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Exposure to Polycyclic aromatic hydrocarbons (PAHs) has been associated with inflammatory responses. Fractional exhaled nitric oxide (FeNO) and exhaled carbon monoxide (eCO) are both important inflammatory mediators especially in airways. However, few studies have investigated associations of PAH exposures with FeNO or eCO. Therefore, we aimed to quantify the associations of urinary PAH metabolites with FeNO and eCO levels, and investigate their potential effect modifiers by linear mixed models among 4133 participants from the Wuhan-Zhuhai cohort in China. We further performed stratified analyses to estimate effect modification. We found significant associations of increased urinary PAH metabolites with elevated eCO and FeNO. Among all participants, each 1% increase of 1-hydroxynaphthalene, 2-hydroxynaphthalene, 2-hydroxyfluorene, 4-hydroxyphenanthrene, 3-hydroxyphenanthrene, and total PAH metabolites was significantly associated with a 12.6% (95% confidence interval: 9.3%, 15.9%), 9.7% (6.5%, 12.9%), 7.5% (4.1%, 10.9%), 3.2% (0.2%, 6.2%), 2.7% (0.1%, 5.3%), and 6.5% (2.7%, 10.4%) increased eCO level, respectively; while each 1% increase of urinary 1-hydroxynaphthalene, 9-hydroxyphenanthrene, 3-hydroxyphenanthrene, and 2-hydroxyphenanthrene was associated with a − 3.0% (− 5.8%, − 0.2%), 2.9% (0.3%, 5.6%), 3.2% (1.0%, 5.4%), and 4.5% (2.2%, 6.9%) change of FeNO level, respectively. Positive associations between certain urinary PAH metabolites and eCO were observed among both ever-smokers and non-smokers, and the associations were stronger among ever-smokers than that among non-smokers. Increased urinary PAH metabolites were associated with decreased FeNO among ever-smokers and elevated FeNO levels among non-smokers. Our findings suggest that PAH exposures may impair airway through inducing inflammatory response, especially among ever-smokers. [ABSTRACT FROM AUTHOR]

We present a new image restoration method by combining iterative VanCittert algorithm with noise reduction modeling. Our approach enables decoupling between deblurring and denoising during the restoration process, so allows any well-established noise reduction operator to be implemented in our model, independent of the VanCittert deblurring operation. Such an approach has led to an analytic expression for error estimation of the restored images in our method as well as simple parameter setting for real applications, both of which are hard to attain in many regularization-based methods. Numerical experiments show that our method can achieve good balance between structure recovery and noise reduction, and perform close to the level of the state of the art method and favorably compared to many other methods. [ABSTRACT FROM AUTHOR]

Metal exposure were assumed to be closely related with declined renal function, but the conclusions were controversial. We employed diverse statistical models and assessed the association between metal mixture exposure and mild renal impairment. A total of 13 plasma metals were measured in 896 general population from Southern China. Subjects with estimated glomerular filtration rate within 60–89 ml/min/1.73 m2 and urinary albumin-creatinine ratio <30 mg/g creatinine were defined as mild renal impairment (MRI). About 31.47 % participants showed MRI. In the multivariate logistic regression models, compared with the first quartile, high levels of arsenic and molybdenum (the fourth quartile) were both associated with MRI, and the ORs (95 % CI) were 1.68 (1.05, 2.68) and 2.21 (1.40, 3.48), respectively. Their predominant roles were identified by the weighted quantile regression (WQS). Besides, restricted cubic spline analysis verified the relationship between molybdenum level and increased MRI risk in a linear and dose-response manner. High levels of arsenic and molybdenum might be independent risk factors of MRI, and they showed combined effect. Our findings might provide vigorous evidence in preventing mild decline in renal function. [Display omitted] • High levels of As and Mo were positively related with MRI. • Mo showed linear dose-response relationship with MRI. • Mo and As were two predominant metals associated with the increased risk of MRI. [ABSTRACT FROM AUTHOR]

Quorum sensing inhibitors (QSIs) are considered to be promising antibiotic alternatives and will be increasingly exposed to the environment together with antibiotics after their research and development process; it is therefore necessary to study the joint effects of QSIs and antibiotics. In this study, single and mixed toxicity of sulfonamide (SAs) and QSIs under acute and chronic conditions and their corresponding toxicity mechanisms were investigated. The results indicated that the acute joint effect was extremely complex, ranging from an antagonistic to synergistic response, while the chronic joint effect was primarily an antagonistic response. Using a molecular docking and regression model, we found that the acute joint effect could be determined by the hydrion’s, ability to be oxidized, as well as the binding energy. The chronic joint effect was primarily an antagonistic response, which was due to the QSI competing against AHL for luxR generated by SAs, leading to negative effects of the QSI-luxR complexes on luxI. This phenomenon eventually weakened the stimulatory effect caused by SAs. Finally, the main differences between acute and chronic mixtures were analyzed: (1) The target protein was different between acute and chronic toxicity mixtures, and (2) effective concentration in acute and chronic toxicity mixtures was also different. These deep insights into mixed toxicity mechanisms will play an important role in the study of antibiotic resistance genes in response to antibiotic replacements. [ABSTRACT FROM AUTHOR]

Rationale: Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with adverse effects on the respiratory system. However, the association between internal levels of PAH metabolites and lung function levels remains unclear.Objectives: We investigated the relationships between urinary PAH metabolite concentrations and lung function levels in a general Chinese population.Methods: Lung function and 12 urinary PAH metabolites were measured in 2,747 participants from the Wuhan-Zhuhai cohort in China. Associations between urinary PAH metabolites and lung function were analyzed by linear mixed models. We also investigated associations among urinary PAH metabolite concentrations, traffic exposure time, and dietary PAH exposure.Measurements and Main Results: We found significant associations between increased levels of urinary PAH metabolites and reduced lung function. Each 1-U increase in log-transformed levels of 2-hydroxynaphthalene, 9-hydroxyfluorene, 2-hydroxyfluorene, 4-hydroxyphenanthrene, 9-hydroxyphenanthrene, 3-hydroxyphenanthrene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, 1-hydroxypyrene, or total urinary PAH metabolites was associated with a 23.79-, 19.36-, 41.76-, 36.87-, 33.47-, 27.37-, 39.53-, 34.35-, 25.03-, or 37.13-ml reduction in FEV1, respectively (all P < 0.05). Each 1-U increase in 2-hydroxynaphthalene, 2-hydroxyfluorene, 4-hydroxyphenanthrene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, or total urinary PAH metabolites was associated with a 24.39-, 33.90-, 27.15-, 28.56-, 27.46-, or 27.99-ml reduction in FVC, respectively (all P < 0.05). The total urinary PAH metabolites concentration was positively associated with both traffic exposure time and dietary PAH exposure among nonsmokers.Conclusions: Total and specific urinary PAH metabolites were associated with lung function reduction in a general Chinese population. Further studies are needed to investigate the potential mechanism by which PAHs induces lung function reduction. [ABSTRACT FROM AUTHOR]

Current epidemiological studies suggest that crystalline silica exposure is associated with an increased risk of cardiovascular and renal disease; however, the potential pathological damage of the heart and kidney and its underlying mechanisms have not been completely elucidated. This study tried to investigate the silica-induced inflammatory and fibrotic changes in the heart and kidney and evaluate the role of interleukin (IL)-1 beta (β) in silica-induced cardiac and renal damage. In this study, a silica-exposed model was generated by intratracheally instilling silica dust in mice. The anti-IL-1β monoclonal antibody (mAb) was used to neutralise IL-1β in the pulmonary alveolus and serum. The real-time PCR studies showed that (1) inhalational silica induced inflammatory responses in the heart and kidney by elevated mRNA levels of TNF-α, IL-6 and MCP-1; (2) early fibrotic responses in the heart were observed as elevated mRNA levels of collagen I and fibronectin. What is more, fibrosis of the kidney was demonstrated by pathological results and significantly increased mRNA levels of TGF-β, collagen I, collagen III and fibronectin. Further studies showed that usage of anti-IL-1β mAb decreased the inflammatory response of the heart and kidney induced by inhalational silica and also attenuated fibrosis in the mouse kidney. In conclusion, this study found that inhaled silica induced inflammatory and early fibrotic responses in the mouse heart and inflammatory response and fibrosis in the mouse kidney. Neutralisation of IL-1β attenuated the silica-induced inflammatory response of the heart and kidney and decreased fibrosis in the mouse kidney. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between air pollutants and methylation of peripheral brain-derived neurotrophic factor (BDNF) promoters. A total of 101 individuals were recruited in this panel study. BDNF promoter methylation was detected by bisulfite-PCR amplification and pyrosequencing. Participants' exposure to air pollutants was estimated using a satellite-based random forests approach. A generalized estimated equation model with natural cubic splines was employed to examine the associations between air pollutants and BDNF promoter methylation levels. The associations between air pollution and BDNF promoter methylation showed nonlinear curves with threshold effects. The threshold concentration for the association of nitrogen dioxide (NO 2) with average methylation level was 59.7 μg/m3, and that for the association of particulate matter ≤ 1 µm in diameter (PM 1) with CpG2 methylation level was 70.9 μg/m3. The percent change of average methylation level at the 95th percentile of NO 2 against the threshold concentration was 43.25% (95%CI: 13.10%, 73.40%), and that of CpG2 methylation at the 95th percentile of PM 1 was 128.29% (95%CI: 43.27%, 213.31%). Overall, long-term exposures of PM 1 , PM 2.5 , PM 10 , and NO 2 were associated with significant changes in BDNF promoter methylation levels with threshold effects. [Display omitted] • Ambient PM and NO 2 exposures were associated with BDNF promoter methylation. • It showed non-linear associations of air pollutants with BDNF promoter methylation. • Air pollution exposure showed threshold effects on BDNF promoter methylation. [ABSTRACT FROM AUTHOR]

To study the association between short-term exposure to air pollutants and mortality of Chronic Ischemic Heart Disease (CIHD). Using a case-crossover design, we investigated 148,443 CIHD deaths from 2015 to 2020 in Jiangsu Province, China. Exposure to six ambient pollutants, including PM 10 , PM 2.5 , NO 2 , CO, SO 2 , and O 3, was assessed by extracting daily concentrations from validated 10 km × 10 km pollutant grids at each subject's residential address. A conditional logistic regression approach was used to explore the exposure-response relationship with adjustment for temperature and relative humidity. We calculated the Population Attributable Fractions (PAFs) and the attributable deaths number of CIHD. An increase of 10 μg/m3 in PM 10 and PM 2.5 exposure was associated with a 1.16% (95% CI: 0.85–1.48%) and 1.80% (1.36–2.24%) increase in CIHD mortality, respectively. A threshold value of 123 µg/m3 was identified for the association between O 3 exposure and CIHD mortality. Controlling for PM 2.5 , each increase of 10 µg/m3 in O 3 (>threshold) was statistically significantly associated with a 0.94% (0.19–1.71%) increase in CIHD mortality, however there was no association between NO 2 , SO 2 , CO exposure and CIHD mortality. Reducing PM 2.5 , PM 10 and O 3 to the WHO air quality guidelines would prevent 6.16% (95% CI: 4.70–7.58%), 4.30% (3.18–5.43%) and 1.29% (0.48–4.20%) of CIHD deaths, respectively. During the warm season, mortality and PAFs of CIHD associated with PM 2.5 , PM 10 , and O 3 were significantly higher. Short-term exposure to ambient PM 2.5 , PM 10, and O 3 might trigger deaths from CIHD. These findings indicate that the premature deaths of CIHD patients can be alleviated by reducing exposure to polluted air. • Short-term particulate matter exposure linearly correlated with CIHD mortality. • O 3 threshold for CIHD mortality was 123 µg/m3. • WHO-qualified PM 2.5 , PM 10 and O 3 would prevent 6.16%, 4.30%, and 1.29% CIHD deaths. [ABSTRACT FROM AUTHOR]

Low-temperature photoluminescence properties of the β-Ca 2(1− x ) Ce x Na x SiO 4 ( x = 0.0005) phosphor synthesized by a solid-state reaction method are investigated with excitation energies in the vacuum ultraviolet (VUV) to ultraviolet (UV) range. Two distinct types of emission and excitation spectra are observed, which are attributed to 4f–5d transitions of two different sets of Ce 3+ centers. On the basis of density functional theory (DFT) calculations within the supercell model and wave function-based CASSCF/CASPT2 embedded cluster calculations, the two sets of Ce 3+ centers are ascribed to the Ce 3+ located on the seven-coordinated Ca1 and eight-coordinated Ca2 sites, respectively. Furthermore, from the observed relative spectral intensities, DFT total energy calculations, and comparison of experimental and calculated 4f → 5d transition energies, it is concluded that the occupation of Ce 3+ on the Ca2 site is more energetically favorable than the occupation on the Ca1 site. Finally, the redshift of the lowest 4f → 5d transition of Ce 3+ on the Ca2 site relative to that on the Ca1 site is discussed in terms of the changes of the 5d centroid energy and crystal-field splitting with the local coordination structure. [ABSTRACT FROM AUTHOR]

Abstract: Red-emitting phosphors Ba2Gd8(SiO4)6O2:Eu3+ (BGS:Eu3+) with silicate apatite structure were prepared by the conventional high temperature solid state reaction method. Rietveld structural refinement based on X-ray diffraction data indicated that there are two different sites for Eu3+ occupying in the host. It was found that the phosphors BGS:Eu3+ exhibit red emission with high quenching concentration at ~70.75at%, then the critical transfer distance of Eu3+ in BGS:Eu3+ was calculated to be ~12.3Å. More importantly, it has better CIE chromaticity coordinate for white light-emitting diode (w-LED) application in comparison with the commercial phosphor (Y,Gd)BO3:Eu3+ (YGB:Eu3+) under near ultraviolet (n-UV) 393nm excitation. [Copyright &y& Elsevier]

Sea breezes are one of the most important weather processes affecting the environmental and climatic features over coastal areas, and the sea breeze from the Pearl River Estuary (PRE) has significant effects on the Pearl River Delta (PRD) region. We simulated a typical sea breeze process that occurred on 27 December 2020 in the PRD region using the Weather Research and Forecasting (WRF) model to quantify the effects of topography and city clusters on the development of the sea breeze circulation. The results show that: (1) the topography on the west coast of the PRD tends to block the intrusion of the sea breeze and detour it along the eastern part of the terrain in the southeast of Jiangmen. The depth of sea breeze along the position of the detour is increased by 120 m, the penetration distance is increased by 40 km, the maximum intensity of sea breeze decreases by ~0.4 m/s, and the time of maximum speed delays for 4 h. However, on the east coast, the topography promotes the sea breeze, resulting in an occurrence about 4 h earlier due to the heating effects. The depth and the speed of the sea breeze are increased by 466 m and 1.2 m/s, respectively. (2) Under the influence of Urban Heat Island Circulation (UHIC), the sea breezes reach cities near the coast an hour earlier and are later inhibited from propagating further inland. Moreover, a wind convergence zone with a speed of 3–5 m/s and a width of about 25 km is formed along the boundary of suburbs and cities in the PRD region. As a result, two important convergence areas: Foshan–Guangzhou, and Dongguan–Shenzhen are formed. (3) Overall, the topography has a more remarkable impact on the mesoscale wind field especially in the mountain and bay areas, resulting in an average speed disturbance of 2.8 m/s. The urban heat island effect is relatively small and on average it causes only ± 0.9–1.8 m/s wind speed perturbations in the periphery of two convergence areas and over PRE. [ABSTRACT FROM AUTHOR]

The short-term adverse effects of ambient fine particulate matter (PM 2.5) and ozone (O 3) on anxiety disorders (ADs) remained inconclusive. We applied an individual-level time-stratified case-crossover study, which including 126,112 outpatient visits for ADs during 2019–2021 in Guangdong province, China, to investigate the association of short-term exposure to PM 2.5 and O 3 with outpatient visits for ADs, and estimate excess outpatient visits in South China. Daily residential air pollutant exposure assessments were performed by extracting grid data (spatial resolution: 1 km × 1 km) from validated datasets. We employed the conditional logistic regression model to quantify the associations and excess outpatient visits. The results of the single-pollutant models showed that each 10 μg/m3 increase of PM 2.5 and O 3 exposures was significantly associated with a 3.14 % (95 % confidence interval: 2.47 %, 3.81 %) and 0.88 % (0.49 %, 1.26 %) increase in odds of outpatient visits for ADs, respectively. These associations remained robust in 2-pollutant models. The proportion of outpatient visits attributable to PM 2.5 and O 3 exposures was up to 7.20 % and 8.93 %, respectively. Older adults appeared to be more susceptible to PM 2.5 exposure, especially in cool season, and subjects with recurrent outpatient visits were more susceptible to O 3 exposure. As our study subjects were from one single hospital in China, it should be cautious when generalizing our findings to other regions. Short-term exposure to ambient PM 2.5 and O 3 was significantly associated with a higher odds of outpatient visits for ADs, which can contribute to considerable excess outpatient visits. • Exposure to ambient PM 2.5 and O 3 was associated with an increased odds of outpatient visits for anxiety disorders. • PM 2.5 and O 3 exposures were attributable to considerable excess outpatient visits. • Older adults were more susceptible to PM 2.5 exposure, especially in cool season. • Subjects with recurrent outpatient visits were more susceptible to O 3 exposure. [ABSTRACT FROM AUTHOR]

• Nitrogen doped carbon is synthesized from potassium phthalimide in one-step. • The specific surface area of the carbon reaches 2053 m2/g. • The nitrogen content of the carbon is 3.3–9.1 wt%. • CO 2 uptake at 0.15 bar and the adsorption selectivity show a linear relationship. In the current work, we reported the synthesis of nitrogen doped carbons (NDCs) with a very convenient one-step strategy. Highly porous NDCs were successfully prepared from the direct pyrolysis of potassium phthalimide at 600−900 °C. The obtained carbon had a high specific surface area (2053 m2/g) and pore volume (1.14 cm3/g) after pyrolysis at 900 °C. The nitrogen content of the carbon was 3.3–9.1 wt%, and decreased with the increase of pyrolysis temperature. The combination of high porosity and nitrogen content made the synthesized NDCs attractive CO 2 adsorbents. At 25 °C, the carbon exhibited CO 2 uptakes of 1.1 mmol/g at 0.15 bar, and 3.4 mmol/g at 1 bar. The experiment results also revealed a linear relationship between the uptake at 0.15 bar and the CO 2 /N 2 adsorption selectivity. Small micropores and nitrogen containing functionalities had decisive effects on these properties. [ABSTRACT FROM AUTHOR]

Background: Both cigarette smoking and long-term exposure to crystalline silica dust were reported to be associated with increased mortality. However, the combined effect of both factors has not been well evaluated.Methods: We investigated a retro-prospective cohort of 7,665 workers from one Chinese iron mine with a median follow-up of 42.8 years. Cumulative silica exposure was estimated for each worker by linking work histories with a job-exposure matrix. Cigarette smoking information was collected through face-to-face questionnaires. Hazard ratios (HRs) for total and cause-specific mortality due to silica exposure and smoking were estimated using Cox proportional hazards models.Results: A total of 2,814 deaths occurred during 315,772.9 person-years of follow-up. Significantly elevated mortality from all causes, cardiovascular disease, non-malignant respiratory disease and lung cancer was observed among silica-exposed workers, while elevated mortality from non-malignant respiratory disease and lung cancer was observed among smokers. Combined exposure to silica dust and cigarette smoking elevated the proportion of mortality and accounted for 21.2, 76.0, 35.7 and 81.4% of all causes, non-malignant respiratory disease, cardiovascular disease, and lung cancer, respectively. Significant additive joint effects of silica exposure and cigarette smoking on mortality from lung cancer (HR 1.893, 95% CI 0.628 to 3.441) and pneumoconiosis (6.457, 0.725 to 39.114), together with a significant multiplicative joint effect from all causes (1.002, 1.000 to 1.004) were observed.Conclusions: The present findings indicated that silica exposure in combination with cigarette smoking accounted for a fraction of extra deaths in our cohort. Our research showed the urgent need for smoking cessation and silica control among iron miners. [ABSTRACT FROM AUTHOR]

Background: Little is known about the different risk of silicosis in metal mines and pottery factories. We aimed to compare the silicosis risks among silica-exposed workers in different industrial circumstances.Research Question: Are the silicosis risks among silica-exposed workers in industrial circumstances different?Study Design and Methods: We studied 39,808 workers followed up from January 1, 1960 to December 31, 2003 in China. Cumulative respirable silica dust exposure (CDE) was estimated by linking a job-exposure matrix to personal work history. Silicosis of stage I or higher was diagnosed by Chinese pneumoconiosis Roentgen diagnostic criteria.Results: A total of 9,377 silicosis patients were diagnosed during 1,153,580.9 person-years' follow-up in the cohort. Hazard ratios of silicosis for each 1 mg/m3-year increase in CDE were 1.08 (1.07-1.08) for tungsten mines, 1.41 (1.33-1.48) for iron and copper mines, 1.14 (1.11-1.17) for tin mines, and 1.03 (1.02-1.04) for pottery factories, respectively. When exposed to 0.05 mg/m3 of respirable silica dust for 45 years, the cumulative risks in metal mines (2.3%, 9.9%, 1.5% for tungsten mines, iron and copper mines, and tin mines, respectively) were still higher than those in pottery factories (0.6%). The joint effect of silica and smoking on silicosis was more than multiplicative.Interpretation: The risk of silicosis in metal miners is higher than that in pottery workers when exposed to the same level of silica dust. The silica dust exposed years should be under 10 years for metal miners and 40 years for pottery workers at 0.05 mg/m3 to keep lifetime risk within 0.1%. Current exposure limits should take into account differences in various industrial circumstances. Smoking cessation could help reduce silicosis risk for silica-exposed workers. [ABSTRACT FROM AUTHOR]

Background: General obesity classified by body mass index has been linked to a reduction in semen quality; however, evidence on the adverse effect of central obesity on semen quality remains limited. Objectives: To investigate the association between central obesity and semen quality. Materials and methods: We conducted a cross‐sectional study of 4513 sperm donation volunteers in Guangdong Provincial Human Sperm Bank during 2018–2021. Three central obesity indicators, including waist circumference, waist‐to‐hip ratio, and waist‐to‐height ratio, were measured using a multi‐frequency bioelectrical impedance analysis for each subject. Semen analysis was conducted according to the World Health Organization laboratory manual for the examination and processing of human semen 5th edition. Linear regression models and unconditional logistic regression models were used to quantify the association between central obesity and semen parameters. Results: With adjustment for age, race, education level, marital status, fertility status, occupation, year of semen collection, abstinence period, ambient temperature, and relative humidity, central obesity defined as waist circumference ≥90 cm, waist‐to‐hip ratio ≥0.9, or waist‐to‐height ratio ≥0.5 was significantly associated with a 0.27 (95% confidence interval: 0.15, 0.38) mL, 14.47 (3.60, 25.34) × 106, 7.06 (0.46, 13.76) × 106, and 6.80 (0.42, 13.18) × 106 reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number, respectively, and a 53% (10%, 112%) increase in odds of below the World Health Organization 2010 reference value for semen volume. These associations did not significantly vary across age. Similar results were observed for central obesity defined using each of the three indicators, except that subjects with a waist circumference ≥90 cm had a slightly higher total motility (estimated change: 1.30%; 95% confidence interval: 0.27%, 2.34%) and progressive motility (estimated change: 1.27%; 95% confidence interval: 0.23%, 2.31%). Discussion and conclusion: We found that central obesity was significantly associated with a reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number. Future studies are warranted to confirm our results in other regions and populations. [ABSTRACT FROM AUTHOR]

Background The effect of exposure to extreme temperature events (ETEs) on dementia mortality remains largely unknown. We aimed to quantify the association of ETE exposure with dementia mortality. Methods We conducted a population-based, case-crossover study among 57 791 dementia deaths in Jiangsu province, China, during 2015–20. Daily mean temperatures were extracted from a validated grid dataset at each subject's residential address, and grid-specific exposures to heat wave and cold spell were assessed with a combination of their intensity and duration. We applied conditional logistic regression models to investigate cumulative and lag effects for ETE exposures. Results Exposure to ETE with each of all 24 definitions was associated with an increased odds of dementia mortality, which was higher when exposed to heat wave. Exposure to heat wave (daily mean temperature ≥95th percentile, duration ≥3 days (d); P95_3d) and cold spell (≤5th percentile, duration ≥3 d; P5_3d) was associated with a 75% (95% CI: 61%, 90%) and 30% (19%, 43%) increase in odds of dementia mortality, respectively. Definitions with higher intensity were generally associated with a higher odds of dementia mortality. We estimated that 6.14% of dementia deaths were attributable to exposure to heat wave (P90_2d) and cold spell (P10_2d). No effect modifications were observed by sex or age, except that the association for heat wave was stronger among women. Conclusions Exposure to both heat wave and cold spell was associated with an increased odds of dementia mortality. Our findings highlight that reducing individual ETE exposures may be helpful in preventing deaths from dementia, especially among women in summer. [ABSTRACT FROM AUTHOR]