{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:46:23Z","timestamp":1792784783804,"version":"4.5.0"},"reference-count":77,"publisher":"American Chemical Society (ACS)","issue":"9","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2023YFC3605001"],"award-info":[{"award-number":["2023YFC3605001"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["42275187"],"award-info":[{"award-number":["42275187"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Key Research Base of Humanities and Social Sciences of the Ministry of Education","award":["22JJD790004"],"award-info":[{"award-number":["22JJD790004"]}]},{"name":"Guangdong Provincial Center for Disease Control and Prevention","award":["2023D001"],"award-info":[{"award-number":["2023D001"]}],"id":[{"id":"https:\/\/ror.org\/04tms6279","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Guangdong-Hong Kong-Macao Greater Bay Area Collaborative Research Project on Meteorological Science and Technology","award":["GHMA2024Z05"],"award-info":[{"award-number":["GHMA2024Z05"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Although short-term exposure to heatwaves has been linked to an elevated risk of stroke onset, evidence regarding the long-term impact of heatwave exposure on poststroke disability remains limited, particularly for nighttime heatwaves. We conducted a cross-sectional study that included 29,447 participants from the Guangdong Province High-Risk Population Screening and Intervention Project for Stroke (2016\u20132021). Using a generalized additive model, we compared the effects of long-term exposure to heatwaves between daytime and nighttime on poststroke disability, as measured by modified Rankin Scale (mRS) scores. Furthermore, we projected the future burden of poststroke disability attributable to heatwave changes under different climate change scenarios. Both long-term exposure to daytime and nighttime heatwaves increased poststroke disability risk. Specifically, each additional day of nighttime heatwave was associated with an excess risk (ER) of 4.62% (95% CI: 4.36%\u20134.89%) in poststroke disability, which is higher than daytime heatwave (ER = 3.71%, 95% CI: 3.46%\u20133.97%). Similarly, for each 1 \u00b0C increase in heatwave intensity, the risk was also greater for nighttime heatwaves (ER = 4.36%, 95% CI: 4.01%\u20134.72%) than for daytime events (ER = 1.60%, 95% CI: 1.45%\u20131.76%). Subgroup analyses revealed similar patterns. Projections indicate that global warming will escalate heatwave-related poststroke disability burden, with greater burden for nighttime heatwaves than daytime events. For instance, under the SSP5-8.5 scenario by the 2080s, the projected increases in the attributable fraction (AF) for both nighttime heatwave duration (15.63%, 95% eCI: 13.39%\u201317.99%) and intensity (14.86%, 95% eCI: 12.73%\u201317.11%) were higher than those for daytime heatwaves (5.22%, 95% eCI: 4.47%\u20136.01% for heatwave duration; 12.68%, 95% eCI: 10.86%\u201314.60% for heatwave intensity). These findings highlight nighttime heatwave as a critical and underaddressed risk factor for poststroke outcomes in the context of climate change.<\/jats:p>","DOI":"10.1021\/envhealth.6c00078","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:43:32Z","timestamp":1777657412000},"page":"1930-1940","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of\nNighttime Heatwave on Poststroke Disability\nin Subtropical Cities of China"],"prefix":"10.1021","volume":"4","author":[{"given":"Di","family":"Wu","sequence":"first","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelong","family":"Gu","sequence":"additional","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Yang","sequence":"additional","affiliation":[{"name":"The National Center for Chronic and Noncommunicable Disease Control and Prevention , ,","place":["Beijing, China, 100050"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenping","family":"Zhao","sequence":"additional","affiliation":[{"name":"The National Center for Chronic and Noncommunicable Disease Control and Prevention , ,","place":["Beijing, China, 100050"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ni","family":"Xiao","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Wang","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanhao","family":"He","sequence":"additional","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1451-5251","authenticated-orcid":true,"given":"Tao","family":"Liu","sequence":"additional","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maigeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]},{"name":"The National Center for Chronic and Noncommunicable Disease Control and Prevention , ,","place":["Beijing, China, 100050"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiansen","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention , ,","place":["Guangzhou, China, 511430"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxiong","family":"Hu","sequence":"additional","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9266-4802","authenticated-orcid":true,"given":"Wenjun","family":"Ma","sequence":"additional","affiliation":[{"name":"Jinan University , , ,","place":["Guangzhou, China, 510632"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"issue":"6","key":"2026091808062213500_cit1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15620\/cdc:104186","article-title":"Deaths: Leading\nCauses for 2016","volume":"67","author":"Heron","year":"2018","journal-title":"Natl. 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Stroke"},{"key":"2026091808062213500_cit21","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.3390\/rs13112179","article-title":"HGPT2:\nAn ERA5-Based Global Model\nto Estimate Relative Humidity","volume":"13","author":"Mateus","year":"2021","journal-title":"Remote Sens"},{"issue":"8","key":"2026091808062213500_cit22","doi-asserted-by":"publisher","DOI":"10.1016\/s2542-5196(22)00139-5","article-title":"The effects\nof night-time warming on mortality burden\nunder future climate change scenarios: a modelling study","volume":"6","author":"He","year":"2022","journal-title":"Lancet Planet Health"},{"issue":"Pt 1","key":"2026091808062213500_cit23","doi-asserted-by":"publisher","first-page":"116740","DOI":"10.1016\/j.envres.2023.116740","article-title":"Daytime and nighttime high temperatures differentially\nincreased the risk of cardiovascular disease: A nationwide hospital-based\nstudy in China","volume":"236","author":"Tao","year":"2023","journal-title":"Environ. 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Total\nEnviron."},{"issue":"2","key":"2026091808062213500_cit41","doi-asserted-by":"publisher","DOI":"10.1097\/EE9.0000000000000005","article-title":"Effect\nof night-time temperatures\non cause and age-specific mortality in London","volume":"1","author":"Murage","year":"2017","journal-title":"Environ. Epidemiol"},{"issue":"24","key":"2026091808062213500_cit42","doi-asserted-by":"publisher","first-page":"2158","DOI":"10.1093\/eurheartj\/ehae277","article-title":"Nocturnal heat exposure and stroke risk","volume":"45","author":"He","year":"2024","journal-title":"Eur. Heart J."},{"key":"2026091808062213500_cit43","doi-asserted-by":"publisher","first-page":"175815","DOI":"10.1016\/j.scitotenv.2024.175815","article-title":"Potential\nmechanisms of ischemic stroke induced by heat exposure","volume":"952","author":"Zhou","year":"2024","journal-title":"Sci. Total Environ."},{"issue":"6","key":"2026091808062213500_cit44","doi-asserted-by":"publisher","DOI":"10.1016\/s2542-5196(22)00117-6","article-title":"Heat exposure\nand cardiovascular health outcomes: a systematic review\nand meta-analysis","volume":"6","author":"Liu","year":"2022","journal-title":"Lancet Planet Health"},{"key":"2026091808062213500_cit45","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/3-540-28862-7_7","article-title":"Temperature Regulation,\nHeat Balance and Climatic Stress","volume-title":"Extreme\nWeather Events and Public Health Responses","author":"Havenith","year":"2005"},{"key":"2026091808062213500_cit46","doi-asserted-by":"publisher","first-page":"118814","DOI":"10.1016\/j.ecoenv.2025.118814","article-title":"Heatwave increases\nthe risk of ischemic stroke by promoting platelet activation","volume":"303","author":"Wang","year":"2025","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"2026091808062213500_cit47","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3390\/biology12030416","article-title":"Profiling the Hsp70 Chaperone Network\nin Heat-Induced Proteotoxic\nStress Models of Human Neurons","volume":"12","author":"Alharbi","year":"2023","journal-title":"Biology"},{"issue":"3","key":"2026091808062213500_cit48","doi-asserted-by":"publisher","first-page":"173","DOI":"10.7326\/0003-4819-129-3-199808010-00001","article-title":"Near-fatal heat\nstroke during the 1995 heat wave in Chicago","volume":"129","author":"Dematte","year":"1998","journal-title":"Ann. Int. Med."},{"issue":"8","key":"2026091808062213500_cit49","doi-asserted-by":"publisher","first-page":"087006","DOI":"10.1289\/EHP1026","article-title":"Heat Wave and Mortality: A Multicountry,\nMulticommunity Study","volume":"125","author":"Guo","year":"2017","journal-title":"Environ. 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