An Assessment of the Impact of Climate Change on Human Health in New Hampshire

Climate change threatens human health in many ways. The negative impacts of climate change on human health are likely to increase in both magnitude and frequency as the climate continues to change in response to ever increasing global emissions of heat-trapping gases released from a variety of human activities.The Centers for Disease Control and Prevention (CDC) Building Resilience Against Climate Effects (BRACE) framework provides guidance to states and cities to develop strategies and programs to confront the health implications of climate change. This report serves to address Steps 1 and 2 of the BRACE framework via an assessment of past and future climate change across New Hampshire combined with an assessment of the impact of climate change on human health. A key component of the BRACE framework is building resilience. In public health, resilience is a measure of a community’s ability to utilize available resources to respond to, withstand, and recover from adverse situations. More generally, people think of resilience as the ability to recover, persist, or thrive amid change. The New Hampshire Climate and Health Workgroup has tentatively developed the following definition: Resilience is the ability and capacity to anticipate, prepare for, respond to, and recover from significant threats with minimum damage to human health and well-being, the economy, and the environment. The importance of the way we plan our built environment—including land use, transportation, and water management decisions, as well as how we interact with our natural environment and preserve its life-supporting functions—must be emphasized as pivotal points of intersection as we develop climate adaptation strategies. Notably, a resilience-based approach to climate change adaptation should align with New Hampshire’s transformative State Health Improvement Plan. That plan underscores the importance of cross-sector collaboration and coordinated strategies to address the social and environmental determinants of health. These strategies not only support healthy communities for all New Hampshire residents, but they are also critically important for reducing health care costs and reducing the burden of disease

FDG uptake and walking ability

Includes bibliographical references.Motor impairments of the upper and lower extremities are common symptoms of multiple sclerosis (MS). While some peripheral effects like muscle weakness and loss of balance have been shown to influence these symptoms, central nervous system activity has not been fully elucidated. The purpose of this study was to determine if alterations in glucose uptake were associated with motor impairments in patients with multiple sclerosis. Eight patients with multiple sclerosis (4 men) and 8 sex matched healthy controls performed 15 minutes of treadmill walking at a self-selected pace, during which ≈ 322 MBq of the positron emission tomography glucose analogue [18F]-Fluorodeoxyglucose was injected. Immediately after the cessation of walking, participants underwent positron emission tomography imaging. Patients with MS had lower FDG uptake in ≈ 40% of the brain compared to the healthy controls (pFWE-corr > 0.001, qFDR-corr -0.75, P < 0.032). Within patients with MS only 3 of the 15 regions showed significant correlations: insula (r = -0.74, P = 0.036), hippocampus (r = -0.72, P = 0.045), and calcarine sulcus (r = -0.77, P = 0.026). This data suggests that walking impairments in patients with MS may be due to network wide alterations in glucose metabolism. Understanding how brain activity and metabolism are altered in patients with MS may allow for better measures of disability and disease status within this clinical population.Published with support from the Colorado State University Libraries Open Access Research and Scholarship Fund

Alzheimer\u27s Disease Microbiome Is Associated with Dysregulation of the Anti-Inflammatory P-Glycoprotein Pathway

The microbiota-gut-brain axis is a bidirectional communication system that is poorly understood. Alzheimer\u27s disease (AD), the most common cause of dementia, has long been associated with bacterial infections and inflammation-causing immunosenescence. Recent studies examining the intestinal microbiota of AD patients revealed that their microbiome differs from that of subjects without dementia. In this work, we prospectively enrolled 108 nursing home elders and followed each for up to 5 months, collecting longitudinal stool samples from which we performed metagenomic sequencing and in vitro T84 intestinal epithelial cell functional assays for P-glycoprotein (P-gp) expression, a critical mediator of intestinal homeostasis. Our analysis identified clinical parameters as well as numerous microbial taxa and functional genes that act as predictors of AD dementia in comparison to elders without dementia or with other dementia types. We further demonstrate that stool samples from elders with AD can induce lower P-gp expression levels in vitro those samples from elders without dementia or with other dementia types. We also paired functional studies with machine learning approaches to identify bacterial species differentiating the microbiome of AD elders from that of elders without dementia, which in turn are accurate predictors of the loss of dysregulation of the P-gp pathway. We observed that the microbiome of AD elders shows a lower proportion and prevalence of bacteria with the potential to synthesize butyrate, as well as higher abundances of taxa that are known to cause proinflammatory states. Therefore, a potential nexus between the intestinal microbiome and AD is the modulation of intestinal homeostasis by increases in inflammatory, and decreases in anti-inflammatory, microbial metabolism.IMPORTANCE Studies of the intestinal microbiome and AD have demonstrated associations with microbiome composition at the genus level among matched cohorts. We move this body of literature forward by more deeply investigating microbiome composition via metagenomics and by comparing AD patients against those without dementia and with other dementia types. We also exploit machine learning approaches that combine both metagenomic and clinical data. Finally, our functional studies using stool samples from elders demonstrate how the c microbiome of AD elders can affect intestinal health via dysregulation of the P-glycoprotein pathway. P-glycoprotein dysregulation contributes directly to inflammatory disorders of the intestine. Since AD has been long thought to be linked to chronic bacterial infections as a possible etiology, our findings therefore fill a gap in knowledge in the field of AD research by identifying a nexus between the microbiome, loss of intestinal homeostasis, and inflammation that may underlie this neurodegenerative disorder

High lift aerodynamics

The current program is aimed at providing a physical picture of the flow physics and quantitative turbulence data of the interaction of a high Reynolds number wake with a flap element. The impact of high lift on aircraft performance is studied for a 150 passenger transport aircraft with the goal of designing optimum high lift systems with minimum complexity

Immaturity of the Oculomotor Saccade and Vergence Interaction in Dyslexic Children: Evidence from a Reading and Visual Search Study

Studies comparing binocular eye movements during reading and visual search in dyslexic children are, at our knowledge, inexistent. In the present study we examined ocular motor characteristics in dyslexic children versus two groups of non dyslexic children with chronological/reading age-matched. Binocular eye movements were recorded by an infrared system (mobileEBT®, e(ye)BRAIN) in twelve dyslexic children (mean age 11 years old) and a group of chronological age-matched (N = 9) and reading age-matched (N = 10) non dyslexic children. Two visual tasks were used: text reading and visual search. Independently of the task, the ocular motor behavior in dyslexic children is similar to those reported in reading age-matched non dyslexic children: many and longer fixations as well as poor quality of binocular coordination during and after the saccades. In contrast, chronological age-matched non dyslexic children showed a small number of fixations and short duration of fixations in reading task with respect to visual search task; furthermore their saccades were well yoked in both tasks. The atypical eye movement's patterns observed in dyslexic children suggest a deficiency in the visual attentional processing as well as an immaturity of the ocular motor saccade and vergence systems interaction

The high prevalence of Clostridioides difficile among nursing home elders associates with a dysbiotic microbiome

Clostridioides difficile disproportionally affects the elderly living in nursing homes (NHs). Our objective was to explore the prevalence of C. difficile in NH elders, over time and to determine whether the microbiome or other clinical factors are associated with C. difficile colonization. We collected serial stool samples from NH residents. C. difficile prevalence was determined by quantitative polymerase-chain reaction detection of Toxin genes tcdA and tcdB; microbiome composition was determined by shotgun metagenomic sequencing. We used mixed-effect random forest modeling machine to determine bacterial taxa whose abundance is associated with C. difficile prevalence while controlling for clinical covariates including demographics, medications, and past medical history. We enrolled 167 NH elders who contributed 506 stool samples. Of the 123 elders providing multiple samples, 30 (24.4%) elders yielded multiple samples in which C. difficile was detected and 78 (46.7%) had at least one C. difficile positive sample. Elders with C. difficile positive samples were characterized by increased abundances of pathogenic or inflammatory-associated bacterial taxa and by lower abundances of taxa with anti-inflammatory or symbiotic properties. Proton pump inhibitor (PPI) use is associated with lower prevalence of C. difficile (Odds Ratio 0.46; 95%CI, 0.22-0.99) and the abundance of bacterial species with known beneficial effects was higher in PPI users and markedly lower in elders with high C. difficile prevalence.C. difficile is prevalent among NH elders and a dysbiotic gut microbiome associates with C. difficile colonization status. Manipulating the gut microbiome may prove to be a key strategy in the reduction of C. difficile in the NH

Anterior cervical osteophytes as a cause of progressive dysphagia

An uncommon cause of progressive dysphagia may be large cervical osteophytes impinging upon the cervical esophagus. Dysphagia may be due to the mechanical mass effect of a large anterior osteophyte, trapping the esophagus opposite a fixed point such as the cricoid cartilage, or a local inflammatory reaction resulting in cricopharyngeal spasm. We report three patients with progressive dysphagia due to large anterior cervical osteophytes. All three patients were treated with anterior cervical approach with removal of the osteophytes without fusion. A review of the literature in addition to the specific case histories, video fluoroscopic and radiographic findings are presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41644/1/701_2005_Article_BF01410071.pd

Management of anteriorly located C1-C2 neurofibromata

The authors discuss their recent experience with anteriorly located Cl-C2 neurofibromata in five patients with cervical myelopathy and magnetic resonance scans consistent with intradural extramedullary masses in this region. Surgery was performed using a posterolateral approach with microscopic intradural exploration. Gross total intradural tumor removal was achieved in all cases. Improvement in cervical myelopathy occurred in all patients.This report concludes that Cl-C2 neurofibromata located anterior to the spinal cord can be totally and safely removed using a posterolateral approach. Improvement in neurologic dysfunction accompanies posterior decompression and gross total intradural tumor removal.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28766/1/0000598.pd

Pool boiling of refrigerants over nanostructured and roughened tubes

This study investigated the heat transfer performance of three nanostructured surfaces and two plain surfaces: one roughened and one polished during the saturated pool boiling of refrigerants R-134a at 5 and 25 °C and R-245fa at 20 °C. Nanocoatings were applied to polished copper tubes through a layer-by-layer (LbL) process that deposited silica nanoparticles, a chemical oxidation process where an intertwined mat of sharp copper oxide (CuO) structures were generated and a commercial nanocoating process (nanoFLUX). A polished copper tube and a roughened copper tube were tested as comparison cases. All tubes were tested in the horizontal position in pool boiling over heat fluxes of 20 to 100 kW/m2, followed by a further increase in heat flux in an attempt to reach critical heat flux. The tubes were internally water heated and Wilson plots were conducted to characterise the internal heat transfer characteristics. The nanoFLUX surface had the highest heat transfer coefficients, the LbL and polished surfaces had the lowest heat transfer coefficients, and the CuO and roughened surfaces had intermediate heat transfer coefficients. The nanoFLUX surface had between 40 and 200% higher heat transfer coefficients than those of the polished tube. Both roughened tubes and nanocoated tubes showed typical exponentially increased heat transfer coefficients as heat flux was increased. However, the nanoFLUX and CuO surfaces displayed more heat flux sensitivity compared with the other surfaces. The nanoFLUX surfaces outperformed the other nanostructured surfaces due to a higher nucleation site density and outperformed the roughened tube due to a unique heat transfer mechanism. The nanoFLUX and CuO surfaces also experienced reduced critical heat flux compared with plain surfaces, thought to be caused by the trapping of vapour in the fibrous nanostructures, resulting in reduced wetting in the Cassie-Baxter state.The MIT International Science and Technology Initiatives (MISTI) programme under an MIT-Africa-Imperial College London seed fund grant, by the UK Department for International Development (DFID) through the Royal Society-DFID Africa Capacity Building Initiative and by the European Union's Horizon 2020 Research and Innovation Programme within the ThermaSMART network under the Marie Sklodowska-Curie Grant Agreement No. 778104.http://www.elsevier.com/locate/hmt2021-12-01hj2020Mechanical and Aeronautical Engineerin