•Multi-city study with highly standardized particle size distribution measurements.•We applied a novel multilevel model to meta-analyze site-specific results.•No clear associations for ultrafine ...particles (UFP) and cause-specific hospital admissions.•Consistent effects for larger particle size fractions and fine particles (PM2.5).•Higher respiratory hospital admission risk for children, and in the cold season.
Numerous studies have shown associations between daily concentrations of fine particles (e.g., particulate matter with an aerodynamic diameter ≤2.5 µm; PM2.5) and morbidity. However, evidence for ultrafine particles (UFP; particles with an aerodynamic diameter of 10–100 nm) remains conflicting. Therefore, we aimed to examine the short-term associations of UFP with five cause-specific hospital admission endpoints for Leipzig, Dresden, and Augsburg, Germany.
We obtained daily counts of (cause-specific) cardiorespiratory hospital admissions between 2010 and 2017. Daily average concentrations of UFP, total particle number (PNC; 10–800 nm), and black carbon (BC) were measured at six sites; PM2.5 and nitrogen dioxide (NO2) were obtained from monitoring networks. We assessed immediate (lag 0–1), delayed (lag 2–4, lag 5–7), and cumulative (lag 0–7) effects by applying station-specific confounder-adjusted Poisson regression models. We then used a novel multi-level meta-analytical method to obtain pooled risk estimates. Finally, we performed two-pollutant models to investigate interdependencies between pollutants and examined possible effect modification by age, sex, and season.
UFP showed a delayed (lag 2–4) increase in respiratory hospital admissions of 0.69% 95% confidence interval (CI): −0.28%; 1.67%. For other hospital admission endpoints, we found only suggestive results. Larger particle size fractions, such as accumulation mode particles (particles with an aerodynamic diameter of 100–800 nm), generally showed stronger effects (respiratory hospital admissions & lag 2–4: 1.55% 95% CI: 0.86%; 2.25%). PM2.5 showed the most consistent associations for (cardio-)respiratory hospital admissions, whereas NO2 did not show any associations. Two-pollutant models showed independent effects of PM2.5 and BC. Moreover, higher risks have been observed for children.
We observed clear associations with PM2.5 but UFP or PNC did not show a clear association across different exposure windows and cause-specific hospital admissions. Further multi-center studies are needed using harmonized UFP measurements to draw definite conclusions on the health effects of UFP.
Female veterans experience interpersonal violence (ie, physical and sexual violence) more often than male veterans and nonveteran females. There is limited knowledge of types of interpersonal ...violence across the lifespan in relation to suicidal ideation and suicide attempt. Prior research has also focused on those accessing the Veterans Health Administration (VHA) care.
This study examined if physical and sexual violence at differing time points (ie, premilitary, during military service) were associated with suicidal ideation and a suicide attempt at subsequent time points. We anticipated that violence would be associated with an increased risk of suicidal ideation and attempt; however, given limited prior research, we were uncertain which types of violence and time points would be associated with risk.
Data from a cross-sectional national survey.
A total of 407 female veterans using, formerly using, or who never used VHA care.
Suicidal ideation, suicide attempt, physical violence, and sexual violence were assessed.
Premilitary sexual, but not physical, violence was associated with military suicidal ideation. Both premilitary and military sexual and physical violence were associated with postmilitary suicidal ideation. Premilitary and military sexual, but not physical, violence were associated with a postmilitary suicide attempt. These results were maintained after accounting for VHA use. A significant model for military suicide attempt was not generated.
Assessment of premilitary and military sexual violence among female veterans is warranted within the context of suicide risk assessment and prevention. Preventing sexual violence among female veterans may be important for preventing suicidal ideation and attempt.
Abstract
Experimental monitoring of blade vibration in turbomachinery is typically based on blade-mounted strain gauges. Their signals are used to derive vibration amplitudes which are compared to ...previously determined modal scope limits, including a safety factor. According to industrial guidelines, this factor is chosen conservatively to ensure safe operation of the machine.
For the experimental campaign with the open test case fan ECL5, which is representative for modern lightweight UHBR architectures, it is planned to conduct measurements close to the stability limit. These investigations require a close approach to the limit and hence demand for accurate quantification of vibration amplitudes to ensure secure operation without exhaustive safety margins. It is required that the surveillance is possible in real time and not only in post-processing.
Historically, short-time Fourier transformations of vibration sensors are used, but the complex nature of coupled phenomena near the stability limit has an influence on the amplitude accuracy, depending on evaluation parameters. This was demonstrated in a previous study using fast response wall pressure transducers. The present study investigates the influence on blade vibration data of a modern composite material transonic fan. Different methods are compared, sensitivity to evaluation parameters is analyzed and guidelines are given for fast and robust surveillance of critical vibration modes.
Floods have affected billions worldwide. Yet, the indirect health impacts of floods on vulnerable groups, particularly women in the developing world, remain underexplored. Here, we evaluated the risk ...of pregnancy loss for women exposed to floods. We analyzed 90,465 individual pregnancy loss records from 33 developing countries, cross-referencing each with spatial-temporal flood databases. We found that gestational flood exposure is associated with increased pregnancy loss with an odds ratio of 1.08 (95% confidence interval: 1.04 - 1.11). This risk is pronounced for women outside the peak reproductive age range (<21 or >35) or during the mid and late-stage of pregnancy. The risk escalated for women dependent on surface water, with lower income or education levels. We estimated that, over the 2010s, gestational flood events might be responsible for approximately 107,888 (CIs: 53,944 - 148,345) excess pregnancy losses annually across 33 developing countries. Notably, there is a consistent upward trend in annual excess pregnancy losses from 2010 to 2020, and was more prominent over Central America, the Caribbean, South America, and South Asia. Our findings underscore the disparities in maternal and child health aggravated by flood events in an evolving climate.
Abstract
Heat-induced labor loss is a major economic cost related to climate change. Here, we use hourly heat stress data modeled with a regional climate model to investigate the heat-induced labor ...loss in 231 Chinese cities. Results indicate that future urban heat stress is projected to cause an increase in labor losses exceeding 0.20% of the total account gross domestic product (GDP) per year by the 2050s relative to the 2010s. In this process, certain lower-paid sectors could be disproportionately impacted. The implementation of various urban adaptation strategies could offset 10% of the additional economic loss per year and help reduce the inequality-related impact on lower-paid sectors. So future urban warming can not only damage cities as a whole but can also contribute to income inequality. The implication of adaptation strategies should be considered in regard to not only cooling requirements but also environmental justice.
Air temperature has been the most commonly used exposure metric in assessing relationships between thermal stress and mortality. Lack of the high-quality meteorological station data necessary to ...adequately characterize the thermal environment has been one of the main limitations for the use of more complex thermal indices. Global climate reanalyses may provide an ideal platform to overcome this limitation and define complex heat and cold stress conditions anywhere in the world. In this study, we explored the potential of the Universal Thermal Climate Index (UTCI) based on ERA5 – the latest global climate reanalysis from the European Centre for Medium-Range Weather Forecasts (ECMWF) – as a health-related tool. Employing a novel ERA5-based thermal comfort dataset ERA5-HEAT, we investigated the relationships between the UTCI and daily mortality data in 21 cities across 9 European countries. We used distributed lag nonlinear models to assess exposure-response relationships between mortality and thermal conditions in individual cities. We then employed meta-regression models to pool the results for each city into four groups according to climate zone. To evaluate the performance of ERA5-based UTCI, we compared its effects on mortality with those for the station-based UTCI data. In order to assess the additional effect of the UTCI, the performance of ERA5-and station-based air temperature (T) was evaluated. Whilst generally similar heat- and cold-effects were observed for the ERA5-and station-based data in most locations, the important role of wind in the UTCI appeared in the results. The largest difference between any two datasets was found in the Southern European group of cities, where the relative risk of mortality at the 1st percentile of daily mean temperature distribution (1.29 and 1.30 according to the ERA5 vs station data, respectively) considerably exceeded the one for the daily mean UTCI (1.19 vs 1.22). These differences were mainly due to the effect of wind in the cold tail of the UTCI distribution. The comparison of exposure-response relationships between ERA5-and station-based data shows that ERA5-based UTCI may be a useful tool for definition of life-threatening thermal conditions in locations where high-quality station data are not available.
•The suitability of ERA5-based UTCI for health-related studies was demonstrated.•ERA5-based UTCI was evaluated with respect to station-based observations.•ERA5-and station-based air temperature was assessed as a reference thermal metric.•Consistent exposure-response relationships were modelled by ERA5 and station data.•The effect of wind on mortality in cold environments calls for future investigation.
The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, ...separately, accounting for heat wave duration and intensity.
Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated.
The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions.
Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.
Military sexual trauma (MST; i.e., sexual harassment and/or sexual assault during one’s military service) is highly prevalent among female veterans and is associated with numerous adverse health and ...psychosocial sequelae. When institutions fail to prevent sexual trauma from happening or respond in an unsupportive manner (i.e., institutional betrayal IB), MST survivors typically report more severe health-related outcomes. Although the Institutional Betrayal Questionnaire.2 (IBQ.2) was developed to assess IB, no studies have examined the factor structure or dimensionality of the IBQ.2 among MST survivors. In addition, initial research has reported differing factor structures for this measure. The present study examined the dimensionality and factor structure of the IBQ.2, and tested for differential item functioning (DIF) based on whether military sexual assault was experienced. The sample comprised 235 female veterans who reported a history of MST in an anonymous national survey. Rasch analysis suggested multidimensionality and DIF based on history of military sexual assault. Exploratory factor analysis and parallel analysis suggested the IBQ.2 comprises three factors: (1) Environment Leading to MST, (2) Institutional Response to MST, and (3) Institutional Belongingness following MST. Although these results suggest that the IBQ.2 is multidimensional, the three-factor model had significant issues with respect to dimensionality, item fit, and person separation and reliability. Thus, using the full IBQ.2 may be more advantageous. Further examination of the IBQ.2 is warranted to ensure optimal assessment of IB in relation to MST, irrespective of whether the MST comprised sexual harassment or sexual assault, as well as to ensure that the IBQ.2 is culturally meaningful for MST survivors.
Facially amphiphilic polymers carrying cationic and hydrophobic groups on the same repeat unit have shown promising antimicrobial activity and biocompatibility, yet they are prone to suffer from ...protein adhesion which may induce biofilm formation. To overcome this problem, poly(diitaconate)‐based copolymers with cationic/hydrophobic and protein‐repellent/charge‐neutral repeat units are synthesized. The bioactivity profile of surface‐attached polymer networks made from these copolymers depends on the ratio of the cationic and charge‐neutral repeat units. In all cases, the protein adhesion is substantially reduced compared to purely cationic polymers. At a 50:50 ratio, the polymer coatings are partially protein‐repellent and antimicrobial, yet slightly cell toxic. At an intermediate composition of 30:70, they are still antimicrobial and the cell compatibility is substantially improved. The long‐term stability of these materials still has to be determined to judge their suitability for medical applications.
The bioactivity profile of poly(diitaconate) copolymers with cationic, facially amphiphilic units and hydrophilic, charge‐neutral repeat units is investigated and optimized, so that surface coatings with antimicrobial activity, cell compatibility, and substantially reduced protein adhesion are obtained.
Objectives
The US Veterans Health Administration (VHA) has begun using predictive modeling to identify Veterans at high suicide risk to target care. Initial analyses are reported here.
Methods
A ...penalized logistic regression model was compared with an earlier proof‐of‐concept logistic model. Exploratory analyses then considered commonly‐used machine learning algorithms. Analyses were based on electronic medical records for all 6,360 individuals classified in the National Death Index as having died by suicide in fiscal years 2009–2011 who used VHA services the year of their death or prior year and a 1% probability sample of time‐matched VHA service users alive at the index date (n = 2,112,008).
Results
A penalized logistic model with 61 predictors had sensitivity comparable to the proof‐of‐concept model (which had 381 predictors) at target thresholds. The machine learning algorithms had relatively similar sensitivities, the highest being for Bayesian additive regression trees, with 10.7% of suicides occurred among the 1.0% of Veterans with highest predicted risk and 28.1% among the 5.0% of with highest predicted risk.
Conclusions
Based on these results, VHA is using penalized logistic regression in initial intervention implementation. The paper concludes with a discussion of other practical issues that might be explored to increase model performance.
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