on behalf of the PENUT Trial Consortium* Objective To evaluate whether extremely low gestational age neonates (ELGANs) randomized to erythropoietin have better or worse kidney-related outcomes during hospitalization and at 22-26 months of corrected gestational age (cGA) compared with those randomized to placebo. Study designWe performed an ancillary study to a multicenter double-blind, placebo-controlled randomized clinical trial of erythropoietin in ELGANs. ResultsThe prevalence of severe (stage 2 or 3) acute kidney injury (AKI) was 18.2%. We did not find a statistically significant difference between those randomized to erythropoietin vs placebo for in-hospital primary (severe AKI) or secondary outcomes (any AKI and serum creatinine/cystatin C values at days 0, 7, 9, and 14). At 22-26 months of cGA, 16% of the cohort had an estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m 2 , 35.8% had urine albumin/creatinine ratio >30 mg/g, 23% had a systolic blood pressure (SBP) >95th percentile for age, and 40% had a diastolic blood pressure (DBP) >95th percentile for age. SBP >90th percentile occurred less often among recipients of erythropoietin (P < .04). This association remained even after controlling for gestational age, site, and sibship (aOR 0.6; 95% CI 0.39-0.92). We did not find statistically significant differences between treatment groups in eGFR, albumin/creatinine ratio, rates of SBP >95th percentile, or DBP >90th or >95th percentiles at the 2 year follow-up visit.Conclusions ELGANs have high rates of in-hospital AKI and kidney-related problems at 22-26 months of cGA.Recombinant erythropoietin may protect ELGANs against long-term elevated SBP but does not appear to protect from AKI, low eGFR, albuminuria, or elevated DBP at 22-26 months of cGA.

Background Suicide is among the top 10 causes of premature death in the United States. This study provides details on farmer and rancher suicide decedents, including demographic information, mental health status, history of suicidal thoughts and attempts, and circumstances associated with death. Methods Data for this study were obtained from the Centers for Disease Control and Prevention's National Violent Death Reporting System Restricted Access Database for the years 2003–2018. Descriptive statistics and adjusted odds ratios are presented for farm and nonfarm populations in addition to farm populations by age groups and sex. Results This study found that almost half of the farmer suicide decedents were over 65 years old. Firearms were the most widely used method for farmers and ranchers regardless of age and sex. Young farmers and ranchers that died by suicide were more likely to have had relationship problems and older farmers and ranchers that died by suicides were more likely to have had a physical health problem. Male farmer and rancher suicide decedents were more likely to die by firearm than females, and female farmer and rancher suicide decedents were likely to have resided in a small metropolitan area, however, due to small numbers and suppression in the data, most sex comparisons were not able to be presented. Conclusions While no clear risk factor for suicide among farmers and ranchers emerged, results underscore the complex nature of suicide and the need for multifaceted, culturally competent interventions and campaigns that address suicide risk and prevention at the individual and community levels.

Abstract. Health limitations and disabilities among farmers, farmworkers, and farm family members may have implications on their day-to-day activities and well-being as well as the farm business, but little is known about the extent of these limitations and disabilities. Using the U.S. Census Bureau’s American Community Survey (ACS) Public Use Microdata Sample (PUMS) files from 2008 to 2016, the following questions were examined: what is the prevalence of disability in the overall farm population; what is the prevalence of health difficulties and disability among farmers, farmworkers, and farm family members; and do farmer and farmworker disability prevalence rates vary over time, by state, gender, or race/ethnicity. Finally, the effects of demographic factors were estimated on the likelihood that farmers and farmworkers might experience a disability. The findings of this study indicated that the disability rate in the farm population was 12.9%. On average, almost two out of ten farmers (19.2%) and nearly one out of ten farmworkers (9.0%) had a disability. One in 25 farm family children (4.2%, ages 6 to 17) and slightly more than two in 25 farm family adults (10.5%) had a disability. Keywords: Cognitive difficulty, Disability, Farm children, Farmer, Farm household, Farmworker, Hearing difficulty, Independent living difficulty, Physical difficulty, Self-care difficulty, Vision difficulty.

Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0-18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7-19) versus 34.7 (20.4-53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheterrelated bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients' family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion:The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system.