Dynamic changes in bacterial communities in three species of corals during the 2017 bleaching event in subtropical Hong Kong waters

Bacteria play important roles in coral health, yet little is known about the dynamics of coral-associated bacterial communities during coral bleaching. Here, we reported the dynamic changes of bacterial communities in three scleractinian corals (Montipora peltiformis, Pavona decussata and Platygyra carnosa) during and after bleaching through amplicon sequencing. Our results revealed that the bacterial composition and dominant bacteria varied among the three coral species. The higher susceptibility of M. peltiformis to bleaching corresponded to a lower bacterial community diversity, and the dominant Synechococcus shifted in abundance during the bleaching and coral recovery phases. The resilient P. decussata and P. carnosa had higher bacterial diversity and a more similar bacterial composition between the healthy and bleached conditions. Overall, our study reveals the dynamic changes in coral-associated microbial diversity under different conditions, contributing to explaining the differential susceptibility of corals to extreme climate conditions.

Heatwave characteristics complicate the association between PM2.5 components and schizophrenia hospitalizations in a changing climate: Leveraging of the individual residential environment

BACKGROUND

In the era characterized by global environmental and climatic changes, understanding the effects of PM2.5 components and heatwaves on schizophrenia (SCZ) is essential for implementing environmental interventions at the population level. However, research in this area remains limited, which highlights the need for further research and effort. We aim to assess the association between exposure to PM2.5 components and hospitalizations for SCZ under different heatwave characteristics.

METHODS

We conducted a 16 municipalities-wide, individual exposure-based, time-stratified, case-crossover study from January 1, 2017, to December 31, 2020, encompassing 160736 hospitalizations in Anhui Province, China. Daily concentrations of PM2.5 components were obtained from the Tracking Air Pollution in China dataset. Conditional logistic regression models were used to investigate the association between PM2.5 components and hospitalizations. Additionally, restricted cubic spline models were used to identify protective thresholds of residential environment in response to environmental and climate change.

RESULTS

Our findings indicate a positive correlation between PM2.5 and its components and hospitalizations. Significantly, a 1 μg/m3 increase in black carbon (BC) was associated with the highest risk, at 1.58% (95%CI: 0.95-2.25). Exposure to heatwaves synergistically enhanced the impact of PM2.5 components on hospitalization risks, and the interaction varied with the intensity and duration of heatwaves. Under the 99th percentile heatwave events, the impact of PM2.5 and its components on hospitalizations was most pronounced, which were PM2.5 (2-4d: 4.59%, 5.09%, and 5.09%), sulfate (2-4d: 21.73%, 23.23%, and 25.25%), nitrate (2-4d: 17.51%, 16.93%, and 20.31%), ammonium (2-4d: 27.49%, 31.03%, and 32.41%), organic matter (2-4d: 32.07%, 25.42%, and 24.48%), and BC (2-4d: 259.36%, 288.21%, and 152.52%), respectively. Encouragingly, a protective effect was observed when green and blue spaces comprised more than 17.6% of the residential environment.

DISCUSSION

PM2.5 components and heatwave exposure were positively associated with an increased risk of hospitalizations, although green and blue spaces provided a mitigating effect.

Tissue-specific transcriptional response of post-larval clownfish to ocean warming

Anthropogenically driven climate change is predicted to increase average sea surface temperatures, as well as the frequency and intensity of marine heatwaves in the future. This increasing temperature is predicted to have a range of negative physiological impacts on multiple life-stages of coral reef fish. Nevertheless, studies of early-life stages remain limited, and tissue-specific transcriptomic studies of post-larval coral reef fish are yet to be conducted. Here, in an aquaria-based study we investigate the tissue-specific (brain, liver, muscle, and digestive tract) transcriptomic response of post-larval (20 dph) Amphiprion ocellaris to temperatures associated with future climate change (+3 °C). Additionally, we utilized metatranscriptomic sequencing to investigate how the microbiome of the digestive tract changes at +3 °C. Our results show that the transcriptional response to elevated temperatures is highly tissue-specific, as the number of differentially expressed genes (DEGs) and gene functions varied amongst the brain (102), liver (1785), digestive tract (380), and muscle (447). All tissues displayed DEGs associated with thermal stress, as 23 heat-shock protein genes were upregulated in all tissues. Our results indicate that post-larval clownfish may experience liver fibrosis-like symptoms at +3 °C as genes associated with extracellular matrix structure, oxidative stress, inflammation, glucose transport, and metabolism were all upregulated. We also observe a shift in the digestive tract microbiome community structure, as Vibrio sp. replace Escherichia coli as the dominant bacteria. This shift is coupled with the dysregulation of various genes involved in immune response in the digestive tract. Overall, this study highlights post-larval clownfish will display tissue-specific transcriptomic responses to future increases in temperature, with many potentially harmful pathways activated at +3 °C.

Impacts of compounding drought and heatwave events on child mental health: insights from a spatial clustering analysis

BACKGROUND

Concurrent heatwave and drought events may have larger health impacts than each event separately; however, no US-based studies have examined differential mental health impacts of compound drought and heatwave events in pediatric populations.

OBJECTIVE

To examine the spatial patterns of mood disorders and suicide-related emergency department (ED) visits in children during heatwave, drought, and compound heatwave and drought events. We tested whether the occurrence of compound heatwave and drought events have a synergistic (multiplicative) effect on the risk of mental health related outcomes in children as compared to the additive effect of each individual climate hazard. Lastly, we identified household and community-level determinants of geographic variability of high psychiatric burden.

METHODS

Daily counts of psychiatric ED visits in North Carolina from 2016 to 2019 (May to Sept) for pediatric populations were aggregated at the county scale. Bernoulli cluster analyses identified high-risk spatial clusters of psychiatric morbidity during heatwave, drought, or compound heatwave and drought periods. Multivariate adaptive regression models examined the individual importance of household and community-level determinants in predicting high-risk clustering of mood disorders or suicidality across the three climate threats.

RESULTS

Results showed significant spatial clustering of suicide and mood disorder risks in children during heatwave, drought, and compound event periods. Periods of drought were associated with the highest likelihood of spatial clustering for suicide and mood disorders, where the risk of an ED visit was 4.48 and 6.32 times higher, respectively, compared to non-drought periods. Compounding events were associated with a threefold increase in both suicide and mood disorder-related ED visits. Community and household vulnerability factors that most contributed to spatial clustering varied across climate hazards, but consistent determinants included residential segregation, green space availability, low English proficiency, overcrowding, no broadband access, no vehicle access, housing vacancy, and availability of housing units.

CONCLUSION

Findings advance understanding on the locations of vulnerable pediatric populations who are disproportionately exposed to compounding climate stressors and identify community resilience factors to target in public health adaptation strategies.

Heatwave exposure in relation to decreased sleep duration in older adults

Few studies have delved into the effects of heatwaves on sleep duration loss among older adults. Our study examined correlations between heatwave exposure and sleep duration reductions in this demographic. Utilizing data of 7,240 older adults drawn from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2018, we assessed sleep duration differences between the baseline year (2015) and follow-up year (2018). Absolute reductions in sleep duration were defined as differences of ≥ 1, 1.5, or 2 h. Changes in sleep duration were categorized based on cut-offs of 5 and 8 h, including excessive decrease, moderate to short and persistent short sleep duration types. 12 heatwave definitions combining four thresholds (90th, 92.5th, 95th, and 97.5th percentiles of daily minimum temperature) and three durations (≥2, ≥3 and ≥ 4 days) were used. Heatwave exposure was determined by the difference in the number of 12 preceding months' heatwave days or events in 2015 and the number of 12 preceding months' heatwave days or events in 2018. The results showed that increased heatwave events (defined as ≥ P90th percentile & lasting three days) were associated with a higher likelihood of ≥ 1-hour sleep reduction and persistent short sleep duration. An increase in heatwave event (defined as ≥ P95th percentile & lasting three days) was linked to shifts from moderate to short sleep duration. For the association between an absolute reduction in sleep duration and heatwave exposure, while higher thresholds signified greater sleep reduction risks, the effect estimates of longer durations were not uniformly consistent. We observed that air pollution and green space modified the relationship between heatwaves and sleep duration. Females, urban residents, and individuals with chronic diseases were identified as vulnerable populations. This study found that increased heatwave exposure was associated with a higher risk of sleep duration loss in older adults.

Increase in summertime ambient temperature is associated with decreased sick leave risk in Helsinki, Finland

OBJECTIVES

Climate change has increased attention to the health effects of high ambient temperatures and heatwaves worldwide. Both cause-specific mortality and hospital admissions are studied widely, mainly concentrating on warmer climates, but studies focusing on more subtle health effects and cold climates lack. This study investigated the effect of summertime daily ambient temperatures and heatwaves on sick leaves in the employed population in Helsinki, Finland, a Nordic country with a relatively cold climate.

METHODS

We obtained from the City of Helsinki personnel register data on sick leaves for the summer months (June-August) of 2002-2017. We estimated the overall cumulative association of all and short (maximum 3-day) sick leaves with daily mean temperature over a 21-day lag period using a negative binomial regression model coupled with a penalized distributed lag non-linear model (penalized DLNM). The association of sick leaves with heatwaves (cut-off temperature 20.8 °C), and prolonged heatwaves, was estimated using a negative binomial regression model coupled with DLNM. We adjusted the time series model for potential confounders, such as air pollution, relative humidity, time trends, and holidays.

RESULTS

Increasing daily temperature tended to be associated with decreased overall cumulative risk of sick leaves and short sick leaves over a 21-day lag period. In addition, heatwaves and prolonged heatwaves were associated with decreased overall cumulative risk of sick leaves compared to all other summer days: RR 0.87 (95 % CI 0.78 to 0.97) and RR 0.83 (95 % CI 0.70 to 0.98), respectively.

CONCLUSIONS

This research suggests that summertime daily temperatures that are high for this northern location have protective effects on the health of the working population.

A novel optimized model based on NARX networks for predicting thermal anomalies in Polish lakes during heatwaves, with special reference to the 2018 heatwave

In 2018, Europe experienced one of the most severe heatwaves ever recorded. This extreme event's impact on lake surface water temperature (LSWT) in Polish lakes has largely remained unknown. In this study, the impact of the 2018 European heatwave on LSWT in 24 Polish lakes was investigated based on a long-term observed dataset (1987-2020). To capture the LSWT dynamics during the heatwave period and reproduce lake heatwaves, a novel BO-NARX-BR model was developed and evaluated. This model combines the capabilities of the Nonlinear Autoregressive network with Exogenous Inputs (NARX) neural network, the Bayesian Optimization (BO) algorithm for optimizing the number of NARX hidden nodes and lagged input/target values, and the Bayesian Regularization (BR) backpropagation algorithm for the NARX training. The results showed that from April to October 2018, the mean and maximum LSWTs were 2.35 and 3.38 °C warmer than the base-period average (1987-2010) due to the impact of the extreme heatwave. The NARX-based model outperformed another widely used model called air2water in calibration and validation periods. The results also revealed that the BO-NARX-BR model produced significantly better results in capturing lake heatwaves, with computed duration and intensity of lake heatwaves close to the in-situ data. Additionally, LSWT anomaly significantly impacted the duration and intensity of heatwaves that occurred in lakes. Extreme climatic events are gaining increasing importance for the functioning of various elements of the hydrosphere. Such a situation encourages the search for more accurate methods and tools for their prediction. The model applied in the paper corresponds with these assumptions, and its good performance allows for its adaptation to lakes in other regions.

The effects of heatwave on cognitive impairment among older adults: Exploring the combined effects of air pollution and green space

The association between heatwaves and cognitive impairment in older adults, especially the joint effect of air pollution and green space on this association, remains unknown. The present cohort study used data from waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Heatwaves were defined as having daily maximum temperature ≥ 92.5th, 95th and 97.5th percentile that continued at least two, three and four days, measured as the one-year heatwave days prior to the participants' incident cognitive impairment. Data on the annual average air pollutant concentrations of fine particulate matter (PM2.5) and ozone (O3) as well as green space exposure (according to the Normalized Difference Vegetation Index (NDVI)) were collected. Time-varying Cox proportional hazards models were constructed to examine the independent effect of heatwaves on cognitive impairment and the combined effect of heatwaves, air pollution, and green space on cognitive impairment. Potential multiplicative interactions were examined by adding a product term of air pollutants and NDVI with heatwaves in the models. The relative excess risk due to interaction (RERI) was calculated to reflect additive interactions. We found that heatwave exposure was associated with higher risks of cognitive impairment, with hazard ratios (HRs) and 95 % confidence intervals (CIs) ranging from 1.035 (95 % CI: 1.016-1.055) to 1.058 (95 % CI: 1.040-1.075). We observed a positive interaction of PM2.5 concentrations, O3 concentrations, lack of green space, and heatwave exposure on a multiplicative scale (HRs for product terms >1). Furthermore, we found a synergistic interaction of PM2.5 concentrations, O3, lack of green space, and heatwave exposure on an additive scale, with RERIs >0. These results suggest that extreme heat exposure may be a potential risk factor for cognitive impairment in older adults. Additionally, coexposure to air pollution and lack of green space exacerbated the adverse effects of heatwaves on cognitive function.

The association of heatwave with drowning mortality in five provinces of China

Drowning is a serious public health problem in the world. Several studies have found that ambient temperature is associated with drowning, but few have investigated the effect of heatwave on drowning. This study aimed to explore the associations between heatwave and drowning mortality, and further estimate the mortality burden of drowning attributed to heatwave in China. Drowning mortality data were collected in 71 prefectures in China during 2013-2018 from provincial vital register system. Meteorological data at the same period were collected from European Centre for Medium-Range Weather Forecasts (ECMWF). A distributed lag non-linear model (DLNM) was first to explore the association between heatwave and drowning mortality in each prefecture. Secondly, the prefecture-specific associations were pooled using meta-analysis. Finally, attributable fractions (AFs) of drowning deaths caused by heatwave were estimated. Compared to normal day, the mortality risk of drowning significantly increased during heatwave (RR = 1.20, 95%CI: 1.18-1.23). Higher risks were observed in males (RR = 1.23, 95%CI: 1.20-1.27) than females (RR = 1.18, 95%CI: 1.13-1.23), in children aged 5-14 years old (RR = 1.24, 95%CI: 1.15-1.33) than other age groups, in urban city (RR = 1.32, 95%CI: 1.28-1.36) than rural area (RR = 1.09, 95%CI: 1.07-1.12) and in Jilin province (RR = 2.85, 95%CI: 1.61-5.06) than other provinces. The AF of drowning deaths due to heatwave was 11.4 % (95%CI: 10.0 %-12.9 %) during heatwave and 1.0 % (95%CI: 0.9 %-1.1 %) during study period, respectively. Moreover, the AFs during study period were higher for male (1.2 %, 95%CI: 1.0 %-1.3 %), children 5-14 years (1.1 %, 95%CI: 0.7 %-1.6 %), urban city (1.6 %, 95%CI: 1.4 %-1.8 %) than their correspondents. These differences were also observed in AFs during heatwave. We found that heatwave may significantly increase the mortality risk of drowning mortality, and its mortality burden attributable to heatwave was noteworthy. Targeted intervention should be carried out to decrease drowning mortality during heatwave.

Global warming and heat wave risks for cardiovascular diseases: A position paper from the Portuguese Society of Cardiology

Global warming is a result of the increased emission of greenhouse gases. The consequences of this climate change threaten society, biodiversity, food and resource availability. The consequences include an increased risk of cardiovascular (CV) disease and cardiovascular mortality. In this position paper, we summarize the data from the main studies that assess the risks of a temperature increase or heat waves in CV events (CV mortality, myocardial infarction, heart failure, stroke, and CV hospitalizations), as well as the data concerning air pollution as an enhancer of temperature-related CV risks. The data currently support global warming/heat waves (extreme temperatures) as cardiovascular threats. Achieving neutrality in emissions to prevent global warming is essential and it is likely to have an effect in the global health, including the cardiovascular health. Simultaneously, urgent steps are required to adapt the society and individuals to this new climatic context that is potentially harmful for cardiovascular health. Multidisciplinary teams should plan and intervene healthcare related to temperature changes and heat waves and advocate for a change in environmental health policy.

Analysis of heatwaves based on the universal thermal climate index and apparent temperature over mainland Southeast Asia

Heatwaves have caused significant damage to human health, infrastructure, and economies in recent decades, and the occurrences of heatwaves are becoming more frequent and severe across the globe under climate change. The previous studies on heatwaves have primarily focused on air temperature, neglecting other variables like wind speed, relative humidity, and radiation, which could lead to a serious underestimation of the adverse effects of heatwaves. To address this issue, this study proposed to the use of more sophisticated thermal indices, such as universal thermal climate index (UTCI) and apparent temperature (AT), to define heatwaves and carry out a comprehensive heatwave assessment over mainland southeast Asia (MSEA) from 1961 to 2020. The traditional temperature-based method was also compared. The results of the study demonstrate that the annual maximum temperature in heatwave days (HWA) and the annual average temperature in heatwave days (HWM) are significantly underestimated if only air temperature is considered. However, UTCI and AT tend to predict a lower frequency of yearly heatwave occurrences and shorter durations. Trend analysis indicates a general increase in heatwave occurrences across MSEA under all thermal indices in the past six decades, particularly in the last 30 years. This study's approach and findings provide a holistic view of heatwave characteristics based on thermal indices and highlight the risk of intensified heat stress during heatwaves in MSEA.

Evolution of surface ozone pollution pattern in eastern China and its relationship with different intensity heatwaves

With climate warming, eastern China has experienced a significant increase in temperature accompanied by intensified ozone pollution. We aimed to investigate the spatiotemporal patterns and relationships between ozone levels and temperature in eastern China using observation-based ozone data from 418 air quality monitoring stations and temperature data from ERA5. The summer maximum temperature and annual ozone concentration in eastern China increased significantly between 2015 and 2022, with increases rate of 10% and 2.84 μg/m3 yr-1, respectively. The baseline ozone concentration was increasing over time. The average difference in MDA8 O3 concentration in spring, summer, and autumn decreased, with more ozone pollution spreading into spring and autumn, indicating a trend of prolonging the ozone season. During the June-July-August (JJA) period of 2015-2022, heatwaves increased significantly in eastern China. The frequency of heatwave events >10 days played a vital role in exacerbating ozone pollution. During the JJA period, the increase rate in MDA8 O3 concentration was 9.31 μg/m3 yr-1 during heatwave periods, significantly higher than that during non-heatwave periods (4.01 μg/m3 yr-1). The correlation between MDA8 O3 concentration and temperature was as high as 0.99, indicating that temperature was vital in ozone formation during the JJA period in eastern China. This study suggests that more stringent actions are needed to control ozone-precursor compounds during frequent summertime heatwaves in eastern China.

Evaluation of species thermal sensitivity with individual-based physiological performance

Ignoring intraspecific variations can prevent us from accurately assessing species' thermal sensitivity to global warming. Individual-based physiological performance provides a feasible solution to depict species' thermal sensitivity using a bottom-up approach. We measured the cardiac performance of intertidal bivalves (1159 individuals from multiple populations of six bivalves), determined the upper thermal limit of each individual, calculated the proportions of individuals suffering sublethal/lethal heat stress, and mapped sensitive regions to high temperatures. Results showed that high inter-individual variations of physiological performance existed in levels of populations and species, and species' thermal sensitivity was positively related to the intraspecific variations of heat tolerance. This bottom-up approach scaled up from individual, population to species emphasizes the importance of individual-based physiology performance in assessing thermal sensitivity across different hierarchical levels and enables better evaluating and forecasting of species responses to global warming.

Descriptive analysis of occupational accidents in Spain and their relationship with heatwaves

OBJECTIVE

The purpose of this work is to carry out a descriptive analysis of occupational accidents and to evaluate the relationship between heatwaves and work accidents in Spain's three most populated provinces: Madrid, Barcelona and Valencia.

METHODS

Daily data of work accidents (including for each case: gender, age, date, length of time in the position, type of work, place of accident and duration of medical leave) was collected. A heatwave was defined when daily mean temperatures above the threshold (95th percentile) of the climatological period (1990-2021) were recorded for at least three consecutive days. To estimate the association between daily workplace accidents and heatwave events, we applied a Generalized Additive Model combined with a Distributed Lag Non-linear Model with a quasi-Poisson distribution.

RESULTS

The average annual accident rate was 33.2 work accidents/100,000 employees in Madrid, 35.8 work accidents/100,000 employees in Barcelona and 31.8 work accidents/100,000 employees in Valencia. The total accident rates followed a downward trend between 2005 and 2021. The difference in work accident rates between sex decreased over the studied period (p < 0.005). In the first month of work, the highest casualty rate occurs among construction workers in Madrid and Barcelona, and in primary sector workers in Valencia. Work accidents tend to increase during heatwaves. The highest risk was recorded when considering a cumulative lagged effect of 3 days in Madrid and Barcelona and 5 days in Valencia.

CONCLUSIONS

Since work accidents increase during heatwaves, risk prevention services and public administrations must take special measures to prevent them.

Immediate and delayed effects of a heatwave and Prorocentrum lima ((Ehrenberg) Stein 1878) bloom on the toxin accumulation, physiology, and survival of the oyster Magallana gigas (Thunberg, 1793)

Warming could facilitate the intensification of toxic algal blooms, two important stressors for marine organisms that are predicted to co-occur more frequently in the future. We investigated the immediate and delayed effects of a heatwave and a simulated bloom (3 × 106 cells L-1) of the diarrhetic shellfish toxin (DST)-producing benthic dinoflagellate Prorocentrum lima on the survival, physiology (oxygen consumption rate, condition index, immune parameters), and toxin accumulation in the Pacific rock oyster Magallana (Crassostrea) gigas. Oysters exposed to both stressors contained higher mean DST concentrations (mean ± 1 SE: 173.3 ± 19.78 μg kg-1 soft tissue) than those exposed to P. lima bloom alone (120.4 ± 20.90 μg kg-1) and exceeded the maximum permitted levels for human consumption. Exposure to individual stressors and their combination modified the physiology of M. gigas. Oysters exposed to heatwave alone had significantly higher oxygen consumption rates (0.7 ± 0.06 mg O2 h-1 g-1) than the control (0.3 ± 0.06 mg O2 h-1 g-1). However, this was not observed in oysters exposed to both heatwave and P. lima (0.5 ± 0.06 mg O2 h-1 g-1). This alteration of the metabolic response to warming in the presence of P. lima may affect the ability of rock oysters to adapt to environmental stressors (i.e., a heatwave) to ensure survival. Immunomodulation, through changes in total hemocyte count, was observed in oysters exposed to P. lima alone and in combination with warming. Individual stressors and their combination did not influence the condition index, but one mortality was recorded in oysters exposed to both stressors. The findings of this study highlight the vulnerability of rock oysters to the predicted increased frequency of heatwaves and toxic algal blooms, and the increased likelihood of shellfish containing higher than regulatory levels of DST in warming coasts.

Analysis of heatwave characteristics under climate change over three highly populated cities of South India: a CMIP6-based assessment

Climate change is arguably the most alarming global concern of the twenty-first century, particularly due to the increased frequency of meteorological extremes, e.g., heatwaves, droughts, and floods. Heatwaves are considered a potential health risk and urge further study, robust preparedness, and policy framing. This study presents an analysis of heatwave characteristics for historical (1980-2014), near-future (2021-2055), and far-future (2056-2090) scenarios over three highly populated cities of South India, i.e., Bangalore, Chennai, and Hyderabad. Two different approaches, i.e., the India Meteorological Department (IMD) criterion and the percentile-based criterion, are considered for defining the threshold of a heatwave day. Nine general circulation models (GCMs) from the Coupled Model Inter-comparison Project phase 6 (CMIP6) experiment are selected, evaluated after bias correction, and the best performer was utilized to obtain the temperature projections corresponding to two shared socioeconomic pathways (SSP 2-4.5 and 5-8.5) for the future periods. The results reveal a high frequency of heatwave days over the cities in recent years from both approaches, which may further exacerbate in the future, thereby putting a large population at risk. The number of heatwave days is much higher for SSP5-8.5 than that for SSP2-4.5, depicting the direct effects of anthropogenic activities on the frequency of heatwaves. The detailed analysis of heatwave projections will help develop equitable heat resilient mitigation and adaptation strategies for the future, thereby alleviating their pernicious impacts.

Evaluating the Applicability and Health Benefits of the Graded Heat Health Risk Early Warning Model - Jinan City, Shandong Province, China, 2022

What is already known about this topic?

The heat health early warning model serves as an effective strategy for reducing health risks related to heatwaves and improving population adaptability. Several high-income countries have taken the lead in conducting research and implementing measures aimed at safeguarding their populations.

What is added by this report?

The graded heat health risk early warning model (GHREWM) in Jinan City has demonstrated efficacy in safeguarding males, females, individuals aged above 75 years, and those with cardiopulmonary diseases. During the summer of 2022, the warning stage of GHREWM contributed to the prevention of 10.9 deaths per million individuals, concurrently averting health-related economic losses estimated at approximately 227 million Chinese Yuan (CNY).

What are the implications for public health practice?

The GHREWM has the potential to enhance cities' adaptability to climate change. It is crucial to incorporate additional adverse health endpoint data in the development of early warning models, as this will improve their applicability and protective efficacy.

Surviving high temperatures: a case study of the spotted munia (Lonchura punctulata)

Every year, a combination of summer with extreme weather events such as "heatwaves" affects the life of organisms on earth. Previous studies on humans, rodents, and some birds signify the impact of heat stress on their survival and existence. Over the past four decades, the frequency of heatwaves has increased because of global warming. Therefore, we performed a longitudinal study on a resident bird species, the spotted munia (Lonchura punctulata) by simulating a heatwave-like condition. We were interested in understanding how a Passeriformes native to a sub-tropical country deals with heatwave-like conditions. Initially, the birds were subjected to room temperature (25 ± 2 °C; T1) for 10 days, followed by a simulated heatwave-like condition (42 ± 1 °C; T2) for 7 days and again back to room temperature (25 ± 2 °C; RT1) for the next 7 days. To elucidate how birds cope with simulated heatwave conditions, we examined different behavioral and physiological parameters. We found that although heat stress significantly reduced total activity counts and food intake but, the body mass, blood glucose, and hemoglobin levels remained unaffected by any of the temperature conditions. Furthermore, HSP70 and biochemical markers of liver injuries such as ALP, AST, ALT, bilirubin direct, and bilirubin total were found elevated in response to the simulated heatwave-like condition, whereas uric acid and triglyceride were reduced. Creatinine and total protein levels were unaffected by the heatwave. The post heatwave treatment resulted in a rebound of the behavioral and physiological responses, but the recovered responses were not equivalent to the pre-heatwave levels (T1 conditions). Thus, the present study demonstrates heatwave-associated behavioral and physiological changes in a resident passerine finch which has tremendous physiological flexibility.

Evolution of the local climate in Montreal and Ottawa before, during and after a heatwave and the effects on urban heat islands

The heatwave event to which the Ontario-Quebec area was subjected in 2018 resulted in significant morbidity and mortality. In this study, an investigation was conducted on how this heatwave affected the respective urban heat islands (UHIs) in Montreal and Ottawa. The modelled urban climates were compared before, during and after the heatwave using a Weather Research and Forecast (WRF) model having a 1 km spatial resolution. The UHI was calculated using two methods. As a first method, the "rural-ring" method was used to calculate the UHI in regard to temperature differences between urban and surrounding rural areas. The second method used the "urban-increment" approach where simulation results were compared to another simulation in which urban cells are replaced by croplands. Results show that urban land can raise temperatures by up to 12 °C at surfaces and 6 °C in the near-surface air. A synoptic anticyclone in the lower atmosphere was responsible for the heatwave, although both cities were located in areas peripheral to the anticyclone. During the heatwave, precipitation at the initial stage of the event and low wind conditions largely varied the pattern of the UHI effect within each urban center. The UHI was generally unchanged or even reduced during this heatwave, but there was substantial diurnal variation. Around noon and in the afternoon, the UHI was amplified by up to 3 °C, whereas it was suppressed or even negative at sunrise.

Effect of the historic Spanish heatwave over glycemic control in adult patients with type 1 diabetes

AIM

To evaluate the effect of the historic Spanish heatwave (9th-26th July 2022) over glycemic control in adults with type 1 diabetes (T1D).

METHODS

Cross-sectional retrospective analysis of adult patients with T1D in Castilla-La Mancha (south-central Spanish region) using intermittently scanned continuous glucose monitoring (isCGM) during and after the heatwave. Primary outcome was change in time in range (TIR) 3.0-10 mmol/L (70-180 mg/dL) of interstitial glucose in the two weeks following the heatwave.

RESULTS

A total of 2701 T1D patients were analyzed. We detected a TIR reduction of 4.0 % (95 % CI -3.4, -4.6; P < 0.001) in the two weeks following the heatwave. Patients in the highest daily scan frequency quartile (>13 scans/day) during the heatwave showed the greatest deterioration in TIR after it concluded (-5.4 % [95 % CI -6.5, -4.3; P < 0.001]). The percentage of patients meeting all the recommendations of the International Consensus of Time in Range was greater during the heatwave than after it ended (10.6 % vs. 8.4 %, P < 0.001).

CONCLUSIONS

Adults with T1D had better glycemic control during the historic Spanish heatwave compared to the following period.

Mortality, metabolic rate, and oviposition of Gryllus (Gryllus) assimilis (Fabricius, 1775) (Orthoptera: Gryllidae) females under constant and fluctuating warm temperatures

The global average temperature will increase by up to 5.7 °C, under high greenhouse gas emissions, consequently increasing the frequency of heatwaves, according to recent IPCC forecasts. These especially impacts ectotherms, such as insects, which are the most susceptible animals to changes in environmental temperature, affecting their physiology and reproduction. Thus, we investigated the effects of a 96-h exposure to constant temperatures (CT: 27, 30.5, 34, 39, 41, or 43 °C) and fluctuating temperatures (FT: 27/34 °C, 12/12 h) on the survival, metabolic rate, and oviposition of the female cricket Gryllus (Gryllus) assimilis (Orthoptera: Gryllidae). Mortality, body mass and water content of females and males were quantified and compared. It was found that CT₂₇, CT₃₄ and FT_27/34 do not cause mortality in females of G. (G.) assimilis. CT_30.5 (average temperature between 27 and 34), despite causing mortality of 5.0 ± 3.5%, do not differ from CT₂₇, CT₃₄ or FT_27/34. CT₃₉ causes a mortality of 8.3 ± 5.5%. Estimated lethal temperature for 50% of the population of females (LT_50Temp) is 40 °C, and 43 °C promotes 100% mortality in 96 h. Comparing mortality between sexes, females present higher LT_50Temp and thermotolerance than males. In addition, FT_27/34 and CT₃₄ do not differ in the metabolic rate, but both have higher values than CT₂₇. CT₃₄ strongly reduces oviposition in females, however FT_27/34 does not. We suggest that CT₃₄ reduces oviposition in females in two ways: by affecting the endocrine system related to egg production, or by causing behavioral egg retention, as a strategy to survive thermal stress. Moreover, females had a higher wet body mass and present a lower average weight loss than males. In conclusion, despite females present a higher mortality at temperatures above 39 °C, they are more thermotolerant than males. Furthermore, CT₃₄ is detrimental to the oviposition of G. (G.) assimilis.

Effects of high temperatures and heatwaves on dengue fever: a systematic review and meta-analysis

BACKGROUND

Studies have shown that dengue virus transmission increases in association with ambient temperature. We performed a systematic review and meta-analysis to assess the effect of both high temperatures and heatwave events on dengue transmission in different climate zones globally.

METHODS

A systematic literature search was conducted in PubMed, Scopus, Embase, and Web of Science from January 1990 to September 20, 2022. We included peer reviewed original observational studies using ecological time series, case crossover, or case series study designs reporting the association of high temperatures and heatwave with dengue and comparing risks over different exposures or time periods. Studies classified as case reports, clinical trials, non-human studies, conference abstracts, editorials, reviews, books, posters, commentaries; and studies that examined only seasonal effects were excluded. Effect estimates were extracted from published literature. A random effects meta-analysis was performed to pool the relative risks (RRs) of dengue infection per 1 °C increase in temperature, and further subgroup analyses were also conducted. The quality and strength of evidence were evaluated following the Navigation Guide systematic review methodology framework. The review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO).

FINDINGS

The study selection process yielded 6367 studies. A total of 106 studies covering more than four million dengue cases fulfilled the inclusion criteria; of these, 54 studies were eligible for meta-analysis. The overall pooled estimate showed a 13% increase in risk of dengue infection (RR = 1.13; 95% confidence interval (CI): 1.11-1.16, I2 = 98.0%) for each 1 °C increase in high temperatures. Subgroup analyses by climate zones suggested greater effects of temperature in tropical monsoon climate zone (RR = 1.29, 95% CI: 1.11-1.51) and humid subtropical climate zone (RR = 1.20, 95% CI: 1.15-1.25). Heatwave events showed association with an increased risk of dengue infection (RR = 1.08; 95% CI: 0.95-1.23, I2 = 88.9%), despite a wide confidence interval. The overall strength of evidence was found to be "sufficient" for high temperatures but "limited" for heatwaves. Our results showed that high temperatures increased the risk of dengue infection, albeit with varying risks across climate zones and different levels of national income.

INTERPRETATION

High temperatures increased the relative risk of dengue infection. Future studies on the association between temperature and dengue infection should consider local and regional climate, socio-demographic and environmental characteristics to explore vulnerability at local and regional levels for tailored prevention.

FUNDING

Australian Research Council Discovery Program.

Heatwave and mental health

Physical health has been associated with ambient temperature and heatwave. With the frequent occurrence of heatwave, the adaptive effects and mechanisms on mental health remain uncertain. On the basis of the China Health and Nutrition Survey, we estimated the relationship between heatwaves and self-assessed mental health scores in the Chinese population aged 50 and above. This study has identified that with each additional heatwave event, mental health scores decreased by an average of 0.027 points, which is equivalent to 0.3% of the average level. Heat is more likely to affect groups with low education, no medical insurance, and living in rural areas. In mechanistic exploration, we found that stress emotion is a fully mediating effect. Heat led to reduced health activities and more frequent drinking, which may lead to lower psychological well-being. Moreover, good dietary preference is a regulator that can help mitigate the adverse effects of heat on mental health. This study corroborates the impact of heat on spiritual welfare, and demonstrates the mechanisms and channels of impact, which can help reduce global economic losses due to mental health problems.

Impacts of rising temperatures and water acidification on the oxidative status and immune system of aquatic ectothermic vertebrates: A meta-analysis

Species persistence in the Anthropocene is dramatically threatened by global climate change. Large emissions of carbon dioxide (CO₂) from human activities are driving increases in mean temperature, intensity of heatwaves, and acidification of oceans and freshwater bodies. Ectotherms are particularly sensitive to CO₂-induced stressors, because the rate of their metabolic reactions, as well as their immunological performance, are affected by environmental temperatures and water pH. We reviewed and performed a meta-analysis of 56 studies, involving 1259 effect sizes, that compared oxidative status or immune function metrics between 42 species of ectothermic vertebrates exposed to long-term increased temperatures or water acidification (≥48 h), and those exposed to control parameters resembling natural conditions. We found that CO₂-induced stressors enhance levels of molecular oxidative damages in ectotherms, while the activity of antioxidant enzymes was upregulated only at higher temperatures, possibly due to an increased rate of biochemical reactions dependent on the higher ambient temperature. Differently, both temperature and water acidification showed weak impacts on immune function, indicating different direction (increase or decrease) of responses among immune traits. Further, we found that the intensity of temperature treatments (Δ°C) and their duration, enhance the physiological response of ectotherms, pointing to stronger effects of prolonged extreme warming events (i.e., heatwaves) on the oxidative status. Finally, adult individuals showed weaker antioxidant enzymatic responses to an increase in water temperature compared to early life stages, suggesting lower acclimation capacity. Antarctic species showed weaker antioxidant response compared to temperate and tropical species, but level of uncertainty in the antioxidant enzymatic response of Antarctic species was high, thus pairwise comparisons were statistically non-significant. Overall, the results of this meta-analysis indicate that the regulation of oxidative status might be one key mechanism underlying thermal plasticity in aquatic ectothermic vertebrates.