A report in the National Center for Health Statistics Data Brief found that from 2007 to 2017, US fertility rates decreased 12% in rural areas, 16% in small and medium cities, and 18% in metro counties. During the same time, the average age among women having their first child increased from 23 to almost 25 in rural areas, from 24 to 26 in small or medium cities, and from 26 to 28 in large cities.

Researchers found that infants whose mothers took beta-blockers during the first trimester of pregnancy didn't have a significantly higher likelihood of developing congenital malformations, cardiac or central nervous system defects, and cleft lip or palate, compared with those whose mothers weren't exposed to beta-blockers during gestation. The findings were published online in the Annals of Internal Medicine.

Australian researchers conducted a meta-analysis of 39 studies involving 359,783 diabetes patients and found those with stress hyperglycemia were at an increased risk for poorer outcomes after stroke and mortality, compared with the general population. The findings in the Journal of Diabetes Investigation revealed that those with high A1C levels had higher mortality rates and stroke recurrence and severity.

Australian investigators who conducted a rapid scale-up of pre-exposure prophylaxis treatment among 3,645 gay and bisexual men who engaged in high-risk sexual behaviors from the state of New South Wales found that new HIV infections dropped 32% one year after the program was started, based on data published in The Lancet HIV. One challenge to replicating this effect in the US would be access to PrEP due to its cost and insurance copayments, according to Jeffrey D. Klausner, of the University of California at Los Angeles, who wasn't involved in the study.

Danish women with a history of preeclampsia had a 53% higher dementia risk and were more than three times as likely to develop vascular dementia, compared with those who didn't have preeclampsia, researchers reported in The BMJ. The findings, based on an analysis of registry data involving more than 1.1 million women who gave birth from 1978 to 2015, also showed that preeclampsia was more strongly associated with vascular dementia in late-onset than early-onset disease and had a modest link to Alzheimer's disease and other/unspecified dementia.

A study in Medical Care found that the cost of delivering Medicare diabetes prevention services to a safety-net population may substantially exceed reimbursements. Researchers examined costs and projected reimbursements for MDPP services delivered to 213 primarily minority, low-income Medicare recipients in Denver, and they found that the average expected reimbursement under CMS' coverage rules was around $139 per patient, $661 less than the cost.

Researchers at Purdue University have developed paper-based electronic devices that can eventually be used to develop health monitoring and therapeutic medical devices. The flexible, breathable devices, called "smart stickers" by the scientists, are intended to be wirelessly powered and repel oils and water, as the cellulose they are made of is infused with hydrophobic and hydrophilic molecules.

Relieve stress at any time of day through mindfulness, a meditative practice that requires taking a short break to re-focus and center on what's important. A 10-minute yoga session at the start of the day can be helpful, but for those pressed for time in the morning, a short de-stress activity during lunch break or listening to a guided mindfulness podcast can be beneficial as well.

Senate Majority Leader Mitch McConnell, R-Ky., said Senate Republicans are not satisfied with how the Affordable Care Act is performing and may attempt again to repeal the law, but the feasibility depends on the results of next month's midterm election. "If we had the votes to completely start over, we'd do it. But that depends on what happens in a couple weeks," McConnell said.

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