Northeastern United States Research Articles

Abstract WMP25: Predictors of Certified Stroke Center Presence in the Northeastern United States

Abstract WMP25: Predictors of Certified Stroke Center Presence in the Northeastern United States

Characterizing Model Uncertainties in Simulated Coast-to-Offshore Wind over the Northeast U.S. Using Multi-platform Measurements from the TCAP Field Campaign

Numerical weather prediction models, such as the Weather Research and Forecasting model, are widely used to provide estimates of the offshore wind energy resource owing to their large spatial coverage compared to available observations. Nevertheless, spatiotemporal distribution of model biases is highly dependent on factors including model configuration, location, and the interplay of multiscale physical processes. Here we focus on the characterization of model uncertainties in simulated coast-to-offshore winds over the northeast United States by varying sea surface temperature (SST) forcings and surface layer (SL) and planetary boundary layer (PBL) parameterizations, as well as identifying biases that may be directly passed from initial and boundary conditions. Multiple measurements, including aircraft data collected during the U.S. Department of Energy's Two-Column Aerosol Project experiment, are used to constrain the model results, and facilitate quantitative comparisons. Our analysis indicates that while SST forcing has notable impacts on simulated air temperature and moisture within PBL, the modeled winds are in general more sensitive to the choices of SL and PBL physics than to SST. The model’s forcing data not only controls the vertical dependence of wind speed errors, but also alters regional variability in the wind speed’s spatial correlation, which underscores the impact of initial and boundary conditions on simulated winds. Coastal and offshore near-surface wind speed biases tend to exhibit much higher similarity in winter than in summer due to the presence of much stronger and more persistent synoptic wind conditions. This study highlights the importance of accurate atmospheric forcing and parameterization choices in improving wind forecasts and suggests the potential for extrapolating coastal wind biases to offshore locations, aiding wind energy forecasting and informing the third Wind Forecast Improvement Project.

Declining trends in canopy disturbance across reserve forest landscapes of the northeastern US

Declining trends in canopy disturbance across reserve forest landscapes of the northeastern US

A Model to Validate Different Inflections of Assamese Verbs

: A verb in a sentence defines the action to be performed and keeps the subject of the sentence in motion. Assamese is a language spoken by millions of people in Assam, a North Eastern state of India. In the Assamese language, different inflections of verbs express the tense of the action, whether it is present, past or future. Verbs are inflected according to person, number, gender, tense, and voice, thus showing their existence in different situations. In this research work, we have built a tool to check whether an Assamese verb form is valid or invalid. After checking the validity, it also displays the meaning of the inflected form of the root verb in English. The root verbs are conjugated with the inflectional morphemes, and inflected verb forms are recorded. Background: This work is completely new and done by the authors for the Assamese language. To build this tool, a few research papers on this language were studied, and a summary of them is written in the Related Work section. Methods: In this experiment, 72 root verbs and 132 inflections were used. GUI was designed by using Tkinter in Python. The inflected verb form passed through three modules consisting of different searching techniques. Assamese corpus, Google search, Assamese Wikipedia, and Manual evaluation, respectively. Result: Finally, 662 Assamese valid verb forms were found that have meaning and are used in a different context. Corpus search, Google search, Assamese Wikipedia and Manual Evaluation gave 232, 733, 550 and 112 numbers of overall search results accordingly. Novelty: This paper presents a novel validation framework for Assamese language verb inflections, which could help the linguistic community better comprehend verb inflection patterns and linguistic diversity. The manuscript explores the inflections of a lesser-known low-resource language that would be beneficial. This study could be considered as innovative and important because it has applications in areas like speech recognition, machine translation, and natural language processing. Social Implication: The linguistic community would benefit greatly from the creation of a new, freely accessible, user-friendly interface intended exclusively for validating Assamese verb inflections. The approaches used here to recognize correct inflections of Assamese verbs have been performed with in-depth analysis. The approach could have implications for language learning and education, improving machine translation and natural language processing systems. Validating the verb inflections may help in raising the awareness and recognition of research focused on underdeveloped or marginalized languages. As a result, speakers of these languages might have more equitable access to information, resources, and opportunities, thus resulting in a decrease in linguistic prejudice.

P-1480. Staphylococcus aureus Susceptibilities Among Patients Who Use Illicit Fentanyl in Philadelphia, Pennsylvania

Abstract Background Patients who use drugs are at high risk for Staphylococcus aureus infection. Within the Northeastern United States, fentanyl has become the prominent substance in the illicit opioid supply. We developed a S. aureus antibiogram among patients who use fentanyl (PWUF) presenting with acute S. aureus skin or skin structure infections (SSSI) in Philadelphia, Pennsylvania. Table 1 In vitro susceptibility of S. aureus clinical isolates from the wounds of people who use fentanyl. Susceptibilities presented as a proportion of total isolates tested for each antibiotic. Methods In this retrospective, multi-center study, patients presenting to one of four Penn Medicine hospitals with an acute S. aureus SSSI and illicit fentanyl use within the previous year were included. Susceptibilities of S. aureus isolated from skin and skin structure cultures were described among the PWUF cohort and compared to the health system’s outpatient wound antibiogram. Opioid withdrawal parameters were compared between patients who left the hospital prior to and after the availability of S. aureus susceptibilities. Table 2 In vitro susceptibility of S. aureus clinical isolates from the wounds of people who use fentanyl compared to S. aureus isolated from wounds of all outpatients in the health system. Susceptibilities presented as a proportion of total isolates tested for each antibiotic. Results Among 131 S. aureus isolates from 131 PWUF presenting with an acute SSSI, 35/131 (26.7%) were susceptible to oxacillin, 73/121 (60.3%) were susceptible to clindamycin, 77/122 (63.1%) were susceptible to tetracycline, and 119/126 (94.4%) were susceptible to trimethoprim-sulfamethoxazole (Table 1). PWUF displayed significantly reduced susceptibility to oxacillin and tetracycline compared to the health system’s outpatient wound S. aureus antibiogram (Table 2). Seventy (53.4%) patients were discharged prior to the availability of S. aureus susceptibilities, 46 (65.7%) of which were patient-directed discharges. Compared to patients discharged prior to the availability of susceptibilities, a greater proportion of patients discharged after the reporting of susceptibilities were administered buprenorphine or methadone in the hospital (82.0% vs 51.4%, p< 0.001). Conclusion High rates of non-susceptibility to clindamycin and tetracycline suggest these agents should not be prescribed as empiric therapy for acute S. aureus SSSI in PWUF. PWUF would benefit from joint management by infectious diseases and addiction medicine experts to prevent premature discharge and ensure prescription of active therapy. Disclosures Christina Maguire, PharmD, Viiv: Advisor/Consultant

P-2153. Babesia Coinfection is not Associated with Higher Mortality in the United States, 2015-2023: a Retrospective Cohort Study

Abstract Background Babesiosis is a tickborne illness caused by the Apicomplexan parasites known as Babesia spp, and severe disease is associated with a high mortality rate. Babesiosis is often co-transmitted by other deer-associated zoonoses, including Lyme disease, Ehrlichiosis, and Anaplasmosis maintained by the same vector tick, Ixodes spp. These zoonoses are endemic in the Northeastern United States. Babesiosis-associated coinfection and mortality outcomes are not fully elucidated. The objective of the present study is determining babesiosis coinfection prevalence rates and estimate mortality outcomes. Methods TriNetX database between 2015 and 2023 was queried for patients with Babesiosis. Cox-proportional hazard model was employed to estimate the mortality risk associated with coinfections (Babesiosis infection co-diagnosed with one or more tickborne illnesses). The analysis focused on Babesiosis coinfection with Lyme disease, Ehrlichiosis, and Anaplasmosis. The exposure was coinfection, and the control group was the Babesia-only population. The primary outcome was a 90-day mortality from the diagnosis of Babesia. Results Of the 3521 Babesiosis patients, the mean age was 55 years (SD:18), 51% were male, 75% were White, 2% had asplenia, and 11% had malignancies. Babesiosis cases are on the rise with highest incidence in summer (Fig 1). The prevalence rate of 1 or more co-infection was 42%; 95% CI (40%-43%, Fig 2). Coinfection with Borrelia burgdorferi was the highest with 41%; 95% CI (39%-42%), followed by Ehrlichiosis at 3.7%; 95% CI (3.1%-4.4%). Overall, 90-day mortality was 1.4%; 95% CI (1.0%-1.8%). After adjusting for potential confounders, compared to the coinfections group, the mortality risk was lower in the Babesiosis-only group (HR: 0.43; (95% CI: 0.20-0.90, Fig 3). Conclusion In the extensive study of over 3000 patients with Babesiosis in the United States, the prevalence rates of coinfection were highest with Borrelia burgdorferi, followed by Ehrlichiosis. Rates for Anaplasmosis were low. Coinfection with other tick-borne infections did not increase mortality. It is plausible the findings are due to the likelihood of earlier detection and treatment of coinfection (particularly Lyme disease) with doxycycline. Disclosures All Authors: No reported disclosures

P-1405. Drivers of Unplanned Pregnancy among Women with HIV in the Northern and Southern United States

Abstract Background National estimates from 1986-2015 show that the proportion of unplanned pregnancies among women with HIV (WWH) is high at 78% and that Black/African American women are disproportionately impacted. We aimed to evaluate the prevalence of unplanned pregnancy using a contemporary cohort of pregnant and postpartum WWH (2019-2024), and identify the individual, interpersonal, community and societal factors associated with pregnancy planning.Table 1.Sociodemographic, sociocultural, and psychosocial variables in a cohort of pregnant and postpartum women (2019-2024)Footnote: social support (Likert scale 1=never 5=always), HIV provider trust (Likert scale 1=strongly disagree 5=strongly agree), self-efficacy (additive scale 0=cannot do at all 10=completely certain can do), HIV related stigma (additive 0=never experienced 9=heavily experienced) Methods We performed a secondary data analysis of cross-sectional surveys from an on-going randomized controlled trial testing a peer-led behavioral intervention to improve postpartum retention in HIV care. WWH were recruited from six sites in the northeast and southern US. We used unadjusted and adjusted logistic regression to estimate the association between study outcome, pregnancy planning (“Were you planning to get pregnant?” Yes/No) and individual/interpersonal (self-efficacy, social support, HIV provider trust, HIV related stigma) and community/societal (race, ethnicity, marital status, income, employment) factors.Table 2.Factors associated with pregnancy planning among women with HIV Results To date, a total of 137 women (83% Black, 7% White, 10% Asian, American Indian/Alaska Native, Native Hawaiian/Pacific Islander categorized as other race; 14% Hispanic ethnicity) enrolled in the trial and were included in this analysis. The proportion of unplanned pregnancy was high at 73%. Among WWH with unplanned pregnancy, 90% were Black, 4% were White, 6% were women of other race (p=0.002). While Black women had significantly reduced odds of pregnancy planning (OR 0.18, 95% CI 0.046-0.68), married women (OR=3.33, 95% CI 1.26-8.85), women with higher income (OR=1.27, 95% CI 1.03-1.57) and those with employment (OR 2.33, 95% CI 1.08-5.03) had higher odds of pregnancy planning. In the fully adjusted model, Black race (aOR 0.11 95% CI 0.02 -0.48) was the only factor negatively associated with pregnancy planning. Conclusion Unplanned pregnancy among women with HIV and its disproportionate burden on Black women continues to be an area we have yet to make significant progress. Interventions addressing social determinants of unplanned pregnancy and racial disparities are needed to improve reproductive health care for WWH. Disclosures William R. Short, MD, Gilead: Grant/Research Support|Janssen: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Honoraria Rachel Scott, MD,MPH,FACOG, DHHS Perinatal Guidelines: Board Member|UW STD Prevention Training Center (UW STD PTC): Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support|Vindico CME: Honoraria

P-1429. Racial Disparities in Childhood Vaccination Rates and Their Association with State-Level Structural Racism

Abstract Background Racial disparities in childhood vaccination rates are well-documented nationally. These disparities may vary across states due to multiple reasons, including vaccine exemptions. A structural racism score is a measure developed to quantify systemic racial disparities across various domains, including segregation, economic status, and incarceration. Notably, structural racism is more pronounced in Northeastern and Midwestern states of the United States. Leveraging recently published Black structural racism scores at the state level, we examined the relationship between structural racism and childhood vaccination rates among non-Hispanic Black and non-Hispanic White children. Methods We analyzed 5-year aggregate vaccination rates (2017-2022) for children aged 19-35 months using data from the US Centers for Disease Control and Prevention National Immunization Survey-Child (NIS-Child). The main outcome was the difference in percentage points between non-Hispanic Black and non-Hispanic White childhood vaccination rates for each state. The childhood vaccination rate was defined by whether children received all recommended vaccines (4+ DTaP/DTP/DT; 3+ polio; 1+ measles-containing vaccine; full series Hib; 3+ Hep B; 1+ varicella at or after 12 months of age; and 4+ PCV). Eleven states were excluded from analysis due to fewer than 30 non-Hispanic Black respondents. We investigated the relationship between state-level structural racism scores for non-Hispanic Black individuals and calculated vaccination rate differences by linear regression analyses. Additionally, we examined the relationship in states that allowed religious exemptions for childhood vaccinations. Results At the state level, higher structural racism scores were associated with greater disparities in childhood vaccination rates between non-Hispanic Black and non-Hispanic White children (Figure 1). Importantly, these associations were significant only in states that allowed religious exemptions for childhood vaccinations (Figure 2, p = 0.046). Conclusion When childhood vaccination exemptions are permitted, state-level structural racism may significantly contribute to the observed racial disparities in vaccination rates among non-Hispanic Black children. Disclosures All Authors: No reported disclosures

Anticoagulant rodenticides may affect fisher population trends in the northeastern United States

AbstractRegrowth of forests across the northeastern United States in recent decades has allowed for range expansion of many forest‐dependent mammals in the region. However, these contemporary forests have smaller patch sizes, putting humans in closer proximity to previously remote forested areas, and different species compositions and structure compared to historical forests. These conditions pose an increased risk of exposure to anthropogenic disturbances and contaminants for forest‐dwelling wildlife. We evaluated the relationship between contemporary forest conditions and anticoagulant rodenticides (ARs) on recent population trends for fishers (Pekania pennanti). We acquired a snapshot of recent population trends for fishers across New York, Vermont, and New Hampshire, USA, using standardized catch‐per‐unit‐effort (CPUE) data from the regulated fall harvest spanning 2016‐2020, when harvest regulations remained consistent across the states. We used regression models to relate the probability of CPUE increase to measures of forest habitat (age, structure, productivity), length of winter snow cover, and human disturbance (land use patterns and AR detection). The top model indicated that the probability of CPUE increase declined 43% for every 10% increase in the percent of the population exposed to at least 1 AR and by 24% for every 1‐day increase in the length of winter snow cover, while measures of forest conditions had no significant relationship. The relationship between AR detection and suppressed CPUE increase is compelling, as few mammalian studies effectively link the detection of AR residues in animal tissues to population‐level performance in the wild. Nevertheless, longer time frames are required to fully understand population trends and their drivers across heterogeneous landscapes. We recommend the fisher as a model species for longer‐term monitoring of AR detections and for comparing outcomes of measures potentially designed to reduce AR impacts on wildlife in this region.

COBERTURA VACINAL NA REGIÃO NORDESTE NO PERÍODO PRÉ E PANDÊMICO ENTRE DOS ANOS DE 2018 A 2022: UM ESTUDO DESCRITIVO

ABSTRACT The study aimed to analyze vaccination coverage in the northeast region in the pre- and pandemic period between the years 2018 to 2022. This work was configured as an epidemiological and retrospective, descriptive study, analyzing secondary data, obtained from the Health Information System for Primary Care - SISAB and data collected from the National Health Survey (PNS) and Unified Health System (DATASUS). Thus, vaccination coverage in the northeast region decreased in the years 2019, 2020 and 2021, with 2021 having the lowest vaccination coverage, with 35.33% coverage in the region. In 2018, when all the states of the northeast were analyzed, the state of Sergipe had the highest vaccination coverage, reaching 100% coverage. Regarding the proportion of 1-year-old children vaccinated in PHC against Diphtheria, Tetanus, Pertussis, Hepatitis B, infections caused by Haemophilus influenzae type b and inactive Poliomyelitis, it was found that in 2018, Maceió, Salvador, Fortaleza, São Luís and Natal reached 100% vaccination coverage, while other capitals had varied rates. In 2022, there was a significant drop in all northeastern states. In addition, it was possible to observe that the highest hepatitis B vaccination coverage in the northeast region was in 2018, which reached 89.52% of vaccination coverage. It is expected that the study will assist policies to combat vaccination coverage in the northeast region, in addition to contributing to the literature and medical sciences in a broad way. Keywords: Immunization Schedule; Collective Immunity; Hepatitis B vaccine.

Navigating Migration: Role of Body Image and Cultural Intelligence in Racial Minority Adaptation

This study investigated the interrelations of body image and cultural intelligence in the acculturation process and outcomes for an internal migrant group belonging to the northeastern states of India ( N = 246). Outside the Northeast India region, the sample formed a racial minority that often faced discrimination. Experiencing race and appearance-induced discrimination evidently influenced the body image, well-being and adjustment of the sample. Responses to self-reported questionnaires indicated that body image positively correlated to cultural intelligence and the integration acculturation strategy, both of which promoted adaptation. Body image also negatively related to the least adaptive marginalisation acculturation strategy. Furthermore, path analysis indicated that body image predicted life satisfaction ( β = 0.22, p < .05), and cultural intelligence positively moderated ( β = 0.21, p < .05) effects of body image on life satisfaction. It is suggested that cultural intelligence may promote viable outcomes of body image through its influence on self-esteem and facilitating adaptive outcomes of acculturation strategies among racial minorities in contexts characterised by prejudice.

Airspace closures due to reentering space objects

Uncontrolled reentries of space objects create a collision risk with aircraft in flight. While the probability of a strike is low, the consequences could be catastrophic. Moreover, the risk is rising due to increases in both reentries and flights. In response, national authorities may choose to preemptively close airspace during reentry events; some have already done so. We determine the probability for a rocket body reentry within airspace over a range of air traffic densities. The highest-density regions, around major airports, have a 0.8% chance per year of being affected by an uncontrolled reentry. This rate rises to 26% for larger but still busy areas of airspace, such as that found in the northeastern United States, northern Europe, or around major cities in the Asia-Pacific region. For a given reentry, the collision risk in the underlying airspace increases with the air traffic density. However, the economic consequences of flight delays also increase should that airspace be closed. This situation puts national authorities in a dilemma—to close airspace or not—with safety and economic implications either way. The collision risk could be mitigated if controlled reentries into the ocean were required for all missions. However, over 2300 rocket bodies are already in orbit and will eventually reenter in an uncontrolled manner. Airspace authorities will face the challenge of uncontrolled reentries for decades to come.

On-farm evaluation of swede midge (Diptera: Cecidomyiidae) susceptibility among popular kale varieties.

The swede midge, Contarinia nasturtii Kieffer (Diptera:Cecidomyiidae), is a gall-forming insect pest that targets cruciferous plants. Since its introduction to North America in the early 2000s, the midge has expanded its range to include farming regions in Quebec and the Northeastern USA. In this study, we evaluated the susceptibility of 4 popular kale varieties-Green Curly-(Vates), Red Russian, Red Curly (RedBor), and Lacinato/Tuscan-to swede midge infestation in on-farm trials conducted over consecutive years. Our results indicate substantial variability in susceptibility among varieties, with Red Russian kale consistently exhibiting the highest damage incidence across both years. These findings provide valuable insights for developing effective integrated pest management (IPM) strategies tailored to organic and small-scale vegetable farming contexts, emphasizing the role of crop genetic resources in pest mitigation and sustainable agriculture. In addition, this study highlights the potential of non-chemical approaches for managing swede midge, leading to a more diverse and adaptable IPM toolbox for growers.

Prevalence of complications and comorbidities associated with obesity: a health insurance claims analysis

BackgroundDespite the substantial burden of obesity in the United States (US), data on the comprehensive range of comorbidities in different age groups is limited. This study assessed the prevalence of various comorbidities among people diagnosed with obesity (as per ICD-10 diagnosis code) across age cohorts and compared how they differ from people without obesity.MethodsThis cross-sectional study analyzed individuals from all four regions (Midwest, Northeast, South, and West) of the US who had continuous insurance coverage from 2018 to 2020, using a large health insurance claims database (Merative™ MarketScan®). Identification of disorders relied on ICD-10 diagnosis code in patient claims and their prevalence was calculated.ResultsOf 6,935,911 individuals, people with a diagnosis of obesity accounted for 22.0%, 33.6%, and 34.4% in the 18–39 years, 40–64 years, and ≥ 65 years age groups, respectively. Within age strata, the mean age of people with obesity was comparable with those without obesity. Comorbidity burden was significantly higher among people with obesity, but increased with age in both obesity and non-obesity groups. Comorbidities with highest prevalence in people with obesity included: (i) hypertension (18–39 years: 29.0%, 40–64 years: 66.2%, ≥ 65 years: 89.4%), (ii) dyslipidemia (18–39 years: 28.1%, 40–64 years: 65.4%, ≥ 65 years: 88.0%), (iii) depression or anxiety (18–39 years: 44.1%, 40–64 years: 39.0%, ≥ 65 years: 38.9%), and (iv) prediabetes (18–39 years: 17.1%, 40–64 years: 32.2%, ≥ 65 years: 35.3%). Notably, increased prevalence of cardiometabolic risk factors such as hypertension and dyslipidemia began at an earlier age in people with obesity as compared with those without obesity. Ratio of prevalence between obesity and non-obesity groups was highest for the 18–39 years age group, as compared to older groups. Disorders such as obstructive sleep apnea, osteoarthritis, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, coronary heart diseases (CHD), and chronic kidney diseases also exhibited substantial burden among those with obesity.ConclusionsIn this claims study, hypertension and dyslipidemia were the leading comorbidities in people with obesity, with an increasing prevalence with age. The burden of cardiometabolic comorbidities among the younger age group suggested potential risk for early onset of CHD in later life. Understanding the range of obesity-related comorbidities seen in this claims data may encourage healthcare professionals and healthcare systems to systematically diagnose and better manage these disorders. Further research using additional data sources can offer a more accurate view of the prevalence of obesity and its impact.

Implementation of an Advance Directives Completion Protocol for Hospitalized Patients With Serious Illness: A Quality Improvement Initiative.

Despite mandates requiring hospitals to offer advance directives to all patients, many adults do not have advance directives in place at the end of life. This quality improvement project aimed to implement an evidence-based, standardized protocol to increase advance directive completion rates for hospitalized patients with serious illnesses. A preimplementation and postimplementation design was used to evaluate the impact of an educational intervention and advance directive completion protocol. The project was conducted at a midsized urban community hospital in the Northeastern United States. Charts were reviewed for 250 patients with serious, chronic illnesses admitted under family medicine. Over the 11-month project period, advance directive completion rates increased from 21% (17/82) preintervention to 43% (73/168) postintervention, a statistically significant improvement of 22% (P = .001). Protocol compliance rates increased from 0% to 50% (8/16) for nurses and from 17% to 31% (9/52 to 21/68) for resident providers. The results support the use of a standardized advance directive completion protocol, combined with educational sessions, to improve advance directive completion rates for seriously ill patients and safeguard their autonomy at the end of life.

A Study of Customary Laws and Child Adoption Practices by Infertile Parents Amongst the Rongmei Tribes With Special Reference to Noney District, Manipur

The Rongmei, otherwise referred to as “Kabui“, is a significant indigenous ethnic community and one of the prominent Naga tribes having their beautiful vibrant cultural heritage, traditional music, dance and customary rites and rituals, inhabiting primarily in the northeastern states of India, Manipur, Assam, Nagaland, and Tripura. The Rongmei people still contribute to the rich tapestry of cultures in this region of India, and their distinctive traditions continue to play a vital role in shaping the cultural mosaic of this ethnically diverse part of the country. Large numbers of this tribe concentrate in the state of Manipur, particularly in Nrianghluang (Tamenglong) district, north-west of Manipur and speaking the Language know as “Ruanglat” with their currently written in Roman Alphabets, but also they are working on developing a new Script. Infertility problem in traditional Rongmei family is believed to be caused by the evil spirit called Kairoa. Kairoa are the evil spirits of the ancestors who died an unnatural deaths (e.g. suicide, lightening strike etc.) in order to perform a ritual successfully the family has to study the history of their ancestors to find out if there is any Kairoa in the families in the past. Before performing the fertility Ritual, the family members has to make appease with this spirits. Adoption on the other hand is an age old tradition of Rongmei infertile parents to have an offspring outside of their marriage. In spite of all the rituals perform for fertility of the married couples, if the infertile couple did not have a child, they look forward to adopt a child. Rongmei community in traditional way has their own way of child adoption practices. Generally there is no definite rule exist in the Rongmei tribal community. It is mainly the married couple to decide whom to adopt as their offspring. This research paper will study on the fertility rituals adoption practices perform by the village elders and this work will be a significant contribution to the lacking documentation of the oral traditions which are richly practice by this community, Rongmei. It will also give light to the future generations to consider their traditional laws and customs significantly beyond legalities.

Real-World Rollout of Injectable Antiretrovirals for HIV Prevention and Treatment: Correlates of Early Adoption

Abstract Background Data is limited on implementation of long-acting injectable (LAI) HIV treatment (ART) and pre-exposure prophylaxis (PrEP). We characterized “early adopters” of LAI ART and PrEP in terms of social determinants of health, using a health equity lens. Methods A retrospective cohort included patients prescribed ART or PrEP through a large urban health system (January 2021-September 2023) in the Northeastern US. We used EHR data for PrEP and ART to examine group differences between those on LAI or oral medications for each, using ANOVA, chi-square tests or Fisher’s exact tests. Bivariate logistic regression modeled associations between LAI ART or LAI PrEP and social determinants of health. Results In the PrEP group, 238 patients were prescribed LAI (n=63) or oral (n=193) PrEP. Most PrEP patients were men (80.7%), non-Hispanic (79.5%), white (60.7%) and had public insurance (83.1%). Compared to patients on oral PrEP, those on LAI less often experienced food insecurity, financial strain, depression, anxiety or substance use disorders. In bivariate models, LAI PrEP inversely correlated with female sex, current smoking, depression, anxiety, and substance use disorders. In the treatment group, 1194 patients were prescribed LAI (n=76) or oral (n=1118) ART, with median age 57.0; 63.6% were from minoritized groups. Only age was significantly associated with LAI ART (OR=0.97,95% CI=0.961-0.993, p=0.005). Conclusion In this large retrospective cohort of patients on LAI PrEP and ART, patients receiving LAI less often experienced social barriers. Public health interventions are needed to overcome health inequities tied to access of LAI for HIV prevention and treatment.

Modeling dissolved organic carbon export from water supply catchments in the northeastern United States.

Natural organic matter (NOM) in rivers is an important energy source to sustain aquatic ecosystem health. However, in surface water supply systems where chlorination is often used for disinfection, NOM is also a precursor for the carcinogenic and mutagenic disinfection byproducts such as trihalomethanes and haloacetic acids. Effective management of NOM in rivers to maintain both aquatic ecosystem functions and high-quality water supply requires better understanding of the NOM transport patterns. NOM is often operationally measured by dissolved organic carbon (DOC). Challenges of using DOC data for analysis on a catchment scale largely relate to the spatial and temporal variations in DOC, and low sampling frequency which fails to capture the multi-scale transport patterns. To help improve the understanding of DOC sources and transport, we analyzed its long-term patterns in six water supply catchments in the New York City Water Supply System using monitoring data and models. We tested six empirical models for DOC prediction including linear, nonlinear and time-series based model formulations. We found that generalized additive models (GAMs) produced the most robust results across catchments. Then, we applied the calibrated GAM to predict daily DOC concentrations to estimate fluxes and analyze for trends. Finally, we compared the relationships between temporal patterns in DOC and catchment features to investigate the regional differences, focusing on the catchment mechanistic processes associated with DOC by parsing out the hydrological signals. The results showed that hydrology plays a larger role on DOC temporal patterns in three catchments where the top 5% streamflow corresponded to nearly 50% of the annual DOC export, whereas nutrient associated production processes were more important in others. The study presents a robust approach for DOC prediction in streams and can inform targeted monitoring strategies for DOC management in water supply source waters.

Parental Factors Associated With Measles-Mumps-Rubella Vaccination in US Children Younger Than 5 Years.

Objectives. To determine the association between parental characteristics and MMR (measles-mumps- rubella) vaccination status of children in the United States. Methods. We conducted a cross-sectional study from July 2023 to April 2024 using a digital health survey via OutbreaksNearMe, weighted to target national population characteristics. We analyzed the responses of 19 892 parents of children younger than 5 years to examine the association between self-reported parental characteristics (i.e., sociodemographics, politics, COVID-19 vaccination status) and children's MMR vaccination rates using logistic regression. Results. Children of parents who received at least 1 dose of the COVID-19 vaccine had higher MMR vaccination rates (80.8%) than did children of unvaccinated parents (60.9%; odds ratio [OR] = 1.84; 95% confidence interval [CI] = 1.68, 2.00). We observed lower MMR vaccination rates among children of parents who identified as Republican versus Democratic (OR = 0.73; 95% CI = 0.64, 0.82), parents on Medicaid or Medicare versus private insurance (OR = 0.85; 95% CI = 0.76, 0.95), and minority (OR = 0.44) versus White (OR = 0.71) parents. We found higher MMR vaccination rates in the Northeast and Midwest United States. Conclusions. Early data indicate that parental sociodemographic characteristics and COVID-19 vaccine status are associated with children's MMR vaccine uptake, emphasizing the need for further investigations into multipronged public health interventions. (Am J Public Health. Published online ahead of print January 16, 2025:e1-e5. https://doi.org/10.2105/AJPH.2024.307912).

Respectful Maternity Care in the United States: A Scoping Review of the Research and Birthing People's Experiences.

Birthing people around the world experience mistreatment during labor and birth, contributing to adverse maternal health outcomes. The adoption of respectful maternity care (RMC) has been recommended to address this mistreatment and improve care quality. Most RMC and mistreatment research has been conducted internationally. The purpose of this scoping review was to (1) explore the extent of RMC research and (2) describe labor and birth experiences in the United States. Embase, Scopus, and CINAHL databases were searched for concepts relating to RMC and mistreatment. A total of 66 studies met review inclusion criteria. Two reviewers screened titles, abstracts, and full-text articles. Data were extracted and categorized using the Bohren et al typology of mistreatment. Summary statistics and narrative summaries were used to describe study characteristics and birthing people's experiences. Most studies represented national or urban samples and Western or Northeastern US regions. Few were from the South, and only one represented rural participants specifically. Few studies represented the unique experiences of justice-involved birthing people, and none represented sexual and gender minorities or Indigenous people. Qualitative methods were predominant. The most common forms of mistreatment included (1) poor rapport between women and health care providers (88% of studies), (2) stigma and discrimination (79%), and (3) a failure to meet professional standards of care (73%). The extent of mistreatment in the United States highlights the need for robust programs and policies targeting provision of RMC. Additional research is needed to better understand the experiences of additional minority communities and those living rural areas and in the Southern United States.