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Background Although methamphetamine abuse is associated with the development of heart failure (HF), nationwide data on methamphetamine-associated HF (MethHF) hospitalizations are limited. This study evaluates nationwide HF hospitalizations associated with substance abuse to better understand MethHF prevalence trends and the clinical characteristics of those patients. Methods and Results This cross-sectional period-prevalence study used hospital discharge data from the National Inpatient Sample to identify adult primary HF hospitalizations with a secondary diagnosis of abuse of methamphetamines, cocaine, or alcohol in the United States from 2002 to 2014. All 2014 MethHF admissions were separated by regional census division to evaluate geographical distribution. Demographics, payer information, and clinical characteristics of MethHF hospitalizations were compared with all other HF hospitalizations. Total nationwide MethHF hospitalizations increased from 547 in 2002 to 6625 in 2014 with a predominance on the West Coast. Methamphetamine abuse was slightly more common among primary HF hospitalizations compared with all-cause hospitalizations (7.4 versus 6.4 per 1000; Cohen h=0.012; P

ObjectiveMethamphetamine use is associated with systolic dysfunction, pulmonary arterial hypertension and may also be associated with diastolic dysfunction. The impact of methamphetamine cessation on methamphetamine-associated heart failure (MethHF) remains poorly characterised. We aimed to longitudinally characterise methamphetamine-associated heart failure patients with reduced (METHrEF) and preserved (METHpEF) left ventricular ejection fraction (EF), and evaluate the relationship between methamphetamine cessation and clinical outcomes.MethodsWe performed a retrospective cohort study, and reviewed medical records of patients with METHrEF, METHpEF and heart failure controls without methamphetamine use. Echocardiographic variables were recorded for up to 12 months, with clinical follow-up extending to 24 months.ResultsAmong METHrEF patients (n=28, mean age 51±9 years, 82.1% male), cessation was associated with improvement in EF (+10.6±13.1%, p=0.009) and fewer heart failure admissions per year compared with continued use (median 0.0, IQR 0.0-1.0 vs median 2.0, IQR 1.0-3.0, p=0.039). METHpEF patients (n=28, mean age 50±8 years, 60.7% male) had higher baseline right ventricular systolic pressure (median 53.44, IQR 43.70-84.00 vs median 36.64, IQR 29.44-45.95, p=0.011), and lower lateral E/E' ratio (8.1±3.6 vs 11.2±4., p

BackgroundThe burden of substance abuse among patients with heart failure and its association with subsequent emergency department visits and hospital admissions are poorly characterized.MethodsWe evaluated the medical records of patients with a diagnosis of heart failure treated at the University of California-San Diego from 2005 to 2016. We identified substance abuse via diagnosis codes or urine drug screens. We used Poisson regression to evaluate the incidence rate ratios (IRR) of substance abuse for emergency department visits or hospitalizations with a primary diagnosis of heart failure, adjusted for age, sex, race, medical insurance status, and medical diagnoses.ResultsWe identified 11,268 patients with heart failure and 15,909 hospital encounters for heart failure over 49,712 person-years of follow-up. Substance abuse was diagnosed in 15.2% of patients. Disorders such as methamphetamine abuse (prevalence 5.2%, IRR 1.96, 95% confidence interval [CI] 1.85-2.07), opioid use and abuse (8.2%, IRR 1.54, 95% CI 1.47-1.61), and alcohol abuse (4.5%, IRR 1.51, 95% CI 1.42-1.60) were associated with a greater number of hospital encounters for heart failure, with associations that were comparable to diagnoses such as atrial fibrillation (37%, IRR 1.78, 95% CI 1.73-1.84), ischemic heart disease (24%, IRR 1.67, 95% CI 1.62-1.73), and chronic kidney disease (26%, IRR 1.57, 95% CI 1.51-1.62).ConclusionsAlthough less prevalent than common medical comorbidities in patients with heart failure, substance-abuse disorders are significant sources of morbidity that are independently associated with emergency department visits and hospitalizations for heart failure. Greater recognition and treatment of substance abuse may improve outcomes among patients with heart failure.

Several fire safety benefits are realised when considering autonomous vehicles (AVs) using parking buildings. Hazards posed by the increasing number of alternatively powered vehicles on the road, such as electric vehicles (EVs), may be mitigated. Parking AVs in designated zones would allow for the installation of fire-suppression systems other than those that are water-based, permit alternative ventilation requirements and allow for the reconfiguration of the building structure. Connected AVs could communicate with other vehicles, the parking building and the emergency services, resulting in a more effective response to a developing fire incident. However, AVs may increase fire safety hazards when considering alternative parking arrangements that promote more extensive fire spread, increase the median fire load energy density by at least 13% and inhibit firefighting. This may impact on the operational capability of the emergency services and the expectations of the structural fire safety design of the building. In this paper, options are presented that would influence the design and use of parking buildings where AVs and EVs are present. Presently, it is unclear whether the introduction of AVs will increase or decrease the fire safety risk to life and property, and further research is suggested to better understand such matters. [ABSTRACT FROM AUTHOR]

The article informs readers about the release of Coastal Sand Dune Geology maps for the Kittery to Robbinston area in Maine. Topics covered include the nature of coastal sand dune systems, erosion hazards, Maine's Natural Resources Protection Act regulations related to coastal development, and the mapping process utilized by the Maine Geological Survey.

Hydrographic data--obtained concurrently along the 25 km longitudinal axis of the Kennebec River estuary during a 13 h semidiurnal tidal cycle of a spring freshet superimposed on near-perigean spring tides--revealed a strong ebb-current dominance along the length of the estuary. Ebb-current dominance is produced by riverine flow that supplants a substantial part of the flood-tidal prism. In addition, side-scan sonograms showed a suite of large bed forms (1-12 m height) with nearly ubiquitous ebb orientations veneering the estuary bottom. Embayment geometry, salinity, water temperature, discharge, current velocity, and bed-form data all suggest that ebb-velocity asymmetry, set up by seasonal changes in freshwater discharge superimposed on ebb-directed tides, is the most important control on net bed-load sediment transport within this high-latitude, rock-bound estuary. These data augment a model that shows that a freshwater discharge threshold exists for net seaward bed-load sediment transport. The results from this study can be used to refine existing conceptual sedimentologic and morphologic classifications of estuaries. Keywords: currents, discharge, estuary, freshet, sediment transport.

Circular depressions, or pockmarks, cover the sea floor in many estuarine regions of the western Gulf of Maine. In Belfast Bay, Maine, they are found in densities up to 160/km squared, are up to 350 m in diameter and 35 m in relief, and are among the largest and deepest known. The pockmarks appear to form from the escape of biogenic natural gas and pore water and are far larger than features associated with thermogenic gas elsewhere. These pockmarks are thought to have formed (1) catastrophically during an earthquake, tsunami, or storm, or (2) slowly over thousands of years. Recent observations of bubble releases suggest continuing activity and a potential geologic hazard. The pockmarks involve a poorly documented coastal process of sediment redistribution and methane release, largely unrecognized in the rock record but widespread in middle- to high-latitude embayments.

The article focuses on the 2019 Maine Beach Profile Report to observe changes at Maine beaches that are monitored as part of the State of Maine Beach Profiling Project (SMBPP) and the Maine Beach Mapping Program (MBMAP) from 2007 to 2019. Topics discussed include the use of a Real Time Kinematic Global Positioning System (RTK-GPS) for data collection, collection of shore-parallel data by the Maine Geological Survey scientists and the time-series analysis of various features of beach profile.

The article reports that WI01 is located near a seawall with little to no dune or berm as WI03 is in the center of the beach near an entrance, and WI06 is near the northern edge of the beach. Topics include considered that the WI01 has a seasonal beach signature with lows in the summer and highs in the winter.

The article reports that the HI01 and HI02 are located along seawalls, and HI03 is located at a dune and spit complex near the Spurwink River. Topics include considered that the HI01 shows a strong seasonal dune/berm gain in summer, and loss in winter as this trend is smaller at HI02 and HI03 has strong seasonal signal of dune gains in early summer, and losses in winter, with beach and berm gains during the winter.

The article focuses on four sites at West Grand Beach are located adjacent to one another in a natural dune. Topics include considered that average monthly dune volumes are large, exceeding beach and berm values, and show seasonal highs during the summer as although there are data gaps for 2021-2022 delta values, data indicates consistent berm losses in WG01 to WG03, but dune volume gains at all profiles.

The article reports that several profiles at Ferry Beach are located along a dune. Topics include considered that all profiles show roughly the same average monthly trends, with large and more variable dune volumes, and much smaller and consistent beach and berm volumes as from 2021-2022, Ferry Beach showed the most consistent gains of all the beaches, with volumetric gains in dune, berm, and beach, but especially the dune.

The article focuses on several profiles at Ferry Beach that are located along a dune. Topics include considered that all profiles show roughly the same average monthly trends, with large and more variable dune volumes, and much smaller and consistent beach and berm volumes and from 2021-2022, Ferry Beach showed the most consistent gains of all the beaches, with volumetric gains in dune, berm, and beach, but especially the dune.

The article reports that the GR01 at Goose Rocks Beach is located near the Batson River, GR02 in a western pocket beach, GR03 in an eastern pocket, and GR04 at a seawall near the Little River. Topics include examines that strong seasonal patterns are evident at GR02 and GR03, with noted beach highs in winter and lows in summer, with dune and berm gains during the summer months and losses in the winter months.

The article reports that the Gooches Beach consists of four profiling sites such as GO04, GO01, GO02, and GO03. Topics include considered that all four sites are located along a seawall with small dunes and significantly larger beach volumes as the beach volumes vary seasonally, with GO01 having lows in spring and highs in late fall, GO02 being relatively consistent, and GO03 having lows in summer and highs in winter.

The article reports that LH01 is in the middle of the beach, LH03 at the northern end near the Little River and LH05 at the southern end near Drakes Island, all in natural dunes. Topics include considered that most sites on this beach are lacking 2021-2022 data between June 2021 and January 2022 during the time of this analysis, winter data suggests that sediment transport from the dune to the beach increased in the winter of 2021.

The article reports that both sites DI03 and DI05 are located along a seawall. Topics include considered that the DI03 shows similar dune and beach volumes that follow similar trends, with highs in the early spring and late fall as the DI05 has very similar berm and dune volumes, with seasonal highs in the summer to fall, and lows in the winter.