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Solar ultraviolet-B radiation in urban environments: the case of Baltimore, Maryland.

Ultraviolet-B radiation (UV-B, 280-320 nm) has important effects in urban areas, including those on human health. Broadband UV-B radiation is monitored in Baltimore, MD, as part of the Baltimore Ecosystem Study, a long-term ecological research program. We compare broadband UV-B irradiance in Baltimore with UV-B at two nearby locations: a more rural station 64 km southeast and a suburban station 42 km southwest. The monitoring station in Baltimore is on the roof of a 33-m-tall building; there are no significant obstructions to sky view. The U.S. Department of Agriculture UV-B Monitoring and Research Program provided all sensors, which were calibrated at the National Oceanic and Atmospheric Administration Central UV Calibration Facility. UV-B irradiances at the three sites generally were similar. Over all conditions, Baltimore and the suburban site measured 3.4% less irradiance than the rural site. This difference is within the anticipated +/-3% calibration uncertainty of the pyranometers. On 59 days with cloud-free conditions at all three sites, average differences in measured UV-B among the three sites were even smaller; Baltimore measured 1.2% less irradiance than the rural site. High aerosol optical thickness strongly reduced daily UV-B dose, whereas [SO2] had no influence. Surface O3 increased with increasing UV-B dose when [NO2] exceeded 10 ppb.

Baltimore↗

Norway rat population in Baltimore, Maryland, 2004.

Norway rats are reservoirs for several zoonotic agents, including hantaviruses, and are implicated in the transmission of pathogens to humans in urban environments. The rat population of Baltimore, Maryland was estimated from surveys in 1949 and again in 1952, but has not been evaluated for more than 50 years. Previously identified sociodemographic risk factors for rat infestation, including median income, human density, and percentage of rental properties, were used to categorize census block groups in Baltimore. Rat infestation risk factors, including median income and human density, have improved over the last 50 years in Baltimore. Rat infestation was determined both by observation and trapping of rats in alleys that were representative of the different strata of risk factors. Despite improvements in risk factors, the outdoor, residential rat population of Baltimore in 2004 was estimated to be approximately 48,420 +/- 14,883 rats, which is comparable to the 1949 and 1952 estimates. Approximately half of the rats trapped in Baltimore City had detectable antibody against Seoul virus. The failure to substantially impact rat population levels in the past 50 years indicate that alternative control strategies for rat infestation are needed to reduce the risk of rat-borne pathogen spillover to the human population.

Animals↗

Modeled cost-effectiveness of the Experience Corps Baltimore based on a pilot randomized trial.

The Experience Corps program was designed to harness the social capital of an aging society to improve outcomes for public elementary schools. The objectives of this article are (1) to model the cost-effectiveness of the Experience Corps Baltimore using data from a pilot randomized trial, including costs, older adults' health status, and quality of life and cost data from the Medical Expenditure Panel Survey, and (2) to describe the relationship between children experiencing increased expected lifetime earnings through improved educational attainment resulting from exposure to the Experience Corps Baltimore volunteers and the program's costs and cost-effectiveness. On average, each quality adjusted life year (QALY) gained by older adults in Experience Corps Baltimore costs $205,000. The lower bound of the 95% confidence interval for the cost-effectiveness is $65,000/QALY. The upper bound is undefined as 15% of the simulations indicated no QALY improvements. If 0.3% of students exposed to the Experience Corps Baltimore changed from not graduating to graduating, the increased lifetime earnings would make the incremental cost-effectiveness ratio $49,000/QALY. If an additional 0.1% changed to graduating from high school, the program would be cost-saving. Using conservative modeling assumptions and excluding benefits to teachers, principals, and the surrounding community, the Experience Corps Baltimore appears expensive for the older adults' health improvements, but requires only small long-term benefits to the target children to make the program cost-effective or cost-saving.

Aged↗

The spatial variation of the weekday/weekend differences in the Baltimore area.

This study examined the spatial distribution of the weekday/weekend difference in Baltimore, MD, and vicinity. The difference in Baltimore was characterized by having approximately 39% more NOx, approximately 59% more CO, and approximately 27% more volatile organic compounds (VOCs) on the average weekday, but there was approximately 13% more O3 on the weekend day. Spatially, the difference was elongated in the northeast-southwest direction. It decreased from 13% more O3 in Baltimore to 6% at approximately 20 km west of Baltimore and to 4% at approximately 40 km south of Baltimore. It also appeared to decrease to the east, but the magnitude of the decrease could not be determined because of the lack of data east of the Chesapeake Bay. However, the difference increased to the north, reaching a value of almost 18% at a northern Delaware site.

Air Pollution↗

Chromatographic, ultracentrifugal, and related studies of fibrinogen "Baltimore".

Chromatographic, ultracentrifugal, and related studies of the fibrinogen of a patient with a congenital disorder of fibrinogen (fibrinogen "Baltimore" have provided evidence of structural differences from normal.Diethylaminoethyl-cellulose (DEAE-cellulose) gradient elution chromatography demonstrated two major peaks in the elution pattern of fibrinogen Baltimore as was the case for normal fibrinogen. However, the first peak of fibrinogen Baltimore was somewhat broader and more symmetrical and was eluted significantly later in the chromatogram than the corresponding peak of normal fibrinogen. Additionally, in some elution patterns, a shoulder on the ascending limb of peak 1 was present, suggesting the presence of chromatographically "normal" fibrinogen. Thrombin time determinations of eluted column fractions from a chromatogram of propositus fibrinogen supported this conclusion by demonstrating that fibrinogen from the ascending portion of peak 1 behaved functionally more like normal than that later in the chromatogram. Chromatograms of mixtures of propositus and normal fibrinogen confirmed the ability of this technique to distinguish normal from Baltimore fibrinogen. Chromatograms of fibrinogen isolated from two affected daughters displayed the characteristic increased anionic binding of peak 1 fibrinogen. Sedimentation velocity experiments indicated that the S(o) (20, [unk]) of fibrinogen Baltimore was slightly greater (8.13S vs. 7.85S) than that of normal fraction I-4. Differences in concentration dependence (- 0.65 c vs. - 1.30 c for normal) of the sedimentation coefficient could be attributable in part to spatial conformational differences. Molecular sieving experiments in acrylamide gels indicated that the molecular weight of propositus fraction I-2 was about the same as that of normal fibrinogen of comparable solubility (i.e. I-4, mol wt 325,000). Studies of the UV spectra, tyrosine/tryptophan ratios, sialic acid and hexose content, and N-terminal amino acids demonstrated no consistent significant differences from normal fraction I-4.

Amino Acids↗

Invasive pneumococcal infection in Baltimore, Md: implications for immunization policy.

BACKGROUND: Streptococcus pneumoniae is a leading cause of infectious morbidity and mortality. Although blacks are known to have a higher incidence of invasive pneumococcal infection than whites, detailed analyses of these differences and their implications for vaccine prevention have not been reported. OBJECTIVE: To describe the epidemiological characteristics of invasive pneumococcal infection in Baltimore, Md, and its implications for immunization policy. METHODS: Analysis of active, laboratory-based surveillance during 1995 and 1996 among residents of the Baltimore metropolitan area. RESULTS: Of 1412 cases, 615 patients (43.6%) were classified as white and 766 (54.2%) as black. The annual incidence of invasive pneumococcal infection among white and black residents of the Baltimore metropolitan area was 17.8 and 59.2 per 100000 population, respectively (P<.01). Among patients aged 18 years and older, the median age of blacks with invasive pneumococcal infections was 27 years younger than that of whites (P<.01). Among males 40 to 49 years old, blacks had a 12-fold higher average incidence than whites (average incidence, 114.5 and 9.3, respectively; P<.01). By the age of 65 years, 83.8% of cases had occurred in black adults, as compared with 43.8% in white adults (P<.01). In a regression model, age, black race, male sex, low median family income, and county prevalence of acquired immunodeficiency syndrome were each independently associated with a higher incidence of pneumococcal infection. CONCLUSIONS: Young urban black adults in the Baltimore metropolitan area have a dramatically higher incidence of invasive pneumococcal infection than whites. The vast majority of cases of invasive pneumococcal infection in blacks occur before age 65 years. Current immunization efforts have not addressed the high incidence of pneumococcal infection in this population.

Adult↗

Infection with human T lymphotropic virus types I and II in sexually transmitted disease clinics in Baltimore and New Orleans.

Patients attending sexually transmitted disease (STD) clinics in Baltimore (n = 4880) and New Orleans (n = 1054) were surveyed in 1987 to estimate the prevalence of human T lymphotropic virus (HTLV)-I/II infection. In Baltimore, 0.4% (95% confidence interval [CI], 0.2-1.1) were HTLV-I/II-seropositive and 4.9% were human immunodeficiency virus (HIV-1)-positive. In New Orleans, 1.8% (CI, 1.2-2.9) of sera were HTLV-I/II-seropositive and 5.1% were HIV-1-seropositive. In both cities, HTLV-I/II prevalence increased significantly with age, and the New Orleans age- and sex-adjusted HTLV-I/II prevalence was significantly higher than that of Baltimore (P less than .001). In Baltimore, almost all HTLV-I/II seropositivity was associated with a history of parenteral drug use or sexual contact with partners who were drug users or male homosexuals. In addition, individuals in both cities who were seropositive for HIV-1 or syphilis were significantly more likely to be HTLV-I/II-seropositive.

Adolescent↗

Sexually transmitted diseases in patients attending a Baltimore tuberculosis clinic. Assessment of use of multiple categoric services.

BACKGROUND: Recent increases in the incidence of tuberculosis and syphilis have occurred disproportionately in young heterosexuals of low socioeconomic status. The authors hypothesized that an overlap of tuberculosis and sexually transmitted disease clinic populations potentially could result in inefficient use of limited public health resources. METHODS: The authors conducted a retrospective study to determine the coinfection rate of syphilis and other sexually transmitted diseases in patients seen for evaluation at the Baltimore City Tuberculosis Clinic, Baltimore, Maryland. The authors determined the sexually transmitted disease clinic utilization patterns of this patient population. RESULTS: For patients referred to the tuberculosis clinic, 9.0% had a history of syphilis and 13.6% had at least one documented visit at a Baltimore City sexually transmitted disease clinic. Blacks presenting to the tuberculosis clinic were more likely to have previously diagnosed syphilis (13.6%) and to have had visited the sexually transmitted disease clinics (16.5%). CONCLUSIONS: In Baltimore, the patient population of tuberculosis clinics overlaps with those at the public sexually transmitted disease clinics. Thus, cross screening for syphilis and tuberculosis at urban clinics would be an important mechanism for identifying new cases of disease and increasing the efficiency of the public health system.

Adult↗

An exposure assessment study of ambient heat exposure in an elderly population in Baltimore, Maryland.

Because of concern for heat-related mortality in vulnerable populations, particularly the elderly, practical epidemiologic methods are needed for the assessment of ambient heat exposure on individuals. We used a personal monitor to measure body temperature, ambient temperature, heart rate, and activity level of 42 elderly residents of Baltimore, Maryland, in the summer months of 2000. Each participant was monitored for approximately 48 hr to examine the association between ambient temperature and body temperature, using regression methods that account for highly correlated data within individuals. We also examined the associations of Baltimore temperature data with personal ambient temperature and body temperature. An average 0.15 degrees F [95% confidence interval (CI), 0.05-0.25] increase in median body temperature was found for each 1 degrees F increase in median ambient temperature. Heart rate and activity level were not found to be related to body temperature or ambient temperature, although heart rate was associated with activity level. Median heart rate increased an average of 0.17 (95% CI, 0.13-0.21) beats per minute for every unit increase in median activity level. Personal ambient temperature was slightly lower than Baltimore temperatures, whereas an association was not found between body temperature and Baltimore temperatures. The protocol established in this study for heat exposure assessment could feasibly be applied on a larger scale.

Aged↗

The Baltimore Youth Ammunition Initiative: a model application of local public health authority in preventing gun violence.

In 2002, the Baltimore City Health Department, in collaboration with the Baltimore Police Department and the Johns Hopkins Center for Gun Policy and Research, launched the Youth Ammunition Initiative. The initiative addressed Baltimore's problem of youth gun violence by targeting illegal firearm ammunition sales to the city's young people. The initiative included undercover "sting" investigations of local businesses and issuance of health department violation and abatement notices. Intermediate results included the passage of 2 Baltimore city council ordinances regulating ammunition sales and reducing the number of outlets eligible to sell ammunition. Although it is too early to assess effects on violent crime, the intervention could theoretically reduce youth violence by interrupting one source of ammunition to youths. More important, the initiative can serve as a policy model for health commissioners seeking to become more active in gun violence prevention efforts.

Adolescent↗

Increased HIV/AIDS mortality among residents aged 25-44 years--Baltimore, Maryland, 1987-1989.

From 1987 through 1989, overall mortality among Baltimore residents aged 25-44 years increased from 380.7 deaths per 100,000 residents to 452.6 deaths per 100,000, reflecting the substantial impact of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). To better characterize this increase in mortality, the Baltimore City Health Department analyzed information on death certificates from the Baltimore City Bureau of Vital Statistics for persons aged 25-44 years for 1987-1989. This report summarizes the analysis and characterizes HIV-infection/AIDS-related deaths among residents of Baltimore in this age group.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Baltimore City Health Department: 200 years of progress and partnership.

The Baltimore City Health Department began its long history of protecting the health of Baltimore citizens in 1793. An outbreak of yellow fever in Fells Point on the northwest branch of the Patapsco River was the impetus for the governor's appointment of the first two health officers. Since that time, the health department has worked closely with the medical community to promote education and preventive measures (e.g., sewer systems, water chlorination, food inspection) in order to stop the spread of communicable diseases. For 200 years, the Baltimore City Health Department has provided "the advocacy and leadership necessary to ensure the protection and promotion of the health of Baltimore's citizens."

Baltimore↗

Outbreak of primary and secondary syphilis--Baltimore City, Maryland, 1995.

From 1993 to 1995, the number of primary and secondary syphilis cases reported in Baltimore City (1990 population: 736,014) increased 97%, from 179 to 352 cases per year (Figure 1). To identify potential reasons for this increase, CDC, in collaboration with the Baltimore City Health Department (BCHD) and the Maryland Department of Health and Mental Hygiene, analyzed data about primary and secondary syphilis cases during 1992-1995 and about temporal trends in factors that may affect syphilis rates (e.g., partner-notification results, access to medical care, and community illicit-drug use). In addition, data were analyzed from the two public sexually transmitted disease (STD) clinics in Baltimore City. BCHD collects demographic data for all cases of reported syphilis among patients who reside in Baltimore City and attempts to interview and provide partner notification and treatment for these patients. This report summarizes the results of the analysis, which suggest the outbreak has been associated with decreases in partner notification and health department clinical services and a substantial increase in community cocaine use.

Adolescent↗

Organochlorine contaminant exposure and reproductive success of black-crowned night-herons (Nycticorax nycticorax) nesting in Baltimore harbor, Maryland.

The declining size of the Baltimore Harbor black-crowned night-heron (Nycticorax nycticorax) colony has been hypothesized to be linked to polychlorinated biphenyl (PCB) exposure. In 1998, a "sample egg" was collected from 65 black-crowned night-heron nests (each containing > or = three eggs) for contaminant analysis, and the remaining eggs in these 65 nests, plus four two-egg nests, were monitored for hatching and fledging success. Eggs were also collected from 12 nests at Holland Island, a reference site in southern Chesapeake Bay. Samples were analyzed for 26 organochlorine pesticides and metabolities and 145 PCB congeners. Pesticide and metabolite concentrations, including p,p'-DDE, were well below thresholds associated with adverse reproductive effects at both sites. Average concentration of total PCBs, 12 Ah receptor-active PCB congeners, and toxic equivalents in eggs from Baltimore Harbor were greater (up to 35-fold) than that observed in Holland Island samples. Overall nest success at the Baltimore Harbor heronry was estimated by the Mayfield method to be 0.74, and the mean number of young fledged/hen was 2.05, which is within published productivity estimates for maintaining a stable black-crowned night-heron population. Using logistic regression, no significant relationships were found between organochlorine contaminant concentrations in sample eggs and hatching, fledging, or overall reproductive success. Processes other than poor reproduction (e.g., low postfledging survival, emigration, habitat degradation) may be responsible for the declining size of the Baltimore Harbor colony.

Animals↗

Hb Lepore-Baltimore (delta 68Leu-beta 84Thr) and Hb Lepore-Washington-Boston (delta 87Gln-beta IVS-II-8) in central Portugal and Spanish Alta Extremadura.

Hb Lepore is one of the most common abnormal haemoglobins in Caucasians in Central Portugal and in the Spanish Alta Extremadura (0.28% in a survey of school children). A group of 19 Portuguese and 14 Spanish Hb Lepore carriers (all unrelated) was characterised at the molecular level by the polymerase chain reaction, sequencing and restriction enzyme analysis. The Portuguese and one Spanish carrier were heterozygous for Hb Lepore-Baltimore, whereas all other Spanish subjects were Hb Lepore-Washington-Boston carriers. Sequencing of the Hb Lepore-Baltimore gene further established the crossover at delta 68-beta 84, a region two codons (CDs) shorter than that previously described and easily confirmed by digestion with MaeI and BanI. Data from haplotype analysis suggest that this crossover occurred as an independent event on the Iberian Peninsula. The haematological data were similar in both groups except for the levels of Hb F and the G gamma chain, which were significantly higher in the Hb Lepore-Baltimore heterozygotes. Quantification of the globin chains and the mRNA transcripts showed that the delta beta gene is transcribed at a higher level than the delta gene with levels of translation giving rise to 10%-15% of Hb Lepore. The different levels of Hb F observed in the two groups are the results of the higher transcription rate of the gamma genes in Hb Lepore-Baltimore heterozygotes and an apparently less efficient translation of G gamma genes in Hb Lepore-Washington-Boston heterozygotes.

Base Sequence↗

Seasonal and annual air-water exchange of polychlorinated biphenyls across Baltimore Harbor and the northern Chesapeake Bay.

As part of the Atmospheric Exchange Over Lakes and Oceans Study (AEOLOS), air-water exchange fluxes of polychlorinated biphenyls (PCBs) were determined along a transect in the Baltimore Harbor from the Inner Harbor of Baltimore, MD, to the mainstem of the northern Chesapeake Bay to assess the overall contributions of urban source PCBs through air-water exchange and their impacts on coastal waters. Six sites were sampled during three intensive sampling periods in June 1996, February 1997, and July 1997 and at two sites (urban and rural) every ninth day between March 1997 and March 1998 to measure spatial and temporal variability in the PCB air-water exchange fluxes. During the intensive sampling campaigns, net total PCB (t-PCBs) volatilization fluxes ranged between 5 and 2120 ng m(-2) day(-1), varying on both temporal and spatial scales. Volatilization fluxes were highest in February, driven by high winds and elevated dissolved PCB concentrations. Throughout the annual sampling period, t-PCB volatilization fluxes were similar between urban (130 microg m(-2) yr(-1)) and rural (120 microg m(-2) yr(-1)) sites. Approximately 10% of the dissolved t-PCB inventory in the water column in Baltimore Harbor exchanges with the atmosphere each day. From air-water exchange alone, the estimated residence time of dissolved t-PCBs in the harbor is approximately 10 days (estimated hydraulic residence time of water in the harbor is between 7 and 14 days), indicating that air-water exchange is an efficient removal mechanism of t-PCBs from urban coastal waters. Furthermore, the annual flux of t-PCBs volatilizing from Baltimore Harbor is approximately 12% of the gas-phase t-PCB inventory over the water, and at the northern Chesapeake Bay site, the t-PCB flux is approximately 40% of the gas-phase t-PCB inventory. This suggests that air-water exchange of t-PCBs has the potential to be a significant source of PCBs to the rural atmosphere.

Air↗

Globin chain synthesis in Hb J Baltimore-beta (+)-thalassemia.

An American black family in whom hemoglobin J Baltimore and beta (+)-thalassemia genes coexisted is described. The proposita is a 23-year-old woman with a hemoglobin (Hb) level of 11.5 g/dl, microcytic, hypochromic indices, increased values of Hbs A2 and F, and alpha/non-alpha synthetic ratio of 1.52. Hbs A and J Baltimore (beta 16 Gly---Asp) constituted 12% and 81.3%, respectively, of her total hemoglobin. Her sister had a very similar peripheral blood picture, but Hbs A and J Baltimore constituted 6.8% and 85.5%, respectively, of her total hemoglobin, and the alpha/non-alpha synthetic ratio was 1.39. The mother had beta(+)-thalassemia trait only, a moderate degree of anemia, and greater synthetic imbalance (alpha/non-alpha raio of 1.73). These findings suggest that the presence of the Hb J Baltimore gene ameliorates the effects of a coexistent beta-thalassemia gene.

Adult↗

Functional evaluation of an inherited abnormal fibrinogen: fibrinogen "Baltimore".

The rate of clotting and the rate of development and degree of turbidity after addition of thrombin to plasma or purified fibrinogen from a patient with fibrinogen Baltimore was delayed when compared with normal, especially in the presence of low concentrations of thrombin. Optimal coagulation and development of translucent, rather than opaque, clots occurred at a lower pH with the abnormal fibrinogen than with normal. Development of turbidity during clotting of the abnormal plasma or fibrinogen was less than normal at each pH tested, but was maximal in both at approximately pH 6.4. The physical quality of clots formed from fibrinogen Baltimore was abnormal, as demonstrated by a decreased amplitude on thromboelastography. The morphologic appearance of fibrin strands formed from fibrinogen Baltimore by thrombin at pH 7.4 was abnormal when examined by phase contrast or electron microscopy, but those formed by thrombin at pH 6.4 or by thrombin and calcium chloride were similar to, though less compact, than normal fibrin. The periodicity of fibrin formed from fibrinogen Baltimore was similar to normal and was 231-233 A.A study of the release of the fibrinopeptides from the patient's fibrinogen and its chromatographic subfractions verified the existence of both a normally behaving and a defective form of fibrinogen in the patient's plasma. The defective form differed from normal in three functionally different ways: (a) the rate of release of fibrinopeptides A and AP was slower than normal; (b) no visible clot formation accompanied either partial or complete release of the fibrinopeptides from the defective form in 0.3 M NaCl at pH 7.4; and (c) the defective component possessed a high proportion of phosphorylated, relative to nonphosphorylated, fibrinopeptide A, while the coagulable component contained very little of the phosphorylated peptide (AP). The high phosphate content of the defective component did not appear to be the cause of the abnormality, but may be the result of an associated metabolic or genetic phenomenon.

Blood Coagulation↗