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Are the current thresholds, indicators, and time window for cold warning effective enough to protect cardiovascular health?

ABSTRACT: More extreme cold weather and larger weather variations have raised concerns regarding their effects on public health. Although prior studies assessed the effects of cold air temperature on health, especially mortality, limited studies evaluated wind chill temperatures on morbidity, and health effects under the current cold warning threshold. This study identified the thresholds, lag periods, and best indicators of extreme cold on cardiovascular disease (CVD) by comparing effects of wind chill temperatures and cold air temperatures on CVD emergency department (ED) visits in winter and winter transition months. Information was collected on 662,625 CVD ED visits from statewide hospital discharge dataset in New York State. Meteorological factors, including air temperature, wind speed, and barometric pressure were collected from National Oceanic and Atmospheric Administration. A case-crossover approach was used to assess the extreme cold-CVD relationship in winter (December-February) and transition months (November and March) after controlling for PM2.5. Conditional logistic regression models were employed to analyze the association between cold weather factors and CVD ED visits. We observed CVD effects occurred when wind chill temperatures were as high as -3.8?°C (25?°F), warmer than current wind chill warning standard (?-28.8?°C or ?-20?°F). Wind chill temperature was a more sensitive indicator of CVD ED visits during winter with temperatures???-3.8?°C (25?°F) with delay effect (lag 6); however, air temperature was better during transition months for temperatures???7.2?°C (45?°F) at earlier lag days (1-3). Among all CVD subtypes, hypertension ED visit had the strongest negative association with both wind chill temperature and air temperature. This study recommends modifying the current cold warning temperature threshold given larger proportions of CVD cases are occurring at considerably higher temperatures than the current criteria. We also recommend issuing cold warnings in winter transitional months.

SUBMITTER: Lin S

PROVIDER: S-EPMC6021135 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Are the current thresholds, indicators, and time window for cold warning effective enough to protect cardiovascular health?

Lin Shao S Lawrence Wayne R WR Lin Ziqiang Z DiRienzo Stephen S Lipton Kevin K Dong Guang-Hui GH Leung Ricky R Lauper Ursula U Nasca Philip P Stuart Neil N

The Science of the total environment 20180526

More extreme cold weather and larger weather variations have raised concerns regarding their effects on public health. Although prior studies assessed the effects of cold air temperature on health, especially mortality, limited studies evaluated wind chill temperatures on morbidity, and health effects under the current cold warning threshold. This study identified the thresholds, lag periods, and best indicators of extreme cold on cardiovascular disease (CVD) by comparing effects of wind chill t ...[more]

PMID: 29929324

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Project description:BackgroundIt is assumed that different pain phenotypes are based on varying molecular pathomechanisms. Distinct ion channels seem to be associated with the perception of cold pain, in particular TRPM8 and TRPA1 have been highlighted previously. The present study analyzed the distribution of cold pain thresholds with focus at describing the multimodality based on the hypothesis that it reflects a contribution of distinct ion channels.MethodsCold pain thresholds (CPT) were available from 329 healthy volunteers (aged 18 - 37 years; 159 men) enrolled in previous studies. The distribution of the pooled and log-transformed threshold data was described using a kernel density estimation (Pareto Density Estimation (PDE)) and subsequently, the log data was modeled as a mixture of Gaussian distributions using the expectation maximization (EM) algorithm to optimize the fit.ResultsCPTs were clearly multi-modally distributed. Fitting a Gaussian Mixture Model (GMM) to the log-transformed threshold data revealed that the best fit is obtained when applying a three-model distribution pattern. The modes of the identified three Gaussian distributions, retransformed from the log domain to the mean stimulation temperatures at which the subjects had indicated pain thresholds, were obtained at 23.7 °C, 13.2 °C and 1.5 °C for Gaussian #1, #2 and #3, respectively.ConclusionsThe localization of the first and second Gaussians was interpreted as reflecting the contribution of two different cold sensors. From the calculated localization of the modes of the first two Gaussians, the hypothesis of an involvement of TRPM8, sensing temperatures from 25 - 24 °C, and TRPA1, sensing cold from 17 °C can be derived. In that case, subjects belonging to either Gaussian would possess a dominance of the one or the other receptor at the skin area where the cold stimuli had been applied. The findings therefore support a suitability of complex analytical approaches to detect mechanistically determined patterns from pain phenotype data.

Project description:Water quality deterioration is expected to worsen the light conditions in shallow coastal waters with increasing human activities. Temperate seagrasses are known to tolerate a highly fluctuating light environment. However, depending on their ability to adjust to some decline in light conditions, decreases in daily light quantity and quality could affect seagrass physiology, productivity, and, eventually, survival if the Minimum Quantum Requirements (MQR) are not reached. To better understand if, how, and to what extent photosynthetic adjustments contribute to light acclimation, eelgrass (Zostera marina L.) shoots from the cold temperate St. Lawrence marine estuary (Rimouski, QC, Canada) were exposed to seven light intensity treatments (6, 36, 74, 133, 355, 503, and 860 μmol photons m-2 s-1, 14:10 light:dark photoperiod). Photosynthetic capacity and efficiency were quantified after five and 25 days of light exposure by Pulse Amplitude Modulated (PAM) fluorometry to assess the rapid response of the photosynthetic apparatus and its acclimation potential. Photoacclimation was also studied through physiological responses of leaves and shoots (gross and net primary production, pigment content, and light absorption). Shoots showed proof of photosynthetic adjustments at irradiances below 200 μmol photons m-2 s-1, which was identified as the threshold between limiting and saturating irradiances. Rapid Light Curves (RLC) and net primary production (NPP) rates revealed sustained maximal photosynthetic rates from the highest light treatments down to 74 μmol photons m-2 s-1, while a compensation point (NPP = 0) of 13.7 μmol photons m-2 s-1 was identified. In addition, an important package effect was observed, since an almost three-fold increase in chlorophyll content in the lowest compared to the highest light treatment did not change the leaves' light absorption. These results shed new light on photosynthetic and physiological processes, triggering light acclimation in cold temperate eelgrass. Our study documents an MQR value for eelgrass in the St. Lawrence estuary, which is highly pertinent in the context of conservation and restoration of eelgrass meadows.

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Are the current thresholds, indicators, and time window for cold warning effective enough to protect cardiovascular health?

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Are the current thresholds, indicators, and time window for cold warning effective enough to protect cardiovascular health?

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