TY - JOUR A1 - Herpich, Catrin A1 - Müller-Werdan, Ursula A1 - Norman, Kristina T1 - Role of plant-based diets in promoting health and longevity JF - Maturitas : The European menopause journal N2 - Western-style obesity-promoting diets are associated with increased inflammation, higher disease incidence and mortality. In contrast, plant-based diets (PBDs), which incorporate large amounts of vegetables and fruit, legumes, whole grains and only a small amount of meat, are generally associated with better health and lower mortality. This narrative review summarizes the evidence on health and life span in adults adhering to PBDs and discusses the potentially longevity-promoting mechanism of PBDs as well as limitations due to nutrient deficiencies. Epidemiologic studies consistently report lower mortality rates in adults who adhering to PBDs when compared with people whose diet regularly includes meat. PBDs are associated with many health benefits, such as improved metabolic and inflammatory profile. In turn, the incidence of cardiovascular disease is lower in adults consuming PBDs, which contributes to their better health. The health-promoting effects of PBDs are still not entirely clear but most likely multifactorial and include modulation of the gut microbiome. The interest in possible longevity-promoting mechanisms of PBDs has increased in recent years, as many characteristics of PBDs such as protein restriction and restriction of certain amino acids are known to extend the life span. While there is ample evidence from animal studies, large-scale human studies, which also provide insight into the specific mechanisms of the effect of PBDs on longevity, are missing. However, due to the lower protein content of PBDs, there appears to be an age limit for the anticipated health effects, as adults over 65 require larger amounts of protein. KW - plant-based diets KW - mortality KW - health span KW - longevity Y1 - 2022 U6 - https://doi.org/10.1016/j.maturitas.2022.07.003 SN - 0378-5122 SN - 1873-4111 VL - 165 SP - 47 EP - 51 PB - Elsevier Science CY - Amsterdam [u.a.] ER - TY - JOUR A1 - Premier, Joseph A1 - Fickel, Jörns A1 - Heurich, Marco A1 - Kramer-Schadt, Stephanie T1 - The boon and bane of boldness BT - movement syndrome as saviour and sink for population genetic diversity JF - Movement Ecology N2 - Background: Many felid species are of high conservation concern, and with increasing human disturbance the situation is worsening. Small isolated populations are at risk of genetic impoverishment decreasing within-species biodiversity. Movement is known to be a key behavioural trait that shapes both demographic and genetic dynamics and affects population survival. However, we have limited knowledge on how different manifestations of movement behaviour translate to population processes. In this study, we aimed to 1) understand the potential effects of movement behaviour on the genetic diversity of small felid populations in heterogeneous landscapes, while 2) presenting a simulation tool that can help inform conservation practitioners following, or considering, population management actions targeting the risk of genetic impoverishment. Methods: We developed a spatially explicit individual-based population model including neutral genetic markers for felids and applied this to the example of Eurasian lynx. Using a neutral landscape approach, we simulated reintroductions into a three-patch system, comprising two breeding patches separated by a larger patch of differing landscape heterogeneity, and tested for the effects of various behavioural movement syndromes and founder population sizes. We explored a range of movement syndromes by simulating populations with various movement model parametrisations that range from 'shy' to 'bold' movement behaviour. Results: We find that movement syndromes can lead to a higher loss of genetic diversity and an increase in between population genetic structure for both "bold" and "shy" movement behaviours, depending on landscape conditions, with larger decreases in genetic diversity and larger increases in genetic differentiation associated with bold movement syndromes, where the first colonisers quickly reproduce and subsequently dominate the gene pool. In addition, we underline the fact that a larger founder population can offset the genetic losses associated with subpopulation isolation and gene pool dominance. Conclusions We identified a movement syndrome trade-off for population genetic variation, whereby bold-explorers could be saviours - by connecting populations and promoting panmixia, or sinks - by increasing genetic losses via a 'founder takes all' effect, whereas shy-stayers maintain a more gradual genetic drift due to their more cautious behaviour. Simulations should incorporate movement behaviour to provide better projections of long-term population viability and within-species biodiversity, which includes genetic diversity. Simulations incorporating demographics and genetics have great potential for informing conservation management actions, such as population reintroductions or reinforcements. Here, we present such a simulation tool for solitary felids. KW - Lynx lynx KW - neutral landscape models KW - eurasian lynx KW - natal dispersal KW - home range KW - fragmented landscapes KW - behavioral syndromes KW - habitat loss KW - personality KW - mortality Y1 - 2020 U6 - https://doi.org/10.1186/s40462-020-00204-y SN - 2051-3933 VL - 8 IS - 1 SP - 1 EP - 17 PB - BioMed Central CY - London ER - TY - JOUR A1 - Vaid, Akhil A1 - Somani, Sulaiman A1 - Russak, Adam J. A1 - De Freitas, Jessica K. A1 - Chaudhry, Fayzan F. A1 - Paranjpe, Ishan A1 - Johnson, Kipp W. A1 - Lee, Samuel J. A1 - Miotto, Riccardo A1 - Richter, Felix A1 - Zhao, Shan A1 - Beckmann, Noam D. A1 - Naik, Nidhi A1 - Kia, Arash A1 - Timsina, Prem A1 - Lala, Anuradha A1 - Paranjpe, Manish A1 - Golden, Eddye A1 - Danieletto, Matteo A1 - Singh, Manbir A1 - Meyer, Dara A1 - O'Reilly, Paul F. A1 - Huckins, Laura A1 - Kovatch, Patricia A1 - Finkelstein, Joseph A1 - Freeman, Robert M. A1 - Argulian, Edgar A1 - Kasarskis, Andrew A1 - Percha, Bethany A1 - Aberg, Judith A. A1 - Bagiella, Emilia A1 - Horowitz, Carol R. A1 - Murphy, Barbara A1 - Nestler, Eric J. A1 - Schadt, Eric E. A1 - Cho, Judy H. A1 - Cordon-Cardo, Carlos A1 - Fuster, Valentin A1 - Charney, Dennis S. A1 - Reich, David L. A1 - Böttinger, Erwin A1 - Levin, Matthew A. A1 - Narula, Jagat A1 - Fayad, Zahi A. A1 - Just, Allan C. A1 - Charney, Alexander W. A1 - Nadkarni, Girish N. A1 - Glicksberg, Benjamin S. T1 - Machine learning to predict mortality and critical events in a cohort of patients with COVID-19 in New York City: model development and validation JF - Journal of medical internet research : international scientific journal for medical research, information and communication on the internet ; JMIR N2 - Background: COVID-19 has infected millions of people worldwide and is responsible for several hundred thousand fatalities. The COVID-19 pandemic has necessitated thoughtful resource allocation and early identification of high-risk patients. However, effective methods to meet these needs are lacking. Objective: The aims of this study were to analyze the electronic health records (EHRs) of patients who tested positive for COVID-19 and were admitted to hospitals in the Mount Sinai Health System in New York City; to develop machine learning models for making predictions about the hospital course of the patients over clinically meaningful time horizons based on patient characteristics at admission; and to assess the performance of these models at multiple hospitals and time points. Methods: We used Extreme Gradient Boosting (XGBoost) and baseline comparator models to predict in-hospital mortality and critical events at time windows of 3, 5, 7, and 10 days from admission. Our study population included harmonized EHR data from five hospitals in New York City for 4098 COVID-19-positive patients admitted from March 15 to May 22, 2020. The models were first trained on patients from a single hospital (n=1514) before or on May 1, externally validated on patients from four other hospitals (n=2201) before or on May 1, and prospectively validated on all patients after May 1 (n=383). Finally, we established model interpretability to identify and rank variables that drive model predictions. Results: Upon cross-validation, the XGBoost classifier outperformed baseline models, with an area under the receiver operating characteristic curve (AUC-ROC) for mortality of 0.89 at 3 days, 0.85 at 5 and 7 days, and 0.84 at 10 days. XGBoost also performed well for critical event prediction, with an AUC-ROC of 0.80 at 3 days, 0.79 at 5 days, 0.80 at 7 days, and 0.81 at 10 days. In external validation, XGBoost achieved an AUC-ROC of 0.88 at 3 days, 0.86 at 5 days, 0.86 at 7 days, and 0.84 at 10 days for mortality prediction. Similarly, the unimputed XGBoost model achieved an AUC-ROC of 0.78 at 3 days, 0.79 at 5 days, 0.80 at 7 days, and 0.81 at 10 days. Trends in performance on prospective validation sets were similar. At 7 days, acute kidney injury on admission, elevated LDH, tachypnea, and hyperglycemia were the strongest drivers of critical event prediction, while higher age, anion gap, and C-reactive protein were the strongest drivers of mortality prediction. Conclusions: We externally and prospectively trained and validated machine learning models for mortality and critical events for patients with COVID-19 at different time horizons. These models identified at-risk patients and uncovered underlying relationships that predicted outcomes. KW - machine learning KW - COVID-19 KW - electronic health record KW - TRIPOD KW - clinical KW - informatics KW - prediction KW - mortality KW - EHR KW - cohort KW - hospital KW - performance Y1 - 2020 U6 - https://doi.org/10.2196/24018 SN - 1439-4456 SN - 1438-8871 VL - 22 IS - 11 PB - Healthcare World CY - Richmond, Va. ER - TY - JOUR A1 - Salzwedel, Annett A1 - Jensen, Katrin A1 - Rauch, Bernhard A1 - Doherty, Patrick A1 - Metzendorf, Maria-Inti A1 - Hackbusch, Matthes A1 - Völler, Heinz A1 - Schmid, Jean-Paul A1 - Davos, Constantinos H. T1 - Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine BT - update of the Cardiac Rehabilitation Outcome Study (CROS-II) JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background Despite numerous studies and meta-analyses the prognostic effect of cardiac rehabilitation is still under debate. This update of the Cardiac Rehabilitation Outcome Study (CROS II) provides a contemporary and practice focused approach including only cardiac rehabilitation interventions based on published standards and core components to evaluate cardiac rehabilitation delivery and effectiveness in improving patient prognosis. Design A systematic review and meta-analysis. Methods Randomised controlled trials and retrospective and prospective controlled cohort studies evaluating patients after acute coronary syndrome, coronary artery bypass grafting or mixed populations with coronary artery disease published until September 2018 were included. Resulte Based on CROS inclusion criteria out of 7096 abstracts six additional studies including 8671 patients were identified (two randomised controlled trials, two retrospective controlled cohort studies, two prospective controlled cohort studies). In total, 31 studies including 228,337 patients were available for this meta-analysis (three randomised controlled trials, nine prospective controlled cohort studies, 19 retrospective controlled cohort studies; 50,653 patients after acute coronary syndrome 14,583, after coronary artery bypass grafting 163,101, mixed coronary artery disease populations; follow-up periods ranging from 9 months to 14 years). Heterogeneity in design, cardiac rehabilitation delivery, biometrical assessment and potential confounders was considerable. Controlled cohort studies showed a significantly reduced total mortality (primary endpoint) after cardiac rehabilitation participation in patients after acute coronary syndrome (prospective controlled cohort studies: hazard ratio (HR) 0.37, 95% confidence interval (CI) 0.20-0.69; retrospective controlled cohort studies HR 0.64, 95% CI 0.53-0.76; prospective controlled cohort studies odds ratio 0.20, 95% CI 0.08-0.48), but the single randomised controlled trial fulfilling the CROS inclusion criteria showed neutral results. Cardiac rehabilitation participation was also associated with reduced total mortality in patients after coronary artery bypass grafting (retrospective controlled cohort studies HR 0.62, 95% CI 0.54-0.70, one single randomised controlled trial without fatal events), and in mixed coronary artery disease populations (retrospective controlled cohort studies HR 0.52, 95% CI 0.36-0.77; two out of 10 controlled cohort studies with neutral results). Conclusion CROS II confirms the effectiveness of cardiac rehabilitation participation after acute coronary syndrome and after coronary artery bypass grafting in actual clinical practice by reducing total mortality under the conditions of current evidence-based coronary artery disease treatment. The data of CROS II, however, underscore the urgent need to define internationally accepted minimal standards for cardiac rehabilitation delivery as well as for scientific evaluation. KW - cardiac rehabilitation KW - cardiac rehabilitation delivery KW - acute coronary KW - syndrome KW - coronary bypass grafting KW - coronary artery disease KW - mortality Y1 - 2020 U6 - https://doi.org/10.1177/2047487320905719 SN - 2047-4873 SN - 2047-4881 VL - 27 IS - 16 SP - 1756 EP - 1774 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Stoppel, Relika T1 - Alcohol availability and alcohol-attributable mortality BT - economic implications following a change in sales policy JF - CESifo economic studies : CESifo, a joint initiative of the University of Munich's Center for Economic Studies and the Ifo Institute N2 - It is commonly known that irresponsible alcohol use can have adverse effects. For some people, it results in health problems, for others in productivity loss, and some experience the worst possible outcome of alcohol misuse - death. This paper estimates the effect of reduced alcohol sales hours on alcohol-attributable mortality (AAM) in Estonia. Using novel mortality data from 1997 to 2015, this paper analyzes the effect of alcohol sales policies at both the county level and the country level. By applying the difference-in-differences method and the ARIMA model, this paper finds that the alcohol sales policy reduced AAM to between 1.710 and 2.401 deaths per 100,000 per month, which equals a reduction of 31% to 40% in AAM deaths. These findings suggest that individuals who are the most at risk of dying from alcohol-attributable causes of death benefit remarkably from reduced alcohol availability. KW - health policy KW - mortality KW - public health KW - alcohol Y1 - 2021 U6 - https://doi.org/10.1093/cesifo/ifab008 SN - 1610-241X SN - 1612-7501 VL - 67 IS - 4 SP - 463 EP - 487 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Neufeld, Maria A1 - Bobrova, Anastacia A1 - Davletov, Kairat A1 - Stelemekas, Mindaugas A1 - Stoppel, Relika A1 - Ferreira-Borges, Carina A1 - Breda, Joao A1 - Rehm, Jürgen T1 - Alcohol control policies in Former Soviet Union countries BT - a narrative review of three decades of policy changes and their apparent effects JF - Drug and alcohol review N2 - Issues The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. Approach The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments.
Key Findings Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three 'best buys' put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. Implications In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions. Conclusion Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall. KW - alcohol KW - alcohol policy KW - Eastern Europe KW - Former Soviet Union KW - mortality Y1 - 2020 U6 - https://doi.org/10.1111/dar.13204 SN - 0959-5236 SN - 1465-3362 VL - 40 IS - 3 SP - 350 EP - 367 PB - Wiley CY - Hoboken ER - TY - THES A1 - Krummenauer, Linda T1 - Global heat adaptation among urban populations and its evolution under different climate futures T1 - Globale Hitzeanpassung urbaner Bevölkerungen und deren Entwicklung unter verschiedenen klimatischen Zukünften N2 - Heat and increasing ambient temperatures under climate change represent a serious threat to human health in cities. Heat exposure has been studied extensively at a global scale. Studies comparing a defined temperature threshold with the future daytime temperature during a certain period of time, had concluded an increase in threat to human health. Such findings however do not explicitly account for possible changes in future human heat adaptation and might even overestimate heat exposure. Thus, heat adaptation and its development is still unclear. Human heat adaptation refers to the local temperature to which populations are adjusted to. It can be inferred from the lowest point of the U- or V-shaped heat-mortality relationship (HMR), the Minimum Mortality Temperature (MMT). While epidemiological studies inform on the MMT at the city scale for case studies, a general model applicable at the global scale to infer on temporal change in MMTs had not yet been realised. The conventional approach depends on data availability, their robustness, and on the access to daily mortality records at the city scale. Thorough analysis however must account for future changes in the MMT as heat adaptation happens partially passively. Human heat adaptation consists of two aspects: (1) the intensity of the heat hazard that is still tolerated by human populations, meaning the heat burden they can bear and (2) the wealth-induced technological, social and behavioural measures that can be employed to avoid heat exposure. The objective of this thesis is to investigate and quantify human heat adaptation among urban populations at a global scale under the current climate and to project future adaptation under climate change until the end of the century. To date, this has not yet been accomplished. The evaluation of global heat adaptation among urban populations and its evolution under climate change comprises three levels of analysis. First, using the example of Germany, the MMT is calculated at the city level by applying the conventional method. Second, this thesis compiles a data pool of 400 urban MMTs to develop and train a new model capable of estimating MMTs on the basis of physical and socio-economic city characteristics using multivariate non-linear multivariate regression. The MMT is successfully described as a function of the current climate, the topography and the socio-economic standard, independently of daily mortality data for cities around the world. The city-specific MMT estimates represents a measure of human heat adaptation among the urban population. In a final third analysis, the model to derive human heat adaptation was adjusted to be driven by projected climate and socio-economic variables for the future. This allowed for estimation of the MMT and its change for 3 820 cities worldwide for different combinations of climate trajectories and socio-economic pathways until 2100. The knowledge on the evolution of heat adaptation in the future is a novelty as mostly heat exposure and its future development had been researched. In this work, changes in heat adaptation and exposure were analysed jointly. A wide range of possible health-related outcomes up to 2100 was the result, of which two scenarios with the highest socio-economic developments but opposing strong warming levels were highlighted for comparison. Strong economic growth based upon fossil fuel exploitation is associated with a high gain in heat adaptation, but may not be able to compensate for the associated negative health effects due to increased heat exposure in 30% to 40% of the cities investigated caused by severe climate change. A slightly less strong, but sustainable growth brings moderate gains in heat adaptation but a lower heat exposure and exposure reductions in 80% to 84% of the cities in terms of frequency (number of days exceeding the MMT) and intensity (magnitude of the MMT exceedance) due to a milder global warming. Choosing a 2 ° C compatible development by 2100 would therefore lower the risk of heat-related mortality at the end of the century. In summary, this thesis makes diverse and multidisciplinary contributions to a deeper understanding of human adaptation to heat under the current and the future climate. It is one of the first studies to carry out a systematic and statistical analysis of urban characteristics which are useful as MMT drivers to establish a generalised model of human heat adaptation, applicable at the global level. A broad range of possible heat-related health options for various future scenarios was shown for the first time. This work is of relevance for the assessment of heat-health impacts in regions where mortality data are not accessible or missing. The results are useful for health care planning at the meso- and macro-level and to urban- and climate change adaptation planning. Lastly, beyond having met the posed objective, this thesis advances research towards a global future impact assessment of heat on human health by providing an alternative method of MMT estimation, that is spatially and temporally flexible in its application. N2 - Hitze und steigende Umgebungstemperaturen im Zuge des Klimawandels stellen eine ernsthafte Bedrohung für die menschliche Gesundheit in Städten dar. Die Hitzeexposition wurde umfassend auf globaler Ebene untersucht. Studien, die eine definierte Temperaturschwelle mit der zukünftigen Tagestemperatur während eines bestimmten Zeitraums verglichen, hatten eine Zunahme der Gefährdung der menschlichen Gesundheit ergeben. Solche Ergebnisse berücksichtigen jedoch nicht explizit mögliche Veränderungen der zukünftigen menschlichen Hitzeadaption und könnten daher sogar die Hitzeexposition überschätzen. Somit ist die menschliche Adaption an Hitze und ihre zukünftige Entwicklung noch unklar. Die menschliche Hitzeadaption bezieht sich auf die lokale Temperatur, an die sich die Bevölkerung angepasst hat. Sie lässt sich aus dem Tiefpunkt der U- oder V-förmigen Relation zwischen Hitze und Mortalität (HMR), der Mortalitätsminimaltemperatur (MMT), ableiten. Während epidemiologische Fallstudien über die MMT auf Stadtebene informieren, wurde ein auf globaler Ebene anwendbares allgemeines Modell, um auf die zeitliche Veränderung der MMTs zu schließen, bisher noch nicht realisiert. Der konventionelle Ansatz ist abhängig von der Datenverfügbarkeit, ihrer Robustheit und dem Zugang zu täglichen Mortalitätsdaten auf Stadtebene. Eine gründliche Analyse muss jedoch zukünftige Veränderungen in der MMT berücksichtigen, da die menschliche Hitzeanpassung teils passiv erfolgt. Die menschliche Hitzeanpassung besteht aus zwei Aspekten: (1) aus der Intensität der Hitze, die von der menschlichen Bevölkerung noch toleriert wird, also die Hitzebelastung, die sie ertragen kann, und (2) aus vermögensbedingten technologischen, sozialen und verhaltensbezogenen Maßnahmen, die zur Vermeidung von Hitzeexposition eingesetzt werden können. Das Ziel dieser Arbeit ist es, die menschliche Hitzeanpassung der städtischen Bevölkerung unter dem aktuellen Klima auf globaler Ebene zu untersuchen und zu quantifizieren und die zukünftige Anpassung an den Klimawandel bis zum Ende des Jahrhunderts zu projizieren. Dies wurde bis heute noch nicht erreicht. Die Bewertung der globalen Hitzeanpassung städtischer Bevölkerungen und ihrer Entwicklung unter dem Klimawandel umfasst drei Analyseebenen. Erstens wird am Beispiel Deutschlands die MMT auf Stadtebene nach der konventionellen Methode berechnet. Zweitens trägt diese Arbeit einen Datenpool von 400 städtischen MMTs zusammen, um auf dessen Basis ein neues Modell zu entwickeln und zu trainieren, welches in der Lage ist, MMTs auf der Grundlage von physischen und sozioökonomischen Stadtmerkmalen mittels multivariater nichtlinearer multivariater Regression zu schätzen. Es wird gezeigt, dass die MMT als Funktion des aktuellen Klimas, der Topographie und des sozioökonomischen Standards beschrieben werden kann, unabhängig von täglichen Sterblichkeitsdaten für Städte auf der ganzen Welt. Die stadtspezifischen MMT-Schätzungen stellen ein Maß für die menschliche Hitzeanpassung der städtischen Bevölkerung dar. In einer letzten dritten Analyse wurde das Modell zur Schätzung der menschlichen Hitzeadaption angepasst, um von für die Zukunft projizierten Klima- und sozioökonomischen Variablen angetrieben zu werden. Dies ermöglichte eine Schätzung des MMT und seiner Veränderung für 3 820 Städte weltweit für verschiedene Kombinationen aus Klimatrajektorien und sozioökonomischen Entwicklungspfaden bis 2100. Das Wissen über die Entwicklung der menschlichen Hitzeanpassung in der Zukunft ist ein Novum, da bisher hauptsächlich die Hitzeexposition und ihre zukünftige Entwicklung erforscht wurden. In dieser Arbeit wurden die Veränderungen der menschlichen Hitzeadaptation und der Hitzeexposition gemeinsam analysiert. Das Ergebnis ist ein breites Spektrum möglicher gesundheitsbezogener Zukünfte bis 2100, von denen zum Vergleich zwei Szenarienkombinationen mit den höchsten sozioökonomischen Entwicklungen, aber gegensätzlichen starken Erwärmungsniveaus hervorgehoben wurden. Ein starkes Wirtschaftswachstum auf der Grundlage der Nutzung fossiler Brennstoffe fördert zwar einen hohen Zugewinn an Hitzeanpassung, kann jedoch die damit verbundenen negativen gesundheitlichen Auswirkungen aufgrund der erhöhten Exposition in rund 30% bis 40% der untersuchten Städte aufgrund eines starken Klimawandels möglicherweise nicht ausgleichen. Ein etwas weniger starkes, dafür aber nachhaltiges Wachstum bringt aufgrund einer milderen globalen Erwärmung eine moderate Hitzeanpassung und eine geringere Hitzeexposition und sogar eine Abnahme der Exposition in 80% bis 84% der Städte in Bezug auf Häufigkeit (Anzahl der Tage über der MMT) und Intensität (Magnitude der MMT-Überschreitung). Die Wahl einer 2 ° C-kompatiblen Entwicklung bis 2100 würde daher das Risiko einer hitzebedingten Sterblichkeit am Ende des Jahrhunderts senken. Zusammenfassend liefert diese Dissertation vielfältige und multidisziplinäre Beiträge zu einem tieferen Verständnis der menschlichen Hitzeanpassung unter dem gegenwärtigen und zukünftigen Klima. Es ist eine der ersten Studien, die eine systematische und statistische Analyse städtischer Merkmale durchführt, die sich als MMT-Treiber verwenden lassen, um ein verallgemeinertes Modell der menschlichen Hitzeanpassung zu erarbeiten, das auf globaler Ebene anwendbar ist. Erstmals wurde ein breites Spektrum möglicher hitzebedingter Gesundheitsoptionen für verschiedene Zukunftsszenarien aufgezeigt. Diese Arbeit ist von Bedeutung für die Bewertung von hitzebezogener Gesundheitsauswirkungen in Regionen, in denen Mortalitätsdaten nicht zugänglich sind oder fehlen. Die Ergebnisse sind nützlich für die Gesundheitsplanung auf Meso- und Makroebene sowie für die Stadtplanung und die Planung der Anpassung an den Klimawandel. Über das Erreichen des gestellten Ziels hinaus treibt diese Dissertation die Forschung in Richtung einer globalen zukünftigen Folgenabschätzung von Hitze auf die menschliche Gesundheit voran, indem eine alternative Methode der MMT-Schätzung bereitgestellt wird, die in ihrer Anwendung räumlich und zeitlich flexibel ist. KW - heat KW - adaptation KW - global KW - populations KW - climate change KW - temperature KW - mortality KW - minimum mortality temperature KW - projection KW - future KW - health KW - model KW - socio-economy KW - wealth KW - acclimatisation KW - Akklimatisierung KW - Anpassung KW - Hitzeanpassung KW - Klimawandel KW - Zukunft KW - global KW - Gesundheit KW - Hitze KW - Mortalitäts-Minimal-Temperatur KW - Modell KW - Mortalität KW - Bevölkerung KW - Projektion KW - Sozioökonomie KW - Temperatur KW - Wohlstand KW - exposure KW - hazard KW - cities KW - Exposition KW - Naturgefahr KW - Städte Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-559294 ER - TY - JOUR A1 - Baritello, Omar A1 - Salzwedel, Annett A1 - Sündermann, Simon A1 - Niebauer, Josef A1 - Völler, Heinz T1 - The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review JF - Journal of Clinical Medicine N2 - Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text KW - frailty tool KW - TAVI KW - older patients KW - elderly KW - cardiology KW - mortality Y1 - 2021 U6 - https://doi.org/10.3390/jcm10194506 SN - 2077-0383 VL - 10 SP - 1 EP - 17 PB - MDPI CY - Basel, Schweiz ET - 19 ER - TY - GEN A1 - Baritello, Omar A1 - Salzwedel, Annett A1 - Sündermann, Simon A1 - Niebauer, Josef A1 - Völler, Heinz T1 - The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 765 KW - frailty tool KW - TAVI KW - older patients KW - elderly KW - cardiology KW - mortality Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-550440 SN - 1866-8364 VL - 10 SP - 1 EP - 17 PB - Universitätsverlag Potsdam CY - Potsdam ET - 19 ER - TY - JOUR A1 - Nitezki, Tina A1 - Kleuser, Burkhard A1 - Krämer, Stephanie T1 - Fatal gastric distension in a gold thioglucose mouse model of obesity JF - Laboratory Animals N2 - This case report addresses the problem of underreporting negative results and adverse side effects in animal testing. We present our findings regarding a hyperphagic mouse model associated with unforeseen high mortality. The results outline the necessity of reporting detailed information in the literature to avoid duplication. Obese mouse models are essential in the study of obesity, metabolic syndrome and diabetes mellitus. An experimental model of obesity can be induced by the administration of gold thioglucose (GTG). After transcending the blood-brain barrier, the GTG molecule interacts with regions of the ventromedial hypothalamus, thereby primarily targeting glucose-sensitive neurons. When these neurons are impaired, mice become insensitive to the satiety effects of glucose and develop hyperphagia. In a pilot study for optimising dosage and body weight development, C57BL/6 mice were treated with GTG (0.5 mg/g body weight) or saline, respectively. Animals were provided a physiological amount of standard diet (5 g per animal) for the first 24 hours after treatment to prevent gastric dilatation. Within 24 hours after GTG injection, all GTG-treated animals died of gastric overload and subsequent circulatory shock. Animals developed severe attacks of hyperphagia, and as the amount of provided chow was restricted, mice exhibited unforeseen pica and ingested bedding material. These observations strongly suggest that restricted feeding is contraindicated concerning GTG application. Presumably, the impulse of excessive food intake was a strong driving force. Therefore, the actual degree of suffering in the GTG-induced model of hyperphagia should be revised from moderate to severe. KW - appetite KW - distress KW - refinement KW - mortality Y1 - 2018 U6 - https://doi.org/10.1177/0023677218803384 SN - 0023-6772 SN - 1758-1117 VL - 53 IS - 1 SP - 89 EP - 94 PB - Sage Publ. CY - Thousand Oaks ER -