Very high air pollution event on 2-5 Nov 2023 in Delhi NCR couldn’t be explained by crop residue burning

Reports and Proceedings

RESEARCH INSTITUTE FOR HUMANITY AND NATURE

 

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FIGURE 1: TIME SERIES OF PM2.5 MEASURED AT THE CUPI-G SITES IN PUNJAB, HARYANA AND DELHI NCR DURING 01 OCT TO 06 NOV OF 2022 AND 2023. WE ALSO DEPICT THE RAINFALL AROUND THE SITES IN BOTH YEARS BY GREEN BARS, AND THE GREEN/RED DOTS ARE MARKED ON THE FINAL DAY OF MEASUREMENTS. DATA SUBJECTED TO FINAL QUALITY CONTROL (QA/QC).

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CREDIT: AAKASH PROJECT, RIHN

While cricket world cup games are waiting to be played in Delhi stadiums, celebration of goddess Durga’s defense of demon attack is just finished, festival of lights Diwali is just around the corner, but various activities in the Delhi National Capital Region (NCR) were restricted to protect residents from exposure to air pollution, i.e., particulate matter less than 2.5 µm in diameter (PM2.5). This is not for first time and will not be for the last as well until the policymakers work in harmony, based on scientific evidences, to limit direct emissions of air pollutants. 

Since the late October this year we can find how many crop residue burning (CRB) hotspots are detected in Punjab and Haryana, how the farmers are being tracked for their activities by the law-and-order departments. Tens of newspapers in English language alone are covering the daily updates on the situation on crop residue burning in the neighbouring states of Haryana and Punjab. But none have raised a question whether the CRB in Punjab is single most important cause of overall increase in air pollution through the month of October 2023 or in the earlier years, and the eventual closure of Delhi NCR on 2nd Nov 2023.

In 2022, a group of international collaborators led by the Research Institute for Humanity and Nature (RIHN) team have conducted field campaign in the region of Punjab, Haryana and Delhi NCR (Singh et al., 2023; RIHN press release on 2nd Oct 2023). A network of about 30 low-cost Compact and Useful PM2.5 Instrument with Gas sensors (CUPI-Gs) has been established in the region for this year as well (Figure 1). These measurements, for the first time, provided a wholesome picture of month-long CRB activities in the source regions and their contribution to the limited number of high PM2.5 events over the Delhi NCR. In the air pollution events that occurred in Delhi last November, the impact of CRB was found to be severe. Our analysis also suggested its predictive capability by using the data from the whole CUPI-G measurements (Singh et al., 2023; unpublished analysis).

In response to recent reports suggesting that farming practices such as crop residue burning are the primary cause of air pollution in New Delhi, scientists in Japan and India are today setting the record straight. Their research and analysis (e.g., Figure 2) shows conclusively that blaming farmers for the city's air pollution crisis is not only misleading but also unjust. The data show that the real culprit is local emissions of Delhi NCR itself, which coupled with the recent adverse weather, has led to recent spikes in levels of PM2.5. The FLEXPART model simulation (Takigawa et al., 2020), representing fire emission tracer from the Visible Infrared Imaging Radiometer Suite (VIIRS) fire detections, shows the transport of airmass were limited to the source regions of Punjab and Haryana, and transported to the southern and western area more frequently than to the Delhi NCR.

Our analysis shows contrasting behaviour in two markers for CRB, carbon monoxide (CO) and PM2.5. These pollutants have evolved quite differently in recent days as shown at 4 selected sites, with both PM2.5 and CO increasing rapidly on 02nd Nov 2023 at Jawaharlal Nehru University (JNU) and other sites in Delhi NCR, but values increased much more slowly in the source region in Punjab and Haryana (Figure 3). What does this mean? Firstly, that CO and PM2.5 levels must be coming from common sources - their behaviour can't be explained through a single phenomenon such as crop residue fires, but local burning related sources must have large contributions (e.g., Mishra et al., 2023). Secondly, the behaviour of the background levels points to a local source of pollution, pollution that is trapped nearby and not blown away/in on the winds. Delhi NCR has in fact experiencing the consequences of their own local emissions. The weather pattern traps the air over Delhi NCR and prevents its dispersal. This build-up has led to the current crisis.

When we think about air pollution in Delhi NCR, it's wrong to hurry to judgement. Sometimes the real causes behind this emergency are industrial emissions, vehicular pollution, urban construction and developments and other urban factors that often go unchecked (e.g., Sawlani et al., 2018). As a community, we must address all causes of air pollution and not abjugate agricultural community only.

Aakash Project at the Research Institute for Humanity and Nature (RIHN), Japan is working closely with Indian counterparts to address the issue of "An Interdisciplinary Study toward Clean Air, Public Health and Sustainable Agriculture: The Case of Crop Residue Burning in North India". The article is prepared with inputs from Paul Griffiths of Cambridge University (visiting scientist at JAMSTEC), who is not a member of Aakash project, and we acknowledge his contribution.

* The second report is available at https://www.chikyu.ac.jp/rihn_e/news/detail/414/

Figure 2: showing the progression of daily mean PM2.5 at CUPI-G sites (red dots), VIIRS fire counts and rainfall maps, and NCEP-FNL wind vectors at 10 m height.

Figure 3: Day (0600-1800 IST) and night (1800-0600 IST) time average values of PM2.5 and CO at 4 selected sites. CO can be used as a tracer for (incomplete) biomass burning. Analysis based on data subjected to final QA/QC.

CREDIT

Aakash Project, RIHN

ARTICLE PUBLICATION DATE

8-Nov-2023

 

Putting an end to plastic separation anxiety

Researchers have developed a process to break down the mixture of conventional and bio-based plastics that ends up at recycling centers

Peer-Reviewed Publication

DOE/LAWRENCE BERKELEY NATIONAL LABORATORY

 

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AN ILLUSTRATION SHOWCASING THE DIFFICULTY OF CORRECTLY SORTING PLASTIC AND PLASTIC-LIKE MATERIALS.

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CREDIT: JENNY NUSS/BERKELEY LAB

Bio-based plastics such as polylactic acid (PLA) were invented to help solve the plastic waste crisis, but they often end up making waste management more challenging. Because these materials look and feel so similar to conventional, petroleum-based plastics, many products end up not in composters, where they break down as designed, but instead get added to the recycling stream by well-intentioned consumers. There, the products get shredded and melted down with the recyclable plastics, bringing down the quality of the mixture and making it harder to manufacture functional products out of recycled plastic resin. The only solution, currently, is to try to separate the different plastics at recycling facilities. Yet even with the most high-end, automated sorting tools, some biobased plastics end up contaminating the sorted streams.

Scientists at Lawrence Berkeley National Laboratory (Berkeley Lab) and the Joint BioEnergy Institute (JBEI) are collaborating with X – the moonshot incubator led by Alphabet, Google’s parent company – to not only skip the problematic separation step, but also make the final product better for the planet. 

The team has invented a simple “one pot” process to break down mixtures of petroleum-based and bio-based plastics using naturally derived salt solutions paired with specialized microbes. In a single vat, the salts act as a catalyst to break the materials down from polymers, large structures of repeating molecules bonded together, into the individual molecules called monomers, which the microbes then ferment into a new type of biodegradable polymer that can be made into fresh commodity products. The process is described in a One Earth paper published November 17.

“It’s sort of ironic because the purpose of using bio-based plastics is to be more sustainable, but it’s causing problems,” said first author Chang Dou, a senior scientific engineering associate at the Advanced Biofuels and Bioproducts Process Development Unit (ABPDU) at Berkeley Lab. Dou was recently named as one of the American Institute of Chemical Engineer’s 35 Under 35. “Our project is trying to get around the separation issue and make it so you don’t have to worry about whether you mix your recycling bin. You can put all the plastic in one bucket.” 

In addition to streamlining recycling, the team’s approach could enable bio-based manufacturing of other valuable products using the same bacteria that are happily munching on plastic monomers. Imagine a world where biofuels or even medicines could be made from plastic waste – of which there is about 8.3 billion tons sitting around in landfills.  

“There is an open discussion on whether we can use waste plastics as a carbon source for biomanufacturing. It is a very advanced idea. But we proved that using waste plastics, we can feed microbes. With more genetic engineering tools, microbes might be able to grow on multiple types of plastics at the same time. We foresee the potential to continue this study where we can replace the sugars, traditional carbon sources for microbes, with the processed hard-to-recycle mixed plastics that can be converted to valuable products through fermentation,” said Zilong Wang, a UC Berkeley postdoctoral researcher working at JBEI. 

The Berkeley Lab scientists’ next step is to experiment with other organic salt catalysts to try to find one that is both highly effective at breaking polymers down and can be reused in multiple batches to lower costs. They are also modeling how the process would work at the large scales of real-world recycling facilities. 

In their recent paper, the scientists demonstrated the potential of their approach in laboratory bench-scale experiments with mixtures of polyethylene terephthalate (PET) – the most common petroleum-based plastic, used in things like water bottles and spun into polyester fibers – and PLA, the most common bio-based plastic. 

They used an amino-acid-based salt catalyst previously developed by colleagues at JBEI  and a strain of Pseudomonas putida engineered by scientists at Oak Ridge National Laboratory. This combination successfully broke down 95% of the PET/PLA mixture and converted the molecules into a type of polyhydroxyalkanoate (PHA) polymer. PHAs are a new class of biodegradable plastic substitutes designed to efficiently break down in a variety of natural environments, unlike petroleum-based plastics.

Team member Hemant Choudhary noted that although their chemical recycling process is currently only proven for PET plastics contaminated with biodegradable PLA, it would still be beneficial for the diverse plastic streams encountered in real recycling facilities. “It can be completely integrated with existing plastic sources,” said Choudhary, a Sandia National Laboratories staff scientist working at JBEI. Most commercial products are not just one kind of plastic, but a handful of different kinds combined, he explained. For example, a fleece jacket is made with PET-based polyesters alongside polyolefins or polyamides. “We can throw it in our one-pot process and easily process the polyester component from that mixture and convert it into a bioplastic. These monomers are soluble in water, but the leftover parts, the polyolefins or polyamides, are not.” The leftovers can be easily removed by simple filtration and then sent off for a traditional mechanical recycling process where the material is shredded and melted, said Choudhary. 

“Chemical recycling has been a hot topic, but it’s difficult to make it happen at the commercial scale because all the separation steps are so expensive,” said Ning Sun, a staff scientist at the ABPDU, lead author, and principal investigator of this project. "But by using a biocompatible catalyst in water, the microbes can directly convert the depolymerized plastics without extra separation steps. These results are very exciting, although we acknowledge that a number of improvements are still needed to realize the economic viability of the developed process.”

Co-authors Nawa R. Baral and Corinne Scown, experts in technoeconomic analysis in JBEI and Berkeley Lab’s Biosciences Area, also demonstrated that once optimized with a reusable salt solution, the process could reduce the cost and carbon footprint of PHAs by 62% and 29%, respectively, compared with today’s commercial PHA production.

JBEI is a Department of Energy (DOE) Bioenergy Research Center managed by Berkeley Lab. The ABPDU is a collaboration facility supported by the DOE BioEnergy Technologies Office.

 

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Founded in 1931 on the belief that the biggest scientific challenges are best addressed by teams, Lawrence Berkeley National Laboratory and its scientists have been recognized with 16 Nobel Prizes. Today, Berkeley Lab researchers develop sustainable energy and environmental solutions, create useful new materials, advance the frontiers of computing, and probe the mysteries of life, matter, and the universe. Scientists from around the world rely on the Lab’s facilities for their own discovery science. Berkeley Lab is a multiprogram national laboratory, managed by the University of California for the U.S. Department of Energy's Office of Science.
 
DOE's Office of Science is the single largest supporter of basic research in the physical sciences in the United States, and is working to address some of the most pressing challenges of our time. For more information, please visit energy.gov/science.

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JOURNAL

One Earth

ARTICLE TITLE

A hybrid chemical-biological approach can upcycle mixed plastic waste with reduced cost and carbon footprint

ARTICLE PUBLICATION DATE

17-Nov-2023

 

Evidence of climate change in the North Atlantic can be seen in the deep ocean, study finds

North Atlantic circulation reduced little Ice Age cooling

Peer-Reviewed Publication

WOODS HOLE OCEANOGRAPHIC INSTITUTION

 

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THIS SHOWS THE MULTICORER BEING RECOVERED. THE SEDIMENT IN THE TUBES IS APPROXIMATELY HOW MUCH HAS ACCUMULATED IN THE PAST 1,000 YEARS. 

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CREDIT: PHOTO CREDIT: PROF. IAN HALL (CARDIFF UNIVERSITY.)

Woods Hole, Mass. (November 17, 2023) –Evidence of climate change in the North Atlantic during the last 1,000 years can be seen in the deep ocean, according to a newly published paper led by researchers from the Woods Hole Oceanographic Institution (WHOI) and University College London. 

The paper, “Surface climate signals transmitted rapidly to deep North Atlantic throughout last millennium,” published in Science, presents records from North Atlantic sediments that agree with observations of recent surface and deep ocean warming and freshening. 

The scientists’ data also show a connection between the surface and the deep ocean throughout the last 1,200 years. This time period includes climate oscillations such as the warm Medieval Climate Anomaly (around 850-1250 Common Era, CE) and the cold Little Ice Age spanning around 1400-1850 CE], as well as modern warming.

“Our data provide strong support for the idea that the overflows have consistently transferred surface climate changes to the deep ocean throughout the past 1,200 years,” said article lead author Wanyi Lu, a post-doctoral scientist at WHOI. 

The scientists used samples from 11 sediment cores taken from the sea south of Iceland, where overflows of cold, dense waters from the Nordic seas sink and fill the deep North Atlantic. These overflows are a part of the deep limb of the Atlantic Meridional Ocean Circulation, which acts like a conveyor belt in carrying warm surface water north from the equator and returning cool deep water south. 

The Earth’s surface has gotten warmer in the past hundred years. However, the ocean has slowed this warming by absorbing and storing more than 90% of the excess heat. 

“We provide evidence that the deep ocean cooled from the Medieval Climate Anomaly to the Little Ice Age. This means that the deep ocean gave heat back to the atmosphere, and therefore reduced Little Ice Age surface cooling. This is the same process –but acting in the opposite direction –that has caused the ocean to reduce modern surface warming,” said Lu.

From the sediment cores, the researchers removed the tiny fossil shells of foraminifera (single-celled organisms living in surface and deep water) and measured the chemistry of the shells. This gave the researchers information about the ocean’s environment when those foraminifera lived and formed their shells. 

A key finding of the study is that most of the surface and deep records show warming and freshening during the 20th century, whereas most surface and deep records show that the Little Ice Age was cooler than the Medieval Climate Anomaly.

“The 20th-century changes we see in our surface records agree with the fast warming and freshening of North Atlantic surface waters that we know from modern measurements. This gives us confidence that the older surface and deep ocean changes we see are reliable, and that the deep North Atlantic was cooling before the current warming,” said Lu. 

 

“Since we don't have a long record of deep ocean temperature from thermometers, these data fill an important gap” said co-author Jake Gebbie, a senior scientist and physical oceanographer at WHOI. “These observations promise to reduce our dependence on climate models to understand how Earth's climate varies.” 

The study also shows that local differences and short-term changes at the ocean surface are averaged by the deep ocean. This means that in locations with a strong surface to deep connection, climate reconstructions from the deep ocean could be a better monitor than individual surface records for the timing and size of surface climate changes that took place on decadal and longer time scales. 

“Many researchers focus on the upper ocean because that is where most of the excess heat is stored in the modern ocean. However, at the location where we sampled sediment cores – the overflow region where surface water from the Nordic seas flows over the Iceland-Scotland ridge and sinks to great depths – there is a pathway for heat and carbon to be transferred from the surface to the deep Atlantic,” said co-author Delia Oppo, a senior scientist and paleoceanographer at WHOI. 

“Our work suggests that the deep ocean is feeling the heat that human activities have been generating. Climate change is recorded in the deep ocean.” Lu said. 

Oppo added, “People should understand how important the ocean is to their climate. Without the ocean uptake of heat, global warming would be even worse than it is.” 

Funding for this research was provided by the National Science Foundation; WHOI’s Edna McConnell Clark Foundation Fund; and the WHOI Postdoctoral Scholar Program, with funding provided by the Weston Howland Jr. Postdoctoral Scholarship. 

Authors: Wanyi Lu1*, Delia Oppo1, Geoffrey Gebbie1, David Thornalley 1,2 

 

Affiliations: 

1Woods Hole Oceanographic Institution, Woods Hole, MA, USA 

2Department of Geography, University College London, London, UK 

*Corresponding author 

 

About Woods Hole Oceanographic Institution 

The Woods Hole Oceanographic Institution (WHOI) is a private, non-profit organization on Cape Cod, Massachusetts, dedicated to marine research, engineering, and higher education. Established in 1930, its primary mission is to understand the ocean and its interaction with the Earth as a whole, and to communicate an understanding of the ocean’s role in the changing global environment. WHOI’s pioneering discoveries stem from an ideal combination of science and engineering—one that has made it one of the most trusted and technically advanced leaders in basic and applied ocean research and exploration anywhere. WHOI is known for its multidisciplinary approach, superior ship operations, and unparalleled deep-sea robotics capabilities. We play a leading role in ocean observation and operate the most extensive suite of data-gathering platforms in the world. Top scientists, engineers, and students collaborate on more than 800 concurrent projects worldwide—both above and below the waves—pushing the boundaries of knowledge and possibility. For more information, please visit www.whoi.edu 

Key takeaways: 

• The study presents high-resolution records from North Atlantic sediments that agree with instrumental observations of 20th century surface and deep warming and freshening. 

• The results suggest that Earth's cooling climate from the Medieval Climate Anomaly to the Little Ice was transmitted to the deep North Atlantic by an active overflow. 

• The results imply that ocean circulation reduced the size of surface climate change that occurred between the warmest part of Medieval Climate Anomaly and the coldest part of the Little Ice Age. 

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JOURNAL

Science

DOI

10.1126/science.adf1646 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Surface climate signals transmitted rapidly to deep North Atlantic throughout last millennium

ARTICLE PUBLICATION DATE

17-Nov-2023

 

Biomedical engineers at Case Western Reserve University, University of Chicago to restore sense of feeling for breast cancer patients

CASE WESTERN RESERVE UNIVERSITY
GRANT AND AWARD ANNOUNCEMENT

CLEVELAND—With a $3.99 million grant from the National Institutes of Health, biomedical engineers from Case Western Reserve University and the University of Chicago will begin testing an implantable device that restores the sense of touch to breast cancer patients after reconstructive surgery.

In this project, a medical device called a C-FINE­ will send touch signals to the nervous system. This type of technology has been used to provide a sense of touch to a prosthetic device after a limb is amputated.  

But the study marks the first application of the C-FINE in intercostal nerves, which communicate signals from the breast. Once implanted, the research team will investigate how to stimulate the nerves to create the sense of touch on the breast and how to shape the sensory experience.

“Losing a breast to cancer can be a devastating experience,” said Emily Graczyk, an assistant professor of biomedical engineering, who is leading the work at Case Western Reserve. “In addition to facing the psychological challenges of mastectomy, such as grief and social stigma, breast cancer survivors also have to contend with lifelong numbness and pain that frequently results from having the breasts removed.”

Graczyk and her team have been studying nerve stimulation to restore sensation to people with limb loss and spinal cord injury for more than a decade. They will join their expertise in neuromodulation with the University of Chicago team’s clinical expertise in breast cancer treatment and surgery. The University of Chicago team is led by Stacy Tessler Lindau, professor of obstetrics and gynecology.

The work builds on research by Dustin Tyler, a professor of biomedical engineering at Case Western Reserve and consultant on the NIH project. His vast research has demonstrated that nerve stimulation can recreate the sense of touch for people who have lost limbs.

“We’ve conducted extensive studies over the past decade to understand how to provide useful information to the nerves,” Tyler said. “Because this technology has already shown a positive impact for people with limb amputation, we’re highly optimistic that similar benefits will be possible for breast cancer survivors.”

Clinical trials

To test the device, the team will recruit patients scheduled for a bilateral mastectomy for breast cancer in Chicago. The mastectomy and initial phase of breast reconstruction will occur concurrently with the implantation of the C-FINE device, which wraps around the intercostal nerve branches. Thin, flexible wires will exit the skin under the arm to connect to an external neurostimulation system.

In a lab, the researchers will test the system by sending small electrical signals to the implanted electrodes around the nerves. These electrical signals activate the nerves to create touch sensation. Patients will describe aspects of the sensations, including their location, intensity and how natural it feels. The stimulation can be adjusted to improve the sensations.

In the clinical trial’s initial phase, the devices will be removed when the patient returns for the second phase of reconstructive surgery. But the long-term goal is to create a permanent system patients can use in their daily lives.

The technology is still being developed to create this permanent, fully implanted system for patients to use outside the lab. Researchers at the University of Chicago are creating an implanted flexible sensor, which will be placed beneath the areola and nipple, to detect touches applied to the breast.

The device would then send an electrical output to the neural interfacing system. Future phases of the clinical trial will test the sensor, as well as fully implanted versions of the electronic components, for effects on sensation and pain over longer periods.

“Without sensation in the breast, cancer survivors struggle to know when clothing or people are touching their body, which can be distressing,” Graczyk said. “Imagine hugging your spouse or child and feeling nothing from your chest. The emotional connection could feel muted. We believe nerve stimulation will be able to provide realistic touch sensation to the breast, which will help women find a new sense of normalcy at the end of their fight against breast cancer.”

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Case Western Reserve University is one of the country's leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing and social work. About 6,000 undergraduate and 6,300 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.

17-Nov-2023

 

U$A

State reporting requirements for involuntary holds, court-ordered guardianship, and the national firearm background check system

JAMA Health Forum

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this study of state laws, there was substantial heterogeneity in National Instant Criminal Background Check System (NICS) reporting requirements for mental health prohibitions for firearm possession and a lack of clarity around processes. This raises questions about the ability of NICS to be used to block firearm purchases or possession by individuals with court-identified high risk of perpetrating violence toward themselves or others. 

Authors: Marian E. Betz, M.D., M.P.H., of the University of Colorado Anschutz Medical Campus School of Medicine in Aurora, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamahealthforum.2023.3945)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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Embed this link to provide your readers free access to the full-text article 

https://jamanetwork.com/journals/jama-health-forum/fullarticle/10.1001/jamahealthforum.2023.3945?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=111723

About JAMA Health Forum: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.

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JOURNAL

JAMA Health Forum

 

Benefits of adolescent fitness to future cardiovascular health possibly overestimated

Peer-Reviewed Publication

KAROLINSKA INSTITUTET

There is a well-known relationship between good physical fitness at a young age and a lower risk of cardiovascular disease later in life. However, when researchers adjusted for familial factors by means of sibling analysis, they found a weaker association, although the link between high body mass index (BMI) and cardiovascular disease remained strong. The study, which was conducted by researchers from Karolinska Institutet and other universities, is published in JAMA Network Open.

“This does not mean that fitness is irrelevant,” says the study’s last author Viktor Ahlqvist, doctoral student at the Department of Global Public Health, Karolinska Institutet. “We could still see an association, although it was weaker after taking into account factors shared by full siblings. We also think that adolescence is an important time in life for establishing good habits such as exercising and having a healthy diet.”

Challenging to prove causal associations

Many observational studies have previously demonstrated links between various risk factors at a young age and cardiovascular disease in adulthood. However, whether the associations are causal is challenging to prove because of the potential influence of unaccounted genetic and environmental factors. A collaborative team including researchers from Karolinska Institutet in Sweden has therefore tried to examine if a large proportion of cardiovascular diseases in adulthood could indeed be prevented with a lower BMI, lower blood pressure, improved physical fitness or improved muscle strength in adolescence.

Sourcing data from the Swedish Military Conscription Register and other Swedish registries, the researchers identified over a million 18-year-old males and followed them for 60 years. Almost half of them were full brothers.

“The strength of our study, which makes it more reliable than many other conventional observational studies, is that we have used sibling analyses,” says the study’s first author Marcel Ballin, researcher at Uppsala University and analyst at Region Stockholm’s Centre for Epidemiology and Community Medicine. “By doing so we could examine how the relationship changes when controlling for all shared sibling factors. This includes environmental factors such as childhood environment and half of the genetics.”

High BMI is a strong risk factor

The results show that a high BMI in late adolescence was strongly associated with future cardiovascular disease, even after the researchers had controlled for shared familial factors. However, the association between physical fitness and cardiovascular disease was considerably weaker in the sibling analysis, suggesting that many previous observational studies might have overestimated the relevance of adolescent fitness to cardiovascular health later in life.

“Our conclusion is that of the risk factors studied, high BMI is the strongest individual risk factor for cardiovascular disease, and that efforts to tackle the obesity epidemic should continue to be given high priority,” says co-author Daniel Berglind, docent at the Department of Global Public Health, Karolinska Institutet. “A good level of fitness and muscle strength in adolescence doesn’t seem as crucial, but physical activity still remains important for public health, as it can bring other health benefits.”

Several limitations

The study examined the association between risk factors at a young age and future cardiovascular disease; other disease outcomes were not investigated. The researchers had no data on whether the participants’ risk factors varied later in life, and they only studied men, which makes it difficult to extend their findings to women. The Military Conscription Register also lacks details on certain risk factors for future cardiovascular disease, such as diet, alcohol consumption, smoking, blood lipids and blood glucose.

The researchers received no specific grant for this study. Co-author Martin Neovius is on the advisory panels for Ethicon, Johnson & Johnson and Itrim and has been a consultant for the Swedish armed forces outside the scope of this study. No other conflicts of interest have been reported.

Publication: “Genetic and environmental factors and cardiovascular disease risk in adolescents”, Marcel Ballin, Martin Neovius, Francisco B. Ortega, Pontus Henriksson, Anna Nordström, Daniel Berglind, Peter Nordström, Viktor H. Ahlqvist, JAMA Network Open, online 17 November 2023, doi: 10.1001/jamanetworkopen.2023.43947.

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JOURNAL

JAMA Network Open

DOI

10.1001/jamanetworkopen.2023.43947 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Genetic and Environmental Factors and Cardiovascular Disease Risk in Adolescents

ARTICLE PUBLICATION DATE

17-Nov-2023

 

U$A

Research spotlight: prescribing of benzodiazepines in a homeless veteran population

Peer-Reviewed Publication

MASSACHUSETTS GENERAL HOSPITAL

 

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INFOGRAPHIC DETAILING KEY FINDINGS OF THE STUDY.

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CREDIT: MASS GENERAL RESEARCH INSTITUTE

What Question Were You Investigating?

Despite elevated risk for substance use disorder and overdose death in the homeless population, benzodiazepine prescribing for this population has not been examined.

Our team therefore set out to answer the questions:

• What is the rate of benzodiazepine prescribing to homeless vs. non-homeless veterans with mental illness in the VA system?
• Are homeless veterans more likely to receive risky and potentially inappropriate prescriptions?
   

What Methods Did You Use?

We used logistic regression to compare likelihood of benzodiazepine prescribing and t tests to compare indicators of risky and potentially inappropriate benzodiazepine prescribing patterns for homeless veterans with mental illness and their housed counterparts.

Our approach was unique in that it is the first study to attempt to investigate this question. We were able to do so in a large, national VA database, the country's largest provider of homeless services.
 

What Did You Find?

We found that although homeless veterans were less likely than their housed peers to receive a benzodiazepine prescription, they were more likely to receive risky and potentially in appropriate prescriptions, including multiple concurrent benzodiazepine prescriptions and concurrent prescriptions for benzodiazepines and opioids or sedatives.
 

What Are the Implications?

To our knowledge this was the first study to examine prescribing patterns for benzodiazepines as treatments for a homeless population, providing novel evidence about a vulnerable and understudied population at high risk for substance use disorder, overdose, and death. These findings of high rates of concurrent prescribing with other sedating medications are of substantial clinical concern, given that drug overdose death in the homeless population is a leading cause of death, at rates up to 30-fold higher than for the U.S. general population. Our results highlight the need for heightened attention to safe benzodiazepine prescribing practices for homeless veterans.


What are the next steps?

Our hope is that paper can inform clinicians about the importance of prudent prescribing of benzodiazepines to homeless patients and encourage providers to talk with patients about whether and how they combine substances when considering whether to prescribe benzodiazepines.
 

Paper Cited:

Koh, K. A., Szymkowiak, D., & Tsai, J. (2023). Benzodiazepine Prescriptions for Homeless Veterans Affairs Service Users With Mental Illness. Psychiatric services (Washington, D.C.), appips20220472. Advance online publication. https://doi.org/10.1176/appi.ps.20220472

 

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JOURNAL

Psychiatric Services

DOI

10.1176/appi.ps.20220472 

ARTICLE TITLE

Benzodiazepine Prescriptions for Homeless Veterans Affairs Service Users With Mental Illness