Comparing the Health Care Resource Utilization and Medication Adherence of People with Epilepsy and People with Diabetes by Insurance Status

Background: Epilepsy is one of the most common neurological diseases worldwide; diabetes is a chronic metabolic disease that affects how the body produces and uses insulin. Prescribed medications are vital for controlling these and other chronic diseases by minimizing severe health issues, which can be affected by insurance type and status. Consequences of non-adherence include uncontrolled blood glucose in people with diabetes and uncontrolled seizures in people with epilepsy. We aimed to compare the healthcare resource utilization and medication adherence of people with epilepsy and people with diabetes by insurance status. Methods: Data was from the 2021 National Health Interview Survey. The sample (n=3,645) focused on adults 18 and older who self-reported having epilepsy (n=511) or diabetes (n=3,134). Covariates included sex, age, education level, and race. Descriptive and logistic regression analyses were weighted to account for the complex survey design. Results: When compared with public insurance and after adjusting for covariates, uninsured people with epilepsy had 5.96 times (95% CI 1.71-20.75) the odds and uninsured people with diabetes had 5.33 times (95% CI 3.11-9.12) the odds of delaying care. The uninsured with epilepsy had 9.63 (95% CI 2.24-41.43) times the odds, and those with diabetes had 3.82 (95% CI 2.16-6.73) times the odds of taking less medication. Conclusions: In line with previous research, being uninsured is a barrier to adherence and to healthcare utilization. Uninsured people with epilepsy and people with diabetes had higher odds of non-adherence with prescriptions; they also had higher odds of inconsistent healthcare resource utilization

The Pandora SmallSat: Multiwavelength Characterization of Exoplanets and their Host Stars

Pandora is a SmallSat mission concept, selected as part of NASA’s Astrophysics Pioneers Program, designed to study the atmospheres of exoplanets using transmission spectroscopy. Transmission spectroscopy of transiting exoplanets provides our best opportunity to identify the makeup of planetary atmospheres in the coming decade. Stellar brightness variations due to star spots, however, can seep into these measurements and contaminate the observed spectra. Pandora is designed to disentangle star and planet signals in transmission spectra and reliably characterize the planetary atmospheres. Pandora will collect long-duration photometric observations with a visible-light channel, and simultaneous spectra with a near-IR channel, where water is a strong molecular absorber. The broad wavelength coverage will provide constraints on spot covering fractions of the stars and determine the impact of these active regions on the planetary spectra. Pandora will observe at least 20 exoplanets with sizes ranging from Earth-size to Jupiter-size, with host stars spanning mid-K to late-M spectral types. The project is made possible by leveraging investments in other projects, including an all-aluminum 0.45-meter Cassegrain telescope design, and an IR sensor chip assembly from the James Webb Space Telescope. The mission will last five years from initial formulation to closeout, with one-year of science operations. Launch is planned for the mid-2020s as a secondary payload in Sun-synchronous low-Earth orbit. By design, Pandora has a diverse team, with over half of mission leadership roles filled by early career scientists and engineers, demonstrating the high value of SmallSats for developing the next generation of space mission leaders

The L 98-59 System: Three Transiting, Terrestrial-size Planets Orbiting a Nearby M Dwarf

We report the Transiting Exoplanet Survey Satellite (TESS) discovery of three terrestrial-size planets transiting L 98-59 (TOI-175, TIC 307210830)—a bright M dwarf at a distance of 10.6 pc. Using the Gaia-measured distance and broadband photometry, we find that the host star is an M3 dwarf. Combined with the TESS transits from three sectors, the corresponding stellar parameters yield planet radii ranging from 0.8 R ⊕ to 1.6 R ⊕. All three planets have short orbital periods, ranging from 2.25 to 7.45 days with the outer pair just wide of a 2:1 period resonance. Diagnostic tests produced by the TESS Data Validation Report and the vetting package DAVE rule out common false-positive sources. These analyses, along with dedicated follow-up and the multiplicity of the system, lend confidence that the observed signals are caused by planets transiting L 98-59 and are not associated with other sources in the field. The L 98-59 system is interesting for a number of reasons: the host star is bright (V = 11.7 mag, K = 7.1 mag) and the planets are prime targets for further follow-up observations including precision radial-velocity mass measurements and future transit spectroscopy with the James Webb Space Telescope; the near-resonant configuration makes the system a laboratory to study planetary system dynamical evolution; and three planets of relatively similar size in the same system present an opportunity to study terrestrial planets where other variables (age, metallicity, etc.) can be held constant. L 98-59 will be observed in four more TESS sectors, which will provide a wealth of information on the three currently known planets and have the potential to reveal additional planets in the system

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Early United States experience with liver donation after circulatory determination of death using thoraco‐abdominal normothermic regional perfusion: A multi‐institutional observational study

Mortality on the liver waitlist remains unacceptably high. Donation after circulatory determination of death (DCD) donors are considered marginal but are a potentially underutilized resource. Thoraco‐abdominal normothermic perfusion (TA‐NRP) in DCD donors might result in higher quality livers and offset waitlist mortality. We retrospectively reviewed outcomes of the first 13 livers transplanted from TA‐NRP donors in the US. Nine centers transplanted livers from eight organ procurement organizations. Median donor age was 25 years; median agonal phase was 13 minutes. Median recipient age was 60 years; median lab MELD score was 21. Three patients (23%) met early allograft dysfunction (EAD) criteria. Three received simultaneous liver‐kidney transplants; neither had EAD nor delayed renal allograft function. One recipient died 186 days post‐transplant from sepsis but had normal presepsis liver function. One patient developed a biliary anastomotic stricture, managed endoscopically; no recipient developed clinical evidence of ischemic cholangiopathy (IC). Twelve of 13 (92%) patients are alive with good liver function at 439 days median follow‐up; one patient has extrahepatic recurrent HCC. TA‐NRP DCD livers in these recipients all functioned well, particularly with respect to IC, and provide a valuable option to decrease deaths on the waiting list

The First Habitable-zone Earth-sized Planet from TESS. I. Validation of the TOI-700 System

We present the discovery and validation of a three-planet system orbiting the nearby (31.1 pc) M2 dwarf star TOI-700 (TIC 150428135). TOI-700 lies in the TESS continuous viewing zone in the Southern Ecliptic Hemisphere; observations spanning 11 sectors reveal three planets with radii ranging from 1 R⊕ to 2.6 R⊕ and orbital periods ranging from 9.98 to 37.43 days. Ground-based follow-up combined with diagnostic vetting and validation tests enables us to rule out common astrophysical false-positive scenarios and validate the system of planets. The outermost planet, TOI-700 d, has a radius of 1.19 ± 0.11 R⊕ and resides within a conservative estimate of the host star's habitable zone, where it receives a flux from its star that is approximately 86% of Earth's insolation. In contrast to some other low-mass stars that host Earth-sized planets in their habitable zones, TOI-700 exhibits low levels of stellar activity, presenting a valuable opportunity to study potentially rocky planets over a wide range of conditions affecting atmospheric escape. While atmospheric characterization of TOI-700 d with the James Webb Space Telescope (JWST) will be challenging, the larger sub-Neptune, TOI-700 c (R = 2.63 R⊕), will be an excellent target for JWST and future space-based observatories. TESS is scheduled to once again observe the Southern Hemisphere, and it will monitor TOI-700 for an additional 11 sectors in its extended mission. These observations should allow further constraints on the known planet parameters and searches for additional planets and transit timing variations in the system

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4 m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5 m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 yr, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit