Entire Record Research Articles

High incidence of varicocele among young men in Public Police Hospital Denpasar, Bali, Indonesia: a descriptive study

Background: Varicocele is a progressive disease which possibly starts from puberty. When left untreated, it could progress and causes complications such as infertility. Determination on the representative national incidence and characteristic of varicocele has been a hard challenge due to the lack of data on varicocele epidemiological studies, especially in Bali. This study aims to know the characteristic of varicocele patients undergoing varicocelectomy in Bhayangkara Denpasar Hospital from January 2017 to December 2018. Methods: This research is a descriptive retrospective study with cross sectional approach. The population of the study consists of patients who were diagnosed with varicocele and underwent varicocelectomy in Bhayangkara Denpasar Hospital from January 2017 to December 2018. Total sampling method was used. Research data were retrieved by taking the patient’s entire medical record with varicocele in Bhayangkara Denpasar Hospital from January 2017 to December 2018.Results: Ninty five samples were diagnosed with varicocele and underwent varicocelectomy. The highest percentage among age groups is 15 to 24 years (89.5%), with normal stature (94%), normal weight (86%), asymptomatic (90.5%), left unilateral varicocele (86.%), grade III varicocele (82,1%) and without comorbid (93.8%). The samples underwent varicocelectomy with Ivanissevich procedure (72.8%), operation time of ≤ 60 minutes (95.8%) and length of stay of ≤ 2 days (95.8%).Conclusion: The high incidence of varicocele in young adulthood is due to a majority of the samples being young police recruitment participants who were accidentally diagnosed during general medical check-up. Early screening on varicocele in the age group of 15 to 24 years is recommended to consider the need of sperm analysis examination and further deciding on the treatment options. One of the options is surgery.

PERBEDAAN RERATA FAKTOR HEMOSTASIS PADA PREEKLAMPSIA BERAT DAN EKLAMPSIA

Objective : To find the difference in mean hemostatic factors in severe preeclampsia and eclampsia. Method : The study was analytic descriptive using a cross sectional study design by looking at the subject's Medical Record according to the time and place of research. The sample is the entire medical record of pregnant women who suffer from preeclampsia and eclampsia in the obstetric and gynecology departments of Dr. M. Djamil Padang Hospital in the period 15 January 2016 to 31 December 2017. The assessment was in the form of assessed platelet levels, PT, APTT and D-Dimer. Samples were taken from populations that met the inclusion criteria and did not have exclusion criteria. Sampling using consecutive sampling techniques taken from the Medical Record Dr. M.Djamil Padang. Statistical analysis to assess significance using the T-Test. Result : The severity the condition of pregnancy the lower the platelet mean and PT. Significant differences were obtained between platelets in PEB and eclampsia (p> 0.05). The mean PT, APTT and D-Dimer showed no significant differences in pregnancy conditions. Statistical test with T-Test did not show significant differences in mean PT, APTT, and D-dimer between eclampsia and PEB (p> 0.05). Conclusion : There were significant differences in mean in platelets, whereas in PT, APTT, and D-dimers in PEB and eclampsia there were no significant differences. Keywords: Pregnancy, severe preeclampsia, eclampsia, platelets, PT, APTT, D-Dimer.

PERBEDAAN RERATA FAKTOR HEMOSTASIS PADA PREEKLAMPSIA BERAT DAN EKLAMPSIA

Objective : To find the difference in mean hemostatic factors in severe preeclampsia and eclampsia.Method : The study was analytic descriptive using a cross sectional study design by looking at the subject's Medical Record according to the time and place of research. The sample is the entire medical record of pregnant women who suffer from preeclampsia and eclampsia in the obstetric and gynecology departments of Dr. M. Djamil Padang Hospital in the period 15 January 2016 to 31 December 2017. The assessment was in the form of assessed platelet levels, PT, APTT and D-Dimer. Samples were taken from populations that met the inclusion criteria and did not have exclusion criteria. Sampling using consecutive sampling techniques taken from the Medical Record Dr. M.Djamil Padang. Statistical analysis to assess significance using the T-Test.Result : The severity the condition of pregnancy the lower the platelet mean and PT. Significant differences were obtained between platelets in PEB and eclampsia (p> 0.05). The mean PT, APTT and D-Dimer showed no significant differences in pregnancy conditions. Statistical test with T-Test did not show significant differences in mean PT, APTT, and D-dimer between eclampsia and PEB (p> 0.05).Conclusion : There were significant differences in mean in platelets, whereas in PT, APTT, and D-dimers in PEB and eclampsia there were no significant differences.Keywords: Pregnancy, severe preeclampsia, eclampsia, platelets, PT, APTT, D-Dimer.

Crustal evolution of peri-Gondwana crust into present day Europe: The Serbo-Macedonian and Rhodope massifs as a case study

The continental crust of Europe west of the Trans-European Suture Zone (TESZ), is mostly a collage of Peri-Gondwana Cadomian and Avalonian terranes that were formed on the late Neoproterozoic active margins of the supercontinent, rifted from it during consecutive opening of oceanic basins, and variably involved in Ordovician, Carboniferous (Variscan), and Cretaceous-Eocene (Alpine) orogenies. While in many localities it is possible to study isolated portions of the European geologic history, few sites can hold evidence for the entire record in a relatively small area. The Balkan terranes of the Serbo-Macedonian (SMM) and the Rhodope massifs, which contain Neoproterozoic Cadomian remnant basement, and were involved in multiple Phanerozoic phases of magmatism and metamorphism, provide an ideal locality in which we can study the entire crustal evolutionary history of Europe (west of the TESZ). Here we present new zircon U-Pb-Hf and rutile UPb data from basement rocks of the SMM and Rhodope as well as of beach placers from mouths of the large rivers draining the Balkan towards the Aegean Sea (Strymon, Nestos and Evros Rivers). Basement igneous rocks of the SMM and Circum-Rhodope were dated to the late Neoproterozoic (588 Ma), middle Ordovician (ca. 460 Ma), Carboniferous (300 Ma), Permo-Triassic (254 Ma), Paleocene (65 Ma) and Miocene (ca. 23 Ma), demonstrating the episodic nature of crustal evolution in this terrane assemblage. Hf-in zircon shows these intrusions evolve from negative εHf(t) values in the Ordovician towards positive values in the Paleocene. Zircons in beach placer samples also show distinct age peaks that follow the pulses of igneous activity in the source terranes, with the addition of Jurassic (ca. 150 Ma) zircons. The UPb system in rutiles from the beach placer samples was mostly reset, and records the final metamorphic phase during Alpine orogeny (35 Ma), with some rutiles preserving Eo-Alpine (80 Ma) ages. In contrast to the igneous samples, detrital zircons from the beach placer samples follow a trend bound by evolution lines leading to Hf-TDM model ages between 0.6 and 1.6 Ga. As a whole since the late Neoproterozoic the Balkan crust was the subject of repeated reworking in a series of magmatic/orogenic events. Some extent of juvenile igneous addition on this evolving Cadomian substrate brings about the shallow rise in εHf(t) values we observe in the igneous basement rocks. The end result observed in the Balkan is of a continental crust comprising a Neoproterozoic peri-Gondwana Cadomian core, reworked in multiple episodes of Phanerozoic orogenies, and augmented to some extent by variable mantle derived input. We argue that this mode of crustal origin and evolution is also applicable to many peri-Gondwana terranes of Western Europe.

ХАРАКТЕР ИЗМЕНЧИВОСТИ ТЕРМОХАЛИННОЙ СТРУКТУРЫ ВОД НАД КОНТИНЕНТАЛЬНЫМ СКЛОНОМ СЕВЕРО-ЗАПАДНОЙ ЧАСТИ ЯПОНСКОГО МОРЯ У ПОБЕРЕЖЬЯ ПРИМОРЬЯ

The study is based on unique data from the autonomous Aqualog profiler installed in the northwestern Japan Sea at the continental slope off the southeastern Primorye coast from April 18 through October 14, 2015. Data set for the 64–300 m depths, with the depth step of 1 m and time step of 6 hours, and the time series averaged for the 320–420 m depths, with the time step of 6 days, are used. Variability in the upper and lower profiled layers is found to be of different nature. Above 100–150 m short-lived (2–4 days) temperature and salinity anomalies are mostly of the same sign. Based on our earlier analysis of satellite information it is possible to link these anomalies with water intrusions of different origins. Conversely, these anomalies are usually of the opposite signs and are longer-lived (up to 10–15 days) in the lower layer which can be explained by vertical displacements of isopycnals, probably due to passing mesoscale and submesoscale disturbances. Based on wavelet transform it is found that the longest-period fluctuations (with the periods of 80–110 days) were the most intense in the entire profiled layer throughout the entire record. Isopycnal displacements with the periods of 80–110 days were also found, being in-phase with the temperature fluctuations. The wavelet transform also revealed that variability strengthened in the upper layer and weakened in the lower layer from mid-August onwards.

Completeness of informed consent in supporting national standard accreditation of patient and family rights 5 hospitals at Ropanasuri surgical special hospital in Padang

Background: Completeness of informed consent is one indicator in supporting the accreditation of national hospital standards through the assessment of patient and family rights (PFR) assessment standards 5. In the health service process, informed consent can also be used as evidence and has a strong legal value in the form of a sheet of paper containing the doctor’s explanation about the diagnosis of the disease and the actions that will be performed on the patient.Methods: This research uses descriptive method with a qualitative approach. The population used was the entire patient medical record file in 2018, which was 3.093 medical record files. Sampling was done by random sampling using a formula according to Notoatmodjo for the calculation of the number of samples and obtained 355 files of medical records. Data processing using Microsoft Excel computer programs. For observing the completeness of the standard rights of patients and families using national standards for hospital accreditation.Results: Based on the analysis of 355 medical record files at Ropanasuri specialty hospital it is known that 296 pieces of informed consent were filled in with a percentage of 83.38%, 59 sheets of informed consent were incomplete with a percentage of 16.62%. The results showed the greatest incompleteness found in filling the informed consent items of witness signatures of 2.81%, providing information on the completeness of filling the doctor's identity by 2.54% and the name of the witness 1.70% on filling the authentication.Conclusions: 296 pieces of informed consent were filled in with a percentage of 83.38%, 59 sheets of informed consent were incomplete with a percentage of 16.62%.

White oak and red maple tree ring analysis reveals enhanced productivity in urban forest patches

Many aspects of the urban environment have the potential to affect tree growth and physiology in forest patches, including higher temperatures, elevated CO2 concentrations, and modified soil biogeochemistry from increased nutrient and heavy metal inputs. However, these changes in tree growth are likely to vary by species and across urban areas, reflecting the local environmental conditions associated with the idiosyncratic trajectory of development in a city. Here, we examine growth rates of two dominant native tree species (white oak (Quercus alba L.) and red maple (Acer rubrum L.)) across urban and reference forest sites of three major cities in the eastern United States (New York, NY (NYC); Philadelphia, PA; and Baltimore, MD). We also characterized soil physical and chemical properties around each tree and monitored air temperature over three growing seasons at each site. Throughout the growing season, the urban sites had consistently warmer daytime and nighttime temperatures than reference sites. Urban forest patch soils also had elevated calcium, magnesium, and heavy metal concentrations compared to reference forest soils. Urban vs. reference tree growth rates varied by species, by city, and over time. Despite differences in the two native species’ ecophysiology, both grew more rapidly in the urban environment than at nearby reference sites, particularly in recent decades. Over the entire 145-year tree ring record analyzed, white oak basal area increment was significantly higher in urban trees compared to reference trees. Changes in the relative production of white oak earlywood and latewood between site types in each city and over time may relate to precipitation patterns. Perhaps due to their ability to persist in a wide variety of environmental conditions, mature trees of both species appear to be acclimating to urban forest patch conditions of the eastern U.S. and in some cases are experiencing enhanced growth rates compared to trees in nearby reference forests. An understanding of past and present growth rates of trees in urban forest patches can provide insight into future ecosystem functioning of these urban green spaces as well as that of more rural ecosystems experiencing environmental change factors similar to those associated with urbanization.

Human versus machine in medicine: can scientific literature answer the question?

Human versus machine in medicine: can scientific literature answer the question?

Largest Cretaceous lizard track assemblage, new morphotypes and longest trackways comprise diverse components of an exceptional Korean Konservat-Lagerst\xe4tten ichnofauna

A newly discovered assemblage of lizard tracks from the Lower Cretaceous Jinju Formation (Sindong Group, Gyeongsang Basin) Korea is the largest yet reported from the Cretaceous. It consists of at least 95 tracks comprising five trackways, including a meter-long trackway (T1) with 50 footprints assigned to the new ichnotaxon Neosauroides innovatus ichnosp. nov. Two other trackways (T2 and T3) are designated N. innovatus paratypes characterized by strong heteropody, relatively wide trackways and small narrow manus tracks. These morphological characteristics distinguish Neosauroides innovatus from the previously reported lizard trackways Sauripes hadongensis from the Hasandong Formation and Neosauroides koreaensis from the Haman Formation, both also from the Gyeongsang Basin. These three lizard track assemblages from the Korean Cretaceous constitute the entire global lizard track record for this period. The Mesozoic record of lizard tracksites is more localized than the lizard body fossil record. This limited distribution suggests bias in the track record and the fossil record more generally. However, due to deposition of fine-grained substrates, suitable for high definition track registration, the Jinju Formation is increasingly well known as an ichnological window on small tetrapod activity and based on diversity, abundance and high-quality preservation, is regarded as an exceptional Konservat-Lagerstätten.

Patient engagement or information overload: patient and physician views on sharing the medical record in the acute setting

Background: Patient and professional views about the impact of providing full real-time access to the medical record in the in-hospital setting are unknown.Methods: Likert-scale and free-text validated questionnaire survey of physicians and patients from acute medical units in two hospitals. The questionnaire explored recent experiences; views on the formation of trust, and views on sharing either the entire medical record or a summary.Results: Two-hundred and forty-eight patient questionnaires (62% response rate) and 32 physician questionnaires (21% response rate) were returned. Twenty-seven per cent of patients did not recall being told their diagnosis. Doctors and patients differed on what practices that they believed built trust.Eighty-one per cent of patients supported the idea of having access to the full medical record (for empowerment; the right to information about oneself; as an aide-memoire for discussion). Doctors feared it might provoke anxiety and change the nature of what was written. A written lay summary record was preferred by doctors and patients.Conclusions: The current system of providing information verbally to patients is inadequate. Patients want more information and are less concerned than physicians about potential negative effects of real-time access to their records. Patient access to medical records (in both full and summary forms) should be evaluated.

An Extractive Summarization Technique for Text Documents

In order to read as well as search information quickly, there was a need to reduce the size of the documents without any changes to its content. Therefore, in order to solve this problem, there was a solution to it by introducing a technique called as automatic text summarization which is used to generate summaries from the input document by condensing large sized input documents into smaller documents without losing its meaning as well as relevancy with respect to the original document. Text summarization stands for shortening of text into accurate, meaningful sentences. The paper shows an implementation of summarization of the original document by scoring the sentence based on term frequency and inverse document frequency matrix. The entire record was compressed so that only the relevant sentences in the document were retained. This technique can be applicable in various applications like automating text documents, quicker understanding of documents because of summarization.

Stochastic thermodynamics with arbitrary interventions.

We extend the theory of stochastic thermodynamics in three directions: (i) instead of a continuously monitored system we consider measurements only at an arbitrary set of discrete times, (ii) we allow for imperfect measurements and incomplete information in the description, and (iii) we treat arbitrary manipulations (e.g., feedback control operations) which are allowed to depend on the entire measurement record. For this purpose we define for a driven system in contact with a single heat bath the four key thermodynamic quantities-internal energy, heat, work, and entropy-along a single "trajectory" for a causal model. The first law at the trajectory level and the second law on average is verified. We highlight the special case of Bayesian or "bare" measurements (incomplete information, but no average disturbance) which allows us to compare our theory with the literature and to derive a general inequality for the estimated free energy difference in Jarzynski-type experiments. An analysis of a recent Maxwell demon experiment using real-time feedback control is also given. As a mathematical tool, we prove a classical version of Stinespring's dilation theorem, which might be of independent interest.

The fossil record of Ceratophrys Wied-Neuwied (Anura: Ceratophryidae): a revision and update of fossil South American horned frogs.

Ceratophrys is the most diverse and widely distributed genus of Ceratophryidae, the clade of South American horned frogs. Numerous anuran fossil remains, including several fossil species, have been assigned to this genus. However, this seemingly extensive fossil record is problematic because several of the fossils are not properly identified and most of the taxonomic assignations are not justified. The present study traces all the fossil material attributed to Ceratophrys, clarifying, when possible, institutional allocations. Each of the remains was examined and its taxonomic assignation revisited, based on the morphology and possible synapomorphies of the genus, including its living species. Numerous fossils were properly identified and assigned with certainty to Ceratophrys. Only one fossil species, Ceratophrys ameghinorum, is considered valid. This information, along with recently reported evidence of fossil Ceratophrys, is briefly summarized to serve as a practical reference for the entire known fossil record of the genus. The fossil record is not especially informative about the evolution or distribution pattern of Ceratophrys, because most of the remains are relatively young (post-Miocene), collected within the present distribution of the genus, and morphologically consistent with that of the extant species. However, some useful information has emerged. The presence of Ceratophrys is well documented since the Neogene in the Pampean Region of South America. The single valid fossil species, Ceratophrys ameghinorum, possesses a unique combination of characters that reflects a mixture of characters observed in different clades of the genus; thus, resolution of its phylogentic position will inform our understanding of the evolution of the genus. The paleoenvironmental significance of some Ceratophrys fossils is also discussed, addressing the wide, but incompletely known current distribution and environmental tolerance of the genus.

Comparing the sandpile model with targeted triggering and the Olami-Feder-Christensen model as models of seismicity using recurrence network analysis

Slowly driven sandpile models has found applications in modelling earthquakes due to the observed power law statistics in its magnitude distributions, like the behaviour of earthquakes. Adding a probability to target the most susceptible site in the grid, the sandpile model recovers even the spatio-temporal statistics of earthquake events. In this work, we compare the sandpile model with targeted triggering to the Olami-Feder-Christensen (OFC) model: a standard earthquake model that also exhibits self-organized criticality. The sandpile model captures the magnitude distributions of earthquake events at a value of targeted triggering probability p = [0.004,0.007]. The triggering probability value p = 1.0, showing that the most susceptible site is always triggered, follows the magnitude distribution of the OFC model. A comparison was done by constructing a record-breaking recurrence network for the events. Spatial and magnitude criteria set the temporally directed links between events across the entire record. Both the models recover power-law exponents comparable to those previously obtained for earthquake data, which is 1.0 for recurrence distance and recurrence time distributions, and 2.1 for the in-degree distributions for the farthest recurrence criteria. The sandpile model with targeted triggering exhibits a behaviour in between a slowly driven sandpile and the OFC model.

Weathering: Earth's Inexorable Millstone

Mere centuries from now, almost every physical object you've bought or wrought will have disappeared from the face of the Earth. Nature's forces will conspire to erase your archeological record. Unless you live in a stone manor, the foundations of your home will gradually crumble due to carbonic acid seeping into hairline cracks. Soil will migrate and turn over, shifting and consuming whatever objets d'art now grace your yard. Oxidation and sunlight will yellow and crack exposed plastic and paper. And everywhere, always, a teeming horde of plant roots, invertebrates, moles, and their microbial friends and relations will disaggregate and eat whatever they can. In the blink of a geological eye, almost your entire archaeological record will very likely be buried, broken down, and swept away.

The International Comprehensive Ocean-Atmosphere Data Set – Meeting Users Needs and Future Priorities

The International Comprehensive Ocean-Atmosphere Data Set (ICOADS) is a collection and archive of in situ marine observations, which has been developed over several decades as an international project and recently guided by formal international partnerships and the ICOADS Steering Committee. ICOADS contains observations from many different observing systems encompassing the evolution of measurement technology since the 18th century. ICOADS provides an integrated source of observations for a range of applications, is widely used for the development of research and climate monitoring, and forms the main marine in situ surface data source, e.g. near-surface ocean observations and lower atmospheric marine-meteorological observations from buoys, ships, coastal stations, and oceanographic sensors, for oceanic and atmospheric research and reanalysis. ICOADS has developed ways to incorporate user and reanalyses feedback information associated with permanent unique identifiers, and is also the main repository for data that have been rescued from ships’ logbooks and other marine data digitisation activities. ICOADS has been adopted widely because it provides convenient access to a range of observation types, globally, and through the entire marine instrumental record. ICOADS has for decades provided a secure home for such observations. Because of the increased volume of observations, particularly those available in near-real-time, and an expansion of their diversity, the ICOADS processing system now requires extensive modernisation. Based on user feedback, we will outline the improvements that are required, the challenges to their implementation, and the benefits of upgrading this important and diverse marine archive and distribution activity.

Multi-sensor detection of forest-cover change across 45 years in Mato Grosso, Brazil

The ongoing march toward freely available, highly pre-processed satellite imagery has given both researchers and the public unprecedented access to a vast and varied data stream teeming with potential. Among many sources, the multi-decade Landsat archive is certainly the best known, but legacy and current data from other sensors is available as well through the USGS data portals: these include CBERS, ASTER, and more. Though the particular band combinations or non-global missions have made their integration into analyses more challenging, these data, in conjunction with the entire Landsat record, are available to contribute to multi-decade surveys of land-cover change.With the goal of tracing forest change through time near the Roosevelt River in the state of Mato Grosso, Brazil, we used BULC and Google Earth Engine to fuse information from 13 space-borne imagers capturing 140 images spanning 45 years. With high accuracy, the resulting time series of classifications shows the timing and location of land-use/land-cover change—both deforestation and regrowth—at sub-annual time scales. Accuracy estimates showed that the synthesized BULC classification time series was better than nearly all of the single-day image classifications, covering the entire study area at sub-annual frequency while reducing the impact of clouds and most unwanted noise as it fused information derived from a wide array of imaging platforms. The time series improved and gradually sharpened as the density of observations increased in recent decades, when there were three or more clear, higher-resolution views of a pixel annually from any sensor combination. In addition to detailing the methodology and results of multi-source data fusion with the BULC approach, this study raises timely points about integrating information from early satellite data sources and from sensors with footprints smaller than Landsat's. There are decades of research deriving sensor-specific techniques for classifying land use and land cover from a single image in a variety of settings. The BULC approach leverages the many successes of single-sensor research and can be used as a straightforward, complementary tool for blending many good-quality mapped classifications from disparate sources into a coherent, high-quality time series.

User behaviour pattern for online learning system: UiTM iLearn portal case

<span>A Web server log files contain an entire record of the user’s browsing history such as referrer, date and time access, path, operating system (OS), browser and IP address. User navigation pattern discovery involves learning of user’s browsing behaviour to gain the pattern from web server log file. This paper emphasizes on identifying user navigation pattern from web server log file data of iLearn portal. The study implements the framework for user navigation including phases of acquisition of weblog, log query parser, preprocessor, navigational pattern modelling, clustering, and classification. This study is conducted in the context of the actual data logs of the iLearn portal of Universiti Teknologi MARA (UiTM). This study revealed the navigational patterns of online learners which relatively related to their intake or group along the semester of 14 weeks. Besides, access patterns for students along the semester are different and can be classified into three (3) quarter, namely Q1, Q2 and Q3 based on the total of week per semester. Future work will focus on the development of prototype to improve the security of online learning especially during the assessment progress such as online quiz, test and examination.</span>

Long-term changes of water quality in aquaculture-dominated lakes as revealed by sediment geochemical records in Lake Taibai (Eastern China)

The rapid development and exploitation of the Yangtze River basin in order to ensure human food security and increase living space in recent decades has resulted in significant potential for degradation of water quality in the river and in hundreds of lakes. Understanding how lake environments have evolved to their present state under a variety of external influences is crucial for evaluating their current status and anticipating future scenarios of environmental changes. However, the lakes along the middle reaches of the Yangtze River (MRY) are as yet little studied. Here, we described the long-term anthropogenic environmental transformations of a small lake (Lake Taibai) in the MRY area, based on a detailed quantitative geochemical analysis of the aliphatic hydrocarbons, nutrients (N and P), biogenic silica (BSi), and major and trace elements present in a dated sediment core retrieved from the lake. Our data revealed that levels of short-chain n-alkanes, αβ-hopanes and the trace elements arsenic (As) and cadmium (Cd) were all low for the entire record in sediments prior to ca. 1970, reflecting unpolluted natural state of the lake. Pronounced anthropogenic effects began to appear in sediments deposited in the subsequent years ca. 1970–1990, during which the levels of all these components were elevated, most likely driven by input of nitrogen (N) and phosphorus (P) containing chemical fertilizers, pesticides and diesel oil respectively. Since ca. 1990, changes of short-chain n-alkane levels in the sediment suggested the lake had undergone dramatic eutrophication in which existing anthropogenic stressors were exacerbated by technological advances that extended the use of chemical fertilizer into aquaculture. This pattern contrasted with an otherwise comparable lake in the lower Yangtze River basin, Lake Changdang, in which trace element and petroleum pollution were much more prominent due to dramatic urbanization and industrialization of the catchment.

The impact of heat waves on mortality in Northwest India

Heat waves are anticipated to worsen with climate change. India, an understudied area with >15% of the world’s population, commonly experiences temperature extremes and already resembles potential future climates of more temperate regions. Registry data from local municipal corporations and government offices were collected and translated, yielding daily all-cause mortality for 4 communities in Northwest India for all or part of the period 2000–2012. Heat waves were defined as ≥2 days with local temperature ≥97th percentile for that community. An alternate definition matching that used by the Indian Meteorological Department was also developed, to enhance policy relevance. Community-specific average daily maximum temperature over the entire record ranged from 32.5 to 34.2 °C (90.5–93.6 °F). Across communities, total mortality increased 18.1% during heat wave days compared with non-heat-wave days [95% confidence interval (CI): −5.3%, 47.3%], with the highest risk in Jaipur (29.9% [95% CI: 24.6%, 34.9%]). Evidence of effect modification by heat wave characteristics (intensity, duration, and timing in season) was limited. Findings indicate health risks associated with heat waves in communities with high baseline temperatures. Results can inform heat wave-health assessments in temperate regions in future, and improve our understanding of temperature-health associations under climate change. Further investigation of potential effect modification by heat wave characteristics is needed.