Blood and Taxes

Nothing is certain, but blood pressure does increase in the end of  winter and beginning of spring. According to Aurametrix users and google statistics. As a matter of fact, it highly correlates with tax fever - as found by Google Correlate algorithm comparing millions of web queries  - see the figure on the right with searches for property taxes shown in red. Or check it yourself!

But the reason for raising blood pressure is not always taxes. Seasonal variation in blood pressure was noticed and described more than 50 years ago and was connected to periods of decreasing outdoor temperature. It happens to healthy individuals and those who suffer from high blood pressure, especially in the elderly.

The figure shows fluctuations in blood pressure observed by French researchers in a large study of 9294 65+ old residents of Bordeaux, Dijon, and Montpellier. Both systolic and diastolic parts of blood pressure as well as heart rate measurements significantly differed across the seasons with a clear trend for increase in colder months. And decreases following warmer weather - the higher the temperature, the larger the blood pressure decreases. Changes in blood pressure relative to outdoor temperature were largest in the elderly (80+ years old).  On average, for a 15°C decrease in outdoor temperature, Systolic blood pressure (SBP) increased 0.8 mm Hg in those aged 65 to 74 years compared with 5.1 mm Hg in the oldest group (≥80 years). For a 15°C increase in temperature, SBP decreased 9.9 mm Hg in the youngest group vs 13.8 mm Hg in those 80 years or older. Winter increases in blood pressure did not seem to be caused by increased alcohol consumption and decreased activity. Neither were they dependent on the indoor temperatures - spending over 12 hours in warm rooms did not help.

The inverse correlation of blood pressure and outdoor temperature is even stronger for "apparent temperature"- aka the perceived coldness derived from the combination of temperature and wind. And it was observed all over the world - as documented in studies performed in US, Denmark, China, Japan... Possible explanations include direct thermoregulation-mediated vasoconstriction, hypothalamic-pituitary-adrenocortical axis (HPAA) and sympathetic nervous system (SNS) activation, sodium/volume retention and impaired endothelial-dependent vasodilatation.  Reduced sleep duration or quality could be also contributing.

Environmental hypertensionology is a very young science. Many things in our environment can cause high blood pressure. The exact mechanisms are not well understood, but systems like Aurametrix could utilize the wealth of empirical evidence and use it for prediction and prevention.

The high blood pressure season is almost over. Fortunately, many critically ill people made it through and, hopefully, learned more. Let's gear up to make the next time easier.

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REFERENCES

Alpérovitch, A. (2009). Relationship Between Blood Pressure and Outdoor Temperature in a Large Sample of Elderly IndividualsThe Three-City Study Archives of Internal Medicine, 169 (1) DOI: 10.1001/archinternmed.2008.512

Halonen, J., Zanobetti, A., Sparrow, D., Vokonas, P., & Schwartz, J. (2010). Relationship between outdoor temperature and blood pressure Occupational and Environmental Medicine, 68 (4), 296-301 DOI: 10.1136/oem.2010.056507

Brook RD, Weder AB, & Rajagopalan S (2011). "Environmental hypertensionology" the effects of environmental factors on blood pressure in clinical practice and research. Journal of clinical hypertension (Greenwich, Conn.), 13 (11), 836-42 PMID: 22051429

Will you get the flu this season?

Worst of flu season may be over. But you can still catch a chill. If you shake hands with lots of sick people, for example. Or don't keep sufficiently warm. Yes, your mother has told you, and you thought it was just an old wives' tale, but it wasn't. Scientists (Johnson and Eccles, 2005) provide evidence that cold exposure may induce cold symptoms without any contact to sick individuals. As we all carry dormant (sub-clinical) infections in our nose, genitals and other parts of the body, and these viruses may get reactivated. Ever noticed the need to blow nose after spending some time in cold air? Your body might be trying to expel the waking-up microbes.

Emerging health analysis software tools like Aurametrix aim at keeping us healthy by warning about symptoms and diseases. Prolonged exposure to cold means that 4-5 days after the exposure there is 10% probability of developing nasal stuffiness, sneezing, throat irritation of mild fever. 10% if Aurametrix knows nothing else about you. Higher if you are in the most vulnerable age & health conditions group, have a history of more frequent cold infections in prior years or were recently exposed to other stressors. Aurametrix can draw additional conclusions from looking at ingredients in your diet and chemicals in your environment.  Medical records could add another thousand variables. Medical codes given to every documented complaint, prior medications, procedures, information about attending doctors and payments were shown to help predict C.difficile infections in hospitals using machine learning (Wiens, Guttag, Horvitz, 2012).

Social media (in addition to notifications by official sources) keeps us more aware and more afraid of the flu. But what if we are not able to keep away from exposure to a virus, forgot to clean our hands and could not avoid a non-ventilated area with sneezing sick people? The good news is that if we did everything else right we have a fighting chance. As it was shown in a scientific study (Huang et al., 2011), only 9 out of 17 healthy human volunteers exposed to H3N2 virus developed mild to severe symptoms.

So be happy to be healthy, in addition to doing your best to stay flu-free.

Image Credits: Allison Morris, OnlineEducation.net  

REFERENCES

Johnson C, & Eccles R (2005). Acute cooling of the feet and the onset of common cold symptoms. Family practice, 22 (6), 608-13 PMID: 16286463

Jankowski R, Philip G, Togias A, Naclerio R. Demonstration of bilateral cholinergic secretory response after unilateral nasal cold, dry air challenge. Rhinology 1993; 31: 97-100

J. Wiens, J. Guttag, E. Horvitz. Learning Evolving Patient Risk Processes for C. Diff Colonization, Machine Learning for Clinical Data Analysis, ICML 2012, Edinburgh, Scotland, June 2012.

Huang Y, Zaas AK, Rao A, Dobigeon N, Woolf PJ, Veldman T, Øien NC, McClain MT, Varkey JB, Nicholson B, Carin L, Kingsmore S, Woods CW, Ginsburg GS, & Hero AO 3rd (2011). Temporal dynamics of host molecular responses differentiate symptomatic and asymptomatic influenza a infection. PLoS genetics, 7 (8) PMID: 21901105

On Apples and Trees

An apple doesn't fall far from the tree. So if you don't like apples, trees won't like you either. And the other way around.

If your mother ate apples during pregnancy, she might have protected you from asthma. And if you like apple juice, this might help you avoid chronic wheezing issues.

 

Research has already proven these and many similar connections. Now a new study suggests that eating apples could also help you cope with seasonal allergies - particularly with allergies to birch pollen. And vice versa - a birch pollen therapy can help you tolerate apples.

Allergies affect many people in westernized countries. 10-15% of the population in North America and Europe suffer from immediate allergic reactions (type I), and birch pollen is a considerable cause of seasonal allergies. Its major allergen Betv 1  (responsible for more than 95% of allergies to birch pollen) can cross-react with Mal d 1 - the main allergen in apple. Thus during the pollination season, people sensitive to birch also might be sensitive to apples. But as Swiss and Slovenian scientists showed this year, just a piece of apple - 1-128 grams per day can help Birch-sensitive individuals to prepare for the allergy season. And it can increase their tolerance to apples - to the extent they can eat an entire apple per day after the treatment. Unfortunately, subsequently cutting apple intake means that birch allergies will return. 


Another recent study by Japanese allergists showed that injections of birch, ragweed and cedar pollen helped a highly allergic person tolerate apples. She could increase her intake from 3 grams (which is a tiny piece the size of half of a grape) to 50 grams, which is almost a half of an apple!  Allergy symptoms to most other fruits and vegetables also improved or disappeared. 

What is your relationship with apples and trees? Aurametrix can help you track your food sensitivities along with seasonal allergies, finding what combinations and amounts are right for you.


REFERENCES

Kopac P, Rudin M, Gentinetta T, Gerber R, Pichler Ch, Hausmann O, Schnyder B, & Pichler WJ (2012). Continuous apple consumption induces oral tolerance in birch-pollen-associated apple allergy. Allergy, 67 (2), 280-5 PMID: 22070352


Okamoto Y, & Kurihara K (2012). [A case of oral allergy syndrome whose symptoms were dramatically improved after rush subcutaneous injection immunotherapy with pollen extracts of birch]. Arerugi = [Allergy], 61 (5), 652-8 PMID: 22705787

Okoko BJ, Burney PG, Newson RB, Potts JF, Shaheen SO. Childhood asthma and fruit consumption. Eur Respir J. 2007 Jun;29(6):1161-8. Epub 2007 Feb 14.   


Miyake Y, Sasaki S, Tanaka K, Hirota Y. SAllergy. 2010 Jun 1;65(6):758-65. Epub 2010 Jan 22. Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infants.  

Hokkaido Igaku Zasshi. 1994 Nov;69(6):1409-26. [Clinical and immunological analysis of Birch pollenosis]. [Article in Japanese] Takagi S. Source Department of Otorhinolaryngology, Hokkaido University School of Medicine, Sapporo, Japan.

Seasonal Allergies in Japan

Japan belongs to the temperate zone with four distinct seasons, and has six principal climatic zones: Hokkaidō (北海道) with long, cold winters and cool summers; Central Highland (中央高地) with typical inland climate and large temperature differences between summers and winters and between days and nights; Seto Inland Sea (瀬戸内海): with mild climate; Pacific Ocean (太平洋): with cold rainy winters and hot humid summers;  Ryukyu Islands (南西諸) with warm rainy winters and hot humid summers. Heat and high humidity can lead to possible food poisoning, fatigue and heat stroke.

More than 5,000 species of plants find home in these diverse climatic conditions and more than 60 types produce pollen that can cause allergic reactions. In Tokyo, common allergy-causing plants and their pollen seasons are as follows:

Japanese cedar sugi (February - April)

Japanese cypress hinoki (mid March - early May)

Rice plant ine (May - mid July / mid August - mid October)

Ragweed butakusa (mid August - October)

Artemisia yomogi (mid August - October)

Japanese Cedar is one of the major causes of seasonal allergic rhinitis and seasonal allergic conjunctivitis (itchy eyes). Its pollen is one of the most potent known and may cause severe symptoms. In Tokyo, about one in 3.5 people is believed to suffer from sugi allergy. The Japanese cedar pollen is present from approximately the end of January until the beginning of April on the north island and mid-April until early May on the south island. The cypress tree flowers a little later than that of the cedar tree and could also contribute to allergies. The pollination of Ragweed begins in late summer, around August, but its impact is less significant than in North America. 

January

February

March

April

May

June

July

August

September

October

November

December

Trees

Grasses

Weeds

See this site by Allergy Research Group, Department of Otorhinolaryngolgy, Jikei Medical School, for more information. Or sign up for Aurametrix and start analyzing your allergies - to control them wherever you go.

More apps, less flu?

Fewer people caught the flu this season compared with  past years. And many more apps tracking the flu have been developed.  Any relationship between these two trends?

Of course, less flu could be just the result of fewer mutations in bugs, warmer weather and more vaccinations. Yet the power of good software - such as google flu trends, twitter-based trackers and numerous apps can not be underestimated. Thanks to these tools, we are now more aware (and more afraid).

The flu is inherently social. "Nip the flu in the bud by spreading information, not germs, through the social network", says Flu Alert app. and lets you sort your friends by their flu exposures. Virtual flu in Fluville is promoting healthy habits by showing how flu can spread. Fluspotter let's you exchange warnings with your facebook friends, Flutracking reads your e-mails, while Influ takes your voice messages and shares it with users around the world. Biodisapora is tracking disease outbreaks by monitoring air travel. Sickweather scans Twitter and Facebook posts, and Germtrax lets you also sync with Foursquare and Google+  to geo-locate your wereabouts while being sick - with one of 6067 sicknesses available in their database.

According to multiple research studies, flu-related Internet searches, use of certain phrases on Twitter and Facebook posts peak 1-2 weeks earlier than the epidemic curve and align reasonably well with CDC data.

Social media is a noisy but powerful adjunct to surveillance systems based on official sources. It gives us an opportunity of contributing to the community's common good. It raises our awareness, but is not sufficient on its own. Many other factors increase our individual risks. Air travel. Or stress (haven't you noticed flu season in Greece was the worst in the world this year?) Age and food, too.

Aurametrix is a personal health analysis system that tackles this problem with an integrative approach. It aligns your medical history and historical CDC information with your food, mood and amount of sleep. It  looks at all environmental predictions for today telling you if pollen, mold spores or air quality are more likely to be the reason for your symptoms, or if it is the rise in infectious diseases in your area. Aurametrix relies on a range of official sources and social media predictions. The data are constantly updated and refined, and causes linked with effects.

REFERENCES

Dugas, A., Hsieh, Y., Levin, S., Pines, J., Mareiniss, D., Mohareb, A., Gaydos, C., Perl, T., & Rothman, R. (2012). Google Flu Trends: Correlation With Emergency Department Influenza Rates and Crowding Metrics Clinical Infectious Diseases, 54 (4), 463-469 DOI: 10.1093/cid/cir883

Manago, Adriana M., Taylor, T., Greenfield, P.M. Me and my 400 friends: The anatomy of college students' Facebook networks, their communication patterns, and well-being. (2012) Developmental Psychology, Jan 30. doi: 10.1037/a0026338

Signorini A, Segre AM, Polgreen PM. The use of Twitter to track levels of disease activity and public concern in the U.S. during the influenza A H1N1 pandemic. PLoS One. 2011 May 4;6(5):e19467. PMID: 21573238

Ginsberg J, et al. Detecting influenza epidemics using search engine query data. (2009) Nature 457, 1012–1014.

Ortiz JR, et al. Monitoring influenza activity in the United States: A comparison of traditional surveillance systems with Google Flu Trends. PLoS ONE 6(4):e18687. 2011.

Christakis NA, et al. Social network sensors for early detection of contagious outbreaks. PLoS ONE 5(9):e12948. 2010.

Malik MT, Gumel A, Thompson LH, Strome T, Mahmud SM. "Google flu trends" and emergency department triage data predicted the 2009 pandemic H1N1 waves in Manitoba. Can J Public Health. 2011 Jul-Aug;102(4):294-7. PMID: 21913587

Collier N, Son NT, Nguyen NM. OMG U got flu? Analysis of shared health messages for bio-surveillance. J Biomed Semantics. 2011 Oct 6;2 Suppl 5:S9. PMID: 22166368

Basak P. Development of an online tool for public health: the European Public Health Law Network.
Public Health. 2011 Sep;125(9):600-3. Epub 2011 Aug 23. PMID: 21864871

Chew C, Eysenbach G. Pandemics in the age of Twitter: content analysis of Tweets during the 2009 H1N1 outbreak. PLoS One. 2010 Nov 29;5(11):e14118. PMID: 21124761

Scanfeld D, Scanfeld V, Larson EL. Dissemination of health information through social networks: twitter and antibiotics. Am J Infect Control. 2010 Apr;38(3):182-8. PMID: 20347636

Eysenbach G. Infodemiology and infoveillance: framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the Internet. J Med Internet Res. 2009 Mar 27;11(1):e11. PMID: 19329408

Hello Summertime!.. Owls Beware

Environment can significantly affect human health. And the risks are not limited to air pollution, seasonal allergies, tainted water or chemicals in food. Our life dramas are set against the backdrop of world events that contribute to environmental health too, to a lesser or greater extent.

How does springing clocks forward affect our lives?

Hopefully, not much financially. Despite earlier predictions that average stock market returns are likely to be lower on Mondays following time changes (Kamstra et al, 2000), unbiased modeling techniques in later studies proposed that markets are not really influenced by this event (Berument et al., 2010). So we can all sleep sound tonight.

Daylight savings time (DST) will make some of us a little bit more active. By about 2%, as measured by scientists in  Indiana (Holmes et al., 2009). It will lead to a 3% drop in crime, as estimated by the Home Office in UK. So we have something to look forward to.

Still, as we are going to loose 1 hour of sleep, would it not affect our mood, our attention and the ability to work productively? Would it increase the probability of being involved in health-related catastrophes? What about traffic accidents? Some studies suggest they will increase (by 8-17% according to Stanley Coren), while others say there will be no impact or even less accidents during DST transition (if 1 day or week before is compared to 1 day/week after, see articles by Ferguson, Coate, Lahti). The results about occupational accidents and hospitalizations are also inconsistent (Janszky, Lahti).

But there was one result that scientific studies from all over the world had in common:  the impact of DST transition was different on larks and owls. And night owls were the ones that suffered the most, during spring transitions - in Finland, Germany, Korea, Russia and everywhere else.

So let's enjoy the extra hour of sunshine. And if you are a morning lark, bear with the sleepiness of night owls  - they'll need more time to adjust.

Aurametrix is an advanced analysis tool that correlates our symptoms, reactions and feelings with  environmental factors such as weather, air, pollen and time transitions.

REFERENCES

Janszky, I., Ahnve, S., Ljung, R., Mukamal, K., Gautam, S., Wallentin, L., & Stenestrand, U. (2012). Daylight saving time shifts and incidence of acute myocardial infarction – Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA) Sleep Medicine, 13 (3), 237-242 DOI: 10.1016/j.sleep.2011.07.019

Lahti T, Sysi-Aho J, Haukka J, Partonen T.  Work-related accidents and daylight saving time in Finland.  Occup Med (Lond). 2011 Jan;61(1):26-8.

Morassaei S, Smith PM. Switching to Daylight Saving Time and work injuries in Ontario, Canada: 1993-2007.  Occup Environ Med. 2010 Dec;67(12):878-80. Epub 2010 Sep 30.

Lahti T, Sysi-Aho J, Haukka J, Partonen T.  Work-related accidents and daylight saving time in Finland. Occup Med (Lond). 2011 Jan;61(1):26-8. Epub 2010 Nov 15.

Lahti T, Nysten E, Haukka J, Sulander P, Partonen T. Daylight saving time transitions and road traffic accidents.  J Environ Public Health. 2010;2010:657167.

Lahti TA, Haukka J, Lönnqvist J, Partonen T. Daylight saving time transitions and hospital treatments due to accidents or manic episodes. BMC Public Health. 2008 Feb 26;8:74.

Lahti TA, Leppämäki S, Lönnqvist J, Partonen T. Transitions into and out of daylight saving time compromise sleep and the rest-activity cycles.  BMC Physiol. 2008 Feb 12;8:3.

Lahti TA, Haukka J, Lönnqvist J, Partonen T. Daylight saving time transitions and hospital treatments due to accidents or manic episodes. BMC Public Health. 2008 Feb 26;8:74.

Lim, S., Park, Y., Yang, K., & Kwon, H. (2010). Effects of Daylight Saving Time on Health Journal of Korean Medical Association, 53 (2) DOI: 10.5124/jkma.2010.53.2.155

Berument MH, Dogan N, Onar B. Effects of daylight savings time changes on stock market volatility. Psychol Rep. 2010 Apr;106(2):632-40.

Kamstra M.J., Lisa A. Kramer L.A., and Levi M.D.. The American Economic Review. Vol. 90, No. 4 (Sep., 2000), pp. 1005-1011

Holmes AM, Lindsey G, Qiu C. Ambient air conditions and variation in urban trail use.
J Urban Health. 2009 November; 86(6): 839–849.

Lofthouse N, Fristad M, Splaingard M, Kelleher K, Hayes J, Resko S. Web survey of sleep problems associated with early-onset bipolar spectrum disorders. J Pediatr Psychol. 2008 May;33(4):349-57. Epub 2008 Jan 11.

Varughese J, Allen RP. Fatal accidents following changes in daylight savings time: the American experience.
Sleep Med. 2001 Jan;2(1):31-36.

Lambe M, Cummings P. The shift to and from daylight savings time and motor vehicle crashes.
Accid Anal Prev. 2000 Jul;32(4):609-11.

Vincent A. Effects of daylight savings time on collision rates. N Engl J Med. 1998 Oct 15;339(16):1167-8.

Hicks GJ, Davis JW, Hicks RA. Fatal alcohol-related traffic crashes increase subsequent to changes to and from daylight savings time. Percept Mot Skills. 1998 Jun;86(3 Pt 1):879-82.

Coren S. Accidental death and the shift to daylight savings time. Percept Mot Skills. 1996 Dec;83(3 Pt 1):921-2.

Coren S. Daylight savings time and traffic accidents. N Engl J Med. 1996 Apr 4;334(14):924.

Ferguson SA, Preusser DF, Lund AK, Zador PL, Ulmer RG. Daylight saving time and motor vehicle crashes: the reduction in pedestrian and vehicle occupant fatalities. American Journal of Public Health. 1995;85(1):92–95.

Coren S. Daylight savings time and traffic accidents. New England Journal of Medicine. 1996;334(14):p. 924.

Coren S. Accidental death and the shift to daylight savings time. Perceptual and Motor Skills. 1996;85(3):921–922.

Coate D, Markowitz S. The effects of daylight and daylight saving time on US pedestrian fatalities and motor vehicle occupant fatalities. Accident Analysis and Prevention. 2004;36(3):351–357.

Kantermann T., Juda M., Merrow M. The human circadian clock's seasonal adjustment is disrupted by daylight saving time - Current Biology, 2007

Schneider, A., & Randler, C. (2009). Daytime sleepiness during transition into daylight saving time in adolescents: Are owls higher at risk? Sleep Medicine, 10 (9), 1047-1050 DOI: 10.1016/j.sleep.2008.08.009

Allergy Seasons in New Zealand

Calendar by Allergy New Zealand

New Zealand has mild temperatures, moderately high rainfall, and many hours of sunshine. The sunniest city is Tauranga, the wettest - Wellington, the driest Christchurch and the warmest city is Auckland. 

January and February are the warmest months, and July is the coldest month of the year. In summer, the average maximum temperature ranges between 20-30ºC and in winter between 10-15ºC.
New Zealand has relatively little air pollution and very strong UV rays during the summer months.
The country has a unique variety of native flora, mostly evergreen.  The introduced plants are the main source of pollen allergies. Rye is the most troublesome plant and the major cause of springtime hay fever. The pollen season starts about one month earlier at the top of the North Island than the bottom of the south Island. Pollen concentrations are slightly lower in coastal areas. Inland pastoral areas such as Hamilton and Palmerston North, can have relatively severe allergy seasons. In Auckland the main pollen season is between October and February, and  - unlike Europe and USA - is not well defined.
People of New Zealand, however, are not as affected by humidity and temperature changes as Western Europe is [1].  Similar to the rest of the world [2], prenatal and early life exposure to pollen can offer protection  against asthma, respiratory  allergy and eczema, but continued exposure may be required to maintain optimal protection [3].

1. Asher MI, Stewart AW, Mallol J, Montefort S, Lai CK, Aït-Khaled N, Odhiambo J; ISAAC Phase One Study Group. Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One. Respir Res. 2010 Jan 21;11:8.

2. Burr ML, Emberlin JC, Treu R, Cheng S, Pearce NE; ISAAC Phase One Study Group.
Pollen counts in relation to the prevalence of allergic rhinoconjunctivitis, asthma and atopic eczema in the International Study of Asthma and Allergies in Childhood (ISAAC). Clin Exp Allergy. 2003 Dec;33(12):1675-80.

3. Douwes J, Cheng S, Travier N, Cohet C, Niesink A, McKenzie J, Cunningham C, Le Gros G, von Mutius E, Pearce N. Farm exposure in utero may protect against asthma, hay fever and eczema. Eur Respir J. 2008 Sep;32(3):603-11. Epub 2008 Apr 30.