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Nursing professional organizations and media sources indicated early in the pandemic that the physical and psychological effects of COVID-19 might be distinct and possibly greater in nurses than in other types of healthcare workers (HCWs).Based on survey data collected in Healthcare Worker Exposure Response and Outcomes (HERO), a national registry of U.S. HCWs, this study compared the self-reported experiences of nurses with other HCWs during the first 13 months of the pandemic.Nurse responses were compared to responses of nonnurse HCWs in terms of viral exposure, testing and infection, access to personal protective equipment (PPE), burnout, and well-being. Logistic regression models were used to examine associations between nurse and nonnurse roles for the binary end points of viral testing and test positivity for COVID-19. We also examined differences by race/ethnicity and high-risk versus low-risk practice settings.Of 24,343 HCWs in the registry, one third self-identified as nurses. Nurses were more likely than other HCWs to report exposure to SARS-CoV-2, problems accessing PPE, and decreased personal well-being, including burnout, feeling tired, stress, trouble sleeping, and worry. In adjusted models, nurses were more likely than nonnurse HCWs to report viral testing and test positivity for COVID-19 infection. Nurses in high-risk settings were more likely to report viral exposure and symptoms related to well-being; nurses in low-risk settings were more likely to report viral testing and test positivity. Black or Hispanic nurses were most likely to report test positivity.Differences were identified between nurses and nonnurse HCWs in access to PPE, physical and mental well-being measures, and likelihood of reporting exposure and infection. Among nurses, testing and infection differed based on race and ethnicity, and type of work setting. Our findings suggest further research and policy are needed to elucidate and address social and occupational disparities.

The Appalachian Mountains in northern Vermont host a complex rock record of the tectonic evolution of eastern Laurentia, from the opening of the Iapetus Ocean to the subsequent formation of a convergent Paleozoic margin involving multiple phases of orogenesis. Prior 40Ar/39Ar studies in Vermont and northern Massachusetts have generally interpreted two major events associated with a dominantly Ordovician Taconic orogeny and a Devonian Acadian orogeny; intermediate ages were considered to reflect Taconic metamorphism and/or deformation that was “partially reset” during the Acadian orogeny. However, recent studies have documented Salinic ages in northern Vermont, aligning with multiple lines of evidence in southern Quebec for an intervening Salinic orogeny during the Silurian. This study reports integrated microstructural and 40Ar/39Ar geochronological analyses of samples collected across the Green Mountain anticlinorium in northern Vermont. The dominant S2 and S3 foliations are defined in thin section by predominantly white mica/quartz microlithons and aligned mica cleavage domains in schist to graphitic schist that formed under greenschist-facies conditions. Correlation of microstructures across the field area and associated 40Ar/39Ar plateau ages reveal a spatial pattern associated with microstructural development across the anticlinorium. In the eastern limb, the oldest plateau age, 457.6 ± 2.0 Ma (1σ), is interpreted to reflect the timing of formation of S2. The youngest plateau age, 419.0 ± 2.4 Ma, comes from the western limb of the anticline near the trace of the Honey Hollow fault, where S2 is completely transposed by S3. Intermediate ages were obtained across the axis of the anticline, where S3 is a crenulation cleavage. While the Green Mountain anticlinorium has been previously interpreted to have formed in the Devonian during the Acadian orogeny, the typical ca. 386–355 Ma ages are notably absent in the data set, except in locally disturbed spectra. The results of this work are closely aligned with published results of 40Ar/39Ar dating in southern Quebec that reflect deformation during Taconic and Salinic orogenesis. These new data, together with recently reported ages of west-directed transport on Taconic thrusts along the western Green Mountain front at ca. 420 Ma, suggest a phase of mountain building in the New England Appalachians that has been previously unreported in Vermont. The formation of the Green Mountain anticlinorium coincided with a complex tectonic interval that overlapped temporally with (1) the transition from Salinic thrusting to normal faulting, (2) magmatism attributed to slab breakoff, and (3) syntectonic deposition in the Connecticut Valley–Gaspé Basin.

Paleoproterozoic gneisses of the Ellesmere–Devon crystalline terrane on southeastern Ellesmere Island are deformed by metre-scale, east-striking mylonite zones. The shear zones commonly offset pegmatitic dikes and represent the last episode of ductile deformation. Samples were dated by the 40Ar/39Ar step-heating method to put an upper limit on the time of deformation. Biotite from one tonalitic protolith and five shear zones give geologically meaningful results. Clusters of unoriented biotite grains pseudomorph granulite-facies orthopyroxene in some of the weakly deformed gneisses, whereas the shape-preferred orientation of biotite defines the mylonitic fabric. The intrusive age of the tonalitic protolith is 1958 ± 12 Ma, based on previous U–Pb dating of zircon. 40Ar/39Ar analysis of biotite from the same sample gave a plateau age of 1929 ± 23 Ma, which is interpreted as cooling from regional granulite facies metamorphism. Three nearby samples of mylonitic tonalite have 40Ar/39Ar ages in the range of ≈1870–1840 Ma. Biotite from two granitic mylonites over 80 km away return high-resolution Ar spectra in the same range, implying that widespread ductile shearing occurred at ≈1870–1840 Ma, or ≈90 million years after cooling from regional metamorphism. Although the 2.0–1.9 Ga gneisses of southeastern Ellesmere Island correlate with the Inglefield Mobile Belt in North-West Greenland and the Thelon Tectonic Zone, the late shear zones are superimposed on that juvenile arc long after the 1.97 Ga Thelon orogeny.

The Early Cretaceous New England-Quebec igneous province is a classic example of postrift magmatism along the eastern North American passive margin. Although a suite of 40Ar/39Ar ages has been available for the Monteregian Hills lobe in the Quebec portion of the New England-Quebec igneous province for many years, only a single high accuracy radiometric age has been published for the Burlington lobe and none for the Taconic lobe in the New England portion of the province. As a result, the timing of and driving mechanisms behind the magmatism have remained unresolved, and a hotspot origin for the entire province persists in the literature. We have dated four dikes and one pluton in the Burlington and Taconic lobes using 40Ar/39Ar and U–Pb geochronology to improve understanding of the age of magmatism in the New England portion of the province. In the Burlington lobe, 40Ar/39Ar plateau ages include a 137.55 ± 1.80 Ma biotite age and a 136.9 ± 4.2 Ma amphibole age for a lamprophyre dike from Charlotte, Vermont, and a 133.6 ± 2.2 Ma biotite age for a lamprophyre dike from Colchester, Vermont. In the Taconic lobe, ages include an 40Ar/39Ar plateau amphibole age of 107.09 ± 1.32 Ma for a lamprophyre dike from Castleton, Vermont, a 122 Ma minimum 40Ar/39Ar biotite age for a lamprophyre dike from Poultney, Vermont, and a 103.13 ± 0.53 Ma LA-ICP-MS U–Pb zircon age from the quartz syenite of the Cuttingsville complex. These results show that magmatism spanned at least 35 Ma, from ∼138 to 103 Ma, which is broadly consistent with the span of magmatism suggested by workers in the 1970s and 1980s based on K–Ar and Rb–Sr ages. This extended span of magmatism for the Burlington and Taconic lobes is in contrast to the brief 1 to 2 Ma episode of magmatism at ∼124 Ma inferred for the Monteregian Hills lobe. The New England-Quebec igneous province has traditionally been attributed to passage of the Great Meteor hotspot. However, given the close proximity of the Burlington and Taconic lobes, the magmatism in these lobes should span only a few Ma if the product of a hotspot. The age data are also difficult to reconcile with a more complex expression of hotspot magmatism in continental lithosphere related to either plume head magmatism or long-distance migration of plume material. Instead, the extended duration of Early Cretaceous New England-Quebec igneous province magmatism in New England may represent an expression of edge-driven convection, a process known to occur along passive margins and inferred to be operating beneath the eastern North American margin today.

The 40Ar/39Ar dating method is among the most versatile of geochronometers, having the potential to date a broad variety of K-bearing materials spanning from the time of Earth’s formation into the historical realm. Measurements using modern noble-gas mass spectrometers are now producing 40Ar/39Ar dates with analytical uncertainties of ~0.1%, thereby providing precise time constraints for a wide range of geologic and extraterrestrial processes. Analyses of increasingly smaller subsamples have revealed age dispersion in many materials, including some minerals used as neutron fluence monitors. Accordingly, interpretive strategies are evolving to address observed dispersion in dates from a single sample. Moreover, inferring a geologically meaningful “age” from a measured “date” or set of dates is dependent on the geological problem being addressed and the salient assumptions associated with each set of data. We highlight requirements for collateral information that will better constrain the interpretation of 40Ar/39Ar data sets, including those associated with single-crystal fusion analyses, incremental heating experiments, and in situ analyses of microsampled domains. To ensure the utility and viability of published results, we emphasize previous recommendations for reporting 40Ar/39Ar data and the related essential metadata, with the amendment that data conform to evolving standards of being findable, accessible, interoperable, and reusable (FAIR) by both humans and computers. Our examples provide guidance for the presentation and interpretation of 40Ar/39Ar dates to maximize their interdisciplinary usage, reproducibility, and longevity.

Background The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers. Objective Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry. Design Cross-sectional, self-administered registry enrollment survey conducted from April 10 to July 31, 2020. Setting Participants worked in hospitals (74.4%), outpatient clinics (7.4%), and other settings (18.2%) located throughout the nation. Participants A total of 14,600 healthcare workers. Main Measures COVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, job burnout, and physical and emotional distress. Key Results Mean age was 42.0 years, 76.4% were female, 78.9% were White, 33.2% were nurses, 18.4% were physicians, and 30.3% worked in settings at high risk for COVID-19 exposure (e.g., ICUs, EDs, COVID-19 units). Overall, 43.7% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.8% in both high- and low-risk settings experienced COVID-19 illness. In regression analyses controlling for demographics, professional role, and work setting, the risk of COVID-19 illness was higher for Black/African-Americans (aOR 2.32, 99% CI 1.45, 3.70, p < 0.01) and Hispanic/Latinos (aOR 2.19, 99% CI 1.55, 3.08, p < 0.01) compared with Whites. Overall, 41% responded that they were experiencing job burnout. Responding about the day before they completed the survey, 53% of participants reported feeling tired a lot of the day, 51% stress, 41% trouble sleeping, 38% worry, 21% sadness, 19% physical pain, and 15% anger. On average, healthcare workers reported experiencing 2.4 of these 7 distress feelings a lot of the day. Conclusions Healthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness were low. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers. The HERO registry will continue to monitor changes in healthcare worker well-being during the pandemic. Trial Registration ClinicalTrials.gov identifier NCT04342806 Supplementary Information The online version contains supplementary material available at 10.1007/s11606-020-06529-z.

The objective of this study was to determine the circulating microRNA (miRNA) profile in over-conditioned (HBCS) versus normal-conditioned (NBCS) dairy cows in combination with pathway enrichment analyses during the transition period. Thirty-eight multiparous Holstein cows were selected 15 wk before anticipated calving date based on their current and previous body condition scores (BCS) for forming either a HBCS group (n = 19) or a NBCS group (n = 19). They were fed different diets during late lactation to reach the targeted differences in BCS and backfat thickness until dry-off. A subset of 15 animals per group was selected based on their circulating concentrations of nonesterified fatty acids (on d 14 postpartum) and β-hydroxybutyrate (on d 21 postpartum), representing the greater or the lower extreme values within their BCS group. Blood serum obtained at d -49 and 21 relative to parturition (3 pools with 5 cows per each group and time point) were used to identify miRNA that were differentially expressed (DE) between groups or time points using miRNA sequencing. No DE-miRNA were discovered between NBCS versus HBCS. Comparing pooled samples from d -49 and d 21 resulted in 7 DE-miRNA in the NBCS group, of which 5 miRNA were downregulated and 2 miRNA were overexpressed on d 21 versus -49. The abundance of 5 of these DE-miRNA was validated in all individual samples via quantitative PCR and extended to additional time points (d -7, 3, 84). Group differences were observed for miR-148a, miR-122 as well as miR-455-5p, and most DE-miRNA (miR-148a, miR-122, miR-30a, miR-450b, miR-455-5p) were downregulated directly after calving. Subsequently, the DE-miRNA was used for bioinformatics analysis to identify putative target genes and the most enriched biological pathways. The most significantly enriched pathways of DE-miRNA were associated with cell cycle and insulin signaling as well as glucose and lipid metabolism. Overall, we found little differences in circulating miRNA in HBCS versus NBCS cows around calving.

Introduction: Reduced doses of direct oral anticoagulants (DOACs) are approved to prevent bleeding complications in specified populations of patients with non-valvular atrial fibrillation (NVAF). Little is known about the accuracy of DOAC dosing in patients with renal dysfunction. Hypothesis: We hypothesized that NVAF patients with renal dysfunction would be more likely to receive an inappropriate dose of a DOAC compared with patients with normal renal function. Methods: We examined all patients who had at least two claims for NVAF between 2015 and 2017 in the Symphony Health claims dataset. We defined under-dosing as patients treated with a reduced dose without meeting label specified criteria for dose reduction, and excess dosing as patients treated with a full dose despite meeting criteria for dose reduction. We performed a logistic regression model to measure the effect of CrCl on DOAC dosing. Results: Among 86,919 patients with NVAF and CHA 2 DS 2 -VASc > 2, 12.3% were underdosed and 5.0% were excess dosed. Patients who received excess-dosed or under-dosed DOACs were older and more likely to have comorbidities such as heart failure or history of prior stroke (all p 60 ml/min, under-dosing occurred in 9% of patients, highest among patients treated with edoxaban (18%) and rivaroxaban (10.4%). Under-dosing rates were higher among patients with CrCl 30-59 ml/min, especially for apixaban and dabigatran ( Table) . Excess dosing occurred in approximately 1 in 5 patients with CrCl Conclusions: Incorrect DOAC dosing was observed in a substantial number of patients with NVAF in this large national study. Dosing errors occurred more frequently in patients with lower renal function, suggesting the need for efforts to improve effective and safe dosing of DOACs.

Multiple sodium glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to impart significant cardiovascular and kidney benefits, but are underused in clinical practice. Both SGLT-2i and GLP-1RA were first studied as glucose-lowering drugs, which may have impeded uptake by cardiologists in the wake of proven cardiovascular efficacy. Their significant effect on cardiovascular and kidney outcomes, which are largely independent of glucose-lowering effects, must drive a broader use of these drugs. Cardiologists are 3 times more likely than endocrinologists to see patients with both type 2 diabetes and cardiovascular disease, thus they are ideally positioned to share responsibility for SGLT-2i and GLP-1RA treatment with primary care providers. In order to increase adoption, SGLT-2i and GLP-1RA must be reframed as primarily cardiovascular and kidney disease risk-reducing agents with a side effect of glucose-lowering. Coordinated and multifaceted interventions engaging clinicians, patients, payers, professional societies, and health systems must be implemented to incentivize the adoption of these medications as part of routine cardiovascular and kidney care. Greater use of SGLT-2i and GLP-1RA will improve outcomes for patients with type 2 diabetes at high risk for cardiovascular and kidney disease.

Background Direct oral anticoagulants (DOACs) are effective in reducing the stroke risk for patients with nonvalvular atrial fibrillation if prescribed at the labeled dose, yet underdosing is frequent. Little is known about clinician knowledge and patient or clinician preferences for DOAC dosing. Methods and Results From April 2019 to March 2020, 240 clinicians and 343 patients with atrial fibrillation completed an assessment of anticoagulation knowledge/preferences. Clinician knowledge of DOAC dosing was tested with 4 hypothetical patient scenarios. Patients and clinicians were asked to grade the importance of 25 factors in anticoagulation decision making. Among clinicians, the median age was 55 years, and 23% were primary care clinicians. In scenarios of a patient indicated for full‐dose DOAC, 41.2% of clinicians underdosed apixaban and 17.6% underdosed rivaroxaban. In scenarios of a patient indicated for reduced‐dose DOAC, 64.6% and 71.7% of clinicians chose to use reduced‐dose apixaban and rivaroxaban, respectively. Only 35.0% of clinicians correctly answered all 4 scenarios with the label‐indicated dose; this knowledge gap was similar between clinicians who did and did not underdose. Among patients with atrial fibrillation, the median age was 65 years, and 89% were currently anticoagulated. Patients and clinicians ranked stroke prevention and avoiding severe bleeding as very important to anticoagulation decision making. Patients were more likely than clinicians to rank the ability to reduce anticoagulation dose if needed as very important (70.5% versus 43.6%; P Conclusions There are considerable knowledge gaps regarding DOAC dosing in clinicians treating patients with atrial fibrillation, as well as significant differences in treatment dosing preferences between clinicians and patients.

A new multidisciplinary project in southwest New Zealand that combines geological and geophysical data shows how and why deep lithospheric displacements were transferred vertically through the upper plate of an incipient ocean-continent subduction zone. A key discovery includes two zones of steep, downward-curving reverse faults that uplifted and imbricated large slices of Cretaceous lower, middle, and upper crust in the Late Miocene. Geochemical and structural analyses combined with 40Ar/39Ar geochronology and published images from seismic tomography suggest that the reverse faults formed at 8–7 Ma as a consequence of a deep (~100 km) collision between subducting oceanic lithosphere and previously subducted material. This collision localized shortening and reactivated two crustal-scale shear zones from the upper mantle to the Earth’s surface. The event, which is summarized in a new lithospheric-scale profile, is helping us answer some long-standing questions about the origin of Fiordland’s unique lower-crustal exposures and what they tell us about how inherited structures can transfer motion vertically through the lithosphere as subduction initiates.

BACKGROUND Financial burden for patients, providers, and payers can reduce access to physical therapy (PT) after total knee arthroplasty (TKA). The purpose of the present study was to examine the effect of a virtual PT program on health-care costs and clinical outcomes as compared with traditional care after TKA. METHODS At least 10 days before unilateral TKA, patients from 4 clinical sites were enrolled and randomized 1:1 to the virtual PT program (involving an avatar [digitally simulated] coach, in-home 3-dimensional biometrics, and telerehabilitation with remote clinician oversight by a physical therapist) or to traditional PT care in the home or outpatient clinic. The primary outcome was total health-care costs for the 12-week post-hospital period. Secondary (noninferiority) outcomes included 6 and 12-week Knee injury and Osteoarthritis Outcome Score (KOOS); 6-week knee extension, knee flexion, and gait speed; and 12-week safety measures (patient-reported falls, pain, and hospital readmissions). All outcomes were analyzed on a modified intent-to-treat basis. RESULTS Of 306 patients (mean age, 65 years; 62.5% women) who were randomized from November 2016 to November 2017, 290 had TKA and 287 (including 143 in the virtual PT group and 144 in the usual care group) completed the trial. Virtual PT had lower costs at 12 weeks after discharge than usual care (median, $1,050 compared with $2,805; p < 0.001). Mean costs were $2,745 lower for virtual PT patients. Virtual PT patients had fewer rehospitalizations than the usual care group (12 compared with 30; p = 0.007). Virtual PT was noninferior to usual PT in terms of the KOOS at 6 weeks (difference, 0.77; 90% confidence interval [CI], -1.68 to 3.23) and 12 weeks (difference, -2.33; 90% CI, -4.98 to 0.31). Virtual PT was also noninferior to usual care at 6 weeks in terms of knee extension, knee flexion, and gait speed and at 12 weeks in terms of pain and hospital readmissions. Falls were reported by 19.4% of virtual PT patients and 14.6% of usual care patients (difference, 4.83%; 90% CI, -2.60 to 12.25). CONCLUSIONS Relative to traditional home or clinic PT, virtual PT with telerehabilitation for skilled clinical oversight significantly lowered 3-month health-care costs after TKA while providing similar effectiveness. These findings have important implications for patients, health systems, and payers. Virtual PT with clinical oversight should be considered for patients managed with TKA. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Structural interpretation of 2-D seismic reflection data and subsurface-outcrop correlations reveal six distinct phases of deformation recorded in the Paleozoic basement rocks and Mesozoic-Cenozoic basin fill of the East Gobi Basin (EGB), southeastern Mongolia. These phases include arc accretion and arc-continent collision in late Paleozoic time, Late Triassic sinistral shear-zone development, Early Jurassic fold and thrust belt style shortening, Middle Jurassic-Lower Cretaceous extension and rift basin development, middle Cretaceous shortening with basin inversion and regional unconformity development, and Late Cretaceous-Oligocene thermal subsidence with renewed Paleogene left-lateral strike slip faulting across the fault zone. The five post-amalgamation deformation phases are localized along the East Gobi Fault Zone, suggesting that preexisting structures and boundary conditions exert fundamental controls on the long term evolution of intracontinental basins such as the EGB. Subsurface geophysical data and outcrop correlations demonstrate that the main subbasins of the EGB contain major differences in basement metamorphic and structural fabrics, basin fill patterns, and distinct Mesozoic-Cenozoic fault generations. Potential causes related to far-field boundary conditions and other driving factors are suggested for each of the major deformation phases.

Background The SARS CoV-2 virus has caused one of the deadliest pandemics in recent history, resulting in over 170 million deaths and global economic disruption. There remains an urgent need for clinical trials to test therapies for treatment and prevention. Design An online research platform was created to support a registry community of healthcare workers (HCWs) to understand their experiences and conduct clinical studies to address their concerns. The first study, HERO-HCQ, was a double-blind, multicenter, randomized, pragmatic trial to evaluate the superiority of hydroxychloroquine (HCQ) vs placebo for pre-exposure prophylaxis (PrEP) of COVID-19 clinical infection in HCWs. Secondary objectives were to assess the efficacy of HCQ in preventing viral shedding of COVID-19 among HCWs and to assess the safety and tolerability of HCQ. Methods HCWs joined the Registry and were pre-screened for trial interest and eligibility. Trial participants were randomized 1:1 to receive HCQ or placebo. On-site baseline assessment included a COVID-19 nasopharyngeal PCR and blood serology test. Weekly follow-up was done via an online portal and included screening for symptoms of COVID-19, self-reported testing, adverse events, and quality of life assessments. The on-site visit was repeated at Day 30. Discussion The HERO research platform offers an approach to rapidly engage, screen, invite and enroll into clinical studies using a novel participant-facing online portal interface and remote data collection, enabling limited onsite procedures for conduct of a pragmatic clinical trial. This platform may be an example for future clinical trials of common conditions to enable more rapid evidence generation.

Single‐site, intensive, community‐based blood pressure (BP) intervention programs have led to BP improvements. The authors examined the American Heart Association's Check. Change. Control. (CCC) program (4069 patients/18 cities) to determine whether BP interventions can effectively be scaled to multiple communities, using a simplified template and local customization. Effectiveness was evaluated at each site via site percent enrollment goals, participant engagement, and BP change from first to last measurement. High‐enrolling sites frequently recruited at senior residential institutions and service organizations held hypertension management classes and utilized established and new community partners. High‐engagement sites regularly held hypertension education classes and followed up with participants. Top‐performing sites commonly distributed BP cuffs, checked BP at engagement activities, and trained volunteers. CCC demonstrated that simplified community‐based hypertension intervention programs may lead to BP improvements, but there was high outcomes variability among programs. Several factors were associated with BP improvement that may guide future program development.

Integrated structural and 40 Ar/ 39 Ar geochronologic analyses of basement rocks exposed along the north-central coast of Chile (~ 33.5°S) allow a reconstruction of a multistage history of magmatism, metamorphism, and deformation since the late Paleozoic. Each phase of ductile deformation documented from the Late Carboniferous-Late Jurassic is inextricably linked to coeval magmatism or melt infiltration. A regionally recognized NW-WNW-striking structural architecture, formed initially in the Late Carboniferous during intrusion of the igneous Santo Domingo Complex, modulated subsequent phases of deformation and magmatism during periods of oblique convergence. All together, the new data document a punctuated history of subduction, arc magmatism, accretion, and segmentation along the proto-Pacific margin of Gondwana and development of the Andean margin. Because the reactivation of NW-striking structures during great earthquakes is recognized regionally, the results of this work are pertinent to a holistic understanding of seismic hazards in suprasubduction zone settings.

Today, we see a growing concern for the quality of life of nonhuman animals and an accompanying call for viable means of assessing how well animals thrive. Past research focused on minimizing negatives such as stress, while more recent endeavors strive to promote positives such as happiness. But what is animal happiness? Although often mentioned, the term lacks a clear definition. With recent advances in the study of animal emotion, current interest into positive rather than negative experiences, and the call for captive and domesticated animals to have good lives, the time is ripe to examine the concept of animal happiness. We draw from the human and animal literature to delineate a concept of animal happiness and propose how to assess it. We argue that animal happiness depends on how an individual feels generally—that is, a typical level of affect., The aim of our review is to propose a framework for the concept and assessment of animal happiness. To this end, we first study the literature on human quality of life, in particular, human happiness, and identify concepts that may also apply to animals and compare these with notions of animal welfare. Following this, possible methodologies to assess the proposed concept of animal happiness are examined.

Background: Patient participation in clinical research is low, in part because of the length and complexity of the informed consent process. Video informed consent may enhance the appeal of research and help break down barriers to participation. Methods and Results: The PALM study (Patient and Provider Assessment of Lipid Management) enrolled 7904 patients at cardiology, endocrinology, and primary care clinics across the United States to evaluate cholesterol management practices. Of 153 participating clinics, 67 (43.8%) secured institutional review board approval to use a tablet-based video informed consent tool that patients could select to navigate through the informed consent process instead of traditional text-based informed consent. At sites without institutional review board approval of video consent, all patients read a text-based informed consent document. Site activation times and enrollment volumes, as well as characteristics of enrolled patients, were compared between sites with and without video consent capability. Sites with video consent capability more often used a central institutional review board (89.6% versus 73.3%), were more often rural (16.7% versus 3.8%), and tended to have fewer providers. Compared with sites without video consent capability, sites with video consent capability had shorter times from site approach to first patient enrollment (median 178 versus 207 days; P =0.02). Sites with video consent capability enrolled similar numbers of patients as sites without video consent capability ( P =0.48) but enrolled a greater proportion of patients who were ≥75 years old (27.5% versus 23.6%; P P Conclusions: In this observational study of recruitment in a multicenter registry, sites approved for video consent use enrolled the same number of patients as sites with only traditional text-based informed consent but had faster speed to first patient enrolled and more often enrolled older and nonwhite patients. Future randomized trials are needed to assess the impact of video consent on enrollment mechanics and demographics. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02341664