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Long-term and short-term changes in ambient temperature can cause stress in birds, leading to changes in the level of hematological parameters. The H:L ratio (heterophil-to-lymphocyte ratio) is a hematological index that allows for the assessment of the stress induced by environmental changes, including weather conditions. In this paper, we examined the influence of temperatures and the sum of precipitation on the health of nestling pied flycatchers (Ficedula hypoleuca) by using the H:L ratio reflecting the body’s response to stress. All examined temperature indicators influenced the H:L ratio, yet the average value of daily minimum temperature during the first 12 days of nestling life had the strongest influence, maximum temperature had the weakest effect, while precipitation had no significant influence. Our research indicates that even a small increase in temperature caused a stress reaction in nestling pied flycatchers, which was reflected by an increase in the H:L ratio. The increase in the stress index (H:L ratio) was probably a result of poor weather conditions (precipitation, low temperature), which prevented the adult birds from actively foraging and properly feeding the nestlings.

This paper describes a Cold Weather Ensemble Decision Aid (CoWEDA) that provides guidance for cold weather injury prevention, mission planning, and clothing selection. CoWEDA incorporates current science from the disciplines of physiology, meteorology, clothing, and computer modeling. The thermal performance of a cold weather ensemble is defined by endurance times, which are the time intervals from initial exposure until the safety limits are reached. These safety limits correspond to conservative temperature thresholds that provide a warning of the approaching onset of frostbite and/or hypothermia. A validated six-cylinder thermoregulatory model is used to predict human thermal responses to cold while wearing different ensembles. The performance metrics, model, and a database of clothing properties were integrated into a user-friendly software application. CoWEDA is the first tool that allows users to build their own ensembles from the clothing menu (i.e., jackets, footwear, and accessories) for each body region (i.e., head, torso, lower body, hands, feet) and view their selections in the context of physiological strain and the operational consequences. Comparison of predicted values to skin and core temperatures, measured during 17 cold exposures ranging from 0 to −40°C, indicated that the accuracy of CoWEDA prediction is acceptable, and most predictions are within measured mean ± SD. CoWEDA predicts the risk of frostbite and hypothermia and ensures that a selected clothing ensemble is appropriate for expected weather conditions and activities. CoWEDA represents a significant enhancement of required clothing insulation (IREQ, ISO 11079) and wind chill index-based guidance for cold weather safety and survival.

This paper analyses how recent trends in heat waves impact heat warning systems. We performed a retrospective analysis of the challenges faced by the French heat prevention plan since 2004. We described trends based on the environmental and health data collected each summer by the French heat warning system and prevention plan. Major evolutions of the system were tracked based on the evaluations organized each autumn with the stakeholders of the prevention plan. Excess deaths numbering 8000 were observed during heat waves between 2004 and 2019, 71% of these between 2015 and 2019. We observed major changes in the characteristics, frequency and the geographical spread of heat waves since 2015. Feedbacks led to several updates of the warning system such as the extension of the surveillance period. They also revealed that risk perception remained limited among the population and the stakeholders. The sharp increase in the number of heat warnings issued per year since 2015 challenges the acceptability of the heat warnings. Recent heat waves without historical equivalent interfere with the development of evidence-based prevention strategies. The growing public health impacts heat waves emphasize the urgent need to act to adapt the population, at different levels of intervention, from individual comportments to structural modifications. A specific attention should be given to increase the resources allocated to the evaluation and the management of heat-related risks, especially considering the needs to catch with the rapid rhythm of the changing climate. Supplementary Information The online version contains supplementary material available at 10.1007/s00484-021-02123-y.

The purpose of the study was to investigate the quality and reliability of YouTube videos as a source of information in water treatments. We searched videos on YouTube ( www.youtube.com ) using the following keywords: "health resort medicine," "spa treatment," "spa therapy," "hydrotherapy," "thermal medicine," "balneology," and "balneotherapy" on June 17th, 2021. The global quality scale (GQS) was used to evaluate the quality of the videos. The assessment of reliability was evaluated using the modified DISCERN tool. Some other video parameters and sources of the videos were also recorded. One hundred twenty-one (121) videos were analyzed. The most common video source was advertisement (46.3%). GQS and modified DISCERN median scores were generally low. They were superior for "hydrotherapy" and "balneotherapy" and were also higher in videos uploaded by health-related persons or organizations (physicians, health-related professionals, and health-related websites). A statistically significant positive correlation was found between investigated parameters (like view ratio, number of likes, video power index, video length) and GQS. Only video length was correlated with modified DISCERN for investigated parameters. The median video power index scores were statistically higher for "spa therapy" and "spa treatment." The YouTube content linked with water treatments has poor quality and reliability most of time. The hydrotherapy and balneotherapy keywords have the best quality and reliability.We think that designers of water treatment videos should involve health professionals more often so that the content of their video will better explain the details of medical conditions or interventions.The scientific experts should ensure a consensus in terminology to straighten the awareness of water treatments for patients and physicians.

Climate change is affecting many living organisms; however, the responses of many of them remain unknown. In this paper, we present the results regarding the response of a bird species from the rallid family to the increased temperatures during the breeding season. We analysed the breeding data of Eurasian Coots nesting during 30 seasons between 1972 and 2019. During the study period, mean temperatures in April, the month when Coots start nesting, increased by 3.5 °C, and in months corresponding with the species breeding season by 2.6 °C. Breeding Coots advanced their earliest and median laying dates across the study period; however, the duration of their breeding season remained unchanged. We did not detect any significant temporal changes in clutch size, but clutches have become much more variable in size throughout the study period. Nest failures and production of offspring per nest did not change over the study period; however, the production of young per successful nest significantly declined. It is likely that this decline is the effect of mismatch between the period of food abundance (dipterans collected from water), and hatchling emergence, which is advanced due to change in climate. Future studies investigating the occurrence of dipteran resources at water bodies are needed to test this hypothesis. Electronic supplementary material The online version of this article (10.1007/s00484-020-01972-3) contains supplementary material, which is available to authorized users.

Under the variant climate conditions in the transitional regions between tropics and subtropics, the impacts of climate factors on influenza subtypes have rarely been evaluated. With the available influenza A (Flu-A) and influenza B (Flu-B) outbreak data in Shenzhen, China, which is an excellent example of a transitional marine climate, the associations of multiple climate variables with these outbreaks were explored in this study. Daily laboratory-confirmed influenza virus and climate data were collected from 2009 to 2015. Potential impacts of daily mean/maximum/minimum temperatures (T/Tmax/Tmin), relative humidity (RH), wind velocity (V), and diurnal temperature range (DTR) were analyzed using the distributed lag nonlinear model (DLNM) and generalized additive model (GAM). Under its local climate partitions, Flu-A mainly prevailed in summer months (May to June), and a second peak appeared in early winter (December to January). Flu-B outbreaks usually occurred in transitional seasons, especially in autumn. Although low temperature caused an instant increase in both Flu-A and Flu-B risks, its effect could persist for up to 10 days for Flu-B and peak at 17 C (relative risk (RR) = 14.16, 95% CI: 7.46–26.88). For both subtypes, moderate–high temperature (28 C) had a significant but delayed effect on influenza, especially for Flu-A (RR = 26.20, 95% CI: 13.22–51.20). The Flu-A virus was sensitive to RH higher than 76%, while higher Flu-B risks were observed at both low ( 83%) humidity. Flu-A was active for a short term after exposure to large DTR (e.g., DTR = 10 C, RR = 12.45, 95% CI: 6.50–23.87), whereas Flu-B mainly circulated under stable temperatures. Although the overall wind speed in Shenzhen was low, moderate wind (2–3 m/s) was found to favor the outbreaks of both subtypes. This study revealed the thresholds of various climatic variables promoting influenza outbreaks, as well as the distinctions between the flu subtypes. These data can be helpful in predicting seasonal influenza outbreaks and minimizing the impacts, based on integrated forecast systems coupled with short-term climate models. Supplementary Information The online version contains supplementary material available at 10.1007/s00484-021-02204-y.

Heat stress decreases human physical work capacity (PWC), but the extent to which solar radiation (SOLAR) compounds this response is not well understood. This study empirically quantified how SOLAR impacts PWC in the heat, considering wide, but controlled, variations in air temperature, humidity, and clothing coverage. We also provide correction equations so PWC can be quantified outdoors using heat stress indices that do not ordinarily account for SOLAR (including the Heat Stress Index, Humidex, and Wet-Bulb Temperature). Fourteen young adult males (7 donning a work coverall, 7 with shorts and trainers) walked for 1 h at a fixed heart rate of 130 beats∙min−1, in seven combinations of air temperature (25 to 45°C) and relative humidity (20 or 80%), with and without SOLAR (800 W/m2 from solar lamps). Cumulative energy expenditure in the heat, relative to the work achieved in a cool reference condition, was used to determine PWC%. Skin temperature was the primary determinant of PWC in the heat. In dry climates with exposed skin (0.3 Clo), SOLAR caused PWC to decrease exponentially with rising air temperature, whereas work coveralls (0.9 Clo) negated this effect. In humid conditions, the SOLAR-induced reduction in PWC was consistent and linear across all levels of air temperature and clothing conditions. Wet-Bulb Globe Temperature and the Universal Thermal Climate Index represented SOLAR correctly and did not require a correction factor. For the Heat Stress Index, Humidex, and Wet-Bulb Temperature, correction factors are provided enabling forecasting of heat effects on work productivity. Supplementary Information The online version contains supplementary material available at 10.1007/s00484-021-02205-x.

Temperature has been studied in relation to many health outcomes. However, few studies have explored its effect on the risk of hospital admission for rheumatoid arthritis (RA). A distributed lag non-linear model (DLNM) was used to analyze associations between mean temperature, diurnal temperature range (DTR), temperature change between neighboring days (TCN), and daily admissions for RA from 2015 to 2019 in Anqing, China. Subgroup analyses based on age, gender, rheumatoid factors, and admission route were performed. In total, 1456 patients with RA were hospitalized. Regarding the cumulative-lag effects of extreme cold temperature (5th percentile = 3℃), the risks of admissions for RA were increased and highest at lag 0–11 (RR = 2.68, 95% CI: 1.23–5.86). Exposing to low (5th percentile = 1.9℃) and high (95th percentile = 14.2℃) DTRs both had increased risks of RA admission, with highest RRs of 1.40 (95% CI: 1.03–1.91) and 1.24 (95% CI: 1.0–1.53) at lag 0 day, respectively. As for TCN, the marginal risk of admission in RA patients was found when exposed to high TCN (95th percentile = 2.9℃) with the largest single-day effect at lag 10 (RR = 1.11, 95% CI: 1.01–1.23). In subgroup analyses, females were more susceptible to extreme cold temperature, low and high DTRs, and high TCN. In regard to extreme cold temperature, significant risk of hospital admission in females only appeared at lag 2 (RR = 1.48, 95% CI: 1.02–2.15) and lag 0–2 (RR = 2.35, 95% CI: 1.11–4.95). It is clear that RA patients exposed to changing temperature may increase risks of admission. Supplementary Information The online version contains supplementary material available at 10.1007/s00484-021-02207-9.

Changes in frequency and severity of heat waves due to climate change pose a considerable challenge to livestock production systems. Although it is well known that heat stress reduces feed intake in cattle, effects of heat stress vary between animal genotypes and climatic conditions and are context specific. To derive a generic global prediction that accounts for the effects of heat stress across genotypes, management and environments, we conducted a systematic literature review and a meta-analysis to assess the relationship between dry matter intake (DMI) and the temperature-humidity index (THI), two reliable variables for the measurement of feed intake and heat stress in cattle, respectively. We analysed this relationship accounting for covariation in countries, breeds, lactation stage and parity, as well as the efficacy of various physical cooling interventions. Our findings show a significant negative correlation (r = − 0.82) between THI and DMI, with DMI reduced by 0.45 kg/day for every unit increase in THI. Although differences in the DMI-THI relationship between lactating and non-lactating cows were not significant, effects of THI on DMI varied between lactation stages. Physical cooling interventions (e.g. provision of animal shade or shelter) significantly alleviated heat stress and became increasingly important after THI 68, suggesting that this THI value could be viewed as a threshold for which cooling should be provided. Passive cooling (shading) was more effective at alleviating heat stress compared with active cooling interventions (sprinklers). Our results provide a high-level global equation for THI-DMI across studies, allowing next-users to predict effects of heat stress across environments and animal genotypes.

The inter- and intra-annual variability in radial growth reflects responses to climatic variability and water shortage, especially in areas subjected to seasonal drought. However, it is unknown how this variability is related to forest productivity, which can be assessed by measuring changes in canopy greenness and cover through remote sensing products as the Normalized Difference Vegetation Index (NDVI). We combine xylogenesis with measurements of inter-annual changes in seasonal wood production (earlywood width, adjusted latewood width) and NDVI to improve the understanding of climate and drought impacts on growth and forest productivity in a Pinus teocote stand located in northern Mexico. Cambial dynamics accelerated in March and a high production of radially enlarging and thickening tracheids were observed from April to October and from June to October, respectively. Tracheid maturation was very active in October when latewood production peaked. Wet conditions in winter-spring and summer-autumn enhanced earlywood and latewood production, respectively. Earlywood and latewood were constrained by long (4–10 months) and short (2–3 months) droughts, respectively. The earlywood production depended on April soil moisture, which agrees with the peak of radially enlarging tracheid production found during that month. Aligning drought proxies at inter- and intra-annual scales by using growth and productivity measures improves our understanding of conifer forest responses to water shortage.

With the global warming, the harm of heat stress (HS) to the breeding industry has become more common, which causes the decline of animal production performance and low immunity. This study aimed to analyze the effect of HS on the intestinal immune function of Salmonella-infected chickens. Fourteen-day-old broilers were divided into the following four groups of eight replicates: control (Control), heat stress (HS), Salmonella Typhimurium (ST), and heat stress + Salmonella Typhimurium (HS+ST). The broilers were subjected to a heat stress of 35 °C from 15 to 28 days of age. Salmonella Typhimurium (ST, 14028, 109 cfu/mL) was inoculated, via oral administration at 29 days of age, into ST and HS+ST group birds. On the 4th day after Salmonella Typhimurium administration, an increase in jejunum IgA levels was observed in chickens infected with Salmonella Typhimurium. Mechanistic regulation of TLR4-NFκB-NLRP3 and TLR4-TBK1 signaling by heat stress was evaluated in Salmonella Typhimurium–infected broilers. Heat stress markedly inhibited the expression of cytokines including TNF-α, IL-6, IL-1β, NLRP3, caspase-1, NF-κB-p65, and p-NF-κB-p65, and the TLR4-TBK1 cytokines IFN-α, IFN-γ, p-IRF3, and p-TBK1 in jejunum of broilers infected with Salmonella Typhimurium. Collectively, our results demonstrate that heat stress can inhibit intestinal immune response by downregulating the expression of TLR4-NFκB-NLRP3 and TLR4-TBK1 signaling pathways in broilers infected with Salmonella Typhimurium.

The twig method in climate chambers has been shown to successfully work as a proxy for outdoor manipulations in various experimental setups. This study was conducted to further establish this method for the investigation of allergenic pollen from tree species (hazel, alder, and birch). Direct comparison under outdoor conditions revealed that the cut twigs compared to donor trees were similar in the timing of flowering and the amount of pollen produced. Cut twigs were able to flower in climate chambers and produced a sufficient amount of pollen for subsequent laboratory analysis. The addition of different plant or tissue fertilizers in the irrigation of the twigs did not have any influence; rather, the regular exchange of water and the usage of fungicide were sufficient for reaching the stage of flowering. In the experimental setup, the twigs were cut in different intervals before the actual flowering and were put under warming conditions in the climate chamber. An impact of warming on the timing of flowering/pollen characteristics could be seen for the investigated species. Therefore, the twig method is well applicable for experimental settings in pollen research simulating, e.g., accelerated warming under climate change.

Urban air pollution can have negative short- and long-term impacts on health, including cardiovascular, neurological, immune system and developmental damage. The irritant qualities of pollutants such as ozone (O3), nitrogen dioxide (NO2) and particulate matter (PM) can cause respiratory and cardiovascular distress, which can be heightened during physical activity and particularly so for those with respiratory conditions such as asthma. Previously, research has only examined marathon run outcomes or running under laboratory settings. This study focuses on elite 5-km athletes performing in international events at nine locations. Local meteorological and air quality data are used in conjunction with race performance metrics from the Diamond League Athletics series to determine the extent to which elite competitors are influenced during maximal sustained efforts in real-world conditions. The findings from this study suggest that local meteorological variables (temperature, wind speed and relative humidity) and air quality (ozone and particulate matter) have an impact on athletic performance. Variation between finishing times at different race locations can also be explained by the local meteorology and air quality conditions seen during races.

Multimodal therapies comprising spa applications are widely used as non-pharmaceutical treatment options for musculoskeletal diseases. The purpose of this randomized, controlled, open pilot study was to elucidate the involvement of the endocannabinoid system in a multimodal therapy approach. Twenty-five elderly patients with knee osteoarthritis (OA) received a 2-week spa therapy with or without combination of low-dose radon therapy in the Bad Gastein radon gallery. A 10-point numerical rating scale (pain in motion and at rest), WOMAC questionnaire, and the EuroQol-5D (EQ-5D) questionnaire were recorded at baseline, and during treatment period at weeks one and two, and at 3-month and 6-month follow-ups. Plasma levels of the endocannabinoid anandamide (AEA) were determined at baseline and at 2 weeks, and serum levels of several cartilage metabolism markers at all five time-points. A significant and sustained reduction of self-reported knee pain was observed in the study population, but no further significant effect of the additional radon therapy up and above base therapy. This pain reduction was accompanied by a significant reduction of AEA plasma levels during treatment in both groups. No significant differences were seen in serum marker concentrations between the groups treated with or without radon, but a small reduction of serum cartilage degradation markers was observed during treatment in both groups. This is the first study investigating AEA levels in the context of a non-pharmacological OA treatment. Since the endocannabinoid system represents a potential target for the development of new therapeutics, further studies will have to elucidate its involvement in OA pain.

In order to assess the influence of atmospheric conditions and particulate matter (PM) on the seasonally varying incidence of influenza-like illnesses (ILI) in the capital of Poland—Warsaw, we analysed time series of ILI reported for the about 1.75 million residents in total and for different age groups in 288 approximately weekly periods, covering 6 years 2013–2018. Using Poisson regression, we predicted ILI by the Universal Thermal Climate Index (UTCI) as biometeorological indicator, and by PM2.5 and PM10, respectively, as air quality measures accounting for lagged effects spanning up to 3 weeks. Excess ILI incidence after adjusting for seasonal and annual trends was calculated by fitting generalized additive models. ILI morbidity increased with rising PM concentrations, for both PM2.5 and PM10, and with cooler atmospheric conditions as indicated by decreasingUTCI. While the PM effect focused on the actual reporting period, the atmospheric influence exhibited a more evenly distributed lagged effect pattern over the considered 3-week period. Though ILI incidence adjusted for population size significantly declined with age, age did not significantly modify the effect sizes of both PM andUTCI. These findings contribute to better understanding environmental conditionings of influenza seasonality in a temperate climate. This will be beneficial to forecasting future dynamics of ILI and to planning clinical and public health resources under climate change scenarios.

Standard succulent vegetation mixes developed mostly in temperate climates are being increasingly used on green roofs in different climate zones with uncertain outcome regarding vegetation survival and cover. We investigated vegetation on green roofs at nine temperate, cold, and/or wet locations in Norway and Sweden covering wide ranges of latitude, mean annual temperature, annual precipitation, frequencies of freeze-thaw cycles, and longest annual dry period. The vegetation on the roofs were surveyed in two consecutive years, and weather data were compiled from meteorological databases. At all sites we detected a significant decline in species compared to originally intended (planted/sown) species. Both the survival rate and cover of the intended vegetation were positively related to the mean annual temperature. Contrary to a hypothesis, we found that intended vegetation cover was negatively rather than positively related to mean annual precipitation. Conversely, the unintended (spontaneous) vegetation was favoured by high mean annual precipitation and low mean annual temperature, possibly by enabling it to colonize bare patches and outcompete the intended vegetation. When there is high mortality and variation in cover of the intended vegetation, predicting the strength of ecosystem services the vegetation provides on green roofs is difficult. The results highlight the needs for further investigation on species traits and the local factors driving extinction and colonizations in order to improve survivability and ensure a dense vegetation throughout the successional stages of a green roof. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Weather conditions regulate the growth and yield of crops, especially in rain-fed agricultural systems. This study evaluated the use and relative importance of readily available weather data to develop yield estimation models for maize and soybean in the US central Corn Belt. Total rainfall (Rain), average air temperature (Tavg), and the difference between maximum and minimum air temperature (Tdiff) at weekly, biweekly, and monthly timescales from May to August were used to estimate county-level maize and soybean grain yields for Iowa, Illinois, Indiana, and Minnesota. Step-wise multiple linear regression (MLR), general additive (GAM), and support vector machine (SVM) models were trained with Rain, Tavg, and with/without Tdiff. For the total study area and at individual state level, SVM outperformed other models at all temporal levels for both maize and soybean. For maize, Tavg and Tdiff during July and August, and Rain during June and July, were relatively more important whereas for soybean, Tavg in June and Tdiff and Rain during August were more important. The SVM model with weekly Rain and Tavg estimated the overall maize yield with a root mean square error (RMSE) of 591 kg ha−1(4.9%nRMSE) and soybean yield with a RMSE of 205 kg ha−1(5.5%nRMSE). Inclusion of Tdiff in the model considerably improved yield estimation for both crops; however, the magnitude of improvement varied with the model and temporal level of weather data. This study shows the relative importance of weather variables and reliable yield estimation of maize and soybean from readily available weather data to develop a decision support tool in the US central Corn Belt.

One of the major sources of uncertainty in large-scale crop modeling is the lack of information capturing the spatiotemporal variability of crop sowing dates. Remote sensing can contribute to reducing such uncertainties by providing essential spatial and temporal information to crop models and improving the accuracy of yield predictions. However, little is known about the impacts of the differences in crop sowing dates estimated by using remote sensing (RS) and other established methods, the uncertainties introduced by the thresholds used in these methods, and the sensitivity of simulated crop yields to these uncertainties in crop sowing dates. In the present study, we performed a systematic sensitivity analysis using various scenarios. The LINTUL-5 crop model implemented in the SIMPLACE modeling platform was applied during the period 2001–2016 to simulate maize yields across four provinces in South Africa using previously defined scenarios of sowing dates. As expected, the selected methodology and the selected threshold considerably influenced the estimated sowing dates (up to 51 days) and resulted in differences in the long-term mean maize yield reaching up to 1.7 t ha−1 (48% of the mean yield) at the province level. Using RS-derived sowing date estimations resulted in a better representation of the yield variability in space and time since the use of RS information not only relies on precipitation but also captures the impacts of socioeconomic factors on the sowing decision, particularly for smallholder farmers. The model was not able to reproduce the observed yield anomalies in Free State (Pearson correlation coefficient: 0.16 to 0.23) and Mpumalanga (Pearson correlation coefficient: 0.11 to 0.18) in South Africa when using fixed and precipitation rule-based sowing date estimations. Further research with high-resolution climate and soil data and ground-based observations is required to better understand the sources of the uncertainties in RS information and to test whether the results presented herein can be generalized among crop models with different levels of complexity and across distinct field crops.

This study assessed the additional contribution of balneotherapy on physical therapy in subacute supraspinatus tendinopathy. Ninety patients with subacute supraspinatus tendinopathy were included. They were randomized into two equal groups. In group 1 (n = 45), transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound treatments, and Codman’s and range of motion (ROM) exercises were performed. In group 2 (n = 45), balneotherapy was added to the treatment program. In both groups, shoulder active ROM and handgrip strength were measured. Pain was evaluated using a Visual Analogue Scale (VAS) (rest, sleep, movement); functional assessment and quality of life were measured respectively with the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), and the Short Form-36 health survey (SF 36) form. All measurements were repeated before and after 15 treatment sessions. There were statistically significant differences between the before and after assessment parameters in group 1 (all p < 0.05), but not for SF-36 General Health Perceptions, SF-36 Mental Health sub-parameters, and handgrip strengths. However, there were statistically significant differences between all the evaluation before and after the treatment in group 2 (all p < 0.05). When the two groups were compared in terms of alpha gains, statistically significant differences were observed in favor of group 2 in all measurements (all p < 0.05) except for SF-36 Emotional Role Difficulty and SF-36 Mental Health sub-parameters. This study shows that the addition of balneotherapy to physical therapy for subacute supraspinatus tendinopathy can make additional contributions to shoulder ROM, pain, handgrip strength, functional status, and quality of life.

There is substantial epidemiological evidence on the associations between cold weather and adverse health effects. Meteorological alarm systems are being developed globally, and generalized protective advice is given to the public based on outdoor exposure parameters. It is not clear how these shared outdoor exposure parameters relate to the individual-level thermal exposure indoors, where the majority of time is spent. We hypothesized a priori that there are opposite correlations between indoor and outdoor temperatures in residential apartments. Apartments were classified into 3 categories according to their response to declining outdoor temperature: under-controlled apartments cool down, controlled apartments maintain constant indoor temperature level, and over-controlled apartments warm up. Outdoor and indoor temperatures were measured in 30-min intervals in 417 residential apartments in 14 buildings in Kotka, Finland, between February and April 2018 with outdoor temperatures ranging from − 20.4 °C to + 14.0 °C. Different apartment types were present in all buildings. Floor and orientation did not explain the divergence. Indoor temperatures below the limit value + 20 °C by building code occurred in 26.2%, 7.9%, and 23.6% of the under-controlled, controlled, and over-controlled apartments, some in conjunction with increasing outdoor temperatures. Indoor temperatures above the limit + 25 °C occurred but were more rare. This proof-of-concept study demonstrates that while the home environment may be a source of thermal stress during cold weather, generalized advice for adjusting the heating may lead to paradoxical exposures in some cases. More elaborate conceptualizations of everyday thermal exposures are needed to safely reduce weather-related health risks using shared meteorological alarm systems. Electronic supplementary material The online version of this article (10.1007/s00484-020-01998-7) contains supplementary material, which is available to authorized users.

Plant phenological dataset collected at 42 sites across the mainland of Finland and covering the years 1997–2017 is presented and analysed for temporal trends. The dataset of n = 16,257 observations represents eleven plant species and fifteen phenological stages and results in forty different variables, i.e. phenophases. Trend analysis was carried out for n = 808 phenological time-series that contained at least 10 observations over the 21-year study period. A clear signal of advancing spring and early-summer phenology was detected, 3.4 days decade−1, demonstrated by a high proportion of negative trends for phenophases occurring in April through June. Latitudinal correlation indicated stronger signal of spring and early-summer phenology towards the northern part of the study region. The autumn signal was less consistent and showed larger within-site variations than those observed in other seasons. More than 60% of the dates based on single tree/monitoring square were exactly the same as the averages from multiple trees/monitoring squares within the site. In particular, the reliability of data on autumn phenology was increased by multiple observations per site. The network is no longer active. Electronic supplementary material The online version of this article (10.1007/s00484-020-01961-6) contains supplementary material, which is available to authorized users.

Low back pain (LBP) is one of the most costly diseases in the developed world. This study aimed to investigate the effects of underwater traction therapy on chronic low back pain. The primary objective was to prove that underwater traction therapy has favorable effects on LBP. Our secondary objective was to evaluate whether it also leads to improvement in the quality of life. This is a prospective, multicenter, follow-up study. A total of 176 patients with more than 3 months of low back pain enrolled from outpatient clinics were randomized into three groups: underwater weight bath traction therapy and non-steroidal anti-inflammatory drugs (NSAIDs); weight bath; and only NSAIDs. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: levels of low back pain in rest and during activity were tested using the visual analogue scale (VAS), the Oswestry Low Back Disability Questionnaire, and the EuroQol-5D-5L Questionnaire.The VAS levels improved significantly (p Based on our results, for patients suffering from LBP pain who underwent underwater weight bath traction therapy, there were favorable impacts on the pain levels at rest or during activity. Clinical trial registration ID: NCT03488498, April 5, 2018

To investigate the effect of balneotherapy on body mass index, adipokine levels, sleep disturbances, and quality of life in women with morbid obesity. Fifty-four women with morbid obesity were included in the study. The body mass indexes (BMI) and waist/hip ratios (WHR) of the women were calculated. Subcutaneous fat thickness was measured using a *skinfold meter, and the percentage of adipose tissue was calculated. The *Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and the Nottingham Health Profile (NHP) was used to assess quality of life. In addition to routine biochemical tests, leptin, adipokine, visfatin from blood, and cortisol from saliva samples were studied. Participants were given 15 sessions of balneotherapy for 20 min each. After treatment, the laboratory and clinical parameters of the participants were *reevaluated. There was no statistically significant difference of BMI, WHR, and percentage of adipose tissue between before and after treatment measurements (p ˃ 0.05).There was a statistically significant improvement in PSQI and NSP scores (p ˂ 0.001). The levels of blood glucose, leptin, and visfatin were significantly decreased, and adiponectin was significantly increased after treatment (p = 0.047, p ˂ 0.001, p ˂ 0.001, and p ˂ 0.001, respectively).There was no statistically significant changes in salivary cortisol levels (p = 0.848). Patients with diabetes showed a statistically significant decrease in glucose levels after treatment (p = 0.017).There was a statistically significant decrease in low-density lipoprotein cholesterol levels in patients with dyslipidemia compared with pre-treatment (p = 0.018). Balneotherapy improves sleep and quality of life of women with morbid obesity. After balneotherapy, glucose, leptin, adiponectin, and visfatin levels may change positively. © 2020, ISB.

In human biometeorology, the estimation of mean radiant temperature (MRT) is generally considered challenging. This work presents a general framework to compute the MRT at the global scale for a human subject placed in an outdoor environment and irradiated by solar and thermal radiation both directly and diffusely. The proposed framework requires as input radiation fluxes computed by numerical weather prediction (NWP) models and generates as output gridded globe-wide maps of MRT. It also considers changes in the Sun’s position affecting radiation components when these are stored by NWP models as an accumulated-over-time quantity. The applicability of the framework was demonstrated using NWP reanalysis radiation data from the European Centre for Medium-Range Weather Forecasts. Mapped distributions of MRT were correspondingly computed at the global scale. Comparison against measurements from radiation monitoring stations showed a good agreement with NWP-based MRT (coefficient of determination greater than 0.88; average bias equal to 0.42 °C) suggesting its potential as a proxy for observations in application studies.

Balneotherapy (BT) is one of the most commonly used complementary therapies for many pathological conditions. Its beneficial effects are related to physical and chemical factors, but the exact mechanism of action is not fully understood. Recently, there has been an increased interest in the use of preclinical models to investigate the influence of BT on inflammation, immunity, and cartilage and bone metabolism. The objective of this comprehensive analysis was to summarize the current knowledge about the in vitro studies in BT and to revise the obtained results on the biological effects of mineral waters. Special attention has been paid to the main rheumatological and dermatological conditions, and to the regulation of the immune response. The objective of this review was to summarize the in vitro studies, on human and animal samples, investigating the biological effects of BT. In particular, we analyzed the properties of a thermal water, as a whole, of an inorganic molecule, such as hydrogen sulfide in different cell cultures (keratinocytes, synoviocytes, chondrocytes, and peripheral blood cells), or of the organic component. The results corroborated the scientific value of in vitro studies in demonstrating the anti-inflammatory, antioxidant, chondroprotective, and immunosuppressive role of BT at the cellular level. However, the validity of the cell culture model is limited by several sources of bias, as the differences in experimental procedures, the high heterogeneity among the available researches, and the difficulties in considering all the chemical and physical factors of BT. We would like to stimulate the scientific community to standardize the experimental procedures and enhance in vitro research in the field of BT.

In some countries (e.g. Poland, Czechia, Slovakia, Russia, Germany), oxidation-reduction potential (ORP) measurements are required to document the quality of groundwater which are planned to be used as therapeutic waters. ORP is still rarely studied and not fully availed in therapeutic water research. Studies of ORP in various types of therapeutic, mineral and thermal waters in sites of Poland integrated with geochemical equilibrium approach were employed to characterize two redox-sensitive and bioactive elements, i.e. iron and sulphur. Studied waters present reducing conditions (EH between − 406 and − 41 mV) at outflow or extraction sites; however, they significantly differ in terms of total dissolved solids, temperature, and iron, sulphur(II) and sulphate concentrations. These result in recognizable differences, e.g. in terms of saturation state with respect to aquifer rock minerals and the dominating forms of occurrence of elements studied disclosed on the stability field diagrams. Considering the methodological determinants, ORP orchestrated with geochemical modelling tools might be successfully applied for studying natural linkages between various groundwater in natural systems, protecting the therapeutic water resource, and identifying the changes of water quality both at exploitation sites (springs, wells) and treatment places.