Environmental risk factors for dementia: a systematic review

Background - Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia. Methods - We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed. Results - We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields. Conclusions - Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations

xclim: xarray-based climate data analytics

xclim is a Python library that enables computation of climate indicators over large, hetero- geneous data sets. It is built using xarray objects and operations, can seamlessly benefit from the parallelization handling provided by dask, and relies on community conventions for data formatting and metadata attributes. xclim is meant as a tool to facilitate both climate science research and the delivery of operational climate services and products. In addition to climate indicator calculations, xclim also includes utilities for bias correction and statistical adjustment, ensemble analytics, model diagnostics, data quality assurance, and metadata standards compliance

The long-acting C5 inhibitor, Ravulizumab, is effective and safe in adult patients with atypical hemolytic uremic syndrome naïve to complement inhibitor treatment.

Ravulizumab is a long-acting C5 inhibitor engineered from eculizumab with increased elimination half-life, allowing an extended dosing interval from two to eight weeks. Here we evaluate the efficacy and safety of ravulizumab in adults with atypical hemolytic uremic syndrome presenting with thrombotic microangiopathy. In this global, phase 3, single arm study in complement inhibitor-naïve adults (18 years and older) who fulfilled diagnostic criteria for atypical hemolytic uremic syndrome, enrolled patients received ravulizumab through a 26-week initial evaluation period. The primary endpoint was complete thrombotic microangiopathy response defined as normalization of platelet count and lactate dehydrogenase and 25% or more improvement in serum creatinine. Secondary endpoints included changes in hematologic variables and renal function. Safety was also evaluated. Ravulizumab treatment resulted in an immediate, complete, and sustained C5 inhibition in all patients. Complete thrombotic microangiopathy response was achieved in 53.6% of patients. Normalization of platelet count, lactate dehydrogenase and 25% or more improvement in serum creatinine was achieved in 83.9%, 76.8% and 58.9% of patients, respectively. Improvement in estimated glomerular filtration rate by one or more stage was achieved in 68.1% of patients by day 183. No unexpected adverse events were reported across a safety analysis set of 58 patients. Four deaths occurred (three within one month of study initiation, including one in a patient excluded based on eligibility criteria after the first dose) with none considered treatment-related by the study investigator. Thus, treatment with ravulizumab once every eight weeks resulted in rapidly improved hematologic and renal endpoints with no unexpected adverse events in adults with atypical hemolytic uremic syndrome

Ouranosinc/xclim: v0.41.0

Contributors to this version: Trevor James Smith (@Zeitsperre), Pascal Bourgault (@aulemahal), Ludwig Lierhammer (@ludwiglierhammer), Éric Dupuis (@coxipi). New features and enhancements New properties xclim.sdba.properties.decorrelation_length and xclim.sdba.properties.transition_probability. (PR/1252) New indicators ensembles.change_significance now supports Mann-whitney U-test and flexible realization. (PR/1285). New indices and indicators for converting from snow water equivalent to snow depth (snw_to_snd) and snow depth to snow water equivalent (snd_to_snw) using snow density [kg / m^3]. (PR/1271). New indices and indicators for determining upwelling radiation (shortwave_upwelling_radiation_from_net_downwelling and longwave_upwelling_radiation_from_net_downwelling; CF variables rsus and rlus) from net and downwelling radiation (shortwave: rss and rsds; longwave: rls and rlds). (PR/1271). New indice and indicator {snd | snw}_season_{length | start | end} which generalize snow_cover_duration and continuous_snow_cover_{start | end} to allow using these functions with variable snw (PR/1275). New indice and indicator (dryness_index) for estimating soil humidity classifications for winegrowing regions (based on Riou et al. (1994)). (GH/355, PR/1235). Breaking changes xclim testing default behaviours have been changed (GH/1295, PR/1297): Running pytest will no longer use pytest-xdist distributed testing be default (can be set with -n auto|logical|#. Coverage is also no longer gathered/reported by default. Running tox will now set pytest-xdist to use -n logical processes (with a max of 10). Default behaviour for testing is to no longer always fetch xclim-testdata. If testdata is found in $HOME/.xclim_testing_data, files will be copied to individual processes, otherwise, will be fetched as needed. Environment variables evaluated when running pytest have been changed (GH/1295, PR/1297): For testing against specific branches of xclim-testdata: MAIN_TESTDATA_BRANCH -&gt; XCLIM_TESTDATA_BRANCH The option to skip fetching of testdata (SKIP_TEST_DATA) has been removed A new environment variable (XCLIM_PREFETCH_TESTING_DATA) is now available to gather xclim-testdata before running test ensemble (default: False). Environment variables are now passed to tox on execution. Bug fixes build_indicator_module_from_yaml now accepts a reload argument. When re-building a module that already exists, reload=True removes all previous indicator before creating the new ones. (GH/1192, PR/1284). The test for French translations of official indicators was fixed and translations for CFFWIS indices, FFDI, KDBI, DF and Jetstream metric woollings have been added or fixed. (PR/1271). use_ufunc in windowed_run_count is now supplied with argument freq to warn users that the 1d method does not support resampling after run length operations (GH/1279, PR/1291). {snd | snw}_max_doy now avoids an error due to xr.argmax when there are all-NaN slices. (PR/1277). Internal changes xclim has adopted PEP 517 and PEP 621 (pyproject.toml using the flit backend) to replace the legacy setup.py used to manage package organisation and building. Many tooling configurations that already supported the pyproject.toml standard have been migrated to this file. CI and development tooling documentation has been updated to reflect these changes. (PR/1278, suggested from PyOpenSci Software Review). Documentation source files have been moved around to remove some duplicated image files. (PR/1278). Coveralls GitHub Action removed as it did not support pyproject.toml-based configurations. (PR/1278). Add a remark about how xclim's CFFWIS is different from the original 1982 implementation. (GH/1104, PR/1284). Update CI runs to use Python3.9 when examining upstream dependencies. Replace setup-conda action with provision-with-micromamba action. (PR/1286). Update CI runs to always use tox~=4.0 and the latest virtual machine images (now ubuntu-22.04). (PR/1288, PR/1297). SBCK installation command now points to the official development repository. (PR/1288). Some references in the BibTeX were updated to point to better resources. (PR/1288). Add a GitHub CI workflow for performing dependency security review scanning. (PR/1287). Grammar and spelling corrections were applied to some docstrings. (PR/1271). Added [radiation] ([power] / [area]) to list of defined acceptable units. (PR/1271). Updated testing data used to generate the atmosds dataset to use more reproducibly-converted ERA5 data, generated with the miranda Python package. (PR/1269). Updated testing dependencies to use pytest-xdist&gt;=3.2, allowing for the new --dist=worksteal scheduler for distributing the pool of remaining tests across workers after individual workers have exhausted their own queues. (PR/1235). Adding infer context to the unit conversion in of the training of ExtremeValues. (PR/1299). Added sphinxcontrib-svg2pdfconverter for converting SVG graphics within documentation to PDF-compatible images. (PR/1296). README badges for supported Python versions and repository health have been added. (GH/1304, PR/1307). </ul

Ouranosinc/xclim: v0.42.0

Contributors to this version: Trevor James Smith (@Zeitsperre), Juliette Lavoie (@juliettelavoie), Éric Dupuis (@coxipi), Pascal Bourgault (@aulemahal). Announcements xclim now supports testing against tagged versions of Ouranosinc/xclim-testdata &lt;https://github.com/Ouranosinc/xclim-testdata&gt;_ in order to support older versions of xclim. For more information, see the Contributing Guide for more details. (PR/1339). xclim v0.42.0 will be the last version to explicitly support Python3.8. (GH/1268, PR/1344). New features and enhancements Two previously private functions for selecting a day of year in a time series when performing calendar conversions are now exposed. (GH/1305, PR/1317). New functions are: xclim.core.calendar.yearly_interpolated_doy xclim.core.calendar.yearly_random_doy scipy is no longer pinned below v1.9 and lmoments3&gt;=1.0.5 is now a core dependency and installed by default with pip. (GH/1142, PR/1171). Fix bug on number of bins in xclim.sdba.propeties.spatial_correlogram. (PR/1336) Add resample_before_rl argument to control when resampling happens in maximum_consecutive_{frost|frost_free|dry|tx}_days and in heat indices (in _threshold) (GH/1329, PR/1331) Add xclim.ensembles.make_criteria to help create inputs for the ensemble-reduction methods. (GH/1338, PR/1341). Bug fixes Warnings emitted from regular usage of some indices (snowfall_approximation with method="brown", effective_growing_degree_days) due to successive convert_units_to calls within their logic have been silenced. (PR/1319). Fixed a bug that prevented the use of the sdba_encode_cf option with xarray 2023.3.0 (PR/1333). Fixed bugs in xclim.core.missing and xclim.sdba.base.Grouper when using pandas 2.0. (PR/1344). Breaking changes The call signatures for xclim.ensembles.create_ensemble and xclim.ensembles._base._ens_align_dataset have been deprecated. Calls to these functions made with the original signature will emit warnings. Changes will become breaking in xclim&gt;=0.43.0.(GH/1305, PR/1317). Affected variable: mf_flag (bool) -&gt; multifile (bool) The indice and indicator for last_spring_frost has been modified to use tasmin by default, reflecting its docstring and literature definition (GH/1324, PR/1325). following indices now accept the op argument for modifying the threshold comparison operator (PR/1325): snw_season_length, snd_season_length, growing_season_length, frost_season_length, frost_free_season_length, rprcptot, daily_pr_intensity In order to support older environments, pandas is now conditionally pinned below v2.0 when installing xclim on systems running Python3.8. (PR/1344). Bug fixes xclim.indices.run_length.last_run nows works when freq is not None. (GH/1321, PR/1323). Internal changes Added xclim to the ouranos Zenodo community . (PR/1313). Significant documentation adjustments. (GH/1305, PR/1308): The CONTRIBUTING page has been moved to the top level of the repository. Information concerning the licensing of xclim is clearly indicated in README. sphinx-autodoc-typehints is now used to simplify call signatures generated in documentation. The SDBA module API is now found with the rest of the User API documentation. HISTORY.rst has been renamed CHANGES.rst, to follow dask-like conventions. Hyperlink targets for individual indices and indicators now point to their entries under API or Indices. Module-level docstrings have migrated from the library scripts directly into the documentation RestructuredText files. The documentation now includes a page explaining the reasons for developing xclim and a section briefly detailing similar and related projects. Markdown explanations in some Jupyter Notebooks have been edited for clarity Removed Mapping abstract base class types in call signatures (dict variables were always expected). (PR/1308). Changes in testing setup now prevent test_mean_radiant_temperature from sometimes causing a segmentation fault. (GH/1303, PR/1315). Addressed a formatting bug that caused Indicators with multiple variables returned to not be properly formatted in the documentation. (GH/1305, PR/1317). tox now include sbck and eofs flags for easier testing of dependencies. CI builds now test against sbck-python @ master. (PR/1328). upstream CI tests are now run on push to master, at midnight, and can also be triggered via workflow_dispatch. Failures from upstream build will open issues using xarray-contrib/issue-from-pytest-log. (PR/1327). Warnings from set _version_deprecated within Indicators now emit FutureWarning instead of DeprecationWarning for greater visibility. (PR/1319). The Graphics section of the Usage notebook has been expanded upon while grammar and spelling mistakes within the notebook-generated documentation have been reduced. (GH/1335, PR/1338, suggested from PyOpenSci Software Review). The Contributing guide now lists three separate subsections to help users understand the gains from optional dependencies. (GH/1335, PR/1338, suggested from PyOpenSci Software Review). </ul