Seasonal variations and social disparities in asthma hospitalizations and outcomes.

OBJECTIVE: Exposure to asthma exacerbating triggers may be dependent on the season and an individual's social factors and subsequent means to avoid triggers. We assessed for seasonal variations and differential outcomes based on race and income in admissions for asthma in a United States nationwide assessment. METHODS: This retrospective study assessed adult hospitalizations for asthma 2016-2019 using the National Inpatient Sample. Hospitalizations were categorized by season: winter (December-February), spring (March-May), summer (June-August), fall (September-November). Multivariable linear and logistic regression were used to assess associations between season, race, income quartile (determined by the median income within a patient's ZIP code), and outcomes. RESULTS: The study included 423,140 admissions with a mean age of 51 years, and 73% of the cohort being female and 56% non-white. Admissions peaked during winter (124, 145) and were lowest in summer (80,525). Intubation rates were increased in summer compared to winter (2.73 vs 1.93%, aOR = 1.19, 95% CI: 1.04-1.37) as were rates of noninvasive positive pressure ventilation (NIPPV) (7.92 vs 7.06%, aOR = 1.08, 95% CI: 1.00-1.17). Compared to white patients, intubation (2.53 vs 1.87%, absolute difference 0.66%, aOR = 1.14, 95% CI: 1.02-1.29) and NIPPV (9.95 vs 5.45%, absolute difference 4.5%, aOR = 1.69, 95% CI: 1.57-1.82) were increased in Black patients. No significant associations between income and clinical outcomes were found. CONCLUSIONS: Asthma admission peak during winter, while summer admissions and non-white race are associated with higher rates of NIPPV and intubation. Public health initiatives and strategically timed outpatient visits could combat seasonal variation and social disparities in asthma outcomes.

Seasonal patterns of communicable disease incidence and antibiotic prescribing in Moria refugee camp, Greece.

BACKGROUND: Infectious diseases remain a major risk for refugees living in camps. Limited research has been undertaken into the burden and impact of infections in the current refugee crisis around the Mediterranean.This analysis examines the frequency and incidence rates of common infections, and use of antibiotics at a healthcare facility inside Moria refugee camp on the island of Lesvos, Greece, during the winter and summer seasons of 2019. METHODS: This is a retrospective analysis of routinely, prospectively collected service data from the main acute healthcare facility inside Moria camp. RESULTS: Of a total of 9601 consultations, 25.16% were for infections (winter: 31.53%, summer: 19.45%). Respiratory, skin and gastrointestinal infections were the most frequent, with incidence rates up to 3.5 times, 50 times and twice as high as those in Western Europe, respectively. Antibiotic prescribing was high (27.7% of all respiratory infections) with high use of broad-spectrum antibiotics (40.2%), raising concerns about induction of antimicrobial resistance. CONCLUSIONS: The burden of infectious diseases in refugee camps remains high throughout all seasons. Antimicrobial stewardship programmes should be adapted to refugee camp settings to prevent the development of unnecessary antimicrobial resistance. Improving living conditions and access to healthcare in refugee camps is likely to reduce infection rates and antimicrobial resistance among refugees.

Food consumption patterns, seasonal dietary diversity, and factors affecting food intake in rural Eastern Uganda: A mixed-methods cross-sectional study.

This mixed-methods cross-sectional study examines food consumption patterns, dietary diversity, and factors affecting food intake and malnutrition in the rural Mbale District in Eastern Uganda, during both wet and dry seasons. Participants (n = 100; 66% females) completed a food frequency questionnaire identifying foods and beverages consumed in the preceding 12 months. Individual interviews (n = 8) were conducted with key workers. Analysis of seventeen food items revealed seasonal variations in carbohydrate and protein sources. During the dry season, staples like matooke (mashed boiled plantains) and sweet and Irish potatoes were affected, while protein-rich foods such as beans and groundnuts saw increased consumption in the wet season. Fruit and vegetable intake also rose during the wet season. The main causes of malnutrition that emerged from the interviews were the lack of knowledge about food and nutrition, financial struggles, climate impact, and cultural beliefs. The last theme covered strategies to combat malnutrition. Although carbohydrate intake remains consistent throughout seasons due to reliance on posho (maize flour porridge) and cassava, variations in the number of meals and protein sources, particularly beans and groundnuts, were observed. Both of these, being the primary protein sources in rural households' diets, are highly susceptible to climate fluctuations. This may pose significant implications for food security, as heightened climate instability may impede their production. Solutions to combat malnutrition discussed by the interviewees include education, employment, family planning, and healthcare improvements. Professionals emphasise the need for comprehensive approaches to address these complex issues. In addition, data on food consumption during the dry and wet seasons should be collected as a difference in food consumption during the seasons may become more prominent with the need to implement tailored interventions.

Seasonality and sun exposure in incidence of major depression, bipolar disorder, and first-time use of antidepressant medication.

INTRODUCTION: Seasonality in depressive and bipolar disorders, are recognized in the ICD-10/11 and DSM-5 diagnostic systems. The existence of a seasonal pattern of hospital diagnosis of major depression, bipolar disorder and prescription of antidepressant medications has not been evaluated in the Danish population. METHODS: We retrieved date and year for all first-time hospital contacts with depression or bipolar disorder between 1999 and 2019, registered in the Danish National Patient Registry. Depression was defined using the ICD-10 F32-F33 codes, and for bipolar disorder the F30 or F31 codes. Date and year of all first-time purchases of antidepressant medications with ATC codes (N06A) between 1999 and 2021 were retrieved from the Danish National Prescription Registry, containing information on all prescribed drugs dispensed at pharmacies since 1995. Data on sunlight hours from 2012 to 2021 were retrieved from the Danish Metrological Institute. RESULTS: Incidences of hospital diagnoses as well as purchases of medication varied with month and season. The monthly variations were larger for antidepressant medication and smallest for bipolar disorder. The multiple linear regression analysis showed that number of first-time diagnoses of depression or bipolar disorder did not correlate with season. For antidepressant medication the number of first-time prescriptions was significantly lower in summer compared to the winter season. CONCLUSION: This study found a seasonal variation of first-time prescriptions of antidepressant medication. We did not find a seasonal variation in first-time hospital diagnoses. Further research looking into depression severity, polarity of bipolar illness episodes, lag-time for sunlight exposure, and specific parts of the yearly photoperiods should be conducted.

Microplastics and plastisphere at surface waters in the Southwestern Caribbean sea.

Pollution generated by plastic waste has brought an environmental problem characterized by the omnipresence of smaller pieces of this material known as microplastics (MP). This issue was addresses by collecting samples with 250 µm pore size nets in two marine-coastal sectors of Southwestern Caribbean Sea during two contrasting seasons. Higher concentrations were found in rainy season than in dry season, reaching respectively 1.72 MP/m3 and 0.22 MP/m3. Within each sector, there were differences caused firstly by localities of higher concentrations of semi-closed water bodies localities during rainy season (Ciénaga Grande de Santa Marta and La Caimanera marsh), and secondly by lower concentrations of localities with less influenced of flow rates during dry season (Salamanca and Isla Fuerte). Moreover, the lowest concentration in dry season corresponding to La Caimanera marsh reflects how the community environmental management might decrease MP pollution. In both sectors and seasons, the particles of 0.3 mm (0.3-1.4 mm) size class dominated over those of 1.4 mm (1.4-5.0 mm) (reaching each respectively 1.33 MP/m3 and 0.39 MP/m3), with a dominance of fibers, except in the rainy season in Magdalena, where they were films. Using the FTIR technique, polypropylene was identified as the most abundant polymer in both sectors. The composition of the assemblage of microorganisms attached to microplastics presented higher richness and differed from that of free-living planktonic microbes. The most abundant members of the plastisphere were proteobacteria whose major representation was the pathogenic genus Vibrio, while the cyanobacteria dominated in seawater samples.

Sources, fate and influencing factors of nitrate in farmland drainage ditches of the irrigation area.

Global irrigation areas face the contradictory challenges of controlling nitrate inputs and ensuring food-safe production. To prevent and control nitrate pollution in irrigation areas, the study using the Yellow River basin (Ningxia section) of China as a case study, employed nitrogen and oxygen dual isotope tracing and extensive field investigations to analyze the sources, fate, and influencing factors of nitrate in agricultural drainage ditches. The results of source tracing of nitrate showed that annual proportions of nitrate sources entering the Yellow River in the ditches are as follows: for manure & sewage, fertilizer, and natural sources, the ratios are 33%, 35%, and 32% overall. The results of nitrate fate showed that nitrates derived from nitrate fertilizer exhibit a lower residual rate in drainage ditches (ecological ditches) compared to ammonium fertilizer, which can undergo self-ecological restoration within one year. The results of influencing factors showed that crops with high water and nutrient requirements, such as vegetables, the nitrate pollution and environmental harm resulting from "exploitative cultivation" are five times more than normal cultivation practices in dryland and paddy fields, especially winter irrigation without crop interception exacerbates the leaching of nitrate from the soil. Therefore, nitrate management in irrigation areas should focus on preventing and controlling "exploitative cultivation" and losses during winter irrigation, while appropriately adjusting the application ratio of ammonium nitrogen fertilizers. The results of the study can guide strategies to mitigate nitrate pollution in irrigated areas such as livestock farming, fertilizer application, irrigation management, ditch optimization, and crop cultivation.

How physicochemical and nutritional traits of potatoes may vary under field conditions over long periods.

BACKGROUND: Potato is the most important non-grain crop worldwide, whose quality characteristics are always affected by temporal and spatial variability. Knowledge of the performance consistency of quality characteristics over long periods could prove very important to identify which quality traits are less variable over time, and therefore provide greater guarantees of stability. In this research, variations in physicochemical and nutritional traits of tubers over five consecutive growing seasons of two potato genotypes (Arizona and Vogue) were monitored in two locations. RESULTS: Although qualitative performances of genotypes fluctuated across the seasons in both locations, two physicochemical traits (pH and dry matter content) and starch content showed less variability throughout the five seasons compared to total soluble solids and most of the nutritional traits (namely reducing sugars, citric acid, vitamin C, total phenolics and antioxidant capacity), which were considerably influenced by weather conditions. CONCLUSION: The results suggest that pH, dry matter content and starch content traits could be used advantageously in studies of temporal stability in potatoes. This approach could prove useful in providing scientific support for the setup of potato protected geographical identifications. © 2024 Society of Chemical Industry.

Injection of antioxidant trace minerals/vitamins into peripartum crossbred cows improves the nutritional and immunological properties of colostrum/milk and the health of their calves under heat stress conditions.

Multimineral and vitamin injections can provide better nutrient availability at the cellular level, which is essential for mitigating transition period stress and improving the wellbeing and productivity of dairy cows. The present study was conducted to assess the colostrum quality and calf health after intramuscular injection of multi-minerals (MM) and multi-vitamins (MV) to peripartum cows during winter (THI = 58 to 66) and summer (THI = 78 to 82) months. In each season, twenty-four pregnant crossbred Karan Fries cows were grouped into four, each consisting of six cows. Group I, referred to as the Control, received solely the basal diet, without any additional supplements. Groups II, III, and IV were administered additional MM (T1), MV (T2), and a combined MM and MV (T3) along with their basal diet, starting 30 days before calving and continuing for 30 days after calving. Blood samples were collected from the calves, while colostrum/milk samples were obtained from the cows on days 1, 3, 7, and 15 after calving. The somatic cell counts (SCC) in the milk were determined using a cell counter. Cortisol, IgG, IGF1 and total immunoglobulins (TIG) in whey and plasma from cow colostrum/milk or calf blood samples were estimated by ELISA. Cows that calved in the summer exhibited notably reduced levels (P < 0.05) of IgG, milk, and plasma IGF1, along with lower calf body weights, in comparison to those calving in the winter season. Furthermore, the summer months saw significant increases (P < 0.05) in plasma and milk cortisol levels, as well as total somatic cell counts (SCC) in both colostrum and milk samples. Maximum beneficial effect was observed in T3 group. Results indicate that injections to peripartum cows could be an important strategy for improving colostrum quality and calf health during the summer seasons.

Host individual and gut location are more important in gut microbiota community composition than temporal variation in the marine herbivorous fish Kyphosus sydneyanus.

BACKGROUND: Gut microbiota play a key role in the nutrition of many marine herbivorous fishes through hindgut fermentation of seaweed. Gut microbiota composition in the herbivorous fish Kyphosus sydneyanus (family Kyphosidae) varies between individuals and gut sections, raising two questions: (i) is community composition stable over time, especially given seasonal shifts in storage metabolites of dietary brown algae, and (ii) what processes influence community assembly in the hindgut? RESULTS: We examined variation in community composition in gut lumen and mucosa samples from three hindgut sections of K. sydneyanus collected at various time points in 2020 and 2021 from reefs near Great Barrier Island, New Zealand. 16S rRNA gene analysis was used to characterize microbial community composition, diversity and estimated density. Differences in community composition between gut sections remained relatively stable over time, with little evidence of temporal variation. Clostridia dominated the proximal hindgut sections and Bacteroidia the most distal section. Differences were detected in microbial composition between lumen and mucosa, especially at genus level. CONCLUSIONS: High variation in community composition and estimated bacterial density among individual fish combined with low variation in community composition temporally suggests that initial community assembly involved environmental selection and random sampling/neutral effects. Community stability following colonisation could also be influenced by historical contingency, where early colonizing members of the community may have a selective advantage. The impact of temporal changes in the algae may be limited by the dynamics of substrate depletion along the gut following feeding, i.e. the depletion of storage metabolites in the proximal hindgut. Estimated bacterial density, showed that Bacteroidota has the highest density (copies/mL) in distal-most lumen section V, where SCFA concentrations are highest. Bacteroidota genera Alistipes and Rikenella may play important roles in the breakdown of seaweed into useful compounds for the fish host.

No seasonality in the risk of multiple sclerosis in an equatorial country: A case-control ecological study.

BACKGROUND: Multiple sclerosis risk has been shown to have seasonal variations that are more pronounced in higher latitudes. However, this phenomenon has not been adequately studied near the Equator. OBJECTIVE: To explore the risk of multiple sclerosis associated with month, season of birth, and sunlight exposure variables in Colombia. METHODS: In this case-control study, 668 multiple sclerosis cases were matched to 2672 controls by sex and age. Association of multiple sclerosis with each month/season of birth and sunlight exposure variables was estimated with multilevel mixed-effects logistic regression and ecological regression models, respectively. Seasonality in the births of multiple sclerosis was assessed with a non-parametric seasonality test. RESULTS: We found a higher probability of multiple sclerosis in September (0.25; 95% confidence interval (CI) = 0.21-0.31) and lower in March (0.15; 95% CI = 0.10-0.18), which turned non-significant after a multiple comparisons test. Sunlight exposure variables had no significant effect on the risk of MS, and the tests of seasonality in the births of MS did not show significant results. CONCLUSION: Our results show no seasonality in the risk of multiple sclerosis near the Equator, supporting the hypothesis that this phenomenon is latitude dependent.

Daytime light exposure is a strong predictor of seasonal variation in sleep and circadian timing of university students.

In the absence of electric light, sleep for humans typically starts soon after dusk and at higher latitudes daily sleep timing changes seasonally as photoperiod changes. However, access to electric light shields humans from natural photoperiod changes, and whether seasonal changes in sleep occur despite this isolation from the natural light-dark cycle remains a matter of controversy. We measured sleep timing in over 500 university students living in the city of Seattle, WA (47.6°N) throughout the four seasons; we show that even when students are following a school schedule, sleep timing is delayed during the fall and winter. For instance, during the winter school days, students fell asleep 35 min later and woke up 27 min later (under daylight-savings time) than students during the summer school days, a change that is an hour larger relative to solar midnight. Furthermore, chronotype defined by mid-sleep on free days corrected for oversleep (MSFc), an indirect estimate of circadian phase, was more than 30 min later in the winter compared with the summer. Analysis of the effect of light exposure showed that the number of hours of light exposure to at least 50 lux during the daytime was a stronger predictor of MSFc than the exposure time to this illuminance after dusk. Specifically, MSFc was advanced by 30 min for each additional hour of light exposure during daytime and delayed by only 15 min for each additional hour of postdusk exposure to light. Additionally, the time of the day of exposure to high light intensities was more predictive of MSFc when daytime exposure was considered than when exposure for the full 24-h day was considered. Our results show that although sleep time is highly synchronized to social time, a delayed timing of sleep is evident during the winter months. They also suggest that daily exposure to daylight is key to prevent this delayed phase of the circadian clock and thus circadian disruption that is typically exacerbated in high-latitude winters.

Water Level Fluctuations Modulate the Microbiomes Involved in Biogeochemical Cycling in Floodplains.

Drastic changes in hydrological conditions within floodplain ecosystems create distinct microbial habitats. However, there remains a lack of exploration regarding the variations in microbial function potentials across the flooding and drought seasons. In this study, metagenomics and environmental analyses were employed in floodplains that experience hydrological variations across four seasons. Analysis of functional gene composition, encompassing nitrogen, carbon, and sulfur metabolisms, revealed apparent differences between the flooding and drought seasons. The primary environmental drivers identified were water level, overlying water depth, submergence time, and temperature. Specific modules, e.g., the hydrolysis of ß-1,4-glucosidic bond, denitrification, and dissimilatory/assimilatory nitrate reduction to ammonium, exhibited higher relative abundance in summer compared to winter. It is suggested that cellulose degradation was potentially coupled with nitrate reduction during the flooding season. Phylogenomic analysis of metagenome-assembled genomes (MAGs) unveiled that the Desulfobacterota lineage possessed abundant nitrogen metabolism genes supported by pathway reconstruction. Variation of relative abundance implied its environmental adaptability to both the wet and dry seasons. Furthermore, a novel order was found within Methylomirabilota, containing nitrogen reduction genes in the MAG. Overall, this study highlights the crucial role of hydrological factors in modulating microbial functional diversity and generating genomes with abundant nitrogen metabolism potentials.

Risk factors for inadequate bowel preparation before colonoscopy: a retrospective cohort study.

BACKGROUND: Colonoscopy is the standard and most effective screening tool for colonic diseases and the accuracy of colonoscopy depends on the quality of bowel preparation. The aim of this study was to analyze the risk factors for inadequate bowel preparation before colonoscopy. METHODS: In this retrospective study, patients who underwent colonoscopy in 2018 and received 3 L of Polyethylene Glycol Electrolytes powder were included. They were instructed to drink 1.5 L the night before the colonoscopy and 1.5 L 4-6 h before the procedure given in doses of 250 ml every 10 min with 30 ml of simethicone given 4-6 h before the colonoscopy. Patient- and procedure-related parameters were recorded. An adequate bowel preparation was defined as all 3 segments rated 2 or 3 on the Boston Bowel Preparation scale. Risk factors for inadequate bowel preparation were identified using multivariate logistic regression analysis. RESULTS: A total of 6720 patients were included in the present study. The mean age of these patients was 49.7 ± 13.0 years old. Inadequate bowel preparation was found in 233 (12.4%), 139 (6.4%), 131 (7%), 68 (8.6%) patients in spring, summer, autumn and winter respectively. On the multivariate analysis, male gender (OR: 1.295; 95% CI: 1.088-1.542; P = 0.005), inpatient status (OR: 1.377; 95% CI: 1.040-1.822; P = 0.025) and season (spring vs. winter, OR: 1.514; 95% CI: 1.139-2.012; P = 0.004) were the independent risk factors for inadequate bowel preparation. CONCLUSIONS: Male gender, inpatient status and spring season were the independent risk factors for inadequate bowel preparation. For patients with risk factors for inadequate bowel preparation, enhanced bowel preparation and instructions may help to optimize the quality of bowel preparation.

Consequences of COVID-19-related lockdowns and reopenings on emergency hospitalizations in pediatric patients in Denmark during 2020-2021.

There is a considerable burden of children being hospitalized due to infectious diseases worldwide. The COVID-19 pandemic provided a unique opportunity to examine effects of worldwide efforts to control spread of infection. We aimed to investigate overall age-specific hospitalizations due to viral and bacterial infections and diseases triggered by respiratory tract infections during and after lockdown. This nationwide register-based observational study included children from 29 days to 17 years old hospitalized in all Danish pediatric emergency departments during the years 2015-2021. Main outcomes were ICD-10 diagnoses for infectious diseases and infection triggered illnesses. Fluctuations in hospitalization events were explored using figures with weekly events per 100,000. Total events followed a predictable pattern during 2015-2019. In 2020-2021, there was a drop in hospital encounters after lockdowns and surge after reopenings. In 2021, there was a surge of hospital encounters in the late summer due to respiratory syncytial virus infections and asthmatic bronchitis mostly in infants from 29 days to 2 years. For the infectious diseases, there was a dramatic decrease in events after lockdowns and immediate increase in cases that followed the same pattern of previous years after reopenings. Bacterial infections, like urinary tract infections, sepsis, and meningitis followed a steady pattern throughout all calendar-years. CONCLUSIONS: Nationwide efforts to minimize infectious disease spread like lockdowns have a preventative and period lasting effect but reopenings/reunions result in surges of infectious diseases. This might be due to children not getting immunized steadily thereby increasing the pool of possible hosts for potential viral infections. WHAT IS KNOWN: • There is a seasonal fluctuation in viral/respiratory infections in children with higher infection rates in the winter and lower rates in the summer. • RSV infection is a major source of concern. WHAT IS NEW: • Major lockdowns and reopenings disrupt the seasonal fluctuations which can result in high surges in infections that increases the burden of children emergency departments and the risk of serious complications.

Association between serum Vitamin D levels and asthma severity and control in children and adolescents.

OBJECTIVE: To assess the association of serum Vitamin D (vitD) levels with asthma control and severity in children and adolescents in different seasons of the year. METHOD: Longitudinal, prospective study with 7- to 17-year-old children and adolescents diagnosed with asthma. All participants underwent two assessments conducted in opposite seasons of the year which included a clinical assessment, a questionnaire for classification of asthma control (Asthma Control Test), spirometry, and blood collection to measure serum vitD levels. RESULTS: In total, 141 individuals with asthma were evaluated. The mean vitD was lower in females (p = 0.006) and sunlight exposure appears not to be an influencing factor for vitD levels. We found no differences in mean vitD of patients with controlled and uncontrolled asthma (p = 0.703; p = 0.956). However, the severe asthma group had lower mean Vitamin D than the mild/moderate asthma group for both assessments (p = 0.013; p = 0.032). In the first assessment, the group with vitD insufficiency had a higher prevalence of severe asthma (p = 0.015). Vitamin D was positively correlated with FEV1 in both assessments (p = 0.008; p = 0.006) and with FEF25-75% in the first assessment (p = 0.038). CONCLUSION: In a tropical climate zone, there is no evidence of association between seasonality and serum vitD levels or between serum vitD levels and asthma control in children and adolescents. However, vitD and lung function were positively correlated and the group with vitD insufficiency had a higher prevalence of severe asthma.

Epidemiologic changes of infectious diseases in the post-SARS era in China, 2004-2018.

OBJECTIVES: To outline 44 major infectious diseases in the post-SARS (severe acute respiratory syndrome) in China and describe their long-term trends and changes by age, sex, epidemic season, and province. BACKGROUND: After the outbreak of severe acute respiratory syndrome (SARS) in 2003, with the change of infectious disease prevention and control system and the improvement of residents' quality of life, the incidence and mortality of infectious diseases have undergone major changes. METHODS: The data of 44 major infectious diseases in China from 2004 to 2018 were obtained from the monthly analysis report of the China Information System for Disease Control and Prevention (CISDCP) and the Public Health Science Data Center. Joinpoint r regression models were used to examine trends in incidence and mortality for 44 major and important infectious diseases from 2004 to 2018. RESULTS: From 2004 to 2018, 20,105, 500, 772 patients (10, 306, 546, 523 males and 9, 798, 954, 249 females) were diagnosed with 44 major infectious diseases. The overall incidence of 44 infectious diseases increased significantly from 294.6 per 100,000 people in 2004 to 479.1 per 100,000 people in 2010, with 7.9% APC (95% CI 5.2% -10.7%, P < 0.001), then slowed, and then increased to 561.2 per 100,000 people in 2018, with 1.5% APC (-0.1%-3.2%, P = 0.070). The overall mortality rose significantly, from 0.49 to 1.13 per 100,000 people between 2004 and 2011, with an APC increase of 11.6% (7.7% -15.6%, P < 0.001), and then remained stable until 2018. Among these, the prevalence of vaccine-preventable diseases and gastrointestinal & enteroviral diseases remained high and increased year by year. Patients with zoonotic diseases have the greatest risk of death, while patients with sexually transmitted and blood-borne diseases have the greatest number of deaths. Incidence rates vary considerably across geographic regions. Western China has a disproportionate burden of infectious diseases compared with eastern regions. CONCLUSIONS: After the event of SARS in 2003, infectious disease preventing and controlling model has undergone major changes in China, and certain achievements have been made in this field. Although overall morbidity and case fatality rates are still rising, they have leveled off. In reducing the disproportionate disease burden in the western region, expanding vaccination programs, preventing further increases in rates of sexually transmitted diseases, renewing efforts for emerging and persistent infectious diseases, and addressing seasonal and unpredictable outbreaks (such as the COVID-19 pandemic), there are still remain many challenges.

Risk of ischemic and hemorrhagic stroke in relation to cold spells in four seasons.

BACKGROUND: Cold winter weather increases the risk of stroke, but the evidence is scarce on whether the risk increases during season-specific cold weather in the other seasons. The objective of our study was to test the hypothesis of an association between personal cold spells and different types of stroke in the season-specific context, and to formally assess effect modification by age and sex. METHODS: We conducted a case-crossover study of all 5396 confirmed 25-64 years old cases with stroke in the city of Kaunas, Lithuania, 2000-2015. We assigned to each case a one-week hazard period and 15 reference periods of the same calendar days of other study years. A personal cold day was defined for each case with a mean temperature below the fifth percentile of the frequency distribution of daily mean temperatures of the hazard and reference periods. Conditional logistic regression was applied to estimate odds ratios (OR) and 95% confidence intervals (95% CI) representing associations between time- and place-specific cold weather and stroke. RESULTS: There were positive associations between cold weather and stroke in Kaunas, with each additional cold day during the week before the stroke increases the risk by 3% (OR 1.03; 95% CI 1.00-1.07). The association was present for ischemic stroke (OR 1.05; 95% CI 1.01-1.09) but not hemorrhagic stroke (OR 0.98; 95% CI 0.91-1.06). In the summer, the risk of stroke increased by 8% (OR 1.08; 95% CI 1.00-1.16) per each additional cold day during the hazard period. Age and sex did not modify the effect. CONCLUSIONS: Our findings show that personal cold spells increase the risk of stroke, and this pertains to ischemic stroke specifically. Most importantly, cold weather in the summer season may be a previously unrecognized determinant of stroke.

Association between Physical Activity in Rural Life and Sarcopenia in Community-Dwelling Middle-Aged and Older Japanese Adults: A Cross-Sectional Study.

Physical activity is crucial to prevent sarcopenia, but there is scant data on the link between sarcopenia and physical activity in rural communities. Therefore, this study investigated associations of farming activity and snow removal with sarcopenia in a middle-aged and older population in rural Japan. This cross-sectional study enrolled 3,056 residents aged ≥ 40 years (49.2% men; mean age, 64.2 years) in Yuzawa, Japan. Information on farming activity and snow removal were collected via questionnaire from May through November and from December through April, respectively. Sarcopenia was assessed by the SARC-F (strength, ambulation, rising from a chair, stair climbing, and history of falling) score. Associations of farming activity and snow removal with sarcopenia were assessed using multivariable logistic regression analysis with adjustment for potential confounders. Participants who engaged in farming activity, snow removal, and both accounted for 3.8%, 40.5%, and 29.4% of the total, respectively. In the multivariable logistic regression analysis, adjusted odds ratios [95% confidence intervals (CI)] of sarcopenia for farming activity and snow removal were 0.80 (0.63-1.03) and 0.68 (0.53-0.87), respectively. Compared with participants who did not engage in farming activity or snow removal, participants who engaged in both had a significantly lower adjusted odds ratio of sarcopenia [0.63 (95% CI 0.47-0.86)]. Participants who engaged in snow removal and those who engaged in both farming activity and snow removal showed inverse associations with sarcopenia. Our findings further support the importance of physical activity in preventing or mitigating sarcopenia in rural communities.

Impact of seasonal variations on incidence and laterality of testicular torsion.

Nowadays, there is confusing evidence in the literature regarding the association between seasonal variations and events of testicular torsion (TT). We attempted to assess the correlation between seasonal variations, including season, ambient temperatures, and humidity levels to onset and laterality of testicular torsion. We conducted a retrospective review of patients diagnosed with testicular torsion and confirmed surgically between January 2009 and December 2019, at Hillel Yaffe Medical Center. Weather data was collected from meteorological observation stations near the hospital. TT incidents were stratified into five temperature categories (< 15 °C, 15-20 °C, 20-25 °C, 25-30 °C, > 30 °C) and into two categories of humidity (≤ 50%, > 50%). Potential associations between TT and seasonal variations were investigated. Of 235 patients diagnosed with TT, 156 (66%) were children and adolescents and 79 (34%) were adults. In both groups, rate of TT incidents increased in winter and fall months. Significant correlation between TT and temperatures below 15 °C was observed in both groups; OR 3.3 [95% IC 1.54-7.07], p = 0.002 in children and adolescents and 3.77 [1.79-7.94], p < 0.001) in adults. The correlation between TT and humidity was non-significant in both groups. Among children and adolescents left-sided TT was observed in most of the cases, with strong correlation to lower temperatures; OR 3.15 [1.34-7.40], p = 0.008. Higher rates of acute TT were observed in patients admitted to the emergency department (ED) during the cold seasons in Israel. Significant association was observed between left-side TT and temperatures below 15 °C in the children and adolescents' group. Our findings suggest that there might be a predilection for TT occurrence in cold weather, particularly left-side laterality among children and adolescents.

Effects of temperature adjustment with a heating device in weak honey bee colonies in cold seasons.

Temperature adjustment was used to buffer against changes in external environmental temperature by a heating device. Two groups of honey bee colonies Apis mellifera anatoliaca were used: one as experimental (20) and the other control (10), which were equalized in terms of the number of brood frames, frames with bees, food, hive materials, and health treatments. The experimental colonies were heated during the cold season, and the temperature and humidity inside the hive were recorded. The number of frames of brood, frames of bees, and Varroa destructor mite numbers were also determined for all hives. Results suggest that the number of brood frames and frames with bees increased significantly in the hives with the heating treatment. However, varroa mite numbers also increased significantly in the heated colonies in comparison to the control colonies. Colony losses were significantly less (15%) in heated colonies compared to a 40% loss in control colonies. This is the first account demonstrating that using simple heating devices can support weak colonies during the cold season in general, and colony losses can be reduced significantly from this heating treatment in cold seasons.