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1. Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study

Author: European Commission, 0000-0002-8105-0522, 0000-0002-2271-3568, 0000-0002-6970-9216, 0000-0002-1084-2442, 0000-0001-6428-6755, 0000-0003-2362-3940, 0000-0003-3471-4928, 0000-0002-2225-9457, 0000-0002-8890-6848, 0000-0002-1871-8999, 0000-0002-6170-1287, 0000-0001-5279-877X, 0000-0001-7417-3287, 0000-0001-7869-3909, 0000-0003-2248-1629, 0000-0003-2517-1087, 0000-0002-3965-1359, Wen, Bo, Wu, Yao, Guo, Yuming, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobias, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih-Chun, Íñiguez, Carmen, Ameling, Caroline, Valencia, César De la Cruz, Åström, Christofer, Houthuijs, Danny, Van Dung, Do, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Rao, Shilpa, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian-Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni J. K., Katsouyanni, Klea, Diaz, Magali Hurtado, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Coélho, Micheline de Sousa Zanotti Stagliorio, Ortega, Nicolás Valdés, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Saldiva, Paulo Hilario Nascimento, Raz, Raanan, Abrutzky, Rosana, Osorio, Samuel, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Kim, Yoonhee, Guo, Yue Leon, Bell, Michelle L., Li, Shanshan, European Commission, 0000-0002-8105-0522, 0000-0002-2271-3568, 0000-0002-6970-9216, 0000-0002-1084-2442, 0000-0001-6428-6755, 0000-0003-2362-3940, 0000-0003-3471-4928, 0000-0002-2225-9457, 0000-0002-8890-6848, 0000-0002-1871-8999, 0000-0002-6170-1287, 0000-0001-5279-877X, 0000-0001-7417-3287, 0000-0001-7869-3909, 0000-0003-2248-1629, 0000-0003-2517-1087, 0000-0002-3965-1359, Wen, Bo, Wu, Yao, Guo, Yuming, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobias, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih-Chun, Íñiguez, Carmen, Ameling, Caroline, Valencia, César De la Cruz, Åström, Christofer, Houthuijs, Danny, Van Dung, Do, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Rao, Shilpa, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian-Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni J. K., Katsouyanni, Klea, Diaz, Magali Hurtado, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Coélho, Micheline de Sousa Zanotti Stagliorio, Ortega, Nicolás Valdés, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Saldiva, Paulo Hilario Nascimento, Raz, Raanan, Abrutzky, Rosana, Osorio, Samuel, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Kim, Yoonhee, Guo, Yue Leon, Bell, Michelle L., and Li, Shanshan
Abstract: Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects.
Published: 2024

2. Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study

Author: Qi Zhao, ProfPhD, Yuming Guo, ProfPhD, Tingting Ye, MSc, Antonio Gasparrini, ProfPhD, Shilu Tong, ProfPhD, Ala Overcenco, PhD, Aleš Urban, PhD, Alexandra Schneider, PhD, Alireza Entezari, PhD, Ana Maria Vicedo-Cabrera, PhD, Antonella Zanobetti, PhD, Antonis Analitis, PhD, Ariana Zeka, PhD, Aurelio Tobias, PhD, Baltazar Nunes, PhD, Barrak Alahmad, MPH, Ben Armstrong, ProfPhD, Bertil Forsberg, ProfPhD, Shih-Chun Pan, PhD, Carmen Íñiguez, PhD, Caroline Ameling, BS, César De la Cruz Valencia, MSc, Christofer Åström, PhD, Danny Houthuijs, MSc, Do Van Dung, PhD, Dominic Royé, PhD, Ene Indermitte, PhD, Eric Lavigne, ProfPhD, Fatemeh Mayvaneh, PhD, Fiorella Acquaotta, PhD, Francesca de'Donato, PhD, Francesco Di Ruscio, PhD, Francesco Sera, MSc, Gabriel Carrasco-Escobar, MSc, Haidong Kan, ProfPhD, Hans Orru, PhD, Ho Kim, ProfPhD, Iulian-Horia Holobaca, PhD, Jan Kyselý, PhD, Joana Madureira, PhD, Joel Schwartz, ProfPhD, Jouni J K Jaakkola, ProfPhD, Klea Katsouyanni, ProfPhD, Magali Hurtado Diaz, ProfPhD, Martina S Ragettli, PhD, Masahiro Hashizume, ProfPhD, Mathilde Pascal, PhD, Micheline de Sousa Zanotti Stagliorio Coélho, PhD, Nicolás Valdés Ortega, MSc, Niilo Ryti, PhD, Noah Scovronick, PhD, Paola Michelozzi, MSc, Patricia Matus Correa, MSc, Patrick Goodman, ProfPhD, Paulo Hilario Nascimento Saldiva, ProfPhD, Rosana Abrutzky, MSc, Samuel Osorio, MSc, Shilpa Rao, PhD, Simona Fratianni, PhD, Tran Ngoc Dang, PhD, Valentina Colistro, MSc, Veronika Huber, PhD, Whanhee Lee, PhD, Xerxes Seposo, PhD, Yasushi Honda, ProfPhD, Yue Leon Guo, ProfPhD, Michelle L Bell, ProfPhD, and Shanshan Li, PhD
Subjects: Environmental sciences, GE1-350
Abstract: Summary: Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. Interpretation: Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios. Funding: Australian Research Council and the Australian National Health and Medical Research Council.
Published: 2021
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3. A methodology for measuring the form of organic settlements

Author: Egin Zeka and Mehmet Ali Yuzer
Subjects: Science
Abstract: This article introduces a methodology that aims to develop a detailed framework and guideline for analyzing and measuring the urban form of any settlement, and especially the urban fabric that represents an organic layout. The basis of the methodology lays on Conzenian approach that analyzes the urban morphology by categorizing it in three main elements: streets, plots, and buildings. Since then, many studies are conducted in the field of urban morphology but only few of them focuses on measuring the spatial features of the urban space. Especially, the measurement of irregular (organic) settlements has been a real challenge since it represents a high complexity that is difficult to be measured with mathematical tools. This study tries to develop a method that is useful for measuring the spatial qualities of an organic historic settlement. Firstly, it makes a more detailed categorization and structure of the urban components. Secondly, it makes detailed mathematical measurement to extract the distances, dimensions, areas, proportions and other relationships in the settlement in different scales. The methodology uses AutoCAD and GIS tools for producing maps and making different measurements. • The methodology is useful for measuring the complexity of urban form in organic settlements. • It makes a detailed framework of urban components and is helpful for synthesizing the information and understanding the relationships among different units of the complex urban system. • It can be useful to develop an automated software/tool that makes these measurements and makes correlations between different features of measured units. Method name: Organic urban form measurement, Keywords: Urban morphology, Measuring urban form, Organic settlement, ArcGIS
Published: 2019
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4. Climate change and ecological public health: an integrated framework

Author: Zeka, Ariana, primary, Leonardi, Giovanni, additional, and Lauriola, Paolo, additional
Published: 2020
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5. List of contributors

Author: Chalabi, Zaid, primary, George, Frank, additional, Guerriero, Carla, additional, Lauriola, Paolo, additional, Leonardi, Giovanni, additional, Luchini, Stéphane, additional, Martuzzi, Marco, additional, Pacelli, Antonia, additional, Papirio, Stefano, additional, Pirozzi, Francesco, additional, Ranzi, Andrea, additional, Rebolledo, L.E. Loria, additional, Regier, Dean, additional, Schulz, Rainer, additional, Watson, Verity, additional, Wright, John S.F., additional, and Zeka, Ariana, additional
Published: 2020
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6. Projections of excess mortality related to diurnal temperature range under climate change scenarios: a multi-country modelling study

Author: Whanhee Lee, PhD, Yoonhee Kim, PhD, Francesco Sera, MSc, Antonio Gasparrini, ProfPhD, Rokjin Park, ProfPhD, Hayon Michelle Choi, MSc, Kristi Prifti, MPH, Michelle L Bell, ProfPhD, Rosana Abrutzky, PhD, Yuming Guo, ProfPhD, Shilu Tong, ProfPhD, Micheline de Sousa Zanotti Stagliorio Coelho, PhD, Paulo Hilario Nascimento Saldiva, ProfPhD, Eric Lavigne, ProfPhD, Hans Orru, PhD, Ene Indermitte, PhD, Jouni J K Jaakkola, ProfPhD, Niilo R I Ryti, PhD, Mathilde Pascal, PhD, Patrick Goodman, ProfPhD, Ariana Zeka, ScD, Masahiro Hashizume, ProfPhD, Yasushi Honda, ProfPhD, Magali Hurtado Diaz, ProfPhD, Julio César Cruz, MSc, Ala Overcenco, PhD, Baltazar Nunes, ProfPhD, Joana Madureira, PhD, Noah Scovronick, PhD, Fiorella Acquaotta, PhD, Aurelio Tobias, PhD, Ana Maria Vicedo-Cabrera, PhD, Martina S Ragettli, PhD, Yue-Liang Leon Guo, ProfPhD, Bing-Yu Chen, PhD, Shanshan Li, PhD, Ben Armstrong, ProfPhD, Antonella Zanobetti, PhD, Joel Schwartz, ProfPhD, and Ho Kim, ProfPhD
Subjects: Environmental sciences, GE1-350
Abstract: Summary: Background: Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. Methods: DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985–2015) and future (2020–99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. Findings: The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by −0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2–7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to increase in all countries or regions by 1·4–10·3% in 2090–99. Interpretation: This study suggests that globally, DTR-related excess mortality might increase under climate change, and this increasing pattern is likely to vary between countries and regions. Considering climatic changes, our findings could contribute to public health interventions aimed at reducing the impact of DTR on human health. Funding: Korea Ministry of Environment.
Published: 2020
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7. HIV care in Central and Eastern Europe: How close are we to the target?

Author: Deniz Gokengin, Cristiana Oprea, Josip Begovac, Andrzej Horban, Arzu Nazlı Zeka, Dalibor Sedlacek, Bayjanov Allabergan, Esmira A. Almamedova, Tatevik Balayan, Denes Banhegyi, Pavlina Bukovinova, Nikoloz Chkhartishvili, Alymbaeva Damira, Edona Deva, Ivaylo Elenkov, Luljeta Gashi, Dafina Gexha-Bunjaku, Vesna Hadciosmanovic, Arjan Harxhi, Tiberiu Holban, Djorje Jevtovic, David Jilich, Justyna Kowalska, Djhamal Kuvatova, Natalya Ladnaia, Adkhamjon Mamatkulov, Aleksandra Marjanovic, Maria Nikolova, Mario Poljak, Kristi Rüütel, Azzaden Shunnar, Milena Stevanovic, Zhanna Trumova, and Oleg Yurin
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: Objectives: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90–90–90. Methods: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. Results: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14–80%) and 25.4% (range 9–50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of
Published: 2018
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8. Global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019: a multi-country time-series study

Author: European Commission, Ministerio de Ciencia e Innovación (España), Huang, Wenzhong, Li, Shanshan, Vogt, Thomas, Xu, Rongbin, Tong, Shilu, Molina, Tomás, Masselot, Pierre, Gasparrini, Antonio, Armstrong, Ben, Pascal, Mathilde, Royé, Dominic, Sheng Ng, Chris Fook, Vicedo-Cabrera, Ana Maria, Schwartz, Joel, Lavigne, Eric, Kan, Haidong, Goodman, Patrick, Zeka, Ariana, Hashizume, Masahiro, Diaz, Magali Hurtado, De la Cruz Valencia, César, Seposo, Xerxes, Nunes, Baltazar, Madureira, Joana, Kim, Ho, Lee, Whanhee, Tobias, Aurelio, Íñiguez, Carmen, Guo, Yue Leon, Pan, Shih-Chun, Zanobetti, Antonella, Dang, Tran Ngoc, Van Dung, Do, Geiger, Tobias, Otto, Christian, Johnson, Amanda, Hales, Simon, Yu, Pei, Yang, Zhengyu, Ritchie, Elizabeth A, Guo, Yuming, European Commission, Ministerio de Ciencia e Innovación (España), Huang, Wenzhong, Li, Shanshan, Vogt, Thomas, Xu, Rongbin, Tong, Shilu, Molina, Tomás, Masselot, Pierre, Gasparrini, Antonio, Armstrong, Ben, Pascal, Mathilde, Royé, Dominic, Sheng Ng, Chris Fook, Vicedo-Cabrera, Ana Maria, Schwartz, Joel, Lavigne, Eric, Kan, Haidong, Goodman, Patrick, Zeka, Ariana, Hashizume, Masahiro, Diaz, Magali Hurtado, De la Cruz Valencia, César, Seposo, Xerxes, Nunes, Baltazar, Madureira, Joana, Kim, Ho, Lee, Whanhee, Tobias, Aurelio, Íñiguez, Carmen, Guo, Yue Leon, Pan, Shih-Chun, Zanobetti, Antonella, Dang, Tran Ngoc, Van Dung, Do, Geiger, Tobias, Otto, Christian, Johnson, Amanda, Hales, Simon, Yu, Pei, Yang, Zhengyu, Ritchie, Elizabeth A, and Guo, Yuming
Abstract: The global spatiotemporal pattern of mortality risk and burden attributable to tropical cyclones is unclear. We aimed to evaluate the global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019.
Published: 2023

9. Factors impacting survival after transarterial radioembolization in patients with hepatocellular carcinoma: Results from the prospective CIRT study

Author: Kolligs, Frank, Arnold, Dirk, Golfieri, Rita, Pech, Maciej, Peynircioglu, Bora, Pfammatter, Thomas, Ronot, Maxime, Sangro, Bruno, Schaefer, Niklaus, Maleux, Geert, Munneke, Graham, Pereira, Helena, Zeka, Bleranda, de Jong, Niels, Helmberger, Thomas, Kolligs, Frank, Arnold, Dirk, Golfieri, Rita, Pech, Maciej, Peynircioglu, Bora, Pfammatter, Thomas, Ronot, Maxime, Sangro, Bruno, Schaefer, Niklaus, Maleux, Geert, Munneke, Graham, Pereira, Helena, Zeka, Bleranda, de Jong, Niels, and Helmberger, Thomas
Abstract: BACKGROUND & AIMS Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is an established treatment option for patients with hepatocellular carcinoma (HCC). However, optimising treatment application and patient selection remains challenging. We report here on the effectiveness, safety and prognostic factors, including dosing methods, associated with TARE for HCC in the prospective observational CIRT study. METHODS We analysed 422 patients with HCC enrolled between Jan 2015 and Dec 2017, with follow-up visits every 3 months for up to 24 months after first TARE. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every 3-month follow-up visit. We used the multivariable Cox proportional hazard model and propensity score matching to identify independent prognostic factors for effectiveness outcomes. RESULTS The median OS was 16.5 months, the median PFS was 6.1 months, and the median hepatic PFS was 6.7 months. Partition model dosimetry resulted in improved OS compared to body surface area calculations on multivariable analysis (hazard ratio 0.65; 95% CI 0.46-0.92; p = 0.0144), which was confirmed in the exact matching propensity score analysis (hazard ratio 0.56; 95% CI 0.35-0.89; p = 0.0136). Other independent prognostic factors for OS were ECOG-performance status >0 (p = 0.0018), presence of ascites (p = 0.0152), right-sided tumours (p = 0.0002), the presence of portal vein thrombosis (p = 0.0378) and main portal vein thrombosis (p = 0.0028), ALBI grade 2 (p = 0.0043) and 3 (p = 0.0014). Adverse events were recorded in 36.7% of patients, with 9.7% of patients experiencing grade 3 or higher adverse events. CONCLUSIONS This large prospective observational dataset shows that TARE is an effective and safe treatment in patients with HCC. Using partition model dosimetry was associated with a significa
Published: 2023

10. Use of natural products in the prevention and management of type 2 diabetes

Author: Zeka, Keti, primary, Alfa, Hajara H., additional, Ruparelia, Ketan C., additional, and Arroo, Randolph R.J., additional
Published: 2019
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11. Factors impacting survival after transarterial radioembolization in patients with hepatocellular carcinoma: Results from the prospective CIRT study

Author: Frank Kolligs, Dirk Arnold, Rita Golfieri, Maciej Pech, Bora Peynircioglu, Thomas Pfammatter, Maxime Ronot, Bruno Sangro, Niklaus Schaefer, Geert Maleux, Graham Munneke, Helena Pereira, Bleranda Zeka, Niels de Jong, Thomas Helmberger, Thomas Albrecht, Olivier D’Archambeau, Tugsan Balli, Sadik Bilgic, Allan Bloom, Roberto Cioni, Roman Fischbach, Patrick Flamen, Laurent Gerard, Gerd Grözinger, Marcus Katoh, Michael Koehler, Jan Robert Kröger, Christiane Kuhl, Franco Orsi, Murat Özgün, Peter Reimer, Axel Schmid, Alessandro Vit, CIRT Principal Investigators, Albrecht, T., D'Archambeau, O., Balli, T., Bilgic, S., Bloom, A., Cioni, R., Fischbach, R., Flamen, P., Gerard, L., Grözinger, G., Katoh, M., Koehler, M., Kröger, J.R., Kuhl, C., Orsi, F., Özgün, M., Reimer, P., Ronot, M., Schmid, A., Vit, A., University of Zurich, and de Jong, Niels
Subjects: Hepatology, 10042 Clinic for Diagnostic and Interventional Radiology, 2724 Internal Medicine, 2723 Immunology and Allergy, Gastroenterology, Internal Medicine, Immunology and Allergy, 610 Medicine & health, 2721 Hepatology, 2715 Gastroenterology, ALBI, albumin-bilirubin, BCLC, Barcelona Clinic Liver Cancer, BSA, body surface area, CIRSE, Cardiovascular and Interventional Radiological Society of Europe, CIRT, CIRSE Registry for SIR-Spheres Therapy, ECOG, Eastern Cooperative Oncology Group, HCC, hepatocellular carcinoma, HR, hazard ratio, INR, international normalized ratio, IPTW, inverse probability of treatment weighting, OS, overall survival, PFS, progression-free survival, PVT, portal vein thrombosis, REILD, radioembolization-induced liver disease, SIRT, TACE, transcatheter arterial chemoembolization, TARE, transarterial radioembolization, Y90, Yttrium-90, dosimetry, hPFS, hepatic progression-free survival, liver, mBSA, modified body surface area, observational, radioembolization, registry
Abstract: Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is an established treatment option for patients with hepatocellular carcinoma (HCC). However, optimising treatment application and patient selection remains challenging. We report here on the effectiveness, safety and prognostic factors, including dosing methods, associated with TARE for HCC in the prospective observational CIRT study. We analysed 422 patients with HCC enrolled between Jan 2015 and Dec 2017, with follow-up visits every 3 months for up to 24 months after first TARE. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every 3-month follow-up visit. We used the multivariable Cox proportional hazard model and propensity score matching to identify independent prognostic factors for effectiveness outcomes. The median OS was 16.5 months, the median PFS was 6.1 months, and the median hepatic PFS was 6.7 months. Partition model dosimetry resulted in improved OS compared to body surface area calculations on multivariable analysis (hazard ratio 0.65; 95% CI 0.46-0.92; p = 0.0144), which was confirmed in the exact matching propensity score analysis (hazard ratio 0.56; 95% CI 0.35-0.89; p = 0.0136). Other independent prognostic factors for OS were ECOG-performance status >0 (p = 0.0018), presence of ascites (p = 0.0152), right-sided tumours (p = 0.0002), the presence of portal vein thrombosis (p = 0.0378) and main portal vein thrombosis (p = 0.0028), ALBI grade 2 (p = 0.0043) and 3 (p = 0.0014). Adverse events were recorded in 36.7% of patients, with 9.7% of patients experiencing grade 3 or higher adverse events. This large prospective observational dataset shows that TARE is an effective and safe treatment in patients with HCC. Using partition model dosimetry was associated with a significant improvement in survival outcomes. Transarterial radioembolization (TARE) is a form of localised radiation therapy and is a potential treatment option for primary liver cancer. We observed how TARE was used in real-life clinical practice in various European countries and if any factors predict how well the treatment performs. We found that when a more complex but personalised method to calculate the applied radiation activity was used, the patient responded better than when a more generic method was used. Furthermore, we identified that general patient health, ascites and liver function can predict outcomes after TARE. NCT02305459.
Published: 2023
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12. Solidification behaviour and microstructure of AlSi7Mg cast alloy with addition of Li

Author: Mitja Petrič, Bastri Zeka, Primož Mrvar, Aleš Nagode, Maja Vončina, and Tilen Balaško
Subjects: Biomaterials, udc:669, lithium addition, Metals and Alloys, Ceramics and Composites, Al-cast alloy, solidification, thermal analysis, hardness, Surfaces, Coatings and Films
Abstract: The constant need for the development of new alloys with an improved ratio between weight and strength is the driving force for the progress of the present work, which deals with the production of a new Al-cast alloy with the addition of lithium (Li). 0.8 wt% Li was added to the AlSi7Mg alloy. The solidification behaviour of such a new alloy was the focus of the work. The melt was produced in an inert gas atmosphere in an induction furnace. The solidification behaviour was described by CALPHAD simulations, optical microscopy, scanning electron microscopy (SEM) and simple thermal analysis. In addition, the Vickers hardness (HV) was measured 29 days after casting and compared with the results of the AlSi7Mg base alloy. Solidification proceeds somewhat differently from the base alloy, where the liquidus temperature is raised to 637 °C, where the primary AlLiSi phase forms, followed by α$_{Al}$ dendrites, eutectic β$_{Si}$ and other phases in the form of eutectics, which are known to occur during solidification of the AlSi7Mg alloy. The hardness of the new alloy is increased compared to the base alloy, especially at higher cooling rates, where the hardness gain is up to 36%.
Published: 2022

13. Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19:a three-stage modelling study

Author: Wu, Y. (Yao), Li, S. (Shanshan), Zhao, Q. (Qi), Wen, B. (Bo), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), Iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), De'Donato, F. (Francesca), Rao, S. (Shilpa), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Nascimento Saldiva, P. H. (Paulo Hilario), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), Guo, Y. (Yuming), Wu, Y. (Yao), Li, S. (Shanshan), Zhao, Q. (Qi), Wen, B. (Bo), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), Iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), De'Donato, F. (Francesca), Rao, S. (Shilpa), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Nascimento Saldiva, P. H. (Paulo Hilario), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), and Guo, Y. (Yuming)
Abstract: Background: Increased mortality risk is associated with short-term temperature variability: However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000–19. Methods: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° degrees from 2000–19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. Findings: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1753392 deaths (95% CI 1159 901–2357 718) were associated with temperature variability per year, ac
Published: 2022

14. Disposable paper-based microfluidics for fertility testing

Author: Taşoğlu, Savaş (ORCID 0000-0003-4604-217X & YÖK ID 291971); Sarabi, Misagh Rezapour; Yığcı, Defne; Ata, Barış, Alseed, M. Munzer; Mathyk, Begüm Aydoğan; Halıcıgil, Cihan, Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); KU Arçelik Research Center for Creative Industries (KUAR) / KU Arçelik Yaratıcı Endüstriler Uygulama ve Araştırma Merkezi (KUAR); Koç Üniversitesi İş Bankası Yapay Zeka Uygulama ve Araştırma Merkezi (KUIS AI)/ Koç University İş Bank Artificial Intelligence Center (KUIS AI), School of Medicine; College of Engineering; Graduate School of Sciences and Engineering, Department of Mechanical Engineering, Taşoğlu, Savaş (ORCID 0000-0003-4604-217X & YÖK ID 291971); Sarabi, Misagh Rezapour; Yığcı, Defne; Ata, Barış, Alseed, M. Munzer; Mathyk, Begüm Aydoğan; Halıcıgil, Cihan, Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); KU Arçelik Research Center for Creative Industries (KUAR) / KU Arçelik Yaratıcı Endüstriler Uygulama ve Araştırma Merkezi (KUAR); Koç Üniversitesi İş Bankası Yapay Zeka Uygulama ve Araştırma Merkezi (KUIS AI)/ Koç University İş Bank Artificial Intelligence Center (KUIS AI), School of Medicine; College of Engineering; Graduate School of Sciences and Engineering, and Department of Mechanical Engineering
Abstract: Fifteen percent of couples of reproductive age suffer frominfertility globally and the burden of infertility disproportionately impacts residents of developing countries. Assisted reproductive technologies (ARTs), including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), have been successful in overcoming various reasons for infertility including borderline and severe male factor infertility which consists of 20%-30% of all infertile cases. Approximately half of male infertility cases stem from suboptimal sperm parameters. Therefore, healthy/normal sperm enrichment and sorting remains crucial in advancing reproductive medicine. Microfluidic technologies have emerged as promising tools to develop in- home rapid fertility tests and point-of-care (POC) diagnostic tools. Here, we review advancements in fabrication methods for paper-based-microfluidic devices and their emerging fertility testing applications assessing sperm concentration, sperm motility, sperm DNA analysis, and other sperm functionalities, and provide a glimpse into future directions for paper-based fertility microfluidic systems., Scientific and Technological Research Council of Turkey (TÜBİTAK); 2232 International Fellowship for Outstanding Researchers Award; European Union (EU); Horizon 2020; Marie Sklodowska-Curie Individual Fellowship; Royal Academy Newton-Katip Çelebi Transforming Systems Through Partnership Award; Alexander von Humboldt Research Fellowship for Experienced Researchers; Science Academy Young Scientist Awards Program (BAGEP); Outstanding Young Scientists Awards (GEBİP); Bilim Kahramanlari Dernegi Young Scientist Award
Published: 2022

15. Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19: a three-stage modelling study

Author: European Commission, Wu, Yao, Li, Shanshan, Zhao, Qi, Wen, Bo, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobías, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih Chun, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Van Dung, Do, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Rao, Shilpa, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni, Katsouyanni, Klea, Hurtado-Díaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Sousa Zanotti Stagliorio Coélho, Micheline de, Valdés Ortega, Nicolás, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Guo, Yue Leon, Bell, Michelle L., Guo, Yuming, European Commission, Wu, Yao, Li, Shanshan, Zhao, Qi, Wen, Bo, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobías, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih Chun, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Van Dung, Do, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Rao, Shilpa, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni, Katsouyanni, Klea, Hurtado-Díaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Sousa Zanotti Stagliorio Coélho, Micheline de, Valdés Ortega, Nicolás, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Guo, Yue Leon, Bell, Michelle L., and Guo, Yuming
Abstract: Background: Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000–19. Methods: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° from 2000–19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. Findings: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1 753 392 deaths (95% CI 1 159 901–2 357 718) were associated with temperature variability per year, accounting for
Published: 2022

16. Fluctuating temperature modifies heat-mortality association around the globe

Author: 0000-0002-8105-0522, 0000-0002-1766-6592, Wu, Yao, Wen, Bo, Li, Shanshan, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobías, Aurelio, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Van Dung, Do, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian-Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Katsouyanni, Klea, Hurtado-Díaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Sousa Zanotti Stagliorio Coélho, Micheline de, Scovronick, Noah, Michelozzi, Paola, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Bell, Michelle L, Guo, Yuming, 0000-0002-8105-0522, 0000-0002-1766-6592, Wu, Yao, Wen, Bo, Li, Shanshan, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobías, Aurelio, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Van Dung, Do, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian-Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Katsouyanni, Klea, Hurtado-Díaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Sousa Zanotti Stagliorio Coélho, Micheline de, Scovronick, Noah, Michelozzi, Paola, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Bell, Michelle L, and Guo, Yuming
Abstract: Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days' minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: -0.33 to 1.69), 1.34% (95% CI: -0.14 to 2.73), 1.99% (95% CI: 0.29-3.57), and 2.73% (95% CI: 0.76-4.50) of total deaths for Q1-Q4 (first quartile-fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25-9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: -0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.
Published: 2022

17. Prognostic Factors for Effectiveness Outcomes After Transarterial Radioembolization in Metastatic Colorectal Cancer: Results From the Multicentre Observational Study CIRT

Author: Schaefer, Niklaus, Grözinger, Gerd, Pech, Maciej, Pfammatter, Thomas, Soydal, Cigdem, Arnold, Dirk, Kolligs, Frank, Maleux, Geert, Munneke, Graham, Peynircioglu, Bora, Sangro, Bruno, Pereira, Helena, Zeka, Bleranda, de Jong, Niels, Helmberger, Thomas, Schaefer, Niklaus, Grözinger, Gerd, Pech, Maciej, Pfammatter, Thomas, Soydal, Cigdem, Arnold, Dirk, Kolligs, Frank, Maleux, Geert, Munneke, Graham, Peynircioglu, Bora, Sangro, Bruno, Pereira, Helena, Zeka, Bleranda, de Jong, Niels, and Helmberger, Thomas
Abstract: BACKGROUND Transarterial radioembolisation (TARE) with Yttrium-90 resin microspheres is a treatment option for patients with metastatic colorectal cancer in the liver (mCRC). A better understanding of the prognostic factors and treatment application can improve survival outcomes. METHODS We analysed the safety and effectiveness of 237 mCRC patients included in the prospective observational study CIRSE Registry for SIR-Spheres Therapy (CIRT) for independent prognostic factors for overall survival (OS), progression-free survival (PFS) and hepatic progression-free survival (hPFS) using the Cox proportional-hazard model. RESULTS The median OS was 9.8 months, median PFS was 3.4 months and median hPFS was 4.2 months. Independent prognostic factors for an improved overall survival were the absence of extra-hepatic disease (P= .0391), prior locoregional procedures (P= .0037), an Aspartate transaminase to Platelet Ratio Index (APRI) value of ≤0.40 (P< .0001) and International Normalized Ratio (INR) ≤1 (P= .0078). Partition model dosimetry resulted in improved OS outcomes compared to the body surface area model (P = .0120). Independent predictors for PFS were APRI >0.40 (P = .0416) and prior ablation (P = .0323), and for hPFS these were 2 to 5 tumor nodules (P = .0148), Albumin-bilirubin (ALBI) grade 3 (P = .0075) and APRI >0.40 (P = .0207). During the study, 95 of 237 (40.1%) patients experienced 197 adverse events, with 28 of 237 (11.8%) patients having a grade 3 or higher adverse events. CONCLUSION Including easy-to-acquire laboratory markers INR, APRI, ALBI and using partition model dosimetry can identify mCRC patients that may benefit from TARE.
Published: 2022

18. A methodology for measuring the form of organic settlements

Author: Mehmet Ali Yüzer and Egin Zeka
Subjects: Structure (mathematical logic), Organic urban form measurement, Computer science, Settlement (structural), business.industry, Clinical Biochemistry, Urban morphology, Measuring urban form, Field (geography), Construction engineering, Medical Laboratory Technology, Software, Categorization, Human settlement, Organic settlement, Environmental Science, lcsh:Q, business, lcsh:Science, Urban space, ArcGIS, ComputingMethodologies_COMPUTERGRAPHICS
Abstract: Graphical abstract, This article introduces a methodology that aims to develop a detailed framework and guideline for analyzing and measuring the urban form of any settlement, and especially the urban fabric that represents an organic layout. The basis of the methodology lays on Conzenian approach that analyzes the urban morphology by categorizing it in three main elements: streets, plots, and buildings. Since then, many studies are conducted in the field of urban morphology but only few of them focuses on measuring the spatial features of the urban space. Especially, the measurement of irregular (organic) settlements has been a real challenge since it represents a high complexity that is difficult to be measured with mathematical tools. This study tries to develop a method that is useful for measuring the spatial qualities of an organic historic settlement. Firstly, it makes a more detailed categorization and structure of the urban components. Secondly, it makes detailed mathematical measurement to extract the distances, dimensions, areas, proportions and other relationships in the settlement in different scales. The methodology uses AutoCAD and GIS tools for producing maps and making different measurements. • The methodology is useful for measuring the complexity of urban form in organic settlements. • It makes a detailed framework of urban components and is helpful for synthesizing the information and understanding the relationships among different units of the complex urban system. • It can be useful to develop an automated software/tool that makes these measurements and makes correlations between different features of measured units.
Published: 2019

19. Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019:a three-stage modelling study

Author: Zhao, Q. (Qi), Guo, Y. (Yuming), Ye, T. (Tingting), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Van Dung, D. (Do), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), de'Donato, F. (Francesca), Di Ruscio, F. (Francesco), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Saldiva, P. H. (Paulo Hilario Nascimento), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Rao, S. (Shilpa), Fratianni, S. (Simona), Dang, T. N. (Tran Ngoc), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), Li, S. (Shanshan), Zhao, Q. (Qi), Guo, Y. (Yuming), Ye, T. (Tingting), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Van Dung, D. (Do), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), de'Donato, F. (Francesca), Di Ruscio, F. (Francesco), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Saldiva, P. H. (Paulo Hilario Nascimento), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Rao, S. (Shilpa), Fratianni, S. (Simona), Dang, T. N. (Tran Ngoc), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), and Li, S. (Shanshan)
Abstract: Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), l
Published: 2021

20. Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study

Author: Zhao, Qi, Guo, Yuming, Ye, Tingting, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobías, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih Chun, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Dung, Do Van, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Di Ruscio, Francesco, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni, Katsouyanni, Klea, Hurtado-Díaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Sousa Zanotti Stagliorio Coélho, Micheline de, Valdés Ortega, Nicolás, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Rao, Shilpa, Fratianni, Simona, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Guo, Yue Leon, Bell, Michelle L., Li, Shanshan, Zhao, Qi, Guo, Yuming, Ye, Tingting, Gasparrini, Antonio, Tong, Shilu, Overcenco, Ala, Urban, Aleš, Schneider, Alexandra, Entezari, Alireza, Vicedo-Cabrera, Ana Maria, Zanobetti, Antonella, Analitis, Antonis, Zeka, Ariana, Tobías, Aurelio, Nunes, Baltazar, Alahmad, Barrak, Armstrong, Ben, Forsberg, Bertil, Pan, Shih Chun, Íñiguez, Carmen, Ameling, Caroline, De la Cruz Valencia, César, Åström, Christofer, Houthuijs, Danny, Dung, Do Van, Royé, Dominic, Indermitte, Ene, Lavigne, Eric, Mayvaneh, Fatemeh, Acquaotta, Fiorella, de'Donato, Francesca, Di Ruscio, Francesco, Sera, Francesco, Carrasco-Escobar, Gabriel, Kan, Haidong, Orru, Hans, Kim, Ho, Holobaca, Iulian Horia, Kyselý, Jan, Madureira, Joana, Schwartz, Joel, Jaakkola, Jouni, Katsouyanni, Klea, Hurtado-Díaz, Magali, Ragettli, Martina S., Hashizume, Masahiro, Pascal, Mathilde, Sousa Zanotti Stagliorio Coélho, Micheline de, Valdés Ortega, Nicolás, Ryti, Niilo, Scovronick, Noah, Michelozzi, Paola, Matus Correa, Patricia, Goodman, Patrick, Nascimento Saldiva, Paulo Hilario, Abrutzky, Rosana, Osorio, Samuel, Rao, Shilpa, Fratianni, Simona, Dang, Tran Ngoc, Colistro, Valentina, Huber, Veronika, Lee, Whanhee, Seposo, Xerxes, Honda, Yasushi, Guo, Yue Leon, Bell, Michelle L., and Li, Shanshan
Abstract: Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), leading to
Published: 2021

21. Mortality risk attributable to wildfire-related PM2·5 pollution: a global time series study in 749 locations

Author: Klea Katsouyanni, Jan Kyselý, Noah Scovronick, Do Van Dung, Simona Fratianni, Antonella Zanobetti, Christofer Åström, Iulian-Horia Holobaca, Ala Overcenco, João Paulo Teixeira, Paulo Hilário Nascimento Saldiva, Alireza Entezari, Yasushi Honda, Jonathan M. Samet, Xerxes Seposo, Ana M. Vicedo-Cabrera, Aleš Urban, Danny Houthuijs, Shanshan Li, Whanhee Lee, Haidong Kan, Rosana Abrutzky, Gongbo Chen, Michael J. Abramson, Yadong Lei, Shih-Chun Pan, Carmen Iñiguez, Barrak Alahmad, Masahiro Hashizume, Ai Milojevic, Aurelio Tobias, Rebecca M. Garland, Francesco Sera, Wenhua Yu, Patricia Matus, Hans Orru, Yue Leon Guo, César De la Cruz Valencia, Joel Schwartz, Massimo Stafoggia, Fatemeh Mayvaneh, Mathilde Pascal, Ho Kim, Niilo R.I. Ryti, Marek Maasikmets, Nicolas Valdes Ortega, Eric Lavigne, Shilu Tong, Antonio Gasparrini, Patrick Goodman, Baltazar Nunes, Michelle L. Bell, Yuming Guo, Valentina Colistro, Veronika Huber, Ben Armstrong, Bertil Forsberg, Shilpa Rao, Evangelia Samoli, Magali Hurtado-Díaz, Alexandra Schneider, Tingting Ye, Micheline de Sousa Zanotti Stagliorio Coelho, Tran Ngoc Dang, Samuel David Osorio García, Jouni J. K. Jaakkola, Matteo Scortichini, Ariana Zeka, Gabriel Carrasco-Escobar, Xu Yue, Dominic Royé, Martina S. Ragettli, Caroline Ameling, Joana Madureira, Tobías, Aurelio [0000-0001-6428-6755], Instituto de Saúde Pública da Universidade do Porto, and Tobías, Aurelio
Subjects: Pollution, Health (social science), all cause mortality, media_common.quotation_subject, Population, Medicine (miscellaneous), 610 Medicine & health, PM2.5, medical research, wildfire, health hazard, 360 Social problems & social services, cardiovascular mortality, Environmental health, Medicine, controlled study, human, education, Mortality risk, Cardiovascular mortality, media_common, Series (stratigraphy), education.field_of_study, business.industry, Health Policy, public health, Public Health, Environmental and Occupational Health, article, risk assessment, Public Health, Global Health, Social Medicine and Epidemiology, short term exposure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Increased risk, risk factor, city, Relative risk, time series analysis, Attributable risk, PM 2·5 Pollution, mortality risk, Determinantes da Saúde e da Doença, Genotoxicidade Ambiental, business, Global time, meta analysis
Abstract: Summary Background Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of the world. Methods For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000–16. Daily concentrations of wildfire-related PM2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM2·5 exposure was calculated. Findings 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m3 increase in the 3-day moving average (lag 0–2 days) of wildfire-related PM2·5 exposure were 1·019 (95% CI 1·016–1·022) for all-cause mortality, 1·017 (1·012–1·021) for cardiovascular mortality, and 1·019 (1·013–1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48–0·75) of all-cause deaths, 0·55% (0·43–0·67) of cardiovascular deaths, and 0·64% (0·50–0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM2·5 exposure during the study period., Australian Research Council, Australian National Health & Medical Research Council.
Published: 2021

22. Projections of excess mortality related to diurnal temperature range under climate change scenarios: a multi-country modelling study

Author: Joel Schwartz, Hayon Michelle Choi, Shilu Tong, Ben Armstrong, Ariana Zeka, Whanhee Lee, Antonio Gasparrini, Patrick Goodman, Jouni J. K. Jaakkola, Joana Madureira, Aurelio Tobias, Yoonhee Kim, Ene Indermitte, Ho Kim, Mathilde Pascal, Ana M. Vicedo-Cabrera, Paulo Hilário Nascimento Saldiva, Masahiro Hashizume, Francesco Sera, Antonella Zanobetti, Michelle L. Bell, Shanshan Li, Rosana Abrutzky, Rokjin J. Park, Bing-Yu Chen, Yueliang Leon Guo, Kristi Prifti, Noah Scovronick, Niilo R.I. Ryti, Eric Lavigne, Micheline de Sousa Zanotti Stagliorio Coelho, Hans Orru, Baltazar Nunes, Yuming Guo, Julio Cruz, Magali Hurtado Diaz, Ala Overcenco, Yasushi Honda, Fiorella Acquaotta, Martina S. Ragettli, Tobías, Aurelio, Tobías, Aurelio [0000-0001-6428-6755], and Instituto de Saúde Pública da Universidade do Porto
Subjects: Hot Temperature, Time Factors, Health (social science), Climate Change, Medicine (miscellaneous), Climate change, 610 Medicine & health, 010501 environmental sciences, Global Health, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, 360 Social problems & social services, Risk Factors, Climate change scenario, Medicine and Health Sciences, Humans, 030212 general & internal medicine, Diurnal Temperature Range, Cities, Mortality, lcsh:Environmental sciences, Projections, Retrospective Studies, 0105 earth and related environmental sciences, lcsh:GE1-350, Excess mortality, Temperatures, Health Policy, Diurnal temperature variation, Temperature, Public Health, Environmental and Occupational Health, Representative Concentration Pathways, 3. Good health, Cold Temperature, Excess Mortality, 13. Climate action, Linear Models, Environmental science, Christian ministry, Seasons, Avaliação do Risco, Weather factors, Demography, Multi country
Abstract: Summary Background Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. Methods DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985–2015) and future (2020–99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. Findings The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by −0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2–7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to increase in all countries or regions by 1·4–10·3% in 2090–99. Interpretation This study suggests that globally, DTR-related excess mortality might increase under climate change, and this increasing pattern is likely to vary between countries and regions. Considering climatic changes, our findings could contribute to public health interventions aimed at reducing the impact of DTR on human health.
Published: 2020

23. Responding to COVID-19 requires strong epidemiological evidence of environmental and societal determining factors

Author: Antonio Gasparrini, Ariana Zeka, Sotiris Vardoulakis, Masahiro Hashizume, Giovanni Leonardi, Matthew Ashworth, Ana Maria Vicedo, Helen Crabbe, Aurelio Tobias, Paolo Lauriola, Lisbeth E. Knudsen, Fabrizio Bianchi, Yasushi Honda, Yuming Guo, Francesco Sera, Tobías, Aurelio, and Tobías, Aurelio [0000-0001-6428-6755]
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Health (social science), Coronavirus disease 2019 (COVID-19), Climate Change, Pneumonia, Viral, Medicine (miscellaneous), 610 Medicine & health, Health(social science), Betacoronavirus, 360 Social problems & social services, Epidemiology, Pandemic, medicine, Humans, Pandemics, biology, Viral Epidemiology, SARS-CoV-2, Health Policy, Comment, Public Health, Environmental and Occupational Health, COVID-19, Environmental and societal determining factors, medicine.disease, biology.organism_classification, Virology, Sociological Factors, Pneumonia, Geography, Sociological Factor, Coronavirus Infections, Environmental Pollution
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated COVID-19 have caused a global emergency that requires an engaged, integrated, interdisciplinary, and rapid response from the scientific community. Climate change, ecological change, and biodiversity loss might have played an important role in the occurrence of this zoonotic pandemic. Climatic and environmental factors, such as temperature, humidity, and air pollution, are potentially influencing the transmission, spread, and severity of SARS-CoV-2 infection. Strong scientific evidence about the contributions of these environmental determinants in the COVID-19 pandemic is needed, in combination with an understanding of the role of other important societal factors and public health interventions. This evidence will support the public health community in responding to the current crisis, and inform strategies to prevent the recurring effects of the COVID-19 pandemic and future emergencies.
Published: 2020

24. Climate change and ecological public health: an integrated framework

Author: Giovanni Leonardi, Ariana Zeka, and Paolo Lauriola
Subjects: medicine.medical_specialty, Human health, Scientific progress, Ecology, Public health, Political science, Social change, Psychological intervention, Global health, medicine, Climate change, Economic model
Abstract: Climate and ecological change impacts represent the greatest global health challenge but also the greatest opportunity of the 21st century. Interlinking climate and ecological change impacts, with societal change and human health, should form the scientific progress in public health for current and future generations of researchers. Ecological public health approach is proposed to address the challenges faced by public health today, by its aims to integrate complexity, multiple interactions and change of societal and environmental systems, and also as an adaptable approach which can assist in exploring and understanding complex public health questions in a way that are usable to all. The aim of this chapter is to outline why ecological public health approach is a useful framework when trying to understand and measure the public health impacts of complex ecological and climate change, and societal systems transitions. To achieve its aim the chapter highlights key issues within this framework, and also illustrates with a few examples, to make it more explicit on how this system's approach can assist any economic models of cost–benefits of environmental health interventions.
Published: 2020

25. List of contributors

Author: Zaid Chalabi, Frank George, Carla Guerriero, Paolo Lauriola, Giovanni Leonardi, Stéphane Luchini, Marco Martuzzi, Antonia Pacelli, Stefano Papirio, Francesco Pirozzi, Andrea Ranzi, L.E. Loria Rebolledo, Dean Regier, Rainer Schulz, Verity Watson, John S.F. Wright, and Ariana Zeka
Published: 2020

26. Projections of excess mortality related to diurnal temperature range under climate change scenarios:a multi-country modelling study

Author: Lee, W. (Whanhee), Kim, Y. (Yoonhee), Sera, F. (Francesco), Gasparrini, A. (Antonio), Park, R. (Rokjin), Choi, H. M. (Hayon Michelle), Prifti, K. (Kristi), Bell, M. L. (Michelle L.), Abrutzky, R. (Rosana), Guo, Y. (Yuming), Tong, S. (Shilu), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. (Patrick), Zeka, A. (Ariana), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Diaz, M. H. (Magali Hurtado), Cruz, J. C. (Julio Cesar), Overcenco, A. (Ala), Nunes, B. (Baltazar), Madureira, J. (Joana), Scovronick, N. (Noah), Acquaotta, F. (Fiorella), Tobias, A. (Aurelio), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Chen, B.-Y. (Bing-Yu), Li, S. (Shanshan), Armstrong, B. (Ben), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Kim, H. (Ho), Lee, W. (Whanhee), Kim, Y. (Yoonhee), Sera, F. (Francesco), Gasparrini, A. (Antonio), Park, R. (Rokjin), Choi, H. M. (Hayon Michelle), Prifti, K. (Kristi), Bell, M. L. (Michelle L.), Abrutzky, R. (Rosana), Guo, Y. (Yuming), Tong, S. (Shilu), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. (Patrick), Zeka, A. (Ariana), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Diaz, M. H. (Magali Hurtado), Cruz, J. C. (Julio Cesar), Overcenco, A. (Ala), Nunes, B. (Baltazar), Madureira, J. (Joana), Scovronick, N. (Noah), Acquaotta, F. (Fiorella), Tobias, A. (Aurelio), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Chen, B.-Y. (Bing-Yu), Li, S. (Shanshan), Armstrong, B. (Ben), Zanobetti, A. (Antonella), Schwartz, J. (Joel), and Kim, H. (Ho)
Abstract: Background: Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. Methods: DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985–2015) and future (2020–99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. Findings: The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by −0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2–7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to incre
Published: 2020

27. Responding to COVID-19 requires strong epidemiological evidence of environmental and societal determining factors

Author: Tobías, Aurelio [0000-0001-6428-6755], Zeka, Ariana, Tobías, Aurelio, Bianchi, Fabrizio, Leonardi, Giovanni, Lauriola, Paolo, Crabbe, Helen, Vardoulakis, Sotiris, Guo, Yuming, Honda, Yasushi, Gasparrini, Antonio, Hashizume, Masahiro, Vicedo, Ana María, Knudsen, Lisbeth E., Sera, Francesco, Ashworth, Matthew, Tobías, Aurelio [0000-0001-6428-6755], Zeka, Ariana, Tobías, Aurelio, Bianchi, Fabrizio, Leonardi, Giovanni, Lauriola, Paolo, Crabbe, Helen, Vardoulakis, Sotiris, Guo, Yuming, Honda, Yasushi, Gasparrini, Antonio, Hashizume, Masahiro, Vicedo, Ana María, Knudsen, Lisbeth E., Sera, Francesco, and Ashworth, Matthew
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated COVID-19 have caused a global emergency that requires an engaged, integrated, interdisciplinary, and rapid response from the scientific community. Climate change, ecological change, and biodiversity loss might have played an important role in the occurrence of this zoonotic pandemic. Climatic and environmental factors, such as temperature, humidity, and air pollution, are potentially influencing the transmission, spread, and severity of SARS-CoV-2 infection. Strong scientific evidence about the contributions of these environmental determinants in the COVID-19 pandemic is needed, in combination with an understanding of the role of other important societal factors and public health interventions. This evidence will support the public health community in responding to the current crisis, and inform strategies to prevent the recurring effects of the COVID-19 pandemic and future emergencies.
Published: 2020

28. Predicted temperature-increase-induced global health burden and its regional variability

Author: Francesco Sera, Haidong Kan, Jan Kyselý, Julio Cruz, Baltazar Nunes, Yuming Guo, Ariana Zeka, Patricia Matus Correa, Paola Michelozzi, Masahiro Hashizume, Micheline de Sousa Zanotti Stagliorio Coelho, Niilo R.I. Ryti, Hans Orru, Aurelio Tobias, Jae-Young Lee, Nicolas Valdes Ortega, Carmen Iñiguez, Aleš Urban, Mathilde Pascal, Paulo Hilário Nascimento Saldiva, Christofer Åström, Dung Do Van, Yasushi Honda, Ho Kim, Martina S. Ragettli, Matteo Scortichini, Bing-Yu Chen, Fetemeh Mayvaneh, Yueliang Leon Guo, Tran Ngoc Dang, Antonella Zanobetti, Shanshan Li, Rosana Abrutzky, Ana M. Vicedo-Cabrera, Michelle L. Bell, Shilu Tong, Ala Overcenco, Bertil Forsberg, Xerxes Seposo, Antonio Gasparrini, Patrick Goodman, Joel Schwartz, João Paulo Teixeira, Samuel David Osorio García, Eric Lavigne, Magali Hurtado, Ben Armstrong, Jouni J. K. Jaakkola, Ene Indermitte, Tobías, Aurelio, and Tobías, Aurelio [0000-0001-6428-6755]
Subjects: 010504 meteorology & atmospheric sciences, vulnerability, Vulnerability, Hot temperature, projection, 010501 environmental sciences, Global Health, 01 natural sciences, Global Warming, Regional variation, Hot Temperature, Animal science, Elderly population, Physical Sciences and Mathematics, Global health, Humans, Climate change, Projection, Mortality, lcsh:Environmental sciences, 0105 earth and related environmental sciences, General Environmental Science, lcsh:GE1-350, Excess mortality, Temperature, regional variation, Public Health, Global Health, Social Medicine and Epidemiology, Atmospheric temperature range, mortality, 3. Good health, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, climate change, Avaliação do Impacte em Saúde, 13. Climate action, Environmental science, Determinantes da Saúde e da Doença, Forecasting
Abstract: An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010–2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (−0.92%p/°C) and Australia (−0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population. © 2019, This study was supported by the Global Research Lab (# K21004000001-10A0500-00710 ) through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT (Information and Communication Technologies), and Future Planning. JL was supported by the National Research Foundation of Korea as NRF-SNSF Researcher Exchange Program ( NRF-2018K2A9A1A06086694 ). AG was supported by Medical Research Council UK (Grant ID: MR/M022625/1 ) and Natural Environment Research Council UK (Grant ID: NE/R009384/1 ). JK and AU were supported by the Czech Science Foundation , project no. 18-22125S . HO and EI were supported by the Estonian Ministry of Education and Research (Grant no IUT34-17 ). JJKJ and NRIR were supported by the Research Council for Health, Academy of Finland (Grant no 266314 and 310372 ). MH and YH were supported by the Environment Research and Technology Development Fund (S-14) of the Environmental Restoration and Conservation Agency . AT was supported by the Japan Society for the Promotion of Science (JSPS) Invitational Fellowships for Research in Japan ( S18149 ). Appendix A
Published: 2019

29. Use of Natural Products in the Prevention and Management of Type 2 Diabetes

Author: Ketan C. Ruparelia, Hajara H. Alfa, Randolph R.J. Arroo, and Keti Zeka
Subjects: Traditional medicine, business.industry, Streptozotocin, Diabetes, Type 2 diabetes, medicine.disease, Glucomannan, Anti hyperglycemic, chemistry.chemical_compound, Anti hyperlipidemic, chemistry, Alloxan, Diabetes mellitus, medicine, Anti-hyperlipidemic, Anti-hyperglycemic, business, medicine.drug
Abstract: Book chapter, jointly written with authors from University of Cambridge, UK (Department of Haematology) and IBB University, Nigeria (Faculty of Natural Sciences) Metabolic syndrome is an umbrella term for a group of disorders related to imbalance of energy utilization and storage. It includes obesity, hypertension, increased triglyceride levels, aberrant cholesterol levels, and insulin resistance with resulting elevated fasting blood glucose levels that usually result in diabetes. Metabolic syndrome is associated with chronic low-grade local tissue inflammation and increased susceptibility to a variety of degenerative diseases. Lifestyle changes, e.g. more physical exercise, a diet rich in fruits and vegetables, etc. can help prevent or delay metabolic syndrome related problems. In addition, certain food supplements or herbal extracts are commonly believed to make an important contribution to a healthy life style, i.e glucomannan. Whereas there is a consensus that a vegetable-rich diet contributes to a lower occurrence of metabolic syndrome related disorders, the exact nature of the compounds in the diet that contribute to the prevention of degenerative diseases is still a matter of debate. This chapter book sets out to evaluate several natural products that are currently considered to play a role in the prevention or management of type 2 diabetes. Phytochemicals with antioxidant activity were long believed to be a major contributing factor in the suppression of chronic inflammation. However, not all antioxidant compounds have anti-inflammatory properties. Further, the peroxisome proliferator-activated receptor gamma (PPARγ)-activating potential of a wide range of natural products has been explored in great detail, and resulted in a credible model. A third model considers the potential role of phytoestrogens on human physiology. These compounds are known to interact with oestrogen receptors and can modulate a range of cell signalling pathways, either as agonists or as antagonists. The efficacy of several of the identified pharmaceutically active compounds and plant extracts, either as supplements, dietary factors or as part of a healthy life style, may be supported by laboratory results. However, caution is justified when considering food supplements in doses that greatly exceed the amounts that would be obtained through a regular diet.
Published: 2019

30. Predicted temperature-increase-induced global health burden and its regional variability

Author: Young Lee, J. (Jae), Kim, H. (Ho), Gasparrini, A. (Antonio), Armstrong, B. (Ben), Bell, M. L. (Michelle L.), Sera, F. (Francesco), Lavigne, E. (Eric), Abrutzky, R. (Rosana), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio Garcia, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G.), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado, M. (Magali), Cruz, J. (Julio), Seposo, X. (Xerxes), Nunes, B. (Baltazar), Paulo Teixeira, J. (João), Tobias, A. (Aurelio), Íñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, C. (Christofer), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Leon Guo, Y.-L. (Yue-Liang), Chen, B.-Y. (Bing-Yu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Ngoc Dang, T. (Tran), Van, D. D. (Dung Do), Mayvaneh, F. (Fetemeh), Overcenco, A. (Ala), Li, S. (Shanshan), Guo, Y. (Yuming), Young Lee, J. (Jae), Kim, H. (Ho), Gasparrini, A. (Antonio), Armstrong, B. (Ben), Bell, M. L. (Michelle L.), Sera, F. (Francesco), Lavigne, E. (Eric), Abrutzky, R. (Rosana), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio Garcia, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G.), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado, M. (Magali), Cruz, J. (Julio), Seposo, X. (Xerxes), Nunes, B. (Baltazar), Paulo Teixeira, J. (João), Tobias, A. (Aurelio), Íñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, C. (Christofer), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Leon Guo, Y.-L. (Yue-Liang), Chen, B.-Y. (Bing-Yu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Ngoc Dang, T. (Tran), Van, D. D. (Dung Do), Mayvaneh, F. (Fetemeh), Overcenco, A. (Ala), Li, S. (Shanshan), and Guo, Y. (Yuming)
Abstract: An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010–2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (−0.92%p/°C) and Australia (−0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population.
Published: 2019

31. Projections of temperature-related excess mortality under climate change scenarios

Author: Gasparrini, A. (Antonio), Guo, Y. (Yuming), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana Maria), Huber, V. (Veronika), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Jaakkola, J. J. (Jouni J K), Ryti, N. R. (Niilo R I), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado-Diaz, M. (Magali), Cesar Cruz, J. (Julio), Seposo, X. (Xerxes), Kim, H. (Ho), Tobias, A. (Aurelio), Iñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, D. O. (Daniel Oudin), Ragettli, M. S. (Martina S), Guo, Y. L. (Yue Leon), Wu, C.-f. (Chang-fu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Bell, M. L. (Michelle L), Dang, T. N. (Tran Ngoc), Van, D. D. (Dung Do), Heaviside, C. (Clare), Vardoulakis, S. (Sotiris), Hajat, S. (Shakoor), Haines, A. (Andy), Armstrong, B. (Ben), Gasparrini, A. (Antonio), Guo, Y. (Yuming), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana Maria), Huber, V. (Veronika), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Jaakkola, J. J. (Jouni J K), Ryti, N. R. (Niilo R I), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado-Diaz, M. (Magali), Cesar Cruz, J. (Julio), Seposo, X. (Xerxes), Kim, H. (Ho), Tobias, A. (Aurelio), Iñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, D. O. (Daniel Oudin), Ragettli, M. S. (Martina S), Guo, Y. L. (Yue Leon), Wu, C.-f. (Chang-fu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Bell, M. L. (Michelle L), Dang, T. N. (Tran Ngoc), Van, D. D. (Dung Do), Heaviside, C. (Clare), Vardoulakis, S. (Sotiris), Hajat, S. (Shakoor), Haines, A. (Andy), and Armstrong, B. (Ben)
Abstract: Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates. Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature–mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990–2099 under each scenario of climate change, assuming no adaptation or population changes. Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sh
Published: 2017

32. Petals of Crocus sativus L. as a potential source of the antioxidants crocin and kaempferol

Author: Keti Zeka, Francesco Vegliò, Randolph R.J. Arroo, Maria Adelaide Continenza, Dimitrios Stagos, and Ketan C. Ruparelia
Subjects: DPPH, ved/biology.organism_classification_rank.species, Crocetin, Flowers, Antioxidants, Crocin, Kaempferol, chemistry.chemical_compound, Drug Discovery, Crocus sativus, media_common.cataloged_instance, Kaempferols, European union, media_common, Crocus, Pharmacology, Traditional medicine, biology, Plant Extracts, ved/biology, General Medicine, biology.organism_classification, Carotenoids, Crocus sativus L, crocin, antioxidants, Petals, Italy, chemistry, Waste, Petal
Abstract: Collaboration between Leicester School of Pharmacy - De Montfort Universit, Department of Life, Health and Environmental Sciences - University of L'Aquila, and Department of Biochemistry and Biotechnology - University of Thessaly The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Saffron fromthe province of L'Aquila, in the Abruzzo region of Italy, is highly prized and has been awarded a formal recognition by the European Union with EU Protected Designation of Origin (PDO) status. Despite this, the saffron regions are abandoned by the younger generations because the traditional cultivation of saffron (Crocus sativus L.) is labour intensive and yields only one crop of valuable saffron stamens per year. Petals of the saffron Crocus have had additional uses in traditional medicine and may add value to the crops for local farmers. This is especially important because the plant only flowers between October andNovember, and farmers will need to make the best use of the flowers harvested in this period. Recently, the petals of C. sativus L., which are considered a wastematerial in the production of saffron spice,were identified as a potential source of natural antioxidants. The antioxidants crocin and kaempferol were purified by flash column chromatography, and identified by thin layer chromatography (TLC), HPLC–DAD, infrared (IR), and nuclear magnetic resonance (1H & 13C NMR) spectroscopy. The antioxidant activity was determined with the ABTS and DPPH tests. The antioxidant activities are mainly attributed to carotenoid and flavonoid compounds, notably glycosides of crocin and kaempferol. We found in dried petals 0.6% (w/w) and 12.6 (w/w) of crocin and kaempferol, respectively. Petals of C. sativus L. have commercial potential as a source for kaempferol and crocetin glycosides, natural compounds with antioxidant activity that are considered to be the active ingredients in saffron-based herbal medicine.
Published: 2015

33. Projections of excess mortality related to diurnal temperature range under climate change scenarios: a multi-country modelling study

Author: Lee, Whanhee, Kim, Yoonhee, Sera, Francesco, Gasparrini, Antonio, Park, Rokjin, Michelle Choi, Hayon, Prifti, Kristi, Bell, Michelle L, Abrutzky, Rosana, Guo, Yuming, Tong, Shilu, De Sousa Zanotti Stagliorio Coelho, Micheline, Nascimento Saldiva, Paulo Hilario, Lavigne, Eric, Orru, Hans, Indermitte, Ene, Jaakkola, Jouni J K, Ryti, Niilo R I, Pascal, Mathilde, Goodman, Patrick, Zeka, Ariana, Hashizume, Masahiro, Honda, Yasushi, Hurtado Diaz, Magali, César Cruz, Julio, Overcenco, Ala, Nunes, Baltazar, Madureira, Joana, Scovronick, Noah, Acquaotta, Fiorella, Tobias, Aurelio, Vicedo-Cabrera, Ana Maria, Ragettli, Martina S, Guo, Yue-Liang Leon, Chen, Bing-Yu, Li, Shanshan, Armstrong, Ben, Zanobetti, Antonella, Schwartz, Joel, and Kim, Ho
Subjects: 13. Climate action, 610 Medicine & health, 360 Social problems & social services, 3. Good health
Abstract: BACKGROUND Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. METHODS DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985-2015) and future (2020-99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. FINDINGS The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by -0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2-7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to increase in all countries or regions by 1·4-10·3% in 2090-99. INTERPRETATION This study suggests that globally, DTR-related excess mortality might increase under climate change, and this increasing pattern is likely to vary between countries and regions. Considering climatic changes, our findings could contribute to public health interventions aimed at reducing the impact of DTR on human health. FUNDING Korea Ministry of Environment.

34. Predicted temperature-increase-induced global health burden and its regional variability

Author: Lee, Jae Young, Kim, Ho, Gasparrini, Antonio, Armstrong, Ben, Bell, Michelle L., Sera, Francesco, Lavigne, Eric, Abrutzky, Rosana, Tong, Shilu, Coelho, Micheline de Sousa Zanotti Stagliorio, Saldiva, Paulo Hilario Nascimento, Correa, Patricia Matus, Ortega, Nicolas Valdes, Kan, Haidong, Garcia, Samuel Osorio, Kyselý, Jan, Urban, Aleš, Orru, Hans, Indermitte, Ene, Jaakkola, Jouni J. K., Ryti, Niilo R. I., Pascal, Mathilde, Goodman, Patrick G., Zeka, Ariana, Michelozzi, Paola, Scortichini, Matteo, Hashizume, Masahiro, Honda, Yasushi, Hurtado, Magali, Cruz, Julio, Seposo, Xerxes, Nunes, Baltazar, Teixeira, João Paulo, Tobias, Aurelio, Íñiguez, Carmen, Forsberg, Bertil, Åström, Christofer, Vicedo-Cabrera, Ana Maria, Ragettli, Martina S., Guo, Yue-Liang Leon, Chen, Bing-Yu, Zanobetti, Antonella, Schwartz, Joel, Dang, Tran Ngoc, Do Van, Dung, Mayvaneh, Fetemeh, Overcenco, Ala, Li, Shanshan, and Guo, Yuming
Subjects: 13. Climate action, 3. Good health

35. A multi-country analysis on potential adaptive mechanisms to cold and heat in a changing climate

Author: Vicedo-Cabrera, Ana M., Sera, Francesco, Guo, Yuming, Chung, Yeonseung, Arbuthnott, Katherine, Tong, Shilu, Tobias, Aurelio, Lavigne, Eric, de Sousa Zanotti Stagliorio Coelho, Micheline, Hilario Nascimento Saldiva, Paulo, Goodman, Patrick G., Zeka, Ariana, Hashizume, Masahiro, Honda, Yasushi, Kim, Ho, Ragettli, Martina S., Röösli, Martin, Zanobetti, Antonella, Schwartz, Joel, Armstrong, Ben, and Gasparrini, Antonio
Subjects: 13. Climate action

36. Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study

Author: Bo Wen, Yao Wu, Yuming Guo, Antonio Gasparrini, Shilu Tong, Ala Overcenco, Aleš Urban, Alexandra Schneider, Alireza Entezari, Ana Maria Vicedo-Cabrera, Antonella Zanobetti, Antonis Analitis, Ariana Zeka, Aurelio Tobias, Baltazar Nunes, Barrak Alahmad, Ben Armstrong, Bertil Forsberg, Shih-Chun Pan, Carmen Íñiguez, Caroline Ameling, César De la Cruz Valencia, Christofer Åström, Danny Houthuijs, Do Van Dung, Dominic Royé, Ene Indermitte, Eric Lavigne, Fatemeh Mayvaneh, Fiorella Acquaotta, Francesca de’Donato, Shilpa Rao, Francesco Sera, Gabriel Carrasco-Escobar, Haidong Kan, Hans Orru, Ho Kim, Iulian-Horia Holobaca, Jan Kyselý, Joana Madureira, Joel Schwartz, Jouni J.K. Jaakkola, Klea Katsouyanni, Magali Hurtado Diaz, Martina S. Ragettli, Masahiro Hashizume, Mathilde Pascal, Micheline de Sousa Zanotti Stagliorio Coélho, Nicolás Valdés Ortega, Niilo Ryti, Noah Scovronick, Paola Michelozzi, Patricia Matus Correa, Patrick Goodman, Paulo Hilario Nascimento Saldiva, Raanan Raz, Rosana Abrutzky, Samuel Osorio, Tran Ngoc Dang, Valentina Colistro, Veronika Huber, Whanhee Lee, Xerxes Seposo, Yasushi Honda, Yoonhee Kim, Yue Leon Guo, Michelle L. Bell, and Shanshan Li
Subjects: Temperature variability, Mortality, Inter-day, Intra-day, Environmental sciences, GE1-350
Abstract: Background: Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects. Objectives: We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality. Methods: We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates. Results: Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV0–7 (0.9 °C). An IQR increase in inter-day TV0–7 (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV0–7 and inter-day TV0–7 was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type. Conclusions: Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.
Published: 2024
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37. Temperature frequency and mortality: Assessing adaptation to local temperature

Author: Yao Wu, Bo Wen, Antonio Gasparrini, Ben Armstrong, Francesco Sera, Eric Lavigne, Shanshan Li, Yuming Guo, Ala Overcenco, Aleš Urban, Alexandra Schneider, Alireza Entezari, Ana Maria Vicedo-Cabrera, Antonella Zanobetti, Antonis Analitis, Ariana Zeka, Aurelio Tobias, Baltazar Nunes, Barrak Alahmad, Bertil Forsberg, Carmen Íñiguez, Caroline Ameling, César De la Cruz Valencia, Danny Houthuijs, Do Van Dung, Dominic Roye, Ene Indermitte, Fatemeh Mayvaneh, Fiorella Acquaotta, Francesca de'Donato, Gabriel Carrasco-Escobar, Haidong Kan, Hanne Krage Carlsen, Hans Orru, Ho Kim, Iulian-Horia Holobaca, Jan Kyselý, Joana Madureira, Joel Schwartz, Jouni J.K. Jaakkola, Klea Katsouyanni, Magali Hurtado Diaz, Martina S. Ragettli, Masahiro Hashizume, Mathilde Pascal, Micheline de Sousa Zanotti Stagliorio Coelho, Nicolás Valdés Ortega, Niilo Ryti, Noah Scovronick, Paola Michelozzi, Patricia Matus Correa, Patrick Goodman, Paulo Hilario Nascimento Saldiva, Raanan Raz, Rosana Abrutzky, Samuel Osorio, Shih-Chun Pan, Shilpa Rao, Shilu Tong, Souzana Achilleos, Tran Ngoc Dang, Valentina Colistro, Veronika Huber, Whanhee Lee, Xerxes Seposo, Yasushi Honda, Yoonhee Kim, and Yue Leon Guo
Subjects: Temperature, Adaptation, Frequency, Mortality, Climate change, Environmental sciences, GE1-350
Abstract: Assessing the association between temperature frequency and mortality can provide insights into human adaptation to local ambient temperatures. We collected daily time-series data on mortality and temperature from 757 locations in 47 countries/regions during 1979–2020. We used a two-stage time series design to assess the association between temperature frequency and all-cause mortality. The results were pooled at the national, regional, and global levels. We observed a consistent decrease in the risk of mortality as the normalized frequency of temperature increases across the globe. The average increase in mortality risk comparing the 10th to 100th percentile of normalized frequency was 13.03% (95% CI: 12.17–13.91), with substantial regional differences (from 4.56% in Australia and New Zealand to 33.06% in South Europe). The highest increase in mortality was observed for high-income countries (13.58%, 95% CI: 12.56–14.61), followed by lower-middle-income countries (12.34%, 95% CI: 9.27–15.51). This study observed a declining risk of mortality associated with higher temperature frequency. Our findings suggest that populations can adapt to their local climate with frequent exposure, with the adapting ability varying geographically due to differences in climatic and socioeconomic characteristics.
Published: 2024
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38. Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19: a three-stage modelling study

Author: Yao Wu, MSc, Shanshan Li, PhD, Qi Zhao, PhD, Bo Wen, MSc, Antonio Gasparrini, ProfPhD, Shilu Tong, ProfPhD, Ala Overcenco, PhD, Aleš Urban, PhD, Alexandra Schneider, PhD, Alireza Entezari, PhD, Ana Maria Vicedo-Cabrera, PhD, Antonella Zanobetti, PhD, Antonis Analitis, PhD, Ariana Zeka, PhD, Aurelio Tobias, PhD, Baltazar Nunes, PhD, Barrak Alahmad, MPH, Ben Armstrong, ProfPhD, Bertil Forsberg, ProfPhD, Shih-Chun Pan, MSc, Carmen Íñiguez, PhD, Caroline Ameling, BS, César De la Cruz Valencia, MSc, Christofer Åström, PhD, Danny Houthuijs, PhD, Do Van Dung, PhD, Dominic Royé, PhD, Ene Indermitte, PhD, Eric Lavigne, ProfPhD, Fatemeh Mayvaneh, MSc, Fiorella Acquaotta, PhD, Francesca de'Donato, PhD, Shilpa Rao, PhD, Francesco Sera, MSc, Gabriel Carrasco-Escobar, MSc, Haidong Kan, ProfPhD, Hans Orru, PhD, Ho Kim, ProfPhD, Iulian-Horia Holobaca, PhD, Jan Kyselý, PhD, Joana Madureira, PhD, Joel Schwartz, ProfPhD, Jouni J K Jaakkola, ProfPhD, Klea Katsouyanni, ProfPhD, Magali Hurtado Diaz, ProfPhD, Martina S Ragettli, PhD, Masahiro Hashizume, ProfPhD, Mathilde Pascal, PhD, Micheline de Sousa Zanotti Stagliorio Coélho, PhD, Nicolás Valdés Ortega, MSc, Niilo Ryti, PhD, Noah Scovronick, PhD, Paola Michelozzi, MSc, Patricia Matus Correa, MSc, Patrick Goodman, ProfPhD, Paulo Hilario Nascimento Saldiva, ProfPhD, Rosana Abrutzky, MSc, Samuel Osorio, MSc, Tran Ngoc Dang, PhD, Valentina Colistro, MSc, Veronika Huber, PhD, Whanhee Lee, PhD, Xerxes Seposo, PhD, Yasushi Honda, ProfPhD, Yue Leon Guo, ProfPhD, Michelle L Bell, ProfPhD, and Yuming Guo, ProfPhD
Subjects: Environmental sciences, GE1-350
Abstract: Summary: Background: Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000–19. Methods: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° from 2000–19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. Findings: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1 753 392 deaths (95% CI 1 159 901–2 357 718) were associated with temperature variability per year, accounting for 3·4% (2·2–4·6) of all deaths. Most of Asia, Australia, and New Zealand were observed to have a higher percentage excess in mortality than the global mean. Globally, the percentage excess in mortality increased by about 4·6% (3·7–5·3) per decade. The largest increase occurred in Australia and New Zealand (7·3%, 95% CI 4·3–10·4), followed by Europe (4·4%, 2·2–5·6) and Africa (3·3, 1·9–4·6). Interpretation: Globally, a substantial mortality burden was associated with temperature variability, showing geographical heterogeneity and a slightly increasing temporal trend. Our findings could assist in raising public awareness and improving the understanding of the health impacts of temperature variability. Funding: Australian Research Council, Australian National Health & Medical Research Council.
Published: 2022
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39. Predicted temperature-increase-induced global health burden and its regional variability

Author: Jae Young Lee, Ho Kim, Antonio Gasparrini, Ben Armstrong, Michelle L. Bell, Francesco Sera, Eric Lavigne, Rosana Abrutzky, Shilu Tong, Micheline de Sousa Zanotti Stagliorio Coelho, Paulo Hilario Nascimento Saldiva, Patricia Matus Correa, Nicolas Valdes Ortega, Haidong Kan, Samuel Osorio Garcia, Jan Kyselý, Aleš Urban, Hans Orru, Ene Indermitte, Jouni J.K. Jaakkola, Niilo R.I. Ryti, Mathilde Pascal, Patrick G. Goodman, Ariana Zeka, Paola Michelozzi, Matteo Scortichini, Masahiro Hashizume, Yasushi Honda, Magali Hurtado, Julio Cruz, Xerxes Seposo, Baltazar Nunes, João Paulo Teixeira, Aurelio Tobias, Carmen Íñiguez, Bertil Forsberg, Christofer Åström, Ana Maria Vicedo-Cabrera, Martina S. Ragettli, Yue-Liang Leon Guo, Bing-Yu Chen, Antonella Zanobetti, Joel Schwartz, Tran Ngoc Dang, Dung Do Van, Fetemeh Mayvaneh, Ala Overcenco, Shanshan Li, and Yuming Guo
Subjects: Environmental sciences, GE1-350
Abstract: An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010–2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (−0.92%p/°C) and Australia (−0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population. Keywords: Projection, Mortality, Climate change, Regional variation, Vulnerability
Published: 2019
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40. A multi-country analysis on potential adaptive mechanisms to cold and heat in a changing climate

Author: Ana M. Vicedo-Cabrera, Francesco Sera, Yuming Guo, Yeonseung Chung, Katherine Arbuthnott, Shilu Tong, Aurelio Tobias, Eric Lavigne, Micheline de Sousa Zanotti Stagliorio Coelho, Paulo Hilario Nascimento Saldiva, Patrick G. Goodman, Ariana Zeka, Masahiro Hashizume, Yasushi Honda, Ho Kim, Martina S. Ragettli, Martin Röösli, Antonella Zanobetti, Joel Schwartz, Ben Armstrong, and Antonio Gasparrini
Subjects: Environmental sciences, GE1-350
Abstract: Background: Temporal variation of temperature-health associations depends on the combination of two pathways: pure adaptation to increasingly warmer temperatures due to climate change, and other attenuation mechanisms due to non-climate factors such as infrastructural changes and improved health care. Disentangling these pathways is critical for assessing climate change impacts and for planning public health and climate policies. We present evidence on this topic by assessing temporal trends in cold- and heat-attributable mortality risks in a multi-country investigation. Methods: Trends in country-specific attributable mortality fractions (AFs) for cold and heat (defined as below/above minimum mortality temperature, respectively) in 305 locations within 10 countries (1985–2012) were estimated using a two-stage time-series design with time-varying distributed lag non-linear models. To separate the contribution of pure adaptation to increasing temperatures and active changes in susceptibility (non-climate driven mechanisms) to heat and cold, we compared observed yearly-AFs with those predicted in two counterfactual scenarios: trends driven by either (1) changes in exposure-response function (assuming a constant temperature distribution), (2) or changes in temperature distribution (assuming constant exposure-response relationships). This comparison provides insights about the potential mechanisms and pace of adaptation in each population. Results: Heat-related AFs decreased in all countries (ranging from 0.45–1.66% to 0.15–0.93%, in the first and last 5-year periods, respectively) except in Australia, Ireland and UK. Different patterns were found for cold (where AFs ranged from 5.57–15.43% to 2.16–8.91%), showing either decreasing (Brazil, Japan, Spain, Australia and Ireland), increasing (USA), or stable trends (Canada, South Korea and UK). Heat-AF trends were mostly driven by changes in exposure-response associations due to modified susceptibility to temperature, whereas no clear patterns were observed for cold. Conclusions: Our findings suggest a decrease in heat-mortality impacts over the past decades, well beyond those expected from a pure adaptation to changes in temperature due to the observed warming. This indicates that there is scope for the development of public health strategies to mitigate heat-related climate change impacts. In contrast, no clear conclusions were found for cold. Further investigations should focus on identification of factors defining these changes in susceptibility. Keywords: Climate change, Heat, Cold, Adaptation, Mortality
Published: 2018
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41. Projections of temperature-related excess mortality under climate change scenarios

Author: Antonio Gasparrini, PhD, Yuming Guo, PhD, Francesco Sera, MSc, Ana Maria Vicedo-Cabrera, PhD, Veronika Huber, PhD, Shilu Tong, ProfPhD, Micheline de Sousa Zanotti Stagliorio Coelho, PhD, Paulo Hilario Nascimento Saldiva, ProfPhD, Eric Lavigne, PhD, Patricia Matus Correa, MSc, Nicolas Valdes Ortega, MSc, Haidong Kan, PhD, Samuel Osorio, MSc, Jan Kyselý, PhD, Aleš Urban, PhD, Jouni J K Jaakkola, ProfPhD, Niilo R I Ryti, PhD, Mathilde Pascal, PhD, Patrick G Goodman, ProfPhD, Ariana Zeka, PhD, Paola Michelozzi, MSc, Matteo Scortichini, MSc, Masahiro Hashizume, ProfPhD, Yasushi Honda, ProfPhD, Magali Hurtado-Diaz, ProfPhD, Julio Cesar Cruz, MSc, Xerxes Seposo, PhD, Ho Kim, ProfPhD, Aurelio Tobias, PhD, Carmen Iñiguez, PhD, Bertil Forsberg, ProfPhD, Daniel Oudin Åström, PhD, Martina S Ragettli, PhD, Yue Leon Guo, ProfPhD, Chang-fu Wu, PhD, Antonella Zanobetti, PhD, Joel Schwartz, ProfPhD, Michelle L Bell, ProfPhD, Tran Ngoc Dang, PhD, Dung Do Van, ProfPhD, Clare Heaviside, PhD, Sotiris Vardoulakis, PhD, Shakoor Hajat, PhD, Andy Haines, ProfFMedSci, and Ben Armstrong, ProfPhD
Subjects: Environmental sciences, GE1-350
Abstract: Summary: Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates. Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature–mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990–2099 under each scenario of climate change, assuming no adaptation or population changes. Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (−3·0 to 9·3) in Central America to 12·7% (−4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet. Interpretation: This study shows the negative health impacts of climate change that, under high-emission scenarios, would disproportionately affect warmer and poorer regions of the world. Comparison with lower emission scenarios emphasises the importance of mitigation policies for limiting global warming and reducing the associated health risks. Funding: UK Medical Research Council.
Published: 2017
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42. Disposable paper-based microfluidics for fertility testing

Author: Taşoğlu, Savaş (ORCID 0000-0003-4604-217X & YÖK ID 291971), Sarabi, Misagh Rezapour, Yığcı, Defne, Ata, Barış, Alseed, M. Munzer, Mathyk, Begüm Aydoğan, Halıcıgil, Cihan, Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM), KU Arçelik Research Center for Creative Industries (KUAR) / KU Arçelik Yaratıcı Endüstriler Uygulama ve Araştırma Merkezi (KUAR), Koç Üniversitesi İş Bankası Yapay Zeka Uygulama ve Araştırma Merkezi (KUIS AI)/ Koç University İş Bank Artificial Intelligence Center (KUIS AI), School of Medicine, College of Engineering, Graduate School of Sciences and Engineering, and Department of Mechanical Engineering
Subjects: Multidisciplinary sciences, Science and technology
Abstract: Fifteen percent of couples of reproductive age suffer frominfertility globally and the burden of infertility disproportionately impacts residents of developing countries. Assisted reproductive technologies (ARTs), including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), have been successful in overcoming various reasons for infertility including borderline and severe male factor infertility which consists of 20%-30% of all infertile cases. Approximately half of male infertility cases stem from suboptimal sperm parameters. Therefore, healthy/normal sperm enrichment and sorting remains crucial in advancing reproductive medicine. Microfluidic technologies have emerged as promising tools to develop in- home rapid fertility tests and point-of-care (POC) diagnostic tools. Here, we review advancements in fabrication methods for paper-based-microfluidic devices and their emerging fertility testing applications assessing sperm concentration, sperm motility, sperm DNA analysis, and other sperm functionalities, and provide a glimpse into future directions for paper-based fertility microfluidic systems., Scientific and Technological Research Council of Turkey (TÜBİTAK); 2232 International Fellowship for Outstanding Researchers Award; European Union (EU); Horizon 2020; Marie Sklodowska-Curie Individual Fellowship; Royal Academy Newton-Katip Çelebi Transforming Systems Through Partnership Award; Alexander von Humboldt Research Fellowship for Experienced Researchers; Science Academy Young Scientist Awards Program (BAGEP); Outstanding Young Scientists Awards (GEBİP); Bilim Kahramanlari Dernegi Young Scientist Award
Published: 2022

43. CutESC: Cutting edge spatial clustering technique based on proximity graphs

Author: Tansel Özyer, Reda Alhajj, Alper Aksac, TOBB ETU, Faculty of Engineering, Department of Computer Engineering, TOBB ETU, Faculty of Engineering, Department of Artificial Intelligence Engineering, TOBB ETÜ, Mühendislik Fakültesi, Bilgisayar Mühendisliği Bölümü, TOBB ETÜ, Mühendislik Fakültesi, Yapay Zeka Mühendisliği Bölümü, and Özyer, Tansel
Subjects: Computer science, graph theory, Value (computer science), Proximity Graphs, 02 engineering and technology, Spatial data mining, 01 natural sciences, Clustering, Set (abstract data type), proximity graphs, Artificial Intelligence, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Spatial Data Mining, 010306 general physics, Cluster analysis, business.industry, Pattern recognition, Graph theory, Image segmentation, Graph, Graph Theory, Signal Processing, Outlier, Spatial clustering, 020201 artificial intelligence & image processing, Computer Vision and Pattern Recognition, Artificial intelligence, Enhanced Data Rates for GSM Evolution, business, Software, clustering
Abstract: In this paper, we propose a cut-edge algorithm for spatial clustering (CutESC) based on proximity graphs. The CutESC algorithm removes edges when a cut-edge value for the edge's endpoints is below a threshold. The cut-edge value is calculated by using statistical features and spatial distribution of data based on its neighborhood. Also, the algorithm works without any prior information and preliminary parameter settings while automatically discovering clusters with non-uniform densities, arbitrary shapes, and outliers. However, there is an option which allows users to set two parameters to better adapt clustering solutions for particular problems. To assess advantages of CutESC algorithm, experiments have been conducted using various two-dimensional synthetic, high-dimensional real-world, and image segmentation datasets. Published by Elsevier Ltd.
Published: 2019

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