PurposeAgricultural workers represent an important part of the population exposed to high heat-related health and productivity risks. This study aims to estimate the heat-related productivity loss (PL) for moderate work activities in sun and shady areas and evaluating the economic cost locally in an Italian farm and generally in the whole province of Florence. Benefits deriving by working in the shade or work-time shifting were provided. Comparisons between PL estimated in Mediterranean (Florence, Italy) and subtropical (Guangzhou, China) areas were also carried out.Design/methodology/approachMeteorological data were collected during summers 2017–2018 through a station installed in a farm in the province of Florence and by two World Meteorological Organization (WMO)‐certified meteorological stations located at the Florence and Guangzhou airports. These data were used to calculate the wet-bulb globe temperature and to estimate the hourly PL and the economic cost during the typical working time (from 8 a.m. to 5 p.m.) and by advancing of 1 h and 2 h the working time. Significant differences were calculated through nonparametric tests.FindingsThe hourly PL and the related economic cost significantly decreased (p < 0.05) by working in the shade and by work-time shifting. Higher PL values were observed in Guangzhou than in Florence. The decrease of PL observed by work-time shifting was greater in Florence than in Guangzhou.Originality/valueUseful information to plan suitable heat-related prevention strategies to counteract the effects of heat in the workplace are provided. These findings are essential to quantify the beneficial effects due to the implementation of specific heat-related adaptation measures to counter the impending effects of climate change.
Background A systematic understanding of the burden of neurological disorders at the subnational level is not readily available for India. We present a comprehensive analysis of the disease burden and trends of neurological disorders at the state level in India.Methods Using all accessible data from multiple sources, we estimated the prevalence or incidence and disabilityadjusted life-years (DALYs) for neurological disorders from 1990 to 2019 for all states of India as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We assessed the contribution of each neurological disorder to deaths and DALYs in India in 2019, their trends in prevalence or incidence and DALY rates over time, and heterogeneity between the states of India. We also assessed the Pearson correlation coefficient between Sociodemographic Index (SDI) of the states and the prevalence or incidence and DALY rates of each neurological disorder. Additionally, we estimated the contribution of known risk factors to DALYs from neurological disorders. We calculated 95% uncertainty intervals (UIs) for the mean estimates.
Findings The contribution of non-communicable neurological disorders to total DALYs inIndia doubled from 4•0% (95% UI 3•2-5•0) in 1990 to 8•2% (6•6-10•2) in 2019, and the contribution of injury-related neurological disorders increased from 0•2% (0•2-0•3) to 0•6% (0•5-0•7). Conversely, the contribution of communicable neurological disorders decreased from 4•1% (3•5-4•8) to 1•1% (0•9-1•5) during the same period. In 2019, the largest contributors to the total neurological disorder DALYs in India were stroke (37•9% [29•9-46•1]), headache disorders (17•5% [3•6-32•5]), epilepsy (11•3% [9•0-14•3]), cerebral palsy (5•7% [4•2-7•7]), and encephalitis (5•3% [3•7-8•9]). The crude DALY rate of several neurological disorders had considerable heterogeneity between the states in 2019, with the highest variation for tetanus (93•2 times), meningitis (8•3 times), and stroke (5•5 times). SDI of the states had a moderate significant negative correlation with communicable neurological disorder DALY rate and a moderate significant positive correlation with injury-related neurological disorder DALY rate in 2019. For most of the noncommunicable neurological disorders, there was an increase in prevalence or incidence from 1990 to 2019. Substantial decreases were evident in the incidence and DALY rates of communicable neurological disorders during the same period. Migraine and multiple sclerosis were more prevalent among females than males and traumatic brain injuries were more common among males than females in 2019. Communicable diseases contributed to the majority of total neurological disorder DALYs in children younger than 5 years, and non-communicable neurological disorders were the highest contributor in all other age groups. In 2019, the leading risk factors contributing to DALYs due to noncommunicable neurological disorders in India included high systolic blood pressure, air pollution, dietary risks, high fasting plasma glucose, and h...
Growing evidence has demonstrated that hypertension was associated with dysbiosis of intestinal flora. Since intestinal microbes could critically regulate neurofunction via the intestinal–brain axis, the study aimed to reveal the role and prediction value of intestinal flora alteration in hypertension-associated cognitive impairment. A cohort of 97 participants included 63 hypertension patients and 34 healthy controls. The structure of intestinal flora was analyzed by V3–V4 16S rRNA amplicon sequencing. The cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, and 31 patients were considered to have cognitive impairment (MoCA < 26). Patients with cognitive impairment had considerable alterations in intestinal flora structure, composition, and function compared with normal-cognitive patients. In particular, the abundance of LPS-containing taxa (Proteobacteria, Gammaproteobacteria, Enterobacterales, Enterobacteriaceae, and Escherichia–Shigella) and SCFA-producing taxon (Prevotella) significantly changed in cognition-impaired patients. Tax4Fun predication results showed downregulation of glycan biosynthesis and metabolism in hypertension patients with cognitive impairment. Additionally, the pathway was demonstrated to be significantly correlated with LPS-containing taxa (Proteobacteria, Gammaproteobacteria, Enterobacterales, Enterobacteriaceae, and Escherichia–Shigella) and SCFA-producing taxon Prevotella. Furthermore, the taxa-based multiple joint prediction model (9×) was demonstrated to have excellent diagnostic potential for cognitive impairment of hypertension patients (AUC = 0.944). The current study revealed the involvement of intestinal microbiota dysbiosis in cognition-impaired hypertension patients and provided an objective predictive index for this cognition disorder.
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