Application of time series analysis in predicting postpartum depression: integrating data from the hospitalization period and early postpartum weeks.

PURPOSE: This study aimed to explore the dynamic changes in postpartum depressive symptoms from the hospitalization period to 4-8 weeks postpartum using time series analysis techniques. By integrating depressive scores from the hospital stay and the early postpartum weeks, we sought to develop a predictive model to enhance early identification and intervention strategies for Postpartum Depression (PPD). METHODS: A longitudinal design was employed, analyzing Edinburgh Postnatal Depression Scale (EPDS) scores from 1,287 postpartum women during hospitalization and at 4, 6, and 8 weeks postpartum. Descriptive statistics summarized demographic characteristics. Time Series Analysis using the Auto-Regressive Integrated Moving Average (ARIMA) model explored temporal trends and seasonal variations in EPDS scores. Correlation analysis examined the relationships between EPDS scores and demographic characteristics. Model validation was conducted using a separate dataset. RESULTS: EPDS scores significantly increased from the hospitalization period to 4-8 weeks postpartum (p < .001). The ARIMA model revealed seasonal and trend variations, with higher depressive scores in the winter months. The model's fit indices (AIC = 765.47; BIC = 774.58) indicated a good fit. The Moving Average (MA) coefficient was - 0.69 (p < .001), suggesting significant negative impacts from previous periods' errors. CONCLUSIONS: Monitoring postpartum depressive symptoms dynamically was crucial, particularly during the 4-8 weeks postpartum. The seasonal trend of higher depressive scores in winter underscored the need for tailored interventions. Further research using longitudinal and multi-center designs was warranted to validate and extend these findings. Our predictive model aimed to enhance early identification and intervention strategies, contributing to better maternal and infant health outcomes.

More than just a stye: identifying seasonal patterns using google trends, and a review of infodemiological literature in ophthalmology.

PURPOSE: We aim to evaluate the utility of internet search query data in ophthalmology by: (1) Evaluating trends in searches for styes in the United States and worldwide, and (2) Performing a review of literature of infodemiological data in ophthalmology. METHODS: Google Trends search data for "stye" was analyzed from January 2004 to January 2020 in the United States and worldwide. Spearman's correlation coefficient and sinusoidal modeling were performed to assess the significance and seasonality of trends. Review of literature included searches for "ophthalmology Google trends," "ophthalmology twitter trends," "ophthalmology infodemiology," "eye google trends," and "social media ophthalmology." RESULTS: Searches for styes were cyclical in the United States and globally with a steady increase from 2004 to 2020 (sum-of-squares F-test for sinusoidal model: p < .0001, r2 = 0.96). Peak search volume index (SVI) months were 7.9 months in the United States and 6.8 months worldwide. U.S. temperature and SVI for stye were correlated in the United States at the state, divisional, and country-wide levels (p < .005; p < .005; p < .01 respectively). Seven articles met our literature review inclusion criteria. CONCLUSIONS: We present a novel finding of seasonality with global and U.S. searches for stye, and association of searches with temperature in the United States. Within ophthalmology, infodemiological literature has been used to track trends and identify seasonal disease patterns, perform disease surveillance, improve resource optimization by identifying regional hotspots, tailor marketing, and monitor institutional reputation. Future research into this domain may help identify further trends, improve prevention efforts, and reduce medical costs.

Multi-class organic pollutants in atmospheric particulate matter (PM2.5) from a Southwestern Europe industrial area: Levels, sources and human health risk.

The occurrence of 50 multi-class pollutants comprising 18 polycyclic aromatic hydrocarbons (PAHs), 12 phthalate esters (PAEs), 12 organophosphorus flame retardants (OPFRs), 6 synthetic musk compounds (SMCs) and 2 bisphenols was studied in atmospheric particulate matter (PM2.5) samples collected at an industrial area focused on automotive manufacturing located at the Southwestern Atlantic European region (Vigo city, Spain) during 1-year period. Among all quantitated pollutants in PM2.5 samples, bisphenol A (BPA) was the most predominant with an average concentration of 6180 pg m-3, followed by PAHs comprising benzo(b+j)fluoranthene (BbF + BjF) and benzo(g,h,i)perylene (BghiP), accounting for 546 pg m-3 and 413 pg m-3 respectively. In addition, two OPFRs concerning tris(chloropropyl) phosphate (TCPP) and triphenyl phosphine oxide (TPPO) were the next following the concentration order, accounting for 411 pg m-3 and 367 pg m-3 respectively; being butyl benzyl phthalate (BBP) the most profuse PAE (56.1 pg m-3 by average). High relative standard deviations (RSDs) were observed during the whole sampling period, while statistically significant differences were only observed for PAHs concentrations during cold and warm seasons. Furthermore, some water-soluble ions and metal(oid)s were analysed in PM2.5 samples to be used as PM source tracers, whose concentrations were quite below the target levels set in the current legislation. Data obtained from principal component analysis (PCA) and PAHs molecular indices suggested a pyrogenic and petrogenic origin for PAHs, whereas occurrence of the remaining compounds seems to be attributed to resources used in the automotive industrial activity settled in the sampling area. Moreover, although a substantial anthropogenic source to PM2.5 in the area was observed, marine and soil resuspension contributions were also accounted. Finally, carcinogenic and non-carcinogenic risks posed by PM2.5-bound pollutants inhalation were assessed, being both averages within the safe level considering the whole period.

Three-year pollen and fungi calendar in a Mediterranean region of the Northeast Greece.

INTRODUCTION AND OBJECTIVES: Pollen calendars have been proved clinically important in allergic disease management, as differences in airborne allergens exist not only between different countries but also between regions of the same country as well. This study aims to provide new data regarding the atmospheric pollen and fungi content of a Mediterranean region (Western Thrace/North-East Greece) and discuss seasonal trends, differences in pollen grains and fungi spores' circulation over the years, and correlations with climate parameters. MATERIAL AND METHODS: A 7-day continuously running volumetric trap was used to collect circulating pollen grains and fungi spores. Pollen taxa and fungi were characterized by standard protocols and counted as grains /m3 and average total grains and spores. The primary allergenic pollen season was discovered, and their 10-day averages were measured over time. Correlations with temperature, rain, and humidity were assessed by single linear regression analysis. RESULTS: Pollen grains from nine pollen families were identified, including five arboreal, two nonarboreal taxa, and spores from two fungi species. The three most prevalent taxa were Oleaceae, Poaceae, Pinaceae, and Cladosporium in the fungi. Peak pollen concentrations were detected during April and May, with daily averages exceeding 170 grains/m3. Poaceae presented the longest pollen season of 342 days and Oleaceae the shortest, extending to only 110 days, during the 3years. Cladosporium was the fungus with the highest spore concentration (180,129.9 spores) compared with Alternaria (28,026.1 spores). Correlations with meteorological parameters showed variable associations among different taxa, with rainfall and relative humidity being the most significant determinants. CONCLUSION: In this study, the pollenic and fungal spectrum of a Mediterranean region and information that can be proved clinically significant for the appropriate diagnostic and therapeutic approach of allergic patients was presented.

Time series decomposition into dyslipidemia prevalence among urban Chinese population: secular and seasonal trends.

BACKGROUND: Previous epidemiological studies have indicated the seasonal variability of serum lipid levels. However, little research has explicitly examined the separate secular and seasonal trends of dyslipidemia. The present study aimed to identify secular and seasonal trends for the prevalence of dyslipidemia and the 4 clinical classifications among the urban Chinese population by time series decomposition. METHODS: A total of 306,335 participants with metabolic-related indicators from January 2011 to December 2017 were recruited based on routine health check-up systems. Multivariate direct standardization was used to eliminate uneven distributions of the age, sex, and BMI of participants over time. Seasonal and trend decomposition using LOESS (STL decomposition) was performed to break dyslipidemia prevalence down into trend component, seasonal component and remainder component. RESULTS: A total of 21.52 % of participants were diagnosed with dyslipidemia, and significant differences in dyslipidemia and the 4 clinical classifications were observed by sex (P <0.001). The secular trends of dyslipidemia prevalence fluctuated in 2011-2017 with the lowest point in September 2016. The dyslipidemia prevalence from January to March and May to July was higher than the annual average (λ = 1.00, 1.16, 1.06, 1.01, 1.02, 1.03), with the highest point in February. Different seasonal trends were observed among the 4 clinical classifications. Compared to females, a higher point was observed among males in February, which was similar to participants aged < 55 years (vs. ≥ 55 years) and participants with a BMI ≤ 23.9 (vs. BMI > 23.9). CONCLUSIONS: There were significant secular and seasonal features for dyslipidemia prevalence among the urban Chinese population. Different seasonal trends were found in the 4 clinical classifications of dyslipidemia. Precautionary measures should be implemented to control elevated dyslipidemia prevalence in specific seasons, especially in the winter and during traditional holidays.

Statistical significance of seasonal warming/cooling trends.

The question whether a seasonal climate trend (e.g., the increase of summer temperatures in Antarctica in the last decades) is of anthropogenic or natural origin is of great importance for mitigation and adaption measures alike. The conventional significance analysis assumes that (i) the seasonal climate trends can be quantified by linear regression, (ii) the different seasonal records can be treated as independent records, and (iii) the persistence in each of these seasonal records can be characterized by short-term memory described by an autoregressive process of first order. Here we show that assumption ii is not valid, due to strong intraannual correlations by which different seasons are correlated. We also show that, even in the absence of correlations, for Gaussian white noise, the conventional analysis leads to a strong overestimation of the significance of the seasonal trends, because multiple testing has not been taken into account. In addition, when the data exhibit long-term memory (which is the case in most climate records), assumption iii leads to a further overestimation of the trend significance. Combining Monte Carlo simulations with the Holm-Bonferroni method, we demonstrate how to obtain reliable estimates of the significance of the seasonal climate trends in long-term correlated records. For an illustration, we apply our method to representative temperature records from West Antarctica, which is one of the fastest-warming places on Earth and belongs to the crucial tipping elements in the Earth system.

Otitis externa-climatic associations and evidence-based management strategies for Australian practice.

OBJECTIVES: There is a lack of consensus for the management of otitis externa. In addition to looking at seasonal trends surrounding otitis externa, this article also reviews a collection of local and international guidelines on the management of this condition. DESIGN: Retrospective case audit of clinician-diagnosed otitis externa at the Hedland Health Campus over 18 months. Review of 2007-2017 evidence-based guidelines relevant to area of practice. SETTING: Hedland Health Campus Emergency Department in the remote Pilbara region of Western Australia. PARTICIPANTS: Two-hundred-thirty-six otitis externa cases in 193 individuals were seen by our service. MAIN OUTCOME MEASURED: Number of otitis externa presentations each month. RESULT: Nine guidelines were reviewed, which varied widely in recommendations. An overrepresentative proportion of patients identified as either Aboriginal or Torres Strait Islander. There was a strong positive correlation between the monthly rainfall and otitis externa, moderate correlation between higher monthly minimum temperatures and no correlation with maximum temperature. Given the variety of guidelines available, it was difficult to assess whether prescribing was always consistent with guidelines. CONCLUSION: This research makes evidence-based suggestions for Australian practitioners. Patients should be treated with oral analgesia, ear toileting and targeted topical therapy. There is no evidence for swabs, ear wicks and oral antibiotics. The authors hypothesise that re-presentation rates might be in part attributable to freshwater pseudomonal infection.

Effect of climatic variability on malaria trends in Baringo County, Kenya.

BACKGROUND: Malaria transmission in arid and semi-arid regions of Kenya such as Baringo County, is seasonal and often influenced by climatic factors. Unravelling the relationship between climate variables and malaria transmission dynamics is therefore instrumental in developing effective malaria control strategies. The main aim of this study was to describe the effects of variability of rainfall, maximum temperature and vegetation indices on seasonal trends of malaria in selected health facilities within Baringo County, Kenya. METHODS: Climate variables sourced from the International Research Institute (IRI)/Lamont-Doherty Earth Observatory (LDEO) climate database and malaria cases reported in 10 health facilities spread across four ecological zones (riverine, lowland, mid-altitude and highland) between 2004 and 2014 were subjected to a time series analysis. A negative binomial regression model with lagged climate variables was used to model long-term monthly malaria cases. The seasonal Mann-Kendall trend test was then used to detect overall monotonic trends in malaria cases. RESULTS: Malaria cases increased significantly in the highland and midland zones over the study period. Changes in malaria prevalence corresponded to variations in rainfall and maximum temperature. Rainfall at a time lag of 2 months resulted in an increase in malaria transmission across the four zones while an increase in temperature at time lags of 0 and 1 month resulted in an increase in malaria cases in the riverine and highland zones, respectively. CONCLUSION: Given the existence of a time lag between climatic variables more so rainfall and peak malaria transmission, appropriate control measures can be initiated at the onset of short and after long rains seasons.

Flea species infesting dogs in Spain: updated spatial and seasonal distribution patterns.

This entomological survey examines the spatial and seasonal distribution patterns of flea species infesting dogs in Spain. Bioclimatic zones covering broad climate and vegetation ranges were surveyed according to size. In a cross-sectional spatial survey carried out from late May 2013 to mid-July 2015, 1084 dogs from 42 different locations were examined. A total of 3032 fleas were collected and identified as belonging to the following species: Ctenocephalides felis (Siphonaptera: Pulicidae) (81.7%, 2476 fleas); Ctenocephalides canis (11.4%, 347 fleas); Pulex irritans (Siphonaptera: Pulicidae) (6.9%, 208 fleas), and Echidnophaga gallinacea (Siphonaptera: Pulicidae) (0.03%, one flea). Variables observed to have effects on flea abundance were animal weight, sex, length of hair and habitat. In the seasonal survey conducted from June 2014 to June 2015, 1014 fleas were collected from 239 dogs at 30 veterinary practices across Spain. Peaks in C. felis abundance were observed in early summer and late autumn, whereas high numbers of P. irritans and C. canis were recorded in autumn. Numbers of fleas detected in winter were low overall. Based on these findings, the present study updates the spatial and seasonal distributions of flea species in Spain and assesses the impacts of host and habitat variables on flea infestation.

Geographic Distribution and Temporal Trends of Zika Virus Outbreaks in India (2016-2023): Insights From the Integrated Disease Surveillance Programme Data.

Introduction This study examines the geographic distribution and temporal trends of Zika virus (ZIKV) outbreaks in India from 2016 to 2023 using data from the Integrated Disease Surveillance Programme (IDSP). The burden of ZIKV in India has risen due to its rapid spread and significant health impacts. Existing literature highlights seasonal and geographic patterns but lacks a comprehensive, long-term analysis specific to India. This study addresses this gap by analyzing trends over seven years to inform better public health responses. Methods A secondary data analysis was conducted using publicly available data from the IDSP on reported Zika cases from January 2016 to December 2023. Descriptive statistical methods and geographic information system (GIS) mapping techniques were employed to analyze the geographic distribution and temporal trends of ZIKV outbreaks in India. The data were analyzed and visualized using R software version 4.3.2 (R Foundation for Statistical Computing, Vienna, Austria), with heat maps and choropleth maps to identify hotspots, and line diagrams to identify temporal trends. Results Zika outbreaks predominantly occurred during the post-monsoon season, accounting for 47.62% (n = 10) of the total 21 outbreaks, followed by the monsoon season with 33.33% (n = 7), and summer with 19.05% (n = 4). Two deaths were reported during a significant outbreak in Madhya Pradesh in 2018. Temporal trends indicated notable spikes in cases in 2018 (131 cases) and 2021 (234 cases), with no cases reported in 2019 and 2020. The geographic distribution maps highlighted significant concentrations of ZIKV outbreaks in specific districts within Uttar Pradesh, Madhya Pradesh, and Kerala. Discussion The study identified seasonal patterns, with most cases occurring in the post-monsoon season. The geographic spread of the ZIKV was observed in eight states from 2016 to 2023. GIS identified three hotspots in Uttar Pradesh, Madhya Pradesh, and Kerala. Conclusion The study highlights the need for heightened surveillance and targeted intervention preparedness during high-risk seasons. Enhancing testing facilities and data reporting systems could improve outbreak identification, management, and response.

Skinfold thickness in elite male professional football players: changes across 3 seasons including a COVID-19 lockdown period.

This study investigates variations in skinfold thickness in a European professional football team within and across multiple seasons, including before and after COVID-19 restrictions. Skinfold thickness was measured in 49 male players on 32 occasions across three seasons (2018/19, 2019/20 and 2020/21). Intra- and inter-seasonal trends were examined by comparing values for the sum of eight skinfolds (sum8) at key time points using linear mixed models. In each season, the largest differences in sum8 occurred after the preseason period. These differences ranged from a mean difference (Mdiff) of -11.0 mm (p < 0.001) in 2018/19 to -4.8 mm (p < 0.001) in 2020/21. Increases in sum8 occurred after each off-season; however, the increase after the off-season before the 2020/21 season (which included the COVID-19 lockdown period) was the lowest in magnitude and was not statistically significant (Mdiff = 2.9 mm, p = 0.06). Changes occurring in sum8 between the start and end of the competitive season did not follow a consistent pattern and were generally smaller in magnitude than the changes between other seasonal time points. Despite the notable heterogeneity in sum8 between players, changes within players generally followed a similar pattern between the different seasonal timepoints. In summary, changes in skinfold thickness were predominantly related to off-season and 'preparation for competition' periods. Increases in skinfold thickness can be mitigated during extended remote training periods with appropriate training and nutritional strategies.

Determining the true incidence of seasonal respiratory syncytial virus-confirmed hospitalizations in preterm and term infants in Western Australia.

Respiratory syncytial virus contributes to significant global infant morbidity and mortality. We applied a previously developed statistical prediction model incorporating pre-pandemic RSV testing data and hospital admission data to estimate infant RSV-hospitalizations by birth month and prematurity, focused on infants aged <1 year. The overall predicted RSV-hospitalization incidence rates in infants <6 months were 32.7/1,000 child-years (95 % CI: 31.8, 33.5) and 3.1/1,000 child-years (95 % CI: 3.0, 3.1) in infants aged 6-<12 months. Predicted RSV-hospitalization rates for infants aged <6 months were highest for infants born in April/May. Predicted rates for preterm infants born 29-32 weeks gestation were highest in March-May, whereas infants born >33 weeks had peak RSV-hospitalization rates from May-June, similar to late preterm or term births. RSV-hospitalization rates in the pre-pandemic era were highly seasonal, and seasonality varied with degree of prematurity. Accurate estimates of RSV-hospitalization in high-risk sub-groups are essential to understand preventable burden of RSV especially given the current prevention landscape.

Multi-class organic pollutants in PM2.5 in mixed area of Shanghai: Levels, sources and health risk assessment.

The occurrence of 25 multi-class pollutants comprising phthalate esters (PAEs), polycyclic aromatic hydrocarbons (PAHs), and synthetic musks (SMs) were studied in PM2.5 samples collected at an industrial/commercial/residential/traffic mixed area in Shanghai during four seasons. During the whole period, a slight exceedance of the PM2.5 annual limit was observed, with an average of 36.8 µg/m3, and PAEs were the most predominant, accounting for >70 % of the studied organic pollutants in PM2.5, followed by PAHs and SMs. Statistically significant differences were observed for the concentrations of PM2.5, PAEs, PAHs, and SMs in winter and summer. This seasonal variation could be derived from anthropogenic activities and atmospheric dynamics. Principal component analysis (PCA) and PAHs ratios suggested a mixed source mainly derived from vehicle emissions and industrial processes. Moreover, gaseous pollutants were also accounted for, indicating the emission of PAHs might accompany the NO2 emission process. Finally, inhalation of PM2.5-bound organic pollutants for carcinogenic and non-carcinogenic risks were estimated as average values for each season, showing outside the safe levels in autumn and winter in some cases, suggesting that new policies should be to developed to reduce their emissions and protect human health in this area.

Gaseous polycyclic aromatic hydrocarbons over the South China Sea: Implications for atmospheric transport under monsoon influences.

The seasonal monsoon variations have significant impact on the atmospheric transport of semi-volatile organic pollutants over the South China Sea (SCS). We analyzed polycyclic aromatic hydrocarbons (PAHs) over the basin and island areas (Yongxing Island and Yongshu Island) in 2017. Gaseous PAHs (0.17-1.4 ng m-3) showed spatio-temporal distinctions in their composition and sources among the basin and island areas. Mixed combustion sources of PAHs were identified over the SCS, including a petroleum source near the island areas. The transport routes of PAHs were inferred by the air mass back trajectories and potential source contribution factor analysis, identifying strong biomass burning signals from the Indochina Peninsula and other Southeast Asian countries. Emissions from approximately 90 % of the combustion sources were transported to basin areas by monsoons, whereas the island areas were dominated by local emissions. This study emphasizes the main potential terrestrial source of PAHs over the SCS under monsoon influences.

Investigating the associations between organophosphate flame retardants (OPFRs) and fine particles in paired indoor and outdoor air: A probabilistic prediction model for deriving OPFRs in indoor environments.

Contaminants of emerging concern such as organophosphate flame retardants (OPFRs) are associated with atmospheric fine particles (PM2.5), which pose the greatest health risk in the world. However, few surveys have explored the interaction between PM2.5 and OPFRs in residential paired indoor/outdoor environments. 11 priority OPFRs and PM2.5 were investigated across 178 paired indoor and outdoor air samples taken from 89 children's households in southern Taiwan, across cold and warm seasons. This involved exploring their associations with building characteristics, interior materials, and human activities. We developed a probabilistic predictive model for indoor OPFRs based on the indoor/outdoor (I/O) ratio of contaminants and an air quality index. The significant associations of paired indoor/outdoor OPFRs and PM2.5 were explored. The indoor level of OPFRs was greater than that of outdoor households, contrasting with PM2.5. The I/O OPFRs ratio was higher than 1 (except for TEHP, EHDPP, and TCP), which suggests that the sources of OPFRs were primarily emitted from indoors. Indoor TCEP was significantly positively associated with indoor and outdoor PM2.5. The OPFR level detected in apartments was higher than in houses due to the greater decoration, furniture and electronic devices. However, this was not the case for PM2.5. TCIPP was the dominant compound in paired indoor and outdoor air. The indoor OPFR predictive model obtained a high accuracy with an R2 value of 0.87. The material used in mattresses, the use of purifiers and heaters, and the total material area were the main influencing factors for indoor OPFRs in households. These findings could provide important evidence of the interaction between paired indoor/outdoor OPFRs and PM2.5 and interior equipment in different building types. In addition, it could prevent the potential risks posed by indoor/outdoor air pollutants and eliminate OPFR emissions through the selection of better construction and building materials.

Seasonal trends and retention of polycyclic aromatic compounds (PACs) in a remote sub-Arctic catchment.

Atmospheric deposition is the most dominant source of polycyclic aromatic hydrocarbons (PAHs) in remote and pristine areas. Despite low bioaccumulation potential, PAHs and their persistent transformation products (PAH-derivatives) are chemicals of concern as they can harm human and animal health through chronic low dose exposure. In this study, atmospheric deposition fluxes of polycyclic aromatic compounds (PACs) were measured on a seasonal basis (3-month periods) from 2012 to 2016 in a remote subarctic forest catchment in northern Europe. The target PACs included 19 PAHs and 15 PAH-derivatives (oxygenated, nitrogenated, and methylated PAHs). The deposition fluxes of Æ©PAHs and Æ©PAH-derivatives were in the same range and averaged 530 and 500 ng m2 day-1, respectively. The fluxes were found to be higher with a factor of 2.5 for Æ©PAHs and a factor of 3 for Æ©PAH-derivatives during cold (<0 °C) in comparison to warm (>10 °C) periods. PAHs and PAH-derivatives showed similar seasonal patterns, which suggests that these two compound classes have similar sources and deposition mechanisms, and that the source strength of the PAH-derivatives in air follows that of the PAHs. The terrestrial export of PACs via the outlet of the catchment stream was estimated to be 1.1% for Æ©PAHs and 1.7% for Æ©PAH-derivatives in relation to the annual amounts deposited to the catchment, which suggests that boreal forests are sinks for PACs derived from the atmosphere. Some individual PACs showed higher export than others (i.e. chrysene, cyclopenta(c,d)pyrene, carbazole, quinoline, and benzo(f)quinoline), with high export PACs mostly characterized by low molecular weight and low hydrophobicity (2-3 benzene rings; log Kow<6.0).

Seasonal variation and deposition of atmospheric organophosphate esters in the coastal region of Shanghai, China.

The coastal megacity Shanghai is located in the center of the Yangtze River Delta, a dominant flame retardants (FRs) production region in China, especially for organophosphate esters (OPEs). This prompted us to investigate occurrence and seasonal changes of atmospheric OPEs in Shanghai, as well as to evaluate their sources, environmental behavior and fate as a case study for global coastal regions. Atmospheric gas and particle phase OPEs were weekly collected at two coastal sites - the emerging town Lingang New Area (LGNA), and the chemical-industry zone Jinshan Area (JSA) from July 2016-June 2017. Total atmospheric concentrations of the observed OPEs were significantly higher in JSA (median of 1800 pg m-3) than LGNA (median of 580 pg m-3). Tris(1-chloro-2-propyl) phosphate (TCPP) was the most abundant compound, and the proportion of three chlorinated OPEs were higher in the particle phase (55%) than in the gas phase (39%). The year-round median contribution of particle phase OPEs was 33%, which changed strongly with seasons, accounting for 10% in summer in contrast to 62% in winter. Gas and particle phase OPEs in JSA exhibited significant correlations with inverse of temperature, respectively, indicating the importance of local/secondary volatilization sources. The estimated fluxes of gaseous absorption were almost 2 orders of magnitude higher than those of particle phase deposition, which could act as sources of organic phosphorus to coastal and open ocean waters.

Influence of Weekday and Seasonal Trends on Urgency and In-hospital Mortality of Emergency Department Patients.

Background: Given the scarcity of resources, the increasing use of emergency departments (ED) represents a major challenge for the care of emergency patients. Current health policy interventions focus on restructuring emergency care with the help of patient re-direction into outpatient treatment structures. A precise analysis of ED utilization, taking into account treatment urgency, is essential for demand-oriented adjustments of emergency care structures. Methods: Temporal and seasonal trends in the use of EDs were investigated, considering treatment urgency and hospital mortality. Secondary data of 287,119 ED visits between 2015 and 2017 of the two EDs of Charité Universitätsmedizin Berlin, Campus Charité Mitte and Campus Virchow Klinikum were analyzed. Result: EDs were used significantly more frequently on weekends than on weekdays (Mdn = 290 vs. 245 visits/day; p < 0.001). The proportion of less urgent, outpatient emergency visits on weekends was above average. Holiday periods were characterized by at least 6, and at most 176 additional ED visits. In a comparison of different holidays, most ED visits were observed at New Year (+68% above average). In addition, a significant increase in in-hospital mortality on holidays was evident among inpatients admitted to hospital via the ED (3.0 vs. 3.2%; p < 0.001), with New Year's Day being particularly striking (5.4%). Conclusion: These results suggest that, in particular, the resource planning of outpatient emergency treatment capacities on weekends and holidays should be adapted to the increased volume of non-urgent visits in EDs. Nevertheless, treatment capacities for the care of urgent, inpatient emergencies should not be disregarded and further research projects are necessary to investigate the causes of increased mortality during holiday periods.