Air temperature has been shown to be associated with mortality; however, only very few studies have been conducted in Germany. This study examined the association between daily air temperature and ...cause-specific mortality in Bavaria, Southern Germany. Moreover, we investigated effect modification by age and ambient air pollution.
We obtained data from Munich, Nuremberg as well as Augsburg, Germany, for the period 1990 to 2006. Data included daily cause-specific death counts, mean daily meteorology and air pollution concentrations (particulate matter with a diameter<10 μm PM10 and maximum 8-h ozone). We used Poisson regression models combined with distributed lag non-linear models adjusting for long-term trend, calendar effects, and meteorological factors. Air pollutant concentrations were categorized into three levels, and an interaction term was included to quantify potential effect modification of the air temperature effects.
The temperature-mortality relationships were non-linear for all cause-specific mortality categories showing U- or J-shaped curves. An increase from the 90th (20.0 °C) to the 99th percentile (24.8 °C) of 2-day average temperature led to an increase in non-accidental mortality by 11.4% (95% CI: 7.6%-15.3%), whereas a decrease from the 10th (-1.0 °C) to the 1st percentile (-7.5 °C) in the 15-day average temperature resulted in an increase of 6.2% (95% CI: 1.8%-10.8%). The very old were found to be most susceptible to heat effects. Results also suggested some effect modification by ozone, but not for PM10.
Results indicate that both very low and very high air temperature increase cause-specific mortality in Bavaria. Results also pointed to the importance of considering effect modification by age and ozone in assessing temperature effects on mortality.
Assessments of reproductive potential and spawning history of marine and estuarine crabs are limited due to issues with determination of age and spawning history. The spawning stock of the blue crab
...Callinectes sapidus
in Chesapeake Bay was heavily fished and declined in the 1990s. Management actions were implemented between 2001 and 2008 to reduce spawning stock exploitation and trigger recovery. Whether these actions impacted the demography of female spawners is unknown. We assessed demographics of overwintering mature female crabs in 1992-1996 and 2020-2022 by classifying them as first-year (imminent primiparous) or second-year (primiparous and multiparous) spawners based on presence of mature nemertean worms
(Carcinonemertes carcinophila)
in their gill chambers. We also investigated organismal and environmental predictors of second-year spawners. We provide the first annual estimates of the proportion of multi-year spawners at the population level. Management actions reduced exploitation rates by 41% after 2008, and the proportion of second-year spawners was greater than in the 1990s. Nonetheless, exploitation rate in a given year did not predict proportion of second-year spawners in the following year. Second-year spawners tended to be smaller females, or females with a high gonadosomatic index or longevity indicators (i.e. fouling by barnacles). High proportions of large, highly fecund, overwintering first-year spawners in the 2020s support the need for enhanced protection of females in spring to allow these females to spawn. Finally, nemertean worms are a useful, easily implemented tool to determine spawning history and age-specific reproductive potential of crabs that undergo a terminal molt prior to spawning.
Associations between several persistent organic pollutants (POPs) and type 2 diabetes have been found in humans, but the relationship has rarely been investigated in the general population. The ...current nested case-control study examined internal exposure to polychlorinated biphenyls (PCB) and pesticides and the incidence of type 2 diabetes among participants of two population-based German cohort studies.
We retrospectively selected 132 incident cases of type 2 diabetes and 264 age- and sex-matched controls from the CARdiovascular Living and Aging in Halle (CARLA) study (2002–2006, East Germany) and the Cooperative Health Research in the Region of Augsburg (KORA) study (1999–2001, South Germany) based on diabetes status at follow-up examinations in 2007–2010 and 2006–08, respectively (60% male, mean age 63 and 54 years). We assessed the association between baseline POP concentrations and incident diabetes by conditional logistic regression adjusted for cohort, BMI, cholesterol, alcohol, smoking, physical activity, and parental diabetes. Additionally, we examined effect modification by sex, obesity, parental diabetes and cohort.
In both cohorts, diabetes cases showed a higher BMI, a higher frequency of parental diabetes, and higher levels of POPs. We observed an increased chance for incident diabetes for PCB-138 and PCB-153 with an odds ratio (OR) of 1.50 (95%CI: 1.07–2.11) and 1.53 (1.15–2.04) per interquartile range increase in the respective POP. In addition, explorative results suggested higher OR for women and non-obese participants.
Our results add to the evidence on diabetogenic effects of POPs in the general population, and warrant both policies to prevent human exposure to POPs and additional research on the adverse effects of more complex chemical mixtures.
•Longitudinal studies on the association between POPs and diabetes in the general population are scarce.•We investigated 132 incident cases of type 2 diabetes and 264 age- and sex-matched controls.•Internal exposure to 3 polychlorinated biphenyls and 3 pesticides was determined at baseline.•PCB-138 and PCB-153 were positively associated with incident type 2 diabetes.•Women and non-obese participants indicated higher OR.
Fine particulate matter (PM2.5) exposure is associated with increased morbidity and mortality, particularly for cardiovascular disease. The association between long-term exposure to PM2.5 and ...measures of lipoprotein subfractions remains unclear. Therefore, we examined associations between long-term PM2.5 exposure and traditional and novel lipoprotein measures in a cardiac catheterization cohort in North Carolina.
This cross-sectional study included 6587 patients who had visited Duke University for a cardiac catheterization between 2001 and 2010 and resided in North Carolina. We used estimates of daily PM2.5 concentrations on a 1 km-grid based on satellite measurements. PM2.5 predictions were matched to the address of each patient and averaged for the year prior to catheterization date. Serum lipids included HDL, LDL, and triglyceride-rich particle, and apolipoprotein B concentrations (HDL-P, LDL-P, TRL-P, and apoB, respectively). Linear and quantile regression models were used to estimate change in lipoprotein levels with each μg/m3 increase in annual average PM2.5. Models were adjusted for age, sex, race/ethnicity, history of smoking, area-level education, urban/rural status, body mass index, and diabetes.
For a 1-μg/m3 increment in PM2.5 exposure, we observed increases in total and small LDL-P, LDL-C, TRL-P, apoB, total cholesterol, and triglycerides. The percent change from the mean outcome level was 2.00% (95% CI: 1.38%, 2.64%) for total LDL-P and 2.25% (95% CI: 1.43%, 3.06%) for small LDL-P.
Among this sample of cardiac catheterization patients residing in North Carolina, long-term PM2.5 exposure was associated with increases in several lipoprotein concentrations. This abstract does not necessarily reflect U.S. EPA policy.
•We examined associations between long-term PM2.5 exposure and lipoprotein measures.•Associations were present for several measures including total and small LDL-P.•Quantile regression results showed an increasing trend for percentiles of LDL.
•Surveyed 439 female veterans on suicidal ideation (SI) and suicide attempt (SA).•Lifetime prevalence: SI (47.9%), SA (17.7%) and non-suicidal self-injury (13.2%).•SI and SA were more prevalent ...after, rather than preceding, military service.•Initial onset was more likely pre- (vs post-) military service for all SDV types.•Current (vs never) VHA users more commonly reported lifetime SI.
Suicide rates among female veterans have continued to increase, particularly among those not using Veterans Health Administration (VHA) care. Nonetheless, suicide research has rarely focused on female veterans, particularly non-VHA users. The present study examined the prevalence and onset of suicidal ideation (SI), suicide attempt (SA), and non-suicidal self-injury (NSSI) in relation to military service among female veterans. Additionally, current, past, and never VHA users were compared in regard to SI, SA, and NSSI prevalence.
Female veterans (n = 439) participated in a national, cross-sectional survey.
Lifetime prevalence of SI (47.9%), SA (17.7%), and NSSI (13.2%) were high. Participants were more likely to report experiencing SI and SA following separation, compared to preceding (SI, SA) or during (SI only) military service, controlling for time at risk. However, onset was more likely to occur prior to military service, compared to after separation, for SI, SA, and NSSI. In age-adjusted analyses, current and past users of VHA care were more likely to report experiencing lifetime SI, compared to those who never used VHA care. However, when adjusting for service era, past and never VHA users did not significantly differ.
Cross-sectional design, retrospective recall, and convenience sample.
For female veterans, onset of SI, SA, and NSSI appears to most commonly occur before military service. However, SI and SA prevalence are highest following separation, suggesting a period warranting additional support and intervention. Results underscore the need for continued suicide surveillance, prevention, and intervention efforts for female veterans, especially current VHA users.
Bright light therapy (BLT) is efficacious for seasonal and non-seasonal depression. However, the current state of BLT use in practice is unknown, impeding efforts to identify and address utilization ...gaps. This study's objective was to investigate BLT delivery in a nationwide U.S. healthcare system.
This was a retrospective observational study of electronic medical records from all veterans who received outpatient mood disorder-related care in the Veterans Health Administration (VHA) from October 2008 through September 2020. BLT delivery was measured through the placement of light box consults.
Of the 3,442,826 veterans who received outpatient mood disorder care, only 57,908 (1.68 %) received a light box consult. Consults increased by 548.44 % (99.9 % credible interval: 467.36 %, 638.74 %) over the timeframe and displayed a robust yearly cycle that peaked on either December 21st or December 22nd. Past mental health treatment for a mood disorder was associated with a higher probability of a consult (relative risk = 4.79, 99.9 % CI: 4.21, 5.60). There was low representation related to veteran age, gender, race, and ethnicity.
No information on patients who declined light boxes or actual light box use following consult placement.
Outpatient BLT delivery for mood disorders in the VHA remains low, despite significant growth over the past decade. It also displays a strong seasonal rhythm that peaks on the winter solstice, suggesting a limited focus on seasonal depression and a suboptimal reactive approach to changing sunlight. Overall, there exists ample opportunity for novel implementation efforts aimed at increasing utilization of BLT.
•Despite growth over the past 12 years, bright light therapy sees infrequent use.•Light box delivery peaks on the winter solstice and is minimal in summer.•There is low representation of light box delivery across veteran groups.•There is opportunity to expand bright light delivery and enhance depression care.
Climate change is likely to further worsen ozone pollution in already heavily polluted areas, leading to increased ozone-related health burdens. However, little evidence exists in China, the world's ...largest greenhouse gas emitter and most populated country. As China is embracing an aging population with changing population size and falling age-standardized mortality rates, the potential impact of population change on ozone-related health burdens is unclear. Moreover, little is known about the seasonal variation of ozone-related health burdens under climate change. We aimed to assess near-term (mid-21st century) future annual and seasonal excess mortality from short-term exposure to ambient ozone in 104 Chinese cities under 2 climate and emission change scenarios and 6 population change scenarios.
We collected historical ambient ozone observations, population change projections, and baseline mortality rates in 104 cities across China during April 27, 2013, to October 31, 2015 (2013-2015), which included approximately 13% of the total population of mainland China. Using historical ozone monitoring data, we performed bias correction and spatially downscaled future ozone projections at a coarse spatial resolution (2.0° × 2.5°) for the period April 27, 2053, to October 31, 2055 (2053-2055), from a global chemistry-climate model to a fine spatial resolution (0.25° × 0.25°) under 2 Intergovernmental Panel on Climate Change Representative Concentration Pathways (RCPs): RCP4.5, a moderate global warming and emission scenario where global warming is between 1.5°C and 2.0°C, and RCP8.5, a high global warming and emission scenario where global warming exceeds 2.0°C. We then estimated the future annual and seasonal ozone-related acute excess mortality attributable to both climate and population changes using cause-specific, age-group-specific, and season-specific concentration-response functions (CRFs). We used Monte Carlo simulations to obtain empirical confidence intervals (eCIs), quantifying the uncertainty in CRFs and the variability across ensemble members (i.e., 3 predictions of future climate and air quality from slightly different starting conditions) of the global model. Estimates of future changes in annual ozone-related mortality are sensitive to the choice of global warming and emission scenario, decreasing under RCP4.5 (-24.0%) due to declining ozone precursor emissions but increasing under RCP8.5 (10.7%) due to warming climate in 2053-2055 relative to 2013-2015. Higher ambient ozone occurs under the high global warming and emission scenario (RCP8.5), leading to an excess 1,476 (95% eCI: 898 to 2,977) non-accidental deaths per year in 2053-2055 relative to 2013-2015. Future ozone-related acute excess mortality from cardiovascular diseases was 5-8 times greater than that from respiratory diseases. Ozone concentrations increase by 15.1 parts per billion (10-9) in colder months (November to April), contributing to a net yearly increase of 22.3% (95% eCI: 7.7% to 35.4%) in ozone-related mortality under RCP8.5. An aging population, with the proportion of the population aged 65 years and above increased from 8% in 2010 to 24%-33% in 2050, will substantially amplify future ozone-related mortality, leading to a net increase of 23,838 to 78,560 deaths (110% to 363%). Our analysis was mainly limited by using a single global chemistry-climate model and the statistical downscaling approach to project ozone changes under climate change.
Our analysis shows increased future ozone-related acute excess mortality under the high global warming and emission scenario RCP8.5 for an aging population in China. Comparison with the lower global warming and emission scenario RCP4.5 suggests that climate change mitigation measures are needed to prevent a rising health burden from exposure to ambient ozone pollution in China.
Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on non-accidental morbidity or mortality, with ...far less research on heat-related accidental events.
We collected individual accidental death records among all residents in Chinese mainland from June to August during 2013–2019. Accidental deaths were further divided into several subtypes by different causes. We used an individual-level, time-stratified, case-crossover study design to estimate the association between daily mean temperature and accidental deaths, and estimate its variation in seven geo-climatic zones, age (5–64, 65–74, ≥75), and sex (male, female). We then estimated the temperature-related excess accidental deaths under global warming scenarios of 1.5, 2, and 3℃.
A total of 711,929 accidental death records were included in our study. We found that higher temperatures were associated with increased risks of deaths from the total accidental events and four main subtypes, including traffic, falls, drowning, and unintentional injuries. We also found that younger individuals (ages 5–64) and males faced a higher risk of heat-related mortality due to total accidents, traffic incidents, and drowning. For future climate scenarios, even under the 1.5℃ climate change scenario, 6,939 (95% eCI (empirical Confidence Interval): 6,818–7,067) excess accidental deaths per year are attributed to higher summertime daily temperature over mainland China, and the number of accidental deaths would increase by 16.71% and 33.59% under the 2℃ and 3℃ climate change scenarios, respectively. For residents living in southern coastal and northwest inland regions, the projected increase in accidental death is higher.
This nationwide study confirms that higher summer temperatures are linked to an increased risk of accidental deaths. Younger age groups and males face a higher risk. This indicates that current estimates of the health effects of climate change might be underestimated, particularly for younger populations.
Background
Suicide rates have increased among women Veterans, with increased use of firearms as the method. Addressing suicide risk in this population requires understanding the prevalence and ...correlates of firearm access in healthcare settings frequented by women Veterans.
Objectives
Characterize the prevalence and correlates of firearm ownership and storage practices among women Veterans using Department of Veterans Affairs (VA) reproductive healthcare (RHC) services.
Design
Cross-sectional national survey conducted in 2018–2019 (17.9% response rate).
Participants
Post-9/11 women Veterans using RHC (
n
=350).
Main Measures
VA Military Sexual Trauma Screen, PTSD Checklist for DSM-5, Hurt/Insult/Threaten/Scream, Columbia-Suicide Severity Rating Scale screener, self-reported firearm access.
Key Results
38.0% (95% confidence interval 95% CI: 32.9, 43.3) of participants reported personally owning firearms, and 38.9% (95% CI: 33.7, 44.2) reported other household members owned firearms. Among those with firearms in or around their homes, 17.8% (95% CI: 12.3, 24.4) and 21.9% (95% CI: 15.9, 28.9) reported all were unsafely stored (loaded or unlocked, respectively). Women who experienced recent intimate partner violence were less likely to report personally owning firearms (adjusted prevalence ratio APR=0.75; 95% CI: 0.57, 0.996). Those who experienced military sexual harassment (APR=1.46; 95% CI=1.09, 1.96), were married (APR=1.74; 95% CI: 1.33, 2.27), or lived with other adult(s) (APR=6.26; 95% CI: 2.87, 13.63) were more likely to report having household firearms owned by someone else. Storing firearms loaded was more prevalent among women with lifetime (APR=1.47; 95% CI=1.03, 2.08) or past-month (APR=1.69; 95% CI=1.15, 2.48) suicidal ideation and less likely among those with other adult(s) in the home (unadjusted PR=0.62; 95% CI=0.43, 0.91). Those with parenting responsibilities (APR=0.61; 95% CI=0.38, 0.97) were less likely to store firearms unlocked.
Conclusions
Firearm access is prevalent among post-9/11 women Veterans using VA RHC. Interpersonal factors may be important determinants of firearm access in this population. Safe firearm storage initiatives are needed among women Veterans using RHC, particularly for those with suicidal ideation.
Abstract
The effect of individual and population-level egg mortality is important to quantify to maintain sustainable crustacean fisheries. The nemertean worm Carcinonemertes carcinophila (Kölliker, ...1845) is an egg predator of the Atlantic blue crab, Callinectes sapidusRathbun, 1896; however, little is known about the impact this nemertean has on the reproduction of the blue crab. We assessed the prevalence and intensity of the infestation of nemerteans in ovigerous blue crabs using a fishery-independent trawl survey. During the primary spawning period of the crab, May–September 2022, 126 ovigerous females were collected and analyzed for worms. Prevalence over this time was 66.6% and mean brood infestation was 53.9 worms per infested crab host. Nemertean egg consumption was quantified with a six-day microcosm experiment. Of the 48 worms in the experiment, 71% actively fed on crab eggs and their consumption ranged 0.16–4.5 eggs day–1. Consumption rates were used to estimate population-level impact of nemertean feeding on crab brood mortality. Modeled proportions of brood loss per crab ranged 0–0.0044%. At the current prevalence and intensity of infestation, egg consumption by nemerteans has a negligible effect on blue crab reproductive output and batch fecundity in Chesapeake Bay. We also investigated the use of mature nemertean worms as a biomarker for establishing the spawning history of ovigerous female blue crabs and determined that the presence of worms in the clutch and in the gills can be used to indicate parity in ovigerous female crabs.