External validation of predictive models of sexual, urinary, bowel and hormonal function after surgery in prostate cancer subjects.

BACKGROUND: In 2020, a research group published five linear longitudinal models, predict Expanded Prostate Cancer Index Composite-26 (EPIC-26) scores post-treatment for radical prostatectomy, external beam radiotherapy and active surveillance collectively in US patients with localized prostate cancer. METHODS: Our study externally validates the five prediction models for patient reported outcomes post-surgery for localised prostate cancer. The models' calibration, fit, variance explained and discrimination (concordance-indices) were assessed. Two Australian validation cohorts 1 and 2 years post-prostatectomy were constructed, consisting of 669 and 439 subjects, respectively (750 in total). Patient reported function in five domains post-prostatectomy: sexual, bowel, hormonal, urinary incontinence and other urinary dysfunction (irritation/obstruction). Domain function was assessed using the EPIC-26 questionnaire. RESULTS: 1 year post-surgery, R2 was highest for the sexual domain (35%, SD = 0.02), lower for the bowel (21%, SD = 0.03) and hormone (15%, SD = 0.03) domains, and close to zero for urinary incontinence (1%, SD = 0.01) and irritation/obstruction (- 5%, SD = 0.04). Calibration slopes for these five models were 1.04 (SD = 0.04), 0.84 (SD = 0.06), 0.85 (SD = 0.06), 1.16 (SD = 0.13) and 0.45 (SD = 0.04), respectively. Calibration-in-the-large values were - 2.2 (SD = 0.6), 2.1 (SD = 0.01), 5.1 (SD = 0.1), 9.6 (SD = 0.9) and 4.0 (SD = 0.2), respectively. Concordance-indices were 0.73, 0.70, 0.70, 0.58 and 0.62, respectively (all had SD = 0.01). Mean absolute error and root mean square error were similar across the validation and development cohorts. The validation measures were largely similar at 2 years post-surgery. CONCLUSIONS: The sexual, bowel and hormone domain models validated well and show promise for accurately predicting patient reported outcomes in a non-US surgical population. The urinary domain models validated poorly and may require recalibration or revision.

Thermal Oscillations of Nanobubbles.

Nanobubble cavitation is advancing technologies in enhanced wastewater treatment, cancer therapy and diagnosis, and microfluidic cleaning. Current macroscale models predict that nanobubble oscillations should be isothermal, yet recent studies suggest that they are adiabatic with an associated increase in natural frequency, which becomes challenging when characterizing nanobubble sizes using ultrasound in experiments. We derive a new theoretical model that considers the nonideal nature of the nanobubble's internal gas phase and nonequilibrium effects, by employing the van der Waals (vdW) equation of state and implementing a temperature jump term at the liquid-gas interface, respectively, finding excellent agreement with molecular dynamics (MD) simulations. Our results reveal how adiabatic behavior could be erroneously interpreted when analyzing the thermal response of the gas using the commonly employed polytropic process and explain instead how nanobubble oscillations are physically closer to their isothermal limit.

Contaminant Removal from Nature's Self-Cleaning Surfaces.

Many organisms in nature have evolved superhydrophobic surfaces that leverage water droplets to clean themselves. While this ubiquitous self-cleaning process has substantial industrial promise, experiments have so far been unable to comprehend the underlying physics. With the aid of molecular simulations, here we rationalize and theoretically explain self-cleaning mechanisms by resolving the complex interplay between particle-droplet and particle-surface interactions, which originate at the nanoscale. We present a universal phase diagram that consolidates (a) observations from previous surface self-cleaning experiments conducted at micro-to-millimeter length scales and (b) our nanoscale particle-droplet simulations. Counterintuitively, our analysis shows that an upper limit for the radius of the droplet exists to remove contaminants of a particular size. We are now able to predict when and how particles of varying scale (from nano-to-micrometer) and adhesive strengths are removed from superhydrophobic surfaces.

Rolling and Sliding Modes of Nanodroplet Spreading: Molecular Simulations and a Continuum Approach.

Molecular simulations discover a new mode of dynamic wetting that manifests itself in the very earliest stages of spreading, after a droplet contacts a solid. The observed mode is a "rolling" type of motion, characterized by a contact angle lower than the classically assumed value of 180°, and precedes the conventional "sliding" mode of spreading. This motivates the development of a novel continuum framework that captures all modes of motion, allows the dominant physical mechanisms to be understood, and permits the study of larger droplets.

Interfacial Adsorption Kinetics of Methane in Microporous Kerogen.

Rapid declines in unconventional shale production arise from the poorly understood interplay between gas transport and adsorption processes in microporous organic rock. Here, we use high-fidelity molecular dynamics (MD) simulations to resolve the time-varying adsorption of methane gas in realistic organic rock samples, known as kerogen. The kerogen samples derive from various geological shale fields with porosities ranging between 20% and 50%. We propose a kinetics sorption model based on a generalized solution of diffusive transport inside a nanopore to describe the adsorption kinetics in kerogen, which gives excellent fits with all our MD results, and we demonstrate it scales with the square of the length of kerogen. The MD adsorption time constants for all samples are compared with a simplified theoretical model, which we derive from the Langmuir isotherm for adsorption capacitance and the free-volume theory for steady, highly confined bulk transport. While the agreement with the MD results is qualitatively very good, it reveals that, in the limit of low porosity, the diffusive transport term dominates the characteristic time scale of adsorption, while the adsorption capacitance becomes important for higher pressures. This work provides the first data set for adsorption kinetics of methane in kerogen, a validated model to accurately describe this process, and a qualitative model that links adsorption capacitance and transport with the adsorption kinetics. Furthermore, this work paves the way to upscale interfacial adsorption processes to the next scale of gas transport simulations in mesopores and macropores of shale reservoirs.

Current and projected heatwave-attributable occupational injuries, illnesses, and associated economic burden in Australia.

INTRODUCTION: The costs of global warming are substantial. These include expenses from occupational illnesses and injuries (OIIs), which have been associated with increases during heatwaves. This study estimated retrospective and projected future heatwave-attributable OIIs and their costs in Australia. MATERIALS AND METHODS: Climate and workers' compensation claims data were extracted from seven Australian capital cities representing OIIs from July 2005 to June 2018. Heatwaves were defined using the Excess Heat Factor. OIIs and associated costs were estimated separately per city and pooled to derive national estimates. Results were projected to 2030 (2016-2045) and 2050 (2036-2065). RESULTS: The risk of OIIs and associated costs increased during heatwaves, with the risk increasing during severe and particularly extreme heatwaves. Of all OIIs, 0.13% (95% empirical confidence interval [eCI]: 0.11-0.16%) were heatwave-attributable, equivalent to 120 (95%eCI:70-181) OIIs annually. 0.25% of costs were heatwave-attributable (95%eCI: 0.18-0.34%), equal to $AU4.3 (95%eCI: 1.4-7.4) million annually. Estimates of heatwave-attributable OIIs by 2050, under Representative Concentration Pathway [RCP]4.5 and RCP8.5, were 0.17% (95%eCI: 0.10-0.27%) and 0.23% (95%eCI: 0.13-0.37%), respectively. National costs estimates for 2030 under RCP4.5 and RCP8.5 were 0.13% (95%eCI: 0.27-0.46%) and 0.04% (95%eCI: 0.66-0.60), respectively. These estimates for extreme heatwaves were 0.04% (95%eCI: 0.02-0.06%) and 0.04% (95%eCI: 0.01-0.07), respectively. Cost-AFs in 2050 were, under RCP4.5, 0.127% (95%eCI: 0.27-0.46) for all heatwaves and 0.04% (95%eCI: 0.01-0.09%) for extreme heatwaves. Attributable fractions were approximately similar to baseline when assuming theoretical climate adaptation. DISCUSSION: Heatwaves represent notable and preventable portions of preventable OIIs and economic burden. OIIs are likely to increase in the future, and costs during extreme heatwaves in 2030. Workplace and public health policies aimed at heat adaptation can reduce heat-attributable morbidity and costs.

High-repetition-rate krypton tagging velocimetry in Mach-6 hypersonic flows.

A 100 kHz krypton (Kr) tagging velocimetry (KTV) technique was demonstrated in a Mach-6 Ludwieg tube using a burst-mode laser-pumped optical parametric oscillator system. The single-beam KTV scheme at 212 nm produced an insufficient signal in this large hypersonic wind tunnel because of its low Kr seeding (≤5%), low static pressure (∼2.5torr), and long working distance (∼1m). To overcome these issues, a new scheme using two excitation beams was developed to enhance KTV performance. A 355 nm laser beam was combined with the 212 nm beam to promote efficient two-photon Kr excitation at 212 nm, and increase the probability of 2 + 1 resonant-enhanced multiphoton ionization by adding a 355 nm beam. A signal enhancement of approximately six times was obtained. Using this two-excitation beam approach, strong long-lasting KTV was successfully demonstrated at a 100 kHz repetition rate in a Mach-6 flow.

Quantitative focused laser differential interferometry with hypersonic turbulent boundary layers.

The effect of turbulent wind-tunnel-wall boundary layers on density change measurements obtained with focused laser differential interferometry (FLDI) was studied using a detailed direct numerical simulation (DNS) of the wall from the Boeing/AFOSR Mach-6 Quiet Tunnel run in its noisy configuration. The DNS was probed with an FLDI model that is capable of reading in three-dimensional time-varying density fields and computing the FLDI response. Simulated FLDI measurements smooth the boundary-layer root-mean-square (RMS) profile relative to true values obtained by directly extracting the data from the DNS. The peak of the density change RMS measured by the FLDI falls within 20% of the true density change RMS. A relationship between local spatial density change and temporal density fluctuations was determined and successfully used to estimate density fluctuations from the FLDI measurements. FLDI measurements of the freestream fluctuations are found to be dominated by the off-axis tunnel-wall boundary layers for lower frequencies despite spatial suppression provided by the technique. However, low-amplitude (0.05%-5% of the mean density) target signals placed along the tunnel centerline were successfully measured over the noise of the boundary layers (which have RMS values of about 12% of the mean). Overall, FLDI was shown to be a useful technique for making quantitative turbulence measurements and to measure finite-width sinusoidal signals through turbulent boundary layers, but may not provide enough off-focus suppression to provide accurate freestream noise measurements, particularly at lower frequencies.

Acoustothermal Nucleation of Surface Nanobubbles.

Ultrasonic surface vibration at high frequencies (O(100 GHz)) can nucleate bubbles in a liquid within a few nanometres from a surface, but the underlying mechanism and the role of surface wettability remain poorly understood. Here, we employ molecular simulations to study and characterize this phenomenon, which we call acoustothermal nucleation. We observe that nanobubbles can nucleate on both hydrophilic and hydrophobic surfaces, and molecular energy balances are used to identify whether these are boiling or cavitation events. We rationalize the nucleation events by defining a physics-based energy balance, which matches our simulation results. To characterize the interplay between the acoustic parameters, surface wettability, and nucleation mechanism, we produce a regime map of nanoscopic nucleation events that connects observed nanoscale results to macroscopic experiments. This work provides insights to better design a range of industrial processes and clinical procedures such as surface treatments, mass spectroscopy, and selective cell destruction.

Shock-induced collapse of surface nanobubbles.

The collapse of cavitation bubbles often releases high-speed liquid jets capable of surface damage, with applications in drug delivery, cancer treatment, and surface cleaning. Spherical cap-shaped surface nanobubbles have previously been found to exist on immersed substrates. Despite being known nucleation sites for cavitation, their collapsing dynamics are currently unexplored. Here, we use molecular dynamics simulations to model the shock-induced collapse of different surface nanobubble sizes and contact angles. Comparisons are made with additional collapsing spherical nanobubble simulations near a substrate, to investigate the differences in their jet formation and resulting substrate pitting damage. Our main finding is that the pitting damage in the surface nanobubble simulations is greatly reduced, when compared to the spherical nanobubbles, which is primarily caused by the weaker jets formed during their collapse. Furthermore, the pit depths for surface nanobubble collapse do not depend on bubble size, unlike in the spherical nanobubble cases, but instead depend only on their contact angle. We also find a linear scaling relationship for all bubble cases between the final substrate damage and the peak pressure impulse at the impact centre, which can now be exploited to assess the relative damage in other computational studies of collapsing bubbles. We anticipate the more controlled surface-damage features produced by surface nanobubble cavitation jets will open up new applications in advanced manufacturing, medicine, and precision cleaning.

Occupational heat stress and economic burden: A review of global evidence.

BACKGROUND: The adverse effects of heat on workers' health and work productivity are well documented. However, the resultant economic consequences and productivity loss are less understood. This review aims to summarize the retrospective and potential future economic burden of workplace heat exposure in the context of climate change. METHODS: Literature was searched from database inception to October 2020 using Embase, PubMed, and Scopus. Articles were limited to original human studies investigating costs from occupational heat stress in English. RESULTS: Twenty studies met criteria for inclusion. Eighteen studies estimated costs secondary to heat-induced labor productivity loss. Predicted global costs from lost worktime, in US$, were 280 billion in 1995, 311 billion in 2010 (≈0.5% of GDP), 2.4-2.5 trillion in 2030 (>1% of GDP) and up to 4.0% of GDP by 2100. Three studies estimated heat-related healthcare expenses from occupational injuries with averaged annual costs (US$) exceeding 1 million in Spain, 1 million in Guangzhou, China and 250,000 in Adelaide, Australia. Low- and middle-income countries and countries with warmer climates had greater losses as a proportion of GDP. Greater costs per worker were observed in outdoor industries, medium-sized businesses, amongst males, and workers aged 25-44 years. CONCLUSIONS: The estimated global economic burden of occupational heat stress is substantial. Climate change adaptation and mitigation strategies should be implemented to likely minimize future costs. Further research exploring the relationship between occupational heat stress and related expenses from lost productivity, decreased work efficiency and healthcare, and costs stratified by demographic factors, is warranted. Key messages. The estimated retrospective and future economic burden from occupational heat stress is large. Responding to climate change is crucial to minimize this burden. Analyzing heat-attributable occupational costs may guide the development of workplace heat management policies and practices as part of global warming strategies.

Impact of surface nanostructure and wettability on interfacial ice physics.

Ice accumulation on solid surfaces is a severe problem for safety and functioning of a large variety of engineering systems, and its control is an enormous challenge that influences the safety and reliability of many technological applications. The use of molecular dynamics (MD) simulations is popular, but as ice nucleation is a rare event when compared to simulation timescales, the simulations need to be accelerated to force ice to form on a surface, which affects the accuracy and/or applicability of the results obtained. Here, we present an alternative seeded MD simulation approach, which reduces the computational cost while still ensuring accurate simulations of ice growth on surfaces. In addition, this approach enables, for the first time, brute-force all-atom water simulations of ice growth on surfaces unfavorable for nucleation within MD timescales. Using this approach, we investigate the effect of surface wettability and structure on ice growth in the crucial surface-ice interfacial region. Our main findings are that the surface structure can induce a flat or buckled overlayer to form within the liquid, and this transition is mediated by surface wettability. The first overlayer and the bulk ice compete to structure the intermediate water layers between them, the relative influence of which is traced using density heat maps and diffusivity measurements. This work provides new understanding on the role of the surface properties on the structure and dynamics of ice growth, and we also present a useful framework for future research on surface icing simulations.

Hypersonic N2 boundary layer flow velocity profile measurements using FLEET.

Femtosecond laser electronic excitation tagging (FLEET) velocimetry was used in the boundary layer of an ogive-cylinder model in a Mach-6 Ludwieg tube. One-dimensional velocity profiles were extracted from the FLEET signal in laminar boundary layers from pure N2 flows at unit Reynolds numbers ranging from 3.4×106/m to3.9×106/m. The effects of model tip bluntness and the unit Reynolds number on the velocity profiles were investigated. The challenges and strategies of applying FLEET for direct boundary layer velocity measurement are discussed. The potential of utilizing FLEET velocimetry for understanding the dynamics of laminar and turbulent boundary layers in hypersonic flows is demonstrated.

Perceptions of workplace heat exposure and adaption behaviors among Chinese construction workers in the context of climate change.

BACKGROUND: Workplace heat exposure can cause a series of heat-related illnesses and injuries. Protecting workers especially those undertake work outdoors from the risk of heat strain is a great challenge for many workplaces in China under the context of climate change. The aim of this study is to investigate the perceptions and adaptation behaviors of heat exposure among construction workers and to provide evidence for the development of targeted heat adaptation strategies nationally and internationally. METHODS: In 2020, we conducted a cross-sectional online questionnaire survey via WeChat Survey Star in China, using a purposive snowball sampling approach. A total of 326 construction workers submitted completed questionnaires. The perceptions of workplace heat exposure were measured using seven indicators: concerns over high temperature, perception of high temperature injury, attitudes towards both heat-related training and regulations, adjustment of working habits during heat, heat prevention measures in the workplace, and reduction of work efficiency. Bivariate and multivariate regression analyses were used to identify the factors significantly associated with workers' heat perceptions and behavioral responses. RESULTS: 33.3% of the respondents were moderately or very concerned about heat exposure in the workplace. Less than half of the workers (43.8%) were worried about heat-related injuries. Workers who have either experienced work-related injuries (OR = 1.30, 95% CI 1.03-1.62) or witnessed injuries to others during high temperatures (OR = 1.12, 95% CI 1.02-1.27) were more concerned about heat exposure compared to other workers. Most respondents (63.5%) stated that their work efficiency declined during extremely hot weather. The factors significantly associated with a reduction of work efficiency included undertaking physically demanding jobs (OR = 1.28, 95% CI 1.07-1.54) and witnessing other workers' injuries during high temperatures (OR = 1.26, 95% CI 1.11-1.43). More than half of the workers were willing to adjust their work habits to adapt to the impact of high temperatures (81.6%). The internet was the most common method to obtain heat prevention information (44.7%), and the most frequently used heat prevention measure was the provision of cool drinking water (64.8%). CONCLUSIONS: Chinese construction workers lack heat risk awareness and are not well prepared for the likely increasing heat exposure in the workplace due to global warming. Therefore, there is a need to improve their awareness of heat-related injuries, strengthen high temperature related education and training, and update the current heat prevention policies to ensure compliance and implementation.

100 kHz PLEET velocimetry in a Mach-6 Ludwieg tube.

Picosecond laser electronic-excitation tagging (PLEET) was demonstrated in a Mach-6 Ludwieg tube at a repetition rate of 100 kHz using a 1064 nm, 100 ps burst-mode laser. The system performance of high-speed velocimetry in unseeded air and nitrogen Mach-6 flows at a static pressure in the range of 5-20 torr were evaluated. Based on time-resolved freestream flow measurements and computational fluid dynamics (CFD) calculations, we concluded that the measurement uncertainty of 100 kHz PLEET measurement for Mach 6 freestream flow condition is ∼1%. The measured velocity profiles with a cone-model agreed well with the CFD computations upstream and downstream of the shockwave; downstream of the shockwave the discrepancy between the CFD and experimental measurement could be attributed to a slight nonzero angle of attack (AoA) or flow unsteadiness. Our results show the potential of utilizing 100 kHz PLEET velocimetry for understanding real-time dynamics of turbulent hypersonic flows and provide the capability of collecting sufficient data across fewer tests in large hypersonic ground test facilities.

Forced oscillation dynamics of surface nanobubbles.

Surface nanobubbles have potential applications in the manipulation of nanoscale and biological materials, waste-water treatment, and surface cleaning. These spherically capped bubbles of gas can exist in stable diffusive equilibrium on chemically patterned or rough hydrophobic surfaces, under supersaturated conditions. Previous studies have investigated their long-term response to pressure variations, which is governed by the surrounding liquid's local supersaturation; however, not much is known about their short-term response to rapid pressure changes, i.e., their cavitation dynamics. Here, we present molecular dynamics simulations of a surface nanobubble subjected to an external oscillating pressure field. The surface nanobubble is found to oscillate with a pinned contact line, while still retaining a mostly spherical cap shape. The amplitude-frequency response is typical of an underdamped system, with a peak amplitude near the estimated natural frequency, despite the strong viscous effects at the nanoscale. This peak is enhanced by the surface nanobubble's high internal gas pressure, a result of the Laplace pressure. We find that accurately capturing the gas pressure, bubble volume, and pinned growth mode is important for estimating the natural frequency, and we propose a simple model for the surface nanobubble frequency response, with comparisons made to other common models for a spherical bubble, a constant contact angle surface bubble, and a bubble entrapped within a cylindrical micropore. This work reveals the initial stages of growth of cavitation nanobubbles on surfaces, common in heterogeneous nucleation, where classical models based on spherical bubble growth break down.

Analysis of lifetime death probability for major causes of death among residents in China.

BACKGROUND: Cumulative mortality rate and cumulative mortality risk are two commonly used indicators to measure the impact and severity of diseases. However, they are calculated during a defined life span and assume the subject does not die from other causes. This study aims to use a new indicator, lifetime death probability (LDP), to estimate the lifetime death probabilities for the top five leading causes of death in China and explore the regional differences and trends over time. METHODS: LDPs were calculated using a probability additive formula and abridged life tables. RESULTS: In 2014, LDPs for heart disease, cerebrovascular disease, malignancy, respiratory disease, and injury and poisoning were 24.4, 23.7, 19.2, 15.5, and 5.3%, respectively. The LDPs for heart disease and malignancy increased by 7.3 and 0.5%, respectively, compared to those from 2004 to 2005. In contrast, the LDPs for cerebrovascular and respiratory disease decreased by 1.0 and 3.9%, respectively, compared to those in 2004-2005. Across the eastern, central and western regions, malignancy had the highest LDP in the eastern region, cerebrovascular and heart diseases in the central region, and respiratory diseases, and injury and poisoning in the western region. CONCLUSIONS: LDP is an effective indicator for comparing health outcomes and can be applied for future disease surveillance. Heart disease and malignancy were the two most common causes of death in China, but with regional differences. There is a need to implement targeted measures to prevent chronic diseases in different regions.

Droplet Coalescence is Initiated by Thermal Motion.

The classical notion of the coalescence of two droplets of the same radius R is that surface tension drives an initially singular flow. In this Letter we show, using molecular dynamics simulations of coalescing water nanodroplets, that after single or multiple bridges form due to the presence of thermal capillary waves, the bridge growth commences in a thermal regime. Here, the bridges expand linearly in time much faster than the viscous-capillary speed due to collective molecular jumps near the bridge fronts. Transition to the classical hydrodynamic regime only occurs once the bridge radius exceeds a thermal length scale l_{T}∼sqrt[R].

Mechanical Stability of Surface Nanobubbles.

Bubble cavitation is important in technologies such as noninvasive cancer treatment and diagnosis, surface cleaning, and waste-water treatment. The cavitation threshold is the critical external tensile pressure that induces unstable growth of the bubble. Surface nanobubbles have been previously shown experimentally to be stable down to -6 MPa, in disagreement with the Blake threshold, which is the classical cavitation model that predicts bulk bubbles with radii ∼100 nm should be unstable below -0.6 MPa. Here, we use molecular dynamics to simulate quasi-two-dimensional (2D) and three-dimensional (3D) nitrogen surface nanobubbles immersed in water, subject to a range of pressure drops until unstable growth is observed. We propose and assess new cavitation threshold models, derived from mechanical equilibrium analyses for both the quasi-2D and 3D cavitating bubbles. The discrepancies from the Blake threshold are attributed to the pinned contact line, within which the surface nanobubbles grow with constant lateral contact diameter, and consequently a reduced radius of curvature. We conclude with a critical discussion of previous experimental results on the cavitation of relatively large surface nanobubbles.

Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia.

The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016-1.076), urolithiasis (IRR 1.106, 95% 1.046-1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258-1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048-1.133) and AKI (IRR 1.335, 95% CI 1.204-1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.