Climate change: Attitudes and concerns of, and learnings from, people with neurological conditions, carers, and health care professionals.

OBJECTIVE: Concern about climate change among the general public is acknowledged by surveys. The health care sector must play its part in reducing greenhouse gas emissions and adapting to a changing climate, which will require the support of its stakeholders including those with epilepsy, who may be especially vulnerable. It is important to understand this community's attitudes and concerns about climate change and societal responses. METHODS: A survey was made available to more than 100 000 people among a section of the neurological community (patients, carers, and clinicians), focused on epilepsy. We applied quantitative analysis of Likert scale responses supported by qualitative analyses of free-text questions with crossover analyses to identify consonance and dissonance between the two approaches. RESULTS: A small proportion of potential respondents completed the survey; of 126 respondents, 52 had epilepsy and 56 explicitly declared no illness. The survey indicated concern about the impact of climate change on health within this neurological community focused on epilepsy. More than half of respondents considered climate change to have been bad for their health, rising to 68% in a subgroup with a neurological condition; over 80% expected climate change to harm their health in future. Most (>75%) believed that action to reduce greenhouse gas emissions will lead to improved health and well-being. The crossover analysis identified cost and accessibility as significant barriers. SIGNIFICANCE: The high level of concern about climate change impacts and positive attitudes toward policies to reduce greenhouse gas emissions provide support for climate action from the epilepsy community. However, if policies are implemented without considering the needs of patients, they risk being exclusionary, worsening inequalities, and further threatening neurological health and well-being.

Towards Quantifying the Uncertainty in Estimating Observed Scaling Rates.

Short-duration precipitation extremes (PE) increase at a rate of around 7%/K explained by the Clausius-Clapeyron relationship. Previous studies show uncertainty in the extreme precipitation-temperature relationship (scaling) due to various thermodynamic/dynamic factors. Here, we show that uncertainty may arise from the choice of data and methods. Using hourly precipitation (PPT) and daily dewpoint temperature (DPT) across 2,905 locations over the United States, we found higher scaling for quality-controlled data, all locations showing positive (median 6.2%/K) scaling, as compared to raw data showing positive (median 5.3%/K) scaling over 97.5% of locations. We found higher scaling for higher measurement precision of PPT (0.25 mm: median 7.8%/K; 2.54 mm: median 6.6%/K). The method that removes seasonality in PPT and DPT gives higher (with seasonality: median 6.2%/K; without seasonality: median 7.2%/K) scaling. Our results demonstrate the importance of quality-controlled, high-precision observations and robust methods in estimating accurate scaling for a better understanding of PE change with warming.

Carbon emission savings and short-term health care impacts from telemedicine: An evaluation in epilepsy.

OBJECTIVE: Health systems make a sizeable contribution to national emissions of greenhouse gases that contribute to global climate change. The UK National Health Service is committed to being a net zero emitter by 2040, and a potential contribution to this target could come from reductions in patient travel. Achieving this will require actions at many levels. We sought to determine potential savings and risks over the short term from telemedicine through virtual clinics. METHODS: During the severe acute respiratory syndrome coronavirus 2 (SARS-2-CoV) pandemic, scheduled face-to-face epilepsy clinics at a specialist site were replaced by remote teleclinics. We used a standard methodology applying conversion factors to calculate emissions based on the total saved travel distance. A further conversion factor was used to derive emissions associated with electricity consumption to deliver remote clinics from which net savings could be calculated. Patients' records and clinicians were interrogated to identify any adverse clinical outcomes. RESULTS: We found that enforced telemedicine delivery for over 1200 patients resulted in the saving of ~224 000 km of travel with likely avoided emissions in the range of 35 000-40 000 kg carbon dioxide equivalent (CO2 e) over a six and half month period. Emissions arising directly from remote delivery were calculated to be <200 kg CO2 e (~0.5% of those for travel), representing a significant net reduction of greenhouse gas emissions. Only one direct adverse outcome was identified, with some additional benefits identified anecdotally. SIGNIFICANCE: The use of telemedicine can make a contribution toward reduced emissions in the health care sector and, in the delivery of specialized epilepsy services, had minimal adverse clinical outcomes over the short term. However, these outcomes will likely vary with clinic locations, medical specialties and conditions.

Climate change and epilepsy: Insights from clinical and basic science studies.

Climate change is with us. As professionals who place value on evidence-based practice, climate change is something we cannot ignore. The current pandemic of the novel coronavirus, SARS-CoV-2, has demonstrated how global crises can arise suddenly and have a significant impact on public health. Global warming, a chronic process punctuated by acute episodes of extreme weather events, is an insidious global health crisis needing at least as much attention. Many neurological diseases are complex chronic conditions influenced at many levels by changes in the environment. This review aimed to collate and evaluate reports from clinical and basic science about the relationship between climate change and epilepsy. The keywords climate change, seasonal variation, temperature, humidity, thermoregulation, biorhythm, gene, circadian rhythm, heat, and weather were used to search the published evidence. A number of climatic variables are associated with increased seizure frequency in people with epilepsy. Climate change-induced increase in seizure precipitants such as fevers, stress, and sleep deprivation (e.g. as a result of more frequent extreme weather events) or vector-borne infections may trigger or exacerbate seizures, lead to deterioration of seizure control, and affect neurological, cerebrovascular, or cardiovascular comorbidities and risk of sudden unexpected death in epilepsy. Risks are likely to be modified by many factors, ranging from individual genetic variation and temperature-dependent channel function, to housing quality and global supply chains. According to the results of the limited number of experimental studies with animal models of seizures or epilepsy, different seizure types appear to have distinct susceptibility to seasonal influences. Increased body temperature, whether in the context of fever or not, has a critical role in seizure threshold and seizure-related brain damage. Links between climate change and epilepsy are likely to be multifactorial, complex, and often indirect, which makes predictions difficult. We need more data on possible climate-driven altered risks for seizures, epilepsy, and epileptogenesis, to identify underlying mechanisms at systems, cellular, and molecular levels for better understanding of the impact of climate change on epilepsy. Further focussed data would help us to develop evidence for mitigation methods to do more to protect people with epilepsy from the effects of climate change.

Towards advancing scientific knowledge of climate change impacts on short-duration rainfall extremes.

A large number of recent studies have aimed at understanding short-duration rainfall extremes, due to their impacts on flash floods, landslides and debris flows and potential for these to worsen with global warming. This has been led in a concerted international effort by the INTENSE Crosscutting Project of the GEWEX (Global Energy and Water Exchanges) Hydroclimatology Panel. Here, we summarize the main findings so far and suggest future directions for research, including: the benefits of convection-permitting climate modelling; towards understanding mechanisms of change; the usefulness of temperature-scaling relations; towards detecting and attributing extreme rainfall change; and the need for international coordination and collaboration. Evidence suggests that the intensity of long-duration (1 day+) heavy precipitation increases with climate warming close to the Clausius-Clapeyron (CC) rate (6-7% K-1), although large-scale circulation changes affect this response regionally. However, rare events can scale at higher rates, and localized heavy short-duration (hourly and sub-hourly) intensities can respond more strongly (e.g. 2 × CC instead of CC). Day-to-day scaling of short-duration intensities supports a higher scaling, with mechanisms proposed for this related to local-scale dynamics of convective storms, but its relevance to climate change is not clear. Uncertainty in changes to precipitation extremes remains and is influenced by many factors, including large-scale circulation, convective storm dynamics andstratification. Despite this, recent research has increased confidence in both the detectability and understanding of changes in various aspects of intense short-duration rainfall. To make further progress, the international coordination of datasets, model experiments and evaluations will be required, with consistent and standardized comparison methods and metrics, and recommendations are made for these frameworks. This article is part of a discussion meeting issue 'Intensification of short-duration rainfall extremes and implications for flash flood risks'.

An Observation-Based Dataset of Global Sub-Daily Precipitation Indices (GSDR-I).

Precipitation indices based on daily gauge observations are well established, openly available and widely used to detect and understand climate change. However, in many areas of climate science and risk management, it has become increasingly important to understand precipitation characteristics, variability and extremes at shorter (sub-daily) durations. Yet, no unified dataset of sub-daily indices has previously been available, due in large part to the lesser availability of suitable observations. Following extensive efforts in data collection and quality control, this study presents a new global dataset of sub-daily precipitation indices calculated from a unique database of 18,591 gauge time series. Developed together with prospective users, the indices describe sub-daily precipitation variability and extremes in terms of intensity, duration and frequency properties. The indices are published for each gauge where possible, alongside a gridded data product based on all gauges. The dataset will be useful in many fields concerned with variability and extremes in the climate system, as well as in climate model evaluation and management of floods and other risks.

COVID-19 Restriction Movement Control Order (MCO) Impacted Emissions of Peninsular Malaysia Using Sentinel-2a and Sentinel-5p Satellite.

The unprecedented outbreak of Coronavirus Disease 2019 (COVID-19) has impacted the whole world in every aspect including health, social life, economic activity, education, and the environment. The pandemic has led to an improvement in air quality all around the world, including in Malaysia. Lockdowns have resulted in industry shutting down and road travel decreasing which can reduce the emission of Greenhouse Gases (GHG) and air pollution. This research assesses the impact of the COVID-19 lockdown on emissions using the Air Pollution Index (API), aerosols, and GHG which is Nitrogen Dioxide (NO2) in Malaysia. The data used is from Sentinel-5p and Sentinel-2A which monitor the air quality based on Ozone (O3) and NO2 concentration. Using an interpolated API Index Map comparing 2019, before the implementation of a Movement Control Order (MCO), and 2020, after the MCO period we examine the impact on pollution during and after the COVID-19 lockdown. Data used Sentinel-5p, Sentinel-2A, and Air Pollution Index of Malaysia (APIMS) to monitor the air quality that contains NO2 concentration. The result has shown the recovery in air quality during the MCO implementation which indirectly shows anthropogenic activities towards the environmental condition. The study will help to enhance and support the policy and scope for air pollution management strategies as well as raise public awareness of the main causes that contribute to air pollution.

Taking action on climate change: Testimonials and position statement from the International League Against Epilepsy Climate Change Commission.

The release of the 2021 Intergovernmental Panel on Climate Change (IPCC) report makes clear that human activities have resulted in significant alterations in global climate. There is no doubt that climate change is upon us; chronic global warming has been punctuated by more frequent extreme weather events. Humanity will have to mitigate climate change and adapt to these changing conditions or face dire consequences. One under-appreciated aspect of this global crisis is its impact on healthcare, particularly people with epilepsy and temperature-sensitive seizures. As members of the inaugural International League Against Epilepsy (ILAE) Climate Change Commission, we recount the personal motivations that have led each team member to decide to take action, in the hope that our journeys as ordinary clinicians and scientists will help persuade others that they too can act to foster change within their spheres of influence.

Sub-hourly resolution quality control of rain-gauge data significantly improves regional sub-daily return level estimates.

This research demonstrates how the use of high-resolution rain-gauge data for quality control (QC) significantly changes extreme rainfall estimates, with implications in scientific, meteorological and engineering applications. Current open QC algorithms only consider data at hourly or daily accumulations. Here we present the first open QC algorithm utilising sub-hourly rain-gauge data from official networks at a national, multi-decade scale. We use data from 1,301 rain-gauges in Great Britain (GB) to develop a threshold-based methodology for sub-hourly QC that can be used to complement existing, freely available hourly QC methods by developing an algorithm for sub-hourly QC that uses monthly thresholds for 1 hr, 15 min and 1 min rainfall totals. We then evaluated the effect of combining these QC procedures on rainfall distributions using graphical and statistical methods, with an emphasis on extreme value analysis. We demonstrate that the additional information in sub-hourly rainfall allows our new QC to remove spuriously large values undetected by existing methods which generate errors in extreme rainfall estimates. This results in statistically significant differences between extreme rainfall estimates for 15 min and 1 hr accumulations, with smaller differences found for 6 and 24 hr totals. We also find that extremes in the distributions of 15 min and 1 hr rainfall accumulations tend to grow more rapidly with return period than for longer accumulation periods. We observe similarities between the shape parameter populations for 15 min and 1 hr rainfall accumulations, suggesting that hourly records may be used to improve shape parameter estimates for extreme sub-hourly rainfall in GB. Sub-hourly QC moderates unrealistically large return level estimates for short-duration rainfall, with beneficial impacts on data required for the design of urban drainage infrastructure and the validation of high-resolution climate models.

UKGrsHP: a UK high-resolution gauge-radar-satellite merged hourly precipitation analysis dataset.

There is an urgent need for high-quality and high-spatial-resolution hourly precipitation products around the globe, including the UK. Although hourly precipitation products exist for the UK, these either contain large errors, or are insufficient in spatial resolution. An efficient way to solve this is to develop a merged precipitation product that combines the information and benefits from multiple data sources, improving both the spatial resolution and accuracy of hourly precipitation estimates over the UK. In this study, we develop a UK high-resolution gauge-radar-satellite merged hourly precipitation analysis: the UKGrsHP. It covers the UK from 12.5° W to 3.5° E, 49° N-60° N, with a spatial resolution of 0.01° × 0.01° in latitude/longitude (equivalent to 1 km resolution in the mid-latitudes). An optimal interpolation (OI)-based multi-source merging scheme with compound strategy is developed and tested for producing the UKGrsHP. Three input data sources are used: gauge analysis data interpolated from 1903 quality-controlled hourly observations, the UK Nimrod radar precipitation analysis and the GSMaP global satellite precipitation analysis. Using independent tests against ~ 220 independent gauge observations on 1 year's experimental UKGrsHP, covering the period from January to December 2014, we find that the final merged data performs better than three individual precipitation analyses used as inputs. A full version of the UKGrsHP starting in April 2004 is now under production, which will have wide applications in climate services and scientific research across multiple disciplines.

Thermodynamic controls of the Western Tibetan Vortex on Tibetan air temperature.

The "Western Tibetan Vortex" (WTV)-also termed the Karakoram Vortex-dominates the middle-to-lower troposphere and the near-surface air temperature variability above the western Tibetan Plateau (TP). Here, we explore the thermodynamic mechanisms through which the WTV modulates air temperature over the western TP by diagnosing the three major terms of the thermodynamic energy equation-adiabatic heating, horizontal temperature advection, and diabatic heating-that maintain the atmospheric thermal balance. We composite these major terms to examine the differences between anti-cyclonic and cyclonic WTV events. Our theoretical approach demonstrates that adiabatic sinking-compression (rising-expansion) provides the overwhelming control on both the middle-to-lower tropospheric and lower stratospheric temperature increases (decreases) under anti-cyclonic (cyclonic) WTV conditions over the western TP high mountain area in all four seasons. This also explains the mechanisms behind the anomalous temperature "dipole" found between the mid-lower troposphere and lower stratosphere when the WTV was initially identified. Spatially, adiabatic heating effects are centred on the central western TP in summer and the south slope centring at 70°-80°E of the TP in other seasons. The other two terms, horizontal temperature advection and diabatic heating, have localized importance over the edges of the western TP. In a case study over the Karakoram area, we further demonstrate that adiabatic heating (rising-expanding-cooling/sinking-compressing-warming) is the dominant thermodynamic process controlling Karakoram air temperatures under WTV variability, except for at the very near surface in autumn and winter. Our analysis methods can be applied to investigate the thermodynamic processes of other atmospheric circulation systems or climate variability modes.

Synoptic-Scale Precursors of Extreme U.K. Summer 3-Hourly Rainfall.

The synoptic-scale meteorological conditions leading up to the 30 most extreme subdaily summer rain events for two regions of the United Kingdom (northwest and southeast) were examined for the period 1979-2013. Using a recently available, quality controlled, national hourly rain gauge data set, we were able to identify extreme 3-hr rainfall accumulations that may be indicative of flash flooding. Composites of the state of the atmosphere leading up to these dates were produced to investigate synoptic-scale processes, thus potentially allowing for them to be identified in coarse resolution reanalyses and in climate models. The results show that the two regions have different dominant synoptic-scale conditions leading to extreme 3-hr rainfall, which is thought to be related to the type of rainfall typically experienced in each region. In particular, positive anomalies in mean sea level pressure and the geopotential height at 200 hPa over the United Kingdom are associated with extreme rainfall in the northwest, where the position of the westerly jet is also important. For the southeast, no clear anomalous synoptic-scale conditions could be identified; however, localized moisture sources and unstable air masses were observed in association with extremes. These results indicate the importance of better understanding of both synoptic-scale and thermodynamic drivers of short-duration extreme rainfall, with potential implications in forecasting and flood warning, as well as for understanding the representation of key processes by regional climate models.

Quality-control of an hourly rainfall dataset and climatology of extremes for the UK.

Sub-daily rainfall extremes may be associated with flash flooding, particularly in urban areas but, compared with extremes on daily timescales, have been relatively little studied in many regions. This paper describes a new, hourly rainfall dataset for the UK based on ∼1600 rain gauges from three different data sources. This includes tipping bucket rain gauge data from the UK Environment Agency (EA), which has been collected for operational purposes, principally flood forecasting. Significant problems in the use of such data for the analysis of extreme events include the recording of accumulated totals, high frequency bucket tips, rain gauge recording errors and the non-operation of gauges. Given the prospect of an intensification of short-duration rainfall in a warming climate, the identification of such errors is essential if sub-daily datasets are to be used to better understand extreme events. We therefore first describe a series of procedures developed to quality control this new dataset. We then analyse ∼380 gauges with near-complete hourly records for 1992-2011 and map the seasonal climatology of intense rainfall based on UK hourly extremes using annual maxima, n-largest events and fixed threshold approaches. We find that the highest frequencies and intensities of hourly extreme rainfall occur during summer when the usual orographically defined pattern of extreme rainfall is replaced by a weaker, north-south pattern. A strong diurnal cycle in hourly extremes, peaking in late afternoon to early evening, is also identified in summer and, for some areas, in spring. This likely reflects the different mechanisms that generate sub-daily rainfall, with convection dominating during summer. The resulting quality-controlled hourly rainfall dataset will provide considerable value in several contexts, including the development of standard, globally applicable quality-control procedures for sub-daily data, the validation of the new generation of very high-resolution climate models and improved understanding of the drivers of extreme rainfall.

Climate change impacts on the leaching of a heavy metal contamination in a small lowland catchment.

The Keersop catchment (43km(2)) in the south of The Netherlands has been contaminated by the emissions of four zinc ore smelters. The objective of this study was to assess the effects of future projected climate change on the hydrology and the leaching of heavy metals (i.e. Cd and Zn) in the catchment. The numerical, quasi-2D, unsaturated zone Soil Water Atmosphere Plant model was used with 100-year simulated daily time series of precipitation and potential evapotranspiration. The time series are representative of stationary climates for the periods 1961-1990 ("baseline") and 2071-2100 ("future"). The time series of future climate were obtained by downscaling the results of eight regional climate model (RCM) experiments, driven by the SRES A2 emissions scenario, using change factors for a series of climate statistics and applying them to stochastic weather generator models. The time series are characterized by increased precipitation in winter, less precipitation in summer, and higher air temperatures (between 2°C and 5°C) throughout the year. Future climate scenarios project higher evapotranspiration rates, more irrigation, less drainage, lower discharge rates and lower groundwater levels, due to increased evapotranspiration and a slowing down of the groundwater system. As a result, lower concentrations of Cd and Zn in surface water are projected. The reduced leaching of heavy metals, due to drying of the catchment, showed a positive impact on a limited aspect of surface water quality.