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At least 73 records · Page 4

Mortality and injury assessment for three species of fish exposed to simulated turbine blade strike

Injury and mortality of fish during downstream passage through hydropower turbines is among the leading direct impacts of hydropower. Understanding the relationships among various strike variables and injury and mortality rates are necessary for improvements in turbine design. We subjected three species of fish to simulated blade strike in laboratory studies with different blade thicknesses, impact velocities, and body orientations to develop relationships between these variables and probability of injury and mortality. Midbody strikes resulted in higher mortality than head strikes, and tail strikes produced the least mortality. Lateral strikes caused more mortality than dorsal and ventral strikes, and higher strike velocities and thinner blades contributed to increased mortality. Several injury types were significantly associated with increased mortality, including injuries to the operculum, gills, viscera, heart, liver, swim bladder, muscle, and bone fractures. Here, the results from this study will be used to define biologically based design criteria that can be used by turbine designers to improve designs (e.g., increased leading-edge thickness and slower turbine speeds) to minimize the probability and impact of blade strike.

60 APPLIED LIFE SCIENCES↗

Breast Cancer Mortality vs. Exercise and Breast Size in Runners and Walkers

Purpose: Identify predictors of breast cancer mortality in women who exercised below (,7.5 metabolic equivalent hours/ week, MET-hours/wk), at (7.5 to 12.5 MET-hours/wk), or above ($12.5 MET-hours/wk) recommended levels. Methods: Cox proportional hazard analyses of baseline pre-diagnosis MET-hours/wk vs. breast cancer mortality adjusted for follow-up age, race, baseline menopause, and estrogen and oral contraceptive use in 79,124 women (32,872 walkers, 46,252 runners) from the National Walkers’ and Runners’ Health Studies. Results: One-hundred eleven women (57 walkers, 54 runners) died from breast cancer during the 11-year follow-up. The decline in mortality in women who exercised $7.5 MET-hours/wk was not different for walking and running (P = 0.34), so running and walking energy expenditures were combined. The risk for breast cancer mortality was 41.5% lower for $7.5 vs. ,7.5 MET-hours/wk (HR: 0.585, 95%CI: 0.382 to 0.924, P = 0.02), which persisted when adjusted for BMI (HR: 0.584, 95%CI: 0.368 to 0.956, P = 0.03). Other than age and menopause, baseline bra cup size was the strongest predictor of breast cancer mortality, i.e., 57.9% risk increase per cup size when adjusted for MET-hours/wk and the other covariates (HR: 1.579, 95%CI: 1.268 to 1.966, P,0.0001), and 70.4% greater when further adjusted for BMI (HR: 1.704, 95%CI: 1.344 to 2.156, P = 1025 ). Breast cancer mortality was 4.0-fold greater (HR: 3.980, 95%CI: 1.894 to 9.412, P = 0.0001) for C-cup, and 4.7-fold greater (HR: 4.668, 95%CI: 1.963 to 11.980, P = 0.0004) for $D-cup vs. A-cup when adjusted for BMI and other covariates. Adjustment for cup size and BMI did not eliminate the association between breast cancer mortality and $7.5 MET-hour/wk walked or run (HR: 0.615, 95%CI: 0.389 to 1.004, P = 0.05). Conclusion: Breast cancer mortality decreased in association with both meeting the exercise recommendations and smaller breast volume.

59 BASIC BIOLOGICAL SCIENCES↗

The Relationship of Walking Intensity to Total and Cause-Specific Mortality. Results from the National Walkers’ Health Study

Purpose: Test whether: 1) walking intensity predicts mortality when adjusted for walking energy expenditure, and 2) slow walking pace (≥24-minute mile) identifies subjects at substantially elevated risk for mortality. Methods: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile) in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. Results: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10-5), cardiovascular diseases (2.4% increase, P=0.001, 637 deaths), ischemic heart disease (2.8% increase, P=0.003, 336 deaths), heart failure (6.5% increase, P=0.001, 36 deaths), hypertensive heart disease (6.2% increase, P=0.01, 31 deaths), diabetes (6.3% increase, P=0.004, 32 deaths), and dementia (6.6% increase, P=0.0004, 44 deaths). Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001), cardiovascular diseases (43.9% increased risk, P=0.03), and dementia (5.0-fold increased risk, P=0.0002) even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET)-hours per week. Conclusions: The risk for mortality: 1) decreases in association with walking intensity, and 2) increases substantially in association for walking pace ≥24 minute mile (equivalent to <400m during a six-minute walk test) even among subjects who exercise regularly.

59 BASIC BIOLOGICAL SCIENCES↗

Growth-Mortality Relationships in Piñon Pine ( Pinus edulis ) during Severe Droughts of the Past Century: Shifting Processes in Space and Time

The processes leading to drought-associated tree mortality are poorly understood, particularly long-term predisposing factors, memory effects, and variability in mortality processes and thresholds in space and time. We use tree rings from four sites to investigate Pinus edulis mortality during two drought periods in the southwestern USA. We draw on recent sampling and archived collections to (1) analyze P. edulis growth patterns and mortality during the 1950s and 2000s droughts; (2) determine the influence of climate and competition on growth in trees that died and survived; and (3) derive regression models of growth-mortality risk and evaluate their performance across space and time. Recent growth was 53% higher in surviving vs. dying trees, with some sites exhibiting decades-long growth divergences associated with previous drought. Differential growth response to climate partly explained growth differences between live and dead trees, with responses wet/cool conditions most influencing eventual tree status. Competition constrained tree growth, and reduced trees’ ability to respond to favorable climate. The best predictors in growth-mortality models included long-term (15–30 year) average growth rate combined with a metric of growth variability and the number of abrupt growth increases over 15 and 10 years, respectively. The most parsimonious models had high discriminatory power (ROC >0.84) and correctly classified ~70% of trees, suggesting that aspects of tree growth, especially over decades, can be powerful predictors of widespread drought-associated die-off. However, model discrimination varied across sites and drought events. Weaker growth-mortality relationships and higher growth at lower survival probabilities for some sites during the 2000s event suggest a shift in mortality processes from longer-term growth-related constraints to shorter-term processes, such as rapid metabolic decline even in vigorous trees due to acute drought stress, and/or increases in the attack rate of both chronically stressed and more vigorous trees by bark beetles.

54 ENVIRONMENTAL SCIENCES↗

Development and validation of a 30-day mortality index based on pre-existing medical administrative data from 13,323 COVID-19 patients: The Veterans Health Administration COVID-19 (VACO) Index

Background Available COVID-19 mortality indices are limited to acute inpatient data. Using nationwide medical administrative data available prior to SARS-CoV-2 infection from the US Veterans Health Administration (VA), we developed the VA COVID-19 (VACO) 30-day mortality index and validated the index in two independent, prospective samples. Methods and findings We reviewed SARS-CoV-2 testing results within the VA between February 8 and August 18, 2020. The sample was split into a development cohort (test positive between March 2 and April 15, 2020), an early validation cohort (test positive between April 16 and May 18, 2020), and a late validation cohort (test positive between May 19 and July 19, 2020). Our logistic regression model in the development cohort considered demographics (age, sex, race/ethnicity), and pre-existing medical conditions and the Charlson Comorbidity Index (CCI) derived from ICD-10 diagnosis codes. Weights were fixed to create the VACO Index that was then validated by comparing area under receiver operating characteristic curves (AUC) in the early and late validation cohorts and among important validation cohort subgroups defined by sex, race/ethnicity, and geographic region. We also evaluated calibration curves and the range of predictions generated within age categories. 13,323 individuals tested positive for SARS-CoV-2 (median age: 63 years; 91% male; 42% non-Hispanic Black). We observed 480/3,681 (13%) deaths in development, 253/2,151 (12%) deaths in the early validation cohort, and 403/7,491 (5%) deaths in the late validation cohort. Age, multimorbidity described with CCI, and a history of myocardial infarction or peripheral vascular disease were independently associated with mortality–no other individual comorbid diagnosis provided additional information. The VACO Index discriminated mortality in development (AUC = 0.79, 95% CI: 0.77–0.81), and in early (AUC = 0.81 95% CI: 0.78–0.83) and late (AUC = 0.84, 95% CI: 0.78–0.86) validation. The VACO Index allows personalized estimates of 30-day mortality after COVID-19 infection. For example, among those aged 60–64 years, overall mortality was estimated at 9% (95% CI: 6–11%). The Index further discriminated risk in this age stratum from 4% (95% CI: 3–7%) to 21% (95% CI: 12–31%), depending on sex and comorbid disease. Conclusion Prior to infection, demographics and comorbid conditions can discriminate COVID-19 mortality risk overall and within age strata. The VACO Index reproducibly identified individuals at substantial risk of COVID-19 mortality who might consider continuing social distancing, despite relaxed state and local guidelines.

60 APPLIED LIFE SCIENCES↗

Mortality correlates with tree functional traits across a wood density gradient in the Central Amazon

Introduction: Understanding the mechanisms of tree mortality in tropical ecosystems remains challenging, in part due to the high diversity of tree species and the inherently stochastic nature of mortality. Plant functional traits offer a mechanistic link between plant physiology and performance, yet their ability to predict growth and mortality remains poorly understood. Given recent increases in tree mortality rates in the Amazon forest following extreme drought and wind events, we tested if lower wood density and acquisitive plant functional traits were associated with increased growth and mortality for common co-occurring trees in the Central Amazon. Methods: Seventeen trees of different species with similar sizes but a range in wood density (WD) and wood traits were felled, then assessed for 27 different individual functional parameters, including whole tree architecture, stem xylem anatomical and hydraulic traits and leaf traits. Traits of the individual trees were related to stand-level growth and mortality rates collected periodically over 30 years from nearby permanent inventory plots. Results: Higher wood density was associated with smaller leaf size, lower foliar base cations, lower stem water content and sapwood fraction, in agreement with the fast-slow plant economics spectrum. Lower wood density was associated with more acquisitive characteristics with greater hydraulic capacity and foliar nutrient concentrations, correlating with greater growth and mortality rates. Discussion: Our results show that lower wood density is part of a coordinated suite of traits linked to high resource acquisition, fast growth, and increased mortality risk, providing a functional framework for predicting species performance and forest vulnerability under future climate stress.

demographics↗

Sensitivity of Optical Satellites to Estimate Windthrow Tree-Mortality in a Central Amazon Forest

Windthrow (i.e., trees broken and uprooted by wind) is a major natural disturbance in Amazon forests. Images from medium-resolution optical satellites combined with extensive field data have allowed researchers to assess patterns of windthrow tree-mortality and to monitor forest recovery over decades of succession in different regions. Although satellites with high spatial-resolution have become available in the last decade, they have not yet been employed for the quantification of windthrow tree-mortality. Here, we address how increasing the spatial resolution of satellites affects plot-to-landscape estimates of windthrow tree-mortality. We combined forest inventory data with Landsat 8 (30 m pixel), Sentinel 2 (10 m), and WorldView 2 (2 m) imagery over an old-growth forest in the Central Amazon that was disturbed by a single windthrow event in November 2015. Remote sensing estimates of windthrow tree-mortality were produced from Spectral Mixture Analysis and evaluated with forest inventory data (i.e., ground true) by using Generalized Linear Models. Field measured windthrow tree-mortality (3 transects and 30 subplots) crossing the entire disturbance gradient was 26.9 ± 11.1% (mean ± 95% CI). Although the three satellites produced reliable and statistically similar estimates (from 26.5% to 30.3%, p < 0.001), Landsat 8 had the most accurate results and efficiently captured field-observed variations in windthrow tree-mortality across the entire gradient of disturbance (Sentinel 2 and WorldView 2 produced the second and third best results, respectively). As expected, mean-associated uncertainties decreased systematically with increasing spatial resolution (i.e., from Landsat 8 to Sentinel 2 and WorldView 2). However, the overall quality of model fits showed the opposite pattern. We suggest that this reflects the influence of a relatively minor disturbance, such as defoliation and crown damage, and the fast growth of natural regeneration, which were not measured in the field nor can be captured by coarser resolution imagery. Our results validate the reliability of Landsat imagery for assessing plot-to-landscape patterns of windthrow tree-mortality in dense and heterogeneous tropical forests. Satellites with high spatial resolution can improve estimates of windthrow severity by allowing the quantification of crown damage and mortality of lower canopy and understory trees. However, this requires the validation of remote sensing metrics using field data at compatible scales.

54 ENVIRONMENTAL SCIENCES↗

Future Global Mortality from Changes in Air Pollution Attributable to Climate Change

Ground-level ozone and fine particulate matter (PM (sub 2.5)) are associated with premature human mortality; their future concentrations depend on changes in emissions, which dominate the near-term, and on climate change. Previous global studies of the air-quality-related health effects of future climate change used single atmospheric models. However, in related studies, mortality results differ among models. Here we use an ensemble of global chemistry-climate models to show that premature mortality from changes in air pollution attributable to climate change, under the high greenhouse gas scenario RCP (Representative Concentration Pathway) 8.5, is probably positive. We estimate 3,340 (30,300 to 47,100) ozone-related deaths in 2030, relative to 2000 climate, and 43,600 (195,000 to 237,000) in 2100 (14 percent of the increase in global ozone-related mortality). For PM (sub 2.5), we estimate 55,600 (34,300 to 164,000) deaths in 2030 and 215,000 (76,100 to 595,000) in 2100 (countering by 16 percent the global decrease in PM (sub 2.5)-related mortality). Premature mortality attributable to climate change is estimated to be positive in all regions except Africa, and is greatest in India and East Asia. Most individual models yield increased mortality from climate change, but some yield decreases, suggesting caution in interpreting results from a single model. Climate change mitigation is likely to reduce air-pollution-related mortality.

Atmohspheric chemistry↗

Risk of Mortality in Family Members of Men Seeking Fertility Assessment

Objective: To assess mortality in family members of men seeking fertility assessment. Subfertility serves as a biomarker for overall somatic health, and poor semen quality is associated with increased risk of hospitalization and mortality from chronic conditions. However, it is unclear if these risks extend to family members of men with low sperm count. Design: Retrospective cohort study. Subjects: Family members, up to third-degree relatives, of men in the Subfertility, Health and Assisted Reproduction and the Environment cohort who underwent a semen analysis as part of a fertility assessment 1996–2017. Relatives of men with a recorded total sperm count who lived in Utah for ≥1 year 1904–2017 were included in the analysis (N = 22,280 families). Exposure: Individuals were classified by family membership. Families were classified as relatives of azoospermic (0M), oligozoospermic (<39M), or normozoospermic (≥39M) men. The average total sperm count of the proband (male relative) with fertility assessment was also included as a continuous exposure measure. Main Outcome Measures: The main outcomes were all-cause and cause-specific mortality risk by sex, age, and degree of relation: first-, second-, and third-degree. Cox proportional hazard models were used to test the association between fertility classification and mortality, controlling for sex, race/ethnicity, and birth year. Results: A total of 666,437 relatives of men with fertility assessment (N deaths = 183,974) were included in the analysis. Relative to normozoospermia families, all-cause mortality risk increased in oligozoospermia families (hazard ratio [HR] oligozoospermia , 1.03; 95% confidence interval [CI], 1.01–1.05). Close relatives, first- (HR oligozoospermia , 1.17; 95% CI, 1.07–1.28) and second-degree relatives (HR azoospermia , 1.11; 95% CI, 1.04–1.20; HR oligozoospermia , 1.05; 95% CI,1.01–1.09), of azoospermic and oligozoospermic men had the highest all-cause and cause-specific mortality risk, including death attributed to cardiovascular disease or congenital birth conditions. Conclusion: Our results suggest that familial all-cause and cause-specific mortality risk differ by fertility phenotype. Families of azoospermic and oligozoospermic men showed significantly increased risk, particularly for close relatives. This study provides further evidence that shared genetic and/or environmental factors could influence both fertility and somatic health.

Male fertility↗

Development and validation of an imaging and clinical scoring system to predict early mortality in spontaneous ruptured hepatocellular carcinoma treated with transarterial embolization

Purpose: To develop and validate a scoring system using a combination of imaging and clinical parameters to predict 30-day mortality in ruptured HCC (rHCC) patients after transarterial embolization (TAE). Methods: 98 consecutive patients with rHCC who underwent abdominal CT and subsequent TAE between January 2007 and December 2016 were retrospectively reviewed. The CT scans were reviewed by two radiologists blinded to the patient outcome. Clinical parameters including serum bilirubin, albumin, INR, creatinine, and hemoglobin were recorded. Independent risk factors for 30-day mortality after TAE were identified using multivariate binary logistic regression, for development of a scoring system. The scoring system was then validated in 20 patients between January 2017 and May 2018. Results: In the development cohort, bilobar tumor distribution (OR = 29.6), clinical parameters of bilirubin > 2.5 mg/dL (OR = 5.9), and albumin < 30 g/L (OR = 4.1) were independent predictors for 30-day mortality. A 6-point score was derived and yielded area-under-the-receiver-operating-characteristic-curve (AUC) of 0.904. A score ≥ 4 resulted in sensitivity of 80.5% and specificity of 91.2% for 30-day mortality. In the validation cohort, AUC for 30-day mortality was 0.939. A score ≥ 4 resulted in sensitivity of 81.2% and specificity of 88.9%. In both development and validation cohorts, the proposed scoring system was better than biochemical components of Child–Pugh score and serum bilirubin to predict 30-day mortality. Conclusion: Imaging and clinical parameters can be combined into a scoring system to accurately predict 30-day mortality after TAE in rHCC patients. The score may help identify and counsel high-risk patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Two-Year Mortality After Angioplasty of the Femoro-Popliteal Artery with Uncoated Balloons and Paclitaxel-Coated Balloons—A Pooled Analysis of Four Randomized Controlled Multicenter Trials

Purpose: In view of a recent meta-analysis reporting increased mortality following angioplasty with paclitaxel-coated devices in peripheral arteries, we performed a patient-level 2-year mortality analysis based on pooled original data of four randomized controlled trials (THUNDER, FEMPAC, PACIFIER and CONSEQUENT). Methods and Results: Clinical data of four randomized controlled trial were pooled to assess 2-year mortality following paclitaxel-coated balloon (PCB) angioplasty compared to angioplasty without paclitaxel (control group). A logistic regression model was applied to identify potential predictors of mortality. At two years, 13 of 185 (7.0%) patients had died in the control group and 16/184 (8.7%) in the PBC group, p = 0.55. Kaplan–Meier analysis revealed no significant difference from all-cause death at 2 years (log rank p = 0.54). Causes of death were well balanced between the groups with no pattern or trend in favour of any specific causes in the PBC group. Logistic regression revealed that treatment groups (controls or PBC) were not a predictor of 2-year mortality. The only predictor for mortality was patient age ≥ 75 years. The delivered paclitaxel doses per patient were not significantly different in patients that died and those who did not die during the 24-month follow-up (5.300 ± 4.224 μg vs. 6.248 ± 4.629 μg, p = 0.433). Conclusions: Based on original patient-level data of four pooled randomized controlled trials, we found no increase in 2-year mortality in patients treated with PCB compared to control patients treated with uncoated balloons. Causes of death were well balanced between PCB and control patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Projection of temperature-related mortality due to cardiovascular disease in beijing under different climate change, population, and adaptation scenarios

Highlights: • The population change can bring 5 times growth to temperature-related CVD deaths. • Increase of heat-related CVD deaths is higher than decrease of cold-related ones. • The adaptation to climate change may cause more temperature-related CVD deaths. Human health faces unprecedented challenges caused by climate change. Thus, studies of the effect of temperature change on total mortality have been conducted in numerous countries. However, few of those studies focused on temperature-related mortality due to cardiovascular disease (CVD) or considered future population changes and adaptation to climate change. We present herein a projection of temperature-related mortality due to CVD under different climate change, population, and adaptation scenarios in Beijing, a megacity in China. To this end, 19 global circulation models (GCMs), 3 representative concentration pathways (RCPs), 3 socioeconomic pathways, together with generalized linear models and distributed lag non-linear models, were used to project future temperature-related CVD mortality during periods centered around the years 2050 and 2070. The number of temperature-related CVD deaths in Beijing is projected to increase by 3.5–10.2% under different RCP scenarios compared with that during the baseline period. Using the same GCM, the future daily maximum temperatures projected using the RCP2.6, RCP4.5, and RCP8.5 scenarios showed a gradually increasing trend. When population change is considered, the annual rate of increase in temperature-related CVD deaths was up to fivefold greater than that under no-population-change scenarios. The decrease in the number of cold-related deaths did not compensate for the increase in that of heat-related deaths, leading to a general increase in the number of temperature-related deaths due to CVD in Beijing. In addition, adaptation to climate change may enhance rather than ameliorate the effect of climate change, as the increase in cold-related CVD mortality greater than the decrease in heat-related CVD mortality in the adaptation scenarios will result in an increase in the total number of temperature-related CVD mortalities.

54 ENVIRONMENTAL SCIENCES↗

Context matters: Natural tree mortality can lead to neighbor growth release or suppression

Where competition suppresses tree growth, mortality of adjacent trees can release the surviving individuals, leading to a growth increase. However, primary forests are complicated systems, where trees interact in both competitive and facilitative ways mediated by their size, species, and the broad ecological context in which they grow. Thus, the magnitude and even direction of growth responses to the mortality of nearby trees may vary, which has implications for our understanding of community- and ecosystem-level dynamics following mortality events. Unfortunately, although many studies focus on the impacts of light availability and general crowding on tree growth, we know relatively little about the effects of naturally occurring mortality events on the growth of neighboring trees. To address this issue, we used 40 years of data from 15 permanent forest-monitoring plots in Mt Rainier old-growth forests, comparing observed to expected radial growth of individual trees following the death of their nearest neighbor. Although we found evidence of a general growth-release response, this was not universal among all trees, with small trees in particular exhibiting growth suppression (rather than release) following neighboring tree mortality. In addition to small size, growth-suppression was more likely if the dead neighbor was the same species, consistent with facilitative effects as mediated through belowground networks. At the stand level, the average growth release after nearest neighbor mortality was greatest in low-density stands with large trees, with elevation and community composition also playing a role. Decades more monitoring could reveal how long growth release (or suppression) is sustained by individual trees following neighboring mortality events, as well as potential response lags and the role of species identity in determining whether interactions with neighbors are competitive or facilitative. Nonetheless, our results suggest that although mature trees have competitive effects on their larger neighbors, they also have an important role in supporting the ingrowth of small trees. More broadly, we demonstrate that the nature of interactions between individual neighboring trees is highly context dependent.

54 ENVIRONMENTAL SCIENCES↗

Reduced ecosystem resilience quantifies fine-scale heterogeneity in tropical forest mortality responses to drought

Sensitivity of forest mortality to drought in carbon-dense tropical forests remains fraught with uncertainty, while extreme droughts are predicted to be more frequent and intense. Here, in this study, the potential of temporal autocorrelation of high-frequency variability in Landsat Enhanced Vegetation Index (EVI), an indicator of ecosystem resilience, to predict spatial and temporal variations of forest biomass mortality is evaluated against in situ census observations for 64 site-year combinations in Costa Rican tropical dry forests during the 2015 ENSO drought. Temporal autocorrelation, within the optimal moving window of 24 months, demonstrated robust predictive power for in situ mortality (leave-one- out cross-validation R 2 = 0.54), which allows for estimates of annual biomass mortality patterns at 30 m resolution. Subsequent spatial analysis showed substantial fine-scale heterogeneity of forest mortality patterns, largely driven by drought intensity and ecosystem properties related to plant water use such as forest deciduousness and topography. Highly deciduous forest patches demonstrated much lower mortality sensitivity to drought stress than less deciduous forest patches after elevation was controlled. Our results highlight the potential of high-resolution remote sensing to “fingerprint” forest mortality and the significant role of ecosystem heterogeneity in forest biomass resistance to drought.

59 BASIC BIOLOGICAL SCIENCES↗

Processes and mechanisms of coastal woody-plant mortality

Observations of woody plant mortality in coastal ecosystems are globally widespread, but the overarching processes and underlying mechanisms are poorly understood. This knowledge deficiency, combined with rapidly changing water levels, storm surges, atmospheric CO 2 , and vapor pressure deficit, creates large predictive uncertainty regarding how coastal ecosystems will respond to global change. Here we synthesize the literature on the mechanisms that underlie coastal woody-plant mortality, with the goal of producing a testable hypothesis framework. The key emergent mechanisms underlying mortality include hypoxic, osmotic, and ionic-driven reductions in whole-plant hydraulic conductance and photosynthesis that ultimately drive the coupled processes of hydraulic failure and carbon starvation. The relative importance of these processes in driving mortality, their order of progression, and their degree of coupling depends on the characteristics of the anomalous water exposure, on topographic effects, and on taxa-specific variation in traits and trait acclimation. Greater inundation exposure could accelerate mortality globally; however, the interaction of changing inundation exposure with elevated CO 2 , drought, and rising vapor pressure deficit could influence mortality likelihood. Models of coastal forests that incorporate the frequency and duration of inundation, the role of climatic drivers, and the processes of hydraulic failure and carbon starvation can yield improved estimates of inundation-induced woody-plant mortality.

salinity↗

Climate-Induced Mortality of Siberian Pine and Fir in the Lake Baikal Watershed, Siberia

Siberian pine (Pinus sibirica) and fir (Abies sibirica) (so called ''dark needle conifers", DNC) showed decreased radial growth increment within the Lake Baikal watershed since the 1980s with increasing mortality recorded since the year 2000. Tree ring width was strongly correlated with vapor pressure deficit, aridity and root zone moisture. Water stress from droughts made trees more susceptible to insect attacks causing mortality in about 10% of DNC stands within the Lake Baikal watershed. Within Siberia DNC mortality increased in the southern part of the DNC range. Biogeographically, tree mortality was located within the DNC - forest-steppes transition. Tree mortality was significantly correlated with drought and soil moisture anomalies. Within the interior of the DNC range mortality occurred within relief features with high water stress risk (i.e., steep convex south facing slopes with shallow well-drained soils). In general, DNC mortality in Siberia was induced by increased aridity and severe drought (inciting factors) in synergy with biotic attacks (contributing factor). In future climate scenarios with predicted increase in aridity DNC could be eliminated from the southern part of its current range and will be replaced by drought-resistant conifers and broadleaf species (e.g., Larix sibirica, Pinus silvestris, and Betula pubescence).

Conifer Mortality↗

Impact of Climate Change on Heat-Related Mortality in Jiangsu Province, China

A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

projection↗

Present-Day and Future PM 2.5 and O 3 -Related Global and Regional Premature Mortality in the EVAv6.0 Health Impact Assessment Model

We used the EVAv6.0 system to estimate the present (2015) and future (2015–2050) global PM 2.5 and O 3 -related premature mortalities, using simulated surface concentrations from the GISS-E2.1-G Earth system model. The PM 2.5 -related global premature mortality is estimated to be 4.3 and 4.4 million by the non-linear and linear models, respectively. Ischemic heart diseases are found to be the leading cause of PM 2.5 -related premature deaths, contributing by 35% globally. Both long-term and short-term O 3 -related premature deaths are estimated to be around 1 million, globally. Overall, PM 2.5 and O 3 -related premature mortality leads to 5.3–5.4 million premature deaths, globally. The global burden of premature deaths is mainly driven by the Asian region, which in 2015 contributes by 75% of the total global premature deaths. An increase from 6.2% to 8% in the PM 2.5 relative risk as recommended by the WHO leads to an increase of PM 2.5 -related premature mortality by 28%, to 5.7 million. Finally, bias correcting the simulated PM 2.5 concentrations in 2015 leads to an increase of up to 73% in the global PM 2.5 -related premature mortality, leading to a total number of global premature deaths of up to 7.7 million, implying the necessity of bias correction to get more robust health burden estimates. PM 2.5 and O 3 -related premature mortality in 2050 decreases by up to 57% and 18%, respectively, due to emission reductions alone. However, the projected increase and aging of the population leads to increases of premature mortality by up to a factor of 2, showing that the population exposed to air pollution is more important than the level of air pollutants, highlighting that the population dynamics should be considered when setting up health assessment systems.

Premature mortality↗