ライフサイエンスコーパス: metropolitan

1 compared to that of hepatologists at a large metropolitan academic medical center.

2 treated at primary care practices (n=81) in metropolitan Adelaide, 3 rural regions of South Australi

3 tenofovir (300 mg) for 1 year at 17 Bangkok Metropolitan Administration drug-treatment clinics.

4 sease Control and Prevention and the Bangkok Metropolitan Administration.

5 African American, and this occurred in both metropolitan and nonmetropolitan areas.

6 rdiology practices in the Chicago, Illinois, metropolitan and suburban areas from June 2 to July 22,

7 with IMT progression without adjustment for metropolitan area (0.4 microm/y [95% CI -0.4 to 1.2 micr

8 s of 5 and 34 years in the Portland, Oregon, metropolitan area (2002-2015, catchment population appro

9 mple of employed adults in the New York City metropolitan area (2005-2012), and the National Health a

10 .29-1.69], P < .001), hospital location in a metropolitan area (not metropolitan or micropolitan: 0.6

11 In the Portland, Ore, metropolitan area (population approximately 1 million),

12 nvestigation of SCA in the Portland, Oregon, metropolitan area (population approximately 1 million).

13 ulate matter (PM) concentration in the Seoul Metropolitan Area (SMA), South Korea, are puzzling.

14 The Sao Paulo Metropolitan Area (SPMA) is a megacity with 20 million p

15 Paul, Minnesota, metropolitan area (Twin Cities) and the entire US popula

16 Jewish individuals from the greater New York metropolitan area and 6,578 LIPA alleles from African-Am

17 articipants were identified from the Chicago metropolitan area and randomized between January 6, 2012

18 any of the 8 local government areas of Kano Metropolitan Area and satisfied age criteria were recrui

19 ng prehurricane residents of the New Orleans metropolitan area and the remainder of the areas in Alab

20 part of a birth cohort study in the Detroit metropolitan area and were interviewed about prior docto

21 visits for asthma and wheeze in the Atlanta metropolitan area between 1993 and 2004.

22 conducted in the Philadelphia, Pennsylvania, metropolitan area between 2009 and 2012.

23 stolic function, randomized from the Chicago metropolitan area between October 2001 and October 2004

24 /N=23 controls) recruited from Washington DC metropolitan area completed a simple emotion identificat

25 all 11 medical centers in the Worcester, MA, metropolitan area during 6 biennial periods between 2001

26 ) for 193 ZIP codes in the Atlanta, Georgia, metropolitan area from 1999 through 2002 for PM2.5 and i

27 articipants were recruited from the New York metropolitan area from August 20, 2008, through January

28 of 13 663 residents of the Worcester (Mass) metropolitan area hospitalized with acute myocardial inf

29 lio seroprevalence surveys conducted in Kano Metropolitan Area in 2011, 2013, and 2014 served to asse

30 sive symptoms among older adults living in a metropolitan area in attainment of current U.S. regulato

31 a full-scale water treatment plant serving a metropolitan area in Australia was assessed using in vit

32 A commonly employed method of defining a metropolitan area is the Metropolitan Statistical Areas

33 atients with coronary artery disease among a metropolitan area of 1 000 000 residents (2002 to 2006);

34 ty and Lymphedema trial) in the Philadelphia metropolitan area of 154 breast cancer survivors 1 to 5

35 e particulate matter (PM10) collected in the metropolitan area of Aracaju, Sergipe, Brazil.

36 used to draw a representative sample of the metropolitan area of Porto Alegre, Brazil.

37 is cohort study of youth from a mid-Atlantic metropolitan area of the United States, repeated assessm

38 is time-frame, we address the concept of the metropolitan area or city in physical terms, in that urb

39 s and one community hospital) in the Detroit metropolitan area over a 22-year period.

40 ulations and the Han Chinese from the Denver metropolitan area panel in Phase 3 (p < 0.0001).

41 s, but adjustment for population density and metropolitan area population attenuated the segregation

42 ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classi

43 ican-American girls from the Houston, Texas, metropolitan area recruited in 2005, the authors investi

44 Paul, Minnesota (population 2.6 million) metropolitan area residents aged 30-74 years from 1980 t

45 Block groups with the highest metropolitan area segregation had the highest estimated

46 ing children from 25 schools in the Brisbane Metropolitan Area showed similar trends for all particip

47 ry and physical adversity in the New Orleans metropolitan area subsample and property loss in the rem

48 y related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sa

49 ommunity health centers in the New York City metropolitan area to determine the nature (clonal type)

50 h changes in land use from urbanized Raleigh metropolitan area to the largely agricultural Southeaste

51 ethnically diverse residents of the New York metropolitan area using Positron Emission Tomography (PE

52 tribution of PM1 components in the Barcelona metropolitan area was investigated using on-road mobile

53 university-affiliated hospitals in a single metropolitan area was queried for patients 18-35 years o

54 unevaporated) gasoline samples from a single metropolitan area were differentiated based on a covaria

55 Prehurricane residents of the New Orleans metropolitan area were estimated to have a 49.1% 30-day

56 y age (+/-5 years), sex, ethnicity/race, and metropolitan area were identified by random-digit dialin

57 iduals experiencing SCA in the Portland, OR, metropolitan area were identified prospectively.

58 pants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physic

59 >/=70 years old and residing in the San Juan metropolitan area were invited to this cross-sectional s

60 o consider spatial gradients within a single metropolitan area when examining the relationship betwee

61 tudied 1421 subjects residing in the Atlanta metropolitan area who participated in the META-Health st

62 ed 3 to 6 years from the St Louis, Missouri, metropolitan area who were observed for up to 11 years i

63 Berlin, Delhi NCT, Mexico City, and New York metropolitan area) applying a consistent method that can

64 are frequently observed in the Delhi, India metropolitan area, although the sources of lead particle

65 ge or older, living in Rio de Janeiro or its metropolitan area, and having a valid peer recruitment c

66 graphically distributed within the UK London metropolitan area, and how the strength of associations

67 t issue in the study of cities is defining a metropolitan area, because different definitions affect

68 l polio seroprevalence surveys (SPS) in Kano Metropolitan Area, comprising 8 local government areas (

69 d February 24, 2012, from MSM in the Detroit metropolitan area, Michigan.

70 an urban-to-rural gradient in Guangzhou City metropolitan area, South China.

71 high schools in the Los Angeles, California, metropolitan area, surveys were administered during 10th

72 ) visits in the St. Louis, Missouri-Illinois metropolitan area, using 2 years of daily PM2.5 and PM2.

73 ing treated effluent from the greater Boston metropolitan area, where conjugated and halogenated estr

74 e exposure, and residence in the New Orleans metropolitan area, with baseline health problems predict

75 ditions increased with increasing degrees of metropolitan area-level segregation.

76 ltivariable analysis and examined pooled and metropolitan area-specific models.

77 Metropolitan area-specific results exhibited considerabl

78 y participant residential annual mean, or in metropolitan area-wide mean, were consistent with baseli

79 7 million residents in the Portland, Oregon, metropolitan area.

80 of elderly men in the Boston, Massachusetts, metropolitan area.

81 imes varied substantially by health plan and metropolitan area.

82 es of participants in the Chicago, Illinois, metropolitan area.

83 als with T1DM were recruited from the Denver metropolitan area.

84 r IMT progressions among persons in the same metropolitan area.

85 "structure of co-presence" across the whole metropolitan area.

86 s living in the greater Salisbury, Maryland, metropolitan area.

87 hologic cohort study of aging in the Chicago metropolitan area.

88 tected the most frequently (41%) and in each metropolitan area.

89 2-40% and those of PM(2.5) by 1-15% over the metropolitan area.

90 l admission counts in the five-county Denver metropolitan area.

91 ord-Ouest Department to 70.0% in Cite Soleil Metropolitan Area.

92 es were obtained for the five-county Atlanta metropolitan area.

93 consin; and in 2005 in the Phoenix, Arizona, metropolitan area.

94 d patients in the event of an NDD in a major metropolitan area.

95 ac disease in adolescents born in the Denver metropolitan area.

96 n a cohort of older men living in the Boston Metropolitan area.

97 mary care and day care sites in the St Louis metropolitan area; they were annually assessed behaviora

98 % CI, 12.9%-14.7%) and those living in large metropolitan areas (11.7%; 95% CI, 11.1%-12.3%) and in N

99 t (33 days; P < .001), and patients in large metropolitan areas (32 days; P < .001) had longer delays

100 but similar in rural departments (79.4%) and metropolitan areas (78.6%; P = .61).

101 The authors examined whether living in metropolitan areas (MAs) with high levels of residential

102 , Houston, San Francisco, and Washington, DC metropolitan areas about work and family life.

103 ecticides in stream bed sediments from seven metropolitan areas across the United States.

104 e Amazonas of Venezuela, rural Malawi and US metropolitan areas and included mono- and dizygotic twin

105 age sample of registered nurses nested in 51 metropolitan areas and nine non-metropolitan, rural area

106 While some large European metropolitan areas are already in breach of EU safety li

107 on-based surveillance for invasive MRSA in 9 metropolitan areas covering a population of approximatel

108 ere evaluated for 445,860 adults in 100 U.S. metropolitan areas followed from 1982 through 2004 for v

109 t previous cardiovascular disease in 36 U.S. metropolitan areas from 1994 to 1998, with a median foll

110 We analyzed population-based data from 9 US metropolitan areas from 2005 to 2011.

111 ere collected from grocery stores in 10 U.S. metropolitan areas from December 2010 through June 2011.

112 ndividuals residing in the Midwest and/or in metropolitan areas had the highest seroprevalence estima

113 This study uses census data for all US metropolitan areas in 1980 and 2010 to compare decline i

114 issions from European countries and selected metropolitan areas in 2004, which indicated that the dil

115 97% of PrEP users were male and 98% lived in metropolitan areas in 2014.

116 ts for the Right From the Start study from 8 metropolitan areas in 3 states in the United States duri

117 g Kaiser Permanente health plan members in 2 metropolitan areas in California and Oregon.

118 ity-specific source apportionment in 8 major metropolitan areas in California from 2005-2009 to exami

119 ducted among individuals living in 1 of 7 US metropolitan areas in Colorado, Georgia, Maryland, Minne

120 We analyze the diversity of US metropolitan areas in terms of profession diversity and

121 esidential segregation was characterized for metropolitan areas in the United States and Puerto Rico

122 traffic fatalities in the 100 most populated metropolitan areas in the United States using negative b

123 ality based on time-series data from </= 108 metropolitan areas in the United States.

124 ool fifth-graders and their parents in three metropolitan areas in the United States.

125 ion of automobile round trips </= 8 km in 11 metropolitan areas in the upper midwestern United States

126 clerosis and Air Pollution (MESA Air) in six metropolitan areas in the USA.

127 white men and women in all 16 states and six metropolitan areas included.

128 rrigation water consumption across the major metropolitan areas is reduced by up to 9% and irrigation

129 ed CCR for out-of-hospital cardiac arrest in metropolitan areas of Arizona and found a greater than 3

130 emiology, and End Results registries for the metropolitan areas of Los Angeles, California, and Detro

131 troenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid

132 Many general surgeons in metropolitan areas performed an array of procedures that

133 children who were randomly selected from 12 metropolitan areas provided written informed consent to

134 variation in pyrethroid concentrations among metropolitan areas suggests regional differences in pyre

135 ions with increased vulnerability to heat in metropolitan areas throughout the United States.

136 as were more likely than students from large metropolitan areas to consume 15 or more drinks.

137 between city size and CO2 emissions for U.S. metropolitan areas using a production accounting allocat

138 timated separately for physicians located in metropolitan areas with high and low fees in 2001.

139 eristics for 211 county units in the 51 U.S. metropolitan areas with matching data on fine-particulat

140 an hours were less than 49 hours per week in metropolitan areas with the lowest physician fees, where

141 More than 48% were in metropolitan areas, 39% were suburban, and 13% were rura

142 bon) between examinations and within the six metropolitan areas, adjusting for baseline age, sex, eth

143 icity, annual household income, residence in metropolitan areas, and history of child moving to a new

144 e United States, and most end up residing in metropolitan areas, clustered within a select few neighb

145 Here, we introduce a method to designate metropolitan areas, denoted "City Clustering Algorithm"

146 irms reported associations such as living in metropolitan areas, higher household education level, an

147 2.5 and traffic-related air pollution within metropolitan areas, in ranges commonly encountered world

148 r period from 2005 through 2008 in 9 diverse metropolitan areas, rates of invasive health care-associ

149 In metropolitan areas, road traffic is a major contributor

150 With most dermatologists residing in metropolitan areas, teledermatology provides an apparent

151 ively low HCF in the central cities of large metropolitan areas, the more extensive suburbanization i

152 Specifically, we determine which US metropolitan areas, US states, and international export

153 Improving air quality in large metropolitan areas, where much of the aging US populatio

154 3,295 adults (45-84 years of age) from three metropolitan areas.

155 r most European countries and all landlocked metropolitan areas.

156 lation scale observed at the level of entire metropolitan areas.

157 = 9,480), equally distributed across six US metropolitan areas.

158 F) for U.S. zip codes, cities, counties, and metropolitan areas.

159 therosclerosis participants residing in 6 US metropolitan areas.

160 irectories for the largest MA plans in 12 US metropolitan areas.

161 rall net increase in HCF compared to smaller metropolitan areas.

162 roximately 25 to >80 tCO2e in the 50 largest metropolitan areas.

163 United States is limited to primarily large metropolitan areas.

164 neumonia (PNEUMO) during 2005-2007 from 6 US metropolitan areas.

165 and most O3 benefits to populations outside metropolitan areas.

166 ghway-building environments are prevalent in metropolitan areas.

167 ry (comparison areas), after excluding major metropolitan areas.

168 ere also more likely to be black and live in metropolitan areas.

169 lack children and that for white children in metropolitan areas.

170 the Nurses' Health Study in northeastern US metropolitan areas.

171 ); and the Minneapolis-St. Paul, MN (n=150), metropolitan areas.

172 adults and children (66,000 events) in eight metropolitan areas.

173 ps based on population size and adjacency to metropolitan areas.

174 Surveillance records obtained from the Metropolitan Atlanta Congenital Defects Program, which c

175 viral Pregnancy Registry modification of the Metropolitan Atlanta Congenital Defects Program.

176 132,110 adult symptomatic cases of pH1N1 in metropolitan Atlanta during the investigation time frame

177 it (ICU) admissions, and deaths occurring in metropolitan Atlanta during the period August 16, 2009-S

178 ted active, population-based surveillance in metropolitan Atlanta, Georgia, and Baltimore City/County

179 den of the pandemic H1N1 (pH1N1) outbreak in metropolitan Atlanta, Georgia, in the fall of 2009, when

180 A 20-year study of IPD performed in metropolitan Atlanta, Georgia, using active, population-

181 f HO2 from observations of HO2NO2 and NO2 in metropolitan Atlanta, US, in winter 2014 and summer 2015

182 f ED visits, hospitalizations, and deaths in metropolitan Atlanta.

183 aving sex with men in the past 12 months) in metropolitan Bangkok.

184 These infrastructures extend well outside metropolitan boundaries and impact distal river ecosyste

185 ients, the distribution of injury in a large metropolitan catchment, and the patterns of injury refer

186 ion-based longitudinal birth cohort study in metropolitan Cebu, the Philippines, and DNAm was charact

187 equestration due to their proximity to major metropolitan centers, and thus to large industrial sourc

188 nsive care unit mortality at a tertiary care metropolitan children's hospital in Memphis, Tennessee.

189 of protocol compliance, patients from the 2 metropolitan cities and 60 additional fire departments i

190 urban mobility patterns of people in several metropolitan cities around the globe by analyzing a larg

191 ts with out-of-hospital cardiac arrests in 2 metropolitan cities in Arizona before and after MICR tra

192 Among the 886 patients in the 2 metropolitan cities, survival-to-hospital discharge incr

193 model for acute stroke care across an entire metropolitan city appears to have reduced mortality for

194 Residents of a U.S. metropolitan city with characteristics similar to New Yo

195 Southwestern United States, Metropolitan community-based clinic.

196 0000, respectively) than southern states and metropolitan counties (6.8/100000 and 11.0/100000, respe

197 n the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the asso

198 in counties with small urban areas and 62 in metropolitan counties.

199 counties with small urban areas, and 66% in metropolitan counties.

200 t the deployment of Uber services in a given metropolitan county had no association with the number o

201 es and control individuals originally from a metropolitan county in the Midwest.

202 network of acute care facilities in a large metropolitan county.

203 n middle Tennessee, and each ZIP code within metropolitan Davidson County, was scored for risk factor

204 Among black women, in age-, nativity-, and metropolitan demographic-adjusted models, high segregati

205 aged 18 to 74 years diagnosed with NSCLC in metropolitan Detroit between November 1, 2001 and Octobe

206 These rural metropolitan differences were smaller after controlling

207 rveillance pilot programme in the Ekurhuleni Metropolitan District, and the successes and challenges

208 January 1, 2001, and December 31, 2009, in a metropolitan emergency medical service (EMS) system.

209 m a municipal fire department, from 17 large metropolitan fire departments, and from a national datab

210 l Assistance structure was supposed to bring metropolitan France's model of universal and free public

211 admitted to cardiac intensive care units in metropolitan France.

212 Metropolitan greenhouse gas and air emissions inventorie

213 cardiopulmonary resuscitation in a larger or metropolitan hospital were associated with lower surviva

214 dy recruitment will take place at four major metropolitan hospitals in Melbourne, Australia.

215 tudy explores the potential effectiveness of metropolitan land cover change as a climate change adapt

216 ion study of organ donors treated at a major metropolitan level I trauma center.

217 tates; and b) consider the modifying role of metropolitan level racial residential segregation.

218 hypertension disparities varied by level of metropolitan-level racial residential segregation and wh

219 2006) to investigate the association between metropolitan-level racial/ethnic residential segregation

220 After adjusting for confounders, metropolitan living was found to be a significant factor

221 2007, as reported to the SEER registries of metropolitan Los Angeles and Detroit, about experiences

222 2007 and reported to the SEER registries of metropolitan Los Angeles and Detroit.

223 on outcomes differed between recipients from metropolitan (M) centers and those from nonmetropolitan

224 Previously published research for a single metropolitan market (Austin, Texas) found that periodont

225 ts were consistent and repeated in all three metropolitan markets evaluated in this study.

226 findings by expanding datasets to additional metropolitan markets of various sizes and geographic loc

227 In all metropolitan markets, periodontists were outperformed by

228 ington), and large (New York City, New York) metropolitan markets.

229 y from low-risk, public maternity clinics in metropolitan Melbourne, Australia.

230 Schools were randomly selected from greater metropolitan Melbourne, Australia.

231 s have been found to be unexpectedly high in metropolitan Melbourne.

232 Ambient samples collected in metropolitan Miami and the Everglades National Park can

233 emissions of ethanol, and those collected in metropolitan Miami, have anomalously enriched delta(13)C

234 or non-government), teaching status, locale (metropolitan, micropolitan, or rural), and size (average

235 al sediments were collected in the eThekwini metropolitan municipality, South Africa, and analyzed fo

236 contact remains difficult to trace in large metropolitan networks, though it is a key vehicle for th

237 intervention conducted in small practices in metropolitan New York was clinically effective in improv

238 ospital location in a metropolitan area (not metropolitan or micropolitan: 0.60 [0.49-0.72], P < .001

239 ents, a suburban urgent-care facility, and a metropolitan outpatient physician group were subjected t

240 ck, in 2 regional dispatch centers servicing metropolitan Phoenix, Arizona.

241 ionally, and represent roughly 78% of the US metropolitan population.

242 r type, and county characteristics (rural vs metropolitan; poverty rate).

243 Patients from a large metropolitan quaternary care medical center with a diagn

244 ing early life in a low-income population of metropolitan Quetzaltenango in relation to stunting in c

245 temperatures in a large and rapidly warming metropolitan region of the United States.

246 and cover change at the periphery of a large metropolitan region on temperature within the city cente

247 ites and the human population density of the metropolitan region that the landfill serves were highly

248 outh Coast Air Basin (the larger Los Angeles metropolitan region).

249 09 summertime satellite image of the Detroit metropolitan region, Michigan; b) SI from the 2006 Natio

250 riod at 19 residences throughout the Detroit metropolitan region.

251 in greenhouse gas emissions over time from a metropolitan region.

252 most common types in the New York/New Jersey metropolitan region.

253 April 2015 and March 2017, we worked with 12 metropolitan regions across the United States with 132 p

254 by light absorption coefficient) in six U.S. metropolitan regions from 1999 through early 2012 as par

255 ms Accelerator program, implemented in 16 US metropolitan regions, resulted in more patients receivin

256 climate change adaptation strategy for large metropolitan regions.

257 the hospital, and patients at facilities in metropolitan regions.

258 y validated and if a rural, micropolitan, or metropolitan residence location affects outcome of waitl

259 nested in 51 metropolitan areas and nine non-metropolitan, rural areas in 34 states and the District

260 The first study to directly model a metropolitan scale heat transfer mechanism, we find both

261 The study was conducted at 2 metropolitan Seattle pediatric clinics and an academic p

262 ) examined the relationship between Hispanic metropolitan segregation and respondent-rated health for

263 ic health, few studies have investigated how metropolitan segregation shapes the health of the fastes

264 c nucleic acid amplification testing in this metropolitan setting compared to the reliability of repe

265 um CP concentrations found in proximity to a metropolitan sewage treatment plant, a wood-related indu

266 for HIV infection, using patient data from a metropolitan sexually transmitted disease clinic in Denv

267 sidency programs increasingly enter urban or metropolitan specialty practice.

268 e dynamic behavior of the City, Suburbs, and Metropolitan Statistical Area (MSA) of Cincinnati was ev

269 rd administrative definition of cities, i.e. Metropolitan Statistical Area (MSA).

270 died VA and non-VA hospitals within the same metropolitan statistical area (MSA).

271 S geographic region, and population density (metropolitan statistical area).

272 recruitment across the Jackson, Mississippi, Metropolitan Statistical Area.

273 eristics and food store distributions in the Metropolitan Statistical Areas (MSAs) of 4 US cities (Bi

274 ethod of defining a metropolitan area is the Metropolitan Statistical Areas (MSAs), based on rules at

275 Also for suicides in US, but using the Metropolitan Statistical Areas (MSAs), we obtain beta =

276 easonal mortality curves were created for 28 metropolitan statistical areas across the United States,

277 e correlated with air-pollution data from 96 metropolitan statistical areas in the United States.

278 The nurses came from metropolitan statistical areas or rural areas that were

279 p = 0.003), and urban (percentage located in metropolitan statistical areas with more than 1 million

280 annual visits), 15.6% presented to ED in non-Metropolitan Statistical Areas, and 53.5% presented to E

281 mation at monitoring locations in California Metropolitan Statistical Areas, with a maximum divergenc

282 om 2011 through 2013 at hospitals located in metropolitan statistical areas.

283 the sun safety school practices studied (eg, metropolitan status) or were inconsistently associated w

284 tients waiting for PICC insertion at a large metropolitan teaching hospital were recruited between Ma

285 in 2011-2013); b. in sewage samples (27 from metropolitan Tel-Aviv, 14 from the other 3 cities and 6

286 system was installed into a 45 km link of a metropolitan telecom network for a 2.5 month period, dur

287 al) and intensive care unit (rural/regional, metropolitan, tertiary, and private) descriptors, was de

288 -based surveillance for IPD was conducted in Metropolitan Toronto and Peel Region, Canada.

289 al/rectal swabs of healthy pregnant women in metropolitan Toronto, Canada.

290 bination in selected colonizing strains from metropolitan Toronto, which revealed multiple episodes o

291 ong patients with invasive GBS infections in metropolitan Toronto.

292 ences of research-led teaching at Manchester Metropolitan University (UK) which have been used succes

293 ce of physician-diagnosed sleep disorders in metropolitan, urban, and rural US Georgia populations.

294 ased prospective cohort study (n=380,738) of metropolitan Vancouver (BC) residents who were 45-85 y o

295 ll residents aged 45-85 years who resided in Metropolitan Vancouver, Canada, during the exposure peri

296 s who were 45-85 years of age and resided in metropolitan Vancouver, Canada, during the exposure peri

297 individuals enrolled in research studies in metropolitan Washington, D.C., were used to identify TDR

298 study, conducted from June to August 2011 in metropolitan Washington, DC, of 407 adults aged 18-39 y,

299 nce of TDR among HIV-infected individuals in metropolitan Washington, DC, regardless of gender.

300 300,000 people in Charleston, West Virginia metropolitan, while the short-term and long-term health