Low Supply Research Articles

Evaluating GPU's Instruction-Level Error Characteristics Under Low Supply Voltages

Evaluating GPU's Instruction-Level Error Characteristics Under Low Supply Voltages

Breastfeeding with primary low milk supply: a phenomenological exploration of mothers’ lived experiences of postnatal breastfeeding support

BackgroundMost women can produce enough milk to exclusively breastfeed. However, a small cohort are prevented from doing so due to a condition known as primary low milk supply. The aim of the study was to provide new insights into how mothers with this condition experience help and support from professionals, volunteer support groups, and partners.MethodsInterpretative phenomenological analysis was used to explore the lived experiences of nine first-time breastfeeding mothers in Ireland who had primary low milk supply. One-hour interviews were conducted over Zoom between April and October 2021.ResultsBeing with Others, one of four superordinate themes identified in this study, concerns the participants’ experiences of receiving professional, voluntary, and partner breastfeeding support. Four sub-themes were identified: Disconnected Encounters, Perceiving Judgement from Others, Being in a Safe Space and Having a Saviour. The encounters of participants with healthcare professionals revealed a lack of rapport, intrusive hands-on support, poor perceived quality of breastfeeding support and a heightened sensitivity to language and tone. Participants expressed that they valued empathy and emotional support from lactation professionals as much as they valued skilled lactation support. Furthermore, participants appeared to experience an enhanced motherhood self-identity and self-acceptance through seeing their experiences mirrored in the experiences of other mothers with primary low milk supply in specialist low milk supply-specific support groups.ConclusionThe interactions that mothers with primary low milk supply have with various others in their world (healthcare professionals, lactation consultants, volunteer breastfeeding supporters, and partners) can shape how they view themselves and can have a profound impact on their breastfeeding journey. There is a need for greater knowledge and understanding among healthcare professionals of the phenomenon of primary low milk supply so that women suspected of having the condition may receive appropriate support. Where possible, mothers with primary low milk supply should be directed to specialist breastfeeding support groups.

Introducing maximum sustainable yield targets in fisheries could enhance global food security

Aquatic foods are crucial for global food and nutrition security, but overfishing has led to depleted fish stocks, threatening both food security and the environment. Here, we combine a fish stock model with a global agriculture and food market model in order to analyze scenarios involving a continuation of current fishing trends versus optimal management through maximum sustainable yield targets. Maximum sustainable yield management of overfished stocks could increase yields by 10.6 Megatons, equivalent to 12% of total catches and 6% of aquatic animal production in 2022. This would alleviate the need for aquaculture expansion by an equivalent of 3 years of growth in the aquaculture sector at its current level, and reduce meat and feed demand. Lower food prices and additional supply could enhance global food security. Conversely, continued overfishing will likely lead to lower catches over time, adding pressure to the agricultural and aquaculture sectors. Although maximum sustainable yield management is not a panacea, it represents a positive step towards achieving sustainable food production.

Milk Composition Is Predictive of Low Milk Supply Using Machine Learning Approaches.

Background/Objectives: The causes of low milk supply are multifactorial, including factors such as gene mutations, endocrine disorders, and infrequent milk removal. These factors affect the functional capacity of the mammary gland and, potentially, the concentrations of milk components. This study aimed to investigate the differences in milk composition between mothers with low and normal milk supply and develop predictive machine learning models for identifying low milk supply. Methods: Twenty-four-hour milk production measurements were conducted using the test-weigh method. An array of milk components was measured in 58 women with low milk supply (<600 mL/24 h) and 106 with normal milk supply (≥600 mL/24 h). Machine learning algorithms were employed to develop prediction models integrating milk composition and maternal and infant characteristics. Results: Among the six machine learning algorithms tested, deep learning and gradient boosting machines methods had the best performance metrics. The best-performing model, incorporating 14 milk components and maternal and infant characteristics, achieved an accuracy of 87.9%, an area under the precision-recall curve (AUPRC) of 0.893, and an area under the receiver operating characteristic curve (AUC) of 0.917. Additionally, a simplified model, optimised for clinical applicability, maintained a reasonable accuracy of 78.8%, an AUPRC of 0.776, and an AUC of 0.794. Conclusions: These findings demonstrate the potential of machine learning models to predict low milk supply with high accuracy. Integrating milk composition and maternal and infant characteristics offers a practical approach to identify women at risk of low milk supply, facilitating timely interventions to support breastfeeding and ensure adequate infant nutrition.

Customer ESG performance and supplier greenwashing behaviour: evidence from China

ABSTRACT Based on a Chinese sample of customer-supplier firm pairs from 2012–2022, we explore the impacts of customer ESG performance on supplier greenwashing behaviour along the supply chain. The results indicate that customer ESG performance can effectively inhibit supplier greenwashing behaviour, and the association is particularly pronounced with lower supplier’s bargaining power or lower customer’s greenwashing tolerance. Our findings offer insights into the development of greenwashing correction mechanisms within the context of China.

Financial Barriers to Expanded Birth Center Access in New Jersey: A Qualitative Thematic Analysis.

Birth centers are an underused care setting with potential to improve birth experience and satisfaction. Both hospital-based and freestanding birth centers operate with the midwifery model of care that focuses on safe, low-intervention physiologic birth experiences for healthy, low-risk pregnant people. However, financial barriers limit freestanding birth center sustainability and accessibility in New Jersey, especially for traditionally marginalized populations. This qualitative study explores the financial barriers faced by freestanding birth centers in order to expand access and choice for pregnant people in New Jersey. Semistructured interviews were conducted with participants from 4 sectors: (1) birth center or health system, (2) policy-adjacent philanthropy or research, (3) state departments, and (4) health insurance. Coding and analysis followed a reflexive thematic analysis process, resulting in the identification of 4 financial barriers to birth center access. Facility Medicaid reimbursement rates are a primary barrier for birth centers, along with startup and operating costs and, more indirectly, low supply of midwives and low patient demand for birth center care. New Jersey is well-positioned to enact critical policies and programs that can improve out-of-hospital birth center access, based on the findings and recommendations from this research. Other states can follow suit in pursuit of solutions to improve maternal health access and equitable birth center sustainability.

“There’s a Little Bit of Tension There:” Perspectives of Mothers and Early Childhood Educators on Breastfeeding in Child Care Centers

ABSTRACT Objective: To explore mothers’ and early childhood (EC) educators’ experiences of breastfeeding/breast milk provision and breastfeeding support in child care centers (CCCs) in the United States (U.S.). Design: We conducted one-time, semi-structured phone interviews with mothers and EC educators to examine perceptions of support, accommodations, and barriers to breastfeeding in CCCs. We administered a background survey to assess participant characteristics and quantify perceived degree of breastfeeding support in the workplace (mothers) and CCCs (mothers and EC educators). Setting: U.S.-based CCCs Participants: 50 working mothers using CCCs for their infants and 22 EC educators Results: Interview themes and background surveys reflected neutral feelings toward breastfeeding support received (mothers) and provided (EC educators) in CCCs. Maternal expectations for breastfeeding support in CCCs were generally low; workplace and social support for breastfeeding were perceived as the most important factors impacting breastfeeding. EC educators’ capacity to offer breastfeeding support was constrained by CCC infant feeding regulations, inadequate breastfeeding training, and time limitations. Tensions arose when mothers attempted to manage low milk supply at the CCC level by requesting EC educators to individualize feeding or milk storage practices for their infant. Conclusions: Breastfeeding efforts of working mothers are undermined in multiple settings, including the workplace and CCCs. Improving breastfeeding outcomes for this population requires structural/policy changes that: 1) maximize opportunities for continued, direct breastfeeding and maternal/infant proximity and 2) enforce evidence-based CCC feeding protocols and standards and EC educator lactation training.

Measuring the Impact of Healthcare Provider Availability on Quality of Care and Disease Burden in Ohio: A Cross-Sectional Study.

Chronic lower respiratory disease, heart disease, and diabetes have a higher prevalence in rural areas. Previous studies raise concerns that a lower supply of physicians is associated with negative outcomes. To assess disease burden across the 88 counties in Ohio, including Appalachian and non-Appalachian counties, and examine associations with the number of healthcare providers. We utilized data sourced from the Centers for Medicare & Medicaid Services (CMS) and the Mapping Medicare Disparities tool. We conducted ANOVA to compare the mean number of primary care physicians (PCP), specialty physicians, advanced practice providers (APP), and other healthcare providers for Ohio counties. We calculated mean prevalence, principal cost, and prevention quality indicator (PQI) by health condition. We analyzed the relationship between healthcare providers and the PQI across counties, and examined differences in healthcare providers and disease burden between Appalachian and non-Appalachian regions. The mean number of providers per 100,000 people significantly differed between PCP, specialty physicians, APP, and other healthcare providers (F = 13.9, P < 0.001). The prevalence of hypertension (mean = 67.0, SD = 2.2) and diabetes (mean = 27.1, SD = 2.4) was the highest of the selected conditions. The number of preventable hospitalizations from chronic conditions (mean = 2024.9, SD = 526.8) was significantly higher (P < 0.001) than the number of preventable hospitalizations from acute conditions (mean = 851.6, SD = 262.2). The multivariate mixed effects model of PCP*Specialist*APP*Other was the best predictive model for all health conditions (P < 0.001). COPD (mean = 17.4, SD = 2.8) and diabetes (mean = 28.4, SD = 2.3) in Appalachian counties were significantly higher (P < 0.001) than COPD (mean = 13.7, SD = 1.9) and diabetes (mean = 26.2, SD = 2.1) in non-Appalachian counties. This study found higher PQI scores for chronic conditions than acute conditions, indicating the need for higher-quality outpatient care to prevent avoidable hospital admissions. Further, Appalachian counties had fewer other healthcare providers and many counties lacked specialist physicians, highlighting significant disparities in healthcare access in Appalachian Ohio.

Childbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization.

to analyze the spatial-temporal pattern of childbirths and flow of postpartum women assisted at a regional reference maternity hospital. ecological study of 4,081 childbirths, between September 2018 and December 2021, at a public maternity hospital in the Baixo Tocantins region, Pará, Brazil. With data collected from five sources, a geographic database was constructed, and spatial analysis was used with Kernel density interpolator. Maps were generated using QGis/3.5 and TerraView/4.3, calculating chi-square (p<0.05). the highest concentrations of normal and cesarean childbirths were observed in Barcarena (n=2,558/62.68%), Abaetetuba (n=750/18.38%), Moju (n=363/8.89%) and Igarapé-Miri (n=219/5.37%). Among the municipalities in the region, ten had obstetric beds, totaling 210 beds. In this scenario, postpartum women traveled up to 288 km to reach the maternity hospital. long distances between certain municipalities of residence and maternity hospital, and low supply of obstetric beds, were identified as risk factors for unfavorable obstetric outcomes.

Barriers and facilitators to implementing six monthly multi-month dispensing of antiretroviral therapy in two urban HIV clinics during the COVID-19 Era in Malawi.

Following the COVID-19 pandemic, the Malawi Government released a policy that promoted the scale-up of six-monthly multi-month dispensing (6-MMD) of antiretroviral therapy (ART) to people living with HIV in order to decrease congestion at health facilities and transmission of COVID-19. We evaluated the barriers and facilitators to implementing the scale-up of 6-MMD.We conducted a cross-sectional study and collected quantitative and qualitative data from 13 January 2022 to 5 February 2022 at two high-volume primary health facilities in urban Blantyre, Malawi. A survey was self-administered to healthcare workers (HCWs) and a subset were purposively selected for key informant interviews. The interviews were guided by the consolidated framework for implementation research and questions focused on perceived barriers and facilitators to 6-MMD. We calculated proportions of reported barriers and facilitators based on the Likert scale. A thematic content analysis was done for qualitative data. Of the 77 HCWs who participated in the surveys, 56 (73%) were female and 22 (29%) were nurses. Major barriers to the implementation of 6-MMD were low drug supply and lack of understanding of the policy. Other reported barriers were s missing clinic appointments and viral load sample collection, if timelines for ART dispensation and viral load testing were misaligned. The major facilitators were orientation and review meetings, teamwork among staff, and the use of the electronic medical records system to track patients. Additionally, reduction in the number of patient visits, which reduced the workload of healthcare workers was cited as another motivator for implementing 6-MMD. Major facilitators to transition to 6-MMD included health care worker capacity building, teamwork and use of electronic medical records while major barriers included low drug supplies and lack of understanding of policy guidance. These findings may be helpful when developing strategies for increasing coverage and uptake of 6-MMD of ART.

Domestic Interest Rate and Capital Inflows Policy in Nigeria

The implementation of sterilization policy has been noted to raise domestic interest rates as it is designed to lower money supply. This occurs due to the inverse relationship between money supply and interest rates, with a rise in interest rates attracting additional inflows into the economy, putting pressure on monetary authorities. The verification of this hypothesis in the Nigerian context formed the motivation for this study. The main purpose of this study is to investigate whether sterilization policy actually raises domestic interest rates in Nigeria. Using a monthly dataset from 2010M1 to 2021M3 and the ARDL estimation technique, total sterilization serves as a proxy for sterilization policy, while the treasury bills rate proxies the domestic interest rate. Findings reveal that sterilization policy has a positive and significant impact on domestic interest rates in both the short-run and long-run. Additionally, money supply negatively affects domestic interest rates in the short-run, while world interest rates have a negative and significant impact on domestic rates in both the short and long runs.

Seed soaking treatments differently effect seed germination and seedling phenology for different populations of Vitex doniana Sweet

Vitex doniana is one of the highly demanded traditional vegetables in West Africa, yet supply is still too low to meet demand. Among the reasons for the low supply is the constraint related to the propagation of the species. Sexual propagation of this species is limited by seed dormancy which hinders cultivation. To achieve homogeneous germination and produce seedlings for horticultural production, two soaking techniques were applied on freshly harvested and three-month-stored seeds collected from eight populations in three climatic zones in Benin. Seed viability differed significantly between seed populations. Seeds stored for three months at ambient room conditions (25°C) followed by wet-dry cycling twice daily for 14 days achieved 96.7% germination within 12 days after sowing. This finding represents a remarkable improvement in seedling production for V. doniana over the past 10 years. This study is one step further toward the domestication of V. doniana.

A Low Supply Voltage Current and Voltage Reference Using Self–Cascode Composite Transistor

A Low Supply Voltage Current and Voltage Reference Using Self–Cascode Composite Transistor

Placental and Fetal Metabolic Reprogramming in Pregnancies with Intrauterine Growth Restriction.

The high-altitude hypoxia model demonstrates that insufficiently oxygenated placentas activate compensatory mechanisms to ensure fetal survival, hinging on the transcription factor hypoxia-inducible factor-1. The aim of the present study is to investigate whether and when similar mechanisms are also activated during intrauterine growth restriction (IUGR). A retrospective observational study evaluated a series of umbilical cord blood samples, which provide a realistic representation of the fetal intrauterine status, collected from a cohort of preterm and term neonates, both affected and not affected by IUGR. Results demonstrate that preterm IUGR fetuses receive a lower supply of oxygen and glucose from the placenta, along with a greater provision of lactate and carbon dioxide compared to non-IUGR neonates. Simultaneously, preterm IUGR fetuses increase oxygen extraction and reduce lactate production. These differences between IUGR and non-IUGR placentas and fetuses disappear as the term of pregnancy approaches. In conclusion, this study suggests that hypoperfused placentas in preterm pregnancies with IUGR activate a metabolic reprogramming aimed at favoring glycolytic metabolism to ensure fetal oxygenation, even though the availability of glucose for the fetus is reduced. Consequently, preterm IUGR fetuses activate gluconeogenetic metabolic reprogramming, despite it being energetically expensive. These metabolic adaptations disappear in the last weeks of pregnancy, likely due to physiological placental aging that increases the fetoplacental availability of oxygen. Placental oxygenation appears to be the main driver of metabolic reprogramming; however, further studies are necessary to identify the underlying biological mechanisms modulated by oxygen.

Novel Structure of Fin-iTFET with Main Gate and Source Metal Formed Simultaneously while Control Gate and Drain Formed Simultaneously

Abstract In this paper, we propose a new structure for Fin-iTFET where the main gate and source metal are formed simultaneously, and the control gate and drain are formed simultaneously. The process used for the realization is simple, costless, and fully compact with conventional CMOS technology. With the help of a control gate, our Fin-iTFET can achieve a steep subthreshold swing (SSavg) and a high ION/IOFF ratio. Using Sentaurus TCAD simulations, we confirm that the current transport mechanism of our Fin-iTFET is based on band-to-band line-tunneling, which enhances the ON current (ION) and mitigates leakage with a reduced trap-assisted tunneling (TAT) effect. Instead of relying on dopant implantations and thermal annealing, we utilize a metal-semiconductor Schottky junction to enhance the minority carrier concentration at the source end, increase band bending, increase the overlap between the conduction band and valence band, increase the vertical electric field, and thereby increase the line tunneling generation rates, ultimately enhancing the ON current of the device. The simulations show that the device exhibits an SSavg of 13.6 mV/dec with an ION/IOFF ratio of 10⁹ at VD = -0.2V and VCG = 0.2V. In short, our Fin-iTFET can achieve excellent electrical performance at low power supply voltages.

Exploring Potential of Organo-mineral Fertilizers in Augmenting Crop Yield and Quality – A Review

Inorganic fertilizers are essential for improving crop yield and quality through enhanced crop efficiency. However, their continuous use often causes nutrient imbalances, leading to poor yield and quality. Organic manures, while effective in improving soil fertility and crop productivity, face challenges such as limited availability, variable quality, transportation issues, heavy metal contamination and slow nutrient release. The exclusive dependence of either organic or inorganic fertilizers has not adequately fulfilled the increasing demands for enhanced agricultural output and quality. To address these challenges, organo-mineral fertilizers (OMFs) have emerged as an innovative solution. OMFs are derived from the combination of mineral and organic nutrient sources, integrating the benefits of both. This low input technology supplies nutrients in balanced quantities that are readily and steadily available throughout the growing season. OMFs improve soil physical properties, enhance fertility and support sustainable crop production. They also promote plant resistance to biotic and abiotic stress, offering a holistic approach to agricultural challenges. The development of OMFs aligns with the recycling of urban, industrial and agricultural residues, reducing dependency on raw materials for chemical fertilizers and contributing to environmental sustainability. Advances in OMF preparation, using various mineral and organic matrices, have demonstrated their ability to address nutrient deficiencies, particularly in tropical soils, where poor fertility often limits productivity. OMFs enhance soil physico-chemical and biological properties, addressing soil degradation while improving crop yield and quality. They ensure an optimal supply of nutrients, support long-term soil health and align with modern fertilizer management strategies aimed at sustainable agricultural productivity. In conclusion, OMFs are a promising solution for boosting crop quality and yield while maintaining soil fertility. By incorporating the advantages of organic and inorganic inputs, they provide a balanced, sustainable, and efficient strategy to address growing demands for food production.

The Adoption of E-Government Systems in Public Sector Accounting: Case Study of Zimbabwe

This paper addresses the use of e-government tools in Zimbabwe's public sector accounting, highlighting how these systems enhance the efficiency, openness, and accountability of government financial management. Technologies for e-government can automate financial procedures, cut down on errors, and supply real-time data for well-informed decision-making. This essay addresses the use of e-government tools in Zimbabwe's public sector accounting, highlighting how these systems enhance the efficiency, openness, and accountability of government financial management. Financial procedures can be automated by e-government technologies, which can also lower errors and supply real-time data for defensible decision-making. Using a mixed-methods approach, the study collects secondary data from official publications and policy documents in addition to quantitative surveys and qualitative interviews with government officials, accountants, auditors, and IT specialists. The findings indicate noteworthy advancements in more expansive ministries, propelled by policies and programs designed to enhance openness and counteract malfeasance. Smaller departments do, however, encounter difficulties that cause unequal adoption, such as tight funds, a lack of qualified staff, and antiquated IT equipment. Notwithstanding these obstacles, e-government programs have improved Zimbabwe's financial reporting accuracy, accountability, and audit trails. However, problems including system failures, reluctance to adapt, and insufficient training still make them less successful. To increase the use of e-government in public spaces, the report suggests more robust policy frameworks, focused investments in ICT infrastructure, capacity-building initiatives, and regular monitoring.

Immediate postpartum contraceptive implant placement and breastfeeding success in postpartum people at risk for low milk supply: A randomized non-inferiority trial.

Our goal was to measure the impact of postpartum contraceptive implant insertion timing on breastfeeding success and duration in a population at high-risk for low milk supply. We conducted a three-armed randomized non-inferiority study of postpartum people who plan to breastfeed and have known risk factors for low milk supply. Participants were randomized to one of three groups for the timing of implant placement: within 30minutes of placental delivery, 24-72hours postpartum, or 6+weeks postpartum. The primary outcome was time to lactogenesis II (LII). Secondary outcomes included duration and exclusivity of breastfeeding and implant satisfaction through 6 months postpartum. We enrolled 155 participants. Compared to those who received implants 6+weeks postpartum, those who received it ≤30minutes postpartum (mean difference: 2.92hours, 95% CI: -9.26, 15.1, p=0.64) or 1-3 days postpartum (mean difference: -0.75hours, 95%CI: -13.02, 11.51, p=0.90) had similar time to LII. Similar results were observed for intention to treat analysis. Duration and exclusivity of breastfeeding and implant satisfaction were similar among all groups. Unfortunately, our results did not meet the threshold of non-inferiority because the confidence intervals included the 8hours non-inferiority margin defined a priori. However, our results indicate similar time to LII between groups. Ultimately, our study suggests that early etonogestrel implant insertion does not affect breastfeeding success among postpartum people at risk for low milk supply. Etonogestrel implant insertion can be offered anytime postpartum to meet the needs of postpartum people.

Waterfalls Alter Reach‐Scale Fluvial Erosion Rates: Evidence From Field Data and Process Modeling

AbstractWaterfalls are often interpreted as transient, upstream‐propagating features that mark changes in external conditions. Thus, waterfalls are commonly used to infer past tectonic and climatic forcing, making understanding the controls on waterfall erosion central to predicting how external perturbations move through landscapes. Surprisingly, there exist few direct field measurements of waterfall erosion, and existing waterfall retreat measurements are rarely paired with measurements of waterfall morphology and frequency, which, theory suggests, modulate retreat rates. This lack of data limits our ability to test existing theory and explore how waterfalls alter reach‐scale bedrock erosion rates. Here, we use cosmogenic 10Be accumulated in bedrock riverbeds to measure erosion rates in fluvial reaches with varying waterfall frequency and morphology. We find that waterfall‐rich reaches erode one to five times faster than the landscape average, and that reach‐averaged erosion rates increase with increasing waterfall frequency. We develop a new, process‐based model combining waterfall and planar‐channel erosion to explore mechanistic controls on the relative erosion rate between waterfall‐rich and waterfall‐free reaches. This model predicts that reach‐averaged erosion rates increase with waterfall frequency at low sediment supply, consistent with our field measurements, but that waterfalls can also slow reach‐averaged erosion rates for high sediment supply, large grain sizes, low water discharge, or large plunge pools. Our work is consistent with previous suggestions that waterfall erosion rates may decrease in low drainage areas and can influence long‐profile morphology.

Understanding modifiable barriers to human milk donation in the United Kingdom.

When premature infants cannot receive their own mother's milk, donor human milk (DHM) is the first-line recommended option, with growing demand for DHM use outside of neonatal units. To meet the potential need, we need to consider whether DHM supply can increase. This study aimed to explore the reasons that prevent women who wish to donate their milk in the United Kingdom from doing so to understand which barriers may be modifiable. Women who wanted to donate their milk but did not do so completed an online survey. Open and closed questions examined the response they received, their reasons for not donating and what they did with any milk that they had already stored. Out of 732 mothers, 391 (53.4%) did not enquire as they did not think it was possible for them, 218 (29.8%) enquired but were told that they could not donate, 59 (8.1%) enquired but decided not to proceed and 64 (8.7%) received no response. Reasons for being told they could not donate included the use of certain medications, infant age, inadequate staffing, geographic barriers and incorrect storage. Process aspects (e.g., blood tests, practicalities) and lifestyle limitations led mothers to decide not to donate. Although some women will be prevented from donating due to medication or health issues, investment in milk banking staffing and infrastructure and awareness campaigns could increase DHM supply, enabling guidelines to extend eligibility criteria for receiving DHM such as for late preterm infants, gestational diabetes or to support low maternal milk supply.