Isabelle Marie Kramer

In Germany, insecticide use is recommended during mosquito-borne disease outbreaks, yet nationwide data on insecticide resistance in key vector species are scarce. This is particularly relevant for Culex pipiens s.l., a vector of West Nile virus. Here, we provide the first broad-scale assessment of molecular insecticide resistance (kdr and ace-1 mutations) in Cx. pipiens f. pipiens across Germany. We associated insecticide resistances with environmental conditions, potential links with mitochondrial variation of the cytochrome c oxidase I (COI) gene as well as phenotypic resistance (CDC bottle assay with permethrin) of the Frankfurt population with elevated kdr frequencies. Kdr resistance alleles were detected in German Cx. pipiens f. pipiens reaching frequencies of up to 50% in the metropolitan areas of Berlin and Frankfurt am Main. Annual precipitation was negatively associated with kdr allele frequency. Interesstingly, ace-1 resistance mutations were only present in the metropolitan area of Frankfurt am Main and in Muggensturm (Rhine valley, southwestern Germany). COI haplotype analyses revealed low genetic variability within German Cx. pipiens f. pipiens populations with no association to the insecticide resistance genotype. Phenotypic assays of the Frankfurt population showed early signs of permethrin resistance, but unmatched genotypic and phenotypic resistance state. This study provides the first broad-scale assessment of molecular insecticide resistance in Cx. pipiens f. pipiens across Germany, establishing a baseline for resistance surveillance and vector control. Further research is needed to identify factors shaping phenotypic resistance, as molecular markers alone may not reliably predict resistance. Since sampling was restricted to urban green spaces, broader sampling across environmental gradients is needed to identify additional environmental effectors.

The frequency and intensity of storms are influenced by climate change. That will lead to more dangerous disasters that will reach additional parts of the world, claim human lives, destroy environmental niches, reduce biodiversity, and cause enormous economic costs. Assessing, preparing for, and understanding what lies ahead is essential for all stakeholders, but it is also challenging, as many uncertainties remain. To enable better planning, financing, and research, this study aims to provide relevant scientific background information on previous scientific efforts and on what should be done and by whom. Most publications deal with tropical cyclones. In addition to the principal scientific players, the USA and China, several European countries are particularly involved in research into storms related to climate change (S _CC ). Australia and New Zealand are at the top of the socioeconomic indicator rankings. Measured by the number of S _CC articles per storm-related death, Israel leads. These countries have their own regional interests in S _CC , but tropical cyclone disasters in the USA have the greatest impact on the global scientific landscape. Hurricane Katrina in 2005 significantly increased the number of publications on S _CC , and Hurricanes Sandy and Harvey further increased it. Various research approaches are already being brought together internationally in scientific networks, particularly for modeling and simulating storm behavior under changing climatic conditions. However, there is an urgent need for globally supported regional programs and strategies to address and anticipate future storm-related disasters. These efforts should continue to be underpinned by scientific evidence, particularly considering the interconnectedness and vulnerability of severely affected low-income countries.

Background: Although almost two-thirds of medical students in Germany are female, medical leadership positions remain predominantly held by men. This study investigated gender-specific career progression in psychiatry/psychotherapy and neurology, two closely related clinical specialties, using spatio-temporal analyses over a 20-year period. Methods: The study analyzed five time points (2004, 2009, 2014, 2019, and 2024) to evaluate the temporal and spatial distribution of gender representation across Germany. Data on medical students, hospital-based specialists in psychiatry/psychotherapy and neurology, and department chairs were obtained from the Federal Statistical Office, the Federal Chamber of Physicians, and the medical faculties of 38 universities. Female-to-male ratios (f:m) were calculated for each career stage and applied to the established academic Brüggmann-Groneberg (BG) Index and to a newly developed clinical leadership version introduced in this study (BGclin Index). Results: In 2024, 64.9% of German medical students were female. Gender parity was reached among hospital-based specialists in psychiatry/psychotherapy and neurology, with f:m ratios increasing from 0.71 (2004) to 1.17 (2024) and from 0.40 (2004) to 1.00 (2024), respectively. Women remained markedly underrepresented in clinical leadership roles (2024 psychiatry/psychotherapy: 0.48; neurology: 0.23) and among department chairs (2024 psychiatry/psychotherapy: 0.15; neurology: 0.14). BG Indices reflected these disparities, with the highest academic BG Index observed in psychiatry/psychotherapy in 2019 (0.112) and in neurology in 2019 (0.091), while BGclin values remained higher, around 0.199 in psychiatry/psychotherapy and around 0.120 in neurology. Spatial analysis revealed substantial regional variation across Germany, with persistent gender disparities across federal states. Conclusions: Despite achieving gender parity at the specialist level, substantial gender disparities persist in both academic and clinical leadership in the examined specialties. The BG Indices highlighted a sustained disparity in women’s advancement, which was more pronounced in neurology than in psychiatry/psychotherapy.

Climate warming is intensifying heatwaves across Europe, but the upper thermal limits of arboviral mosquito vectors—and their implications for future distribution—remain poorly understood. Using experimentally derived life‐stage‐specific upper thermal limits, we identified the impact of heat extremes on the persistence of Culex pipiens , Aedes albopictus and Aedes aegypti in Europe under present and future climate scenarios (SSP126, SSP370 and SSP585). Our projections reveal that by 2100, large parts of southern Europe, including the Iberian Peninsula, will exceed the thermal limits for Cx. pipiens , with heat‐limited zones expanding northward into central Europe. Aedes albopictus faces moderate future constraints, while Ae. aegypti remains largely unrestricted by extreme heat, though high mortality at low humidity may still limit its establishment in continental Europe. Divergent plasticity in heat tolerance among life‐stages, species, their acclimation status and the interplay with humidity exposure underscore the complexity of thermal adaptation. This integrative experimental‐modelling framework highlights when and where it may become too hot for Europe's major mosquito vectors, refining spatial risk forecasts for arbovirus emergence under climate change.

Due to the sharp increase in dengue infections in recent years, developing effective and regionally adapted vaccines is imperative. This requires research strategies aimed at vaccines that are free of side effects and effective for all four serotypes. Currently, two vaccines are licenced in some countries, each with certain restrictions. Advanced vaccines are in demand. This study, therefore, analyzes what has been done so far, by whom, and under what conditions. Who has benefited, and where is there an urgent need for further research? An advanced strategy with chronological, geographical, and socio‐economic patterns was applied to answer these questions. A total of 1758 publications and 137 clinical studies were identified. The results show that the pharmaceutical industry dominates the research both in their countries of origin and in their study sites. Sustainable collaboration between academic institutions, industry, and government agencies is crucial for research on DENV _VAC. However, this generally applies to vaccine research, in which universities and industry play an important role. Depending on historical networking, better or worse conditions have developed for regional research. The Global South is exemplified by South American nations like Brazil, which is actively developing its vaccine, as well as by Southeast Asian countries such as India, which is also pursuing the development of its vaccine. Africa is not represented in the research, although there is evidence of virus circulation and a potentially underestimated disease burden. Financial support comes mainly from government agencies, except in France and Japan, where industry sets the research framework. This results in a clear regional concentration of research, which can be explained by the lack of access to reliable monitoring and serological data, but also by the regional interests of pharmaceutical companies, their resources, and financial support. This is what future research must be concerned with.

Due to the sharp increase in dengue infections in recent years, developing effective and regionally adapted vaccines is imperative. This requires research strategies aimed at vaccines that are free of side effects and effective for all four serotypes. Currently, two vaccines are licenced in some countries, each with certain restrictions. Advanced vaccines are in demand. This study, therefore, analyzes what has been done so far, by whom, and under what conditions. Who has benefited, and where is there an urgent need for further research? An advanced strategy with chronological, geographical, and socio-economic patterns was applied to answer these questions. A total of 1758 publications and 137 clinical studies were identified. The results show that the pharmaceutical industry dominates the research both in their countries of origin and in their study sites. Sustainable collaboration between academic institutions, industry, and government agencies is crucial for research on DENV_VAC. However, this generally applies to vaccine research, in which universities and industry play an important role. Depending on historical networking, better or worse conditions have developed for regional research. The Global South is exemplified by South American nations like Brazil, which is actively developing its vaccine, as well as by Southeast Asian countries such as India, which is also pursuing the development of its vaccine. Africa is not represented in the research, although there is evidence of virus circulation and a potentially underestimated disease burden. Financial support comes mainly from government agencies, except in France and Japan, where industry sets the research framework. This results in a clear regional concentration of research, which can be explained by the lack of access to reliable monitoring and serological data, but also by the regional interests of pharmaceutical companies, their resources, and financial support. This is what future research must be concerned with.

The Hindu Kush Himalayan region is a global hotspot for climate change and highly vulnerable to its direct and indirect impacts. Understanding people’s perception of climate change is crucial for effective adaptation strategies. We conducted a study by using quantitative (Household survey, n = 660) and qualitative data collection tools (Focus group discussion, n = 12; In-depth interviews, n = 27) in central Nepal encompassing three altitudinal regions: Lowland (<1000 m amsl; Terai region), Midland (1000–1500 m amsl; hilly region) and Highland (1500–2100 m amsl; mountainous region). We analyzed 37 years (1981–2017) of climatic data from respective districts (Lowland: Chitwan, Dhading; Midland: Kathmandu, Lalitpur; Highland: Nuwakot, Rasuwa). People’s perception was compared with climate extreme indices measured along these regions and evaluated if they accurately recognized the impacts on the environment and human health. Our findings show significant climate changes, including rising summer temperature, region-specific winter temperatures and extended monsoon seasons in Nepal. Participants in our study accurately perceived these trends but misperceived heavy precipitation patterns. Reported impacts are rise in crop diseases, human diseases, vector expansion and climate induced disasters like floods, landslides, and water resource depletion, with perception accuracy varying by region. These insights highlight the importance of understanding regional and cross-regional perceptions in relation to climate data in order to develop tailored climate adaptation strategies. Policymakers can use this information to establish region-specific educational and communication initiatives, addressing communities’ distinctive vulnerabilities and needs across diverse landscapes. Such approaches can enhance equitable and effective climate resilience in subtropical to alpine regions.

Driven by globalization, urbanization and climate change, the distribution range of invasive vector species has expanded to previously colder ecoregions. To reduce health‐threatening impacts on humans, insect vectors are extensively studied. Population genomics can reveal the genomic basis of adaptation and help to identify emerging trends of vector expansion. By applying whole genome analyses and genotype‐environment associations to populations of the main dengue vector Aedes aegypti, sampled along an altitudinal gradient in Nepal (200–1300 m), we identify putatively adaptive traits and describe the species' genomic footprint of climate adaptation to colder ecoregions. We found two differentiated clusters with significantly different allele frequencies in genes associated to climate adaptation between the highland population (1300 m) and all other lowland populations (≤800 m). We revealed nonsynonymous mutations in 13 of the candidate genes associated to either altitude, precipitation or cold tolerance and identified an isolation‐by‐environment differentiation pattern. Other than the expected gradual differentiation along the altitudinal gradient, our results reveal a distinct genomic differentiation of the highland population. Local high‐altitude adaptation could be one explanation of the population's phenotypic cold tolerance. Carrying alleles relevant for survival under colder climate increases the likelihood of this highland population to a worldwide expansion into other colder ecoregions.

Background: The common house mosquito Culex pipiens is known to be a major vector for West Nile virus. In order to decrease risks of West Nile virus outbreaks in Europe, insecticides and the bio-larvicide Bacillus thuringiensis israelensis (Bti) are commonly used for vector control. Alarmingly, insecticide resistance has been reported in Cx. pipiens populations from Southern Europe and several countries neighbouring Europe. For Central and Northern Europe, however, the phenotypic insecticide resistance status of Cx. pipiens has not yet been investigated. Methods: A literature review was performed to assess the geographical distribution of insecticide resistance in Cx. pipiens. To fill the gap of knowledge for Central and Northern Europe, WHO susceptibility tests with permethrin, deltamethrin, malathion, bendiocarb and DDT and a larval toxicity test with Bti were performed with a Cx. pipiens population from Belgium, a country in Central Europe. Results: This research provides the first evidence of widespread phenotypic insecticide resistance in Cx. pipiens. In general, Cx. pipiens developed resistance against multiple insecticides in several countries. Another Cx. pipiens population from Belgium was tested and showed insecticide resistance against deltamethrin, permethrin, DDT and possibly against bendiocarb. The bio-larvicide Bti caused lower mortality than reported for other Cx. pipiens populations in the literature. Conclusions: These results indicate the urgent need for insecticide resistance monitoring against commonly used adulticides and larvicides in Europe, for the translation of knowledge gained regarding the limited efficiency and availability of insecticide into EU legislation and the need for innovative non-chemical vector control tools in order to counter the widespread insecticide resistance in Culex populations. Graphical

Background: Vector-borne diseases are on the rise on a global scale, which is anticipated to further accelerate because of anthropogenic climate change. Resource-limited regions are especially hard hit by this increment with the currently implemented surveillance programs being inadequate for the observed expansion of potential vector species. Cost-effective methods that can be easily implemented in resource-limited settings, e.g. under field conditions, are thus urgently needed to function as an early warning system for vector-borne disease epidemics. Our aim was to enhance entomological capacity in Nepal, a country with endemicity of numerous vector-borne diseases and with frequent outbreaks of dengue fever.Methods: We used a field barcoding pipeline based on DNA nanopore sequencing (Oxford Nanopore Technologies) and verified its use for different mosquito life stages and storage methods. We furthermore hosted an online workshop to facilitate knowledge transfer to Nepalese scientific experts from different disciplines.Results: The use of the barcoding pipeline could be verified for adult mosquitos and eggs, as well as for homogenized samples, dried specimens, samples that were stored in ethanol and frozen tissue. The transfer of knowledge was successful, as reflected by feedback from the participants and their wish to implement the method.Conclusions: Cost effective strategies are urgently needed to assess the likelihood of disease outbreaks. We were able to show that field sequencing provides a solution that is cost-effective, undemanding in its implementation and easy to learn. The knowledge transfer to Nepalese scientific experts from different disciplines provides an opportunity for sustainable implementation of low-cost portable sequencing solutions in Nepal.Graphical