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Extreme heat in Arizona sent 11 people to hospital as they waited to enter a campaign rally with former President Donald Trump.
This week brought the first test of the year for millions of Americans in the south-west who routinely see high heat come summer.
Temperatures on Thursday were expected to hit as high as 112F (44C) in parts of Nevada, Texas and California, reaching 121F in California's scorching Death Valley.
As Trump took the stage just after 17:00 EST (22:00 GMT) in Phoenix, the temperature was 111F.
Trump fans began lining up for the event early on Thursday morning, local reporters said, in what was the first rally for the former president since his criminal conviction in a New York hush-money case.
There were several thousand people queuing outside the massive Phoenix Dream City Church to see Trump speak on Thursday.
Strict security measures meant it took time to get everyone inside the mega-church.
As supporters waited outside the campaign rally, BBC News saw several people being treated for heat-related issues and two were taken to hospital.
Eleven attendees in total were taken to hospital with heat-related symptoms, according to Phoenix Fire officials.
Firefighters were seen using ice to treat others and cool them down.
On Thursday - two weeks before summer even officially starts - the National Weather Service (NWS) forecast record-breaking temperatures in interior California, and parts of Nevada and Arizona.
In Phoenix, an excessive heat warning is in place through Friday, with people being asked to limit time outdoors and stay hydrated.
The forecast high of 112F in Las Vegas would be the city's earliest observed 112F day on record.
Temperatures will be 20 to 30 degrees Fahrenheit above average for this time of year, according to the NWS.
The intense heat has placed more than 30 million people across the south-west region under alerts for dangerously hot temperatures, with officials asking residents to take precautions.
Heat-related illness and even death are becoming more common in Phoenix and the American south-west.
While heat domes were once described as rare, heatwaves and heat domes are becoming more common and intense because of human-induced climate change, scientists say.
The world hit 12 straight months of record-high temperatures, the European Union's Copernicus Climate Change Service said earlier this week.
Last month was the hottest recorded May in history.
With reporting from Emma Vardy and Regan Morris in Phoenix