Assessing community-wide health impacts of natural disasters: studies of a severe flood in Beijing and tropical cyclones in the United States

2018 Fall.Includes bibliographical references.Death and injury tolls occurring during natural disasters have traditionally been estimated using a disaster surveillance approach, where each death or injury is considered case-by-case to determine if it can be attributed to the disaster. This approach may not always capture the overall community-wide health effects associated with disaster exposure, especially in cases where much of the excess morbidity and mortality result from outcomes common outside of disaster periods (e.g., heart attacks, respiratory problems) rather than well-characterized disaster-related risks that are rarer outside of storm events (e.g., drowning, carbon monoxide poisoning, trauma). The goal of this dissertation is to examine the community-wide impacts of natural disasters on some common health outcomes. To achieve this goal, we assessed the community-wide health risks from exposure to two types of climate-related natural disasters, a severe flood and tropical cyclones, as compared with matched unexposed days in the same community. Our results can provide new evidence on how natural disasters affect human health, contributing to and complementing the large base of existing literature generated using a disaster surveillance approach. Mortality risk of a severe flood. On July 21–22, 2012, Beijing, China, suffered its heaviest rainfall in 60 years, which caused heavy flooding throughout Beijing. We conducted a matched analysis comparing mortality rates on the peak flood day and the four following days to similar unexposed days in previous years (2008–2011), controlling for potential confounders, to estimate the relative risks (RRs) of daily mortality among Beijing residents associated with this flood. Compared to the matched unexposed days, mortality rates were substantially higher during the flood period for all-cause, circulatory, and accidental mortality, with the highest risks observed on the peak flood day. No evidence of increased risk of respiratory mortality was observed in this study. We estimated a total of 79 excess deaths among Beijing residents on July 21–22, 2012; by contrast, only 34 deaths were reported among Beijing residents in a study estimating the flood's fatality toll using a traditional surveillance approach. Results were robust to study design and modeling choices. Our results indicate considerable impacts of this flood on public health, and that much of this impact may come from increased risk of non-accidental deaths. To our knowledge, this is the first study analyzing the community-wide changes in mortality rates during the 2012 flood in Beijing, and one of the first to do so for any major flood worldwide. This study offers critical evidence in assessing flood-related health impacts, as urban flooding is expected to become more frequent and severe in China. Health risk of tropical cyclones. To measure storm exposure, we separately considered five metrics—distance to storm track; cumulative rainfall; maximum sustained wind speed; flooding; and tornadoes. For mortality outcomes, we used community vital records for 78 large eastern United States (U.S.) communities, 1988–2005, to estimate the risks of storm exposure on four mortality outcomes. For emergency hospitalization outcomes, we used Medicare claims for 180 eastern US counties, 1999–2010, to estimate storm-related risks on emergency hospitalizations from cardiovascular and respiratory disease among Medicare beneficiaries. We compared the health outcome rates across the study population (all community residents for the mortality analysis; community Medicare beneficiaries for the hospitalization analysis) on storm-exposed days versus similar unexposed days within each community. For each combination of exposure metric and health outcome, we estimated storm-associated health risks for a window from two days before to seven days after the day of storm's closest approach. For the mortality analysis, 92 Atlantic Basin tropical cyclones were considered based on U.S. landfall or close approach, with 70 communities exposed to at least one storm; for the hospitalization analysis, 74 storms were considered for 175 exposed counties. Under the wind-based exposure metric, we found substantially elevated risk for all mortality outcomes considered compared with matched unexposed days, with risk typically highest on the day of the storm's closest approach. When excluding the ten most severe storm events based on wind exposures, however, we did not observe significantly increased risk for the remaining storm exposures on any mortality outcomes. Among Medicare beneficiaries, the cumulative risks of respiratory hospitalizations were increased under all storm exposure metrics considered, for all storm exposures and across all exposed counties; these risks remained significantly elevated even when the ten most severe storm exposures (based on wind exposure) were excluded. Our findings on community-wide health risks from tropical cyclones add important insights to results from disaster surveillance: first, the impacts of tropical cyclones on non-accidental mortality can, in some cases, be much greater than identified in case-by-case surveillance studies; second, there is strong evidence that risks of Medicare emergency hospital admissions due to non-injury morbidity are elevated during the storm exposure period; and third, intense wind exposure can characterize many of the tropical cyclone exposures with particularly high risk on non-accidental mortality, as well as respiratory hospitalizations in the elderly

Comparative germination of Tamarix ramosissima spring and summer seeds

Tamarix ramosissima has bi-seasonal flowering and fruit-setting characteristics. This study compared the morphology and germination characteristics of seeds from Tamarix ramosissima plants during the spring flowering period and the summer flowering period. The results are as follows: there is no significant difference in morphology, such as size and thousandseed weight, between seeds from different the spring and summer flowering periods. Freshly harvested spring and summer flowering period seeds can both rapidly germinate under the 5/15 °C, 5/25 °C, 15/25 °C or 25/35 °C thermoperiods. Average germination time of the spring flowering period seeds is shorter than that of the summer flowering period seeds, with a TG50 of 2-18 hours (TG50 = the time when germinate percentage reached 50 %). NaCl solutions at concentrations below 0.2 mol/L have no significant effect on the germination of Tamarix ramosissima seeds from either flowering periods. However, at above 0.4 mol/L, higher NaCl concentrations adversely affect the Tamarix ramosissima seeds’ germination rates. Seeds from the summer flowering period have higher tolerance of NaCl solutions than seeds from the spring flowering period. Seeds that were incubated in NaCl solution for 8 days cannot recover after being transferred to distilled water (0 % recovery), indicating that NaCl treated seeds permanently lost their germination capability. After storing in room temperature for 2 months, Tamarix ramosissima seeds from both spring and summer flowering periods maintain above 80 % viability. After 2 months, the seed viabilities decrease as the storage time lengthens. The viabilities of seeds from both spring and summer flowering periods decrease to about 40-50 % after storage for 6 months. This study can provide scientific basis for rational utilization of the biological resources in arid desert ecosystems

SE-KGE: A Location-Aware Knowledge Graph Embedding Model for Geographic Question Answering and Spatial Semantic Lifting

Learning knowledge graph (KG) embeddings is an emerging technique for a variety of downstream tasks such as summarization, link prediction, information retrieval, and question answering. However, most existing KG embedding models neglect space and, therefore, do not perform well when applied to (geo)spatial data and tasks. For those models that consider space, most of them primarily rely on some notions of distance. These models suffer from higher computational complexity during training while still losing information beyond the relative distance between entities. In this work, we propose a location-aware KG embedding model called SE-KGE. It directly encodes spatial information such as point coordinates or bounding boxes of geographic entities into the KG embedding space. The resulting model is capable of handling different types of spatial reasoning. We also construct a geographic knowledge graph as well as a set of geographic query-answer pairs called DBGeo to evaluate the performance of SE-KGE in comparison to multiple baselines. Evaluation results show that SE-KGE outperforms these baselines on the DBGeo dataset for geographic logic query answering task. This demonstrates the effectiveness of our spatially-explicit model and the importance of considering the scale of different geographic entities. Finally, we introduce a novel downstream task called spatial semantic lifting which links an arbitrary location in the study area to entities in the KG via some relations. Evaluation on DBGeo shows that our model outperforms the baseline by a substantial margin.Comment: Accepted to Transactions in GI

The role of peroxisome proliferator-activated receptor in the treatment of non-alcoholic fatty liver diseases

Non-alcoholic fatty liver disease (NAFLD) has been defined as a spectrum of histological abnormalities and is characterized by significant and excessive accumulation of triglycerides in the hepatocytes in patients without alcohol consumption or other diseases. Current studies are targeting new molecular mechanisms that underlie NAFLD and associated metabolic disorders. Many therapeutic targets have been found and used in clinical studies. Peroxisome proliferator-activated receptors (PPARs) are among the potential targets and have been demonstrated to exert a pivotal role in modulation of NAFLD. Many drugs developed so far are targeted at PPARs. Thus, the aim of this paper is to summarize the roles of PPARs in the treatment of NAFLD

What is learning in service-learning? Findings from service-learning research at Beijing Normal University

What is learning in service-learning? The question was put forward decades ago but has not been answered clearly in the international context. Focused on this important issue, we conducted a series of studies with mixed method approach. We surveyed 844 college students and 6203 middle school students respectively in mainland China. Results indicated that most students had some experience of service activities. However, the quality of such practice was not satisfying in the aspects of duration, intensity and link to curriculum. Based on the above investigation, we conducted a service-learning program through the course of Psychology of Learning for undergraduate students of Psychology Department in Beijing Normal University. The instructor, together with teaching assistants who had rich experience on special education, gave a two hour lecture in class each week and guided students to interact with special children (the mentally retarded, autism) in groups at weekend during one semester. Following the basic procedure of service-learning, students were encouraged to apply what they learned in classroom to the service practice and to reflect the effectiveness of their behavior modification plans for special children as well as their own thoughts, feelings and behaviors during interactive process. Especially, students were asked to think critically about issues on inclusion, welfare and social support for special children and their families. Students received feedbacks on their reflection journals and discussions after every service practice. This program had been conducted for about 3 semesters successively in BNU and more than 200 undergraduate students engaged in it. Data were collected and analyzed from interactive video, group discussion and focused group interview, self-report surveys, reflection journals and feedbacks from parents of special children. In general, the program had great effects on students’ attitude to special children and their families. Students showed significant change from unconcerned, wondering, sympathetic, or credit-driven at the beginning to caring, patient, empathetic, and problem-solving driven at the end of service practice. Results also indicated that service-learning improved students’ higher cognitive abilities such as transfer abilities of problem solving, critical thinking and students’ academic expertise, such as Applied Behavior Analysis skills

Effects of High-Grain Diet With Buffering Agent on the Hepatic Metabolism in Lactating Goats

To gain insight on the effects of a high-grain diet with buffering agent on liver metabolism and the changes of plasma biochemical parameters and amino acids in hepatic vein and portal vein, commercial kit and high performance liquid chromatography (HPLC) were applied to determine the concentration of amino acids of hepatic vein and portal vein blood samples, quantitative real-time PCR and comparative proteomic approach was employed to investigate proteins differentially expressed in liver in lactating dairy goats feeding high-grain diet with buffering agent or only high-grain diet. Results showed that feeding high-grain diet with buffering agent to lactating dairy goats could outstanding increase amino acid content of Gln (p < 0.01), and the amino acid contents of Arg and Tyr in BG were significantly higher (p < 0.05) than that in HG. After adding the buffering agent, the metabolism of amino acids in the liver were changed and most of the amino acids were increasingly synthesized and decreasingly consumed in the liver. In addition, 46 differentially expressed protein spots (≥1.5-fold changed) were detected in buffering group vs. control group using 2-DE technique and MALDI-TOF/TOF proteomics analyzer. Of these, 24 proteins showed increased expression and 22 proteins showed decreased expression in the buffer group vs. control group. Data on Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis reveals that the high-grain diet with buffering agent alter the expression of proteins related to amino acids metabolism and glycometabolism. In addition, the results conclude that feeding high-grain diet with buffering agent can strengthen anti-oxidant capacity, stress ability, slow down urea metabolism, and alter amino acid metabolism as well as glycometabolism in the liver through different detection methods including proteomic analysis, real-time PCR analysis and biochemical analysis

Streptococcus suis 2 Transcriptional Regulator TstS Stimulates Cytokine Production and Bacteremia to Promote Streptococcal Toxic Shock-Like Syndrome

Two large-scale outbreaks of streptococcal toxic shock-like syndrome (STSLS) have revealed Streptococcus suis 2 to be a severe and evolving human pathogen. We investigated the mechanism by which S. suis 2 causes STSLS. The transcript abundance of the transcriptional regulator gene tstS was found to be upregulated during experimental infection. Compared with the wild-type 05ZY strain, a tstS deletion mutant (ΔtstS) elicited reduced cytokine secretion in macrophages. In a murine infection model, tstS deletion resulted in decreased virulence and bacterial load, and affected cytokine production. Moreover, TstS expression in the P1/7 strain of S. suis led to the induction of STSLS in the infected mice. This is noteworthy because, although it is virulent, the P1/7 strain does not normally induce STSLS. Through a microarray-based comparative transcriptomics analysis, we found that TstS regulates multiple metabolism-related genes and several virulence-related genes associated with immune evasion

Shape of the concentration–response association between fine particulate matter pollution and human mortality in Beijing, China, and its implications for health impact assessment, The

Includes bibliographical references (pages 107009-12-107009-14).Publisher version: https://doi.org/10.1289/EHP4464.Background: Studies found approximately linear short-term associations between particulate matter (PM) and mortality in Western communities. However, in China, where the urban PM levels are typically considerably higher than in Western communities, some studies suggest nonlinearity in this association. Health impact assessments (HIA) of PM in China have generally not incorporated nonlinearity in the concentration–response (C-R) association, which could result in large discrepancies in estimates of excess deaths if the true association is nonlinear. Objectives: We investigated nonlinearity in the C-R associations between with PM with aerodynamic diameter ≤2.5μm (PM2.5) and mortality in Beijing, China, and the sensitivity of HIA to linearity assumptions. Methods: We modeled the C-R association between PM2.5 and cause-specific mortality in Beijing, China (2009–2012), using generalized linear models (GLM). PM2.5 was included through either linear, piecewise-linear, or spline functions to investigate evidence of nonlinearity. To determine the sensitivity of HIA to linearity assumptions, we estimated PM2.5-attributable deaths using both linear- and nonlinear-based C-R associations between PM2.5 and mortality. Results: We found some evidence that, for nonaccidental and circulatory mortality, the shape of the C-R association was relatively flat at lower concentrations of PM2.5, but then had a positive slope at higher concentrations, indicating nonlinearity. Conversely, the shape for respiratory mortality was positive and linear at lower concentrations of PM2.5, but then leveled off at the higher concentrations. Estimates of excess deaths attributable to short-term PM2.5 exposure were, in some cases, very sensitive to the linearity assumption in the association, but in other cases robust to this assumption. Conclusions: Our results demonstrate some evidence of nonlinearity in PM2.5–mortality associations and that an assumption of linearity in this association can influence HIAs, highlighting the importance of understanding potential nonlinearity in the PM2.5–mortality association at the high concentrations of PM2.5 in developing megacities like Beijing. https://doi.org/10.1289/EHP446

Assessing United States county-level exposure for research on tropical cyclones and human health

Includes bibliographical references (pages 067007-12-067007-13).Background: Tropical cyclone epidemiology can be advanced through exposure assessment methods that are comprehensive and consistent across space and time, as these facilitate multiyear, multistorm studies. Further, an understanding of patterns in and between exposure metrics that are based on specific hazards of the storm can help in designing tropical cyclone epidemiological research. Objectives: a) Provide an open-source data set for tropical cyclone exposure assessment for epidemiological research; and b) investigate patterns and agreement between county-level assessments of tropical cyclone exposure based on different storm hazards. Methods: We created an open-source data set with data at the county level on exposure to four tropical cyclone hazards: peak sustained wind, rainfall, flooding, and tornadoes. The data cover all eastern U.S. counties for all land-falling or near-land Atlantic basin storms, covering 1996–2011 for all metrics and up to 1988–2018 for specific metrics. We validated measurements against other data sources and investigated patterns and agreement among binary exposure classifications based on these metrics, as well as compared them to use of distance from the storm’s track, which has been used as a proxy for exposure in some epidemiological studies. Results: Our open-source data set was typically consistent with data from other sources, and we present and discuss areas of disagreement and other caveats. Over the study period and area, tropical cyclones typically brought different hazards to different counties. Therefore, when comparing exposure assessment between different hazard-specific metrics, agreement was usually low, as it also was when comparing exposure assessment based on a distance-based proxy measurement and any of the hazard-specific metrics. Discussion: Our results provide a multihazard data set that can be leveraged for epidemiological research on tropical cyclones, as well as insights that can inform the design and analysis for tropical cyclone epidemiological researc