Accomplishments

DAI's research activities and epidemiologic services are based on decades of experience.

Completed

Recently completed research projects include three publications on the use of remote sensing (satellite) methodology to evaluate the adverse effects of elevated ambient fine PM concentration levels on respiratory-cardiovascular hospital events in the Baltimore study area (Braggio, Hall, Weber, Huff, 2020, 2021, 2022).

Key results demonstrated significant associations (worse outcomes) between higher concentration levels of aerosol optical depth-PM_2.5 and increased asthma emergency department visits and asthma, myocardial infarction, and heart failure inpatient hospitalizations.

In addition, these studies showed that persons residing in rural areas had higher risk of developing a respiratory-cardiovascular chronic disease following exposure to elevated aerosol optical depth-PM_2.5 concentration levels than persons living in urban areas.

Another important outcome was greater risk of respiratory-cardiovascular chronic diseases during the warm season than during the cold season.

As mentioned above, of the three recently published studies, two studies described newly developed data analysis procedures:

• One paper showed that the odds ratio was a less accurate statistic in estimating the differential risk of cases and controls, either exposed (cases) or not exposed (controls) to higher ambient aerosol optical depth-PM_2.5 concentration levels and its association with respiratory-cardiovascular chronic disease hospital events (Braggio, Hall, Weber, Huff, 2021). However, the newly developed data analysis method correctly identified more cases and controls than were detected by the odds ratio.

• Another publication used the temporal case-crossover design to develop a new spatial case-crossover design (Braggio, Hall, Weber, Huff, 2022). Results showed the advantage of using the spatial case-crossover method to identify homogeneous 12 km² spatial areas with similar environmental hazard exposure-health outcome associations.

• The size of the homogeneous spatial areas was more prominent in rural grids without air monitors than in urban grids with air monitors (Braggio, Hall, Weber, Huff, 2022).

• The spatial case-crossover analysis confirmed higher aerosol optical depth-PM_2.5 concentration levels, ambient temperature, and respiratory-cardiovascular emergency department and inpatient hospitalizations during the warm season compared to the cold season (Braggio, Hall, Weber, Huff, 2022).

In Progress

Some estimates are that about 40% of the world's population have eating disorders that result in the development of obesity. Another 30% of the world's population has already developed the metabolic syndrome.

Obesity and the metabolic syndrome are two metabolic disorders that can occur because of higher caloric intake through excessive eating of processed carbohydrates such as sugars and decreased activity manifested as a sedentary lifestyle.

Obesity and the metabolic syndrome can be comorbidities of respiratory-cardiovascular-cerebrovascular chronic diseases.

Elevated air pollution is associated with obesity and the metabolic syndrome.

A book on night eating events is in the final stages of completion. The book includes chapters on using a serotonin-reuptake inhibitor (sertraline) with and without exercise duration to lower the frequency of night eating events.

The author reduced the occurrence of night eating events while taking sertraline daily and engaging in daily exercise. The eventual decrease in night eating events occurred after the author stopped taking sertraline but continued to exercise vigorously and decrease his daily caloric intake.

Final outcomes included long-term (multi-year) maintenance of a 34.3% decrease in body weight and a body fat percent of 18.7.

Asthma management is more challenging in persons who are also obese or manifest the metabolic syndrome. A version of the weight loss protocol developed by the author could be used to decrease the body weight of persons who also have asthma and are overweight. Asthma management instruction would be provided to asthmatics after the start of the weight reduction epidemiologic intervention program.

A similar weight reduction program could be administered to persons who have other chronic respiratory diseases or cardiovascular-cerebrovascular chronic diseases and an obesity or metabolic syndrome comorbidity.