Environmental sympatry through time: spatio-temporal distribution and conservation status of two sympatric anuran species (Leptodactylidae) in South America / Simpatría ambiental a través del tiempo: distribución espacio-temporal y estado de conservación de dos especies de anuros simpátricos (Leptodactylidae) en América del Sur

Abstract Introduction: Leptodactylus latinasus and Physalaemus cuqui are sympatric anuran species with similar environmental requirements and contrasting reproductive modes. Climatic configuration determines distribution patterns and promotes sympatry of environmental niches, but specificity/selectivity determines the success of reproductive modes. Species distribution models (SDM) are a valuable tool to predict spatio-temporal distributions based on the extrapolation of environmental predictors. Objectives: To determine the spatio-temporal distribution of environmental niches and assess whether the protected areas of the World Database of Protected Areas (WDPA) allow the conservation of these species in the current scenario and future. Methods: We applied different algorithms to predict the distribution and spatio-temporal overlap of environmental niches of L. latinasus and P. cuqui within South America in the last glacial maximum (LGM), middle-Holocene, current and future scenarios. We assess the conservation status of both species with the WDPA conservation units. Results: All applied algorithms showed high performance for both species (TSS = 0.87, AUC = 0.95). The L. latinasus predictions showed wide environmental niches from LGM to the current scenario (49 % stable niches, 37 % gained niches, and 13 % lost niches), suggesting historical fidelity to stable climatic-environmental regions. In the current-future transition, L. latinasus would increase the number of stable (70 %) and lost (20 %) niches, suggesting fidelity to lowland regions and a possible trend toward microendemism. P. cuqui loses environmental niches from the LGM to the current scenario (25 %) and in the current-future transition (63 %), increasing the environmental sympathy between both species; 31 % spatial overlap in the current scenario and 70 % in the future. Conclusion: Extreme drought events and rainfall variations, derived from climate change, suggest the loss of environmental niches for these species that are not currently threatened but are not adequately protected by conservation units. The loss of environmental niches increases spatial sympatry which represents a new challenge for anurans and the conservation of their populations.

Resumen Introducción: Leptodactylus latinasus y Physalaemus cuqui son especies de anuros simpátricos con requerimientos ambientales similares y modos reproductivos contrastantes. La configuración climática determina los patrones de distribución y promueve la simpatría de los nichos ambientales, pero la especificidad/selectividad determina el éxito de los modos reproductivos. Los modelos de distribución de especies (MDE) son una herramienta valiosa para predecir distribuciones espacio-temporales basadas en la extrapolación de predictores ambientales. Objetivos: Determinar la distribución espacio-temporal de los nichos ambientales y evaluar si las áreas protegidas de la base de Datos Mundial de Áreas Protegidas (DMAP) permiten la conservación de estas especies en el escenario actual y futuro. Métodos: Aplicamos diferentes algoritmos para predecir la distribución y superposición espacio-temporal de nichos ambientales de L. latinasus y P. cuqui dentro de América del Sur en el último máximo glacial (UGM), Holoceno medio, actual y futuro. Evaluamos el estado de conservación de ambas especies con las unidades de conservación de la DMAP. Resultados: Todos los algoritmos aplicados mostraron un alto rendimiento para ambas especies (TSS = 0.87, AUC = 0.95). Las predicciones de L. latinasus mostraron amplios nichos ambientales desde LGM hasta el escenario actual (49 % de nichos estables, 37 % de nichos ganados y 13 % de nichos perdidos), sugiriendo fidelidad histórica por regiones climático-ambientales estables. En la transición actual-futura L. latinasus incrementaría la cantidad de nichos estables (70 %) y perdidos (20 %), sugiriendo fidelidad por regiones de tierras bajas y la posible tendencia hacia el microendemismo. P. cuqui pierde nichos ambientales desde el LGM al escenario actual (25 %) y en la transición actual-futura (63 %), incrementando la simpatría ambiental entre ambas especies; 31 % de superposición espacial en el escenario actual y 70 % en el futuro. Conclusión: Los eventos de sequía extrema y las variaciones de precipitaciones, derivados del cambio climático, sugieren la pérdida de nichos ambientales para estas especies, actualmente no se encuentran amenazadas, pero no están adecuadamente protegidas por las unidades de conservación. La pérdida de nichos ambientales aumenta la simpatría espacial que representa un nuevo desafío para estos anuros y la conservación de sus poblaciones.

How does planetary health redefine our steps? An integrative review on climate change and global physical activity

Introduction: Climate change is altering individual behaviors, particularly in terms of physical activity, with significant implications for body and mental health. Objective: This review aims to provide insights for researchers, public health professionals, and policymakers to promote physical activity effectively in the face of climate change challenges. Methods: We conducted an integrative review of studies involving adults published in English, Portuguese, or Spanish, using databases such as PubMed, Scielo, Lilacs, Web of Science, and Embase. Results: Eighty-three papers were included, revealing that heat waves reduce outdoor physical activity, while indoor activities are gaining popularity due to poor air quality. Sea level rise affects coastal areas and water-based sports, limiting access to these activities. Public policies are needed to promote physical activity for various groups, considering their specific needs and limitations. Despite these challenges, physical activity can increase resilience and be a catalyst for lifestyle changes, especially in areas most affected by climate change. Conclusion: A multidisciplinary approach is crucial for developing solutions to mitigate the negative impacts of climate change on physical activity. This review highlights the urgent need for adaptation strategies in promoting physical activity in the face of a changing environment and its implications for public health.

Prediction of the global occurrence of maize diseases and estimation of yield loss under climate change.

BACKGROUND: Climate change significantly impacts global maize production via yield reduction, posing a threat to global food security. Disease-related crop damage reduces quality and yield and results in economic losses. However, the occurrence of diseases caused by climate change, and thus crop yield loss, has not been given much attention. RESULTS: This study aims to investigate the potential impact of six major diseases on maize yield loss over the next 20 to 80 years under climate change. To this end, the Maximum Entropy model was implemented, based on Coupled Model Intercomparison Project 6 data. The results indicated that temperature and precipitation are identified as primary limiting factors for disease onset. Southern corn rust was projected to be the most severe disease in the future; with a few of the combined occurrence of all the selected diseases covered in this study were predicted to progressively worsen over time. Yield losses caused by diseases varied per continent, with North America facing the highest loss, followed by Asia, South America, Europe, Africa, and Oceania. CONCLUSION: This study provides a basis for regional projections and global control of maize diseases under future climate conditions. © 2024 Society of Chemical Industry.

Breeding phenology drives variation in reproductive output, reproductive costs and offspring fitness in a viviparous ectotherm.

Phenological advances are a widespread response to global warming and can contribute to determine the climate vulnerability of organisms, particularly in ectothermic species which are highly dependent on ambient temperatures to complete their life cycle. Yet, the relative contribution of breeding dates and temperature conditions during gestation on fitness of females and their offspring is poorly documented in reptiles. Here, we exposed females of the common lizard Zootoca vivipara to contrasting thermal scenarios (cold versus hot treatment) during gestation and quantified effects of parturition dates and thermal treatment on life-history traits of females and their offspring for one year. Overall, our results suggest that parturition date has a greater impact than thermal conditions during gestation on life history strategies. In particular, we found positive effects of an earlier parturition date on juvenile survival, growth and recruitment suggesting that environmental dependent selection and/or differences in parental quality between early and late breeders underlie seasonal changes in offspring fitness. Yet, an earlier parturition date compromised the energetic condition of gravid females, which suggests the existence of a mother-offspring conflict regarding the optimisation of parturition dates. While numerous studies focused on the direct effects of alterations in incubation temperatures on reptile life-history traits, our results highlight the importance of considering the role of breeding phenology in assessing the short- and long-term effects of thermal developmental plasticity.

The global burden of breast cancer in women from 1990 to 2030: assessment and projection based on the global burden of disease study 2019.

Background and aim: This study aims to analyze the worldwide prevalence, mortality rates, and disability-adjusted life years (DALYs) attributed to breast cancer in women between 1990 and 2019. Additionally, it seeks to forecast the future trends of these indicators related to the burden of breast cancer in women from 2020 to 2030. Methods: Data from the Global Burden of Disease Study (GBD) 2019 was analyzed to determine the age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of DALYs due to breast cancer in women across 204 countries and territories from 1990 to 2019. Socio-economic development levels of countries and regions were assessed using Socio-demographic Indexes, and trends in the burden of breast cancer in women worldwide from 2020 to 2030 were projected using generalized additive models (GAMs). Results: The estimated annual percentage change (EAPC) in the ASIR breast cancer in women globally was 0.36 from 1990 to 2019 and is expected to increase to 0.44 from 2020 to 2030. In 2019, the ASIR of breast cancer in women worldwide was 45.86 and is projected to reach 48.09 by 2030. The burden of breast cancer in women generally rises with age, with the highest burden expected in the 45-49 age group from 2020 to 2030. The fastest increase in burden is anticipated in Central sub-Saharan Africa (EAPC in the age-standardized death rate: 1.62, EAPC in the age-standardized DALY rate: 1.52), with the Solomon Islands (EAPC in the ASIR: 7.25) and China (EAPC in the ASIR: 2.83) projected to experience significant increases. Furthermore, a strong positive correlation was found between the ASIR breast cancer in women globally in 1990 and the projected rates for 2030 (r = 0.62). Conclusion: The anticipated increase in the ASIR of breast cancer in women globally by 2030 highlights the importance of focusing on women aged 45-49 in Central sub-Saharan Africa, Oceania, the Solomon Islands, and China. Initiatives such as breast cancer information registries, raising awareness of risk factors and incidence, and implementing universal screening programs and diagnostic tests are essential in reducing the burden of breast cancer and its associated morbidity and mortality.

Reimagining nutrition education for pregnant adolescents in the face of climate change: a community approach.

Objectives: To explore challenges with current nutrition education for teenage pregnant women in a drought-prone community in Kenya and to elicit the communities' suggestions on how to best adapt it in the face of climate change. Design: Nine serial focus group discussions (four with adolescents, two with their parents, two with community health volunteers and one with healthcare workers) were conducted on a purposively selected study population in Kaloleni, Kilifi County, Kenya. Data collection took place between March and November 2022, with a total of 73 participants. An inductive approach was used, and interpretive thematic coding was done as the primary analytic strategy to allow themes derived from participants' reflections. Results: First, participants reported that unpredictable rainfall patterns had affected nutrition intake and variety due to reduced yield from farmland, diseases in livestock and insufficient income. Second, participants reported barriers to accessing nutrition education, as it was mainly given in clinics and not targeted at adolescents or men. Third, they experienced challenges in applying nutrition education in daily life due to a mismatch between available foods and cultural practices. Recommendations for the future encompassed equipping individuals with practical cooking skills tailored to available nutrients, initiatives aimed at water conservation and addressing animal health concerns, enhancing accessibility through community-based training programmes and fostering collaborative efforts to ensure the provision of essential nutrients. Conclusion: Food choices in Kilifi County are getting more limited due to unpredicted rainfall patterns. Therefore, a reorientation of nutrition education is needed in order to build resilience in the community. Strengthening community action, including developing skills to increase long-term local support, would be needed to ensure the adequate nutrition status of vulnerable groups like pregnant adolescent women.

Urine Epidermal Growth Factor and Kidney Function Decline in Middle-Aged Adults.

Rationale & Objective: The diagnosis and prognostication of chronic kidney disease (CKD) largely rely on glomerular measures that may not reflect tubular damage. We investigated the associations of urine kidney tubule biomarkers with estimated glomerular filtration rate (eGFR) change among middle-aged adults, when chronic diseases typically emerge. Study Design: An observational cohort study. Setting & Participants: A total of 1,145 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study without CKD, hypertension, or cardiovascular disease at the year 20 visit. Exposures: Seven different biomarkers of tubular health: urine epidermal growth factor (EGF), alpha-1-microglobulin (α1m), interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, uromodulin, and chitinase-3-like protein 1. Outcomes: Ten-year eGFR change and incident reduced eGFR (new onset of eGFR < 60 mL/min/1.73 m2). Analytical Approach: We examined associations of tubular health biomarkers with 10-year eGFR change and incident reduced eGFR with linear mixed models and interval-censored proportional hazards regression models, respectively. Both minimally and fully adjusted models were controlled for urine creatinine levels. Results: The mean age of participants was 44.8 ± 3.7 years, with 39% African American and 56% female. The average 10-year change in eGFR was -18.6 mL/min/1.73 m2 (95% CI, -19.4 to -17.8). In contrast to the other tubular biomarkers, which showed conflicting results, EGF demonstrated strong, consistent associations with both kidney outcomes. Each 1-standard deviation (SD) higher EGF was associated with a 2.37 mL/min/1.73 m2 (95% CI, 0.64-4.10) smaller 10-year decrease in eGFR and a 42% (95% CI, 4%-64%) lower risk of incident reduced eGFR in the fully adjusted model. Limitations: Observational design, measurements of eGFR were done only at 5-year intervals during follow-up. Conclusions: In middle-aged, community-dwelling adults without hypertension, cardiovascular disease or CKD, higher urine EGF concentrations are associated with slower eGFR decline, whereas other kidney tubule biomarkers lacked a consistent association with kidney function decline.

Current measures of chronic kidney disease (CKD) rely on markers of glomerular health and function. This approach inadequately captures the role of kidney tubule health, a known histopathological predictor of CKD development. We investigated associations of 7 biomarkers of kidney tubule health with 10-year estimated glomerular filtration rate (eGFR) change and incident reduced eGFR. Among 7 biomarkers, only epidermal growth factor showed persistent and inverse associations with both 10-year eGFR change and incident reduced eGFR. These findings suggest that epidermal growth factor has an association with kidney function changes and might play a protective role in kidney disease development.

Leveraging emotional intelligence to foster proactive climate change adaptation: A study of engineering decision-making.

The impacts of climate change and development present significant challenges and complexities that require new solutions, wise choices, and multi-disciplinary integration. In this context, emotional intelligence (EI) plays a crucial role. However, traditional engineering education and practice overlook the importance of understanding and managing emotions. This research aims to determine the impact of EI as a tool to enhance proactive decision-making and implement sustainable measures within the engineering profession.The study makes three main research contributions. First, it confirms a positive relationship between EI and proactive sustainable decision-making among engineers. This means that engineers with high EI are more likely to consider the impacts of their decisions on various stakeholders and dimensions of sustainability. Second, it suggests that EI can enhance creativity and innovative thinking in engineering, helping engineers to develop effective solutions for challenges related to climate change. Third, the study advocates for incorporating EI training and assessment into engineering curriculums to foster a sustainable and ethical engineering culture. By improving EI, engineers can enhance their interpersonal skills, self-awareness, and emotional management, which in turn can significantly improve teamwork in addressing challenges related to climate change.

Watershed hydrology mediates the recovery of an arsenic impacted subarctic landscape.

A holistic understanding of the chemical recovery of lakes from arsenic (As) pollution requires consideration of within-lake biogeochemical cycling of As and processes occurring in the surrounding catchment. This study used a watershed mass balance approach, complemented by experimental sediment incubations, to assess the mobility and transport of As within a subarctic watershed (155 km2) impacted by more than 60 years of atmospheric mining emissions. The period of record spanned a transition from drought to high streamflow between September 2017 and September 2019, which yielded insights into the interacting effects of hydrology and within-lake biogeochemical cycling of As. Internal loading of As from contaminated lake sediments (25 - 46 kg As year-1) and contributions from terrestrial sources (16 - 56 kg As yr-1) continue to negatively impact lake water quality (19 - 144 µg As L-1), but the relative importance of these loads varies seasonally and inter-annually in response to changing hydrological conditions. Wet conditions resulted in greater transport of As from terrestrial reservoirs and upstream areas, shorter lake water retention time, and increased the downstream export of As. During dry periods, the lake was disconnected from the surrounding watershed resulting in limited terrestrial contributions and longer lake water residence time, which delayed recovery due to the greater relative influence of internal loading from contaminated sediments. This study highlights that changing hydroclimatic regimes will alter trajectories of chemical recovery for arsenic impacted lakes through the coupling of within-lake and watershed transport processes.

Exploring behavioural and physiological adaptations in mountain pine beetle in response to elevated ozone concentrations.

Elevated ozone (eO3) concentrations pose a threat to insect populations by potentially altering their behaviour and physiology. This study investigates the effects of eO3 concentrations on the mountain pine beetle which is a major tree-killing species of conifers in northwestern North America. We are particularly interested in understanding the effects of eO3 concentrations on beetle behaviour and physiology and possible transgenerational impacts on bark beetle broods. We conducted O3-enrichment experiments in a controlled laboratory setting using different O3 concentrations (100-200 ppb; projected for 2050-2100) and assessed various beetle responses, including CO2 respiration, mating behaviour, survival probability, locomotion, and attraction behaviour. Transgenerational impacts on the first and second generations were also analyzed by studying brood morphology, mating behaviour, survival, and pheromone production. We found that beetles exposed to eO3 concentrations had shorter oviposition galleries and reduced brood production. Beetle pheromones were also degraded by eO3 exposure. However, exposure to eO3 also prompted various adaptive responses in beetles. Despite reduced respiration, eO3 improved locomotor activity and the olfactory response of beetles. Surprisingly, beetle survival probability was also improved both in the parents and their broods. We also observed transgenerational plasticity in the broods of eO3-exposed parents, suggesting potential stress resistance mechanisms. This was evident by similar mating success, oviposition gallery length, and brood numbers produced in both control and eO3 concentration treatments. This study demonstrates the sensitivity of mountain pine beetles to increased O3 concentrations, contributing crucial insights into the ecological implications of eO3 concentrations on their populations. Overall, the outcome of this study contributes to informed climate change mitigation strategies and adaptive management practices for the development of resilient forests in response to emerging forest insect pests worldwide.

Biomechanical changes in lower extremity in individuals with knee osteoarthritis in the past decade: A scoping review.

Biomechanic studies can provide a powerful theoretical and scientific basis for studies on knee osteoarthritis (OA), which is of great significance for clinical management as it provides new concepts and methods in clinical and research settings. This study aimed to discuss and summarize biomechanical research on lower extremities in individuals with knee OA in the past ten years. The methodology of this review followed the framework outlined in the Joanna Briggs Institute (JBI) guidelines and strictly followed the checklist for drafting the findings. A literature search was conducted using PubMed, Scopus, Cochrane Library, Embase, Web of Science, Grey literature search in Open Library, and Google Academic databases. Relevant literature was searched from 2011 to 2023. Sixteen studies were included in this scoping review. Biomechanical research on knee OA in the last decade demonstrates that the biomechanics of the hip, knee, and ankle have a profound influence on the pathogenesis and treatment of knee OA. Individuals with knee OA have biomechanical changes in hip, knee, and ankle joints such as a significant defect in the strength of ankle varus muscles, weakness of hip abductor muscle, walking with toes outwards, increased knee adduction moment and angle, and decreased knee extensor moment. As the severity of knee OA increases, the tendency of hip abduction positions also increases. Further research with a longitudinal study design should focus on the determination of the relative importance of different biomechanical and neuromuscular factors in the development and progression of the disease.

A satellite-derived dataset on vegetation phenology across Central Asia from 2001 to 2023.

Satellite-observed land surface phenology (LSP) data have helped us better understand terrestrial ecosystem dynamics at large scales. However, uncertainties remain in comprehending LSP variations in Central Asian drylands. In this article, an LSP dataset covering Central Asia (45-100°E, 33-57°N) is introduced. This LSP dataset was produced based on Moderate Resolution Imaging Spectroradiometer (MODIS) 0.05-degree daily reflectance and land cover data. The phenological dynamics of drylands were tracked using the seasonal profiles of near-infrared reflectance of vegetation (NIRv). NIRv time series processing involved the following steps: identifying low-quality observations, smoothing the NIRv time series, and retrieving LSP metrics. In the smoothing step, a median filter was first applied to reduce spikes, after which the stationary wavelet transform (SWT) was used to smooth the NIRv time series. The SWT was performed using the Biorthogonal 1.1 wavelet at a decomposition level of 5. Seven LSP metrics were provided in this dataset, and they were categorized into the following three groups: (1) timing of key phenological events, (2) NIRv values essential for the detection of the phenological events throughout the growing season, and (3) NIRv value linked to vegetation growth state during the growing season. This LSP dataset is useful for investigating dryland ecosystem dynamics in response to climate variations and human activities across Central Asia.

Infectious Diarrhea Risks as a Public Health Emergency in Floods; a Systematic Review and Meta-Analysis.

Introduction: Infectious diarrhea, a significant global health challenge, is exacerbated by flooding, a consequence of climate change and environmental disruption. This comprehensive study aims to quantify the association between flooding events and the incidence of infectious diarrhea, considering diverse demographic, environmental, and pathogen-specific factors. Methods: In this systematic review and meta-analysis, adhering to PROSPERO protocol (CRD42024498899), we evaluated observational studies from January 2000 to December 2023. The analysis incorporated global data from PubMed, Scopus, Embase, Web of Science, and ProQuest, focusing on the relative risk (RR) of diarrhea post-flooding. The study encompassed diverse variables like age, sex, pathogen type, environmental context, and statistical modeling approaches. Results: The meta-analysis, involving 42 high-quality studies, revealed a substantial increase (RR = 1.40, 95% CI [1.29-1.52]) in the incidence of diarrhea following floods. Notably, bacterial and parasitic diarrheas demonstrated higher RRs (1.82 and 1.35, respectively) compared to viral etiologies (RR = 1.15). A significant sex disparity was observed, with women exhibiting a higher susceptibility (RR = 1.55) than men (RR = 1.35). Adults (over 15 years) faced a greater risk than younger individuals, highlighting age-dependent vulnerability. Conclusion: This extensive analysis confirms a significant correlation between flood events and increased infectious diarrhea risk, varying across pathogens and demographic groups. The findings highlight an urgent need for tailored public health interventions in flood-prone areas, focusing on enhanced sanitation, disease surveillance, and targeted education to mitigate this elevated risk. Our study underscores the critical importance of integrating flood-related health risks into global public health planning and climate change adaptation strategies.

Practical weight management to minimize pregnancy complications and promote women's health: the possibility of interpregnancy care.

Pregnancy is an excellent opportunity to provide medical interventions to women. It is also a stress test used to predict health. Numerous studies have demonstrated that the pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are critical factors for pregnancy complications such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), large or small gestational age infants, and spontaneous preterm birth (sPTB). These complications are associated with an increased risk of cardiovascular disease (CVD), which is a leading cause of mortality in women. In addition, complications adversely affect the short- and long-term prognoses of children. Optimal GWG to reduce complications is recommended based on pre-pregnancy BMI; however, racial differences should also be noted. The values in the Japanese guidelines are lower than those in the American Institute of Medicine guidelines. The Asian BMI thresholds for CVD risk are also lower than those in Europe. Therefore, weight management should be based on racial/genetic background. Interpregnancy weight gain or loss has also been reported to be associated with the risk of pregnancy complications; however, few studies have been conducted in Asian populations. Our previous reports suggested that avoiding an excess of 0.6 kg/m2/year of annual BMI gain may reduce the risk of HDP or GDM, and insufficient gain of < 0.25 kg/m2/year may increase sPTB recurrence. Annual BMI is useful for practical weight control during interpregnancy. Based on these findings, effective approaches should be established to improve the health of women and their offspring.

An increase in global daily precipitation records in response to global warming based on reanalysis and observations.

Understanding trends in extreme precipitation events in the context of global warming is critical for assessing climate change impacts. This study employs a novel methodology developed by Giorgi and Ciarlo (2022) to analyze record-breaking daily precipitation events from 1980 to 2020, utilizing three reanalysis products (ERA5, MERRA-2, and JRA-55) and one global observation dataset (MSWEP). Our results indicate a consistent and statistically significant increase in record-breaking precipitation events globally, with variations across different latitude bands and between land and ocean areas. This trend is evident in all datasets, with the most substantial increases observed over oceans in ERA5 and over land in JRA and MERRA. Notably, the Southern Hemisphere shows mixed results, with some regions displaying negative trends. This study highlights the increasing frequency of extreme precipitation events, supporting the hypothesis of intensified hydrological cycles under a warming climate. Our findings enhance understanding of precipitation extremes and underscore the importance of regional analyses in climate impact studies. Future work could extend these findings to formal attribution studies linking observed trends directly to anthropogenic climate change.

In recent decades, observations have shown changes in how often and how intensely it rains, which can be linked to global warming. Our study analyses record-breaking rainfall events, i.e. days when rainfall reaches unprecedented highs, in different observational and reanalysis records for the last 40 years. We use a new method to compare daily rainfall records with the values that would be expected in stable climate conditions, i.e. without warming. Our findings show that extreme rainfall events have become more frequent around the world. This trend is predominant across various latitudinal regions and over oceans and land, though there are some differences depending on the location. Notably, the increase in record rainfall events is more consistent across the oceans than the continental regions, with some of the latter showing negative trends in the southern hemisphere. This conclusion has important implications for how we prepare for and manage flooding and other related natural disasters in the future.

How the experiences of implementation support recipients contribute to implementation outcomes.

Introduction: There is a growing body of literature on the activities and competencies of implementation support practitioners (ISPs) and the outcomes of engaging ISPs to support implementation efforts. However, there remains limited knowledge about the experiences of implementation support recipients who engage with ISPs and how these experiences shape the trajectory of implementation and contribute to implementation outcomes. This study aimed to extend the research on ISPs by describing the experiences of professionals who received implementation support and inform our understanding of the mechanisms by which ISPs produce behavior change and contribute to implementation outcomes. Methods: Thirteen individuals with roles in supporting implementation efforts at a private foundation participated in semi-structured interviews. Data were analyzed using qualitative narrative analysis and episode profile analysis approaches. Iterative diagramming was used to visualize the pathway of experiences of implementation support recipients evidenced by the interview data. Results: The majority of recipients described how positive experiences and trusting relationships with ISPs increased acceptance of implementation science throughout the foundation and increased the perception of implementation science as both an appropriate and feasible approach for strengthening the impact of foundation strategies. As perceptions of appropriateness and feasibility increased, recipients of implementation support described increasing knowledge and application of implementation science in their funding engagements and internal foundation strategies. Finally, recipients reported that the application of implementation science across the foundation led to sustained implementation capacity and better outcomes. Discussion: The experiences of implementation support recipients described in this paper provide a source for further understanding the mechanisms of change for delivering effective implementation support leading to better implementation quality. Insights from these experiences can enhance our understanding for building implementation capacity and the rationales for evolving approaches that emphasize the dynamic, emotional, and highly relational nature of supporting others to use evidence in practice.

Assessment of Heat Exposure and Health Outcomes in Rural Populations of Western Kenya by Using Wearable Devices: Observational Case Study.

BACKGROUND: Climate change increasingly impacts health, particularly of rural populations in sub-Saharan Africa due to their limited resources for adaptation. Understanding these impacts remains a challenge, as continuous monitoring of vital signs in such populations is limited. Wearable devices (wearables) present a viable approach to studying these impacts on human health in real time. OBJECTIVE: The aim of this study was to assess the feasibility and effectiveness of consumer-grade wearables in measuring the health impacts of weather exposure on physiological responses (including activity, heart rate, body shell temperature, and sleep) of rural populations in western Kenya and to identify the health impacts associated with the weather exposures. METHODS: We conducted an observational case study in western Kenya by utilizing wearables over a 3-week period to continuously monitor various health metrics such as step count, sleep patterns, heart rate, and body shell temperature. Additionally, a local weather station provided detailed data on environmental conditions such as rainfall and heat, with measurements taken every 15 minutes. RESULTS: Our cohort comprised 83 participants (42 women and 41 men), with an average age of 33 years. We observed a positive correlation between step count and maximum wet bulb globe temperature (estimate 0.06, SE 0.02; P=.008). Although there was a negative correlation between minimum nighttime temperatures and heat index with sleep duration, these were not statistically significant. No significant correlations were found in other applied models. A cautionary heat index level was recorded on 194 (95.1%) of 204 days. Heavy rainfall (>20 mm/day) occurred on 16 (7.8%) out of 204 days. Despite 10 (21%) out of 47 devices failing, data completeness was high for sleep and step count (mean 82.6%, SD 21.3% and mean 86.1%, SD 18.9%, respectively), but low for heart rate (mean 7%, SD 14%), with adult women showing significantly higher data completeness for heart rate than men (2-sided t test: P=.003; Mann-Whitney U test: P=.001). Body shell temperature data achieved 36.2% (SD 24.5%) completeness. CONCLUSIONS: Our study provides a nuanced understanding of the health impacts of weather exposures in rural Kenya. Our study's application of wearables reveals a significant correlation between physical activity levels and high temperature stress, contrasting with other studies suggesting decreased activity in hotter conditions. This discrepancy invites further investigation into the unique socioenvironmental dynamics at play, particularly in sub-Saharan African contexts. Moreover, the nonsignificant trends observed in sleep disruption due to heat expose the need for localized climate change mitigation strategies, considering the vital role of sleep in health. These findings emphasize the need for context-specific research to inform policy and practice in regions susceptible to the adverse health effects of climate change.

A facilitator's reflection on the democratizing potential of emancipatory practice development.

Emancipatory practice development (ePD) is a practitioner-led research methodology which enables workplace transformation. Underpinned by the critical paradigm, ePD works through facilitation and workplace learning, with people in their local context on practice issues that are significant to them. Its purpose is to embed safe, person-centred learning cultures which transform individuals and workplaces. In this article, we critically reflect on a year-long ePD study in an acute care hospital ward. We explore the challenges of practice change within systems, building collective strength with frontline collaborations and leadership to sustain new learning cultures. Our work advances practice development dialogue through working closely with the underpinning theories. Our critique analyses how ePD can enact and sustain change within a complex system. We argue that ePD works to strengthen safety cultures by challenging antidemocratic practices through communicative action. By opening communicative spaces, ePD enables staff to collectively deliberate and reach consensus. Their raised awareness supports staff to resist ways of working which conspire against safe patient care. Sustainability of practice change is fostered by the co-operative democracies created within the frontline team and meso level enablement. We conclude that the democratising potential of ePDt generates staff agency at the frontline.