Facilitators and Barriers for Keeping Cool in an Urban Heat Island: Perspectives from Residents of an Environmental Justice Community.

Background: Extreme heat is a leading cause of morbidity and mortality during summer months in the United States. Risk of heat exposure and associated health outcomes are disproportionately experienced by people with lower incomes, people of color, and/or immigrant populations. Methods: As qualitative research on the experiences of residents in heat islands is limited, this community-based study examined barriers and coping strategies for keeping cool among residents of Chelsea and East Boston, Massachusetts-environmental justice (EJ) areas that experience the urban heat island effect-through semistructured interviews and qualitative content analysis. Results: Results indicate that all participants (n = 12) had air conditioning, but high energy bills contributed to low use. Eight participants were self-described heat-sensitive, with five experiencing poor health in heat. In addition, nine reported insufficient hydration due to work schedules, distaste of water, or perceptions of it being unsafe. Discussion: This research highlights the importance of understanding perceptions of residents in EJ communities to contextualize vulnerability and identify multipronged heat coping strategies and targeted interventions.

Simultaneous detection and differentiation of Mycobacterium tuberculosis and nontuberculous mycobacteria coexisting in patients with pulmonary tuberculosis by single-tube multiplex PCR.

Background and Objectives: In clinical diagnostics, molecular methods are used to detect Mycobacterium tuberculosis bacilli (MTB) and to distinguish them from non-tuberculous mycobacteria (NTM). They are also used to make the right treatment decision for the patient as soon as possible. The aim of this study was to establish a rapid and novel multiplex PCR (mPCR) assay for the detection and differentiation of MTB and NTM in a single tube. Materials and Methods: 100 sputum samples positive for acid-fast bacilli (AFB) were included in this study. Mycobacterial culture, biochemical tests, and antibiotic susceptibility testing were performed on samples. After alkaline decontamination, total DNA was extracted from the samples. A primer pair targeting the rpoB gene, encoding the beta-subunit of RNA polymerase, was used to detect MTB and NTM, amplifying a 235-bp fragment of MTB and a 136-bp sequence of NTM. A pair of primers targeting a 190-bp fragment of the IS6110 region of MTB was also used to confirm the results. The sensitivity and specificity of the mPCR assay were evaluated using DNA extracted from standard strains. The amplified products were then analyzed by conventional agarose gel electrophoresis. Results: Of 100 AFB smear-positive sputum samples, 92 MTB DNA, 7 NTM DNA, and one mixed-infection sample were identified in a single tube using mPCR assay. There was no correlation between the AFB degree of smear positivity and PCR results. Of seven NTM isolates, 6 (86%) were resistant to rifampin, isoniazid, and ethambutol, the three first-line anti-tuberculosis drugs. Conclusion: A single-tube mPCR assay based on the rpoB gene provides a rapid and reliable means of detecting and differentiating MTB and NTM in sputum specimens.

Mixed methods assessment of personal heat exposure, sleep, physical activity, and heat adaptation strategies among urban residents in the Boston area, MA.

The growing frequency, intensity, and duration of extreme heat events necessitates interventions to reduce heat exposures. Local opportunities for heat adaptation may be optimally identified through collection of both quantitative exposure metrics and qualitative data on perceptions of heat. In this study, we used mixed methods to characterize heat exposure among urban residents in the area of Boston, Massachusetts, US, in summer 2020. Repeated interviews of N = 24 study participants ascertained heat vulnerability and adaptation strategies. Participants also used low-cost sensors to collect temperature, location, sleep, and physical activity data. We saw significant differences across temperature metrics: median personal temperature exposures were 3.9 °C higher than median ambient weather station temperatures. Existing air conditioning (AC) units did not adequately control indoor temperatures to desired thermostat levels: even with AC use, indoor maximum temperatures increased by 0.24 °C per °C of maximum outdoor temperature. Sleep duration was not associated with indoor or outdoor temperature. On warmer days, we observed a range of changes in time-at-home, expected given our small study size. Interview results further indicated opportunities for heat adaptation interventions including AC upgrades, hydration education campaigns, and amelioration of energy costs during high heat periods. Our mixed methods design informs heat adaptation interventions tailored to the challenges faced by residents in the study area. The strength of our community-academic partnership was a large part of the success of the mixed methods approach.

Long-term Survival and Prognostic Factors of Breast Cancer.

BACKGROUND: Breast cancer survival rate is an important index for assessment of treatment effect in reducing the mortality. Weaimed to determine the fifteen-year survival rate for breast cancer at a referral center in Iran and its correlated factors. METHODS: This survival study enrolled patients with breast cancer who referred to Motamed Cancer Institute (MCI) from 1998 to2016. The survival rate was calculated using the Kaplan-Meier method. The relationship of demographic, clinical and therapeuticfactors with overall survival (OS) was studied using Cox's proportional hazard model. RESULTS: Totally, 3443 patients were studied. Their mean age and follow-up period were 47.7 (±11.43) years and 61.66 (±52.1)months, respectively. The median follow-up time was 48.4 months (range: 1-413 months), 49.7% of the patients had high schoolor higher education, and 71.3% presented in the early stage of the disease. Death occurred in 505 (14.7%) of the patients. Theoverall 2-, 5-, 7-, 10- and 15-year survival rates were 93%, 82%, 78%, 74%, and 66%, respectively. Lymph node involvement(HR=2.07; 95% CI: 1.38-3.09), tumor size≥5 cm (HR=2.83; 95% CI: 1.59-2.04), being single/divorced/widowed (HR=1.65;95% CI: 1.13-2.4), and education level

Petrochemical waste characterization and management at Pars Special Economic Energy Zone in the south of Iran.

Industrial waste management generated by different petrochemical complexes at Pars Special Economic Energy Zone, located in the south of Iran, was investigated. All 10 active petrochemical complexes were visited and generated wastes were identified by a checklist. Petrochemical plants were classified regarding feeds, process, and products and nine representative wastes were sampled. Physicochemical characteristics were analyzed and appropriate management approaches were proposed according to the literature review and the results of waste characterization. The generated wastes were classified as hazardous and non-hazardous according to the Basel Convention and Environmental Protection Agency lists of waste classification. Also, the concentrations of organic compounds and heavy metals were measured to classify wastes characteristically. Comparing concentrations of the most important heavy metals in sampled wastes illustrated that sandblast with Cu concentration of 4295 mg kg-1, spent activated carbon with Hg concentration of 127 mg kg-1, and spent catalyst with 25% Ni content can be categorized as hazardous wastes, due to the exceeding Total Threshold Limit Concentration levels. Based on laboratory results, all industrial waste generated in the petrochemical complexes were categorized into three groups, namely Organic Waste with High Calorific Value, Non-organic Recyclable Waste, and Non-organic Non-recyclable Waste. Finally, management approaches, including material recycling, energy recovery (through incineration), and landfilling, were proposed and a conceptual model was suggested in order to show different routes and final destination for each kind of waste generated in all similar petrochemical complexes.

A tree-planting decision support tool for urban heat mitigation.

Heat poses an urgent threat to public health in cities, as the urban heat island (UHI) effect can amplify exposures, contributing to high heat-related mortality and morbidity. Urban trees have the potential to mitigate heat by providing substantial cooling, as well as co-benefits such as reductions in energy consumption. The City of Boston has attempted to expand its urban canopy, yet maintenance costs and high tree mortality have hindered successful canopy expansion. Here, we present an interactive web application called Right Place, Right Tree-Boston that aims to support informed decision-making for planting new trees. To highlight priority regions for canopy expansion, we developed a Boston-specific Heat Vulnerability Index (HVI) and present this alongside maps of summer daytime land surface temperatures. We also provide information about tree pests and diseases, suitability of species for various conditions, land ownership, maintenance tips, and alternatives to tree planting. This web application is designed to support decision-making at multiple spatial scales, to assist city officials as well as residents who are interested in expanding or maintaining Boston's urban forest.

Leadership Disparities in State Governmental Public Health Workforce: Examining the Influence of Gender.

OBJECTIVE: To determine the extent to which gender disparities exist in either obtaining a leadership position or pay equity among those with leadership positions in state governmental public health agencies. DESIGN: Utilizing the 2014 Public Health Workforce Interests and Needs Survey, a nationally representative cross-sectional study of state governmental public health agency employees, the characteristics of the state governmental public health agency leadership were described. We estimated the odds of being a manager or an executive leader and the odds of leaders earning greater than $95 000 annually for women compared with men using polytomous multinomial regression and logistic regression models, respectively. SETTING AND PARTICIPANTS: The Public Health Workforce Interests and Needs Survey was conducted via electronic survey at 37 state health departments. This study utilized only those respondents who listed their current position as a supervisory position (n = 3237). MAIN OUTCOME MEASURES: Leadership position and high-earning leadership were the 2 main outcome measures explored. Leadership position was defined as a 3-level ordinal variable: supervisor, manager, or executive leader. High-earning leadership was defined as a member of leadership earning $95 000 or greater. RESULTS: Women accounted for 72.0% of the overall state governmental public health agency workforce and 67.1% of leadership positions. Women experienced lower odds (odds ratio = 0.55, 95% confidence interval: 0.39-0.78) of holding executive leadership positions than men and lower odds (odds ratio = 0.64, 95% confidence interval: 0.50-0.81) of earning an annual salary greater than $95 000. CONCLUSION: While women were represented in similar proportions in the general workforce as in leadership positions, gender disparities still existed within leadership positions. Increased effort is needed to ensure that opportunities exist for women in executive leadership positions and in pay equity. With public health's commitment to social justice and the benefits of diversity to an agency's policies and programs, it is important to ensure that women's voices are equally represented at all levels of leadership.

Molecular analysis of PmrA and PmrB genes in colistin-resistant Pseudomonas aeruginosa strains via PCR method.

Pseudomonas aeruginosa is one of the most common pathogens in hospitals. Along with the advent of various drug resistance patterns, rising resistance to colistin, the last alternative against this bacterium, is reported as a major clinical concern all over the world. Initially, Pseudomonas aeruginosa strains were identified by diagnostic tests including phenotypic method, growth at 42°C, Gram staining, culture on Blood Agar, EMB Agar, and biochemical oxidase, and catalase tests. The strains were confirmed using Microgen kit. Then, the resistance pattern of the identified strains was evaluated by Antibiogram. The presence of PmrA and PmrB genes were investigated by PCR method.A total of 60 strains of Pseudomonas aeruginosa were isolated and identified using microscopic, macroscopic and microbiological methods. The lowest resistance was observed against chloramphenicol and colistin antibiotics. Most of the strains harbored the PmrA and PmrB genes. The results of this study indicated an increasing trend in the resistance of the bacterium against different antibiotics. Accordingly, it is necessary to establish an infection control and therapeutic strategy in preventing the spread of such as similar resistant organisms.

Supplemental Learning in the Laboratory: An Innovative Approach for Evaluating Knowledge and Method Transfer.

The Multi-Rule Quality Control System (MRQCS) is a tool currently employed by the Centers for Disease Control and Prevention (CDC) to evaluate and compare laboratory performance. We have applied the MRQCS to a comparison of instructor and computer-led pre-laboratory lectures for a supplemental learning experiment. Students in general chemistry and analytical chemistry from both two- and four-year institutions performed two laboratory experiments as part of their normal laboratory curriculum. The first laboratory experiment was a foundational learning experiment in which all the students were introduced to Beer-Lambert's Law and spectrophotometric light absorbance measurements. The foundational learning experiment was instructor-led only, and participant performance was evaluated against a mean characterized value. The second laboratory experiment was a supplemental learning experiment in which students were asked to build upon the methodology they learned in the foundational learning experiment and apply it to a different analyte. The instruction type was varied randomly into two delivery modes, participants receiving either instructor-led or computer-led pre-laboratory instruction. The MRQCS was applied and determined that no statistical difference was found to exist in the QC (quality control) passing rates between the participants in the instructor-led instruction and the participants in the computer-led instruction. These findings demonstrate the successful application of the MRQCS to evaluate knowledge and technology transfer.

Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA.

Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI) may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED) visits were collected in Atlanta, Georgia, USA during 1993-2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index) modeled using linear, quadratic, and cubic terms to allow for non-linear associations. Effect modification by potential determinants of heat susceptibility (sex; race; comorbid congestive heart failure, kidney disease, and diabetes; and neighborhood poverty and education levels) was assessed via stratification. Higher warm-season ambient temperature was significantly associated with FEI ED visits, regardless of temperature metric used. Stratified analyses suggested heat-related risks for all populations, but particularly for males. This work highlights the utility of FEI as an indicator of heat morbidity, the health threat posed by warm-season temperatures, and the importance of considering susceptible populations in heat-health research.

INTEGRATING HEALTH INTO BUILDINGS OF THE FUTURE.

The health and wellbeing of building occupants should be a key priority in the design, building, and operation of new and existing buildings. Buildings can be designed, renovated, and constructed to promote healthy environments and behaviors and mitigate adverse health outcomes. This paper highlights health in terms of the relationship between occupants and buildings, as well as the relationship of buildings to the community. In the context of larger systems, smart buildings and green infrastructure strategies serve to support public health goals. At the level of the individual building, interventions that promote health can also enhance indoor environmental quality and provide opportunities for physical activity. Navigating the various programs that use metrics to measure a building's health impacts reveals that there are multiple co-benefits of a "healthy building," including those related to the economy, environment, society, transportation, planning, and energy efficiency.

Synthesis, characterization and multi-spectroscopic DNA interaction studies of a new platinum complex containing the drug metformin.

A new platinum(II) complex; [Pt(Met)(DMSO)Cl]Cl in which Met = metformin and DMSO: dimethylsulfoxide, was synthesized and characterized by (1)H NMR, IR, UV-Vis spectra, molar conductivity and computational methods. Binding interaction of this complex with calf thymus (CT) DNA has been investigated by using absorption, emission, circular dichroism, viscosity measurements, differential pulse voltammetry and cleavage studies by agarose gel electrophoresis. UV-Vis absorption studies showed hyperchromism. CD studies showed less perturbation on the base stacking and helicity bands in the CD spectrum of CT-DNA (B→C structural transition). In fluorimeteric studies, the Pt(II) complex can bind with DNA-NR complex and forms a new non-fluorescence adduct. The anodic peak current in the differential pulse voltammogram of the Pt(II) complex decreased gradually with the addition of DNA. Cleavage experiments showed that the Pt(II) complex does not induce any cleavage under the experimental setup. Finally all results indicated that Pt(II) complex interact with DNA via groove binding mode.

Binding studies of the antidiabetic drug, metformin to calf thymus DNA using multispectroscopic methods.

Interaction between antidiabetic drug, Metformin and calf thymus DNA (CT-DNA) in (50mM Tris-HCl) buffer were studied by UV-Visible absorption, fluorescence, CD spectroscopy and viscosity measurements. In fluorimetric studies, the enthalpy and entropy of the reaction between the drug and CT-DNA showed that the reaction is exothermic (ΔH=-35.4522 kJ mol(-1); ΔS=-49.9523 J mol(-1)K(-1)). The competitive binding studies showed that the drug could release Hoechst 33258 completely. The complex showed absorption hyperchromism in its UV-Vis spectrum with DNA. The calculated binding constant, K(b), obtained from UV-Vis absorption studies was 8.3×10(4)M(-1). Moreover, the changes in the CD spectra in the presence of the drug show stabilization of the right-handed B form of CT-DNA. Finally, viscosity measurements revealed that the binding of the complex with CT-DNA could be surface binding, mainly due to groove binding.