Students use Health Systems Science concepts to address actual system-level problems and submit project-based deliverables and other assignments. The study describes the design as an authentic-learning approach, with the reported aim of preparing physicians to contribute to and lead efforts aimed at transforming complex health systems. Its focus is therefore on physician preparation through practical engagement with health-system problems, not on measuring changes in clinical outcomes.

Researchers evaluated the selectives using evidence routinely collected by the school: end-of-course surveys, transcripts from curricular feedback sessions, project-based deliverables and other student assignments. They generated descriptive statistics from survey ratings and thematically analyzed feedback transcripts, using authentic learning theory as a sensitizing concept for the analysis. Among survey respondents, 93.6% agreed that teaching supported their learning and 88.6% agreed that instructional materials did so.

The results are based on students’ evaluations and their submitted work at a single medical school, rather than on a controlled comparison with another curriculum or measurements of improvements in patient care, institutional performance or population health. Students particularly valued opportunities to apply Health Systems Science concepts to real-world issues that had seemed vague or abstract in didactic or classroom-based learning. The analysis identified four elements that students described as influential: the authenticity of the health-system context, the authenticity of the problem-solving activities, access to system experts, and exposure to different system roles and perspectives.

These observations show that students associated the learning experience with genuine problems, expert involvement and multiple viewpoints. The reported findings do not separately quantify the contribution of each element or establish that one feature was more important than the others. The authors conclude that authentic, system-foregrounded experiential curricula can foster system-thinking skills and promote roles for physicians as contributors to and leaders of system transformation.

The evidence supports that conclusion as the program authors’ interpretation of the students’ experiences and assessments, while the study’s design does not determine the size of any effect or establish long-term changes in professional behavior. The curriculum offers a tested model for exposing future physicians to complex systems and engaging them in system-change efforts, and the authors suggest that other medical schools may develop comparable learning experiences.

Subject of Research: Evaluation of an experiential Health Systems Science curriculum for medical students at one school

Article Title: Cultivating physician change agents by foregrounding systems: experiential learning in health systems science

Article References: Solomon, L. S., Kanter, M. H., Chung, P. J., Robbins, C. W., Schmittdiel, J. A., Chen, I. L., Ryan, G. W., Perlman, S. M., & Chen, H. C. (2026). Cultivating physician change agents by foregrounding systems: experiential learning in health systems science. BMC Medical Education. https://doi.org/10.1186/s12909-026-10457-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10457-7

Keywords: medical education, Health Systems Science, experiential learning, medical students, authentic learning, system thinking, physician leadership, curriculum evaluation, health systems, Cultivating, physician, change

The report was prepared by a six-member committee comprising chair Wolfgang Willner and Andraž Čarni, Federico Fernández-González, Jens Pallas, Massimo Terzi and Jean-Paul Theurillat. Massimo Terzi was co-opted in May 2022. Publication was delayed by two years because several cases raised fundamental questions about interpretation of the ICPN and exposed ambiguities that may need to be addressed in the Code’s next edition. The report covers final decisions on earlier recommendations, four published requests for binding decisions, several additional requests arising during discussions, and nine published conservation or rejection proposals.

GPN members voted by email from 10 March to 10 April 2023 on recommendations from the committee’s previous report. They accepted conservation of Berberidion Braun-Blanquet 1950 against Prunion spinosae Soó 1931 by 22 votes to none and conservation of Aceretalia pseudoplatani Moor 1976 against Tilietalia Moor 1973 by 23 votes to none. The original version of the Festucetalia valesiacae proposal received 12 votes in favor and six against, while a modified version with a conserved type passed unanimously, 21 votes to none. All recommendations, including those opposed by the committee, were accepted, and the relevant entries are to be added to Appendix 3 of the ICPN.

The committee recommended that Xerobromion and Mesobromion be regarded as validly published by Zoller in 1954. Braun-Blanquet and Moor had proposed both names as suballiances in 1938, but their original use of the “-ion” termination was ambiguous because the same ending was then applied to alliances and suballiances. Although Zoller did not state the rank consistently, he explicitly used “Xerobromion-Verband” and “Mesobromion-Verband” at a few locations. A modified proposal to conserve Mesobromion erecti against Bromion erecti Koch 1926 received three votes in favor, two against and one abstention.

Several recommendations addressed the naming of European oak-hornbeam forests. The committee supported conserving Galio sylvatici-Carpinetum betuli Oberdorfer 1957 against Querco roboris-Carpinetum Klika 1928 because the earlier name would have replaced a widely used name and could have been misleading about the communities’ natural tree composition. It also recommended the modified proposal to conserve Lithospermo-Carpinetum betuli against Carpinetum betuli Issler 1924, after a majority concluded that Issler’s synoptic species lists with ranges of cover values constituted a sufficient diagnosis for valid publication. By contrast, the committee did not recommend conserving Stellario holosteae-Carpinetum betuli against Alno glutinosae-Carpinetum betuli: members had unresolved doubts about whether the names referred to the same association, and the vote was one in favor, three against and two abstentions.

Recommended binding decisions concerned the identity of name-giving taxa. These included Cyperus flavescens for Nanocyperetalia Klika 1935, Isoetes durieui for both Isoetetalia Braun-Blanquet 1936 and Isoetion Braun-Blanquet 1936, and Quercus robur for the two Molinio arundinaceae-Quercetum names. The committee also recommended conserving Nanocyperetalia against Nanocypero-Polygonetalia Koch 1926. The latter was considered valid and legitimate even though, to the authors’ knowledge, it had not been used since its first publication. A further recommendation would conserve Isoetetalia with a conserved type, avoiding an inappropriate change to a commonly used name.

Two conservation proposals were not recommended. The proposal concerning Omphalodo nitidae-Coryletum avellanae received two votes in favor and four against. Its holotype had been selected deliberately and was dominated by Quercus robur, while the name-giving Corylus avellana occurred mainly in the shrub layer, prompting discussion of the Code’s requirement that a name-giving taxon belong to the highest dominant stratum. The proposal for Polysticho setiferi-Fraxinetum excelsioris received two votes in favor, three against and one abstention. The report noted that the original relevés had been regarded as atypical by their authors, that the earlier lectotypification therefore required rejection, and that neotypification was necessary, but found no immediate need to conserve a type.

The report records several points of interpretive uncertainty, including the treatment of inverted names and the relationship between a type and the rules governing the order of name-giving taxa. It also states that no data were used. Authors may submit proposals or requests as independent articles in Vegetation Classification and Survey, with article-processing charges potentially applying depending on country and status, or by email to the report’s first author using the same structure. Publication within the next CCCN report is free of charge, and proposals and requests published in the journal are automatically processed by the committee under the ICPN rules.

Subject of Research: Phytosociological nomenclature decisions on conservation, rejection and name-giving taxa

Article Title: Report 3 of the Committee for Change and Conservation of Names ( CCCN )

Article References: Willner, W., Čarni, A., Fernández-González, F., Pallas, J., Terzi, M., & Theurillat, J.-P. (2024). Report 3 of the Committee for Change and Conservation of Names (CCCN). Vegetation Classification and Survey, 5, 257-265. https://doi.org/10.3897/vcs.142803

Image Credits: AI Generated

DOI: 10.3897/VCS.142803

Keywords: phytosociological nomenclature, plant community names, syntaxon conservation, binding decisions, name-giving taxa, ICPN, taxonomy, GPN Assembly, Report, Committee, Change, Conservation

The findings are summarized in the published abstract of a study drawing on the China PEACE Million Persons Project between 2017 and 2023. Participants were considered at high cardiovascular risk if they had a history of cardiovascular disease, hypertension or dyslipidemia, or a 10-year CVD risk of at least 20%. Investigators used K-means clustering to identify BMI trajectories from baseline BMI and the annual rate of BMI change. Multivariable Cox models then assessed associations between those trajectories and the primary outcomes of all-cause and CVD hospitalization. During a median follow-up of 3.6 years, the study recorded 2,272 all-cause hospitalizations and 617 CVD hospitalizations.

Four trajectories were identified. The largest, comprising 50.9% of participants, was normal weight-stable. Rapid gainers accounted for 4.4% and had a normal baseline BMI with a median annual increase of 1.80 kg/m² per year. Obese-slow losers represented 39.5%, remaining obese with minimal weight reduction and a median annual change of −0.20 kg/m² per year. Obese-rapid losers made up 4.9%; this group had the highest baseline BMI and a median annual change of −2.20 kg/m² per year.

Compared with normal weight-stable participants, rapid gainers had an adjusted hazard ratio of 1.44 (95% confidence interval [CI] 1.10–1.88) for all-cause hospitalization, while obese-slow losers had an adjusted hazard ratio of 1.17 (95% CI 1.07–1.28). Obese-rapid losers also had higher all-cause hospitalization risk, with an adjusted hazard ratio of 1.39 (95% CI 1.09–1.78). For CVD hospitalization, the association was significant among rapid gainers, with an adjusted hazard ratio of 1.86 (95% CI 1.16–2.96), and obese-slow losers, with an adjusted hazard ratio of 1.26 (95% CI 1.06–1.50). The corresponding estimate for obese-rapid losers was 1.57 (95% CI 0.97–2.54), which the abstract described as borderline.

The results are observational associations and do not establish that BMI changes caused the hospitalization outcomes. The obese-rapid-loser group had higher socioeconomic status but also a greater burden of comorbidity, complicating interpretation of its elevated all-cause risk. The study’s scope was limited to adults at high CVD risk in Anhui, and the available source is the article abstract rather than a full assessment of the published paper. The authors concluded that rapid weight loss among people with obesity was not uniformly associated with favorable hospitalization outcomes and called for evaluation of the nature of weight loss, not only its magnitude.

Subject of Research: Associations between BMI change patterns and hospitalization risk among high-cardiovascular-risk adults in Anhui, China

Article Title: Body mass index change patterns and risk of hospitalization among populations at high cardiovascular risk: findings from the China PEACE Million Persons Project

Article References: Wang, Q., Wang, K., Liu, Z., Wu, G., Yuan, F., & Chen, K. (2026). Body mass index change patterns and risk of hospitalization among populations at high cardiovascular risk: findings from the China PEACE Million Persons Project. BMC Public Health. https://doi.org/10.1186/s12889-026-29855-z

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29855-z

Keywords: body mass index, BMI trajectories, hospitalization risk, cardiovascular disease, high-risk adults, prospective cohort, weight change, China, Body, mass, index, change

The investigators divided the six-year observation window into four periods: a pre-pandemic baseline from January 2018 through January 2020; Pandemic-I, from February 2020 through June 2021, when Guangzhou used stringent measures including lockdowns, school closures, masking and travel restrictions; Pandemic-II, from July 2021 through November 2022, when restrictions were relaxed and intermittent Omicron outbreaks occurred; and a post-pandemic period from December 2022 through December 2023, after full reopening. They tested associations using multivariable logistic regression, comparing positivity in each later period with the pre-pandemic baseline while adjusting for age, sex, inpatient or outpatient status and hospital campus. Age-period interactions were evaluated with robust Wald tests, and analyses were repeated in some form to assess the influence of repeated observations and changing denominators.

Most respiratory viruses were detected less often during Pandemic-I, but the suppression was neither universal nor equally durable. Influenza A positivity fell from 19.2% before the pandemic to 5.0% during Pandemic-I, and influenza B declined from 6.5% to 0.5%. RSV fell from 21.8% to 12.3%, adenovirus from 18.4% to 1.1%, and M. pneumoniae from 12.4% to 2.2%. Rhinovirus, cytomegalovirus and bocavirus were notable exceptions to the broader viral decline. When controls were relaxed, influenza A positivity rose to 25.0%, already above its baseline, and reached 29.7% after reopening. M. pneumoniae increased more slowly, reaching 7.4% during Pandemic-II before surging to 24.1% in the post-pandemic period, the highest rate recorded for that pathogen across the four periods.

Adjustment for the changing clinical population sharpened the principal contrasts. Relative to pre-pandemic levels, influenza A had an adjusted odds ratio of 0.23 during Pandemic-I, 1.26 during Pandemic-II and 1.52 after reopening. M. pneumoniae remained below baseline during Pandemic-II, with an adjusted odds ratio of 0.54, but reached 1.99 after reopening despite a 9.3-fold expansion in the number tested. RSV produced a particularly instructive result: its crude post-pandemic positivity rate of 12.8% remained below the 21.8% baseline, yet its adjusted odds ratio was 1.31, with a 95% confidence interval of 1.06 to 1.63. Comparable-denominator analyses retained the post-pandemic increases for RSV, influenza A and M. pneumoniae, indicating that expanding testing alone did not fully account for the changes.

Age-stratified models showed that these pathogen-level averages concealed substantial differences between younger and older children. RSV positivity after reopening was elevated among children aged 29 days to 23 months, with an adjusted odds ratio of 1.50, and among those aged 2 to 4 years, where the estimate was 1.86. No significant post-pandemic increase was detected in school-aged children or adolescents, while some estimates could not be calculated because of sparse events. Influenza A increased after reopening in every age group with estimable results except neonates aged 0 to 28 days. Its largest post-pandemic estimate occurred among children aged 5 to 9 years, at 1.74, followed by 1.42 among adolescents aged 10 to 17 years.

Influenza B followed an unusual split between younger and older children. Positivity remained below baseline after reopening among children aged 29 days to 23 months and 2 to 4 years, with adjusted odds ratios of 0.53 and 0.58, respectively. In contrast, it increased among children aged 5 to 9 years, with an adjusted odds ratio of 1.21, and rose more strongly among adolescents aged 10 to 17 years, reaching 2.88. The difference between the overall and age-specific results was significant for all four principal pathogens, with age-period interaction P values below 0.001. M. pneumoniae showed a delayed increase concentrated in school-aged children: its post-pandemic adjusted odds ratio was 3.32 at ages 5 to 9 and 1.74 at ages 2 to 4, with no significant increase among infants or adolescents.

Outpatient and inpatient sensitivity analyses indicated that care setting also shaped the apparent recovery in some pathogens. Influenza A was elevated overall during Pandemic-II, but its adjusted odds ratio in inpatients was 0.64, suggesting that the early rebound was driven primarily by outpatient testing. Influenza B remained suppressed among inpatients, including an adjusted odds ratio of 0.15 after reopening, while its strong post-pandemic increase among adolescents suggested that the adolescent resurgence was concentrated in outpatient care. Because inpatient testing was used as a proxy for more consistent clinical indications, and because testing indications were not systematically recorded, the authors cautioned that residual confounding could remain even after adjustment and restriction.

Common bacterial culture results followed a different and more uncertain pattern from the viral findings. Staphylococcus aureus positivity increased from 2.7% before the pandemic to 4.2% during Pandemic-I and remained at 3.6% after reopening; its adjusted odds ratios were elevated in all three later periods. Escherichia coli also had elevated adjusted odds across the later periods, while Streptococcus pneumoniae declined after reopening, with an adjusted odds ratio of 0.77, and Pseudomonas aeruginosa reached 0.61. These estimates remain difficult to interpret because the composition of cultures changed markedly. Upper-respiratory specimens rose from 91.9% before the pandemic to 99.2% after reopening, while lower-respiratory specimens had much higher culture yields. Hospitalization rates, prior antibiotic exposure, specimen quality and reasons for obtaining cultures also varied, and some bacterial effect estimates reversed when specimen type was included in the model.

Co-infection patterns shifted as the dominant pathogens changed. During Pandemic-I, bacterial-bacterial combinations represented 49.0% of co-infections in the study’s main analysis, a period when viral positivity was at its lowest. In a sensitivity analysis excluding dual influenza A and B antigen results, bacterial-bacterial combinations declined from 62.0% during Pandemic-I to 11.2% after reopening, while bacterial-influenza combinations increased substantially and reached 22.9% after reopening. Influenza A-B dual antigen positivity accounted for 49.7% of all co-infections overall and was particularly common among children aged 5 to 9 years and adolescents, but the investigators warned that cross-reactivity in rapid antigen testing could inflate this category. Cytomegalovirus and Epstein-Barr virus detections also required caution because they may represent reactivation rather than acute respiratory infection.

The study supports an interpretation of disruption followed by non-uniform recovery, not a simple return to the old epidemiological baseline. It also cannot establish the cause of the changes. An immune gap, altered transmission, shifts in social mixing and changing patterns of healthcare use are plausible explanations discussed by the authors, but no serological or immunological measurements were collected, so the immune-gap mechanism remains a hypothesis. Other limitations include the retrospective design, restriction to two referral hospitals in one city, changing test denominators, lower sensitivity of rapid antigen assays for influenza, sparse data in some age-specific strata and differences in period lengths that prevented a strict interrupted time-series analysis. The investigators concluded that the divergent results support consideration of pathogen- and age-specific surveillance, while describing the findings as observations among tested children rather than direct measures of population incidence or evidence that any prevention strategy would prevent infection.

Subject of Research: Age-specific changes in pediatric respiratory pathogen test positivity across COVID-19 pandemic periods in Guangzhou

Article Title: Disruption and change in positivity of respiratory pathogen epidemiology in children during and after the COVID-19 pandemic, 2018–2023: a large-scale period-comparison study in Guangzhou, southern China

Article References: Li, H., Bai, R., Tang, Z., Li, P., Tang, L., Zheng, X., Gu, C., Ji, C., Luo, Y., & Luo, M. (2026). Disruption and change in positivity of respiratory pathogen epidemiology in children during and after the COVID-19 pandemic, 2018–2023: a large-scale period-comparison study in Guangzhou, southern China. Frontiers in Microbiology, 17, Article 1992791. https://doi.org/10.3389/fmicb.2026.1992791

Image Credits: AI Generated

DOI: 10.3389/fmicb.2026.1992791

Keywords: COVID-19 pandemic, pediatric respiratory infections, influenza A, influenza B, respiratory syncytial virus, Mycoplasma pneumoniae, pathogen positivity, age stratification, Guangzhou, post-pandemic epidemiology, Disruption, change

The study assessed 13 aquifer models within the AquiFR platform, covering Nord Pas-de-Calais, Basse-Normandie, the Paris Basin, the Loire and Poitou-Charentes basins, Alsace, and Tarn-et-Garonne. AquiFR combines physically based hydrogeological models, including EauDyssée and MARTHE, with the SURFEX land-surface model, which calculates runoff and drainage used as groundwater-recharge terms. Its climate forcing came from the EXPLORE2 ensemble, a downscaled and bias-corrected subset of Euro-CORDEX projections derived from the CMIP5 climate experiment. The simulations covered 1975–2099, with a 1975–2004 reference period and future horizons of 2021–2050, 2041–2070, and 2071–2099.

Groundwater conditions were evaluated with the Standardized Piezometric Level Index, or SPLI, a normalized measure that expresses each monthly water level relative to the historical distribution for the same calendar month. Values above zero represent levels above the historical median, while negative values represent lower, drier conditions. The index also expresses conditions as historical return periods, allowing wet and dry events to be compared across heterogeneous aquifers. Kolmogorov–Smirnov tests assessed whether future and historical distributions differed, while Mann–Kendall tests evaluated whether conditions changed monotonically through time. The significance threshold was p ≤ 0.05. In the full ensemble analysis, areas associated with more moderate 2.5-year events declined, areas associated with 5-year events changed little, and the footprint of 10-year extremes expanded.

Disagreement among the climate projections was substantial, particularly over the short- and intermediate-term horizons, preventing a single trend from emerging for every scenario. Among 17 available RCP8.5 global and regional climate-model combinations, 11, or about 65%, indicated generally increasing groundwater levels, four produced decreases, and two indicated relatively stable conditions. The study linked much of this spread to the climate component of the modelling chain, including internal climate variability and differences among global and regional climate models. Historical groundwater cumulative-distribution functions derived from the climate projections generally followed those produced using the SAFRAN reanalysis, suggesting that much of the future divergence originated in projected rainfall, drainage, and runoff rather than in the construction of the groundwater index.

Four RCP8.5 storylines were selected to represent contrasting but internally consistent climate futures without combining their trajectories into an averaged projection. The orange storyline paired strong warming with very dry summers and produced the most adverse groundwater outcome. By the end of the century, nearly 60% of the modelled domain was affected by 10-year dry events in the area-based analysis, while more than 75% of the domain experienced extreme dry conditions in the separate time-proportion analysis. The green storyline, characterized by serious warming and increased rainfall, instead generated widespread wetter conditions. Under it, the area affected by 10-year wet events increased from 3.7% in the historical period to almost 20%.

The purple storyline, defined by a strong seasonal contrast in precipitation with wet winters and dry summers, increased both wet and dry extremes. Under this projection, extreme dry conditions occupied more than half of the time across more than half of the modelled domain late in the century. The yellow storyline, designed around relatively modest future changes, produced the smallest overall shifts and a more spatially varied pattern without a dominant tendency. Statistical tests identified significant differences between historical and future distributions and significant temporal changes for almost all event categories in the four storylines. Those results apply separately to each physically consistent projection, however, and do not establish one deterministic future.

Across the full RCP8.5 ensemble, the area affected by extreme wet groundwater conditions increased by a factor of 4.5 over the long-term horizon, a result supported by the green, purple, and yellow storylines. Extreme dry events also increased overall, although generally by less than wet extremes; the driest orange storyline produced a much larger increase, reaching a factor of 25. The ensemble analysis found that the surface assigned to 2.5-year dry and wet conditions decreased, while 5-year dry and wet areas changed only slightly and 10-year events expanded. This pattern points toward greater separation between ordinary conditions and the most extreme states, rather than a broad increase in the frequency of all wet or dry categories.

Maps of the proportion of time spent in extreme events revealed clear differences among the storylines. The orange projection reduced the time associated with extreme wet events to less than 5% over almost the entire AquiFR domain while extending extreme dry conditions across more than 75% of it. The green projection had the opposite tendency, strongly increasing extreme wet events while reducing extreme dry ones. The purple projection increased both, whereas the yellow projection remained more heterogeneous. In the combined RCP8.5 analysis, the time spent in extreme wet events was close to historical conditions over part of the domain in the short term but increased toward 2100, especially in northern France. Extreme dry conditions showed a contrasting long-term pattern, with lower values in the north and higher values in the south.

The simulations were designed to isolate climate effects by holding land use and groundwater abstraction constant at historical climatological levels. This separation avoids confounding climatic change with human water use, but it also means the projections do not represent how abstraction, demand, or policy might change as groundwater availability evolves. The assumption is particularly consequential in southern areas where some simulations produce lower levels. AquiFR also does not apply multiple interchangeable groundwater models throughout its full domain, so the contribution of hydrogeological-model uncertainty cannot be fully quantified. Southern coverage is sparse: the Alsace and Tarn-et-Garonne models each cover about 1,100 square kilometres, compared with roughly 7,000–66,000 square kilometres for most other modelled aquifer systems. These limitations prevent the findings from establishing a nationwide north–south divide with the same confidence across all of metropolitan France.

The study’s broad conclusion is that climate projections imply contrasting regional futures and a growing separation between exceptionally wet and exceptionally dry groundwater conditions, rather than a uniform rise or fall across France. Under RCP2.6 and RCP4.5, the 2021–2050 and 2041–2070 results were too divergent for reliable trend statements. Over 2071–2099, they showed greater convergence toward wetter conditions in the north, while the remote Tarn-et-Garonne and Alsace models continued to disagree. The authors identify expansion of southern model coverage, fuller quantification of uncertainty across groundwater software, and integration of socio-economic water demand as priorities for future assessment. Until then, the four storylines demonstrate how a single national projection can conceal materially different outcomes among aquifers, including futures in which extreme groundwater drought expands across nearly the entire modelled region.

Subject of Research: Modelled climate-change impacts on groundwater levels and extremes across French aquifers

Article Title: Climate change impacts on groundwater simulated using the AquiFR modelling platform

Article References: Jeantet, A., Vergnes, J.-P., Munier, S., & Habets, F. (2026). Climate change impacts on groundwater simulated using the AquiFR modelling platform. Hydrology and Earth System Sciences, 30(20), 6381-6420. https://doi.org/10.5194/hess-30-6381-2026

Image Credits: AI Generated

DOI: 10.5194/hess-30-6381-2026

Keywords: groundwater, climate change, France, AquiFR, hydrogeological modelling, climate projections, extreme events, aquifer recharge, RCP8.5, water resources, Climate, change

The June event was Belgium’s deadliest heatwave on record. Maximum temperatures in Uccle reached 35.5°C on 26 June, while Belgium’s average daily maximum temperature peaked at an observed 36.0°C. Overnight conditions were also exceptional: on the night of 24–25 June, the temperature in Uccle did not fall below 24.1°C, the highest overnight minimum recorded during a Belgian heatwave since observations began in 1892.

Emergency services faced exceptional demand, with calls to the 112 emergency number reaching nearly twice their usual daily volume on 26 June and geriatric wards reaching full capacity. The study’s central result comes from a modeled comparison between the observed heatwave and a counterfactual in which human-induced climate change is absent. Under that counterfactual, the peak 12-day period would have been 3.9°C cooler.

On the hottest day, Belgium’s average daily maximum temperature would have reached 32.1°C rather than the observed 36.0°C. The researchers estimated that 1,181 deaths were statistically linked to heat during the event, equivalent to about one-quarter of all deaths recorded during the heatwave. Of these heat-related deaths, 665, or 56%, are attributed to the additional warming caused by human influence on the climate.

These findings are model-based attribution estimates rather than a direct count of deaths in which climate change was identified as a cause on individual death certificates. The established epidemiological component links daily maximum temperatures to mortality risk, while the extreme-event attribution component estimates how much human-induced warming altered the heatwave’s intensity. Combining the two allows researchers to estimate how many heat-linked deaths would not have occurred without the additional warming.

The report describes this as the first attribution of heat-related deaths to human-induced climate change for a specific Belgian heatwave and presents it as a rapid attribution report rather than a clinical trial or an evaluation of a particular intervention. The estimated mortality burden was not distributed evenly. Women accounted for more heat-related deaths than men.

People aged 85 and older represented half of all deaths linked to heat, whether or not climate change contributed to those deaths. Lead author Maxim Sleypen said the findings showed that the June 2026 heatwave would have been nearly 4°C cooler without human-induced climate change and that more than half of the nearly 1,200 heat-linked deaths would not have occurred without the extra warming. “This means that global warming is already costing lives in Belgium today,” he said, adding that every fraction of a degree of warming avoided will save lives. Co-author Emma Kuijt said the heatwave’s burden fell most heavily on older people, women and communities in the most deprived areas.

She said the disparity was likely exacerbated by factors beyond temperature alone, including pre-existing health conditions and socioeconomic influences such as housing with poor insulation and limited access to cooling. These factors were not isolated as the cause of every death, but the researchers said they help explain why the estimated consequences of extreme heat were not shared equally. Understanding those inequalities, Kuijt said, is essential for protecting the people most vulnerable to heat.

Regional estimates also showed substantial geographic variation. Liège had the highest provincial death rate attributable to climate change, at an estimated 9–11 deaths per 100,000 inhabitants. Hainaut and Namur followed, each with an estimated 7–9 deaths per 100,000 inhabitants.

In parts of southern Belgium, temperature anomalies exceeded 9.5–10°C above normal. The report situates the event within a broader pattern in which Europe has warmed about twice as quickly as the global average since the 1980s. It further states that heat extremes in western Europe have intensified even faster, with diminishing air pollution and changes in global circulation identified as contributing to that amplification.

The report explains that the additional warming pushed some temperatures from a low-risk range into a high-risk range of the relationship between temperature and mortality. Excessive heat disrupts normal physiological functioning, can aggravate pre-existing conditions and can cause serious complications such as heatstroke, dehydration and organ failure. The study’s mortality models indicate that risk rises steeply once temperatures pass a critical threshold.

In this event, the combination of rapid regional warming, intensifying heat extremes and the sharp increase in mortality risk above that threshold contributed to the unusually high toll. The estimate concerns deaths expected under the study’s models and counterfactual, rather than assigning a single climate cause to any individual death. Senior author Wim Thiery described three compounding factors behind the heatwave’s severity: Europe’s faster-than-global-average warming, the still faster intensification of heat extremes and the steep rise in mortality risk beyond a critical threshold.

The wider summer of 2026 was Belgium’s warmest on record and included three officially declared heatwaves. The June event was also identified by World Weather Attribution as part of a wider European heatwave that would have been virtually impossible in a pre-industrial climate. The report says that as global temperatures continue to rise, events like this are expected to become more frequent, more intense and more deadly unless mitigation is accelerated, while noting that every fraction of a degree of warming prevented translates into lives saved.

Against this background, the authors call for keeping warming in line with the Paris Agreement, substantially increasing investment in adaptation and strengthening protection for populations most exposed to extreme heat. Measures named in the report include heat action plans, early-warning systems and reinforced public-health infrastructure. The rapid attribution study does not directly test the effectiveness of those measures, because it analyzes the contribution of human-induced warming to mortality during a specific 12-day event rather than evaluating an intervention.

Its principal contribution is instead a quantified estimate: within the study’s models and counterfactual climate, human-induced climate change made Belgium’s June 2026 heatwave 3.9°C hotter and was attributed to 665 of the 1,181 deaths statistically linked to its extreme temperatures.

Subject of Research: Rapid attribution of human-induced climate change to heat-related mortality during Belgium’s June 2026 heatwave.

Article Title: Climate change doubled heat deaths in Belgium during the June 2026 heatwave

Article References: Climate change doubled heat deaths in Belgium during the June 2026 heatwave. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: Climate attribution, Heat mortality, Belgium, June 2026 heatwave, Human-induced warming, Extreme heat, Epidemiology, Rapid attribution study, Vrije Universiteit Brussel, Public health, Climate, change

Alpine Entomology was created in spring 2017, when then-SEG president Hannes Baur approached the founding editor-in-chief to lead a journal with a newly defined scope and an agreement with Pensoft. It replaced the society’s traditional “Mitteilungen der Schweizerischen Entomologischen Gesellschaft/Bulletin de la Société Entomologique Suisse” with an online, open-access publication. The first issue was planned for release before Christmas in 2017, after which publication generally followed an end-of-year schedule, except in 2020 and in the year of the sixth issue. The fixed schedule became less important once accepted articles were available online as soon as their final versions were ready.

Although its name suggests a regional focus, the journal was established as an international venue for research on insects and other arthropods associated with mountainous environments. It was not restricted to work from the Alps, and submissions were also considered from other mountainous regions when the connection to mountains was sufficiently strong. The editor-in-chief screened manuscripts before forwarding them to subject editors, who assisted with decisions in doubtful cases. This arrangement allowed the journal to retain a recognizable mountain focus while accepting relevant research from beyond the Alps.

Indexing was a central objective from the beginning. The journal was indexed by Scopus in 2020, and the editor reported that it would receive its first impact factor from Clarivate Analytics in 2023. Its output has included scientific papers, the society’s annual report and reference resources such as checklists for Switzerland. Individual articles have received more than 3,000 unique views on the journal website, which the editor presented as evidence that the online, open-access format reaches entomologists both within Switzerland and internationally.

The leadership change follows a decision made after the publication of the fifth volume to step down once a suitable successor could be found. A candidate has been selected, although the successor’s identity and formal election were still pending at the time of the announcement. Two recently launched topical collections, one on aquatic arthropods and another on alien insects, were identified as possible supports for increasing interest in submissions. The outgoing editor also credited the subject editors and editorial board for the journal’s development and expressed the hope that broader indexing, new leadership and the collections would help consolidate Alpine Entomology’s position within the international entomological community.

Subject of Research: The six-year development and planned leadership transition of the open-access entomology journal Alpine Entomology.

Article Title: Time to change after six issues of Alpine Entomology

Article References: Lachat, T. (2022). Time to change after six issues of Alpine Entomology. Alpine Entomology, 6, 159-160. https://doi.org/10.3897/alpento.6.98667

Image Credits: AI Generated

DOI: 10.3897/alpento.6.98667

Keywords: Alpine Entomology, entomology, arthropods, Swiss Entomological Society, open-access publishing, scientific journals, editorial transition, journal indexing, aquatic arthropods, alien insects, Time, change

The study, published in Biogeosciences by Iuliia Burdun of Aalto University and KU Leuven, Jiabin Pu and Ranga B. Myneni of Boston University, and corresponding author Miina Rautiainen of Aalto University, tracked leaf area index (LAI) across peatland-dominated pixels north of 45 degrees North from 2001 to 2023. LAI is an Essential Climate Variable that describes the amount of green foliage above the ground, defined as one half of the total green leaf area per unit of horizontal ground surface. In simple terms, higher LAI means more green leaf area, and the team interpreted increases over time as greening and decreases as browning.

What makes the analysis technically distinctive is the data record itself. The researchers used a gap-filled, sensor-independent LAI climate data record at 500-meter resolution, which merges high-quality retrievals from MODIS Terra, MODIS Aqua, and VIIRS for each eight-day period. This sensor-independence reduces biases tied to any single satellite’s calibration and overpass time, while a spatio-temporal tensor completion model fills gaps left by clouds, aerosols, and snow. The result is a consistently processed, uncertainty-quantified time series stable enough for climate-scale analysis, a critical requirement when the goal is to detect subtle, multi-decadal canopy change.

The peatland mask was built conservatively by integrating four complementary global datasets: PEATMAP, OpenStreetMap wetland polygons, ESA WorldCover herbaceous wetlands, and the Global Peatland Map 2.0. Areas were retained only when supported by at least two of the three wetland-mapping sources and located within the Global Peatland Map 2.0, yielding roughly 535,017 square kilometers of conservatively mapped peatland. The team then kept only 500-meter pixels with at least 90 percent mapped peatland cover and excluded any pixel classified as burned between 2001 and 2023 in the MCD64A1 fire dataset, leaving 1,244,063 pixels capturing more than half of the conservative peatland mask. This pixel selection was designed to minimize mixed-pixel effects from adjacent forests, open water, and farmland, and to avoid confounding by abrupt fire disturbance and post-fire recovery.

The headline numbers are striking. More than 77 percent of the studied peatland area, about 203,269 of roughly 261,819 square kilometers, showed positive LAI trends, corresponding to a greening-to-browning ratio of 3.5:1. The strongest greening clustered in southern West Siberia, Central Europe, and southern Fennoscandia, while the largest browning pattern appeared near the Hudson Bay Lowlands in North America. Across the distribution, decadal LAI trends ranged from -1.07 to 0.78 square meters per square meter per decade, with 95 percent of values between -0.07 and 0.09. Yet here is the twist: when the researchers accounted for spatial autocorrelation across the map using a partitioned spatial generalised least squares framework, the area-weighted LAI trend at the map scale was statistically indistinguishable from zero. Widespread local greening did not add up to a significant overall increase in greenness.

The climate associations were equally counterintuitive. LAI anomalies showed a weak but predominantly positive partial correlation with air temperature anomalies and a weak, predominantly negative partial correlation with precipitation anomalies, with the strongest associations in West Siberia and the Hudson Bay Lowlands. In the best-fitting model of long-term LAI trends, multi-year mean annual precipitation, rather than air temperature, was retained. The authors argue that this negative LAI-precipitation relationship aligns with peatland hydrology: reduced precipitation lowers the water table and dries peatlands, favouring the expansion of dry-habitat vascular plants at the expense of Sphagnum mosses, the ecosystem engineers that maintain the acidic, waterlogged conditions under which peat accumulates. Greening in northern peatlands may therefore reflect vascular plant expansion rather than enhanced moss growth, a shift with potential consequences for peat-forming function and carbon sequestration.

Perhaps the most intriguing finding involves the Pacific Decadal Oscillation, a pattern of Pacific climate variability that modulates temperature and precipitation north of 40 degrees North. Most peatland pixels followed a linear LAI trend with no detected breakpoint, but where non-linear trends occurred, their breakpoints were often temporally aligned with phase shifts in the PDO. Cup-shaped trends, in which LAI first declined and then increased, were concentrated in West Siberia, with breakpoints peaking during 2005-2010. Hat-shaped trends, in which LAI first rose and then fell, were widespread across Europe, northeastern Asia, and Canada, with a later breakpoint density peak during 2012-2016. In both non-linear classes, peaks in breakpoint density occurred soon after a PDO phase change, the first observation, to the authors’ knowledge, that a PDO shift might contribute to changes in peatland vegetation trends.

Tree cover also shaped the trajectories. Greater tree cover was associated with less greening, but the effect was numerically small and varied by continent, canopy type, and precipitation regime. In Asian peatlands where the nearest surrounding trees in 2001 were evergreen needleleaf, each additional 1 percent of tree cover was associated with a mean decline of 1.06 x 10^-4 square meters per square meter per decade, and the penalty was markedly steeper in North America. Deciduous needleleaf cover, such as larch, attenuated the negative tree-cover effect, consistent with field studies showing that larch mitigates the negative association between tree mortality and greening. Higher multi-year mean annual precipitation moderated the negative slope, making it less negative in sufficiently wet sites. Counterintuitively, the largest positive LAI trends in North America occurred at high tree-cover levels, a pattern that can arise when partial conifer mortality and understory release increase vascular leaf area despite high initial canopy cover.

Permafrost thaw added another pathway of decadal non-linearity. Frozen ground acts as a hydrological dam, and thermokarst-lake drainage breaches it, reconfiguring drainage pathways and triggering land cover transitions. Pixels overlapping mapped drained lakes showed a higher prevalence of increasing LAI trends, with 94.5 percent of the 2,328 overlapping pixels trending upward, predominantly in Asian peatlands. The relative share of drained-lake overlap was highest for cup-shaped increasing trends, compatible with a vegetation shift in which initial permafrost disturbance is followed by graminoid and shrub colonisation and, locally, tree establishment after two to three decades. Because moderate-resolution LAI integrates heterogeneous peatland-lake mosaics, part of the apparent increase may reflect a decline in the open-water fraction rather than canopy change alone, and the authors caution that this exploratory pattern should not be generalised.

Protection status, notably, did not explain LAI trends once differences in climate and canopy were accounted for. About 11 percent of the studied pixels fell within protected areas, mirroring global estimates that only about 17 percent of peatlands are protected. The authors stress that a null association should not be read as evidence that protection is ineffective; benefits may occur in attributes not captured by LAI, such as biodiversity, or at magnitudes below detectability given limited protected-area coverage. Taken together, the findings suggest that recent peatland canopy change was not a uniform increase in greenness but a moisture-sensitive, tree-composition-dependent response modulated by decadal climate variability. As northern Eurasia grows more arid and Arctic heatwaves expand, the authors argue that future work should link observed LAI trends with peatland-specific land-surface models to detect moisture-driven regime shifts at the circumpolar scale, and that climate-aware management, rather than legal designation alone, will be essential for conserving these carbon-rich ecosystems.

Subject of Research: Biogeosciences

Article Title: Detecting long-term canopy change and vegetation shifts in northern peatlands using LAI and climate data

Article References: Burdun, I., Pu, J., Myneni, R. B., & Rautiainen, M. (2026). Detecting long-term canopy change and vegetation shifts in northern peatlands using LAI and climate data. Biogeosciences, 23(20), 7289-7308. https://doi.org/10.5194/bg-23-7289-2026

Image Credits: AI Generated

DOI: 10.5194/bg-23-7289-2026

Keywords: peatlands, LAI, remote sensing, climate change, Pacific Decadal Oscillation, carbon storage, permafrost, Biogeosciences, Detecting, long-term, canopy, change

Syros lies at the heart of the Cyclades archipelago and covers 84 square kilometres, with its highest point, Pyrgos peak, reaching 442 metres above sea level. With roughly 21,500 inhabitants recorded in 2011, it is the most populous island in the Cyclades and hosts Ermoupoli, the administrative capital of the southern Aegean region. The island is sharply divided: the northern half is largely uninhabited, treeless and dominated by dry Phrygana vegetation, while the southern half is intensively farmed and urbanised. This split landscape shapes the distribution of the island’s reptiles and amphibians, which depend heavily on the scarce water bodies found mainly in the cultivated south.

The historical record for Syros begins with Theodor Erhard’s Fauna of the Cyclades, published in 1858, although Bedriaga later criticised Erhard’s work as riddled with errors, claiming he confused species and islands. Bedriaga himself documented the Balkan Terrapin and the Balkan Water Frog on Syros in 1882, noting that he found adult tadpoles of the Green Toad there as early as mid-March 1880. Werner recorded eight species in 1938, but the most intensive herpetological work was carried out by Frör and Beutler, who visited the island in 1974 and 1977 and evaluated museum collections from Bonn, Munich and Vienna. Their 1980 overview listed thirteen species for Syros, placing its herpetofauna within the Central Cyclades group.

During the 2024 survey, conducted from 3 to 16 April with daytime temperatures between 18 and 21 degrees Celsius and windy conditions throughout, the team could confirm only six of the thirteen previously recorded species. The Kotschy’s Gecko proved widespread, found more than twenty times in stone walls, under rocks and in fountains, particularly in the north of the island. The Aegean Wall Lizard was omnipresent and emerged as the most common reptile. The European Snake-eyed Skink appeared several times in the leaf litter of the northern Phrygana. The Large Whip Snake was confirmed at two northern sites, validating Clark’s original 1969 discovery, while four relatively small Nose-horned Vipers, measuring between 35 and 45 centimetres, were encountered across the island, including one fresh roadkill victim.

Several species proved conspicuously absent. The Mediterranean House Gecko, previously recorded around Ermoupoli and near Kini, was not found despite extensive searches of wells, stone walls and buildings. The Balkan Green Lizard, described by earlier researchers as rare due to intensive agriculture and heavy traffic, was observed only once, when a single individual crossed the road near the pass between Ermoupoli and Kini on 15 April. The Leopard Snake and the European Cat Snake, both historically documented, were neither seen by the previous surveyors nor by the current team. The Grass Snake, recorded by Beutler and Frör at Posidonia, Kini and Galissas in 1980, was entirely absent, although a local landowner recalled seeing snakes in a spring catchment near Aghios Athanasios ten to fifteen years ago, suggesting a possible former occurrence.

A central focus of the survey was the search for wetlands, which are naturally rare on Cycladic islands smaller than 100 square kilometres because they lack substantial hydrological catchment areas. The WWF Greece wetland inventory designates only two sites on Syros. At the estuary of Varvaroussa Beach near Kini, only a remnant of a brackish backwater measuring approximately 10 square metres remained on 12 April. At Ghalissas Bay, which should encompass a brackish backwater of 1.18 hectares, there was no surface water at all during the site visit on 5 April, only remnants of a reed bed. Every spring location marked on the Skai map was either captured or dried up, and flowing water was observed only in a short open sewer in the southern industrial area of Ermoupoli.

The water scarcity on Syros reflects both human pressure and climate change. The southern half of the island demands enormous quantities of water for intensive vegetable and horticultural cultivation, and no other Cycladic island has had such a dense network of cisterns and groundwater wells. Yet many open cisterns have fallen into disuse, and groundwater in abandoned wells now sits at an estimated depth of eight to ten metres. During the summer tourist season, the island’s population temporarily doubles, and drinking water comes overwhelmingly from the sea, with 95 percent treated in desalination plants. Meteorological data from the ERAS fifth-generation atmospheric reanalysis, covering 1979 to 2021, show that the average temperature on Syros has risen by 1.6 degrees Celsius since 1979, while average annual precipitation between 1979 and 2023 was just 289 millimetres, with conditions growing consistently drier since 2020.

These drying trends have devastating consequences for the Green Toad, which has historically benefited from anthropogenic spawning grounds in the form of open cisterns, a relationship also documented on the Cycladic island of Kythnos. The three locations where Beutler and Frör recorded the species in 1980 were searched intensively, especially during an overnight stay in Kini. Only two open cisterns filled with water were identified as possible spawning sites, but both contained Goldfish, which devour amphibian spawn, particularly in the absence of protective vegetation. Goldfish were also found in several other cisterns in the south of the island, where any benefit to humans is difficult to conceive while the harm to amphibians is immense. The intensive search on 10 April led to a single open cistern in Posidonia, roughly 12 by 12 metres in size, where well-developed Green Toad tadpoles were found. This remained the only island record, and the species must now be considered threatened with extinction on Syros.

The same conditions explain the disappearance of the Balkan Water Frog, which Bedriaga described as present on Syros in 1882 but which Beutler and Frör already considered questionable in 1980. The Balkan Terrapin presents a more intriguing case. In the village of Hartiana, two local residents recounted that a friend had seen turtles in a body of water in Sykaminia Bay below the hamlet of Kambos, marking the location on a map several hundred metres above the shoreline, which ruled out confusion with sea turtles. A search the following day found no indication of a suitable habitat, and geologists working in the area confirmed they had never seen surface water there. The study’s author concludes that suitable habitats for the terrapin are lacking across the island and that its local extinction must be confirmed for Syros.

Four interlocking conclusions emerge from the survey regarding the state of the hygrophilous herpetofauna. First, wetlands on small Cycladic islands are inherently vulnerable, supporting relictual animal and plant populations with virtually no possibility of genetic exchange. Second, these fragile aquatic habitats face mounting conflicts of use with agriculture, which cultivates areas where watercourses flow into the sea and channels winter water through hoses into reservoirs and cisterns, while pumping lowers the groundwater table, and with tourism, which seeks to exploit sandy beaches at estuary mouths. Third, while the hygrophilous herpetofauna once benefited from anthropogenic structures such as open cisterns, ongoing structural change in agriculture has led to the abandonment of these complex irrigation regimes, rendering sub-optimal habitats unavailable and introducing the additional threat of Goldfish stocking. Fourth, climate change manifests through marked temperature increases and drier winter months lacking the usual heavy rainfall, massively reducing suitable habitats and preventing amphibian reproduction. Across the Cyclades, species such as the Balkan Water Frog, the Green Toad, the Common Toad and the Tree Frog are particularly affected, while among the reptiles the Balkan Terrapin, the Grass Snake and the Dice Snake face the greatest risks, with the Nose-horned Viper and the Balkan Green Lizard, which also prefer humid structures, suffering to a lesser extent. Without urgent intervention to protect and restore the island’s remaining water bodies, Syros risks losing what little remains of its wetland-dependent herpetofauna within a generation.

Subject of Research: Update on the herpetofauna of Syros (Cyclades, Greece) and current land-use and climate change threats

Article Title: Update on the herpetofauna of Syros (Cyclades, Greece) and current land-use and climate change threats

Article References: Broggi, M. F. (2024). Update on the herpetofauna of Syros (Cyclades, Greece) and current land-use and climate change threats. Herpetozoa, 37, 339-346. https://doi.org/10.3897/herpetozoa.37.e129656

Image Credits: AI Generated

DOI: 10.3897/herpetozoa.37.e129656

Keywords: Update, herpetofauna, Syros, Cyclades, Greece, current, land-use, climate, change, threats, scientific research

The research drew on the Busselton Healthy Ageing Study, a population-based cohort conducted in the coastal town of Busselton in Western Australia, a region internationally renowned for the depth and continuity of its health data. Adults aged between 45 and 70 years at baseline underwent comprehensive audiometric testing and general health assessments between 2010 and 2015, then returned for a follow-up examination six years later. From the full cohort, 3,596 participants had reliable audiometry at both time points and formed the analytical sample, with a mean baseline age of 57.9 years and 55 percent of participants being women.

The researchers quantified hearing using two complementary measures derived from pure tone audiometry. The first, the four-frequency pure tone average, or 4FPTA, averaged hearing thresholds across the speech-critical frequencies of 0.5 to 4 kilohertz, capturing the range most relevant to everyday conversation. The second, the high-frequency pure tone average, or HFPTA, focused on 4 and 8 kilohertz, the frequencies that typically deteriorate earliest and most steeply with age. Hearing loss was classified according to World Health Organization criteria, allowing the team to track both the continuous shift in thresholds and the categorical movement of individuals across clinical severity grades.

The headline numbers are sobering. Over the six-year follow-up, the prevalence of mild-or-greater hearing loss in the better ear, as measured by the 4FPTA, rose from 14 percent to 26 percent of participants. When the high-frequency measure was applied, the picture was even more dramatic: prevalence climbed from 53 percent to 71 percent. In other words, by the end of the study period, more than seven in ten middle-aged adults showed high-frequency hearing loss of at least mild degree in their better ear, a figure that underscores how widespread subclinical auditory decline already is well before retirement age.

Thresholds worsened across every age category in the cohort, but the deterioration was not uniform. Men experienced greater hearing decline than women, and higher frequencies deteriorated faster than the speech frequencies, consistent with the classic pattern of noise-induced and age-related cochlear damage that begins at the basal end of the hearing organ. Because the study followed individuals longitudinally rather than comparing separate age groups at a single point in time, the results provide direct evidence of within-person change, eliminating many of the confounds that plague cross-sectional surveys of hearing.

Beyond age and sex, the analysis uncovered a set of modifiable and clinical factors associated with faster decline. Using linear mixed models adjusted for age and sex, the researchers found that higher body mass index, smoking, tinnitus, chronic ear infection, and noisy workplace exposure were each significantly linked to steeper hearing deterioration. Notably, the effect of occupational noise was most pronounced among workers with inconsistent or absent hearing protection, a finding with obvious implications for workplace safety programs. Hypertension and pre-diabetes also emerged as significant predictors, suggesting that the vascular and metabolic changes that precede overt disease may already be compromising the delicate blood supply of the inner ear.

The involvement of metabolic factors fits with a growing body of research implicating microvascular health in hearing. The cochlea depends on an extraordinarily dense capillary network and high metabolic activity to transduce sound into neural signals, and it has minimal capacity for repair once the sensory hair cells or their supporting structures are lost. Conditions such as hypertension and impaired glucose regulation are known to damage small blood vessels throughout the body, and the inner ear may be among the first organs to show the consequences. Similarly, smoking delivers oxidative stress and vasoconstrictive compounds that can starve cochlear tissue, while elevated body mass index is associated with chronic inflammation and metabolic dysregulation that may accelerate cellular aging in the auditory system.

The study’s authors emphasize that hearing loss progression in midlife is shaped not only by age and sex but also by broader metabolic and environmental health profiles. This reframing matters clinically because it suggests that hearing checks should not be reserved for older adults. If a substantial fraction of people in their fifties are crossing the threshold of measurable hearing loss within six years, and if factors such as blood pressure, blood glucose, smoking status, and noise protection are influencing the pace of that decline, then midlife represents a critical intervention window. Managing cardiovascular risk factors, enforcing consistent hearing protection in noisy occupations, and lowering the threshold for audiometric screening could potentially delay the onset of disabling hearing loss by years.

The public health stakes are considerable. Disabling hearing loss affects hundreds of millions of people worldwide, and as the global population ages, its burden is projected to grow substantially. Untreated hearing loss in adults is associated with social isolation, depression, cognitive decline, and dementia, making it one of the largest modifiable risk factors for dementia identified in recent Lancet Commission analyses. A decline that begins in midlife, decades before most people seek help, means that the cumulative exposure to auditory deprivation and its downstream consequences may be far greater than current clinical practice assumes.

The researchers caution that their findings highlight the need for future research to further clarify the complex interplay between metabolic health, environmental exposures, and hearing outcomes. Longitudinal data from the Busselton cohort will continue to support this effort, and the study’s community-based design, with its high participation rates and standardized audiometric protocols, lends credibility to the estimates. For now, the message for middle-aged adults is clear: hearing is not a fixed asset that can be taken for granted until retirement. It is a dynamic health parameter, responsive to the same lifestyle and metabolic factors that shape heart disease and diabetes, and it deserves the same early and proactive attention.

Subject of Research: Hearing loss progression and general health in middle-aged adults

Article Title: Change in hearing loss and its association with general health in a community-based longitudinal study of middle-aged individuals: The Busselton healthy ageing study

Article References: Smit, A. L., Eikelboom, R. H., Mao, Y., Hunter, M., Atlas, M. D., Swanepoel, D. W., & Stegeman, I. (2026). Change in hearing loss and its association with general health in a community-based longitudinal study of middle-aged individuals: The Busselton healthy ageing study. PLOS One, 21(10), e0360651. https://doi.org/10.1371/journal.pone.0360651

Image Credits: AI Generated

DOI: 10.1371/journal.pone.0360651

Keywords: hearing loss, audiometry, ageing, Busselton Healthy Ageing Study, public health, hypertension, pre-diabetes, occupational noise, tinnitus, longitudinal study, Change, hearing