Artigos e Materiais de Revistas Científicas - ODS/11

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  • article 1 Citação(ões) na Scopus
    Infrared Imaging of the Brain-Eyelid Thermal Tunnel: A Promising Method for Measuring Body Temperature in Afebrile Children
    (2023) MENECK, F. De; SANTANA, V.; BRIOSCHI, G. C.; HADDAD, D. S.; NEVES, E. B.; FRANCO, M. D. C.; BRIOSCHI, M. L.
    (1) Infrared thermography of the inner canthus of the eye has emerged as a promising tool for temperature screening and fever diagnosis. Its non-invasive nature lends itself well to mass screening in diverse settings such as schools, public transport, and healthcare facilities. Swift and accurate temperature assessment plays a pivotal role in the early identification of potential fever cases, facilitating timely isolation, testing, and treatment, thereby mitigating the risk of disease transmission. Nonetheless, the reliability of this approach in the pediatric population, especially when compared to conventional thermometry methods, remains unexplored. This preliminary study aimed to evaluate the concordance between the temperature of the inner canthus of the eye (Tic,eye), referred to as the brain-eyelid thermal tunnel (BTT°), with axillary and tympanic methods in afebrile children. (2) Methods: A cohort of 36 children, matched in a 1:1 ratio for gender and age, underwent comprehensive assessments encompassing anthropometric data, blood pressure evaluations, axillary (Tax) and tympanic (Tty) temperature measurements, as well as BTT° infrared thermography. (3) Results: The findings revealed a high level of concordance among the tympanic, axillary, and BTT° measurement methods. Bland–Altman plots showed that the bias was minimal, and no statistically significant differences were observed when comparing BTT° with axillary (p = 0.136) and tympanic (p = 0.268) measurements. Passing–Bablok regression scatter plots further confirmed the agreement, aligning the fitted regression line closely with the identity line for both axillary versus BTT° and tympanic (Tty) versus BTT° comparisons. (4) Conclusions: This study holds significant implications for public health, especially in the context of infectious disease outbreaks such as COVID-19. BTT° infrared thermography of the inner canthus of the eye (Tic,eye) reliably measures body temperature in afebrile children in controlled settings; nevertheless, its practical application necessitates the adaptation of biothermodynamic parameters to accommodate diverse environmental conditions.
  • article 0 Citação(ões) na Scopus
    Morphofunctional parameters, physical fitness and musculoskeletal symptoms in cooperative recyclers
    (2023) GARCIA, R. C.; SANTOS, N. Q. dos; NASCIMENTO, D. E. do; ANTUNES, M. D.; KERBER, V. L.; BERTOLINI, S. M. M. G.
    Introduction: Members of solid waste recycling cooperatives are exposed to serious conditions and complications in their everyday life, which makes them likely to present poor quality of life and unfavorable health conditions in their work environment. Objectives: To evaluate morphofunctional parameters, physical fitness, and musculoskeletal symptoms of workers at solid waste recycling cooperatives in Maringá, state of Paraná, Brazil. Methods: This was a quantitative, cross-sectional, descriptive study. Data were collected from 60 cooperative members of both sexes linked to the Popular and Solidarity Recycling Association of Maringá. Participants underwent a medical screening at the cooperative, involving anamnesis, pulmonary and cardiac auscultation, and blood pressure measurement. In a second moment, they underwent physical assessment in the laboratory, using instruments for physical tests and questionnaires. Results: There was a predominance of females in the sample (54%), with a mean age of 41.82±12.03 years, and most participants did not practice physical activity (70%). With regard to body composition, women had the highest body mass index (28.29±6.61 kg/m2); as for the variables physical and aerobic fitness, men showed better scores than women (p < 0.05). In relation to musculoskeletal symptoms, most participants complained of lower back pain (56.66%). Conclusions: Although the results for anthropometric variables are within normal standards in most cooperative members, most of them present with musculoskeletal symptoms and do not practice physical activity, which can have negative implications in their health conditions in the medium and long term.
  • article 4 Citação(ões) na Scopus
    Joint effect of heat and air pollution on mortality in 620 cities of 36 countries
    (2023) STAFOGGIA, Massimo; MICHELOZZI, Paola; SCHNEIDER, Alexandra; ARMSTRONG, Ben; SCORTICHINI, Matteo; RAI, Masna; ACHILLEOS, Souzana; ALAHMAD, Barrak; ANALITIS, Antonis; ASTROM, Christofer; BELL, Michelle L.; CALLEJA, Neville; CARLSEN, Hanne Krage; CARRASCO, Gabriel; CAUCHI, John Paul; COELHO, Micheline D. S. Z. S.; CORREA, Patricia M.; DIAZ, Magali H.; ENTEZARI, Alireza; FORSBERG, Bertil; GARLAND, Rebecca M.; GUO, Yue Leon; GUO, Yuming; HASHIZUME, Masahiro; HOLOBACA, Iulian H.; INIGUEZ, Carmen; JAAKKOLA, Jouni J. K.; KAN, Haidong; KATSOUYANNI, Klea; KIM, Ho; KYSELY, Jan; LAVIGNE, Eric; LEE, Whanhee; LI, Shanshan; MAASIKMETS, Marek; MADUREIRA, Joana; MAYVANEH, Fatemeh; NG, Chris Fook Sheng; NUNES, Baltazar; ORRU, Hans; V, Nicolas Ortega; OSORIO, Samuel; PALOMARES, Alfonso D. L.; PAN, Shih-Chun; PASCAL, Mathilde; RAGETTLI, Martina S.; RAO, Shilpa; RAZ, Raanan; ROYE, Dominic; RYTI, Niilo; SALDIVA, Paulo H. N.; SAMOLI, Evangelia; SCHWARTZ, Joel; SCOVRONICK, Noah; SERA, Francesco; TOBIAS, Aurelio; TONG, Shilu; VALENCIA, Cesar D. L. C.; VICEDO-CABRERA, Ana Maria; URBAN, Ales; GASPARRINI, Antonio; BREITNER, Susanne; DONATO, Francesca K. de
    Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mor-tality 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 mu m (PM10), PM <= 2.5 mu m (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 mu g/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 mu g/ m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 mu g/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.
  • article 4 Citação(ões) na Scopus
    Greenness and excess deaths from heat in 323 Latin American cities: Do associations vary according to climate zone or green space configuration?
    (2023) SCHINASI, Leah H.; BAKHTSIYARAVA, Maryia; SANCHEZ, Brisa N.; KEPHART, Josiah L.; JU, Yang; ARUNACHALAM, Sarav; GOUVEIA, Nelson; CAIAFFA, Waleska Teixeira; O'NEILL, Marie S.; DRONOVA, Iryna; ROUX, Ana V. Diez; RODRIGUEZ, Daniel A.
    Green vegetation may protect against heat-related death by improving thermal comfort. Few studies have investigated associations of green vegetation with heat-related mortality in Latin America or whether associations are modified by the spatial configuration of green vegetation. We used data from 323 Latin American cities and meta-regression models to estimate associations between city-level greenness, quantified using populationweighted normalized difference vegetation index values and modeled as three-level categorical terms, and excess deaths from heat (heat excess death fractions [heat EDFs]). Models were adjusted for city-level fine particulate matter concentration (PM2.5), social environment, and country group. In addition to estimating overall associations, we derived estimates of association stratified by green space clustering by including an interaction term between a green space clustering measure (dichotomized at the median of the distribution) and the three-level greenness variable. We stratified analyses by climate zone (arid vs. temperate and tropical combined). Among the 79 arid climate zone cities, those with moderate and high greenness levels had modestly lower heat EDFs compared to cities with the lowest greenness, although protective associations were more substantial in cities with moderate versus high greenness levels and confidence intervals (CI) crossed the null (Beta: -0.41, 95% CI: -1.06, 0.25; Beta -0.23, 95% CI: -0.95, 0.49, respectively). In 244 non-arid climate zone cities, associations were approximately null. We did not observe evidence of effect modification by green space clustering. Our results suggest that greenness may offer modest protection against heat-related mortality in arid climate zone Latin American cities.
  • article 0 Citação(ões) na Scopus
    Spatial data collection and qualification methods for urban parks in Brazilian capitals: An innovative roadmap
    (2023) SLOVIC, Anne Dorothee; KANAI, Claudio; SALES, Denise Marques; ROCHA, Solimar Carnavalli; ANDRADE, Amanda Cristina de Souza; MARTINS, Lucas Soriano; COELHO, Debora Morais; FREITAS, Anderson; MORAN, Mika; MASCOLLI, Maria Antonietta; CAIAFFA, Waleska Teixeira; GOUVEIA, Nelson
    Urban parks have been studied for their effects on health and the environment. Accessing park data from reliable and comparable sources remains challenging, reinforcing the importance of standardized search tools, notably in Latin America. We designed a systematized methodology to identify processes of accessing, collecting, verifying, and harmonizing urban park spatial data in all Brazilian capitals included in the Urban Health in Latin America (SALURBAL) project. We developed a research protocol using official and non-official sources combining the results of Google Maps (GMaps) points and OpenStreetMap (OSM) polygons-GMaps-OSM. Descriptive analyses included the frequency of the distribution of parks before and after harmonization stratified by data source. We used the intraclass correlation coefficient (ICC) to assess agreement in the area between official and GMaps-OSM data. Official data were obtained for 16 cities; for the remaining 11 capitals, we used GMaps-OSM. After verification and harmonization, 302 urban parks were obtained from official data and 128 from GMaps-OSM. In a sub-study of the 16 cities with official data (n = 302 parks), we simulated a collection of non-official data using GMaps-OSM and OSM only. From GMaps-OSM, we obtained 142 parks, and from OSM, 230 parks. Statistical analysis showed a better agreement between official data and OSM. After completing verification and harmonization, the complete dataset (official and GMaps-OSM) included 430 urban parks with a total area of 145.14 km(2). The mean number of parks across cities was 16, with a mean size area of 0.33 km(2). The median number of parks was nine, with a median area of 0.07 km(2). This study highlights the importance of creating mechanisms to access, collect, harmonize, and verify urban park data, which is essential for examining the impact of parks on health. It also stresses the importance of providing reliable urban park spatial data for city officials.
  • article 0 Citação(ões) na Scopus
    Acute and subchronic exposure to urban atmospheric pollutants aggravate acute respiratory failure in infants
    (2023) NETO, Amanda Barbosa; FERRARO, Alexandre A.; VIEIRA, Sandra E.
    Urban air pollution is a major factor that affects the respiratory health of children and adolescents. Less studied is exposure during the first two years of life. This study analyzed the influence of acute and subchronic exposure to urban air pollutants on the severity of acute respiratory failure (ARF) in the first two years of life. This population-based study included 7364 infants hospitalized with ARF. Acute exposure was considered to have occurred 1, 3 and 7 days before hospitalization and subchronic exposure was considered the mean of the last 30 and 60 days. We found that for acute exposure, significant increases in days of hospitalization (LOS) occurred at lag 1 day for NO2 (0.24), SO2 (6.64), and CO (1.86); lag 3 days for PM10 (0.30), PM2.5 (0.37), SO2 (10.8), and CO (0.71); and lag 7 days for NO2 (0.16), SO2 (5.07) and CO (0.87). Increases in the risk of death occurred at lag 1 day for NO2 (1.06), SO2 (3.64), and CO (1.28); and lag 3 days for NO2 (1.04), SO2 (2.04), and CO (1.19). Subchronic exposures at 30 and 60 days occurred for SO2 (9.18, 3.77) and CO (6.53, 2.97), respectively. The associations were more pronounced with higher temperatures and lower relative humidity levels. We concluded that acute and subchronic exposure to higher atmospheric concentrations of all the pollutants studied were associated with greater severity of ARF. The greatest increases in LOS and risk of death occurred with hot and dry weather.
  • article 0 Citação(ões) na Scopus
    COVID-19 infection in nursing staff: A cohort study
    (2023) NOGUEIRA, Lilia de Souza; POVEDA, Vanessa de Brito; LEMOS, Cassiane de Santana; BRUNA, Camila Quartim de Moraes; MOURA, Bruna Roberta Siqueira
    AimThis study aims to identify the working conditions of Brazilian nursing professionals and the risk factors for these professionals to become infected by coronavirus disease. BackgroundUnderstanding the factors that affected nursing professionals during the pandemic can support better nursing management. DesignThis is a quantitative, cross-sectional survey study. MethodsData collection was carried out between February and March 2022 in Brazil. All nursing professionals registered in the national database received by e-mail the study instrument with the data collection variables: professionals' sociodemographic and comorbid, professional and institutional characteristics, and professionals' health conditions and disease-related aspects for COVID-19. ResultsFour thousand eight hundred sixty-two nursing professionals reported a lack of personal protective equipment for patient care, and 4424 were infected by coronavirus disease. The risk factors to become infected were having cardiovascular disease, being under 60 years of age, living in the northern region, using public transportation, working in a hospital, an emergency department or reference institution for COVID-19, living with an infected person and lack of respirators or waterproof aprons. ConclusionMultiple risk factors for infection with SARS-CoV-2 were demonstrated for the nursing professionals during the pandemic, highlighting current and future pandemics factors that are modifiable in a worthwhile time frame to minimize nurses' infection risks, such as inadequate working conditions associated with lack of essential personal protective equipment.
  • article 4 Citação(ões) na Scopus
    Assessing socioeconomic bias of exposure to urban air pollution: an autopsy-based study in Sao Paulo, Brazil
    (2023) SINGER, Julio da Motta; ANDRE, Carmen Diva Saldiva de; ANDRE, Paulo Afonso de; ROCHA, Francisco Marcelo Monteiro; WAKED, Dunia; VAZ, Aline Macedo; GOIS, Gustavo Ferreira; ANDRADE, Maria de Fatima; VERAS, Mariana Matera; SALDIVA, Paulo Hilario Nascimento; BARROZO, Ligia Vizeu
    Background The characterisation of individual exposure to air pollution in urban scenarios is a challenge in environmental epidemiological studies. We investigated if the city's pollution monitoring stations over or underes-timate the exposure of individuals depending on their socioeconomic conditions and daily commuting times. Methods The amount of black carbon accumulated in the lungs of 604 deceased who underwent autopsy in Sao Paulo was considered as a proxy for PM10. The concentrations of PM10 in the residence of the deceased were estimated by interpolating an ordinary kriging model. These two-exposure metrics allowed us to construct an environmental exposure misclassification index ranging from -1 to 1. The association between the index and daily commuting, socioeconomic context index (GeoSES), and street density as predictors was assessed by means of a multilevel linear regression model. Findings With a decrease of 0.1 units in GeoSES, the index increases, on average, by 0.028 units and with an increase of 1 h in daily commuting, the index increases, on average, by 0.022 units indicating that individual exposure to air pollution is underestimated in the lower GeoSES and in people with many hours spent in daily commuting. Interpretation Reduction of health consequences of air pollution demands not only alternative fuel and more efficient mobility strategies, but also should include profound rethink of cities.
  • article 7 Citação(ões) na Scopus
    Short-Term Association between Sulfur Dioxide and Mortality: A Multicountry Analysis in 399 Cities
    (2023) O'BRIEN, Edward; MASSELOT, Pierre; SERA, Francesco; ROYE, Dominic; BREITNER, Susanne; NG, Chris Fook Sheng; COELHO, Micheline de Sousa Zanotti Stagliorio; MADUREIRA, Joana; TOBIAS, Aurelio; VICEDO-CABRERA, Ana Maria; BELL, Michelle L.; LAVIGNE, Eric; KAN, Haidong; GASPARRINI, Antonio
    BACKGROUND: Epidemiological evidence on the health risks of sulfur dioxide (SO2) is more limited compared with other pollutants, and doubts remain on several aspects, such as the form of the exposure-response relationship, the potential role of copollutants, as well as the actual risk at low concentrations and possible temporal variation in risks.OBJECTIVES: Our aim was to assess the short-term association between exposure to SO2 and daily mortality in a large multilocation data set, using advanced study designs and statistical techniques. METHODS: The analysis included 43,729,018 deaths that occurred in 399 cities within 23 countries between 1980 and 2018. A two-stage design was applied to assess the association between the daily concentration of SO2 and mortality counts, including first-stage time-series regressions and second-stage multilevel random-effect meta-analyses. Secondary analyses assessed the exposure-response shape and the lag structure using spline terms and distributed lag models, respectively, and temporal variations in risk using a longitudinal meta-regression. Bi-pollutant models were applied to examine confounding effects of particulate matter with an aerodynamic diameter of <= 10 mu m (PM10) and 2.5 mu m (PM2.5), ozone, nitrogen dioxide, and carbon monoxide. Associations were reported as relative risks (RRs) and fractions of excess deaths.RESULTS: The average daily concentration of SO2 across the 399 cities was 11.7 mu g/m3, with 4.7% of days above the World Health Organization (WHO) guideline limit (40 mu g/m3, 24-h average), although the exceedances occurred predominantly in specific locations. Exposure levels decreased considerably during the study period, from an average concentration of 19.0 mu g/m3 in 1980-1989 to 6.3 mu g/m3 in 2010-2018. For all locations com-bined, a 10-mu g/m3 increase in daily SO2 was associated with an RR of mortality of 1.0045 [95% confidence interval (CI): 1.0019, 1.0070], with the risk being stable over time but with substantial between-country heterogeneity. Short-term exposure to SO2 was associated with an excess mortality fraction of 0.50% [95% empirical CI (eCI): 0.42%, 0.57%] in the 399 cities, although decreasing from 0.74% (0.61%, 0.85%) in 1980-1989 to 0.37% (0.27%, 0.47%) in 2010-2018. There was some evidence of nonlinearity, with a steep exposure-response relationship at low concentrations and the risk attenuating at higher levels. The relevant lag window was 0-3 d. Significant positive associations remained after controlling for other pollutants. DISCUSSION: The analysis revealed independent mortality risks associated with short-term exposure to SO2, with no evidence of a threshold. Levels below the current WHO guidelines for 24-h averages were still associated with substantial excess mortality, indicating the potential benefits of stricter air quality standards. https://doi.org/10.1289/EHP11112
  • article 3 Citação(ões) na Scopus
    Assessment of wing geometric morphometrics of urban Culex quinquefasciatus (Diptera: Culicidae) populations
    (2023) OLIVEIRA-CHRISTE, Rafael; CARVALHO, Gabriela Cristina de; WILKE, Andre Barretto Bruno; MARRELLI, Mauro Toledo
    Culex quinquefasciatus is a cosmopolitan species distributed throughout tropical and subtropical areas of the world. The species is of great epidemiological importance as it is responsible for vectoring the causative agent of lymphatic filariasis and several arboviruses, including West Nile virus. Wing geometric morphometrics has been widely used to assess phenotypic variations in mosquito species. Here, we hypothesize that Cx. quinquefasciatus populations in urban parks in the city of Sa & SIM;o Paulo, Brazil, have been subjected to anthropogenic selective pressures that are responsible for driving their ecology and behavior. Mosquitoes were collected by CDC traps in five municipal parks in the city of Sa & SIM;o Paulo. Eighteen anatomical landmark coordinates on each female right wing were digitized. Canonical variate analysis, wireframe graphs, cross-validated reclassification tests and the neighbor-joining method were used to assess phenotypical dissimilarity in wing shape between populations. Centroid size was calculated to assess differences in wing size between populations, which can result from different environmental conditions during immature mosquito development. Moderately heterogeneous wing shape and wing size patterns were found in the populations analyzed, indicating that selective pressures in the urban environment are affecting the wing patterns of Cx. quinquefasciatus populations in the city of Sa & SIM;o Paulo, Brazil.
  • article 3 Citação(ões) na Scopus
    Accumulation of trace element content in the lungs of Sao Paulo city residents and its correlation to lifetime exposure to air pollution
    (2022) SANTOS, Nathalia Villa dos; VIEIRA, Carolina Leticia Zilli; SALDIVA, Paulo Hilario Nascimento; ANDRE, Carmen Diva Saldiva De; MAZZILLI, Barbara Paci; ANDRADE, Maria de Fatima; SAUEIA, Catia Heloisa; SAIKI, Mitiko; VERAS, Mariana Matera; KOUTRAKIS, Petros
    Heavy metals are natural and essential elements of the environment and living beings, produced from natural (e.g. volcanic activity and cosmic ray-induced spallation) and anthropogenic processes (e.g. industrial and fossil fuel combustion). High-concentrations of heavy metals and radionuclides are also originated from anthropogenic activities in urban and industrial areas. In this preliminary study, we analyzed the levels of heavy metals and Polonium-210 (Po-210) in lung tissues in autopsies from residents of the city of Sao Paulo, SP, Brazil. In order to identify the link among sources of the heavy metals in lungs, factor analysis was performed. Of the first four factors, which explain 66% of the total variability, three were associated with vehicular sources. The fitting of a regression model with Po-210 as the response variable and with the four factors as explanatory variables, controlling for age, sex and tobacco, showed a significant association between the concentration of polonium and the first factor that is generated by catalysts and brakes (coefficient = 0.90, standard error = 0.33, p = 0.016). Our findings suggest an association between traffic-related trace metals and Po-210 in lung autopsies.
  • article 0 Citação(ões) na Scopus
    Cyclist mortality in the municipality of Sao Paulo, Brazil: recent demographic characteristics and trends
    (2023) MASCOLLI, Maria Antonietta; FRANCA, Raony Ferreira; GOUVEIA, Nelson
    Bicycles are a low cost and healthy means of transport, however accidents represent the negative downside. This study sought to describe the characteristics of cyclist deaths, their recent evolution, and the status of the cycle path structure in the city of Sao Paulo. It involved a descriptive study using information from the Mortality Information System (SIM-DATASUS) between 2000 and 2017. The relationship between the cyclist mortality rate and the cycling path network was evaluated using Pearson's correlation test. A comparison was made with bicycle journeys in the same period. The sociodemographic profile of deaths was compared with that of the general population. The mortality rate peaked at 7.91/million inhabitants in 2006 and decreased to 1.8/million in 2017; in this period, there was an increase in cycling journeys and in the cycle path structure. A negative correlation was observed between the mortality rate and the cycle path structure. The analysis of deaths indicates a predominantly male, white, young profile, with <= 7 years of schooling; 65% died in collisions with vehicles. There was a decrease in cyclist deaths in the city of Sao Paulo correlated with the increase in the bicycle path grid from 2008 onwards, in a scenario of increased demand for bicycle transport.
  • article 2 Citação(ões) na Scopus
    Heat exposure and hospitalisation for epileptic seizures: A nationwide case-crossover study in Brazil
    (2023) ZHANG, Yiwen; XU, Rongbin; YE, Tingting; YU, Wenhua; YU, Pei; CHEN, Zhuying; MAHENDRAN, Rahini; SALDIVA, Paulo Hilario Nascimento; COEL, Micheline de Sousa Zanotti Stagliorio; GUO, Yuming; LI, Shanshan
    Climate change is increasing human exposure to heat, especially in tropical regions such as Brazil where temperature reaches up to 40 degrees C in summer. However, the association between heat exposure and epileptic seizures has not been well demonstrated in Brazil, where lifetime preva-lence of epilepsy can range from 11.9/1000 to 21/1000. We collected a total of 225,699 hospi-talisation records for epileptic seizures of 1816 municipalities in Brazil, during the hot season from 2000 to 2015, covering nearly 79% of the national population. We implemented a time -stratified case-crossover design combined with distributed lag model with further stratified in-vestigations regarding sex, age, socioeconomic status and region. We found temperature impact threshold was 26 degrees C in Brazil nationally. Every 1 degrees C increase from the threshold was associated with an overall 4.3% increased risk of hospitalisation for epileptic seizures on the current day of hospital admission and up to seven days before, which was most pronounced on the second-day exposure to heat. Females, individuals aged 20-30 and persons living in high-income or Southeast regions were more vulnerable. Our results highlight the enhanced risk of heat exposure for epi-lepsy patients and could contribute to epilepsy management, such as forecasting epileptic sei-zures. Multi-dimensional adaptive strategies were proposed, covering individual protection, occupational health surveillance, and urban planning management, aiming to reduce heat -induced hospitalisations for epilepsy, and be generalizable to other heat-related diseases.
  • article 5 Citação(ões) na Scopus
    Modification of temperature-related human mortality by area-level socioeconomic and demographic characteristics in Latin American cities
    (2023) BAKHTSIYARAVA, Maryia; SCHINASI, Leah H.; SANCHEZ, Brisa N.; DRONOVA, Iryna; KEPHART, Josiah L.; JU, Yang; GOUVEIA, Nelson; CAIAFFA, Waleska Teixeira; O'NEILL, Marie S.; YAMADA, Goro; ARUNACHALAM, Sarav; DIEZ-ROUX, Ana V.; RODRIGUEZ, Daniel A.
    Background: In Latin America, where climate change and rapid urbanization converge, non-optimal ambient temperatures contribute to excess mortality. However, little is known about area-level characteristics that confer vulnerability to temperature-related mortality. Objectives: Explore city-level socioeconomic and demographic characteristics associated with temperature-related mortality in Latin American cities. Methods: The dependent variables quantify city-specific associations between temperature and mortality: heatand cold-related excess death fractions (EDF, or percentages of total deaths attributed to cold/hot temperatures), and the relative mortality risk (RR) associated with 1 degrees C difference in temperature in 325 cities during 2002-2015. Random effects meta-regressions were used to investigate whether EDFs and RRs associated with heat and cold varied by city-level characteristics, including population size, population density, built-up area, age-standardized mortality rate, poverty, living conditions, educational attainment, income inequality, and residential segregation by education level. Results: We find limited effect modification of cold-related mortality by city-level demographic and socioeconomic characteristics and several unexpected associations for heat-related mortality. For example, cities in the highest compared to the lowest tertile of income inequality have all-age cold-related excess mortality that is, on average, 3.45 percentage points higher (95% CI: 0.33, 6.56). Higher poverty and higher segregation were also associated with higher cold EDF among those 65 and older. Large, densely populated cities, and cities with high levels of poverty and income inequality experience smaller heat EDFs compared to smaller and less densely populated cities, and cities with little poverty and income inequality. Discussion: Evidence of effect modification of cold-related mortality in Latin American cities was limited, and unexpected patterns of modification of heat-related mortality were observed. Socioeconomic deprivation may impact cold-related mortality, particularly among the elderly. The findings of higher levels of poverty and income inequality associated with lower heat-related mortality deserve further investigation given the increasing importance of urban adaptation to climate change.
  • article 5 Citação(ões) na Scopus
    Detection of Hepatitis E Virus Genotype 3 in Feces of Capybaras (Hydrochoeris hydrochaeris) in Brazil
    (2023) CUNHA, Lia; LUCHS, Adriana; AZEVEDO, Lais S. S.; SILVA, Vanessa C. M.; LEMOS, Marcilio F. F.; COSTA, Antonio C. C.; COMPRI, Adriana P. P.; FRANCA, Yasmin; VIANA, Ellen; MALTA, Fernanda; MEDEIROS, Roberta S. S.; GUIDUCCI, Raquel; MORILLO, Simone G. G.; GOMES-GOUVEA, Michele S. S.; AMGARTEN, Deyvid; PINHO, Joao R. R.; MOREIRA, Regina C. C.
    Hepatitis E virus (HEV) is an emerging zoonotic pathogen associated with relevant public health issues. The aim of this study was to investigate HEV presence in free-living capybaras inhabiting urban parks in Sao Paulo state, Brazil. Molecular characterization of HEV positive samples was undertaken to elucidate the genetic diversity of the virus in these animals. A total of 337 fecal samples were screened for HEV using RT-qPCR and further confirmed by conventional nested RT-PCR. HEV genotype and subtype were determined using Sanger and next-generation sequencing. HEV was detected in one specimen (0.3%) and assigned as HEV-3f. The IAL-HEV_921 HEV-3f strain showed a close relationship to European swine, wild boar and human strains (90.7-93.2% nt), suggesting an interspecies transmission. Molecular epidemiology of HEV is poorly investigated in Brazil; subtype 3f has been reported in swine. This is the first report of HEV detected in capybara stool samples worldwide.
  • article 1 Citação(ões) na Scopus
    Lack of molecular evidence of fecal-borne viruses in capybaras from Sao Paulo state, Brazil, 2018-2020: a minor public health issue
    (2023) AZEVEDO, Lais Sampaio de; FRANCA, Yasmin; VIANA, Ellen; MEDEIROS, Roberta Salzone; MORILLO, Simone Guadagnucci; GUIDUCCI, Raquel; RIBEIRO, Cibele Daniel; VIEIRA, Heloisa Rosa; BARRIO-NUEVO, Karolina Morales; CUNHA, Mariana Sequetin; GUERRA, Juliana Mariotti; SILVA, Dulcilena de Matos Castro e; DUO FILHO, Valter Batista; ARAUJO, Emerson Luiz Lima; FERREIRA, Sergio Roberto Santos; BATISTA, Camila Freitas; SILVA, Gislaine Celestino Dutra da; NOGUEIRA, Mauricio Lacerda; AHAGON, Cintia Mayumi; MOREIRA, Regina Celia; CUNHA, Lia; MORAIS, Vanessa Santos; COSTA, Antonio Charlys da; LUCHS, Adriana
    Capybara (Hydrochoerus hydrochaeris) is the world's largest rodent species distributed throughout South America. These animals are incredibly tolerant to anthropogenic environments and are occupying large urban centers. Capybaras are known to carry potentially zoonotic agents, including R. rickettsia, Leishmania spp., Leptospira spp., Trypanosoma spp., Salmonella spp., Toxoplasma gondii, and rabies virus. Focusing on the importance of monitoring potential sources of emerging zoonotic viruses and new viral reservoirs, the aim of the present study was to assess the presence of fecal-borne viruses in the feces of capybaras living in urban parks in Sao Paulo state, Brazil. A total of 337 fecal samples were collected between 2018 and 2020 and screened for the following: (i) Rotavirus group A (RVA) by ELISA; (ii) non-RVA species and Picobirnavirus (PBV) using PAGE; (iii) Human Bocaparvovirus (HBoV), Bufavirus (BuV), Tusavirus (TuV), and Cutavirus (CuV) qPCR; (iv) Human Enterovirus (EV), Norovirus GII (NoV), and Hantavirus by in houses RT-qPCR; (v) SARS-CoV-2 via commercial RT-qPCR kit assay; and (vi) Astrovirus (AstV) and Adenovirus (AdV) using conventional nested (RT)-PCRs. All fecal samples tested were negative for fecal-borne viruses. This study adds further evidence that the fecal-borne viruses is a minor public health issue in Brazilian capybaras, at least during the surveillance period and surveyed areas. Continuous monitoring of sylvatic animals is essential to prevent and control the emergence or re-emergence of newly discovered virus as well as viruses with known zoonotic potential.
  • article 8 Citação(ões) na Scopus
    New approaches for mental health of social minorities
    (2022) VENTRIGLIO, Antonio; CASTALDELLI-MAIA, Joao Mauricio; TORALES, Julio; CHUMAKOV, Egor; BERARDIS, Domenico De; BHUGRA, Dinesh
    Mental health of social minorities is a challenge of modern psychiatry. It is largely described that people reporting sexual, cultural, religious variations are exposed to an amount of social stress deriving from the contrast between their minority status and the dominant societal norms and values. Minority stress leads to higher level of psychosocial distress and mental illness among these vulnerable populations. This conceptual research paper reports on evidences regarding the mental health issues related to the minority social condition and proposes a set of actions to address these challenges in a global perspective. Specifically, political, social and educational interventions are discussed in order to contrast stigma, discrimination, promote integration and health services for vulnerable populations. Policymakers are invited to deliver ad-hoc policies on minorities and homeless people with specific funding to address related public mental health issues. Educational programs are encouraged in the school setting as well as in the training of health care professionals in order to improve the level of acceptance and competencies in the treatment of minorities' health needs. We firmly believe there is no healthy society without healthy minorities.
  • article 1 Citação(ões) na Scopus
    Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019
    (2023) LI, Chuanxi; WANG, Zhendong; YAN, Yu; QU, Yinan; HOU, Liangyu; LI, Yijie; CHU, Cordia; WOODWARD, Alistair; SCHIKOWSKI, Tamara; SALDIVA, Paulo Hilario Nascimento; LIU, Qiyong; ZHAO, Qi; MA, Wei
    IMPORTANCE Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear. OBJECTIVE To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and -2 for extreme dry conditions. The SPEI-dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022. EXPOSURES City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019. MAIN OUTCOMES AND MEASURES The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI-dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development. RESULTS Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60). CONCLUSIONS AND RELEVANCE Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.
  • article 63 Citação(ões) na Scopus
    City-level impact of extreme temperatures and mortality in Latin America
    (2022) KEPHART, Josiah L.; SANCHEZ, Brisa N.; MOORE, Jeffrey; SCHINASI, Leah H.; BAKHTSIYARAVA, Maryia; JU, Yang; GOUVEIA, Nelson; CAIAFFA, Waleska T.; DRONOVA, Iryna; ARUNACHALAM, Saravanan; ROUX, Ana V. Diez; RODRIGUEZ, Daniel A.
    Climate change and urbanization are rapidly increasing human exposure to extreme ambient temperatures, yet few studies have examined temperature and mortality in Latin America. We conducted a nonlinear, distributed-lag, longitudinal analysis of daily ambient temperatures and mortality among 326 Latin American cities between 2002 and 2015. We observed 15,431,532 deaths among approximate to 2.9 billion person-years of risk. The excess death fraction of total deaths was 0.67% (95% confidence interval (CI) 0.58-0.74%) for heat-related deaths and 5.09% (95% CI 4.64-5.47%) for cold-related deaths. The relative risk of death was 1.057 (95% CI 1.046-1.067%) per 1 degrees C higher temperature during extreme heat and 1.034 (95% CI 1.028-1.040%) per 1 degrees C lower temperature during extreme cold. In Latin American cities, a substantial proportion of deaths is attributable to nonoptimal ambient temperatures. Marginal increases in observed hot temperatures are associated with steep increases in mortality risk. These risks were strongest among older adults and for cardiovascular and respiratory deaths. An ecological analysis of 326 cities in 9 countries across Latin America found that changes in ambient temperature have a substantial contribution to all-cause mortality, with small increases in extreme heat associated with steep increases in mortality risk.
  • article 1 Citação(ões) na Scopus
    Gene Expression Profile of Uterine Leiomyoma from Women Exposed to Different Air Pollution Levels in Metropolitan Cities of Sao Paulo, Brazil
    (2023) ANJOS, Laura Gonzalez dos; ALMEIDA, Bruna Cristine de; BARACAT, Edmund Chada; AL-HENDY, Ayman; YANG, Qiwei; CARVALHO, Katia Candido
    Leiomyomas (LMs) are the most frequent uterine benign tumors, representing the leading cause of hysterectomy indications worldwide. They are highly associated with women's reproductive complications, and endocrine disruptors may influence their etiology. In this sense, air pollution represents a relevant hormonal disruptor that acts on key signaling pathways, resulting in tumor development and infertility. Our goal was to evaluate submucosal LM samples from patients living in the metropolitan and Sao Paulo city regions, focusing on genes involved in tumor development and infertility features. Twenty-four patients were selected based on their region of residence and clinical information availability. Several genes were differentially expressed between women living in metropolitan areas and Sao Paulo city. Significant associations were observed between BCL-2, DVL1, FGFR3, and WNT5b downregulation and contraceptive use in the samples from women living in Sao Paulo city. ESR1 and HHAT downregulation was associated with ethnicity. WNT5b and GREM were associated with LM treatment and related pathologies, respectively. In the samples from women living in other cities of the metropolitan region, abortion occurrence was associated with BMP4 upregulation. Although further studies may be necessary, our results showed that air pollution exposure influences the expression of genes related to LM development and female reproductive features.