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The purpose of this study was to assess the HEARTS (Health, Experience of Abuse, Resilience, Technology use, and Safety) of older adults (OAs). More particularly, we aimed to assess three components of the HEARTS (health, experience of abuse, and resilience) of OAs and explore the relationships among health, resilience, the experience of abuse, and other demographic variables. Forty-two male and female OAs in Pittsburgh, Pennsylvania, USA participated in the study. A correlational design was used in this study. The variables correlated were health, the experience of abuse, and the resilience of OAs. We used a community-engaged research approach in that participants were more than research volunteers but stakeholders in the research project. Findings showed that the means for more positive health features (physical function, and social roles) increased with increases in education, while more negative health features (anxiety, depression, fatigue, sleep disturbance, pain interference, and pain intensity) decreased with higher levels of education. Regression models indicated that above and beyond demographic features, resilience had a significant prediction of anxiety and depression. None of the other health outcomes were significantly predicted by either resilience or older adults' abuse suspicion. Adding health to years in older adults is a collaborative effort with healthcare providers, healthcare systems, families, and communities. This study has identified three components of HEARTS (Health, Experience of Abuse, and Resilience) that blend with successful aging and provide data and possible prevention and intervention strategies, and family and community education programs that could add health to years in older adults. [ABSTRACT FROM AUTHOR]

The article focuses on Atmospheric Radiation Measurement (ARM) Program which was created by the U.S. Department of Energy (DOE) in 1989. It was aimed to address scientific uncertainties related to global climate change. It reports that ARM has established six permanent ARM Climate Research Facility (ACRF) sites to perform long-term continuous field measurements.

Research on forecasting the seasonality and growth trend of natural gas (NG) production and consumption will help organize an analysis base for NG inspection and development, social issues, and allow industrials elements to operate effectively and reduce economic issues. In this situation, we handle a comparison structure on the application of different models in monthly NG production and consumption forecasting using the cross-correlation function and then analyze the association between exogenous variables. Moreover, the SARIMA-X model is tested for US monthly NG production and consumption prediction via the proposed method for the first time in the literature review in this study. The performance of that model has been compared with SARIMA (p, d, q) * (P, D, Q)s. The results from RMSE and MAPE indicate that the superiority of the best model. By applying this method, the US monthly NG production and consumption is forecast until 2025. The success of the proposed method allows the use of seasonality patterns. If this seasonal approach continues, the United States' NG production (16%) and consumption (24%) are expected to increase by 2025. The results of this study provide effective information for decision-makers on NG production and consumption to be credible and to determine energy planning and future sustainable energy policies. [ABSTRACT FROM AUTHOR]

Objective: Internet-based patient education materials (PEMs) are often above the recommended sixth grade reading level recommended by the U.S. Department of Health and Human Services. In 2016 the U.S. Food and Drug Administration (FDA) released a warning statement against use of general anesthetic drugs in children and pregnant women due to concerns about neurotoxicity. The aim of this study is to evaluate readability, content, and quality of Internet-based PEMs on anesthesia in the pediatric population and neurotoxicity., Study Design: The websites of U.S. medical centers with pediatric anesthesiology fellowship programs were searched for PEMs pertaining to pediatric anesthesia and neurotoxicity. Readability was assessed. PEM content was evaluated using matrices specific to pediatric anesthesia and neurotoxicity. PEM quality was assessed with the Patient Education Material Assessment Tool for Print. A one-sample t -test was used to compare the readability of the PEMs to the recommended sixth grade reading level., Results: We identified 27 PEMs pertaining to pediatric anesthesia and eight to neurotoxicity. Mean readability of all PEMs was greater than a sixth grade reading ( p <0.001). While only 13% of PEMs on anesthesia for pediatric patient mentioned the FDA warning, 100% of the neurotoxicity materials did. PEMs had good understandability (83%) and poor actionability (60%)., Conclusion: The readability, content, and quality of PEMs are poor and should be improved to help parents and guardians make informed decisions about their children's health care., Key Points: · The FDA issued a warning statement against the use of general anesthetic drugs in children and pregnant women.. · Readability, content, and quality of Internet-based patient education materials on the topic of neurotoxicity are poor.. · Improving the readability, content, and quality of PEMs could aid parents in making important health care decisions.., Competing Interests: P.T., MD, MPH was supported by grants from the Agency for Healthcare Research and Quality and National Institute on Minority Health and Health Disparities (R03MD011628, R03HS025267, and R18HS026169). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality (AHRQ) or the National Institute on Minority Health and Health Disparities., (Thieme. All rights reserved.)

Background: Early reports associating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with adverse pregnancy outcomes were biased by including only women with severe disease without controls. The Society for Obstetric Anesthesia and Perinatology (SOAP) coronavirus disease 2019 (COVID-19) registry was created to compare peripartum outcomes and anesthetic utilization in women with and without SARS-CoV-2 infection delivering at institutions with widespread testing., Methods: Deliveries from 14 US medical centers, from March 19 to May 31, 2020, were included. Peripartum infection was defined as a positive SARS-CoV-2 polymerase chain reaction test within 14 days of delivery. Consecutive SARS-CoV-2-infected patients with randomly selected control patients were sampled (1:2 ratio) with controls delivering during the same day without a positive test. Outcomes were obstetric (eg, delivery mode, hypertensive disorders of pregnancy, and delivery <37 weeks), an adverse neonatal outcome composite measure (primary), and anesthetic utilization (eg, neuraxial labor analgesia and anesthesia). Outcomes were analyzed using generalized estimating equations to account for clustering within centers. Sensitivity analyses compared symptomatic and asymptomatic patients to controls., Results: One thousand four hundred fifty four peripartum women were included: 490 with SARS-CoV-2 infection (176 [35.9%] symptomatic) and 964 were controls. SARS-CoV-2 patients were slightly younger, more likely nonnulliparous, nonwhite, and Hispanic than controls. They were more likely to have diabetes, obesity, or cardiac disease and less likely to have autoimmune disease. After adjustment for confounders, individuals experiencing SARS-CoV-2 infection exhibited an increased risk for delivery <37 weeks of gestation compared to controls, 73 (14.8%) vs 98 (10.2%) (adjusted odds ratio [aOR], 1.47; 95% confidence interval [CI], 1.03-2.09). Effect estimates for other obstetric outcomes and the neonatal composite outcome measure were not meaningfully different between SARS-CoV-2 patients versus controls. In sensitivity analyses, compared to controls, symptomatic SARS-CoV-2 patients exhibited increases in cesarean delivery (aOR, 1.57; 95% CI, 1.09-2.27), postpartum length of stay (aOR, 1.89; 95% CI, 1.18-2.60), and delivery <37 weeks of gestation (aOR, 2.08; 95% CI, 1.29-3.36). These adverse outcomes were not found in asymptomatic women versus controls. SARS-CoV-2 patients (asymptomatic and symptomatic) were less likely to receive neuraxial labor analgesia (aOR, 0.52; 95% CI, 0.35-0.75) and more likely to receive general anesthesia for cesarean delivery (aOR, 3.69; 95% CI, 1.40-9.74) due to maternal respiratory failure., Conclusions: In this large, multicenter US cohort study of women with and without peripartum SARS-CoV-2 infection, differences in obstetric and neonatal outcomes seem to be mostly driven by symptomatic patients. Lower utilization of neuraxial analgesia in laboring patients with asymptomatic or symptomatic infection compared to patients without infection requires further investigation., Competing Interests: Conflicts of Interest: See Disclosures at the end of the article., (Copyright © 2020 International Anesthesia Research Society.)

Background: As of November 18, 2020, more than 11 million people have been infected with coronavirus disease 2019 and almost 250,000 people have died from the disease in the United States, less than 1 year since its discovery. Although literature is beginning to emerge on pregnancy as a risk factor for severe coronavirus disease 2019, these studies are heterogeneous and use primary outcomes such as intensive care unit admission or hospitalization as surrogate markers that may subject analyses to misclassification bias in pregnant patients., Objective: This study aimed to determine the risk of severe coronavirus disease 2019 among pregnant women with symptomatic coronavirus disease 2019 compared with nonpregnant women using nonadmission-based, standardized clinical criteria for severe disease., Study Design: This is a retrospective cohort study of women aged 13 to 45 years and diagnosed as having symptomatic coronavirus disease 2019 between May 28, 2020, and July 22, 2020. The primary outcome was severe coronavirus disease 2019 as defined by 2 sets of nonadmission-based, clinical criteria: the World Health Organization Ordinal Scale for Clinical Improvement and the Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. Adjusted risk ratios were estimated using multivariable logistic regression analyses., Results: Of 262 women aged 13 to 45 years with symptomatic coronavirus disease 2019, 22 (8.4%) were pregnant and 240 (91.6%) were nonpregnant. After adjusting for covariates potentially associated with the primary outcome, symptomatic pregnant women were at a significantly increased risk of severe coronavirus disease 2019 compared with nonpregnant women using both the World Health Organization Ordinal Scale for Clinical Improvement (adjusted relative risk, 3.59; 95% confidence interval, 1.49-7.01) and Novel Coronavirus Pneumonia Emergency Response Epidemiology Team (adjusted relative risk, 5.65; 95% confidence interval, 1.36-17.31) criteria., Conclusion: Pregnancy significantly increases the risk of severe coronavirus disease 2019 as defined by nonadmission-based, clinical criteria., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The value of importing expanded criteria donor (ECD) kidneys is uncertain., Methods: We retrospectively reviewed our single-center experience with ECD kidney transplants (KT)., Results: Over 12.8 years, we performed 497 ECD KTs including 247 local and 250 imported from other donor service areas. The import ECD group had more donors (16% vs 9%) ≥ age 70, more zero human leukocyte antigen mismatches (14% vs 2%), more KTs with a cold ischemia time >30 hours (46% vs 19%), and fewer kidneys managed with pump preservation (78% vs 92%, all P≤.05) compared to the local ECD group. Mean Kidney Donor Profile Index were 80% import vs 84% local. With a mean follow-up of 55 months, actual patient and graft survival rates were 71% and 58% in import vs 76% and 58% in local ECD KTs, respectively. Death-censored graft survival rates were 70% in import vs 69% in local ECD KTs. Delayed graft function occurred in 28% import vs 23% local ECD KTs (P=NS) whereas the incidence of primary nonfunction was slightly higher with import ECD kidneys (4.8% vs 2.4%, P=.23)., Conclusions: Midterm outcomes are remarkably similar for import vs local ECD KTs, suggesting that broader sharing of ECD kidneys may improve utilization without compromising outcomes., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Variants in donor multidrug resistance protein 1 (ABCB1) and caveolin 1 (CAV1) genes are associated with renal allograft failure after transplantation in Europeans. Here we assessed transplantation outcomes of kidneys from 368 African American (AA) and 314 European American (EA) deceased donors based on 38 single-nucleotide polymorphisms (SNPs) spanning ABCB1 and 16 SNPs spanning CAV1, including previously associated index and haplotype-tagging SNPs. Tests for association with time to allograft failure were performed for the 1233 resultant kidney transplantations, adjusting for recipient age, sex, ethnicity, cold ischemia time, panel reactive antibody, human leukocyte antigen match, expanded-criteria donation, and APOL1-nephropathy variants in AA donors. Interaction analyses between APOL1 with ABCB1 and CAV1 were performed. In a meta-analysis of all transplantations, ABCB1 index SNP rs1045642 was associated with time to allograft failure and other ABCB1 SNPs were nominally associated, but not CAV1 SNPs. ABCB1 SNP rs1045642 showed consistent effects with the 558 transplantations from EA donors, but not with the 675 transplantations from AA donors. ABCB1 SNP rs956825 and CAV1 SNP rs6466583 interacted with APOL1 in transplants from AA donors. Thus, the T allele at ABCB1 rs1045642 is associated with shorter renal allograft survival for kidneys from American donors. Interactions between ABCB1 and CAV1 with APOL1 may influence allograft failure for transplanted kidneys from AA donors.