Frequency dominates intensity of future heat waves over India.

Future changes in heat wave characteristics over India have been analyzed using Coordinated Regional Climate Downscaling Experiments (CORDEX) for South Asia (SA) regional climate model simulations for mid-term (2041-2060) and long-term (2081-2099) future under the representative concentration pathway (RCP) 4.5 and RCP 8.5 emission scenarios, respectively. SMHI_CSIRO-MK3.6 was found to be the best model in simulating heat wave trend over India for historical period. Future projections show a four-to-seven-fold increase in heat wave frequency for mid-term and long-term future under RCP 4.5 scenario, and five-to-ten-fold increase under RCP 8.5 scenario with increase in frequency dominating intensity in both the scenarios. Northwestern, Central, and South-central India emerged as future heat wave hotspots with largest increase in the south-central region. This high-resolution regional future projection of heat wave occurrence will serve as a baseline for developing transformational heat-resilient policies and adaptation measures to reduce potential impact on human health, agriculture, and infrastructure.

Hydrogeochemical characterization and geochemical modeling for the evaluation of groundwater quality and health risk assessment in the Varuna River basin, India.

This study focuses on determining significant controlling factors of chemical consequences, inverse geochemical modeling, water quality, and human health risk in the Varuna River basin of India. The study interprets that according to pH, total dissolved solids, and total hardness, the maximum number of groundwater samples are alkaline, fresh, and have substantial hardness. The abundance of major ions follows a pattern: Na > Ca > Mg > K, and HCO3 > Cl > SO4 > NO3 > F. Piper diagram shows that Ca-Mg-HCO3 facies are predominant during both seasons. Na-normalized molar ratios of HCO3/Na, Mg/Na, and Ca/Na are 0.62, 0.95, and 1.82 (pre-monsoon) and 0.69, 0.91, and 1.71 (post-monsoon), respectively, elucidating the coupled silicate and carbonate weathering (dolomite dissolution) sources. The Na/Cl molar ratio is 5.3 (pre-monsoon) and 3.2 (post-monsoon), indicating silicate alteration as the primary process rather than halite dissolution. The chloro-alkaline indices confirm the presence of reverse ion- exchange. Geochemical modeling using PHREEQC identifies the formation of secondary kaolinite minerals. The inverse geochemical modeling categorizes the groundwaters along the flow path from recharge area waters (Group I: Na-HCO3-Cl), transitional area waters (Group II: Na-Ca-HCO3), and discharge area waters (Group III: Na-Mg-HCO3). The model demonstrates the prepotency of water-rock interactions in pre-monsoon justified by the precipitation of Chalcedony and Ca-montmorillonite. The mixing analysis shows that in the alluvial plains, groundwater mixing is a significant hydrogeochemical process that affects groundwater quality. The Entropy Water Quality Index ranks 45% (pre-monsoon) and 50% (post-monsoon) of samples as an excellent category. However, the non-carcinogenic health risk assessment shows that children are more susceptible to fluoride and nitrate contamination.

Association between climate and infectious diseases among children in Varanasi city, India: A prospective cohort study.

The effects of climate on infectious diseases could influence the health impacts, particularly in children in countries with the unfair socioeconomic conditions. In a prospective cohort of 461 children under 16-years-of-age in Varanasi city, India, the association of maximum-temperature (Tmax), relative humidity (RH), absolute humidity (AH), rainfall (RF), wind-speed (WS), and solar radiation (SLR) with prevalent infectious diseases (Diarrhea, Common cold and flu, Pneumonia, Skin-disease and Malaria, and Dengue) was examined using binomial-regression, adjusting for confounders and effect modifiers (socioeconomic-status; SES and child anthropometry), from January 2017 to January 2020. Attributable-fraction (AFx) was calculated due to each climate variable for each infectious disease. The result showed that each unit (1 °C) rise in Tmax was associated with an increase in diarrhea and skin-disease cases by 3.97% (95% CI: 2.92, 5.02) and 3.94% (95% CI: 1.67, 6.22), respectively, whereas, a unit decline in Tmax was associated with an increase in cold and flu cases by 3.87% (95% CI: 2.97, 4.76). Rise in humidity (RH) was associated with increase in cases of cold and flu by 0.73% (95% CI: 0.38, 1.08) and malaria (AH) by 7.19% (95% CI: 1.51, 12.87) while each unit (1 g/m3) decrease in humidity (AH) observed increase in pneumonia cases by 3.02% (95% CI: 0.75, 5.3). WS was positively associated with diarrhea (14.16%; 95% CI: 6.52, 21.80) and negatively with dengue (17.40%; 12.32, 22.48) cases for each unit change (kmph). RF showed marginal association while SLR showed no association at all. The combined AFx due to climatic factors ranged from 9 to 18%. SES and anthropometric parameters modified the climate-morbidity association in children with a high proportion of children found suffering from stunting, wasting, and underweight conditions. Findings from this study draw the attention of government and policymakers to prioritize effective measures for child health as the present association may increase disease burden in the future under climate-change scenarios in already malnourished paediatric population through multiple pathways.

Japanese Encephalitis and Associated Environmental Risk Factors in Eastern Uttar Pradesh: A time series analysis from 2001 to 2016.

India and other Southeast Asian countries are severely affected by Japanese encephalitis (JE), one of the deadliest vector-borne disease threat to human health. Several epidemiological observations suggest climate variables play a role in providing a favorable environment for mosquito development and virus transmission. In this study, generalized additive models were used to determine the association of JE admissions and mortality with climate variables in Gorakhpur district, India, from 2001-2016. The model predicted that every 1 unit increase in mean (Tmean;°C), and minimum (Tmin;°C) temperature, rainfall (RF; mm) and relative humidity (RH; %) would on average increase the JE admissions by 22.23 %, 17.83 %, 0.66 %, and 5.22 % respectively and JE mortality by 13.27 %, 11.77 %, 0.94 %, and 3.27 % respectively Conversely, every unit decrease in solar radiation (Srad; MJ/m2/day) and wind speed (WS; Kmph) caused an increase in JE admission by 17% and 11.42% and in JE mortality by 9.37% and 4.88% respectively suggesting a protective effect at higher levels. The seasonal analysis shows that temperature was significantly associated with JE in pre-monsoon and post-monsoon while RF, RH, Srad, and WS are associated with the monsoon. Effect modification due to age and gender showed an equal risk for both genders and increased risk for adults above 15 years of age, however, males and age groups under 15 years outnumbered females and adults. Sensitivity analysis results to explore lag effects in climate variables showed that climate variables show the strongest association at lag 1 to 1.5 months with significant lag effect up tp lag 0-60 days. The exposure-response curve for climate variables showed a more or less linear relationship, with an increase in JE admissions and mortality after a certain threshold and decrease were reported at extreme levels of exposure. The study concludes that climate variables could influence the JE vector development and multiplication and parasite maturation and transmission in the Gorakhpur region whose indirect impact was noted for JE admission and mortality. In response to the changing climate, public health interventions, public awareness, and early warning systems would play an unprecedented role to compensate for future risk.

Vulnerability of Indian wheat against rising temperature and aerosols.

Potential impacts of change in climate on Indian agriculture may be significantly adverse, if not disastrous. There are projections of potential loss in wheat yield due to the rise in daily minimum (Tmin) and maximum (Tmax) temperature, but only few researchers have considered the extent of such loss on a spatial scale. We therefore, systematically studied the effect of change in Tmax, Tmean (daily average temperature) and Tmin, solar radiation (Srad) and precipitation (RAIN) during wheat growing seasons (from 1986 to 2015) on wheat crop yield over five wheat growing zones across India, taking into account the effect modification by aerosol loading (in terms of aerosol optical depth, 2001-2015). We note that for the entire India, 1 °C rise in Tmean resulted a 7% decrease in wheat yield which varied disproportionately across the crop growing zones by a range of -9% (peninsular zone, PZ) to 4% (northern hills zone, NHZ). The effect of Tmean on wheat yield was identical to the marginal effect of Tmax and Tmin, while 1% increase in Srad enhance wheat yield by 4% for all India with small geographical variations (2-5%), except for the northern hill region (-4%). Rise in 1 °C Tmean exclusively during grain filling duration was noted positive for all the wheat growing regions (0-2%) except over central plain zone (-3%). When estimates of weather variables on wheat yield was combined with the estimated impact of aerosols on weather, the most significant impact was noted over the NHZ (-23%), which otherwise varied from -7% to -4%. Overall, the study brings out the conclusive evidence of negative impact of rising temperature on wheat yield across India, which we found spatially inconsistent and highly uncertain when integrated with the compounding effect of aerosols loading.

Attributing mortality from temperature extremes: A time series analysis in Varanasi, India.

Climate extremes are often associated with increased human mortality and such association varies considerably with space and time. We therefore, aimed to systematically investigate the effects of temperature extremes, daily means and diurnal temperature variations (DTV) on mortality in the city of Varanasi, India during 2009-2016. Time series data on daily mortality, air quality (SO2, NO2, O3 and PM10) and weather variables were obtained from the routinely collected secondary sources. A semiparametric quasi-Poisson regression model estimated the effects of temperature extremes on daily all-cause mortality adjusting nonlinear confounding effects of time trend, relative humidity and air pollution; stratified by seasons. An effect modification by age, gender and place of death as semi-economic indicator were also explored. Daily mean temperature was strongly associated with excess mortality, both during summer (5.61% with 95% CI: 4.69-6.53% per unit increase in mean temperature) and winter (1.53% with 95% CI: 0.88-2.18% per unit decrease in mean temperature). Daily mortality was found to be increased by 12.02% (with 95% CI: 4.21-19.84%) due to heat wave. The DTV has exhibited downward trend over the years and showed a negative association with all-cause mortality. Significant association of mortality and different metric of temperature extreme along with decreasing trend in DTV clearly indicate the potential impact of climate change on human health in the city of Varanasi. The finding may well be useful to prioritize the government policies to curb the factors that causes the climate change and for developing early warning system.

Airing 'clean air' in Clean India Mission.

The submission explores the possibility of a policy revision for considering clean air quality in recently launched nationwide campaign, Clean India Mission (CIM). Despite of several efforts for improving availability of clean household energy and sanitation facilities, situation remain still depressing as almost half of global population lacks access to clean energy and proper sanitation. Globally, at least 2.5 billion people do not have access to basic sanitation facilities. There are also evidences of 7 million premature deaths by air pollution in year 2012. The situation is even more disastrous for India especially in rural areas. Although, India has reasonably progressed in developing sanitary facilities and disseminating clean fuel to its urban households, the situation in rural areas is still miserable and needs to be reviewed. Several policy interventions and campaigns were made to improve the scenario but outcomes were remarkably poor. Indian census revealed a mere 31% sanitation coverage (in 2011) compared to 22% in 2001 while 60% of population (700 million) still use solid biofuels and traditional cook stoves for household cooking. Further, last decade (2001-2011) witnessed the progress decelerating down with rural households without sanitation facilities increased by 8.3 million while minimum progress has been made in conversion of conventional to modern fuels. To revamp the sanitation coverage, an overambitious nationwide campaign CIM was initiated in 2014 and present submission explores the possibility of including 'clean air' considerations within it. The article draws evidence from literatures on scenarios of rural sanitation, energy practises, pollution induced mortality and climatic impacts of air pollution. This subsequently hypothesised with possible modification in available technologies, dissemination modes, financing and implementation for integration of CIM with 'clean air' so that access to both sanitation and clean household energy may be effectively addressed.

Antithrombin III in liver disorders.

Biological and immunological antithrombin III was studied in 26 patients of viral hepatitis including 6 with encephalopathy, and in 11 patients with cirrhosis of liver. There was a significant reduction in both biological and immunological activity of antithrombin III in all the groups of liver disorders studied. There was a good correlation between biological and immunological activity of antithrombin III (P less than 0.05). Further, there was a significant inverse correlation between immunological activity of antithrombin III and SGOT/SGPT (P less than 0.01) as well as serum bilirubin (P less than 0.001), signifying the prognostic value of antithrombin III in hepatitis. Biological activity on the other hand did not show any relation with the hepatic enzymes or bilirubin elevation. The antithrombin III levels appeared to decline in direct proportion to the degree of hepatic necrosis, probably due to reduced synthesis.