Lower Initial Rate Research Articles

How long does it take to start minimal enteral feeding in preterm Neonates admitted to NICUs in Southern Oromia, Ethiopia?

BackgroundThe timely initiation of trophic feeding (TF) is crucial for premature newborns, but challenging due to immaturity, respiratory instability, abdominal distension, resource scarcity, and healthcare worker expertise. Moreover, there is a dearth of information on predictors of full trophic feeding time. Therefore, this retrospective cohort study aimed to investigate the time it takes and its predictors to initiate minimal enteral feeding in preterm neonates in Southern Oromia, Ethiopia.MethodA facility-based retrospective follow up study was conducted among 434 randomly selected preterm neonates admitted to NICU of Bule Hora University Teaching Hospital and Yabello General Hospital from January 1, 2021 to December 30, 2022. Data were extracted by a pretested structured checklist, entered into Epidata 3.1 and then transferred to Stata version 17 for analysis. Kaplan Meier survival curve and log rank test were used to estimate survival time and a statistical comparison respectively. Bivariable and multivariable cox proportional hazard model was fitted to identify predictors of time to initiate TF and their outputs are presented using Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CIs).ResultThe overall incidence density of TF initiation was reported as 43.6 per 100 neonate-days. Moreover, the median (IQR) time to initiate TF was found to be 2 (1–4) days. Neonates delivered vaginally had a higher likelihood of early TF initiation (AHR: 1.64, CI: 1.26, 2.13), while those born between 32 and 34 weeks (AHR: 0.61, CI: 0.46, 0.81), VLBW neonates (AHR: 0.45, CI: 0.34, 0.60), neonates without KMC (AHR: 0.59, CI: 0.46, 0.79), and those in level II hospitals were less likely to start TF promptly (AHR: 0.78, CI: 0.62, 0.99). Furthermore, neonates with sepsis (AHR: 1.76, CI: 1.36, 2.28) and hypothermia (AHR: 1.51, CI: 1.19, 1.93) had delayed TF initiation.ConclusionWe observed a significant low rate of early TF initiation and higher death rate of preterm newborn in our study as compared to the global. Preterm neonates with lower GA, no KMC, and a VLBW are more likely to have a delayed initiation. Our results highlight that staff training on identifying neonates suitable for TF, and ensuring adequate resources for KMC in all NICU levels should be considered.

Trends and determinants of obesity among ever-married women aged 15–49 in India: insights from National Family Health Surveys (NFHS 1998–2021)

BackgroundObesity has emerged as a significant public health concern in India, particularly among ever-married women of reproductive age (EMWRA). This study analyses trends in obesity among EMWRA across India and its states from 1998 to 2021 and explores the factors contributing to obesity in this group.MethodsData from four National Family Health Survey (NFHS) rounds, spanning 1998-99 to 2019-21, were pooled to create a dataset of 1,117,433 participants. We analysed obesity trends in India and its states and assessed β- and σ-convergence in obesity rates during this period. Additionally, we examined changes in socioeconomic differentials in obesity over this period. Binary logistic regression was used to explore the association of obesity with socioeconomic, demographic, and temporal factors.ResultsOver the study period, obesity among ever-married women of reproductive age (EMWRA) in India has shown a startling increase, tripling from 5.1% (95% CI: 4.7–5.5) in 1998-99 to 15.7% (15.4–15.9) in 2019-21. While obesity rates have surged across all states, the degree of increase varies significantly (ranging from 22.9% points in Tamil Nadu to 2.6 in Meghalaya). Presently, two prominent regions in the country exhibit high obesity rates: the southern region, including Tamil Nadu (29%), Kerala (25%), Goa (25%), and Andhra Pradesh (23%), and the northwestern region, encompassing Delhi (33%), Punjab (31%), and Haryana (24%). Moreover, the disparity in obesity rates across states has widened over time, with states initially showing higher rates experiencing a faster growth rate compared to those with lower initial rates, as highlighted by the β- and σ-convergence analyses. There was substantial variation in obesity rates across education, wealth, place of residence, and social group categories. The risk of obesity is higher among older, educated, wealthy, non-Hindu EMWRAs and TV watchers, but lower among those living in rural areas, the southern region, smaller households, and belonging to SC, ST, and OBC social groups.ConclusionThe surge in obesity among Indian ever married women of reproductive age calls for immediate public health measures. Customized strategies, acknowledging regional differences, are vital to tackle diverse obesity rates across states. Prioritizing vulnerable groups, including the poor, uneducated, and urban populations, is critical for ensuring fair health outcomes.

P-786. Rates of Treatment Discontinuation over Time with Rifampin versus Isoniazid for Latent Tuberculosis Infection: A 6-year Experience at a Large Safety-Net Clinic

Abstract Background Treatment of latent tuberculosis infection (LTBI) is a crucial component of tuberculosis (TB) eradication plans in the United States (US). It is estimated that 80% of active TB cases arise from LTBI reactivation. Numerous gaps have been identified in the LTBI care cascade, leading to low rates of treatment initiation and completion. Treatment duration has shown to be a significant factor influencing completion rates for LTBI treatment. Since 2020, the Center for Disease Control and Prevention (CDC) recommends 4 months of daily rifampin (4R) as the preferred regimen for LTBI, while 6 to 9 months of isoniazid (9H) is now considered an alternative regimen.Table 1.Characteristics of the Patients by Drug Used Methods We conducted a retrospective cohort analysis including all patients treated for LTBI with 4R or 9H (May 2015 - September 2021) at the Boston Medical Center/Boston Public Health Commission TB Clinic. The primary objective was to compare completion rates between patients with LTBI treated with 4R versus 9H. For this, completion of 95% of the planned course was considered sufficient. We also compared rates of treatment discontinuation by plotting a survival curve. Data analysis was performed with R statistical software (version 4.3.2). The study was approved by the Institutional Review Board (IRB) of Boston University.Figure 1.Rates of Treatment Discontinuation over Time for Rifampin versus Isoniazid Results A total of 2178 patients with a median age of 40 years-old were treated for LTBI during the study period, 958 (43.99%) with 4R and 1220 (56.01%) with 9H (Table 1). The completion rates differed significantly, with 652 (68.1%) completing 4R compared to 550 (45.1%) completing 9H (p < 0.001). A Kaplan-Meier curve showed similar rates of discontinuation over time between the 2 regimens (Figure 1). After adjusting for key confounders using multivariable logistic regression model, the sole variable significantly associated with LTBI treatment completion was the use of 4R with an odds ratio of 2.805 (95% CI: 2.313 - 3.406) (p < 0.001) (Table 2).Table 2.Factor's Association with Treatment CompletionOR: odds ratio; CI: confidence interval Conclusion Our findings confirm that 4R has better completion rates than 9H. Importantly, treatment completion on the survival curve was similar in the first 4 months of therapy, supporting the notion that treatment duration is a key factor determining LTBI treatment completion rate regardless of the drug used. Disclosures All Authors: No reported disclosures

504. Missed opportunities for HIV Prevention and Treatment in People Hospitalized with Serious Injection Related Infections: The CHOICE+ Cohort

Abstract Background Harm reduction for persons who inject drugs (PWID) has many components, including HIV testing and Pre-exposure Prophylaxis (PrEP). However, despite the increasing evidence of effectiveness, PrEP remains highly underutilized in these patients at high-risk for infection and subsequent transmission risk to others. Our aim is to identify the gaps in HIV prevention care among a hospitalized PWID population.Table 1:Demographics and Clinical Characteristics Methods CHOICE+ is a multisite retrospective cohort study of adults hospitalized with infectious complications of active injection opioid use between 1/1/2018 and 3/31/2022 at four US medical centers. Data were collected by abstraction of the electronic medical record and analyzed by chi-square and multivariate logistic regression.Table 2:Multivariate Analysis of Factors Associated with HIV Screening Results 1168 (74%) adults with unknown HIV status underwent HIV screening during sentinel admission. For risk comparison, 48% of this cohort had active HCV infection. HIV screening was less likely to occur in PWID who were male (69% vs 78% females), Black (51% vs 78% White), hospitalized < 3 days (56%), on non-medical services (62% vs 75%), and without ID consult (56% vs 79%). Only 3 participants were referred for PrEP, and only 4 initiated PrEP within 1 year of discharge. Additionally, nearly half (49%) of this HIV (-) cohort did not have follow up HIV screening. There were 79 HIV (+) individuals: 66 known HIV (+) and 13 new diagnoses. Forty-five (57%) were on anti-retroviral therapy during hospitalization, 28 (35%) had CD4 < 200, 47 (59%) had detectable viral load, and 49 (62%) were referred for HIV care. However, only 37% were confirmed linked to care. Of those in care, 59% were virally suppressed within 12 months.Table 3:HIV Prevention Outcomes among HIV negative group within 12 months Conclusion In a cohort of high-risk PWID hospitalized with infectious complications of substance use, there were low rates of HIV screening, PrEP initiation, and referrals for treatment in HIV (-) individuals. The lack of PrEP initiation in this study is unsurprising; however, the absence of referring patients suggests a lack of awareness of increased PrEP availability. More concerning are the gaps in HIV screening among this high-risk cohort. Clinicians must capitalize on opportunities to provide this population with tools to reduce their risks, which includes HIV screening and PrEP.Figure 1:HIV Care Cascade Disclosures Elana S. Rosenthal, MD, Gilead Sciences: Grant/Research Support|Merck: Grant/Research Support

P-2288. Antibiotic Use and Infectious Complications in Hematological Patients Undergoing CAR T-Cell Therapy

Abstract Background Patients undergoing chimeric antigen receptor (CAR) T-cell therapy face significant infection risks. Current data on the frequency and nature of these infections remain limited. Table 1 Methods Prospective multicenter cohort including all consecutive patients treated with CD19 or BCMA CAR T-cell therapy from January 2022 to February 2024 in three university hospitals in Spain. All participants provided informed consent and were monitored for 90 days post-treatment. Table 1 (continued) Results A total of 210 patients were enrolled. Demographics, comorbidities, and specific therapy details are outlined in Table 1. Overall, 71% of patients experienced fever at a median of 2 days (IQR 1-3) after CAR T-cell infusion. Antibiotics were administered to 79.3% of patients for a median duration of 7 days (IQR 4-11) with meropenem (57.6%) and piperacillin-tazobactam (40.5%) being the most frequently used. Bacteremia was evidenced in 17 (8.1%) patients, with 6 (2.9%) patients experiencing multiple episodes. The median onset of first bacteremia was 27 days (IQR 16.5-36), with 14/17 (82.3%) episodes occurring over 2 weeks after CAR T-cell infusion. Predominant pathogens were P. aeruginosa (5, 2.4%), coagulase-negative staphylococci (5, 2.4%), and E. coli (4, 1.9%). Clostridioides difficile infection occurred in 7 (3.3%) patients. Viral infections were reported in 37 (17.6%) patients, primarily due to SARS-CoV-2 (22, 10.5%) and Influenza (6, 2.9%), while fungal infections were noted in 10 (4.8%) patients (4 aspergillosis, 3 candidemia, 1 mucormycosis, 1 other mold, and 1 possible fungal infection). ICU admission was required for 38 (18.1%) patients, with infections prompting 6 of these cases. The 90-day mortality rate stood at 6.2%, with 61.5% of these deaths attributed to infections. Patients suffering any infection (bacterial, viral, or fungal) had significantly higher 90-day mortality (17.2% vs 2.0%, p < 0.001). Table 2 shows the different 90-day mortality rates regarding the type of infection. Conclusion Antibiotic use is prevalent immediately following CAR T-cell infusion, despite a low initial bacterial infection rate. Nonetheless, infections within the first 90 days post-CAR-T infusion are common and correlate with worse outcomes. Disclosures All Authors: No reported disclosures

Unveiling Risk Factors for Treatment Failure in Patients with Graves' Disease: A Nationwide Cohort Study in Korea.

Antithyroid drug (ATD) treatment is the preferred initial treatment for Graves' disease (GD) in South Korea, despite higher treatment failure rates than radioactive iodine (RAI) therapy or thyroidectomy. This study aimed to evaluate the incidence of treatment failure associated with the primary modalities for GD treatment in real-world practice. We included 452,001 patients diagnosed with GD between 2004 and 2020 from the Korean National Health Insurance Service-National Health Information Database. Treatment failure was defined as switching from ATD, RAI, or thyroidectomy treatments, and for ATD specifically, inability to discontinue medication for over 2 years. Mean age was 46.2 years, with females constituting 70.8%. Initial treatments for GD included ATDs (98.0%), thyroidectomy (1.3%), and RAI (0.7%), with a noted increment in ATD application from 96.2% in 2004 to 98.8% in 2020. During a median follow- up of 8.5 years, the treatment failure rates were 58.5% for ATDs, 21.3% for RAI, and 2.1% for thyroidectomy. Multivariate analysis indicated that the hazard ratio for treatment failure with ATD was 2.81 times higher than RAI. RAI treatments ≥10 mCi had 37% lower failure rates than doses <10 mCi. ATDs are the most commonly used for GD in South Korea, followed by thyroidectomy and RAI. Although the risk of treatment failure for ATD is higher than that of RAI therapy, initial RAI treatment in South Korea is relatively limited compared to that in Western countries. Further studies are required to evaluate the cause of low initial RAI treatment rates in South Korea.

Strategies for designing high-performance hard carbon anodes with enhanced lithium-ion diffusion and rate capability

The performance of the electrodes is closely related to the structure of the electrode sheet, and the construction of advanced electrodes is crucial for the lithium-ion diffusion process in high-performance lithium-ion batteries (LIBs). Hard carbon, with its irregular polycrystalline microstructure, is an ideal candidate material for the anode electrode of LIBs. However, its have some drawbacks such as low initial coulombic efficiency (ICE), low capacity and poor rate performance. In this work, two electrode casting approaches are proposed and tested in pouch cells, which are double-layer blade coated electrode and patterned coated electrode. The results show that both coating methods show a combination of high ICE and rate capability, exceeding the performance of conventional single-coated electrodes composed of the same material. The designed coating method improves the dynamics of lithium ion diffusion process in the electrode, and the magnification performance and comprehensive electrochemical performance are improved. The research has a wide application prospect and can provide design guidance for obtaining high-power batteries.

Epidemiological Characteristics and Diagnostic Outcomes of Suspected Occupational Noise-Induced Deafness - Guangdong Province, China, 2014-2023.

Suspected occupational noise-induced deafness (ONID) represents the most prevalent suspected occupational disease in Guangdong Province and is among the most frequently reported nationwide. Given its public health significance, we conducted a systematic investigation of suspected ONID cases in Guangdong from 2014 to 2023, analyzing their epidemiological characteristics and diagnostic outcomes to inform evidence-based policies for ONID prevention and management. Data on suspected ONID cases reported in Guangdong Province from 2014 to 2023 were extracted from the "Occupational Diseases and Health Hazard Factors Monitoring Information System." Cases were analyzed using descriptive epidemiological methods, with joinpoint regression analysis employed to assess long-term trends. From 2014 to 2023, 16,987 suspected ONID cases were reported in Guangdong Province, comprising 65.22% of all suspected occupational disease cases (26,044). Cases exhibited a significant increasing trend (Average annual percentage change: 11.8%, 95% CI: 2.9%-22.3%, P = 0.013). The Pearl River Delta region accounted for 87.9% of all cases, with manufacturing being the predominant industry (90.1%). Within manufacturing, the metal products industry represented the highest proportion (15.2%). Males constituted 87.7% (14,905/16,987) of cases. Analysis of diagnostic outcomes from 2020 to 2023 revealed an overall diagnostic procedure initiation rate of 45.1%, with a subsequent confirmation rate of 48.9%. Guangdong Province demonstrates high occurrence patterns of suspected ONID cases, particularly concentrated in the Pearl River Delta region and manufacturing sectors. The low rates of diagnostic procedure initiation and confirmation highlight the urgent need for enhanced regulatory oversight of diagnostic procedures and the development of expert consensus on suspected ONID identification criteria to improve diagnostic confirmation rates.

Density amplifiers of cooperation for spatial games

Spatial games provide a simple and elegant mathematical model to study the evolution of cooperation in networks. In spatial games, individuals reside in vertices, adopt simple strategies, and interact with neighbors to receive a payoff. Depending on their own and neighbors' payoffs, individuals can change their strategy. The payoff is determined by the Prisoners' Dilemma, a classical matrix game, where players cooperate or defect. While cooperation is the desired behavior, defection provides a higher payoff for a selfish individual. There are many theoretical and empirical studies related to the role of the network in the evolution of cooperation. However, the fundamental question of whether there exist networks that for low initial cooperation rate ensure a high chance of fixation, i.e., cooperation spreads across the whole population, has remained elusive for spatial games with strong selection. In this work, we answer this fundamental question in the affirmative by presenting network structures that ensure high fixation probability for cooperators in the strong selection regime. Besides, our structures have many desirable properties: (a) they ensure the spread of cooperation even for a low initial density of cooperation and high temptation of defection, (b) they have constant degrees, and (c) the number of steps, until cooperation spreads, is at most quadratic in the size of the network.

Acceptance, knowledge, and attitude of family physicians towards obesity as a chronic disease: a multinational cross-sectional study.

Obesity was previously perceived to be a lifestyle issue; however, it was declared a chronic disease by the American Medical Association (AMA) in 2013. However, family physician's views and actions toward managing obesity remain ambiguous and occasionally conflicting. This cross-sectional study explores the acceptance and knowledge of 171 family medicine physicians regarding obesity as a chronic disease. Family physicians were recruited through different channels, including members of professional scientific societies of family medicine that belong to the World Organization of Family Doctors (WONCA) Eastern Mediterranean Regional Office EMRO, a publicly available list of United States (US) family physicians, and authors' personal Facebook and LinkedIn connections. Data was collected across various countries through an anonymous online survey. While most participants acknowledged obesity as a chronic condition with multifactorial origins, there was a notable discrepancy in treatment practices compared to other chronic diseases. A dual perspective emerged, as family physicians often emphasized self-responsibility and behavioral change over medical interventions, potentially hindering effective management. Lower initiation rates for obesity management was exhibited compared to other chronic diseases. There is a gap between recognition and effective management of obesity as a chronic disease within family practice. The findings underscore the need for comprehensive obesity education in medical training to bridge knowledge gaps and reduce weight stigma, enabling physicians to provide optimal care for patients with obesity.

Некоторые факторы неблагоприятного прогноза на один год у пациентов с фибрилляцией предсердий

The aim of the study to determine factors of unfavorable influence on 12-months prognosis of life of patients with atrial fibrillation. Materials and methods of the study: The study included 183 patients (52.5% men) with atrial fibrillation (AF), with an average age of 66.2±10.0 years. Results of the study: It was found that 36% of patients had paroxysmal AF, 16% had persistent AF, and 48% had permanent AF. Non-valvular etiology of AF was identified in 85.3% of patients. Initially, 22% of patients were taking warfarin, while 37% were taking novel oral anticoagulants (NOACs). Based on the results of the one-year follow-up, patients were divided into two groups: group 1 with a favorable outcome (n=156) and group 2 (n=27) with an unfavorable outcome (total of 15 deaths, of which 11 were due to cardiovascular causes, including 6 cases of sudden death, 5 cases of chronic heart failure (CHF) decompensation requiring rehospitalization, 3 cases of ischemic stroke, including 1 fatal, and 4 cases of bleeding). Conclusion: A low initial rate of anticoagulant use was identified – 59%, including NOACs in 37%. High overall mortality (8.2%) and cardiovascular mortality (6.0%) were observed among AF patients over 12 months. Overall, an unfavorable prognosis was seen in 14.8% of patients.

Response of submarine braided channels to varying inflow hydrographs: Geomorphic experiments and stratigraphic implications

AbstractSubmarine channels on the seafloor experience a range of turbidity current‐flood hydrographs. The characteristics of the flood hydrograph influence channel dimensions, the number of channel threads (i.e. braiding intensity) and the depositional properties of sandbars within the channels. However, the morphodynamic response of submarine braided channels to different hydrograph patterns is poorly understood. In this study, six geomorphic experiments are used to test how varied flood hydrographs affect the braiding intensity and sandbar geometry within submarine channels. Three experiments represent the control group with constant density‐current inflow, and three experiments use different time‐varying hydrograph patterns. The experiments show that, as the inflow‐to‐sediment discharge ratio increases, multiple small channels coalesce into a few main channels, causing a decrease in active braiding intensity defined by the channel threads with flow. When the flow returns to the initial low flow rate, active braiding intensity increases again. These observations show that the inflow‐to‐sediment discharge ratio determines the value of active braiding intensity. Additionally, active braiding intensity is directly proportional to dimensionless sediment‐stream power and dimensionless stream power, in agreement with previously established trends for both submarine and fluvial braided channels. In contrast to active braiding intensity changes, the measured sandbar aspect ratio and compactness ratio (i.e. ratio of planform area to perimeter) of submarine braided channels is insensitive to changes in the hydrograph. However, when inflows reach peak discharge, the higher transport capacity erodes pre‐existing deposits, forming noticeable erosional surfaces, and subsequently depositing thicker sandbars during that stage. These observations imply that sandbar planform morphology is largely insensitive to hydrograph, but hydrograph variability induces a greater variability in the resultant stratigraphic packages. The experimental results predict that field‐scale stratigraphy should be dominated by strata deposited during intervals of high flow, but that these strata will also exhibit reduced lateral continuity compared to formation scenarios with constant discharge.

Hazardous Alcohol Use and Its Effect on Direct-Acting Antiviral Therapy Initiation among People with Active Injection Drug Use and Current Hepatitis C Infection.

Hepatitis C virus (HCV) infection and hazardous alcohol use are both preventable causes of morbidity and mortality among people who inject drugs (PWID). In the general population, hazardous alcohol is associated with a reduced likelihood of HCV treatment initiation. Less is known about the prevalence and impact of hazardous alcohol use on direct-acting antiviral (DAA) therapy initiation among PWID with active injection drug use. PWID were recruited via street outreach in Baltimore, Maryland, between 2018 and 2019 and were enrolled in a study cohort. Participants completed a study survey and underwent HCV testing. Self-reported DAA therapy initiation was evaluated at follow-up visits every six months. Hazardous alcohol use was determined based on an AUDIT-C score of ≥4 for men or ≥3 for women. Data were analyzed using multivariable logistic regression with generalized estimating equations. Of the 720 PWID recruited, 291 had detectable HCV RNA, and only 134 were aware of their HCV infection. The mean (±standard deviation) age of those that were aware of their infection was 48.7 (±10.3) years, with a slight majority (53.0%) being male and predominantly African American (64.9%). The majority (80/134, 59.7%) met criteria for hazardous alcohol use. Only 16 (11.9%) PWID reported DAA therapy initiation within six months, and 20 (14.9%) reported it within 12 months of follow-up. Hazardous alcohol use (aOR = 1.23, 95% CI = 0.43-3.53) was not associated with DAA treatment initiation. There was a high prevalence of hazardous alcohol use, low rates of oral DAA therapy initiation, and no association between self-reported hazardous alcohol use and initiation of oral DAA therapy in our sample of PWID that were aware of their chronic HCV infection. Strategies to increase HCV treatment uptake in PWID with active drug use are urgently needed and should integrate alcohol and drug use evaluation and care.

Assessing the influence of superabsorbent polymers on corrosion resistance of reinforced ultra-high performance concrete exposed to chloride and compound saltwater via electrochemical impedance spectroscopy

The corrosion resistance of ultra-high performance concrete (UHPC) with superabsorbent polymers (SAPs) submerged in deionized water, chloride saltwater, and compound saltwater was studied. The investigated mixtures included a control UHPC mixture and UHPC mixtures with 0.3 % sodium polyacrylates and 0.3 % polyacrylate-co-acrylamide. The corrosion performance was evaluated using electrochemical impedance spectroscopy, while scanning electron microscopy-energy dispersive X-ray (SEM/EDX) analysis was used to analyze micro-morphology changes and chemical composition. Polarization analysis revealed that the control specimens exhibited the highest resistance to chloride and sulfate penetration, resulting in negligible corrosion rates after 240 days (icorr from 0.0013 to 0.0063 µA/cm2). The SAP-modified specimens also showed high resistance, with an initial low corrosion rate (icorr of 0.101 µA/cm2) that decreased to negligible levels after 28 days (icorr from 0.047 to 0.088 µA/cm2). SEM/EDX results revealed that SAPs facilitate the formation of Friedel’s salt and Ettringite crystals in chloride and compound saltwater, contributing to the reduction in corrosion resistance.

Mechanistic insight into the impact of dry-state prelithiated SiOx thin-film anode toward extremely fast-charging and long-term stability

Silicon suboxides (SiOx) have achieved partial success in commercialization as high-capacity anode materials to replace graphite because of optimal electrochemical properties over silicon. Unfortunately, the further development has been sluggish, jeopardizing the urgent need of green energy. The daunting challenges to tackle include low initial coulombic efficiency (ICE) and low charging rate due to poor electron and ionic conductivity. In the context of thin film microbattery, we propose to precisely control the chemical states of SiOx films through varying sputtering power followed by dry-state pre-lithiation through Li-metal thermal evaporation, superior to the current pre-lithiation approaches for SiOx thin-film anodes. We addressed the leading roles of the surface chemical states of the as-deposited SiOx in the formation of the high ionic conductive Li4SiO4 phase as the pre-solid electrolyte interphase during the proposed dry-state prelithiation process. Ultimately, the prelithiated SiOx successfully mitigated the most confronted issues as low ICE and C-rate limitation, achieving an unprecedented rate performance of 72.8 % at 20 C, and ultra-long-cycle retention of 54.2 % over 5000 cycles at 10 C. These results strongly prove that appropriate pre-lithiation provides tremendous advantages to SiOx thin film anode not only in prolonging electrode stability but also promoting a significant fast-cycling.

Smoking patterns by birth cohort in Argentina: an age-period-cohort population-based modeling study

Argentina's smoking rates remain high. We aim to estimate Argentina age-specific histories of smoking initiation, cessation, prevalence, and intensity by birth-cohort to inform policy interventions. Modeling study. Data from three Argentinian nationally representative surveys conducted from 2004 to 2018 (n=268,193) were used to generate smoking histories. The Cancer Intervention and Surveillance Modeling (CISNET) Network Lung Working Group age, period, and cohort modeling approach was used to calculate smoking initiation and cessation probabilities, ever and current smoking prevalence, and intensity (cigarettes per day, CPD) by age, sex, and birth cohort from 1950 to2018. Ever smoking prevalence increases with age up to 25 and decreases with birth cohorts after 1990. Smoking initiation peaks between 15 and 18 years of age. Among females, initiation probabilities increased until the 1955 cohort, reaching a second peak in 1980-85 cohorts and declining thereafter. Males have higher initiation probabilities than females. Among males, initiation has decreased since the 1950 birth cohort, with a slight increase around the 1985 cohort. Current smoking prevalence has been decreasing since the 1960 birth cohort, except for a peak in 1980-85 cohorts. Cessation increases with age. Mean CPD increases with age and peaks around age 40, appearing flat in females since the 1985 cohort. Recent birth cohorts seem to be experiencing lower rates of initiation, stable rates of quitting and lower current and ever smoking prevalence. The stabilization of cessation probabilities and mean CPD indicate the need to strengthen existing tobacco control measures and advance new ones. NIH/NCI U01CA253858 grant.

Effects of four types of natural bait on water quality, feeding, growth, and antioxidant enzyme activity of Monopterus albus in a recirculating aquaculture system

Monopterus albus is one of China’s renowned and superior aquaculture species, with its seedlings mainly sourced from wild capture. One of the bottlenecks in M. albus aquaculture is the high mortality rate and low feeding initiation rate from stocking wild fry to the initiation of feeding. In production, trash fish is commonly used to wean M. albus juveniles onto feeding. In this study, we introduced three other natural feeds, earthworms (EW), yellow mealworms (YMW), and fly maggots (FM), with frozen trash fish (TF) serving as the control group, to evaluate the effects of these four natural feeds on the survival rate, feeding initiation, antioxidant enzymes activity, and body composition of M. albus juveniles under recirculating water aquaculture conditions. The experiment comprised four treatments, each with three replicates. Each replicate consisted of stocking 150 M. albus juveniles weighing 10.02 ± 0.89 g in size, raised for 5 weeks. The survival rate of the YMW group was 73.33%–85.33%, which was significantly higher than that of the other three bait groups (p &amp;lt; 0.05). The four bait groups showed no significant differences in final body weight and specific growth rate (SGR) (p &amp;gt; 0.05). The EW group showed the highest final body weight, with an average SGR of 2.73, whereas the YMW group had an average SGR of 1.87. The average daily feeding amount was significantly higher in EW and YMW groups than in the other two groups (p &amp;lt; 0.05). The percentage of feeding amount to fish weight in the EW group reached 7.3% in the fifth week. After 5 weeks of cultivation, NO2−-N content was significantly higher in the waters of the TF and EW groups than in the waters of the FM and YMW groups (p &amp;lt; 0.05), there was no significant difference in TAN content among the treatment groups (p &amp;gt; 0.05). Liver malondialdehyde content was significantly higher in the TF group than in the other bait groups (p &amp;lt; 0.05). GSH-Px activity was significantly higher in the EW group than in the FM group and YMW group. No significant differences in SOD and CAT activity and T-AOC were observed among the bait groups (p &amp;gt; 0.05). The increase in crude protein content was significantly higher in the TF group than in the FM group, but the increase in crude ash content was significantly lower in the TFgroup. In conclusion, Tenebrio molitor could potentially serve as one of the alternative feeds during the initial stages of M. albus juveniles stocking.

Synergistic effect of interlayered doping and surface modification to improve the performance of Li-rich manganese-based cathode materials

Li-rich manganese-based oxides (LRMOs) with high energy density have been intensively studied, but their practical use as cathode materials for lithium-ion batteries is still impeded by the shortcomings such as low initial coulombic efficiency, voltage decay and poor rate capability. To address these issues, element Nb is selected to bulk dope and simultaneously surface modify the hierarchical Li1.20Mn0.54Co0.13Ni0.13O2 spheres in this work. Synergistic effect of Nb doping and surface modification on the crystalline structure and electrochemical performance of the resultant LRMOs is characterized in detail. The results suggest that Nb5+ ions are doped into the interlayer sites within the crystals while the LiMn2O4 and LiNb3O8 double layers are coated on the primary nanoparticles. The galvanostatic charge-discharge measurements reveal that the optimal LRMO-Nb2 sample can deliver the capacities of 286 and 167 mAh g−1 at the rates of 0.1 C and 5 C, respectively, and retains a capacity of 191 mAh g−1 at 1 C rate after 200 cycles. Ex-situ XRD patterns prove that the layered structure is strongly pillared by the interlayer-doped Nb5+ during the delithiation/lithiation processes. Especially, some lithium vacancies formed around Nb5+ ions can accelerate the diffusion of Li+ ions, which was proved by DFT calculations and experimental results. Our research demonstrates that cooperating of the interlayered doping of Nb5+ with surface coating of LiNb3O8 layer can improve rate capability and cyclability of the resultant LRMOs significantly.

IJCM_17A: Infant and young child feeding practices among Refugees in Gangavalli block of Salem district: cross-sectional study.

Background: Refugees often face worse health outcomes due to barriers including language, cultural differences, inaccessibility to health care services. World Health Organization works around the globe to secure the health of refugees &amp; migrants and to achieve universal health coverage through implementation of “Health and Migration Programme” (2020). Children are more vulnerable &amp; easily prone to malnutrition in refugee &amp; migrant population. Infant and Young child feeding practice is a key area to improve child survival and promote healthy growth. Objectives: 1. To estimate the prevalence of early initiation of breastfeeding and exclusive breastfeeding of refugee children under two years of age. 2. To determine the factors influencing the feeding practices of children under 2 years among refugee children. Methodology: A Cross-sectional study was conducted among 97 refugee children under two years of age in Gangavalli block of Salem district over period of 1month (September 2023). Data collection was done using interviewer administered semi-structured questionnaire and statistical analysis done-IBM SPSS Version 21. Results: Early initiation of breastfeeding (within 1 hour of birth) was done in 53.6% children (52 out of 97). Only 26.8% children received Exclusive breastfeeding for more than 5 months of age. 64.9% children initiated on complementary feeding around 6-8 months of age. 76.3% children received semi-solid foods/soft foods during weaning. Only 5% children have Minimum Diet Diversity. Conclusion: The low rates of early initiation of breastfeeding and exclusive breastfeeding for over 5 months of age highlight a concerning trend. Additionally, the delayed initiation of complementary feeding with minimal diet diversity in majority of children suggests a critical need for targeted interventions to improve and promote appropriate infant and young child feeding practices within this vulnerable population.

Breastfeeding Initiation in People With Hepatitis C Virus Infection in the United States.

To evaluate breastfeeding initiation rates among people living with and without hepatitis C virus (HCV) infection during pregnancy and to identify characteristics associated with breastfeeding initiation. We conducted a cross-sectional analysis of individuals who had a live birth in the United States from 2016 to 2021 using the National Center for Health Statistics birth certificate data. We grouped participants by whether they had HCV infection during pregnancy. Using propensity-score matching, we assessed the association between breastfeeding initiation before hospital discharge , defined as neonates receiving any parental breast milk or colostrum, and HCV infection during pregnancy in a logistic regression model. We also assessed factors associated with breastfeeding initiation among those with HCV infection. There were 96,896 reported cases (0.5%) of HCV infection among 19.0 million births that met inclusion criteria during the study period. Using propensity-score matching, we matched 87,761 individuals with HCV infection during pregnancy with 87,761 individuals without HCV infection. People with HCV infection during pregnancy were less likely to initiate breastfeeding compared with those without HCV infection (51.5% vs 64.2%, respectively; odds ratio 0.59, 95% CI, 0.58-0.60, P <.001). Characteristics associated with higher rates of breastfeeding initiation among individuals with HCV infection included a college degree (adjusted odds ratio [aOR] 1.22, 95% CI, 1.21-1.24); self-identified race or ethnicity as Native Hawaiian or Pacific Islander (aOR 1.22, 95% CI, 1.06-1.40), Asian (aOR 1.09, 95% CI, 1.06-1.13), or Hispanic (aOR 1.09, 95% CI, 1.08-1.11); private insurance (aOR 1.07, 95% CI, 1.06-1.08); nulliparity (aOR 1.09, 95% CI, 1.08-1.10), and being married (aOR 1.08, 95% CI, 1.07-1.09). Characteristics associated with not breastfeeding before hospital discharge included receiving no prenatal care (aOR 0.81, 95% CI, 0.79-0.82), smoking during pregnancy (aOR 0.88, 95% CI, 0.88-0.89), and neonatal intensive care unit admission (aOR 0.92, 95% CI, 0.91-0.93). Despite leading health organizations' support for people living with HCV infection to breastfeed, our study demonstrates low breastfeeding initiation rates in this population. Our findings highlight the need for tailored breastfeeding support for people with HCV infection and for understanding the additional effects of human immunodeficiency virus (HIV) co-infection, HCV treatment, and concurrent substance use disorders on breastfeeding initiation.