The Association between Drought Exposure and Respiratory-Related Mortality in the United States from 2000 to 2018

Climate change has brought increasing attention to the assessment of health risks associated with climate and extreme events. Drought is a complex climate phenomenon that has been increasing in frequency and severity both locally and globally due to climate change. However, the health risks of drought are often overlooked, especially in places such as the United States, as the pathways to health impacts are complex and indirect. This study aims to conduct a comprehensive assessment of the effects of monthly drought exposure on respiratory mortality for NOAA climate regions in the United States from 2000 to 2018. A two-stage model was applied to estimate the location-specific and overall effects of respiratory risk associated with two different drought indices over two timescales (the US Drought Monitor and the 6-month and 12-month Evaporative Demand Drought Index). During moderate and severe drought exposure, respiratory mortality risk ratio in the general population increased up to 6.0% (95% Cr: 4.8 to 7.2) in the Northeast, 9.0% (95% Cr: 4.9 to 13.3) in the Northern Rockies and Plains, 5.2% (95% Cr: 3.9 to 6.5) in the Ohio Valley, 3.5% (95% Cr: 1.9 to 5.0) in the Southeast, and 15.9% (95% Cr: 10.8 to 20.4) in the Upper Midwest. Our results showed that age, ethnicity, sex (both male and female), and urbanicity (both metro and non-metro) resulted in more affected population subgroups in certain climate regions. The magnitude and direction of respiratory risk ratio differed across NOAA climate regions. These results demonstrate a need for policymakers and communities to develop more effective strategies to mitigate the effects of drought across regions

The RCSB Protein Data Bank: views of structural biology for basic and applied research and education.

The RCSB Protein Data Bank (RCSB PDB, http://www.rcsb.org) provides access to 3D structures of biological macromolecules and is one of the leading resources in biology and biomedicine worldwide. Our efforts over the past 2 years focused on enabling a deeper understanding of structural biology and providing new structural views of biology that support both basic and applied research and education. Herein, we describe recently introduced data annotations including integration with external biological resources, such as gene and drug databases, new visualization tools and improved support for the mobile web. We also describe access to data files, web services and open access software components to enable software developers to more effectively mine the PDB archive and related annotations. Our efforts are aimed at expanding the role of 3D structure in understanding biology and medicine

The Association Between Ambient Temperatures and Hospital Admissions Due to Respiratory Diseases in the Capital City of Vietnam

This study aimed to examine the short-term effects of ambient temperature on hospital admissions due to respiratory diseases among Hanoi residents. We collected 34,653 hospital admissions for 365 days (November 1, 2017, to November 31, 2018) from two hospitals in Hanoi. A quasi-Poisson regression model with time series analysis was used to explore the temperature-health outcome relationship's overall pattern. The non-linear curve indicated the temperatures with the lowest risk range from 22 degrees (Celcius) to 25 degrees (Celcius). On average, cold temperatures showed a higher risk than hot temperatures across all genders and age groups. Hospital admissions risk was highest at 13 degrees (Celcius) (RR = 1.39; 95% CI = 1.26–1.54) for cold effects and at 33 degrees (Celcius) (RR = 1.21, 95% CI = 1.04–1.39) for the hot effects. Temporal pattern analysis showed that the most effect on respiratory diseases occurred at a lag of 0 days for hot effect and at a lag of 1 day for cold effect. The risk of changing temperature among women and people over 5 years old was higher than other groups. Our results suggest that the risk of respiratory admissions was greatest when the temperature was low. Public health prevention programs should be enhanced to improve public awareness about the health risks of temperature changes, especially respiratory diseases risked by low temperatures

A common root for coevolution and substitution rate variability in protein sequence evolution

We introduce a simple model that describes the average occurrence of point variations in a generic protein sequence. This model is based on the idea that mutations are more likely to be fixed at sites in contact with others that have mutated in the recent past. Therefore, we extend the usual assumptions made in protein coevolution by introducing a time dumping on the effect of a substitution on its surrounding and makes correlated substitutions happen in avalanches localized in space and time. The model correctly predicts the average correlation of substitutions as a function of their distance along the sequence. At the same time, it predicts an among-site distribution of the number of substitutions per site highly compatible with a negative binomial, consistently with experimental data. The promising outcomes achieved with this model encourage the application of the same ideas in the field of pairwise and multiple sequence alignment

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Spatio-Temporal Dynamics of Tick-Borne Diseases in North-Central Wisconsin from 2000–2016

Lyme disease is a well-recognized public health problem in the USA, however, other tick-borne diseases also have major public health impacts. Yet, limited research has evaluated changes in the spatial and temporal patterns of non-Lyme tick-borne diseases within endemic regions. Using laboratory data from a large healthcare system in north-central Wisconsin from 2000&ndash;2016, we applied a Kulldorf&rsquo;s scan statistic to analyze spatial, temporal and seasonal clusters of laboratory-positive cases of human granulocytic anaplasmosis (HGA), babesiosis, and ehrlichiosis at the county level. Older males were identified as the subpopulation at greatest risk for non-Lyme tick-borne diseases and we observed a statistically significant spatial and temporal clustering of cases (p &lt; 0.05). HGA risk shifted from west to east over time (2000&ndash;2016) with a relative risk (RR) ranging from 3.30 to 11.85, whereas babesiosis risk shifted from south to north and west over time (2004&ndash;2016) with an RR ranging from 4.33 to 4.81. Our study highlights the occurrence of non-Lyme tick-borne diseases, and identifies at-risk subpopulations and shifting spatial and temporal heterogeneities in disease risk. Our findings can be used by healthcare providers and public health practitioners to increase public awareness and improve case detection

The Effects of Daily Temperature on Crime Events in Urban Hanoi, Vietnam Using Seven Years of Data (2013&ndash;2019)

The effects of temperature on behavior change and mental health have previously been explored, but the association between temperature and crime is less well understood, especially in developing countries. Single-city-level data were used to evaluate the association between the short-term effects of temperature on crime events in urban Hanoi, Vietnam. We used quasi-Poisson regression models to investigate the linear effects and distributed lag non-linear models to investigate the non-linear association between daily temperature and daily crime events from 2013 to 2019. There were 3884 crime events, including 1083 violent crimes and 2801 non-violent crimes during the 7-year study period. For both linear and non-linear effects, there were positive associations between an increase in daily temperature and crime, and the greatest effects were observed on the first day of exposure (lag 0). For linear effects, we estimated that each 5 &deg;C increase in daily mean temperature was associated with a 9.9% (95%CI: 0.2; 20.5), 6.8% (95%CI: 0.6; 13.5), and 7.5% (95%CI: 2.3; 13.2) increase in the risk of violent, non-violent, and total crime, respectively. For non-linear effects, however, the crime risk plateaued at 30 &deg;C and decreased at higher exposures, which presented an inverted U-shape response with a large statistical uncertainty

Low-cost NO2 monitoring and predictions of urban exposure using universal kriging and land-use regression modelling in Mysore, India

In Low- and Middle-Income Countries, rapid urbanization has led to poorer air quality, yet pollution monitoring networks are often sparse or non-existent. Few previous studies have sought to understand the unique predictors of air pollution exposure in Indian urban environments. Our study monitored and modeled nitrogen dioxide (NO2) in Mysore, a rapidly urbanizing city in India. NO2 sampling was conducted in four seasonal campaigns (each lasting 2 weeks) in 2016-2017, at 150 sites throughout Mysore. Seasonal spatial interpolation of NO2 levels was conducted using 2 distinct models, the first utilizing a land use regression (LUR) approach and the second using universal kriging methods. Model performance was determined using adjusted R-2, and validated using leave-one-out cross validation. Measured NO2 concentrations ranged from 0.3 to 51.9 ppb across the four seasons of the study period, with higher concentrations in the center of the city. In the LUR model (R-2 = 0.535), proximity to major roads, point sources of pollution such as industrial sites and religious points of interest (PoI), land uses with high human activity, and high population density were associated with higher levels of NO2. Proximity to minor roads and coverage of land uses characterized by low human activity were inversely associated with air pollution. Cross-validation of results confirmed the reliability of each model. Few studies have applied spatially heterogeneous sampling to assess ambient air pollution levels in India. The combination of passive NO2 sampling and LUR/kriging modeling methods allowed for characterization of NO2 patterns in Mysore. While previous work indicates traffic pollution as a major contributor to ambient air pollution levels in urbanizing centers in Asia, our results indicate the influence of other pollution factors (e.g., point sources), as well as highly localized characteristics of the urban environment (e.g., proximity to religious points of interest) in urban India. Areas of Mysore consistently experienced pollution in excess of World Health Organization (WHO) health-protective guidelines for NO2

Drought and the risk of hospital admissions and mortality in older adults in western USA from 2000 to 2013: a retrospective study

Background: Occurrence, severity, and geographic extent of droughts are anticipated to increase under climate change, but the health consequences of drought conditions are unknown. We estimate risks of cardiovascular-related and respiratory-related hospital admission and mortality associated with drought conditions for the elderly population in western USA. Methods: For this retrospective study, we analysed the 2000 to 2013 data from the US Drought Monitor for 618 counties in the western USA to identify full drought periods, non-drought periods, and worsening drought periods stratified by low severity and high severity. We used Medicare claims made between Jan 1, 2000, and Dec 31, 2013, to calculate daily rates of cardiovascular admissions, respiratory admissions, and deaths among adults aged 65 years or older. Using a two-stage hierarchical model, we estimated the percentage change in health risks when comparing drought with non-drought period days, controlling for daily weather and seasonal trends. Findings: On average, 2·1 million days were classified as non-drought periods and 0·6 million days were classified as drought periods. Compared with non-drought periods, respiratory admissions significantly decreased by −1·99% (95% posterior interval −3·56 to −0·38) during the full drought period, but not during worsening drought conditions. Mortality risk significantly increased by 1·55% (0·17 to 2·95) during the high-severity worsening drought period, but not the full drought or low-severity worsening drought periods. Cardiovascular admissions did not differ significantly during either full drought or worsening drought periods. In counties where drought occurred less frequently, we found risks for cardiovascular disease and mortality to increase during worsening drought conditions. Interpretation: Drought conditions increased risk of mortality during high-severity worsening drought, but decreased the risk of respiratory admissions during full drought periods among adults aged 65 years and older. Counties that previously had fewer drought events show larger risk for mortality and cardiovascular disease. This research describes an understudied environmental association with global health significance. Funding: The Yale Institute of Biospheric Studies, the National Institute of Environmental Health Sciences, the US Environmental Protection Agency

NO2 exposure and lung function decline in a cohort of adults in Mysore, India

Increasing air pollution in low- and middle-income countries (LMICs) may be contributing to worsening respiratory health, yet to date most relevant studies have been conducted in industrialized nations. Particularly, there are few studies for India, the world's second most populated country, and on this country's poorest populations, who may be at the highest risk. We investigated the influence of long-term nitrogen dioxide (NO2) exposure at residential location on lung function decline over a 5-year period in a cohort of low-income adults in Mysore, Karnataka, India. In 2012-2014 and in 2017-2018, we conducted standardized interviews and performed in-home field spirometry before and after bronchodilation. We estimated annual average NO2 in 2017 based on interpolation of seasonal air pollution sampling and used linear mixed effects models with a person-specific random effect to estimate NO2 versus lung function cross-sectionally at baseline and longitudinally, adjusting for potential confounders (age at baseline, sex, smoking status, and long-term seasonality). Among healthy participants (with no COPD or asthma based on lung function tests), NO2 levels were associated with a decline in lung function pre- and post-bronchodilation (-21.7 ml 95% CI: -42.1, -1.3] for FEV1 and -22.2 ml 95% CI: -46.8, 2.3] for FVC pre-bronchodilation, -25.2 ml 95% CI: -48.4, -4.1] for FEV1 and -26.6 ml 95% CI: -51.1, -2.2] for FVC post-bronchodilation) per interquartile range (10 ppb) increase in NO2. Longitudinal impacts of air pollution on lung function were not statistically significant. Results suggest that air pollution exposure is associated with worse lung function among apparently healthy individuals among urban poor communities in India. Future studies should further characterize time-varying air pollution exposures and collect further longitudinal health data in these understudied communities