Fetuin A concentration in the second trimester amniotic fluid of fetuses with Trisomy 21 appears to be lower: phenotypic considerations

Objective: We investigated whether the concentration of the glycoprotein fetuin A is altered in the second trimester amniotic fluid of trisomy 21 pregnancies compared with euploid pregnancies. Methods. 25 pregnancies with an extra chromosome 21 were matched for maternal and gestational age with 25 pregnancies with normal karyotype. Levels of fetuin A in amniotic fluid were measured by a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Results: The median concentration of fetuin A in amniotic fluid of trisomy 21 pregnancies (5.3 ng/ml) was statistically significantly lower (P value = 0.008) compared with that in euploid pregnancies (6.8 ng/mL). Conclusion: Lower levels of fetuin A in trisomy 21 may indicate an association with altered metabolic pathways in this early stage that could potentially be associated with features of the syndrome, such as growth restriction or impaired osteogenesi

Associations between fine and coarse particles and mortality in Mediterranean cities: results from the MED-PARTICLES project

Few studies have investigated the independent health effects of different size fractions of particulate matter (PM) in multiple locations, especially in Europe. We estimated the short-term effects of PM with aerodynamic diameter = 10 µm (PM10), = 2.5 µm (PM2.5), and between 2.5 and 10 µm (PM2.5–10) on all-cause, cardiovascular, and respiratory mortality in 10 European Mediterranean metropolitan areas within the MEDPARTICLES project. We analyzed data from each city using Poisson regression models, and combined cityspecific estimates to derive overall effect estimates. We evaluated the sensitivity of our estimates to co-pollutant exposures and city-specific model choice, and investigated effect modification by age, sex, and season. We applied distributed lag and threshold models to investigate temporal patterns of associations. A 10-µg/m3 increase in PM2.5 was associated with a 0.55% (95% CI: 0.27, 0.84%) increase in all-cause mortality (0–1 day cumulative lag), and a 1.91% increase (95% CI: 0.71, 3.12%) in respiratory mortality (0–5 day lag). In general, associations were stronger for cardiovascular and respiratory mortality than all-cause mortality, during warm versus cold months, and among those = 75 versus < 75 years of age. Associations with PM2.5–10 were positive but not statistically significant in most analyses, whereas associations with PM10 seemed to be driven by PM2.5. We found evidence of adverse effects of PM2.5 on mortality outcomes in the European Mediterranean region. Associations with PM2.5–10 were positive but smaller in magnitude. Associations were stronger for respiratory mortality when cumulative exposures were lagged over 0–5 days, and were modified by season and age.Peer ReviewedPostprint (published version

Long-Term Exposure to Nitrogen Dioxide and Ozone and Mortality: Update of the WHO Air Quality Guidelines Systematic Review and Meta-Analysis

Objectives: We performed a systematic review and meta-analysis on long-term exposure to nitrogen dioxide (NO2) and ozone (O3) with mortality, to expand evidence that informed 2021 the WHO Air Quality Guidelines and guide the Health Risks of Air Pollution in Europe project.Methods: We included cohorts investigating NO2 and O3 mortality from all-causes, respiratory diseases, chronic obstructive pulmonary disease (COPD), acute lower respiratory infections (ALRI); and NO2 mortality from circulatory, ischemic heart, cerebrovascular diseases and lung cancer. We pooled estimates by random-effects models and investigated heterogeneity. We assessed the certainty of the evidence using the Grading of Recommendations Assessment Development approach and Evaluation (GRADE).Results: We selected 83 studies for NO2 and 26 for O3 for the meta-analysis. NO2 was associated with all outcomes, except for cerebrovascular mortality. O3 was associated with respiratory mortality following annual exposure. There was high heterogeneity, partly explained by region and pollutant levels. Certainty was high for NO2 with COPD and ALRI, and annual O3 with respiratory mortality.Conclusion: An increasing body of evidence, with new results from countrywide areas and the Western Pacific, supports certainty, including new outcomes.Fil: Kasdagli, Maria Iosifina. Kapodistrian University Of Athens; GreciaFil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Pérez Velasco, Román. Organizacion Mundial de la Salud; ArgentinaFil: Samoli, Evangelia. Kapodistrian University Of Athens; Greci

Atmospheric circulation types and daily mortality in Athens, Greece

We investigated the short-term effects of synoptic and mesoscale atmospheric circulation types on mortality in Athens, Greece. The synoptic patterns in the lower troposphere were classified in 8 a priori defined categories. The mesoscale weather types were classified into 11 categories, using meteorologic parameters from the Athens area surface monitoring network; the daily number of deaths was available for 1987-1991. We applied generalized additive models (GAM), extending Poisson regression, using a LOESS smoother to control for the confounding effects of seasonal patterns. We adjusted for long-term trends, day of the week, ambient particle concentrations, and additional temperature effects. Both classifications, synoptic and mesoscale, explain the daily variation of mortality to a statistically significant degree. The highest daily mortality was observed on days characterized by southeasterly flow [increase 10%; 95% confidence interval (CI), 6.1-13.9% compared to the high-low pressure system), followed by zonal flow (5.8%; 95% CI, 1.8-10%). The high-low pressure system and the northwesterly flow are associated with the lowest mortality. The seasonal patterns are consistent with the annual pattern. For mesoscale categories, in the cold period the highest mortality is observed during days characterized by the easterly flow category (increase 9.4%; 95% CI, 1.0-18.5% compared to flow without the main component). In the warm period, the highest mortality occurs during the strong southerly flow category (8.5% increase; 95% CI, 2.0-15.4% compared again to flow without the main component). Adjusting for ambient particle levels leaves the estimated associations unchanged for the synoptic categories and slightly increases the effects of mesoscale categories. In conclusion, synoptic and mesoscale weather classification is a useful tool for studying the weather-health associations in a warm Mediterranean climate situation

The role of a Mediterranean diet on the risk of oral and pharyngeal cancer.

BACKGROUND: The Mediterranean diet has a beneficial role on various neoplasms, but data are scanty on oral cavity and pharyngeal (OCP) cancer. METHODS: We analysed data from a case-control study carried out between 1997 and 2009 in Italy and Switzerland, including 768 incident, histologically confirmed OCP cancer cases and 2078 hospital controls. Adherence to the Mediterranean diet was measured using the Mediterranean Diet Score (MDS) based on the major characteristics of the Mediterranean diet, and two other scores, the Mediterranean Dietary Pattern Adherence Index (MDP) and the Mediterranean Adequacy Index (MAI). RESULTS: We estimated the odds ratios (ORs), and the corresponding 95% confidence intervals (CI), for increasing levels of the scores (i.e., increasing adherence) using multiple logistic regression models. We found a reduced risk of OCP cancer for increasing levels of the MDS, the ORs for subjects with six or more MDS components compared with two or less being 0.20 (95% CI 0.14-0.28, P-value for trend &lt;0.0001). The ORs for the highest vs the lowest quintile were 0.20 (95% CI 0.14-0.28) for the MDP score (score 66.2 or more vs less than 57.9), and 0.48 (95% CI 0.33-0.69) for the MAI score (score value 2.1 or more vs value less 0.92), with significant trends of decreasing risk for both scores. The favourable effect of the Mediterranean diet was apparently stronger in younger subjects, in those with a higher level of education, and in ex-smokers, although it was observed in other strata as well. CONCLUSIONS: Our study provides strong evidence of a beneficial role of the Mediterranean diet on OCP cancer

Prediction of PM2.5 concentrations at the locations of monitoring sites measuring PM10 and NOx using generalized additive models and machine learning methods: A case study in London

The adverse health effects of air pollutants, especially those of PM 2.5, are well documented. However, a lack of adequate monitoring and weaknesses in modelling approaches do not allow a good assessment of health effects in many areas of the World. Advances in computational methods and the availability of new data sets, e.g. satellite remote observations, have enlarged the possibilities of modelling for application in large scale health effects studies. However, PM 2.5 monitoring is very recent in most of the World and more limited compared to other pollutants, and understanding how to use PM 10 monitors to estimate PM 2.5 exposure is therefore important. Since interest in these methods is relatively recent, there is a need for testing their performance against ambient measurements, but long term PM 2.5 datasets are less readily available than PM 10 in many regions. In the present study we report the methodology and results of using regression modelling and a machine learning method (Random Forest-RF), as well as a combination of the two, to enhance a PM 2.5 measurement data base in London using PM 10 and NO x measurements as well as other predictors and compare the relative performance of each method. We found that the combination of predictions by the regression model and the RF performs best and we obtain a cross-validation R 2 of 99.29% and 98.22% for the 5-year periods 2004–2008 and 2009–2013, respectively, and a Mean Square Error near 1. Our enhanced data base for PM 2.5 is available for use by other researchers. </p

Investigation of Midtrimester Amniotic Fluid Factors as Potential Predictors of Term and Preterm Deliveries

Aims. Our aim is to investigate, in 13 cases (delivering preterm) and 21 matched (for age, parity, and gestational age) controls (delivering at term), whether midtrimester amniotic fluid concentrations of elastase, secretory leukocyte proteinase inhibitor (SLPI), soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule predict asymptomatic intra-amniotic inflammation/infection and preterm labor. Results. Concentrations of all substances were not statistically different among mothers, delivering preterm or at term. SLPI concentrations significantly increased in women, going into labor without ruptured membranes, irrespective of pre- or term delivery (P < .007, P < .001, resp) and correlated with elastase (r = 0.508, P < .002). Conclusions. Midtrimester amniotic fluid SLPI concentrations significantly decrease when membrane rupture precedes pre- or full-term labor. However, none of the investigated substances predict preterm delivery

Determinants of personal exposure to ozone in school children. Results from a panel study in Greece

BACKGROUND: In the wider framework of the RESPOZE (ReSPiratory effects of OZone Exposure in Greek children) panel study, we investigated possible determinants of O3 exposure of school children, measured with personal passive samplers, in Athens and Thessaloniki, Greece.METHODS: Personal exposure to O3 was measured for five weeks spread along the academic year 2013-14, in 186 school children in Athens and Thessaloniki, Greece. At the same time, at-school outdoor measurements were performed and ambient levels of 8-h daily maximum O3 from fixed sites were collected. We also collected information on lifestyle and housing characteristics through an extended general questionnaire (GQ) and each participant completed daily time activity diaries (TADs) during the study period.RESULTS: Mean outdoor concentrations were higher during the warmer months, in the suburbs of the cities and in Athens. Personal exposure concentrations were significantly lower compared to outdoor. Daily levels of at-school outdoor and ambient levels of O3 from fixed sites were significant determinants of personal exposure to O3. For a 10μg/m(3) increase in at-school outdoor O3 concentrations and PM10 measurements a 20.9% (95% CI: 13%, 28%) increase in personal exposure to O3 was found. For a half an hour more spent in transportation an average increase of 7% (95% CI: 0.3%, 14.6%) in personal exposure to O3 was observed. Among other possible determinants, time spent in transportation (TAD variable) and duration of open windows were the ones associated with personal O3 exposure levels.CONCLUSIONS: Our results support the use of outdoor and ambient measurements from fixed sites in epidemiological studies as a proxy of personal exposure to O3, but this has to be calibrated taking into account personal measurements and time-activity patterns.</p