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At least 19 records

Moving Beyond Mortality: Development and Application of a Desirability of Outcome Ranking (DOOR) Endpoint for Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia

Abstract Background Hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) are frequently caused by multidrug-resistant organisms. Patient-centered endpoints in clinical trials are needed to develop new antibiotics for HABP/VABP. Desirability of outcome ranking (DOOR) is a paradigm for the design, analysis, and interpretation of clinical trials based on a patient-centered, benefit-risk evaluation. Methods A multidisciplinary committee created an infectious diseases DOOR endpoint customized for HABP/VABP, incorporating infectious complications, serious adverse events, and mortality. We applied this to 2 previously completed, large randomized controlled trials for HABP/VABP. ZEPHyR compared vancomycin to linezolid and VITAL compared linezolid to tedizolid. For each trial, we evaluated the DOOR distribution and probability, including DOOR component and partial credit analyses. We also applied DOOR in subgroup analyses. Results In both trials, the HABP/VABP DOOR demonstrated similar overall clinical outcomes between treatment groups. In ZEPHyR, the probability that a participant treated with linezolid would have a more desirable outcome than a participant treated with vancomycin was 50.2% (95% confidence interval [CI], 45.1%­−55.3%). In VITAL, the probability that a participant treated with tedizolid would have a more desirable outcome than a participant treated with linezolid was 48.7% (95% CI, 44.8%–52.6%). The DOOR component analysis revealed that participants treated with tedizolid had a less desirable outcome than those treated with linezolid when considering clinical response alone. However, participants with decreased renal function had improved overall outcomes with tedizolid. Conclusions The HABP/VABP DOOR provided more granular information about clinical outcomes than is typically presented in clinical trials. HABP/VABP trials would benefit from prospectively using DOOR.

Immunology↗

Predator mass mortality events restructure food webs through trophic decoupling

Predators have a key role in structuring ecosystems. However, predator loss is accelerating globally, and predator mass-mortality events (MMEs)—rapid large-scale die-offs—are now emblematic of the Anthropocene epoch. Owing to their rare and unpredictable nature, we lack an understanding of how MMEs immediately impact ecosystems. Past predator-removal studies may be insufficient to understand the ecological consequences of MMEs because, in nature, dead predators decompose in situ and generate a resource pulse, which could alter ensuing ecosystem dynamics by temporarily enhancing productivity. Here we experimentally induce MMEs in tritrophic, freshwater lake food webs and report ecological dynamics that are distinct from predator losses or resource pulses alone, but that can be predicted from theory. MMEs led to the proliferation of diverse consumer and producer communities resulting from weakened top-down predator control and stronger bottom-up effects through predator decomposition. In contrast to predator removals alone, enhanced primary production after MMEs dampened the consumer community response. As a consequence, MMEs generated biomass dynamics that were most similar to those of undisturbed systems, indicating that they may be cryptic disturbances in nature. These biomass dynamics led to trophic decoupling, whereby the indirect beneficial effects of predators on primary producers are lost and later materialize as direct bottom-up effects that stimulate primary production amid intensified herbivory. Furthermore, these results reveal ecological signatures of MMEs and demonstrate the feasibility of forecasting novel ecological dynamics arising with intensifying global change.

Food webs↗

The Effect of Future Ambient Air Pollution on Human Premature Mortality to 2100 Using Output from the ACCMIP Model Ensemble

Ambient air pollution from ground-level ozone and fine particulate matter (PM(sub 2.5)) is associated with premature mortality. Future concentrations of these air pollutants will be driven by natural and anthropogenic emissions and by climate change. Using anthropogenic and biomass burning emissions projected in the four Representative Concentration Pathway scenarios (RCPs), the ACCMIP ensemble of chemistry climate models simulated future concentrations of ozone and PM(sub 2.5) at selected decades between 2000 and 2100. We use output from the ACCMIP ensemble, together with projections of future population and baseline mortality rates, to quantify the human premature mortality impacts of future ambient air pollution. Future air-pollution-related premature mortality in 2030, 2050 and 2100 is estimated for each scenario and for each model using a health impact function based on changes in concentrations of ozone and PM(sub 2.5) relative to 2000 and projected future population and baseline mortality rates. Additionally, the global mortality burden of ozone and PM(sub 2.5) in 2000 and each future period is estimated relative to 1850 concentrations, using present-day and future population and baseline mortality rates. The change in future ozone concentrations relative to 2000 is associated with excess global premature mortality in some scenarios/periods, particularly in RCP8.5 in 2100 (316 thousand deaths per year), likely driven by the large increase in methane emissions and by the net effect of climate change projected in this scenario, but it leads to considerable avoided premature mortality for the three other RCPs. However, the global mortality burden of ozone markedly increases from 382000 (121000 to 728000) deaths per year in 2000 to between 1.09 and 2.36 million deaths per year in 2100, across RCPs, mostly due to the effect of increases in population and baseline mortality rates. PM(sub 2.5) concentrations decrease relative to 2000 in all scenarios, due to projected reductions in emissions, and are associated with avoided premature mortality, particularly in 2100: between 2.39 and 1.31 million deaths per year for the four RCPs. The global mortality burden of PM(sub 2.5) is estimated to decrease from 1.70 (1.30 to 2.10) million deaths per year in 2000 to between 0.95 and 1.55 million deaths per year in 2100 for the four RCPs due to the combined effect of decreases in PM(sub 2.5) concentrations and changes in population and baseline mortality rates. Trends in future air-pollution-related mortality vary regionally across scenarios, reflecting assumptions for economic growth and air pollution control specific to each RCP and region. Mortality estimates differ among chemistry climate models due to differences in simulated pollutant concentrations, which is the greatest contributor to overall mortality uncertainty for most cases assessed here, supporting the use of model ensembles to characterize uncertainty. Increases in exposed population and baseline mortality rates of respiratory diseases magnify the impact on premature mortality of changes in future air pollutant concentrations and explain why the future global mortality burden of air pollution can exceed the current burden, even where air pollutant concentrations decrease.

Silva, Raquel A.↗

Characterizing post-fire delayed tree mortality with remote sensing: sizing up the elephant in the room

Abstract Background Despite recent advances in understanding the drivers of tree-level delayed mortality, we lack a method for mapping delayed mortality at landscape and regional scales. Consequently, the extent, magnitude, and effects of delayed mortality on post-fire landscape patterns of burn severity are unknown. We introduce a remote sensing approach for mapping delayed mortality based on post-fire decline in the normalized burn ratio (NBR). NBR decline is defined as the change in NBR between the first post-fire measurement and the minimum NBR value up to 5 years post-fire for each pixel. We validate the method with high-resolution aerial photography from six wildfires in California, Oregon, and Washington, USA, and then compare the extent, magnitude, and effects of delayed mortality on landscape patterns of burn severity among fires and forest types. Results NBR decline was significantly correlated with post-fire canopy mortality (r 2 = 0.50) and predicted the presence of delayed mortality with 83% accuracy based on a threshold of 105 NBR decline. Plots with NBR decline greater than 105 were 23 times more likely to experience delayed mortality than those below the threshold (p < 0.001). Delayed mortality occurred across 6–38% of fire perimeters not affected by stand-replacing fire, generally affecting more areas in cold (22–41%) and wet (30%) forest types than in dry (1.7–19%) types. The total area initially mapped as unburned/very low-severity declined an average of 38.1% and generally persisted in smaller, more fragmented patches when considering delayed mortality. The total area initially mapped as high-severity increased an average of 16.2% and shifted towards larger, more contiguous patches. Conclusions Differences between 1- and 5-year post-fire burn severity maps depict dynamic post-fire mosaics resulting from delayed mortality, with variability among fires reflecting a range of potential drivers. We demonstrate that tree-level delayed mortality scales up to alter higher-level landscape patterns of burn severity with important implications for forest resilience and a range of fire-driven ecological outcomes. Our method can complement existing tree-level studies on drivers of delayed mortality, refine mapping of fire refugia, inform estimates of habitat and carbon losses, and provide a more comprehensive assessment of landscape and regional scale fire effects and trends.

Environmental Sciences & Ecology↗

Geographic disparities of cardiovascular and cancer mortality in the USA: 1981–2019

Background: Cardiovascular and cancer mortality are the two leading causes of death in the developed world including the USA. However, mortality trends for these diseases are highly dynamic, and the geographic landscape is in transition. We analyze patterns of mortality improvement at county level during recent decades focusing on mortality decline and geographic diversity. Methods: We grouped age-adjusted mortality rates of cardiovascular and cancer diseases from CDC WONDER for 2959 US counties into 3-year time periods to improve reliability. We calculated percent mortality decrease between 1981–83 and 2016–19 for both causes to quantify mortality improvements for counties. Results: Using standard deviation as an index of disparities, place-based cancer mortalities were 68% larger than cardiovascular disparities. Significantly, 566 US counties had same or higher rates of cancer mortality in 2019 as in 1981. The geographic distribution of mortality improvement in either cause tends to favor largely populated areas along coasts. Less-populated, rural places in the interior and southeastern regions were experiencing less improvement. Conclusions: At the county level, large place-based disparities exist for both causes of death with the magnitude of disparities being substantially larger for the reduction in cancer deaths. Put differently, place matters, more for cancer than cardiovascular mortality.

60 APPLIED LIFE SCIENCES↗

Siberian Pine Decline and Mortality in Southern Siberian Mountains

The causes and resulting spatial patterns of Siberian pine mortality in eastern Kuznetzky Alatau Mountains, Siberia were analyzed based on satellite (Landsat, MODIS) and dendrochronology data. Climate variables studied included temperature, precipitation and Standardized Precipitation-Evapotranspiration Index (SPEI) drought index. Landsat data analysis showed that stand mortality was first detected in the year 2006 at an elevation of 650 m, and extended up to 900 m by the year 2012. Mortality was accompanied by a decrease in MODIS derived vegetation index (EVI).. The area of dead stands and the upper mortality line were correlated with increased drought. The uphill margin of mortality was limited by elevational precipitation gradients. Dead stands (i.e., >75% tree mortality) were located mainly on southern slopes. With respect to slope, mortality was observed within a 7 deg - 20 deg range with greatest mortality occurring on convex terrain. Tree radial incrementmeasurements correlate and were synchronous with SPEI (r sq = 0.37, r(sub s) = 80). Increasing synchrony between tree ring growth and SPEI indicates that drought has reduced the ecological niche of Siberian pine. The results also showed the primary role of drought stress on Siberian pine mortality. A secondary role may be played by bark beetles and root fungi attacks. The observed Siberian pine mortality is part of a broader phenomenon of "dark needle conifers" (DNC, i.e., Siberian pine, fir and spruce) decline and mortality in European Russia, Siberia, and the Russian Far East. All locations of DNC decline coincided with areas of observed drought increase. The results obtained are one of the first observations of drought-induced decline and mortality of DNC at the southern border of boreal forests. Meanwhile if model projections of increased aridity are correct DNC, within the southern part of its range may be replaced by drought-resistant Pinus silvestris and Larix sibirica.

tree die-off↗

Gut microbiome dynamics and associations with mortality in critically ill patients

Abstract Background Critical illness and care within the intensive care unit (ICU) leads to profound changes in the composition of the gut microbiome. The impact of such changes on the patients and their subsequent disease course remains uncertain. We hypothesized that specific changes in the gut microbiome would be more harmful than others, leading to increased mortality in critically ill patients. Methods This was a prospective cohort study of critically ill adults in the ICU. We obtained rectal swabs from 52 patients and assessed the composition the gut microbiome using 16 S rRNA gene sequencing. We followed patients throughout their ICU course and evaluated their mortality rate at 28 days following admission to the ICU. We used selbal, a machine learning method, to identify the balance of microbial taxa most closely associated with 28-day mortality. Results We found that a proportional ratio of four taxa could be used to distinguish patients with a higher risk of mortality from patients with a lower risk of mortality (p = .02). We named this binarized ratio our microbiome mortality index (MMI). Patients with a high MMI had a higher 28-day mortality compared to those with a low MMI (hazard ratio, 2.2, 95% confidence interval 1.1–4.3), and remained significant after adjustment for other ICU mortality predictors, including the presence of the acute respiratory distress syndrome (ARDS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) score (hazard ratio, 2.5, 95% confidence interval 1.4–4.7). High mortality was driven by taxa from theAnaerococcus(genus) andEnterobacteriaceae(family), while lower mortality was driven byParasutterellaandCampylobacter(genera). Conclusions Dysbiosis in the gut of critically ill patients is an independent risk factor for increased mortality at 28 days after adjustment for clinically significant confounders. Gut dysbiosis may represent a potential therapeutic target for future ICU interventions.

Gastroenterology & Hepatology↗

Estimating Individual Tree Mortality in the Sierra Nevada Using Lidar and Multispectral Reflectance Data

Widespread tree mortality events occur during periods of severe drought in temperate conifer forests and are expected to become more frequent in many areas due to climate change. Improved mapping of individual tree mortality is needed to identify risk factors and design effective conservation strategies. In this study, we used National Ecological Observatory Network (NEON) lidar and multispectral reflectance airborne observations to map individual tree mortality over a 160 km 2 area during and after the 2012–2016 drought for two sites in California's Sierra National Forest. We used NEON lidar to derive tree locations and crown perimeters and multispectral data to map tree mortality for more than 1 million trees. We found that 25.4% of the trees in our study area died between 2013 and 2017, with considerably higher mortality at the lower-elevation Soaproot Saddle site. Between 2017 and 2019, an additional 2.0%–2.8% of the trees died each year. Two wildfires in 2020 and 2021 increased tree mortality within burned area perimeters by 49%–89% between 2019 and 2021. Consistent with previous work, we found that tree mortality risk increased as a function of tree height. Tree mortality was positively associated with distance from rivers, trees per hectare, and decreasing slope at the lower elevation site. In contrast, increasing slope was positively associated with tree mortality at the higher elevation site. Our approach and dataset provide a means to study the combined effects of drought and wildfire on tree mortality and may improve projections of forest resilience under a changing climate.

54 ENVIRONMENTAL SCIENCES↗

deadtrees.earth — An open-access and interactive database for centimeter-scale aerial imagery to uncover global tree mortality dynamics

Excessive tree mortality is a global concern and remains poorly understood as it is a complex phenomenon. We lack global and temporally continuous coverage on tree mortality data. Ground-based observations on tree mortality, e.g., derived from national inventories, are very sparse, and may not be standardized or spatially explicit. Earth observation data, combined with supervised machine learning, offer a promising approach to map overstory tree mortality in a consistent manner over space and time. However, global-scale machine learning requires broad training data covering a wide range of environmental settings and forest types. Low altitude observation platforms (e.g., drones or airplanes) provide a cost-effective source of training data by capturing high-resolution orthophotos of overstory tree mortality events at centimeter-scale resolution. Here, we introduce deadtrees.earth, an open-access platform hosting more than two thousand centimeter-resolution orthophotos, covering more than 1,000,000 ha, of which more than 58,000 ha are manually annotated with live/dead tree classifications. This community-sourced and rigorously curated dataset can serve as a comprehensive reference dataset to uncover tree mortality patterns from local to global scales using space-based Earth observation data and machine learning models. This will provide the basis to attribute tree mortality patterns to environmental changes or project tree mortality dynamics to the future. The open nature of deadtrees.earth, together with its curation of high-quality, spatially representative, and ecologically diverse data will continuously increase our capacity to uncover and understand tree mortality dynamics.

Citizen science↗

Detecting Early Warning Signals of Tree Mortality in Boreal North America Using Multiscale Satellite Data

Increasing tree mortality from global change drivers such as drought and biotic infestations is a widespread phenomenon, including in the boreal zone where climate changes and feedbacks to the Earth system are relatively large. Despite the importance for science and management communities, our ability to forecast tree mortality at landscape to continental scales is limited. However, two independent information streams have the potential to inform and improve mortality forecasts: repeat forest inventories and satellite remote sensing. Time series of tree-level growth patterns indicate that productivity declines and related temporal dynamics often precede mortality years to decades before death. Plot-level productivity, in turn, has been related to satellite-based indices such as the Normalized difference vegetation index (NDVI). Here we link these two data sources to show that early warning signals of mortality are evident in several NDVI-based metrics up to 24 years before death. We focus on two repeat forest inventories and three NDVI products across western boreal North America where productivity and mortality dynamics are influenced by periodic drought. These data sources capture a range of forest conditions and spatial resolution to highlight the sensitivity and limitations of our approach. Overall, results indicate potential to use satellite NDVI for early warning signals of mortality. Relationships are broadly consistent across inventories, species, and spatial resolutions, although the utility of coarse-scale imagery in the heterogeneous aspen parkland was limited. Longer-term NDVI data and annually remeasured sites with high mortality levels generate the strongest signals, although we still found robust relationships at sites remeasured at a typical 5 year frequency. The approach and relationships developed here can be used as a basis for improving forest mortality models and monitoring systems.

heat↗

Who is benefiting from the dramatic decline in U.S. cancer mortality? Place-based evidence of disparities in rates of improvement

After decades of increasing cancer mortality, U.S. rates declined from 1991 to 2019, a 32% decrease. we investigated rates of cancer mortality improvement across 2954 counties and selected characteristics associated with mortality improvements. Data was 21,381,009 county-level neoplasm deaths gleaned from death certificates via CDC WONDER. Analytical techniques included GIS and Moran’s I, OLS, GWR models, and trend comparisons. Counties with the greatest improvement (reduction) in cancer mortality tended to be coastal, higher-income, metropolitan locations. OLS model (R 2 = 0.65) indicated that greatest improvements were observed in counties with higher initial mortality ($\beta =.32$) closely followed by percent urban ($\beta =.31$) and median household income ($\beta =.16$). Whereas percent Black residents ($\beta =-.06$), and percent with education beyond high school ($\beta =-.10$) was less associated on outcomes. Highest income counties were the first to experience improvement in cancer mortality, the highest rates of mortality decline, and the greatest reduction in excess deaths. Even though there was significant improvement in cancer mortality nationally, there were variations in the degree of improvement linked to county location, income, and urbanisation. These results underlie the need to expand place-based initiatives designed to advance cancer health and more equitable improvements in cancer mortality outcomes.

developing world↗

Climate-Induced Mortality of Spruce Stands in Belarus

The aim of this work is an analysis of the causes of spruce (Picea abies L.) decline and mortality in Belarus. The analysis was based on forest inventory and Landsat satellite (land cover classification, climate variables (air temperature, precipitation, evaporation, vapor pressure deficit, SPEI drought index)), and GRACE-derived soil moisture estimation (equivalent of water thickness anomalies, EWTA). We found a difference in spatial patterns between dead stands and all stands (i.e., before mortality). Dead stands were located preferentially on relief features with higher water stress risk (i.e., higher elevations, steeper slopes, south and southwestern exposure). Spruce mortality followed a series of repeated droughts between 1990 and 2010. Mortality was negatively correlated with air humidity (r = -0.52), and precipitation (r = -0.57), and positively correlated with the prior year vapor pressure deficit (r = 0.47), and drought increase (r = 0.57). Mortality increased with the increase in occurrence of spring frosts (r = 0.5), and decreased with an increase in winter cloud cover (r = -0.37). Spruce mortality was negatively correlated with snow water accumulation (r = -0.81) and previous year anomalies in water soil content (r = -0.8). Weakened by water stress, spruce stands were attacked by pests and phytopathogens. Overall, spruce mortality in Belarussian forests was caused by drought episodes and drought increase in synergy with pest and phytopathogen attacks. Vast Picea abies mortality in Belarus and adjacent areas of Russia and Eastern Europe is a result of low adaptation of that species to increased drought. This indicates the necessity of spruce replacement by drought-tolerant indigenous (e.g., Pinus sylvestris, Querqus robur) or introduced (e.g., Larix sp. or Pseudotsuga menzieslii) species to obtain sustainable forest growth management.

spruce decline↗

The Importance of Addressing Disagreements Between Nominal and Effective Treatments During Bat Mortality Minimization Validation Studies

As the wind energy industry grows, so too does our need for effective and low-cost bat mortality minimization solutions. Despite knowledge gaps in our understanding of what drives bats to collide with spinning turbines, minimization solutions have shown success during validation studies. Curtailment has been consistently effective, reducing bat mortality from 33%-79%, depending on the curtailment scenario and species present. Several validation studies have demonstrated deterrent solutions, specifically ultrasonic deterrents, to be effective, but overall, more variable compared to curtailment solutions. Further, a study combining curtailment with ultrasonic deterrents produced encouraging results, finding that adding ultrasonic deterrents to turbines that were designated to curtail, significantly reduced mortality rates compared to curtailment only turbines. Despite positive results, the strength of inference achieved with validation studies is limited by methodological constraints associated with appropriately assigning fatalities to treatments. Because of the temporal separation between when a bat collides with a turbine and when it is discovered during a ground-based carcass survey, we must assign carcasses to a treatment that ran during the prior night(s). This process may introduce errors at multiple stages. First, for studies that rotate treatments among turbines, mortality surveyors must be confident that carcasses are 'fresh' such that mortalities are correctly assigned to the treatment from the previous night(s). Second, we must reconcile any misalignments between how we assign treatments and how we implement treatments (e.g., turbines assigned with a deterrent treatment may be implemented as another treatment when deterrent devices are not operating as designed). Finally, for curtailment solutions, it is critical to recognize that measured effects are a function of not just the treatment as implemented but the proportion of the night the treatment is realized (e.g., if wind speeds are greater than the curtailment treatment cut-in speed for the entire night, we cannot expect there to me any differences in mortality reduction relative to control turbines). Using a dataset collected between June and October 2017, that rotated 3 treatments (Deterrent Only, 5 m/s Curtail only, and 5 m/s Curtail & Deterrent) and 1 control condition across 16 turbines each night, we explored the importance and implications of accounting for potential errors in assigning fatalities to treatments. We present preliminary results comparing the mortality associated with error-corrected treatments and control conditions highlighting how the measured effect of a treatment (mortality) greatly depends on site specific implementation.

bats↗

Mortality correlates with tree functional traits across a wood density gradient in the Central Amazon

Introduction: Understanding the mechanisms of tree mortality in tropical ecosystems remains challenging, in part due to the high diversity of tree species and the inherently stochastic nature of mortality. Plant functional traits offer a mechanistic link between plant physiology and performance, yet their ability to predict growth and mortality remains poorly understood. Given recent increases in tree mortality rates in the Amazon forest following extreme drought and wind events, we tested if lower wood density and acquisitive plant functional traits were associated with increased growth and mortality for common co-occurring trees in the Central Amazon. Methods: Seventeen trees of different species with similar sizes but a range in wood density (WD) and wood traits were felled, then assessed for 27 different individual functional parameters, including whole tree architecture, stem xylem anatomical and hydraulic traits and leaf traits. Traits of the individual trees were related to stand-level growth and mortality rates collected periodically over 30 years from nearby permanent inventory plots. Results: Higher wood density was associated with smaller leaf size, lower foliar base cations, lower stem water content and sapwood fraction, in agreement with the fast-slow plant economics spectrum. Lower wood density was associated with more acquisitive characteristics with greater hydraulic capacity and foliar nutrient concentrations, correlating with greater growth and mortality rates. Discussion: Our results show that lower wood density is part of a coordinated suite of traits linked to high resource acquisition, fast growth, and increased mortality risk, providing a functional framework for predicting species performance and forest vulnerability under future climate stress.

demographics↗

Sensitivity of Optical Satellites to Estimate Windthrow Tree-Mortality in a Central Amazon Forest

Windthrow (i.e., trees broken and uprooted by wind) is a major natural disturbance in Amazon forests. Images from medium-resolution optical satellites combined with extensive field data have allowed researchers to assess patterns of windthrow tree-mortality and to monitor forest recovery over decades of succession in different regions. Although satellites with high spatial-resolution have become available in the last decade, they have not yet been employed for the quantification of windthrow tree-mortality. Here, we address how increasing the spatial resolution of satellites affects plot-to-landscape estimates of windthrow tree-mortality. We combined forest inventory data with Landsat 8 (30 m pixel), Sentinel 2 (10 m), and WorldView 2 (2 m) imagery over an old-growth forest in the Central Amazon that was disturbed by a single windthrow event in November 2015. Remote sensing estimates of windthrow tree-mortality were produced from Spectral Mixture Analysis and evaluated with forest inventory data (i.e., ground true) by using Generalized Linear Models. Field measured windthrow tree-mortality (3 transects and 30 subplots) crossing the entire disturbance gradient was 26.9 ± 11.1% (mean ± 95% CI). Although the three satellites produced reliable and statistically similar estimates (from 26.5% to 30.3%, p < 0.001), Landsat 8 had the most accurate results and efficiently captured field-observed variations in windthrow tree-mortality across the entire gradient of disturbance (Sentinel 2 and WorldView 2 produced the second and third best results, respectively). As expected, mean-associated uncertainties decreased systematically with increasing spatial resolution (i.e., from Landsat 8 to Sentinel 2 and WorldView 2). However, the overall quality of model fits showed the opposite pattern. We suggest that this reflects the influence of a relatively minor disturbance, such as defoliation and crown damage, and the fast growth of natural regeneration, which were not measured in the field nor can be captured by coarser resolution imagery. Our results validate the reliability of Landsat imagery for assessing plot-to-landscape patterns of windthrow tree-mortality in dense and heterogeneous tropical forests. Satellites with high spatial resolution can improve estimates of windthrow severity by allowing the quantification of crown damage and mortality of lower canopy and understory trees. However, this requires the validation of remote sensing metrics using field data at compatible scales.

54 ENVIRONMENTAL SCIENCES↗

Future Global Mortality from Changes in Air Pollution Attributable to Climate Change

Ground-level ozone and fine particulate matter (PM (sub 2.5)) are associated with premature human mortality; their future concentrations depend on changes in emissions, which dominate the near-term, and on climate change. Previous global studies of the air-quality-related health effects of future climate change used single atmospheric models. However, in related studies, mortality results differ among models. Here we use an ensemble of global chemistry-climate models to show that premature mortality from changes in air pollution attributable to climate change, under the high greenhouse gas scenario RCP (Representative Concentration Pathway) 8.5, is probably positive. We estimate 3,340 (30,300 to 47,100) ozone-related deaths in 2030, relative to 2000 climate, and 43,600 (195,000 to 237,000) in 2100 (14 percent of the increase in global ozone-related mortality). For PM (sub 2.5), we estimate 55,600 (34,300 to 164,000) deaths in 2030 and 215,000 (76,100 to 595,000) in 2100 (countering by 16 percent the global decrease in PM (sub 2.5)-related mortality). Premature mortality attributable to climate change is estimated to be positive in all regions except Africa, and is greatest in India and East Asia. Most individual models yield increased mortality from climate change, but some yield decreases, suggesting caution in interpreting results from a single model. Climate change mitigation is likely to reduce air-pollution-related mortality.

Atmohspheric chemistry↗

Risk of Mortality in Family Members of Men Seeking Fertility Assessment

Objective: To assess mortality in family members of men seeking fertility assessment. Subfertility serves as a biomarker for overall somatic health, and poor semen quality is associated with increased risk of hospitalization and mortality from chronic conditions. However, it is unclear if these risks extend to family members of men with low sperm count. Design: Retrospective cohort study. Subjects: Family members, up to third-degree relatives, of men in the Subfertility, Health and Assisted Reproduction and the Environment cohort who underwent a semen analysis as part of a fertility assessment 1996–2017. Relatives of men with a recorded total sperm count who lived in Utah for ≥1 year 1904–2017 were included in the analysis (N = 22,280 families). Exposure: Individuals were classified by family membership. Families were classified as relatives of azoospermic (0M), oligozoospermic (<39M), or normozoospermic (≥39M) men. The average total sperm count of the proband (male relative) with fertility assessment was also included as a continuous exposure measure. Main Outcome Measures: The main outcomes were all-cause and cause-specific mortality risk by sex, age, and degree of relation: first-, second-, and third-degree. Cox proportional hazard models were used to test the association between fertility classification and mortality, controlling for sex, race/ethnicity, and birth year. Results: A total of 666,437 relatives of men with fertility assessment (N deaths = 183,974) were included in the analysis. Relative to normozoospermia families, all-cause mortality risk increased in oligozoospermia families (hazard ratio [HR] oligozoospermia , 1.03; 95% confidence interval [CI], 1.01–1.05). Close relatives, first- (HR oligozoospermia , 1.17; 95% CI, 1.07–1.28) and second-degree relatives (HR azoospermia , 1.11; 95% CI, 1.04–1.20; HR oligozoospermia , 1.05; 95% CI,1.01–1.09), of azoospermic and oligozoospermic men had the highest all-cause and cause-specific mortality risk, including death attributed to cardiovascular disease or congenital birth conditions. Conclusion: Our results suggest that familial all-cause and cause-specific mortality risk differ by fertility phenotype. Families of azoospermic and oligozoospermic men showed significantly increased risk, particularly for close relatives. This study provides further evidence that shared genetic and/or environmental factors could influence both fertility and somatic health.

Male fertility↗