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Hoffmann-Dishon N, Barnett-Itzhaki Z, Zalko D, Hemi R, Farzam N, Hauser R, Racowsky C, Baccarelli AA, Machtinger R. Endocrine-disrupting chemical concentrations in follicular fluid and follicular reproductive hormone levels. J Assist Reprod Genet 2024:10.1007/s10815-024-03101-0. [PMID: 38557803 DOI: 10.1007/s10815-024-03101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE To determine correlations between chemicals in follicular fluid (FF) and follicular reproductive hormone levels. METHODS The analysis was part of a larger cohort study to determine associations between exposure to EDCs and in vitro fertilization (IVF) outcomes. FF was aspirated from a single leading follicle per participant. Demographics and data on exposure to EDCs were self-reported by the participants using a questionnaire. The concentrations of estradiol (E2), progesterone (PG), anti-Mullerian hormone (AMH), and inhibin B, as well as that of 12 phthalate metabolites and 12 phenolic chemicals were measured in each FF sample. Multivariate linear regression model was used to identify the drivers of hormone levels based on participant's age, BMI, smoking status, and chemical exposure for the monitored chemicals detected in more than 50% of the samples. Benjamini-Hochberg false discovery rate (FDR) correction was applied on the resulting p values (q value). RESULTS FF samples were obtained from 72 women (mean age 30.9 years). Most of the phthalates and phenolic substances monitored (21/24, 88%) were identified in FF. Ten compounds (7 phthalate metabolites, 3 phenols) were found in more than 50% of samples. In addition, there were positive associations between E2 levels and mono-n-butyl phthalate (MnBP) (beta = 0.01) and mono-isobutyl phthalate (MiBP) (beta = 0.03) levels (q value < 0.05). CONCLUSION Higher concentrations of several phthalate metabolites, present among others in personal care products, were associated with increased E2 levels in FF. The results emphasize the need to further investigate the mechanisms of action of such EDCs on hormonal cyclicity and fertility in women.
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Affiliation(s)
- Nathalie Hoffmann-Dishon
- Infertility and IVF Unit, Department of Obstetrics and Gynecology, Division of IVF, Sheba Medical Center, Ramat-Gan 5262000, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 9446724, Jerusalem, Israel
- Faculty of Engineering, Ruppin Academic Center, 4025000, Emek Hefer, Israel
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, 4025000, Emek Hefer, Israel
| | - Daniel Zalko
- UMR1331 Toxalim (Research Center in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Rina Hemi
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat-Gan 5262000, Israel
| | - Nahid Farzam
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat-Gan 5262000, Israel
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Catherine Racowsky
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital Foch, Suresnes, France
| | - Andrea A Baccarelli
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Ronit Machtinger
- Infertility and IVF Unit, Department of Obstetrics and Gynecology, Division of IVF, Sheba Medical Center, Ramat-Gan 5262000, Israel.
- School of Medicine, Tel-Aviv University, 6997801, Tel Aviv, Israel.
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2
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Barnett-Itzhaki G, Barnett-Itzhaki Z, Ela-Dalman N, Mezad-Koursh D. Evaluating distance stereoacuity in children 4-17 years of age with a novel digital application. J AAPOS 2024:103904. [PMID: 38552945 DOI: 10.1016/j.jaapos.2024.103904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 04/15/2024]
Abstract
Distance stereoacuity measurement enables the evaluation and management of binocular vision disorders. Here, we compare the results obtained using standard tests for distance stereoacuity measurement with the novel STab test. We tested 87 children (4-17 years of age) using different tests for the quantification of stereopsis at distance: Distance Randot Stereotest (DRS), M&S random dots (M&S), and STab. A strong correlation was demonstrated between M&S-DRS (0.8), M&S-STab (0.81), DRS-STab (0.85) (all P < 0.0001). The limit of agreement between M&S and DRS was 0.45; between M&S and STab, 0.47; and between DRS and STab, 0.38. Our results suggest that all three methods can be used interchangeably.
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Affiliation(s)
- Guy Barnett-Itzhaki
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel; Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
| | | | - Noa Ela-Dalman
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel; Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Daphna Mezad-Koursh
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
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Berman T, Rorman E, Groisman L, Keinan-Boker L, Shimony T, Barnett-Itzhaki Z. Association between parental smoking and child exposure to environmental tobacco smoke in Israel. Isr J Health Policy Res 2023; 12:37. [PMID: 38115120 PMCID: PMC10731699 DOI: 10.1186/s13584-023-00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure in children can cause delayed lung development and lifelong cardiovascular damage. The aim of this study was to measure ETS exposure in children in Israel in 2020-2021 using urinary cotinine (UC) measurements and to assess correlates of ETS exposure, including parental smoking. METHODS In the framework of the National Human Biomonitoring Program, spot urine samples and questionnaire data were collected from 166 children aged 4-12 years, during the years 2020-2021. We collected urine samples in 233 adults, 69 of whom were parents of children included in the study. Parents of participating children were asked about parental smoking, child's exposure to ETS and smoking policy at home. Cotinine and creatinine were measured in urine. Creatinine-adjusted and unadjusted urine cotinine (UC) geometric means were calculated. Associations between potential correlates and UC concentrations were analyzed in univariate and multivariate analyses. For 69 child-parent pairs, correlation between child and parental UC was analyzed. RESULTS Based on urinary cotinine measurement, 65.2% of children of smokers are exposed to ETS, compared to 20.7% of children in non-smoking families. Greater numbers of smokers living in the home (beta = 1.27, p < 0.01), and low maternal education (beta = - 2.32, p < 0.01) were associated with higher levels of UC in a multivariate analysis. Spearman correlations showed a positive moderate correlation between UC in 69 child-parent pairs (r = 0.52, p < 0.01). CONCLUSIONS In order to reduce child exposure to ETS, smoking parents should be urgently targeted for smoking cessation and smoke-free home interventions. Further interventions are needed to protect all children from ETS.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Efrat Rorman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Luda Groisman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel.
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
- Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel.
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4
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Barnett-Itzhaki Z, Sar-Shalom A, Cohn L, Chen L, Steinitz O. The effect of heatwaves on the number of visits to national parks and reserves. PLoS One 2023; 18:e0289201. [PMID: 37556414 PMCID: PMC10411752 DOI: 10.1371/journal.pone.0289201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Climate change is leading to an increase in the frequency and intensity of heatwaves in many regions of the world. Climate change is also related to air pollution. Both heatwaves and air pollution have adverse health effects, and can also affect social behaviors, including tourism and touristic activities. The aim of this study was to examine the association between heatwaves, air pollution and visits to national parks and reserves in Israel. METHODS Data on 68,518 visits in 51 national parks and reserves in Israel in the years 2016-2019 was crossed with temperature and air pollution data (represented by particulate matter PM10) and analyzed using statistical tests. RESULTS Number of visits, as a function of temperature followed a unimodal distribution, in which more visits were reported on mild temperature days (in comparison to hot or cold days). In addition, the number of visits in sites with beaches was linearly correlated with temperature. Negative associations were found between number of visits and heatwaves, and between number of visits and exceedances in PM10 levels. CONCLUSIONS Heatwaves were shown to have a negative effect on the number of visits in national parks and reserves in Israel. The negative association between exceedances in air pollution and number of visits may be mediated by the positive correlation between air pollution exceedance events and heatwaves.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel
- Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel
| | | | - Liav Cohn
- Ruppin Academic Center, Emek Hefer, Israel
| | - Lior Chen
- Israel Nature and Parks Authority, Jerusalem, Israel
| | - Ofer Steinitz
- Israel Nature and Parks Authority, Jerusalem, Israel
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Ali JH, Abdeen Z, Azmi K, Berman T, Jager K, Barnett-Itzhaki Z, Walter M. Influence of exposure to pesticides on telomere length and pregnancy outcome: Diethylphosphates but not Dimethylphosphates are associated with accelerated telomere attrition in a Palestinian cohort. Ecotoxicol Environ Saf 2023; 256:114801. [PMID: 36989559 DOI: 10.1016/j.ecoenv.2023.114801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Exposure to environmental pesticides during pregnancy is associated with adverse health outcomes such as low birth weight and impaired neuro-development. In this study, we assessed maternal leukocyte telomere lengths (TL) in Palestinian pregnant women and compared the data with urinary organophosphate concentrations, demographic, lifestyle and dietary factors, birth weight, body length, gestational age, and head circumference. Women with high urine levels of creatinine adjusted diethylphosphate(DE)derived pesticide metabolites DEP, DETP or DEDTP had shorter telomeres (p = 0.05). Women living in proximity to agricultural fields had shorter telomeres compared to women not living in proximity to agricultural fields (p = 0.011). Regular consumption of organic food was associated with shorter telomeres (p = 0.01), whereas the consumption of other vegetables such as artichokes was rather associated with longer telomeres. By contrast, urine levels of dimethylphosphate(DM)-derived pesticide metabolites DMTP and DMDTP were associated with lower birth weight (p = 0.05) but not with shrter telomeres. In conclusion organophosphate pesticides and living in proximity to agriculture are associated with shorter TL, likely due to higher consumption of contaminated fruits and vegetables and/or the transport of pesticides to non-treatment sites. DE and DM substituted pesticides seem to have different effects on telomeres and development.
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Affiliation(s)
- Jaber Haj Ali
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Rostock, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin, Berlin, Germany; Consulting Medical Laboratory, Nablus, Palestine
| | - Ziad Abdeen
- Al-Quds Nutrition and Health Research Institute, Al-Quds University, Jerusalem, Palestine
| | - Kifaya Azmi
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, The West Bank, Palestine; Al-Quds Public Health Society, Jerusalem, Palestine
| | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Kathrin Jager
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Rostock, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin, Berlin, Germany
| | - Zohar Barnett-Itzhaki
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel
| | - Michael Walter
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Rostock, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin, Berlin, Germany.
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Berman TS, Barnett-Itzhaki Z, Berman T, Marom E. Antimicrobial resistance in food-producing animals: towards implementing a one health based national action plan in Israel. Isr J Health Policy Res 2023; 12:18. [PMID: 37101188 PMCID: PMC10132406 DOI: 10.1186/s13584-023-00562-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/01/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Development of antimicrobial resistance poses a major threat to human and animal health worldwide. Antimicrobials are frequently used in animal husbandry, making food-producing animals a widespread and important source of antimicrobial resistance. Indeed, recent evidence demonstrates that antimicrobial resistance in food-producing animals poses a threat to the health of humans, animals and the environment. To address this threat, national action plans have been implemented based on a 'One Health' approach, which integrates actions across human and animal health sectors to combat antimicrobial resistance. Although under development, Israel has yet to publish a national action plan against antimicrobial resistance, despite alarming findings of resistant bacteria in food-producing animals in the country. Here we review several national action plans against antimicrobial resistance around the world in order to suggest approaches to develop a national action plan in Israel. MAIN BODY We investigated worldwide national action plans against antimicrobial resistance based on a 'One Health' approach. We also conducted interviews with representatives of relevant Israeli ministries to understand antimicrobial resistance policy and regulatory frameworks in Israel. Finally, we present recommendations for Israel towards implementing a 'One Health' national action plan against antimicrobial resistance. Many countries have developed such plans, however, only a few are currently funded. Furthermore, many countries, especially in Europe, have taken action to reduce the use of antimicrobials and the spread of antimicrobial resistance in food-producing animals by banning the use of antimicrobials to promote growth, reporting data on the use and sales of antimicrobials in food-producing animals, operating centralized antimicrobial resistance surveillance systems and preventing the use of antimicrobials important to human medicine to treat food-producing animals. CONCLUSIONS Without a comprehensive and funded national action plan, the risks of antimicrobial resistance to the public health in Israel will escalate. Thus, several actions should be considered: (1) Reporting data on the use of antimicrobials in humans and animals. (2) Operating a centralized surveillance system for antimicrobial resistance in humans, animals and the environment. (3) Improving awareness regarding antimicrobial resistance in the general public and in health practitioners from both human and animal sectors. (4) Composing a list of critically important antimicrobials to human medicine that's use should be avoided in food-producing animals. (5) Enforcing best practices of antimicrobial use at the farm-level. (6) Reducing incidence of infection through farm biosecurity. (7) Supporting research and development of new antimicrobial treatments, vaccines and diagnostic tools.
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Affiliation(s)
- Tali Sarah Berman
- Mimshak, The Israel Society of Ecology and Environmental Sciences, 19 Kehilat New York St, Tel Aviv, Israel.
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel.
- Department of Entomology, Newe Ya'ar Research Center, ARO, Ramat Yishai, Israel.
| | - Zohar Barnett-Itzhaki
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, 4025000, Emek Hefer, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
| | - Eli Marom
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
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Amitay M, Barnett-Itzhaki Z, Sudri S, Drori C, Wase T, Abu-El-Naaj I, Ben-Ari MK, Rieck M, Avni Y, Pogozelich G, Weiss E, Mosseri M. Deep convolution neural network for screening carotid calcification in dental panoramic radiographs. PLOS Digit Health 2023; 2:e0000081. [PMID: 37043433 PMCID: PMC10096511 DOI: 10.1371/journal.pdig.0000081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/13/2023] [Indexed: 04/13/2023]
Abstract
Ischemic stroke, a leading global cause of death and disability, is commonly caused by carotid arteries atherosclerosis. Carotid artery calcification (CAC) is a well-known marker of atherosclerosis. Such calcifications are classically detected by ultrasound screening. In recent years it was shown that these calcifications can also be inferred from routine panoramic dental radiographs. In this work, we focused on panoramic dental radiographs taken from 500 patients, manually labelling each of the patients' sides (each radiograph was treated as two sides), which were used to develop an artificial intelligence (AI)-based algorithm to automatically detect carotid calcifications. The algorithm uses deep learning convolutional neural networks (CNN), with transfer learning (TL) approach that achieved true labels for each corner, and reached a sensitivity (recall) of 0.82 and a specificity of 0.97 for individual arteries, and a recall of 0.87 and specificity of 0.97 for individual patients. Applying and integrating the algorithm in healthcare units and dental clinics has the potential of reducing stroke events and their mortality and morbidity consequences.
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Affiliation(s)
- Moshe Amitay
- ODMachine Ltd., Herzliya, Israel
- Bioinformatic Department, Jerusalem College of Technology, Jerusalem 9372115, Israel
| | - Zohar Barnett-Itzhaki
- ODMachine Ltd., Herzliya, Israel
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Israel
| | - Shiran Sudri
- Department of Oral and Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, affiliated with Azrieli Faculty of medicine, Bar Ilan University, Israel
| | | | | | - Imad Abu-El-Naaj
- Department of Oral and Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, affiliated with Azrieli Faculty of medicine, Bar Ilan University, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | | | | | | | | | - Ervin Weiss
- ODMachine Ltd., Herzliya, Israel
- Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Morris Mosseri
- ODMachine Ltd., Herzliya, Israel
- Sackler Faculty of Medicine, Tel Aviv University
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8
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Machtinger R, Racowsky C, Baccarelli AA, Bollati V, Orvieto R, Hauser R, Barnett-Itzhaki Z. Recombinant human chorionic gonadotropin and gonadotropin-releasing hormone agonist differently affect the profile of extracellular vesicle microRNAs in human follicular fluid. J Assist Reprod Genet 2023; 40:527-536. [PMID: 36609942 PMCID: PMC10033801 DOI: 10.1007/s10815-022-02703-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 12/19/2022] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To compare the expression profile of extracellular vesicle microRNAs (EV-miRNAs) derived from follicular fluid after a trigger with recombinant human chorionic gonadotropin (r-hCG) or with a gonadotropin-releasing hormone GnRH agonist (GnRH-a) for final oocyte maturation. METHODS A retrospective analysis of a prospective cohort. Women undergoing in vitro fertilization at a tertiary university-affiliated hospital were recruited between 2014 and 2016. EV-miRNAs were extracted from the follicular fluid of a single follicle, and their expression was assessed using TaqMan Open Array®. Genes regulated by EV-miRNAs were analyzed using miRWalk2.0 Targetscan database, DAVID Bioinformatics Resources, Kyoto-Encyclopedia of Genes and Genomes (KEGG), and Gene Ontology (GO). RESULTS Eighty-two women were included in the r-hCG trigger group and 9 in the GnRH-a group. Of 754 EV-miRNAs screened, 135 were detected in at least 50% of the samples and expressed in both groups and were further analyzed. After adjusting for multiple testing, 41 EV-miRNAs whose expression levels significantly differed between the two trigger groups were identified. Bioinformatics analysis of the genes regulated by these EV-miRNAs showed distinct pathways between the two triggers, including TGF-beta signaling, cell cycle, and Wnt signaling pathways. Most of these pathways regulate cascades associated with apoptosis, embryo development, implantation, decidualization, and placental development. CONCLUSIONS Trigger with GnRH-a or r-hCG leads to distinct EV-miRNAs expression profiles and to downstream biological effects in ovarian follicles. These findings may provide an insight for the increased apoptosis and the lower implantation rates following GnRH-a trigger vs. r-hCG in cases lacking intensive luteal phase support.
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Affiliation(s)
- R Machtinger
- Department of Obstetrics and Gynecology, Division of IVF, Sheba Medical Center, Ramat Gan 5262000, Israel.
- Sackler School of Medicine, Tel-Aviv University, 6997801, Tel Aviv, Israel.
| | - C Racowsky
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital Foch, Suresnes, France
| | - A A Baccarelli
- Laboratory of Precision Environmental Biosciences, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, 10032, USA
| | - V Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, 20122, Milan, Italy
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - R Orvieto
- Department of Obstetrics and Gynecology, Division of IVF, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - R Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Z Barnett-Itzhaki
- Public Health Services, Ministry of Health, 9446724, Jerusalem, Israel
- Faculty of Engineering, Ruppin Academic Center, 4025000, Emek Hefer, Israel
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, 4025000, Emek Hefer, Israel
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Tarazona JV, Cattaneo I, Niemann L, Pedraza-Diaz S, González-Caballero MC, de Alba-Gonzalez M, Cañas A, Dominguez-Morueco N, Esteban-López M, Castaño A, Borges T, Katsonouri A, Makris KC, Ottenbros I, Mol H, De Decker A, Morrens B, Berman T, Barnett-Itzhaki Z, Probst-Hensch N, Fuhrimann S, Tratnik JS, Horvat M, Rambaud L, Riou M, Schoeters G, Govarts E, Kolossa-Gehring M, Weber T, Apel P, Namorado S, Santonen T. A Tiered Approach for Assessing Individual and Combined Risk of Pyrethroids Using Human Biomonitoring Data. Toxics 2022; 10:toxics10080451. [PMID: 36006130 PMCID: PMC9416723 DOI: 10.3390/toxics10080451] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022]
Abstract
Pyrethroids are a major insecticide class, suitable for biomonitoring in humans. Due to similarities in structure and metabolic pathways, urinary metabolites are common to various active substances. A tiered approach is proposed for risk assessment. Tier I was a conservative screening for overall pyrethroid exposure, based on phenoxybenzoic acid metabolites. Subsequently, probabilistic approaches and more specific metabolites were used for refining the risk estimates. Exposure was based on 95th percentiles from HBM4EU aligned studies (2014–2021) covering children in Belgium, Cyprus, France, Israel, Slovenia, and The Netherlands and adults in France, Germany, Israel, and Switzerland. In all children populations, the 95th percentiles for 3-phenoxybenzoic acid (3-PBA) exceeded the screening value. The probabilistic refinement quantified the risk level of the most exposed population (Belgium) at 2% or between 1–0.1% depending on the assumptions. In the substance specific assessments, the 95th percentiles of urinary concentrations in the aligned studies were well below the respective human biomonitoring guidance values (HBM-GVs). Both information sets were combined for refining the combined risk. Overall, the HBM data suggest a low health concern, at population level, related to pyrethroid exposure for the populations covered by the studies, even though a potential risk for highly exposed children cannot be completely excluded. The proposed tiered approach, including a screening step and several refinement options, seems to be a promising tool of scientific and regulatory value in future.
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Affiliation(s)
- Jose V. Tarazona
- European Food Safety Authority (EFSA), 43126 Parma, Italy
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
- Correspondence: (J.V.T.); (T.S.)
| | - Irene Cattaneo
- European Food Safety Authority (EFSA), 43126 Parma, Italy
| | - Lars Niemann
- Department of Safety of Pesticides, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Susana Pedraza-Diaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | | | | | - Ana Cañas
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | | | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Teresa Borges
- General-Directorate of Health, Ministry of Health, 1049-005 Lisbon, Portugal
| | | | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Ilse Ottenbros
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, The Netherlands
| | - Hans Mol
- Wageningen Food Safety Research (WFSR), 6700 Wageningen, The Netherlands
| | | | - Bert Morrens
- Department of Sociology, University of Antwerp, 2020 Antwerpen, Belgium
| | | | - Zohar Barnett-Itzhaki
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer 4025000, Israel
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Samuel Fuhrimann
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Janja Snoj Tratnik
- Jozef Stefan Institute, Department of Environmental Sciences, 1000 Jubljana, Slovenia
| | - Milena Horvat
- Jozef Stefan Institute, Department of Environmental Sciences, 1000 Jubljana, Slovenia
| | - Loic Rambaud
- Department of Environmental and Occupational Health, Santé Publique France, 12 rue du Val d’Osne, Saint-Maurice, CEDEX, 94415 Paris, France
| | - Margaux Riou
- Department of Environmental and Occupational Health, Santé Publique France, 12 rue du Val d’Osne, Saint-Maurice, CEDEX, 94415 Paris, France
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2020 Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2020 Mol, Belgium
| | | | - Till Weber
- German Environment Agency (UBA), 14195 Berlin, Germany
| | - Petra Apel
- German Environment Agency (UBA), 14195 Berlin, Germany
| | - Sonia Namorado
- Department of Epidemiology, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - Tiina Santonen
- Finnish Institute of Occupational Health, Työterveyslaitos, P.O. Box 40, 00032 Helsinki, Finland
- Correspondence: (J.V.T.); (T.S.)
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10
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Tarazona JV, González-Caballero MDC, de Alba-Gonzalez M, Pedraza-Diaz S, Cañas A, Dominguez-Morueco N, Esteban-López M, Cattaneo I, Katsonouri A, Makris KC, Halldorsson TI, Olafsdottir K, Zock JP, Dias J, Decker AD, Morrens B, Berman T, Barnett-Itzhaki Z, Lindh C, Gilles L, Govarts E, Schoeters G, Weber T, Kolossa-Gehring M, Santonen T, Castaño A. Improving the Risk Assessment of Pesticides through the Integration of Human Biomonitoring and Food Monitoring Data: A Case Study for Chlorpyrifos. Toxics 2022; 10:toxics10060313. [PMID: 35736921 PMCID: PMC9228629 DOI: 10.3390/toxics10060313] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
The risk assessment of pesticide residues in food is a key priority in the area of food safety. Most jurisdictions have implemented pre-marketing authorization processes, which are supported by prospective risk assessments. These prospective assessments estimate the expected residue levels in food combining results from residue trials, resembling the pesticide use patterns, with food consumption patterns, according to internationally agreed procedures. In addition, jurisdictions such as the European Union (EU) have implemented large monitoring programs, measuring actual pesticide residue levels in food, and are supporting large-scale human biomonitoring programs for confirming the actual exposure levels and potential risk for consumers. The organophosphate insecticide chlorpyrifos offers an interesting case study, as in the last decade, its acceptable daily intake (ADI) has been reduced several times following risk assessments by the European Food Safety Authority (EFSA). This process has been linked to significant reductions in the use authorized in the EU, reducing consumers’ exposure progressively, until the final ban in 2020, accompanied by setting all EU maximum residue levels (MRL) in food at the default value of 0.01 mg/kg. We present a comparison of estimates of the consumer’s internal exposure to chlorpyrifos based on the urinary marker 3,5,6-trichloro-2-pyridinol (TCPy), using two sources of monitoring data: monitoring of the food chain from the EU program and biomonitoring of European citizens from the HB4EU project, supported by a literature search. Both methods confirmed a drastic reduction in exposure levels from 2016 onwards. The margin of exposure approach is then used for conducting retrospective risk assessments at different time points, considering the evolution of our understanding of chlorpyrifos toxicity, as well as of exposure levels in EU consumers following the regulatory decisions. Concerns are presented using a color code, and have been identified for almost all studies, particularly for the highest exposed group, but at different levels, reaching the maximum level, red code, for children in Cyprus and Israel. The assessment uncertainties are highlighted and integrated in the identification of levels of concern.
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Affiliation(s)
- Jose V. Tarazona
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
- European Food Safety Authority (EFSA), I-43126 Parma, Italy;
- Correspondence: (J.V.T.); (A.C.)
| | - Maria del Carmen González-Caballero
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Mercedes de Alba-Gonzalez
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Susana Pedraza-Diaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Ana Cañas
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Noelia Dominguez-Morueco
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
| | - Irene Cattaneo
- European Food Safety Authority (EFSA), I-43126 Parma, Italy;
| | | | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus;
| | - Thorhallur I. Halldorsson
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, 102 Reykjavik, Iceland;
- Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Kristin Olafsdottir
- Department of Pharmacology and Toxicology, University of Iceland, 107 Reykjavik, Iceland;
| | - Jan-Paul Zock
- National Institute for Public Health and the Environment (RIVM), Bilthoven, 3720 BA De Bilt, The Netherlands;
| | - Jonatan Dias
- Wageningen Food Safety Research (WFSR), 6700 AE Wageningen, The Netherlands;
| | | | - Bert Morrens
- Department of Sociology, University of Antwerp, 2020 Antwerpen, Belgium;
| | - Tamar Berman
- Ministry of Health, Jerusalem 9446724, Israel; (T.B.); (Z.B.-I.)
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jerusalem 9446724, Israel; (T.B.); (Z.B.-I.)
- Ruppin Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer 4025000, Israel
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, 22363 Lund, Sweden;
| | - Liese Gilles
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (E.G.); (G.S.)
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (E.G.); (G.S.)
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (E.G.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, 2020 Antwerp, Belgium
| | - Till Weber
- German Environment Agency (UBA), 14195 Berlin, Germany; (T.W.); (M.K.-G.)
| | | | - Tiina Santonen
- Finnish Institute of Occupational Health, P.O. Box 40 Helsinki, Finland;
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Madrid, Spain; (M.d.C.G.-C.); (M.d.A.-G.); (S.P.-D.); (A.C.); (N.D.-M.); (M.E.-L.)
- Correspondence: (J.V.T.); (A.C.)
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11
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Negev M, Barnett-Itzhaki Z, Berman T, Reicher S, Cohen N, Ardi R, Shammai Y, Zohar T, Diamond ML. Hazardous chemicals in outdoor and indoor surfaces: artificial turf and laminate flooring. J Expo Sci Environ Epidemiol 2022; 32:392-399. [PMID: 34697408 DOI: 10.1038/s41370-021-00396-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Synthetic materials, increasingly used for indoor and outdoor surfaces including homes and playgrounds, may contain toxic chemicals. Infants have a higher potential of exposure to chemicals in these materials, which may pose a risk to their health. OBJECTIVE To understand potential risks related to outdoor surface coverings, based on a review of the literature and regulations, and to assess levels of hazardous chemicals in surface coverings in Israel. METHODS We reviewed the literature and regulations on artificial turf. We tested 46 samples of surfaces for trace metals in synthetic playground surfaces; trace metals, phthalates, and di(2-ethylhexyl) terephthalate (DEHT) in synthetic grass, and phthalates, DEHT and formaldehyde in laminate flooring. RESULTS Twelve studies reporting high levels of polycyclic aromatic hydrocarbons (PAH), and varying levels of trace metals in synthetic playground surfaces were identified, as well as five international regulations on lead with maximum acceptable concentrations in the range 40-500 mg/kg. Surface tests showed that 20 out of 30 samples of synthetic playground surfaces exceeded relevant standards for trace metals, of which five had cadmium levels ≥30 mg/kg and four had chromium levels ≥510 mg/kg. In synthetic grass, three out of eight samples exceeded relevant standards, with lead levels ≥1200 mg/kg. In Laminate flooring (n = 8) formaldehyde levels were in the range of 0.7-1.2 mg/m2 formaldehyde, and five samples contained ~5% DEHT. SIGNIFICANCE The literature on chemicals in surfaces is limited, but indicates some exceedance of regulatory limits. Trace metals in synthetic playground surfaces and synthetic grass, not regulated in Israel, exceeded relevant international standards in 72% of samples. Laminate flooring, regulated for formaldehyde, did not exceed the 3.5 mg/m2 standard, but contained DEHT, a replacement for ortho-substituted phthalates. The results of this preliminary study show that flooring surfaces may be a source of children's exposure to toxic chemicals. IMPACT STATEMENT Synthetic surfaces are increasingly being used in, for example, children's playgrounds and sports fields. Exceedances of regulatory limits from other jurisdictions, of heavy metal levels in most outdoor surfaces sampled in Israel indicates the potential for children's exposure. Domestic regulations should be implemented to reduce the risk to children from exposure to these surfaces.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel.
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
- School of Engineering, Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, 4025000, Israel
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Naor Cohen
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Ruti Ardi
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Yaniv Shammai
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Tamar Zohar
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel
| | - Miriam L Diamond
- Department of Earth Sciences, University of Toronto, 22 Russell Street, Toronto, M5S 3B1, ON, Canada
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12
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Barnett-Itzhaki Z, Ehrlich D, Troen AM, Rorman E, Groismann L, Blaychfeld-Magnazi M, Endevelt R, Berman T. Results of the national biomonitoring program show persistent iodine deficiency in Israel. Isr J Health Policy Res 2022; 11:18. [PMID: 35346362 PMCID: PMC8960077 DOI: 10.1186/s13584-022-00526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Adequate iodine intake is essential for human health, for normal thyroid function, and for attainment of full intellectual potential in children. In light of Israel's lack of a mandatory salt fortification policy, heavy reliance on desalination and low iodine intake from dairy products and seafood, there is concern in Israel that the population is iodine deficient. Indeed, the first Israeli National Iodine Survey in 2016 found a median urinary iodine concentration (UIC) of 83 µg/L among school age children, falling below the WHO’s adequacy range of 100–299 µg/L for children.
Methods
In the framework of the National Human Biomonitoring Program in Israel, spot urine samples and questionnaire data were collected from 166 healthy children aged 4–12 years in 2020–2021. Urinary iodine concentrations were measured at the Ministry of Health National Biomonitoring Laboratory, using mass spectrometry. An international comparison of median urinary iodine concentrations (UIC) was performed taking into consideration the levels of desalinated water per capita, and fortification policies.
Results
The overall median (interquartile range [IQR]) UIC was 80.1 µg/L (44.7–130.8 µg/L) indicating that the population’s iodine status has not improved in the five years that have passed since inadequacy was first identified. When comparing 13 countries with population size above 150,000, whose desalinated water per capita was at least 1 m3, Israel and Lebanon were the only countries with median UIC below the WHO adequacy range.
Conclusions
There is an urgent need for mandatory salt fortification in Israel. Based on our international comparison, we conclude that the potential impact of desalination on iodine intake can be compensated for using the implementation of salt fortification policy. This study highlights the critical need for public health surveillance of nutritional and environmental exposures using human biomonitoring, with emphasis on vulnerable populations such as pregnant women and children.
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13
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Negev M, Berman T, Goulden S, Reicher S, Barnett-Itzhaki Z, Ardi R, Shammai Y, Diamond ML. Lead in children's jewelry: the impact of regulation. J Expo Sci Environ Epidemiol 2022; 32:10-16. [PMID: 33654269 DOI: 10.1038/s41370-021-00308-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2016 we identified a regulatory gap in Israel reflecting a lack of restrictions on lead in children's jewelry. We conducted surveys that found high levels of lead in children's jewelry. Following the findings, a new standard restricting lead content was introduced in 2018. OBJECTIVE The goal of this study is to assess whether the new standard had an impact on lead concentrations in children's jewelry on the market 4 months after entry into force, and to examine factors that influenced the standard's effectiveness. METHODS Thirty-five items of children's jewelry were sampled from stores in Israel in 2018. Lead content of 130 subsamples of these items was tested with X-ray Fluorescence Spectrometry (XRF). We compared these findings to those before the introduction of the standard. We also conducted five structured interviews with professionals from government ministries, industry and expert bodies to examine factors influencing the standard's enactment and implementation. RESULTS 17% of jewelry samples exceeded the ASTM lead standard in 2018 compared with 50% in 2016. The mean of the jewelry subsamples analyzed in 2018 was 936 (±1700) compared to 1420 (±5740) ppm in 2016. Scientific and regulatory consensus among those setting the new standard led to its swift enactment. However, enforcement challenges may reduce the standard's impact. SIGNIFICANCE A new standard on lead in children's jewelry was followed by a decline in lead concentrations, but some products with lead exceedances remained available on the market. Public health campaigns, standards and compliance monitoring, and higher penalties will all help to reach the goal of protecting public health.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel.
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Shula Goulden
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem, 9446724, Israel
- School of Engineering, Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, 4025000, Israel
| | - Ruti Ardi
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Yaniv Shammai
- The Standards Institution of Israel, 42 Chaim Levanon Street, Tel Aviv, 6997701, Israel
| | - Miriam L Diamond
- Department of Earth Sciences, University of Toronto, 22 Russell Street, Toronto, M5S 3B1, ON, Canada
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14
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Inbar Y, Machtinger R, Barnett-Itzhaki Z, Goldblatt A, Stoler E, Rabinovici J. MRI guided focused ultrasound (MRgFUS) treatment for uterine fibroids among women with and without abdominal scars. Int J Hyperthermia 2021; 38:1672-1676. [PMID: 34843654 DOI: 10.1080/02656736.2021.2007302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION MRI guided focused ultrasound (MRgFUS) is a noninvasive technique for treating uterine fibroids. The presence of abdominal scars can limit the number of women eligible for the procedure, due to absorbance of beam energy. The goals of this study were to assess the number of women that fit the procedure and to compare outcomes among women with or without abdominal scars. MATERIAL AND METHODS A prospective cohort study of all women that were interested in MRgFUS in a single University-Affiliated Hospital between November 2012 and December 2019. Rates of women that were referred to further screening, fulfilled selection criteria and underwent the procedure were compared between patients with or without abdominal scars. We evaluated the treatment parameters of the two groups and used linear regression model predict non-perfused volume (NPV) at the end of the process. RESULTS Out of 701 patients, 21.8% were suitable for MRgFUS. Women with scars had significant lower NPV compared with women without scars (60% versus 82.4%, p = 0.021). No serious adverse events were reported in both groups. Linear regression models showed that fibroids' volume, stopping the treatment due to severe pain and the presence of abdominal scars had a statistically significantly negative effect on NPV (betas: -11.51, -6.96, and -6.29, p-values: <0.001, 0.003, and 0.007 respectively), while number of sonication had a statistically significantly positive effect on NPV (beta = 5.98, p = 0.011). CONCLUSION Regardless of strict inclusion criteria, MRgFUS treatment is less efficient among women with abdominal scars, although still feasible for those who are interested in noninvasive option.
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Affiliation(s)
- Yael Inbar
- Departments of Radiology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Advanced Technology Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ronit Machtinger
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Advanced Technology Center, Sheba Medical Center, Tel-Hashomer, Israel.,Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel.,School of Engineering, Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel
| | - Avishai Goldblatt
- Departments of Radiology, Sheba Medical Center, Tel-Hashomer, Israel.,Advanced Technology Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Eti Stoler
- Advanced Technology Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Jaron Rabinovici
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Advanced Technology Center, Sheba Medical Center, Tel-Hashomer, Israel.,Departments of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
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15
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Levi A, Barnett-Itzhaki Z. Effects of chronic exposure to ambient air pollutants, demographic, and socioeconomic factors on COVID-19 morbidity: The Israeli case study. Environ Res 2021; 202:111673. [PMID: 34260961 PMCID: PMC8290351 DOI: 10.1016/j.envres.2021.111673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/03/2021] [Accepted: 07/07/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND Recent studies conducted in several OECD countries have shown that chronic exposure to elevated levels of air pollutants (especially PM2.5, PM10 and NOx), might negatively impact COVID-19 morbidity and mortality rates. The aim of this study was to examine the association between chronic exposure to air pollution in Israeli cities and towns, their demographic and socioeconomic status, and COVID-19 morbidity, during the three local morbidity waves. METHODS We examined the associations between: (a) annual average concentrations of NOx, CO, PM10, PM2.5 and SO2 in 2016-2019, and demographic and socioeconomic parameters, and (b) COVID-19 positive cases in 279 Israeli cities and towns, in the four state-wide morbidity peaks: 1st wave peak: March 31st, 2020; 2nd wave peaks: July 24th and September 27th, 2020, and the 3rd wave peak: January 17th, 2021, which occurred after the beginning of the nationwide vaccination campaign. These associations were calculated using both Spearman correlations and multivariate linear regressions. RESULTS We found statistically significant positive correlations between the concentrations of most pollutants in 2016-19 and COVID-19 morbidity rate at the first three timepoints but not the 4th (January 17th, 2021). Population density and city/town total population were also positively associated with the COVID-19 morbidity rates at these three timepoints, but not the 4th, in which socioeconomic parameters were more dominant - we found a statistically significant negative correlation between socioeconomic cluster and COVID-19 morbidity. In addition, all multivariate models including PM2.5 concentrations were statistically significant, and PM2.5 concentrations were positively associated with the COVID-19 morbidity rates in all models. CONCLUSIONS We found a nationwide association between population chronic exposure to five main air pollutants in Israeli cities and towns, and COVID-19 morbidity rates during two of the three morbidity waves experienced in Israel. The widespread morbidity that was related to socioeconomic factors during the 3rd wave, emphasizes the need for special attention to morbidity prevention in socioeconomically vulnerable populations and especially in large household communities. Nevertheless, this ecological study has several limitations, such as the inability to draw conclusions about causality or mechanisms of action. The growing body of evidence, regarding association between exacerbated COVID-19 morbidity and mortality rates and long-term chronic exposure to elevated concentrations of air pollutants should serve as a wake-up call to policy makers regarding the urgent need to reduce air pollution and its harmful effects.
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Affiliation(s)
- Adi Levi
- School of Sciences, Achva Academic College, Yinon, Israel; Israel Society of Ecology and Environmental Sciences, Tel Aviv, Israel
| | - Zohar Barnett-Itzhaki
- School of Engineering, Ruppin Academic Center, Emek Hefer, Israel; Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel.
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16
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Barnett-Itzhaki G, Barnett-Itzhaki Z, Ela-Dalman N. The dynamic optotype (Dyop): a novel visual acuity test for use in children. J AAPOS 2021; 25:285.e1-285.e5. [PMID: 34562623 DOI: 10.1016/j.jaapos.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/30/2021] [Accepted: 04/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the "dynamic optotype" (Dyop), a simple visual acuity test based on a dynamic target that requires minimal knowledge of symbols and letters. METHODS A total of 160 consecutive, systemically healthy children, 4-17 years of age were prospectively recruited from the Pediatric Ophthalmology Unit of Meir Medical Center. Children were tested with the Dyop visual acuity test and the Early Treatment Diabetic Retinopathy Study (ETDRS) Lea numbers chart. The results of both tests were compared. The eye with the poorest acuity was tested with the new Dyop eye chart and the Lea numbers chart. The order of the testing was reversed between children. The logMAR visual acuity scores for each eye chart were compared. RESULTS We found a strong linear correlation (r = 0.88) between visual acuity measures. The mean difference in visual acuity was -0.01 (95% CI, -0.02 to 0.01). The 95% limits of agreement were ±1.2 lines. The logMAR equivalent mean difference was about less than 1 letter. The Dyop test underestimated visual acuity relative to the Lea numbers chart. CONCLUSIONS The results of this study support the Dyop eye chart as a valid measure of visual acuity in children 4-17 years of age, with visual acuity ranging from 20/16 to 20/200.
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Affiliation(s)
- Guy Barnett-Itzhaki
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Zohar Barnett-Itzhaki
- Public Health Services, Israel Ministry of Health, Jerusalem, Israel; Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel; Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel
| | - Noa Ela-Dalman
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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17
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Bar-Lev S, Reichman S, Barnett-Itzhaki Z. Prediction of vaccine hesitancy based on social media traffic among Israeli parents using machine learning strategies. Isr J Health Policy Res 2021; 10:49. [PMID: 34425894 PMCID: PMC8381350 DOI: 10.1186/s13584-021-00486-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/25/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Vaccines have contributed to substantial reductions of morbidity and mortality from vaccine-preventable diseases, mainly in children. However, vaccine hesitancy was listed by the World Health Organization (WHO) in 2019 as one of the top ten threats to world health. Aim To employ machine-learning strategies to assess how on-line content regarding vaccination affects vaccine hesitancy. Methods We collected social media posts and responses from vaccination discussion groups and forums on leading social platforms, including Facebook and Tapuz (A user content website that contains blogs and forums). We investigated 65,603 records of children aged 0–6 years who are insured in Maccabi’s Health Maintenance Organization (HMO). We applied three machine learning algorithms (Logistic regression, Random forest and Neural networks) to predict vaccination among Israeli children, based on demographic and social media traffic. Results Higher hesitancy was associated with more social media traffic, for most of the vaccinations. The addition of the social media traffic features improved the performances of most of the models. However, for Rota virus, Hepatitis A and hepatitis B, the performances of all algorithms (with and without the social media features) were close to random (accuracy up to 0.63 and F1 up to 0.65). We found a negative association between on-line discussions and vaccination. Conclusions There is an association between social media traffic and vaccine hesitancy. Policy makers are encouraged to perceive social media as a main channel of communication during health crises. Health officials and experts are encouraged to take part in social media discussions, and be equipped to readily provide the information, support and advice that the public is looking for, in order to optimize vaccination actions and to improve public health Supplementary Information The online version contains supplementary material available at 10.1186/s13584-021-00486-6.
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Affiliation(s)
- Shirly Bar-Lev
- The Dror (Imri) Aloni Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel. .,School of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
| | - Shahar Reichman
- Coller School of Management, Tel-Aviv University, Tel-Aviv, Israel
| | - Zohar Barnett-Itzhaki
- The Dror (Imri) Aloni Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel.,School of Engineering, Ruppin Academic Center, Emek Hefer, Israel
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Barnett-Itzhaki Z, Knapp S, Avraham C, Racowsky C, Hauser R, Bollati V, Baccarelli AA, Machtinger R. Association between follicular fluid phthalate concentrations and extracellular vesicle microRNAs expression. Hum Reprod 2021; 36:1590-1599. [PMID: 33885134 PMCID: PMC8599830 DOI: 10.1093/humrep/deab063] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Are phthalate metabolite concentrations in follicular fluid (FF) associated with the expression of extracellular vesicle microRNAs (EV-miRNAs)? SUMMARY ANSWER Phthalate metabolite concentrations are associated with the expression of EV-miRNA and their associated pathways in FFs. WHAT IS KNOWN ALREADY Phthalate metabolites were recently detected in FF. Urinary phthalate metabolite concentrations alter the expression of EV-miRNAs in FF. STUDY DESIGN, SIZE, DURATION Prospective study including 105 women recruited between January 2014 and August 2016 in a tertiary university-affiliated hospital. PARTICIPANTS/MATERIALS, SETTING, METHODS We assessed FF concentrations of 12 phthalate metabolites. EV-miRNAs were isolated from aliquots of the same FF, and their expression profiles were measured using a human miRNA panel. Associations between EV-miRNAs that were present in >50% of the samples and phthalate metabolites that were measured in >74% of the FF samples were tested. Genes regulated by EV-miRNAs that were found to be significantly (false discovery rate q-value < 0.1) correlated with FF-phthalates were analyzed for pathways linked with female fertility using miRWalk2.0 Targetscan database, DAVID Bioinformatics Resources and Kyoto Encyclopedia of Genes and Genomes (KEGG). MAIN RESULTS AND THE ROLE OF CHANCE Of 12 phthalate metabolites, 11 were measured in at least one FF sample. Mono (6-COOH-2-methylheptyl) phthalate (MCOMHP), mono-2-ethyl-5-carboxypentyl phthalate (mECPP), mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), mono-isobutyl phthalate (MiBP), monoethyl phthalate (MEP) and mono (7-COOH-2-methyloctyl) phthalate (MCOMOP) were detected in more than 74% of the samples. Of 754 EV-miRNAs tested, 39 were significantly associated either with MEP, MBzP, MCOMOP, MCOMHP and/or with mECPP, after adjusting for multiple testing (P < 0.05). KEGG-based pathway enrichment analysis of the genes regulated by these miRNAs showed that these EV-miRNAs may be involved in pathways related to ovary or oocyte development, maturation and fertilization. LIMITATIONS, REASONS FOR CAUTION The use of miRNA panel array limits the number of potential relevant miRNAs. Moreover, several of the phthalate metabolites examined may be biased due to internal (enzymatic activity) or external (contamination in medical interventions) causes. WIDER IMPLICATIONS OF THE FINDINGS Phthalate metabolites may alter follicular EV-miRNAs profile and thus impair pathways that are involved with oocyte development, maturation and fertilization. Our results contribute to understanding of possible mechanism(s) in which endocrine disruptor chemicals interfere with female fertility. STUDY FUNDING/COMPETING INTERESTS This work was supported by the National Institutes of Environmental Health Sciences [Grant R21-ES024236]; and Environmental Health Fund, Israel [Grant 1301], no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel
- School of Engineering, Ruppin Academic Center, Emek Hefer, Israel
- Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel
| | - Sarah Knapp
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - Chaya Avraham
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - Catherine Racowsky
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hopital Foch, Suresnes, France
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Andrea A Baccarelli
- Laboratory of Precision Environmental Biosciences, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Ronit Machtinger
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Barnett-Itzhaki Z, Levi A. Effects of chronic exposure to ambient air pollutants on COVID-19 morbidity and mortality - A lesson from OECD countries. Environ Res 2021; 195:110723. [PMID: 33484722 PMCID: PMC7826117 DOI: 10.1016/j.envres.2021.110723] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/10/2020] [Accepted: 01/02/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Exposure to ambient air pollution is related to 4.2 million premature deaths per year worldwide and is associated with a variety of adverse health outcomes, such as respiratory and cardiovascular morbidity. Furthermore, exposure to air pollution can increase human sensitivity to respiratory pathogens via damage to the respiratory tract or via airborne transmission on the surface of particulate matter, and might be an additional factor influencing COVID-19 morbidity and mortality rates. The aim of this study was to examine the association between populations' exposure to air pollution and the morbidity and mortality rates from COVID-19. METHODS We examined the association between population-weighted long-term exposure to PM2.5 and NOx, and the morbidity and mortality over time following the detection of the first COVID-19 positive case in 36 OECD countries. Pearson and Spearman correlations between daily COVID-19 morbidity and mortality (Jan-Jun 2020) on the 10th, 20th, 40th, 60th and 80th days since first confirmed case in the country, and demographic, health, economic, and environmental data were calculated. Multivariate linear regression were used to examine the associations between demographic, health, economic and air pollution features and the rate of confirmed cases and deaths on the 60th and 80th days following the first confirmed case. RESULTS PM2.5 concentrations in 2015-2017 were positively correlated with COVID-19 morbidity and mortality on the 10th, 20th, 40th and 60th days since the first confirmed case in all countries. NOx concentrations in 2015-2017 and country's density (population/Km2) were positively correlated with COVID-19 morbidity and mortality on the 60th day. All multivariate linear regressions consisting PM2.5 concentrations models were statistically significant. Our models also emphasize the importance of the relative number of hospital beds in decreasing the morbidity and mortality of COVID-19. CONCLUSIONS The adverse health outcomes stemming from long-term exposure to various air pollutants has long been known to the scientific community. According to our results and previously published studies, it appears that long-term exposure to air pollutants concentrations exceeding WHO guidelines, such as PM2.5 and NOx, might exacerbate morbidity and mortality rates from COVID-19. These results should raise a red flag globally among decision makers about the urgent need to reduce air pollution and its harmful effects.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel; School of Engineering, Ruppin Academic Center, Emek Hefer, Israel; Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel.
| | - Adi Levi
- Israel Society of Ecology and Environmental Sciences, Tel Aviv, Israel; School of Sciences, Achva Academic College, Yinon, Israel
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20
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Barnett-Itzhaki Z, Elbaz M, Butterman R, Amar D, Amitay M, Racowsky C, Orvieto R, Hauser R, Baccarelli AA, Machtinger R. Machine learning vs. classic statistics for the prediction of IVF outcomes. J Assist Reprod Genet 2020; 37:2405-2412. [PMID: 32783138 DOI: 10.1007/s10815-020-01908-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess whether machine learning methods provide advantage over classic statistical modeling for the prediction of IVF outcomes. METHODS The study population consisted of 136 women undergoing a fresh IVF cycle from January 2014 to August 2016 at a tertiary, university-affiliated medical center. We tested the ability of two machine learning algorithms, support vector machine (SVM) and artificial neural network (NN), vs. classic statistics (logistic regression) to predict IVF outcomes (number of oocytes retrieved, mature oocytes, top-quality embryos, positive beta-hCG, clinical pregnancies, and live births) based on age and BMI, with or without clinical data. RESULTS Machine learning algorithms (SVM and NN) based on age, BMI, and clinical features yielded better performances in predicting number of oocytes retrieved, mature oocytes, fertilized oocytes, top-quality embryos, positive beta-hCG, clinical pregnancies, and live births, compared with logistic regression models. While accuracies were 0.69 to 0.9 and 0.45 to 0.77 for NN and SVM, respectively, they were 0.34 to 0.74 using logistic regression models. CONCLUSIONS Our findings suggest that machine learning algorithms based on age, BMI, and clinical data have an advantage over logistic regression for the prediction of IVF outcomes and therefore can assist fertility specialists' counselling and their patients in adjusting the appropriate treatment strategy.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel. .,School of Engineering, Ruppin Academic Center, Emek Hefer, Israel. .,Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel. .,Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Miriam Elbaz
- Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Rachely Butterman
- Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Devora Amar
- Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Moshe Amitay
- Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Catherine Racowsky
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Raoul Orvieto
- Department of Obstetrics and Gynecology, Sheba Medical Center, 52561, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Andrea A Baccarelli
- Laboratory of Precision Environmental Biosciences, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, 10032, USA
| | - Ronit Machtinger
- Department of Obstetrics and Gynecology, Sheba Medical Center, 52561, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Berman T, Barnett-Itzhaki Z, Göen T, Hamama Z, Axelrod R, Keinan-Boker L, Shimony T, Goldsmith R. Organophosphate pesticide exposure in children in Israel: Dietary associations and implications for risk assessment. Environ Res 2020; 182:108739. [PMID: 32069760 DOI: 10.1016/j.envres.2019.108739] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Human biomonitoring (HBM) data is increasingly being compared to risk-based screening values to assess human health risk. However, as screening values have not been established for assessing biomarker concentrations of organophosphate (OP) pesticide metabolites, there are few studies using HBM data on urinary OP concentrations to assess human health risk. The purpose of the current study was to measure OP exposure in a sample of children in Israel; to explore associations between dietary patterns and OP exposure; and to assess risk of OP pesticides using urinary metabolite concentrations. METHODS We recruited 103 children in Israel and collected demographic and dietary data and urinary samples, and measured creatinine and dialkyl phosphate (DAP) concentrations. We compared urinary DAP concentrations to international populations and analysed associations between fruit and vegetable consumption and urinary DAP concentrations. Using urinary DAP concentrations, we calculated estimated daily intakes (EDI) of OP pesticides in each child and compared those to the acceptable daily intake (ADI). RESULTS Concentrations of several dialkyl phosphate metabolites (dimethylphosphate (DMP) and dimethylthiophosphate (DMTP)) were higher in our study population of Israeli children (geometric mean concentrations of DMP and DMTP were 6.6 μg/L and 7.6 μg/L, respectively) compared to children in the US, Canada, Spain, and Denmark. We found positive correlations between total fruit consumption and creatinine adjusted log transformed urinary DMP, DMTP, diethylthiophopshate (DETP), total dimethyl (DM) and total DAP concentrations (p < 0.05), positive correlations between cucumber consumption and diethylphosphate (DEP), DETP and diethyl (DE) concentrations (p < 0.05), and positive correlations between apple consumption and DETP concentrations (p = 0.02). Based on urinary DAP concentrations, we found that a portion of the children in our study had EDIs above the ADI, ranging from 2.9% to 79.4% of the children, depending on the active OP ingredient. CONCLUSIONS We found that Israeli children in our study are widely exposed to OP pesticides; that levels of dimethyl metabolites were high compared to other international populations; and that fruit consumption was associated with higher urinary DAP levels. Using urinary DAP concentration data, we found that a portion of the children in our study may be exposed to OP pesticides at levels above those considered safe.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Ziva Hamama
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel
| | - Rachel Axelrod
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Rebecca Goldsmith
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, 9446724, Israel
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Deziel NC, Brokovich E, Grotto I, Clark CJ, Barnett-Itzhaki Z, Broday D, Agay-Shay K. Unconventional oil and gas development and health outcomes: A scoping review of the epidemiological research. Environ Res 2020; 182:109124. [PMID: 32069745 DOI: 10.1016/j.envres.2020.109124] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 12/06/2019] [Accepted: 01/06/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Hydraulic fracturing together with directional and horizontal well drilling (unconventional oil and gas (UOG) development) has increased substantially over the last decade. UOG development is a complex process presenting many potential environmental health hazards, raising serious public concern. AIM To conduct a scoping review to assess what is known about the human health outcomes associated with exposure to UOG development. METHODS We performed a literature search in MEDLINE and SCOPUS for epidemiological studies of exposure to UOG development and verified human health outcomes published through August 15, 2019. For each eligible study we extracted data on the study design, study population, health outcomes, exposure assessment approach, statistical methodology, and potential confounders. We reviewed the articles based on categories of health outcomes. RESULTS We identified 806 published articles, most of which were published during the last three years. After screening, 40 peer-reviewed articles were selected for full text evaluation and of these, 29 articles met our inclusion criteria. Studies evaluated pregnancy outcomes, cancer incidence, hospitalizations, asthma exacerbations, sexually transmitted diseases, and injuries or mortality from traffic accidents. Our review found that 25 of the 29 studies reported at least one statistically significant association between the UOG exposure metric and an adverse health outcome. The most commonly studied endpoint was adverse birth outcomes, particularly preterm deliveries and low birth weight. Few studies evaluated the mediating pathways that may underpin these associations, highlighting a clear need for research on the potential exposure pathways and mechanisms underlying observed relationships. CONCLUSIONS This review highlights the heterogeneity among studies with respect to study design, outcome of interest, and exposure assessment methodology. Though replication in other populations is important, current research points to a growing body of evidence of health problems in communities living near UOG sites.
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Affiliation(s)
- Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States.
| | - Eran Brokovich
- Natural Resources Administration, Ministry of Energy, Jerusalem, Israel.
| | - Itamar Grotto
- Ministry of Health, Jerusalem, Israel; School of Public Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer, Sheva, Israel.
| | - Cassandra J Clark
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel; Research Center for Health Informatics, School of Engineering, Ruppin Academic Center, Israel.
| | - David Broday
- Department of Environmental, Water, and Agricultural Engineering, Faculty of Civil and Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Keren Agay-Shay
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
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Levy I, Karakis I, Berman T, Amitay M, Barnett-Itzhaki Z. A hybrid model for evaluating exposure of the general population in Israel to air pollutants. Environ Monit Assess 2019; 192:4. [PMID: 31797164 DOI: 10.1007/s10661-019-7960-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 11/07/2019] [Indexed: 06/10/2023]
Abstract
Exposure to air pollution is associated with a wide range of health effects, including increased respiratory symptoms, cancer, reproductive and birth defects, and premature death. Air quality measurements by standardized measuring equipment, although accurate, can only provide an estimate for part of the population, with decreasing accuracy further away from the monitoring sites. Estimating pollution levels over large geographical domains requires the use of air quality models which ideally incorporate air quality measurements. In order to estimate actual exposure of the population to air pollution (population-weighted concentrations of air pollutants), there is a need to combine data from air quality models with population density data. Here we present the results of exposure estimates for the entire population of Israel using a chemical transport model combined with measurements from the national monitoring network. We evaluated the individual exposure levels for the entire population to several air pollutants based on census tract units. Using this hybrid model, we found that the entire population of Israel is exposed to concentrations of PM10 and PM2.5 that exceed the target values but are below the environmental values according to the Israeli Clean Air Law. In addition, we found and that over 1.5 million residents are exposed to NOx at concentrations higher than the target values. This data may help decision makers develop targeted interventions to reduce the concentrations of specific pollutants, based on population-weighted exposure.
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Affiliation(s)
- Ilan Levy
- Division of Air Quality and Climate Change, Ministry of Environmental Protection, 125 Menachem Begin Road, 61071, Tel Aviv, Israel
| | - Isabella Karakis
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
- Ashkelon Academic College, Ashkelon, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Amitay
- School of Engineering, Ruppin Academic Center, Emek Hefer, Israel
- Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel.
- School of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
- Research Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel.
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
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Ein-Mor E, Berman T, Barnett-Itzhaki Z, Göen T, Ergaz-Shaltiel Z, Natsheh J, Ben-Chetrit A, Haimov-Kochman R, Calderon-Margalit R. Newborn infant urinary cotinine and birth outcomes in the Jerusalem Environment Mother and Child Cohort Study. Int J Hyg Environ Health 2019; 222:1054-1058. [PMID: 31324382 DOI: 10.1016/j.ijheh.2019.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/07/2019] [Accepted: 07/11/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure during pregnancy can cause preterm delivery and childhood cancer. The aim of this study was to measure ETS exposure in pregnant women and in newborn infants in Israel using urinary cotinine measurements, to assess predictors of ETS exposure in these vulnerable groups, and to assess associations with birth effects (birth weight, birth length, head circumference) in newborn infants. METHODS We analyzed urinary cotinine and creatinine in 265 non-smoking pregnant women and 97 newborns, and analyzed associations with self-reported exposure to ETS, paternal smoking, sociodemographic variables and with birth outcomes (birth weight, birth length, head circumference). RESULTS 37.7% of pregnant women and 29.0% of infants had urinary cotinine concentrations above the level of quantification (LOQ) of 1 μg/L, whereas 63.8% and 50.5%, respectively, had urinary cotinine concentrations above the level of detection (LOD) of 0.5 μg/L. Median unadjusted and creatinine adjusted urinary concentrations of cotinine in pregnant women were 0.7 μg/L, and 0.9 μg/g creatinine, respectively, and in newborn infants were 0.5 μg/L, and 1.3 μg/g creatinine, respectively. We did not find an association between maternal and infant urinary cotinine level. Maternal (but not infant) urinary cotinine was significantly associated with paternal smoking (p < 0.05). Infant (but not maternal) cotinine above the LOQ was negatively associated with birth weight (p < 0.05). CONCLUSIONS In this high socioeconomic cohort, almost a third of newborn infants born to non-smoking mothers had quantifiable levels of urinary cotinine. This is the first study showing that newborns with quantifiable urinary cotinine levels have lower birth weight.
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Affiliation(s)
- Eliana Ein-Mor
- Hadassah-Hebrew University Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich- Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Juma Natsheh
- Neonatology Department Hadassah Medical Center, Jerusalem, Israel
| | | | - Ronit Haimov-Kochman
- Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ronit Calderon-Margalit
- Hadassah-Hebrew University Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel
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Barnett-Itzhaki Z, Eaton J, Hen I, Berman T. Heavy metal concentrations in drinking water in a country heavily reliant on desalination. Environ Sci Pollut Res Int 2019; 26:19991-19996. [PMID: 31089993 DOI: 10.1007/s11356-019-05358-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/11/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
Desalination is an important strategy for adapting to the global shortage in safe drinking water. Israel relies heavily on desalinated water (over 50% of supplied drinking water). However, desalinated water may be more corrosive than water from other sources and may cause leaching of heavy metals from materials in contact with water. In this study, we measured heavy metal concentrations (copper, iron, lead) in 1379 drinking water samples in educational institutions in Israel and compared heavy metal concentrations in drinking water from different sources (desalination, groundwater, desalinated and groundwater mixture). 99.9% of the samples met the standard for copper (1400 μg/l), 99.7% for iron (1000 μg/l), and 99.6% for lead (10 μg/l). As expected, heavy metal concentrations were higher in first flush samples compared to flushed samples (significant findings for lead, copper, and iron). Heavy metal concentrations were not higher in desalinated water, or desalinated and groundwater mixture, compared to groundwater. In first flush samples, lead concentrations in groundwater were significantly higher than in desalinated-groundwater mixtures (p = 0.005). In flushed samples, lead concentrations in groundwater were higher than in desalinated-groundwater mixtures but the difference was not significant (p = 0.07). We suggest that regulatory requirements for stabilization of desalinated water and restrictions on lead content of plumbing materials appear to have been effective in preventing increased exposure to lead in desalinated drinking water in Israel. Further study should focus on potential heavy metal leaching in pure desalinated water samples.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, 9446724, Jerusalem, Israel.
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
| | | | - Irit Hen
- Ministry of Health, Jeremiya Street 39, 9446724, Jerusalem, Israel
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, 9446724, Jerusalem, Israel
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Barnett-Itzhaki G, Friehmann A, Barnett-Itzhaki Z, Ela-Dalman N. Diagnosis and Management Practice Patterns among Pediatric Ophthalmology Personnel in Israel. J Binocul Vis Ocul Motil 2019; 69:34-41. [PMID: 30896300 DOI: 10.1080/2576117x.2019.1581552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the diagnosis and management practice patterns of different aspects of pediatric ophthalmology among pediatric ophthalmologists and orthoptists in Israel. METHODS A 21-question survey was delivered to all registered pediatric ophthalmologists and orthoptists in Israel. RESULTS The response rate was 58.3%. Most pediatric ophthalmology personnel in Israel do not document intermittent exotropia (IXT) with a control scale, do not use modalities other than patching for amblyopia, and do not use distance stereoacuity tests. There was no consensus regarding patching and over minus treatments in IXT. In contrast to frequent use of prism adaptation test (PAT) for evaluating strabismus, most Israeli pediatric ophthalmology personnel do not use postoperation diplopia test (PODT). While most orthoptists use a questionnaire when diagnosing convergence insufficiency (CI), most pediatric ophthalmologists do not. CONCLUSION This study highlights the current areas of consensus and disagreement regarding pediatric ophthalmology diagnosis and management practices in Israel. Adopting a uniform approach regarding diagnosing CI, including using a questionnaire by pediatric ophthalmologists and orthoptic exercises in the management of IXT, is warranted to enable unified treatment by pediatric ophthalmologist and orthoptists in Israel.
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Affiliation(s)
- Guy Barnett-Itzhaki
- a Department of Ophthalmology , Meir Medical Center , Kfar Saba , Israel.,b Sackler faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Asaf Friehmann
- a Department of Ophthalmology , Meir Medical Center , Kfar Saba , Israel.,b Sackler faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Zohar Barnett-Itzhaki
- c Public Health Services , Israeli Ministry of Health , Jerusalem , Israel.,d Bioinformatics Department , School of Life and Health Sciences, Jerusalem College of Technology , Jerusalem , Israel
| | - Noa Ela-Dalman
- a Department of Ophthalmology , Meir Medical Center , Kfar Saba , Israel.,b Sackler faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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Berman T, Barnett-Itzhaki Z, Axelrod R, Keinan-Boker L, Shimony T, Goldsmith R, Göen T, Geva H, Rosen L. Socioeconomic inequalities in exposure to environmental tobacco smoke in children in Israel. Environ Int 2018; 121:643-648. [PMID: 30316179 DOI: 10.1016/j.envint.2018.09.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 05/11/2023]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure in infants and children causes more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome. The aim of this study was to measure ETS exposure in children in Israel (ages 4-11 years) using urinary cotinine measurements, in order to compare exposure levels to other international populations, and to assess predictors of ETS exposure in children in Israel. METHODS A subset of children who participated in the National Health and Nutrition Survey (RAV- MABAT) in 2015-2016 were invited to participate in the Second Israel Biomonitoring Survey. We analyzed urinary cotinine and creatinine concentrations in 103 children. Parents of study participants were interviewed in person on children's exposure to ETS at home and in other environments and on sociodemographic variables. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means in children and analyzed associations in univariable and multivariable analyses, between sociodemographic variables and parental - reported exposure, and urinary cotinine concentrations. RESULTS Based on urinary creatinine measurement, over 60% of children are exposed to ETS (compared to <40% based on parental report). Linear regression showed a positive association between urinary cotinine concentration and reported ETS exposure (p = 0.001). Mean cotinine concentration among children whose parents reported that they are exposed to ETS at home (5.1 μg/l) was significantly higher than the concentration among children whose parents reported they are not exposed to ETS at home (1.6 μg/l, p < 0.001). There was an inverse relationship between total family income and urinary cotinine concentration (p < 0.05). In a multivariable model adjusted for ethnicity and other factors, family income was a significant predictor of urinary cotinine level (p = 0.04, slope = -0.49). Geometric mean creatinine adjusted concentrations in children in the current study were higher than in children in Canada and selected European countries. CONCLUSIONS We found evidence of widespread exposure to ETS in children in the study. There is an urgent need to protect children in Israel from exposure to ETS.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Rachel Axelrod
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel.
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel.
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel.
| | - Rebecca Goldsmith
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
| | - Haim Geva
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem 9446724, Israel.
| | - Laura Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
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Berman T, Barnett-Itzhaki Z, Reicher S, Ardi R, Shammai Y, Aruas L, Negev M. Lead in spray paint and painted surfaces in playgrounds and public areas in Israel: Results of a pilot study. Sci Total Environ 2018; 637-638:455-459. [PMID: 29754080 DOI: 10.1016/j.scitotenv.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
Exposure to low levels of lead in children can cause cognitive deficits (reduced IQ) and behavioral changes such as reduced attention span and increased antisocial behavior. There are no mandatory limits on lead in paint in Israel, with the exception of paints used on toys and children's furniture. However, paints in playgrounds and public areas may be a source of exposure to lead in young children. In this study, we quantified lead concentrations in painted surfaces in public playgrounds and public areas, and in spray paints in Israel, using X-ray fluorescence (XRF). Lead was detected in 43/48 (90%) of surfaces; concentrations exceeded the US regulatory limit for lead in paint (90 ppm) in 4/5 (80%) of tested surfaces on wooden picnic tables and benches, and 22/25 (88%) of surfaces in playgrounds. In 15 surfaces, lead concentrations were 10-700 times higher than the US limit. Out of 11 spray paints sampled, three (27%) had concentrations above the US standard for residential paints. In order to prevent exposure of the general public to lead in playgrounds and public areas and in spray paints, we recommend an integrated approach, including regulatory restrictions (mandatory lead limit of 90 ppm in all paints except labeled industrial paints); awareness raising in the public and in national agencies and local authorities responsible for maintenance in playgrounds, schools and public areas; and encouragement of voluntary measures by industry to prevent sale of industrial paints for use in areas accessible to the public.
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Affiliation(s)
- Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel
| | - Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel; Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
| | - Shay Reicher
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel
| | - Ruti Ardi
- Standards Institution of Israel, Tel Aviv, Israel
| | | | - Lior Aruas
- Standards Institution of Israel, Tel Aviv, Israel
| | - Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel 3498838, Israel
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Aker M, Ohanona S, Fisher S, Katsman E, Dvorkin S, Kopelowitz E, Goldstein M, Barnett-Itzhaki Z, Amitay M. CDB—a database for protein heterodimeric complexes. Protein Eng Des Sel 2018; 31:361-365. [DOI: 10.1093/protein/gzy030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Malka Aker
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
| | - Shirly Ohanona
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
| | - Shira Fisher
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
| | - Efrat Katsman
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
| | - Shirit Dvorkin
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
| | - Efrat Kopelowitz
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
| | - Moshe Goldstein
- Department of Computer Science, Jerusalem College of Technology, 21 Havaad Haleumi St., Jerusalem, Israel
| | - Zohar Barnett-Itzhaki
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Moshe Amitay
- Department of Bioinformatics, Jerusalem College of Technology, 21 Havaad Haleumi Street, Jerusalem, Israel
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Adamker G, Holzer T, Karakis I, Amitay M, Anis E, Singer SR, Barnett-Itzhaki Z. Prediction of Shigellosis outcomes in Israel using machine learning classifiers. Epidemiol Infect 2018; 146:1445-1451. [PMID: 29880081 PMCID: PMC9133678 DOI: 10.1017/s0950268818001498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/24/2018] [Accepted: 05/05/2018] [Indexed: 01/19/2023] Open
Abstract
Shigellosis causes significant morbidity and mortality in developing and developed countries, mostly among infants and young children. The World Health Organization estimates that more than one million people die from Shigellosis every year. In order to evaluate trends in Shigellosis in Israel in the years 2002-2015, we analysed national notifiable disease reporting data. Shigella sonnei was the most commonly identified Shigella species in Israel. Hospitalisation rates due to Shigella flexenri were higher in comparison with other Shigella species. Shigella morbidity was higher among infants and young children (age 0-5 years old). Incidence of Shigella species differed among various ethnic groups, with significantly high rates of S. flexenri among Muslims, in comparison with Jews, Druze and Christians. In order to improve the current Shigellosis clinical diagnosis, we developed machine learning algorithms to predict the Shigella species and whether a patient will be hospitalised or not, based on available demographic and clinical data. The algorithms' performances yielded an accuracy of 93.2% (Shigella species) and 94.9% (hospitalisation) and may consequently improve the diagnosis and treatment of the disease.
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Affiliation(s)
- G. Adamker
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - T. Holzer
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - I. Karakis
- Public Health Services, Ministry of Health, Jerusalem, Israel
- Ashkelon Academic College, Ashkelon, Israel
| | - M. Amitay
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
| | - E. Anis
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - S. R. Singer
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Z. Barnett-Itzhaki
- Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
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Barnett-Itzhaki Z, Esteban López M, Puttaswamy N, Berman T. A review of human biomonitoring in selected Southeast Asian countries. Environ Int 2018; 116:156-164. [PMID: 29684824 DOI: 10.1016/j.envint.2018.03.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 06/08/2023]
Abstract
Rapid development and industrialization in Southeast (SE) Asia has led to environmental pollution, potentially exposing the general population to environmental contaminants. Human biomonitoring (HBM), measurement of chemical and/or their metabolites in human tissues and fluids, is an important tool for assessing cumulative exposure to complex mixtures of chemicals and for monitoring chemical exposures in the general population. While there are national HBM programs in several developed countries, there are no such national programs in most of the SE Asian countries. However, in recent years there has been progress in the field of HBM in many of the SE Asian countries. In this review, we present recent HBM studies in five selected SE Asian countries: Bangladesh, Indonesia, Malaysia, Myanmar and Thailand. While there is extensive HBM research in several SE Asian countries, such as Thailand, in other countries HBM studies are limited and focus on traditional environmental pollutants (such as lead, arsenic and mercury). Further development of this field in SE Asia would be benefited by establishment of laboratory capacity, improving quality control and assurance, collaboration with international experts and consortiums, and sharing of protocols and training both for pre-analytical and analytical phases. This review highlights the impressive progress in HBM research in selected SE Asian countries and provides recommendations for development of this field.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel; Bioinformatics Department, School of Life and Health Science, Jerusalem College of Technology, Jerusalem, Israel.
| | - Marta Esteban López
- Área de Toxicología Ambiental, Centro Nacional de Sanidad Ambiental, Instituto de Salud Carlos III, Madrid, Spain
| | - Naveen Puttaswamy
- Center for Air Quality, Climate and Health, Department of Environmental Health Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Tamar Berman
- Ministry of Health, Jeremiya Street 39, Jerusalem 9446724, Israel
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Berman T, Barnett-Itzhaki Z, Mery N, Keinan-Boker L, Shimony T, Goldsmith R, Göen T, Geva H, Rosen L. Exposure to environmental tobacco smoke in non - smoking adults in Israel: results of the second Israel biomonitoring survey. Isr J Health Policy Res 2018; 7:33. [PMID: 29936912 PMCID: PMC6016141 DOI: 10.1186/s13584-018-0229-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/08/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Exposure to environmental tobacco smoke (ETS) increases the risk of heart and respiratory disease, cancer, and premature mortality in non-smoking individuals. Results from the first Israel Biomonitoring Study in 2011 showed that over 60% of non-smoking adults are exposed to ETS. The purpose of the current study was to assess whether policies to restrict smoking in public places have been associated with reductions in exposure to ETS, and to examine predictors of exposure. METHODS We analyzed urinary cotinine and creatinine concentrations in 194 adult participants in the National Health and Nutrition (RAV MABAT) Survey in 2015-2016. Study participants were interviewed in person on smoking status and exposure to ETS. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means and medians among smokers and non-smokers. We analyzed associations in univariable analyses, between socio-demographic variables and self - reported exposure, and urinary cotinine concentrations. RESULTS There was no reduction in geometric mean urinary cotinine levels in non-smokers in the current study (1.7 μg/g) compared to that in 2011 (1.6 μg/g). Median cotinine levels among the non - smoking Arab participants were higher in comparison to the Jewish and other participants (2.97 versus 1.56 μg/l, p = 0.035). Participants who reported that they were exposed to ETS at home had significantly higher median levels of creatinine adjusted urinary cotinine than those reporting they were not exposed at home (4.19 μg/g versus 2.9 μg/g, p = 0.0039). CONCLUSIONS Despite additional restrictions on smoking in public places in 2012-2016, over 60% of non-smoking adults in Israel continue to be exposed to ETS. Urinary cotinine levels in non-smokers have not decreased compared to 2011. Results indicate higher exposure to ETS in Arab study participants and those reporting ETS exposure at home. There is an urgent need: (1) to increase enforcement on the ban on smoking in work and public places; (2) for public health educational programs and campaigns about the adverse health effects of ETS; and (3) to develop and disseminate effective interventions to promote smoke free homes. Periodic surveys using objective measures of ETS exposure (cotinine) are an important tool for monitoring progress, or lack thereof, of policies to reduce exposure to tobacco smoke in non-smokers.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel. .,Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel.,Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Nisim Mery
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel
| | - Rebecca Goldsmith
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
| | - Thomas Göen
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine of the University Erlangen-Nuremberg, Erlangen, Germany
| | - Haim Geva
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, 9446724, Jerusalem, Israel
| | - Laura Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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33
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Milo I, Blecher-Gonen R, Barnett-Itzhaki Z, Bar-Ziv R, Tal O, Gurevich I, Feferman T, Drexler I, Amit I, Bousso P, Shakhar G. The bone marrow is patrolled by NK cells that are primed and expand in response to systemic viral activation. Eur J Immunol 2018; 48:1137-1152. [PMID: 29624673 DOI: 10.1002/eji.201747378] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/30/2018] [Accepted: 03/27/2018] [Indexed: 12/11/2022]
Abstract
The bone marrow hosts NK cells whose distribution, motility and response to systemic immune challenge are poorly understood. At steady state, two-photon microscopy of the bone marrow in Ncr1gfp/+ mice captured motile NK cells interacting with dendritic cells. NK cells expressed markers and effector molecules of mature cells. Following poly (I:C) injection, RNA-Seq of NK cells revealed three phases of transcription featuring immune response genes followed by posttranscriptional processes and proliferation. Functionally, poly (I:C) promoted upregulation of granzyme B, enhanced cytotoxicity in vitro and in vivo, and, in the same individual cells, triggered proliferation. Two-photon imaging revealed that the proportion of sinusoidal NK cells decreased, while at the same time parenchymal NK cells accelerated, swelled and divided within the bone marrow. MVA viremia induced similar responses. Our findings demonstrate that the bone marrow is patrolled by mature NK cells that rapidly proliferate in response to systemic viral challenge while maintaining their effector functions.
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Affiliation(s)
- Idan Milo
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel.,Institut Pasteur, Dynamics of Immune Responses Unit, Equipe Labéllisée Ligue Contre le Cancer, Institut Pasteur, Paris, France
| | | | | | - Raz Bar-Ziv
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel
| | - Orna Tal
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel
| | - Irina Gurevich
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel
| | - Tali Feferman
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel
| | - Ingo Drexler
- Institute for Virology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ido Amit
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel
| | - Philippe Bousso
- Institut Pasteur, Dynamics of Immune Responses Unit, Equipe Labéllisée Ligue Contre le Cancer, Institut Pasteur, Paris, France
| | - Guy Shakhar
- Department of Immunology, the Weizmann Institute of Science, Rehovot, Israel
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Schwartzberg E, Barnett-Itzhaki Z, Grotto I, Marom E. Strategies for patient empowerment through the promotion of medicines in Israel: regulatory framework for the pharmaceutical industry. Isr J Health Policy Res 2017; 6:50. [PMID: 28962636 PMCID: PMC5622432 DOI: 10.1186/s13584-017-0175-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 09/24/2017] [Indexed: 11/20/2022] Open
Abstract
The correct and rational use of medications can have a positive direct impact on disease outcomes, as well on the utilization of the health system resources. Unfortunately, 50% of the patients do not take their medications as prescribed, largely due to lack of patients’ understanding of their medical condition, as well as the lack of reliable medicine information. There are multiple strategies implemented in many countries to tackle this challenge including: disease awareness campaigns (DAC) to raise the public awareness to specific diseases, direct-to-consumer advertisement (DTCA) to raise the public awareness to prescription medicines, specific treatments and over-the-counter (OTC) products to improve the accessibility of patients to specific medicines. Prior to 2013, the Israeli policy prohibited prescribing medication advertising and prevented the flow of information from pharmaceutical companies to the patient. In the last five years, the Pharmaceutical division in the Israeli Ministry of Health, as part of the “empowering the patient” agenda, has taken new innovative approaches to raise public awareness to diseases, medications and appropriate usage, as well as promotion of information to improve patient adherence to the prescribed medication. This paper elaborates on the aforementioned strategies implemented in developed countries, and specifically focuses on newly implemented strategies and regulations in Israel regarding pre- and post-prescription information, to improve patient appropriate utilization and adherence to medication.
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Affiliation(s)
- Eyal Schwartzberg
- Pharmaceutical & Enforcement Divisions, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel.,Ben-Gurion University of the Negev, Beer sheva, Israel.,Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, USA
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel. .,Bioinformatics department, school of life and health science, Jerusalem College of Technology, Jerusalem, Israel.
| | - Itamar Grotto
- Ben-Gurion University of the Negev, Beer sheva, Israel.,Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Eli Marom
- Pharmaceutical & Enforcement Divisions, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
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Mildner A, Chapnik E, Varol D, Aychek T, Lampl N, Rivkin N, Bringmann A, Paul F, Boura-Halfon S, Hayoun YS, Barnett-Itzhaki Z, Amit I, Hornstein E, Jung S. MicroRNA-142 controls thymocyte proliferation. Eur J Immunol 2017; 47:1142-1152. [PMID: 28471480 DOI: 10.1002/eji.201746987] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/03/2017] [Accepted: 04/28/2017] [Indexed: 01/25/2023]
Abstract
T-cell development is a spatially and temporally regulated process, orchestrated by well-defined contributions of transcription factors and cytokines. Here, we identify the noncoding RNA miR-142 as an additional regulatory layer within murine thymocyte development and proliferation. MiR-142 deficiency impairs the expression of cell cycle-promoting genes in mature mouse thymocytes and early progenitors, accompanied with increased levels of cyclin-dependent kinase inhibitor 1B (Cdkn1b, also known as p27Kip1 ). By using CRISPR/Cas9 technology to delete the miR-142-3p recognition element in the 3'UTR of cdkn1b, we confirm that this gene is a novel target of miR-142-3p in vivo. Increased Cdkn1b protein expression alone however was insufficient to cause proliferation defects in thymocytes, indicating the existence of additional critical miR-142 targets. Collectively, we establish a key role for miR-142 in the control of early and mature thymocyte proliferation, demonstrating the multifaceted role of a single miRNA on several target genes.
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Affiliation(s)
- Alexander Mildner
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Elik Chapnik
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Diana Varol
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Tegest Aychek
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Nardi Lampl
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Natalia Rivkin
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Anita Bringmann
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Franziska Paul
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | | | - Yifat Segal Hayoun
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | | | - Ido Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Eran Hornstein
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Steffen Jung
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
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Abstract
BACKGROUND Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminating waste-water, water resources and even drinking water. There is evidence that pharmaceutical active ingredients reach the environment, including food, however the risk to public health from low level exposure to pharmaceuticals in the environment is currently unknown. In Israel, there is no legislation regarding household medical waste collection and disposal. Furthermore, only less than 14 % of Israelis return unused medications to Health Maintenance Organization (HMO) pharmacies. METHODS In this study, we investigated world-wide approaches and programs for household medical waste collection and disposal. RESULTS In many countries around the world there are programs for household medical waste collection. In many countries there is legislation to address the issue of household medical waste, and this waste is collected in hospitals, clinics, law enforcement agencies and pharmacies. Furthermore, in many countries, medication producers and pharmacies pay for the collection and destruction of household medical waste, following the "polluter pays" principle. CONCLUSIONS Several approaches and methods should be considered in Israel: (a) legislation and regulation to enable a variety of institutes to collect household medical waste (b) implementing the "polluter pays" principle and enforcing medical products manufactures to pay for the collection and destruction of household medical waste. (c) Raising awareness of patients, pharmacists, and other medical health providers regarding the health and environmental risks in accumulation of drugs and throwing them to the garbage, sink or toilet. (d) Adding specific instructions regarding disposal of the drug, in the medication label and leaflet. (e) Examining incentives for returning medications to pharmacies. (f) Examining drug collection from deceased in retirement homes and hospitals.
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Affiliation(s)
- Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
- Mimshak, The Israel society of ecology and environmental sciences, 19 Kehilat New York St, Tel Aviv, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
| | - Itamar Grotto
- Public Health Services, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel
| | - Eyal Schwartzberg
- Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel
- Pharmaceutical Division, Ministry of Health, 39 Yirmiyahu St, Jerusalem, Israel
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Barzilai S, Blecher-Gonen R, Barnett-Itzhaki Z, Zauberman A, Lebel-Haziv Y, Amit I, Alon R. M-sec regulates polarized secretion of inflammatory endothelial chemokines and facilitates CCL2-mediated lymphocyte transendothelial migration. J Leukoc Biol 2015; 99:1045-55. [DOI: 10.1189/jlb.3vma0915-427r] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/04/2015] [Indexed: 12/17/2022] Open
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Bornstein C, Winter D, Barnett-Itzhaki Z, David E, Kadri S, Garber M, Amit I. A negative feedback loop of transcription factors specifies alternative dendritic cell chromatin States. Mol Cell 2014; 56:749-62. [PMID: 25453760 DOI: 10.1016/j.molcel.2014.10.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 08/13/2014] [Accepted: 10/14/2014] [Indexed: 01/11/2023]
Abstract
During hematopoiesis, cells originating from the same stem cell reservoir differentiate into distinct cell types. The mechanisms enabling common progenitors to differentiate into alternative cell fates are not fully understood. Here, we identify cell-fate-determining transcription factors (TFs) governing dendritic cell (DC) development by annotating the enhancer landscapes of the DC lineage. Combining these analyses with detailed overexpression, knockdown, and ChIP-Seq studies, we show that Irf8 functions as a plasmacytoid DC epigenetic and fate-determining TF, regulating massive, cell-specific chromatin changes in thousands of pDC enhancers. Importantly, Irf8 forms a negative feedback loop with Cebpb, a monocyte-derived DC epigenetic fate-determining TF. We show that using this circuit logic, a pulse of TF expression can stably define epigenetic and transcriptional states, regardless of the microenvironment. More broadly, our study proposes a general paradigm that allows closely related cells with a similar set of signal-dependent factors to generate differential and persistent enhancer landscapes.
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Affiliation(s)
| | - Deborah Winter
- Department of Immunology, Weizmann Institute, Rehovot 76100, Israel
| | | | - Eyal David
- Department of Immunology, Weizmann Institute, Rehovot 76100, Israel
| | - Sabah Kadri
- Broad Institute, 7 Cambridge Center, Cambridge, MA 02142, USA
| | - Manuel Garber
- Program in Bioinformatics and Integrative Biology and Program in Molecular Biology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Ido Amit
- Department of Immunology, Weizmann Institute, Rehovot 76100, Israel.
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39
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Cohen M, Matcovitch O, David E, Barnett-Itzhaki Z, Keren-Shaul H, Blecher-Gonen R, Jaitin DA, Sica A, Amit I, Schwartz M. Chronic exposure to TGFβ1 regulates myeloid cell inflammatory response in an IRF7-dependent manner. EMBO J 2014; 33:2906-21. [PMID: 25385836 DOI: 10.15252/embj.201489293] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Tissue microenvironment influences the function of resident and infiltrating myeloid-derived cells. In the central nervous system (CNS), resident microglia and freshly recruited infiltrating monocyte-derived macrophages (mo-MΦ) display distinct activities under pathological conditions, yet little is known about the microenvironment-derived molecular mechanism that regulates these differences. Here, we demonstrate that long exposure to transforming growth factor-β1 (TGFβ1) impaired the ability of myeloid cells to acquire a resolving anti-inflammatory phenotype. Using genome-wide expression analysis and chromatin immunoprecipitation followed by next-generation sequencing, we show that the capacity to undergo pro- to anti-inflammatory (M1-to-M2) phenotype switch is controlled by the transcription factor interferon regulatory factor 7 (IRF7) that is down-regulated by the TGFβ1 pathway. RNAi-mediated perturbation of Irf7 inhibited the M1-to-M2 switch, while IFNβ1 (an IRF7 pathway activator) restored it. In vivo induction of Irf7 expression in microglia, following spinal cord injury, reduced their pro-inflammatory activity. These results highlight the key role of tissue-specific environmental factors in determining the fate of resident myeloid-derived cells under both physiological and pathological conditions.
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Affiliation(s)
- Merav Cohen
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Orit Matcovitch
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Eyal David
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | | | - Hadas Keren-Shaul
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | | | | | - Antonio Sica
- Humanitas Clinical and Research Center, Rozzano Milan, Italy DiSCAFF, University of Piemonte Orientale A. Avogadro, Novara, Italy
| | - Ido Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Michal Schwartz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
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40
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Baruch K, Deczkowska A, David E, Castellano JM, Miller O, Kertser A, Berkutzki T, Barnett-Itzhaki Z, Bezalel D, Wyss-Coray T, Amit I, Schwartz M. Aging. Aging-induced type I interferon response at the choroid plexus negatively affects brain function. Science 2014; 346:89-93. [PMID: 25147279 PMCID: PMC4869326 DOI: 10.1126/science.1252945] [Citation(s) in RCA: 395] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Aging-associated cognitive decline is affected by factors produced inside and outside the brain. By using multiorgan genome-wide analysis of aged mice, we found that the choroid plexus, an interface between the brain and the circulation, shows a type I interferon (IFN-I)-dependent gene expression profile that was also found in aged human brains. In aged mice, this response was induced by brain-derived signals, present in the cerebrospinal fluid. Blocking IFN-I signaling within the aged brain partially restored cognitive function and hippocampal neurogenesis and reestablished IFN-II-dependent choroid plexus activity, which is lost in aging. Our data identify a chronic aging-induced IFN-I signature, often associated with antiviral response, at the brain's choroid plexus and demonstrate its negative influence on brain function, thereby suggesting a target for ameliorating cognitive decline in aging.
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Affiliation(s)
- Kuti Baruch
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | | | - Eyal David
- Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Joseph M Castellano
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Omer Miller
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Alexander Kertser
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Tamara Berkutzki
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | | | - Dana Bezalel
- Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Tony Wyss-Coray
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ido Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel.
| | - Michal Schwartz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel.
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41
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Raza S, Barnett MW, Barnett-Itzhaki Z, Amit I, Hume DA, Freeman TC. Analysis of the transcriptional networks underpinning the activation of murine macrophages by inflammatory mediators. J Leukoc Biol 2014; 96:167-83. [PMID: 24721704 PMCID: PMC4378362 DOI: 10.1189/jlb.6hi0313-169r] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 01/17/2014] [Accepted: 02/23/2014] [Indexed: 01/09/2023] Open
Abstract
Macrophages respond to the TLR4 agonist LPS with a sequential transcriptional cascade controlled by a complex regulatory network of signaling pathways and transcription factors. At least two distinct pathways are currently known to be engaged by TLR4 and are distinguished by their dependence on the adaptor molecule MyD88. We have used gene expression microarrays to define the effects of each of three variables--LPS dose, LPS versus IFN-β and -γ, and genetic background--on the transcriptional response of mouse BMDMs. Analysis of correlation networks generated from the data has identified subnetworks or modules within the macrophage transcriptional network that are activated selectively by these variables. We have identified mouse strain-specific signatures, including a module enriched for SLE susceptibility candidates. In the modules of genes unique to different treatments, we found a module of genes induced by type-I IFN but not by LPS treatment, suggesting another layer of complexity in the LPS-TLR4 signaling feedback control. We also observe that the activation of the complement system, in common with the known activation of MHC class 2 genes, is reliant on IFN-γ signaling. Taken together, these data further highlight the exquisite nature of the regulatory systems that control macrophage activation, their likely relevance to disease resistance/susceptibility, and the appropriate response of these cells to proinflammatory stimuli.
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Affiliation(s)
- Sobia Raza
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Scotland, United Kingdom; and
| | - Mark W Barnett
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Scotland, United Kingdom; and
| | | | - Ido Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - David A Hume
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Scotland, United Kingdom; and
| | - Tom C Freeman
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Scotland, United Kingdom; and
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42
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Altboum Z, Steuerman Y, David E, Barnett-Itzhaki Z, Valadarsky L, Keren-Shaul H, Meningher T, Mendelson E, Mandelboim M, Gat-Viks I, Amit I. Digital cell quantification identifies global immune cell dynamics during influenza infection. Mol Syst Biol 2014; 10:720. [PMID: 24586061 PMCID: PMC4023392 DOI: 10.1002/msb.134947] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Hundreds of immune cell types work in coordination to maintain tissue homeostasis. Upon infection, dramatic changes occur with the localization, migration, and proliferation of the immune cells to first alert the body of the danger, confine it to limit spreading, and finally extinguish the threat and bring the tissue back to homeostasis. Since current technologies can follow the dynamics of only a limited number of cell types, we have yet to grasp the full complexity of global in vivo cell dynamics in normal developmental processes and disease. Here, we devise a computational method, digital cell quantification (DCQ), which combines genome‐wide gene expression data with an immune cell compendium to infer in vivo changes in the quantities of 213 immune cell subpopulations. DCQ was applied to study global immune cell dynamics in mice lungs at ten time points during 7 days of flu infection. We find dramatic changes in quantities of 70 immune cell types, including various innate, adaptive, and progenitor immune cells. We focus on the previously unreported dynamics of four immune dendritic cell subtypes and suggest a specific role for CD103+CD11b−DCs in early stages of disease and CD8+pDC in late stages of flu infection.
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Affiliation(s)
- Zeev Altboum
- Department of Immunology, Weizmann Institute, Rehovot, Israel
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