{"id":"https://openalex.org/W7206217617","doi":"https://doi.org/10.64898/2026.08.31.26361879","title":"Warming, thermal variability, and the 96% decline in childhood respiratory-infection mortality in China: a national time-series analysis of the Global Burden of Disease Study 2021 and the C-LSAT high-resolution climate dataset","display_name":"Warming, thermal variability, and the 96% decline in childhood respiratory-infection mortality in China: a national time-series analysis of the Global Burden of Disease Study 2021 and the C-LSAT high-resolution climate dataset","publication_year":2026,"publication_date":"2026-09-02","ids":{"openalex":"https://openalex.org/W7206217617","doi":"https://doi.org/10.64898/2026.08.31.26361879"},"language":"en","primary_location":{"id":"doi:10.64898/2026.08.31.26361879","doi":"https://doi.org/10.64898/2026.08.31.26361879","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.31.26361879","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/02/2026.08.31.26361879.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/02/2026.08.31.26361879.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5148819529","display_name":"Deze Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I183519381","display_name":"Capital Medical University","ror":"https://ror.org/013xs5b60","country_code":"CN","type":"education","lineage":["https://openalex.org/I183519381"]},{"id":"https://openalex.org/I4210144404","display_name":"Beijing Children\u2019s Hospital","ror":"https://ror.org/04skmn292","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210144404"]},{"id":"https://openalex.org/I4210151382","display_name":"Children's Hospital of Suzhou University","ror":"https://ror.org/05a9skj35","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210151382"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Deze Li","raw_affiliation_strings":["Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University, Suzhou, People\u2019s China","National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University, Suzhou, People\u2019s China","institution_ids":["https://openalex.org/I4210151382"]},{"raw_affiliation_string":"National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China","institution_ids":["https://openalex.org/I183519381","https://openalex.org/I4210144404"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5125123531","display_name":"Yu Miao","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210151382","display_name":"Children's Hospital of Suzhou University","ror":"https://ror.org/05a9skj35","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210151382"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yu Miao","raw_affiliation_strings":["Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University, Suzhou, People\u2019s China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University, Suzhou, People\u2019s China","institution_ids":["https://openalex.org/I4210151382"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102195625","display_name":"Y Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210151382","display_name":"Children's Hospital of Suzhou University","ror":"https://ror.org/05a9skj35","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210151382"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yuxiang Zhang","raw_affiliation_strings":["Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University, Suzhou, People\u2019s China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University, Suzhou, People\u2019s China","institution_ids":["https://openalex.org/I4210151382"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5150002799","display_name":"Hao Chen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I183519381","display_name":"Capital Medical University","ror":"https://ror.org/013xs5b60","country_code":"CN","type":"education","lineage":["https://openalex.org/I183519381"]},{"id":"https://openalex.org/I4210144404","display_name":"Beijing Children\u2019s Hospital","ror":"https://ror.org/04skmn292","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210144404"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hao Chen","raw_affiliation_strings":["National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China","institution_ids":["https://openalex.org/I183519381","https://openalex.org/I4210144404"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5149340536","display_name":"Xiaotong Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I183519381","display_name":"Capital Medical University","ror":"https://ror.org/013xs5b60","country_code":"CN","type":"education","lineage":["https://openalex.org/I183519381"]},{"id":"https://openalex.org/I4210144404","display_name":"Beijing Children\u2019s Hospital","ror":"https://ror.org/04skmn292","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210144404"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaotong Wang","raw_affiliation_strings":["National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China","institution_ids":["https://openalex.org/I183519381","https://openalex.org/I4210144404"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5030702329","display_name":"Chen Shen","orcid":"https://orcid.org/0000-0002-0119-4455","observed_orcids":["https://orcid.org/0000-0002-0119-4455"]},"institutions":[{"id":"https://openalex.org/I183519381","display_name":"Capital Medical University","ror":"https://ror.org/013xs5b60","country_code":"CN","type":"education","lineage":["https://openalex.org/I183519381"]},{"id":"https://openalex.org/I4210144404","display_name":"Beijing Children\u2019s Hospital","ror":"https://ror.org/04skmn292","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210144404"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Chen Shen","raw_affiliation_strings":["National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Center for Children\u2019s Health, Beijing Children\u2019s Hospital, Capital Medical University, Beijing, China","institution_ids":["https://openalex.org/I183519381","https://openalex.org/I4210144404"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5030702329"],"corresponding_institution_ids":["https://openalex.org/I183519381","https://openalex.org/I4210144404"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11244","display_name":"Climate Change and Health Impacts","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T11244","display_name":"Climate Change and Health Impacts","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10190","display_name":"Air Quality and Health Impacts","score":0.0020000000949949026,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10654","display_name":"Pneumonia and Respiratory Infections","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/lower-respiratory-tract-infection","display_name":"lower respiratory tract infection","score":0.7749999761581421},{"id":"https://openalex.org/keywords/childhood-asthma","display_name":"childhood asthma","score":0.8100000023841858},{"id":"https://openalex.org/keywords/global-warming","display_name":"global warming","score":0.6539999842643738},{"id":"https://openalex.org/keywords/temperature-mortality-relationship","display_name":"temperature-mortality relationship","score":0.5839999914169312},{"id":"https://openalex.org/keywords/diurnal-temperature-variation","display_name":"diurnal temperature range","score":0.875},{"id":"https://openalex.org/keywords/seasonal-amplitude","display_name":"seasonal amplitude","score":0.6740000247955322},{"id":"https://openalex.org/keywords/interannual-temperature-variability","display_name":"interannual temperature variability","score":0.9480000138282776},{"id":"https://openalex.org/keywords/minimum-mortality-temperature","display_name":"minimum mortality temperature","score":0.9369999766349792},{"id":"https://openalex.org/keywords/climate-change-and-health","display_name":"climate change and health","score":0.39399999380111694},{"id":"https://openalex.org/keywords/china","display_name":"China","score":0.45899999141693115},{"id":"https://openalex.org/keywords/global-burden-of-disease","display_name":"global burden of disease","score":0.6710000038146973},{"id":"https://openalex.org/keywords/climate-zones","display_name":"climate zones","score":0.5410000085830688}],"concepts":[{"id":"https://openalex.org/C3020448403","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Burden of disease","level":3,"score":0.5917999744415283},{"id":"https://openalex.org/C39432304","wikidata":"https://www.wikidata.org/wiki/Q188847","display_name":"Environmental science","level":0,"score":0.5504999756813049},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.5454000234603882},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.507099986076355},{"id":"https://openalex.org/C49204034","wikidata":"https://www.wikidata.org/wiki/Q52139","display_name":"Climatology","level":1,"score":0.49050000309944153},{"id":"https://openalex.org/C167678106","wikidata":"https://www.wikidata.org/wiki/Q5283759","display_name":"Diurnal temperature variation","level":2,"score":0.4465000033378601},{"id":"https://openalex.org/C2780664029","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Disease burden","level":3,"score":0.4251999855041504},{"id":"https://openalex.org/C42683663","wikidata":"https://www.wikidata.org/wiki/Q3517834","display_name":"Mean radiant temperature","level":3,"score":0.4212999939918518},{"id":"https://openalex.org/C115343472","wikidata":"https://www.wikidata.org/wiki/Q7942","display_name":"Global warming","level":3,"score":0.4101000130176544},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3880000114440918},{"id":"https://openalex.org/C132651083","wikidata":"https://www.wikidata.org/wiki/Q7942","display_name":"Climate change","level":2,"score":0.3772999942302704},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.37389999628067017},{"id":"https://openalex.org/C191935318","wikidata":"https://www.wikidata.org/wiki/Q148","display_name":"China","level":2,"score":0.33709999918937683},{"id":"https://openalex.org/C134097258","wikidata":"https://www.wikidata.org/wiki/Q1507383","display_name":"Sea surface temperature","level":2,"score":0.3303000032901764},{"id":"https://openalex.org/C132459708","wikidata":"https://www.wikidata.org/wiki/Q744069","display_name":"Extrapolation","level":2,"score":0.3294000029563904},{"id":"https://openalex.org/C168754636","wikidata":"https://www.wikidata.org/wiki/Q620920","display_name":"Climate model","level":3,"score":0.31769999861717224},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.3050999939441681},{"id":"https://openalex.org/C204323151","wikidata":"https://www.wikidata.org/wiki/Q905424","display_name":"Range (aeronautics)","level":2,"score":0.30480000376701355},{"id":"https://openalex.org/C2983524802","wikidata":"https://www.wikidata.org/wiki/Q41299","display_name":"Quadratic model","level":3,"score":0.30320000648498535},{"id":"https://openalex.org/C49364354","wikidata":"https://www.wikidata.org/wiki/Q1293777","display_name":"Apparent temperature","level":3,"score":0.29739999771118164},{"id":"https://openalex.org/C159009313","wikidata":"https://www.wikidata.org/wiki/Q5283159","display_name":"Distributed lag","level":2,"score":0.2964000105857849},{"id":"https://openalex.org/C127142870","wikidata":"https://www.wikidata.org/wiki/Q7838279","display_name":"Trend analysis","level":2,"score":0.29249998927116394},{"id":"https://openalex.org/C41426520","wikidata":"https://www.wikidata.org/wiki/Q1192065","display_name":"Point estimation","level":2,"score":0.28850001096725464},{"id":"https://openalex.org/C2985831756","wikidata":"https://www.wikidata.org/wiki/Q107291880","display_name":"Maximum temperature","level":2,"score":0.28519999980926514},{"id":"https://openalex.org/C2993220731","wikidata":"https://www.wikidata.org/wiki/Q215864","display_name":"Heat wave","level":3,"score":0.2815000116825104},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.2680000066757202},{"id":"https://openalex.org/C607359","wikidata":"https://www.wikidata.org/wiki/Q845339","display_name":"Atmospheric temperature","level":2,"score":0.2648000121116638},{"id":"https://openalex.org/C107054158","wikidata":"https://www.wikidata.org/wiki/Q25257","display_name":"Precipitation","level":2,"score":0.26440000534057617},{"id":"https://openalex.org/C29374701","wikidata":"https://www.wikidata.org/wiki/Q1931388","display_name":"Cause of death","level":3,"score":0.2637999951839447},{"id":"https://openalex.org/C3018792137","wikidata":"https://www.wikidata.org/wiki/Q6914399","display_name":"Excess mortality","level":3,"score":0.2606000006198883}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.08.31.26361879","doi":"https://doi.org/10.64898/2026.08.31.26361879","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.31.26361879","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/02/2026.08.31.26361879.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.08.31.26361879","doi":"https://doi.org/10.64898/2026.08.31.26361879","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.31.26361879","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/02/2026.08.31.26361879.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0},{"id":"https://metadata.un.org/sdg/13","display_name":"Climate action","score":0.5351999998092651}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320315116","display_name":"Institute for Health Metrics and Evaluation","ror":"https://ror.org/02684h094"},{"id":"https://openalex.org/F4320321160","display_name":"Sun Yat-sen University","ror":"https://ror.org/0064kty71"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7206217617.pdf","grobid_xml":"https://content.openalex.org/works/W7206217617.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W1497902458","https://openalex.org/W1985376010","https://openalex.org/W2006203329","https://openalex.org/W2011743386","https://openalex.org/W2021600729","https://openalex.org/W2022981541","https://openalex.org/W2043524982","https://openalex.org/W2162775913","https://openalex.org/W2417537877","https://openalex.org/W2462161029","https://openalex.org/W2561220038","https://openalex.org/W2766890467","https://openalex.org/W3181205698","https://openalex.org/W4391449267","https://openalex.org/W4393858312","https://openalex.org/W4403899685","https://openalex.org/W4414623380","https://openalex.org/W4415091769","https://openalex.org/W4415092550","https://openalex.org/W4415092555"],"related_works":["https://openalex.org/W7206161255","https://openalex.org/W2913179812","https://openalex.org/W3122365816","https://openalex.org/W4280647152","https://openalex.org/W2096581150","https://openalex.org/W4413498177","https://openalex.org/W2954724106","https://openalex.org/W3126639245","https://openalex.org/W7121088301","https://openalex.org/W3022557627"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Childhood":[2],"respiratory":[3,27,46,259],"mortality":[4,28,40,87,102,247,260],"in":[5,12,122,126,185,249,257,296],"China":[6,43,266],"has":[7],"fallen":[8],"by":[9,119,135],"over":[10],"90%":[11],"three":[13],"decades":[14],"alongside":[15],"sustained":[16],"national":[17,20,212],"warming,":[18],"yet":[19],"long-run":[21],"evidence":[22],"on":[23,268],"temperature":[24,61,77,103,142,150,162,167,217],"and":[25,51,66,108,111,132,148,193,202,223,245,275],"child":[26],"is":[29,231],"lacking.":[30],"Methods":[31],"We":[32],"linked":[33],"Global":[34],"Burden":[35],"of":[36,85,228,272,279],"Disease":[37],"(GBD)":[38],"2021":[39],"estimates":[41],"for":[42,293],"\u2014":[44,56,215],"lower":[45],"infections":[47],"(LRI),":[48],"ages":[49,53],"0\u201319,":[50],"asthma,":[52],"0\u201324,":[54],"1990\u20132021":[55],"with":[57,89,105],"C-LSAT":[58],"0.5\u00b0":[59],"gridded":[60],"data":[62],"(1990\u20132019),":[63],"aggregated":[64],"nationally":[65],"to":[67,124,138,264,285],"five":[68],"climate":[69],"zones.":[70],"Four":[71],"annual":[72],"indicators":[73],"(mean":[74,161],"temperature,":[75],"diurnal":[76,149,166],"range,":[78,243],"seasonal":[79,172],"amplitude,":[80],"interannual":[81,177],"variability)":[82],"entered":[83],"regressions":[84],"log":[86,186],"rates":[88],"Newey\u2013West":[90],"standard":[91],"errors.":[92],"A":[93],"bootstrapped":[94],"(500":[95],"resamples)":[96],"quadratic":[97],"model":[98],"probed":[99],"the":[100,189,198,211,224,241,250,269,273,276],"minimum":[101],"(MMT),":[104],"PM2.5-adjusted":[106],"analyses":[107],"future-exposure,":[109],"permutation,":[110],"detrended":[112],"falsification":[113,288],"tests.":[114],"Results":[115],"LRI":[116],"deaths":[117,134],"fell":[118],"96.3%":[120],"(330,194":[121],"1990":[123],"12,098":[125],"2021;":[127],"95%":[128],"uncertainty":[129],"interval":[130],"9,669\u201314,891)":[131],"asthma":[133],"94.9%":[136],"(3,287":[137],"167),":[139],"while":[140],"mean":[141],"rose":[143],"0.364":[144],"\u00b0C":[145,154,184,230],"per":[146,155,182],"decade":[147],"range":[151,168],"narrowed":[152],"0.092":[153],"decade.":[156],"Baseline":[157],"coefficients":[158],"were":[159],"large":[160],"\u22121.696,":[163],"SE":[164,170,175,180],"0.174;":[165],"+2.408,":[169],"0.336;":[171],"amplitude":[173],"\u22120.162,":[174],"0.082;":[176],"variability":[178],"+2.924,":[179],"1.514,":[181],"1":[183],"rate),":[187],"but":[188],"future-exposure":[190],"test":[191],"failed":[192],"detrending":[194],"nullified":[195],"every":[196],"coefficient:":[197],"associations":[199],"are":[200,206],"trend-level,":[201],"short-cycle":[203],"causal":[204],"effects":[205],"not":[207],"identifiable.":[208],"Nor":[209],"was":[210],"MMT":[213],"identifiable":[214],"observed":[216,242],"support":[218],"spans":[219],"only":[220],"6.66\u20138.13":[221],"\u00b0C,":[222],"nominal":[225],"turning":[226],"point":[227],"35.84":[229],"an":[232],"extrapolation":[233],"artifact":[234],"(quadratic":[235],"term":[236],"p":[237],"=":[238],"0.963).":[239],"Within":[240],"warming":[244,281],"declining":[246],"moved":[248],"same":[251],"direction.":[252],"Conclusions":[253],"The":[254,287],"96%":[255],"decline":[256],"childhood":[258],"cannot":[261],"be":[262],"attributed":[263],"warming.":[265],"sits":[267],"low-temperature":[270],"side":[271],"optimum,":[274],"marginal":[277],"direction":[278],"future":[280],"requires":[282],"stronger":[283],"designs":[284],"establish.":[286],"framework":[289],"offers":[290],"a":[291],"discipline":[292],"climate\u2013health":[294],"inference":[295],"China.":[297]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-09-03T00:00:00"}