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Extreme weather events are becoming more severe due to climate change, increasing the risk of contaminant releases from hazardous sites disproportionately located in low-income communities of color. We evaluated contaminant releases during Hurricanes Rita, Ike, and Harvey in Texas and used regression models to estimate associations between neighborhood racial/ethnic composition and residential proximity to hurricane-related contaminant releases. Two-to-three times as many excess releases were reported during hurricanes compared to business-as-usual periods. Petrochemical manufacturing and refineries were responsible for most air emissions events. Multivariable models revealed sociodemographic disparities in likelihood of releases; compared to neighborhoods near regulated facilities without a release, a one-percent increase in Hispanic residents was associated with a 5 and 10% increase in the likelihood of an air emissions event downwind and within 2 km during Hurricanes Rita and Ike (odds ratio and 95% credible interval= 1.05 [1.00, 1.13], combined model) and Harvey (1.10 [1.00, 1.23]), respectively. Higher percentages of renters (1.07 [1.03, 1.11], combined Rita and Ike model) and rates of poverty (1.06 [1.01, 1.12], Harvey model) were associated with a higher likelihood of a release to land or water, while the percentage of Black residents (0.94 [0.89, 1.00], Harvey model) was associated with a slightly lower likelihood. Population density was consistently associated with a decreased likelihood of a contaminant release to air, land, or water. Our findings highlight social inequalities in the risks posed by natural-technological disasters that disproportionately impact Hispanic, renter, low-income, and rural populations.

BackgroundIdentifying factors associated with post-disaster youth substance use is a crucial element of developing evidence-based prevention and intervention efforts. Hurricane María struck Puerto Rico in September of 2017 and the wide-spread impact from this disaster, including exposure to trauma, displacement, and disrupted social supports had the potential to negatively impact levels of substance use among youth across the archipelago. However, post-disaster substance use remains under-investigated in this context. The current study sought to identify risk and protective factors associated with substance use among Puerto Rican youth in the aftermath of Hurricane Maria.MethodsCross-sectional, secondary data analyses were conducted using school-based survey data collected at all schools in Puerto Rico between February 1 and June 29, 2018 (5-9 months after Hurricane María). Social supports, substance use, and trauma symptoms were assessed. An ordinal regression analysis was conducted to identify student factors associated with greater likelihood of post-disaster substance use.ResultsA total of 36,485 participants (50.7% female, grades 7-12), were included in an ordinal regression analysis that compared the likelihood of respondents endorsing high, low, or no substance use after Hurricane María based on reported adult social support, counselor/teacher social support, peer social support, ptsd symptomatology, and gender. Findings showed that, when compared to students that endorsed low or no substance use, those who reported having adult social support demonstrated a 58% reduction in odds (OR = 0.42, 95% CI: 0.34-0.53) of reporting high substance use after Hurricane María, while students who reported having teacher/counselor social support demonstrated a 21% reduction in odds (OR = 0.79, 95% CI: 0.69-0.89) of reporting high substance use. Additionally, those that reported having peer social support demonstrated a 31% increase in odds (OR = 1.31, 95% CI: 1.10 to 1.58) of reporting higher substance use, compared to those that reported low or no substance use.ConclusionsWhile social support was generally protective, prevention efforts to build positive family and community connections may be indicated. Evidence-based school screenings of substance use and trauma may help direct intervention to those most at risk for co-occurring issues.

BACKGROUND AND AIMS: Understanding shifts in the demographic and functional composition of forests after major natural disturbances has become increasingly relevant given the accelerating rates of climate change and elevated frequency of natural disturbances. Although plant demographic strategies are often described across a slow-fast continuum, severe and frequent disturbance events influencing demographic processes may alter the demographic trade-offs and the functional composition of forests. We examined demographic trade-offs and the shifts in functional traits in a hurricane-disturbed forest using long-term data from the Luquillo Forest Dynamics Plot (LFPD) in Puerto Rico. METHODS: We analysed information on growth, survival, seed rain and seedling recruitment for 30 woody species in the LFDP. In addition, we compiled data on leaf, seed and wood functional traits that capture the main ecological strategies for plants. We used this information to identify the main axes of demographic variation for this forest community and evaluate shifts in community-weighted means for traits from 2000 to 2016. KEY RESULTS: The previously identified growth-survival trade-off was not observed. Instead, we identified a fecundity-growth trade-off and an axis representing seedling-to-adult survival. Both axes formed dimensions independent of resprouting ability. Also, changes in tree species composition during the post-hurricane period reflected a directional shift from seedling and tree communities dominated by acquisitive towards conservative leaf economics traits and large seed mass. Wood specific gravity, however, did not show significant directional changes over time. CONCLUSIONS: Our study demonstrates that tree demographic strategies coping with frequent storms and hurricane disturbances deviate from strategies typically observed in undisturbed forests, yet the shifts in functional composition still conform to the expected changes from acquisitive to conservative resource-uptake strategies expected over succession. In the face of increased rates of natural and anthropogenic disturbance in tropical regions, our results anticipate shifts in species demographic trade-offs and different functional dimensions.

Knowledge of excess deaths after tropical cyclones is critical to understanding their impacts, directly relevant to policies on preparedness and mitigation. We applied an ensemble of 16 Bayesian models to 40.7 million U.S. deaths and a comprehensive record of 179 tropical cyclones over 32 years (1988-2019) to estimate short-term all-cause excess deaths. The deadliest tropical cyclone was Hurricane Katrina in 2005, with 1491 [95% credible interval (CrI): 563, 3206] excess deaths (>99% posterior probability of excess deaths), including 719 [95% CrI: 685, 752] in Orleans Parish, LA (>99% probability). Where posterior probabilities of excess deaths were >95%, there were 3112 [95% CrI: 2451, 3699] total post-hurricane force excess deaths and 15,590 [95% CrI: 12,084, 18,835] post-gale to violent storm force deaths; 83.1% of post-hurricane force and 70.0% of post-gale to violent storm force excess deaths occurred more recently (2004-2019); and 6.2% were in least socially vulnerable counties.

Background: Tropical cyclones are associated with acute increases in mortality and morbidity, but few studies have examined their longer-term health consequences. We assessed whether tropical cyclones are associated with a higher frequency of symptom exacerbation among children with asthma in the following 12 months in eastern United States counties, 2000-2018. Methods: We defined exposure to tropical cyclones as a maximum sustained windspeed >21 meters/second at the county center and used coarsened exact matching to match each exposed county to one or more unexposed counties. We used longitudinal, de-identified administrative claims data to estimate the county-level, monthly risk of experiencing at least one asthma exacerbation requiring medical attention among commercially insured children aged 5-17 with prior diagnosis of asthma. We used a difference-in-differences approach implemented via a Poisson fixed effects model to compare the risk of asthma exacerbation in the 12 months before versus after each storm in exposed versus unexposed counties. Results: Across 43 tropical cyclones impacting the eastern United States, we did not observe evidence of an increase in the risk of symptom exacerbation in the 12 months following the storm (random-effects meta-analytic summary estimate: risk ratio = 1.03 [95% confidence interval = 0.96, 1.10], I² = 17%). However, certain storms, such as Hurricane Sandy, were associated with a higher risk of symptom exacerbation. Conclusions: These findings are consistent with the hypothesis that some tropical cyclones are detrimental to children's respiratory health. However, tropical cyclones were not associated in aggregate with long-term exacerbation of clinically apparent asthma symptoms among a population of children with commercial health insurance. [ABSTRACT FROM AUTHOR]

The goal of this nationally representative, cross-sectional study is to evaluate the trends in routine checkup within the last year associated with exposure to a hurricane. We compared Puerto Rico (2017 Hurricane Irma, Hurricane Maria), Texas (2017 Hurricane Harvey), and Florida (2017 Hurricane Irma, Hurricane 2018 Michael) with states that had a category 1-2 hurricane make landfall from 2014 to 2019: Georgia, Louisiana, Mississippi, North Carolina, and South Carolina. We found that states impacted by a major hurricane in 2017 had a drop in routine checkup while the states that experienced a category 1-2 landfall did have a change in that year. By the following year, all states reported an increase in routine checkup suggesting that the disruption in routine care was temporary.

In the past decade, high-dimensional single-cell technologies have revolutionized basic and translational immunology research and are now a key element of the toolbox used by scientists to study the immune system. However, analysis of the data generated by these approaches often requires clustering algorithms and dimensionality reduction representation, which are computationally intense and difficult to evaluate and optimize. Here, we present Cytometry Clustering Optimization and Evaluation (Cyclone), an analysis pipeline integrating dimensionality reduction, clustering, evaluation, and optimization of clustering resolution, and downstream visualization tools facilitating the analysis of a wide range of cytometry data. We benchmarked and validated Cyclone on mass cytometry (CyTOF), full-spectrum fluorescence-based cytometry, and multiplexed immunofluorescence (IF) in a variety of biological contexts, including infectious diseases and cancer. In each instance, Cyclone not only recapitulates gold standard immune cell identification but also enables the unsupervised identification of lymphocytes and mononuclear phagocyte subsets that are associated with distinct biological features. Altogether, the Cyclone pipeline is a versatile and accessible pipeline for performing, optimizing, and evaluating clustering on a variety of cytometry datasets, which will further power immunology research and provide a scaffold for biological discovery.

Natural disasters have been purported to increase, and decrease, hostile conflict in intimate relationships, but heavy reliance on retrospective designs prohibits strong tests of these contrasting perspectives. The present study aims to resolve this ambiguity using a sample of newlywed couples from Houston, Texas who reported their levels of hostile conflict three times before and three times after experiencing Hurricane Harvey. Latent growth curve piecewise regression models showed that robust declines in conflict prior to the hurricane were slowed after the hurricane hit, such that posthurricane conflict slopes flattened and became nonsignificant. Thus, by disrupting natural declines in conflict that occur in the early years of marriage, Hurricane Harvey appears to have been detrimental for couples. Factors examined in relation to hostile conflict (including personality traits, adverse childhood events, stress, and relationship satisfaction) were similar in their predictive power prior to and following the hurricane, suggesting that the hurricane did not markedly alter which couples were most prone to hostile interactions. Implications for understanding relationships in the context of natural disasters are outlined. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

While tropical cyclone regimes are shifting with climate change, the mechanisms underpinning the resistance (ability to withstand disturbance-induced change) and resilience (capacity to return to pre-disturbance reference) of tropical forest litterfall to cyclones remain largely unexplored pantropically. Single-site studies in Australia and Hawaii suggest that litterfall on low-phosphorus (P) soils is more resistant and less resilient to cyclones. We conducted a meta-analysis to investigate the pantropical importance of total soil P in mediating forest litterfall resistance and resilience to 22 tropical cyclones. We evaluated cyclone-induced and post-cyclone litterfall mass (g/m2 /day), and P and nitrogen (N) fluxes (mg/m2 /day) and concentrations (mg/g), all indicators of ecosystem function and essential for nutrient cycling. Across 73 case studies in Australia, Guadeloupe, Hawaii, Mexico, Puerto Rico, and Taiwan, total litterfall mass flux increased from ~2.5 ± 0.3 to 22.5 ± 3 g/m2 /day due to cyclones, with large variation among studies. Litterfall P and N fluxes post-cyclone represented ~5% and 10% of the average annual fluxes, respectively. Post-cyclone leaf litterfall N and P concentrations were 21.6 ± 1.2% and 58.6 ± 2.3% higher than pre-cyclone means. Mixed-effects models determined that soil P negatively moderated the pantropical litterfall resistance to cyclones, with a 100 mg P/kg increase in soil P corresponding to a 32% to 38% decrease in resistance. Based on 33% of the resistance case studies, total litterfall mass flux reached pre-disturbance levels within one-year post-disturbance. A GAMM indicated that soil P, gale wind duration and time post-cyclone jointly moderate the short-term resilience of total litterfall, with the nature of the relationship between resilience and soil P contingent on time and wind duration. Across pantropical forests observed to date, our results indicate that litterfall resistance and resilience in the face of intensifying cyclones will be partially determined by total soil P.

ImportanceDuring the past century, more than 100 catastrophic hurricanes have impacted the Florida coast; climate change will likely be associated with increases in the intensity of future storms. Despite these annual threats to residents, to our knowledge, no longitudinal studies of representative samples at risk of hurricane exposure have examined psychological outcomes associated with repeated exposure.ObjectiveTo assess psychosocial and mental health outcomes and functional impairment associated with repeated hurricane exposure.Design, setting, and participantsIn this survey study, a demographically representative sample of Florida residents was assessed in the 60 hours prior to Hurricane Irma (wave 1: September 8-11, 2017). A second survey was administered 1 month after Hurricane Irma (wave 2: October 12-29, 2017), and a third survey was administered after Hurricane Michael (wave 3: October 22 to November 6, 2018). Data were analyzed from July 19 to 23, 2021.ExposureHurricanes Irma and Michael.Main outcomes and measuresThe main outcomes were posttraumatic stress symptoms (PTSS), global distress, worry about future events (generalized worries), and functional impairment. Path models were used to assess associations of individual-level factors (prior mental health, recent adversity), prior storm exposures (loss and/or injury, evacuation), and direct, indirect, and media-based exposures to hurricanes Irma and Michael with those outcomes. Poststratification weights were applied to facilitate population-based inferences.ResultsOf 2873 individuals administered the survey in wave 1, 1637 responded (57.0% completion rate) (894 [54.6%, weighted] women; mean [SD] age, 51.31 [17.50] years); 1478 in wave 2 (90.3% retention from wave 1) and 1113 in wave 3 (75.3% retention from wave 2) responded. Prior mental health ailments (b, 0.18; 95% CI, 0.07-0.28), prior hurricane-related loss and/or injury (b, 0.09; 95% CI, 0.02-0.17), hours of Hurricane Irma-related media exposure (b, 0.03; 95% CI, 0.02-0.04), being in an evacuation zone during Hurricane Irma and not evacuating (b, 0.14; 95% CI, 0.02-0.27), and loss and/or injury in Hurricane Irma (b, 0.35; 95% CI, 0.25-0.44) were positively associated with PTSS after Hurricane Irma; most associations persisted and were associated with responses to Hurricane Michael. Prior mental health ailments (b, 0.10; 95% CI, 0.03-0.17), hours of Hurricane Michael-related media exposure (b, 0.01; 95% CI, 0.003-0.02), hurricane Irma-related PTSS (b, 0.42; 95% CI, 0.34-0.50), recent individual-level adversity (b, 0.03; 95% CI, 0.005-0.05), being in an evacuation zone during Hurricane Irma and evacuating (b, 0.10; 95% CI, 0.002-0.19), and direct (b, 0.36; 95% CI, 0.16-0.55) and indirect (b, 0.12; 95% CI, 0.05-0.18) Hurricane Michael-related exposures were directly associated with Hurricane Michael-related PTSS. After Hurricane Michael, prior mental health ailments (b, 0.17; 95% CI, 0.06-0.28), and PTSS related to hurricanes Irma (b, 0.11; 95% CI, 0.001-0.22) and Michael (b, 0.58; 95% CI, 0.47-0.69) were associated with respondents' functional impairment. Analogous analyses using global distress and generalized worries as mediators of functional impairment yielded a similar pattern of results.Conclusions and relevanceIn this survey study, repeated direct, indirect, and media-based exposures to hurricanes were associated with increased mental health symptoms among Florida residents who experienced hurricanes Irma and Michael, suggesting that people were sensitized to respond with more psychological symptoms over time. These results may inform targeted public health intervention efforts for natural disasters.

Increases in precipitation rates and volumes from tropical cyclones (TCs) caused by anthropogenic warming are predicted by climate modeling studies and have been identified in several high intensity storms occurring over the last half decade. However, it has been difficult to detect historical trends in TC precipitation at time scales long enough to overcome natural climate variability because of limitations in existing precipitation observations. We introduce an experimental global high-resolution climate data record of precipitation produced using infrared satellite imagery and corrected at the monthly scale by a gauge-derived product that shows generally good performance during two hurricane case studies but estimates higher mean precipitation rates in the tropics than the evaluation datasets. General increases in mean and extreme rainfall rates during the study period of 1980-2019 are identified, culminating in a 12-18%/40-year increase in global rainfall rates. Overall, all basins have experienced intensification in precipitation rates. Increases in rainfall rates have boosted the mean precipitation volume of global TCs by 7-15%/year, with the starkest rises seen in the North Atlantic, South Indian, and South Pacific basins (maximum 59-64% over 40 years). In terms of inland rainfall totals, year-by-year trends are generally positive due to increasing TC frequency, slower decay over land, and more intense rainfall, with an alarming increase of 81-85% seen from the strongest global TCs. As the global trend in precipitation rates follows expectations from warming sea surface temperatures (11.1%/°C), we hypothesize that the observed trends could be a result of anthropogenic warming creating greater concentrations of water vapor in the atmosphere, though retrospective studies of TC dynamics over the period are needed to confirm.

The 2020 North Atlantic hurricane season was one of the most active on record, causing heavy rains, strong storm surges, and high winds. Human activities continue to increase the amount of greenhouse gases in the atmosphere, resulting in an increase of more than 1 °C in the global average surface temperature in 2020 compared to 1850. This increase in temperature led to increases in sea surface temperature in the North Atlantic basin of 0.4-0.9 °C during the 2020 hurricane season. Here we show that human-induced climate change increased the extreme 3-hourly storm rainfall rates and extreme 3-day accumulated rainfall amounts during the full 2020 hurricane season for observed storms that are at least tropical storm strength (>18 m/s) by 10 and 5%, respectively. When focusing on hurricane strength storms (>33 m/s), extreme 3-hourly rainfall rates and extreme 3-day accumulated rainfall amounts increase by 11 and 8%, respectively.

Climate change is already increasing the severity of extreme weather events such as with rainfall during hurricanes. But little research to date investigates if, and to what extent, there are social inequalities in climate change-attributed extreme weather event impacts. Here, we use climate change attribution science paired with hydrological flood models to estimate climate change-attributed flood depths and damages during Hurricane Harvey in Harris County, Texas. Using detailed land-parcel and census tract socio-economic data, we then describe the socio-spatial characteristics associated with these climate change-induced impacts. We show that 30 to 50% of the flooded properties would not have flooded without climate change. Climate change-attributed impacts were particularly felt in Latina/x/o neighborhoods, and especially so in Latina/x/o neighborhoods that were low-income and among those located outside of FEMA's 100-year floodplain. Our focus is thus on climate justice challenges that not only concern future climate change-induced risks, but are already affecting vulnerable populations disproportionately now.

How do natural disasters affect intimate relationships? Some research suggests that couples are brought closer together after a disaster, whereas other research suggests that relationships become more strained in the aftermath. Yet all of this work is limited by a lack of predisaster data that would allow for examination of how relationships actually change. The current study is the first to use longitudinal data collected before and after a natural disaster to examine its effect on relationship outcomes. Using a sample of 231 married couples in Harris County, Texas, who experienced Hurricane Harvey, we found that spouses experienced significant increases in satisfaction from before to after the hurricane, but the increase was temporary; couples decreased in satisfaction after the initial boost. Thus, couples appear to grow closer in the immediate aftermath of a natural disaster but then revert to their prehurricane levels of functioning as the recovery period continues.

The human toll of disasters extends beyond death, injury and loss. Post-traumatic stress (PTS) can be common among directly exposed individuals, and children are particularly vulnerable. Even children far removed from harm's way report PTS, and media-based exposure may partially account for this phenomenon. In this study, we examine this issue using data from nearly 400 9- to 11-year-old children collected before and after Hurricane Irma, evaluating whether pre-existing neural patterns moderate associations between hurricane experiences and later PTS. The 'dose' of both self-reported objective exposure and media exposure predicted PTS, the latter even among children far from the hurricane. Furthermore, neural responses in brain regions associated with anxiety and stress conferred particular vulnerability. For example, heightened amygdala reactivity to fearful stimuli moderated the association between self-reported media exposure and PTS. Collectively, these findings show that for some youth with measurable vulnerability, consuming extensive disaster-related media may offer an alternative pathway to disaster exposure that transcends geography and objective risk.

Background: This year has seen the emergence of two major crises, a significant increase in the frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic. Methods: Semi-structured interviews were conducted with 26 representatives of 24 different community-based programs in southern Louisiana. Data were analyzed using procedures embedded in the Rapid Assessment Procedure-Informed Community Ethnography methodology, using techniques of immersion and crystallization and focused thematic analysis. Results: The pandemic has impacted the form and function of disaster preparedness, making it harder to plan for evacuations in the event of a hurricane. Specific concerns included being able to see people in person, providing food and other resources to residents who shelter in place, finding volunteers to assist in food distribution and other forms of disaster response, competing for funds to support disaster-related activities, developing new support infrastructures, and focusing on equity in disaster preparedness. However, several strengths based on disaster preparedness experience and capabilities were identified, including providing a framework for how to respond and adapt to COVID and integration of COVID response with their normal disaster preparedness activities. Conclusions: Although prior experience has enabled community-based organizations to respond to the pandemic, the pandemic is also creating new challenges to preparing for and responding to natural disasters.

Hurricane Maria was the largest disaster in Puerto Rico's history, affecting Puerto Rican communities throughout the United States. We conducted focus groups using a grounded theory approach with adults displaced from Puerto Rico to a northeastern community 12 (n = 5) and 17 months (n = 7) postdisaster. Key informant interviews were also conducted with nine community advocates working with displaced hurricane survivors. Emerging themes reflect narrative and social identity processes following collective trauma. Findings emphasize the need for timely and long-term disaster responses that build on community strengths without leaving communities to cope on their own. We discuss how incorporating group storytelling in postdisaster research is a culturally sensitive practice that can promote resiliency among survivors.

Some of the most devastating natural events on Earth, such as earthquakes and tropical cyclones, are prone to trigger other natural events, critical infrastructure failures, and socioeconomic disruptions. Man-made disasters may have similar effects, although to a lesser degree. We investigate the space of possible interactions between 19 types of loss-generating events, first by encoding possible one-to-one interactions into an adjacency matrix A, and second by calculating the interaction matrix M of emergent chains-of-events. We first present the impact of 24 topologies of A on M to illustrate the non-trivial patterns of cascading processes, in terms of the space of possibilities covered and of interaction amplification by feedback loops. We then encode A from 29 historical cases of cascading disasters and compute the matching matrix M. We observe, subject to data incompleteness, emergent cascading behaviors in the technological and socioeconomic systems, across all possible triggers (natural or man-made); disease is also a systematic emergent phenomenon. We find interactions being mostly amplified via two events: network failure and business interruption, the two events with the highest in-degree and betweenness centralities. This analysis demonstrates how cascading disasters grow in and cross over natural, technological, and socioeconomic systems.

Helping the world's coastal communities adapt to climate change impacts requires evaluating the vulnerability of coastal communities and assessing adaptation options. This includes understanding the potential for 'natural' infrastructure (ecosystems and the biodiversity that underpins them) to reduce communities' vulnerability, alongside more traditional 'hard' infrastructure approaches. Here we present a spatially explicit global evaluation of the vulnerability of coastal-dwelling human populations to key climate change exposures and explore the potential for coastal ecosystems to help people adapt to climate change (ecosystem-based adaptation (EbA)). We find that mangroves and coral reefs are particularly well situated to help people cope with current weather extremes, a function that will only increase in importance as people adapt to climate change now and in coming decades. We find that around 30.9 million people living within 2km of the coast are highly vulnerable to tropical storms and sea-level rise (SLR). Mangroves and coral reefs overlap these threats to at least 5.3 and 3.4 million people, respectively, with substantial potential to dissipate storm surges and improve resilience against SLR effects. Significant co-benefits from mangroves also accrue, with 896 million metric tons of carbon stored in their soils and above- and below-ground biomass. Our framework offers a tool for prioritizing 'hotspots' of coastal EbA potential for further, national and local analyses to quantify risk reduction and, thereby, guide investment in coastal ecosystems to help people adapt to climate change. In doing so, it underscores the global role that conserving and restoring ecosystems can play in protecting human lives and livelihoods, as well as biodiversity, in the face of climate change.

In this article, a dynamical downscaling (DD) procedure is proposed to downscale tropical cyclones (TCs) from a general circulation model, with the goal of investigating inland intense precipitation from these storms in the future. This DD procedure is sequential as it is performed from the large scale to the small scale within a one-way nesting modeling framework with the Weather Research and Forecasting (WRF) model. Furthermore, it involves a two-step validation process to ensure that the model produces realistic TCs, both in terms of their general properties and in terms of their intense precipitation statistics. In addition, this procedure makes use of several algorithms such as for the detection and tracking of TCs, with the objective of automatizing the DD process as much as possible so that this approach could be used to downscale massively many climate projections with several sets of model options. The DD approach was applied to the Community Climate System Model (CCSM) version 4 using Representative Concentration Pathway (RCP) 4.5 during the period 2005⁻2100, and the resulting TCs and their intense precipitation were examined.

ImportanceExposure to disaster-related media coverage is associated with negative mental health outcomes. However, risk factors that render individuals vulnerable to this exposure are unknown. Hurricane-associated media exposure was expected to explain the association between forecasted posttraumatic stress (PTS) and adjustment after the hurricane.ObjectiveTo examine forecasted PTS responses and media coverage as risk factors for negative mental health outcomes in the context of media coverage of an approaching disaster (Hurricane Irma).Design, setting, and participantsIn a representative probability community sample of 1637 adults from Florida, respondents completed 2 online surveys: the first during the 60 hours before Hurricane Irma's landfall (wave 1; September 8-11, 2017) and the second approximately 1 month later (wave 2; October 12-29, 2017). Poststratification weights were applied to facilitate population-based inferences. Data were analyzed from October 19 through 31, 2018.Main outcomes and measuresPosttraumatic stress responses, psychological distress, functional impairment, and worry about future events.ResultsThe wave 1 survey included 1637 participants (57.0% response rate); 1478 participants were retained at the wave 2 follow-up (90.3% retention) (weighted proportion of women, 62.2%; mean [SD] age, 59.1 [15.2] years). The final weighted sample closely approximated US Census benchmarks for the state of Florida. Data analyses using structural equation modeling revealed that exposure to media coverage of the hurricane (β = 0.21; 95% CI, 0.11-0.31; P

Introduction: This study examines the use of dialysis services by end-stage renal disease (ESRD) patients following the Superstorm Sandy-related, months-long closure of the New York campus of the US Department of Veterans Affairs (VA) New York Harbor VA Healthcare System (NYHHS, Manhattan VAMC). Methods: Outpatient visits, dialysis care, emergency department visits, and hospitalizations at VA and non-VA facilities for 47 Manhattan VAMC ESRD patients were examined 12 months pre- and post-Sandy using VA administrative and clinical data. Results: The Brooklyn campus of NYHHS, which is within ten miles of Manhattan VAMC, experienced the largest increase in the number of dialysis encounters after the closure. Dialysis encounters for VA patients also increased at non-VA facilities, rising on average, to 106 per month. For the James J Peters Bronx VAMC, the number of total dialysis encounters for Manhattan VAMC patients fluctuated between 39 and 43 per month, dropping to less than 30 after the Manhattan VAMC dialysis unit reopened. Conclusion: Manhattan VAMC ESRD patients used nearby alternate VA sites and non-VA clinics for their care during the closure of the Manhattan VAMC dialysis unit. The VA electronic health records played an important role in ensuring continuity of care for patients who exclusively used VAMC facilities post-Sandy because patient information was immediately accessible at other VA facilities. The events related to Superstorm Sandy highlight the need for dialysis providers to have a comprehensive disaster plan, including nearby alternate care sites that can increase service capacity when a dialysis facility is closed because of a disaster.

Introduction: This study examines the use of dialysis services by end-stage renal disease (ESRD) patients following the Superstorm Sandy-related, months-long closure of the New York campus of the US Department of Veterans Affairs (VA) New York Harbor VA Healthcare System (NYHHS, Manhattan VAMC). Methods: Outpatient visits, dialysis care, emergency department visits, and hospitalizations at VA and non-VA facilities for 47 Manhattan VAMC ESRD patients were examined 12 months pre- and post-Sandy using VA administrative and clinical data. Results: The Brooklyn campus of NYHHS, which is within ten miles of Manhattan VAMC, experienced the largest increase in the number of dialysis encounters after the closure. Dialysis encounters for VA patients also increased at non-VA facilities, rising on average, to 106 per month. For the James J Peters Bronx VAMC, the number of total dialysis encounters for Manhattan VAMC patients fluctuated between 39 and 43 per month, dropping to less than 30 after the Manhattan VAMC dialysis unit reopened. Conclusion: Manhattan VAMC ESRD patients used nearby alternate VA sites and non-VA clinics for their care during the closure of the Manhattan VAMC dialysis unit. The VA electronic health records played an important role in ensuring continuity of care for patients who exclusively used VAMC facilities post-Sandy because patient information was immediately accessible at other VA facilities. The events related to Superstorm Sandy highlight the need for dialysis providers to have a comprehensive disaster plan, including nearby alternate care sites that can increase service capacity when a dialysis facility is closed because of a disaster.

This study explored the land use land cover (LULC) change over 45 years (1975 -2020) in the world’s largest mangrove forest, Sundarbansusing Landsat imagery. LULC maps were created with same-season imagery with the lowest cloud cover at four intervals: 1975, 1990, 2005, and 2020. Maximum likelihood classification (MLC) was applied to assign five classes: dense forest, moderate forest, sparse forest, barren land, and water body. Accuracy assessment was carried out with 250 control points for each year resulting in overall accuracy and kappa coefficient ranging from 84.8% to 90.0% and 0.81 to 0.87, respectively. Results show dense forest at its highest cover in 1975 and then decreasing by an estimated annual rate of 1.3% from 1975 to 2020, but not consistently. Dense forest class mostly turned moderate and sparse; most of the sparse forest class turned to barren land. Most of the barren lands were located near the boundary between forest and human settlement, and these two classes were more frequent in the Indian part of Sundarbans than in the Bangladesh part. The conclusion is that the time-series of remote sensing data can validly support effective forest management by identifying space and time changes in the biodiversity of Sundarbans.

There is no consensus on whether climate change has yet affected the statistics of tropical cyclones, owing to their large natural variability and the limited period of consistent observations. In addition, projections of future tropical cyclone activity are uncertain, because they often rely on coarse-resolution climate models that parameterize convection and hence have difficulty in directly representing tropical cyclones. Here we used convection-permitting regional climate model simulations to investigate whether and how recent destructive tropical cyclones would change if these events had occurred in pre-industrial and in future climates. We found that, relative to pre-industrial conditions, climate change so far has enhanced the average and extreme rainfall of hurricanes Katrina, Irma and Maria, but did not change tropical cyclone wind-speed intensity. In addition, future anthropogenic warming would robustly increase the wind speed and rainfall of 11 of 13 intense tropical cyclones (of 15 events sampled globally). Additional regional climate model simulations suggest that convective parameterization introduces minimal uncertainty into the sign of projected changes in tropical cyclone intensity and rainfall, which allows us to have confidence in projections from global models with parameterized convection and resolution fine enough to include tropical cyclones.

Background: In December 2020, over 500 residents of Eluru City were hospitalised with seizures and sudden loss of consciousness (LOC) resembling the neurotoxic effects of organochlorine poisoning after a flooding event during the last week of November 2020. We described the epidemiological investigation of outbreak and identified risk factors. Methods: We performed descriptive analysis followed by 1:1 unmatched case-control study. Cases were identified through house-to-house search and review of medical records at district hospital. A case defined as sudden onset LOC or new-onset seizures in an Eluru resident aged ≥1 year, December 1–15, 2020 and a control as absence of neurological symptoms in a person aged ≥1 year selected randomly from same administrative division of the case. We compared cases and controls for possible risk factors and calculated adjusted odds ratio (aOR) with 95% confidence interval (CI). Biological and environmental samples were tested for contaminants. Results: We identified 545 cases (56% males), including one death. Seizures were reported in 491 (90%) cases. Median age was 27 years (interquartile range: 17–37 years) and 480 (88%) cases resided in urban area. Cases were clustered in administrative divisions supplied by municipal water reservoirs. Cases were more likely than controls to use municipal water as primary source of drinking water (aOR = 4.6, 95% CI = 1.6–13.0). High levels (average: 14.6 mg/l) of organochlorine compounds were detected in all municipal water samples (acceptable limit:

OBJECTIVE:To test whether effects of multiple (up to 5) disasters on mental health responses were cumulative (additive effects), or whether an earlier disaster produced sensitization (higher) or habituation (lower) responses to a later one. METHOD:The Gulf Resilience on Women's Health study interviewed 1,366 southern Louisiana women regarding their exposure to Hurricanes Katrina, Rita, Gustav, and Ike and the Gulf oil spill (measured several ways), and administered validated measures of symptoms of depression and posttraumatic stress disorder (PTSD). Multiple linear and logistic regression with disaster exposures entered singly, combined, and as an interaction were used to model mental health. RESULTS:Both exposure to the oil spill and hurricane disaster were associated with likely depression and PTSD, consistent with a cumulative model, but we did not find statistical interactions that would suggest sensitization or habituation. When results were examined with continuous symptom measures of depression and PTSD, they were similar, with the exception that exposure to the oil spill and experiencing illness or injury because of the hurricane disaster showed a significant interaction (p < .05) in a manner consistent with a sensitization effect when predicting PTSD symptoms. The results of this study point mainly to a cumulative risk for the mental health effects of multiple disasters, although some indication of sensitization occurred among those with particularly severe experiences. There was no evidence for habituation. CONCLUSIONS:These findings may guide efforts to assist those in regions experiencing multiple disasters that occur in close sequence. (PsycINFO Database Record

The speed at which tropical cyclones travel has slowed globally in the past seven decades, especially over some coastlines. This effect can compound flooding by increasing regional total rainfall from storms.

Objectives: Tropical storms and hurricanes often produce ocean wave conditions that attract surfers. The risk for serious injury or death from "storm surfing" has not yet been described in the medical literature. This study aimed to quantify deaths attributable to storm surfing along the coasts of North America and the Caribbean islands.Methods: This was a retrospective review of cases of surfing-related fatalities reported in the tropical cyclone reports of the National Hurricane Center from 1995 to 2020. Media reports were used to identify additional cases and, when available, to provide supplemental demographic and geographical information.Results: There have been 27 reported storm surfing deaths during this time period. Among those for whom demographic data were available, all of the decedents were male and three were children younger than 18 years old. All but three of the deaths occurred among those surfing Atlantic storms, and one-third of the fatal injuries occurred off the coast of Florida. Eight deaths occurred while surf conditions were affected by tropical storms that did not reach hurricane status.Conclusions: Both tropical storms and hurricanes produce dangerous surf conditions that have resulted in fatal injuries among surfers during the past 25 years. [ABSTRACT FROM AUTHOR]

Coral reefs are at risk due to various global and local anthropogenic stressors that impact the health of reef ecosystems worldwide. The most recent climate models predict that climate change will increase the frequency and intensity of tropical storms. This increased storm occurrence and strength will likely compromise coral reef structures and habitats for reef-dwelling organisms, including across the Florida Keys Reef Tract (FKRT), the most extensive tropical reef system along the US coast. While several recent studies reveal the chronic impacts of tropical storms on corals, relatively little is known about the effects of major storm events on coral growth and how these effects vary over spatiotemporal scales. Here, I characterize the skeletal growth of two common Caribbean reef-building coral species, Siderastrea siderea and Pseudodiploria strigosa, before and after Hurricane Irma to investigate the storm's impact on coral skeletal growth on inner and outer reefs of the FKRT. Coral cores were extracted from both species at four inner and four outer reef sites in May 2015, before Hurricane Irma struck the Florida Keys in September 2017. Subsequently, 33 micro-cores were collected in May 2019, two years after the storm traversed our previously cored coral colonies. A three-way ANOVA model with storm, species, and reef location as the three factors was used to assess the impact of the storm on each of three growth parameters: skeletal density, linear extension, and calcification rates. Results reveal no difference in the coral annual skeletal growth parameters pre- and post-Hurricane Irma, although previously quantified differences in these growth parameters across species and location were observed. However, analysis of the "yearly" change in annual skeletal growth parameters showed significant differences in skeletal density across groups before and after Hurricane Irma, but not for linear extension and calcification rates. Our findings improve an understanding of the impacts of tropical storms on coral skeletal growth and offer new insights into how we can employ corals' innate growth capacities to help conserve coral reefs under climate change., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology.)

Recurrent landslide events triggered by typhoons and tropical storms over Vietnam pose a longstanding threat to the nation's population and infrastructure. Changes in hydroclimatic conditions, especially the growing intensity and frequency of storms, have elevated landslide susceptibility in many parts of the country. This research examines the spatio-temporal variations in landslide susceptibility across central Vietnam over several years, using multi-temporal landslide inventories from Typhoon Ketsana (2009), Tropical Storm Podul (2013), and Typhoon Molave (2020). Additionally, the research explores the impact of individual landslide causative factors on the probabilistic occurrences of landslides. The post-event landslide susceptibility models of these three climate extreme events were developed using nine causative factors and a Random Forest machine learning algorithm. The results indicate a notable areal expansion of high to very high landslide susceptibility in the northern and eastern regions and a moderate reduction in the central and southern areas during the post-Molave period compared to the post-Ketsana period. These changes may be early indicators of increasing landslide susceptibility in response to changing hydro-climatic conditions. The research found that annual average rainfall and topographic elevation are the two most important variables influencing landslide prediction, showing a nonlinear relationship with landslide probability. The landslide susceptibility models achieved high Area Under the Receiver Operating Characteristic Curve (AUC) (>95%), accuracy (>89%), and sensitivity (>90%) scores, signifying the robustness of the models. Additionally, the uncertainty of the models was quantified and spatially mapped. This multi-temporal analysis of landslide susceptibility is crucial for understanding the regional susceptibility trends and identifying areas with increasing, decreasing, and consistently high susceptibility to landslides. These insights are invaluable for prioritizing mitigation and risk reduction strategies in landslide-prone regions and guiding appropriate land use planning., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Das et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Motivation for the study. Dengue epidemics caused by A. aegypti occur during climatic events in tropical countries such as Peru; however, the feeding behavior of the mosquito usually goes unnoticed., Background: Main findings. A. aegypti populations in Marcavelica and Querecotillo showed anthropophilic feeding behavior during cyclone Yaku and in the 2023 El Niño. However, populations with different feeding patterns are not ruled out., Background: Implications. The PCR-RFLP technique of the blood cell cytochrome B gene could be implemented in vector control policies through an entomo-virological surveillance plan., Objective.: To determine the feeding behavior of Aedes aegypti in dengue outbreaks in two rural areas of Peru during the Yaku cyclone and El Niño phenomenon of 2023., Material and Methods.: Eight blood samples (8 pools) were obtained from the abdomen of 80 Aedes aegypti specimens captured in the rural districts of Querecotillo and Marcavelica during the Yaku cyclone and El Niño dengue outbreaks. DNA was extracted from the analyzed samples, then a PCR was directed at the CytB gene as a genetic marker and the PCR products were enzymatically digested with the restrictases Hae III and Mwo I. The PCR-RFLP products were visualized by agarose gel electrophoresis at 4%., Results.: DNA was obtained from all samples and a 358 bp amplicon was obtained as a PCR product. Likewise, the only RFLP found in Hae III was from Homo sapiens sapiens (233 and 125 bp). RFLP was not found in Hae III of Gallus gallus and RFLP in Mwo I of Canis familiaris and Mus musculus., Conclusion.: Aedes aegypti showed conserved anthropophilic feeding behavior in dengue outbreaks in rural areas during the Yaku cyclone and El Niño.

Tropical cyclones (TCs) displace millions every year. While TCs pose hardships and threaten lives, their negative impacts can be reduced by anticipatory actions like evacuation and humanitarian aid coordination. In addition to weather forecasts, impact forecast enables more effective response by providing richer information on the numbers and locations of people at risk of displacement. We introduce a fully open-source implementation of a globally consistent and regionally calibrated TC-related displacement forecast at low computational costs, combining meteorological forecast with population exposure and respective vulnerability. We present a case study of TC Yasa which hit Fiji in December 2020. We emphasise the importance of considering the uncertainties associated with hazard, exposure, and vulnerability in a global uncertainty analysis, which reveals a considerable spread of possible outcomes. Additionally, we perform a sensitivity analysis on all recorded TC displacement events from 2017 to 2020 to understand how the forecast outcomes depend on these uncertain inputs. Our findings suggest that for longer forecast lead times, decision-making should focus more on meteorological uncertainty, while greater emphasis should be placed on the vulnerability of the local community shortly before TC landfall. Our open-source codes and implementations are readily transferable to other users, hazards, and impact types., (© 2024. The Author(s).)

Since 2017, Puerto Rico has faced environmental, economic, and political crises, leading to the emigration of healthcare workers and weakening the healthcare system. These challenges have affected cancer treatment continuity, exacerbating healthcare access challenges island-wide. In this study, we estimate the effect of the residence region on cancer treatment disruption following Hurricanes Irma and María (2017). Telephone surveys were conducted with 241 breast and colorectal cancer patients aged 40 and older who were diagnosed within six months before the hurricanes and were receiving treatment at the time of the hurricanes. Treatment disruption was defined as any pause in surgery, chemotherapy, radiotherapy, or oral treatment due to the hurricanes. Prevalence ratios (PRs) of treatment disruption by residence region were estimated using the San Juan Metropolitan Area (SJMA) as the reference. Fifty-nine percent of respondents reported treatment disruption; among them, half experienced disruptions lasting more than 30 days, with 14% of these enduring disruptions longer than 90 days. Adjusted models showed a 48% higher prevalence of disruption outside the SJMA (PR = 1.48, 95% CI: 1.06-2.07). Specific geographic regions (Arecibo, Bayamón, Caguas, and Mayagüez) exhibited higher disruption prevalence. These findings emphasize the need for disaster preparedness strategies that ensure equitable healthcare access for all cancer patients following environmental calamities.

The intersection of the COVID-19 pandemic with other crises can amplify vulnerabilities and push communities further into poverty. In low-income countries, the dual impacts of COVID-19 and extreme weather events, along with multidimensional poverty and structural vulnerabilities in agriculture can decimate farmer livelihoods. This study aims to understand the effects of individual and compounding crises (COVID-19, cyclones, and vanilla price collapse) on smallholder vanilla farmers and local coping strategies in Madagascar, one of the world's largest vanilla producers and poorest countries. We used semi-structured and scenario-based interviews across two case study villages with contrasting enforcement of forest regulations. We found that the impact of the pandemic, combined with the cyclone event, disrupted livelihoods, resulting in income losses and food security challenges that exacerbated farmer vulnerabilities. Sixty eight percent of households reported crop losses due to strong winds and heavy rainfall brought by cyclone Enawo in 2017. The COVID-19 outbreak struck the region just as the residents were recovering from the effects of the cyclone. COVID-19-related travel restrictions in the aftermath of the cyclone took a substantial economic toll, with 54.1% of respondents experiencing a decline in earnings, and 17% facing a total loss of income due to the imposed lockdown. The decline in vanilla prices at the onset of 2020 had a far-reaching additional impact, affecting not only farmers but also residents who rely on other sources of income. Local communities reported using the forest resources more frequently as a safety net during crises in the village with more lenient regulations. This study underscores the importance of understanding the interconnectedness and compounding impacts of cascading crises on food security and natural resource use. We highlight the need for a comprehensive approach to increasing farmer resilience, particularly for those reliant on global market crops such as vanilla., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Harison et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

To improve preparedness for natural disasters, it is imperative to understand the factors that enable individual risk-reduction actions. This study offers such insights using innovative real-time (N = 871) and repeated (N = 255) surveys of a sample of coastal residents in Florida regarding flood preparations and their drivers during an imminent threat posed by Hurricane Dorian and its aftermath. Compared with commonly employed cross-sectional surveys, our methodology better represents relationships between preparedness actions undertaken during the disaster threat and their drivers derived from an extended version of Protection Motivation Theory (PMT). The repeated survey allows for examining temporal dynamics in these drivers. Our results confirm the importance of coping appraisals and show that risk perceptions relate more strongly to emergency protection decisions made during the period of the disaster threat than to decisions made well before. Moreover, we find that several personal characteristics that we add to the standard PMT framework significantly relate to undertaking preparedness actions, especially locus of control and social norms. Significant changes in key explanatory variables occur following the disaster threat, including a decline in risk perception, a potential learning effect in coping appraisals, and a decline in risk aversion. Our results confirm the advantage of the real-time and repeated survey approach in understanding both short- and long-term disaster preparedness actions., (© 2024 The Authors. Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

As climate change continues to displace greater numbers of people, transnational ties are important sources of social protection for climate migrants. Migrants assemble unique configurations of formal and informal social protections depending on the resources available within their sending and receiving communities. However, the specific constellations of social protections that climate migrants use following disaster and displacement remain underexamined. Authors conducted semistructured interviews with Puerto Ricans who migrated in the aftermath of Hurricane Maria (N = 41) and used qualitative content analysis to trace the assemblages of formal and informal social protections used to navigate the resettlement process. Results suggest that informal support from migrants' transnational ties was instrumental in successfully making use of formal sources of support, including federal emergency relief programs, to leave the island and resettle on the U.S. mainland. This reliance on informal social protections often strained participants' informal networks and raised questions of equity for people internally displaced by climate change. These findings highlight the need for a more equitable and effective linkage of climate migrants with public resources., (© 2024 National Association of Social Workers.)

On September 20, 2017, Hurricane Maria made landfall in Puerto Rico, devastating the archipelago and forcing thousands of Puerto Ricans to migrate to the U.S. mainland. Guided by a cultural stress theory framework, the present mixed method study examined how various cultural stressors impact participants' daily interactions and mental health outcomes. A total of 319 adult Hurricane Maria survivors residing on the U.S. mainland participated in the study. A mixed method sequential explanatory design was used. First, we used latent profile analysis (LPA) and multinomial logistic regression to identify the varied cultural stress experiences that participants had. Then we used data from semistructured interviews to better understand the experiences of participants classified into the different LPA profiles. Four profiles were identified: "moderate cultural stress" (35%), "overall low" (29%), "high cultural stress" (26%), and "low language stress" (10%). Multinomial regression indicated that members of the moderate cultural stress, high cultural stress, and low language stress profiles all reported significantly higher depressive and anxiety symptoms compared to members of the overall low profile. Qualitative data exemplified the daily experiences of participants placed into each profile, demonstrating that participants have rich and varied experiences that can contribute to their mental health symptoms. The present study documents the contributions of hurricane trauma and cultural stress vis-à-vis current mental health symptoms. Clinicians working with Hurricane Maria survivors should be cognizant of and inquire about migration-related cultural stressors including discrimination, feelings of being unwelcomed, and difficulty communicating in the destination community's dominant language. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Puerto Rico (PR) is highly vulnerable to hurricanes, which severely impact cancer survivors by causing healthcare disruptions and increasing stress. This study investigates the reliability and factor structure of the Hurricane Hazards Inventory (HHI) and its relationship with psychological distress among cancer survivors and non-cancer controls in PR., Methods: Using secondary data from a longitudinal study following Hurricane Maria (HM), the baseline assessment included sociodemographic data from participants, HHI, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7). Statistical analyses involved descriptive statistics, Exploratory Factor Analysis (EFA), and Partial Least Squares Structural Equation Modeling (PLS-SEM)., Results: Among 260 participants, 78.7% were women, with a median age of 58.0 years. EFA reduced the HHI to 17 items grouped into three factors explaining 62.6% of the variance with excellent reliability (Cronbach's alpha 0.91). The three factors also showed good to excellent reliability (alpha 0.81 to 0.92). The median HHI score was 11.0 (range 4.0-26.5) out of 68. PLS-SEM revealed a direct effect of being a cancer survivor and tertiary hazards on depression and anxiety., Conclusion: The HHI is a valid and reliable tool for assessing mental health impact in cancer survivors after hurricanes. However, the study had limitations, including its small sample size and lack of control for all confounding variables. Future research with larger and more diverse samples is needed to further validate the HHI and examine its generalizability.

Background: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors., Methods: This secondary data analysis ( n = 101) was part of a longitudinal case-control cohort study ( n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t -test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed., Results: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods., Conclusions: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.

Mosquitoes are the most common disease vectors worldwide. In coastal cities, the spread, activity, and longevity of vector mosquitoes are influenced by environmental factors such as temperature, humidity, and rainfall, which affect their geographic distribution, biting rates, and lifespan. We examined mosquito abundance and species composition before and after Hurricane Irma in Miami, Dade County, Florida, and identified which mosquito species predominated post-Hurricane Irma. Our results showed that mosquito populations increased post-Hurricane Irma: 7.3 and 8.0 times more mosquitoes were captured in 2017 than at baseline, 2016 and 2018 respectively. Warmer temperatures accelerated larval development, resulting in faster emergence of adult mosquitoes. In BG-Sentinel traps, primary species like Ae. tortills, Cx. nigripalpus, and Cx. quinquefasciatus dominated the post-Hurricane Irma period. Secondary vectors that dominated post-Hurricane Irma include An. atropos, An. crucians, An. quadrimaculatus, Cx. erraticus, and Ps. columbiae. After Hurricane Irma, the surge in mosquito populations in Miami, Florida heightened disease risk. To mitigate and prevent future risks, we must enhance surveillance, raise public awareness, and implement targeted vector control measures., (© 2024. The Author(s).)

Background: Patients undergoing maintenance hemodialysis face heightened vulnerability during disasters like tropical cyclones, yet there is sparse research on their treatment-related challenges and countermeasures. This scoping review aims to highlight the issues maintenance hemodialysis patients encounter following tropical cyclones., Methods: A systematic scoping review of 19 articles from 2000 to 2023 was conducted, evaluating eligibility against predefined criteria., Results: Hemodialysis patients encounter substantial challenges during and after tropical cyclones in the United States, Puerto Rico, Australia, and Taiwan. Thematic analysis identified 3 themes related to "challenges" (Hemodialysis health-related challenges, socially relevant challenges, and challenges of management inefficiencies). "Recommendations" comprised 4 themes and 4 phases across the "mitigation phase" (fortifying healthcare infrastructure and mobilizing community-focused risk mitigation initiatives), "preparedness" (emergency plan development, training, and patient education), "response" (activation of emergency plans and providing emergency healthcare services), and "recovery" (intersectoral collaboration for recovery and rebuilding)., Conclusion: This scoping review underscores challenges confronted by patients undergoing maintenance hemodialysis post-tropical cyclones, highlighting the urgent need for targeted strategies to ensure the continuity of dialysis care during and after such disasters.

Under two detection schemes, this study analyzes one of the most destructive weather systems - the explosive cyclones - in the South Atlantic, from 2010 to 2020. Then, two methods are presented to study these systems: the Observational Method (OBSM) and the Automated Method (AUTM). The first uses visual analysis of the mean sea level pressure (mslp) fields and functions to identify the local minimums using the Grid Analysis and Display (GrADS) software. The second utilizes a function from OpenGrADS called mfhilo. It shows the local minimum in the grid using laplacian, magnitude, and percentile. Two shell algorithms for data manipulation are used for the AUTM: one to trace the cyclones' trajectories according to a previously defined fixed area and the other to separate them into explosives. The OBSM methodology showed 271 cases averaging 25 yearly and revealed important characteristics regarding the intensities. According to AUTM's methodology, from the 2705 ordinary cyclone cases identified, 299 are explosives. There is a clear seasonality pattern in the systems' distribution along South America, similar to OBSM, but more highlighted. In summer, they concentrate at high latitudes, while in winter and spring, they are assembled near southern Brazilian and Uruguayan coasts.

Leptospirosis, an acute bacterial zoonotic disease, is endemic in Puerto Rico. Infection in approximately 10%-15% of patients with clinical disease progresses to severe, potentially fatal illness. Increased incidence has been associated with flooding in endemic areas around the world. In 2022, Hurricane Fiona, a Category 1 hurricane, made landfall and inundated Puerto Rico with heavy rainfall and severe flooding, increasing the risk for a leptospirosis outbreak. In response, the Puerto Rico Department of Health (PRDH) changed guidelines to make leptospirosis cases reportable within 24 hours, centralized the case investigation management system, and provided training and messaging to health care providers. To evaluate changes in risk for leptospirosis after Hurricane Fiona to that before the storm, the increase in cases was quantified, and patient characteristics and geographic distribution were compared. During the 15 weeks after Hurricane Fiona, 156 patients experienced signs and symptoms of leptospirosis and had a specimen with a positive laboratory result reported to PRDH. The mean weekly number of cases during this period was 10.4, which is 3.6 as high as the weekly number of cases during the previous 37 weeks (2.9). After Hurricane Fiona, the proportion of cases indicating exposure to potentially contaminated water increased from 11% to 35%, and the number of persons receiving testing increased; these factors likely led to the resulting overall surge in reported cases. Robust surveillance combined with outreach to health care providers after flooding events can improve leptospirosis case identification, inform clinicians considering early initiation of treatment, and guide public messaging to avoid wading, swimming, or any contact with potentially contaminated floodwaters., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Melissa Marzán-Rodríguez reported being a member of the board of directors of COAI, Inc. (LGBT Health). No other potential conflicts of interest were disclosed.

People who use drugs (PWUD) disproportionately experience health-related and social vulnerabilities, which may affect service needs and access during and after natural disasters. We conducted qualitative interviews with N = 18 PWUD recruited via a syringe services program in Houston, Texas. We assessed their health and social service needs, as well as related service access experiences, during and after natural disasters using a combined inductive-deductive approach. Participants described a range of service-related needs related to illicit drug use, poverty, neighborhood disadvantage, acute and chronic health problems, and housing insecurity. They endorsed decreased access to medical and substance-related services and difficulty accessing disaster relief aid. Interviews highlighted the importance of mutual aid for sharing harm reduction supplies and meeting practical needs. Results suggest that some PWUD experience disproportionate vulnerability after natural disasters related to multiple marginalized identities that intersect with illicit drug use.

Background: The proportion of intense tropical cyclones is expected to increase in a changing climate. However, there is currently no consistent and comprehensive assessment of infectious disease risk following tropical cyclone exposure across countries and over decades. We aimed to explore the tropical cyclone-associated hospitalisation risks and burden for cause-specific infectious diseases on a multi-country scale., Methods: Hospitalisation records for infectious diseases were collected from six countries and territories (Canada, South Korea, New Zealand, Taiwan, Thailand, and Viet Nam) during various periods between 2000 and 2019. The days with tropical cyclone-associated maximum sustained windspeeds of 34 knots or higher derived from a parametric wind field model were considered as tropical cyclone exposure days. The association of monthly infectious diseases hospitalisations and tropical cyclone exposure days was first examined at location level using a distributed lag non-linear quasi-Poisson regression model, and then pooled using a random-effects meta-analysis. The tropical cyclone-attributable number and fraction of infectious disease hospitalisations were also calculated., Findings: Overall, 2·2 million people who were hospitalised for infectious diseases in 179 locations that had at least one tropical cyclone exposure day in the six countries and territories were included in the analysis. The elevated hospitalisation risks for infectious diseases associated with tropical cyclones tended to dissipate 2 months after the tropical cyclone exposure. Overall, each additional tropical cyclone day was associated with a 9% (cumulative relative risk 1·09 [95% CI 1·05-1·14]) increase in hospitalisations for all-cause infectious diseases, 13% (1·13 [1·05-1·21]) for intestinal infectious diseases, 14% (1·14 [1·05-1·23]) for sepsis, and 22% (1·22 [1·03-1·46]) for dengue during the 2 months after a tropical cyclone. Associations of tropical cyclones with hospitalisations for tuberculosis and malaria were not significant. In total, 0·72% (95% CI 0·40-1·01) of the hospitalisations for all-cause infectious diseases, 0·33% (0·15-0·49) for intestinal infectious diseases, 1·31% (0·57-1·95) for sepsis, and 0·63% (0·10-1·04) for dengue were attributable to tropical cyclone exposures. The attributable burdens were higher among young populations (aged ≤19 years) and male individuals compared with their counterparts, especially for intestinal infectious diseases. The heterogeneous spatiotemporal pattern was further revealed at the country and territory level-tropical cyclone-attributable fractions showed a decreasing trend in South Korea during the study period but an increasing trend in Viet Nam, Taiwan, and New Zealand., Interpretation: Tropical cyclones were associated with persistent elevated hospitalisation risks of infectious diseases (particularly sepsis and intestinal infectious diseases). Targeted interventions should be formulated for different populations, regions, and causes of infectious diseases based on evidence on tropical cyclone epidemiology to respond to the increasing risk and burden., Funding: Australian Research Council, Australian National Health, and Medical Research Council., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Tropical cyclone causes large-scale devastation and destruction in the coastal plains of India, particularly in Odisha, which is the most cyclone-affected state in the country. Tropical cyclones are projected to be more powerful and widespread due to changing climate. Hence, the risk assessment of tropical cyclone is necessary to identify cyclone-risk areas in coastal Odisha which may help in the mitigation of the damages caused by cyclones. Therefore, this study utilizes geospatial techniques to produce a comprehensive risk map posed by tropical cyclones and to estimate the degree of risk for coastal districts of Odisha. For this, we evaluated the district-level cyclone risk for coastal Odisha using multi-criteria decision-making (MCDM) technique by considering 21 parameters for each of the four components of risk, i.e., exposure, hazard, vulnerability, as well as mitigation capacity. For each criterion, thematic raster map layers were created and weighted using a fuzzy analytical hierarchy process (FAHP). We prepared individual risk component maps using weighted overlay techniques and finally integrated all indices to create the risk map. The study shows that 13% area of the study area comes under a very high-risk zone whereas, 25% area comes under a high-risk zone. The central (Cuttack, northern parts of Khordha, and south-western parts of Jajpur district) and the eastern part (most of the parts of Jagatsinghpur, Kendrapara, and northern parts of Puri district) of the study area come under high to very high tropical cyclone impact zone. Almost 67% of the total area is highly vulnerable to tropical cyclones and mainly concentrated near the shoreline. The applied approach and results can assist the local authorities in identifying vulnerable and hazardous locations and developing workable solutions for the mitigation of revised cyclone threats in the coastal districts of Odisha., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Demographic processes that ensure the recovery and resilience of marine populations are critical as climate change sends an increasing proportion on a trajectory of decline. Yet for some populations, recovery potential remains high. We conducted annual monitoring over 9 years (2012-2020) to assess the recovery of coral populations belonging to the genus Pocillopora. These populations experienced a catastrophic collapse following a severe typhoon in 2009. From the start of the monitoring period, high initial recruitment led to the establishment of a juvenile population that rapidly transitioned to sexually mature adults, which dominated the population within 6 years after the disturbance. As a result, coral cover increased from 1.1% to 20.2% during this time. To identify key demographic drivers of recovery and population growth rates (λ), we applied kernel-resampled integral projection models (IPMs), constructing eight successive models to examine annual change. IPMs were able to capture reproductive traits as key demographic drivers over the initial 3 years, while individual growth was a continuous key demographic driver throughout the entire monitoring period. IPMs further detected a pulse of reproductive output subsequent to two further Category 5 typhoon events during the monitoring period, exemplifying key mechanisms of resilience for coral populations impacted by disturbance. Despite rapid recovery, (i.e., increased coral cover, individual colony growth, low mortality), IPMs estimated predominantly negative values of λ, indicating a declining population. Indeed, while λ translates to a change in the number of individuals, the recovery of coral populations can also be driven by an increase in the size of surviving colonies. Our results illustrate that accumulating long-term data on historical dynamics and applying IPMs to extract demographic drivers are crucial for future predictions that are based on comprehensive and robust understandings of ecological change., (© 2024 The Ecological Society of America.)