Date

13/03/2024 - 10/07/2024

Place

Online

La movilidad humana constituye un determinante del conjunto de nuestras sociedades y de los derechos y aspiraciones más fundamentales de las poblaciones. La salud global es una de ellas. El ciclo internacional “Salud de personas migrantes y refugiadas en Chile y España: aprendizajes y desafíos de salud global” aborda algunos de los desafíos fundamentales de esta relación, centrándose en las regiones de Europa y América Latina.

El ciclo se desarrolló en cinco sesiones, a lo largo del primer semestre de 2024. Los detalles de cada una están disponibles en los enlaces adjuntos. Esta es una colaboración entre el Centro de Salud Global Intercultural de la Universidad del Desarrollo (Santiago de Chile) y el Instituto de Salud Global de Barcelona.

1. 13/03/2024 | Salud Mental y migración: https://uddtv.udd.cl/video/webinarsalud-de-personas-migrantes-y-refugiadas-en-chile-y-espana-aprendizajes-salud-global/
2. 17/04/2024 | Salud de niños, niñas y adolescentes en movilidad internacional: https://uddtv.udd.cl/video/webinar-salud-de-personas-migrantes-y-refugiadas-en-chile-y-espana-aprendizajes-y-desafios-2/
3. 15/05/2024 | Salud de diversidades sexo-genéricas en movilidad internacional: https://uddtv.udd.cl/video/webinar-salud-de-personas-migrantes-y-refugiadas-en-chile-y-espana-aprendizajes-en-salud-global/ 
4. 19/06/2024 | Irregularidad migratoria y salud: https://uddtv.udd.cl/video/webinarsalud-de-personas-migrantes-y-refugiadas-en-chile-y-espana-aprendizajes-y-desafios-salud-2/
5. 10/07/2024 | Narrativas discriminatorias y salud de personas en movilidad internacional: https://uddtv.udd.cl/video/webinarsalud-de-personas-migrantes-y-refugiadas-chile-y-espanaaprendizajes-y-desafios-en-salud-2/

The Minister of Science, Innovation and Universities, Diana Morant, visited the Barcelona Institute for Global Health (ISGlobal) on Wednesday 24 July to celebrate the renewal of the institution's accreditation as a 'Severo Ochoa Centre of Excellence'.

During the visit, Morant highlighted the fact that ISGlobal had received this prestigious distinction from the Ministry of Science, Innovation and Universities for the second consecutive time. The award recognises centres that stand out for their scientific impact and international leadership.

For their part, ISGlobal's Director General, Quique Bassat, and the Institute's former Director of Global Development, Leire Pajín, stressed that ISGlobal is the only centre of epidemiology and global public health to be recognised as a Severo Ochoa Centre of Excellence. This is an important boost for this area of research, both in Spain and internationally'.

Mark Nieuwenhuijsen and Giulia Pollarolo, Scientific Director and Coordinator, respectively, of the Severo Ochoa Programme at ISGlobal, then reviewed the achievements of the first Severo Ochoa programme, awarded in 2019, and presented the main objectives of this second phase. "The new Severo Ochoa Programme aims to better understand the interaction between infectious diseases, chronic non-communicable diseases and environmental factors, as well as their combined and individual effects," they stressed.

The meeting was also attended by representatives of the ISGlobal Board of Trustees, including Josep M. Campistol, Director General of the Hospital Clínic, Ignasi López, Director of Relations with Research and Health Institutions of the 'la Caixa' Foundation, and Maria Eugènia Gay, Second Deputy Mayor of Barcelona City Council.

After the meeting, Minister Morant visited the ISGlobal laboratory, where she was briefed by ISGlobal researchers on the Institute's research in the field of malaria and antimicrobial resistance.

An international panel of experts led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the “la Caixa” Foundation, under the umbrella of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment, has produced a consensus statement on sex and gender disparities in resilience to Alzheimer's disease and call for incorporating these differences in future research. The work has been published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

Women make up the majority of people with Alzheimer's disease and have twice the lifetime risk. The prevalence of protective and risk factors, as well as the burden of Alzheimer’s disease pathologies and related conditions such as cerebrovascular disease, differ by sex and gender because of biological factors (e.g. genetic risk) and socially constructed factors (e.g. education and lifestyle).

"Assessing how sex and gender interact is crucial to understanding the mechanisms that maintain cognitive function and reduce the accumulation of pathologies in ageing and Alzheimer's disease, i.e. resilience and resistance factors," says Eider Arenaza-Urquijo, ISGlobal researcher, first author of the study and President of the Reserve, Resilience and Protective Factors Group of the Alzheimer's Association.

Resistance and resilience to Alzheimer’s disease in men and women

Based on a review of a large body of literature, the team identified sex and gender differences in dementia risk and identified a gap in the understanding of specific risk and resilience pathways.

While women tend to have an initial cognitive advantage, they decline faster than men as the disease progresses. This may be due to differential development of pathologies, known as resistance to Alzheimer’s disease, or different ability to maintain normal functioning over time and cope with pathology once this is present, known as cognitive resilience to Alzheimer's disease.

In fact, women initially show greater resilience, coping better with brain pathology and atrophy and maintaining cognitive function. The greater initial resilience in women is supported by animal research showing a protective role of the X-Chromosome in Alzheimer’s disease (females typically have two X chromosomes, while males have one). However, this initial resilience fades away as they progress towards a clinical diagnosis of mild cognitive impairment and Alzheimer’s disease, when they show greater vulnerability. Indeed, studies suggest that women are more likely to have an abnormal build-up of tau protein in the brain and show a higher burden of vascular pathologies, particularly after the menopause.

The authors propose various mechanisms explaining the difference in risk and resilience between women and men, including a higher prevalence of physical inactivity and affective disorders in women, but also biological factors. In this regard, genetic evidence suggests that resilience might be associated with immune pathways in females and cardiovascular pathways in men.

Addressing modifiable factors

According to the research team, studies of resilience in Alzheimer's disease have mainly focused on individual behaviour, without taking into account how social and cultural factors, such as gender, influence behaviour and therefore risk and resilience. Importantly, differences in cognitive function between men and women may be decreasing as gender inequalities also decrease due to more opportunities for women in education, workforce participation, and improvements in their economic status and living conditions. "Protective factors, such as education, may have different effects in men and women. We need to understand the complexity of interactions between biological and social factors to understand resilience to Alzheimer’s disease", argues Arenaza-Urquijo.

For this reason, the authors call for a sex- and gender-sensitive approach to resilience to better understand the complex interplay of biological and social determinants. "Focusing more on the differential effects of modifiable factors will help to determine whether a particular factor has a greater impact on cognitive or brain resilience in men or women", remarks Arenaza-Urquijo.

Recommendations for future research

To improve our understanding of how sex and gender affect cognitive resilience to ageing and Alzheimer's disease, the researchers recommend several directions for future studies. First, they stress the need to explore how sex and gender factors interact across cultures, taking into account the demographic, genetic, social and clinical differences that influence dementia risk.

They point out that sex/gender differences in brain characteristics, such as brain connectivity, remain understudied as resilience factors for Alzheimer’s disease that may minimise the impact of pathologies on cognition.

The authors also argue that publishing negative results is crucial to avoid bias and that all studies should include sex-disaggregated results. Finally, they point out the importance of considering sex and gender in a non-binary way, and of including LGTBIQ+ populations, who are often underrepresented and face a higher burden of chronic disease.

Reference

Arenaza-Urquijo, EM., Boyle, R., Casaletto, K., Anstery, K., Vila-Castelar, C., et al. Sex and gender differences in cognitive resilience to ageing and Alzheimer’s disease. Alzheimer's & Dementia. Doi: 10.1002/alz.13844

An innovative test that combines a DNA extraction system inspired by a modified 3D printer (PrintrLab) with loop-mediated isothermal molecular amplification (LAMP) could be used to detect T. cruzi infection -responsible for Chagas disease- in newborns. This is the conclusion of a proof-of-concept study conducted in the Bolivian Chaco, an endemic area for Chagas disease. The study was coordinated by the Barcelona Institute for Global Health (ISGlobal), a centre supported by "la Caixa" Foundation, in collaboration with the CEADES Foundation (Bolivia), CONICET-INGEBI (Argentina), AI Biosciences (USA), FIND (Switzerland) and the Mundo Sano Foundation (Argentina).

Twenty percent of new cases of Chagas disease are due to vertical (or congenital) transmission. This occurs when an infected mother passes the parasite to her baby during pregnancy. Early detection of the parasite in women and newborns is therefore a public health priority. The problem is the lack of simple, rapid and reliable tests. In high-income countries like Spain, newborn diagnosis can be done by PCR, but this is an expensive method that requires skilled personnel. In endemic regions, up to two microscopy tests are performed (at birth and at two months), which have low sensitivity and must be followed several months later by a serological test to detect antibodies to the parasite. The number of tests and the time lag between them increases the risk that children will not receive the treatment they need.

"In endemic regions, it would be very useful to have a simple, rapid and sensitive test to detect the parasite in newborns, when treatment is most effective," explains Julio Alonso Padilla, researcher at ISGlobal.

More sensitive than microscopy

In this study, a team led by Alonso-Padilla evaluated an innovative diagnostic test that combines a simple molecular amplification technique (LAMP) developed by the Japanese company Eiken, with a 3D printer modified to extract DNA from a small blood sample (PrintrLab). The results were compared with those of PCR and the "standard" diagnostic methods (microscopy and serology).

The study included 224 infants born to T. cruzi seropositive mothers and followed for eight months. A total of 23 cases of congenital transmission were detected (nine by microscopy at birth and a further 14 by serology eight months later). LAMP was able to detect 13 of the 23 cases early on (i.e. four additional cases to those detected by microscopy), and PCR was able to detect 14 of the 23 (five additional cases). 

"This shows that the sensitivity of PrintrLab-LAMP is higher than that of microscopy and almost equal to that of PCR," says Alonso-Padilla. The advantage is that PrintrLab should be cheaper than PCR and requires minimal infrastructure.

Following the country’s guidelines for diagnosis and treatment of congenital Chagas disease, all infected newborns were treated and cured, highlighting the importance of early detection and treatment.

The research team points out that this was a proof of concept to demonstrate the feasibility of the PrintrLab-LAMP test, and that it now needs to be tested on a larger scale and in a larger number of centres. If its potential is confirmed, the test could also be useful for detecting acute infections in adults, or assessing the effectiveness of treatment.

Referencia

Rojas L, Rivera S, Wehrendt DP et al. Evaluation and validation of a PrintrLab-based LAMP assay to identify Trypanosoma cruzi in newborns in Bolivia: a proof of concept study. Lancet Microbe, doi: 10.1016/S2666-5347(24)00110-1.

Ambient temperatures are associated with over 5 million premature deaths worldwide every year, more than 300,000 of which in Western Europe alone. In a context of rapidly warming temperatures that successively broke previous records during the last two decades , it is essential to use epidemiological models to develop novel, impact-based early warning systems predicting the health effects of forecast temperatures.

This is precisely what the Adaptation group at the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, has done: Forecaster.health is the first pan-European, open-access platform using sex- and age-specific epidemiological models to predict the actual mortality risks of ambient temperatures for different segments of the population.

The tool allows users to enter the date for which they want to obtain the health predictions within a window of up to two weeks, as well as the population subgroup for which they want to obtain the prediction of temperature related mortality . Once these variables have been selected, the system displays a map showing warnings for 580 regions in 31 European countries with colour codes corresponding to four levels of heat and cold related mortality risk: low, moderate, high and extreme.

Change in paradigm: from meteorology to epidemiology

"Until now, temperature warnings have been solely based on the physical information of weather forecasts, and therefore, they ignore the differences in vulnerability to heat and cold among population groups. Our system changes this paradigm by shifting the focus from meteorology to epidemiology and the social determinants of vulnerability to the environmental factors", says Joan Ballester Claramunt, principal investigator of the Adaptation group at ISGlobal. " Forecaster.health does not only forecast the temperatures themselves, but also the actual risks that these temperatures have on the population as a whole, and especially, on specific population subgroups based on sex and age", he adds.

The team used the mortality database of the project EARLY-ADAPT (https://www.early-adapt.eu), which currently includes data for 580 regions in 31 European countries by sex, age and cause of death, to fit separate epidemiological models for population groups. Every day, the tool obtains temperature records and forecasts, and uses the epidemiological models to quantify the risk of temperature related mortality by sex and age group for any given date within the following 15 days.

“We know that vulnerability to heat is influenced by a number of factors, including sex and age. We know, for example, that women are more susceptible to heat than men, and that the risk of death for both heat and cold increases with age. For that reason, our tool separately fits epidemiological models for each sex and age group, which allows us to issue independent warnings accounting for the real impacts on the population”, says Marcos Quijal-Zamorano, researcher at ISGlobal and one of the authors of the system.

The first step towards a multi-hazard platform

Always based on epidemiological evidence and models, Forecaster.health will be expanded in the next months and years in different directions. To begin with, new countries and smaller regions will be added to the platform, as soon as new data is acquired by the team. The tool is also expected to develop new epidemiological models to incorporate health warnings for several air pollutants, such as particulate matter, ozone or nitrogen dioxide. Finally, the platform will also issue warnings for specific causes of death, such as cardiovascular and respiratory diseases, and for other health outcomes, such as hospital admissions and occupational accidents.

“Our approach crucially depends on the availability of health data to fit our epidemiological models. We are eager to add additional health outcomes for more countries or smaller regions, either from Europe or in other continents, if data is provided to us”, emphasises Joan Ballester Claramunt .

Proof-of-Concept Grants of the European Research Council

Forecaster.health has been funded by the Proof-of-Concept Grants HHS-EWS and FORECAST-AIR of the European Research Council (ERC). These grants are aimed at transforming the basic research and resources generated in the ERC Consolidator Grant EARLY-ADAPT into innovative tools to address societal challenges. In that regard, EARLY-ADAPT is studying how populations are adapting to the public health challenge of climate change, and consequently, HHS-EWS and FORECAST-AIR are offering real solutions to increase the resilience of societies to environmental threats such as ambient temperatures and air pollutants.

The team that developed the platform is composed by Joan Ballester Claramunt, Mireia Beas-Moix, Nadia Beltrán-Barrón, Raúl Fernando Méndez Turrubiates, Fabien Peyrusse andMarcos Quijal-Zamorano.

A large study of 35,000 children from eight countries has found a "robust" link between exposure to green spaces in early childhood and better lung function. The study, led by the Barcelona Institute for Global Health (ISGlobal), has been published in Environment International.

The research used data from 10 European birth cohorts from 8 countries (Denmark, France, Italy, Lithuania, Norway, the Netherlands, Spain and the UK) to conduct a meta-analysis. This assessment of the data was done at the individual level for each participant.

Data on exposure to green spaces were available from two different points in time: pregnancy and childhood (from 3 to 12 years of age). As a proxy for residential green space, the research team used the Normalised Difference Vegetation Index (NDVI) in a 300m buffer around the participant's address. NDVI is an index that uses satellite images to estimate the amount of vegetation at a given point.

Lung function was measured using spirometry tests. To assess lung volume, the researchers measured forced vital capacity (FVC), which is the maximum amount of air a person can breathe out without a time limit after taking a deep breath. And as an indicator of how open the airways are, forced expiratory volume in one second (FEV1) was taken. FEV1 is the volume of air exhaled in the first second of forced breathing after a deep inhalation.

Statistical analysis showed that children living in greener neighbourhoods had better lung function, specifically higher FVC and FEV1. On the contrary, those who lived further away from green spaces had a lower lung volume (FVC).

While the positive association of living in greener neighbourhoods with lung function was observed regardless of socioeconomic status, the effect was stronger in children from higher socioeconomic backgrounds. “One possible explanation could be that families with higher education or income may have access to higher-quality, safer, and better-maintained green areas" says Amanda Fernandes, first author and ISGlobal researcher at the time of the study.

Possible mechanisms

The researchers also looked at the mothers' home address during pregnancy, but in this case residential greenness was not associated with any of the indicators of respiratory health, suggesting that the link between green spaces and improved lung function has to do with something that happens in childhood.

"Our understanding of how green spaces affect lung function is still incomplete. We know that green spaces reduce air pollution, which in turn affects respiratory health. We also believe that green spaces may expose children to beneficial microbiota, which may contribute to the development of the immune system and indirectly influence lung function. Finally, green spaces close to home are likely to reflect the presence of play areas that encourage physical activity at an age when the lungs are still developing", says Amanda Fernandes.

"Our findings highlight the importance of integrating green spaces into urban environments for better respiratory health, also in children. If the way cities are configured is a factor that contributes to inequality, urban planning that consciously contributes to alleviating inequity is important", says Martine Vrijheid, lead author of the study and co-director of the Environment and Health over the Lifecourse programme at ISGlobal.

Health outcomes unrelated to green spaces

The study also looked at whether green spaces near the home during pregnancy and childhood were associated with other respiratory, cardiometabolic and neurodevelopmental outcomes, but found no other associations.

The research was conducted within the EU Child Cohort Network as part of the European Union-funded LifeCycle, EUCAN-Connect and ATHLETE projects, which built a fully harmonised data analysis platform. The cohorts involved in the study are Amsterdam Born Children and their Development, Netherlands (ABCD), Avon Longitudinal Study of Parents and Children, United Kingdom (ALSPAC), Born in Bradford, United Kingdom (BiB), Copenhagen subset of the Danish National Birth Cohort, Denmark (DNBC), Etude des Déterminants du développement et de la santé de l'Enfant, France (EDEN), Generation R Study, Netherlands (GenR) , Infancia y Medio Ambiente, Spain, (INMA), Kaunas Birth Cohort, Lithuania (KANC), Norwegian Mother, Father and Child Cohort Study, Norway (MoBa), and Nascita e INFanzia: gli Effetti dell'Ambiente, Italy (NINFEA).

Reference

Amanda Fernandes, Demetris Avraam, Tim Cadman, Payam Dadvand, Mònica Guxens, Anne-Claire Binter, Angela Pinot de Moira, Mark Nieuwenhuijsen, Liesbeth Duijts, Jordi Julvez, Montserrat De Castro, Serena Fossati, Sandra Márquez, Tanja Vrijkotte, Ahmed Elhakeem, Rosemary McEachan, Tiffany Yang, Marie Pedersen, Johan Vinther, Johanna Lepeule, Barbara Heude, Vincent W.V. Jaddoe, Susana Santos, Marieke Welten, Hanan El Marroun, Annemiek Mian, Sandra Andrušaitytė, Aitana Lertxundi, Jesús Ibarluzea, Ferran Ballester, Ana Esplugues, Maria Torres Toda, Jennifer R. Harris, Johanna Lucia Thorbjørnsrud Nader, Giovenale Moirano, Silvia Maritano, Rebecca Catherine Wilson, Martine Vrijheid, Green spaces and respiratory, cardiometabolic, and neurodevelopmental outcomes: An individual-participant data meta-analysis of >35.000 European children, Environment International, Volume 190, 2024, 108853, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2024.108853.

The Parc Científic de Barcelona (PCB) of the University of Barcelona (UB) will host two new research centres with ties to Barcelona's Hospital Clínic: the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and the Barcelona Institute for Global Health (ISGlobal). The Rector of the UB, Joan Guàrdia; the director of the Parc Científic de Barcelona, Maria Terrades; the director of IDIBAPS, Elías Campo, and the director of lSGlobal, Quique Bassat today signed the contract to formalise the transfer of several units of these two CERCA centres of excellence to the PCB facilities.

IDIBAPS, an institution dedicated to biomedical research of excellence that addresses the most common diseases in our society, will incorporate several research groups in these new facilities, which will occupy an area of 530 square metres. Around 70 people are expected to use this cutting-edge space to advance their translational research.

The new facilities of ISGlobal, a centre supported by the "la Caixa" Foundation, will occupy an area of 400 square metres and will share a floor with the IDIBAPS units. This space will house approximately 60 people from different research groups.

The teams from the two institutions, totalling more than 100 people, are expected to start setting up in early January 2025, once the premises that will house them have been completed.

Reinforcement of the Diagonal Health Axis

The moves are part of the future construction of the new Hospital Clínic on the land occupied by the current Esports UB facilities on Avinguda Diagonal, next to the PCB. This reinforces the Diagonal Health Axis – promoted by the University of Barcelona, with broad institutional support – which aims to consolidate this area of the city as one of the most powerful centres of international reference in health in southern Europe, hosting healthcare, academic, research and business innovation in biomedicine in the same environment.

"The partnership between the University of Barcelona and Hospital Clínic goes back a long way and is solid," explained UB Rector Joan Guàrdia, "and now it has been reaffirmed once again with this important step forward with the transfer of IDIBAPS and ISGlobal. The trifecta of research, business and transfer make the PCB a unique benchmark within the University of Barcelona. The arrival of these research centres at the PCB is a first major step towards the new Clínic project. A project that will consolidate the Diagonal Health Axis as one of the most powerful spaces in the field of health in southern Europe and that will promote the role of the UB as a leading player at the forefront of European science". 

According to Maria Terrades, the director of the PCB, "The arrival of these two prestigious and well-established institutions greatly strengthens our centre. We are an infrastructure that hosts 118 entities, where basic research and private enterprise come together, shake hands and work together, and this makes the PCB one of the key players in the national and European health ecosystem". 

The director of IDIBAPS, Elias Campo, stated that this represents a unique opportunity for this centre and the research groups that will be installed, as it "responds to the growing need we have for more research laboratory space, given the total saturation of our current locations. In addition, the PCB ecosystem brings clear added value, as it should allow us to engage in broader interdisciplinary collaboration with other institutes, attract and retain scientific talent, and create joint projects to tackle complex scientific problems with a more holistic vision". 

"The relocation of our units to the Parc Científic de Barcelona is a unique opportunity for ISGlobal. This new space will allow us to strengthen our research and innovation capabilities in global diseases. Close collaboration with other entities at the PCB will enhance synergies and knowledge sharing, key elements in advancing our mission to improve global health. We are very excited to begin this new phase and to contribute to the development of one of the most important health centres in Southern Europe," concluded Quique Bassat, ISGlobal’s director.

A study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, provides new evidence on the adverse effects of prenatal exposure to ethylene oxide (EO) on foetal development. The results, published in Epidemiology, show that increased EO exposure in utero is associated with a reduction in birth weight and head circumference in newborns.

Ethylene oxide is a chemical used in various industrial processes and in hospitals, is known for its mutagenic and carcinogenic properties. Human exposure to EO is mainly through inhalation of tobacco smoke and air pollution produced from various household products, including cleaning and personal care products. Workers in the healthcare and chemical industries are particularly exposed to this substance, which is commonly used in sterilisation processes. Previous studies have found that women exposed to higher levels of EO at work during pregnancy had a higher risk of miscarriage and premature birth than those with lower exposure. 

This new study focused on pregnant women and newborns in the general population, rather than a specific population with known high levels of EO exposure. The research team looked at the levels of EO hemoglobin (Hb) adducts in the cord blood of 1,106 newborns from 5 countries: Greece, Spain, Norway, UK and Denmark. This measurement provides valid information on the amount of EO the foetus was exposed to during the last three months of pregnancy, which may help to better understand potential adverse effects on foetal development and birth outcomes.

The study used data from the NewGeneris project, which aimed to study genotoxic exposures in the environment on children's health by measuring several biomarkers in cord blood. Information on birth weight, head circumference, sex and gestational age was obtained from maternity records. 

Higher exposure, lower birth weight and smaller head circumference

The results of the study showed that median levels of EO-Hb adducts in the umbilical cord were higher in smoking mothers compared to non-smoking mothers. Higher levels of hemoglobin adducts were associated with lower birth weight. Specifically, mean birth weight decreased by 3.30 grams with each 10 pmol/g increase in hemoglobin adducts. Increasing levels of hemoglobin adducts were also associated with a decrease in head circumference.

“Reduced head circumference has been linked to delayed neurodevelopment, and reduced birth weight increases the risk of cardiovascular disease, type 2 diabetes mellitus and osteoporosis,” says Barbara Harding, ISGlobal researcher and first author of the study.

The team found no evidence of an association between EO Hb adduct levels and the risk of being small for gestational age (SGA), a condition that can compromise a baby's short and long-term health.

"The study results highlight the importance of addressing EO exposure in both occupational and non-occupational settings. Policy changes to reduce EO exposure in vulnerable populations, such as women of childbearing age, could protect foetal health and improve birth outcomes," says Manolis Kogevinas, ISGlobal researcher and senior author of the study.

Reference

Harding BN, Agramunt, S., Pedersen, M., Knudsen, LE., Nielsen, JKS, Wright, J, Vafeiadi, M., Merlo, DF., Stayner, L., Kelly-Reif, K., Espinosa, A., Bustamante, M., Gützkow, KB., Granum, B., von Stedingk, H., Rydberg, P., Alexander, J., Törnqvist, M., Kogevinas, M. Ethylene oxide hemoglobin adducts in cord blood and offspring’s size at birth: The NewGeneris European Cohort Study. Epidemiology. 2024. DOI: 10.1097/EDE.0000000000001767

Last issues of ISGlobal Updates

• July-August 2024
• June 2024
• May 2024
• April 2024
• March 2024
• February 2024
• January 2024
• December 2023
• November 2023
• October 2023
• September 2023
• July-August 2023
• June 2023
• May 2023
• April 2023
• March 2023
• February 2023
• January 2023
• December 2022
• November 2022
• October 2022
• September 2022
• July-August 2022
• June 2022
• May 2022
• April 2022
• March 2022
• February 2022
• January 2022
• December 2021
• November 2021
• October 2021
• September 2021
• July-August 2021
• June 2021
• May 2021
• April 2021
• March 2021
• February 2021

Would you like to receive our newsletter?

Date

18/07/2024

Hour

18.30 - 21.00 h

Place

Centre Cívic Casa Golferichs
(Gran Via de les Corts Catalanes, 491) Barcelona

Speakers

Julia Hotz (journalist); Jill Litt (RECETAS Coordinator, ISGlobal); Laura Coll (RECETAS Researcher, UVic)

On 18 July, you have the opportunity to discover the power of human connection for health and well-being. Join us in Barcelona for an inspiring session with journalist Julia Hotz and RECETAS project researchers Laura Coll Planas and Jill Litt.

We will explore the impact of social connection on health through Julia's recent book, 'The Connection Cure', and the cutting-edge nature-based social prescribing research led by the RECETAS project team.

Speakers:

• Julia Hotz, journalist and author of 'The Connection Cure'
• Jill Litt, coordinator of RECETAS Project and Senior Researcher at ISGlobal
• Laura Coll Planas, UVic researcher involved in the RECETAS Project

Don't miss this opportunity to learn how social prescribing can improve our lives. Register now to be part of this transformative discussion.

Researchers from the Institut d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol) and the Barcelona Institute for Global Health (ISGlobal), a center promoted by “la Caixa” Foundation, have led a study on the effectiveness of vaccines against COVID-19 among cancer patients in Catalonia. The research, recently published in the journal Nature Communications, recommends administering additional doses of the vaccine among this risk population.

Cancer patients are at increased risk of death from COVID-19, especially those who have lung cancer, hematological malignancies or are undergoing systemic treatment, such as chemotherapy.

The participation of patients with active cancer in clinical trials that have been carried out to test the effectiveness of vaccines against COVID-19 has been very limited, so it has not been possible to know exactly the effectiveness of immunization against the SARS-CoV-2 virus among this risk group. However, prospective data from several studies show that cancer patients may develop fewer protective antibodies to COVID-19 virus than the general population, especially after receiving a single dose of the vaccine.

Real world data

The study that has just been published in Nature Communications confirms these results, based on the analysis of massive data obtained from clinical registries. This is the most comprehensive work yet on this issue and the first of this kind with information from real-world data, providing a more realistic view of how vaccines are working in everyday clinical practice among people with cancer.

The researchers have analyzed the data of 184,744 patients with neoplasia included in the information system for the development of research in primary care (SIDIAP), the database that includes people treated at the first level of care in Catalonia. Half of the individuals included in the study (92,372) had received at least the first complete immunization (two inoculations of the vaccine) and the other half (92,372) had not been vaccinated at the time of the work.

Researchers have compared the mortality data and serious complications derived from COVID-19 among the immunized group after receiving the first and second doses of the vaccine with those of the unvaccinated group. Next, the researchers compared the results of the members of the experimental group after having received the booster dose of the vaccine (which was 54,267 patients) with an equivalent sample of people in the control group who had only received the first two inoculations.

The results of the study show that the rate of mortality and serious complications among cancer patients not vaccinated against COVID-19 is twice that of those who have received the full first dose. However, this difference is smaller than the observed data among the general population immunized against SARS-CoV-2 and the non-immunized population.

“Our results clearly demonstrate that vaccination against COVID-19 significantly reduces mortality and serious complications among cancer patients, especially those who have received the booster dose,” highlighted ISGlobal researcher Otavio Ranzani, who supervised the study together with Talita Duarte-Sallés from IDIAPJGol.

For her part, this researcher explained that “this work provides essential information to understand the impact of vaccination against COVID-19 on cancer patients, and helps to design public health policies that protect this vulnerable population.”

Reference

Lazar, F., Mercadé-Besora N., Raventós B., Pérez-Crespo L., Castro G., Ranzani O., Duarte-Salles T. Effectiveness of COVID-19 Vaccines Against Severe COVID-19 Among Patients with Cancer in Catalonia, Spain. Nature Communications. 2024. https://doi.org/10.1038/s41467-024-49285-y

What types of cities exist in Europe and which are more favourable in terms of human health, environmental quality and carbon footprint? To answer these questions, a study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, has analysed 919 European cities. The research, published in The Lancet Planetary Health , identified four basic urban configurations on the continent : compact-high density cities, open lowrise-medium density cities, open lowrise-low density cities and green-low density cities. The results show that greener and less densely populated cities have lower mortality rates, lower air pollution levels and lower urban heat island effect, but higher carbon footprints per capita. In contrast, high-density compact cities have higher mortality rates, less green space, poorer air quality and a stronger urban heat island effect, but lower greenhouse gas (CO₂) emissions per capita.

Compact, high-density cities

Compact cities are characterised by small surface area sizes and a high population density. In addition, they tend to have a high density of pedestrian areas, a moderate cycleway density and a low availability of green natural areas. It is the urban typology with the highest number of inhabitants in Europe (more than 68 million). Barcelona, Milan, Paris and Basel are examples of this urban typology.

Cities of this type tend to facilitate short-distance mobility , as they usually have dense public transport networks and infrastructure for walking and cycling. For these reasons, in recent literature, the compact city has emerged as the optimal theoretical model to promote healthier and more sustainable cities.

Open lowrise, medium density cities

Open lowrise, medium density cities have small surface area sizes , medium population densities and a relatively higher density of roads for motorized traffic . The availability of pedestrian areas, cycleways and green areas is intermediate, compared to other city types. Brussels, Dublin or Leipzig are examples of such cities.

Open lowrise, low density cities

Open lowrise low density cities occupy a larger surface area than the two previous typologies and have a lower population density . They are also characterised by a low availability of pedestrian areas and cycleways and moderate to high availability of green natural areas towards the outskirts. Pisa, Oviedo or Toulouse are examples of open lowrise low density cities.

Green, low-density cities

Lastly, the low-density green city is characterised by a large surface area size with a low population density . These sprawled cities are characterized by moderate availability of pedestrian areas and high availability of cycleways and natural green spaces, integrated from the central parts of the urban area. Helsinki, Rennes, Aarhus or Stockholm are examples of cities in this group.

City types comparison

Among the four city types, Compact-High Density and Open Lowrise-Medium Density cities exhibited the highest motorized traffic flows , resulting in the greatest levels of adverse exposure to air pollution and urban heat island effect. Accordingly, these cities also had the highest mortality rates . On the positive side, the concentration of people and services in a smaller space leads to better energy efficiency, so compact cities are also the type of city with the lowest CO ₂ emissions per capita.

In contrast, Green-Low Density cities exhibited the lowest urban heat island effect and air pollution levels , resulting in lower mortality rates. However, as sprawled conurbations, they require longer commutes and are less energy efficient, making them the costliest type of city in terms of carbon footprint per capita.

Most of the population in the study resided in compact high density (n=68,096,496) and open lowrise medium density (n=56,108,876) cities, compared with the open lowrise low density (n=38 559 619 ) and green low density (n=27,474,508) city types.

Leveraging compact cities

“After analysing more than 900 cities in Europe, we believe that, as the literature and experts point out, the compact city may still be the model of the future, but in their current configuration, they show a poor environmental quality and need to overcome important challenges”, says Tamara Iungman, ISGlobal researcher and one of the lead authors of the study. “The potential for reduced car dependency, walkability or access to services and opportunities for social interaction are clear advantages of the compact city model. However, compact cities still show a high presence of motorised transport and a distinct lack of green spaces”, she adds.

“High air pollution levels are a particular challenge for compact cities and a reduction in the levels will reduce the mortality rates significantly”, says Sasha Khomenko, ISGlobal researcher and co-lead author of the study.

“We must leverage the potential of our compact cities through innovative models, such as superblocks, low-traffic or car-free neighbourhoods, incorporating alternatives such as nature-based solutions, including planting trees and green roofs and facades. It is essential to reduce car use and shift even more to active and public transportation. Of course, there is no one-size-fits-all solution for all cities. Each city should carry out specific studies based on its own characteristics and design an ad hoc solution to find the optimal model in terms of health, environmental quality and carbon footprint”, says Mark Nieuwenhuijsen , head of the Climate, Air Pollution, Nature and Urban Health programme at ISGlobal and senior author of the study.

Methodology

The study analyzed 919 European cities included in the 2018 Urban Audit database. The area of each city was divided into five concentric rings for a detailed analysis of each of the variables. The morphological configuration of each of the rings was made using a standardised classification based on satellite imagery; the design and intended use of each street was extracted from the OSM database; traffic volume was obtained from the Open Transport Map (OTM) database; given the limited availability of ambient temperature data, the team opted to use land surface temperature to calculate the surface heat island effect (SUHI) as an indicator of the urban heat island effect, expressed as the difference in degrees Celsius between the city and the surrounding rural areas. Similarly, as an indicator of air pollution, tropospheric NO2 levels were obtained from the Sentinel-5P satellite; CO2 emissions were extracted from the ODIAC inventory; and natural cause mortality rates at city level were obtained from previous studies using the Eurostat database.

Some of the data collected by the team in previous studies are publicly available on isglobalranking.org

Reference

Iungman T, Khomenko S, Pereira Barboza E, Cirach M, Gonçalves K, Petrone P, Erbertseder T, Taubenböck H, Chakraborty T, Mark Nieuwenhuijsen M. The impact of urban configuration types on urban heat islands, air pollution, CO2 emissions and mortality in Europe: a data science approach . The Lancet Planetary Health, July 2024. 8: e489–505. https://doi.org/10.1016/S2542-5196(24)00120-7

BLOG: WHAT POLICIES COULD (COMPACT) CITIES ADOPT TO REDUCE THEIR HEALTH BURDEN?

After its first kick-off meeting in mid-June in Entebbe, Uganda, the PROTECT consortium has started its work to support the implementation of maternal vaccination against Group B Streptococcus (GBS) in Africa. The project, co-funded by the European Union (EDCTP3), is coordinated by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, in collaboration with Makerere University - John Hopkins University Joint Collaboration (MUJHU), Uganda, and brings together up to ten African and European institutions.

In addition, "the project has received strong support from the World Health Organisation (WHO), main regulatory authorities and key international stakeholders, so it has the potential to significantly influence healthpolicy recommendations for GBS maternal vaccination strategies at a global level," stresses Azucena Bardají, coordinator of PROTECT and Associate Research Professor at ISGlobal - Maternal, Child and Reproductive Health Initiative.

A vaccine that could save thousands of lives

The initiative aims to develop pregnancy registries for maternal vaccines safety assessment, establish sentinel sites for GBS infection surveillance, and monitor vaccine confidence in Kenya, Malawi, Mozambique and Uganda, to support the next phases of the maternal GBS vaccine clinical trial and accelerate its development, evaluation and licensure.

Although GBS is normally a harmless bacterium that can form part of our microbiota, it can pose a risk during pregnancy and childbirth, as pregnant women colonised with GBS can spread the bacteria to their infants before or during childbirth and cause serious infection. Today, it remains a major cause of death, disease and disability in newborns and infants, particularly in low- and middle-income countries, as can cause sepsis and meningitis.

The GBS maternal vaccines, currently in development, could save thousands of lives each year by preventing mother-to-child transmission of GBS infection. However, according to the WHO Full Value of Vaccines Assessment (FVVA) for GBS vaccines, there are a number of challenges that need to be addressed before the next phases of the vaccine clinical trial can proceed: the lack of background data on burden of disease and birth outcomes in Africa. It also advocates for capacity building for the maternal GBS vaccine trials at sites across Africa.

PROTECT's decisive role

This is where PROTECT can play a crucial role. It will define the burden of infant GBS in representative populations in sub-Saharan Africa. The consortium will also develop robust pregnancy episode registries with detailed information on pregnancy and infant outcomes to monitor the safety and effectiveness of GBS vaccines.

"Recruiting mothers in vaccine trials is always a challenge. We will work to overcome this through community engagement and education," adds Bardají. "In addition, we will set up a multi-country tracking system to monitor the level of vaccine confidence and develop toolkits to improve knowledge about vaccines and ensure equitable participation in vaccine trials."

As a result of the project, an African network of sites capable of conducting pre- and post-licensure studies of maternal vaccines will be established, providing the necessary baseline data of GBS burden for policy makers to consider the introduction of GBS vaccines in sub-Saharan Africa. In addition, the strengthening of capacities could contribute to the surveillance of other diseases and evaluation of other new vaccines, thereby improving overall health outcomes in the region.

A team from the Barcelona Institute for Global Health, a centre supported by the "la Caixa" Foundation, and the French National Institute of Health and Medical Research (Inserm), has carried out an analysis of hospital admissions related to high summer temperatures in Spain over more than a decade. The study concludes that the causes of hospitalisation in which the heat has the most notable impact are:

• Metabolic disorders and obesity
• Renal failure
• Urinary tract infection
• Sepsis
• Urolithiasis
• Poisoning by drugs and other non-medicinal substances 

The research, published in Environmental Health Perspectives, included data of more than 11.2 million of hospital admissions between 2006 and 2019. Those data were restricted to emergency hospital admissions from 48 provinces in mainland Spain and the Balearic Islands and were provided by the Spanish National Institute of Statistics. The team also calculated the values of daily mean temperatures, daily mean relative humidity and concentrations of different air pollutants (PM_2.5, PM₁₀, NO₂ and O₃). With the help of different models, they estimated the relationships between temperature and the different causes of hospitalisation for the summer season (June to September) and by province.

As expected, the statistical analysis showed that high temperature had “a generalised impact on cause-specific hospitalisations”. Even though heat increased the risk of hospitalization in all age groups, children of less than 1 year of age and adults beyond 85 years were the most vulnerable groups, with higher risk of hospital admission. Differences by sex were also found, since in hotter days men showed a higher risk of hospitalization from injuries than women, while women had a higher risk of admission from parasitic, endocrine and metabolic, respiratory or urinary diseases.

“The underlying mechanisms by which heat triggers adverse health outcomes remain unclear, but they seem to be related to how our body regulates its own temperature”, says Hicham Achebak, researcher at INSERM and ISGlobal and holder of a Marie Sklodowska-Curie postdoctoral fellowship from the European Commission. “Under conditions of heat stress, the body activates cutaneous vasodilation and sweat production in order to lose heat. The subsequent reactions can affect people differently depending on a series of factors, such as age, sex or pre-existing health conditions. We know, for example, that women have a higher temperature threshold above which sweating mechanisms are activated and are more susceptible to the effects of heat”, he adds.

Obesity and metabolic disorders

The group of diseases more largely affected by heat were metabolic disorders and obesity. The risk of hospital admission for this type of diseases on the hottest days nearly duplicated compared to the days of optimum or comfort temperature. “There are a number of reasons to explain this. For example, in people with obesity, heat loss responses work less efficiently, as body fat acts as an insulator, making them more susceptible to heat disorders”, says Hicham Achebak.

Relative humidity, air pollution and heat waves

Regarding other variables included in the study, relative humidity didn’t seem to play a relevant role on the relationship of heat with emergency hospital admissions, except for the risk of acute bronchitis and bronchiolitis, which was stronger on days with lower relative humidity.

In addition, high air pollution days appeared to exacerbate the risk of hospitalization from heat for metabolic disorders and obesity, as well as from diabetes, but not for the rest of the health outcomes.

“We observed that the added effects of heat waves —or extreme high temperatures over consecutive days—were small and specific for a subset of diseases, mainly non-respiratory infectious diseases, endocrine and metabolic disorders or nervous system diseases, among others. For this reason, we believe that current Heat-Health Early Warning Systems should be activated not only during heat waves, but also during non-persistent extreme temperatures”, says Joan Ballester Claramunt, ISGlobal researcher and senior author of the study.

Check the data

Reference

Hicham Achebak, Grégoire Rey, Zhao-Yue Chen, Simon J Lloyd, Marcos Quijal-Zamorano, Raúl Fernando Méndez-Turrubiates, Joan Ballester. Heat exposure and cause-specific hospital admissions in Spain: a nationwide cross-sectional study. Environmental Health Perspectives. 2024. https://doi.org/10.1289/EHP13254

Date

25/09/2024

Hour

9.30 - 14.00 h

Place

PRBB
(Dr. Aiguader, 88) Barcelona

This event aims to facilitate the sharing of knowledge, ideas, and resources within the exposome research community in the Barcelona area. Whether you're a seasoned exposomics researcher or a newcomer to the field, this symposium invites you to join us in building a supportive community dedicated to advancing exposome research. With a series of invited presentations, abstract-selected presentations and posters, it will provide a panorama of exposome research across different institutions in the Barcelona area.

The exposome represents the comprehensive set of environmental exposures that an individual encounters throughout their life. The exposomics field aims to evaluate how the exposome impacts on  biology and health through discovery-based analytical approaches. This local-level symposium is part of a larger initiative to build an International Human Exposome Network.

The symposium is expected to cover the following topics:

1. Technological Innovations and Methodologies in Exposomics

• Advanced Analytical Techniques: Innovations in non-targeted chemical exposome characterization, including anthropogenic pollutants and diet related compounds.
• Computational Methods and Data Science: Application of big data, artificial intelligence, and machine learning in exposome studies
• Novel Biomarkers and Detection Methods: Development of new biomarkers and tools for measuring environmental exposures, e.g. microplastics, accurately and comprehensively
• Sensors and Geospatial Modeling Applications: to collect and analyze spatial data on environmental exposures. This includes wearable sensors, remote sensing, and GIS for mapping and analyzing the spatial distribution of exposures and their health impacts.

2. Exposome and Human Health

• Social and physical environment in Low and Middle Income Countries' contexts.
• Early-life Exposures and Child Health: Research on multiple early-life exposures and their effects on child health and development.
• Chronic Diseases and Aging: The role of cumulative environmental exposures in the development of chronic diseases such as cancer, respiratory diseases, and neurodegenerative disorders.
• Precision Medicine: Utilising exposome data to advance precision medicine and improve health outcomes in clinical settings.

3. Biological Impacts and Experimental Modeling in Exposomics

• Molecular and Cellular Responses: Investigating how environmental exposures influence molecular and cellular processes, including gene expression, epigenetic modifications, and metabolic pathways.
• Animal and In Vitro Models: Use of animal models and in vitro systems to study the biological effects of environmental exposures and to identify potential mechanisms of toxicity.
• Integrative Omics Approaches: Combining genomics, proteomics, metabolomics, and other omics data to understand the comprehensive biological impact of the exposome.

4. Translational Research: Bridging experimental findings with clinical and epidemiological studies to better understand the health implications of exposome-related findings​.

Key Dates

• Abstract Call Deadline: July 1st 2024 — SUBMIT YOUR ABSTRACT! (Further details below)
• Abstract Selection Disclosure: July 26th 2024
• Registration Deadline: Sept 13th 2024 — REGISTER NOW!

Scientific Core Committee

• ISGlobal - Exposome Hub (Léa Maitre, Martine Vrijheid, Mariona Bustamente)
• CSIC - Institute of Environmental Assessment and Water Research (Pablo Gago-Ferrero)
• University of Barcelona - Biomarkers & Nutritional and Food Metabolomics Group (Cristina Andres-Lacueva)
• University of Barcelona - Artificial Intelligence in Medicine Lab (Karim Lekadir)
• EMBL, Barcelona - Organoid models of neuroendocrine development and cancer (Talya L. Dayton)

Agenda Outline

• 09.30 - 10.00 h — Welcome Coffee - Networking
• 10.00 - 10.30 h — Introduction local and global exposome research landscape (ISGlobal)
• 10.30 - 11.30 h — Part 1: Invited scientific presentations
• 11.30 - 12.30 h — Coffee Break - Poster session for early career researchers (selected based on abstract selection before the event)
• 12.30 - 13.30 h — Part 2: Invited and abstract-selected scientific presentations

The detailed programme of the symposium will be available soon (to be published in July 2024). Regarding participation format, the event will be in-person and presentations need to be in this format. Livestream option will be available, but just to follow presentations only.

Abstract Submission and Review Process

Abstracts submitted to the Barcelona Exposome Symposium will undergo a streamlined review process, starting with an initial screening and coordination by the core team, followed by a detailed evaluation by committee members. The scientific committee will then select the final abstracts. Authors of accepted abstracts will be notified by July 27th. The selection criteria focus on relevance to the symposium's topics, scientific rigour, clarity of presentation, interdisciplinary merit, and potential public health impact. This thorough and fair evaluation ensures that the symposium features high-quality discussions that are both impactful and informative.

Oral presentations (12 min) and Posters are invited for broadly defined exposomics and environmental health related topics. Posters can cover a wide range of subjects within these fields.

Poster Dimensions (to be added soon).

Submission Guidelines: Abstracts should be 200 words max.

Submit your abstract by 1 July 2024.

Coordinated by:

Support provided by: