Environmental allergen reduction in asthma management: an overview.

Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.

Spatiotemporal Patterns of Deaths of Despair Across the U.S., 2000-2019.

INTRODUCTION: Deaths of despair (i.e., suicide, drug/alcohol overdose, and chronic liver disease and cirrhosis) have been increasing over the past 2 decades. However, no large-scale studies have examined geographic patterns of deaths of despair in the U.S. This ecologic study identifies geographic and temporal patterns of individual and co-occurring clusters of deaths of despair. METHODS: All individuals aged ≥10 years who died in the U.S. between 2000 and 2019 and resided within the 48 contiguous states and Washington, District of Columbia were included (N=2,171,105). Causes of death were limited to deaths of despair, namely suicide, drug/alcohol overdose, and chronic liver disease and cirrhosis. Univariate and multivariate space-time scan statistics were used to identify individual and co-occurring clusters with excess risk of deaths of despair. County-level RRs account for heterogeneity within each cluster. Analyses were conducted from late 2021 to early 2022. RESULTS: Six suicide clusters, four overdose clusters, nine liver disease clusters, and three co-occurring clusters of all three types of deaths were identified. A large portion of the western U.S., southeastern U.S., and Appalachia/rust belt were contained within the co-occurring clusters. The co-occurring clusters had average county RRs ranging from 1.17 (p<0.001) in the southeastern U.S. to 4.90 (p<0.001) in the western U.S. CONCLUSIONS: Findings support identifying and targeting risk factors common to all types of deaths of despair when planning public health interventions. Resources and policies that address all deaths of despair simultaneously may be beneficial for the areas contained within the co-occurring high-risk clusters.

Exploring attitude-behaviour dynamics during COVID-19: How fear of infection and working from home influence train use and the attitude toward this mode.

Research on the relationships between travel-related attitudes and travel behaviour has recently been reinvigorated by new theorizing as well as new empirical models. While traditional theories assume a rather static role of attitudes, i.e. acting as stable predispositions that cause behaviours in a unidirectional manner, recent models assume that attitudes and behaviours mutually influence each other over time. This study aims at better understanding attitude-behaviour dynamics by capitalizing on the circumstances presented by the ongoing COVID-19 pandemic. It assesses how the fear of COVID-19 infection and (the attitude towards) working-from-home influence train use as well as train use attitudes. To explore the (within-person) reciprocal relationships between these variables, random-intercept cross-lagged panel models were estimated using a 4-wave longitudinal dataset collected during the COVID-19 pandemic from a large panel of train travellers in the Netherlands. The results indicate that train use and the attitude towards train use reciprocally influence each other. Those with stronger fears of infection in one wave tend to use the train less in a subsequent wave, but higher use of the train in one wave also reduces the fear of infection in the next. We also found that working from home (WFH) and travelling by train operate as substitutes for one another. Moreover, people who work from home frequently become more fearful of infection. All the findings are consistent with cognitive dissonance theory that people develop attitudes that align with their behaviours. The paper concludes with several policy implications related to changing attitudes and promoting train use.

Public transit cuts during COVID-19 compound social vulnerability in 22 US cities.

The COVID-19 pandemic has severely impacted public transit services through plummeting ridership during the lockdown and subsequent budget cuts. This study investigates the equity impacts of reductions in accessibility due to transit service cuts during COVID-19 and their association with urban sprawl. We evaluated transit access to food and health care services across 22 US cities in three phases during 2020. We found stark socio-spatial disparities in access to basic services and employment in food and health care. Transit service cuts worsened accessibility for communities with multiple social vulnerabilities, such as neighborhoods with high rates of poverty, low-income workers, and zero-vehicle households, as well as poor neighborhoods with high concentrations of black residents. Moreover, sprawled cities experienced greater access loss during COVID-19 than compact cities. Our results point to policies and interventions to maintain social equity and sustainable urban development while benefiting diverse social groups during disruptions.

Impacts of teleworking and online shopping on travel: a tour-based analysis.

Large-scale adoption of telemobility, such as teleworking and online shopping, has affected travel patterns significantly. The impacts of teleworking and online shopping on travel have been studied separately and with trip-level analyses, thereby ignoring tour complexity, trip chaining, and activity scheduling. We aim to address this gap by investigating the interactions between online shopping, teleworking, and travel at a tour level, considering trip chaining and the importance of the activities involved. We classify tours into mandatory (e.g., travel for work, school), maintenance (e.g., travel for grocery shopping, appointments, errands), and discretionary (e.g., travel for non-grocery shopping, leisure, religious activities) tours according to the primary activity purpose. We then estimate a structural equation model using a one-week activity-travel diary from the 2019 Puget Sound Regional Travel Study. The results indicate that teleworking reduced mandatory and maintenance tours while increasing online shopping. Mandatory tours were negatively associated with both maintenance tours and online shopping, whereas the number of maintenance tours was positively associated with the number of discretionary tours. We did not find a statistically significant relationship between online shopping, maintenance tours, and discretionary tours. Overall, this study offers new insights into the effect of teleworking and online shopping on travel, with potential implications for travel demand modeling and management, as well as for the design of travel surveys that take such virtual activities into account.

COVID-19 exacerbates unequal food access.

Inequality to food access has always been a serious problem, yet it became even more critical during the COVID-19 pandemic, which exacerbated social inequality and reshaped essential travel. This study provides a holistic view of spatio-temporal changes in food access based on observed travel data for all grocery shopping trips in Columbus, Ohio, during and after the state-wide stay-at-home period. We estimated the decline and recovery patterns of store visits during the pandemic to identify the key socio-economic and built environment determinants of food shopping patterns. The results show a disparity: during the lockdown, store visits to dollar stores declined the least, while visits to big-box stores declined the most and recovered the fastest. Visits to stores in low-income areas experienced smaller changes even during the lockdown period. A higher percentage of low-income customers was associated with lower store visits during the lockdown period. Furthermore, stores with a higher percentage of white customers declined the least and recovered faster during the reopening phase. Our study improves the understanding of the impact of the COVID-19 crisis on food access disparities and business performance. It highlights the role of COVID-19 and similar disruptions on exposing underlying social problems in the US.

Correlates of the Built Environment and Active Travel: Evidence from 20 US Metropolitan Areas.

BACKGROUND: Walking and bicycling are health-promoting and environmentally friendly alternatives to the automobile. Previous studies that explore correlates of active travel and the built environment are for a single metropolitan statistical area (MSA) and results often vary among MSAs. OBJECTIVES: Our goal was to model the relationship between the built environment and active travel for 20 MSAs spanning the continental United States. METHODS: We sourced and processed pedestrian and bicycle traffic counts for 20 U.S. MSAs (n=4,593 count locations), with 1­17 y of data available for each count location and the earliest and latest years of data collection being 1999 and 2016, respectively. Then, we tabulated land use, transport, and sociodemographic variables at 12 buffer sizes (100­3,000 m) for each count location. We employed stepwise linear regression to develop predictive models for morning and afternoon peak-period bicycle and pedestrian traffic volumes. RESULTS: Built environment features were significant predictors of active travel across all models. Areas with easy access to water and green space, high concentration of jobs, and high rates of active commuting were associated with higher bicycle and pedestrian volumes. Bicycle facilities (e.g., bike lanes, shared lane markings, off-street trails) were correlated with higher bicycle volumes. All models demonstrated reasonable goodness-of-fit for both bicyclists (adj-R2: 0.46­0.61) and pedestrians (adj-R2: 0.42­0.72). Cross-validation results showed that the afternoon peak-period models were more reliable than morning models. CONCLUSIONS: To our knowledge, this is the first study to model multi-city trends in bicycling and walking traffic volumes with the goal of developing generalized estimates of the impact of the built environment on active travel. Our models could be used for exposure assessment (e.g., crashes, air pollution) to inform design of health-promoting cities. https://doi.org/10.1289/EHP3389.

Lactarius subgenus Russularia (Basidiomycota, Russulales): novel Asian species, worldwide phylogeny and evolutionary relationships.

Lactarius subg. Russularia is a large group of milkcaps occurring almost worldwide and dominant in many ecosystems. In this study we focus on new diversity, evolutionary relationships, divergence time, and origin of the subgenus. Six conifer symbionts are described as new to science: Lactarius atrii, L. aurantionitidus, L. dombangensis, L. flavigalactus, L. lachungensis, and L. sikkimensis. Species delimitation is assessed based on the concordance between morphological characteristics and an ITS phylogeny. Infrageneric relationships were studied using a phylogeny constructed from concatenated ITS-rpb2 data using Maximum Likelihood and Bayesian inference. Results show that species in this subgenus do not cluster together according to their geographic origin. Intercontinental sister relationships between Europe/Asia/North America are common but actual conspecificity is rare. This result suggests that allopatric speciation has played an important role within this subgenus. Only few morphological characteristics tend to be phylogenetically informative, with the most important being presence or absence of true cystidia and the pileipellis structure. Two datasets were generated in order to estimate the age of L. subg. Russularia. The results suggest the origin of L. subg. Russularia to be in the Mid Miocene period.