Analysis of the dynamics of the temperature regime of the North-Western Black Sea region in the context of global climate changes

Air temperature and humidity have a great impact on public health, leads to heat stress. The US National Weather Service uses temperature and relative humidity to build a heat index (HI) as a metric to identify the thresholds for heat stress as felt by the public. Under climate change conditions and especially in hot humid weather during summer, the number of hot days in Hanoi has increased in recent times. Subsequently, the heat index is rising in both number of occurrences and level of intensity leading to increasing temperature stress on people’s health. The daily heat index for the future was simulated using maximum daily temperature and minimum daily relative humidity based on climate change scenarios. Maximum daily temperature was provided by the climate change model, while minimum daily relative humidity was estimated from the following: maximum daily temperature, mean daily temperature and daily rainfall. Results show that in the future, the heat index will increase by 0.0777°C/year in the RCP 4.5 scenario and 0.08°C/year in the RCP 8.5 scenario. Number of weeks with heat at danger tends to increase to 5.5 weeks/5 year for scenario RCP 4.5, and it is 6 weeks/5 years under RCP 8.5 scenario. In particular, the number of days of heatstroke over a 30-year period (from 1991 to 2020) amounted to only 4, that is an average of 0.13 days of the year, which represents a very rare weather phenomenon in the past. In contrast, under an RCP 4.5 scenario in the future over a 30-year period, the average number of days per year will be 2, 57 days; while the average number of days per year under an RCP 8.5 scenario would be 3, 87 days. This phenomenon will be mainly concentrated in the months of June, July, and August. Projections of this type are a key tool for communities working out how they will adapt to heat stress in the context of climate change.

We studied the impact of regional climate changes that have occurred and are expected in the near future on the freshwater balance of quasi-closed lagoons in the North-Western Black Sea region. These lagoons do not have a permanent connection with the sea but are episodically connected to it by artificial channels, straits, or other hydraulic facilities. We used the value of the deficit in their annual freshwater balance as an indicator of vulnerability to climate change for each lagoon. The changes in the multi-year averages of climatic parameters in the North-Western Black Sea region, which determine the components of the water balance and its annual deficit in lagoons, were assessed by observations at hydrometeorological sites and outcomes of the EURO-CORDEX Project for the RCP4.5 and RCP8.5 scenarios. We have found that regional climate changes are resulting in the increasing deficit of annual freshwater balance for all quasi-closed lagoons in the North-Western Black Sea region. Also, climate change can result in excessive shallowing, salinization, and even the complete disappearance of some lagoons due to the lack of or insufficient water exchange with the sea.

The presented article is devoted to the study of the spatio-temporal distribution of the average number of days with snow cover (the number of days when the snow cover of the territory was 60% or more (6 or more points)) for certain months of the cold and certain transitional seasons of the year during certain decades 1991-2020. For the analysis, the materials of observations of the snow cover, which are placed in the Meteorological monthlies in the tables containing the relevant information about the state of the snow cover, were included. The spatio-temporal distribution of the average number of days with snow cover on the territory of Ukraine during individual decades of the specified period is shown, and the centers of their largest and smallest number, as well as the general directions of changes in their distribution from decade to decade, are determined. For each of the studied months, based on the data on the average number of days with snow cover at the meteorological stations of the regions, appropriate maps were constructed showing the spatial distribution of the number of days with snow cover. Changes in the spatio-temporal distribution of the average number of days with snow cover on the territory of Ukraine in some of the studied months were revealed. Thus, for the winter months, especially for January and February, the biggest changes in the average number of days with snow cover are noticeable in the central and southern parts of the country, which are associated with a decrease in their number. In December, these changes are more pronounced. However, the most noticeable downward changes in the average number of days with snow cover from decade to decade occurred in March and November. For April, given the small number of days with snow during this month, it is difficult to make a final conclusion. However, the obtained empirical material indicates a certain decrease in the average number of days with snow cover for most of the country from decade to decade, even for mountainous areas. In general, a general trend towards a decrease in the average number of days with snow cover for the territory of Ukraine was established for the studied months. This is especially true for the second and third decades, which points to continued warming.

In order to reduce the devastating consequences of extreme wind gusts, a significant amount of research is being carried out in the world to study the conditions for the occurrence of this phenomenon, the dynamics of its spatio-temporal distribution, and a possible potential change in the wind regime against the background of modern climate change. Nowadays, it appears that not much research has been carried out to determine the possible impact of climate change on future wind gusts on the territory of Ukraine and, in particular, in the Northern Black Sea region. Global warming scenarios are expected to change the severity and frequency of future wind gusts by the end of this century. Considering this, a study was made of the spatio-temporal features of the formation of wind gusts in the North-Western Black Sea region for the period 2005-2020, and the dependence of their occurrence on air temperature and atmospheric pressure anomalies, which can be used to analyze possible changes of future wind regimes as a result of climate change. To analyze the occurrence of wind gusts in the North-Western Black Sea region, data from three stations located in different parts of the region were selected. The data of METAR telegrams on wind gusts at the Odessa-AMSC, Mykolaiv, Kherson stations and surface weather observations data for the period from January 2005 to December 2020 were used as source material in the work. For statistical analysis of daily air temperature and pressure anomalies, NCEP/NCAR Reanalysis archive data for the same period were used. The obtained results show that in the territory of the North-Western Black Sea region over the past 15 years, wind gusts in the gradation of 13-15 (m.s-1) prevailed, and the speed of wind gusts in most cases rised with an increase of the daily temperature anomaly (from 0.0 to 5.0 °С) and a decrease of the daily pressure anomaly (from 0 to -7.0 hPa).

The paper relevancy is determined by the need to substantiate the feasibility of restoring the ecosystem of the Sasyk estuary after its transformation into a reservoir (1978) and the unsuccessful desalination by the Danube waters for irrigation purposes. The paper is aimed at assessment of the possible inflow of fresh water to the Sasyk estuary from the Kohylnyk and Sarata rivers and their role in the formation of fresh water balance in the first half of the 21st century according to the climate change scenarios RCP4.5 and RCP8.5. The main calculation method is the ‘climate-runoff’ model, which uses meteorological data as input data. Estimates of freshwater inflow into the estuary-reservoir are provided for various calculation periods: before 1989 (before the beginning of significant climate change in the North-Western Black Sea Region); in the period of 1989-2018 according to the hydrometeorological observations; in 2021-2050, according to the averaged data from 14 runs of scenarios RCP4.5 and RCP8.5 under the EVRO-CORDEX project. Estimates of the average long-term values of freshwater inflow in natural conditions and the conditions transformed by water management activity were obtained for each calculation period. It is found that owing to changes in the regional climate for the period of 2021-2050, the total inflow of freshwater from rivers to the estuary in natural conditions will decrease by 23.5 % (by RCP4.5) and by 38.5 % (by RCP8.5) in comparison with the reference period (before 1989). Taking into account the impact of artificial reservoirs, the reduction in the river runoff will be 52.1 % (by RCP4.5) and 64.7 % (by RCP8.5). It is defined, that in case of renaturalization of the Sasyk reservoir into the estuary and the water inflow cut-off from the Danube river, the changes in climatic conditions expected in the first half of the 21st century, combined with water management activity, will result in the increased deficit of annual freshwater balance of the Sasyk reservoir up to 62 % under the RCP4.5 scenario and up to 75 % under the RCP8.5 scenario compared to the period before the emergence of climate change (before 1989). This change must be considered in scientific substantiation of the project on a reversion of the Sasyk Reservoir to the original status of the estuary to ensure such conditions of water exchange with the sea (for compensation of the water balance deficit), which will prevent the long-term trend of salinization.

Radley Horton,1,a Daniel Bader,1,a Yochanan Kushnir,2 Christopher Little,3 Reginald Blake,4 and Cynthia Rosenzweig5 1Columbia University Center for Climate Systems Research, New York, NY. 2Ocean and Climate Physics Department, Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY. 3Atmospheric and Environmental Research, Lexington, MA. 4Physics Department, New York City College of Technology, CUNY, Brooklyn, NY. 5Climate Impacts Group, NASA Goddard Institute for Space Studies; Center for Climate Systems Research, Columbia University Earth Institute, New York, NY

(714) - Comparison of 6 Month Hospitalizations in Mechanical Circulatory Support Patients vs Heart Transplant Patients

SAT0077 Sickness Absence during the Ten-Year Period following Diagnosis in Swedish Patients with Different Subgroups of Spondyloarthritis

FRI0185 Sickness Absence during 2003-2012 in Swedish Patients with Spondyloarthritis

Social tipping processes towards climate action: A conceptual framework

Leveraging emotion for sustainable action

The need for comprehensive palliative care is inevitable with the aging population. Incorporating home-based palliative care is a new frontier within healthcare. The purpose of this study was to embed home-based palliative care services within the visiting nursing association (VNA) at a health system in Pennsylvania, examining effect on quality of life and symptom control, and average number of hospital admission days. A convenience sample of patients with one or more chronic conditions was selected from the existing VNA census (n = 22). A series of topics were outlined for discussion at each weekly visit for the pilot length of up to 6 months, scripted by evidence-based guidelines from the ENABLE II: Charting Your Course booklet (). A pretest/posttest survey method was conducted by utilizing results of the Edmonton Symptom Assessment System (ESAS) and the National Comprehensive Cancer Network Distress Thermometer. The effectiveness of the program was assessed using Spearman correlation to compare the difference in scores to the number of weeks in the program. The average number of hospital admission days during the pilot period was compared with admission days 6 months before enrollment in the pilot using the Wilcoxon signed-rank test. A significant relationship was found between the number of weeks in the program and reduction in the total ESAS symptom scores (rho = -0.484, p = .022), indicating that a reduction in symptoms was significantly more likely the longer a patient was in the program. Percentage of patients hospitalized decreased from 86% during preintervention period to 32% while enrolled. There was a noted reduction in the average number of days patients spent in the hospital while enrolled in the pilot (z = -2.24, p = 0.025).

BackgroundMonoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway, including the fully humanized monoclonal antibody (IgG2Δa) fremanezumab, have demonstrated safety and efficacy for migraine prevention. Clinical trials include responders and nonresponders; efficacy outcomes describe mean values across both groups and thus provide little insight into the clinical benefit in responders. Clinicians and their patients want to understand the extent of clinical improvement in patients who respond. This post hoc analysis of fremanezumab treatment attempts to answer this question: what is the benefit in subjects who responded to treatment during the two, phase 3 HALO clinical trials?MethodsWe included subjects with episodic migraine (EM) or chronic migraine (CM) who received fremanezumab quarterly (675 mg/placebo/placebo) or monthly (EM: 225 mg/225 mg/225 mg; CM: 675 mg/225 mg/225 mg) during the 12-week randomized, double-blind, placebo-controlled HALO EM and HALO CM clinical trials. EM and CM responders were defined as participants with a reduction of ≥ 2 or ≥ 4 monthly migraine days, respectively. Treatment benefits evaluated included reductions in monthly migraine days, acute headache medication use, and headache-related disability, and changes in health-related quality of life (HRQoL).ResultsOverall, 857 participants from the HALO trials were identified as responders (EM: 429 [73.8%]; CM: 428 [56.7%]). Reductions in the monthly average number of migraine days were greater among EM (quarterly: 5.4 days; monthly: 5.5 days) and CM (quarterly: 8.7 days; monthly: 9.1 days) responders compared with the overall population. The proportion of participants achieving ≥ 50% reduction in the average monthly number of migraine days was also greater in responders (EM: quarterly, 59.8%; monthly, 63.7%; CM: quarterly, 52.8%; monthly, 59.0%) than in the overall population. Greater reductions in the average number of days of acute headache medication use, greater reductions in headache-related disability scores, and larger improvements in HRQoL were observed among EM and CM responders compared with the overall populations.ConclusionsFremanezumab responders achieved clinically meaningful improvements in all outcomes. The magnitude of improvements with fremanezumab across efficacy outcomes was far greater in responders than in the overall trial population, providing insight into expected treatment benefits in participants who respond to fremanezumab in clinical practice.Trial registrationClinicalTrials.gov identifiers: NCT02629861 (HALO EM) and NCT02621931 (HALO CM).

To describe exploratory endpoints from a previous phase 2b/3 placebo-controlled trial conducted in Japan and Korea, specifically investigating the effect of fremanezumab or placebo on migraine-associated symptoms and acute headache medication use in patients with episodic migraine (EM). EM is associated with non-head pain symptoms, including nausea, vomiting, photophobia, or phonophobia, which contribute substantially to the disease burden, healthcare resource utilization, and impaired quality of life. Current EM treatments include a mix of nonspecific/migraine-specific acute headache medications, but medication overuse can induce headaches and progression from EM to chronic migraine (CM). In multiple phase 2b/3 trials, the monoclonal antibody fremanezumab significantly reduced the average number of monthly migraine days experienced by patients with EM/CM compared with placebo. This was a prespecified analysis of exploratory endpoints in a multicenter, randomized, double-blind, placebo-controlled, phase 2b/3 trial conducted in Japanese and Korean patients with EM (NCT03303092). Patients were randomized to receive fremanezumab, either monthly or quarterly, or matching placebo, administered subcutaneously at 4-week/28-day ("monthly") intervals to maintain blinding. Exploratory endpoints reported here were the mean change from baseline in the number of days/month with (i) the use of any acute headache medication, (ii) the use of any migraine-specific acute headache medication, (iii) nausea or vomiting, and (iv) photophobia and phonophobia. Overall, 357 Japanese and Korean patients with EM received either monthly (n = 121) or quarterly (n = 119) fremanezumab or placebo (n = 117). Compared with placebo, fremanezumab administered monthly or quarterly was associated with a significant reduction from baseline in the average number of days/month with acute headache medication use over three months (difference vs. placebo -2.81 [95% confidence interval (CI) -3.52, -2.11]; p < 0.001 and -2.79 [95% CI -3.50, -2.08]; p < 0.001, respectively). Similar findings were observed in the monthly average number of days with migraine-specific acute headache medications (difference vs. placebo with monthly and quarterly fremanezumab, -2.63 [95% CI -3.31, -1.95] for both; p < 0.001), the average number of days/month with nausea or vomiting (difference vs. placebo -1.09 [95% CI -1.60, -0.58]; p < 0.001 for monthly fremanezumab and -1.37 [95% CI -1.88, -0.86]; p < 0.001 for quarterly fremanezumab), and the average number of days with photophobia and phonophobia (difference vs. placebo -1.22 [95% CI -1.80, -0.65]; p < 0.001 and -1.64 [95% CI -2.22, -1.06]; p < 0.001, respectively). Monthly and quarterly administered fremanezumab effectively prevented EM in Japanese and Korean patients. Fremanezumab also improved other disease aspects including the need for acute headache medications and the frequency of migraine-associated symptoms.

To plan agrotechnical measures in changing climate it is necessary to track the dynamics of spatial and temporal changes in agrometeorological factors. Late spring and early autumn frosts are a limiting factor for agricultural crop production. In general, such frosts are of the radiation type. To study the spatial and temporal characteristics of the radiation frosts distribution in the North-West region of Russia, data of daily observations of the standard meteorological network from 1966 to 2015 were used. The change over the time in the average number of days with radiation frosts was calculated for two 25-year periods: from 1966 to 1990 and from 1991 to 2015. Two zones of multidirectional change of the average number of days with radiation frosts in the period from 1991 to 2015 were revealed. The decrease in the average number of days with radiation frosts during this period was recorded at the weather stations of Vologda and Leningrad (except for the weather station Belogorka) and the meteorological station Velikie Luky (Pskov region). At the same time all the weather stations of this zone (with the exception of the Vyborg weather station) are characterized by the higher number of days with radiation frosts then the weather station of the other zone. The increase in the average number of days with radiation frosts during this period was noted at the weather stations of the Pskov, Novgorod, Kaliningrad regions and the weather station Belogorka (Leningrad region).