Recent Trends in Heat-Related Mortality in the United States: An Update Through 2018

Much research has shown a general decrease in the negative health response to extreme heat events in recent decades. With a society that is growing older, and a climate that is warming, whether this trend can continue is an open question. Using eight additional years of mortality data, we extend our previous research to explore trends in heat-related mortality across the United States. For the period 1975–2018, we examined the mortality associated with extreme-heat-event days across the 107 largest metropolitan areas. Mortality response was assessed over a cumulative 10-day lag period following events that were defined using thresholds of the excess heat factor, using a distributed-lag nonlinear model. We analyzed total mortality and subsets of age and sex. Our results show that in the past decade there is heterogeneity in the trends of heat-related human mortality. The decrease in heat vulnerability continues among those 65 and older across most of the country, which may be associated with improved messaging and increased awareness. These decreases are offset in many locations by an increase in mortality among men 45–64 (+1.3 deaths per year), particularly across parts of the southern and southwestern United States. As heat-warning messaging broadly identifies the elderly as the most vulnerable group, the results here suggest that differences in risk perception may play a role. Further, an increase in the number of heat events over the past decade across the United States may have contributed to the end of a decades-long downward trend in the estimated number of heat-related fatalities

Minocycline attenuates lipopolysaccharide (LPS)-induced neuroinflammation, sickness behavior, and anhedonia

© 2008 Henry et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

A randomized trial of three videos that differ in the framing of information about mammography in women 40 to 49 years old

OBJECTIVE: To assess the effect of providing structured information about the benefits and harms of mammography in differing frames on women’s perceptions of screening. DESIGN: Randomized control trial. SETTING: General internal medicine academic practice. PARTICIPANTS: One hundred seventy-nine women aged 35 through 49. INTERVENTION: Women received 1 of 3 5-minute videos about the benefits and harms of screening mammography in women aged 40 to 49. These videos differed only in the way the probabilities of potential outcomes were framed (positive, neutral, or negative). MEASUREMENTS AND MAIN RESULTS: We measured the change in accurate responses to questions about potential benefits and harms of mammography, and the change in the proportion of participants who perceived that the benefits of mammography were more important than the harms. Before seeing the videos, women’s knowledge about the benefits and harms of mammography was inaccurate (82% responded incorrectly to all 3 knowledge questions). After seeing the videos, the proportion that answered correctly increased by 52%, 43%, and 30% for the 3 knowledge questions, respectively, but there were no differences between video frames. At baseline, most women thought the benefits of mammography outweighed the harms (79% positive frame, 80% neutral frame, and 85% negative frame). After the videos, these proportions were similar among the 3 groups (84%, 81%, 83%, P = .93). CONCLUSIONS: Women improved the accuracy of their responses to questions about the benefits and harms of mammography after seeing the videos, but this change was not affected by the framing of information. Women strongly perceived that the benefits of mammography outweighed the harms, and providing accurate information had no effect on these perceptions, regardless of how it was framed

Quantifying the utility of taking pills for preventing adverse health outcomes: a cross-sectional survey

ObjectivesThe utility value attributed to taking pills for prevention can have a major effect on the cost-effectiveness of interventions, but few published studies have systematically quantified this value. We sought to quantify the utility value of taking pills used for prevention of cardiovascular disease (CVD).DesignCross-sectional survey.SettingCentral North Carolina.Participants708 healthcare employees aged 18 years and older.Primary and secondary outcomesUtility values for taking 1 pill/day, assessed using time trade-off, modified standard gamble and willingness-to-pay methods.ResultsMean age of respondents was 43 years (19–74). The majority of the respondents were female (83%) and Caucasian (80%). Most (80%) took at least 2 pills/day. Mean utility values for taking 1 pill/day using the time trade-off method were: 0.9972 (95% CI 0.9962 to 0.9980). Values derived from the standard gamble and willingness-to-pay methods were 0.9967 (0.9954 to 0.9979) and 0.9989 (95% CI 0.9986 to 0.9991), respectively. Utility values varied little across characteristics such as age, sex, race, education level or number of pills taken per day.ConclusionsThe utility value of taking pills daily in order to prevent an adverse CVD health outcome is approximately 0.997

Platelets: Functional Biomarkers of Epigenetic Drift

Cardiovascular disease (CVD) risk factors can be classed as modifiable or non-modifiable. Physical inactivity and obesity represent major behavioural risk factors for the initiation, development and progression of CVD. Platelet dysfunction is pivotal to the aetiology of CVD, a chronic vascular inflammatory condition, which is characterised by a lag time between onset and clinical manifestation. This indicates the role of epigenetic drift, defined by stochastic patterns of gene expression not dependent on dynamic changes in coding DNA. The epigenome, a collection of chemical marks on DNA and histones, is established during embryogenesis and modified by age and lifestyle. Biogenesis and effector function of non-coding RNA, such as microRNA, play a regulatory role in gene expression and thus the epigenetic mechanism. In this chapter, we will focus on the effect of the modifiable risk factors of physical activity/inactivity and overweight/obesity on platelet function, via epigenetic changes in both megakaryocytopoiesis and thrombopoiesis. We will also discuss the role of acute exercise on platelet function and the impact of cardiorespiratory fitness (CRF) on platelet responses to acute exercise. This chapter will highlight the potential role of platelets as circulating functional biomarkers of epigenetic drift to implement, optimise and monitor CVD preventive management strategies

Platelets: From Formation to Function

Platelets are small, anucleate cells that travel as resting discoid fragments in the circulation. Their average circulating life span is 8–9 days, and their formation is an elegant and finely orchestrated series of cellular processes known as megakaryocytopoiesis and thrombopoiesis. This involves the commitment of haematopoietic stem cells, proliferation, terminal differentiation of megakaryocytic progenitors and maturation of megakaryocytes to produce functional platelets. This complex process occurs in specialised endosteal and vascular niches in the bone marrow where megakaryocytes form proplatelet projections, releasing platelets into the circulation. Upon contact with an injured blood vessel, they prevent blood loss through processes of adhesion, activation and aggregation. Platelets play a central role in cardiovascular disease (CVD), both in the development of atherosclerosis and as the cellular mediator in the development of thrombosis. Platelets have diverse roles not limited to thrombosis/haemostasis, also being involved in many vascular inflammatory conditions. Depending on the physiological context, platelet functions may be protective or contribute to adverse thrombotic and inflammatory outcomes. In this chapter, we will discuss platelets in context of their formation and function. Because of their multifaceted role in maintaining physiological homeostasis, current and development of platelet function testing platforms will be discussed

Effect of Adding a Values Clarification Exercise to a Decision Aid on Heart Disease Prevention: A Randomized Trial

Experts have called for the inclusion of values clarification (VC) exercises in decision aids (DA) as a means of improving their effectiveness, but little research has examined the effects of such exercises