Extreme climate after massive eruption of Alaska's Okmok volcano in 43 BCE and effects on the late Roman Republic and Ptolemaic Kingdom.

The assassination of Julius Caesar in 44 BCE triggered a power struggle that ultimately ended the Roman Republic and, eventually, the Ptolemaic Kingdom, leading to the rise of the Roman Empire. Climate proxies and written documents indicate that this struggle occurred during a period of unusually inclement weather, famine, and disease in the Mediterranean region; historians have previously speculated that a large volcanic eruption of unknown origin was the most likely cause. Here we show using well-dated volcanic fallout records in six Arctic ice cores that one of the largest volcanic eruptions of the past 2,500 y occurred in early 43 BCE, with distinct geochemistry of tephra deposited during the event identifying the Okmok volcano in Alaska as the source. Climate proxy records show that 43 and 42 BCE were among the coldest years of recent millennia in the Northern Hemisphere at the start of one of the coldest decades. Earth system modeling suggests that radiative forcing from this massive, high-latitude eruption led to pronounced changes in hydroclimate, including seasonal temperatures in specific Mediterranean regions as much as 7 °C below normal during the 2 y period following the eruption and unusually wet conditions. While it is difficult to establish direct causal linkages to thinly documented historical events, the wet and very cold conditions from this massive eruption on the opposite side of Earth probably resulted in crop failures, famine, and disease, exacerbating social unrest and contributing to political realignments throughout the Mediterranean region at this critical juncture of Western civilization.

A health crisis during the Japanese Medieval Period: A new paleodemographic perspective.

OBJECTIVE: To test the hypothesis that the "Little Ice Age" (LIA) (in Japan, ˜1440 - 1730 CE) co-occurred with unique age-at-death patterns. MATERIALS: 810 adult human skeletons from the early Medieval Period (EMP) of Japan, which are contemporaneous with the Medieval Warm Period (10th - mid 13th century AD), and the late Medieval Period (LMP) and Edo Period, which are contemporary with the LIA. METHODS: Age at death and sex was determined for each skeleton and demographic profiles of the Yayoi Period (5th century BC - 3rd century AD), EMP, LMP, and Edo site samples were compared. Paleopathological data from previously published reports were evaluated. RESULTS: The EMP had the highest mortality among young adults. Longevity increased in the samples (LMP and Edo) contemporaneous with the LIA. CONCLUSIONS: EMP early age-at-death was the result of poor community health, violent death, and frequent large-scale natural catastrophes. The LMP and Edo Period samples have an older age-at-death pattern and higher frequency of stress markers, argued to be a consequence of a colder climate. SIGNIFICANCE: This study is the first to synthesize paleodemographic and paleopathological data on a large scale to assess the possible effects of the Little Ice Age in Japan. LIMITATIONS: Varying skeletal preservation and focus on adult skeletons reduces the ability to evaluate health throughout the life span. SUGGESTIONS FOR FURTHER RESEARCH: Analysis of nonadult remains and multiple health indicators will likely shed more light on the effects of the Little Ice Age in Japan.

More frequent extreme climate events stabilize reindeer population dynamics.

Extreme climate events often cause population crashes but are difficult to account for in population-dynamic studies. Especially in long-lived animals, density dependence and demography may induce lagged impacts of perturbations on population growth. In Arctic ungulates, extreme rain-on-snow and ice-locked pastures have led to severe population crashes, indicating that increasingly frequent rain-on-snow events could destabilize populations. Here, using empirically parameterized, stochastic population models for High-Arctic wild reindeer, we show that more frequent rain-on-snow events actually reduce extinction risk and stabilize population dynamics due to interactions with age structure and density dependence. Extreme rain-on-snow events mainly suppress vital rates of vulnerable ages at high population densities, resulting in a crash and a new population state with resilient ages and reduced population sensitivity to subsequent icy winters. Thus, observed responses to single extreme events are poor predictors of population dynamics and persistence because internal density-dependent feedbacks act as a buffer against more frequent events.

The ice age with little effect? Exploring stress in the Danish Black Friars cemetery before and after the turn of the 14th century.

The Little Ice Age, beginning in Europe in the 14th century, saw a period of climatic cooling and increased precipitation where food sources dwindled and famine became rampant, particularly in urban city centers. This study focuses on the Black Friars population (13th-17th centuries) to explore changes in stress in Denmark at the onset of the Little Ice Age. This study specifically explores the periods before and after the turn of the 14th century. Forty-five adult individuals were analyzed for cribra orbitalia, porotic hyperostosis, and enamel hypoplastic lesions. Results showed no statistically significant differences between the prevalence of these stress indicators between either time period; however, reduced age at death and increased lesion frequency was more prevalent post-1300. It was expected that increased stress would be evident in those buried after the turn of the 14th century due to the many challenges associated with wide spread climatic cooling; however, the reliance on nutrient rich marine resources and alms provisions may have helped lessen the burden of these stressors during this period of climatic hardship. Additionally, while famine characterized the beginning of the 14th century, agricultural rebound shortly after this period may have also influenced the stress levels observed.

Colder Weather and Fewer Sunlight Hours Increase Alcohol Consumption and Alcoholic Cirrhosis Worldwide.

Risk of alcoholic cirrhosis is determined by genetic and environmental factors. We aimed to investigate if climate has a causal effect on alcohol consumption and its weight on alcoholic cirrhosis. We collected extensive data from 193 sovereign countries as well as 50 states and 3,144 counties in the United States. Data sources included World Health Organization, World Meteorological Organization, and the Institute on Health Metrics and Evaluation. Climate parameters comprised Koppen-Geiger classification, average annual sunshine hours, and average annual temperature. Alcohol consumption data, pattern of drinking, health indicators, and alcohol-attributable fraction (AAF) of cirrhosis were obtained. The global cohort revealed an inverse correlation between mean average temperature and average annual sunshine hours with liters of annual alcohol consumption per capita (Spearman's rho -0.5 and -0.57, respectively). Moreover, the percentage of heavy episodic drinking and total drinkers among population inversely correlated with temperature -0.45 and -0.49 (P < 0.001) and sunshine hours -0.39 and -0.57 (P < 0.001). Importantly, AAF was inversely correlated with temperature -0.45 (P < 0.001) and sunshine hours -0.6 (P < 0.001). At a global level, all included parameters in the univariable and multivariable analysis showed an association with liters of alcohol consumption and drinkers among population once adjusted by potential confounders. In the multivariate analysis, liters of alcohol consumption associated with AAF. In the United States, colder climates showed a positive correlation with the age-standardized prevalence of heavy and binge drinkers. Conclusion: These results suggest that colder climates may play a causal role on AAF mediated by alcohol consumption.

Infecciones respiratorias agudas bajas en niños menores de 2 años: hospitalizaciones durante el invierno del año 2014 / Low acute respiratory infections in children under 2 years: 2014 winter hospitalizations / Infecções agudas das vias respiratórias inferiores em crianças menores de 2 anos: hospitalizações em 2014

Durante el invierno las infecciones respiratorias agudas bajas (IRAB) determinan un incremento en la demanda asistencial, afectando sobre todo a los niños más pequeños. El objetivo de la investigación fue describir las características clínicas, modalidades de tratamiento y evolución de los menores de 2 años hospitalizados en el Hospital Pediátrico-Centro Hospitalario Pereira Rossell por IRAB de etiología viral durante el invierno de 2014. Se realizó un estudio descriptivo, retrospectivo, describiendo las características de los menores de 2 años hospitalizados del 9/6 al 21/9/2014 por IRAB de probable etiología viral. Se describieron las características epidemiológicas y clínicas, el tratamiento realizado y la evolución de los pacientes. En el período evaluado egresaron 742 niños (34% de los egresos de la institución). Tenían una mediana de edad de 4 meses; 18% presentaba al menos un factor de riesgo de IRAB grave. Se identificó al virus respiratorio sincicial en 59,6%. La estadía hospitalaria tuvo una mediana de 4 días. En las salas de cuidados moderados se aplicó ventilación no invasiva a 46 niños, y oxigenación de alto flujo a 129 niños, logrando una mejoría clínica en el 87,0% y el 87,6% respectivamente. Ingresaron a unidades de cuidados intensivos 217 niños, 54% requirió asistencia ventilatoria mecánica. Dos pacientes fallecieron. En el período evaluado los niños pequeños con IRAB representaron una importante proporción de los egresos, con importante carga asistencial. La mayoría eran niños sin factores de riesgo. La aplicación de las técnicas de tratamiento en cuidados moderados fue efectiva, permitiendo disminuir la demanda de camas de cuidados intensivos.

During the winter, low acute respiratory infections (LARI) determine an increase in care demand, especially affecting younger children. The objective of the research was to describe the clinical characteristics, treatment modalities and evolution of children under 2 years of age hospitalized at the Hospital Pediátrico-Centro Hospitalario Pereira Rossell for viral etiology LARI during the 2014 winter. A descriptive, retrospective study was conducted, describing the characteristics of children under 2 years hospitalized between 9/6 and 9/21/2014 for LARI of probable viral etiology. The following features were described: epidemiological and clinical characteristics, treatment performed and patient's evolution. During the period evaluated, 742 children were discharged (34% of the institution's admissions). They had a median age of 4 months; 18% had at least one risk factor for severe LARI. Respiratory syncytial virus was identified in 59.6%. The hospital stay had a median of 4 days. In moderate care rooms noninvasive ventilation was applied to 46 children, and high flow oxygenation to 129 children, achieving clinical improvement in 87.0% and 87.6%, respectively. Two hundred and seventeen children were admitted 54% required mechanical ventilation. Two patients died. In the evaluated period small children with LARI represented a significant proportion of the discharges, with an important burden of care. The majority were children without risk factors. The application of treatment techniques in moderate care was effective, allowed a decrease in the demand for intensive care beds.

Durante o inverno, as infecções respiratórias agudas baixas (IRAB) determinam o aumento da demanda de cuidados, afetando especialmente as crianças menores. O objetivo da pesquisa foi descrever as características clínicas, as modalidades de tratamento e a evolução de crianças menores de dois anos hospitalizados no Hospital Pediátrico-Centro Hospitalario Pereira Rossell devido a IRAB de etiologia viral, durante o inverno de 2014. Foi realizado um estudo descritivo e retrospectivo, descrevendo as características das crianças menores de 2 anos hospitalizadas entre 9/6 e 21/9/2014 devido a IRAB de provável etiologia viral. Descreveram-se: características epidemiológicas e clínicas, tratamento realizado e evolução dos pacientes. Durante o período avaliado, 742 crianças foram hospitalizadas (34% dos ingressos da instituição). Tinham uma idade média de 4 meses; 18% tinham pelo menos um fator de risco para IRAB severa. O vírus sincicial respiratório foi identificado em 59,6%. A estadia hospitalaria teve uma mediana de 4 dias. Em salas de cuidados moderados, a ventilação não invasiva foi aplicada a 46 crianças e a oxigenação de alto fluxo a 129 crianças, atingindo melhora clínica em 87,0% e 87,6%, respectivamente. Foram internadas em unidades de terapia intensiva 217 crianças, 54% necessitaram de ventilação mecânica. Dois pacientes faleceram. No período avaliado, as crianças pequenas com IRAB representaram uma proporção significativa das despesas, com um carga importante de atendimento. A maioria carecia de fatores de risco. A aplicação de técnicas de tratamento em cuidados moderados foi eficaz, permitindo uma diminuição da demanda por leitos de terapia intensiva.

Can we identify older people most vulnerable to living in cold homes during winter?

PURPOSE: Living in a cold home increases the risk of dying in winter, especially in older people. However, it is unclear which individual factors predict whether older people are living in cold homes. METHODS: Thousand four hundred two men aged 74-95 years from a U.K. population-based study reported difficulties in keeping warm during winter, answering four simple "yes/no" questions. Associations between individual's characteristics and each of the four self-reported measures of cold homes were estimated using logistic regression models. Next, we investigated whether measures of cold homes predict mortality over the subsequent 2.1 years. RESULTS: Manual social class, difficulties making ends meet, and not being married were each associated (P < .05) with each of the four measures of cold homes (adjusted odds ratios ranged from 1.61 to 4.68). Social isolation, poor respiratory health, and grip strength were also associated with reports of cold homes. Hundred twenty-six men died; those who reported the presence of at least three measures cold homes had increased mortality (adjusted hazard ratios 2.85 [95% confidence interval, 1.11-7.30, P = .029]). CONCLUSIONS: Older people who find it hard to keep warm in winter, and have an elevated mortality, could be identified using a self-report questionnaire.

Thermal perception thresholds among workers in a cold climate.

PURPOSE: To investigate whether exposure to cold could influence the thermal perception thresholds in a working population. METHODS: This cross-sectional study was comprised of 251 males and females and was carried out at two mines in the northern part of Norway and Sweden. The testing included a baseline questionnaire, a clinical examination and measurements of thermal perception thresholds, on both hands, the index (Digit 2) and little (Digit 5) fingers, for heat and cold. RESULTS: The thermal perception thresholds were affected by age, gender and test site. The thresholds were impaired by experiences of frostbite in the fingers and the use of medication that potentially could affect neurosensory functions. No differences were found between the calculated normative values for these workers and those in other comparative investigations conducted in warmer climates. CONCLUSIONS: The study provided no support for the hypothesis that living and working in cold climate will lead to impaired thermal perception thresholds. Exposure to cold that had caused localized damage in the form of frostbite was shown to lead to impaired thermal perception.

Neurovascular hand symptoms in relation to cold exposure in northern Sweden: a population-based study.

PURPOSE: To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms. METHODS: A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18-70 years and living in northern Sweden. RESULTS: A total of 12,627 out of 35,144 subjects returned the questionnaire (response rate 35.9%). Subjects living in the rural alpine areas reported more extensive cold exposure both during work and leisure time compared to the urbanized coastal regions. Frostbite in the hands was present in 11.4% of men and 7.1% of women, cold sensitivity was present in 9.7 and 14.4%, and Raynaud's phenomenon was present in 11.0% of men and 14.0% of women. There was a positive association between cumulative cold exposure and neurovascular hand symptoms. CONCLUSION: The present study demonstrates that the cold environment in northern Sweden might be an underestimated health risk. Our hypothesis that cold exposure is positively related to reporting of neurovascular hand symptoms was supported by our findings. In addition, such symptoms were common not only in conjunction with an overt cold injury. Our results warrant further study on pathophysiological mechanisms and suggest the need for confirmatory prevalence studies to support national public health planning.

[THE PREVALENCE OF RESPIRATORY SYMPTOMS AMONG RESIDENTS OF THE RUSSIAN FAR NORTH].

Aim: To study the frequency of respiratory symptoms among the reindeer herders of the Yamal region in the Far North of Russia. We conducted a cross-sectional study of the occurrence of respiratory symptoms among 500 subjects of the tundra Nenets population (28.1% of the adult Nenets population in the district), of which 38.3% were men and 61.7% women (average age 40.1 years). All patients were matched for age and occupation. Medical examination was carried out by a pulmonologist with the use of the GARD questionnaire (WHO, 2004) and spirometry. Spirometry was performed with a SpiroUSB device (UK) according to a unified standard and the criteria of ATS/ERS 2005. The frequency of respiratory symptoms among the tundra population was estimated at 71.8%. Cough with expectoration and dyspnea were found in 22.8% of the respondents. 70.0% of the examined subjects worked in the cold, 33% were exposed to the open flame at home, and 34.4% smoked. Respiratory symptoms developed in 16.3% of those working in the cold and in 37% exposed to open fire. The combination of such complaints as cough and sputum production occurred in smokers twice as frequently as in non-smokers (54.1%) (p<0.01).The combination of such complaints as cough and sputum production was twice as likely note in his those who smoked (54.1% vs 20.2%) (p<0.01). The combination of these problems dyspnea was three times more common in the smokers (23,3%vs 7,3%) (p<0.001). At presence at patients of such a factor as work in the cold and the absence of other only 16.3% of them have respiratory symptoms. When using at home the open flame and the absence of other factors leading up 37.0% of the individuals with symptoms of chronic bronchitis. Cough, sputum and dyspnea are formed only among 26.3% of the smokers face when smoking is the only risk factor. If the surveyed residents of all three negative factors respiratory symptoms met at 62.1%. Disorders of respiratory function according to spirometry were not observed in none of the study participants. Respiratory symptoms developed in 62.1% of the subjects exposed to all three risk factors. External respiration indices remain normal in all he examine subjects. It is concluded that residents of the Far North frequently suffer respiratory symptoms without disorders in the external respiratory function. In most cases they associated with three factors (work in the cold, exposure to open fire at home, and smoking). Compensatory stimulation of lung functions may create additional difficulties for diagnostics of bronchial obstruction.

Major Depression Prevalence Increases with Latitude in Canada.

OBJECTIVE: To determine whether there is an association between latitude and annual major depressive episode (MDE) prevalence in Canada. METHODS: Data from 2 national survey programs (the National Population Health Survey and the Canadian Community Health Survey) were used, providing 10 data sets collected between 1996 and 2013, together including 922,260 respondents, of whom 495,739 were assessed for MDE using 1 of 2 versions of the Composite International Diagnostic Interview, a short-form version (8 studies), and a Canadian adaptation of the World Mental Health version (2 studies). Approximate latitude was determined by linkage to postal code data. Data were analyzed using logistic regression and pooled across surveys using individual-level meta-analytic methods. RESULTS: In models including latitude as a continuous variable, a statistically significant association was observed, with prevalence increasing with increasing latitude. This association persisted after adjustment for a set of known risk factors. The latitude gradient was modest in magnitude, a 1% to 2% increase in the prevalence odds of MDE per degree of latitude was observed. Due to sparse data, this gradient cannot be confidently generalized beyond major population centres, which tend to occur at less than 55° latitude in Canada. CONCLUSION: A latitude gradient has not previously been reported. If replicated, the gradient may have implications for the planning of services and generation of aetiological hypotheses. However, this cross-sectional analysis cannot confirm aetiology and could not evaluate the potential contributions of variables such as light exposure, weather patterns, or social determinants.

Genome-Wide Identification and Characterization of bZIP Transcription Factors in Brassica oleracea under Cold Stress.

Cabbages (Brassica oleracea L.) are an important vegetable crop around world, and cold temperature is among the most significant abiotic stresses causing agricultural losses, especially in cabbage crops. Plant bZIP transcription factors play diverse roles in biotic/abiotic stress responses. In this study, 119 putative BolbZIP transcription factors were identified using amino acid sequences from several bZIP domain consensus sequences. The BolbZIP members were classified into 63 categories based on amino acid sequence similarity and were also compared with BrbZIP and AtbZIP transcription factors. Based on this BolbZIP identification and classification, cold stress-responsive BolbZIP genes were screened in inbred lines, BN106 and BN107, using RNA sequencing data and qRT-PCR. The expression level of the 3 genes, Bol008071, Bol033132, and Bol042729, was significantly increased in BN107 under cold conditions and was unchanged in BN106. The upregulation of these genes in BN107, a cold-susceptible inbred line, suggests that they might be significant components in the cold response. Among three identified genes, Bol033132 has 97% sequence similarity to Bra020735, which was identified in a screen for cold-related genes in B. rapa and a protein containing N-rich regions in LCRs. The results obtained in this study provide valuable information for understanding the potential function of BolbZIP transcription factors in cold stress responses.

Assessment of the Effects of Severe Winter Disasters (Dzud) on Public Health in Mongolia on the Basis of Loss of Livestock.

OBJECTIVE: Mongolia experienced one of its most severe natural winter disasters (dzud) in 2009-2010. It is difficult to accurately assess the risk of the effects of dzud on human lives and public health. This study aimed to evaluate the Mongolian public health risks of dzud by assessing livestock loss. METHODS: We analyzed data from all 21 provinces and Ulaanbaatar in Mongolia and compared the changes in infant mortality (2009-2010) and the decline in the numbers of livestock (percentage change from the previous year), which included horses, cattle, camels, sheep, and goats (2009-2010) and/or meteorological data. We also evaluated the association among the trends in the infant mortality rate, the number of livestock, and foodstuff consumption throughout Mongolia (2001-2012). RESULTS: The change in the infant mortality rate was positively correlated with the rate of decreasing numbers of each type of livestock in 2010. Average temperature and total precipitation were not related to the change in the infant mortality rate. In the trend from 2001 to 2012, there was a significant positive correlation between the infant mortality rate and the number of livestock and the consumption of milk products. CONCLUSIONS: Loss of livestock and shortage of milk products leading to malnutrition might have affected public health as typified by infant mortality in Mongolia. (Disaster Med Public Health Preparedness. 2016;10:549-552).

Hospitalizaciones por IRAB de probable etiología viral en niños durante el año 2012: estrategia asistencial / Child hospitalizations for acute lower respiratory infections probably caused by virus in 2012: a healthcare strategy

Introducción: en el Hospital Pediátrico del Centro Hospitalario Pereira Rossell (HP-CHPR) durante los meses fríos, las infecciones respiratorias agudas bajas (IRAB) determinan gran demanda asistencial. Para afrontarlas se pone en práctica una estrategia de diagnóstico y tratamiento denominada Plan de Invierno (PI), que se planifica anualmente, en función de las características de los pacientes tratados en años anteriores. Objetivos: describir las características epidemiológicas, clínicas y evolutivas de los niños que requirieron admisión por IRAB en el HP-CHPR durante los meses fríos del 2012 y describir las principales acciones de la estrategia Plan Invierno del año 2012 (PI-2012). Metodología: se describieron las características epidemiológicas, clínicas y evolutivas de los menores de 24 meses que egresaron del HP-CHPR, en el marco de la estrategia PI-2012, por IRAB de probable etiología viral. Se describió las principales acciones de la estrategia de diagnóstico y tratamiento realizada. Resultados: durante el PI-2012 egresaron 887 niños (25,5% de los egresos hospitalarios). La mediana de edad fue 4 meses. Menos de 10% tenía factores de riesgo para enfermedad grave. El virus respiratorio sincitial (VRS) fue el más frecuentemente identificado. Se aplicó un protocolo de diagnóstico y tratamiento. Se pusieron en práctica técnicas especiales de tratamiento en salas de cuidados moderados. Se aplicó ventilación no invasiva (VNI) en 87 niños, con éxito en 80% de los casos. Se realizó oxigenación de alto flujo (OAF) a 22 niños, con éxito en 100%. Requirieron ingreso a terapia intensiva (CTI) 149 niños, 55,7% requirió asistencia ventilatoria mecánica (AVM). Dos pacientes fallecieron en salas de cuidados moderados, cuatro en CTI. Conclusiones: las IRAB representaron una causa muy importante de morbimortalidad durante el período descripto. Los niños que requirieron ingreso hospitalario eran en su mayoría pequeños. Un porcentaje importante cursó una enfermedad grave, requiriendo modalidades especiales de tratamiento. Es importante continuar en la búsqueda de la mejor estrategia terapéutica para estos niños.

Introduction: during the colder months, acute lower respiratory infections (ALRI) determine a considerable increase in the demand for care at the Pereira Rossell Pediatric Hospital (HP-CHPR). In order to respond to such demand the hospital implements a diagnosis and treatment strategy called Winter Plan (WP), which is planned annually based on the characteristics of patients treated in previous years. Objectives: to describe the epidemiological and clinical characteristics and evolution of children with ALRI who required hospitalization in the HP-CHPR during the cold months of 2012, and to describe the main actions of the 2012 Winter Plan strategy (2012 WP). Methodology: epidemiological, clinical and evolution characteristics of children under 24 months discharged from HP-CHPR within the 2012WP strategy were described. The strategy’s main action for diagnosis and treatment were described. Results: 887 children were discharged during the 2012 WP strategy, representing 25.5% of hospital discharges. Median age was 4 months. Less than 10% presented risk factors for severe disease. Respiratory syncytial virus (RSV) was the most frequently identified virus. A protocol for diagnosis and treatment was applied. Special techniques for treatment were implemented in transitional care rooms. 87 children were administered non-invasive ventilation, which was successful in 80% of cases. High-flow oxygen was used in 22 children, being this successful in all patients. 149 children required admission to intensive care unit (ICU) , 55.7% needed mechanical ventilation assistance. Two patients died in the medium unit and four in the ICU. Conclusions: ALRI represent a major cause of morbidity and mortality during the period described . Most children who required hospitalization were young. A significant percentage presented a severe disease, requiring special treatment modalities. It is important to continue searching for the best therapeutic strategy for these children.

[The evaluation of economic damage due to premature mortality of population of the Republic of Sakha (Yakutia)].

The evaluation of economic damage was implemented in relation to premature mortality of population of the Republic of Sakha (Yakutia), the region with particular social economic and natural climatic conditions specific to territories of the North. The calculation of economic damage is based on methodology proposed by number of ministries of the Russian Federation and Rosstat in 2012. The presented evaluations and analysis of materials give an idea about total amount of economic damage because of mortality of population of the Republic of Sakha (Yakutia) which is necessary to consider during development of regional programs of decreasing of population mortality.

Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2010-June 2015.

From July 2014 through June 2015, the number of active and reserve component service members treated for cold injuries (n=603) was much lower than the 719 cases diagnosed during the previous, unusually cold winter of 2013- 2014. Army personnel accounted for the majority (51%) of cold injuries. Frostbite was the most common type of cold injury in each of the services except the Marine Corps for which immersion foot was unusually common. Consistent with trends from previous cold seasons, service members who were female, younger than 20 years old, or of black, non-Hispanic race/ethnicity tended to have higher cold injury rates than their respective counterparts. Numbers of cases in the combat zone have decreased in the past 3 years, most likely the result of declining numbers of personnel exposed and the changing nature of operations. It is important that awareness, policies, and procedures continue to be emphasized to reduce the toll of cold injuries among U.S. service members.

Cold climate could be an etiologic factor involved in Raynaud's phenomenon physiopathology. Epidemiological investigation from 954 consultations in general practic.

AIM: The physiopathology of Raynaud's phenomenon (RP) is not currently fully resolved. The cold seems to be not only an important factor triggering attacks, but also inducing RP. The aims of this study were to assess the prevalence of RP in Nantes urban district, and study the relationship between RP prevalence and cold climate. METHODS: Patients aged between 10 and 80 years old, consulting in five Nantes General Practices, from June 2011 and March 2012, were included. Patients presenting RP underwent a full clinical examination. Subjects not meeting Allen and Brown criteria benefited from at least a dosage of Anti-Nuclear Antibodies and a naifold Capillaroscopy. Climate data provided by French national weather agency allowed establishing an average of observed temperatures during the past five years and correlating them to the observed prevalence. RESULTS: Of 954 patients included, 78 had a RP, for an overall prevalence estimated at 8.2%. The prevalence among women (8.9%) was slightly higher than men (7.3%). Secondary form represented 5.1% of RP. In the RP group, 13 patients were active smokers, mean BMI was 22.3±3.2 kg/m², and only 4 patients were treated by vasoconstrictor therapy. According to French national weather agency, between 2007 and 2011, mean temperature of January in Nantes area was 5.8 °C. CONCLUSION: We confirmed that the lower winter temperatures a region experiences, the higher the prevalence of RP, thus raising the question of the physiopathological role of the cold in the induction or in the revelation of RP.