The Melbourne epidemic thunderstorm asthma event 2016: an investigation of environmental triggers, effect on health services, and patient risk factors.

BACKGROUND: A multidisciplinary collaboration investigated the world's largest, most catastrophic epidemic thunderstorm asthma event that took place in Melbourne, Australia, on Nov 21, 2016, to inform mechanisms and preventive strategies. METHODS: Meteorological and airborne pollen data, satellite-derived vegetation index, ambulance callouts, emergency department presentations, and data on hospital admissions for Nov 21, 2016, as well as leading up to and following the event were collected between Nov 21, 2016, and March 31, 2017, and analysed. We contacted patients who presented during the epidemic thunderstorm asthma event at eight metropolitan health services (each including up to three hospitals) via telephone questionnaire to determine patient characteristics, and investigated outcomes of intensive care unit (ICU) admissions. FINDINGS: Grass pollen concentrations on Nov 21, 2016, were extremely high (>100 grains/m3). At 1800 AEDT, a gust front crossed Melbourne, plunging temperatures 10°C, raising humidity above 70%, and concentrating particulate matter. Within 30 h, there were 3365 (672%) excess respiratory-related presentations to emergency departments, and 476 (992%) excess asthma-related admissions to hospital, especially individuals of Indian or Sri Lankan birth (10% vs 1%, p<0·0001) and south-east Asian birth (8% vs 1%, p<0·0001) compared with previous 3 years. Questionnaire data from 1435 (64%) of 2248 emergency department presentations showed a mean age of 32·0 years (SD 18·6), 56% of whom were male. Only 28% had current doctor-diagnosed asthma. 39% of the presentations were of Asian or Indian ethnicity (25% of the Melbourne population were of this ethnicity according to the 2016 census, relative risk [RR] 1·93, 95% CI 1·74-2·15, p <0·0001). Of ten individuals who died, six were Asian or Indian (RR 4·54, 95% CI 1·28-16·09; p=0·01). 35 individuals were admitted to an intensive care unit, all had asthma, 12 took inhaled preventers, and five died. INTERPRETATION: Convergent environmental factors triggered a thunderstorm asthma epidemic of unprecedented magnitude, tempo, and geographical range and severity on Nov 21, 2016, creating a new benchmark for emergency and health service escalation. Asian or Indian ethnicity and current doctor-diagnosed asthma portended life-threatening exacerbations such as those requiring admission to an ICU. Overall, the findings provide important public health lessons applicable to future event forecasting, health care response coordination, protection of at-risk populations, and medical management of epidemic thunderstorm asthma. FUNDING: None

Functional Femtoliter Droplets for Ultrafast Nanoextraction and Supersensitive Online Microanalysis

A universal femtoliter surface droplet-based platform for direct quantification of trace of hydrophobic compounds in aqueous solutions is presented. Formation and functionalization of femtoliter droplets, concentrating the analyte in the solution, are integrated into a simple fluidic chamber, taking advantage of the long-term stability, large surface-to-volume ratio, and tunable chemical composition of these droplets. In situ quantification of the extracted analytes is achieved by surface-enhanced Raman scattering (SERS) spectroscopy by nanoparticles on the functionalized droplets. Optimized extraction efficiency and SERS enhancement by tuning droplet composition enable quantitative determination of hydrophobic model compounds of rhodamine 6G, methylene blue, and malachite green with the detection limit of 10-9 to 10-11 m and a large linear range of SERS signal from 10-9 to 10-6 m of the analytes. The approach addresses the current challenges of reproducibility and the lifetime of the substrate in SERS measurements. This novel surface droplet platform combines liquid-liquid extraction and highly sensitive and reproducible SERS detection, providing a promising technique in current chemical analysis related to environment monitoring, biomedical diagnosis, and national security monitoring

Land use and urban development impact of BART: interpretive summary of the final report.

Transportation Department, Washington, D.C.Housing and Urban Development Department, Washington, D.C.Mode of access: Internet.Author corporate affiliation: Blayney, John, Associates/David M. Dornbusch and Comapany, Inc., A Joint Venture, San Francisco, Calif.Author corporate affiliation: Metropolitan Transportation Commission, Berkeley, Calif.Subject code: DDBRSubject code: SDBFSubject code: SDCDSubject code: SDESubject code: WW

Flow-induced dissolution of femtoliter surface droplet arrays

The dissolution of liquid nanodroplets is a crucial step in many applied processes, such as separation and dispersion in the food industry, crystal formation of pharmaceutical products, concentrating and analysis in medical diagnosis, and drug delivery in aerosols. In this work, using both experiments and numerical simulations, we quantitatively study the dissolution dynamics of femtoliter surface droplets in a highly ordered array under a uniform flow. Our results show that the dissolution of femtoliter droplets strongly depends on their spatial positions relative to the flow direction, drop-to-drop spacing in the array, and the imposed flow rate. In some particular cases, the droplet at the edge of the array can dissolve about 30% faster than the ones located near the centre. The dissolution rate of the droplet increases by 60% as the inter-droplet spacing is increased from 2.5 mu m to 20 mu m. Moreover, the droplets close to the front of the flow commence to shrink earlier than those droplets in the center of the array. The average dissolution rate is faster for the faster flow. As a result, the dissolution time (T-i) decreases with the Reynolds number (Re) of the flow as T-i proportional to Re-3/4. The experimental results are in good agreement with the numerical simulations where the advection-diffusion equation for the concentration field is solved and the concentration gradient on the surface of the drop is computed. The findings suggest potential approaches to manipulate nanodroplet sizes in droplet arrays simply by dissolution controlled by an external flow. The obtained droplets with varying curvatures may serve as templates for generating multifocal microlenses in one array