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Restoring hydrological functions affected by economic development trajectories faces social and economic challenges. Given that stakeholders often only have a partial understanding of functioning socio-hydrological systems, it is expected that knowledge sharing will help them to become more aware of the consequences of their land use choices and options to manage water collectively. This facilitates the collective learning tools needed to represent the essential social and technical aspects of a socio-hydrological system in simple terms. However, data-driven simplification can lead to very site-specific models that are difficult to adapt to different conditions. To address these issues, this study aims to develop a highly adaptable serious game based on process understanding to make it easily applicable to any situation and to facilitate co-learning among stakeholders regarding complex socio-hydrological problems. We developed and tested a serious game that revolves around a simple water balance and economic accounting, with environmental and financial consequences for land users. The game is based on process understanding of the system, allowing for both relevant site specificity and generic replicability. Here, we describe the development of the Water: Use, Resources and Sustainability (H2Ours) game and explore its capacity to visualise, discuss and explore issues at the landscape level. The H2Ours game was designed using a combination of the Actors, Resources, Dynamics and Interaction (ARDI) and Drivers, Pressure, State, Impact and Responses (DPSIR) frameworks. The design steps for constructing the game led to a generic version and two localised versions for two different landscapes in Indonesia: a mountain slope to lowland paddy landscape impacting groundwater availability in East Java and a peatland with drainage rewetting, oil palm conversion and fire as issues triggering responses in West Kalimantan. Based on an evaluation referring to credibility, salience and legitimacy criteria, the H2Ours game met its purpose as a tool for knowledge transfer, learning and action triggering. We discuss the steps that can lead to re-designing and adaptation of the game to other landscapes and their policy-relevant issues.

Indonesia's vast archipelago offers abundant seawater resources, holding the potential for salt production. Salt, a vital commodity in human life, typically contains sodium chloride and impurities like Ca2+, Mg2+, SO42−, and K+. Pharmaceutical salt is an industrial category adhering to pharmacopoeial standards regarding sodium chloride levels and impurity content, ensuring quality for drug preparations in Indonesia. Prior research indicates that recrystallisation, specifically evaporation crystallisation, enhances salt quality by increasing NaCl content. Chemical precipitating agents like NaOH and Na2CO3 can be introduced to improve salt purity further. This study aims to identify optimal conditions for pharmaceutical salt production from processed salt raw materials, considering crystallisation time, stirring speed, chemical additives (NaOH and Na2CO3), and double crystallisation stages. The method commences with pre-treatment, involving salt dissolution in distilled water to saturation, with the addition of precipitating agents as per designated variables. Precipitates formed from precipitating agents (NaOH and Na2CO3) are isolated through filtration. The filtrate undergoes evaporation crystallisation at 103 °C, varying between single and double crystallisation. Salt crystals are separated, dried, and weighed to calculate yield. Pharmaceutical salt is analysed for water content, NaCl, and impurities (Ca2+, Mg2+, SO42−, and K+). The optimal conditions for pharmaceutical salt production were double crystallisation with a 20 % excess of chemicals (NaOH and Na2CO3), 100 min of crystallisation time, and a stirring speed of 600 rpm. This yielded a 15 % NaCl content of 99.87 %, Mg2+ at 0 ppm, Ca2+ at 69.6 ppm, SO42− at 366 ppm, K+ at 370 ppm, and water content at 0.166 %. Notably, the pharmaceutical salt production process generates no waste, as byproducts like Mg(OH)2 and CaCO3 can be recycled and hold commercial value. However, it is essential to re-evaluate raw materials and technologies to address the market's high cost and competitiveness issues.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has posed a global challenge. Experts from various branches of science have endeavoured to find solutions to control its spread, one of which has been the quick and precise detection of the virus and its variants in patients. This study aimed to detect the presence of SARS-CoV-2, notably the rapidly spreading Omicron variant, using the spike (S)-gene target failure (SGTF) and S-gene target positive (SGTP) with the principle of the single nucleotide polymorphism (SNP)-probe test. Our descriptive experimental approach detected Omicron variants with the SNP-probe technique using samples of SARS-CoV-2 patients and controls. The probes were designed to recognize the nucleotide code of the amino acids in positions 371 and 417 of SARS-CoV-2. The existence of variants was monitored by the presence or absence of a fluorescence signal, which was translated into a sigmoidal graph using a real-time (RT)-PCR machine. One hundred and twelve samples that had tested positive for SARS-CoV-2 and the Omicron variant using a registered commercial kit showed a similar result to our in-house-developed SNP-probe 371 and 417 assays. The results of this study indicate that the SNP-probe we designed can be used in the detection of the SARS-CoV-2 Omicron variant.

Abstract Purpose To revisit the concept of retinectomy and the theory of mechanical forces on the retina occurring in rhegmatogenous retinal detachment (RRD) and to describe the potential application of radial retinectomy in RRD with advanced proliferative vitreoretinopathy (PVR). Methods A literature search was performed to identify all English language articles reporting the use of retinectomy for the management of RRD with PVR. We reviewed the theoretical background of mechanical forces occurring in RRD. Results Detachment of the retina from the retinal pigment epithelium (RPE)/choroid is influenced by disequilibrium of several physical forces: tangential forces on the epiretinal membrane $$\left( {T_{1} } \right)$$ T 1 and radial traction on the retina $$F_{R}$$ F R exceeding the retinal adhesion force to the RPE $$\left( {T_{1} \;\text{ + }F_{R} \;\text{ > }\;F_{A} } \right)\,\,$$ T 1 + F R > F A . PVR may exaggerate the amounts of tangential and radial forces ( $$\left( {T_{1} } \right)$$ T 1 and $$F_{R}$$ F R ) that pull the retina off. Relaxing radial retinectomy, by the nature of its cutting pattern, may theoretically decrease the amounts of both forces, therefore restoring the equilibrium between tensile and adhesive forces on the retinal surface $$\left( {T_{1} \;\text{ + }F_{R} \;\text{ = }\;F_{A} } \right)\,\,$$ T 1 + F R = F A . Conclusion Relaxing radial retinectomy may potentially be applied in RRD with advanced PVR but has rarely been reported to date. Future studies are needed to evaluate its outcomes and long-term complications.

Kaolin merupakan salah satu mineral yang d apat digunakan sebagai adsorben. Kaolin yang digunakan untuk menjerap logam berat Zinc (II) berasal dari Daerah Sincalang Provinsi Riau. Kaolin dihancurkan dan diayak hingga berukuran -200+240 mesh. Kaolin direndam dalam 0,1 M NaOH selama 24 jam. Kemudian kaolin dimasukkan ke dalam larutan Zinc (II) dan dianalisa menggunakan AAS (Atomic Absorption Spectrometer). Sampel diambil setiap 15 menit. Variabel yang dipelajari adalah temperatur antara 30˚C - 50˚C dan konsenttasi antara 40 - 120 ppm. Data adsorpsi dianalisa dengan model Freundlich and Langmulir yang diusulkan secara legresi linier. Dari hasil analisa diperoleh bahwa model Freundlich adalah model yang cocok untuk mendiskripkan mendiskripsikankesetimbangan adsorpsi. Dari model Freundlich diperoleh nilai konstanta kesetimbangan; K = 2.6503 pada temperatur 30 ˚C .Kapasitas Jerap (Q ) akan meningkat jika temperatur adsorpsi dinaikkan pada konsentrasi Zn (II) 120 ppm. Temperatur adsorpsi mempengaruhi secara signifikan kapasitas adsorpsi Kata kunci : Adsorpsi Zn (II); model; kesetimbangan;kaolin

Abstract Aging increases liver susceptibility to diseases and it causes inflammation in liver tissue which can lead to fibrosis. Studies suggest that aging is caused by the accumulation of free radicals. Lack of physical activity can lower hormone levels and increase free radicals that can accelerate the aging process. Hence, physical activity is very important to maintain functions of organs. This research was aimed to study the effects of low and moderate treadmill exercise on d‐Galactose‐exposed aging rat model by evaluating the degree of hepatic fibrosis, number of M1 and M2, and M1/M2 ratio. Twenty‐four 3‐month‐old male Wistar aging model rats were randomly divided into four groups, that is, three treatment groups with daily 300 mg kgBW−1 d‐Galactose injection administrated intraperitoneally for 4 weeks and 1 control group with normal saline injection. Two of the d‐Galactose treated groups were given low and moderate treadmill exercise for 4 weeks. It was concluded that low intensity treadmill exercise significantly lowered the degree of d‐Galactose‐exposed hepatic fibrosis, and moderate treadmill exercise was able to restore the injured liver tissue back to the non‐aging state. Administration of d‐Galactose causes inflammation marked by the elevated number of M1 and M2 macrophages. Moderate treadmill exercise drove M1/M2 ratio back to the control condition.

Background: In 2016, 23% of children younger than 5 years were stunted. Global-level modelling has consistently found that climate change impacts on food production are likely to impair progress on reducing undernutrition. We adopt a new perspective, assessing how climate change may affect child stunting via its impacts on two interacting socioeconomic drivers: incomes of the poorest 20% of populations and food prices. Methods: We developed a statistical model, driven by upstream poverty and food price models, to project moderate and severe stunting in children younger than 5 years in rural and urban areas in 2030 under low and high climate change scenarios combined with poverty and prosperity scenarios in 44 countries. Findings: We estimated that, in the absence of climate change, 110 million children younger than 5 years would be stunted in 2030 under the poverty scenario in comparison with 83 million under the prosperity scenario. Estimates of climate change-attributable stunting ranged from 570 000 under the prosperity/low climate change scenario to more than 1 million under the poverty/high climate change scenario. The projected impact of climate change on stunting was greater in rural versus urban areas under both socioeconomic scenarios. Patterns in the results showed that, in countries where incomes remain low and food prices are relatively high (compared with incomes), further price rises tend to increase stunting. In contrast, in countries where incomes rise and food prices are relatively low, slowly rising prices tend to decrease stunting. Interpretation: Shifting the focus from food production to interactions between incomes and food price has provided new insights. The patterns in the results suggest that food prices that provide decent incomes to farmers alongside high employment with living wages will reduce undernutrition and vulnerability to climate change. Futures that protect health should consider not just availability, accessibility, and quality of food, but also the incomes generated by those producing the food. Funding: The research was partially funded by the Office of the Chief Economist of the Climate Change Group and the Global Facility for Disaster Reduction and Recovery of the World Bank, and the NIHR Health Research Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene & Tropical Medicine in partnership with Public Health England (PHE), and in collaboration with the University of Exeter, University College London, and the Met Office. The views expressed are those of the authors and not necessarily those of the World Bank, NHS, the NIHR, the Department of Health, or Public Health England.

This mixed methods study explores instructor motivations for offering massive open online courses (MOOCs) as well as the instructional innovations used to enhance the MOOC design. The researchers surveyed 143 MOOC instructors worldwide and then interviewed 12 of these instructors via Zoom. They also extensively reviewed the MOOCs of the interviewees. The primary motivations for offering MOOCs included “growth” needs such as curiosity about MOOCs and the exploration of new ways of teaching. In addition, “relatedness” needs of instructors included reaching more people, showcasing research and teaching, marketing their university, integrating interactive technology, and obtaining peer reviews. The perceived instructional innovations of these MOOC instructors included using problem-based learning, service learning in MOOCs, and shortening the length of videos. Overall, these MOOC instructors were satisfied with their MOOC designs. Cette étude faisant appel à des méthodes mixtes explore les motivations des instructeurs de cours en ligne ouverts à tous ainsi que les innovations pédagogiques utilisées pour améliorer la conception de ces cours. Les chercheurs ont procédé au sondage de 143 instructeurs de cours en ligne ouverts à tous à travers le monde et ont ensuite interviewé 12 de ces instructeurs par l’entremise de Zoom. Ils ont également réalisé un examen approfondi des cours en ligne ouverts à tous des instructeurs interviewés. Les motivations principales pour l’offre de cours en ligne ouverts à tous comprenaient des besoins relatifs à la « croissance », comme la curiosité au sujet de ces cours et l’exploration de nouvelles façons d’enseigner. De plus, les désirs relationnels des instructeurs comprenaient joindre plus de gens, mettre en lumière la recherche et l’enseignement, publiciser leur université, intégrer la technologie interactive et obtenir des évaluations par les pairs. Les innovations pédagogiques perçues par ces instructeurs de cours en ligne ouverts à tous comprenaient l’utilisation de l’apprentissage par résolution de problèmes, de l’apprentissage par le service dans les cours en ligne ouverts à tous et la durée écourtée des vidéos. Dans l’ensemble, les instructeurs de cours en ligne ouverts à tous étaient satisfaits de leur conception de cours.

As massive open online courses (MOOCs) increase, the large scale and heterogeneity of MOOC participants bring myriad significant design challenges. This mixed methods study explores 143 MOOC instructors’ considerations and challenges in designing MOOCs; 12 of whom were interviewed and had their courses analyzed. The survey, interview, and course review data revealed a variety of considerations and challenges in MOOC design in terms of pedagogy, resources, and logistics. Pedagogical considerations included learning objectives, assessment methods, course length, course content, flexibility, and collaborative learning support. Resource considerations included the affordance of MOOC platforms, support from the host institution and the platform, and the available intellectual and hardware resources. Logistical considerations included the amount of time instructors spent designing the MOOC. The obstacles included pedagogical challenges (engaging students, increasing student interaction, and limited assessment methods), resource challenge (i.e., limitations associated with the affordances of the platform), and logistical challenge (time limitations for designing and developing MOOCs). To address these challenges, the instructors often relied on reviewing other MOOCs. They also sought help from colleagues, their universities, and supporters of the platforms.

This work presents design, instrumented and test of a parabolic trough solar collector under Baghdad climate conditions (of latitude 33.33o N, of longitude 44.4o E). The parabolic trough solar collector consists of: a mirror matrix or tapes which work as reflective surface of (2m *1m), absorber copper tube (receiver), two axis tracking system. Water is used as a heat transfer medium. The setup is tested within clear days from June, to September 2017. The collector heat gain, efficacy and temperature of absorber were presented for absorber five different circulating mass flow rates of (0.15, 0.2, 0.3, 0.4, 0.5) 1pm. The results show that the maximum thermal efficiency of the parabolic trough solar collector is 80.26%. The maximum outlet temperature of the absorber tube reaches 81 oC at the noon when water flows at (0.15) 1pm. The maximum obtained heat gain is (1619W) for (0.5) 1pm flow rate of water.

This study explores the activities, tools, and resources that instructors of massive open online courses (MOOCs) use to improve the personalization of their MOOCs. Following email interviews with 25 MOOC and open education leaders regarding MOOC personalization, a questionnaire was developed. This questionnaire was then completed by 152 MOOC instructors from around the world. While more than 8 in 10 respondents claimed heavy involvement in designing their MOOCs, only one-third placed extensive effort on meeting unique learner needs during course design, and even fewer respondents were concerned with personalization during course delivery. An array of instructional practices, technology tools, and content resources were leveraged by instructors to personalize MOOC-based learning environments. Aligning with previous research, the chief resources and tools employed in their MOOCs were discussion forums, video lectures, supplemental readings, and practice quizzes. In addition, self-monitoring and peer-based methods of learner feedback were more common than instructor monitoring and feedback. Some respondents mentioned the use of flexible deadlines, proposed alternatives to course assignments, and introduced multimedia elements, mobile applications, and guest speakers among the ways in which they attempted to personalize their massive courses. A majority of the respondents reported modest or high interest in learning new techniques to personalize their next MOOC offering.

The aim of this study was to evaluate genetic analysis including heritability and further phenotypicand genetic trends of reproductive traits in Bali cattle. Reproductive traits studied were age at firstcalving (AFC), calving interval (CI) and pregnancy rate (PR). Data of reproductive traits were collectedfrom Breeding Centre of Bali Cattle, Denpasar-Bali at the year period of 2000-2007. To evaluate thegenetic analysis, heritability were estimated using the Mixed Model Least Squares and MaximumLikelihood procedure. The phenotypic and genetic trends were calculated using regression equation.Estimation of heritability for AFC, CI and PR were 0.22, 0.41 and 0.40, respectively. The phenotypictrend of AFC, CI and PR decreased at an average rate of 1.70 month, 10.4 days and 0.75% per year,respectively. The same pattern was showed for genetic trends for AFC, CI and PR decreased at 0.38month, 4.25 days and 0.30% per year respectively in the same period. The heritability of reproductiontraits in Bali cattle were considered as moderate to high (0.22-0.41) which means that the selectionprogram will be more effective and efficient in improving the genetic merits in Bali cattle.

The aim of this study was to evaluate effect of non genetic factors on reproductive performance ofBali cattle. Data on reproduction performance were collected from Breeding Centre of Bali Cattle inDenpasar-Bali. Reproductive traits studied were age at first calving (AFC), calving interval (CI) andpregnancy rate (PR). To observe the effect of non genetic factors on the reproductive traits, a mixedmodel was used because all of the traits studied were measured repeatedly in individuals. The overallmeans for AFC, CI, PR and preweaning mortality were 43.86±0.70 months, 360.93±4.47 days,88.44±1.91% and 7.58±1.07%, respectively. The results showed that AFC and PR were significantly(P0.05) effect. Withregard to CI, dam year of birth and parity affected CI while mating system had no significantly affect(P>0.05) on CI. The preweaning mortality was only affected by the age of dam significantly (P

The aim of this study was to estimate genetic and phenotypic trends for growth traits including birth (BW), weaning (WW) and yearling weight (YW) in Bali cattle. The number of cattle used to determine growth traits of BW, WW, and YW were 235, 215, and 178 heads, respectively. Estimation of breeding value, phenotypic and genetic correlation were calculated by Restricted Maximum Likelihood and General Linier Model (GLM) procedures, respectively. Genetic trends analysis was performed using the regression mean breeding values on birth year. Phenotypic and genetic correlation among BW and WW were 0.10 and 0.08 respectively and 0.90 and 0.70 for WW and YW respectively. The phenotypic trends for traits of birth and weaning weight were constant, whereas yearling weight was fluctuating from 2000 to 2008. Likewise, in the case of genetic trends, the birth and weaning weight were constant from 2000 to 2008 except for WW in 2005, whereas the genetic trends for yearling weight showed a fluctuation of wide range. According to the breeding value estimated for all traits, the best was the sire No. 0565, whose breeding value for BW, WW and YW were +0.07, +2.79, and +10.25 kg, respectively higher than the mean value of the population. The genetic trends showed that there have been a significant and positive genetic improvement in all growth traits and indicate that selection would be effective. Genetic correlation between WW and YW was high (0.70) which indicates that the selection on weaning weight might also increase yearling weight in Bali cattle.

The aim of this study was to evaluate genetic analysis including heritability and further phenotypic and genetic trends of reproductive traits in Bali cattle. Reproductive traits studied were age at first calving (AFC), calving interval (CI) and pregnancy rate (PR). Data of reproductive traits were collected from Breeding Centre of Bali Cattle, Denpasar-Bali at the year period of 2000-2007. To evaluate the genetic analysis, heritability were estimated using the Mixed Model Least Squares and Maximum Likelihood procedure. The phenotypic and genetic trends were calculated using regression equation. Estimation of heritability for AFC, CI and PR were 0.22, 0.41 and 0.40, respectively. The phenotypic trend of AFC, CI and PR decreased at an average rate of 1.70 month, 10.4 days and 0.75% per year, respectively. The same pattern was showed for genetic trends for AFC, CI and PR decreased at 0.38 month, 4.25 days and 0.30% per year respectively in the same period. The heritability of reproduction traits in Bali cattle were considered as moderate to high (0.22-0.41) which means that the selection program will be more effective and efficient in improving the genetic merits in Bali cattle.

The aim of this study was to evaluate effect of non genetic factors on reproductive performance of Bali cattle. Data on reproduction performance were collected from Breeding Centre of Bali Cattle in Denpasar-Bali. Reproductive traits studied were age at first calving (AFC), calving interval (CI) and pregnancy rate (PR). To observe the effect of non genetic factors on the reproductive traits, a mixed model was used because all of the traits studied were measured repeatedly in individuals. The overall means for AFC, CI, PR and preweaning mortality were 43.86±0.70 months, 360.93±4.47 days, 88.44±1.91% and 7.58±1.07%, respectively. The results showed that AFC and PR were significantly (P0.05) effect. With regard to CI, dam year of birth and parity affected CI while mating system had no significantly affect (P>0.05) on CI. The preweaning mortality was only affected by the age of dam significantly (P

Although chronic sympathetic activation provides inotropic and chronotropic support to the failing heart, such activation may also have deleterious effects, including the direct cardiotoxic effects of catecholamines, activation of the renin-angiotensin-aldosterone system and an increase in myocardial oxygen demand. These observations indicate that β-blockade might be beneficial in the treatment of heart failure resulting from dilated cardiomyopathy or ischaemic heart disease. Carvedilol is a non-selective β-blocker acting on β1-, β2-, and α1-adrenoceptors. It possesses potent anti-oxidant and anti-apoptotic properties, along with neuroprotective, vasculoprotective, cardioprotective effects, and it has reduced overall mortality in patients with heart failure in controlled clinical trials. Its role in treating cardiomyopathy requires focus. The fact that anthracyclines are cardiotoxic seriously narrows their therapeutic index in cancer therapy. The cardiotoxic risk increases with the cumulative dose and may lead to congestive heart failure and dilated cardiomyopathy in adults and in children. This review focuses on recent research regarding the beneficial effects of carvedilol in the treatment of dilated cardiomyopathy and to revisit the available evidence on the cardioprotection of carvedilol when associated with anthracycline and to explain the mechanisms underlying the benefits of their co-administration.

Cardiotoxicity, which results from intense cardiac oxidative stress and inflammation, is the main limiting factor of the anthracyclines. Carvedilol, a beta blocker that is used as a multifunctional neurohormonal antagonist, has been shown to act not only as an anti-oxidant, but also as an anti-inflammatory drug. This study was designed to evaluate whether carvedilol exerts a protective role against inflammation-mediated cardiotoxicity in the daunorubicin (DNR)-induced rats. Carvedilol was administered orally to the rats every day for 6 weeks at a cumulative dose of 9 mg/kg body weight DNR. DNR significantly induced cardiac damage and worsened cardiac function as well as increased cardiac mast cell density, elevating the myocardial protein and mRNA expression levels of tumor necrosis factor-α, vascular cell adhesion molecule-1, inter-cellular adhesion molecule-1, nuclear factor kappa-B, cyclooxygenase-2, monocyte chemotactic protein -1 and interleukin -6 compared to that in the control group. Cotreatment with carvedilol significantly attenuated the myocardial protein and mRNA expression levels of these inflammatory markers, decreased cardiac mast cell density, improved histological cardiac damage and cardiac functions. In conclusion, inflammation plays a significant role in DNR-induced cardiotoxicity, and carvedilol contributes to cardioprotection against inflammation-mediated cardiotoxicity in DNR-induced rats through its anti-inflammatory mechanism.

Diabetic cardiomyopathy and nephropathy induce endoplasmic reticulum stress (ERS) and ERS-initiated apoptosis. The primary function of 14-3-3 protein is to inhibit apoptosis, but the roles of this protein in protecting against cardiac ERS and apoptosis in the diabetic heart are largely unknown. In this study, we investigated the in vivo role of 14-3-3 protein in diabetic ERS and apoptosis using streptozotocin (STZ)-induced transgenic mice that showed cardiac-specific expression of a dominant negative (DN) 14-3-3η protein mutant. The expression levels of cardiac glucose-regulated protein (GRP) 78, inositol-requiring enzyme (Ire) 1α, and tumor necrosis factor receptor (TNFR)-associated factor (TRAF) 2 protein were significantly increased in the diabetic DN 14-3-3η mice compared with the diabetic wild-type. Moreover, cardiac apoptosis and the expression of CCAAT / enhancer binding protein homology protein (CHOP), caspase-12, and cleaved caspase-12 protein were significantly increased in the diabetic DN 14-3-3η mice. In conclusion, partial depletion of 14-3-3 protein in the diabetic heart exacerbates cardiac ERS and activates ERS-induced apoptosis pathways, at least in part, through the regulation of CHOP and caspase-12 via the Ire1α/TRAF2 pathway. The enhancement of 14-3-3 protein expression can be used as a novel protective therapy against ERS and ERS-initiated apoptosis in the diabetic heart. Keywords:: 14-3-3 protein, diabetes mellitus, endoplasmic reticulum stress, apoptosis, glucose-regulated protein (GRP) 78

The El Niño-Southern Oscillation (ENSO) is the best known example of quasi-periodic natural climate variability on the interannual time scale. It comprises changes in sea temperature in the Pacific Ocean (El Niño) and changes in atmospheric pressure across the Pacific Basin (the Southern Oscillation), together with resultant effects on world weather. El Niño events occur at intervals of 2-7 years. In certain countries around the Pacific and beyond, El Niño is associated with extreme weather conditions that can cause floods and drought. Globally it is linked to an increased impact of natural disasters. There is evidence that ENSO is associated with a heightened risk of certain vector-borne diseases in specific geographical areas where weather patterns are linked with the ENSO cycle and disease control is limited. This is particularly true for malaria, but associations are also suggested in respect of epidemics of other mosquito-borne and rodent-borne diseases that can be triggered by extreme weather conditions. Seasonal climate forecasts, predicting the likelihood of weather patterns several months in advance, can be used to provide early indicators of epidemic risk, particularly for malaria. Interdisciplinary research and cooperation are required in order to reduce vulnerability to climate variability and weather extremes.