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The Gulf Cooperation Council is a regional cooperation of six Middle Eastern countries--Saudi Arabia, Kuwait, the United Arab Emirates, Qatar, Bahrain, and Oman. A common feature of these countries is the existence of many group quarters, usually called labor camps, a term used to refer to housing accommodations for unskilled migrants where nonrelated people live together. The camp size ranges from a few people to a few thousand people from many different countries who speak dozens of languages. Also, the camp size and the composition of residents inside the camps change relatively quickly as people move in and out of the camps as their labor contracts expire or project needs change. This article presents one way to subsample this dynamic population inside such labor camps. The technique was used in one survey conducted in Qatar, where more than half of the country's population resides in labor camps.

It is estimated that 50,000–60,000 pregnant people in the United States (US) experience severe maternal morbidity (SMM). SMM includes life-threatening conditions, such as acute myocardial infarction, acute renal failure, amniotic fluid embolism, disseminated intravascular coagulation, or sepsis. Prior research has identified both rising rates through 2014 and wide racial disparities in SMM. While reducing maternal death and SMM has been a global goal for the past several decades, limited progress has been made in the US in achieving this goal. Our objectives were to examine SMM trends from 1998–2018 to identify factors contributing to the persistent and rising rates of SMM by race/ethnicity and describe the Black non-Hispanic/White non-Hispanic rate ratio for each SMM condition. We used a population-based data system that links delivery records to their corresponding hospital discharge records to identify SMM rates (excluding transfusion) per 10, 000 deliveries and examined the trends by race/ethnicity. We then conducted stratified analyses separately for Black and White birthing people. While the rates of SMM during the same periods steadily increased for all racial/ethnic groups, Black birthing people experienced the greatest absolute increase compared to any other race/ethnic group going from 69.4 in 1998–2000 to 173.7 per 10,000 deliveries in 2016–2018. In addition, we found that Black birthing people had higher rates for every individual condition compared to White birthing people, with rate ratios ranging from a low of 1.11 for heart failure during surgery to a high of 102.4 for sickle cell anemia. Obesity was not significantly associated with SMM among Black birthing people but was associated with SMM among White birthing people [aRR 1.18 (95% CI: 1.02, 1.36)]. An unbiased understanding of how SMM has affected different race/ethnicity groups is key to improving maternal health and preventing SMM and mortality among Black birthing people. SMM needs to be addressed as both a medical and public health challenge. [ABSTRACT FROM AUTHOR]

Study Question: Do women with polycystic ovary syndrome (PCOS) have a greater risk of adverse pregnancy complications (gestational diabetes, preeclampsia, cesarean section, placental abnormalities) and neonatal outcomes (preterm birth, small for gestational age, prolonged delivery hospitalization) compared to women without a PCOS diagnosis and does this risk vary by BMI, subfertility and fertility treatment utilization?Summary Answer: Deliveries to women with a history of PCOS were at greater risk of complications associated with cardiometabolic function, including gestational diabetes and preeclampsia, as well as preterm birth and prolonged length of delivery hospitalization.What Is Known Already: Prior research has suggested that women with PCOS may be at increased risk of adverse pregnancy outcomes. However, findings have been inconsistent possibly due to lack of consistent adjustment for confounding factors, small samples size and other sources of bias.Study Design, Size, Duration: Massachusetts deliveries among women ≥18 years old during 2013-2017 from state vital records linked to hospital discharges, observational stays and emergency department visits were linked to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) and the Massachusetts All-Payers Claims Database (APCD).Participants/materials, Setting, Methods: PCOS was identified by ICD9 and ICD10 codes in APCD prior to index delivery. Relative risks (RRs) and 95% CI for pregnancy and delivery complications were modeled using generalized estimating equations with a log link and a Poisson distribution to take multiple cycles into account and were adjusted a priori for maternal age, BMI, race/ethnicity, education, plurality, birth year, chronic hypertension and chronic diabetes. Tests for homogeneity investigated differences between maternal pre-pregnancy BMI categories (<30, ≥30, <25 and ≥25 kg/m2) and between non-infertile deliveries and deliveries that used ART or had a history of subfertility (defined by birth certificates, SART CORS records, APCD or hospital records).Main Results and the Role Of Chance: Among 91 825 deliveries, 3.9% had a history of PCOS. Women with a history of PCOS had a 51% greater risk of gestational diabetes (CI: 1.38-1.65) and a 25% greater risk of preeclampsia (CI: 1.15-1.35) compared to women without a diagnosis of PCOS. Neonates born to women with a history of PCOS were more likely to be born preterm (RR: 1.17, CI: 1.06-1.29) and more likely to have a prolonged delivery hospitalization after additionally adjusting for gestational age (RR: 1.23, CI: 1.09-1.40) compared to those of women without a diagnosis of PCOS. The risk for gestational diabetes for women with PCOS was greater among women with a pre-pregnancy BMI <30 kg/m2.Limitations, Reasons For Caution: PCOS was defined by ICD documentation prior to delivery so there may be women with undiagnosed PCOS or PCOS diagnosed after delivery included in the unexposed group. The study population is limited to deliveries within Massachusetts among most private insurance payers and inpatient or observational hospitalization in Massachusetts during the follow-up window, therefore there may be diagnoses and or deliveries outside of the state or outside of our sample that were not captured.Wider Implications Of the Findings: In this population-based study, women with a history of PCOS were at greater risk of pregnancy complications associated with cardiometabolic function and preterm birth. Obstetricians should be aware of patients' PCOS status and closely monitor for potential pregnancy complications to improve maternal and infant perinatal health outcomes.Study Funding/competing Interest(s): This work was supported by the NIH (R01HD067270). S.A.M. receives grant funding from NIH, AbbVie and the Marriot Family Foundation; payment/honoraria from the University of British Columbia, World Endometriosis Research Foundation and Huilun Shanghai; travel support for attending meetings for ESHRE 2019, IASP 2019, National Endometriosis Network UK meeting 2019; SRI 2022, ESHRE 2022; participates on the data safety monitoring board/advisory board for AbbVie, Roche, Frontiers in Reproductive Health; and has a leadership role in the Society for Women's Health Research, World Endometriosis Research Foundation, World Endometriosis Society, American Society for Reproductive Medicine and ESHRE. The other authors have no conflicts of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background: Influenza is a major cause of morbidity and mortality in Africa. However, a lack of epidemiological data remains for this pathology, and the performances of the influenza-like illness (ILI) case definitions used for sentinel surveillance have never been evaluated in Senegal. This study aimed to i) assess the performance of three different ILI case definitions, adopted by the WHO, USA-CDC (CDC) and European-CDC (ECDC) and ii) identify clinical factors associated with a positive diagnosis for Influenza in order to develop an algorithm fitted for the Senegalese context.Methods: All 657 patients with a febrile pathological episode (FPE) between January 2013 and December 2016 were followed in a cohort study in two rural villages in Senegal, accounting for 1653 FPE observations with nasopharyngeal sampling and influenza virus screening by rRT-PCR. For each FPE, general characteristics and clinical signs presented by patients were collected. Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for the three ILI case definitions were assessed using PCR result as the reference test. Associations between clinical signs and influenza infection were analyzed using logistic regression with generalized estimating equations. Sore throat, arthralgia or myalgia were missing for children under 5 years.Results: WHO, CDC and ECDC case definitions had similar sensitivity (81.0%; 95%CI: 77.0-85.0) and NPV (91.0%; 95%CI: 89.0-93.1) while the WHO and CDC ILI case definitions had the highest specificity (52.0%; 95%CI: 49.1-54.5) and PPV (32.0%; 95%CI: 30.0-35.0). These performances varied by age groups. In children < 5 years, the significant predictors of influenza virus infection were cough and nasal discharge. In patients from 5 years, cough, nasal discharge, sore throat and asthenia grade 3 best predicted influenza infection. The addition of "nasal discharge" as a symptom to the WHO case definition decreased sensitivity but increased specificity, particularly in the pediatric population.Conclusion: In summary, all three definitions studies (WHO, ECDC & CDC) have similar performance, even by age group. The revised WHO ILI definition could be chosen for surveillance purposes for its simplicity. Symptomatic predictors of influenza virus infection vary according the age group. [ABSTRACT FROM AUTHOR]

Objectives: To derive and validate a 30‐day mortality clinical prediction rule for heart failure based on admission data and prior healthcare usage. A secondary objective was to determine the discriminatory function for mortality at 1 and 2 years. Design: Observational cohort. Setting: Veterans Affairs inpatient medical centers (n=124). Participants: The derivation (2010–12; n=36,021) and validation (2013–15; n=30,364) cohorts included randomly selected veterans admitted for HF exacerbation (mean age 71±11; 98% male). Measurements: The primary outcome was 30‐day mortality. Secondary outcomes were 1‐ and 2‐year mortality. Candidate variables were drawn from electronic medical records. Discriminatory function was measured as the area under the receiver operating characteristic curve. Results: Thirteen risk factors were identified: age, ejection fraction, mean arterial pressure, pulse, brain natriuretic peptide, blood urea nitrogen, sodium, potassium, more than 7 inpatient days in the past year, metastatic disease, and prior palliative care. The model stratified participants into low‐ (1%), intermediate‐ (2%), high‐ (5%), and very high‐ (15%) mortality risk groups (C‐statistic=0.72, 95% confidence interval (CI)=0.71–0.74). These findings were confirmed in the validation cohort (C‐statistic=0.70, 95% CI=0.68–0.71). Subgroup analysis of age strata confirmed model discrimination. Conclusion: This simple prediction rule allows clinicians to risk‐stratify individuals on admission for HF using characteristics captured in electronic medical record systems. The identification of high‐risk groups allows individuals to be targeted for discussion of goals and treatment. [ABSTRACT FROM AUTHOR]

Abstract: This study explores the impact of investment characteristics, mainly investment location relative to the firm's primary market, on financing choices by real estate investment trusts (REITs). Using a large sample of commercial property acquisitions, we show that REITs are 4–8% less likely to use secured (mortgage) debt when acquiring properties in their primary markets than elsewhere. The documented evidence supports a demand‐side story for the relation between investment characteristics and financing. Moreover, the evidence is consistent with the hypothesis that REITs avoid mortgage financing in their primary markets to preserve operational flexibility in those markets. [ABSTRACT FROM AUTHOR]

Purpose: In May 2012, the Association of Maternal and Child Health (MCH) Programs initiated a project to develop indicators for use at a state or community level to assess, monitor, and evaluate the application of life course principles to public health. Description: Using a developmental framework established by a national expert panel, teams of program leaders, epidemiologists, and academicians from seven states proposed indicators for initial consideration. More than 400 indicators were initially proposed, 102 were selected for full assessment and review, and 59 were selected for final recommendation as Maternal and Child Health (MCH) life course indicators. Assessment: Each indicator was assessed on five core features of a life course approach: equity, resource realignment, impact, intergenerational wellness, and life course evidence. Indicators were also assessed on three data criteria: quality, availability, and simplicity. Conclusion: These indicators represent a major step toward the translation of the life course perspective from theory to application. MCH programs implementing program and policy changes guided by the life course framework can use these initial measures to assess and influence their approaches. [ABSTRACT FROM AUTHOR]

In May 2012, the Division of AIDS Research at the National Institute of Mental Health (NIMH) organized the 'Global NeuroAIDS Roundtable' in conjunction with the 11th International Symposium on Neurovirology and the 2012 Conference on HIV in the Nervous System. The meeting was held in New York, NY, USA and brought together NIMH-funded investigators who are currently working on projects related to the neurological complications of AIDS (NeuroAIDS) in Africa, Asia, Eastern Europe, and Latin America in order to provide an opportunity to share their recent findings and discuss the challenges encountered within each country. The major goals of the roundtable were to evaluate HIV-associated neurocognitive impairment and determine if it may be directly attributable to distinct HIV subtypes or clades and to discuss the future priorities for global NeuroAIDS research. At the 'Global NeuroAIDS Roundtable', presentations of preliminary research indicated that HIV-associated neurocognitive impairment is prevalent in all countries examined regardless of which HIV clade is present in the region. The only clear-cut difference between HIV-1 clades was in relation to subtypes A and D in Uganda. However, a key point that emerged from the discussions was that there is an urgent need to standardize neurocognitive assessment methodologies across the globe before definitive conclusions can be drawn regarding the relationship between HIV clade diversity and neuropathogenesis. Future research directions were also discussed at the roundtable with particular emphasis on the potential of viral and host factor molecular interactions to impact the pathophysiology of HIV-associated neurocognitive disorders (HAND) from a global perspective. [ABSTRACT FROM AUTHOR]

Research clearly shows the importance of obtaining a postsecondary education in terms of accessing job opportunities, higher salaries, and improved benefits for a better quality of life in the United States. Bringing together the literature on school-based caring for Black students and the literature on college preparation, I utilize notions of institutional and interpersonal caring to analyze Black students' perspectives and the complexities of caring embedded within (a) the academic expectations of minihouses, (b) the distributive counseling structure of learning centers, and (c) students' participation in cocurricular activities. The findings provide insight into the ways high school educators, administrators, teachers, and counselors, can create and sustain a college going school culture focusing on the nature, quality, and alignment of institutional and interpersonal structures of care that improve Black students' educational experiences and college access. [ABSTRACT FROM AUTHOR]

Presents a study that examined the extent to which the demand for eastern oysters (Crassostrea virginica) harvested from the Gulf of Mexico has been reduced as a result of mandatory warning labels and negative publicity due to the presence of the marine bacteria Vibrio vulnificus in the oysters. Impact on consumer welfare of further regulation of the harvesting sector; Analysis of other factors that affect the demand for eastern oysters; Background on the U.S. oyster industry.

The objective of this study is to perform trend analysis in the historic data sets of annual and crop season [May–September] precipitation and daily maximum and minimum temperatures across the southwest United States. Eighteen ground-based weather stations were considered across the southwest United States for a total period from 1902 to 2017. The non-parametric Mann–Kendall test method was used for the significance of the trend analysis and the Sen's slope estimator was used to derive the long-term average rates of change in the parameters. The results showed a decreasing trend in annual precipitation at 44.4% of the stations with the Sen's slopes varying from −1.35 to −0.02 mm/year while the other stations showed an increasing trend. Crop season total precipitation showed non-significant variation at most of the stations except two stations in Arizona. Seventy-five percent of the stations showed increasing trend in annual maximum temperature at the rates that varied from 0.6 to 3.1 °C per century. Air cooling varied from 0.2 to 1.0 °C per century with dominant warming phenomenon at the regional scale of the southwest United States. Average annual minimum temperature had increased at 69% of the stations at the rates that varied from 0.1 to 8 °C over the last century, while the annual temperature amplitude showed a decreasing trend at 63% of stations. Crop season maximum temperature had significant increasing trend at 68.8% of the stations at the rates varying from 0.7 to 3.5 °C per century, while the season minimum temperature had increased at 75% of the stations. [ABSTRACT FROM AUTHOR]

Nearly half a million children and young adults are affected by traumatic brain injury each year in the United States. Although adequate cerebral blood flow (CBF) is essential to recovery, complications that disrupt blood flow to the brain and exacerbate neurological injury often go undetected because no adequate bedside measure of CBF exists. In this study we validate a depth-resolved, near-infrared spectroscopy (NIRS) technique that provides quantitative CBF measurement despite significant signal contamination from skull and scalp tissue. The respiration rates of eight anesthetized pigs (weight: 16.2±0.5 kg, age: 1 to 2 monthsold) are modulated to achieve a range of CBF levels. Concomitant CBF measurements are performed with NIRS and CT perfusion. A significant correlation between CBF measurements from the two techniques is demonstrated (r2=0.714, slope=0.92, p<0.001), and the bias between the two techniques is −2.83 mL⋅min−1⋅100 g−1(CI0.95: −19.63 mL⋅min−1⋅100 g−1−13.9 mL⋅min−1⋅100 g−1). This study demonstrates that accurate measurements of CBF can be achieved with depth-resolved NIRS despite significant signal contamination from scalp and skull. The ability to measure CBF at the bedside provides a means of detecting, and thereby preventing, secondary ischemia during neurointensive care. [ABSTRACT FROM AUTHOR]

Objective: To assess whether application of a standard algorithm to hospitalizations in the prenatal and postpartum (42 days) periods increases identification of severe maternal morbidity (SMM) beyond analysis of only the delivery event.Methods: We performed a retrospective cohort study using data from the PELL (Pregnancy to Early Life Longitudinal) database, a Massachusetts population-based data system that links records from birth certificates to delivery hospital discharge records and nonbirth hospital records for all birthing individuals. We included deliveries from January 1, 2009, to December 31, 2018, distinguishing between International Classification of Diseases Ninth (ICD-9) and Tenth Revision (ICD-10) coding. We applied the modified Centers for Disease Control and Prevention algorithm for SMM used by the Alliance for Innovation on Maternal Health to hospitalizations across the antenatal period through 42 days postpartum. Morbidity was examined both with and without blood transfusion.Results: Overall, 594,056 deliveries were included in the analysis, and 3,947 deliveries met criteria for SMM at delivery without transfusion and 9,593 with transfusion for aggregate rates of 150.1 (95% CI 146.7-153.5) using ICD-9 codes and 196.6 (95% CI 189.5-203.7) using ICD-10 codes per 10,000 deliveries. Severe maternal morbidity at birth increased steadily across both ICD-9 and ICD-10 from 129.4 in 2009 (95% CI 126.2-132.6) using ICD-9 to 214.3 per 10,000 (95% CI 206.9-221.8) in 2018 using ICD-10. Adding prenatal and postpartum hospitalizations increased cases by 21.9% under both ICD-9 and ICD-10, resulting in a 2018 rate of 258.7 per 10,000 (95% CI 250.5-266.9). The largest increase in detected morbidity in the prenatal or postpartum time period was attributed to sepsis cases.Conclusion: Inclusion of prenatal and postpartum hospitalizations in the identification of SMM resulted in increased ascertainment of morbid events. These results suggest a need to ensure surveillance of care quality activities beyond the birth event. [ABSTRACT FROM AUTHOR]