Sudden cardiac arrest (SCA) is a global health concern, imposing a substantial mortality burden. However, the understanding of the impact of various extreme temperature events, when accounting for the effect of daily average temperature on SCA, remains incomplete. Additionally, the assessment of SCA mortality burden associated with temperatures from an individual-level design is limited. This nationwide case-crossover study collected individual SCA death records across all (2844) county-level administrative units in the Chinese Mainland from 2013 to 2019. Four definitions for hot nights and ten for both cold spells and heatwaves were established using various temperature thresholds and durations. Conditional logistic regression models combined with distributed lag nonlinear models were employed to estimate the cumulative exposure-response relationships. Based on 887,662 SCA decedents, this analysis found that both hot nights [odds ratio (OR): 1.28; attributable fraction (AF): 1.32 %] and heatwaves (OR: 1.40; AF: 1.29 %) exhibited significant added effects on SCA mortality independent of daily average temperatures, while cold spells were not associated with an elevated SCA risk after accounting for effects of temperatures. Cold temperatures [below the minimum mortality temperature (MMT)] accounted for a larger mortality burden than high temperatures (above the MMT) [AF: 12.2 % vs. 1.5 %]. Higher temperature-related mortality risks and burdens were observed in patients who experienced out-of-hospital cardiac arrest compared to those with in-hospital cardiac arrest. This nationwide study presents the most compelling and comprehensive evidence of the elevated mortality risk and burden of SCA associated with extreme temperature events and ambient temperatures amid global warming.

The summer of 2019 is particularly well known for the famous heatwaves that swept across the European continent, with its associated drought and record-breaking air temperatures. This was followed by powerful thunderstorms, characterised by hail and heavy rain that damaged the crops on a regional scale. Here, we investigated one of the largest storm cells, lasting more than 6 h, which struck southwestern Romania. High-temporal resolution sampling of storm precipitation was performed for stable isotope measurements, rainfall and air temperature, to follow the storm dynamics. Hydrogen and oxygen isotope measurements show an abrupt decreasing temporal trend followed by superimposed V-shaped patterns interpreted as reflecting moisture replenishment by successive rain bands. To model the stable isotope values of precipitation in relation to the general trend of decreasing air temperatures, we applied a numerical Rayleigh condensation model for a non-constant α isotopic fractionation factor between liquid water and water vapour. The storm is powered by four consecutive moisture fronts, each following a Rayleigh distribution. About 40 % of the water vapour condenses during the sampled storm due to adiabatic expansion and cooling, which lowers saturation. Condensation ceases when cooling and absolute humidity can no longer sustain the dew point, stopping the rain. The timing of the event, occurring late at night and early in the morning, its duration of over 6 h as well as its synoptic scale may indicate a mesoscale convective complex.

Plants can acclimate their photosynthesis to growth temperature, but the contribution of local adaptation to intraspecific variation in thermal acclimation of photosynthesis is not fully understood. Here, we experimentally investigated the photosynthetic thermal acclimation in Fagus crenata seedlings from two populations growing at different elevations and temperature regimes (low- and high-elevation sites) in northern Japan. We acclimated seedlings for 14-23 days at 22 °C (control) or 27 °C (warm treatment) daytime temperature and obtained photosynthetic temperature-response curves in the range of 19 to 32 °C. The optimum temperature of photosynthesis (Topt) was ca. 0.6 °C higher in seedlings acclimated at 27 °C than in those acclimated at 22 °C, and it was significantly lower in seedlings with higher stomatal sensitivity to leaf-to-air vapor pressure deficit (VPD) than in those with lower sensitivity. The effects of warm treatment, population, and treatment-population interaction on Topt were not significant in the two-way analysis of variance, but the effect of treatment became significant when stomatal sensitivity to leaf-to-air VPD was included as a covariate in the model. Structural equation modelling (SEM) indicated that seedlings with lower root biomass had lower Topt because of the high stomatal sensitivity to leaf-to-air VPD. SEM also indicated that the way of shifting the Topt differed between the two populations: seedlings from a high-elevation site depended on decreasing photosynthetic rates at low temperatures for the increase in Topt but seedlings from a low-elevation site did not. We suggest that difference in thermal acclimation of photosynthesis between the two populations may reflect adaptation to different climate regimes and that belowground traits should be considered when investigating thermal acclimation capacity, especially in seedlings.

OBJECTIVE: The effect of heat waves on mortality is well known, but current evidence on morbidity is limited. Establishing the consequences of these events in terms of morbidity is important to ensure communities and health systems can adapt to them.
METHODS: We thus collected data on total daily emergency hospital admissions, admissions to critical care units, emergency department admissions, and emergency admissions for specific diagnoses to Hospital Universitario de Son Espases from 1 January 2005 to 31 December 2021. A heat wave was defined as a period of ≥ 2 days with a maximum temperature ≥ 35 °C, including a 7 day lag effect (inclusive). We used a quasi-Poisson generalized linear model to estimate relative risks (RRs; 95%CI) for heat wave-related hospital admissions.
RESULTS: Results showed statistically significant increases in total emergency admissions (RR 1.06; 95%CI 1 - 1.12), emergency department admissions (RR 1.12; 95%CI 1.07 - 1.18), and admissions for ischemic stroke (RR 1.26; 95%CI 1.02 - 1.54), acute kidney injury (RR 1.67; 95%CI 1.16 - 2.35), and heat stroke (RR 18.73, 95%CI 6.48 - 45.83) during heat waves.
CONCLUSIONS: Heat waves increase hospitalization risk, primarily for thromboembolic and renal diseases and heat strokes.

BACKGROUND: In the context of climate change and urbanization, the temporal variation of the adverse health effect of extreme temperature has attracted increasing attention.
METHODS: The meteorological data and the daily death records of mortality from respiratory diseases of 136 Chinese cities were from 2006 to 2019. Heat wave and cold spell were selected as the indicator events of extreme high temperature and extreme low temperature, respectively. The generalized linear model and time-varying distributed lag model were used to perform a two-stage time-series analysis to evaluate the temporal variation of the mortality risk associated with extreme temperature in the total population, sub-populations (sex- and age- specific) and different regions (climatic zone and relative humidity level).
RESULTS: During the study period, relative risk (RR) of respiratory mortality associated with heat wave decreased from 1.22 (95 %CI: 1.07-1.39) to 1.13 (95 %CI: 1.01-1.26) in the total population, and RR of respiratory mortality associated with cold spell decreased from 1.30 (95 %CI: 1.14-1.49) to 1.17 (95 %CI: 1.08-1.26). The impact of heat wave reduced in the males (P = 0.044) and in the females as with cold spell (P < 0.001). The respiratory mortality risk of people over 65 associated with cold spell decreased (P = 0.040 for people aged 65-74 and P < 0.001 for people over 75). The effect of cold spell reduced in cities from tropical or arid zone (P = 0.035). The effects of both heat wave and cold spell decreased in cities with the relative humidity in the first quartile (P = 0.046 and 0.010, respectively).
CONCLUSIONS: The impact of heat wave on mortality of respiratory diseases decreased mainly in males and cities with the lowest relative humidity, while the impact of cold spell reduced in females, people over 65 and tropical and arid zone, suggesting adaptation to extreme temperature of Chinese residents to some extent.

Climate change is causing more frequent and intense heatwaves. Therefore, it is important to understand how heatwaves affect the terrestrial carbon cycle, especially in grasslands, which are especially susceptible to climate extremes. This study assessed the impact of naturally occurring, simultaneous short-term heatwaves on CO2 fluxes in three ecosystems on the Mongolia Plateau: meadow steppe (MDW), typical steppe (TPL), and shrub-grassland (SHB). During three heatwaves, net ecosystem productivity (NEP) was reduced by 86 %, 178 %, and 172 % at MDW, TPL, and SHB, respectively. The changes in ecosystem respiration, gross primary production, evapotranspiration, and water use efficiency were divergent, indicating the mechanisms underlying the observed NEP decreases among the sites. The impact of the heatwave in MDW was mitigated by the high soil water content, which enhanced evapotranspiration and subsequent cooling effects. However, at TPL, insufficient soil water led to combined thermal and drought stress and low resilience. At SHB, the ecosystem\'s low tolerance to an August heatwave was heavily influenced by species phenology, as it coincided with the key phenological growing phase of plants. The potential key mechanism of divergent NEP response to heatwaves lies in the divergent stability and varying importance of environmental factors, combined with the specific sensitivity of NEP to each factor in ecosystems. Furthermore, our findings suggest that anomalies in soil environment, rather than atmospheric anomalies, are the primary determinants of NEP anomalies during heatwaves. This challenges the conventional understanding of heatwaves as a discrete and ephemeral periods of high air temperatures. Instead, heatwaves should be viewed as chronologically variable, compound, and time-sensitive environmental stressors. The ultimate impact of heatwaves on ecosystems is co-determined by a complex interplay of environmental, biological, and heatwave features.

The frequency, duration, and severity of extreme heat events have increased and are projected to continue to increase throughout the next century. As a result, there is an increased risk of excessive heat- and cardiovascular-related morbidity and mortality during these extreme heat events. Therefore, the purposes of this investigation were to establish 1) critical environmental core temperature (Tc) limits for middle-aged adults (MA), 2) environmental thresholds that cause heart rate (HR) to progressively rise in MA and older (O) adults, and 3) examine critical environmental Tc limits and HR environmental thresholds across the adult age span. Thirty-three young (Y) (15 F; 23 ± 3 yr), 28 MA (17 F; 51 ± 6 yr), and 31 O (16 F; 70 ± 3 yr) subjects were exposed to progressive heat stress in an environmental chamber in a warm-humid (WH, 34-36°C, 50-90% rh) and a hot-dry (HD, 38°C-52°C, <30% rh) environment while exercising at a low metabolic rate reflecting activities of daily living (∼1.8 METs). In both environments, there was a main effect of age on the critical environmental Tc limit and environmental HR thresholds (main effect of age all P < 0.001). Across the lifespan, critical environmental Tc and HR thresholds decline linearly with age in HD environments (R2 ≥ 0.3) and curvilinearly in WH environments (R2 ≥ 0.4). These data support an age-associated shift in critical environmental Tc limits and HR thresholds toward lower environmental conditions and can be used to develop evidence-based safety guidelines to minimize future heat-related morbidity and mortality across the adult age span.NEW & NOTEWORTHY This study is the first to identify critical environmental core temperature and heart rate thresholds across the adult age spectrum. In addition, our data demonstrate that the rate of decline in Tc and HR limits with age is environmental-dependent. These findings provide strong empirical data for the development of safety guidelines and policy decisions to mitigate excessive heat- and cardiovascular-related morbidity and mortality for impending heat events.

Extreme temperature events, such as heat waves, can have lasting effects on the behavior, physiology, and reproductive success of organisms. Here, we examine the impact of short-term exposure to a simulated heat wave on condition, parental care, and reproductive success in a population of threespine stickleback (Gasterosteus aculeatus), a small fish with exclusive paternal care, currently experiencing regular heat waves. Males were either exposed to a simulated heat wave (23 °C) for 5 d or held at an ideal temperature (18 °C). Following this 5-d treatment, all males were transferred to 18 °C, where they completed a full parenting cycle. Offspring were raised at 18 °C. We found that while mass and body condition were unaffected in males exposed to a heat wave, cortisol responses were dampened across the nesting cycle compared to control males. In addition, heat wave males had longer latency for eggs to hatch, lower hatching success, and showed lower levels of parental care behavior compared to control males. Offspring of heat wave males had lower body condition, affecting swimming performance. Altogether, our results highlight the long-term impact that even short-term events can have on reproductive success, parental behavior, and subsequent generations, providing insight into population responses to rapid environmental change.

BACKGROUND: Climate change will make extreme weather events more frequent in the 21st century. Extreme ambient temperatures during the prenatal period have been associated with adverse pregnancy outcomes such as preterm birth. It is unclear, however, whether heat waves during pregnancy impact fetal growth in apparently healthy term newborns.
OBJECTIVE: We aimed to investigate associations between heat wave during pregnancy and birth weight outcomes in term newborns from the PARIS birth cohort, and to explore meteorological conditions and air pollution as possible intermediate factors.
METHODS: We examined data on 3,359 newborns born between 37 and 42 weeks in Paris, France, between 2003 and 2006. Associations of maternal exposure to heat wave (during whole pregnancy and each trimester) with birth weight and small for gestational age (SGA) at term were studied using linear and logistic regression models adjusted for potential confounders. Maternal characteristics were investigated as possible modifiers. We explored the mediating role of ambient temperature, relative humidity, and air pollution levels in the relationship between heat wave during the first trimester and term SGA.
RESULTS: Mothers who were pregnant during the 2003 French heat wave (n = 506, 15 %) were more likely to have a term SGA baby (aOR = 2.70; 95 %CI: 1.38, 5.28) compared to mothers who did not experience heat wave during pregnancy. The association was stronger when heat wave occurred during the first trimester (aOR = 4.18; 95 %CI: 1.69, 10.35). Primiparous women were identified as more vulnerable than multiparous women. Average ambient temperature and air quality index explained about 36 % and 56 % of the association between heat wave during the first trimester and term SGA, respectively.
CONCLUSIONS: This study suggests prenatal exposure to heat wave, especially during the first trimester, may adversely affect fetal growth of term newborns, which could be explained by both increasing ambient temperatures and worsening air quality.

OBJECTIVE: The purpose of this research was to explore some morphological, physiological, and biochemical changes in female and fetal Wistar rats under heat stress.
METHODS: The experiment involved 30 animals, including two experimental groups (pregnant and nonpregnant females) kept under heat stress at 32°C and one control group consisting of healthy individuals kept in standard vivarium conditions. After dissection, fixation, dehydration, and primary processing, tissue samples were embedded in a mixture of paraffin and lanolin to obtain material for sections. Sections were made using a freezing and angular microtome and stained with hematoxylin and fuchsine solutions. Changes in morphology were assessed by microscopy using a Leitz DIAPLAN system.
RESULTS: As a result of heat stress, an increase in linear cell size, capillary network area, and adrenal mass was observed; adipocytes lost lipid vacuoles; prismatic thyroid cells were replaced by flat cells; hypothyroidism; an increase in the number of osteocyte lacunae; and increased osteoclast activity in bone tissue; interstitial and intracellular oedema and caryopycnosis of ventricular cardiomyocytes; reduction in the diameter of skeletal muscle fibers and replacement of tissue with collagen fibers; water loss in the structure of myofibrils; destructive local changes, hyperchromatosis and caryopycnosis of the hippocampus.
CONCLUSIONS: The data obtained allows predicting the possible consequences of prolonged overheating of tissues of other vertebrates and the human body.