weather

天气
  • 文章类型: Journal Article
    扩大路网以容纳各种活动,显著增加了城市噪声污染,对人类健康和生活质量产生不利影响。许多因素影响城市地区的噪声水平,包括道路特征,交通特点,周围的建筑物,和天气条件。虽然以前的研究已经单独考虑了许多这些因素,这项研究旨在整合所有相关变量,以全面监测和分析它们对噪声水平的综合影响。目的是确定可以纳入有效降噪策略的最具影响力的因素。这项研究的重点是开罗,世界上人口最稠密的城市之一,高噪声水平是一个持续存在的问题。DokkiTahrir街的详细案例研究,开罗,为本次调查提供了依据。最拥挤的地区之一是Al-Dokki的El-Tahrir街,在这项研究中被选为案例研究。这个地区的交通量很大,在15分钟的间隔内,多达1700辆车通过。这种巨大的交通量是该地区噪声水平升高的主要驱动因素。使用声级计进行现场调查,进行交通和噪声水平监测。因此,进行了统计分析,以研究不同因素与噪声水平之间的相关性,并确定影响最大的因素。研究显示,交通量和拥堵是影响塔里尔街噪声水平的最重要因素,表现出较强的正相关(R=0.38)。此外,这项研究发现,由于高交通量,车辆速度和噪声水平之间的反比关系,并确定建筑特征和风向也起作用,虽然程度较小。
    Expanding road networks to accommodate various activities has significantly increased urban noise pollution, adversely affecting human health and quality of life. Numerous factors influence the noise level in urban areas, including road characteristics, traffic characteristics, surrounding buildings, and weather conditions. While previous studies have considered many of these factors individually, this study aims to integrate all relevant variables to comprehensively monitor and analyze their combined effects on noise levels. The objective is to determine the most influential factors that could be incorporated into effective noise reduction strategies. This research focuses on Cairo, one of the most densely populated cities in the world, where high noise levels are a persistent issue. A detailed case study of Tahrir Street in Dokki, Cairo, provides the basis for this investigation. One of the most crowded areas is El-Tahrir Street in Al-Dokki, which was selected as a case study in this research. This area experiences high traffic volume, with up to 1700 vehicles passing through within a 15-min interval. This significant traffic volume is the primary driver of the elevated noise levels in the area. Traffic and noise level monitoring was conducted using a field survey using the sound level meter. Consequently, a statistical analysis was conducted to investigate the correlation between different factors and the noise level and determine the most influential factors. The study revealed that traffic volume and congestion are the most significant factors influencing noise levels on Tahrir Street, exhibiting strong positive correlations (R = 0.38). Additionally, the study found an inverse relationship between vehicle speed and noise level due to high traffic volumes and identified that building characteristics and wind direction also play roles, albeit to a lesser extent.
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  • 文章类型: Journal Article
    游行乐队(MB)艺术家与其他活跃团体(如工人和运动员)类似,会遭受劳累性热病(EHI)。然而,他们是一个研究不足的人群,没有基于证据的热安全指南。这里介绍的是第233届布里斯托尔年度的案例研究,2018年RI独立日游行产生了50多个EHIs,包括来自明尼阿波利斯郊区的圣安东尼村游行乐队(MB)的25名,MN.这项研究旨在确定导致大量EHIs的因素,以及在未来活动中确保MB艺术家安全的指南。人体热平衡模型与当地天气数据一起用于模拟MB艺术家的热应力。使用了三个建模场景来隔离服装的角色(乐队制服与T恤和短裤),天气(2018年7月4日vs.30年气候学),和代谢率(缓慢,中度,并轻快地进行起搏)在热应力下。结果确定了增加热应激的几个关键因素。气象条件异常炎热,潮湿,对布里斯托尔来说阳光明媚,导致蒸发和对流导致的冷却减少,和增加辐射加热。行为因素也会影响热应激。完整的行进乐队制服使蒸发冷却减少了50%,并且在数小时内行进4公里而没有休息的活动水平导致了无法弥补的条件。最后,据推测,来自较冷地区的参与者缺乏适应环境可能会加剧与热有关的影响。这些发现突出了对MB主管和比赛组织者的一些建议,包括在预期的炎热条件下使用夏季制服,并提前进行游行计划,包括在游行前后为参与者提供遮阳/补水,考虑减少辐射加热的较冷路线,并为预期的与热相关的健康影响做好准备,适合预期的热条件。
    Marching band (MB) artists are subject to exertional heat illnesses (EHIs) similar to other active groups like laborers and athletes. Yet, they are an understudied population with no evidence-based heat safety guidelines. Presented here is a case study of the 233rd annual Bristol, RI Independence Day Parade in 2018 that resulted in over 50 EHIs, including 25 from the Saint Anthony Village marching band (MB) from suburban Minneapolis, MN. This research aims to identify the contributing factors that led to the large number of EHIs, as well as guide ensuring the safety of MB artists in future events. A human heat balance model in conjunction with local weather data was used to simulate heat stress on MB artists. Three modeling scenarios were used to isolate the roles of clothing (band uniform vs. t-shirt and shorts), weather (July 4, 2018 vs. 30-year climatology), and metabolic rate (slow, moderate, and brisk marching pacing) on heat stress. The results identify several key factors that increased heat stress. The meteorological conditions were unusually hot, humid, and sunny for Bristol, resulting in reduced cooling from evaporation and convection, and increased radiant heating. Behavioral factors also affect heat stress. The full marching band uniforms reduced evaporative cooling by 50% and the activity levels of marching 4 km over several hours without breaks resulted in conditions that were uncompensable. Finally, it is speculated that a lack of acclimatization for participants from cooler regions may have exacerbated heat-related impacts. These findings highlight several recommendations for MB directors and race organizers, including the use of summer uniforms for anticipated hot conditions, and advance parade planning that includes providing shade/hydration before and after the parade for participants, considering cooler routes that reduce radiant heating and preparing for anticipated heat-related health impacts appropriate for anticipated hot conditions.
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  • 文章类型: Journal Article
    背景:气候变化对健康的影响越来越大,特别是撒哈拉以南非洲的农村人口,因为他们的适应资源有限。理解这些影响仍然是一个挑战,因为对这些人群的生命体征的连续监测是有限的。可穿戴设备(可穿戴设备)提供了一种可行的方法来实时研究这些对人类健康的影响。
    目的:本研究的目的是评估消费级可穿戴设备在测量天气暴露对生理反应(包括活动,心率,壳体温度,和睡眠)肯尼亚西部农村人口,并确定与天气暴露相关的健康影响。
    方法:我们在肯尼亚西部进行了一项观察性案例研究,在3周内利用可穿戴设备连续监测各种健康指标,例如步数,睡眠模式,心率,和身体外壳温度。此外,当地气象站提供了有关降雨和热量等环境条件的详细数据,每15分钟测量一次。
    结果:我们的队列包括83名参与者(42名女性和41名男性),平均年龄33岁。我们观察到步数与最大湿球温度之间呈正相关(估计值0.06,SE0.02;P=.008)。尽管夜间最低气温和热指数与睡眠时间呈负相关,这些没有统计学意义。在其他应用模型中没有发现显著的相关性。在204天的194天(95.1%)记录了警告热指数水平。204天中有16天(7.8%)发生了暴雨(>20毫米/天)。尽管47台设备中有10台(21%)出现故障,睡眠和步数的数据完整性较高(平均82.6%,SD21.3%,平均值86.1%,SD18.9%,分别),但心率低(平均7%,SD14%),成年女性的心率数据完整性明显高于男性(双侧t检验:P=.003;Mann-WhitneyU检验:P=.001)。车身外壳温度数据达到36.2%(SD24.5%)的完整性。
    结论:我们的研究为肯尼亚农村地区天气暴露对健康的影响提供了细致的理解。我们的研究的可穿戴设备的应用揭示了身体活动水平和高温胁迫之间的显著相关性,与其他表明在较热条件下活动减少的研究相反。这种差异要求进一步调查独特的社会环境动态,特别是在撒哈拉以南非洲地区。此外,在热引起的睡眠中断中观察到的非重要趋势暴露了对局部气候变化缓解策略的需求,考虑到睡眠在健康中的重要作用。这些发现强调需要针对具体情况的研究,以便为容易受到气候变化不利健康影响的地区的政策和实践提供信息。
    BACKGROUND: Climate change increasingly impacts health, particularly of rural populations in sub-Saharan Africa due to their limited resources for adaptation. Understanding these impacts remains a challenge, as continuous monitoring of vital signs in such populations is limited. Wearable devices (wearables) present a viable approach to studying these impacts on human health in real time.
    OBJECTIVE: The aim of this study was to assess the feasibility and effectiveness of consumer-grade wearables in measuring the health impacts of weather exposure on physiological responses (including activity, heart rate, body shell temperature, and sleep) of rural populations in western Kenya and to identify the health impacts associated with the weather exposures.
    METHODS: We conducted an observational case study in western Kenya by utilizing wearables over a 3-week period to continuously monitor various health metrics such as step count, sleep patterns, heart rate, and body shell temperature. Additionally, a local weather station provided detailed data on environmental conditions such as rainfall and heat, with measurements taken every 15 minutes.
    RESULTS: Our cohort comprised 83 participants (42 women and 41 men), with an average age of 33 years. We observed a positive correlation between step count and maximum wet bulb globe temperature (estimate 0.06, SE 0.02; P=.008). Although there was a negative correlation between minimum nighttime temperatures and heat index with sleep duration, these were not statistically significant. No significant correlations were found in other applied models. A cautionary heat index level was recorded on 194 (95.1%) of 204 days. Heavy rainfall (>20 mm/day) occurred on 16 (7.8%) out of 204 days. Despite 10 (21%) out of 47 devices failing, data completeness was high for sleep and step count (mean 82.6%, SD 21.3% and mean 86.1%, SD 18.9%, respectively), but low for heart rate (mean 7%, SD 14%), with adult women showing significantly higher data completeness for heart rate than men (2-sided t test: P=.003; Mann-Whitney U test: P=.001). Body shell temperature data achieved 36.2% (SD 24.5%) completeness.
    CONCLUSIONS: Our study provides a nuanced understanding of the health impacts of weather exposures in rural Kenya. Our study\'s application of wearables reveals a significant correlation between physical activity levels and high temperature stress, contrasting with other studies suggesting decreased activity in hotter conditions. This discrepancy invites further investigation into the unique socioenvironmental dynamics at play, particularly in sub-Saharan African contexts. Moreover, the nonsignificant trends observed in sleep disruption due to heat expose the need for localized climate change mitigation strategies, considering the vital role of sleep in health. These findings emphasize the need for context-specific research to inform policy and practice in regions susceptible to the adverse health effects of climate change.
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  • 文章类型: Journal Article
    在国际上,隐孢子虫病的发生与许多环境中的天气状况有关。我们探索了新西兰(NZ)人类隐孢子虫病的统计聚类及其与恶劣天气事件的关系。从国家监测系统获得了1997年至2015年的隐孢子虫病通报病例。使用回顾性时空排列来识别统计聚类。将集群数据与国家数据库中的恶劣天气事件进行了比较。SaTScan分析检测到38个具有统计学意义的隐孢子虫病簇。大约三分之一(34.2%,13/38)中的这些集群显示出与恶劣天气事件的时间和空间一致性。其中,近一半(46.2%,6/13)发生在春季。只有五个(38%,这些集群中的5/13)对应于先前报道的隐孢子虫病爆发。这项研究提供了其他证据,表明恶劣天气事件可能导致某些隐孢子虫病集群的发展。由于气候变化,预计新西兰的降雨强度将上升,因此需要对这种关联进行进一步研究。研究结果还为提高饮用水源的质量提供了进一步的论据,以最大程度地减少畜牧业径流对病原体的污染。
    Occurrence of cryptosporidiosis has been associated with weather conditions in many settings internationally. We explored statistical clusters of human cryptosporidiosis and their relationship with severe weather events in New Zealand (NZ). Notified cases of cryptosporidiosis from 1997 to 2015 were obtained from the national surveillance system. Retrospective space-time permutation was used to identify statistical clusters. Cluster data were compared to severe weather events in a national database. SaTScan analysis detected 38 statistically significant cryptosporidiosis clusters. Around a third (34.2%, 13/38) of these clusters showed temporal and spatial alignment with severe weather events. Of these, nearly half (46.2%, 6/13) occurred in the spring. Only five (38%, 5/13) of these clusters corresponded to a previously reported cryptosporidiosis outbreak. This study provides additional evidence that severe weather events may contribute to the development of some cryptosporidiosis clusters. Further research on this association is needed as rainfall intensity is projected to rise in NZ due to climate change. The findings also provide further arguments for upgrading the quality of drinking water sources to minimize contamination with pathogens from runoff from livestock agriculture.
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  • 文章类型: Meta-Analysis
    目标:肌肉骨骼健康行为和不良事件的变化经常归咎于天气。然而,尽管这种现象得到认可的频率很高,过去的研究在很大程度上是相互矛盾的。这项荟萃分析回顾了,评估和总结病例交叉研究,评估与天气参数(例如温度,相对湿度,空气压力,和降水)。
    方法:对病例交叉研究进行荟萃分析。两名审阅者独立搜索了MEDLINE,EMBASE,CINAHL,WebofScience,Scopus,和PsycINFO从成立到2023年9月10日。已发表的研究采用案例交叉设计来评估肌肉骨骼健康事件的风险(例如症状,住院)与天气参数相关。主要结果是疼痛(新的疼痛或耀斑发作)。纳入研究的质量是根据选择偏差进行评估的,暴露评估,混杂,和结果评估。使用随机效应模型进行结果汇总,并针对每种条件和天气因素分别进行。纳入研究的异质性采用I2方法进行评估。
    结果:在搜索中确定的1,107项研究中,包括11人(15,315名参与者),提供有关28,010个事件(102,536个控制期)的数据,七种肌肉骨骼疾病。汇总分析显示相对湿度之间没有关联,空气压力,温度,或者沉淀和类风湿关节炎的风险,膝盖疼痛或腰痛。高温和低湿度与疼痛增加有关,发红,痛风患者的关节肿胀(赔率:2.04;95%置信区间:1.26至3.30)。
    结论:尽管有患者的轶事报道,天气因素的变化似乎不是类风湿关节炎的危险因素,膝盖,臀部,或者腰痛,但可能对痛风疾病有重大影响。
    OBJECTIVE: The weather is frequently blamed for changes in musculoskeletal health behaviour and adverse events. However, despite the frequency with which this phenomenon is endorsed, past research is largely conflicting. This meta-analysis has reviewed, appraised and summarised case-crossover studies assessing the transient risk of musculoskeletal health events associated with weather parameters (e.g. temperature, relative humidity, air pressure, and precipitation).
    METHODS: A meta-analysis of case-crossover studies was conducted. Two reviewers independently searched MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, and PsycINFO from inception to 10/09/2023. Published studies that employed a case-crossover design to evaluate the risk of musculoskeletal health events (e.g. symptoms, hospitalisation) associated with weather parameters were included. Primary outcome was pain (new episodes of pain or flares). Quality of included studies was assessed based on selection bias, exposure assessment, confounding, and outcome assessment. Pooling of results was conducted using random effects models and separately performed for each condition and weather factor. Heterogeneity among included studies was assessed using I2 measures.
    RESULTS: Of the 1,107 studies identified in the search, 11 were included (15,315 participants), providing data on 28,010 events (102,536 control periods), for seven musculoskeletal conditions. Pooled analyses showed no association between relative humidity, air pressure, temperature, or precipitation and the risk of rheumatoid arthritis, knee pain or low back pain. High temperatures combined with low humidity were associated with increased pain, redness, and joint swelling in people with gout (Odds Ratio: 2.04; 95 % Confidence Interval: 1.26 to 3.30).
    CONCLUSIONS: Despite anecdotal reports from patients, changes in weather factors do not seem to be risk factors for rheumatoid arthritis, knee, hip, or low back pain, but may have a significant influence in gout disease.
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  • 文章类型: Journal Article
    背景:心房颤动(AF)在人群中非常普遍,然而,在易感人群中,导致房颤事件的因素仍有部分了解.气象因素与房颤之间的潜在关系,特别是异常心电图(ECG)复极化,没有得到充分的研究。这项病例交叉研究的目的是调查在上海的气象因素与每天住院的心电复极异常的房颤之间的关系。中国。
    方法:研究队列包括2015年至2018年在上海第六人民医院寻求治疗的10,325例心电图确诊的房颤患者。气象和空气污染物浓度数据与患者记录相匹配。使用案例交叉设计,我们分析了气象因素与房颤中心心电图复极异常的住院医师每日计数之间的关联.滞后分析模型用于检查气象因素与AF事件之间的时间关系。
    结果:分析显示房颤发生与特定气象因素之间有统计学意义的关联。房颤事件与平均大气压显著相关(滞后0天,OR0.9901,95%CI0.9825-0.9977,P<0.05),平均温度(滞后1天,OR0.9890,95%CI0.9789-0.9992,P<0.05),每日压力范围(滞后7天,OR1.0195,95%CI1.0079-1.0312,P<0.01),和每日温度范围(滞后5天,OR1.0208,95%CI1.0087-1.0331,P<0.01)。此外,在房颤患者的每日压力范围和每日温度范围之间观察到显着的相关性,尤其是心电图复极化异常的患者,在案例交叉分析中很明显。
    结论:本研究强调了上海发生房颤伴心电图复极异常的气象因素与每日就诊之间的显著相关性。中国。此外,与没有这种复极异常的AF患者相比,发现心电图复极异常的AF患者更容易受到压力和温度快速每日变化的影响。
    BACKGROUND: Atrial fibrillation (AF) is highly prevalent in the population, yet the factors contributing to AF events in susceptible individuals remain partially understood. The potential relationship between meteorological factors and AF, particularly with abnormal electrocardiograph (ECG) repolarization, has not been adequately studied. This case-crossover study aims to investigate the association between meteorological factors and daily hospital visits for AF with abnormal ECG repolarization in Shanghai, China.
    METHODS: The study cohort comprised 10,325 patients with ECG-confirmed AF who sought treatment at Shanghai Sixth People\'s Hospital between 2015 and 2018. Meteorological and air pollutant concentration data were matched with the patient records. Using a case-crossover design, we analyzed the association between meteorological factors and the daily count of hospital visitors for AF with abnormal ECG repolarization at our AF center. Lag analysis models were applied to examine the temporal relationship between meteorological factors and AF events.
    RESULTS: The analysis revealed statistically significant associations between AF occurrence and specific meteorological factors. AF events were significantly associated with average atmospheric pressure (lag 0 day, OR 0.9901, 95% CI 0.9825-0.9977, P < 0.05), average temperature (lag 1 day, OR 0.9890, 95% CI 0.9789-0.9992, P < 0.05), daily pressure range (lag 7 days, OR 1.0195, 95% CI 1.0079-1.0312, P < 0.01), and daily temperature range (lag 5 days, OR 1.0208, 95% CI 1.0087-1.0331, P < 0.01). Moreover, a significant correlation was observed between daily pressure range and daily temperature range with AF patients, particularly those with abnormal ECG repolarization, as evident in the case-crossover analysis.
    CONCLUSIONS: This study highlights a significant correlation between meteorological factors and daily hospital visits for AF accompanied by abnormal ECG repolarization in Shanghai, China. In addition, AF patients with abnormal ECG repolarization were found to be more vulnerable to rapid daily changes in pressure and temperature compared to AF patients without such repolarization abnormalities.
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  • 文章类型: Review
    谷热是由吸入关节分生孢子引起的呼吸道疾病,球虫属真菌产生的一种孢子。在干燥中发现,西半球的热生态系统。由于缺乏剂量反应模型和缺乏来自环境样本的定量发生数据,尚未对该疾病进行定量微生物风险评估(QMRA)。进行了文献综述,以收集实验动物给药研究的数据,环境发生,人类疾病爆发,和气象协会。因此,提出了一个风险框架,其中包含了用于参数化球藻的QMRA模型的信息。,提出了八个新的剂量反应模型。对美国西南部农业案例研究进行了概率QMRA,评估与农业职业暴露相关的八种情景。发生ValleyFever的每日工作日风险中位数从2.53×10-7(戴N95面罩时手工种植)到1.33×10-3(不戴面罩时进行机器收获)。文献综述和QMRA合成证实,暴露于雾化的关节分生孢子有可能导致高发作率,但强调环境条件与疾病之间的机制关系仍然知之甚少。为了减少疾病风险,对山谷发烧风险评估研究需求的建议进行了讨论,包括对农民的干预。
    Valley Fever is a respiratory disease caused by inhalation of arthroconidia, a type of spore produced by fungi within the genus Coccidioides spp. which are found in dry, hot ecosystems of the Western Hemisphere. A quantitative microbial risk assessment (QMRA) for the disease has not yet been performed due to a lack of dose-response models and a scarcity of quantitative occurrence data from environmental samples. A literature review was performed to gather data on experimental animal dosing studies, environmental occurrence, human disease outbreaks, and meteorological associations. As a result, a risk framework is presented with information for parameterizing QMRA models for Coccidioides spp., with eight new dose-response models proposed. A probabilistic QMRA was conducted for a Southwestern US agricultural case study, evaluating eight scenarios related to farming occupational exposures. Median daily workday risks for developing severe Valley Fever ranged from 2.53 × 10-7 (planting by hand while wearing an N95 facemask) to 1.33 × 10-3 (machine harvesting while not wearing a facemask). The literature review and QMRA synthesis confirmed that exposure to aerosolized arthroconidia has the potential to result in high attack rates but highlighted that the mechanistic relationships between environmental conditions and disease remain poorly understood. Recommendations for Valley Fever risk assessment research needs in order to reduce disease risks are discussed, including interventions for farmers.
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  • 文章类型: Journal Article
    解开天气对传染病传播的影响对健康保护至关重要,准备和预防。因为天气因素是共同的,部分相关的,我们以弯曲杆菌病作为案例研究,利用地理学来分离出各个天气参数对其他季节变量的影响。弯曲杆菌感染遍布全球,是发达国家最常见的细菌性食源性疾病,它们表现出一致但特定国家的季节性。我们开发了一种新的条件发生方法,基于经典的分层,从长远来看,高分辨率,20年来,英格兰和威尔士约有100万例弯曲杆菌病病例与诊断实验室所在地的当地气象数据集相关联。在8°-15°范围内,温度每升高5°(摄氏度),弯曲杆菌病的预测发病率每百万人增加1例。在该范围之外观察到有限的关联。与日长有很强的关联。随着相对湿度在75-80%的区域内,病例趋于增加,而与降雨和风速的关联较弱。该方法能够检查多个因素,并对复杂趋势的出现进行建模,例如,5月至6月英格兰和威尔士弯曲杆菌病的持续急剧增加及其空间变异性。这种透明和直接的方法导致准确的预测,而不依赖于回归模型和/或假设特定的参数。分析的关键输出是对特定当地天气因素条件下的疾病发病率的全面现象学描述。这项研究对于推断弯曲杆菌病的传播机制至关重要;例如,通过模拟假定机制的条件发生率,并将其与现象学模式进行比较作为基准。这些发现挑战了这一假设,通常用统计模型制作,弯曲杆菌病等疾病的转化平均感染率只是环境变量的累加和组合。
    Disentangling the impact of the weather on transmission of infectious diseases is crucial for health protection, preparedness and prevention. Because weather factors are co-incidental and partly correlated, we have used geography to separate out the impact of individual weather parameters on other seasonal variables using campylobacteriosis as a case study. Campylobacter infections are found worldwide and are the most common bacterial food-borne disease in developed countries, where they exhibit consistent but country specific seasonality. We developed a novel conditional incidence method, based on classical stratification, exploiting the long term, high-resolution, linkage of approximately one-million campylobacteriosis cases over 20 years in England and Wales with local meteorological datasets from diagnostic laboratory locations. The predicted incidence of campylobacteriosis increased by 1 case per million people for every 5° (Celsius) increase in temperature within the range of 8°-15°. Limited association was observed outside that range. There were strong associations with day-length. Cases tended to increase with relative humidity in the region of 75-80%, while the associations with rainfall and wind-speed were weaker. The approach is able to examine multiple factors and model how complex trends arise, e.g. the consistent steep increase in campylobacteriosis in England and Wales in May-June and its spatial variability. This transparent and straightforward approach leads to accurate predictions without relying on regression models and/or postulating specific parameterisations. A key output of the analysis is a thoroughly phenomenological description of the incidence of the disease conditional on specific local weather factors. The study can be crucially important to infer the elusive mechanism of transmission of campylobacteriosis; for instance, by simulating the conditional incidence for a postulated mechanism and compare it with the phenomenological patterns as benchmark. The findings challenge the assumption, commonly made in statistical models, that the transformed mean rate of infection for diseases like campylobacteriosis is a mere additive and combination of the environmental variables.
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  • 文章类型: Journal Article
    虽然环境因素之间的关系,比如天气状况和空气污染,并发现了COVID-19病例死亡率(CFR),感染病例在不同感染阶段所暴露的这些因素的影响(例如,病毒暴露时间,潜伏期,并且在症状发作时或之后)仍然未知。了解这一联系有助于降低死亡率。在第一波COVID-19在英国(英国),CFR在英国四个国家之间差异很大,允许评估这种不同的影响。我们开发了一个与分布滞后非线性模型相结合的广义线性混合效应模型来估计天气因素的优势比(即,温度,阳光,相对湿度,和降雨)和空气污染(即,臭氧,[公式:见正文],[公式:见正文],[公式:见正文],[公式:见正文]和[公式:见正文])使用2020年3月26日至2020年9月15日在英国的数据。经过回顾性时间调整后,使用反投影技术估计CFR,根据Akaike信息标准和CFR预测值与观测值之间的接近程度,采用逐步模型选择方法选择最佳模型。当低温(6°C)发生1天前时,死亡风险达到最大水平(OR1.59;95%CI1.52-1.63),(OR1.24;95%CI1.18-1.30)后3天延长日光持续时间(11-14h),并在症状发作后1天增加[公式:参见正文](19μg/m3)(OR1.12;95%CI1.09-1.16)。重新开放后,许多COVID-19病例会在症状出现后被发现。研究结果强调了考虑到症状发作前后的时间,设计针对严重疾病或死亡的不同预防措施的重要性。
    Although the relationship between the environmental factors, such as weather conditions and air pollution, and COVID-19 case fatality rate (CFR) has been found, the impacts of these factors to which infected cases are exposed at different infectious stages (e.g., virus exposure time, incubation period, and at or after symptom onset) are still unknown. Understanding this link can help reduce mortality rates. During the first wave of COVID-19 in the United Kingdom (UK), the CFR varied widely between and among the four countries of the UK, allowing such differential impacts to be assessed. We developed a generalized linear mixed-effect model combined with distributed lag nonlinear models to estimate the odds ratio of the weather factors (i.e., temperature, sunlight, relative humidity, and rainfall) and air pollution (i.e., ozone, [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text]) using data between March 26, 2020 and September 15, 2020 in the UK. After retrospectively time adjusted CFR was estimated using back-projection technique, the stepwise model selection method was used to choose the best model based on Akaike information criteria and the closeness between the predicted and observed values of CFR. The risk of death reached its maximum level when the low temperature (6 °C) occurred 1 day before (OR 1.59; 95% CI 1.52-1.63), prolonged sunlight duration (11-14 h) 3 days after (OR 1.24; 95% CI 1.18-1.30) and increased [Formula: see text] (19 μg/m3) 1 day after the onset of symptom (OR 1.12; 95% CI 1.09-1.16). After reopening, many COVID-19 cases will be identified after their symptoms appear. The findings highlight the importance of designing different preventive measures against severe illness or death considering the time before and after symptom onset.
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  • 文章类型: Journal Article
    炎症性肠病(IBD)是一种特发性炎症性疾病,其特征是慢性和复发性表现。已知几种环境因素是IBD恶化的触发因素。然而,IBD恶化与环境温度之间的关联尚不确定.这项研究旨在评估由于环境温度引起的IBD急性加重的风险。我们使用来自韩国的全国性索赔数据进行了双向病例交叉研究。外部验证是在英国的一个大型前瞻性队列中进行的。我们证实了IBD急性加重与短期环境温度变化向严寒之间的显著关联,在寒冷天气(-19.4°C-4.3°C)(奇数比[OR]=1.13,95%置信区间[CI]:1.13-1.14)和炎热天气(21.3°C-33.5°C)(OR=1.16,95%CI:1.15-1.17)。然而,在中等天气(4.3°C-21.3°C)中,相关性不明显。外部验证表明,在较冷天气(-13.4°C至2.6°C)(OR=1.90,95%CI:1.62-2.22)和较热天气(15.7°C-28.4°C)(OR=1.41,95%CI:1.32-1.51)中,急性加重风险额外升高的结果是一致的。我们观察并验证了短期环境温度变化与寒冷和炎热天气下IBD的急性加重有关。我们的发现提供了温度变化与IBD急性加重相关的证据。
    Inflammatory bowel disease (IBD) is an idiopathic inflammatory disorder characterized by chronic and relapsing manifestations. Several environmental factors are known as triggers for exacerbation of IBD. However, an association between exacerbation of IBD and ambient temperature is uncertain. This study aimed to estimate the risk of acute exacerbation of IBD due to ambient temperature. We performed a bidirectional case-crossover study using a nationwide claim data from South Korea. The external validation was conducted with a large prospective cohort in the United Kingdom. We confirmed significant associations between acute exacerbation of IBD and the short-term ambient temperature changes toward severe temperatures, in the cold weather (-19.4°C-4.3°C) (odd ratio [OR] = 1.13, 95% confidence interval [CI]: 1.13-1.14) and in the hot weather (21.3°C-33.5°C) (OR = 1.16, 95% CI: 1.15-1.17). However, the association was not significant in the moderate weather (4.3°C-21.3°C). The external validation suggested consistent results with additional elevation of acute exacerbation risk in the colder weather (-13.4°C to 2.6°C) (OR = 1.90, 95% CI: 1.62-2.22) and in the hotter weather (15.7°C-28.4°C) (OR = 1.41, 95% CI: 1.32-1.51). We observed and validated that the short-term ambient temperature changes were associated with acute exacerbation of IBD in the cold and hot weathers. Our findings provide evidence that temperature changes are associated with the acute exacerbation of IBD.
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