It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Friday, May 23, 2025
Kyoto conundrum: More hotels than households exist in ancient capital
Analysis of tourism-accommodation intensity hotspots
Credit: Haruka Kato, Osaka Metropolitan University
While moderate touristification can bring economic benefits to cities, overtourism has adverse social effects on residents and visitors. To prevent this, it is necessary to understand the disrupted balance between tourist accommodations and residential housing.
Junior Associate Professor Haruka Kato investigated the spatial patterns and geographic characteristics of tourism-accommodation hotspots in proximity to tourist locations in Kyoto, one of the most famous tourist cities in the world. In this study, the tourism-accommodation intensity index was calculated using the ratio of the number of accommodation rooms to that of households.
The results revealed that tourism-accommodation intensity hotspots emerged across six neighborhood-units in the periphery of the historical city center’s southeastern area. The hotspots indicate areas with a disrupted balance between the number of residences and accommodations. They emerged when the threshold tourism-accommodation intensity score reached 1.0, indicating that the number of rooms had exceeded that of households in these areas. Additionally, this study revealed that tourism-accommodation intensity hotspots were associated with proximity to transportation hubs. This result means that neighborhood-units closer to main stations are more likely to have tourism-accommodation intensity hotspots.
“These findings support the need for effective zoning policies and indicate that the Kyoto municipal government should develop zoning regulation planning for neighborhood-units close to the historical center’s main stations,” said Dr. Kato.
The findings were published in Annals of Tourism Research Empirical Insights.
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About OMU Established in Osaka as one of the largest public universities in Japan, Osaka Metropolitan University is committed to shaping the future of society through the “Convergence of Knowledge” and the promotion of world-class research. For more research news, visit https://www.omu.ac.jp/en/ and follow us on social media: X, Facebook, Instagram, LinkedIn.
(New York, NY) Fatal drug overdoses among youth aged 15 to 24 in the United States involving synthetic opioids alone—not mixed with other substances—soared by 168 percent over the five-year time period of 2018 to 2022, a new study shows. Published online May 20 in the journal Pediatrics, the work also found that youth overdose rates and drug combinations varied significantly across age, sex and race/ethnicity.
Led by NYU Grossman School of Medicine, the new study is the first, say investigators, to identify which specific combinations of drugs drove synthetic opioid-involved fatal overdoses among young people across sociodemographic groups over time.
Overdoses that involved synthetic opioids alone—predominantly fentanyl—had the highest rates of fatalities when compared to overdoses involving other drug combinations examined by the researchers. This was regardless of age, sex and race/ethnicity.
“Before we looked at the data, we thought we would find that the majority of fatal youth overdoses involved fentanyl combined with other substances, such as prescription opioids or cocaine,” said Noa Krawczyk, PhD, assistant professor in the Department of Population Health, and senior author of the study. “Instead, we found the opposite—that most deaths were caused by fentanyl alone. Our analysis sheds light on the changing nature and risks of the drug supply and how they impact key demographic groups. Some may think they are taking one substance but are actually exposed to another.”
According to Krawczyk, who is also associate director of the Center for Opioid Epidemiology and Policy at NYU Langone, their findings underscore the need to tailor overdose prevention strategies that include harm reduction services specifically to youth to prevent death and suffering among this under-studied population.
How the Study was Conducted Analyzing data from the National Center for Health Statistics, the researchers characterized trends in overdose death involving synthetic opioids (predominantly fentanyl) alone, as well as in combination with five common other drugs (benzodiazepines, heroin, prescription opioids, cocaine, and other stimulants) among youth aged 15-24 across age, sex and race/ethnicity over five years (from 2018 to 2022).
The investigators found that during the five-year study period, overdoses involving synthetic opioids alone increased by 168 percent—the highest rates of fatalities compared to those that included a combination of the examined drugs, regardless of age, sex and race/ethnicity.
After deaths due to synthetic opioids/fentanyl alone, the next highest rates of fatal overdoses involved fentanyl combined with cocaine or another stimulant; however, rates differed by age, sex, race/ethnicity and over time. In 2018, White non-Hispanic youth had the highest rates of overdoses involving synthetic opioids/fentanyl alone. By 2022, rates of overdose deaths involving only fentanyl among Black American, American Indian and Alaska Native, and Hispanic youth exceeded White non-Hispanic youth. When it came to the impact of sex and age, fatal overdoses across all groups were highest among males, as well as all youth aged 20 to 24.
According to the research team, understanding the landscape of overdose patterns provides needed context in terms of how to best inform specific public health interventions that can prevent more deaths.
Megan Miller, a research coordinator at the NYU Center for Opioid Epidemiology and Policy and lead author of the study, emphasized that “there are a variety of ways to engage youth and reduce their risk of overdose. Schools, places of employment, homeless shelters, child welfare services, and juvenile justice settings are all possible touchpoints to offer education and harm reduction tools such as naloxone and fentanyl test strips. Our findings highlight the need to tailor these strategies to different youth groups based on the types of drugs they are using to help prevent further overdose deaths.”
Limitations to the study findings, according to the investigators, include possible misclassification in mortality coding practices, as well as limited sociodemographic information. For example, youth who identify as LGBTQ+ tend to have a higher risk of overdose, yet that information was not available. Due to small sample sizes, the data did not examine youth who may identify as more than one race or ethnicity.
In addition to Krawczyk and Miller, study co-authors from NYU Grossman School of Medicine include Katherine Wheeler-Martin, MPH, Amanda M. Bunting, PhD, and Magdalena Cerdá, DrPH.
Funding for the study was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number K01DA055758. Dr. Bunting was supported by the National Institute on Drug Abuse under Award Number K01DA053435. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
About NYU Langone Health NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone No. 1 out of 115 comprehensive academic medical centers across the nation for three years in a row, and U.S. News & World Report recently placed nine of its clinical specialties among the top five in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across seven inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.
Researchers from the University of Missouri School of Medicine have shed light on what populations are more likely to be prescribed a high dose of opioid medication. This increases their risk of developing opioid use disorder.
Opioids like hydrocodone or oxycodone are typically prescribed to relieve intense pain. A prescription can become an addiction; side effects include building a tolerance to the medication – so the patient has to take a higher dose to feel relief – or becoming physically dependent on the drug. These effects can happen quickly, even when taking opioids as prescribed.
“Many factors increase the risk of developing opioid use disorder,” study author Mirna Becevic said. “These include the severity of pain itself, how long opioids are used, their dosage and other medical conditions, such as neurologic or mental health disorders.”
To determine the populations most at-risk, Becevic and her team combed through over 3 million records of Medicaid claims in Missouri from 2017 to 2021. The study had a total of 306,432 observations, which was compared against 2018 USA census data and data from 2020 detailing the primary care shortage.
Becevic and her team found that male patients and people in the middle age range up to 60 years old were more likely to be prescribed a high dose of opioids. They observed a more conservative prescribing pattern for younger adults, which may be because of increased awareness about the opioid epidemic.
“Incidence of chronic pain increases with age, which may have affected the prescribing patterns we saw,” Becevic said. “Interestingly, the risk of prescription past age 60 sharply declined, though this could be because of the increased risk of adverse effects and potential drug interactions.”
Researchers also determined that areas with the largest risk of high-dose opioids correlated with areas that tended to be more urban and had higher percentages of veterans and primary care providers.
“These findings emphasize the need for public health strategies to address the opioid crisis,” Becevic said. “Opportunities are available for clinicians interested in learning more about evidence-based treatment for pain and opioid use disorder, including our Show Me ECHO program.”
While current clinical guidelines say high-dose opioids prescriptions should be avoided, it remains a common practice in certain areas. Since the study used only Missouri data, Becevic says the findings may not be relevant to other populations in the United States.
“Other states and regions have their own unique demographics, policies and health care access,” Becevic said. “Further studies should investigate long-term trends and why doctors prescribe high-dose opioids. Our study’s findings, however, help identify risk factors for all Missouri patients.”
Mirna Becevic, PhD is an assistant professor of dermatology at the MU School of Medicine. Her research focuses on telemedicine and telehealth.
“Identifying high-dose opioid prescription risks using machine learning: A focus on sociodemographic characteristics” was recently published in the Journal of Opioid Management. In addition to Becevic, MU study authors include Olabode Ogundele, PhD, with the Institute for Data Science and Informatics and the Missouri Telehealth Network; Butros Dahu, PhD, with the Institute for Data Science and Informatics; Praveen Rao, PhD, associate professor of electrical engineering and computer science; Xing Song, PhD, assistant professor of Biomedical Informatics, Biostatistics and Medical Epidemiology; Timothy Haithcoat, PhD, assistant teaching professor of Data Science and Analytics; and Tracy Greever-Rice, PhD, Director of the MU Center for Health Policy. Other authors include Mutiyat Hameed, from SSM Health, and Douglas Burgess, MD, assistant professor of psychiatry at University of Missouri – Kansas City.
How can we reduce wait times for much needed hip and knee replacement surgery in Canada? Coordinated referral and team-based care models show promise, according to research published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.241755.
In Canada, there are long wait times for scheduled surgeries, such as hip and knee joint replacements, which can lead to worsening pain and mobility problems and affect overall health. Canada falls well behind in international comparisons of health systems based on wait times. To address this issue, some Canadian provinces have been experimenting with private for-profit delivery of some surgeries, but there are other potential solutions.
“…Other policy approaches, such as single-entry referral models and team-based care, could reduce surgical wait times substantially and improve geographic and socioeconomic inequities in wait times, which might worsen with other types of interventions,” writes Dr. David Urbach, head of the Department of Surgery and director of Perioperative Services at Women’s College Hospital and professor at the University of Toronto, Toronto, Ontario, with coauthors. “If the potential benefit of these models of care were better quantified, policy-makers and health authorities could more persuasively champion their implementation, which faces stiff resistance from some participants in the health system.”
Researchers compared 3 models of care in the study to determine if there is a better option to deliver surgery more quickly. The research included all patients referred to an orthopedic surgeon by a general practitioner or family physician in 2017 who underwent non-urgent hip or knee joint replacements and for whom there were complete wait time data. The model simulations were based on data from 17 465 surgeries on 17 132 patients, 7783 referring physicians, 274 surgeons, and 71 hospitals from 5 regions in Ontario.
The 3 models of care included single-entry referral or “central intake,” where all patients in each of 5 regions are pooled and queue for the next specialist for consultation; team-based care, where patients enter a regional pool after consultation and queue for surgery in their region; and a fully integrated model, where patients are pooled in a queue to be seen by the next available surgeon in their region then enter another queue for surgery from the next available surgeon in their region.
Both team-based and fully integrated models had much larger effects on reducing wait times than the single-entry referral model.
“Our results provide strong support for the implementation of both single-entry referral models and team-based care as a regional solution to the problem of long wait times for scheduled surgery in Canadian health systems, as well as an effective strategy to improve equity in access to health services. Adoption of these models will require strong leadership among health system leaders and the active participation of surgeons. It will also require some investment in system infrastructure, instead of one-time investments to increase surgical volumes during times of crisis,” write the authors.
Effect of single-entry referral models and team-based care on wait times for hip and knee joint replacement in Ontario: a simulation study
Article Publication Date
20-May-2025
New scientific articles highlight potential link between microplastics in ultra-processed foods and brain health
Groundbreaking collection of four articles in Brain Medicine examines alarming "spoonful" of microplastics in human brains, with possible links to depression and dementia
This cover image depicts a human brain with colorful microplastic particles scattered across its surface, juxtaposed with a white plastic spoon as a visual representation. Research has revealed that the human brain contains approximately "a spoon's worth" of microplastics and nanoplastics, with particularly high concentrations (3-5 times greater) in individuals with dementia. The multicolored particles shown on the brain surface represent the variety of plastic types detected, with polyethylene being predominant. The image illustrates the concerning 50% increase in microplastic concentration observed between 2016 and 2024, highlighting the rapid infiltration of these synthetic materials into our most protected organ.
NEW YORK, New York, USA, 20 May 2025 – A groundbreaking collection of four papers published in the May issue of Brain Medicine synthesizes mounting evidence that microplastics from ultra-processed foods may be accumulating in human brains and potentially contributing to the rising global rates of depression, dementia, and other mental health disorders. The papers provide the most comprehensive analysis to date of how these tiny plastic particles might be affecting brain health through multiple interconnected biological pathways.
The Plastic Spoon in Your Brain
The striking cover of Brain Medicine's May 2025 issue depicts a human brain stippled with colorful microplastic particles alongside a plastic spoon – a visual that powerfully captures the main finding that human brains contain approximately "a spoonful" of microplastic material. This alarming concept is examined in depth across all four articles in this special collection, including a peer-reviewed commentary previously published online titled "Human microplastic removal: what does the evidence tell us?" (https://doi.org/10.61373/bm025c.0020) that now appears in the May issue alongside three new papers being released today.
The featured peer-reviewed viewpoint article by Dr. Nicholas Fabiano from the University of Ottawa, Dr. Brandon Luu from the University of Toronto, Dr. David Puder from Loma Linda University School of Medicine, and Dr. Wolfgang Marx from Deakin University's Food & Mood Centre, titled "Microplastics and mental health: The role of ultra-processed foods" (https://doi.org/10.61373/bm025v.0068), builds upon their earlier commentary on microplastic accumulation in human tissue, "Human microplastic removal: what does the evidence tell us?" (https://doi.org/10.61373/bm025c.0020). This new viewpoint paper synthesizes emerging evidence to propose a novel hypothesis connecting ultra-processed food consumption, microplastic exposure, and mental health outcomes.
"We're seeing converging evidence that should concern us all," explains Dr. Fabiano. "Ultra-processed foods now comprise more than 50% of energy intake in countries like the United States, and these foods contain significantly higher concentrations of microplastics than whole foods. Recent findings show these particles can cross the blood-brain barrier and accumulate in alarming quantities."
The Mental Health Connection
The researchers cite substantial evidence linking ultra-processed food consumption with adverse mental health outcomes. A recent umbrella review published in The BMJ found that people who consumed ultra-processed foods had a 22% higher risk of depression, 48% higher risk of anxiety, and 41% higher risk of poor sleep outcomes.
What makes their hypothesis particularly compelling is the novel suggestion that microplastics—tiny plastic particles less than 5mm in size—may be a missing link in this relationship. The researchers point to disturbing data showing that foods like chicken nuggets contain 30 times more microplastics per gram than chicken breasts, highlighting the impact of industrial processing.
The hypothesis gains further credibility from recent findings published in Nature Medicine that demonstrated alarming microplastic concentrations in the human brain—approximately "a spoon's worth" according to the researchers—with levels three to five times higher in those with documented dementia diagnoses.
Shared Mechanisms of Harm
"This hypothesis is particularly compelling because we see remarkable overlap in biological mechanisms," notes Dr. Marx. "Ultra-processed foods have been linked to adverse mental health through inflammation, oxidative stress, epigenetics, mitochondrial dysfunction, and disruptions to neurotransmitter systems. Microplastics appear to operate through remarkably similar pathways."
The viewpoint article raises an intriguing question: Could the microplastic content of ultra-processed foods be partially responsible for their observed negative mental health effects? To study this relationship more systematically, the authors propose the development of a Dietary Microplastic Index (DMI) to quantify exposure through food consumption.
Possible Removal Pathways
Complementing the viewpoint article is a peer-reviewed Brevia research paper titled "Therapeutic apheresis: A promising method to remove microplastics?" (https://doi.org/10.61373/bm025l.0056) by Dr. Stefan Bornstein and colleagues. This paper, also published in the May issue, examines preliminary evidence that extracorporeal therapeutic apheresis—a technique that filters blood outside the body—may have the potential to remove microplastic particles from human circulation.
"While we need to reduce our exposure to microplastics through better food choices and packaging alternatives, we also need research into how to remove these particles from the human body," notes Dr. Bornstein. "Our early findings suggest that apheresis might offer one possible pathway for microplastic removal, though much more research is needed."
A Call to Action
The issue is further contextualized by a powerful guest editorial by Dr. Ma-Li Wong titled "Una cuchara de plástico en tu cerebro: The calamity of a plastic spoon in your brain" (https://doi.org/10.61373/bm025g.0062), which frames the collection of papers as not just a scientific warning but a paradigm shift in how we must think about environmental contaminants and brain health.
"What emerges from this work is not a warning. It is a reckoning," writes Dr. Wong. "The boundary between internal and external has failed. If microplastics cross the blood-brain barrier, what else do we think remains sacred?"
The authors of all four papers emphasize that while more primary research is needed, their analyses add another dimension to the growing case for reducing ultra-processed food consumption and developing better methods to detect and potentially remove microplastics from the human body.
"As the levels of ultra-processed foods, microplastics, and adverse mental health outcomes simultaneously rise, it is imperative that we further investigate this potential association," concludes Dr. Fabiano. "After all, you are what you eat."
The articles on microplastics and brain health from the May 2025 issue of Brain Medicine will be available on 20 May 2025 via Open Access at the following URLs:
About Brain Medicine: Brain Medicine (ISSN: 2997-2639, online and 2997-2647, print) is a high-quality medical research journal published by Genomic Press, New York. Brain Medicine is a new home for the cross-disciplinary pathway from innovation in fundamental neuroscience to translational initiatives in brain medicine. The journal's scope includes the underlying science, causes, outcomes, treatments, and societal impact of brain disorders, across all clinical disciplines and their interface.
