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    Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities
    (London : BMJ Publ. Group, 2021) Meng, Xia; Liu, Cong; Chen, Renjie; Sera, Francesco; Vicedo-Cabrera, Ana Maria; Milojevic, Ai; Guo, Yuming; Tong, Shilu; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Lavigne, Eric; Correa, Patricia Matus; Ortega, Nicolas Valdes; Osorio, Samuel; Garcia, null; Kyselý, Jan; Urban, Aleš; Orru, Hans; Maasikmets, Marek; Jaakkola, Jouni J. K.; Ryti, Niilo; Huber, Veronika; Schneider, Alexandra; Katsouyanni, Klea; Analitis, Antonis; Hashizume, Masahiro; Honda, Yasushi; Ng, Chris Fook Sheng; Nunes, Baltazar; Teixeira, João Paulo; Holobaca, Iulian Horia; Fratianni, Simona; Kim, Ho; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Ragettli, Martina S.; Guo, Yue-Liang Leon; Pan, Shih-Chun; Li, Shanshan; Bell, Michelle L.; Zanobetti, Antonella; Schwartz, Joel; Wu, Tangchun; Gasparrini, Antonio; Kan, Haidong
    Objective To evaluate the short term associations between nitrogen dioxide (NO2) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. Design Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. Setting 398 cities in 22 low to high income countries/regions. Main outcome measures Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. Results On average, a 10 μg/m3 increase in NO2 concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM10 and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO2 concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. Conclusions This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO2 and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO2.
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    Comments on the authors’ reply to the critical appraisal concerning “Wearable cardioverter defibrillators for the prevention of sudden cardiac arrest: A health technology assessment and patient focus group study”
    (Macclesfield [u.a.] : Dove Medical Press, 2018) Sperzel, Johannes; Staudacher, Ingo; Goeing, Olaf; Stockburger, Martin; Meyer, Thorsten; Oliveira Goncalves, Ana Sofia; Sydow, Hanna; Schoenfelder, Tonio; Amelung, Volker Eric
    [no abstract available]
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    A systematic review of non-productivity-related animal-based indicators of heat stress resilience in dairy cattle
    (San Francisco, California, US : PLOS, 2018-11-1) Galán, Elena; Llonch, Pol; Villagrá, Arantxa; Levit, Harel; Pinto, Severino; del Prado, Agustín
    Introduction Projected temperature rise in the upcoming years due to climate change has increased interest in studying the effects of heat stress in dairy cows. Environmental indices are commonly used for detecting heat stress, but have been used mainly in studies focused on the productivity-related effects of heat stress. The welfare approach involves identifying physiological and behavioural measurements so as to start heat stress mitigation protocols before the appearance of impending severe health or production issues. Therefore, there is growing interest in studying the effects of heat stress on welfare. This systematic review seeks to summarise the animal-based responses to heat stress (physiological and behavioural, excluding productivity) that have been used in scientific literature. Methods Using systematic review guidelines set by PRISMA, research articles were identified, screened and summarised based on inclusion criteria for physiology and behaviour, excluding productivity, for animal-based resilience indicators. 129 published articles were reviewed to determine which animal-based indicators for heat stress were most frequently used in dairy cows. Results The articles considered report at least 212 different animal-based indicators that can be aggregated into body temperature, feeding, physiological response, resting, drinking, grazing and pasture-related behaviour, reactions to heat management and others. The most common physiological animal-based indicators are rectal temperature, respiration rate and dry matter intake, while the most common behavioural indicators are time spent lying, standing and feeding. Conclusion Although body temperature and respiration rate are the animal-based indicators most frequently used to assess heat stress in dairy cattle, when choosing an animal-based indicator for detecting heat stress using scientific literature to establish thresholds, characteristics that influence the scale of the response and the definition of heat stress must be taken into account, e.g. breed, lactation stage, milk yield, system type, climate region, bedding type, diet and cooling management strategies. © 2018 Galan∗E.∗Elena et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.