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Li X, Zhang Y, Tian Z, Wang J, Zhao J, Lyu Y, Ni Y, Guo Y, Cui Z, Zhang W, Li C. Lag effect of ambient temperature on respiratory emergency department visits in Beijing: a time series and pooled analysis. BMC Public Health 2024; 24:1363. [PMID: 38773497 PMCID: PMC11106889 DOI: 10.1186/s12889-024-18839-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Although the association between ambient temperature and mortality of respiratory diseases was numerously documented, the association between various ambient temperature levels and respiratory emergency department (ED) visits has not been well studied. A recent investigation of the association between respiratory ED visits and various levels of ambient temperature was conducted in Beijing, China. METHODS Daily meteorological data, air pollution data, and respiratory ED visits data from 2017 to 2018 were collected in Beijing. The relationship between ambient temperature and respiratory ED visits was explored using a distributed lagged nonlinear model (DLNM). Then we performed subgroup analysis based on age and gender. Finally, meta-analysis was utilized to aggregate the total influence of ambient temperature on respiratory ED visits across China. RESULTS The single-day lag risk for extreme cold peaked at a relative risk (RR) of 1.048 [95% confidence interval (CI): 1.009, 1.088] at a lag of 21 days, with a long lag effect. As for the single-day lag risk for extreme hot, a short lag effect was shown at a lag of 7 days with an RR of 1.076 (95% CI: 1.038, 1.114). The cumulative lagged effects of both hot and cold effects peaked at lag 0-21 days, with a cumulative risk of the onset of 3.690 (95% CI: 2.133, 6.382) and 1.641 (95% CI: 1.284, 2.098), respectively, with stronger impact on the hot. Additionally, the elderly were more sensitive to ambient temperature. The males were more susceptible to hot weather than the females. A longer cold temperature lag effect was found in females. Compared with the meta-analysis, a pooled effect of ambient temperature was consistent in general. In the subgroup analysis, a significant difference was found by gender. CONCLUSIONS Temperature level, age-specific, and gender-specific effects between ambient temperature and the number of ED visits provide information on early warning measures for the prevention and control of respiratory diseases.
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Affiliation(s)
- Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Zhenbiao Tian
- Beijing Red Cross Emergency Center, Beijing, 100085, China
| | - Jianping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuanjun Lyu
- Department of Endocrinology, Tianjin Hospital, Tianjin, China
| | - Ying Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China.
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Achebak H, Rey G, Chen ZY, Lloyd SJ, Quijal-Zamorano M, Méndez-Turrubiates RF, Ballester J. Heat Exposure and Cause-Specific Hospital Admissions in Spain: A Nationwide Cross-Sectional Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57009. [PMID: 38775486 PMCID: PMC11110655 DOI: 10.1289/ehp13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 03/20/2024] [Accepted: 04/02/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND More frequent and intense exposure to extreme heat conditions poses a serious threat to public health. However, evidence on the association between heat and specific diagnoses of morbidity is still limited. We aimed to comprehensively assess the short-term association between cause-specific hospital admissions and high temperature, including the added effect of temperature variability and heat waves and the effect modification by humidity and air pollution. METHODS We used data on cause-specific hospital admissions, weather (i.e., temperature and relative humidity), and air pollution [i.e., fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), fine particulate matter with aerodynamic diameter ≤ 10 μ m (PM 10 ), NO 2 , and ozone (O 3 )] for 48 provinces in mainland Spain and the Balearic Islands between 1 January 2006 and 31 December 2019. The statistical analysis was performed for the summer season (June-September) and consisted of two steps. We first applied quasi-Poisson generalized linear regression models in combination with distributed lag nonlinear models (DLNM) to estimate province-specific temperature-morbidity associations, which were then pooled through multilevel univariate/multivariate random-effect meta-analysis. RESULTS High temperature had a generalized impact on cause-specific hospitalizations, while the added effect of temperature variability [i.e., diurnal temperature range (DTR)] and heat waves was limited to a reduced number of diagnoses. The strongest impact of heat was observed for metabolic disorders and obesity [relative risk (RR) = 1.978; 95% empirical confidence interval (eCI): 1.772, 2.208], followed by renal failure (1.777; 95% eCI: 1.629, 1.939), urinary tract infection (1.746; 95% eCI: 1.578, 1.933), sepsis (1.543; 95% eCI: 1.387, 1.718), urolithiasis (1.490; 95% eCI: 1.338, 1.658), and poisoning by drugs and nonmedicinal substances (1.470; 95% eCI: 1.298, 1.665). We also found differences by sex (depending on the diagnosis of hospitalization) and age (very young children and the elderly were more at risk). Humidity played a role in the association of heat with hospitalizations from acute bronchitis and bronchiolitis and diseases of the muscular system and connective tissue, which were higher in dry days. Moreover, heat-related effects were exacerbated on high pollution days for metabolic disorders and obesity (PM 2.5 ) and diabetes (PM 10 , O 3 ). DISCUSSION Short-term exposure to heat was found to be associated with new diagnoses (e.g., metabolic diseases and obesity, blood diseases, acute bronchitis and bronchiolitis, muscular and connective tissue diseases, poisoning by drugs and nonmedicinal substances, complications of surgical and medical care, and symptoms, signs, and ill-defined conditions) and previously identified diagnoses of hospital admissions. The characterization of the vulnerability to heat can help improve clinical and public health practices to reduce the health risks posed by a warming planet. https://doi.org/10.1289/EHP13254.
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Affiliation(s)
- Hicham Achebak
- Inserm, France Cohortes, Paris, France
- ISGlobal, Barcelona, Spain
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Yuan X, Liu Q, Zhou H, Ni L, Yin X, Zhang X, Du M, Du X. Development and Validation of a Predictive Model for Intraoperative Hypothermia in Elderly Patients Undergoing Craniocerebral Tumor Resection: A Retrospective Cohort Study. World Neurosurg 2024; 184:e593-e602. [PMID: 38325704 DOI: 10.1016/j.wneu.2024.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Timely identification of elderly patients who are at risk of developing intraoperative hypothermia (IH) is imperative to enable appropriate interventions. This study aimed to develop a nomogram for predicting the risk of IH in elderly patients undergoing resection of craniocerebral tumor, and to validate its effectiveness. METHODS Elderly patients who underwent craniocerebral tumor resection at a large tertiary hospital in eastern China between January 2019 and December 2022 were included (n = 988). The study population was divided into a training set and a validation set by time period. Risk factors identified through the Least Absolute Shrinkage and Selection Operator method and logistic regression analysis were used to establish the nomogram. The model was validated internally by Bootstrap method and externally by validation set through receiver operating characteristic curve analysis, Hosmer-Lemeshow test, and decision curve analysis. RESULTS A total of 273 (27.6%) patients developed IH. Duration of anesthesia (P < 0.001), blood loss (P < 0.001), preoperative temperature (P < 0.001), tumor location (P < 0.001), age (P < 0.05), and mean arterial pressure (P < 0.05) were identified as independent risk factors for IH. A nomogram integrating these 6 factors was constructed. The area under the curve was 0.773 (95% confidence interval: 0.735-0.811) (70.5% specificity and 75.0% sensitivity), indicating good predictive performance. The decision curve analysis demonstrated the clinical benefit of using the nomogram. CONCLUSIONS Our model showed good performance in identifying elderly patients who are at high risk of developing IH during craniocerebral tumor resection. The nomogram can help inform timely preventive interventions.
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Affiliation(s)
- Xi Yuan
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Qing Liu
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Huixian Zhou
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Liangyan Ni
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Xuequn Yin
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Xinmei Zhang
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Meilan Du
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China
| | - Xiaohong Du
- Department of Anesthesiology and Surgery, the First Affiliated Hospital of Soochow University, Soochow, China.
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Zhou S, Ouyang L, Li B, Hodder S, Yao R. A thermoregulation model based on the physical and physiological characteristics of Chinese elderly. Comput Biol Med 2024; 172:108262. [PMID: 38479196 DOI: 10.1016/j.compbiomed.2024.108262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/13/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
Given the increasing aging population and rising living standards in China, developing an accurate and straightforward thermoregulation model for the elderly has become increasingly essential. To address this need, an existing one-segment four-node thermoregulation model for the young was selected as the base model. This study developed the base model considering age-related physical and physiological changes to predict mean skin temperatures of the elderly. Measured data for model optimization were collected from 24 representative healthy Chinese elderly individuals (average age: 67 years). The subjects underwent temperature step changes between neutral and warm conditions with a temperature range of 25-34 °C. The model's demographic representation was first validated by comparing the subjects' physical characteristics with Chinese census data. Secondly, sensitivity analysis was performed to investigate the influences of passive system parameters on skin and core temperatures, and adjustments were implemented using measurement or literature data specific to the Chinese elderly. Thirdly, the active system was modified by resetting the body temperature set points. The active parameters to control thermoregulation activities were further optimized using the TPE (Tree-structured Parzen Estimator) hyperparameter tuning method. The model's accuracy was further verified using independent experimental data for a temperature range of 18-34 °C for Chinese elderly. By comprehensively considering age-induced thermal response changes, the proposed model has potential applications in designing and optimizing thermal management systems in buildings, as well as informing energy-efficient strategies tailored to the specific needs of the Chinese elderly population.
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Affiliation(s)
- Shan Zhou
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, 400045, China; National Center for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, 400045, China
| | - Linyuan Ouyang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, 400045, China; National Center for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, 400045, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, 400045, China; National Center for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, 400045, China
| | - Simon Hodder
- School of Design & Creative Arts, Loughborough University, Loughborough, LE11 3TU, UK
| | - Runming Yao
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, 400045, China; National Center for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, 400045, China; School of the Built Environment, University of Reading, Reading, RG6 6DB, UK.
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Achebak H, Rey G, Lloyd SJ, Quijal-Zamorano M, Méndez-Turrubiates RF, Ballester J. Ambient temperature and risk of cardiovascular and respiratory adverse health outcomes: a nationwide cross-sectional study from Spain. Eur J Prev Cardiol 2024:zwae021. [PMID: 38364198 DOI: 10.1093/eurjpc/zwae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/09/2023] [Accepted: 01/08/2024] [Indexed: 02/18/2024]
Abstract
AIMS We assessed the association of temperature and temperature variability with cause-specific emergency hospitalizations and mortality from cardiovascular and respiratory diseases in Spain, as well as the effect modification of this association by individual and contextual factors. METHODS AND RESULTS We collected data on health (hospital admissions and mortality), weather (temperature and relative humidity), and relevant contextual indicators for 48 Spanish provinces during 2004-2019. The statistical analysis was separately performed for the summer (June-September) and winter (December-March) seasons. We first applied a generalized linear regression model with quasi-Poisson distribution to estimate daily province-specific temperature-health associations, and then we fitted multilevel multivariate meta-regression models to the evaluate effect modification of the contextual characteristics on heat- and cold-related risks. High temperature increased the risk of mortality across all cardiovascular and respiratory diseases, with the strongest effect for hypertension (relative risk (RR) at 99th temperature percentile vs. optimum temperature: 1.510 [95% empirical confidence interval {eCI} 1.251 to 1.821]), heart failure (1.528 [1.353 to 1.725]), and pneumonia (2.224 [1.685 to 2.936]). Heat also had an impact on all respiratory hospitalization causes (except asthma), with similar risks between pneumonia (1.288 [1.240 to 1.339]), acute bronchitis and bronchiolitis (1.307 [1.219 to 1.402]), and chronic obstructive pulmonary disease (1.260 [1.158 to 1.372]). We generally found significant risks related to low temperature for all cardiovascular and respiratory causes, with heart failure (RR at 1st temperature percentile vs. optimum temperature: 1.537 [1.329 to 1.779]) and chronic obstructive pulmonary disease (1.885 [1.646 to 2.159]) exhibiting the greatest risk for hospitalization, and acute myocardial infarction (1.860 [1.546 to 2.238]) and pneumonia (1.734 [1.219 to 2.468]) for mortality. Women and the elderly were more vulnerable to heat, while people with secondary education were less susceptible to cold compared to those not achieving this educational stage. Results from meta-regression showed that increasing heating access to the highest current provincial value (i.e. 95.6%) could reduce deaths due to cold by 59.5% (57.2 to 63.5). CONCLUSION Exposure to low and high temperatures was associated with a greater risk of morbidity and mortality from multiple cardiovascular and respiratory conditions, and heating was the most effective societal adaptive measure to reduce cold-related mortality.
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Affiliation(s)
- Hicham Achebak
- Inserm, France Cohortes, 48-50 rue Albert, 75013 Paris, France
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Grégoire Rey
- Inserm, France Cohortes, 48-50 rue Albert, 75013 Paris, France
| | - Simon J Lloyd
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Marcos Quijal-Zamorano
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Doctor Aiguader 80, 08003 Barcelona, Spain
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Visaria A, Huang SP, Su CC, Robinson D, Read J, Lin CY, Nethery R, Josey K, Gandhi P, Bates B, Rua M, Parthasarathi A, Ghosh AK, Kao Yang YH, Setoguchi S. Ambient Heat and Risk of Serious Hypoglycemia in Older Adults With Diabetes Using Insulin in the U.S. and Taiwan: A Cross-National Case-Crossover Study. Diabetes Care 2024; 47:233-238. [PMID: 38060348 PMCID: PMC10834387 DOI: 10.2337/dc23-1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/02/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVE To measure the association between ambient heat and hypoglycemia-related emergency department visit or hospitalization in insulin users. RESEARCH DESIGN AND METHODS We identified cases of serious hypoglycemia among adults using insulin aged ≥65 in the U.S. (via Medicare Part A/B/D-eligible beneficiaries) and Taiwan (via National Health Insurance Database) from June to September, 2016-2019. We then estimated odds of hypoglycemia by heat index (HI) percentile categories using conditional logistic regression with a time-stratified case-crossover design. RESULTS Among ∼2 million insulin users in the U.S. (32,461 hypoglycemia case subjects), odds ratios of hypoglycemia for HI >99th, 95-98th, 85-94th, and 75-84th percentiles compared with the 25-74th percentile were 1.38 (95% CI, 1.28-1.48), 1.14 (1.08-1.20), 1.12 (1.08-1.17), and 1.09 (1.04-1.13) respectively. Overall patterns of associations were similar for insulin users in the Taiwan sample (∼283,000 insulin users, 10,162 hypoglycemia case subjects). CONCLUSIONS In two national samples of older insulin users, higher ambient temperature was associated with increased hypoglycemia risk.
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Affiliation(s)
- Aayush Visaria
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Shu-Ping Huang
- Changhua Christian Hospital Institutional Review Board & Administrative Office, Changhua, Taiwan
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Chou Su
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - David Robinson
- Department of Geography, Rutgers University, Piscataway, NJ
| | - John Read
- Department of Geography, Rutgers University, Piscataway, NJ
| | - Chuan-Yao Lin
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
| | - Rachel Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Kevin Josey
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Poonam Gandhi
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
| | - Benjamin Bates
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
| | - Melanie Rua
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
| | - Ashwagosha Parthasarathi
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
| | - Arnab K. Ghosh
- Department of Medicine, Weill Cornell Medical College of Cornell University, New York, NY
| | - Yea-Huei Kao Yang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Soko Setoguchi
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
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Wee J, Tan XR, Gunther SH, Ihsan M, Leow MKS, Tan DSY, Eriksson JG, Lee JKW. Effects of Medications on Heat Loss Capacity in Chronic Disease Patients: Health Implications Amidst Global Warming. Pharmacol Rev 2023; 75:1140-1166. [PMID: 37328294 DOI: 10.1124/pharmrev.122.000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/20/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
Pharmacological agents used to treat or manage diseases can modify the level of heat strain experienced by chronically ill and elderly patients via different mechanistic pathways. Human thermoregulation is a crucial homeostatic process that maintains body temperature within a narrow range during heat stress through dry (i.e., increasing skin blood flow) and evaporative (i.e., sweating) heat loss, as well as active inhibition of thermogenesis, which is crucial to avoid overheating. Medications can independently and synergistically interact with aging and chronic disease to alter homeostatic responses to rising body temperature during heat stress. This review focuses on the physiologic changes, with specific emphasis on thermolytic processes, associated with medication use during heat stress. The review begins by providing readers with a background of the global chronic disease burden. Human thermoregulation and aging effects are then summarized to give an understanding of the unique physiologic changes faced by older adults. The effects of common chronic diseases on temperature regulation are outlined in the main sections. Physiologic impacts of common medications used to treat these diseases are reviewed in detail, with emphasis on the mechanisms by which these medications alter thermolysis during heat stress. The review concludes by providing perspectives on the need to understand the effects of medication use in hot environments, as well as a summary table of all clinical considerations and research needs of the medications included in this review. SIGNIFICANCE STATEMENT: Long-term medications modulate thermoregulatory function, resulting in excess physiological strain and predisposing patients to adverse health outcomes during prolonged exposures to extreme heat during rest and physical work (e.g., exercise). Understanding the medication-specific mechanisms of altered thermoregulation has importance in both clinical and research settings, paving the way for work toward refining current medication prescription recommendations and formulating mitigation strategies for adverse drug effects in the heat in chronically ill patients.
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Affiliation(s)
- Jericho Wee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Xiang Ren Tan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Samuel H Gunther
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Mohammed Ihsan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Melvin Khee Shing Leow
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Doreen Su-Yin Tan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Johan G Eriksson
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
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Wang J, Solianik R, Eimantas N, Baranauskiene N, Brazaitis M. Age-Related Difference in Cognitive Performance under Severe Whole-Body Hyperthermia Parallels Cortisol and Physical Strain Responses. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1665. [PMID: 37763784 PMCID: PMC10535853 DOI: 10.3390/medicina59091665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/21/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: To date, understanding age-related changes in cognitive processes during heat exposure still needs to be better-understood. Thus, the main aim of the current study was to evaluate the effects of whole-body hyperthermia (WBH), i.e., a ≈ 2.5 °C increase in rectal temperature (Tre) from overnight-fast baseline value, on cognitive functioning in old and young men and to explore factors, such as stress and thermophysiological strain, that could influence such changes. Materials and Methods: Ten young (19-21 years of age) and nine old (61-80 years of age) healthy men underwent an experimental trial with passive lower-body heating in hot water immersion (HWI) at 43 °C (HWI-43 °C) until Tre reached 39 °C in old adults and 39.5 °C in young adults. Cognitive performance and cortisol concentration were assessed before and after HWI, and the physiological strain index (PSI) was assessed during HWI-43 °C. Results: PSI was lower and cortisol concentration was greater after HWI-43 °C in the old group compared with the young group (p < 0.05). Surprisingly, hyperthermia improved cognitive flexibility only in old adults, whereas short-term and visual recognition memories were maintained in both age groups. Conclusions: A ≈ 2.5 °C increase in rectal temperature can improve executive function in old adults, and this increase parallels the increased cortisol concentration and the lower thermophysiological strain under severe WBH conditions.
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Affiliation(s)
| | | | | | | | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, LT-44221 Kaunas, Lithuania; (J.W.); (R.S.); (N.E.); (N.B.)
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Healy JP, Danesh Yazdi M, Wei Y, Qiu X, Shtein A, Dominici F, Shi L, Schwartz JD. Seasonal Temperature Variability and Mortality in the Medicare Population. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:77002. [PMID: 37404028 PMCID: PMC10321237 DOI: 10.1289/ehp11588] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 04/17/2023] [Accepted: 06/12/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Seasonal temperature variability remains understudied and may be modified by climate change. Most temperature-mortality studies examine short-term exposures using time-series data. These studies are limited by regional adaptation, short-term mortality displacement, and an inability to observe longer-term relationships in temperature and mortality. Seasonal temperature and cohort analyses allow the long-term effects of regional climatic change on mortality to be analyzed. OBJECTIVES We aimed to carry out one of the first investigations of seasonal temperature variability and mortality across the contiguous United States. We also investigated factors that modify this association. Using adapted quasi-experimental methods, we hoped to account for unobserved confounding and to investigate regional adaptation and acclimatization at the ZIP code level. METHODS We examined the mean and standard deviation (SD) of daily temperature in the warm (April-September) and cold (October-March) season in the Medicare cohort from 2000 to 2016. This cohort comprised 622,427,230 y of person-time in all adults over the age of 65 y from 2000 to 2016. We used daily mean temperature obtained from gridMET to develop yearly seasonal temperature variables for each ZIP code. We used an adapted difference-in-difference approach model with a three-tiered clustering approach and meta-analysis to observe the relationship between temperature variability and mortality within ZIP codes. Effect modification was assessed with stratified analyses by race and population density. RESULTS For every 1°C increase in the SD of warm and cold season temperature, the mortality rate increased by 1.54% [95% confidence interval (CI): 0.73%, 2.15%] and 0.69% (95% CI: 0.22%, 1.15%) respectively. We did not see significant effects for seasonal mean temperatures. Participants who were classified by Medicare into an "other" race group had smaller effects than those classified as White for Cold and Cold SD and areas with lower population density had larger effects for Warm SD. DISCUSSION Warm and cold season temperature variability were significantly associated with increased mortality rates in U.S. individuals over the age of 65 y, even after controlling for seasonal temperature averages. Warm and cold season mean temperatures showed null effects on mortality. Cold SD had a larger effect size for those who were in the racial subgroup other, whereas Warm SD was more harmful for those living in lower population density areas. This study adds to the growing calls for urgent climate mitigation and environmental health adaptation and resiliency. https://doi.org/10.1289/EHP11588.
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Affiliation(s)
- James P. Healy
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Alexandra Shtein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, Georgia, USA
| | - Joel D. Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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10
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Akbar M, Wandy A, Soraya GV, Goysal Y, Lotisna M, Basri MI. Sudomotor dysfunction in diabetic peripheral neuropathy (DPN) and its testing modalities: A literature review. Heliyon 2023; 9:e18184. [PMID: 37539131 PMCID: PMC10393629 DOI: 10.1016/j.heliyon.2023.e18184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/04/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023] Open
Abstract
Long term consequences of diabetes mellitus (DM) may include multi-organ complications such as retinopathy, cardiovascular disease, neuronal, and kidney damage. One of the most prevalent complication is diabetic peripheral neuropathy (DPN), occurring in half of all diabetics, and is the main cause of disability globally with profound impact on a patient's quality of life. Small fiber neuropathy (SFN) can develop in the pre-diabetes stage preceding large fiber damage in DPN. Asymptomatic SFN is difficult to diagnose in early stages, with sudomotor dysfunction considered one of the earliest manifestations of autonomic neuropathy. Early detection is crucial as it can prevent potential cardiovascular events. Although punch skin biopsy is the gold-standard method for SFN diagnosis, implementation as routine screening is hindered due to its invasive, impractical, and time-consuming nature. Other sudomotor testing modalities, most of which evaluate the postganglionic cholinergic sympathetic nervous system, have been developed with varying sensitivity and specificity for SFN diagnosis. Here, we provide an overview on the general mechanism of DPN, the importance of sudomotor assessment for early detection of autonomic dysfunction in DPN, the benefits and disadvantages of current testing modalities, factors that may affect testing, and the importance of future discoveries on sudomotor testing for successful DPN diagnosis.
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Affiliation(s)
- Muhammad Akbar
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Alvian Wandy
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Gita Vita Soraya
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yudy Goysal
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Mimi Lotisna
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Muhammad Iqbal Basri
- Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Department of Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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11
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Alagiakrishnan K, Dhami P, Senthilselvan A. Predictors of Conversion to Dementia in Patients With Mild Cognitive Impairment: The Role of Low Body Temperature. J Clin Med Res 2023; 15:216-224. [PMID: 37187716 PMCID: PMC10181356 DOI: 10.14740/jocmr4883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
Background Subjects with mild cognitive impairment (MCI) can progress to dementia. Studies have shown that neuropsychological tests, biological or radiological markers individually or in combination have helped to determine the risk of conversion from MCI to dementia. These techniques are complex and expensive, and clinical risk factors were not considered in these studies. This study examined demographic, lifestyle and clinical factors including low body temperature that may play a role in the conversion of MCI to dementia in elderly patients. Methods In this retrospective study, a chart review was conducted on patients aged 61 to 103 years who were seen at the University of Alberta Hospital. Information on onset of MCI and demographic, social, and lifestyle factors, family history of dementia and clinical factors, and current medications at baseline was collected from patient charts on an electronic database. The conversion from MCI to dementia within 5.5 years was also determined. Logistic regression analysis was conducted to identify the baseline factors associated with conversion from MCI to dementia. Results The prevalence of MCI at baseline was 25.6% (335/1,330). During the 5.5 years follow-up period, 43% (143/335) of the subjects converted to dementia from MCI. The factors that were significantly associated with conversion from MCI to dementia were family history of dementia (odds ratio (OR): 2.78, 95% confidence interval (CI): 1.56 - 4.95, P = 0.001), Montreal cognitive assessment (MoCA) score (OR: 0.91, 95% CI: 0.85 - 0.97, P = 0.01), and low body temperature (below 36 °C) (OR: 10.01, 95% CI: 3.59 - 27.88, P < 0.001). Conclusion In addition to family history of dementia and MoCA, low body temperature was shown to be associated with the conversion from MCI to dementia. This study would help clinicians to identify patients with MCI who are at highest risk of conversion to dementia.
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Affiliation(s)
- Kannayiram Alagiakrishnan
- Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Corresponding Author: Kannayiram Alagiakrishnan, Clinical Sciences Building, University of Alberta Hospital, Edmonton, AB T6G 2P4, Canada.
| | - Prabhpaul Dhami
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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12
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de Korte JQ, Eijsvogels TMH, Hopman MTE, Bongers CCWG. Thermoregulatory, Cardiovascular and Perceptual Responses of Spectators of a Simulated Football Match in Hot and Humid Environmental Conditions. Sports (Basel) 2023; 11:sports11040078. [PMID: 37104152 PMCID: PMC10140829 DOI: 10.3390/sports11040078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Major sporting events are often scheduled in thermally challenging environments. The heat stress may impact athletes but also spectators. We examined the thermal, cardiovascular, and perceptual responses of spectators watching a football match in a simulated hot and humid environment. A total of 48 participants (43 ± 9 years; n = 27 participants <50 years and n = 21 participants ≥50 years, n = 21) watched a 90 min football match in addition to a 15 min baseline and 15 min halftime break, seated in an environmental chamber (Tair = 31.9 ± 0.4 °C; RH = 76 ± 4%). Gastrointestinal temperature (Tgi), skin temperature (Tskin), and heart rate (HR) were measured continuously throughout the match. Mean arterial pressure (MAP) and perceptual parameters (i.e., thermal sensation and thermal comfort) were scored every 15 min. Tri (37.3 ± 0.4 °C to 37.4 ± 0.3 °C, p = 0.11), HR (76 ± 15 bpm to 77 ± 14 bpm, p = 0.96) and MAP (97 ± 10 mm Hg to 97 ± 10 mm Hg, p = 0.67) did not change throughout the match. In contrast, an increase in Tskin (32.9 ± 0.8 °C to 35.4 ± 0.3 °C, p < 0.001) was found. Further, 81% of participants reported thermal discomfort and 87% a (slightly) warm thermal sensation at the end of the match. Moreover, the thermal or cardiovascular responses were not affected by age (all p-values > 0.05). Heat stress induced by watching a football match in simulated hot and humid conditions does not result in substantial thermal or cardiovascular strain, whereas a significant perceptual strain was observed.
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Affiliation(s)
- Johannus Q. de Korte
- Department of Medical Biosciences, Radboud University Medical Center, 6500VC Nijmegen, The Netherlands
| | - Thijs M. H. Eijsvogels
- Department of Medical Biosciences, Radboud University Medical Center, 6500VC Nijmegen, The Netherlands
| | - Maria T. E. Hopman
- Department of Medical Biosciences, Radboud University Medical Center, 6500VC Nijmegen, The Netherlands
| | - Coen C. W. G. Bongers
- Department of Medical Biosciences, Radboud University Medical Center, 6500VC Nijmegen, The Netherlands
- School of Sport and Exercise, Health Promotion & Performance, HAN University of Applied Sciences, 6525AJ Nijmegen, The Netherlands
- Correspondence:
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Infrared Thermography in Symptomatic Knee Osteoarthritis: Joint Temperature Differs Based on Patient and Pain Characteristics. J Clin Med 2023; 12:jcm12062319. [PMID: 36983319 PMCID: PMC10055129 DOI: 10.3390/jcm12062319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
The aim of this study was to evaluate osteoarthritis (OA) patients with infrared thermography to investigate imaging patterns as well as demographic and clinical characteristics that influence knee inflammation. Forty patients with one-sided symptomatic knee OA were included and evaluated through knee-specific PROMs and the PainDETECT Questionnaire for neuropathic pain evaluation. Thermograms were captured using a thermographic camera FLIR-T1020 and temperatures were extracted using the software ResearchIR for the overall knee and the five ROIs: medial, lateral, medial patella, lateral patella, and suprapatellar. The mean temperature of the total knee was 31.9 ± 1.6 °C. It negatively correlated with age (rho = −0.380, p = 0.016) and positively correlated with BMI (rho = 0.421, p = 0.007) and the IKDC objective score (tau = 0.294, p = 0.016). Men had higher temperatures in the knee medial, lateral, and suprapatellar areas (p = 0.017, p = 0.019, p = 0.025, respectively). Patients with neuropathic pain had a lower temperature of the medial knee area (31.5 ± 1.0 vs. 32.3 ± 1.1, p = 0.042), with the total knee negatively correlating with PainDETECT (p = 0.045). This study demonstrated that the skin temperature of OA symptomatic knees is influenced by demographic and clinical characteristics of patients, with higher joint temperatures in younger male patients with higher BMI and worst objective knee scores and lower temperatures in patients affected by neuropathic pain.
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Laohaudomchok W, Phanprasit W, Konthonbut P, Tangtong C, Sripaiboonkij P, Ikäheimo TM, Jaakkola JJK, Näyhä S. Self-Assessed Threshold Temperature for Cold among Poultry Industry Workers in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2067. [PMID: 36767437 PMCID: PMC9914996 DOI: 10.3390/ijerph20032067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
The self-assessed threshold temperature for cold in the workplace is not well known. We asked 392 chicken industry workers in Thailand what they regard as the cold threshold (CT) and compared subgroups of workers using linear and quantile regressions by CT sextiles (percentiles P17, P33, P50, P67, and P83, from warmest to coldest). The variables of interest were sex, office work, and sedentary work, with age, clothing thermal insulation, and alcohol consumption as adjustment factors. The mean CT was 14.6 °C. Office workers had a 6.8 °C higher mean CT than other workers, but the difference ranged from 3.8 °C to 10.0 °C from P17 to P83. Sedentary workers had a 2.0 °C higher mean CT than others, but the difference increased from 0.5 °C to 3.0 °C through P17-P83. The mean CT did not differ between sexes, but men had a 1.6-5.0 °C higher CT at P17-P50 (>20 °C) and a 5.0 °C lower CT at P83 (<10 °C). The CT was relatively high at warm (≥10 °C), dry (relative humidity <41%), and drafty (air velocity > 0.35 m/s) worksites. We conclude that office, sedentary, and female workers and those working at warm, dry, and draughty sites are sensitive to the coldest temperatures, whereas male workers are sensitive even to moderate temperatures.
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Affiliation(s)
- Wisanti Laohaudomchok
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 73170, Thailand
| | - Wantanee Phanprasit
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 73170, Thailand
| | - Pajaree Konthonbut
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 73170, Thailand
| | - Chaiyanun Tangtong
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 73170, Thailand
| | - Penpatra Sripaiboonkij
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Tiina M. Ikäheimo
- Research Unit of Population Health, University of Oulu, 90570 Oulu, Finland
- Department of Community Medicine, University of Tromsø, 9019 Tromsø, Norway
| | | | - Simo Näyhä
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 73170, Thailand
- Research Unit of Population Health, University of Oulu, 90570 Oulu, Finland
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Kobayashi S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, Yamamoto K, Seguchi M, Wada H, Fujita H. Influence of daily temperature on the occurrence of ST-elevation myocardial infarction. J Cardiol 2022; 81:544-552. [PMID: 36565995 DOI: 10.1016/j.jjcc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Epidemiological studies reported that acute myocardial infarction (AMI) occurs more often in winter season or days with low temperatures. However, most of these studies did not distinguish ST-elevation myocardial infarction (STEMI) from AMI. The purpose of this study was to investigate the relationship between temperature and the occurrence of STEMI. METHODS We reviewed all daily temperature in Saitama City between January 2015 and December 2021 (2557 days) and divided them into days in which our institution received STEMI (days with STEMI) and days in which our institution did not receive STEMI (days without STEMI). RESULTS The daily maximum temperature was significantly lower in days with STEMI than in days without STEMI [20.0 °C (68.0 °F) versus 21.2 °C (70.2 °F), p = 0.001]. The maximum temperature was significantly lower in days with STEMI than in days without STEMI in the elderly [19.9 °C (67.8 °F) versus 21.1 °C (70.0 °F), p = 0.003], whereas this trend was weaker in the non-elderly [20.2 °C (68.4 °F) versus 20.9 °C (69.6 °F), p = 0.171]. Furthermore, the maximum temperature was significantly lower in days with STEMI than in days without STEMI in male [20.0 °C (68.0 °F) versus 21.1 °C (70.0 °F), p = 0.002], whereas this trend was weaker in females [20.0 °C (68.0 °F) versus 20.9 °C (69.6 °F), p = 0.169]. CONCLUSIONS The daily temperatures were significantly lower in days with STEMI than in days without STEMI, and this relationship was pronounced in elderly or male patients.
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Affiliation(s)
- Satomi Kobayashi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Kenichi Sakakura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan.
| | - Hiroyuki Jinnouchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Yousuke Taniguchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Takunori Tsukui
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Yusuke Watanabe
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Kei Yamamoto
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Masaru Seguchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Hiroshi Wada
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama City, Japan
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16
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Guo W, Jiang L, Cheng B, Yao Y, Wang C, Kou Y, Xu S, Xian D. A study of subtropical park thermal comfort and its influential factors during summer. J Therm Biol 2022; 109:103304. [PMID: 36195380 DOI: 10.1016/j.jtherbio.2022.103304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/31/2022] [Accepted: 08/02/2022] [Indexed: 01/05/2023]
Abstract
Outdoor thermal comfort is significantly relevant to human's quality of life. Thus, it has been frequently studied by investigators. This study explored people's thermal responses to environments and the subjective factors that might affect thermal comforts with respect to two urban parks in Xindu, a satellite city in the Chengdu Plain (CDP). CDP is located at the southwest of China, which has a subtropical climate. The environment from each of the two parks was studied using current micrometeorology and hoped-for landscape changes (tree canopies, artificial canopies, non-canopying plants, and water surfaces); subjective factors included gender, age, body mass index, clothing isolation, and physical activities. It was found that canopies were the most preferred objective cooling elements, while individual thermal perceptions varied subjectively by age. The highest proportion of volunteers voted for tree canopies as their favourite thermal adjusting element. It was observed that those aged above 55 showed low thermal sensitivity. The remaining group's neutral temperatures (indicated by physiologically equivalent temperature, PET) were close, at approximately 25 °C. This study provides significant direction for future urban planning and landscape design.
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Affiliation(s)
- Wei Guo
- Department of Architecture, Deyang Installation Technician College, Deyang, China
| | - Lin Jiang
- School of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang, China
| | - Bin Cheng
- School of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang, China.
| | - Yanfeng Yao
- School of Manufacture Science and Engineering, Southwest University of Science and Technology, Mianyang, China
| | - Chunlu Wang
- College of Humanities, Ningbo University of Finance & Economics, China
| | - Yining Kou
- School of Electrical and Information Engineering, Jiangsu University Jingjiang College, China
| | - Sheng Xu
- School of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang, China
| | - Deqing Xian
- China Southwest Geotechnical Investigation & Design Institute Co., Ltd., China
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17
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Su YC, Chien CY, Chaou CH, Hsu KH, Gao SY, Ng CJ. Revising Vital Signs Criteria for Accurate Triage of Older Adults in the Emergency Department. Int J Gen Med 2022; 15:6227-6235. [PMID: 35898300 PMCID: PMC9309291 DOI: 10.2147/ijgm.s373396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Because of physiologic changes in older adults, their vital signs need to be assessed differently. This study aimed to determine appropriate vital sign cut points for triage designation in older patients presented to the emergency department (ED). Patients and Methods Data from 78,524 ED visits of patients aged ≥65 years in Linkou Chang Gung Memorial Hospital (LCGMH) between 2016 and 2017 were collected. New cut points for vital signs (systolic blood pressure [SBP], heart rate [HR], body temperature [BT], and Glasgow Coma Scale [GCS]) were determined using the critical event rate (the composite of admission to ICU and mortality in hospital) for each vital sign. The newly proposed triage scale was then validated using two other databases (Chang Gung Research Database [CGRD] and Taipei City Hospital [TPECH] database). The Taiwan Triage and Acuity Scale (TTAS) was used in this study. Results In the LCGMH derivation group, older patients presenting with SBP < 80 mmHg, HR < 40 or > 140 beats per minute (bpm), BT < 35°C, and GCS score 3–8 had a critical event rate of >20% and were proposed to be uptriaged to TTAS level 1. Following a reclassification, a portion of older patients are uptriaged by the newly proposed TTAS, and increase in the critical event rate in TTAS level 1 and level 2 groups compared to the existing TTAS. The newly proposed TTAS exhibited comparable discriminatory ability for triage in older patients compared to the existing TTAS (the area under the receiver operating characteristics curve: CGRD, 0.76 vs 0.62; TPECH, 0.71 vs 0.59). Conclusion Revising the vital signs triage criteria for older patients could be a way to improve the identification of patients with critical event outcomes in high TTAS level, thereby improving triage accuracy among older patients visiting the ED.
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Affiliation(s)
- Yi-Chia Su
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Yu Chien
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, Taiwan.,Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chung-Hsien Chaou
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuang-Hung Hsu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Laboratory for Epidemiology, Chang Gung University, Taoyuan, Taiwan.,Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shi-Ying Gao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chip-Jin Ng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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18
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Blessing EM, Parekh A, Betensky RA, Babb J, Saba N, Debure L, Varga AW, Ayappa I, Rapoport DM, Butler TA, de Leon MJ, Wisniewski T, Lopresti BJ, Osorio RS. Association between lower body temperature and increased tau pathology in cognitively normal older adults. Neurobiol Dis 2022; 171:105748. [PMID: 35550158 DOI: 10.1016/j.nbd.2022.105748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Preclinical studies suggest body temperature (Tb) and consequently brain temperature has the potential to bidirectionally interact with tau pathology in Alzheimer's Disease (AD). Tau phosphorylation is substantially increased by a small (<1 °C) decrease in temperature within the human physiological range, and thermoregulatory nuclei are affected by tau pathology early in the AD continuum. In this study we evaluated whether Tb (as a proxy for brain temperature) is cross-sectionally associated with clinically utilized markers of tau pathology in cognitively normal older adults. METHODS Tb was continuously measured with ingestible telemetry sensors for 48 h. This period included two nights of nocturnal polysomnography to delineate whether Tb during waking vs sleep is differentially associated with tau pathology. Tau phosphorylation was assessed with plasma and cerebrospinal fluid (CSF) tau phosphorylated at threonine 181 (P-tau), sampled the day following Tb measurement. In addition, neurofibrillary tangle (NFT) burden in early Braak stage regions was imaged with PET-MR using the [18F]MK-6240 radiotracer on average one month later. RESULTS Lower Tb was associated with increased NFT burden, as well as increased plasma and CSF P-tau levels (p < 0.05). NFT burden was associated with lower Tb during waking (p < 0.05) but not during sleep intervals. Plasma and CSF P-tau levels were highly correlated with each other (p < 0.05), and both variables were correlated with tau tangle radiotracer uptake (p < 0.05). CONCLUSIONS These results, the first available for human, suggest that lower Tb in older adults may be associated with increased tau pathology. Our findings add to the substantial preclinical literature associating lower body and brain temperature with tau hyperphosphorylation. CLINICAL TRIAL NUMBER NCT03053908.
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Affiliation(s)
- Esther M Blessing
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, United States of America.
| | - Ankit Parekh
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America.
| | - Rebecca A Betensky
- Department of NYU School of Global Public Health, New York, NY 10016, United States of America.
| | - James Babb
- Alzheimer's Disease Research Center, Department of Neurology, NYU Grossman School of Medicine, New York, NY 10016, United States of America.
| | - Natalie Saba
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, United States of America.
| | - Ludovic Debure
- Alzheimer's Disease Research Center, Department of Neurology, NYU Grossman School of Medicine, New York, NY 10016, United States of America.
| | - Andrew W Varga
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America.
| | - Indu Ayappa
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America.
| | - David M Rapoport
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America.
| | - Tracy A Butler
- Department of Neurology, Weill Cornell Medicine, New York, NY 10065, United States of America.
| | - Mony J de Leon
- Department of Neurology, Weill Cornell Medicine, New York, NY 10065, United States of America.
| | - Thomas Wisniewski
- Alzheimer's Disease Research Center, Department of Neurology, NYU Grossman School of Medicine, New York, NY 10016, United States of America.
| | - Brian J Lopresti
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, United States of America.
| | - Ricardo S Osorio
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, United States of America; Alzheimer's Disease Research Center, Department of Neurology, NYU Grossman School of Medicine, New York, NY 10016, United States of America.
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19
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Chang AY, Tan AX, Nadeau KC, Odden MC. Aging Hearts in a Hotter, More Turbulent World: The Impacts of Climate Change on the Cardiovascular Health of Older Adults. Curr Cardiol Rep 2022; 24:749-760. [PMID: 35438387 PMCID: PMC9017408 DOI: 10.1007/s11886-022-01693-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW Climate change has manifested itself in multiple environmental hazards to human health. Older adults and those living with cardiovascular diseases are particularly susceptible to poor outcomes due to unique social, economic, and physiologic vulnerabilities. This review aims to summarize those vulnerabilities and the resultant impacts of climate-mediated disasters on the heart health of the aging population. RECENT FINDINGS Analyses incorporating a wide variety of environmental data sources have identified increases in cardiovascular risk factors, hospitalizations, and mortality from intensified air pollution, wildfires, heat waves, extreme weather events, rising sea levels, and pandemic disease. Older adults, especially those of low socioeconomic status or belonging to ethnic minority groups, bear a disproportionate health burden from these hazards. The worldwide trends responsible for global warming continue to worsen climate change-mediated natural disasters. As such, additional investigation will be necessary to develop personal and policy-level interventions to protect the cardiovascular wellbeing of our aging population.
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Affiliation(s)
- Andrew Y Chang
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.,Department of Medicine, Stanford University, Stanford, CA, USA.,Stanford Cardiovascular Institute, 150 Governor's Lane, Stanford, CA, 94305, USA
| | - Annabel X Tan
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Kari C Nadeau
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.,Department of Medicine, Stanford University, Stanford, CA, USA.,Stanford Cardiovascular Institute, 150 Governor's Lane, Stanford, CA, 94305, USA.,Woods Institute for the Environment, Stanford University, Stanford, CA, USA
| | - Michelle C Odden
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA. .,Stanford Cardiovascular Institute, 150 Governor's Lane, Stanford, CA, 94305, USA.
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20
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Akat E, Yenmiş M, Pombal MA, Molist P, Megías M, Arman S, Veselỳ M, Anderson R, Ayaz D. Comparison of Vertebrate Skin Structure at Class Level: A Review. Anat Rec (Hoboken) 2022; 305:3543-3608. [DOI: 10.1002/ar.24908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Esra Akat
- Ege University, Faculty of Science, Biology Department Bornova, İzmir Turkey
| | - Melodi Yenmiş
- Ege University, Faculty of Science, Biology Department Bornova, İzmir Turkey
| | - Manuel A. Pombal
- Universidade de Vigo, Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Bioloxía‐IBIV Vigo, España
| | - Pilar Molist
- Universidade de Vigo, Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Bioloxía‐IBIV Vigo, España
| | - Manuel Megías
- Universidade de Vigo, Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Bioloxía‐IBIV Vigo, España
| | - Sezgi Arman
- Sakarya University, Faculty of Science and Letters, Biology Department Sakarya Turkey
| | - Milan Veselỳ
- Palacky University, Faculty of Science, Department of Zoology Olomouc Czechia
| | - Rodolfo Anderson
- Departamento de Zoologia, Instituto de Biociências Universidade Estadual Paulista São Paulo Brazil
| | - Dinçer Ayaz
- Ege University, Faculty of Science, Biology Department Bornova, İzmir Turkey
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21
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Coull NA, Hodder SG, Havenith G. Age comparison of changes in local warm and cold sensitivity due to whole body cooling. J Therm Biol 2022; 104:103174. [DOI: 10.1016/j.jtherbio.2021.103174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/15/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
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22
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Wang Q, Zhou Y, Ghassemi P, McBride D, Casamento JP, Pfefer TJ. Infrared Thermography for Measuring Elevated Body Temperature: Clinical Accuracy, Calibration, and Evaluation. SENSORS (BASEL, SWITZERLAND) 2021; 22:s22010215. [PMID: 35009758 PMCID: PMC8749858 DOI: 10.3390/s22010215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 05/07/2023]
Abstract
Infrared thermographs (IRTs) implemented according to standardized best practices have shown strong potential for detecting elevated body temperatures (EBT), which may be useful in clinical settings and during infectious disease epidemics. However, optimal IRT calibration methods have not been established and the clinical performance of these devices relative to the more common non-contact infrared thermometers (NCITs) remains unclear. In addition to confirming the findings of our preliminary analysis of clinical study results, the primary intent of this study was to compare methods for IRT calibration and identify best practices for assessing the performance of IRTs intended to detect EBT. A key secondary aim was to compare IRT clinical accuracy to that of NCITs. We performed a clinical thermographic imaging study of more than 1000 subjects, acquiring temperature data from several facial locations that, along with reference oral temperatures, were used to calibrate two IRT systems based on seven different regression methods. Oral temperatures imputed from facial data were used to evaluate IRT clinical accuracy based on metrics such as clinical bias (Δcb), repeatability, root-mean-square difference, and sensitivity/specificity. We proposed several calibration approaches designed to account for the non-uniform data density across the temperature range and a constant offset approach tended to show better ability to detect EBT. As in our prior study, inner canthi or full-face maximum temperatures provided the highest clinical accuracy. With an optimal calibration approach, these methods achieved a Δcb between ±0.03 °C with standard deviation (σΔcb) less than 0.3 °C, and sensitivity/specificity between 84% and 94%. Results of forehead-center measurements with NCITs or IRTs indicated reduced performance. An analysis of the complete clinical data set confirms the essential findings of our preliminary evaluation, with minor differences. Our findings provide novel insights into methods and metrics for the clinical accuracy assessment of IRTs. Furthermore, our results indicate that calibration approaches providing the highest clinical accuracy in the 37-38.5 °C range may be most effective for measuring EBT. While device performance depends on many factors, IRTs can provide superior performance to NCITs.
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Affiliation(s)
- Quanzeng Wang
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.Z.); (P.G.); (J.P.C.); (T.J.P.)
- Correspondence:
| | - Yangling Zhou
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.Z.); (P.G.); (J.P.C.); (T.J.P.)
- Department of Mechanical Engineering, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - Pejman Ghassemi
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.Z.); (P.G.); (J.P.C.); (T.J.P.)
| | - David McBride
- University Health Center, University of Maryland, College Park, MD 20742, USA;
| | - Jon P. Casamento
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.Z.); (P.G.); (J.P.C.); (T.J.P.)
| | - T. Joshua Pfefer
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.Z.); (P.G.); (J.P.C.); (T.J.P.)
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23
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Abstract
The human population is at the centre of research on global environmental change. On the one hand, population dynamics influence the environment and the global climate system through consumption-based carbon emissions. On the other hand, the health and well-being of the population are already being affected by climate change. A knowledge of population dynamics and population heterogeneity is thus fundamental to improving our understanding of how population size, composition, and distribution influence global environmental change and how these changes affect population subgroups differentially by demographic characteristics and spatial distribution. The increasing relevance of demographic research on the topic, coupled with availability of theoretical concepts and advancement in data and computing facilities, has contributed to growing engagement of demographers in this field. In the past 25 years, demographic research has enriched climate change research-with the key contribution being in moving beyond the narrow view that population matters only in terms of population size-by putting a greater emphasis on population composition and distribution, through presenting both empirical evidence and advanced population forecasting to account for demographic and spatial heterogeneity. What remains missing in the literature is research that investigates how global environmental change affects current and future demographic processes and, consequently, population trends. If global environmental change does influence fertility, mortality, and migration, then population estimates and forecasts need to adjust for climate feedback in population projections. Indisputably, this is the area of new research that directly requires expertise in population science and contribution from demographers.
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Affiliation(s)
- Raya Muttarak
- International Institute for Applied Systems Analysis, Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna)
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24
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Penfold RS, Zazzara MB, Österdahl MF, Welch C, Ni Lochlainn M, Freidin MB, Bowyer RCE, Thompson E, Antonelli M, Tan YXR, Sudre CH, Modat M, Murray B, Wolf J, Ourselin S, Veenith T, Lord JM, Steves CJ. Individual factors including age, BMI and heritable factors underlie temperature variation in sickness and in health: an observational, multi-cohort study. J Gerontol A Biol Sci Med Sci 2021; 77:1890-1897. [PMID: 34609487 PMCID: PMC8513412 DOI: 10.1093/gerona/glab295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
Background Aging affects immunity, potentially altering fever response to infection. We assess effects of biological variables on basal temperature, and during COVID-19 infection, proposing an updated temperature threshold for older adults ≥65 years. Methods Participants were from 4 cohorts: 1 089 unaffected adult TwinsUK volunteers; 520 adults with emergency admission to a London hospital with RT-PCR confirmed SARS-CoV-2 infection; 757 adults with emergency admission to a Birmingham hospital with RT-PCR confirmed SARS-CoV-2 infection and 3 972 adult community-based COVID Symptom Study participants self-reporting a positive RT-PCR test. Heritability was assessed using saturated and univariate ACE models; mixed-effect and multivariable linear regression examined associations between temperature, age, sex, and body mass index (BMI); multivariable logistic regression examined associations between fever (≥37.8°C) and age; receiver operating characteristic (ROC) analysis was used to identify temperature threshold for adults ≥ 65 years. Results Among unaffected volunteers, lower BMI (p = .001), and increasing age (p < .001) was associated with lower basal temperature. Basal temperature showed a heritability of 47% (95% confidence interval 18%–57%). In COVID-19+ participants, increasing age was associated with lower temperatures in Birmingham and community-based cohorts (p < .001). For each additional year of age, participants were 1% less likely to demonstrate a fever ≥37.8°C (OR 0.99; p < .001). Combining healthy and COVID-19+ participants, a temperature of 37.4°C in adults ≥65 years had similar sensitivity and specificity to 37.8°C in adults <65 years for discriminating infection. Conclusions Aging affects temperature in health and acute infection, with significant heritability, indicating genetic factors contribute to temperature regulation. Our observations suggest a lower threshold (37.4°C/97.3°F) for identifying fever in older adults ≥65 years.
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Affiliation(s)
- Rose S Penfold
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London.,Guy's and St Thomas' NHS Foundation Trust
| | - Maria Beatrice Zazzara
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London.,Department of Gerontology, Neuroscience and Orthopedics, Sacred Heart Catholic University, Rome, Italy
| | | | | | - Carly Welch
- Institute of Inflammation and Ageing, University of Birmingham, B15 2TT, Birmingham, UK
| | - Mary Ni Lochlainn
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London
| | - Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London
| | - Ruth C E Bowyer
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London
| | - Ellen Thompson
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London
| | - Michela Antonelli
- School of Biomedical Engineering and Imaging Sciences, King's College London, SE17EH, London, UK
| | - Yu Xian Rachel Tan
- Department of Medicine, Royal College of Surgeons in Ireland, 123 St Stephen Green, Dublin 2, Ireland
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, SE17EH, London, UK
| | - Marc Modat
- School of Biomedical Engineering and Imaging Sciences, King's College London, SE17EH, London, UK
| | - Benjamin Murray
- School of Biomedical Engineering and Imaging Sciences, King's College London, SE17EH, London, UK
| | | | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, SE17EH, London, UK
| | - Tonny Veenith
- Institute of Inflammation and Ageing, University of Birmingham, B15 2TT, Birmingham, UK
| | - Janet M Lord
- Institute of Inflammation and Ageing, University of Birmingham, B15 2TT, Birmingham, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London
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25
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Vecellio DJ, Bardenhagen EK, Lerman B, Brown RD. The role of outdoor microclimatic features at long-term care facilities in advancing the health of its residents: An integrative review and future strategies. ENVIRONMENTAL RESEARCH 2021; 201:111583. [PMID: 34192557 DOI: 10.1016/j.envres.2021.111583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/18/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Projections show that Earth's climate will continue to warm concurrent with increases in the percentage of the world's elderly population. With an understanding that the body's resilience to the heat degrades as it ages, these coupled phenomena point to serious concerns of heat-related mortality in growing elderly populations. As many of the people in this age cohort choose to live in managed long-term care facilities, it's imperative that outdoor spaces of these communities be made thermally comfortable so that connections with nature and the promotion of non-sedentary activities are maintained. Studies have shown that simply being outside has a positive impact on a broad range of the psychosocial well-being of older adults. However, these spaces must be designed to afford accessibility, safety, and aesthetically pleasing experiences so that they are taken full advantage of. Here, we employ an integrative review to link ideas from the disciplines of climate science, health and physiology, and landscape architecture to explain the connections between heat, increased morbidity and mortality in aging adults, existing gaps in thermal comfort models, and key strategies in the development of useable, comfortable outdoor spaces for older adults. Integrative reviews allow for new frameworks or perspectives on a subject to be introduced. Uncovering the synergy of these three knowledge bases can contribute to guiding microclimatic research, design practitioners, and care providers as they seek safe, comfortable and inviting outdoor spaces for aging adults.
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Affiliation(s)
- Daniel J Vecellio
- Climate Science Lab, Department of Geography, Texas A&M University, College Station, TX, USA.
| | - Eric K Bardenhagen
- Department of Plant and Soil Sciences, University of Delaware, Newark, DE, USA; Center for Health Systems & Design, Texas A&M University, College Station, TX, USA
| | - Ben Lerman
- Department of Biological Sciences, Hunter College of the City University of New York, New York, NY, USA
| | - Robert D Brown
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA; Center for Health Systems & Design, Texas A&M University, College Station, TX, USA
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26
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Lazarova D, Bordonaro M. Multifactorial causation of early onset colorectal cancer. J Cancer 2021; 12:6825-6834. [PMID: 34659571 PMCID: PMC8517991 DOI: 10.7150/jca.63676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/14/2021] [Indexed: 12/13/2022] Open
Abstract
The multiple-hit hypothesis of cancer, including colorectal cancer (CRC), states that neoplastic development requires a sequence of mutations and epigenetic changes in driver genes. We have previously proposed that obesity increases CRC risk by supporting neoplastic development through adipokine-induced signaling, and this proliferative signaling substitutes for specific driver gene mutations. In support of this hypothesis, analyses of The Cancer Genome Atlas (TCGA) mutation data have revealed that obese patients with microsatellite stable CRC exhibit fewer driver gene mutations than CRC patients with normal body mass index. The lower number of driver gene mutations required for cancer development may shorten the neoplastic process and lead to an early onset of CRC. Therefore, obesity could be one factor explaining the rise of CRC incidence among younger individuals (< 50 years of age); furthermore, early onset CRC has been associated with the increasing incidence of metabolic syndrome and obesity in this age group. However, CRC incidence among older individuals (> 50 years of age) is stable or declining, despite the high rates of metabolic syndrome and obesity in this age group. In search for explanations of this phenomenon, we discuss several factors that may contribute to the divergent CRC incidence trends in populations under, and above, the age of 50, despite the rising levels of metabolic syndrome and obesity across all ages. First, older individuals with metabolic dysregulation are more frequently on maintenance medications, such as aspirin, β-blockers, lipid-lowering drugs, ACE inhibitors, metformin, etc., compared to younger individuals. Such treatments may suppress specific adipokine-induced proliferative signaling pathways, and therefore counteract and slow down neoplastic development in medicated overweight/obese individuals. Second, in the past decades, the incidence of infectious diseases accompanied by febrile episodes has been decreasing and the use of antipyretics increasing. Compared to normal cells, neoplastic cells are more sensitive to high body temperature; therefore, the decreased number of febrile episodes in childhood and adolescence may contribute to increased cancer incidence before the age of 50. Third, obesity at younger age may expand the stem cell compartment. An increased number of intestinal stem cells and stem cell divisions translates into a higher probability of sporadic mutations in the stem cells, and therefore, a greater chance of neoplasia. In conclusion, we hypothesize that early onset CRC has multifactorial causation and the proposed associations could be examined through analyses of existing data.
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Affiliation(s)
| | - Michael Bordonaro
- Department of Medical Education, Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA 18509, USA
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Kim SH, Choi HS, Jin ES, Choi H, Lee H, Lee SH, Lee CY, Lee MG, Kim Y. Predicting severe outcomes using national early warning score (NEWS) in patients identified by a rapid response system: a retrospective cohort study. Sci Rep 2021; 11:18021. [PMID: 34504146 PMCID: PMC8429773 DOI: 10.1038/s41598-021-97121-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/20/2021] [Indexed: 12/26/2022] Open
Abstract
There are insufficient data in managing patients at high risk of deterioration. We aimed to investigate that national early warning score (NEWS) could predict severe outcomes in patients identified by a rapid response system (RRS), focusing on the patient’s age. We conducted a retrospective cohort study from June 2019 to December 2020. Outcomes were unplanned intensive care unit (ICU) admission, ICU mortality, and in-hospital mortality. We analyzed the predictive ability of NEWS using receiver operating characteristics (ROC) curve and the effect of NEWS parameters using multivariable logistic regression. A total of 2,814 RRS activations were obtained. The predictive ability of NEWS for unplanned ICU admission and in-hospital mortality was fair but was poor for ICU mortality. The predictive ability of NEWS showed no differences between patients aged 80 years or older and under 80 years. However, body temperature affected in-hospital mortality for patients aged 80 years or older, and the inverse effect on unplanned ICU admission was observed. The NEWS showed fair predictive ability for unplanned ICU admission and in-hospital mortality among patients identified by the RRS. The different presentations of patients 80 years or older should be considered in implementing the RRS.
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Affiliation(s)
- Sang Hyuk Kim
- Division of Pulmonology and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Suk Choi
- Department of Rapid Response Team, Advanced Practice Nurse, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Eun Suk Jin
- Department of Rapid Response Team, Advanced Practice Nurse, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Hwa Lee
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Chang Youl Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro, Chuncheon, Gangwon-do, 24253, Korea
| | - Myung Goo Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro, Chuncheon, Gangwon-do, 24253, Korea
| | - Youlim Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro, Chuncheon, Gangwon-do, 24253, Korea.
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Renzini A, Riera CS, Minic I, D’Ercole C, Lozanoska-Ochser B, Cedola A, Gigli G, Moresi V, Madaro L. Metabolic Remodeling in Skeletal Muscle Atrophy as a Therapeutic Target. Metabolites 2021; 11:517. [PMID: 34436458 PMCID: PMC8398298 DOI: 10.3390/metabo11080517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 02/07/2023] Open
Abstract
Skeletal muscle is a highly responsive tissue, able to remodel its size and metabolism in response to external demand. Muscle fibers can vary from fast glycolytic to slow oxidative, and their frequency in a specific muscle is tightly regulated by fiber maturation, innervation, or external causes. Atrophic conditions, including aging, amyotrophic lateral sclerosis, and cancer-induced cachexia, differ in the causative factors and molecular signaling leading to muscle wasting; nevertheless, all of these conditions are characterized by metabolic remodeling, which contributes to the pathological progression of muscle atrophy. Here, we discuss how changes in muscle metabolism can be used as a therapeutic target and review the evidence in support of nutritional interventions and/or physical exercise as tools for counteracting muscle wasting in atrophic conditions.
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Affiliation(s)
- Alessandra Renzini
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
| | - Carles Sánchez Riera
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
| | - Isidora Minic
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
| | - Chiara D’Ercole
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
| | - Biliana Lozanoska-Ochser
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
| | - Alessia Cedola
- Institute of Nanotechnology, c/o Dipartimento di Fisica, National Research Council (CNR-NANOTEC), Sapienza University of Rome, 00185 Rome, Italy;
| | - Giuseppe Gigli
- Institute of Nanotechnology, c/o Campus Ecotekne, National Research Council (CNR-NANOTEC), Monteroni, 73100 Lecce, Italy;
| | - Viviana Moresi
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
- Institute of Nanotechnology, c/o Dipartimento di Fisica, National Research Council (CNR-NANOTEC), Sapienza University of Rome, 00185 Rome, Italy;
| | - Luca Madaro
- Unit of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (C.S.R.); (I.M.); (C.D.); (B.L.-O.); (L.M.)
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Singler K, Heppner HJ. Notfallmedizin im Alter. BASISKURS GERIATRIE 2021. [PMCID: PMC8327598 DOI: 10.1007/s40407-021-00014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Katrin Singler
- Klinik für Innere Medizin – Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Prof. Ernst-Nathan-Str. 1, 90419 Nürnberg, Deutschland ,Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland
| | - Hans Jürgen Heppner
- Geriatrische Klinik und Tagesklinik, HELIOS Klinikum Schwelm, Dr.-Moeller-Straße 15, 58332 Schwelm, Deutschland ,Universität Witten/Herdecke, Witten/Herdecke, Deutschland
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Vijg J. From DNA damage to mutations: All roads lead to aging. Ageing Res Rev 2021; 68:101316. [PMID: 33711511 PMCID: PMC10018438 DOI: 10.1016/j.arr.2021.101316] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/20/2022]
Abstract
Damage to the repository of genetic information in cells has plagued life since its very beginning 3-4 billion years ago. Initially, in the absence of an ozone layer, especially damage from solar UV radiation must have been frequent, with other sources, most notably endogenous sources related to cell metabolism, gaining in importance over time. To cope with this high frequency of damage to the increasingly long DNA molecules that came to encode the growing complexity of cellular functions in cells, DNA repair evolved as one of the earliest genetic traits. Then as now, errors during the repair of DNA damage generated mutations, which provide the substrate for evolution by natural selection. With the emergence of multicellular organisms also the soma became a target of DNA damage and mutations. In somatic cells selection against the adverse effects of DNA damage is greatly diminished, especially in postmitotic cells after the age of first reproduction. Based on an abundance of evidence, DNA damage is now considered as the single most important driver of the degenerative processes that collectively cause aging. Here I will first briefly review the evidence for DNA damage as a cause of aging since the beginning of life. Then, after discussing the possible direct adverse effects of DNA damage and its cellular responses, I will provide an overview of the considerable progress that has recently been made in analyzing a major consequence of DNA damage in humans and other complex organisms: somatic mutations and the resulting genome mosaicism. Recent advances in studying somatic mutagenesis and genome mosaicism in different human and animal tissues will be discussed with a focus on the possible mechanisms through which loss of DNA sequence integrity could cause age-related functional decline and disease.
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Affiliation(s)
- Jan Vijg
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA; Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
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Sippli K, Schmalzried P, Rieger MA, Voelter-Mahlknecht S. Challenges arising for older workers from participating in a workplace intervention addressing work ability: a qualitative study from Germany. Int Arch Occup Environ Health 2021; 94:919-933. [PMID: 33491100 PMCID: PMC8238737 DOI: 10.1007/s00420-020-01639-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 12/18/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Studies examining what renders workplace interventions to sustain and promote work ability of older workers successful have largely neglected older workers´ perspective. This paper outlines the results of a study with regard to older workers´ experiences and expectations of a workplace intervention. Based on these findings, some reflections on how to improve the design and the implementation of workplace interventions for older workers are provided. METHODS Semi-structured interviews were conducted with older workers (N = 8) participating in a workplace intervention undertaken at one production site of a large manufacturing company in Baden-Wurttemberg/Germany. The interview guide included questions on participants´ experiences with and expectations of the intervention. The interviews were recorded, transcribed verbatim and analyzed using qualitative content analysis according to Mayring (2014). RESULTS Older workers´ reported some challenges they face due to their participation in the workplace intervention. These resulted from the work environment (physical challenges), the work process design (new long work cycle), the work organization (tight time allowances, little job rotation, change of teams, age stereotypes) and the management of the workplace intervention (bad information, feeling of occupational insecurity and lack of being valued). CONCLUSIONS The study shows that challenges arising for older workers from their participation in the workplace intervention may have counteracted the promotion of work ability. As findings suggest, some of these challenges might have been avoided either by considering workers´ perspective during design and implementation of an intervention or by referring to evidence on aging and work ability.
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Affiliation(s)
- Khira Sippli
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraße 27, 72074, Tübingen, Germany
- Institute for Applied Economic Research at the University Tuebingen, Schaffhausenstr. 73, 72072, Tuebingen, Germany
| | - Pia Schmalzried
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Susanne Voelter-Mahlknecht
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
- Institute of Occupational Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
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Boratyński Z, Mousseau TA, Møller AP. Individual quality and phenology mediate the effect of radioactive contamination on body temperature in Chernobyl barn swallows. Ecol Evol 2021; 11:9039-9048. [PMID: 34257943 PMCID: PMC8258232 DOI: 10.1002/ece3.7742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022] Open
Abstract
Anthropogenic stressors, such as radioactive contaminants released from the Chernobyl and Fukushima Daiichi accidents, deteriorate ecological and evolutionary processes, as evidence for damaging effects of radioactive contamination on wildlife is accumulating. Yet little is known about physiological traits of animals inhabiting contaminated areas, and how those are affected by individual quality and phenology. We investigated variation in body temperature of wild barn swallows, Hirundo rustica, exposed to radioactive contamination from the Chernobyl accident in Ukraine and Belarus. We tested whether exposure to variable levels of radioactive contamination modified core body temperature of birds, and whether individual and phenological characteristics modulated radiosensitivity of body temperature. We showed that barn swallow body temperature varied with exposure to environmental radioactive contamination and that individual characteristics and phenology affected radioactive exposure. Increased radiosensitivity and up-regulation of body temperature were detected in birds of low body condition, high risk of capture, and in animals captured late during the day but early during the season. These results highlight the complex ways that the body temperature of a wild bird is impacted by exposure to increased radioactive contamination in natural habitats. By impacting body temperature, increased radioactive contamination may compromise energetic balance, jeopardize responsiveness to global warming, and increase risk of overheating.
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Affiliation(s)
- Zbyszek Boratyński
- CIBIO/InBioResearch Centre in Biodiversity and Genetic ResourcesUniversity of PortoPortoPortugal
| | - Timothy A. Mousseau
- Department of Biological SciencesUniversity of South CarolinaColumbiaSCUSA
- SURA/LASSO/NASAISS Utilization and Life Sciences DivisionKennedy Space CenterCape CanaveralFLUSA
| | - Anders Pape Møller
- Ministry of Education Key Laboratory for Biodiversity Science and Ecological EngineeringCollege of Life SciencesBeijing Normal UniversityBeijingChina
- Ecologie Systematique EvolutionCNRSAgroParisTechUniversite Paris‐SaclayOrsayFrance
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Ray M, Carney HC, Boynton B, Quimby J, Robertson S, St Denis K, Tuzio H, Wright B. 2021 AAFP Feline Senior Care Guidelines. J Feline Med Surg 2021; 23:613-638. [PMID: 34167339 PMCID: PMC10812122 DOI: 10.1177/1098612x211021538] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The '2021 AAFP Feline Senior Care Guidelines' are authored by a Task Force of experts in feline clinical medicine and serve as an update and extension of those published in 2009. They emphasize the individual patient evaluation and the process of aging, with references to other feline practice guidelines for a more complete discussion of specific diseases. Focusing on each cat encourages and empowers the owner to become a part of the cat's care every step of the way. A comprehensive discussion during the physical examination and history taking allows for tailoring the approach to both the cat and the family involved in the care. Videos and analysis of serial historical measurements are brought into the assessment of each patient. These Guidelines introduce the emerging concept of frailty, with a description and methods of its incorporation into the senior cat assessment. Minimum database diagnostics are discussed, along with recommendations for additional investigative considerations. For example, blood pressure assessment is included as a minimum diagnostic procedure in both apparently healthy and ill cats. Cats age at a much faster rate than humans, so practical timelines for testing frequency are included and suggest an increased frequency of diagnostics with advancing age. The importance of nutrition, as well as senior cat nutritional needs and deficiencies, is considered. Pain is highlighted as its own syndrome, with an emphasis on consideration in every senior cat. The Task Force discusses anesthesia, along with strategies to allow aging cats to be safely anesthetized well into their senior years. The medical concept of quality of life is addressed with the latest information available in veterinary medicine. This includes end of life considerations like palliative and hospice care, as well as recommendations on the establishment of 'budgets of care', which greatly influence what can be done for the individual cat. Acknowledgement is given that each cat owner will be different in this regard; and establishing what is reasonable and practical for the individual owner is important. A discussion on euthanasia offers some recommendations to help the owner make a decision that reflects the best interests of the individual cat.
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Affiliation(s)
| | - Hazel C Carney
- WestVet Emergency and Specialty Center, Garden City, ID, USA
| | - Beth Boynton
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Jessica Quimby
- The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, USA
| | - Sheilah Robertson
- Senior Medical Director, Lap of Love Veterinary Hospice, Lutz, FL, USA
| | | | - Helen Tuzio
- Forest Hills Cat Hospital, Middle Village, NY, USA
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Abstract
This paper investigates the relationship between the actual thermal comfort levels measured according to EN 16798-1 standard and the expected thermal comfort of attendees in five parish churches throughout 2018. This is carried out through statistical analysis of qualitative research based on questionnaire responses from church goers and quantitative research based on indoor measured data. This investigation includes the gathering of scientific data relating to temperature and relative humidity together with statistical data through thermal sensation surveys (TSSs). Thus, this study provides first-hand information about occupants’ diversities of thermal sensations and dynamic behaviour adaptations to the intricate environment within churches. Results determine that a significant correlation exists between the actual thermal comfort levels measured according to EN 16798-1 standard and the expected thermal comfort perceived by the church attendees in most of the parish churches under review. Analysis of the sources of discomfort and suggestions made by the occupants revealed that passive design measures contribute towards improved indoor thermal conditions, reduced energy demand and lower carbon emissions. This information provides assurance for optimised decision-making methods, used to generate accurate solutions for policy-makers, architects and engineers, with an understanding of practical applications of passive measures for places of worship. Moreover, the paper provides insight on indoor comfort levels in places of worship within a Mediterranean context, which is insufficiently addressed by scholars at a global level.
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Toledo LV, Santos BXD, Salgado PDO, Souza LMD, Brinati LM, Januário CDF, Ercole FF. Changes in body temperature of critically ill patients submitted to bed bathing: a crossover clinical trial. Rev Bras Enferm 2021; 74:e20200969. [PMID: 34037151 DOI: 10.1590/0034-7167-2020-0969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/01/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to compare tympanic and axillary body temperature values of critical patients before and after the traditional and dry bed bath. METHODS this is a randomized, open crossover clinical trial conducted with 50 adult critical patients. All patients received both types of bed bathing. The tympanic and axillary temperature values were measured at the beginning and end of the baths. The Wilcoxon test or paired Student's t test was used. RESULTS elderly and male patients predominated. There was no significant difference between tympanic temperature medians measured during the traditional bed bath (p=0.707) and dry bath (p=0.101). Axillary temperature means reduced at the end of the baths (p=0.001), being 36.12ºC in the traditional bath and 35.92ºC in dry bath. CONCLUSIONS bed bath, regardless of the method used, caused a reduction in critical patients' axillary temperature.
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Affiliation(s)
| | | | | | | | | | - Carla de Fátima Januário
- Universidade Federal de Minas Gerais, Hospital das Clínicas. Belo Horizonte, Minas Gerais, Brazil
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Ma X, Tian Y, Du M, Hong B, Lin B. How to design comfortable open spaces for the elderly? Implications of their thermal perceptions in an urban park. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 768:144985. [PMID: 33736312 DOI: 10.1016/j.scitotenv.2021.144985] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
Elderly residents are prominent users of urban parks and comfortable open spaces in parks have been shown to improve their physical health and mental well-being. In this study, the thermal perceptions (thermal sensation, thermal comfort and thermal acceptability) of elderly visitors to an urban park in Xi'an, China was investigated using meteorological measurements, questionnaire surveys and activity records. Physiological equivalent temperature (PET) was used to determine thermal benchmarks. Spatial-temporal distributions of the elderly in open spaces were recorded and relationships among elderly residents' thermal perceptions, their age and chronic disease were analyzed. Finally, optimal design strategies for open spaces suitable for the elderly were proposed based on meteorological characteristics, elderly residents' attendance patterns and their thermal perceptions. Results showed that: 1) globe temperature (Tg) and air temperature (Ta) were the primary meteorological factors that influenced elderly residents' thermal sensation while clothing insulation and activity intensity were negatively correlated with their thermal sensation. 2) Attendance was significantly affected by the outdoor microclimate, space functionality and facilities in spaces. The elderly mainly participated in dynamic activities and social interaction. 3) The neutral PET (NPET) was 13.2 °C, with NPET range (NPETR) of 3.1-23.2 °C. The 90% thermal acceptable PET ranged between 10.9 and 25.9 °C, and the preferred PET was 14.4 °C. Compared with the ISO7730 standard, the predicted percentage of dissatisfied (PPD) elderly park users was lower than users of indoor spaces when -1 ≤ MTSV ≤ + 1, indicating that the elderly preferred to conduct activities outside when the environment was comfortable. Additionally, NPET for the elderly with respiratory disease was higher than those with cardiovascular diseases and diabetes. 4) Optimal design strategies for open spaces were proposed for elderly residents based on their physical, physiological and psychological preferences.
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Affiliation(s)
- Xiaoyan Ma
- College of Landscape Architecture & Arts, Northwest A&F University, Yangling 712100, China
| | - Yu Tian
- College of Landscape Architecture & Arts, Northwest A&F University, Yangling 712100, China
| | - Meng Du
- College of Landscape Architecture & Arts, Northwest A&F University, Yangling 712100, China
| | - Bo Hong
- College of Landscape Architecture & Arts, Northwest A&F University, Yangling 712100, China.
| | - Borong Lin
- School of Architecture, Tsinghua University, Beijing 100084, China; Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, China
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Van Son CR, Eti DU. Screening for COVID-19 in Older Adults: Pulse Oximeter vs. Temperature. Front Med (Lausanne) 2021; 8:660886. [PMID: 33937297 PMCID: PMC8079646 DOI: 10.3389/fmed.2021.660886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/23/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Catherine R. Van Son
- College of Nursing, Washington State University-Vancouver, Vancouver, WA, United States
| | - Deborah U. Eti
- College of Nursing, Washington State University-Spokane, Spokane, WA, United States
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Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev 2021; 101:1873-1979. [PMID: 33829868 DOI: 10.1152/physrev.00038.2020] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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Affiliation(s)
- Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Probing Skin Barrier Recovery on Molecular Level Following Acute Wounds: An In Vivo/Ex Vivo Study on Pigs. Biomedicines 2021; 9:biomedicines9040360. [PMID: 33807251 PMCID: PMC8065685 DOI: 10.3390/biomedicines9040360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 11/17/2022] Open
Abstract
Proper skin barrier function is paramount for our survival, and, suffering injury, there is an acute need to restore the lost barrier and prevent development of a chronic wound. We hypothesize that rapid wound closure is more important than immediate perfection of the barrier, whereas specific treatment may facilitate perfection. The aim of the current project was therefore to evaluate the quality of restored tissue down to the molecular level. We used Göttingen minipigs with a multi-technique approach correlating wound healing progression in vivo over three weeks, monitored by classical methods (e.g., histology, trans-epidermal water loss (TEWL), pH) and subsequent physicochemical characterization of barrier recovery (i.e., small and wide-angle X-ray diffraction (SWAXD), polarization transfer solid-state NMR (PTssNMR), dynamic vapor sorption (DVS), Fourier transform infrared (FTIR)), providing a unique insight into molecular aspects of healing. We conclude that although acute wounds sealed within two weeks as expected, molecular investigation of stratum corneum (SC) revealed a poorly developed keratin organization and deviations in lipid lamellae formation. A higher lipid fluidity was also observed in regenerated tissue. This may have been due to incomplete lipid conversion during barrier recovery as glycosphingolipids, normally not present in SC, were indicated by infrared FTIR spectroscopy. Evidently, a molecular approach to skin barrier recovery could be a valuable tool in future development of products targeting wound healing.
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Briga M, Verhulst S. Mosaic metabolic ageing: Basal and standard metabolic rates age in opposite directions and independent of environmental quality, sex and life span in a passerine. Funct Ecol 2021. [DOI: 10.1111/1365-2435.13785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Michael Briga
- Groningen Institute for Evolutionary Life Sciences University of Groningen Groningen The Netherlands
| | - Simon Verhulst
- Groningen Institute for Evolutionary Life Sciences University of Groningen Groningen The Netherlands
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Eggenberger P, Bürgisser M, Rossi RM, Annaheim S. Body Temperature Is Associated With Cognitive Performance in Older Adults With and Without Mild Cognitive Impairment: A Cross-sectional Analysis. Front Aging Neurosci 2021; 13:585904. [PMID: 33643019 PMCID: PMC7907648 DOI: 10.3389/fnagi.2021.585904] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/19/2021] [Indexed: 12/17/2022] Open
Abstract
Wearable devices for remote and continuous health monitoring in older populations frequently include sensors for body temperature measurements (i.e., skin and core body temperatures). Healthy aging is associated with core body temperatures that are in the lower range of age-related normal values (36.3 ± 0.6°C, oral temperature), while patients with Alzheimer's disease (AD) exhibit core body temperatures above normal values (up to 0.2°C). However, the relation of body temperature measures with neurocognitive health in older adults remains unknown. This study aimed to explore the association of body temperature with cognitive performance in older adults with and without mild cognitive impairment (MCI). Eighty community-dwelling older adults (≥65 years) participated, of which 54 participants were cognitively healthy and 26 participants met the criteria for MCI. Skin temperatures at the rib cage and the scapula were measured in the laboratory (single-point measurement) and neuropsychological tests were conducted to assess general cognitive performance, episodic memory, verbal fluency, executive function, and processing speed. In a subgroup (n = 15, nine healthy, six MCI), skin and core body temperatures were measured continuously during 12 h of habitual daily activities (long-term measurement). Spearman's partial correlation analyses, controlled for age, revealed that lower median body temperature and higher peak-to-peak body temperature amplitude was associated with better general cognitive performance and with better performance in specific domains of cognition; [e.g., rib median skin temperature (single-point) vs. processing speed: rs = 0.33, p = 0.002; rib median skin temperature (long-term) vs. executive function: rs = 0.56, p = 0.023; and peak-to-peak core body temperature amplitude (long-term) vs. episodic memory: rs = 0.51, p = 0.032]. Additionally, cognitively healthy older adults showed lower median body temperature and higher peak-to-peak body temperature amplitude compared to older adults with MCI (e.g., rib median skin temperature, single-point: p = 0.035, r = 0.20). We conclude that both skin and core body temperature measures are potential early biomarkers of cognitive decline and preclinical symptoms of MCI/AD. It may therefore be promising to integrate body temperature measures into multi-parameter systems for the remote and continuous monitoring of neurocognitive health in older adults.
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Affiliation(s)
- Patrick Eggenberger
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Michael Bürgisser
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - René M. Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Simon Annaheim
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
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Interrelationship of Seasons with Inflammation, Red Meat, Fruit, and Vegetable Intakes, Cardio-Metabolic Health, and Smoking Status among Breast Cancer Survivors. J Clin Med 2021; 10:jcm10040636. [PMID: 33562354 PMCID: PMC7915094 DOI: 10.3390/jcm10040636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/18/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Seasons can affect human inflammatory status and the occurrence of diseases, and foods may also have differential impacts on inflammation across seasons; however, few studies have investigated whether there are independent and joint impacts of seasons and red meat, fruit and vegetable intakes on inflammation in breast cancer survivors. We conducted a cross-sectional study by leveraging a large cohort, the Women’s Healthy Eating and Living (WHEL) study. The WHEL study comprised primarily early stage breast cancer survivors and collected blood samples, dietary intake, demographic, and health status information at baseline. We selected 2919 participants who provided baseline dietary information and had measurement of C-reactive protein (CRP), a general marker of inflammation. In our multivariable-adjusted analyses, we found that red meat intakes were positively associated, while fruit and vegetable intakes were inversely associated with CRP; blood collected in the winter season was associated with lower CRP when compared to summer; and increased smoking intensity and body mass index (BMI) as well as having cardio-metabolic conditions (such as heart disease or diabetes) were positively associated with CRP. Furthermore, we examined the joint associations of food intakes and the season of blood draw with CRP in different subgroups. We found that moderate intakes of red meat were associated with a reduction of CRP in winter but not in other seasons; increased intakes of fruit and vegetables were associated with reduced inflammation in most seasons except winter. These associations were observed in most subgroups except past smokers with pack-years ≥ 15, in whom we observed no benefit of red meat intakes in winter. Our study provides valuable evidence for considering seasonal impacts on inflammation and seasonal food impacts in different subgroups among breast cancer survivors. The results of our study are in line with one of the emphases of the current NIH 2020–2030 nutrition strategy plan—namely, pay attention to what, when, and who should eat.
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Thermal Personalities of Older People in South Australia: A Personas-Based Approach to Develop Thermal Comfort Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228402. [PMID: 33202798 PMCID: PMC7698095 DOI: 10.3390/ijerph17228402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
An important consideration for future age-friendly cities is that older people are able to live in housing appropriate for their needs. While thermal comfort in the home is vital for the health and well-being of older people, there are currently few guidelines about how to achieve this. This study is part of a research project that aims to improve the thermal environment of housing for older Australians by investigating the thermal comfort of older people living independently in South Australia and developing thermal comfort guidelines for people ageing-in-place. This paper describes the approach fundamental for developing the guidelines, using data from the study participants' and the concept of personas to develop a number of discrete "thermal personalities". Hierarchical Cluster Analysis (HCA) was implemented to analyse the features of research participants, resulting in six distinct clusters. Quantitative and qualitative data from earlier stages of the project were then used to develop the thermal personalities of each cluster. The thermal personalities represent different approaches to achieving thermal comfort, taking into account a wide range of factors including personal characteristics, ideas, beliefs and knowledge, house type, and location. Basing the guidelines on thermal personalities highlights the heterogeneity of older people and the context-dependent nature of thermal comfort in the home and will make the guidelines more user-friendly and useful.
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Pre-hospital predictors of an adverse outcome among patients with dyspnoea as the main symptom assessed by pre-hospital emergency nurses - a retrospective observational study. BMC Emerg Med 2020; 20:89. [PMID: 33172409 PMCID: PMC7653705 DOI: 10.1186/s12873-020-00384-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/30/2020] [Indexed: 01/10/2023] Open
Abstract
Background Dyspnoea is one of the most common reasons for patients contacting emergency medical services (EMS). Pre-hospital Emergency Nurses (PENs) are independently responsible for advanced care and to meet these patients individual needs. Patients with dyspnoea constitute a complex group, with multiple different final diagnoses and with a high risk of death. This study aimed to describe on-scene factors associated with an increased risk of a time-sensitive final diagnosis and the risk of death. Methods A retrospective observational study including patients aged ≥16 years, presenting mainly with dyspnoea was conducted. Patients were identified thorough an EMS database, and were assessed by PENs in the south-western part of Sweden during January to December 2017. Of 7260 missions (9% of all primary missions), 6354 were included. Among those, 4587 patients were randomly selected in conjunction with adjusting for unique patients with single occasions. Data were manually collected through both EMS- and hospital records and final diagnoses were determined through the final diagnoses verified in hospital records. Analysis was performed using multiple logistic regression and multiple imputations. Results Among all unique patients with dyspnoea as the main symptom, 13% had a time-sensitive final diagnosis. The three most frequent final time-sensitive diagnoses were cardiac diseases (4.1% of all diagnoses), infectious/inflammatory diseases (2.6%), and vascular diseases (2.4%). A history of hypertension, renal disease, symptoms of pain, abnormal respiratory rate, impaired consciousness, a pathologic ECG and a short delay until call for EMS were associated with an increased risk of a time-sensitive final diagnosis. Among patients with time-sensitive diagnoses, approximately 27% died within 30 days. Increasing age, a history of renal disease, cancer, low systolic blood pressures, impaired consciousness and abnormal body temperature were associated with an increased risk of death. Conclusions Among patients with dyspnoea as the main symptom, age, previous medical history, deviating vital signs, ECG pattern, symptoms of pain, and a short delay until call for EMS are important factors to consider in the prehospital assessment of the combined risk of either having a time-sensitive diagnosis or death. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12873-020-00384-1.
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Koleini E, Cohen JS, Darwish OM, Pourafkari L, Rein L, Nader ND. Perioperative Hypothermia after Transurethral Surgeries: Is it Necessary to Heat the Irrigation Fluids? Turk J Anaesthesiol Reanim 2020; 48:391-398. [PMID: 33103144 PMCID: PMC7556645 DOI: 10.5152/tjar.2019.61214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 10/14/2019] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the role of heated irrigation fluids in the risk of hypothermia and related complications in patients undergoing transurethral procedures. Methods The medical records of all patients who underwent transurethral procedures between 2000 and 2016 at the VA Hospital were reviewed. Irrigation fluids have been heated to 42°C since 2013, as per the institutional policy (Group II). Prior to this date, room temperature solutions were used (Group I). The perioperative body temperature, use of warming devices, procedure length, and anaesthesia type were extracted from records and compared for both groups. In addition, demographic and anthropometric data, preoperative comorbidities, laboratory data, admission information and postoperative complications were obtained from the quality improvement database. Results There were 1,363 patients in Group I and 269 patients in Group II. Perioperative temperature was decreased by 0.10°C in Group I compared to a temperature gain of 0.32°C in Group II (p<0.001). Three hundred and forty-eight (21%) patients undergoing transurethral procedures developed hypothermia <36°C. There was no difference in the incidence of postoperative mortality or complications between the normothermic and hypothermic patients. Conclusion The replacement of room temperature solutions with warmed solutions for irrigation during transurethral procedures reduced the risk of temperature loss and hypothermia following these procedures. Available heating strategies effectively prevented the perioperative heat loss; however, such strategies did not affect the incidence of postoperative complications.
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Affiliation(s)
- Evin Koleini
- Department of Anaesthesiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jared S Cohen
- Department of Urology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Oussama M Darwish
- Department of Urology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Leili Pourafkari
- Department of Anaesthesiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Laura Rein
- SUNY Upstate Medical University, School of Medicine and Biomedical Sciences, NY, USA
| | - Nader D Nader
- Department of Anaesthesiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Matsuzaki S, Bonnin M, Fournet-Fayard A, Bazin JE, Botchorishvili R. Effects of Low Intraperitoneal Pressure on Quality of Postoperative Recovery after Laparoscopic Surgery for Genital Prolapse in Elderly Patients Aged 75 Years or Older. J Minim Invasive Gynecol 2020; 28:1072-1078.e3. [PMID: 32979535 DOI: 10.1016/j.jmig.2020.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/04/2020] [Accepted: 09/19/2020] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE Previous clinical trials for laparoscopic surgery have included few elderly patients aged ≥75 years. We aimed to evaluate the quality of postoperative recovery after laparoscopic surgery using low intraperitoneal pressure (IPP) (6 mm Hg) and warmed, humidified carbon dioxide gas for genital prolapse in elderly patients aged ≥75 years. DESIGN Prospective consecutive case series. SETTING University hospital. PATIENTS Consecutive patients (n = 30) aged ≥75 years planning to undergo laparoscopic surgery for genital prolapse by the same surgeon were recruited from October 2016 through December 2019. INTERVENTIONS Laparoscopic promontofixation for the treatment of genital prolapse was performed using low IPP and warmed, humidified carbon dioxide gas. When a promontory could not be easily identified, laparoscopic pectopexy was alternatively performed. MEASUREMENTS AND MAIN RESULTS The primary outcome was the Quality of Recovery-40 (QoR-40) score at 24 hours postoperatively. The secondary outcomes were postoperative pain using a 100-mm visual analog scale and the length of hospital stay after surgery (LHSS). For the global QoR-40 score and for 4 dimensions of the QoR-40, "emotional state," "physical comfort," "psychologic support," and "pain," no differences were observed between the baseline score and the score at 24 hours. The score for the "physical independence" dimension at 24 hours was significantly lower than the baseline score (p <.001). No patient had visual analog scale pain scores >30 out of 100 at 12 hours or later. LHSS was <48 hours in 22 patients (73.3%) and <72 hours in 8 patients (26.7%). Multivariable analysis showed that the odds of an LHSS >48 hours were more than 8 times higher in patients who were discharged from the operating room in the afternoon compared with those with a morning discharge. CONCLUSION The use of a low IPP is feasible, safe, and has clinical benefits for elderly patients aged ≥75 years who undergo laparoscopic surgery for genital prolapse.
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Affiliation(s)
- Sachiko Matsuzaki
- Department of Gynecologic Surgery, CHU Clermont-Ferrand (Drs. Matsuzaki and Botchorishvili); UMR6602, CNRS/UCA/SIGMA, Institute Pascal, University of Clermont Auvergne (Drs. Matsuzaki and Botchorishvili).
| | - Martine Bonnin
- Department of Perioperative Medicine, CHU Clermont-Ferrand (Drs. Bonnin, Fournet-Fayard, and Bazin), Clermont-Ferrand, France
| | - Aurelie Fournet-Fayard
- Department of Perioperative Medicine, CHU Clermont-Ferrand (Drs. Bonnin, Fournet-Fayard, and Bazin), Clermont-Ferrand, France
| | - Jean-Etienne Bazin
- Department of Perioperative Medicine, CHU Clermont-Ferrand (Drs. Bonnin, Fournet-Fayard, and Bazin), Clermont-Ferrand, France
| | - Revaz Botchorishvili
- Department of Gynecologic Surgery, CHU Clermont-Ferrand (Drs. Matsuzaki and Botchorishvili); UMR6602, CNRS/UCA/SIGMA, Institute Pascal, University of Clermont Auvergne (Drs. Matsuzaki and Botchorishvili)
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Childs C, Elliott J, Khatab K, Hampshaw S, Fowler-Davis S, Willmott JR, Ali A. Thermal Sensation in Older People with and without Dementia Living in Residential Care: New Assessment Approaches to Thermal Comfort Using Infrared Thermography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6932. [PMID: 32971989 PMCID: PMC7557728 DOI: 10.3390/ijerph17186932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 01/11/2023]
Abstract
The temperature of the indoor environment is important for health and wellbeing, especially at the extremes of age. The study aim was to understand the relationship between self-reported thermal sensation and extremity skin temperature in care home residents with and without dementia. The Abbreviated Mental Test (AMT) was used to discriminate residents to two categories, those with, and those without, dementia. After residents settled and further explanation of the study given (approximately 15 min), measurements included: tympanic membrane temperature, thermal sensation rating and infrared thermal mapping of non-dominant hand and forearm. Sixty-nine afebrile adults (60-101 years of age) were studied in groups of two to five, in mean ambient temperatures of 21.4-26.6 °C (median 23.6 °C). Significant differences were observed between groups; thermal sensation rating (p = 0.02), tympanic temperature (p = 0.01), fingertip skin temperature (p = 0.01) and temperature gradients; fingertip-wrist p = 0.001 and fingertip-distal forearm, p = 0.001. Residents with dementia were in significantly lower air temperatures (p = 0.001). Although equal numbers of residents per group rated the environment as 'neutral' (comfortable), resident ratings for 'cool/cold' were more frequent amongst those with dementia compared with no dementia. In parallel, extremity (hand) thermograms revealed visual temperature demarcation, variously across fingertip, wrist, and forearm commensurate with peripheral vasoconstriction. Infrared thermography provided a quantitative and qualitative method to measure and observe hand skin temperature across multiple regions of interest alongside thermal sensation self-report. As an imaging modality, infrared thermography has potential as an additional assessment technology with clinical utility to identify vulnerable residents who may be unable to communicate verbally, or reliably, their satisfaction with indoor environmental conditions.
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Affiliation(s)
- Charmaine Childs
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.E.); (K.K.); (S.F.-D.)
| | - Jennifer Elliott
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.E.); (K.K.); (S.F.-D.)
| | - Khaled Khatab
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.E.); (K.K.); (S.F.-D.)
| | - Susan Hampshaw
- School of Health and Related Research (SCHARR), University of Sheffield, Sheffield S10 2TN, UK;
| | - Sally Fowler-Davis
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK; (J.E.); (K.K.); (S.F.-D.)
| | - Jon R. Willmott
- Electronic and Electrical Engineering Department, University of Sheffield, Sheffield S10 2TN, UK;
| | - Ali Ali
- Sheffield Teaching Hospitals, National Institute for Health Research (NIHR), Biomedical Research Centre, Sheffield S10 2JF, UK;
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Use of a Support Surface Standard to Test the Effects of a Turning and Positioning Device Versus Low-Air-Loss Therapy on Temperature and Humidity. Adv Skin Wound Care 2020; 33:S3-S10. [PMID: 32932289 DOI: 10.1097/01.asw.0000695744.57734.7c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Turning and repositioning devices (TRDs) help to reduce strain on caregivers, but clinicians question their effects on humidity and temperature (microclimate) at the skin surface that may increase risk of pressure ulcers. OBJECTIVE To pilot the use of a standard test for support surfaces to compare microclimate at the skin surface in three scenarios: (1) on a low-air-loss (LAL) surface, (2) on a representative TRD with a basic underpad (TRDU) placed on a LAL surface, and (3) on a negative control with full occlusion. The results are designed to inform clinical decision-making in using a TRD on a LAL surface and the viability of using this test to study TRDs. DESIGN Measuring humidity and temperature at the device-surface interface using a heated moisture-exuding bronze thermodynamic human model in a laboratory setting. MAIN OUTCOME MEASURE Humidity and temperature levels across 3 hours 15 minutes of continuous loading with a 45-second complete unloading to simulate a position change at 3 hours. MAIN RESULTS Relative humidity on the TRDU was below that on the LAL surface for the first 110 minutes and was markedly lower than the negative control for the remainder of humidity testing. Temperature on the TRDU was well below the negative control and negligibly higher than the surface alone throughout testing. The position change enhanced the effects of the TRDU. CONCLUSIONS The support surface standard test appears useful in evaluating TRDs. This TRD along with the basic underpad is more comparable to a LAL surface than to full occlusion in managing the microclimate of the skin and pressure ulcer risk.
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Fujimoto Y, Matsuyama T, Morita S, Ehara N, Miyamae N, Okada Y, Jo T, Sumida Y, Okada N, Watanabe M, Nozawa M, Tsuruoka A, Okumura Y, Kitamura T, Takegami T. Indoor Versus Outdoor Occurrence in Mortality of Accidental Hypothermia in Japan: The J-Point Registry. Ther Hypothermia Temp Manag 2020; 10:159-164. [DOI: 10.1089/ther.2019.0017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yoshihiro Fujimoto
- Department of Emergency Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sachiko Morita
- Senri Critical Care Medical Center, Saiseikai Senri Hospital, Suita, Japan
| | - Naoki Ehara
- Department of Emergency Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Nobuhiro Miyamae
- Department of Emergency Medicine, Rakuwa-kai Otowa Hospital, Kyoto, Japan
| | - Yohei Okada
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Society Kyoto Daini Red Cross Hospital, Kyoto, Japan
| | - Takaaki Jo
- Department of Emergency Medicine, Uji-Tokushukai Medical Center, Uji, Japan
| | - Yasuyuki Sumida
- Department of Emergency Medicine, North Medical Center, Kyoto Prefectural University of Medicine, Yosa-gun, Japan
| | - Nobunaga Okada
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Emergency and Critical Care Medicine, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Makoto Watanabe
- Department of Emergency Medicine, North Medical Center, Kyoto Prefectural University of Medicine, Yosa-gun, Japan
| | - Masahiro Nozawa
- Department of Emergency and Critical Care Medicine, Saiseikai Shiga Hospital, Ritto, Japan
| | - Ayumu Tsuruoka
- Department of Emergency and Critical Care Medicine, Kidney and Cardiovascular Center, Kyoto Min-iren Chuo Hospital, Kyoto, Japan
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Yoshiki Okumura
- Department of Emergency Medicine, Fukuchiyama City Hospital, Fukuchiyama, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tetsurou Takegami
- Department of Emergency Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
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da Silva I, de Almeida DS, Hashimoto EM, Martins LD. Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil. Environ Health 2020; 19:79. [PMID: 32631375 PMCID: PMC7336420 DOI: 10.1186/s12940-020-00606-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 05/11/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND Extreme ambient temperatures and air quality have been directly associated with various human diseases from several studies around the world. However, few analyses involving the association of these environmental circumstances with mental and behavioral disorders (MBD) have been carried out, especially in developing countries such as Brazil. METHODS A time series study was carried out to explore the associations between daily air pollutants (SO2, NO2, O3, and PM10) concentrations and meteorological variables (temperature and relative humidity) on hospital admissions for mental and behavioral disorders for Curitiba, Brazil. Daily hospital admissions from 2010 to 2016 were analyzed by a semi-parametric generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM). RESULTS Significant associations between environmental conditions (10 μg/m3 increase in air pollutants and temperature °C) and hospitalizations by MBD were found. Air temperature was the environmental variable with the highest relative risk (RR) at 0-day lag for all ages and sexes analyzed, with RR values of 1.0182 (95% CI: 1.0009-1.0357) for men, and 1.0407 (95% CI: 1.0230-1.0587) for women. Ozone exposure was a risk for all women groups, being higher for the young group, with a RR of 1.0319 (95% CI: 1.0165-1.0483). Elderly from both sexes were more susceptible to temperature variability, with a RR of 1.0651 (95% CI: 1.0213-1.1117) for women, and 1.0215 (95% CI: 1.0195-1.0716) for men. CONCLUSIONS This study suggests that temperatures above and below the thermal comfort threshold, in addition to high concentrations of air pollutants, present significant risks on hospitalizations by MBD; besides, there are physiological and age differences resulting from the effect of this exposure.
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Affiliation(s)
- Iara da Silva
- Federal University of Technology - Paraná, Av. dos Pioneiros, 3131, Londrina, PR, 86036-370, Brazil.
| | - Daniela Sanches de Almeida
- Federal University of Technology - Paraná, Av. dos Pioneiros, 3131, Londrina, PR, 86036-370, Brazil
- State University of Maringa, Av. Colombo, 5790 - Vila Esperança, Maringá, PR, 87020-900, Brazil
| | - Elizabeth Mie Hashimoto
- Federal University of Technology - Paraná, Av. dos Pioneiros, 3131, Londrina, PR, 86036-370, Brazil
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