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- ItemProjections of temperature-related excess mortality under climate change scenarios(Amsterdam : Elsevier B.V., 2017) Gasparrini, A.; Guo, Y.; Sera, F.; Vicedo-Cabrera, A.M.; Huber, V.; Tong, S.; de Sousa Zanotti Stagliorio Coelho, M.; Nascimento Saldiva, P.H.; Lavigne, E.; Matus Correa, P.; Valdes Ortega, N.; Kan, H.; Osorio, S.; Kyselý, J.; Urban, A.; Jaakkola, J.J.K.; Ryti, N.R.I.; Pascal, M.; Goodman, P.G.; Zeka, A.; Michelozzi, P.; Scortichini, M.; Hashizume, M.; Honda, Y.; Hurtado-Diaz, M.; Cesar Cruz, J.; Seposo, X.; Kim, H.; Tobias, A.; Iñiguez, C.; Forsberg, B.; Åström, D.O.; Ragettli, M.S.; Guo, Y.L.; Wu, C.-F.; Zanobetti, A.; Schwartz, J.; Bell, M.L.; Dang, T.N.; Van, D.D.; Heaviside, C.; Vardoulakis, S.; Hajat, S.; Haines, A.; Armstrong, B.Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates. Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature–mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990–2099 under each scenario of climate change, assuming no adaptation or population changes. Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (−3·0 to 9·3) in Central America to 12·7% (−4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet. Interpretation: This study shows the negative health impacts of climate change that, under high-emission scenarios, would disproportionately affect warmer and poorer regions of the world. Comparison with lower emission scenarios emphasises the importance of mitigation policies for limiting global warming and reducing the associated health risks. Funding: UK Medical Research Council.
- ItemGlycosaminoglycan-based hydrogels to modulate heterocellular communication in in vitro angiogenesis models(London : Nature Publishing Group, 2014) Chwalek, K.; Tsurkan, M.V.; Freudenberg, U.; Werner, C.Angiogenesis, the outgrowth of blood vessels, is crucial in development, disease and regeneration. Studying angiogenesis in vitro remains challenging because the capillary morphogenesis of endothelial cells (ECs) is controlled by multiple exogenous signals. Therefore, a set of in situ-forming starPEG-heparin hydrogels was used to identify matrix parameters and cellular interactions that best support EC morphogenesis. We showed that a particular type of soft, matrix metalloproteinase-degradable hydrogel containing covalently bound integrin ligands and reversibly conjugated pro-angiogenic growth factors could boost the development of highly branched, interconnected, and lumenized endothelial capillary networks. Using these effective matrix conditions, 3D heterocellular interactions of ECs with different mural cells were demonstrated that enabled EC network modulation and maintenance of stable vascular capillaries over periods of about one month in vitro. The approach was also shown to permit in vitro tumor vascularization experiments with unprecedented levels of control over both ECs and tumor cells. In total, the introduced 3D hydrogel co-culture system could offer unique options for dissecting and adjusting biochemical, biophysical, and cell-cell triggers in tissue-related vascularization models.
- ItemMedical ethics in the Anthropocene: how are €100 billion of German physicians' pension funds invested?(Amsterdam : Elsevier, 2019) Schulz, Christian M.; Ahrend, Klaus-Michael; Schneider, Gerhard; Hohendorf, Gerrit; Schellnhuber, Hans Joachim; Busse, Reinhard[No abstract available]
- ItemTowards dynamical network biomarkers in neuromodulation of episodic migraine(Berlin : De Gruyter, 2013) Dahlem, M.A.; Rode, S.; May, A.; Fujiwara, N.; Hirata, Y.; Aihara, K.; Kurths, J.Computational methods have complemented experimental and clinical neurosciences and led to improvements in our understanding of the nervous systems in health and disease. In parallel, neuromodulation in form of electric and magnetic stimulation is gaining increasing acceptance in chronic and intractable diseases. In this paper, we firstly explore the relevant state of the art in fusion of both developments towards translational computational neuroscience. Then, we propose a strategy to employ the new theoretical concept of dynamical network biomarkers (DNB) in episodic manifestations of chronic disorders. In particular, as a first example, we introduce the use of computational models in migraine and illustrate on the basis of this example the potential of DNB as early-warning signals for neuromodulation in episodic migraine.