-collinear limit of the null polygonal hexagon super Wilson loop in the planar N = 4 super-Yang–Mills theory. We focus on its Grassmann components which are dual to next-to-maximal helicity-violating (NMHV) scattering amplitudes. The kinematics in question is studied within a framework of the operator product expansion that encodes propagation of excitations on the background of the color flux tube stretched between the sides of Wilson loop contour. While their dispersion relation is known to all orders in 't Hooft coupling from previous studies, we find their form factor couplings to the Wilson loop. This is done making use of a particular tessellation of the loop where pentagon transitions play a fundamental role. Being interested in NMHV amplitudes, the corresponding building blocks carry a nontrivial charge under the SU(4) R-symmetry group. Restricting the current consideration to twist-two accuracy, we analyze two-particle contributions with a fermion as one of the constituents in the pair. We demonstrate that these nonsinglet pentagons obey bootstrap equations that possess consistent solutions for any value of the coupling constant. To confirm the correctness of these predictions, we calculate their contribution to the super Wilson loop demonstrating agreement with recent results to four-loop order in 't Hooft coupling.

Material wealth is a key factor shaping human development and well-being. Every year, hundreds of studies in social science and policy fields assess material wealth in low- and middle-income countries assuming that there is a single dimension by which households can move from poverty to prosperity. However, a one-dimensional model may miss important kinds of prosperity, particularly in countries where traditional subsistence-based livelihoods coexist with modern cash economies. Using multiple correspondence analysis to analyze representative household data from six countries—Nepal, Bangladesh, Ethiopia, Kenya, Tanzania, and Guatemala—across three world regions, we identify a number of independent dimension of wealth, each with a clear link to locally relevant pathways to success in cash and agricultural economies. In all cases, the first dimension identified by this approach replicates standard one-dimensional estimates and captures success in cash economies. The novel dimensions we identify reflect success in different agricultural sectors and are independently associated with key benchmarks of food security and human growth, such as adult body mass index and child height. The multidimensional models of wealth we describe here provide new opportunities for examining the causes and consequences of wealth inequality that go beyond success in cash economies, for tracing the emergence of hybrid pathways to prosperity, and for assessing how these different pathways to economic success carry different health risks and social opportunities.

Human populations differ reliably in the degree to which people favor family, friends, and community members over strangers and outsiders. In the last decade, researchers have begun to propose several economic and evolutionary hypotheses for these cross-population differences in parochialism. In this paper, we outline major current theories and review recent attempts to test them. We also discuss the key methodological challenges in assessing these diverse economic and evolutionary theories for cross-population differences in parochialism.

In this paper we study the four-point correlation function of the energy–momentum supermultiplet in theories with N = 4 superconformal symmetry in four dimensions. We present a compact form of all component correlators as an invariant of a particular abelian subalgebra of the N = 4 superconformal algebra. This invariant is unique up to a single function of the conformal cross-ratios which is fixed by comparison with the correlation function of the lowest half-BPS scalar operators. Our analysis is independent of the dynamics of a specific theory, in particular it is valid in N = 4 super Yang–Mills theory for any value of the coupling constant. We discuss in great detail a subclass of component correlators, which is a crucial ingredient for the recent study of charge-flow correlations in conformal field theories. We compute the latter explicitly and elucidate the origin of the interesting relations among different types of flow correlations previously observed in arXiv:1309.1424.

Background: Antenatal Care (ANC) during pregnancy can play an important role in the uptake of evidence-based services vital to the health of women and their infants. Studies report positive effects of ANC on use of facility-based delivery and perinatal mortality. However, most existing studies are limited to cross-sectional surveys with long recall periods, and generally do not include population-based samples.

Methods: This study was conducted within the Health and Demographic Surveillance System (HDSS) of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in Matlab, Bangladesh. The HDSS area is divided into an icddr,b service area (SA) where women and children receive care from icddr,b health facilities, and a government SA where people receive care from government facilities. In 2007, a new Maternal, Neonatal, and Child Health (MNCH) program was initiated in the icddr,b SA that strengthened the ongoing maternal and child health services including ANC. We estimated the association of ANC with facility delivery and perinatal mortality using prospectively collected data from 2005 to 2009. Using a before-after study design, we also determined the role of ANC services on reduction of perinatal mortality between the periods before (2005 – 2006) and after (2008–2009) implementation of the MNCH program.

Results: Antenatal care visits were associated with increased facility-based delivery in the icddr,b and government SAs. In the icddr,b SA, the adjusted odds of perinatal mortality was about 2-times higher (odds ratio (OR) 1.91; 95% confidence intervals (CI): 1.50, 2.42) among women who received ≤1 ANC compared to women who received ≥3 ANC visits. No such association was observed in the government SA. Controlling for ANC visits substantially reduced the observed effect of the intervention on perinatal mortality (OR 0.64; 95% CI: 0.52, 0.78) to non-significance (OR 0.81; 95% CI: 0.65, 1.01), when comparing cohorts before and after the MNCH program initiation (Sobel test of mediation P < 0.001).

Conclusions: ANC visits are associated with increased uptake of facility-based delivery and improved perinatal survival in the icddr,b SA. Further testing of the icddr,b approach to simultaneously improving quality of ANC and facility delivery care is needed in the existing health system in Bangladesh and in other low-income countries to maximize health benefits to mothers and newborns.