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Climate change is impacting ecosystems worldwide, and the Mediterranean Sea is no exception. Extreme climatic events, such as marine heat waves (MHWs), are increasing in frequency, extent and intensity during the last decades, which has been associated with an increase in mass mortality events for multiple species. Coralligenous assemblages, where the octocoral Paramuricea clavata lives, are strongly affected by MHWs. The Medes Islands Marine Reserve (NW Mediterranean) was considered a climate refugia for P. clavata, as their populations were showing some resilience to these changing conditions. In this study, we assessed the impacts of the MHWs that occurred between 2016 and 2022 in seven shallow populations of the octocoral P. clavata from a Mediterranean Marine Protected Area. The years that the mortality rates increased significantly were associated with the ones with strong MHWs, 2022 being the one with higher mortalities. In 2022, with 50 MHW days, the proportion of total affected colonies was almost 70%, with a proportion of the injured surface of almost 40%, reaching levels never attained in our study site since the monitoring was started. We also found spatial variability between the monitored populations. Whereas few of them showed low levels of mortality, others lost around 75% of their biomass. The significant impacts documented here raise concerns about the future of shallow P. clavata populations across the Mediterranean, suggesting that the resilience of this species may not be maintained to sustain these populations face the ongoing warming trends.
El canvi climatic està impactant els ecosistemes arreu del planeta, i el Mar Mediterrani no n'és una excepció. Els esdeveniments climàtics extrems, com ara les onades de calor marines, estan augmentant en freqüència, extensió i intensitat en les darreres dècades, i estan sent associades a un increment dels esdeveniments de mortalitat massiva de múltiples espècies. El coral·ligen, on hi viu l'octocorall Paramuricea clavata, està altament afectat per les onades de calor marines. La Reserva Marina de les Illes Medes (NO del Mediterrani) es considerava un refugi climàtic per aquesta espècie, degut a que les seves poblacions mostraven certa resiliència a les condicions canviants. En aquest estudi hem avaluat els impactes de les onades de calor marines succeïdes entre els anys 2016 i 2022 a set poblacions someres de l'octocorall P. clavata, en una Àrea Marina Protegida del Mediterrani. Els anys en els quals les taxes de mortalitat van incrementar significativament s'associen amb els anys amb fortes onades de calor marines, sent el 2022 l'any amb la mortalitat més elevada. Al 2022, amb 50 dies d'onada de calor, la proporció total de colònies afectades va ser prop del 70%, amb un percentatge de superfície afectada de gairebé el 40%, arribant a valors mai observats en el lloc d'estudi des de que es va iniciar el seguiment d'aquestes poblacions. També hem observat variabilitat espacial entre les poblacions mostrejades. Mentre que algunes d'elles han mostrat poca mortalitat, altres han perdut al voltant del 75% de la seva biomassa. Els impactes documentats en aquest estudi mostren un futur preocupant de les poblacions someres de P. clavata arreu del Mediterrani, i això suggereix que la resiliència d'aquesta espècie podria no ser suficient per mantenir les seves poblacions en l'escenari d'escalfament que es preveu.
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We present a machine learning framework bridging manifold learning, neural networks, Gaussian processes, and Equation-Free multiscale approach, for the construction of different types of effective reduced order models from detailed agent-based simulators and the systematic multiscale numerical analysis of their emergent dynamics. The specific tasks of interest here include the detection of tipping points, and the uncertainty quantification of rare events near them. Our illustrative examples are an event-driven, stochastic financial market model describing the mimetic behavior of traders, and a compartmental stochastic epidemic model on an Erdös-Rényi network. We contrast the pros and cons of the different types of surrogate models and the effort involved in learning them. Importantly, the proposed framework reveals that, around the tipping points, the emergent dynamics of both benchmark examples can be effectively described by a one-dimensional stochastic differential equation, thus revealing the intrinsic dimensionality of the normal form of the specific type of the tipping point. This allows a significant reduction in the computational cost of the tasks of interest.
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Climate change is causing serious damage to natural and social systems, as well as having an impact on human health. Among the direct effects of climate change is the rise in global surface temperatures and the increase in the frequency, duration, intensity and severity of heat waves. In addition, understanding of the adaptation process of the exposed population remains limited, posing a challenge in accurately estimating heat-related morbidity and mortality. In this context, this study seeks to establish a conceptual framework that would make it easier to understand and organise knowledge about human adaptation to heat and the factors that may influence this process. An inductive approach based on grounded theory was used, through the analysis of case studies connecting concepts. The proposed conceptual framework is made up of five components (climate change, vulnerability, health risks of heat, axes of inequality and health outcomes), three heat-adaptation domains (physiological, cultural and political), two levels (individual and social), and the pre-existing before a heat event. The application of this conceptual framework facilitates the assistance of decision-makers in planning and implementing effective adaptation measures. Recognizing the importance of addressing heat adaptation as a health problem that calls for political solutions and social changes. Accordingly, this requires a multidisciplinary approach that would foster the participation and collaboration of multiple actors for the purpose of proposing effective measures to address the health impact of the rise in temperature.
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Cambio Climático , Calor , Humanos , Calor/efectos adversos , Adaptación FisiológicaRESUMEN
Ocean warming and acidification, decreases in dissolved oxygen concentrations, and changes in primary production are causing an unprecedented global redistribution of marine life. The identification of underlying ecological processes underpinning marine species turnover, particularly the prevalence of increases of warm-water species or declines of cold-water species, has been recently debated in the context of ocean warming. Here, we track changes in the mean thermal affinity of marine communities across European seas by calculating the Community Temperature Index for 65 biodiversity time series collected over four decades and containing 1,817 species from different communities (zooplankton, coastal benthos, pelagic and demersal invertebrates and fish). We show that most communities and sites have clearly responded to ongoing ocean warming via abundance increases of warm-water species (tropicalization, 54%) and decreases of cold-water species (deborealization, 18%). Tropicalization dominated Atlantic sites compared to semi-enclosed basins such as the Mediterranean and Baltic Seas, probably due to physical barrier constraints to connectivity and species colonization. Semi-enclosed basins appeared to be particularly vulnerable to ocean warming, experiencing the fastest rates of warming and biodiversity loss through deborealization.
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Biodiversidad , Invertebrados , Animales , Océanos y Mares , Peces , Temperatura , Agua , Ecosistema , Calentamiento GlobalRESUMEN
Mental and behavioral disorders are an important public health problem and constitute a priority for the WHO, whose recommendations include the surveillance of their risk factors. On the other hand, drought episodes have been increasing in frequency and severity in Europe since 1980. Therefore, to review the present knowledge about the impact of drought on mental and behavioral disorders, in the present climate change context, and to underline potential research gaps, could be of major interest. Thus, we performed a narrative review using online academic databases with the aim of identifying relevant literature about the impact of drought on mental and behavioral disorders. To the best of our knowledge, no study in Europe quantifies the potential association between drought and mental disorders. A limited number of studies have found significant associations between droughts (with different temporal ranges) and various measures of mental health. However, according to our review, only three of them quantified the association between drought and objective mental health outcomes, such as number of emergencies due to clinically diagnosed mental disorders or suicides. Additionally, few studies used specific indices as a measure of drought; and finally, as far as authors are aware, none of them has analyzed this relationship adjusting for various other potential environmental confounders. Moreover, the eventual association could vary between different geographical areas within the same country. Therefore, national and regional studies would be especially necessary. Thus, there is a need for specific national and regional studies, in Europe and globally, that assess the impact of specific indices of drought (with different temporal ranges) on objective mental health outcomes controlling for potential environmental confounders. Moreover, the quantification of its cost would be necessary for health prioritization, evidence-based policies and strategic health planning.
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Cambio Climático , Sequías , Trastornos Mentales , Humanos , Trastornos Mentales/epidemiología , Europa (Continente)RESUMEN
Marine Citizen Science (MCS) has emerged as a promising tool to enhance conservation efforts. Although the quality of volunteer data has been questioned, the design of specific protocols, effective training programs, and data validation by experts have enabled us to overcome these quality concerns, thus ensuring data reliability. Here, we validated the effectiveness of volunteer training in assessing the conservation status of Mediterranean coral species. We conducted a comparative analysis of data collected by volunteers with different levels of expertise, demonstrating improvements in data precision and accuracy with only one training session, thereby achieving values equivalent to those obtained by scientists. These outcomes align with the feedback received from volunteers through a qualitative survey. Finally, we analysed the data generated by volunteers and validated by experts using the developed protocol in the Coral Alert project from the Observadores del Mar MCS initiative. Our findings highlight the importance of proper training, expert validation, robust sampling protocols, and a well-structured platform to ensure the success of long-term MCS projects. Overall, our results stress the key role MCS plays in enhancing the conservation and management strategies designed to mitigate the ongoing environmental crisis.
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Antozoos , Ciencia Ciudadana , Animales , Humanos , Reproducibilidad de los Resultados , Voluntarios , Encuestas y CuestionariosRESUMEN
Climate change is currently regarded as the greatest global threat to human health, and its health-related consequences take different forms according to age, sex, socioeconomic level, and type of territory. The aim of this study is to ascertain the differences in vulnerability and the heat-adaptation process through the minimum mortality temperature (MMT) among the Spanish population aged ≥65 years by territorial classification. A retrospective, longitudinal, ecological time-series study, using provincial data on daily mortality and maximum daily temperature across the period 1983-2018, was performed, differentiating between urban and nonurban populations. The MMTs in the study period were higher for the ≥65-year age group in urban provinces, with a mean value of 29.6 °C (95%CI 29.2-30.0) versus 28.1 °C (95%CI 27.7-28.5) in nonurban provinces. This difference was statistically significant (p < 0.05). In terms of adaptation levels, higher average values were obtained for nonurban areas, with values of 0.12 (95%CI -0.13-0.37), than for urban areas, with values of 0.09 (95%CI -0.27-0.45), though this difference was not statistically significant (p < 0.05). These findings may contribute to better planning by making it possible to implement more specific public health prevention plans. Lastly, they highlight the need to conduct studies on heat-adaptation processes, taking into account various differential factors, such as age and territory.
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Aclimatación , Calor , Humanos , Anciano , España/epidemiología , Estudios Retrospectivos , Adaptación Fisiológica , MortalidadRESUMEN
The accurate delimitation of species boundaries in nonbilaterian marine taxa is notoriously difficult, with consequences for many studies in ecology and evolution. Anthozoans are a diverse group of key structural organisms worldwide, but the lack of reliable morphological characters and informative genetic markers hampers our ability to understand species diversification. We investigated population differentiation and species limits in Atlantic (Iberian Peninsula) and Mediterranean lineages of the octocoral genus Paramuricea previously identified as P. clavata. We used a diverse set of molecular markers (microsatellites, RNA-seq derived single-copy orthologues [SCO] and mt-mutS [mitochondrial barcode]) at 49 locations. Clear segregation of Atlantic and Mediterranean lineages was found with all markers. Species-tree estimations based on SCO strongly supported these two clades as distinct, recently diverged sister species with incomplete lineage sorting, P. cf. grayi and P. clavata, respectively. Furthermore, a second putative (or ongoing) speciation event was detected in the Atlantic between two P. cf. grayi color morphotypes (yellow and purple) using SCO and supported by microsatellites. While segregating P. cf. grayi lineages showed considerable geographic structure, dominating circalittoral communities in southern (yellow) and western (purple) Portugal, their occurrence in sympatry at some localities suggests a degree of reproductive isolation. Overall, our results show that previous molecular and morphological studies have underestimated species diversity in Paramuricea occurring in the Iberian Peninsula, which has important implications for conservation planning. Finally, our findings validate the usefulness of phylotranscriptomics for resolving evolutionary relationships in octocorals.
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The capacity for adaptation to climate change is limited, and the elderly rank high among the most exposed population groups. To date, few studies have addressed the issue of heat adaptation, and little is known about the long-term effects of exposure to heat. One indicator that allows the ascertainment of a population's level of adaptation to heat is the minimum mortality temperature (MMT), which links temperature and daily mortality. The aim of this study was to ascertain, firstly, adaptation to heat among persons aged ≥ 65 years across the period 1983 to 2018 through analysis of the MMT; and secondly, the trend in such adaptation to heat over time with respect to the total population. A retrospective longitudinal ecological time series study was conducted, using data on daily mortality and maximum daily temperature across the study period. Over time, the MMT was highest among elderly people, with a value of 28.6 °C (95%CI 28.3-28.9) versus 28.2 °C (95%CI 27.83-28.51) for the total population, though this difference was not statistically significant. A total of 62% of Spanish provinces included populations of elderly people that had adapted to heat during the study period. In general, elderly persons' level of adaptation registered an average value of 0.11 (°C/decade).
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Termotolerancia , Anciano , Humanos , España/epidemiología , Estudios Retrospectivos , Temperatura , Calor , MortalidadRESUMEN
The SARS-CoV-2 pandemic has favored the expansion of telemedicine. Philadelphia-negative chronic myeloproliferative neoplasms (Ph-MPN) might be good candidates for virtual follow-up. In this study, we aimed to analyze the follow-up of patients with Ph-MPN in Spain during COVID-19, its effectiveness, and acceptance among patients. We present a multicenter retrospective study from 30 centers. Five hundred forty-one patients were included with a median age of 67 years (yr). With a median follow-up of 19 months, 4410 appointments were recorded. The median of visits per patient was 7 and median periodicity was 2.7 months; significantly more visits and a higher frequency of them were registered in myelofibrosis (MF) patients. 60.1% of visits were in-person, 39.5% were by telephone, and 0.3% were videocall visits, with a predominance of telephone visits for essential thrombocythemia (ET) and polycythemia vera (PV) patients over MF, as well as for younger patients (< 50 yr). The proportion of phone visits significantly decreased after the first semester of the pandemic. Pharmacological modifications were performed only in 25.7% of the visits, and, considering overall management, ET patients needed fewer global treatment changes. Telephone contact effectiveness reached 90% and only 5.4% required a complementary in-person appointment. Although 56.2% of the cohort preferred in-person visits, 90.5% of our patients claimed to be satisfied with follow-up during the pandemic, with an 83% of positive comments. In view of our results, telemedicine has proven effective and efficient, and might continue to play a complementary role in Ph-MPN patients' follow-up.
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COVID-19 , Trastornos Mieloproliferativos , Policitemia Vera , Mielofibrosis Primaria , Trombocitemia Esencial , Humanos , Anciano , Pandemias , Estudios Retrospectivos , Satisfacción del Paciente , España/epidemiología , SARS-CoV-2 , Trastornos Mieloproliferativos/epidemiología , Trastornos Mieloproliferativos/terapia , Policitemia Vera/epidemiología , Mielofibrosis Primaria/epidemiología , Trombocitemia Esencial/epidemiologíaRESUMEN
INTRODUCTION: Belantamab mafodotin (BM) is a new anti-BCMA antibody-drug conjugate, recently approved for triple-class relapsed and refractory multiple myeloma (RRMM). We assessed real-world outcomes with BM in patients under the Spanish Expanded Access Program (EAP). METHODS: We conducted an observational, retrospective, multicenter study including RRMM patients who received ≥ 1 dose of BM (Nov 2019 to Jun 2021). The primary endpoint was overall response rate (ORR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and incidence of treatment-emergent adverse events (TEAEs). RESULTS: Thirty-three patients were included with a median of 70 years of age (range, 46-79 years). Median time from diagnosis was 71 months (range, 10-858 months). Median prior lines was 5 (range, 3-8 lines); 90% of patients were triple-/quad-/penta-refractory; 48% showed high-risk cytogenetics. Median BM doses was 3 (range 1-16 doses), with a median follow-up of 11 months (6-15 months). ORR was 42.2% (≥ VGPR, 18.2%). Median PFS was 3 months (95% CI 0.92-5.08) in the overall population, and 11 months (HR 0.26; 95% CI 0.10-0.68) for patients who achieved ≥ PR. PFS was not significantly different according to age, cytogenetic risk, and prior therapy lines. OS was 424 days (95% CI 107-740). Non-hematological TEAEs (57.6% of patients; 30.3% ≥ G3) included keratopathy (51.5%; 21.2% ≥ G3) and patient-reported vision-related symptoms (45.5%). Keratopathy was resolved in 70.6% of patients. G3 hematological TEAEs was 18.2%, thrombocytopenia (21.2%). Dose reductions due to TEAEs: 30.3%; delays: 36.4%. Treatment discontinuation causes: progression (54.5%), toxicity (non-ocular; 6%/ocular; 6% /ocular + non-ocular toxicity; 3%), death (6%), and patient's decision (3%). CONCLUSIONS: BM showed relevant anti-myeloma activity in RRMM with a manageable safety profile. These results corroborate those observed in the BM pivotal trial.
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Food security and food safety are two concepts related to food risks. The majority of studies regarding climate change and food risks are related to the security of food provision. The objective of this study was to review the current state of knowledge of the influence of climate change on food production and food safety. The literature search was carried out by specifying each area individually (crops, ranching, fishing, food safety, etc.), including the term "climate change" and other specific factors such as CO2, ozone, biotoxins, mortality, heat, etc.) The increase in carbon dioxide concentrations together with the increase in global temperatures theoretically produces greater yields in crops destined for human and animal consumption. However, the majority of studies have shown that crop yields are decreasing, due to the increase in the frequency of extreme weather events. Furthermore, these climate anomalies are irregularly distributed, with a greater impact on developing countries that have a lower capacity to address climate change. All of these factors result in greater uncertainty in terms of food provision and market speculation. An increase in average temperatures could lead to an increased risk of proliferation of micro-organisms that produce food-borne illnesses, such as salmonella and campylobacter. However, in developed countries with information systems that document the occurrence of these diseases over time, no clear trend has been determined, in part because of extensive food conservation controls.
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Cambio Climático , Enfermedades Transmitidas por los Alimentos , Animales , Humanos , Productos Agrícolas , Inocuidad de los Alimentos , TemperaturaRESUMEN
The frequency and severity of marine heatwaves causing mass mortality events in tropical and temperate coral species increases every year, with serious consequences on the stability and resilience of coral populations. Although recovery and persistence of coral populations after stress events is closely related to adult fitness, as well as larval survival and settlement, much remains unknown about the effects of thermal stress on early life-history stages of temperate coral species. In the present study, the reproductive phenology and the effect of increased water temperature (+4°C and +6°C above ambient, 20°C) on larval survival and settlement was evaluated for two of the most representative Mediterranean octocoral species (Eunicella singularis and Corallium rubrum). Our study shows that reproductive behavior is more variable than previously reported and breeding period occurs over a longer period in both species. Thermal stress did not affect the survival of symbiotic E. singularis larvae but drastically reduced the survival of the non-symbiotic C. rubrum larvae. Results on larval biomass and caloric consumption suggest that higher mortality rates of C. rubrum exposed to increased temperature were not related to depletion of endogenous energy in larvae. The results also show that settlement rates of E. singularis did not change in response to elevated temperature after 20 days of exposure, but larvae may settle fast and close to their native population at 26°C (+6°C). Although previous experimental studies found that adult colonies of both octocoral species are mostly resistant to thermal stress, our results on early life-history stages suggest that the persistence and inter-connectivity of local populations may be severely compromised under continued trends in ocean warming.
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Antozoos , Animales , Antozoos/fisiología , Simbiosis , Estadios del Ciclo de Vida , Larva , Arrecifes de Coral , TemperaturaRESUMEN
Ambient air quality, pollution and its implication onhealth is a topic of enormous importance that is normallydealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For thisreason, the Health Sciences Foundation, from its preventionarea, has formulated a series of questions to people with veryvaried competences in the area of ambient air quality in orderto obtain a global panorama of the problem and its elementsof measurement and control. The answers have been produced by specialists in each subject and have been subjected to ageneral discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks:external ambient air, internal ambient air, mainly in the workplace, and hospital ambient air and the consequences of itspoor control. Along with the definitions of each area and theindicators of good and bad quality, some necessary solutionshave been pointed out. We have tried to know the current legislation on this problem and the competences of the differentadministrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequentpresence in the general media and we have asked about thecauses of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in thelight of the events that the present pandemic raises. This workaims to provide objective data and opinions that will enablenon-specialists in the field to gain a better understanding ofthis worrying reality. (AU)
La calidad del aire ambiente y su implicación en la salud esun tema de enorme importancia que normalmente es tratadopor grandes especialistas en sus particulares áreas de interés.En general, no es discutido desde enfoques multidisciplinaresni con un lenguaje que pueda llegar a todos. Por ese motivo, laFundación de Ciencias de la Salud desde su área de prevención,ha formulado una serie de preguntas a personas con competencias muy variadas en el área de la calidad del aire ambientepara obtener un panorama global del problema y de sus elementos de medida y control. Las respuestas han sido producidas por especialistas en cada tema y han sido sometidas a unadiscusión general que ha permitido alcanzar conclusiones encada punto. El tema ha sido dividido en tres grandes bloques:el aire ambiente externo, el aire ambiente interno, principalmente en el medio laboral, y el aire ambiente hospitalario ylas consecuencias de su mal control. Junto con las definicionesde cada área y los indicadores de buena y mala calidad, se haapuntado a algunas necesarias soluciones. Hemos tratado deconocer la legislación vigente sobre este problema y las competencias de las distintas administraciones sobre el mismo.Pese a su enorme importancia, la calidad del aire ambiente yla salud no suele ser un tema de frecuente presencia en losmedios de comunicación generales y hemos preguntado sobrelas causas de ello. Finalmente, el documento aborda una seriede reflexiones desde la perspectiva de la ética y muy particularmente a la luz de los acontecimientos que la presente pandemia plantea. Este trabajo pretende aportar datos objetivos yopinión que permitan a los no especialistas en el tema conocermejor esta preocupante realidad. (AU)
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Humanos , Contaminación del Aire/análisis , Contaminación del Aire/prevención & control , Salud Pública , Infecciones del Sistema Respiratorio , Infección Hospitalaria , AspergilosisRESUMEN
Climate change is causing an increase in the frequency and intensity of marine heatwaves (MHWs) and mass mortality events (MMEs) of marine organisms are one of their main ecological impacts. Here, we show that during the 2015-2019 period, the Mediterranean Sea has experienced exceptional thermal conditions resulting in the onset of five consecutive years of widespread MMEs across the basin. These MMEs affected thousands of kilometers of coastline from the surface to 45 m, across a range of marine habitats and taxa (50 taxa across 8 phyla). Significant relationships were found between the incidence of MMEs and the heat exposure associated with MHWs observed both at the surface and across depths. Our findings reveal that the Mediterranean Sea is experiencing an acceleration of the ecological impacts of MHWs which poses an unprecedented threat to its ecosystems' health and functioning. Overall, we show that increasing the resolution of empirical observation is critical to enhancing our ability to more effectively understand and manage the consequences of climate change.
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Organismos Acuáticos , Ecosistema , Cambio Climático , Mar MediterráneoRESUMEN
Background: The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could influence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 â in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Results: Statistically significant associations were found between PM10, NO2 and the CM. These associations had a positive value. In the case of temperature and humidity, the associations had a negative value. PM10 being the variable that showed greater association, with the CM followed of NO2 in the majority of provinces. Anyone of the health determinants considered, could explain the differential geographic behavior. Conclusions: The role of PM10 is worth highlighting, as the chemical air pollutant for which there was a greater number of provinces in which it was associated with CM. The role of the meteorological variables-temperature and HA-was much less compared to that of the air pollutants. None of the social determinants we proposed could explain the heterogeneous geographical distribution identified in this study. Supplementary Information: The online version contains supplementary material available at 10.1186/s12302-022-00617-z.
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This study aims to identify the combined role of environmental pollutants and atmospheric variables at short term on the rate of incidence (TIC) and on the hospital admission rate (TIHC) due to COVID-19 disease in Spain. This study used information from 41 of the 52 provinces of Spain (from Feb. 1, 2021 to May 31, 2021). Using TIC and TIHC as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). Generalized linear models (GLM) with Poisson link were carried out for each provinces The GLM model controlled for trend, seasonalities, and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 µg/m3 in PM10 and NO2 and by 1 °C in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Statistically significant associations were found between PM10, NO2, and the rate of COVID-19 incidence. NO2 was the variable that showed greater association, both for TIC as well as for TIHC in the majority of provinces. Temperature and HA do not seem to have played an important role. The geographic distribution of RR in the studied provinces was very much heterogeneous. Some of the health determinants considered, including income per capita, presence of airports, average number of diesel cars per inhabitant, average number of nursing personnel, and homes under 30 m2 could explain the differential geographic behavior. As findings indicates, environmental factors only could modulate the incidence and severity of COVID-19. Moreover, the social determinants and public health measures could explain some patterns of geographically distribution founded.
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Contaminantes Atmosféricos , Contaminación del Aire , COVID-19 , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , COVID-19/epidemiología , Humanos , Dióxido de Nitrógeno , Material Particulado/análisis , España/epidemiologíaRESUMEN
BACKGROUND: There are studies that analyze the role of meteorological variables on the incidence and severity of COVID-19, and others that explore the role played by air pollutants, but currently there are very few studies that analyze the impact of both effects together. This is the aim of the current study. We analyzed data corresponding to the period from February 1 to May 31, 2020 for the City of Madrid. As meteorological variables, maximum daily temperature (Tmax) in ºC and mean daily absolute humidity (AH) in g/m3 were used corresponding to the mean values recorded by all Spanish Meteorological Agency (AEMET) observatories in the Madrid region. Atmospheric pollutant data for PM10 and NO2 in µg/m3 for the Madrid region were provided by the Spanish Environmental Ministry (MITECO). Daily incidence, daily hospital admissions per 100.000 inhabitants, daily ICU admissions and daily death rates per million inhabitants were used as dependent variables. These data were provided by the ISCIII Spanish National Epidemiology Center. Generalized linear models with Poisson link were performed between the dependent and independent variables, controlling for seasonality, trend and the autoregressive nature of the series. RESULTS: The results of the single-variable models showed a negative association between Tmax and all of the dependent variables considered, except in the case of deaths, in which lower temperatures were associated with higher rates. AH also showed the same behavior with the COVID-19 variables analyzed and with the lags, similar to those obtained with Tmax. In terms of atmospheric pollutants PM10 and NO2, both showed a positive association with the dependent variables. Only PM10 was associated with the death rate. Associations were established between lags 12 and 21 for PM10 and between 0 and 28 for NO2, indicating a short-term association of NO2 with the disease. In the two-variable models, the role of NO2 was predominant compared to PM10. CONCLUSIONS: The results of this study indicate that the environmental variables analyzed are related to the incidence and severity of COVID-19 in the Community of Madrid. In general, low temperatures and low humidity in the atmosphere affect the spread of the virus. Air pollution, especially NO2, is associated with a higher incidence and severity of the disease. The impact that these environmental factors are small (in terms of relative risk) and by themselves cannot explain the behavior of the incidence and severity of COVID-19.