Integrated chemical characterization, metabolite profiling, and pharmacokinetics analysis of Zhijun Tangshen Decoction by UPLC-Q/TOF-MS.

Diabetic nephropathy (DN) is the main cause of end-stage renal disease worldwide and a major public issue affecting the health of people. Therefore, it is essential to explore effective drugs for the treatment of DN. In this study, the traditional Chinese medicine (TCM) formula, Zhijun Tangshen Decoction (ZJTSD), a prescription modified from the classical formula Didang Decoction, has been used in the clinical treatment of DN. However, the chemical basis underlying the therapeutic effects of ZJTSD in treating DN remains unknown. In this study, compounds of ZJTSD and serum after oral administration in rats were identified and analyzed using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS). Meanwhile, a semi-quantitative approach was used to analyze the dynamic changes in the compounds of ZJTSD in vivo. UPLC-Q/TOF-MS analysis identified 190 compounds from ZJTSD, including flavonoids, anthraquinones, terpenoids, phenylpropanoids, alkaloids, and other categories. A total of 156 xenobiotics and metabolites, i.e., 51 prototype compounds and 105 metabolites, were identified from the compounds absorbed into the blood of rats treated with ZJTSD. The results further showed that 23 substances with high relative content, long retention time, and favorable pharmacokinetic characteristics in vivo deserved further investigations and validations of bioactivities. In conclusion, this study revealed the chemical basis underlying the complexity of ZJTSD and investigated the metabolite profiling and pharmacokinetics of ZJTSD-related xenobiotics in rats, thus providing a foundation for further investigation into the pharmacodynamic substance basis and metabolic regulations of ZJTSD.

Evaluating Recall Periods for Patient-Reported Outcome Measures: A Systematic Review of Quantitative Methods.

OBJECTIVES: The current guidance for selection of recall periods recommends considering the design of the study, nature of the condition, patient's burden and ability to recall, and intent of the outcome measure. Empirical study of the accuracy of recall periods is recommended; however, there is not consensus on how to quantitatively evaluate the consistency of results from patient-reported outcome measures (PROMs) with different recall periods. We conducted a systematic review to describe quantitative methods for evaluating results obtained from PROMs with differing recall periods to lay the groundwork for establishing consensus. METHODS: We searched MEDLINE, Embase, Scopus, and American Psychological Association PsycINFO for studies where participants are given the same health-related measure (eg, quality of life, well-being, functioning, and pain) with differing recall periods. RESULTS: A total of 7174 abstracts were screened. The 30 included studies reflected a wide range of domains, including pain, fatigue, and sexual behavior and function. The recall periods ranged from momentary to 6 months. The analytic approaches varied, including different methods for assessing relative agreement, absolute agreement, and for assessing combined relative and absolute agreement. CONCLUSIONS: We found variability in how PROM recall periods were evaluated, suggesting an opportunity for greater consensus on methodological approach. As a starting point, we provide recommendations for which methods are preferred for which contexts.

Health-related quality of life profiles in adolescents and young adults with chronic conditions.

PURPOSE: To assess health-related quality of life (HRQOL) among adolescents and young adults (AYAs) with chronic conditions. METHODS: AYAs (N = 872) aged 14-20 years completed NIH's Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures of physical function, pain interference, fatigue, social health, depression, anxiety, and anger. Latent profile analysis (LPA) was used to group AYAs into HRQOL profiles using PROMIS T-scores. The optimal number of profiles was determined by model fit statistics, likelihood ratio test, and entropy. Multinomial logistic regression models were used to examine how LPA's HRQOL profile membership was associated with patient demographic and chronic conditions. The model prediction accuracy on profile membership was evaluated using Huberty's I index with a threshold of 0.35 for good effect. RESULTS: A 4-profile LPA model was selected. A total of 161 (18.5%), 256 (29.4%), 364 (41.7%), and 91 (10.4%) AYAs were classified into Minimal, Mild, Moderate, and Severe HRQOL Impact profiles. AYAs in each profile had distinctive mean scores with over a half standard deviation (5-points in PROMIS T-scores) of difference between profiles across most HRQOL domains. AYAs who were female or had conditions such as mental health condition, hypertension, and self-reported chronic pain were more likely to be in the Severe HRQOL Impact profile. The Huberty's I index was 0.36. CONCLUSIONS: Approximately half of AYAs with a chronic condition experience moderate to severe HRQOL impact. The availability of risk prediction models for HRQOL impact will help to identify AYAs who are in greatest need of closer clinical care follow-up.

Equal-Material Manufacturing of a Thermoplastic Melt-Cast Explosive Using Thermal-Pressure Coupling Solidification Treatment Technology.

To eliminate internal defects of grains developed during melt-cast charging, the formation mechanism and the trend of crystal morphology of internal defects of 2,4,6-trinitrotoluene and 2,4-dinitroanisole-based melt-cast explosives under different process conditions were simulated. The effects of solidification treatment on melt-cast explosive molding quality were investigated by combining pressurized feeding, head insulation, and water bath cooling. The single pressurized treatment technology results showed that grains were exposed to layer-by-layer solidification from outside to inside, resulting in V-shaped shrink areas of the contract cavity in the core. The defect area was proportional to the treatment temperature. However, the combination of treatment technologies, such as head insulation and water bath cooling, promoted longitudinal gradient solidification of the explosive and controllable migration of its internal defects. Moreover, the combined treatment technologies effectively improved the heat transfer efficiency of the explosive with the help of a water bath to reduce the solidification time, thus achieving highly efficient equal-material manufacturing of microdefect or zero-defect grains.

Applying latent profile analysis to identify adolescents and young adults with chronic conditions at risk for poor health-related quality of life.

The impact of chronic diseases on health-related quality of life (HRQOL) in adolescents and young adults (AYAs) is understudied. Latent profile analysis (LPA) can identify profiles of AYAs based on their HRQOL scores reflecting physical, mental, and social well-being. This paper will (1) demonstrate how to use LPA to identify profiles of AYAs based on their scores on multiple HRQOL indicators; (2) explore associations of demographic and clinical factors with LPA-identified HRQOL profiles of AYAs; and (3) provide guidance on the selection of adult or pediatric versions of Patient-Reported Outcomes Measurement Information System® (PROMIS®) in AYAs. A total of 872 AYAs with chronic conditions completed the adult and pediatric versions of PROMIS measures of anger, anxiety, depression, fatigue, pain interference, social health, and physical function. The optimal number of LPA profiles was determined by model fit statistics and clinical interpretability. Multinomial regression models examined clinical and demographic factors associated with profile membership. As a result of the LPA, AYAs were categorized into 3 profiles: Minimal, Moderate, and Severe HRQOL Impact profiles. Comparing LPA results using either the pediatric or adult PROMIS T-scores found approximately 71% of patients were placed in the same HRQOL profiles. AYAs who were female, had hypertension, mental health conditions, chronic pain, and those on medication were more likely to be placed in the Severe HRQOL Impact Profile. Our findings may facilitate clinicians to screen AYAs who may have low HRQOL due to diseases or treatments with the identified risk factors without implementing the HRQOL assessment.

Modulating crystal and electronic structure of NiFe-MOFs by inorganic acid for highly efficient electrochemical water oxidation.

Seeking new methods to modulate the structure of metal-organic frameworks (MOFs) for diverse applications, particularly for water splitting, is intensively urgent but challenging. Herein, a simple hydrothermal method employing HCl as the modulator is developed to synthesize a series of NiFe-MOF-n/NF. The amount of HCl modulator not only changes the elemental composition and crystal structure but also modulates the electronic structure of NiFe-MOF-n/NF, thus improving intrinsic activity. Owing to the synergetic interactions between Ni and Fe atoms, free-standing feature, the optimized NiFe-MOF-2/NF yields excellent OER activity with overpotentials of 209 and 260 mV at 10 and 100 mA cm-2, respectively, a small Tafel slope of 36.4 mV dec-1 and excellent OER stability for 24 h at 100 mA cm-2 in 1 M KOH. This demonstrates that NiFe-MOF-2/NF are in situ converted into metal oxide/oxyhydroxide after OER, thereby serving as the real active sites. This study offers a feasible way to fabricate low-cost, efficient MOF-based electrocatalysts.

Screening of metabolic markers present in Oxytropis by UHPLC-Q-TOF/MS and preliminary pharmacophylogenetic investigation.

Plants belonging to the Oxytropis genus, family Leguminosae, are found throughout the world, with about 80 species mainly distributed in northwest and northeast China. The plants have medicinal properties and many plants have been used as folk medicine for the treatment of colds, inflammation of carbuncle swelling, pain, and different types of bleeding. In recent years, due to the reduced availability of wild resources and increased clinical demand, additional Oxytropis species have been used in Mongolian medicine. This study explored the medicinal potential of four Oxytropis species, investigating their phylogeny, chemical components, and pharmacological activities. Oxytropis myriophylla (Pall) DC., Oxytropis hirta Bunge, and Oxytropis bicolor Bge. were found to be closely related at the taxonomic level. While previous investigations on the bioactive constituents of Oxytropis have been limited and have concentrated largely on flavonoids and saponins, the present study established a novel UHPLC-Q-TOF/MS based on metabolite profiling to comprehensively analyze the chemical composition of the four Oxytropis species and to identify marker compounds. A total of 75 compounds were identified from the four species, with 23 identified as characteristic marker components. Twenty-six marker compounds were identified in O. myriophylla from different geographical regions. Analysis of pharmacological activity showed that extracts of O. myriophylla and O. hirta had stronger anti-inflammatory activity than the extracts from the other species. The relationships between the chemical components, traditional curative uses, and pharmacological activities were analyzed to provide a preliminary documentation of the pharmacophylogenetic characteristics of the Oxytropis family as a whole. Several marker compounds, including licoricesaponin G2, licoricesaponin J2, and glycyrrhizic acid found in O. hirta were found to have effective anti-inflammatory activity, consistent with the traditional application of reducing swelling and healing wounds. This preliminary investigation into the pharmacophylogeny of the genus Oxytropis will contribute to the conservation and exploitation of the medicinal resources of this genus.

Population Segmentation Using a Novel Socio-Demographic Dataset.

Appending market segmentation data to a national healthcare knowledge, attitude and behavior survey and medical claims by geocode can provide valuable insight for providers, payers and public health entities to better understand populations at a hyperlocal level and develop cohort-specific strategies for health improvement. A prolonged use case investigates population factors, including social determinants of health, in depression and develops cohort-level management strategies, utilizing market segmentation and survey data. Survey response scores for each segment were normalized against the average national score and appended to claims data to identify at-risk segment whose scores were compared with three socio-demographically comparable but not at-risk segments via Nonparametric Mann-Whitney U test to identify specific risk factors for intervention. The marketing segment, New Melting Point (NMP), was identified as at-risk. The median scores of three comparable segments differed from NMP in "Inability to Pay For Basic Needs" (121% vs 123%), "Lack of Transportation" (112% vs 153%), "Utilities Threatened" (103% vs 239%), "Delay Visiting MD" (67% vs 181%), "Delay/Not Fill Prescription" (117% vs 182%), "Depressed: All/Most Time" (127% vs 150%), and "Internet: Virtual Visit" (55% vs 130%) (all with p<0.001). The appended dataset illustrates NMP as having many stressors (e.g., difficult social situations, delaying seeking medical care). Strategies to improve depression management in NMP could employ virtual visits, or pharmacy incentives. Insights gleaned from appending market segmentation and healthcare utilization survey data can fill in knowledge gaps from claims-based data and provide practical and actionable insights for use by providers, payers and public health entities.

Establishment of fingerprint and mechanism of anti-myocardial ischemic effect of Syringa pinnatifolia.

This study established the fingerprint of Syringa pinnatifolia Hemsl. (SP), analyzed the SP ingredients absorbed into the rats blood, and evaluated its anti-myocardial ischemic effect to provide a scientific basis for the follow-up development and research of SP and lay a foundation for its clinical application using ultra-performance liquid chromatography-Q Exactive-mass spectrometry and GC-MS. Myocardial infarction was induced in rat by ligating the left anterior descending branch of the rat coronary artery, and SP alcohol extract was administered to evaluate its anti-myocardial ischemic effect. We analyzed the SP ingredients absorbed into the rats blood, screened the active compounds, established a database of SP anti-myocardial ischemic targets, and explored the possible mechanism of SP in treating myocardial infarction using bioinformatics. The rats were examined using echocardiography, serum biomarkers were determined, and pathological changes were observed by histopathological examination. TUNEL staining was performed to detect the apoptotic level of cells, and Western blot and quantitative real-time polymerase chain reaction were performed to detect the expression levels of Bcl-2, Bax, and Caspase-3 in heart tissues. In the fingerprint of SP, 24 common peaks were established, and the similarity evaluation results of 10 batches of SP were all >0.9. Ultra-performance liquid chromatography-Q Exactive-mass spectrometry and GC-MS detected 17 active ingredients in the drug-containing serum, including terpenoids, flavonoids, phenols, phenylpropanoids, and phenolic acids, the most abundant of which was resveratrol. Enrichment analysis of SP targets against myocardial ischemia revealed that key candidate targets of SP were significantly enriched in multiple pathways associated with apoptosis. Resveratrol was administered to the successfully modeled rats, and the results showed that the resveratrol group significantly decreased left ventricular end-diastolic diameter and left ventricular end-systolic diameter and significantly increased ejection fraction and fractional shortening in all groups compared with the model group. Resveratrol significantly decreased the levels of creatine kinase isoenzyme and lactate dehydrogenase in serum compared to the model group (P < 0.001). Hematoxylin-eosin staining of rat myocardial tissue showed that all lesions were reduced under microscopic observation in the resveratrol group compared with the model group. Real-time polymerase chain reaction and Western blot results showed that the resveratrol group downregulated the expression of the proapoptotic factor Bax, upregulated the expression of the antiapoptotic factor Bcl-2, and decreased the expression of Caspase-3. The established fingerprints are accurate, reliable, and reproducible and can be used as an effective method for quality control of the herbs. The anti-myocardial ischemia effect of SP is that resveratrol improves cardiac function and inhibits cardiomyocyte apoptosis to protect cardiomyocytes. The present study provides ample evidence for the clinical use of SP, suggesting that this drug has great potential in the treatment of ischemic heart disease.

Coordinated regulation of phosphorus/nitrogen doping in fullerene-derived hollow carbon spheres and their synergistic effect for the oxygen reduction reaction.

Fullerene-derived carbons have been demonstrated as effective electrode materials for electrocatalytic reactions. The heteroatoms in the carbon matrix are essential to enhance their electrocatalytic performance but are still challenging for effective doping strategies and understanding their synergistic effect. Herein, we regulate the phosphorus/nitrogen (P/N) doping in the carbon structure based on the control mixing of pyritic acid (PA) with the assembled diamine-C60 hollow spheres (N@FHS). After pyrolysis, the carbon spheres are shown to have a homogenous distribution of N and P (NP@CHS). The structural and molecular analysis reveals that the doping of P may facilitate the formation of graphitic N in the carbon framework. When used as electrocatalysts for the oxygen reduction reaction (ORR), NP@CHSs exhibit superior oxygen reduction reaction (ORR) performance in contrast to those of fullerene-derived carbon with single N doping and the commercial Pt/C (20 wt%) catalyst. Density functional theory (DFT) studies indicate that P/N-doping promotes the charge transfer in the carbon structure owing to its strong electronegativity. The enhanced ORR activity should be mainly due to the P- and N-coordinated neighboring C sites with the defective fullerene pentagon ring.

Biomechanical effects of an oblique lumbar interbody fusion combined with posterior augmentation: a finite element analysis.

BACKGROUND: Oblique lateral interbody fusion (OLIF) is widely used to treat lumbar degenerative disc disease. This study aimed to evaluate the biomechanical stability of OLIF, OLIF including posterior pedicle screw and rod (PSR), and OLIF including cortical screw and rod (CSR) instrumentation through finite element analysis. METHODS: A complete L2-L5 finite element model of the lumbar spine was constructed. Surgical models of OLIF, such as stand-alone, OLIF combined with PSR, and OLIF combined with CSR were created in the L3-L4 surgical segments. Range of motion (ROM), end plate stress, and internal fixation peak stress were compared between different models under the same loading conditions. RESULTS: Compared to the intact model, ROM was reduced in the OLIF model under all loading conditions. The surgical models in order of increasing ROM were PSR, CSR, and stand-alone; however, the difference in ROM between BPS and CSR was less than 0.4° and was not significant under any loading conditions. The stand-alone model had the highest stress on the superior L4 vertebral body endplate under all loading conditions, whereas the end plate stress was relatively low in the BPS and CSR models. The CSR model had the highest internal fixation stress, concentrated primarily at the end of the screw. CONCLUSIONS: OLIF alone significantly reduces ROM but does not provide sufficient stability. Addition of posterior PSR or CSR internal fixation instrumentation to OLIF surgery can significantly improve biomechanical stability of the segment undergoing surgery.

A MEMS-Based High-Fineness Fiber-Optic Fabry-Perot Pressure Sensor for High-Temperature Application.

In this paper, a high-fineness fiber-optic Fabry-Perot high-temperature pressure sensor, based on MEMS technology, is proposed and experimentally verified. The Faber-Perot cavity of the pressure sensor is formed by the anodic bonding of a sensitive silicon diaphragm and a Pyrex glass; a high-fineness interference signal is obtained by coating the interface surface with a high-reflection film, so as to simplify the signal demodulation system. The experimental results show that the pressure sensitivity of this sensor is 55.468 nm/MPa, and the temperature coefficient is 0.01859 nm/°C at 25~300 °C. The fiber-optic pressure sensor has the following advantages: high fineness, high temperature tolerance, high consistency and simple demodulation, resulting in a wide application prospect in the field of high-temperature pressure testing.

Climate change and physical activity: ambient temperature and urban trail use in Texas.

Individuals in the USA are insufficiently active, increasing their chronic disease risk. Extreme temperatures may reduce physical activity due to thermal discomfort. Cooler climate studies have suggested climate change may have a net positive effect on physical activity, yet research gaps remain for warmer climates and within-day physical activity patterns. We determined the association between ambient temperatures (contemporary and projected) and urban trail use in a humid subtropical climate. At a trail in Austin, TX, five electronic counters recorded hourly pedestrian and cyclist counts in 2019. Weather data were acquired from World Weather Online. Generalized additive models estimated the association between temperature and trail counts. We then combined the estimated exposure-response relation with weather projections from climate models for intermediate (RCP4.5) and high (RCP8.5) emissions scenarios by NASA NEX-GDDP. From summer to autumn to spring to winter, hourly trail counts shifted from bimodal (mid-morning and early-evening peaks) to one mid-day peak. Pedestrians were more likely to use the trail between 7 and 27 °C (45-81°F) with peak use at 17 °C (63°F) and cyclists between 15 and 33 °C (59-91°F) with peak use at 27 °C (81°F) than at temperature extremes. A net decrease in trail use was estimated by 2041-2060 (RCP4.5: pedestrians = - 4.5%, cyclists = - 1.1%; RCP8.5: pedestrians = - 6.6%, cyclists = - 1.6%) and 2081-2100 (RCP4.5: pedestrians = - 7.5%, cyclists = - 1.9%; RCP8.5: pedestrians = - 16%, cyclists = - 4.5%). Results suggest climate change may reduce trail use. We recommend interventions for thermal comfort at settings for physical activity.

Numerical Simulation of Impregnation Process of Reactive Injection Pultrusion for Glass Fiber/PA6 Composites.

Pultrusion of thermoplastic composites has been the hotspot of manufacturing high-performance thermoplastic composites in recent years. The optimization of process parameters in the pultrusion usually needed repeated attempts, which wasted lots of manpower and material resources. A numerical simulation method can accelerate the optimization of process parameters. In this work, the impregnation process of reactive injection pultrusion for glass fiber reinforced nylon 6 (GF/PA6) composites was modeled and numerically simulated by a finite element/controlled volume (Fe/CV) method. Based on Darcy's law, the impregnation process can be regarded as the two-phase flow (liquid resin and air) in porous media (undirectional glass fibers). The distribution of resin flow during the impregnation was explored. The effects of pulling rate and injection pressure on the impregnation time and resin reflux distance were analyzed, and the appropriate range of relevant process parameters was determined. The results showed that increasing the pulling rate can significantly control the reflux distance of resin in the impregnation mold and shorten the impregnation time, but too high a pulling rate would increase the impregnation time. Increasing the injection pressure can greatly shorten the resin impregnation time, but it would significantly increase the resin reflux distance. This work can effectively guide the subsequent optimization of process parameters of reactive injection pultrusion for GF/PA6 composites.

Effect of Drawing Parameters on the Properties of Polypropylene/Inorganic Particles Composites by Solid-State Die Drawing.

Die drawing is an effective method for improving the properties of polymer. In this work, polypropylene (PP)/inorganic particle composites were fabricated by a solid-state die drawing process to investigate the effects of drawing parameters, such as inorganic particles types, drawing temperature, and drawing speed, on the thermal properties, microstructure, and mechanical behavior of the drawn composites. The mechanical properties of the material were significantly improved through this processing method. For the drawn PP/inorganic particle composites with 45 wt% CaCO3, when the drawing speed was 2.0 m/min and the drawing temperature was 110 °C, the density of the drawn composites reached the lowest at 1.00 g/cm3. At this time, the tensile strength, flexural strength, and impact strength of the drawn composites were 128.32 MPa, 77.12 MPa, and 170.42 KJ/m2, respectively. This work provides a new strategy for the preparation of lightweight and high-strength PP-based composites, which have broad application prospects in the field of engineering and structural materials.

Environmental Heat Exposure Among Pet Dogs in Rural and Urban Settings in the Southern United States.

With advancing global climate change, heat-related illnesses and injuries are anticipated to become more prevalent for humans and other species. Canine hyperthermia is already considered an important seasonal emergency. Studies have been performed on the risk factors for heat stroke in canine athletes and military working dogs; however there is limited knowledge on environmental risk factors for the average pet dog. This observational study explores variation in individually experienced environmental temperatures of pet dogs (N = 30) in rural and urban environments in central Alabama. Temperature data from dogs and their owners was collected using wearable personal thermometers. Demographic data on the dogs was collected using a brief survey instrument completed by their owners. Dogs included in the study varied in signalment, activity level, and home environment. Linear mixed effects regression models were used to analyze repeated measure temperature and heat index values from canine thermometers to explore the effect of environmental factors on the overall heat exposure risk of canine pets. Specifically, the heat exposures of dogs were modeled considering their owner's experienced temperatures, as well as neighborhood and local weather station measurements, to identify factors that contribute to the heat exposure of individual dogs, and therefore potentially contribute to heat stress in the average pet dog. Results show hourly averaged temperatures for dogs followed a diurnal pattern consistent with both owner and ambient temperature measurements, except for indoor dogs whose recordings remained stable throughout the day. Heat index calculations showed that owners, in general, had more hours categorized into the National Weather Station safe category compared to their dogs, and that indoor dogs had a greater proportion of hours categorized as safe compared to outdoor dogs. Our results suggest that the risk of the average pet dog to high environmental heat exposure may be greater than traditional measures indicate, emphasizing that more localized considerations of temperature are important when assessing a dog's environmental risk for heat-related injury or illness.

Effect of Material Properties on the Foaming Behaviors of PP-Based Wood Polymer Composites Prepared with the Application of Spherical Cavity Mixer.

For the low weight and high strength, the microcellular extrusion foaming technology was applied in the preparation of polypropylene (PP)-based wood polymer composites, and the spherical cavity mixer was used to construct an experimental platform for the uniform dispersion of wood flour (WF). The effects of PP molecular configuration on the composite properties and cell morphology of samples were also investigated. The experimental results indicated that the application of a spherical cavity mixer with a cavity radius of 5 mm could effectively improve the mixing quality and avoid the agglomeration of WF. In addition, compared with the branched molecule, the linear molecule not only increased the melting temperature by about 10 °C, but also endowed composites with a higher complex viscosity at a shear rate lower than 100 s-1, which contributed to the cell morphology of more microporous samples.

A community-engaged approach to understanding environmental health concerns and solutions in urban and rural communities.

BACKGROUND: Focus groups and workshops can be used to gain insights into the persistence of and potential solutions for environmental health priorities in underserved areas. The objective of this study was to characterize focus group and workshop outcomes of a community-academic partnership focused on addressing environmental health priorities in an urban and a rural location in Alabama between 2012 and 2019. METHODS: Six focus groups were conducted in 2016 with 60 participants from the City of Birmingham (urban) and 51 participants from Wilcox County (rural), Alabama to discuss solutions for identified environmental health priorities based on previous focus group results in 2012. Recorded focus groups were transcribed and analyzed using the grounded theory approach. Four follow-up workshops that included written survey instruments were conducted to further explore identified priorities and determine whether the priorities change over time in the same urban (68 participants) and rural (72 participants) locations in 2018 and 2019. RESULTS: Consistent with focus groups in 2012, all six focus groups in 2016 in Birmingham identified abandoned houses as the primary environmental priority. Four groups listed attending city council meetings, contacting government agencies and reporting issues as individual-level solutions. Identified city-level solutions included city-led confiscation, tearing down and transferring of abandoned property ownership. In Wilcox County, all six groups agreed the top priority was drinking water quality, consistent with results in 2012. While the priority was different in Birmingham versus Wilcox County, the top identified reason for problem persistence was similar, namely unresponsive authorities. Additionally, individual-level solutions identified by Wilcox County focus groups were similar to Birmingham, including contacting and pressuring agencies and developing petitions and protesting to raise awareness, while local policy-level solutions identified in Wilcox County included government-led provision of grants to improve septic systems, and transparency in allocation of funds. Workshops in 2018 and 2019 further emphasized water quality as the top priority in Wilcox County, while participants in Birmingham transitioned from abandoned houses as a top priority in 2018 to drinking water quality as a new priority in 2019. CONCLUSIONS: Applying a community-engaged approach in both urban and rural locations provided better understanding of the unique opportunities and challenges for identifying potential interventions for environmental health priorities in both locations. Results can help inform future efforts to address locally defined environmental health issues and solutions.

Heat-Health Behavior Change During Summer 2020 in African American Alabama Residents.

To investigate how heat-health behaviors changed in summer 2020 compared with previous summers, our community-academic partnership conducted telephone surveys to collect data on cooling behaviors, safety concerns, and preferences for cooling alternatives for 101 participants living in Alabama. Participants indicating they would visit cooling centers declined from 23% in previous summers to 10% in summer 2020. The use of cooling centers and other public spaces may be less effective in reducing heat-related illness because of safety concerns amid the COVID-19 pandemic and police brutality.

Characterization of heat index experienced by individuals residing in urban and rural settings.

Heatwave warning systems rely on forecasts made for fixed-point weather stations (WS), which do not reflect variation in temperature and humidity experienced by individuals moving through indoor and outdoor locations. We examined whether neighborhood measurement improved the prediction of individually experienced heat index in addition to nearest WS in an urban and rural location. Participants (residents of Birmingham, Alabama [N = 89] and Wilcox County, Alabama [N = 88]) wore thermometers clipped to their shoe for 7 days. Shielded thermometers/hygrometers were placed outdoors within participant's neighborhoods (N = 43). Nearest WS and neighborhood thermometers were matched to participant's home address. Heat index (HI) was estimated from participant thermometer temperature and WS humidity per person-hour (HI[individual]), or WS temperature and humidity, or neighborhood temperature and humidity. We found that neighborhood HI improved the prediction of individually experienced HI in addition to WS HI in the rural location, and neighborhood heat index alone served as a better predictor in the urban location, after accounting for individual-level factors. Overall, a 1 °C increase in HI[neighborhood] was associated with 0.20 °C [95% CI (0.19, 0.21)] increase in HI[individual]. After adjusting for ambient condition differences, we found higher HI[individual] in the rural location, and increased HI[individual] during non-rest time (5 a.m. to midnight) and on weekdays.