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Pulmonary tuberculosis (PTB) has been a major threat to global public health. The association between meteorological factors and the incidence of PTB has been widely investigated by the generalized additive model, auto-regressive integrated moving average model and the distributed lag model, etc. However, these models could not address a non-linear or lag correlation between them. In this paper, a penalized distributed lag non-linear model, as a generalized and improved one, was applied to explore the influence of meteorological factors (such as air temperature, relative humidity and wind speed) on the PTB incidence in Xinjiang from 2004 to 2019. Moreover, we firstly use a comprehensive index (apparent temperature, AT) to access the impact of multiple meteorological factors on the incidence of PTB. It was found that the relationships between air temperature, relative humidity, wind speed, AT and PTB incidence were nonlinear (showed "wave-type ", "invested U-type", "U-type" and "wave-type", respectively). When air temperature at the lowest value (−16.1 °C) could increase the risk of PTB incidence with the highest relative risk (RR = 1.63, 95% CI: 1.21–2.20). An assessment of relative humidity demonstrated an increased risk of PTB incidence between 44.5% and 71.8% with the largest relative risk (RR = 1.49, 95% CI: 1.32–1.67) occurring at 59.2%. Both high and low wind speeds increased the risk of PTB incidence, especially at the lowest wind speed 1.4 m/s (RR = 2.20, 95% CI: 1.95–2.51). In particular, the lag effects of low and high AT on PTB incidence were nonlinear. The lag effects of extreme cold AT (−18.5 °C, 1st percentile) on PTB incidence reached a relative risk peak (RR = 2.18, 95% CI: 2.06–2.31) at lag 1 month. Overall, it was indicated that the environment with low air temperature, suitable relative humidity and wind speed is more conducive to the transmission of PTB, and low AT is associated significantly with increased risk of PTB in Xinjiang. [ABSTRACT FROM AUTHOR]

The arid region of northwest China (ARNC) is one of the most sensitive areas to global warming. However, the performance of new Global Climate Models (GCMs) from phase 6 of the Coupled Model Intercomparison Project (CMIP6) in simulating climate in this region, especially in the subregions, is not clear yet. Based on the temperature dataset from historical runs of CMIP6, this paper analyzed and evaluated the simulation ability of 29 GCMs in reproducing the annual mean temperature (tas), annual mean maximum temperature (tasmax) and annual mean minimum temperature (tasmin) in the ARNC and subregions from 1961 to 2014. The results show that (1) the correlation coefficients (CCs) between simulation and observation time series for the mean of two model ensembles (MME for equal-weight multi-model ensemble and PME for preferred-model ensemble) are generally better than those of 29 individual GCMs, with CCs ranging from 0.38 to 0.87 (p < 0.01). (2) All the models can simulate the significant warming trend of the three temperature elements in the study area well. However, the warming magnitude simulated by most of the models (41%) is smaller than the observations except for tasmax, which is also shown in the MME. (3) The spatial pattern of the three temperature elements can be better reflected by most models. Model simulation ability for the ARNC is better compared to that of the four subregions, with a spatial CC greater than 0.7 (p < 0.01). Among the subregions, the simulation performance of the north of Xinjiang for spatial pattern is superior to that of the other regions. (4) The preferred models for each subregion are various and should be treated differently when used. Overall, the PME outperforms both the MME and the individual models; it can not only simulate the linear trend accurately but also reduce the deviation effectively. [ABSTRACT FROM AUTHOR]