The effect of alpha-linolenic acid supplementation on ADHD symptoms in children: a randomized controlled double-blind study

Background: Attention deficit-hyperactivity disorder (ADHD) is the most common neuro-developmental disorder in childhood. Its pharmacologic treatment mostly includes methylphenidate, yet many parents seek alternative, “natural,” therapeutic options, commonly omega-3 fatty acids. Previous studies of supplementation with fish oil or long-chain omega-3 fatty acids to children with ADHD yielded mixed results. The use of alpha-linolenic acid (ALA), a medium-chained, plant-based omega-3 fatty acid (18:3 n-3), has not been sufficiently examined in this population. Methods: Forty untreated children with ADHD, aged 6–16 years, were randomized to receive either 2 g/day of oil containing 1 g ALA or placebo, for 8 weeks. Before and after supplementation, the children underwent a physician assessment of ADHD symptoms and a computerized continuous performance functions test. The children’s parents and teachers filled out Conners’ and DSM questionnaires. Results: Seventeen (42.5%) children completed the study, eight in the supplementation group, nine in the placebo group. Main drop-out reasons were capsule size, poor compliance, and a sense of lack of effect. No significant difference was found in any of the measured variables tested before and after supplementation, in both study groups. No between-group difference was found in the changes of the various measures of ADHD symptoms throughout the study period. Conclusion: Supplementation of 2 g/day of oil containing 1 g ALA did not significantly reduce symptoms in children with ADHD. Future studies in this field should consider an alternative method to deliver the oil, a higher dose, and a larger sample size

Joint effect of heat and air pollution on mortality in 620 cities of 36 countries

Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. Methods: We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. Results: We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. Conclusions: Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.Funding: Massimo Stafoggia, Francesca K. de’ Donato, Masna Rai and Alexandra Schneider were partially supported by the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655). Jan Kyselý and Aleš Urban were supported by the Czech Science Foundation project (22-24920S). Joana Madureira was supported by the Fundação para a Ciência e a Tecnologia (FCT) (grant SFRH/BPD/115112/2016). Masahiro Hashizume was supported by the Japan Science and Technology Agency (JST) as part of SICORP, Grant Number JPMJSC20E4. Noah Scovronick was supported by the NIEHS-funded HERCULES Center (P30ES019776). South African Data were provided by Statistics South Africa, which did not have any role in conducting the study. Antonio Gasparrini was supported by the Medical Research Council-UK (Grants ID: MR/V034162/1 and MR/R013349/1), the Natural Environment Research Council UK (Grant ID: NE/R009384/1), and the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655).info:eu-repo/semantics/publishedVersio

Seasonality of mortality under climate change: a multicountry projection study

A warming climate can substantially change the seasonality of mortality in the future. Our projections suggest that health-care systems should consider preparing for a potentially increased demand during warm seasons and sustained high demand during cold seasons, particularly in regions characterised by arid, temperate, and continental climates

Global, regional, and national burden of mortality associated with cold spells during 2000–19: a three-stage modelling study

Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells

Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities: two stage time series analysis

OBJECTIVE: To investigate potential interactive effects of fine particulate matter (PM2.5) and ozone (O3) on daily mortality at global level. DESIGN: Two stage time series analysis. SETTING: 372 cities across 19 countries and regions. POPULATION: Daily counts of deaths from all causes, cardiovascular disease, and respiratory disease. MAIN OUTCOME MEASURE: Daily mortality data during 1994-2020. Stratified analyses by co-pollutant exposures and synergy index (>1 denotes the combined effect of pollutants is greater than individual effects) were applied to explore the interaction between PM2.5 and O3 in association with mortality. RESULTS: During the study period across the 372 cities, 19.3 million deaths were attributable to all causes, 5.3 million to cardiovascular disease, and 1.9 million to respiratory disease. The risk of total mortality for a 10 μg/m3 increment in PM2.5 (lag 0-1 days) ranged from 0.47% (95% confidence interval 0.26% to 0.67%) to 1.25% (1.02% to 1.48%) from the lowest to highest fourths of O3 concentration; and for a 10 μg/m3 increase in O3 ranged from 0.04% (-0.09% to 0.16%) to 0.29% (0.18% to 0.39%) from the lowest to highest fourths of PM2.5 concentration, with significant differences between strata (P for interaction <0.001). A significant synergistic interaction was also identified between PM2.5 and O3 for total mortality, with a synergy index of 1.93 (95% confidence interval 1.47 to 3.34). Subgroup analyses showed that interactions between PM2.5 and O3 on all three mortality endpoints were more prominent in high latitude regions and during cold seasons. CONCLUSION: The findings of this study suggest a synergistic effect of PM2.5 and O3 on total, cardiovascular, and respiratory mortality, indicating the benefit of coordinated control strategies for both pollutants

The Multi-Country Multi-City Collaborative Research Network An international research consortium investigating environment, climate, and health

Research on the health risks of environmental factors and climate change requires epidemiological evidence on associated health risks at a global scale. Multi-center studies offer an excellent framework for this purpose, but they present various methodological and logistical problems. This contribution illustrates the experience of the Multi-Country Multi-City Collaborative Research Network, an international collaboration working on a global research program on the associations between environmental stressors, climate, and health in a multi-center setting. The article illustrates the collaborative scheme based on mutual contribution and data and method sharing, describes the collection of a huge multi-location database, summarizes published research findings and future plans, and discusses advantages and limitations. The Multi-Country Multi-City represents an example of a collaborative research framework that has greatly contributed to advance knowledge on the health impacts of climate change and other environmental factors and can be replicated to address other research questions across various research fields.The MCC Collaborative Research Network: Antonio Gasparrini, London School of Hygiene & Tropical Medicine, London, UK; Michelle Bell, Yale University, New Haven CT, USA; Yuming Guo, Monash University, Melbourne, Australia; Yasushi Honda, National Institute for Environmental Studies, Tsukuba, Japan; Veronika Huber, LMU Munich, Munich, Germany; Jouni J. K. Jaakkola, University of Oulu, Oulu, Finland; Aleš Urban, Czech Academy of Sciences, Prague, Czech Republic; Ana Maria Vicedo-Cabrera, University of Bern, Bern, Switzerland; Pierre Masselot, London School of Hygiene & Tropical Medicine, London, UK; Francesco Sera, University of Florence, Florence, Italy; Rosana Abrutzky, Universidad de Buenos Aires, Buenos Aires, Argentina; Shilu Tong, Chinese Center for Disease Control and Prevention, Beijing, China; Micheline de Sousa Zanotti Stagliorio Coelho, University of São Paulo, São Paulo, Brazil; Paulo Hilario Nascimento Saldiva, NSPER, São Paulo, Brazil; Eric Lavigne, University of Ottawa, Ottawa, Canada; Patricia Matus Correa, Universidad de los Andes, Santiago, Chile; Nicolás Valdés Ortega, Universidad Católica de Chile, Santiago, Chile; Haidong Kan, Fudan University, Shanghai, China; Samuel Osorio, University of São Paulo, São Paulo, Brazil; Dominic Roye, Climate Research Foundation, Madrid, Spain; Souzana Achilleos, University of Nicosia Medical School, Nicosia, Cyprus; Jan Kyselý, Czech Academy of Sciences, Prague, Czech Republic; Hans Orru, University of Tartu, Tartu, Estonia; Ene Indermitte, University of Tartu, Tartu, Estonia; Marek Maasikmets, Estonian Environmental Research Centre, Tallinn, Estonia; Niilo Ryti, University of Oulu, Oulu, Finland; Mathilde Pascal, Santé Publique France, Saint Maurice, France; Alexandra Schneider, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany; Susanne Breitner, LMU Munich, Munich, Germany; Klea Katsouyanni, National and Kapodistrian University of Athens, Greece, and Imperial College, London; Antonis Analitis, National and Kapodistrian University of Athens, Greece; Evangelia Samoli, National and Kapodistrian University of Athens, Greece; Hanne Krage Carlsen, University of Gothenburg, Gothenburg, Sweden; Fatemeh Mayvaneh, University of Münster, Münster, Germany; Alireza Entezari, Hakim Sabzevari University, Khorasan Razavi, Iran; Patrick Goodman, Technological University Dublin, Ireland; Ariana Zeka, UK Health Security Agency, London, UK; Raanan Raz, The Hebrew University of Jerusalem, Israel; Paola Michelozzi, Lazio Regional Health Service, Rome, Italy; Francesca de’Donato, Lazio Regional Health Service, Rome, Italy; Matteo Scortichini, Lazio Regional Health Service, Rome, Italy; Massimo Stafoggia, Lazio Regional Health Service, Rome, Italy; Masahiro Hashizume, The University of Tokyo, Tokyo, Japan; Yoonhee Kim, University of Tokyo, Tokyo, Japan; Chris Fook Sheng Ng, The University of Tokyo, Tokyo, Japan; Barrak Alahmad, Harvard University, Boston, MA, USA; John Paul Cauchy, Malta; Magali Hurtado Diaz, National Institute of Public Health, Cuernavaca, Mexico; Eunice Elizabeth Félix Arellano, National Institute of Public Health, Cuernavaca, Mexico; Ala Overcenco, National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Moldova; Jochem Klompmaker, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Shilpa Rao, Norwegian Institute of Public Health, Oslo, Norway; Gabriel Carrasco, Universidad Peruana Cayetano Heredia, Lima, Peru; Xerxes Seposo, Hokkaido University, Sapporo, Japan; Paul Lester Carlos Chua, The University of Tokyo, Tokyo, Japan; Susana das Neves Pereira da Silva, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal; Joana Madureira, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; Iulian-Horia Holobaca, Babes-Bolay University, Cluj-Napoca, Romania; Ivana Cvijanovic, Barcelona Institute for Global Health, Barcelona, Spain; Malcolm Mistry, London School of Hygiene & Tropical Medicine, London, UK; Noah Scovronick, Emory University, Atlanta, USA; Fiorella Acquaotta, University of Torino, Italy; Rebecca M. Garland, University of Pretoria, Pretoria, South Africa; Ho Kim, Seoul National University, Seoul, South Korea; Whanhee Lee, Pusan National University, Yangsan, South Korea; Aurelio Tobias, Spanish Council for Scientific Research, Barcelona, Spain; Carmen Íñiguez, Universitat de València, Spain; Bertil Forsberg, Umeå University, Umeå, Sweden; Martina S. Ragettli, Swiss Tropical and Public Health Institute, Allschwill, Switzerland; Yue Leon Guo, National Taiwan University College of Medicine, Taipei, Taiwan; Shih-Chun Pan, National Health Research Institutes, Zhunan, Taiwan; Shanshan Li, Monash University, Melbourne, Australia; Ben Armstrong, London School of Hygiene & Tropical Medicine, London, United Kingdom; Valentina Colistro, University of the Republic, Montevideo, Uruguay; Antonella Zanobetti, Harvard University, Boston, MA, USA; Joel Schwartz, Harvard University, Boston, MA, USA; Tran Ngoc Dang, Duy Tan University, Da Nang, Vietnam; Do Van Dung, University of Medicine and Pharmacy, Ho Chi Minh City, VietNam). Past members: Simona Fratianni, University of Torino, Italy; Julio Cesar Cruz, National Institute of Public Health, Cuernavaca, Mexico; Caroline Ameling, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Daniel Oudin Åström, Umeå University, Umeå, Sweden.Peer reviewe