Seasonal Mortality Research Articles

P2653Seasonal variations of myocardial infarction and sex-specific differences in Germany

Abstract Background Ischemic heart disease (IHD) is the most common cause of death with an increasing frequency worldwide. It accounts for approximately 20% of all deaths in Europe and the United States of America. Approximately 1/3 of the IHD patients present with sudden cardiac death. The acute presentation of IHD myocardial infarction (MI) is a life-threatening, serious health problem, which causes substantially morbidity and mortality. It is well established that the onset of MI follows a circadian and seasonal periodicity. Seasonal variation regarding the incidence and the short-term mortality of acute MI was frequently reported, but data about sex-specific differences are sparse. Purpose Thus, our objectives were to investigate seasonal variations of myocardial infarction. Methods We analyzed the impact of seasons on incidence and in-hospital mortality of patients with acute MI in Germany from 2005 to 2015. We included all MI patients (ICD code I21) with an acute MI (, but not those MI patients with a recurrent event in the first 28 days after a previous MI (ICD code I22)), who were hospitalized in Germany between 2005 and 2015, in this analysis (source: RDC of the Federal Statistical Office and the Statistical Offices of the federal states, DRG Statistics 2005–2015, own calculations). Results The nationwide sample comprised 3,008,188 hospitalizations of patients with MI (2005–2015). The annual incidence was 334.7 per 100.000 population. Incidence inclined from 316.3 to 341.6 per 100.000 population per year (β 0.17 [0.10 to 0.24], P<0.001), while in-hospital mortality rate decreased from 14.1% to 11.3% (β −0.29 [−0.30 to −0.28, P<0.001). Overall, 377,028 (12.5%) patients died in-hospital. Seasonal variation of both incidence and in-hospital mortality were of substantial magnitude. Seasonal incidence (86.1 vs. 79.0 per 100.000 population per year, P<0.001) and in-hospital mortality (13.2% vs. 12.1%, P<0.001) were higher in the winter than in the summer saeson. Risk to die in winter was elevated (OR 1.080 (95% CI 1.069–1.091), P<0.001) compared to summer season independently of sex, age and comorbidities. Reperfusion treatment with drug eluting stents and coronary artery bypass graft were more often used in summer. We observed sex-specific differences regarding the seasonal variation of in-hospital mortality: males showed lowest mortality in summer, while females during fall. Low temperature dependency of mortality seems more pronounced in males. Conclusions Incidence of acute MI increased 2005–2015, while in-hospital mortality rate decreased. Seasonal variations of incidence and in-hospital mortality were of substantial magnitude with lowest incidence and lowest mortality in the summer season. Additionally, we observed sex-specific differences regarding the seasonal variation of the in-hospital mortality. Acknowledgement/Funding This study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503)

Potential benefits of cool roofs in reducing heat-related mortality during heatwaves in a European city

Abstract Hot weather can exacerbate health conditions such as cardiovascular and respiratory diseases, and lead to heat stroke and death. In built up areas, temperatures are commonly observed to be higher than those in surrounding rural areas, due to the Urban Heat Island (UHI) effect. Climate change and increasing urbanisation mean that future populations are likely to be at increased risk of overheating in cities, although building and city scale interventions have the potential to reduce this risk. We use a regional weather model to assess the potential effect of one type of urban intervention – reflective ‘cool’ roofs – to reduce local ambient temperatures, and the subsequent impact on heat-related mortality in the West Midlands, UK, with analysis undertaken for the summer of 2006, as well as two shorter heatwave periods in 2006 and 2003. We show that over a summer season, the population-weighted UHI intensity (the difference between simulated urban and rural temperature) was 1.1 °C on average, but 1.8 °C when including only night times, and reached a maximum of 9 °C in the West Midlands. Our results suggest that the UHI contributes up to 40% of heat related mortality over the summer period and that cool roofs implemented across the whole city could potentially offset 18% of seasonal heat-related mortality associated with the UHI (corresponding to 7% of total heat-related mortality). For heatwave periods, our modelling suggests that cool roofs could reduce city centre daytime 2 m air temperature by 0.5 °C on average, and up to a maximum of ~3 °C. Cool roofs reduced average UHI intensity by ~23%, and reduced heat related mortality associated with the UHI by ~25% during a heatwave. Cool roofs were most effective at reducing peak temperatures during the daytime, and therefore have the potential to limit dangerous extreme temperatures during heatwaves. Temperature reductions were dependent on the category of buildings where cool roofs were applied; targeting only commercial and industrial type buildings contributed more than half of the reduction for heatwave periods. Our modelling suggested that modifying half of all industrial/commercial urban buildings could have the same impact as modifying all high-intensity residential buildings in the West Midlands.

Patterns of seasonal and pandemic influenza-associated health care and mortality in Ontario, Canada

BackgroundMathematical and statistical models are used to project the future time course of infectious disease epidemics and the expected future burden on health care systems and economies. Influenza is a particularly important disease in this context because it causes annual epidemics and occasional pandemics. In order to forecast health care utilization during epidemics—and the effects of hospitalizations and deaths on the contact network and, in turn, on transmission dynamics—modellers must make assumptions about the lengths of time between infection, visiting a physician, being admitted to hospital, leaving hospital, and death. More reliable forecasts could be be made if the distributions of times between these types of events (“delay distributions”) were known.MethodsWe estimated delay distributions in the province of Ontario, Canada, between 2006 and 2010. To do so, we used encrypted health insurance numbers to link 1.34 billion health care billing records to 4.27 million hospital inpatient stays. Because the four year period we studied included three typical influenza seasons and the 2009 influenza pandemic, we were able to compare the delay distributions in non-pandemic and pandemic settings. We also estimated conditional probabilities such as the probability of hospitalization within the year if diagnosed with influenza.ResultsIn non-pandemic [pandemic] years, delay distribution medians (inter-quartile ranges) were: Service to Admission 6.3 days (0.1–17.6 days) [2.4 days (-0.3–13.6 days)], Admission to Discharge 3 days (1.4–5.9 days) [2.6 days (1.2–5.1 days)], Admission to Death 5.3 days (2.1–11 days) [6 days (2.6–13.1 days)]. (Service date is defined as the date, within the year, of the first health care billing that included a diagnostic code for influenza-like-illness.) Among individuals diagnosed with either pneumonia or influenza in a given year, 19% [16%] were hospitalized within the year and 3% [2%] died in hospital. Among all individuals who were hospitalized, 10% [12%] were diagnosed with pneumonia or influenza during the year and 5% [5%] died in hospital.ConclusionOur empirical delay distributions and conditional probabilities should help facilitate more accurate forecasts in the future, including improved predictions of hospital bed demands during influenza outbreaks, and the expected effects of hospitalizations on epidemic dynamics.

Usutu virus infection in Dutch blood donors.

The screening of Dutch blood donations for West Nile virus (WNV) may be imminent, as WNV emerges in nearby countries and more donors travel to WNV-affected regions. Since 2016 the related, mosquito-borne Usutu virus (USUV) causes seasonal mortality in Dutch birds. To what extent will human USUV infections affect Dutch WNV donor screening? From April through September 2018, plasma samples from blood donations in blackbird-rich regions were stored. When increased bird mortality was reported in August, samples from July, August, and September were tested for USUV-RNA in pools of eight, using a home-brew combined WNV/USUV-PCR assay. Reactive pools were deconstructed. Original plasma units and samples of previous and follow-up donations of reactive donors were tested for USUV- and WNV-RNA, and for antibody responses. The number of USUV RNA-positive, WNV RNA-negative donations was 0 of 2688 donations in July, 6 of 4416 in August (1:736), and 1 of 4936 in September. The seven infected donors tested negative for USUV-RNA in preceding and follow-up donations. For 6 donors, seroconversion for USUV-antibodies was demonstrated. All index donations tested positive in a commonly used PCR-assay for WNV donor screening. Three exposed recipients did not show signs of infection. Screening a random subset of 1092 donations from September for USUV-IgG antibodies showed that 22 donors tested reactive; for three donors retrospective testing identified an USUV PCR-positive pre-seroconversion donation. Seasonal USUV infection in Dutch blood donors is common. Cross-reactivity in molecular assays for WNV-screening occurs, but can be resolved using USUV- and WNV-specific PCR-primers and sequencing of viral RNA.

Influenza vaccination in the elderly: 25 years follow-up of a randomized controlled trial. No impact on long-term mortality.

Influenza vaccination is proven effective in preventing influenza. However, long-term effects on mortality have never been supported by direct evidence. In this study we assessed the long-term outcome of influenza vaccination on mortality in the elderly by conducting a 25-year follow-up study of a RCT on the efficacy of influenza vaccination as baseline. The RCT had been conducted in the Netherlands 5 years before vaccination was recommended for those aged >65 and 17 years before recommending it for those aged >60. The RCT included 1838 community-dwelling elderly aged ≥ 60 that had received an intramuscular injection with the inactivated quadrivalent influenza vaccine (n = 927) or placebo (n = 911) during the 1991/1992 winter. In our follow-up study, outcomes included all-cause mortality, influenza-related mortality and seasonal mortality. Unadjusted and adjusted hazard ratios (HRs) were estimated by Cox regression and sub-hazard ratios (SHRs) by competing risk models. Secondary analyses included subgroup analyses by age and disease status. The vital status up to January 1, 2017 was provided in 1800/1838 (98%) of the cases. Single influenza vaccination did not reduce all-cause mortality when compared to placebo (adjusted HR 0.95, 95% CI 0.85−1.05). Also, no differences between vaccination and placebo group were shown for underlying causes of death or seasonal mortality. In those aged 60–64, median survival increased with 20.1 months (95% CI 2.4–37.9), although no effects on all-cause mortality (adjusted HR 0.86, 95% CI 0.72−1.03) could be demonstrated in survival analysis. In conclusion, this study did not demonstrate a statistically significant effect following single influenza vaccination on long-term mortality in community-dwelling elderly in general. We propose researchers designing future studies on influenza vaccination in the elderly to fit these studies for longer-term follow-up, and suggest age-group comparisons in observational research.Clinical trial registry number: NTR6179.

Vitamin D status and its association with season and hospital mortality in septic shock patients

Vitamin D status and its association with season and hospital mortality in septic shock patients

Seasonal variation of mortality, detectability, and body condition in a population of the adder (Vipera berus).

We analyzed seasonal variation in mortality rates in adult males and females of the European adder (Vipera berus), using data collected during a 13‐year capture–recapture study (2005–2017) in a large population. We concurrently obtained quantitative information on the seasonal variation in the detectability and body condition of adders. Our results show strong seasonality in body condition, encounter, and capture rates of adult adders, and these patterns differ markedly between sexes and between breeding and nonbreeding females. Seasonal variation in mortality rates was however virtually nonexistent in males and moderately low in both breeding and nonbreeding females. In addition, we found no evidence for among‐year differences in the seasonal mortality schedules of males and females. During periods of intensive basking, both males and pregnant females are highly visible for humans, but are not subject to strong natural mortality. This low susceptibility to predation is presumably induced by various factors, including the limitation of overt exposure to short periods of time and specific microhabitats, the dorsal coloration pattern that provides cryptic protection and possibly also an aposematic warning signal, and presumed seasonal differences in the foraging behavior and food requirements of natural predators. Our data provide some evidence that female adders, but not males, are relatively vulnerable to predation during the seasonal migrations between the hibernation and feeding habitats. Mortality in the females was not much elevated during their breeding years, but was notably highest in the spring of the ensuing nonbreeding year. After giving birth, reproductive females are extremely emaciated and have a weakened general condition. They then run the risk of dying from starvation either before, during, or after hibernation. The higher mortality after giving birth, that is sustained over a period of ca. 9 months, should be considered as an indirect and delayed survival cost of reproduction.

Potential benefits of cool roofs in reducing heat-related mortality during heatwaves in a European city

Hot weather can exacerbate health conditions such as cardiovascular and respiratory diseases, and lead to heat stroke and death. In built up areas, temperatures are commonly observed to be higher than those in surrounding rural areas, due to the Urban Heat Island (UHI) effect. Climate change and increasing urbanisation mean that future populations are likely to be at increased risk of overheating in cities, although building and city scale interventions have the potential to reduce this risk.We use a regional weather model to assess the potential effect of one type of urban intervention – reflective ‘cool’ roofs – to reduce local ambient temperatures, and the subsequent impact on heat-related mortality in the West Midlands, UK, with analysis undertaken for the summer of 2006, as well as two shorter heatwave periods in 2006 and 2003.We show that over a summer season, the population-weighted UHI intensity (the difference between simulated urban and rural temperature) was 1.1 °C on average, but 1.8 °C when including only night times, and reached a maximum of 9 °C in the West Midlands. Our results suggest that the UHI contributes up to 40% of heat related mortality over the summer period and that cool roofs implemented across the whole city could potentially offset 18% of seasonal heat-related mortality associated with the UHI (corresponding to 7% of total heat-related mortality).For heatwave periods, our modelling suggests that cool roofs could reduce city centre daytime 2 m air temperature by 0.5 °C on average, and up to a maximum of ~3 °C. Cool roofs reduced average UHI intensity by ~23%, and reduced heat related mortality associated with the UHI by ~25% during a heatwave. Cool roofs were most effective at reducing peak temperatures during the daytime, and therefore have the potential to limit dangerous extreme temperatures during heatwaves. Temperature reductions were dependent on the category of buildings where cool roofs were applied; targeting only commercial and industrial type buildings contributed more than half of the reduction for heatwave periods. Our modelling suggested that modifying half of all industrial/commercial urban buildings could have the same impact as modifying all high-intensity residential buildings in the West Midlands.

Quantifying risk of whale–vessel collisions across space, time, and management policies

AbstractTransportation industries can negatively impact wildlife populations, including through increased risk of mortality. To mitigate this risk successfully, managers and conservationists must estimate risk across space, time, and alternative management policies. Evaluating this risk at fine spatial and temporal scales can be challenging, especially in systems where wildlife–vehicle collisions are rare or imperfectly detected. The sizes and behaviors of wildlife and vehicles influence collision risk, as well as how much they co‐occur in space and time. We applied a modeling framework based on encounter theory to quantify the risk of lethal collisions between endangered North Atlantic right whales and vessels. Using Automatic Identification System vessel traffic data and spatially explicit estimates of right whale abundance that account for imperfect detection, we modeled risk at fine spatiotemporal scales before and after implementation of a vessel speed rule in the southeastern United States. The expected seasonal mortality rates of right whales decreased by 22% on average after the speed rule was implemented, indicating that the rule is effective at reducing lethal collisions. The rule's effect on risk was greatest where right whales were abundant and vessel traffic was heavy, and its effect varied considerably across time and space. Our framework is spatiotemporally flexible, process‐oriented, computationally efficient and accounts for uncertainty, making it an ideal approach for evaluating many wildlife management policies, including those regarding collisions between wildlife and vehicles and cases in which wildlife may encounter other dangerous features such as wind farms, seismic surveys, or fishing gear.

Excess winter mortality and morbidity before, during, and after the Great Recession: the Portuguese case.

Although winter mortality and morbidity are phenomena common to most European countries, their magnitude varies significantly from country to country. The geographical disparities among regions with similar climates are the result of several social, economic, demographic, and biological conditions that influence an individual's vulnerability to winter conditions. The impact of poor socioeconomic conditions may be of such magnitude that an economic recession may aggravate the seasonal mortality pattern. This paper aims to measure the seasonal winter mortality, morbidity, and their related costs during the Great Recession (2009-2012) in mainland Portugal and its Regional Health Administrations (RHAs) and to compare it with the periods preceding and following it. Monthly mortality and morbidity data were collected and clustered into three periods: Great Recession (2009-2012), Pre-Recession (2005-2008), and Post-Recession (2013-2016). The impact of seasonal winter mortality and morbidity during the Great Recession in Portugal and its Regional Health Administrations was measured through the assessment of age-standardized excess winter (EW) death and hospital admissions rate and index, expected life expectancy gains without EW deaths, EW rate of potential years of life lost, and EW rate of emergency hospital admission costs. Important increases of winter deaths and hospital admissions were identified, resulting in an important number of potential years of life lost (87years of life lost per 100,000 inhabitants in 2009-2012), life expectancy loss (1year in 2009-2012), and National Health Service costs with explicit temporal and spatial variations. These human and economic costs have decreased consistently during the analyzed periods, while no significant increase was found during the Great Recession. Despite its reduction, the winter excess morbidity and mortality highlight that Portugal still faces substantial challenges related to a highly vulnerable population, calling for investments in better social and health protection.

Mechanisms of Bacterial Superinfection Post-influenza: A Role for Unconventional T Cells.

Despite the widespread application of vaccination programs and antiviral drug treatments, influenza viruses are still among the most harmful human pathogens. Indeed, influenza results in significant seasonal and pandemic morbidity and mortality. Furthermore, severe bacterial infections can occur in the aftermath of influenza virus infection, and contribute substantially to the excess morbidity and mortality associated with influenza. Here, we review the main features of influenza viruses and current knowledge about the mechanical and immune mechanisms that underlie post-influenza secondary bacterial infections. We present the emerging literature describing the role of “innate-like” unconventional T cells in post-influenza bacterial superinfection. Unconventional T cell populations span the border between the innate and adaptive arms of the immune system, and are prevalent in mucosal tissues (including the airways). They mainly comprise Natural Killer T cells, mucosal-associated invariant T cells and γδ T cells. We provide an overview of the principal functions that these cells play in pulmonary barrier functions and immunity, highlighting their unique ability to sense environmental factors and promote protection against respiratory bacterial infections. We focus on two major opportunistic pathogens involved in superinfections, namely Streptococcus pneumoniae and Staphylococcus aureus. We discuss mechanisms through which influenza viruses alter the antibacterial activity of unconventional T cells. Lastly, we discuss recent fundamental advances and possible therapeutic approaches in which unconventional T cells would be targeted to prevent post-influenza bacterial superinfections.

Greater sage‐grouse response to bentonite mining

ABSTRACTThe greater sage‐grouse (Centrocercus urophasianus; sage‐grouse) has undergone range contraction and population decline because of anthropogenic land surface disturbances; yet, there is little information on the effects of mining on sage‐grouse populations. In the Bighorn Basin of Montana and Wyoming, USA, bentonite mining is a growing source of surface disturbance that contributes to loss of sagebrush (Artemisia spp.) habitat. We evaluated the response of sage‐grouse to active and reclaimed bentonite mining, relative to nesting, brood‐rearing, adult breeding, and adult winter habitat, through resource selection and habitat‐specific mortality risk analyses, based on female sage‐grouse (n = 321) monitored with telemetry from 2011–2015. A greater proportion of our monitored sample was exposed to mining disturbance during winter (65%) than during other seasons (range = 25%–34%). We observed avoidance of all mining disturbance for selection of nesting habitat (n = 378 nests), adult breeding habitat (n = 1,978 locations), and adult winter habitat (n = 1,365 locations). Evidence was inconclusive for avoidance of mining for brood‐rearing habitat (n = 754 locations). We also observed increased adult breeding season mortality risk (n = 62 mortality events; n = 285 female sage‐grouse) associated with active mining disturbance but observed no effect on nest success (n = 207 mortality events; n = 378 nests). Evidence was inconclusive for increased mortality risk associated with broods (n = 48 mortality events; n = 157 broods) and adults during winter (n = 31 mortality events; n = 220 female sage‐grouse). Stakeholders in the Bighorn Basin should be flexible and proactive to minimize the negative effects of bentonite mining on sage‐grouse habitat use and demographic rates. Stakeholders should prioritize the conservation of winter habitats because of the influence on a greater proportion of the population and because of the lower regulatory priority given to winter habitat and they should strive to perfect mining reclamation to return disturbed sites back to pre‐disturbance conditions to minimize long‐term effects of the mines on sage‐grouse. © 2019 The Wildlife Society.

Excess Deaths Attributable to Influenza-Like Illness in the ESRD Population

Morbidity and mortality vary seasonally. Timing and severity of influenza seasons contribute to those patterns, especially among vulnerable populations such as patients with ESRD. However, the extent to which influenza-like illness (ILI), a syndrome comprising a range of potentially serious respiratory tract infections, contributes to mortality in patients with ESRD has not been quantified. We used data from the Centers for Disease Control and Prevention (CDC) Outpatient Influenza-like Illness Surveillance Network and Centers for Medicare and Medicaid Services ESRD death data from 2000 to 2013. After addressing the increasing trend in deaths due to the growing prevalent ESRD population, we calculated quarterly relative mortality compared with average third-quarter (summer) death counts. We used linear regression models to assess the relationship between ILI data and mortality, separately for quarters 4 and 1 for each influenza season, and model parameter estimates to predict seasonal mortality counts and calculate excess ILI-associated deaths. An estimated 1% absolute increase in quarterly ILI was associated with a 1.5% increase in relative mortality for quarter 4 and a 2.0% increase for quarter 1. The average number of annual deaths potentially attributable to ILI was substantial, about 1100 deaths per year. We found an association between community ILI activity and seasonal variation in all-cause mortality in patients with ESRD, with ILI likely contributing to >1000 deaths annually. Surveillance efforts, such as timely reporting to the CDC of ILI activity within dialysis units during influenza season, may help focus attention on high-risk periods for this vulnerable population.

The main patterns of overall seasonal mortality and the factors influencing the latter

The main patterns of overall seasonal mortality and the factors influencing the latter

Differential Effects of Temperature and Salinity on Growth and Mortality of Oysters (Crassostrea virginica) in Barataria Bay and Breton Sound, Louisiana

Temperature and salinity and their interaction exert a major control on the life cycle of the eastern oyster (Crassostrea virginica), affecting reproduction, development, growth, and mortality. Quantifying specific temperature and salinity relationships on oyster growth and mortality has, however, proven difficult, with data suggesting potentially region-specific responses. Legacy and recent data from field tray studies from public oyster grounds in Barataria Bay (BA) and Breton Sound (BS) were used to estimate growth and mortality rates as a function of temperature and salinity. Previous studies conducted in BA and BS reported differences in growth and mortality between the basins. In the present study, environmental conditions were synchronized to compare growth and mortality between basins at similar combinations of temperature and salinity. Results indicate that when temperature and salinity are the same (synchronized), seasonal oyster growth and mortality rates still differ between BA and BS. Given the same salinity and temperature conditions, differences in growth and mortality rates between estuaries may persist because of differences in other environmental conditions (i.e., food quality and composition, hydrology, site history, and salinity variation) or localized genetic adaptations to environmental conditions.

Climatic influences on the mortality of sheep during long-distance sea transport

Research on the causes of sheep death in sea voyages from Australia to the Middle East is limited, in particular little is known about the influence of climatic factors. Mortality data from 417 shipments of sheep exported over an 11-year period (November 2004 to June 2015) were modelled retrospectively to determine associated climatic factors. The statistical analysis were performed for both the full data set with 417 voyages based on actual and estimated departure and arrival dates and a restricted data set with 71 voyages based on actual dates. The results of the full data set demonstrated a seasonal mortality pattern, with more deaths occurring on sea voyages leaving Australia in the southern hemisphere winter or spring than those departing in Australian summer or autumn. Heat stress and inadequate fat mobilisation for energy supply when sheep are inappetant on shipments may explain this seasonality. Based on these two models, the voyage and weather factors associated with sheep mortalities included departure year, autumn departure in the southern hemisphere, voyage duration, single or multiple loading port(s), weekly mean dry bulb temperature and wind speed at departure ports, and humidity at destination ports. Significant correlations were observed between weather variables at the departure ports in the Australian winter and a high sheep mortality rate during voyages. This, together with the anticipated increased heat stress risk as a result of climate change, suggests that there could be review of the trade from Australia in the southern hemisphere winter. The influence of weather at the departure ports should be considered in sheep mortality prediction models, especially Australia’s heat stress risk assessment model.

Gradients of season length and mortality risk cause shifts in body size, reserves and reproductive strategies of determinate growers

Abstract The theory of life‐history evolution investigates how growth‐reproduction trade‐offs drive evolution of body size in uni‐ and multivoltine (one or more generations per year) arthropods. Existing theory does not predict how the length of the feeding season (season length hereafter) affects body size in semivoltine (i.e., juvenile period longer than 1 year) determinate growers and usually ignores that uni‐ and semivoltine arthropods accumulate large reserves to cover costs of diapause and future reproduction. Here, we present how the trade‐offs between growth, storage and reproduction drive evolution of body mass and reproductive strategy in arthropods with determinate growth. Our life‐history model concerns high‐latitude marine copepods living in a strongly seasonal environment. We find that small changes in season length and mortality rate translate into abrupt shifts in lean body mass (a proxy for body size). Body size shifts are caused by a change from multi‐ to uni‐ and semivoltine life cycles with semivoltine life histories selected for in short seasons and only if background mortality is low. Shifts in the number of generations per year do not translate into shifts in the mass of lipid reserves. The model predicts less reserves the shorter the winter. Season length alone is not a sufficient predictor of the degree of capital breeding. Storing for reproduction is strongly selected for under short season but low mortality rate. Hence, capital breeding contributes to fitness in uni‐ and semivoltine organisms whereas multivoltines are income breeders. We also show that storing reserves for diapause and capital breeding trades off with adult size of determinately growing arthropods. Our results, in particular regarding optimal body size, reproductive strategy (income‐to‐capital breeding) and degree of storage are relevant to a number of determinate growers, including insects and crustaceans. A plain language summary is available for this article.

The endemic deer Haploidoceros mediterraneus (Bonifay) (Cervidae, Mammalia) from the Late Pleistocene of Cova del Rinoceront (Iberian Peninsula): origin, ecomorphology, and paleobiology

ABSTRACTThis article reports the findings from a morphological and demographic analysis of the craniodental remains of the endemic continental deer Haploidoceros mediterraneus from the Late Pleistocene (MIS 5) of the Cova del Rinoceront (Castelldefels, Barcelona, Iberian Peninsula), the most complete assemblage of this species recorded in Europe. The presence of vestigial distal antler palmation and a posterior crown tine suggests that the genus Haploidoceros belongs to the Arvernoceros-Rucervus phylogenetic stock. The direct phyletic relationship between Haploidoceros mediterraneus and the ‘Cervus elaphoides’ from the Early Pleistocene of Venta Micena is confirmed by the dental morphology and the shape of the proximal portions of the antlers. The article discusses the evolution of the typical morphological features of H. mediterraneus: including its protruding tube-shaped orbits; relatively large cheek teeth; and, narrow, pointed premaxillary bones. The demographic structure of the cervid remains (a predominance of juvenile and prime adult males) suggests a seasonal mortality peak for young males expelled from the optimal habitat during autumn and winter.

Future ozone-related acute excess mortality under climate and population change scenarios in China: A modeling study.

BackgroundClimate change is likely to further worsen ozone pollution in already heavily polluted areas, leading to increased ozone-related health burdens. However, little evidence exists in China, the world’s largest greenhouse gas emitter and most populated country. As China is embracing an aging population with changing population size and falling age-standardized mortality rates, the potential impact of population change on ozone-related health burdens is unclear. Moreover, little is known about the seasonal variation of ozone-related health burdens under climate change. We aimed to assess near-term (mid-21st century) future annual and seasonal excess mortality from short-term exposure to ambient ozone in 104 Chinese cities under 2 climate and emission change scenarios and 6 population change scenarios.Methods and findingsWe collected historical ambient ozone observations, population change projections, and baseline mortality rates in 104 cities across China during April 27, 2013, to October 31, 2015 (2013–2015), which included approximately 13% of the total population of mainland China. Using historical ozone monitoring data, we performed bias correction and spatially downscaled future ozone projections at a coarse spatial resolution (2.0° × 2.5°) for the period April 27, 2053, to October 31, 2055 (2053–2055), from a global chemistry–climate model to a fine spatial resolution (0.25° × 0.25°) under 2 Intergovernmental Panel on Climate Change Representative Concentration Pathways (RCPs): RCP4.5, a moderate global warming and emission scenario where global warming is between 1.5°C and 2.0°C, and RCP8.5, a high global warming and emission scenario where global warming exceeds 2.0°C. We then estimated the future annual and seasonal ozone-related acute excess mortality attributable to both climate and population changes using cause-specific, age-group-specific, and season-specific concentration–response functions (CRFs). We used Monte Carlo simulations to obtain empirical confidence intervals (eCIs), quantifying the uncertainty in CRFs and the variability across ensemble members (i.e., 3 predictions of future climate and air quality from slightly different starting conditions) of the global model. Estimates of future changes in annual ozone-related mortality are sensitive to the choice of global warming and emission scenario, decreasing under RCP4.5 (−24.0%) due to declining ozone precursor emissions but increasing under RCP8.5 (10.7%) due to warming climate in 2053–2055 relative to 2013–2015. Higher ambient ozone occurs under the high global warming and emission scenario (RCP8.5), leading to an excess 1,476 (95% eCI: 898 to 2,977) non-accidental deaths per year in 2053–2055 relative to 2013–2015. Future ozone-related acute excess mortality from cardiovascular diseases was 5–8 times greater than that from respiratory diseases. Ozone concentrations increase by 15.1 parts per billion (10−9) in colder months (November to April), contributing to a net yearly increase of 22.3% (95% eCI: 7.7% to 35.4%) in ozone-related mortality under RCP8.5. An aging population, with the proportion of the population aged 65 years and above increased from 8% in 2010 to 24%–33% in 2050, will substantially amplify future ozone-related mortality, leading to a net increase of 23,838 to 78,560 deaths (110% to 363%). Our analysis was mainly limited by using a single global chemistry–climate model and the statistical downscaling approach to project ozone changes under climate change.ConclusionsOur analysis shows increased future ozone-related acute excess mortality under the high global warming and emission scenario RCP8.5 for an aging population in China. Comparison with the lower global warming and emission scenario RCP4.5 suggests that climate change mitigation measures are needed to prevent a rising health burden from exposure to ambient ozone pollution in China.

Seasonal incidence of ruptured abdominal aortic aneurysm and the influence of atmospheric pressure: a systematic review and meta-analysis.

Ruptured abdominal aortic aneurysm (rAAA) is a life-threatening condition with a high mortality rate. Seasonal variations in the incidence of rAAA and the influence of atmospheric pressure have been studied throughout decades; however, the conclusions are contradictory. Therefore, we aimed to conduct a meta-analysis and systematic review of literature on seasonal variations in rAAA incidence and the influence of atmospheric pressure. Studies investigating seasonal variations in rAAA incidence and influence of atmospheric pressure were retrieved. For dichotomous data, we generated risk ratios (RRs) and 95% confidence intervals (CIs) for rAAA incidence compared among seasons. The studies were subdivided according to latitude, elevation, and climatic types, for subgroup comparisons. Studies reporting monthly incidence and seasonal mortality were further investigated. For continuous data, standardized mean differences (SMDs) and 95% CIs were generated for atmospheric pressure comparisons. Twenty-four eligible studies were included, comprising a total of 38,506 patients with rAAA. Pooled rAAA incidence was 25% in spring, 23% in summer, 26% in autumn, and 26% in winter. Pooled analysis demonstrated a statistically significant higher rAAA incidence in winter than in summer (RR 1.10, P = 0.04) and in autumn than in summer (RR 1.11, P < 0.00001). However, there was no statistically significant difference among other seasons. In the study of the influence of atmospheric pressure, no statistically significant difference was observed. In conclusion, our study revealed a higher incidence of rAAA in autumn and winter than in summer; however, atmospheric pressure was found to exert no influence.