The burden of disease in Greece, health loss, risk factors, and health nancing, 2000–16: an analysis of the Global Burden of Disease Study 2016

Background Following the economic crisis in Greece in 2010, the country's ongoing austerity measures include a substantial contraction of health-care expenditure, with reports of subsequent negative health consequences. A comprehensive evaluation of mortality and morbidity is required to understand the current challenges of public health in Greece. Methods We used the results of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to describe the patterns of death and disability among those living in Greece from 2000 to 2010 (pre-austerity) and 2010 to 2016 (post-austerity), and compared trends in health outcomes and health expenditure to those in Cyprus and western Europe. We estimated all-cause mortality from vital registration data, and we calculated cause-specific deaths and years of life lost. Age-standardised mortality rates were compared using the annualised rate of change (ARC). Mortality risk factors were assessed using a comparative risk assessment framework for 84 risk factors and clusters to calculative summary exposure values and population attributable fraction statistics. We assessed the association between trends in total, government, out-of-pocket, and prepaid public health expenditure and all-cause mortality with a segmented correlation analysis. Findings All-age mortality in Greece increased from 944·5 (95% uncertainty interval [UI] 923·1–964·5) deaths per 100 000 in 2000 to 997·8 (975·4–1018) in 2010 and 1174·9 (1107·4–1243·2) in 2016, with a higher ARC after 2010 and the introduction of austerity (2·72% [1·65 to 3·74] for 2010–16) than before (0·55% [0·24 to 0·85] for 2000–10) or in western Europe during the same period (0·86% [0·54 to 1·17]). Age-standardised reduction in ARC approximately halved from 2000–10 (−1·61 [95% UI −1·91 to −1·30]) to 2010–16 (−0·87% [–2·03 to 0·20]), with post-2010 ARC similar to that in Cyprus (−0·86% [–1·4 to −0·36]) and lower than in western Europe (−1·14% [–1·48 to −0·81]). Mortality changes in Greece coincided with a rapid decrease in government health expenditure, but also with aggregate population ageing from 2010 to 2016 that was faster than observed in Cyprus. Causes of death that increased were largely those that are responsive to health care. Comparable temporal and age patterns were noted for non-fatal health outcomes, with a somewhat faster rise in years lived with disability since 2010 in Greece compared with Cyprus and western Europe. Risk factor exposures, especially high body-mass index, smoking, and alcohol use, explained much of the mortality increase in Greek adults aged 15–49 years, but only explained a minority of that in adults older than 70 years. Interpretation The findings of increases in total deaths and accelerated population ageing call for specific focus from health policy makers to ensure the health-care system is equipped to meet the needs of the people in Greece

On the effect of upwind emission controls on ozone in Sequoia National Park

Ozone (O3) air pollution in Sequoia National Park (SNP) is among the worst of any national park in the US. SNP is located on the western slope of the Sierra Nevada Mountains downwind of the San Joaquin Valley (SJV), which is home to numerous cities ranked in the top 10 most O3-polluted in the US. Here, we investigate the influence of emission controls in the SJV on O3 concentrations in SNP over a 12-year time period (2001–2012). We show that the export of nitrogen oxides (NOx) from the SJV has played a larger role in driving high O3 in SNP than transport of O3. As a result, O3 in SNP has been more responsive to NOx emission reductions than in the upwind SJV city of Visalia, and O3 concentrations have declined faster at a higher-elevation monitoring station in SNP than at a low-elevation site nearer to the SJV. We report O3 trends by various concentration metrics but do so separately for when environmental conditions are conducive to plant O3 uptake and for when high O3 is most common, which are time periods that occur at different times of day and year. We find that precursor emission controls have been less effective at reducing O3 concentrations in SNP in springtime, which is when plant O3 uptake in Sierra Nevada forests has been previously measured to be greatest. We discuss the implications of regulatory focus on high O3 days in SJV cities for O3 concentration trends and ecosystem impacts in SNP.</p

Structural and biochemical characterization of the environmental MBLs MYO-1, ECV-1 and SHD-1

BACKGROUND: MBLs form a large and heterogeneous group of bacterial enzymes conferring resistance to β-lactam antibiotics, including carbapenems. A large environmental reservoir of MBLs has been identified, which can act as a source for transfer into human pathogens. Therefore, structural investigation of environmental and clinically rare MBLs can give new insights into structure-activity relationships to explore the role of catalytic and second shell residues, which are under selective pressure. OBJECTIVES: To investigate the structure and activity of the environmental subclass B1 MBLs MYO-1, SHD-1 and ECV-1. METHODS: The respective genes of these MBLs were cloned into vectors and expressed in Escherichia coli. Purified enzymes were characterized with respect to their catalytic efficiency (kcat/Km). The enzymatic activities and MICs were determined for a panel of different β-lactams, including penicillins, cephalosporins and carbapenems. Thermostability was measured and structures were solved using X-ray crystallography (MYO-1 and ECV-1) or generated by homology modelling (SHD-1). RESULTS: Expression of the environmental MBLs in E. coli resulted in the characteristic MBL profile, not affecting aztreonam susceptibility and decreasing susceptibility to carbapenems, cephalosporins and penicillins. The purified enzymes showed variable catalytic activity in the order of &lt;5% to ∼70% compared with the clinically widespread NDM-1. The thermostability of ECV-1 and SHD-1 was up to 8\ub0C higher than that of MYO-1 and NDM-1. Using solved structures and molecular modelling, we identified differences in their second shell composition, possibly responsible for their relatively low hydrolytic activity. CONCLUSIONS: These results show the importance of environmental species acting as reservoirs for MBL-encoding genes

Forum : Populism, Identity Politics, and the Archaeology of Europe

SSR gratefully acknowledges M.J. Walsh, J.-L. Renaud, and another anonymous col- league for comments on this manuscript. MB would like to thank P. Pavúk, N. Vlhová, and M. Havlíková for reading and commenting on his paper. KK grate- fully acknowledges the editorial help of his friend Sappho Haralambous-Howe. Naturally, the views and opinions expressed here are those of the authors and do not reflect the official policy or position of other agencies.Peer reviewedPublisher PD

Development and testing of a novel sulfur dioxide sonde

A novel technique has been developed to measure sulfur dioxide (SO2) using a modification of the existing electrochemical concentration cell (ECC) ozonesonde technology. The current sonde-based method to measure SO2 (i.e., the dual-sonde approach) involves launching two ozonesondes together, with one of the sondes having a filter to remove SO2 at the inlet. The SO2 profile is determined by taking the difference between the measurements from the two instruments. The dual-sonde method works well in typical tropospheric conditions when [O3]&gt;[SO2] but saturates when [SO2]&gt;[O3] and has large uncertainties in the upper troposphere and lower stratosphere that would limit its effectiveness in measuring SO2 from an explosive volcanic eruption. Due to these limitations, several modifications were made to create a single-sonde system that would directly measure SO2 (i.e., the SO2 sonde). These modifications included (1) a positively biased ECC current, (2) the addition of an O3 removal filter, and (3) the addition of a sample dryer. The SO2 sonde measures SO2 as a reduction in the cell current. There was a strong correlation (r2&gt;0.94) between the SO2 sonde and a Thermo 43c analyzer during controlled laboratory tests and pre-flight tests. Varying humidity levels affected the SO2 sonde's sensitivity (avg =84.6±31.7 ppbv µA−1, 1σ RSD =37 %) during initial field tests, which was resolved by adding a sample dryer upstream of the O3 removal filter and pump inlet. This modification significantly reduced the variability and increased the sensitivity of the SO2 measurements (avg =47±5.8 ppbv µA−1, 1σ RSD =12 %). Field tests included measurements near Kīlauea volcano (before and during the 2018 eruption of the Lower East Rift Zone), Costa Rica's Turrialba volcano, and anthropogenic plumes from the Athabasca oil sands region of Alberta, Canada. This single-SO2-sonde system is an effective, inexpensive instrument for measuring both ground-based and vertical profiles of SO2 from anthropogenic and natural sources (i.e., volcanic eruptions) over a wide range of concentrations.</p

Strontium isotope evidence for human mobility in the Neolithic of northern Greece

Strontium isotope ratios are widely used in archaeology to differentiate between local and non-local populations. Herein, strontium isotope ratios of 36 human tooth enamels from seven archaeological sites spanning the Early to Late Neolithic of northern Greece (7th–5th millennia B.C.E.) were analysed with the aim of providing new information relating to the movement of humans across the region. Local bioavailable 87Sr/86Sr signals were established using tooth enamel from 26 domestic animals from the same Neolithic sites. 87Sr/86Sr values of faunal enamel correlate well with predicted strontium isotope ratios of the local geology. This is consistent with animal management occurring at a local level, although at Late Neolithic sites strontium isotope values became more varied, potentially indicating changing herding practices. The strontium isotope analysis of human tooth enamel likewise suggests limited population movement within the Neolithic of northern Greece. Almost all individuals sampled exhibited 87Sr/86Sr values consistent with having spent their early life (during the period of tooth mineralisation) in the local area, although movement could have occurred between isotopically homo- geneous areas. The strontium isotope ratios of only three individuals lay outside of the local bioavailable 87Sr/86Sr range and these individuals are interpreted as having spent their early lives in a region with a more radiogenic biologically available 87Sr/86Sr. Mobility patterns determined using Sr isotope analysis supports the current evidence for movement and exchange observed through studies of pottery circulation. Suggesting limited movement in the Early and Middle Neolithic and greater movement in the Late Neolithic

Validation of formaldehyde products from three satellite retrievals (OMI SAO, OMPS-NPP SAO, and OMI BIRA) in the marine atmosphere with four seasons of ATom aircraft observations

Formaldehyde (HCHO) in the atmosphere is an intermediate product from the oxidation of methane and non-methane volatile organic compounds. In remote marine regions, HCHO variability is closely related to atmospheric oxidation capacity and modeled HCHO in these regions is usually added as a global satellite HCHO background. Thus, it is important to understand and validate the levels of satellite HCHO over the remote oceans. Here we intercompare three satellite retrievals of total HCHO columns (OMI-SAO (v004), OMPS-NPP SAO, and OMI BIRA) and validate them against in situ observations from the NASA Atmospheric Tomography Mission (ATom) mission. All retrievals are correlated with ATom integrated columns over remote oceans, with OMI SAO (v004) showing the best agreement. Three satellite HCHO retrievals and in situ ATom columns all generally captured the spatial and seasonal distributions of HCHO in the remote ocean atmosphere. Retrieval bias varies by latitude and season, but a persistent low bias is found in all products at high latitudes and the general low bias is most severe for the OMI BIRA product. Examination of retrieval components reveals slant column corrections have a larger impact on the retrievals over remote marine regions while AMFs play a smaller role. This study informs that the potential latitude-dependent biases in the retrievals require further investigation for improvement and should be considered when using marine HCHO satellite data, and vertical profiles from in situ instruments are crucial for validating satellite retrievals

Vacuum fluctuations and topological Casimir effect in Friedmann-Robertson-Walker cosmologies with compact dimensions

We investigate the Wightman function, the vacuum expectation values of the field squared and the energy-momentum tensor for a massless scalar field with general curvature coupling parameter in spatially flat Friedmann-Robertson-Walker universes with an arbitrary number of toroidally compactified dimensions. The topological parts in the expectation values are explicitly extracted and in this way the renormalization is reduced to that for the model with trivial topology. In the limit when the comoving lengths of the compact dimensions are very short compared to the Hubble length, the topological parts coincide with those for a conformal coupling and they are related to the corresponding quantities in the flat spacetime by standard conformal transformation. In the opposite limit of large comoving lengths of the compact dimensions, in dependence of the curvature coupling parameter, two regimes are realized with monotonic or oscillatory behavior of the vacuum expectation values. In the monotonic regime and for nonconformally and nonminimally coupled fields the vacuum stresses are isotropic and the equation of state for the topological parts in the energy density and pressures is of barotropic type. In the oscillatory regime, the amplitude of the oscillations for the topological part in the expectation value of the field squared can be either decreasing or increasing with time, whereas for the energy-momentum tensor the oscillations are damping.Comment: 20 pages, 2 figure

The role of TG2 in regulating S100A4-mediated mammary tumour cell migration

The importance of S100A4, a Ca2+-binding protein, in mediating tumour cell migration, both intracellularly and extracellularly, is well documented. Tissue transglutaminase (TG2) a Ca2+-dependent protein crosslinking enzyme, has also been shown to enhance cell migration. Here by using the well characterised non-metastatic rat mammary R37 cells (transfected with empty vector) and highly metastatic KP1 cells (R37 cells transfected with S100A4), we demonstrate that inhibition of TG2 either by TG2 inhibitors or transfection of cells with TG2 shRNA block S100A4-accelerated cell migration in the KP1cells and in R37 cells treated with exogenous S100A4. Cell migration was also blocked by the treatment with the non-cell permeabilizing TG2 inhibitor R294, in the human breast cancer cell line MDA-MB-231 (Clone 16, which has a high level of TG2 expression). Inhibition was paralleled by a decrease in S100A4 polymer formation. co-immunoprecipitation and Far Western blotting assays and cross-linking assays showed not only the direct interaction between TG2 and S100A4, but also confirmed S100A4 as a substrate for TG2. Using specific functional blocking antibodies, a targeting peptide and a recombinant protein as a competitive treatment, we revealed the involvement of syndecan-4 and a5ß1 integrin co-signalling pathways linked by activation of PKCa in this TG2 and S100A4-mediated cell migration. We propose a mechanism for TG2-regulated S100A4-related mediated cell migration, which is dependent on TG2 crosslinking

The role of tissue transglutaminase (TG2) in regulating the tumour progression of the mouse colon carcinoma CT26

The multifunctional enzyme tissue transglutaminase (TG2) is reported to both mediate and inhibit tumour progression. To elucidate these different roles of TG2, we established a series of stable-transfected mouse colon carcinoma CT26 cells expressing a catalytically active (wild type) and a transamidating-inactive TG2 (Cys277Ser) mutant. Comparison of the TG2-transfected cells with the empty vector control indicated no differences in cell proliferation, apoptosis and susceptibility to doxorubicin, which correlated with no detectable changes in the activation of the transcription factor NF-?B. TG2-transfected cells showed increased expression of integrin ß3, and were more adherent and less migratory on fibronectin than control cells. Direct interaction of TG2 with ß3 integrins was demonstrated by immunoprecipitation, suggesting that TG2 acts as a coreceptor for fibronectin with ß3 integrins. All cells expressed the same level of TGFß receptors I and II, but only cells transfected with active TG2 had increased levels of TGFß1 and matrix-deposited fibronectin, which could be inhibited by TG2 site-directed inhibitors. Moreover, only cells transfected with active TG2 were capable of inhibiting tumour growth when compared to the empty vector controls. We conclude that in this colon carcinoma model increased levels of active TG2 are unfavourable to tumour growth due to their role in activation of TGFß1 and increased matrix deposition, which in turn favours increased cell adhesion and a lowered migratory and invasive behaviour