The Challenge of Urban Heat Exposure under Climate Change: An Analysis of Cities in the Sustainable Healthy Urban Environments (SHUE) Database

The so far largely unabated emissions of greenhouse gases (GHGs) are expected to increase global temperatures substantially over this century. We quantify the patterns of increases for 246 globally-representative cities in the Sustainable Healthy Urban Environments (SHUE) database. We used an ensemble of 18 global climate models (GCMs) run under a low (RCP2.6) and high (RCP8.5) emissions scenario to estimate the increase in monthly mean temperatures by 2050 and 2100 based on 30-year averages. Model simulations were from the Coupled Model Inter-comparison Project Phase 5 (CMIP5). Annual mean temperature increases were 0.93 degrees Celsius by 2050 and 1.10 degrees Celsius by 2100 under RCP2.6, and 1.27 and 4.15 degrees Celsius under RCP8.5, but with substantial city-to-city variation. By 2100, under RCP2.6 no city exceeds an increase in Tmean > 2 degrees Celsius (relative to a 2017 baseline), while all do under RCP8.5, some with increases in Tmean close to, or even greater than, 7 degrees Celsius. The increases were greatest in cities of mid to high latitude, in humid temperate and dry climate regions, and with large seasonal variation in temperature. Cities are likely to experience large increases in hottest month mean temperatures under high GHG emissions trajectories, which will often present substantial challenges to adaptation and health protection

Planting Prosperity and Harvesting Health: Trade-offs and Sustainability in the Oregon-Washington Regional Food System

This assessment reveals food system sustainability trends in Oregon and Washington, focusing specifically on the producers in both states and the consumers in the Portland- Vancouver region. We began the assessment by asking a group of food system stakeholders from Oregon and Washington to define broadly supported goals for a sustainable food system. They also helped us identify the data necessary to understand trends in the food system. This information can be used in the future to establish benchmarks and to assess future progress toward food system sustainability goals. Framed by stakeholder concerns, this report will assist program and policy decision makers in prioritizing efforts to shape and strengthen the regional food system. This information is also a foundation for building new and unique partnerships among organizations in food system planning

Environmental Risks of Cities in the European Region:Analyses of the Sustainable Healthy Urban Environments (SHUE) Database

Introduction: In an increasingly urbanized world, cities are a key focus for action on health and sustainability. The Sustainable Healthy Urban Environments (SHUE) project aims to provide a shared information resource to support such action. Its aim is to test the feasibility and methods of assembling data about the characteristics of a globally distributed sample of cities and the populations within them for comparative analyses, and to use such data to assess how policies may contribute to sustainable urban development and human health. Methods: As a first illustration of the database, we present analyses of selected parameters on climate change, air pollution and flood risk for 64 cities in the WHO European Region. Results: Under a high greenhouse gas emissions trajectory (RCP8.5), the analyses suggest damaging temperature rises in European cities that are among the highest of any cities in the global database, while air pollution (PM2.5) levels are appreciably above the WHO guideline level for all but a handful of cities. In several areas, these environmental hazards are compounded by flood risk. Discussion: Such evidence, though preliminary and based on limited data, underpins the need for urgent action on climate change (adaptation and mitigation) and risks relating to air pollution and other environmental hazards

Blind Test of Methods for Obtaining 2-D Near-Surface Seismic Velocity Models from First-Arrival Traveltimes

Seismic refraction methods are used in environmental and engineering studies to image the shallow subsurface. We present a blind test of inversion and tomographic refraction analysis methods using a synthetic first-arrival-time dataset that was made available to the community in 2010. The data are realistic in terms of the near-surface velocity model, shot-receiver geometry and the data’s frequency and added noise. Fourteen estimated models were determined by ten participants using eight different inversion algorithms, with the true model unknown to the participants until it was revealed at a session at the 2011 SAGEEP meeting. The estimated models are generally consistent in terms of their large-scale features, demonstrating the robustness of refraction data inversion in general, and the eight inversion algorithms in particular. When compared to the true model, all of the estimated models contain a smooth expression of its two main features: a large offset in the bedrock and the top of a steeply dipping low-velocity fault zone. The estimated models do not contain a subtle low-velocity zone and other fine-scale features, in accord with conventional wisdom. Together, the results support confidence in the reliability and robustness of modern refraction inversion and tomographic Methods

Array-based sequencing of filaggrin gene for comprehensive detection of disease-associated variants

The filaggrin gene (FLG) is essential for skin differentiation and epidermal barrier formation. FLG loss-of-function (LoF) variants are associated with ichthyosis vulgaris and the major genetic risk factor for developing atopic dermatitis (AD).1, 2, 3 Genetic stratification of patients with AD according to FLG LoF risk is a common practice for both research and clinical studies; however, few studies comprehensively sequence the entire FLG coding region. Most studies that include FLG genotyping have screened for common predominant LoF variants to report allele frequencies after full Sanger sequencing of a smaller batch of test patient samples or previously published data. This strategy potentially results in underreporting of the genetic contribution especially in ethnicities where FLG LoF variants are highly diverse.4 Distinct LoF variants have been reported for most ethnicities studied to date. For example, 2 predominant sequence variants (p.R501X and c.2282del4) make up approximately 80% of the mutation burden in northern Europeans,5 whereas in East Asian ethnicities, a larger FLG LoF mutation spectrum is found with fewer predominating variants.6, 7 However, routinely Sanger sequencing the entire FLG coding region for large cohorts is not always feasible, although desirable as it is essential to correctly stratify patients. To address this, we developed a robust and cost-effective high-throughput PCR-based method for analyzing the entire coding region of FLG using Fluidigm microfluidics technology and next-generation sequencing (NGS). We have applied this method to fully resequence cohorts of Chinese, Malay, and Indian patients with AD from the Singaporean population.ASTAR (Agency for Sci., Tech. and Research, S’pore)Published versio

Author Correction: Cross-ancestry genome-wide association analysis of corneal thickness strengthens link between complex and Mendelian eye diseases.

Emmanuelle Souzeau, who contributed to analysis of data, was inadvertently omitted from the author list in the originally published version of this Article. This has now been corrected in both the PDF and HTML versions of the Article

Prescribing costs of hypoglycaemic agents and associations with metabolic control in Wales; a national analysis of primary care data

Aims: There has been a dramatic increase in hypoglycaemic agent expenditure. We assessed the variability in prescribing costs at the practice level and the relationship between expenditure and the proportion of patients achieving target glycaemic control. Methods: We utilized national prescribing data from 406 general practices in Wales. This was compared against glycaemic control (percentage of patients achieving a HbA1c level < 59 mmol/mol in the preceding 12 months). Analyses were adjusted for the number of patients with diabetes in each general practice and the Welsh Index of Multiple Deprivation. Results: There was considerable heterogeneity in hypoglycaemic agent spend per patient with diabetes, Median = £289 (IQR 247–343) range £31.1–£1713. Higher total expenditure was not associated with improved glycaemic control B(std) = −0.01 (95%CI –0.01, 0.002) p = 0.13. High‐spend practices spent more on SGLT2 inhibitors (16 vs. 9% p < 0.001) and GLP‐1 agonists (13 vs. 11% p < 0.001) and less on insulin (34 vs. 42% p < 0.001), biguanides (9 vs. 11% p = 0.001) and sulphonylureas (2 vs. 3% p < 0.001) than low spend practices. There were no differences in the pattern of drug prescribing between high spend practices with better glycaemic control (mean 68% of patients HbA1c <59 mmol/mol) and those with less good metabolic control (mean 58% of patients HbA1c <59 mmol/mol). Conclusions: Spend on hypoglycaemic agents is highly variable between practices and increased expenditure per patient is not associated with better glycaemic control. Whilst newer, more expensive agents have additional benefits, in individuals where these advantages are more marginal widespread use of these agents has important cost implications