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American Journal of Epidemiology Nov 2018Few investigations have explored temperature and birth outcomes. In a retrospective cohort study, we examined apparent temperature, a combination of temperature and...
Few investigations have explored temperature and birth outcomes. In a retrospective cohort study, we examined apparent temperature, a combination of temperature and relative humidity, and term low birth weight (LBW) among 43,629 full-term LBW infants and 2,032,601 normal-weight infants in California (1999-2013). The California Department of Public Health provided birth certificate data, while meteorological data came from the California Irrigation Management Information System, US Environmental Protection Agency, and National Centers for Environmental Information. After considering several temperature metrics, we observed the best model fit for term LBW over the full gestation (per 10-degrees-Fahrenheit (°F) increase in apparent temperature, 13.0% change, 95% confidence interval: 4.1, 22.7) above 55°F, and the greatest association was for third-trimester exposure above 60°F (15.8%, 95% confidence interval: 5.0, 27.6). Apparent temperature during the first month of pregnancy exhibited no significant risk, while the first trimester had a significantly negative association, and second trimester, last month, and last 2 weeks had slightly increased risks. Mothers who were black or older, delivered male infants, or gave birth during the warm season had infants at the highest risks. This study provides further evidence for adverse birth outcomes from heat exposure for vulnerable subgroups of pregnant women.
Topics: Adolescent; Adult; Age Factors; Body Mass Index; California; Female; Humans; Humidity; Infant; Infant, Low Birth Weight; Infant, Newborn; Male; Pregnancy; Pregnancy Trimesters; Racial Groups; Residence Characteristics; Retrospective Studies; Risk Factors; Seasons; Socioeconomic Factors; Temperature; Young Adult
PubMed: 29901701
DOI: 10.1093/aje/kwy116 -
Annals of Clinical and Laboratory... Jan 2024To present the case of an athlete with hypereosinophilic syndrome (HES).
OBJECTIVE
To present the case of an athlete with hypereosinophilic syndrome (HES).
CASE REPORT
We present a 25-year-old female athlete, with no significant past medical history, who had a two-month history of progressive dry cough, wheezing, exertional dyspnea, and chest pain. Physical examination revealed patient to be febrile to 101.6 degrees Fahrenheit and tachycardic to 120 beats per minute with new leukocytosis of 35.9x10/L and eosinophilia of 24,000/μL. She was also found to have elevated troponins ~1.5 ng/mL and creatine kinase (CK) 203 U/L. Her overall clinical picture was concerning for hypereosinophilic syndrome with multiorgan system involvement.
CONCLUSION
Findings endorse the diagnosis of HES. HES is a rare condition that is difficult to diagnose. Early clinical diagnostic signs of HES may include fatigue, cough, breathlessness, and fever.
Topics: Humans; Female; Adult; Hypereosinophilic Syndrome; Cough; Athletes
PubMed: 38514061
DOI: No ID Found -
International Journal For Quality in... Feb 2021The emergence of coronavirus disease of 2019 (COVID-19) highlights the necessity of rapidly identifying and isolating potentially infected individuals. Evaluating this...
QUALITY ISSUE
The emergence of coronavirus disease of 2019 (COVID-19) highlights the necessity of rapidly identifying and isolating potentially infected individuals. Evaluating this preparedness requires an assessment of the full clinical system, from intake to isolation.
INITIAL ASSESSMENT
Unannounced Standardized Patients (USPs) present a nimble, sensitive methodology for assessing this readiness.
CHOICE OF SOLUTION
Pilot the USP methodology, which employs an actor trained to present as a standardized, incognito potentially infected patient, to assess clinical readiness for potential COVID-19 patients at an urban, community safety-net clinic.
IMPLEMENTATION
The USP was trained to present at each team's front desk with the complaint of feeling unwell (reporting a fever of 101 degrees Fahrenheit in the past 24 hours) and exposure to a roommate recently returned from Beijing. The USP was trained to complete a behaviorally anchored assessment of the care she received from the clinical system.
EVALUATION
There was clear variation in care USPs received; some frontline clerical staff followed best practices; others did not. Signage and information on disease spread prevention publicly available was inconsistent. Qualitative comments shared by the USPs and those gathered during group debrief reinforced the experiences of the USPs and hospital leadership.
LESSONS LEARNED
USPs revealed significant variation in care practices within a clinical system. Utilization of this assessment methodology can provide just-in-time clinical information about readiness and safety practices, particularly during emerging outbreaks. USPs will prove especially powerful as clinicians and systems return to outpatient visits while remaining vigilant about potentially infected individuals.
Topics: COVID-19; Disaster Planning; Humans; New York City; Pandemics; Patient Isolation; Patient Simulation; Pilot Projects; SARS-CoV-2; Safety-net Providers
PubMed: 32991675
DOI: 10.1093/intqhc/mzaa116 -
PloS One 2021Intensity and duration of the COVID-19 pandemic, and planning required to balance concerns of saving lives and avoiding economic collapse, could depend significantly on...
IMPORTANCE
Intensity and duration of the COVID-19 pandemic, and planning required to balance concerns of saving lives and avoiding economic collapse, could depend significantly on whether SARS-CoV-2 transmission is sensitive to seasonal changes.
OBJECTIVE
Hypothesis is that increasing temperature results in reduced SARS CoV-2 transmission and may help slow the increase of cases over time.
SETTING
Fifty representative Northern Hemisphere countries meeting specific criteria had sufficient COVID-19 case and meteorological data for analysis.
METHODS
Regression was used to find the relationship between the log of number of COVID-19 cases and temperature over time in 50 representative countries. To summarize the day-day variability, and reduce dimensionality, we selected a robust measure, Coefficient of Time (CT), for each location. The resulting regression coefficients were then used in a multivariable regression against meteorological, country-level and demographic covariates.
RESULTS
Median minimum daily temperature showed the strongest correlation with the reciprocal of CT (which can be considered as a rate associated with doubling time) for confirmed cases (adjusted R2 = 0.610, p = 1.45E-06). A similar correlation was found using median daily dewpoint, which was highly colinear with temperature, and therefore was not used in the analysis. The correlation between minimum median temperature and the rate of increase of the log of confirmed cases was 47% and 45% greater than for cases of death and recovered cases of COVID-19, respectively. This suggests the primary influence of temperature is on SARS-CoV-2 transmission more than COVID-19 morbidity. Based on the correlation between temperature and the rate of increase in COVID-19, it can be estimated that, between the range of 30 to 100 degrees Fahrenheit, a one degree increase is associated with a 1% decrease-and a one degree decrease could be associated with a 3.7% increase-in the rate of increase of the log of daily confirmed cases. This model of the effect of decreasing temperatures can only be verified over time as the pandemic proceeds through colder months.
CONCLUSIONS
The results suggest that boreal summer months are associated with slower rates of COVID-19 transmission, consistent with the behavior of a seasonal respiratory virus. Knowledge of COVID-19 seasonality could prove useful in local planning for phased reductions social interventions and help to prepare for the timing of possible pandemic resurgence during cooler months.
Topics: COVID-19; Hot Temperature; Humans; Meteorological Concepts; Pandemics; SARS-CoV-2; Seasons; Weather
PubMed: 33596214
DOI: 10.1371/journal.pone.0246167 -
Bulletins Et Memoires de La Societe...
Topics: Body Temperature; Bronchopneumonia; Hypothermia
PubMed: 13329902
DOI: No ID Found -
Sensors (Basel, Switzerland) Apr 2023Temperature-controlled closed-loop systems are vital to the transportation of produce. By maintaining specific transportation temperatures and adjusting to environmental...
Temperature-controlled closed-loop systems are vital to the transportation of produce. By maintaining specific transportation temperatures and adjusting to environmental factors, these systems delay decomposition. Wireless sensor networks (WSN) can be used to monitor the temperature levels at different locations within these transportation containers and provide feedback to these systems. However, there are a range of unique challenges in WSN implementations, such as the cost of the hardware, implementation difficulties, and the general ruggedness of the environment. This paper presents the novel results of a real-life application, where a sensor network was implemented to monitor the environmental temperatures at different locations inside commercial temperature-controlled shipping containers. The possibility of predicting one or more locations inside the container in the absence or breakdown of a logger placed in that location is explored using combinatorial input-output settings. A total of 1016 machine learning (ML) models are exhaustively trained, tested, and validated in search of the best model and the best combinations to produce a higher prediction result. The statistical correlations between different loggers and logger combinations are studied to identify a systematic approach to finding the optimal setting and placement of loggers under a cost constraint. Our findings suggest that even under different and incrementally higher cost constraints, one can use empirical approaches such as neural networks to predict temperature variations in a location with an absent or failed logger, within a margin of error comparable to the manufacturer-specified sensor accuracy. In fact, the median test accuracy is 1.02 degrees Fahrenheit when using only a single sensor to predict the remaining locations under the assumptions of critical system failure, and drops to as little as 0.8 and 0.65 degrees Fahrenheit when using one or three more sensors in the prediction algorithm. We also demonstrate that, by using correlation coefficients and time series similarity measurements, one can identify the optimal input-output pairs for the prediction algorithm reliably under most instances. For example, discrete time warping can be used to select the best location to place the sensors with a 92% match between the lowest prediction error and the highest similarity sensor with the rest of the group. The findings of this research can be used for power management in sensor batteries, especially for long transportation routes, by alternating standby modes where the temperature data for the OFF sensors are predicted by the ON sensors.
PubMed: 37177507
DOI: 10.3390/s23094303 -
Statistics in Medicine Jul 2014We provide a template for finding target allocation proportions in optimal allocation designs where the target will be invariant for both shifts in location and scale of...
We provide a template for finding target allocation proportions in optimal allocation designs where the target will be invariant for both shifts in location and scale of the response distributions. One possible application of such target allocation proportions is to carry out a response-adaptive allocation. While most of the existing designs are invariant for any change in scale of the underlying distributions, they are not location invariant in most of the cases. First, we indicate this serious flaw in the existing literature and illustrate how this lack of location invariance makes the performance of the designs very poor in terms of allocation for any drastic change in location, such as the changes from degrees centigrade to degrees Fahrenheit. We illustrate that unless a target allocation is location invariant, it might lead to a completely irrelevant and useless target for allocation. Then we discuss how such location invariance can be achieved for general continuous responses. We illustrate the proposed method using some real clinical trial data. We also indicate the possible extension of the procedure for more than two treatments at hand and in the presence of covariates.
Topics: Computer Simulation; Humans; Models, Statistical; Neuralgia, Postherpetic; Pain; Pregabalin; Research Design; gamma-Aminobutyric Acid
PubMed: 24549681
DOI: 10.1002/sim.6110 -
Cureus May 2024subspecies () is a zoonotic pathogen that primarily infects horses, pigs, and dogs. Although rare, it has also been shown to infect humans who consume unpasteurized...
subspecies () is a zoonotic pathogen that primarily infects horses, pigs, and dogs. Although rare, it has also been shown to infect humans who consume unpasteurized dairy food or have direct contact with horses. Here, we present a case of bacteremia in a patient without a clear mode of transmission. An 86-year-old male with a past medical history of coronary artery disease, heart failure with reduced ejection fraction, complete heart block status post pacemaker, hypertension, hyperlipidemia, and type 2 diabetes mellitus presented to the Emergency Department with fever and chills. He had fevers and rigors for three days but denied weight loss, cough, sore throat, or rashes. In the Emergency Department, vital signs revealed a fever of 101.2 degrees Fahrenheit and a heart rate of 110 with other stable vital signs. The physical exam was unremarkable except for tachycardia, and laboratory work revealed no leukocytosis but elevated inflammatory markers and elevated lactate. Computed tomography of the chest, abdomen, and pelvis did not reveal any source of infection. Blood cultures grew and the Infectious Diseases team was consulted, who started the patient on Penicillin G. Due to concern for pacer-lead infective endocarditis, transthoracic and transesophageal echocardiograms were performed, which did not show valvular vegetations. Repeat blood cultures showed clearance of the infection, and the patient was ultimately discharged on amoxicillin. While our patient denied consuming unpasteurized dairy products or having direct contact with horses, upon further questioning, he did endorse family members who occasionally interacted with horses. This case is valuable as it adds to the sparse literature on infections specifically in humans. Extensive history taking is of utmost importance when a clear source of infection is not easily identifiable. Further research is also needed to better understand the various modes of transmission of this bacterium to better target and caution those at an increased risk of infection.
PubMed: 38854287
DOI: 10.7759/cureus.59911 -
Weather, Climate, and Society (Print) Jul 2023Climate change is expected to impact individuals' recreational choices, as changing temperatures and precipitation patterns influence participation in outdoor recreation...
Climate change is expected to impact individuals' recreational choices, as changing temperatures and precipitation patterns influence participation in outdoor recreation and alternative activities. This paper empirically investigates the relationship between weather and outdoor recreation using nationally representative data from the contiguous United States. We find that across most outdoor recreational activities, participation is lowest on the coldest days (<35 degrees Fahrenheit) and highest at moderately high temperatures (80 to 90 degrees). Notable exceptions to this trend include water sports and snow and ice sports, for which participation peaks at the highest and lowest temperatures, respectively. If individuals continue to respond to temperature changes the same way that they have in the recent past, in a future climate that has fewer cool days and more moderate and hot days, our model anticipates net participation across all outdoor recreation activities will increase by 88 million trips annually at 1 degree Celsius of warming (CONUS) and up to 401 million trips at 6 degrees of warming, valued between $3.2 billion and $15.6 billion in consumer surplus annually (2010 population). The increase in trips is driven by participation in water sports; excluding water sports from future projections decreases the consumer surplus gains by approximately 75 percent across all modeled degrees of warming. If individuals in northern regions respond to temperature like people in southern regions currently do (a proxy for adaptation), total outdoor recreation trips will increase by an additional 17 percent compared to no adaptation at 6 degrees of warming. This benefit is generally not seen at lower degrees of warming.
PubMed: 37415774
DOI: 10.1175/wcas-d-22-0060.1 -
Cureus Nov 2023A heat stroke (HS) is a medical emergency that can occur when the body is unable to cool itself down after overexertion in a hot condition. It is characterized by a high...
A heat stroke (HS) is a medical emergency that can occur when the body is unable to cool itself down after overexertion in a hot condition. It is characterized by a high body temperature (usually greater than 40.5 degrees Celsius or 104.9 degrees Fahrenheit) and altered mental status. HS can cause a wide range of physiological changes in the body, including damage to the brain, heart, liver, kidneys, and muscles. In the case report presented, the patient was a 40-year-old man who developed severe HS. His condition rapidly deteriorated, and he developed multi-organ failure, involving the brain, liver, kidneys, muscles, and hematological system. The patient was admitted to the intensive care unit (ICU) and intubated, despite aggressive treatment. After an 18-day stay in the ICU, the patient achieved full recovery except for myopathy, which necessitated physiotherapy.
PubMed: 38111401
DOI: 10.7759/cureus.48984