Emerging Trends in Information-Seeking Behavior for Alpha-Gal Syndrome: Infodemiology Study Using Time Series and Content Analysis.

BACKGROUND: Alpha-gal syndrome is an emerging allergy characterized by an immune reaction to the carbohydrate molecule alpha-gal found in red meat. This unique food allergy is likely triggered by a tick bite. Cases of the allergy are on the rise, but prevalence estimates do not currently exist. Furthermore, varying symptoms and limited awareness of the allergy among health care providers contribute to delayed diagnosis, leading individuals to seek out their own information and potentially self-diagnose. OBJECTIVE: The study aimed to (1) describe the volume and patterns of information-seeking related to alpha-gal, (2) explore correlations between alpha-gal and lone star ticks, and (3) identify specific areas of interest that individuals are searching for in relation to alpha-gal. METHODS: Google Trends Supercharged-Glimpse, a new extension of Google Trends, provides estimates of the absolute volume of searches and related search queries. This extension was used to assess trends in searches for alpha-gal and lone star ticks (lone star tick, alpha gal, and meat allergy, as well as food allergy for comparison) in the United States. Time series analyses were used to examine search volume trends over time, and Spearman correlation matrices and choropleth maps were used to explore geographic and temporal correlations between alpha-gal and lone star tick searches. Content analysis was performed on related search queries to identify themes and subcategories that are of interest to information seekers. RESULTS: Time series analysis revealed a rapidly increasing trend in search volumes for alpha-gal beginning in 2015. After adjusting for long-term trends, seasonal trends, and media coverage, from 2015 to 2022, the predicted adjusted average annual percent change in search volume for alpha-gal was 33.78%. The estimated overall change in average search volume was 627%. In comparison, the average annual percent change was 9.23% for lone star tick, 7.34% for meat allergy, and 2.45% for food allergy during this time. Geographic analysis showed strong significant correlations between alpha-gal and lone star tick searches especially in recent years (ρ=0.80; P<.001), with primary overlap and highest search rates found in the southeastern region of the United States. Content analysis identified 10 themes of primary interest: diet, diagnosis or testing, treatment, medications or contraindications of medications, symptoms, tick related, specific sources of information and locations, general education information, alternative words for alpha-gal, and unrelated or other. CONCLUSIONS: The study provides insights into the changing information-seeking patterns for alpha-gal, indicating growing awareness and interest. Alpha-gal search volume is increasing at a rapid rate. Understanding specific questions and concerns can help health care providers and public health educators to tailor communication strategies. The Google Trends Supercharged-Glimpse tool offers enhanced features for analyzing information-seeking behavior and can be valuable for infodemiology research. Further research is needed to explore the evolving prevalence and impact of alpha-gal syndrome.

The Influence of Heat on Daily Police, Medical, and Fire Dispatches in Boston, Massachusetts: Relative Risk and Time-Series Analyses.

Objectives. To examine the impact of extreme heat on emergency services in Boston, MA.Methods. We conducted relative risk and time series analyses of 911 dispatches of the Boston Police Department (BPD), Boston Emergency Medical Services (BEMS), and Boston Fire Department (BFD) from November 2010 to April 2014 to assess the impact of extreme heat on emergency services.Results. During the warm season, there were 2% (95% confidence interval [CI] = 0%, 5%) more BPD dispatches, 9% (95% CI = 7%, 12%) more BEMS dispatches, and 10% (95% CI = 5%, 15%) more BFD dispatches on days when the maximum temperature was 90°F or higher, which remained consistent when we considered multiple days of heat. A 10°F increase in daily maximum temperature, from 80° to 90°F, resulted in 1.016, 1.017, and 1.002 times the expected number of daily BPD, BEMS, and BFD dispatch calls, on average, after adjustment for other predictors.Conclusions. The burden of extreme heat on local emergency medical and police services may be agency-wide, and impacts on fire departments have not been previously documented.Public Health Implications. It is important to account for the societal burden of extreme heat impacts to most effectively inform climate change adaptation strategies and planning.

The Role of Individual and Small-Area Social and Environmental Factors on Heat Vulnerability to Mortality Within and Outside of the Home in Boston, MA.

Climate change is resulting in heatwaves that are more frequent, severe, and longer lasting, which is projected to double-to-triple the heat-related mortality in Boston, MA if adequate climate change mitigation and adaptation strategies are not implemented. A case-only analysis was used to examine subject and small-area neighborhood characteristics that modified the association between hot days and mortality. Deaths of Boston, Massachusetts residents that occurred from 2000-2015 were analyzed in relation to the daily temperature and heat index during the warm season as part of the case-only analysis. The modification by small-area (census tract, CT) social, and environmental (natural and built) factors was assessed. At-home mortality on hot days was driven by both social and environmental factors, differentially across the City of Boston census tracts, with a greater proportion of low-to-no income individuals or those with limited English proficiency being more highly represented among those who died during the study period; but small-area built environment features, like street trees and enhanced energy efficiency, were able to reduce the relative odds of death within and outside the home. At temperatures below current local thresholds used for heat warnings and advisories, there was increased relative odds of death from substance abuse and assault-related altercations. Geographic weighted regression analyses were used to examine these relationships spatially within a subset of at-home deaths with high-resolution temperature and humidity data. This revealed spatially heterogeneous associations between at-home mortality and social and environmental vulnerability factors.

Building Vulnerability in a Changing Climate: Indoor Temperature Exposures and Health Outcomes in Older Adults Living in Public Housing during an Extreme Heat Event in Cambridge, MA.

In the Northeastern U.S., future heatwaves will increase in frequency, duration, and intensity due to climate change. A great deal of the research about the health impacts from extreme heat has used ambient meteorological measurements, which can result in exposure misclassification because buildings alter indoor temperatures and ambient temperatures are not uniform across cities. To characterize indoor temperature exposures during an extreme heat event in buildings with and without central air conditioning (AC), personal monitoring was conducted with 51 (central AC, n = 24; non-central AC, n = 27) low-income senior residents of public housing in Cambridge, Massachusetts in 2015, to comprehensively assess indoor temperatures, sleep, and physiological outcomes of galvanic skin response (GSR) and heart rate (HR), along with daily surveys of adaptive behaviors and health symptoms. As expected, non-central AC units (Tmean = 25.6 °C) were significantly warmer than those with central AC (Tmean = 23.2 °C, p < 0.001). With higher indoor temperatures, sleep was more disrupted and GSR and HR both increased (p < 0.001). However, there were no changes in hydration behaviors between residents of different buildings over time and few moderate/several health symptoms were reported. This suggests both a lack of behavioral adaptation and thermal decompensation beginning, highlighting the need to improve building cooling strategies and heat education to low-income senior residents, especially in historically cooler climates.

Weather and eared grebe winter migration near the Great Salt Lake, Utah.

This study provides insight from the use of weather radar observations to understand the characteristics of the eared grebe migration near the Great Salt Lake (GSL) and provides unique information on weather conditions connected to these migration events. Doppler weather radar measurements from the Salt Lake City, Utah WSR-88D radar site (KMTX), along with meteorological surface and rawinsonde data, were used to identify and examine 281 eared grebe migration events across 15 winters from 1997/1998 through 2011/2012. An average of about 19 migration events occurred each winter with considerable interannual variability, as well as large variance in the spatial area and number of birds departing the GSL during each event. The migration events typically occurred during clear sky conditions in the presence of surface high pressure and colder than average surface temperatures. Migration events began 55 min after sunset, on average across the winter seasons, and in one case we demonstrate that an extended, nonstop flight was initiated of the departing eared grebes to northern Mexico. Eared grebes leaving the GSL largely flew above the freezing level with a mean northerly tailwind at flight altitude of 3.1 m s-1 and a westerly, cross-flight wind of 5.0 m s-1 while having an average flight speed at cruising altitude of 16.9 m s-1, or 61 km h-1. In addition to determining the variability of meteorological conditions during migration events across the 15 winters, atmospheric conditions during the largest migration event observed are presented and discussed.