To our knowledge, no study has assessed the association between heatwaves and risk of hospitalization and how it may change over time in Brazil. We quantified the heatwave-hospitalization association ...in Brazil during 2000-2015.
Daily data on hospitalization and temperature were collected from 1,814 cities (>78% of the national population) in the hottest five consecutive months during 2000-2015. Twelve types of heatwaves were defined with daily mean temperatures of ≥90th, 92.5th, 95th, or 97.5th percentiles of year-round temperature and durations of ≥2, 3, or 4 consecutive days. The city-specific association was estimated using a quasi-Poisson regression with constrained distributed lag model and then pooled at the national level using random-effect meta-analysis. Stratified analyses were performed by five regions, sex, 10 age groups, and nine cause categories. The temporal change in the heatwave-hospitalization association was assessed using a time-varying constrained distributed lag model. Of the 58,400,682 hospitalizations (59% women), 24%, 34%, 21%, and 19% of cases were aged <20, 20-39, 40-59, and ≥60 years, respectively. The city-specific year-round daily mean temperatures were 23.5 ± 2.8 °C on average, varying from 26.8 ± 1.8 °C for the 90th percentile to 28.0 ± 1.6 °C for the 97.5th percentile. We observed that the risk of hospitalization was most pronounced for heatwaves characterized by high daily temperatures and long durations across Brazil, except for the minimal association in the north (the hottest region). After controlling for temperature, the association remained for severe heatwaves in the south and southeast (cold regions). Children 0-9 years, the elderly ≥70 years, and admissions for perinatal conditions were most strongly associated with heatwaves. Over the study period, the strength of the heatwave-hospitalization association declined substantially in the south, while an apparent increase was observed in the southeast. The main limitations of this study included the lack of data on individual temperature exposure and measured air pollution.
There are geographic, demographic, cause-specific, and temporal variations in the heatwave-hospitalization associations across the Brazilian population. Considering the projected increase in frequency, duration, and intensity of heatwaves, future strategies should be developed, such as building early warning systems, to reduce the health risk associated with heatwaves in Brazil.
Background
Long-term exposure to fine particles ≤2.5 μm in diameter (PM
2.5
) has been linked to cancer mortality. However, the effect of wildfire-related PM
2.5
exposure on cancer mortality risk is ...unknown. This study evaluates the association between wildfire-related PM
2.5
and site-specific cancer mortality in Brazil, from 2010 to 2016.
Methods and findings
Nationwide cancer death records were collected during 2010–2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and non-wildfire-related PM
2.5
concentrations, at a resolution of 2.0° latitude by 2.5° longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age ≥ 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM
2.5
concentration was 2.38 μg/m
3
, and the annual non-wildfire-related PM
2.5
concentration was 8.20 μg/m
3
. The RR for mortality from all cancers was 1.02 (95% CI 1.01–1.03,
p
< 0.001) per 1-μg/m
3
increase of wildfire-related PM
2.5
concentration, which was higher than the RR per 1-μg/m
3
increase of non-wildfire-related PM
2.5
(1.01 95% CI 1.00–1.01,
p =
0.007, with
p
for difference = 0.003). Wildfire-related PM
2.5
was associated with mortality from cancers of the nasopharynx (1.10 95% CI 1.04–1.16,
p =
0.002), esophagus (1.05 95% CI 1.01–1.08,
p =
0.012), stomach (1.03 95% CI 1.01–1.06,
p =
0.017), colon/rectum (1.08 95% CI 1.05–1.11,
p <
0.001), larynx (1.06 95% CI 1.02–1.11,
p =
0.003), skin (1.06 95% CI 1.00–1.12,
p =
0.003), breast (1.04 95% CI 1.01–1.06,
p =
0.007), prostate (1.03 95% CI 1.01–1.06,
p =
0.019), and testis (1.10 95% CI 1.03–1.17,
p =
0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders.
Conclusions
Exposure to wildfire-related PM
2.5
can increase the risks of cancer mortality for many cancer sites, and the effect for wildfire-related PM
2.5
was higher than for PM
2.5
from non-wildfire sources.
Heat exposure, which will increase with global warming, has been linked to increased risk of a range of types of cause-specific hospitalizations. However, little is known about socioeconomic ...disparities in vulnerability to heat. We aimed to evaluate whether there were socioeconomic disparities in vulnerability to heat-related all-cause and cause-specific hospitalization among Brazilian cities.
We collected daily hospitalization and weather data in the hot season (city-specific 4 adjacent hottest months each year) during 2000-2015 from 1,814 Brazilian cities covering 78.4% of the Brazilian population. A time-stratified case-crossover design modeled by quasi-Poisson regression and a distributed lag model was used to estimate city-specific heat-hospitalization association. Then meta-analysis was used to synthesize city-specific estimates according to different socioeconomic quartiles or levels. We included 49 million hospitalizations (58.5% female; median interquartile range age: 33.3 19.8-55.7 years). For cities of lower middle income (LMI), upper middle income (UMI), and high income (HI) according to the World Bank's classification, every 5°C increase in daily mean temperature during the hot season was associated with a 5.1% (95% CI 4.4%-5.7%, P < 0.001), 3.7% (3.3%-4.0%, P < 0.001), and 2.6% (1.7%-3.4%, P < 0.001) increase in all-cause hospitalization, respectively. The inter-city socioeconomic disparities in the association were strongest for children and adolescents (0-19 years) (increased all-cause hospitalization risk with every 5°C increase 95% CI: 9.9% 8.7%-11.1%, P < 0.001, in LMI cities versus 5.2% 4.1%-6.3%, P < 0.001, in HI cities). The disparities were particularly evident for hospitalization due to certain diseases, including ischemic heart disease (increase in cause-specific hospitalization risk with every 5°C increase 95% CI: 5.6% -0.2% to 11.8%, P = 0.060, in LMI cities versus 0.5% -2.1% to 3.1%, P = 0.717, in HI cities), asthma (3.7% 0.3%-7.1%, P = 0.031, versus -6.4% -12.1% to -0.3%, P = 0.041), pneumonia (8.0% 5.6%-10.4%, P < 0.001, versus 3.8% 1.1%-6.5%, P = 0.005), renal diseases (9.6% 6.2%-13.1%, P < 0.001, versus 4.9% 1.8%-8.0%, P = 0.002), mental health conditions (17.2% 8.4%-26.8%, P < 0.001, versus 5.5% -1.4% to 13.0%, P = 0.121), and neoplasms (3.1% 0.7%-5.5%, P = 0.011, versus -0.1% -2.1% to 2.0%, P = 0.939). The disparities were similar when stratifying the cities by other socioeconomic indicators (urbanization rate, literacy rate, and household income). The main limitations were lack of data on personal exposure to temperature, and that our city-level analysis did not assess intra-city or individual-level socioeconomic disparities and could not exclude confounding effects of some unmeasured variables.
Less developed cities displayed stronger associations between heat exposure and all-cause hospitalizations and certain types of cause-specific hospitalizations in Brazil. This may exacerbate the existing geographical health and socioeconomic inequalities under a changing climate.
Graphitic carbon nitride (g-C3N4) and boron-doped g-C3N4 were prepared by heating melamine and the mixture of melamine and boron oxide, respectively. X-ray diffraction, X-ray photoelectron ...spectroscopy, and UV−vis spectra were used to describe the properties of as-prepared samples. The electron paramagnetic resonance was used to detect the active species for the photodegradation reaction over g-C3N4. The photodegradation mechanisms for two typical dyes, rhodamine B (Rh B) and methyl orange (MO), are proposed based on our comparison experiments. In the g-C3N4 photocatalysis system, the photodegradation of Rh B and MO is attributed to the direct hole oxidation and overall reaction, respectively; however, for the MO photodegradation the reduction process initiated by photogenerated electrons is a major photocatalytic process compared with the oxidation process induced by photogenerated holes. Boron doping for g-C3N4 can promote photodegradation of Rh B because the boron doping improves the dye adsorption and light absorption of catalyst.
The g-C3N4 photocatalyst was synthesized by directly heating the low-cost melamine. The methyl orange dye (MO) was selected as a photodegrading goal to evaluate the photocatalytic activity of ...as-prepared g-C3N4. The comparison experiments indicate that the photocatalytic activity of g-C3N4 can be largely improved by the Ag loading. The strong acid radical ion (SO4 2− or NO3 −) can promote the degrading rate of MO for g-C3N4 photocatalysis system. The MO degradation over the g-C3N4 is mainly attributed to the photoreduction process induced by the photogenerated electrons. Our results clearly indicate that the metal-free g-C3N4 has good performance in photodegradation of organic pollutant.
Abstract
To assess mortality risks and burdens associated with short-term exposure to wildfire-related fine particulate matter with diameter ≤ 2.5 μm (PM
2.5
), we collect daily mortality data from ...2000 to 2016 for 510 immediate regions in Brazil, the most wildfire-prone area. We integrate data from multiple sources with a chemical transport model at the global scale to isolate daily concentrations of wildfire-related PM
2.5
at a 0.25 × 0.25 resolution. With a two-stage time-series approach, we estimate (i) an increase of 3.1% (95% confidence interval CI: 2.4, 3.9%) in all-cause mortality, 2.6% (95%CI: 1.5, 3.8%) in cardiovascular mortality, and 7.7% (95%CI: 5.9, 9.5) in respiratory mortality over 0–14 days with each 10 μg/m
3
increase in daily wildfire-related PM
2.5
; (ii) 0.65% of all-cause, 0.56% of cardiovascular, and 1.60% of respiratory mortality attributable to acute exposure to wildfire-related PM
2.5
, corresponding to 121,351 all-cause deaths, 29,510 cardiovascular deaths, and 31,287 respiratory deaths during the study period. In this study, we find stronger associations in females and adults aged ≥ 60 years, and geographic difference in the mortality risks and burdens.
Global warming is predicted to indirectly result in more undernutrition by threatening crop production. Whether temperature rise could affect undernutrition directly is unknown. We aim to quantify ...the relationship between short-term heat exposure and risk of hospitalization due to undernutrition in Brazil.
We collected hospitalization and weather data for the hot season (the 4 adjacent hottest months for each city) from 1,814 Brazilian cities during 1 January 2000-31 December 2015. We used a time-stratified case-crossover design to quantify the association between heat exposure and hospitalization due to undernutrition. Region-specific odds ratios (ORs) were used to calculate the attributable fractions (AFs). A total of 238,320 hospitalizations for undernutrition were recorded during the 2000-2015 hot seasons. Every 1°C increase in daily mean temperature was associated with a 2.5% (OR 1.025, 95% CI 1.020-1.030, p < 0.001) increase in hospitalizations for undernutrition across lag 0-7 days. The association was greatest for individuals aged ≥80 years (OR 1.046, 95% CI 1.034-1.059, p < 0.001), 0-4 years (OR 1.039, 95% CI 1.024-1.055, p < 0.001), and 5-19 years (OR 1.042, 95% CI 1.015-1.069, p = 0.002). Assuming a causal relationship, we estimate that 15.6% of undernutrition hospitalizations could be attributed to heat exposure during the study period. The AF grew from 14.1% to 17.5% with a 1.1°C increase in mean temperature from 2000 to 2015. The main limitations of this study are misclassification of different types of undernutrition, lack of individual temperature exposure data, and being unable to adjust for relative humidity.
Our study suggests that global warming might directly increase undernutrition morbidity, by a route other than by threatening food security. This short-term effect is increasingly important with global warming. Global strategies addressing the syndemic of climate change and undernutrition should focus not only on food systems, but also on the prevention of heat exposure.
Summary
Background
Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time.
Objectives
This study aimed to clarify the ...current epidemiological characteristics and pathogen spectrum of tinea capitis in China.
Methods
A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. When necessary, the pathogens were further identified by morphology or molecular sequencing in the central laboratory.
Results
Among all enrolled patients, 74·1% of the cases were in patients aged 2–8 years. The children with tinea capitis were mainly boys (56·2%) and were more likely than adults to have a history of animal contact (57·4% vs. 35·3%, P = 0·012) and zoophilic dermatophyte infection (73·5% vs. 47%). The adults were mainly female (83%) and were more likely than children to have anthropophilic agent infection (53% vs. 23·9%). The most common pathogen was zoophilic Microsporum canis (354, 65·2%), followed by anthropophilic Trichophyton violaceum (74, 13·6%). In contrast to the eastern, western and northeastern regions, where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69%, P < 0·001), where the patients had the most tinea at other sites (20%) and dermatophytosis contact (26%) but the least animal contact (39%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang province.
Conclusions
Boys aged approximately 5 years were the most commonly affected group. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.
What is already known about this topic?
Tinea capitis is an infection of the scalp and hair caused by dermatophytes and is still common in developing countries. Prepubertal children are mainly affected.
The pathogen spectrum of tinea capitis varies across different geographical areas and changes over time.
Nationwide prospective epidemiological surveys of tinea capitis in China are rare and out of date.
What does this study add?
This study provides data concerning the epidemiological characteristics and pathogen spectrum of tinea capitis in contemporary China.
Boys aged approximately 5 years were most commonly affected and were more likely than adults to have zoophilic dermatophyte infection.
The main pathogens of tinea capitis in China are zoophilic dermatophytes, mainly Microsporum canis. In contrast to the other regions, the predominant pathogens in central China are anthropophilic dermatophytes.
Plain language summary available online
Background
Dopamine (DA) is a negative modulator of gut motility. Monoamine oxidase‐B (MAO‐B) is an important metabolic enzyme degrading DA. Rasagiline, an irreversible MAO‐B inhibitor, is used to ...treat Parkinson’s disease because of its neuroprotective effect and increasing central DA. However, it is unclear whether MAO‐B exists in the colon and rasagiline increases colonic DA, thereby affecting colonic motility.
Methods
Immunohistochemistry, western blotting, enzyme activity assay, colonic motility recording, gut transit test, and high‐performance liquid chromatography‐electrochemical detection were employed in this study.
Key Results
Monoamine oxidase‐B was distributed in the colonic muscular layers including neurons and glias of rat and human. When oral treatment of rats with rasagiline for 4 weeks, in vitro colonic motility was significantly reduced, but it was greatly reversed by SCH‐23390, an antagonist of DA D1 receptor. The rasagiline‐treated rats also manifested decreased MAO‐B activity and increased DA content in the colonic muscular layer, but no alterations were detected in the protein expressions of D1 and D2 receptors, and MAO‐A and MAO‐B, as well as in the content of 5‐hydroxytryptamine and noradrenaline. Moreover, acute administration of rasagiline did not affect the colonic motility in vitro and the colonic DA level in rats, although MAO‐B activity was significantly inhibited.
Conclusions & Inferences
Monoamine oxidase‐B is abundant in the colonic muscular layer including myenteric plexus of rat and human. Long‐term administration of rasagiline can increase colonic DA thereby inhibiting colonic motility, suggesting that colonic MAO‐B could be a potential drug target for colonic dysmotility.
Monoamine oxidase‐B was distributed in the colonic muscular layers including neurons and glias of rat and human. Long‐term treatment of rasagiline significantly inhibited colonic monoamine oxidase‐B activity and increased the dopamine content, which may contribute to colonic hypomotility.
The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 10
electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV ...energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays
. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref.
). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane
, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.
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