Background Climate Research Articles

P-1957. Spatiotemporal Association of COVID-19 Cases and Mortality with Exposure to Wildfire Particulate Matter in 2020

Abstract Background Climate change is anticipated to have profound effects on human health including infectious diseases. Wildfires have increased in frequency and intensity due to changes in precipitation and have been linked to worsening respiratory infections. We aimed to demonstrate whether an association existed between wildfire smoke and COVID-19 in California during 2020. Demographic data by county in California based on the 2020 American Census Survey and New York Times mask-use survey conducted in July 2020. The population of California is generally higher in the southern region, especially Los Angeles County. The median income is highest in the San Francisco Bay area. The outdoor laborer rate is generally higher in northern California, especially the rural county of Trinity. Self-reported mask use in July 2020 was high throughout the state, but lowest in the northern region. Methods We performed a population-based ecologic cohort study in California in 2020 using a spatial autoregressive model to test for associations between wildfire smoke and COVID-19 case and death incidence while adjusting for demographic and environmental factors. The counties of California were the units of analysis and all persons who lived in California were accounted for in the data. We used publicly available levels of particulate matter < 2.5 µm (µg/m3 PM2.5) specifically attributable to wildfire smoke in California during 2020. The median COVID-19 case and death incidence for each county in California and the overall case and death incidence in each county in California and the statewide county median case and death incidence is displayed in the first two plots below. The mean wildfire smoke PM2.5 exposure (µg/m3) in each California county and the median smoke exposure among California counties is displayed in the third plot. There was a surge in COVID-19 cases and deaths in California in the summer and winter of 2020 but a large degree of variation across counties. There was a surge in smoke exposure in the fall of 2020 and a large degree of variation across counties. Results In a model adjusted for spatial autocorrelation, environmental and demographic confounders, we found as smoke exposure increased per each 10 µg/m3 in PM2.5, there was an average increase of 175 COVID-19 cases/10,000 persons the following month (1-month lag) at the county level (P< 0.001) and an increase of 1.86 COVID-19 deaths/10,000 persons the following month at the county level (P< 0.001). These findings were attenuated in the 2nd month after smoke exposure where we found as smoke increased per each 10 µg/m3 in PM2.5 there was an average increase of 65.9 COVID-19 cases/10,000 persons the following 2nd month but no increase in deaths. Screenshot of the interactive Shiny app displaying COVID-19 cases, deaths, and smoke PM2.5 for each county in California and each month of 2020. Link: https://mchal053.shinyapps.io/smoke-covid/. Conclusion 2020 was a particularly strong year for wildfires in California and a unique year for infectious diseases with the COVID-19 pandemic. Our findings, using a spatially adjusted autoregressive model which controlled for important confounding variables, demonstrated that wildfire smoke exposure likely increased COVID-19 acquisition potentially via epithelial injury. This may have implications for the transmission risk for other upper respiratory tract infections. Table 1 Adjusted spatial lag model for the COVID-19 case and death incidence per 10,000 persons per 10 µg/m3 increase in PM2.5 smoke exposure in 2020. The model is adjusted for median income, outdoor laborer rate, average 2020 temperature per county, monthly 2020 precipitation per county, average elevation, month of the year, and rate of respondents reporting “Always” wearing a mask when in public within 6-feet of other another person. We found very strong evidence for a 1-month lag increase of 175 COIVD-19 cases/10,000 persons and 1.86 deaths/10,000 persons and a 2-month lag increase of 65.9 COVID-19 cases/10,000 persons. There was no 2-month lag increase in COVID-19 mortality. Disclosures Andrej Spec, MD, MSCI, F2G: Grant/Research Support George R. Thompson, III, MD, Astellas: Advisor/Consultant|Cidara: Advisor/Consultant|Cidara: Grant/Research Support|F2G: Advisor/Consultant|F2G: Grant/Research Support|Melinta: Advisor/Consultant|Melinta: Grant/Research Support|Mundipharma: Advisor/Consultant|Mundipharma: Grant/Research Support|Pfizer: Advisor/Consultant

Spatial variations in urban woodland cooling between background climates

Urban woodland composition and configuration have strong associations with land surface temperatures (LST), but the evidence is contradictory due to different spatial scales, regional climate zones, woodland types and urban contexts. In this study, we analyse associations between urban woodland and LST within and between five cities in different Köppen climate zones. Our consistent methodology is framed around local climate zones and conducted at a fine spatial scale. We find that urban woodland fragmentation, connectedness, and shape complexity all influence LST, though much less than overall cover. The importance of cover holds for all climates except for hot-desert (Cairo). Otherwise, every 1% increase in woodland cover corresponds to a reduction of LST of around 0.07 °C to 0.02 °C (London-Cfb > Toronto-Dfa > Nanjing-Cfa > Shenyang-Dwa). Within cities, increasing urban woodland cover generally reduces LST more in built-up compared to vegetated zones. Nevertheless, associations between local LST and urban woodland composition and configuration are highly heterogeneous across cities, especially in cooler climates. Thus, to unravel the complexities of urban woodland cooling, systematic analysis of contemporaneous local and regional factors is required.

P0027 The carbon footprint of remote monitoring of IBD patients – a green opportunity for sustainable outpatient care

Abstract Background Climate change is a major public health threat, with healthcare systems contributing 4-5% of global greenhouse gas (GHG) emissions. Inflammatory Bowel Disease (IBD), a chronic and increasingly prevalent condition, demands extensive healthcare resources, making healthcare for this patient population a notable contributor to carbon dioxide (CO2) and other GHG emissions. Remote care offers an opportunity by reducing transport-related emissions through fewer outpatient visits. In this study we aimed to assess the carbon footprint of IBD care and compare the emissions associated with remote versus standard care. Methods A randomized controlled trial involving 909 IBD patients from two academic and two non-academic hospitals in the Netherlands compared telemedicine via myIBDcoach with standard outpatient care for a 12-month period.1 In an explorative analysis, the annual carbon footprint of IBD-related healthcare, expressed as CO2-equivalent (CO2e), was estimated, covering outpatient and inpatient services, diagnostic procedures (i.e., endoscopy, radiology), surgeries, and patient travel (assuming 100% car use).2 Staff travel, laboratory tests, and medication use were out of scope. Emission conversion factors were derived primarily from Dutch literature and supplemented with international sources (Table 1). Results The total annual carbon footprint for all patients was 53,779 kg CO2e (Figure 1), mainly driven by hospitalization (50.6%) and patient travel (29.0%, mean travel distance: 20.3 km). Per IBD patient, the mean annual carbon footprint was 65.5 kg CO2e in the standard care group (n=443) and 56.5 kg CO2e in the remote monitoring group (n=438), saving 9.0 kg CO2e per patient annually. Reduced outpatient visits in the remote monitoring group accounted for most savings, with annual emissions dropping from 21.6 kg CO2e to 14.3 kg CO2e, saving 7.3 kg CO2e per year. Scaling remote care to the 120,000 patients IBD patients in the Netherlands3 could save approximately 878 tons CO2e per year. This is equivalent to the annual carbon footprint of 47 average Dutch households, including housing, transport, clothing, food, and other goods. Conclusion IBD care has a substantial environmental impact. Remote care reduces outpatient visits and achieves notable emission savings, with even greater potential in larger countries than the Netherlands. Implementing remote monitoring with tight disease control in routine care can substantially reduce carbon emissions for IBD and other chronic disease populations.

P0906 A comparison of the transport-related carbon footprint of intravenous versus subcutaneous infliximab

Abstract Background Climate change poses a major threat to health and the planet. The United Kingdom’s (UK) National Health Service is thought to account for 5.9% of total UK carbon emissions (1,2). Inflammatory bowel disease (IBD) affects an estimated 500,000 people in the UK (3). Infliximab, a commonly prescribed biological medication for the management of IBD, is available as intravenous (IV) and subcutaneous (SC) preparations. There are numerous benefits to switching patients to SC infliximab (4), but the impact on carbon footprint has not been fully assessed. We aimed to compare the transport-related carbon footprint of IV versus SC infliximab. Methods We analysed data from all adult patients with IBD at Leeds Teaching Hospitals Trust who were eligible to switch from IV to SC infliximab. This included all patients on standard dosing (5mg/kg 8 weekly). Carbon footprint of transport for infliximab was calculated from UK port to the infusion unit for IV or patient’s home for SC. Carbon footprint of patient travel was calculated using distance from patient’s home to the infusion unit and mode of transport from local survey data. Carbon emissions were calculated based on distance travelled, type of vehicle, number of units transported, and weight of units transported. Greenhouse gas conversion factors were used to calculate all carbon emission factors. We then compared the calculated 48-week carbon footprint by intention-to-treat (ITT) (i.e. if all patients had switched from IV to SC) and as-treated (AT) (comparing all on IV pre-switch to some on IV and some SC post switch). Results 169 patients were eligible to switch to SC infliximab and 98 (58%) switched within 3 months. One patient was excluded from analysis as they subsequently moved out of area. Average transport-related carbon footprint was 6.10kgCO2e for IV infliximab and 0.018kgCO2e for SC infliximab per dose, per patient. In the Leeds cohort, over 48 weeks, the transport-related carbon footprint before the switch (168 patients IV) was 6150kgCO2e. Following the switch, the transport-related carbon footprint by ITT analysis (168 patients SC) would have been 71.3kgCO2e and was 2457kgCO2e in the AT analysis (70 patients IV = 2416kgCO2e, 98 patients SC = 41.6kgCO2e SC). Conclusion The use of SC infliximab reduces the carbon footprint associated with transport when compared to IV infliximab delivered at an infusion unit. It is important to note that whilst the transport-related carbon footprint is reduced by switching from IV to SC, a full life cycle assessment including analysis of preparing and administering each form of infliximab is still required to fully understand the impact of switching from IV to SC infliximab on carbon footprint.

Landslide and Slope Protection Measures in Loess Plateau

This paper focuses on the landslide problem in the Loess Plateau. Firstly, the geological, topographic and climatic background characteristics of the Loess Plateau are described, and the causes of landslide in this area are analyzed, including natural factors (such as landform, geotechnical properties, precipitation, earthquake, etc.) and human factors (such as engineering construction, irrigation, mining, etc.). Then, the types and characteristics of landslides in the Loess Plateau are discussed in detail. Finally, the protection measures for the loess Plateau slope are systematically introduced, including engineering measures (such as retaining wall, anti-slide pile, etc.), biological measures (such as afforestation, etc.) and other comprehensive measures, aiming at providing theoretical basis and practical guidance for landslide prevention and ecological protection in the Loess Plateau.

Global Climatology of the Daytime Surface Cooling of Urban Parks Using Satellite Observations

AbstractGreen infrastructure‐based heat mitigation strategies can help alleviate the overheating burden on urban residents. While the cooling effect of parks has been explored in individual satellite‐based studies, a global, multi‐year investigation has been lacking. This study provides a comprehensive global assessment of the daytime surface park cool island (SPCI) climatology, using land surface temperatures from 2,083 systematically selected parks worldwide (2013–2022). Through detailed park selection and data stratification, the key drivers influencing the observed SPCI intensity are isolated. The analysis reveals that cooling is strongly linked to park type, with well‐treed parks being, on average, 3.4°C, cooler than the surrounding urban area during summer. It is further investigated how SPCI is influenced by seasonal variations, droughts, and urban morphology across diverse background climates. These findings, along with the developed global SPCI data set, offer critical insights for designing climate‐resilient green spaces.

Formation and transformation of clay minerals in Mars-analog rock varnish

Abstract Rock varnish is widely distributed across Earth’s various climatic zones, especially prevalent in arid environments similar to Mars. Its potential presence on Mars has made it a significant Mars analog for planetary research. The primary components of rock varnish are clay minerals and iron-manganese oxyhydroxides, with clay minerals possibly playing a crucial role in the enrichment of iron and manganese. However, there has been scarce in-depth and detailed research on these clay minerals within rock varnish. To better understand the formation, transformation mechanisms, and influencing factors of clay minerals in rock varnish, this study conducted X-ray diffraction (XRD) analyses on clay minerals isolated from rock varnish samples collected across different climatic regions in China. Additionally, in situ visible to near-infrared spectroscopy (vis-NIR), scanning electron microscopy (SEM), and focused ion beam-high resolution transmission electron microscopy (FIB-HRTEM) were performed on the rock varnish samples. The results revealed the presence of illite in all rock varnish samples, while the selective occurrence of other clay minerals was closely correlated with climatic backgrounds. Furthermore, the crystallinity of illite was significantly influenced by climatic conditions. Illite found in rock varnish existed as both detrital and authigenic forms. Generally, the detrital illite in rock varnish was thicker than the nanometer-scale authigenic illite and exhibited distinct differences in chemical composition (e.g., Si/Al, K/Al ratios) and nanoscale morphology. In many cases, the possible transformation of illite to chlorite was observed, either internally within illite particles or through the formation of regular or irregular interstratified structures between illite and chlorite. Both interlayer brucitization and talc brucitization mechanisms may be involved in the chloritization (brucitization) of illite in rock varnish. Such transformations are generally uncommon in surface environments and are more frequently associated with low-grade metamorphism, suggesting that the environment at the illuminated rock surfaces, akin to metamorphic conditions, might provide the energy needed for these reactions. Considering the strong solar irradiance characteristic of Mars and its abundance of Mg, Fe-rich rocks, it is plausible to expect the continued occurrence of chloritization on the Martian surface and even within Martian rock varnish. Our findings are significant for better understanding the formation and transformation of clay minerals on Martian surface and Martian rock varnish, and climate-controlled water-rock interactions on Mars.

POTENTIAL IMPLICATIONS OF THE 2011–2012 DROUGHT IN MEXICO ON OLDER ADULT HEALTH

Abstract Background Climate change will increase the frequency and intensity of extreme weather events such as heatwaves, wildfires, hurricanes, and droughts. Few studies have evaluated the health impacts of drought exposure in low- and middle-income countries, which are most vulnerable to effects of climate change. This study evaluates how level of exposure to a major drought that affected Mexico from 2011-2012 related with post-drought health in older adults. Methods We use the 2012 Mexican Health and Aging Study (n=8,954 respondents age 50+) linked with municipality-level data from the Drought Monitor of Mexico to identify droughts in MHAS respondents’ community of residence from October 2010 to October 2012. Health domains evaluated included stress/mental health, physical health, and cognitive health. Linear, logistic, and multinomial regressions are used to estimate associations between the longest streak of consecutive months that one’s community was in a drought and health, controlling for sociodemographic characteristics. Results Six months of additional community-level drought exposure related with worse mental health and stress (higher depressive symptoms [β=-0.04, p<0.001], poorer self-rated health [OR: 1.11, p<0.01], poorer self-rated finances [OR: 1.09, p<0.05]) worse cognitive health (lower Verbal Learning [β=-0.03, p<0.01] and Verbal Recall [β=-0.04, p<0.01]), and increased likelihood of decreasing weight more than 5 kg during the drought (OR: 1.07, p<0.05). Discussion Longer exposure to drought throughout the 2011-2012 drought was associated with worse health across multiple health domains. Future studies should seek to identify factors that may increase vulnerability or facilitate resilience in communities affected by drought.

Examining health equity in Nepal’s climate change and health policies through the lens of environmental justice: insights from a content analysis

ABSTRACT Background Climate change presents a multifaceted challenge with unequal health implications, particularly for vulnerable populations with limited adaptive capacity. Socioeconomic factors are intricately linked with environmental health outcomes and environmental factors significantly exacerbate existing health inequities. Health equity as a goal of environmental justice can address these issues. Objective To examine the integration of health equity within climate change and health policy documents in Nepal. Methods Using a qualitative content analysis approach based on Schlosberg’s framework of environmental justice, we analyzed the coverage of health equity considerations in climate and health policies, assessing aspects of distribution, recognition, and participation. Results Twenty-one national-level policies, strategies, and plans/guidelines on climate change and health were analyzed. Nepal’s policy documents lack clear definitions of health equity in relation to climate change, and related terms are used inconsistently. Health vulnerability is often addressed broadly rather than specifically. Health equity-related statements from environmental justice viewpoint vary across sectors. Many documents emphasize equitable distribution of resources and benefits, with participation in decision-making processes being the least discussed. Conclusions In Nepal, lack of shared understanding of health equity across sectors hinders coordinated policy efforts. There is an urgent need to expand climate change responses to consider specific health vulnerabilities. By positioning health equity as a key element of environmental justice, this study provides a broader perspective on climate change-related health equity that could encourage collaborative action between the environment and health sectors.

Cooling efficacy of trees across cities is determined by background climate, urban morphology, and tree trait

Urban planners and other stakeholders often view trees as the ultimate panacea for mitigating urban heat stress; however, their cooling efficacy varies globally and is influenced by three primary factors: tree traits, urban morphology, and climate conditions. This study analyzes 182 studies on the cooling effects of urban trees across 17 climates in 110 global cities or regions. Tree implementation reduces peak monthly temperatures to below 26 °C in 83% of the cities. Trees can lower pedestrian-level temperatures by up to 12 °C through large radiation blockage and transpiration. In tropical, temperate, and continental climates, a mixed-use of deciduous and evergreen trees in open urban morphology provides approximately 0.5 °C more cooling than a single species approach. In arid climates, evergreen species predominate and demonstrate more effective cooling within compact urban morphology. Our study offers context-specific greening guidelines for urban planners to harness tree cooling in the face of global warming.

The Influence of Arctic Oscillation on South China Precipitation in Winter Is Modulated by the Atlantic Multidecadal Oscillation

AbstractAs the dominant mode of low‐frequency atmospheric variability in extratropical Northern Hemisphere, the Arctic Oscillation (AO) exerts strong impacts on East Asian climate, with the positive AO leading to increased South China winter precipitation (SCWP). Here, we find that such AO–SCWP relationship is nonstationary and controlled by the remote Atlantic Multidecadal Oscillation (AMO). Especially, the relationship between positive AO and SCWP is significantly weakened during the warm phase of AMO. Observational analyses and idealized Atlantic pacemaker simulations indicate that warm AMO forcing is accompanied by a teleconnection wave train extending eastward from the North Atlantic to West Pacific and the western North Pacific sea surface temperature warming, which together induce northerly wind anomalies over South China by enhancing the land–ocean pressure gradient. Such climate background state changes associated with the warm AMO prohibit the positive AO induced water vapor transport to South China, thereby weakening the AO–SCWP relationship.

A Graduate Medical Education Fellowship in Climate Change and Human Health: Experience and Outcomes From the First 5 Years.

Background Climate change is affecting health and health care, but most physicians lack formal training on climate change. There is a need for graduate medical education (GME) programs that prepare physician leaders to address its health impacts. Objective To describe the development and iterative piloting of a GME fellowship in climate change and health and to assess fellows' academic output and public engagement before and after fellowship matriculation. Methods A GME training program was developed and implemented at an emergency medicine department in a US teaching hospital in collaboration with affiliated academic centers. Participants consisted of emergency physicians from the United States and abroad. Program duration and format were adjusted to meet individual career goals. Outcomes assessed include program completion, postgraduation professional roles, and academic outputs and public engagement before and after fellowship matriculation (2019-2023), compared via paired t tests. Results Five fellows have matriculated; 2 have graduated, while 3 remain in training. Costs and in-kind support include salaries, faculty time, research support, travel to conferences, and tuition for a public health degree. Fellows averaged 0.26 outputs per month before matriculation (95% CI 0.01-0.51) and 2.13 outputs per month following matriculation (95% CI 0.77-3.50); this difference was significant via 2-tailed t test (alpha=.05, P=.01). Subanalyses of academic output and public engagement reveal similar increases. Following matriculation, 186 of 191 (97.4%) of outputs were related to climate change. Conclusions For the 5 fellows that have enrolled in this GME climate change fellowship, academic and public engagement output rates increased following fellowship matriculation.

Impacts of land-use and land-cover changes on temperature-related mortality.

Land-use and land-cover change (LULCC) can substantially affect climate through biogeochemical and biogeophysical effects. Here, we examine the future temperature-mortality impact for two contrasting LULCC scenarios in a background climate of low greenhouse gas concentrations. The first LULCC scenario implies a globally sustainable land use and socioeconomic development (sustainability). In the second LULCC scenario, sustainability is implemented only in the Organisation for Economic Cooperation and Development countries (inequality). Using the Multi-Country Multi-City (MCC) dataset on mortality from 823 locations in 52 countries and territories, we estimated the temperature-mortality exposure-response functions (ERFs). The LULCC and noLULCC scenarios were implemented in three fully coupled Earth system models (ESMs): Community Earth System Model, Max Planck Institute Earth System Model, and European Consortium Earth System Model. Next, using temperature from the ESMs' simulations and the estimated location-specific ERFs, we assessed the temperature-related impact on mortality for the LULCC and noLULCC scenarios around the mid and end century. Under sustainability, the multimodel mean changes in excess mortality range from -1.1 to +0.6 percentage points by 2050-2059 across all locations and from -1.4 to +0.5 percentage points by 2090-2099. Under inequality, these vary from -0.7 to +0.9 percentage points by 2050-2059 and from -1.3 to +2 percentage points by 2090-2099. While an unequal socioeconomic development and unsustainable land use could increase the burden of heat-related mortality in most regions, globally sustainable land use has the potential to reduce it in some locations. However, the total (cold and heat) impact on mortality is very location specific and strongly depends on the underlying climate change scenario due to nonlinearity in the temperature-mortality relationship.

Climate Change Curricula in US Graduate Medical Education: A Scoping Review.

Background Climate change threatens humanity's health and well-being. While climate change topics have been increasingly incorporated into undergraduate medical education, it is unclear to what extent they have been incorporated into graduate medical education (GME) curricula in the United States. Objective To examine how climate change has been incorporated into GME curricula in the United States. Methods We conducted a scoping review of published literature from January 2013 through November 2023. PubMed and Scopus were searched, with articles assessed by 3 reviewers in a blinded fashion. Resources were included if they described how climate change is incorporated into GME curricula in the United States, and if they discussed topics such as disaster medicine, mass casualty events, environmental medicine, public health, health policy, wilderness medicine, quality improvement, and sustainability. Articles were analyzed using descriptive numerical analysis and qualitative assessment to identify article characteristics and themes. Results The inclusion criteria generated 17 articles that examined climate change incorporation into GME curricula and curriculum interventions covering topics used for inclusion. The most common type of article (5 of 17, 29%) employed surveys of program directors on the inclusion of climate-related topics. Conclusions Published accounts of climate-related topics in US GME program curricula are few. More content is found in topics related to emergency medicine. Curricula frameworks have been proposed for pediatric and internal medicine residency programs, but we know little about their efficacy. Future scholarship should fill these gaps to educate learners to improve health care sustainability and resiliency.

Teaching Climate and Health in Preventive Medicine Residency Programs: A Survey of Program Directors.

Background Climate change and related pollution and environmental damage are an urgent focus for public health physicians. Curricular content is increasing in medical schools, but to date, only pediatrics has published guidance for residency education. Objective To survey program directors of Accreditation Council for Graduate Medical Education preventive medicine specialties (public health and preventive medicine [PHPM], occupational and environmental medicine [OEM], and aerospace medicine [AM]) for current teaching on climate and health issues. Methods Links to an online 9-question confidential survey were sent to all program directors through Listservs January through March 2024. Questions were developed with guidance from a climate health expert. Responses were analyzed via summary statistics for continuous data, as well as Fisher's Exact, Kruskal-Wallis, and Wilcoxon pairwise comparison tests for nominal data. Results Thirty-five of 71 programs responded (49.3%), including 21 of 42 PHPM, 12 of 23 OEM, and 2 of 6 AM programs. Two (5.9%) reported having a formal curriculum for climate and health issues, and 2 (5.9%) reported not covering any included topics. Programs differed by topic emphasis with OEM and AM more likely to address fire, smoke, wind, and flooding effects. Lectures and local or state health department rotations were the most frequent teaching strategies. Of complete responders, 23 of 34 (67.6%) expressed interest in joining a workgroup to develop shared curricula. Conclusions This survey of preventive medicine residency programs found that most include climate and health topics, but only 2 have a formal curriculum, and 2 reported no topics included in the survey.

International Planetary Health Education in Undergraduate and Graduate Medical Curricula: A Scoping Review.

Background Climate change is a public health emergency, yet planetary health education is absent for many medical and health professions trainees. Objective To perform a scoping review exploring the inclusion of planetary health in undergraduate and graduate medical education. Methods A search strategy was developed with a health sciences librarian and run on 6 databases from their inception to February 2022: MEDLINE, Embase, APA PsycInfo, CINAHL, Global Health, and Scopus. The Arksey and O'Malley framework was employed to broadly select publications that described the implementation of planetary health in undergraduate and postgraduate medical education. Commentaries were included if they outlined a potential curriculum. Extracted data was grouped thematically using an iterative approach based on competencies described, key considerations, and anticipated barriers. Results After screening 2407 articles, 42 were included. Thirty articles involved medical education at undergraduate or postgraduate levels, while 10 discussed multidisciplinary education including veterinary medicine, public health, and nursing. Two articles discussed planetary heath education for staff physicians. Reported competencies included eco-medical literacy, environmental inequity, and planetary health advocacy. Key considerations for curricular development included longitudinal implementation, interprofessional collaboration, and experiential learning through quality improvement projects. Barriers to implementation included time constraints and the lack of knowledgeable educators and administrative support for curricular change. Conclusions This scoping review outlines key recommendations and barriers to help facilitate the implementation of planetary health education in medical training.

Influence of Soil Extractable Plant Nutrients on the Walnut Kernel Ionome in Southern Kyrgyzstan at Different Elevations

Abstract Background and Aims Climate change causes altered precipitation patterns and temperature increases, which may affect food quantity and quality. In Kyrgyzstan anticipated temperature changes are expected to influence the physiology of walnuts (Juglans regia L.) and soil properties relevant to plant nutrition, thereby impacting walnut fruit quality. This study explores the relationship between plant available nutrients in soil and walnut fruit nutrient content as affected by future temperature changes. Methods The soil samples were collected in the walnut forests of Southern Kyrgyzstan from top- and subsoils at three elevation levels (1000, 1300, and 1600 m above sea level). The walnut samples were collected from the same sampling sites and both soil Mehlich-3 extracts and acid digests of walnut fruits analyzed by ICP-OES. Results The results revealed no consistent relationship between Mehlich-3 extractable elements and walnut extractable elements, except for a weak negative correlation with zinc (Zn). Stronger relationships were observed among soil elements, but no clear associations with elevation levels were found. The walnut kernel ionome exhibited differences, particularly in calcium (Ca) and potassium (K) concentrations, with the low elevation site showing higher Ca and lower K concentrations compared to the high elevation site. Conclusions Differences in average temperature as caused by elevation did not affect available plant nutrients in the soil but altered the walnut kernel ionome and thus affected the walnut quality in the investigated forest systems. Future investigations should focus on climate change effects, such as altered precipitation patterns and drought, which may impact walnut fruit development and kernel properties.

Accelerating urban warming effects on the spring phenology in cold cities but decelerating in warm cities

Urban is regarded as the ideal natural laboratory for predicting vegetation growth response to future warming, as urban warming promotes the growth of urban vegetation and advances spring phenology. However, the effects of daytime and nighttime warming on the spring phenology of natural vegetation remain unclear under global warming. Here, we used urbanization intensity (UI) as a proxy for future warming, then investigated the start dates of the growing season (SOS) response to daytime and nighttime warming across different levels of UI. We found both nighttime and daytime temperature sensitivities increased significantly from rural to urban centers in cold cities, decreasing in warm cities. It indicated that the advancement in spring phenology of urban vegetation accelerates along with UI in cold cities but slows down in warm cities. Because in cold cities, urban warming and increased humidity accelerate vegetation growth, while in warm cities urban warming and decreased humidity decelerate growth. Therefore, in future we should consider not only the asymmetrical responses of urban vegetation spring phenology to daytime and nighttime warming, but also the disparate responses in different background climate regions under future warming.

Assessing CMIP Models’ Ability to Detect Observed Surface Warming Signals Related to Climate Change

Abstract Assessing if CMIP models can detect observed climate change signals is crucial for evaluating their realism and strengthening confidence in future projections. These signals can only be compared once distinguishable from the background climate “noise.” Built for impact studies but not detection purpose, the time of emergence (ToE) estimates when this occurs using a fixed signal-to-noise ratio. To more accurately assess models’ ability to reproduce observed climate change signals, we introduce the time of detection (ToD), which employs a statistical significance test of the nonlinear trend, accounting for the time series length. ToD and ToE are computed for sea surface temperature (SST) and relative SST (RSST) across four observational and 69 CMIP5/6 historical and shared socioeconomic pathways 5–8.5 (SSP5–8.5) scenario datasets. ToD precedes ToE and is less sensitive to the chosen threshold. While already detectable in most of the tropics, SST warming in the equatorial Pacific is detectable in ∼90% of models but only one out of four observational datasets, due to a stronger modeled warming. Because RSST signals are weaker than SST signals, they do not emerge anywhere but are detectable in two regions. The enhanced warming in the western Indian Ocean, detected in ∼45% of models, is not robust in observations when excluding pre-1960 dubious data. Conversely, the subdued southeast Pacific warming detected in observations and ∼80% of models is robust and consistent with a poleward extension of the Southern Hemisphere Hadley cell. The ToD’s ability to detect subtle signals allows for assessing the realism of the CMIP warming pattern in this region. Significance Statement Recent studies emphasize the importance of the climate change warming pattern and its apparent discrepancy between climate models and observations in the equatorial Pacific. We argue that our newly proposed time of detection (ToD) is better suited than the well-known time of emergence (ToE) for investigating where modeled and observed warming patterns can be confidently compared. In agreement with previous studies, our analysis indicates model–observations disagreement over the equatorial Pacific. Using ToD instead of ToE allows for detecting a robust subdued warming (i.e., weaker than the tropical average) in the southeast Pacific and therefore confirms the realism of the CMIP warming pattern in this region.

A scaling law for predicting urban trees canopy cooling efficiency

Urban heat mitigation is a pressing concern for cities. Intense urban heat poses a threat to human health and urban sustainability. Tree planting is one of the most widely employed nature-based heat mitigation methods worldwide. Therefore, city policy makers require knowledge of how much temperature will be reduced by increasing urban tree canopy (UTC). Cooling efficiency (CE), which was been proposed to quantify the magnitude of temperature reduction associated with a 1% increase in UTC, has been primarily investigated at smaller scales previously. However, such small-scale results cannot be used to develop policy at the whole-city scale. This study developed a method that reveals the scaling relations of CE so as to predict its effects at the city scale. CE was found to follow the form of a power law as spatial scale increased from the small analytical units through intermediate size units up to the extent of a whole city. The power law form appeared consistently across cities with different climate backgrounds during summer daylight hours. Furthermore, the power law form was robust within cities under different summer weather conditions. The power-law scaling approach can thus be used to predict CE at the whole-city scale, providing a useful tool for managers to set UTC goals to mitigate extreme urban heat.