America Research Articles

Development of a global thermal detection index to prioritize primate research with thermal drones.

Thermal Infrared (TIR) drones are emerging as effective tools for wildlife ecology monitoring and are increasingly employed in primate surveys. However, systematic methods for assessing primate detectability are lacking. We present a comprehensive approach utilizing a novel Thermal Detection Index (TDI) to evaluate the potential of TIR drones for primate monitoring. We developed TDIs for 389 primate species, considering activity patterns, locomotion types, body mass, densities, habitat utilization, and sleeping behaviors during diurnal and nocturnal surveys. Through the integration of TDIs with primates' distribution and climatic variables (average annual temperature, precipitation, and wind speed), we established a Global TDI Suitability Score aimed at pinpointing species and regions most compatible with TIR drone-based monitoring. Atelidae, Cercopithecidae, and Indridae showed the highest TDI values, suggesting their suitability for TIR-drone surveys. We identified optimal regions in Africa, Asia and Latin America for primate monitoring with TIR drones, driven by favorable ecological conditions, habitat types, and high TDI species diversity. However, local ecological factors and regulatory frameworks also influence drone survey feasibility, necessitating careful consideration prior to implementation. Overall, our study provides a valuable framework for prioritizing primate species and regions for TIR drone-based monitoring, facilitating targeted conservation efforts and advancing primate monitoring research.

Assessing yellow fever outbreak potential and implications for vaccine strategy.

Yellow fever (YF), a vector-borne viral hemorrhagic fever, is endemic in tropical regions of Africa and South America, with large vaccination programmes being used for control. However, significant outbreaks have occurred in recent years. Data on infection rates and seroprevalence is often sparse, requiring robust mathematical models to estimate the burden of yellow fever. In particular, modelling is required to estimate the risk of outbreaks and inform policy decisions regarding the targeting of vaccination. We present a dynamic, stochastic model of YF transmission which uses environmental covariates to estimate the force of infection due to spillover from the sylvatic (non-human primate) reservoir and the basic reproduction number for human-to-human transmission. We examine the potential for targets identified by the World Health Organization EYE Strategy (50%, 60% or 80% vaccination coverage in 1-60 year olds) to achieve different threshold values for the effective reproduction number. Threshold values are chosen to reflect the potential for seasonal and/or climatic variation in YF transmission even in a scenario where vaccination lowers the median reproduction number below 1. Based on parameter estimates derived from epidemiological data, it is found that the 2022 EYE Strategy target coverage is sufficient to reduce the static averaged annual effective reproduction number R below 1 across most or all regions in Africa depending on the effectiveness of reported vaccinations, but insufficient to reduce it below 0.5 and thereby eliminate outbreaks in areas with high seasonal range. Coverage levels aligned with the 2026 targets are found to significantly decrease the proportion of regions where R is greater than 0.5.

Impact of the Belt and Road Initiative on Global Trade and Economic Growth Amid China’s Slowing Growth

Since the inception of the Belt and Road Initiative (BRI), China’s trade relations with participating nations have experienced substantial growth. This study utilises data from the World Trade Organization (WTO) covering the years 2003 to 2021 to explore the dynamics of China’s foreign trade and assess the impact of the BRI on trade interactions with China. One of the central objectives of our research is to determine whether participation in the BRI has significantly contributed to trade growth with China, thereby strengthening economic ties and fostering bilateral cooperation. Another important objective is to analyse the changes in the BRI’s role in driving global economic growth amid China’s slowing growth. Through empirical analysis using data from over 180 countries, we evaluate the heterogeneous effects of the BRI across different continents. Our findings indicate that the BRI has had the most pronounced trade-stimulating impact on the continents of America, Europe and Africa, while trade volumes with Asian countries have seen only marginal increases. The relatively smaller trade growth in Asian countries can be attributed to the already high volume of trade activities due to their geographical proximity to China, which diminishes the marginal impact of the BRI. Additionally, the significant infrastructure investments under the BRI have been predominantly directed towards Africa and Europe, further explaining the smaller trade-enhancing effects observed in Asia compared to other continents. Furthermore, we identified the spillover effects of the BRI on non-participating countries. Moreover, significant differences in the BRI’s impact on global economic growth were observed before and after China’s economic slowdown. This article offers actionable policy recommendations to inform future decisions based on these findings.

Urban environments increase generalization of hummingbird–plant networks across climate gradients

Urbanization has reshaped the distribution of biodiversity on Earth, but we are only beginning to understand its effects on ecological communities. While urbanization may have homogenization effects strong enough to blur the large-scale patterns in interaction networks, urban community patterns may still be associated with climate gradients reflecting large-scale biogeographical processes. Using 103 hummingbird-plant mutualistic networks across continental Americas, including 176 hummingbird and 1,180 plant species, we asked how urbanization affects species interactions over large climate gradients. Urban networks were more generalized, exhibiting greater interaction overlap. Higher generalization was also associated with lower precipitation in both urban and natural areas, indicating that climate affects networks irrespective of habitat type. Urban habitats also showed lower hummingbird functional trait diversity and over/underrepresentation of specific clades. From the plant side, urban communities had a higher prevalence of nonnative nectar plants, which were more frequently visited by the hummingbird species occurring in both urban and natural areas. Therefore, urbanization affected hummingbird-plant interactions through both the composition of species and traits, as well as floral resource availability. Taken together, we show that urbanization consistently modifies ecological communities and their interactions, but climate still plays a role in affecting the structure of these novel communities over the scale of continents.

Trends of Climate Extremes and Their Relationships with Tropical Ocean Temperatures in South America

South America has experienced significant changes in climate patterns over recent decades, particularly in terms of precipitation and temperature extremes. This study analyzes trends in climate extremes from 1979 to 2020 across South America, focusing on their relationships with sea surface temperature (SST) anomalies in the Pacific and Atlantic Oceans. The analysis uses precipitation and temperature indices, such as the number of heavy rainfall days (R10mm, R20mm, R30mm), total annual precipitation (PRCPTOT), hottest day (TXx), and heatwave duration (WSDI), to assess changes over time. The results show a widespread decline in total annual precipitation across the continent, although some regions, particularly in the northeast and southeast, experienced an increase in the intensity and frequency of extreme precipitation events. Extreme temperatures have also risen consistently across South America, with an increase in both the frequency and duration of heat extremes, indicating an ongoing warming trend. The study also highlights the significant role of SST anomalies in both the Pacific and Atlantic Oceans in driving these climate extremes. Strong correlations were found between Pacific SST anomalies (Niño 3.4 region) and extreme precipitation events in the northern and southern regions of South America. Similarly, Atlantic SST anomalies, especially in the Northern Atlantic (TNA), exhibited notable impacts on temperature extremes, particularly heatwaves. These findings underscore the complex interactions between SST anomalies and climate variability in South America, providing crucial insights into the dynamics of climate extremes in the region. Understanding these relationships is essential for developing effective adaptation and mitigation strategies in response to the increasing frequency and intensity of climate extremes.

Giants beasts updated: A review of new knowledge about the South American megafauna

ABSTRACTSince the publication of Megafauna: Giant Beasts of Pleistocene South America by Fariña et al. in 2013, much has been published on this fascinating subject. Here, we sum up those contributions according to their aim: taxonomic, geographical and phylogenetic novelty, new approaches to the natural history of those species, and extinction and its aftermath. The traditional centres of interest since the 19th century, especially the Río de la Plata region, have now been complemented as a source of information by many other regions in South America, and the remains are now being studied by biogeochemistry and molecular biology, as well as with finite element analysis and constantly refined statistics. Finally, scholars and the public are becoming more interested in the demise of the megamammals as the starting point of the current process of biodiversity loss.

Population density estimates and conservation status of Aegla jacutinga Marçal & Teixeira, 2020 (Decapoda: Anomura: Aeglidae) from the type locality in Brazil

Abstract Anomuran crabs of the genus AeglaLeach, 1821 are endemic to temperate and subtropical regions of South America and are commonly found in streams and rivers, where they are generally restricted to healthy environments because they are sensitive to environmental changes. The genus presents worrying data regarding its conservation, like the many Brazilian freshwater species classified as being at some level of threat of extinction. We inventoried unexplored watersheds, estimated the population density of Aegla jacutinga Marçal & Teixeira, 2020 in its type locality, updated information on the distribution of the species, and assessed its conservation status using IUCN criteria.

Unveiling Macroecological Patterns of Elasmobranchs in the Eastern Pacific Ocean

ABSTRACTAimTo examine the species richness, distribution and macroecological patterns of elasmobranch assemblages across a broad latitudinal gradient in the Eastern Pacific Ocean (EPO).LocationThe study area encompasses the Pacific coast of the American continent, spanning from 65°N to 60°S, and extending from the coastline to approximately 1000 km offshore, encompassing the oceanic archipelagos.TaxonElasmobranchs.MethodsUtilising the established distribution ranges of 190 elasmobranch species (comprising 89 sharks and 101 rays), we assessed the richness and spatial distribution of these species across the EPO. Subsequently, three macroecological patterns were scrutinised: Rapoport's rule, the Mid Domain Effect with its association to Mean Sea Surface Temperature, and the correlation between body size and latitudinal distribution.ResultsThe analysis of species richness along latitudinal gradients unveiled a bimodal pattern, reaching peaks between 30° to 20°N and 10°N to 5°S. A decline in species richness was observed from tropical to polar regions. Contrary to Rapoport's Rule, Stevens' and midpoint methods demonstrated higher geographic range values at lower latitudes, diminishing towards higher latitudes. Additionally, the mid‐domain effect model exhibited a robust correlation with the mean sea surface temperature. Exploring the interspecific relationship between body size and extent of occurrence, it was found that 29 out of 190 species are more susceptible to extinction.Main ConclusionMarine elasmobranchs of the EPO defy conventional latitudinal richness patterns and deviate from Rapoport's rule. Furthermore, our findings indicate a robust correlation between observed richness and both sea surface temperature and environmental heterogeneity. The proportion of species vulnerable to human or stochastic impacts potentially leading to extirpation in relation to their geographic range was low across the majority of examined provinces.

Innovating smart cities in Latin America: Addressing regional urban challenges and opportunities

This study analyzes the role of innovation in the development of smart cities in Latin America. It focuses on how emerging technologies and sustainable strategies are being integrated into urban planning and urban development. In this sense, this study seeks to contribute to the smart city literature by answering the following research questions: (i) To what extent smart city innovative initiatives have been addressed in Latin America? and (ii) To what extent scholars have addressed sustainable innovation strategies in the smart city literature? To this end, this is the first comprehensive bibliometric analysis of smart city research in Latin America, with a structured and systematized review of the available literature. This methodological approach allows cluster visualization and detailed analysis of inter-node relationships using the VOSViewer software. The research comprises 4 stages: (a) search criteria; (b) selection of documents; (c) software and data extraction; and (d) analysis of results and trends. Results indicate that studies on the Latin America region began to develop in 2012, with Brazil as a leader in this field and the tourism sector as the most relevant. Nevertheless, strong international collaboration was identified in co-authoring studies, underscoring a cooperative approach to solving common urban problems. The most active research area is technological innovation and sustainability, with focus on solutions for urban mobility, quality of life and smart governance. Finally, this work underlines the need to continue exploring the integration of technology in urban development, suggesting an agenda to guide future research to evaluate the sustainability and long-term impacts of smart city initiatives in Latin America. From the policy perspective, smart city initiatives need to be human-centered to boost smart solutions adoption and to guarantee long term local impacts.

Let Them Have the Cities: Inflation, Collapse, and Retreat in the Postwar Survivalist West

Abstract Before our contemporary label of “prepper,” and preceding the widespread adoption of “survivalist” in the late 1970s, those who sought self-sufficiency and security in remote locales of the American continent were known as “retreaters.” Anticipating catastrophes—chiefly hyperinflation, nuclear war, and urban chaos—violent enough to rend the social fabric of an increasingly decadent United States, these retreaters fled the swelling cities for the imagined security of the rural West to ride out the impending apocalypse. This article argues that one of the most salient and overlooked prime movers of the survivalist movement was a pervasive economic anxiety, metastasizing with the rampant stagflation of the 1970s. Drawing, for the first time, on twenty-five years of survivalist books, pamphlets, and newsletters, this paper shows that the secular eschatology of survivalism demands study if historians are to attain a clearer picture of the intellectual heritage of radical right millenarian visions from the late twentieth century up to the present day.

Spinocerebellar ataxia type 10 and Huntington disease-like 2 in Venezuela: Further evidence of two different ancestral founder effects.

The American continent populations have a wide genetic diversity, as a product of the admixture of three ethnic groups: Amerindian, European, and African Sub-Saharan. Spinocerebellar ataxia type 10 (SCA10) and Huntington disease-like 2 (HDL2) have very ancient ancestral origins but are restricted to two populations: Amerindian and African Sub-Saharan, respectively. This study aimed to investigate the genetic epidemiological features of these diseases in Venezuela. In-phase haplotypes with the expanded alleles were established in seven unrelated index cases diagnosed with SCA10 and in 11 unrelated index cases diagnosed with HDL2. The origins of remote ancestors were recorded. The geographic origin of the ancestors showed grouping in clusters. SCA10 had a minimal general prevalence of 1:256,174 families in the country, but within the identified geographic clusters, the prevalence ranged from 5 per 100,000 to 43 per 100,000 families. HDL2 had a general prevalence of 1:163,016 families, however, within the clusters, the prevalence ranged from 31 per 100,000 to 60 per 100,000 families. The locus-specific haplotype shared by all families worldwide, including the Venezuelans, supports a single old ancestral origin in each case. Knowing the genetic ancestry and geographic origins of patients in Ibero-American mixed populations could have significant diagnostic implications; thus, both diseases in Venezuela should always be first explored in patients with a suggestive phenotype and ancestors coming from the same known geographic clusters.

Insights Into the Ecology of a Widespread but Poorly Known Aerial Insectivore and a Theoretical Basis for Range Expansion Following Repeated Vagrancy Events.

Over the course of the last two centuries, Northern Rough-winged Swallows (Stelgidopteryx serripennis) have expanded their range across the North American continent but have remained a relatively poorly known species. In this paper, I discuss two aspects of their nature history that has received little attention. First, I document an instance of Northern Rough-winged Swallows digging their own burrow, which was for the better part of the last century considered a behavior that was either lost or never occurred in the first place. Second, I review the natural history literature to document qualitative patterns evident in their expansion over the last two centuries. In doing so, I define three potentially useful concepts that can he applied to understand species' range shifts: an Expansion Chronology, which is a spatiotemporal map of a range shift; the concept of Vagrancy-induced Range Expansion, where a species undergoes repeated movements outside of their typical geographic range (defined as vagrancy events), leading to the regular occurrence in a new region (e.g., regular overwintering or nonbreeding occurrences); and the concept of Vagrancy-induced Long-distance Dispersal, which is specifically expansion of a species' breeding range following repeated vagrancy events.

Prevalence of Chagas disease among Latin American immigrants in non-endemic countries: an updated systematic review and meta-analysis

BackgroundChagas disease (CD), endemic in 21 Latin American countries, has gradually spread beyond its traditional borders due to migratory movements and emerging as a global health concern. We conducted a systematic review and meta-analysis of available data to establish updated prevalence estimates of CD in Latin American migrants residing in non-endemic countries. MethodsAa systematic search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, Scopus, Web of Science, and LILACS via Virtual Health Library (Biblioteca Virtual em Saúde - BVS), including references published until November 1st, 2023. Pooled prevalence estimates and 95% confidence intervals (CI) were calculated using random effect models. Heterogeneity was assessed by the chi-square test and the I2 statistic. Subgroup analyses were performed to explore potential sources of heterogeneity among studies. The study was registered in the PROSPERO database (CRD42022354237). FindingsFrom a total of 1,474 articles screened, a total of 51 studies were included. Studies were conducted in eight non-endemic countries (most in Spain), between 2006 and 2023, and involving 82,369 screened individuals. The estimated pooled prevalence of CD in Latin American migrants living in non-endemic countries was 3.5% (95% CI: 2.5-4.7; I2: 97.7%), considering studies in which screening was indicated simply because the person was Latin American. Per subgroups, the pooled CD prevalence was 11.0% (95% CI: 7.7-15.5) in non-targeted screening (unselected population in reference centers) (27 studies); in blood donors (4 studies), the pooled prevalence was 0.8% (95% CI: 0.2-3.4); among people living with HIV Latin American immigrants (4 studies) 2.4% (95% CI: 1.4-4.3) and for Latin American pregnant and postpartum women (14 studies) 3.7% (95 CI: 2.4-5.6). The pooled proportion of congenital transmission was 4.4% (95% CI: 3.3-5.8). Regarding the participants’ country of origin, 7,964 were from Bolivia, of which 1,715 (21,5%) were diagnosed with CD, and 21,304 were from other Latin American countries of which 154 (0,72%) were affected. InterpretationCD poses a significant burden of disease in Latin American immigrants in non-endemic countries, suggesting that CD is no longer a problem limited to the American continent and must be considered as a global health challenge. FundingThis study was funded by the World Heart Federation, through a research collaboration with Novartis Pharma AG.

Colonial Exiles: The Tambora Volcanic Explosion, Environmental History, and Swiss Immigration to Nova Friburgo, Brazil, 1815–1821

The 1815 eruption of the Indonesian volcano Mount Tambora triggered a subsistence crisis in Europe, especially in Switzerland. This article retraces the founding of Nova Friburgo, a colony in the mountains near Rio de Janeiro composed of several hundred Swiss families, mostly from the rural canton of Fribourg. This study shows how the unusual central European settler migration to the Brazilian tropics was facilitated by a new class of entrepreneurial go-betweens, acting as dynamic mediators between the effects that the climatic catastrophe caused by Tambora had on Swiss agriculture and politics and the development requirements for building new settlements in a metamorphosing South American continent. By positioning Brazil in the broader environmental history of Tambora, as well as the fallout from the Napoleonic Wars, this article sheds light on how the study of climatic teleconnections requires multiple scales of analysis to understand better how the different politics and scopes of action, and sets of unlikely processes, move into play. These teleconnections were, in fact, socially mediated with eventually wide-reaching social and racial transformations that became foundational prototypes for Brazilian land colonization throughout the nineteenth and into the twentieth century.

Seed Morphology and Tetrazolium Quick Seed Viability Test of Malabar Neem (Melia dubia Cav.) Under Laboratory Condition

Melia dubia Cav. commonly known as Malabar Neem, is an economically important fast-growing indigenous multipurpose tree species of India. It has a wide range of applications from medicinal utilities such as treating pain, fever, and infections, to agricultural and industrial uses viz., fodder, seed oil, resin, fuel wood, timber and its wood being utilized in the paper, matchbox, and plywood industries. Malabar Neem generally is distributed in tropical and sub-tropical regions of India and introduced in many countries of South Africa, the Middle East, North and South America, Brazil, Bermuda, Argentina, Southern Europe, Southeast Australia, and Asia Pacific regions. Nevertheless, it is a most promising tree species which is highly suitable for agroforestry or farm forestry with a life cycle of 8 to 12 years that gaining economic importance both in domestic and global markets and plantations in degraded lands. Consequently, the demand of Melia seedlings among Indian farmers has been increased, however the poor seed viability and very low seed germination hampered the good quality nursery production and large-scale plantations. Before seed sowing in nursery, there is need to determine the actual seed viability and to know the required seed quantity of Melia to be sown in forest nursery. Therefore, the present research study was conducted at Dr. Y. S. Parmar University of Horticulture and Forestry, Nauni, Solan, Himachal Pradesh of India to study the seed morphology and seed viability testing protocol using tetrazolium (TZ) test. The seeds of Melia species stained with 0.5, 1.0, 1.5 and 2.0 % solution of TZ and incubated at 30°C temperature for 24 hours. The tetrazolium test performed with 100 seeds in 4 replications in CRD design and analyzed with OPSTAT statistical software. The length, width and weight of fruit, drupe and seed were recorded in the range of 9.40-12.97 mm, 6.55-9.70 mm & 2.84-2.99 g; 5.84-14.32 mm, 2.76-9.72 mm & 1.672-1.798 g; and 1.2-1.98 mm, 1.02-2.98 mm & 3.12-3.74 g, respectively. The colour of fruit was yellow with oval shape having smooth surface. The result of TZ test showed that the seeds of Malabar Neem soaked in 0.5 % tetrazolium solution at 30 °C temperature for 24 hours found to be the highest seed viability percentage (40.25 %) which is recommended as a quick seed viability protocol in M. dubia. Overall, the results of the present research study fulfilled all the gaps to test quick seed viability of a seed lot before seed sowing in nursery for accurate knowledge of the seed requirement in quantity for the purpose of quality seedling production in nursery.

UBER IN EXURBIA: Peripheral Platformization, Post‐Suburbanization and the Public–Private Ridehail Partnership in the Toronto City Region

AbstractAfter their widespread legalization, ridehailing companies Uber and Lyft soon embarked on a new stage of their respective business models: the initiation of a wave of strategic partnerships with local and regional transit agencies across the North American continent. This article accounts for this trend by putting forward the concept of the public–private ridehail partnership (PPRP). It aims to render visible the PPRP as a variously contradictory attempt to splice Uber and Lyft's platform‐based business models with the existing social and physical realities of North American post‐suburban space. While conceived as a strategic response to pressing sub‐ and exurban problems such as low physical densities, widespread car centrism and extensive transit undersupply, the PPRP, as I argue, is neither able to adequately address these dilemmas nor to ultimately resolve them. Rather, the PPRP latches onto old—and sets in motion new—powerful dynamics of heightened uneven development and continued urban entrepreneurialism. Each of these two dynamics is explored through empirical analyses of two recent PPRPs in the Toronto city region: the Lyft–Metrolinx pilot carried out between July and December 2019; and Uber's ongoing partnership with the town of Innisfil, located about 80 km north of downtown Toronto.

Global burden of drug use disorders by region and country, 1990-2021.

This study used data from the Global Burden of Disease Study (GBD) database to systematically assess the magnitude of drug use disorders (DUD) burden between 1990 and 2021. This study used GBD data to analyze the trends in ASIR, DALYs and other DUD indicators from 1990 to 2021, and compared them among different regions and countries. The Estimated Annual Percentage Change (EAPC) and its 95% Confidence Interval (CI) were calculated to assess the temporal and geographical disparities. ASIR and DALYs were used to evaluate the burden of DUDs, and socio-demographic index (SDI) was used to measure the socio-economic development level of each country. The global ASIR of DUDs showed a slight downward trend (EAPC = -0.26). The age-standardized DALY rate (per 100,000) significantly declined from 1990 to 2021 (EAPC = -1.44). Among the regions, the high SDI region exhibited the most substantial increase in ASIR (EAPC = 0.65). On a regional level, the high-income North America region had the highest EAPC for both age-standardized DALYs and ASIR (EAPC = 4.82, 1.02, respectively). Nationally, the United States of America reported the largest increase in age-standardized DALY rates and EAPC for ASIR (EAPC of 4.88, 1.05, respectively), while South Africa had the most significant decrease in EAPC (EAPC of -3.62, -1.52, respectively). In 2021, the highest ASIR was observed in high-income North America at 520.07; Central Asia had the highest age-standardized DALY rate. Globally, age-standardized DALYs and ASIR for DUDs were generally higher in men than in women, and the burden of DUDs decreased with age. The global burden of DUDs has shown complex and changing trends over the last decades, with large differences in burden between regions and countries. This highlights the need for targeted public health policies and interventions in High income North America region and Eastern Europe.

Natriuretic peptides, kidney function and clinical outcomes in heart failure with mildly reduced or preserved ejection fraction: pooled data from the I-PRESERVE, TOPCAT, PARAGON and DELIVER trials

Abstract Background The prognostic utility of N-terminal pro-B-type (NT-proBNP) in patients with heart failure and chronic kidney disease (CKD) is incompletely understood since elevations in NT-proBNP could be related either to decreased clearance by the kidney or to increased severity of structural heart disease. Purpose We sought to assess the association of NT-proBNP with cardiovascular and mortality outcomes in patients with heart failure and mildly reduced or preserved ejection fraction, stratified by baseline kidney function. Methods We conducted a pooled analysis of individual participants with NT-proBNP and estimated glomerular filtration rate (eGFR) measured at baseline in the I-PRESERVE, TOPCAT (Americas region), PARAGON and DELIVER trials. We evaluated the relationship between NT-proBNP and kidney function using piecewise linear regression. Using multivariable Cox and Poisson regression models, we assessed the association of NT-proBNP with clinical outcomes across different levels of eGFR (≥60, 45-<60 and <45 mL/min/1.73m2). The primary outcome was hospitalisation for heart failure or cardiovascular death. Results Among 14,831 participants (mean age 72.1 years, 50.3% female, mean eGFR 63.3 mL/min/1.73m2 and median NT-proBNP 840 pg/mL) followed for a median 33.5 months, there were 3,092 primary outcomes, 2,184 heart failure hospitalisations, 1,465 cardiovascular and 1,049 non-cardiovascular deaths. Participants in lower eGFR categories were more likely to be older, female, and have atrial fibrillation and diabetes (all p<0.001). NT-proBNP levels increased by 9%, 8%, and 23% per 10 mL/min/1.73m2 lower eGFR in patients with baseline eGFR ≥60, 45-60, and <45 mL/min/1.73m2, respectively (P for non-linearity <0.001). For any given NT-proBNP concentration, participants with eGFR <45 mL/min/1.73m2 were at highest risk (Figure 1). Each doubling in NT-proBNP was associated with a 37% relative increase in the primary outcome (HR 1.37, 95% CI 1.34-1.41), consistent across different eGFR categories (P-interaction=0.42). Association between NT-proBNP and other clinical outcomes were also consistent across different levels of kidney function (all P-interaction>0.3; Figure 1). Equivalent risk for the primary outcome was apparent at NT-proBNP levels approximately 2.5- to 3.5-fold lower in patients eGFR <45 mL/min/1.73m2, compared to those with eGFR ≥60 mL/min/1.73m2. (Figure 2). Conclusion NTproBNP is a potent predictor of risk in patients with heart failure with mildly reduced or preserved ejection fraction across the spectrum of kidney function. However, in patients with reduced kidney function, lower NT-proBNP levels confer absolute risk of cardiovascular outcomes similar to substantially higher NT-proBNP levels in patients with normal kidney function. Accordingly, interpretation of NTproBNP levels should vary according to kidney function, particularly in those with eGFR <45 mL/min/1.73m2.

Self-reported health effects from wildfire smoke: A cross-sectional study in New York State

Abstract Background Wildfires and exposure to wildfire smoke (WFS) are forecasted to increase, in part driven by climate change. As witnessed in 2023, regions in Europe and North America are facing more sustained periods of poor air quality due to WFS. Growing evidence suggests average daily WFS correlates with morbidity and mortality, but the impact of prolonged WFS exposure remains understudied, especially in areas where WFS is a newer occurrence. We examine associations between consecutive days of WFS experienced and self-reported health symptoms in the northeastern United States. Methods This retrospective cross-sectional study explored New York State (NYS) residents’ experience with WFS in summer 2023 via an online survey. Participants reported the longest period of consecutive WFS days and symptoms experienced. Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (CI). Results 553 NYS residents were included, representing a healthy, primarily female and White population, ranging from 18 to 86 years. 549 (99.3%) reported experiencing WFS, with the longest period of consecutive WFS days varying (≤3 days: n = 152; 4 to 6 days: n = 255; ≥7 days: n = 146). 490 (88.6%) reported ≥1 health symptom, with itchy/watery eyes, sore throat, and headache as the most frequent. Compared to ≤ 3 consecutive WFS days, symptom prevalence was 9.1% higher for those reporting 4 to 6 days (PR [95% CI]:1.09 [1.00, 1.19]) and 16.7% higher for ≥7 days (1.17 [1.07, 1.27]). The trend of increased symptom prevalence with longer WFS periods persisted and was pronounced for specific symptoms. Control for potential confounders did not appreciably change estimates. Conclusions Our findings suggest longer sustained WFS exposure associates with higher symptom prevalence, which may be precursors to more serious health conditions. As global populations face more WFS with climate change, public health professionals should prioritize strategies to mitigate prolonged exposure. Key messages • In a convenience sample of 553 primarily healthy New York State residents, 99.3% reported experiencing wildfire smoke and 88.6% reported at least 1 symptom of poor health during summer 2023. • Associations between consecutive days of wildfire smoke experienced and prevalence of any and specific symptoms tended to vary in a dose-response manner.

A Satellite-Based Indicator for Diagnosing Particulate Nitrate Sensitivity to Precursor Emissions: Application to East Asia, Europe, and North America.

Particulate nitrate is a major component of fine particulate matter (PM2.5) and a key target for improving air quality. Its formation is varyingly sensitive to emissions of nitrogen oxides (NOx ≡ NO + NO2), ammonia (NH3), and volatile organic compounds (VOCs). Diagnosing the dominant sensitivity is critical for effective pollution control. Here, we show that satellite observations of the NO2 column and the NH3/NO2 column ratio can effectively diagnose the dominant sensitivity regimes in polluted regions of East Asia, Europe, and North America, in different seasons, though with reduced performance in the summer. We demarcate the different sensitivity regimes using the GEOS-Chem chemical transport model and apply the method to satellite observations from the OMI (NO2) and IASI (NH3) in 2017. We find that the dominant sensitivity regimes vary across regions and remain largely consistent across seasons. Sensitivity to NH3 emissions dominates in the northern North China Plain (NCP), the Yangtze River Delta, South Korea, most of Europe, Los Angeles, and the eastern United States. Sensitivity to NOx emissions dominates in central China, the Po Valley in Italy, the central United States, and the Central Valley in California. Sensitivity to VOCs emissions dominates only in the southern NCP in the winter. These results agree well with those of previous local studies. Our satellite-based indicator provides a simple tool for air quality managers to choose emission control strategies for decreasing PM2.5 nitrate pollution.