Hollow Core-Shelled Na4Fe2.4Ni0.6(PO4)2P2O7 with Tiny-Void Space Capable Fast-Charge and Low-Temperature Sodium Storage.

Iron-based mixed polyanion phosphate Na4Fe3(PO4)2P2O7 (NFPP) is recognized as a promising cathode for Sodium-ion Batteries (SIBs) due to its low cost and environmental friendliness. However, its inherent low conductivity and sluggish Na+ diffusion limit fast charge and low-temperature sodium storage. This study pioneers a scalable synthesis of hollow core-shelled Na4Fe2.4Ni0.6(PO4)2P2O7 with tiny-void space (THoCS-0.6Ni) via a one-step spray-drying combined with calcination process due to the different viscosity, coordination ability, molar ratios, and shrinkage rates between citric acid and polyvinylpyrrolidone. This unique structure with interconnected carbon networks ensures rapid electron transport and fast Na+ diffusion, as well as efficient space utilization for relieve volume expansion. Incorporating regulation of lattice structure by doping Ni heteroatom to effectively improve intrinsic electron and Na+ diffusion path and energy barrier, which achieves fast charge and low-temperature sodium storage. As a result, THoCS-0.6Ni exhibits superior rate capability (86.4 mAh g-1 at 25 C). Notably, THoCS-0.6Ni demonstrates exceptional cycling stability at -20 °C with a capacity of 43.6 mAh g-1 after 2500 cycles at 5 C. This work provides a universal strategy to design the hollow core-shelled structure with tiny-void space cathode materials for reversible batteries with fast-charge and low-temperature storage features.

Beyond guilty by association at scale: searching for causal variants on the basis of genome-wide summary statistics.

Understanding the causal genetic architecture of complex phenotypes is essential for future research into disease mechanisms and potential therapies. Here, we present a novel framework for genome-wide detection of sets of variants that carry non-redundant information on the phenotypes and are therefore more likely to be causal in a biological sense. Crucially, our framework requires only summary statistics obtained from standard genome-wide marginal association testing. The described approach, implemented in open-source software, is also computationally efficient, requiring less than 15 minutes on a single CPU to perform genome-wide analysis. Through extensive genome-wide simulation studies, we show that the method can substantially outperform usual two-stage marginal association testing and fine-mapping procedures in precision and recall. In applications to a meta-analysis of ten large-scale genetic studies of Alzheimer's disease (AD), we identified 82 loci associated with AD, including 37 additional loci missed by conventional GWAS pipeline. The identified putative causal variants achieve state-of-the-art agreement with massively parallel reporter assays and CRISPR-Cas9 experiments. Additionally, we applied the method to a retrospective analysis of 67 large-scale GWAS summary statistics since 2013 for a variety of phenotypes. Results reveal the method's capacity to robustly discover additional loci for polygenic traits and pinpoint potential causal variants underpinning each locus beyond conventional GWAS pipeline, contributing to a deeper understanding of complex genetic architectures in post-GWAS analyses.

Trends in socioeconomic inequalities in malnutrition among children under 5 in the Democratic Republic of the Congo from 2001 to 2018.

OBJECTIVE: Malnutrition in the Democratic Republic of the Congo (DRC) has declined over the past 2 decades. However, malnutrition inequality persists. Evaluating trends of socioeconomic disparities in malnutrition among children under 5 y of age in the DRC can help target meaningful interventions. METHOD: Data from the Multiple Indicator Cluster Survey (2001, 2010, 2018) assessed the prevalence of underweight, stunting, and wasting among children under 5. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) measured socioeconomic inequalities. We evaluated trends in the entire national sample and stratified subsamples based on place of residence and wealth index quintiles. The final sample included 42 976 children. RESULTS: The national prevalence of underweight and wasting decreased from 31% to 26% and 13% to 6% in rural and urban areas. However, trends in stunting prevalence varied between the two areas. Nutritional disparity widened between low- and high-income families (stunting RIIs: 0.61 in 2001, 0.37 in 2018; stunting SIIs: -0.20 in 2001, -0.40 in 2018; underweight RIIs: 0.53 in 2001, 0.35 in 2018; underweight SIIs: -0.21 in 2001, -0.28 in 2018). Urban areas experienced greater inequality than rural areas (stunting in urban RIIs: 0.41 in 2001, 0.33 in 2010, 0.25 in 2018). CONCLUSION: Despite progress in reducing malnutrition, persistent socioeconomic disparities, particularly in urban areas, remain a serious public health concern in the DRC. Addressing the root causes of malnutrition and ensuring socioeconomically equitable access to nutrition is critical to promote the full potential of children.

Factors associated with age-specific maternal health-seeking behaviours among women: A Multiple Indicator Cluster Survey-based study in 10 African countries.

Background: Maternal health-seeking behaviours (MHSB) are crucial for maintaining maternal health and reducing the maternal mortality ratio (MMR). However, little is known about age-specific MHSB in African countries. This study aims to examine the association between composite indicators of maternal characteristics, household conditions, and socioeconomic factors with MHSB among women from different childbearing age groups in 10 African countries. Methods: Based on the responses of 77 303 women and 68 391 households in 10 African countries to a nationally-representative round of the Multiple Indicator Cluster Survey (MICS6), we used age at childbearing to categorize women into groups according to their recent MHSB. In both pooled and age-specific analysis, multivariable logistic regression was applied to identify the predictors associated with MHSB. These factors were ranked with four sets of regression models. Results: This cross-sectional study found a prevalence of 27.69% (95% confidence interval (CI) = 26.93%-28.46%), 45.14% (95% CI = 44.29%-46.00%), and 28.60% (95% CI = 27.82%-29.40%) for four or more antenatal care visits (ANC4), intrapartum care (IPC), and postnatal care (PNC) service utilization, respectively. In the full sample, high household wealth ranked as the strongest determinant for all three MHSB, followed by mass media exposure for ANC4 utilization (odds ratio (OR) = 1.45; 95% CI = 1.20-1.76, P < 0.001), and higher education levels (secondary school education) for IPC and PNC utilization (IPC: OR = 1.49; 95% CI = 1.23-1.79, P < 0.001, PNC: OR = 1.39; 95% CI = 1.20-1.62, P < 0.001). However, higher maternal parity (three births and above) was associated with lower utilization of ANC4 (OR = 0.86; 95% CI = 0.76-0.96, P < 0.007), and residence in rural areas was associated with a lower IPC and PNC utilization (IPC: OR = 0.65; 95% CI = 0.54-0.79, P < 0.001, PNC: OR = 0.70; 95% CI = 0.57-0.85, P < 0.001). Conclusions: Our study provided further information on the direct and indirect factors associated with the utilization of maternal health services by women of different childbearing ages in 10 African countries. Additionally, the heterogeneous results among different childbearing age groups suggest that age-specific programmes and national policies are crucial for improving MHSB, and thus reducing MMR in Africa.

GhostKnockoff inference empowers identification of putative causal variants in genome-wide association studies.

Recent advances in genome sequencing and imputation technologies provide an exciting opportunity to comprehensively study the contribution of genetic variants to complex phenotypes. However, our ability to translate genetic discoveries into mechanistic insights remains limited at this point. In this paper, we propose an efficient knockoff-based method, GhostKnockoff, for genome-wide association studies (GWAS) that leads to improved power and ability to prioritize putative causal variants relative to conventional GWAS approaches. The method requires only Z-scores from conventional GWAS and hence can be easily applied to enhance existing and future studies. The method can also be applied to meta-analysis of multiple GWAS allowing for arbitrary sample overlap. We demonstrate its performance using empirical simulations and two applications: (1) a meta-analysis for Alzheimer's disease comprising nine overlapping large-scale GWAS, whole-exome and whole-genome sequencing studies and (2) analysis of 1403 binary phenotypes from the UK Biobank data in 408,961 samples of European ancestry. Our results demonstrate that GhostKnockoff can identify putatively functional variants with weaker statistical effects that are missed by conventional association tests.

Difference in the Sexual and Reproductive Health of Only-Child Students and Students With Siblings, According to Sex and Region: Findings From the National College Student Survey.

Objective: The differences in sexual knowledge, attitudes, behaviors, seeking behaviors for sex-related knowledge, and sexual and reproductive health (SRH) outcomes among only-child students and students with siblings in China, was examined for sex- and region- specific effects. Research Design and Methods: Data on 49,569 students from the 2019 National College Student Survey on Sexual and Reproductive Health, conducted across 31 provinces in mainland China was utilized. Multivariable regression and stratified analyses were employed to analyze the differences in sexual and reproductive health between only-child students and students with siblings. Results: Only-child students reported higher sexual knowledge, more liberal sexual attitudes, and fewer adverse SRH outcomes compared to those with siblings. Results were found to be influenced by sex and hometown region after controlling for socio-economic factors, parent-child relationship, and sexuality education. Conclusions: Female students with siblings who resided in rural regions were more likely to have poorer SRH compared to male only-child students who resided in urban regions. Comprehensive sexual education for students should aim to better include females and students from rural areas both offline and online, and public healthcare should offer subsidized consultations and contraceptives.

Maternal electronic cigarette exposure in relation to offspring development: a comprehensive review.

Electronic cigarettes (e-cigarettes) have become increasingly popular in young generations in the United States. Because the adverse pregnancy outcomes associated with combustible cigarette smoking are well-recognized, many pregnant women switch to e-cigarettes believing that this alternative is low in toxic chemicals. However, most e-cigarettes contain nicotine, which can easily pass through the placenta and accumulate to a high concentration in fetal blood circulation. Studies have also detected toxic metals (eg, lead, cadmium, and nickel) in e-cigarettes, and carbonyl compounds and flavorings, which are suggested to be irritative and even carcinogenic. There are questions that need to be answered about the risks of e-cigarette exposure during pregnancy. Unfortunately, research evaluating the association between maternal e-cigarette exposure and offspring health is scarce, especially with regard to human studies. Some evidence from laboratory and animal studies, although inconsistent, showed that maternal exposure to e-cigarette vapor may lead to restricted growth of offspring. E-cigarette exposure may also have an impact on the metabolic health of offspring, manifested as distorted glucose homeostasis and energy metabolism. In addition, in utero exposure may lead to defects in respiratory, vascular, and neurologic system development. For humans, investigations mostly focused on immediate birth outcomes such as small-for-gestational-age neonates, low birthweight, and preterm birth; however, the results were inconclusive. Research also suggests that maternal e-cigarette exposure may result in compromised neurodevelopment in newborns. In summary, current evidence is insufficient to rigorously evaluate the health impacts of maternal e-cigarette use on offspring development. Future investigations are warranted.

SO2-Tolerant Catalytic Reduction of NOx via Tailoring Electron Transfer between Surface Iron Sulfate and Subsurface Ceria.

Currently, SO2-induced catalyst deactivation from the sulfation of active sites turns to be an intractable issue for selective catalytic reduction (SCR) of NOx with NH3 at low temperatures. Herein, SO2-tolerant NOx reduction has been originally demonstrated via tailoring the electron transfer between surface iron sulfate and subsurface ceria. Engineered from the atomic layer deposition followed by the pre-sulfation method, the structure of surface iron sulfate and subsurface ceria was successfully constructed on CeO2/TiO2 catalysts, which delivered improved SO2 resistance for NOx reduction at 250 °C. It was demonstrated that the surface iron sulfate inhibited the sulfation of subsurface Ce species, while the electron transfer from the surface Fe species to the subsurface Ce species was well retained. Such an innovative structure of surface iron sulfate and subsurface ceria notably improved the reactivity of NHx species, thus endowing the catalysts with a high NOx reaction efficiency in the presence of SO2. This work unraveled the specific structure effect of surface iron sulfate and subsurface ceria on SO2-toleant NOx reduction and supplied a new point to design SO2-tolerant catalysts by modulating the unique electron transfer between surface sulfate species and subsurface oxides.

Early Sexual Initiation Is Associated with Suicide Attempts among Chinese Young People.

This study aimed to investigate the association between early sexual initiation and suicide attempts (SAs) among Chinese young people. Our analysis included 9131 college students who had sexual experience from a national sample of 31 provincial administrative regions. Self-reported age at first intercourse was categorized as ≤15, 15-18, and ≥18 years, and the experience of SAs was recorded and analyzed. Compared with females whose sexual debut age was ≥18 years, those ≤15 years (defined as early sexual initiation) had higher odds of SAs in both the forced debut group (odds ratio (OR) 17.04, 95% confidence interval (CI) 4.87-59.66) and the voluntary debut group (OR 37.63, 95% CI 14.96-94.66). Early sexual initiators who lived in rural areas were more inclined to have SAs (female: OR 65.76, 95% CI 19.80-218.42; male: OR 15.39, 95% CI 1.64-144.19). Early sexual initiators who never had parent-child communication about sex were more likely to report having SAs (female: OR 37.81, 95% CI 12.28-116.46). Sexual debut during adolescence, particularly early sexual initiation, was a crucial risk factor for SAs among both sexes. Comprehensive sexuality education and smooth parental communication about sex will provide a supportive environment for young people and hence reduce the potential risks of SAs.

Understanding the context of healthcare utilisation for children under-five with diarrhoea in the DRC: based on Andersen behavioural model.

BACKGROUND: Diarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC. METHODS: Data collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey conducted by the National Institute of Statistics in 2017-2018, in collaboration with the United Nations Children's Fund were used in this study. Both direct and indirect relationships among four latent variables: predisposing traits, enabling resources access, health needs, and health services use were measured using the structural equation modelling to test the Andersen behavioural model. The confirmatory Factor Analysis model was also modified based on the DRC context to explore this further. RESULTS: The modified model had the goodness of fit index (GFI) of 0.972, comparative fit index (CFI) of 0.953 and RMSEA of 0.043 (95% CI: 0. 040, 0.047). Health needs (especially diarrhoea) had the largest positive direct effect on healthcare utilisation (standardized regression coefficient [ß] = 0.135, P < 0.001), followed by "enabling resources" (ß = 0.051, P = 0.015). Health needs also emerged as a mediator for the positive effect of predisposing on utilisation (indirect effect, ß = 0.014; P = 0.009). CONCLUSION: Access to improved water and improved sanitation, as well as socioeconomic factors like household wealth, were significantly associated with health-seeking behaviours for diarrhoea treatment in the DRC. Besides, caregivers who own higher levels of educational attainments were more inclined to have positive health services uses during the treatments. Efforts are needed to enhance the oral rehydration therapy coupled with educating caregivers on its appropriate use.

Sexual and reproductive health and attitudes towards sex of young adults in China.

BACKGROUND: The study aimed to discuss the importance of socioeconomic status (SES) and family sexual attitudes and investigate their association with sexual and reproductive health in a large sample of Chinese young adults. METHODS: We analysed a large sample of 53 508 youth aged 15-24 years from an internet-based survey from November 2019 to February 2020. Multivariable logistic regression analyses were employed to examine the association between SES, family sexual attitudes, and sexual and reproductive health (SRH), stratified by sex and adjusting for potential confounders. RESULTS: Individuals with the highest expenditure were more likely to engage in early sexual intercourse (female: OR 4.19, 95% CI 3.00 to 5.87; male: OR 3.82, 95% CI 2.84 to 5.12). For both sexes, the likelihood of young adult sexual risk-taking such as first intercourse without using a condom, acquiring sexually transmitted infections, and pregnancy was lower in those with higher maternal educational attainment, whereas it was higher in those with open family sexual attitudes. CONCLUSIONS: Lower SES and open family attitudes toward sex had a significant association with a range of adverse young adulthood SRH outcomes. Public health policies should focus on more deprived populations and advocate suitable parental participation to reduce risky sexual behaviours in youth.

Socio-economic inequalities in children's nutritional status in Democratic Republic of the Congo in 2017-2018: an analysis of data from a nationally representative survey.

OBJECTIVE: The Democratic Republic of the Congo (DRC) has one of the highest levels of child undernutrition globally; however, little information exists on the underlying socio-economic inequalities resulting in undernutrition. This study aims to examine the differences in the nutritional statuses of children across different wealth quintiles and explores the association between malnutrition in children and related factors. DESIGN: We utilised the 2018 Multiple Indicator Cluster Survey data. We estimated the prevalence of malnutrition across all twenty-six provinces. The study used the WHO 2006 child growth standards to measure stunting, underweight and wasting. We employed a mixed-effect linear model to analyse the association between nutritional status and healthcare accessibility, domestic sanitation, and socio-demographic factors. SETTING: Twenty-six provinces in the DRC. PARTICIPANTS: 21 477 children under 5 years of age and 21 828 women of childbearing age in the DRC. RESULTS: The national prevalence of underweight, stunting and wasting was found to be 23·33 %, 42·05 % and 5·66 %, respectively. Household wealth and mother's education level were significantly positively associated with the nutritional statuses of children. Among households in the lowest wealth quintile, residence in urban areas was a protective factor against undernutrition. CONCLUSION: The findings of this study indicate considerable socio-economic inequalities in the nutritional statuses of children under 5 years of age in the DRC, highlighting the need for nutrition promotion as part of maternal and child healthcare. Interventions and policies should include improving nutrition education for less-educated mothers, in particular, in the central provinces of the DRC.

Trends of maternal health service coverage in the Democratic Republic of the Congo: a pooled cross-sectional study of MICS 2010 to 2018.

BACKGROUND: Maternal health services are essential for reducing maternal and newborn mortality. However, maternal health service status in the Democratic Republic of the Congo (DRC) remains poorly understood. This study aims to explore the trends of antenatal care (ANC) and skilled birth attendance coverage in the past decade in the DRC. METHODS: The 13,361 participants were from two rounds of Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics of the Ministry of Planning of the DRC, in collaboration with the United Nations Children's Fund (UNICEF), in 2010 and 2017-2018. A regression-based method was adopted to calculate adjusted coverage of ANC and skilled birth attendance. Subgroup analysis based on different socioeconomic status (SES) was conducted to explore the impact of domestic conflicts. RESULTS: From 2010 to 2018, the overall weighted ANC coverage in the DRC declined from 87.3 % (95 % CI 86.1-88.0 %) to 82.4 % (95 % CI 81.1-84.0 %), while the overall weighted skilled birth attendance coverage increased from 74.2 % (95 % CI 72.5-76.0 %) to 85.2 % (95 % CI 84.1-86.0 %). Adjusted ANC coverage and adjusted skilled birth attendant coverage both declined in Kasai Oriental, but increased in Nord Kivu and Sud Kivu. In Kasai Occidental, ANC coverage declined, but skilled birth coverage increased. In the Kasai region, the largest decline in adjusted coverage of ANC was found among the poorest women. However, in the Kivu region, both the adjusted coverage of ANC and skilled birth attendance increased among the poorest women. CONCLUSIONS: Due to ongoing conflicts, there has been a systemic deterioration of maternal healthcare coverage in some regions of the DRC, particularly among people with low SES. However, in other regions, maternal healthcare services were not severely disrupted possibly due to substantial international health assistance.

The Effects of Conflicts and Self-Reported Insecurity on Maternal Healthcare Utilisation and Children Health Outcomes in the Democratic Republic of Congo (DRC).

Background The Democratic Republic of Congo (DRC) has experienced political unrest, civil insecurity, and military disputes, resulting in extreme poverty and a severely impaired health care system. To reduce the morbidity and mortality in women and children by strengthening healthcare, this study aimed at exploring the relationship between self-reported insecurity of mothers and maternal health-seeking behaviours and diseases in children in the DRC. Method Data collected from 8144 mothers and 14,403 children from the Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics in 2017-2018, in collaboration with the United Nations Children's Fund (UNICEF), was used. The severity of the conflict in different provinces was measured using the Uppsala Conflict Data Program (UCDP) reports. Multivariate logistic regression and stratified analysis were utilized to explore the association between conflicts with maternal health-seeking behaviours and diseases among children. Results High self-reported insecurity was positively associated with skilled antenatal care (OR1.93, 95%CI 1.50-2.49), skilled attendants at delivery (OR1.42, 95%CI 1.08-1.87), and early initiation of breastfeeding (OR1.32, 95%CI 1.04-1.68). These associations were more significant in regions with more armed conflict. It was also found that children of mothers with high self-reported insecurity were more likely to suffer from diarrhoea (OR1.47, 95%CI: 1.14-1.88), fever (OR1.23, 95%CI 1.01-1.50), cough (OR1.45, 95%CI 1.19-1.77), and dyspnea (OR2.04, 95%CI 1.52-2.73), than children of mothers with low self-reported insecurity. Conclusions Conflicts increases mothers' insecurities and negatively affects children's development. However, high conflict regions have to increase governmental and international assistance to promote the availability and access to maternal and child health services.

Maternal Health-Seeking Behavior and Associated Factors in the Democratic Republic of the Congo.

Maternal health-seeking behavior (MHSB) is crucial for maternal health. However, little is known about MHSB in the Democratic Republic of the Congo (DRC). This study aims to evaluate the situation and socioeconomic associates of MHSB in the DRC. Based on the responses of 8,360 participants in a nationally representative survey, we adopted a K-modes cluster analysis algorithm to categorize women into three groups (i.e., infrequent service-users, partial service-users, and full service-users) according to their recent MHSB. Multinomial logistic regression was applied to identify the associated predictors of MHSB. The results show that most women (90.29%) did not receive integral maternal health services, including antenatal care, institutional delivery, and postnatal care. Compared with their counterparts, women who received higher maternal educational attainment, had good HIV-related knowledge, lived in urban regions, and lived in wealthier households were more likely to be partial service-users or full service-users. Women exposed to mass media at least once a week were more likely to be full service-users rather than infrequent service-users. The majority of participants who lived in Kasai and near provinces were infrequent service-users, indicating poor MHSB status in the region. Interventions to promote maternal health knowledge and awareness are highly recommended to improve MHSB in the DRC.

Association Between Serum Vitamin A Levels and Recurrent Respiratory Tract Infections in Children.

To evaluate the association between serum vitamin A levels and the prevalence of recurrent respiratory tract infections (RRTIs) in children and adolescents and to provide evidence that would help decrease the prevalence of respiratory tract infections (RTIs) in children. This cross-sectional study included 8034 children and adolescents in Beijing aged 6 months to 17 years. RRTI and RTI symptoms were diagnosed according to the Clinical Concept and Management of Recurrent Respiratory Tract Infections in Children. Multivariate logistic regression models were used to evaluate the association between serum vitamin A levels and RRTIs after adjusting for potential confounders. Among the included children, 721 (8.97%) were diagnosed with vitamin A deficiency, whereas 3,073 (38.25%) were diagnosed with subclinical vitamin A deficiency. Only 28.8% (208/721) of children with vitamin A deficiency and 53.1% (1,631/3,073) of children with subclinical vitamin A deficiency had no RRTI and RTI symptoms, respectively. Compared with children with normal vitamin A levels, those with vitamin A deficiency and subclinical vitamin A deficiency had a greater risk for RRTIs, with an odds ratio (OR) of 6.924 [95% confidence interval (CI): 5.433-8.824] and 2.140 (95% CI: 1.825-2.510), respectively]. Vitamin A levels were also positively associated with RTI symptoms, with those having vitamin A deficiency and subclinical vitamin A deficiency showing an OR of 1.126 (95% CI: 0.773-1.640) and 1.216 (95% CI: 1.036-1.427), respectively. The present cross-sectional study found that low serum vitamin A levels were significantly associated with RRTI or RTI prevalence in children and adolescents.