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Journal of Environmental Management Jan 2023Due to increasing population pressure and urbanization, as well as global climate change impacts, many coastal river deltas are experiencing increased exposure,... (Review)
Review
Due to increasing population pressure and urbanization, as well as global climate change impacts, many coastal river deltas are experiencing increased exposure, vulnerability and risks linked to natural hazards. Mapping the vulnerability and risk profiles of deltas is critical for developing preparedness, mitigation and adaptation policies and strategies. Current vulnerability and risk assessments focus predominantly on social factors, and typically, do not systematically incorporate a social-ecological systems perspective, which can lead to incomplete assessments. We argue that ecosystem services, which link both ecosystem functions and human well-being, can be used to better characterize the mutual dependencies between society and the environment within risk assessment frameworks. Thus, building on existing vulnerability and risk assessment frameworks, we propose a revised indicator-based framework for social-ecological systems of coastal delta environments, supported by a list of ecosystem service indicators that were identified using a systematic literature review. This improved framework is an effective tool to address the vulnerability and risk in coastal deltas, enabling the assessment of multi-hazard risks to social-ecological systems within and across coastal deltas and allows more targeted development of management measures and policies aimed at reducing risks from natural hazards.
Topics: Humans; Ecosystem; Climate Change; Acclimatization; Risk Assessment; Urbanization
PubMed: 36375428
DOI: 10.1016/j.jenvman.2022.116682 -
PloS One 2023Variability in spine kinematics is a common motor adaptation to pain, which has been measured in various ways. However, it remains unclear whether low back pain (LBP) is...
BACKGROUND
Variability in spine kinematics is a common motor adaptation to pain, which has been measured in various ways. However, it remains unclear whether low back pain (LBP) is typically characterised by increased, decreased or unchanged kinematic variability. Therefore, the aim of this review was to synthesise the evidence on whether the amount and structure of spine kinematic variability is altered in people with chronic non-specific LBP (CNSLBP).
METHODS
Electronic databases, grey literature, and key journals were searched from inception up to August 2022, following a published and registered protocol. Eligible studies must investigated kinematic variability in CNSLBP people (adults ≥18 years) while preforming repetitive functional tasks. Two reviewers conducted screening, data extraction, and quality assessment independently. Data synthesis was conducted per task type and individual results were presented quantitatively to provide a narrative synthesis. The overall strength of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation guidelines.
FINDINGS
Fourteen observational studies were included in this review. To facilitate the interpretation of the results, the included studies were grouped into four categories according to the task preformed (i.e., repeated flexion and extension, lifting, gait, and sit to stand to sit task). The overall quality of evidence was rated as a very low, primarily due to the inclusion criteria that limited the review to observational studies. In addition, the use of heterogeneous metrics for analysis and varying effect sizes contributed to the downgrade of evidence to a very low level.
INTERPRETATION
Individuals with chronic non-specific LBP exhibited altered motor adaptability, as evidenced by differences in kinematic movement variability during the performance of various repetitive functional tasks. However, the direction of the changes in movement variability was not consistent across studies.
Topics: Adult; Humans; Low Back Pain; Spine; Acclimatization; Benchmarking; Databases, Factual
PubMed: 37315096
DOI: 10.1371/journal.pone.0287029 -
Journal of Occupational and... Feb 2011Acute mountain sickness (AMS) has become a significant environmental health issue as improvements in transportation, "environmental tourism," and resource development... (Review)
Review
OBJECTIVE
Acute mountain sickness (AMS) has become a significant environmental health issue as improvements in transportation, "environmental tourism," and resource development lure more people to the highlands. Whether there is a genetic contribution to AMS susceptibility is a central question in high-altitude medicine. This article provides a systematic review of the evidence supporting such an innate predisposition.
METHODS
Scientific literature databases were screened using the terms "acute mountain sickness/AMS" and "altitude illness" combined with the terms "DNA," "gene," "genetic," or "polymorphism."
RESULTS
Sixteen genes from a variety of pathways have been tested for association with AMS and variants in eight showed positive associations suggesting that AMS is an environmentally mediated polygenic disorder.
CONCLUSIONS
The data suggest that genotype contributes to capacity to rapidly and efficiently acclimatize to altitude; nevertheless, the mechanisms by which this occurs have yet to be elucidated.
Topics: Acclimatization; Acute Disease; Altitude Sickness; Blood Pressure; Female; Genetic Association Studies; Genetic Predisposition to Disease; Humans; Male; Multifactorial Inheritance; Oxidative Stress; Oxygen Consumption; Polymorphism, Genetic; Pulmonary Ventilation; Regional Blood Flow
PubMed: 21270658
DOI: 10.1097/JOM.0b013e318206b112 -
Sports Medicine (Auckland, N.Z.) Sep 2022Physiological heat adaptations can be induced following various protocols that use either artificially controlled (i.e. acclimation) or naturally occurring (i.e....
BACKGROUND
Physiological heat adaptations can be induced following various protocols that use either artificially controlled (i.e. acclimation) or naturally occurring (i.e. acclimatisation) environments. During the summer months in seasonal climates, adequate exposure to outdoor environmental heat stress should lead to transient seasonal heat acclimatisation.
OBJECTIVES
The aim of the systematic review was to assess the available literature and characterise seasonal heat acclimatisation during the summer months and identify key factors that influence the magnitude of adaptation.
ELIGIBILITY CRITERIA
English language, full-text articles that assessed seasonal heat acclimatisation on the same sample of healthy adults a minimum of 3 months apart were included.
DATA SOURCES
Studies were identified using first- and second-order search terms in the databases MEDLINE, SPORTDiscus, CINAHL Plus with Full Text, Scopus and Cochrane, with the last search taking place on 15 July 2021.
RISK OF BIAS
Studies were independently assessed by two authors for the risk of bias using a modified version of the McMaster critical review form.
DATA EXTRACTION
Data for the following outcome variables were extracted: participant age, sex, body mass, height, body fat percentage, maximal oxygen uptake, time spent exercising outdoors (i.e. intensity, duration, environmental conditions), heat response test (i.e. protocol, time between tests), core temperature, skin temperature, heart rate, whole-body sweat loss, whole-body and local sweat rate, sweat sodium concentration, skin blood flow and plasma volume changes.
RESULTS
Twenty-nine studies were included in this systematic review, including 561 participants across eight countries with a mean summer daytime wet-bulb globe temperature (WBGT) of 24.9 °C (range: 19.5-29.8 °C). Two studies reported a reduction in resting core temperature (0.16 °C; p < 0.05), 11 reported an increased sweat rate (range: 0.03-0.53 L·h; p < 0.05), two observed a reduced heart rate during a heat response test (range: 3-8 beats·min; p < 0.05), and six noted a reduced sweat sodium concentration (range: - 22 to - 59%; p < 0.05) following summer. The adaptations were associated with a mean summer WBGT of 25.2 °C (range: 19.6-28.7 °C).
LIMITATIONS
The available studies primarily focussed on healthy male adults and demonstrated large differences in the reporting of factors that influence the development of seasonal heat acclimatisation, namely, exposure time and duration, exercise task and environmental conditions.
CONCLUSIONS
Seasonal heat acclimatisation is induced across various climates in healthy adults. The magnitude of adaptation is dependent on a combination of environmental and physical activity characteristics. Providing environmental conditions are conducive to adaptation, the duration and intensity of outdoor physical activity, along with the timing of exposures, can influence seasonal heat acclimatisation. Future research should ensure the documentation of these factors to allow for a better characterisation of seasonal heat acclimatisation.
PROSPERO REGISTRATION
CRD42020201883.
Topics: Acclimatization; Adult; Body Temperature Regulation; Hot Temperature; Humans; Male; Seasons; Sodium
PubMed: 35460514
DOI: 10.1007/s40279-022-01677-0 -
Neonatology 2015The fetal-to-neonatal transition is a complex process that includes changes in cardiac and respiratory systems. (Review)
Review
BACKGROUND
The fetal-to-neonatal transition is a complex process that includes changes in cardiac and respiratory systems.
OBJECTIVE
The aim of this study is to review the different methods of cardiocirculatory monitoring during the immediate neonatal transition period.
METHODS
A systematic search of PubMed and Ovid Embase was performed using the following terms: infant, newborn, newborn infant, neonate, neonates, heart, cardiac, blood pressure, haemodynamic, hemodynamics, blood circulation, circulation, echocardiography, ultrasonography, sonography, electrocardiography, ECG, oximetry, pulse, pulse oximetry, monitoring, measurement, acclimatization, adaptation, transition, after birth and delivery room. Additional articles were identified by manual search of cited references. Only human studies describing cardiocirculatory monitoring during the first 15 min after birth were included.
RESULTS
Thirteen studies were identified that described heart rate (HR). Additional five studies were identified that measured blood pressure. Four studies performed functional echocardiography during neonatal transition; two in addition to blood pressure monitoring and three in addition to HR monitoring.
CONCLUSION
Routine HR monitoring using electrocardiography or pulse oximetry is used to evaluate adequate hemodynamic transition, and reference ranges have been established. Measuring blood pressure noninvasively though noncontinuously might be of some value in future, considering that the normative data have been established recently. Echocardiographic monitoring during the immediate transition period will improve the knowledge about cardiac function changes, but introduction in clinical routine remains questionable.
Topics: Blood Pressure; Echocardiography; Electrocardiography; Female; Heart Function Tests; Heart Rate; Hemodynamics; Humans; Infant, Newborn; Male; Monitoring, Physiologic; Neonatology; Oximetry; Parturition
PubMed: 25412794
DOI: 10.1159/000368042 -
PloS One 2023Elderly and sedentary individuals are particularly vulnerable to heat related illness. Short-term heat acclimation (STHA) can decrease both the physical and mental...
INTRODUCTION
Elderly and sedentary individuals are particularly vulnerable to heat related illness. Short-term heat acclimation (STHA) can decrease both the physical and mental stress imposed on individuals performing tasks in the heat. However, the feasibility and efficacy of STHA protocols in an older population remains unclear despite this population being particularly vulnerable to heat illness. The aim of this systematic review was to investigate the feasibility and efficacy of STHA protocols (≤twelve days, ≥four days) undertaken by participants over fifty years of age.
METHODS
Academic Search Premier, CINAHL Complete, MEDLINE, APA PsycInfo, and SPORTDiscus were searched for peer reviewed articles. The search terms were; (heat* or therm*) N3 (adapt* or acclimati*) AND old* or elder* or senior* or geriatric* or aging or ageing. Only studies using primary empirical data and which included participants ≥50 years of age were eligible. Extracted data includes participant demographics (sample size, gender, age, height, weight, BMI and [Formula: see text]), acclimation protocol details (acclimation activity, frequency, duration and outcome measures taken) and feasibility and efficacy outcomes.
RESULTS
Twelve eligible studies were included in the systematic review. A total of 179 participants took part in experimentation, 96 of which were over 50 years old. Age ranged from 50 to 76. All twelve of the studies involved exercise on a cycle ergometer. Ten out of twelve protocols used a percentage of [Formula: see text] or [Formula: see text] to determine the target workload, which ranged from 30% to 70%. One study-controlled workload at 6METs and one implemented an incremental cycling protocol until Tre was reached +0.9°C. Ten studies used an environmental chamber. One study compared hot water immersion (HWI) to an environmental chamber while the remaining study used a hot water perfused suit. Eight studies reported a decrease in core temperature following STHA. Five studies demonstrated post-exercise changes in sweat rates and four studies showed decreases in mean skin temperature. The differences reported in physiological markers suggest that STHA is viable in an older population.
CONCLUSION
There remains limited data on STHA in the elderly. However, the twelve studies examined suggest that STHA is feasible and efficacious in elderly individuals and may provide preventative protection to heat exposures. Current STHA protocols require specialised equipment and do not cater for individuals unable to exercise. Passive HWI may provide a pragmatic and affordable solution, however further information in this area is required.
Topics: Aged; Humans; Middle Aged; Hot Temperature; Acclimatization; Aging; Bicycling; Empirical Research
PubMed: 36862716
DOI: 10.1371/journal.pone.0282038 -
Trends in Cardiovascular Medicine Jul 2023High-altitude environments are characterized by decreased atmospheric pressures at which individuals exhibit a reduced volume of maximal oxygen uptake and arterial...
High-altitude environments are characterized by decreased atmospheric pressures at which individuals exhibit a reduced volume of maximal oxygen uptake and arterial partial pressure of oxygen, both of which lead to hypobaric hypoxia. While acute exposure may temporarily offset cardiovascular homeostasis in sea-level residents, native highlanders have become accustomed to these high-altitude conditions and often exhibit variations in normal ECG parameters. As part of the "Altitude Non-differentiated ECG Study" (ANDES) project, this paper aims to systematically review the available literature regarding ECG changes in healthy highlander populations. After searching the PubMed, Medline, and Embase databases, 286 abstracts were screened, of which 13 full-texts were ultimately included. This process was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Major ECG deviations in native healthy highlanders include right QRS axis deviation, right ventricular hypertrophy signs, and more prevalent T-wave inversion in the right precordial leads. Notably, they exhibit a prolonged QTc compared to sea-level residents, although within normal limits. Evidence about increased P-wave amplitude or duration, variations in PR interval, or greater prevalence of complete right bundle branch block is not conclusive. This review provides ECG reference standards that can be used by clinicians, who should be aware of the effects of high-altitude residence on cardiovascular health and how these may change according to age, ethnicity, and other factors.
Topics: Humans; Altitude; Arrhythmias, Cardiac; Electrocardiography; Hypoxia; Oxygen
PubMed: 35121084
DOI: 10.1016/j.tcm.2022.01.013 -
PloS One 2018The cultivation of bananas and other plants is limited by environmental stresses caused by climate change. In order to recognize physiological, biochemical and molecular...
BACKGROUND
The cultivation of bananas and other plants is limited by environmental stresses caused by climate change. In order to recognize physiological, biochemical and molecular components indicated to confer tolerance to water stress in Musa spp. we present the first systematic review on the topic.
METHODS
A systematic literature review was conducted using four databases for academic research (Google Academic, Springer, CAPES Journal Portal and PubMed Central). In order to avoid publication bias, a previously established protocol and inclusion and exclusion criteria were used.
RESULTS
The drought tolerance response is genotype-dependent, therefore the most studied varieties are constituted by the "B" genome. Tolerant plants are capable of super-expressing genes related to reisistance and defense response, maintaining the osmotic equilibrium and elimination of free radicals. Furthermore, they have higher amounts of water content, chlorophyll levels, stomatic conductance and dry root matter, when compared to susceptible plants.
CONCLUSIONS
In recent years, few integrated studies on the effects of water stress on bananas have been carried out and none related to flood stress. Therefore, we highlight the need for new studies on the mechanisms of differentially expressed proteins in response to stress regulation, post-translational mechanisms and epigenetic inheritance in bananas.
Topics: Acclimatization; Chlorophyll; Droughts; Epigenesis, Genetic; Free Radicals; Gene Expression Regulation, Plant; Musa; Organism Hydration Status; Osmoregulation; Plant Proteins; Plant Stomata; Protein Processing, Post-Translational
PubMed: 30507957
DOI: 10.1371/journal.pone.0208052 -
The American Journal of the Medical... May 2021Acute mountain sickness (AMS) is a benign and self-limiting syndrome but can progress to life-threatening conditions if leave untreated. This study aimed to assess the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Acute mountain sickness (AMS) is a benign and self-limiting syndrome but can progress to life-threatening conditions if leave untreated. This study aimed to assess the efficacy of acetazolamide for the prophylaxis of AMS and disclose potential factors that affect the treatment effect of acetazolamide.
MATERIALS AND METHODS
Randomized controlled trials comparing the use of acetazolamide versus placebo for the prevention of AMS were included. The incidence of AMS was the primary endpoint. Meta-regression analysis was conducted to explore potential factors associated with acetazolamide efficacy. Trial sequential analysis (TSA) was conducted to estimate the statistical power of the available data.
RESULTS
A total of 22 trials were included. Acetazolamide at 125, 250, and 375 mg/ twice daily (bid) significantly reduced incidence of AMS compared to placebo. TAS indicated that the current evidence was adequate confirming the efficacy of acetazolamide at 125, 250, and 375 mg/bid in lowering incidence of AMS. There was no evidence of an association between efficacy and dose of acetazolamide, timing at start of acetazolamide treatment, mode of ascent, AMS assessment score, timing of AMS assessment, baseline altitude, and endpoint altitude.
CONCLUSION
Acetazolamide is effective prophylaxis for the prevention of AMS in doses of 125, 250, and 375 mg/bid. Future investigations should focus on personal characteristics, disclosing the correlation between acetazolamide efficacy and body mass, height, degree of prior acclimatization, individual inborn susceptibility, and history of AMS.
Topics: Acetazolamide; Altitude Sickness; Carbonic Anhydrase Inhibitors; Humans; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 33587912
DOI: 10.1016/j.amjms.2020.12.022 -
Annals of Thoracic Medicine 2021Acute mountain sickness (AMS) is a benign and self-limiting syndrome, but can progress to life-threatening conditions if leave untreated. This study aimed to assess the...
BACKGROUND
Acute mountain sickness (AMS) is a benign and self-limiting syndrome, but can progress to life-threatening conditions if leave untreated. This study aimed to assess the efficacy of acetazolamide for the prophylaxis of AMS, and disclose factors that affect the treatment effect of acetazolamide.
METHODS
Randomized controlled trials comparing the use of acetazolamide versus placebo for the prevention of AMS were included. The incidence of AMS was our primary endpoint. Meta-regression analysis was conducted to explore factors that associated with acetazolamide efficacy. Trial sequential analyses were conducted to estimate the statistical power of the available data.
RESULTS
A total of 22 trials were included. Acetazolamide at 125, 250, and 375 mg/bid significantly reduced incidence of AMS compared to placebo. TAS indicated that the current evidence was adequate confirming the efficacy of acetazolamide at 125, 250, and 375 mg/bid in lowering incidence of AMS. There was no evidence of an association between efficacy and dose of acetazolamide, timing at start of acetazolamide treatment, mode of ascent, AMS assessment score, timing of AMS assessment, baseline altitude, and endpoint altitude.
CONCLUSION
Acetazolamide is effective prophylaxis for the prevention of AMS at 125, 250, and 375 mg/bid. Future investigation should focus on personal characteristics, disclosing the correlation between acetazolamide efficacy and body mass, height, degree of prior acclimatization, individual inborn susceptibility, and history of AMS.
PubMed: 34820021
DOI: 10.4103/atm.atm_651_20