Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.
Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.
Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.
Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.
Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.
Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables.
Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983–2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (− 95%) to an increase of 339 deaths per year (+ 359%).
Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.
Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53 cooling centers were evaluated to assess facility and visitor characteristics. Maricopa County staff collected data by directly observing daily operations and by surveying managers and visitors. The cooling centers in Maricopa County were often housed within community, senior, or religious centers, which offered various services for at least 1500 individuals daily. Many visitors were unemployed and/or homeless. Many learned about a cooling center by word of mouth or by having seen the cooling center’s location. The cooling centers provide a valuable service and reach some of the region’s most vulnerable populations. This project is among the first to systematically evaluate cooling centers from a public health perspective and provides helpful insight to community leaders who are implementing or improving their own network of cooling centers.
Adaptive therapy utilizes competitive interactions between resistant and sensitive cells by keeping some sensitive cells to control tumor burden with the aim of increasing overall survival and time to progression. The use of adaptive therapy to treat breast cancer, ovarian cancer, and pancreatic cancer in preclinical models has shown significant results in controlling tumor growth. The purpose of this thesis is to draft a protocol to study adaptive therapy in a preclinical model of breast cancer on MCF7, estrogen receptor-positive, cells that have evolved resistance to fulvestrant and palbociclib (MCF7 R). In this study, we used two protocols: drug dose adjustment and intermittent therapy. The MCF7 R cell lines were injected into the mammary fat pads of 11-month-old NOD/SCID gamma (NSG) mice (18 mice) which were then treated with gemcitabine.<br/>The results of this experiment did not provide complete information because of the short-term treatments. In addition, we saw an increase in the tumor size of a few of the treated mice, which could be due to the metabolism of the drug at that age, or because of the difference in injection times. Therefore, these adaptive therapy protocols on hormone-refractory breast cancer cell lines will be repeated on young, 6-week old mice by injecting the cell lines at the same time for all mice, which helps the results to be more consistent and accurate.
Cancer is a disease acquired through mutations which leads to uncontrolled cell division and destruction of normal tissue within the body. Recent increases in available cross-species data of cancer in mammals, reptiles, birds, and other vertebrates has revealed that the prevalence of cancers varies widely across species. Life-history theory suggests that there could be traits that potentially explain some of that variation. We are particularly interested in species that get very little cancer. How are they preventing cancer and can we learn from them how to prevent cancer in humans? Comparative oncology focuses on the analysis of cancer prevalence and traits in different non-human species and allows researchers to apply their findings to humans with the goal of improving and advancing cancer treatment. We incorporate the predictions that animals with larger bodies have evolved better cancer suppression mechanisms than animals with small bodies. Ruminants in the past were larger in size than modern day ruminants and they may have retained cancer defenses from their large ancestors. The strong cancer defenses and small body size combined may explain the low prevalence of cancer in Ruminants. This paper aims to evaluate the presence of benign and malignant neoplasia prevalence across multiple ruminant species following a time of dramatic decrease in body size across the clade. Our aim is to illuminate the potential impact that these shifts in body size had on their cancer prevalence as well as test the statistical power of other key life history variables to predict cancer prevalence.
M. lignano larvae were isolated into separate wells of 24-well plates. After reaching maturity (30 days), the experimental plates were exposed to 5 Gys of X-rays every 4 days for a total of a 25 Gy exposure. We observed phenotypes that may be attributed to the acute effect of irradiation (e.g. blisters) but we recorded two types of phenotypes that may be a result of long-term effects of exposure to radiation. We observed enlarged testis and dark regions/masses that appeared statistically significantly more frequently in the treated animals (Fisher exact test, p=0.0026). Preliminary histological analyses of the enlarged testis suggest a benign testis enlargement due to an aberrant growth of the testes and an accumulation of aberrant spermatozoa. Importantly, we found that, similar to cancer, the dark masses can grow in size over time and the histological analysis confirms that the observed masses are composed of cells completely different from surrounding normal cells. Notably, we observed that those masses can develop and then completely disappear through an observed method of ejection. M. lignano offer the unique possibility to study in vivo cancer development in a simple organism that can easily be cultured in the lab in large numbers.
