Wednesday, March 01, 2023

Home-based cardiac rehabilitation may help people live longer

Participating in home cardiac rehabilitation was linked with a lower risk of death among veterans during a four-year-follow up, finds new study in the Journal of the American Heart Association

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

Research Highlights:

  • In a study of U.S. military veterans, researchers noted that participating in home-based cardiac rehabilitation was associated with a 36% lower risk of death compared to veterans who chose not to participate in cardiac rehabilitation.
  • Less than half of the study participants enrolled in rehabilitation, which focused on improving heart-healthy behaviors.
  • The research may be the first U.S. study to provide evidence of living longer with home-based cardiac rehabilitation in people with heart disease.

DALLAS, March 1, 2023 — Participating in home-based cardiac rehabilitation after a heart attack or cardiac procedure was associated with a 36% lower likelihood of death from heart-related complications among U.S. military veterans within four years compared to those who opted out of rehabilitation programs, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Although cardiac rehabilitation has been shown to reduce the risks of hospital readmissions and death, it is significantly underused, according to the American Heart Association. Cardiac rehabilitation emphasizes eliminating tobacco use, improving diet, engaging in physical exercise, managing stress and taking medications that treat high blood pressure or high cholesterol.

“Whether in a hospital or home, cardiac rehabilitation is all about healthy behavior changes,” said senior study author Mary A. Whooley, M.D., a primary care physician at the San Francisco Veterans Affairs (VA) Medical Center and professor of medicine at the University of California, San Francisco. “However, changing behaviors is difficult, and while care facilities may offer on-site cardiac rehabilitation, many patients don’t choose to take advantage of follow-up treatment. The biggest surprise of our analysis was how few patients chose to participate in cardiac rehabilitation.”

While cost can be a barrier to participating in cardiac rehabilitation, along with geography and logistics, cost should not have been a factor as health care services were covered by the VA in this study.

“We don’t know why so many patients opted out of rehabilitation,” Whooley said. “Even when home-based cardiac rehabilitation was offered at the time and place of their choosing, only 44% of eligible patients chose to participate. Many patients were simply not interested in changing their behaviors.”

Data indicated that among patients hospitalized for heart attack from 2007-2011, only 16% of Medicare patients and 10% of veterans participated in cardiac rehabilitation. Among eligible Medicare beneficiaries in 2016, only 24% opted to participate in on-site/facility-based cardiac rehabilitation. According to the Million Hearts® Cardiac Rehabilitation Collaborative, a national initiative co-led by the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services, it’s estimated that increasing cardiac rehabilitation participation to 70% of cardiac patients after hospitalization could save 25,000 lives and prevent 180,000 additional hospitalizations each year.

“Many randomized trials have demonstrated similar mortality benefits from home-based and facility-based cardiac rehabilitation,” Whooley said.

This is the first U.S. study to provide evidence of survival benefit with home-based cardiac rehabilitation in people with heart disease, according to the study authors. The ongoing COVID-19 pandemic which temporarily closed countless facility-based rehabilitation programs indicates a growing need to explore opportunities in telehealth care for people with heart disease, they said.

This study analyzed data for 1,120 veterans who were eligible for cardiac rehabilitation at the San Francisco VA Medical Center between August 2013 and December 2018. Among this study group, 98% were men, 2% were women, 76% were white, 88% were non-Hispanic and 68% lived in an urban area. About half had been hospitalized for percutaneous coronary intervention — also known as angioplasty, 20% for coronary artery bypass grafting, 14% for heart attack and 18% for other reasons. Enrolling in the San Francisco Healthy Heart home-based cardiac rehabilitation program was voluntary, and only 44% (490 people) enrolled.

The home-based cardiac rehabilitation program lasted 12 weeks, during which participants received up to nine coaching calls, motivational interviews, a workbook and a personal health journal to document vital signs, exercise and diet. They also received a blood pressure monitor, a scale and (if desired) a stationary bike. A nurse or exercise physiologist worked one-on-one with participants to create achievable physical activity goals. Participants received follow-up phone calls from program staff at three and six months after program completion and were followed for an average of 4.2 years after hospitalization.

Among the researchers’ findings:

  • The death rate at one-year after hospitalization was 4% among those who did not participate in cardiac rehabilitation versus 2% among those who participated in home-based cardiac rehabilitation.
  • Overall, those who participated in the cardiac rehabilitation program were linked with a 36% reduction in odds of dying from complications compared with those who did not.
  • Deaths during the entire follow-up period occurred in 12% of rehabilitation participants versus 20% of non-participants.

Researchers note scientists don’t yet know the optimal number of at-home cardiac rehabilitation sessions are needed to achieve lasting success for people with heart disease, and this warrants further research. Moreover, when compared with traditional, facility-based programs, researchers believe home-based cardiac rehabilitation may lead to more lasting behavior changes that improve outcomes, because integrating healthy behaviors into a participant’s home routine from the outset has been associated with better adherence rates.

While there is no standardized approach to delivering home-based cardiac rehabilitation, it is generally shorter than on-site care, and “as technology expands, behavior modification in a participants’ own home environment may help make cardiac rehabilitation more accessible and lifestyle changes more sustainable,” Whooley said.

Another advantage of home-based cardiac rehabilitation is that, because capacity is not constrained by the availability of facility-based programs, it has shorter wait times to begin therapy (average of 25 days versus 77 days after a cardiac event).

“Our biggest challenge in the U.S. is that home-based cardiac rehabilitation is not covered by many health insurers,” she said. “Currently, Medicare only pays for on-site or facility-based cardiac rehabilitation.”

The American Heart Association supports congressional legislation such as the bipartisan “Increasing Access to Quality Cardiac Rehabilitation Care Act,”’ which calls for expanding cardiac rehabilitation resources.

Randal J. Thomas, M.D., chair of the 2019 joint American Heart Association/American College of Cardiology statement on the effectiveness of home-based cardiac rehabilitation called this study a “unique, landmark report.”

“This study suggests that home-based cardiac rehabilitation is associated with a lower death rate when compared to individuals who receive no cardiac rehabilitation,” said Thomas, who is professor of medicine in the Mayo Clinic Alix School of Medicine working with the Mayo Clinic Cardiac Rehabilitation Program in Rochester, Minnesota. “Previous home-based cardiac rehabilitation studies have not been designed to address this important benefit. Additional studies are needed, but this study strongly suggests a mortality benefit from home-based cardiac rehabilitation.

“Even though the study did not clarify if home-based cardiac rehabilitation impacts death rates as well or even better than center-based rehabilitation, it does show that home-based cardiac rehabilitation reduces death rates compared to those patients who do not participate in cardiac rehabilitation.”

The joint statement strongly recommends cardiac rehabilitation for people diagnosed with heart attack, chest pain, heart failure or after having bypass surgery, percutaneous coronary intervention, heart valve surgery or heart transplantation. In addition, an American Heart Association scientific statement notes that home-based rehabilitation is an effective alternative to cardiac rehabilitation for those unable to participate in an on-site cardiac rehabilitation program.

The study has several limitations, including that there was no comparison to facility-based cardiac rehabilitation; participants were not randomized; and most were English-speaking, older men. Researchers note it’s unclear whether the benefits of home-based cardiac rehabilitation would produce similar benefits in women or non-English speaking people.

Co-authors are Nirupama Krishnamurthi, M.B.B.S, M.P.H.; David W Schopfer, M.D. M.A.S.; Hui Shen, M.Sc.; Gregory Rohrbach, D.N.P.; and Abdelaziz Elnaggar, M.B.B.S., M.P.H. Authors’ disclosures are listed in the manuscript.

The Veterans Health Services Research and Development Quality Enhancement Research Initiative funded the study.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here. 

Additional Resources:

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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JOURNAL

Journal of the American Heart Association

DOI

10.1161/JAHA.122.025856 

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Social workers experienced depression, PTSD, and anxiety at alarming rates during pandemic

40% of survey respondents reported depression — a rate that’s 4 times higher than the general population and substantially higher than other health care professionals working in COVID-19 conditions

Peer-Reviewed Publication

UNIVERSITY OF TORONTO

Toronto, ON — A new study published in the journal International Social Work has uncovered concerning rates of depression, post-traumatic stress disorder (PTSD) and anxiety among social workers.

Stressors related to COVID-19 were the strongest factors associated with the negative mental health outcomes. Those who experienced a higher number of pandemic-related stressors — such as health concerns, increased caregiving responsibilities, violence in the home, family stress due to confinement, and stress associated with work-life balance — experienced mental health problems at a higher rate compared with those who were not as impacted by pandemic-related hardships.

“Like physicians, nurses and other allied health care providers, social workers are feeling the impact of the pandemic, and it is showing up in their mental health,” says lead author Ramona Alaggia, a professor at the University of Toronto's Factor-Inwentash Faculty of Social Work (FIFSW) and the Margaret and Wallace McCain Chair in Child and Family. “As we celebrate Social Work Week in Ontario March 6 - 12 and National Social Work Month in March, it is important to recognize the stressors that affect social workers and the well-being of those working in this essential field.”

An alarming 40% of the sample reported depression — which is four times higher than the general population. The rate of reported depression among social workers is also substantially higher than other health care professionals working in COVID-19 related conditions, where the prevalence rate of depression has been found to be 24%. In total, one fifth of the sample reported PTSD while 15% reported anxiety. 

“As personal stressors among social workers have increased, so too have the needs of those they serve,” says co-author Esme Fuller-Thomson, FIFSW professor and director of the Institute for Life Course and Aging at the University of Toronto. “With rising rates of domestic violence, child abuse, mental health illnesses and addictions, death rates in long-term care systems, and homelessness, social workers’ jobs have become more demanding than ever.”

The majority of survey respondents were from Ontario and married or in common law unions. Half of the respondents had children under the age of 18, and 85% were women, which is consistent with the number of women working in the social work field.

“Recent trends clearly indicate women have felt the most negative employment change and job loss during COVID-19,” says Carolyn O’Connor, co-author and a doctoral candidate at FIFSW. “Time studies consistently show that women are usually the ones carrying most childcare and domestic responsibilities at home. Meanwhile, COVID lockdowns made working from home even more stressful as parents juggle work demands with home-schooling, while experiencing isolation and fewer supports.”

The study also found that the social workers most affected by mental health problems tended to be younger, less experienced and less established in their profession. Levels of resilience were also measured. Those who were older and had higher income had higher resilience scores.

"Job instability is common early in a social worker’s career, especially when working within a neo-liberal environment that promotes precarious, contractual work conditions with fewer benefits and lower pay,” says co-author and FIFSW PhD candidate Keri West.

Alaggia says that in her work with community-based agencies, she has observed that social workers have been leaving in high numbers since the start of 2022, with some agencies reporting as much as 30% shortfalls in staffing levels and significant problems filling those positions.

“It seems a tipping point has been reached where-by social workers are leaving traditional settings because of low wages, job insecurity and meagre benefits,” Alaggia says. “Given the essential societal roles that social workers’ play, strategies to sustain the profession into the next generation and future generations are urgently needed. These strategies should include a trauma informed approach and strong mental health supports for staff. This may be a defining moment in the social work field and building resilience into social service systems is the way forward.”

JOURNAL

International Social Work

DOI

10.1177/00208728221144380 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Troubled times: Canadian social workers’ early adversities, mental health, and resilience during the COVID-19 pandemic.

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PAKISTAN

Menstrual rights are human rights. Period

When I gave her period kits, her eyes filled with a mix of relief and pain. She took off her glass bangles, her only remaining possession that survived the floods, and handed them to me as a token of gratitude.



Bushra Mahnoor 
Published March 8, 2023

As a young girl, I had firsthand experience of the devastating effects of the 2010 floods in Pakistan. Floodwaters had swallowed entire villages and towns adjacent to my own, leaving people stranded on rooftops, desperately waiting for help.

My parents were engaged in relief efforts at a camp in Khairabad, Khyber Pakhtunkhwa. I was 10 years old at the time and I still remember coming across a young girl, no older than myself, whose clothes were stained with blood as she struggled to manage her first period in the cramped relief camp. It was a heartbreaking sight that stayed with me over the years.

On hearing news of the devastating 2022 floods in Pakistan, I was struck by the thought of the thousands of women who would be struggling to manage their periods amidst the chaos of the disaster. I knew I had to take action.

Read more: HEALTH: TACKLING ‘PERIOD POVERTY’

Alongside my friend Anum, I founded Mahwari Justice, a grassroots movement that aimed to not only raise awareness about menstrual rights in Pakistan, but also provide flood affectees with access to menstrual hygiene products.

Making it happen

To achieve this, we set up a GoFundMe account and within a few weeks, we were able to collect sufficient funds to purchase supplies. I remember scouring wholesale markets across Lahore, searching Anarkali, Mochi gate and Shalmi market for underwear, soap, detergent, and period products.

The next step was to pack these supplies into relief kits. We called out for volunteers via Twitter and the response was overwhelming. People from all walks of life came forward to help, each one eager to contribute.

Volunteers packing period relief kits in Lahore. — Photo provided by author

Our office, a small room, hummed with activity as we packed these kits every weekend. Volunteers worked tirelessly, carefully selecting items and packing them with care. There is one moment that truly touched my heart: a father and his daughter came together to help pack relief kits, breaking patriarchal norms that shun any form of talk about menstruation between father and daughter. It was a powerful moment that showed just how far we’d come.
Shelter first, bleed second?

Our efforts did not, however, go without challenge. We faced criticism from people who questioned the necessity of such aid. Others believed that necessities like food, water, and medicine should take precedence over period products. We understood that menstruation is a taboo topic, which made it even more difficult to convince people of the urgency of our cause.

When faced with criticism, my team and I made a conscious effort to remain open-minded and listen with an open ear. I recognised that as students, we were undertaking a massive endeavor with limited resources and that we had much to learn. We listened to our critics and used their feedback to refine our approach, turning some of them into supporters. Our willingness to learn and adapt was critical to our success.

The impact of our work extended beyond just the distribution of relief kits. I remember receiving a call from an old woman who lived in a village near Hyderabad. She had heard about our work on TV and wanted to contribute, despite having limited means. She didn’t have access to any digital payment platforms, so she sent me Rs500 as mobile credit. The gesture may seem small, but it was immensely powerful. It reminded me that our work resonated with the average person on a personal level. We weren’t just a faceless group delivering aid, but rather a group of young people working together to make a difference.

We also faced resistance from men during the early days of Mahwari Justice. Alot of the men we contacted said they didn’t want to work with us because we were only supplying period products. They disregarded these items as a genuine need for flood-affectees, so we decided to pivot our approach and started reaching out to women who were already doing relief work in flooded areas. We also contacted doctors who were arranging medical camps and midwives who were providing essential healthcare services to the flood-affectees for the initial distribution of period relief kits.

Of the many challenges my team faced, the one that stands out the most is the sheer scale of the task at hand. We knew we had to reach as many people as possible, but the enormity of the flood-affected areas left us feeling overwhelmed.

Team Mahwari Justice distributing period relief kits in Gandakha, Balochistan.
 — Photo provided by author

Yet, we refused to be discouraged and with the help of 130 dedicated volunteers, we were able to reach over 100,000 flood affectees across 80 areas including but not limited to Sohbatpur, Naseerabad, Jaffarabad, Lasbela, Qilla Abdullah in Balochistan; Dadu, Umerkot, Naushahro Feroze, Sanghar, Badin in Sindh; Muzaffargarh, Layyah, Rajanpur, DG Khan in Punjab; Swat, Charsadda, Chitral, Nowshera, Dera Ismail Khan in KP as well as Ghizer, Nagar, Diamer in Gilgit, all within a span of six months.

This would not have been possible without the tireless efforts of our volunteers, both on the ground and online. It is a testament to the power of community and the impact that a group of determined individuals can have when they come together for a common cause.
Building on our theoretical framework

In organising relief work to provide menstrual kits, I was careful to ensure that we were addressing the actual needs of the people we were serving. Rather than imposing our ideas on them, we took the time to connect with the affected communities and learn about their specific needs. This approach allowed us to tailor our menstrual relief kits to the unique needs of the women in these areas, creating a more impactful and effective relief effort.


Illustrations of how to use a commercial sanitary pad included in the relief kits. 
— Source: Mahwari Justice

We took inspiration from previous disaster relief efforts and successful campaigns, such as the “Bleed With Dignity” campaign in the 2017 Assam floods in India, to inform our work. By leveraging evidence and research, we were able to address the unique needs of communities in a way that was culturally sensitive and appropriate. This experience taught me that effective relief work goes beyond providing supplies; it requires a deep understanding of the unique needs and cultural context of the people being served.

We carefully crafted our period relief kits to ensure that they were not only practical, but also offered a sense of comfort and dignity. Thus, we created four different types of period relief kits to suit the needs of the flood-affected women.



Products included in the period relief kits provided to flood-affectees. 
— Photos provided by author


The first kit included reusable cloth-based pads, as well as underwear, drawstrings, soaps, and detergents. For the second kit, we opted for reusable microfibre-based towel sheets instead of cloth pads, the third included biodegradable pads made from cotton and gauze and came with panties, detergents, and soaps, and for the fourth kit, we used commercial pads. We also included small items such as combs, mirrors, nail clippers, needles and thread, to ensure our kits were comprehensive and helped women feel taken care of.

During the winter season, we also recognised that the cold can make periods even more challenging for women in flood-affected areas. To help alleviate some of these difficulties, we decided to add warm clothing such as sweaters, shawls, and socks to our relief kits.
Impact beyond relief

Growing up with five sisters in a working-class family, period poverty was a constant battle in my early teenage years. During my period, I was forced to make a single pad last for hours, constantly worried about leaks and the shame that followed.

It was a daily struggle that left me feeling embarrassed and anxious. Nevertheless, my experiences made me realise that period poverty is more than just a lack of access to products. It’s the emotional toll it takes on individuals who are unable to access them, the constant worry and shame that follows them around like a shadow.

This is why I made it my mission to help women feel dignified and respected during their periods. As we distributed the kits, I saw the impact of our work first hand. The tears of gratitude, the hugs, and the kisses on my forehead from women who finally had access to menstrual products were a testament to the importance of this work.

While I was working in the flood-affected areas of Balochistan, I met Amala in Maanjothi village. Amala was a mother of five daughters and had lost her home to the floods. She told me about the hardships her daughters had to face to manage their periods amidst the flood. When I gave her the period kits, her eyes filled with a mix of relief and pain. She took off her glass bangles, her only remaining possession that survived the floods, and handed them to me as a token of gratitude. I stared at Amala, utterly stunned by her extraordinary act of generosity. It was at that moment that I realised the true power of the work I was doing.

Then there was the old woman in Foleji, Balochistan, who approached me, her eyes filled with desperation. In broken Urdu, she explained that her daughter was on her period and was using tree leaves as makeshift pads. I felt a lump in my throat as I witnessed the raw emotion and helplessness in her eyes. When I handed her a menstrual relief kit, she kissed my forehead. The weight of her kiss was heavy with the unspoken suffering and resilience of so many women like her.
Breaking the taboo

Overcoming the stigma around periods is a daunting task, particularly in small towns where cultural norms and practices have a strong hold on communities. When I started my journey, I faced opposition from an unexpected source — my own family. Despite being aware of the harsh realities of period poverty, my mother could not understand why I was talking openly about periods and advocating for menstrual equity. She was worried that my activism would bring shame to our family and harm my sisters’ chances of finding suitable matches for marriage.

At first, her words made me doubt my decision to take action. I felt unsupported and alone. But as I continued to work with flood affectees, I found solace in the courage and strength of the women I worked with, and their determination inspired me to push forward despite the obstacles.

Breaking taboos around periods is an essential part of the work I do. By addressing period poverty and ensuring access to menstrual supplies, my work challenges the stigma and shame surrounding periods. When we openly discuss periods, we create space for conversations that have long been silenced. Through my work, I hope to inspire others to break the taboo around periods and work towards menstrual equity. When we stop treating periods as shameful and start treating them as a natural part of life, we create a world where everyone can menstruate with dignity and respect.

Relief work is not just a humanitarian issue or a matter of charity, but a deeply political one. It is a reflection of the priorities and values of our society and the extent to which we are willing to recognise the dignity and humanity of all people, regardless of their socioeconomic status or gender.

By advocating for safe period products and raising awareness about period poverty, we are not only addressing an urgent and overlooked need, but also challenging the systemic barriers that perpetuate gender-based inequality and discrimination.

My work to address the menstrual needs of flood affectees is just the beginning of our movement for period equity. We recognise that providing immediate aid is not enough to create long-lasting change.

It is the government’s responsibility to ensure that basic human rights, including access to safe and affordable period products, are met for all. The work of Mahwari Justice is not only a political statement, but also a call to action for collective efforts towards creating a more just and equitable world.


Bushra Mahnoor is a 22-year-old student and co-founder of Mahwari Justice, a globally applauded period rights movement in Pakistan.
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Goal: Safer bike lanes

UPV researchers analyze the skid resistance of different pavements used in bike lanes in Valencia

Peer-Reviewed Publication

UNIVERSITAT POLITÈCNICA DE VALÈNCIA

Goal: Safer Bike Lanes 

IMAGE: UPV RESEARCHERS ANALYSE THE SKID RESISTANCE OF DIFFERENT PAVEMENTS USED IN BIKE LANES IN VALENCIA view more 

CREDIT: UPV

Among the conclusions, the study notes the risk of painted cobble and smooth painted tile pavements, warning that they "should not be used due to their low and variable skid resistance, as well as the high vibrations they cause to users". The paper has been published in Sustainability journal.

According to the study's authors, the new mobility has increased crashes involving users, mainly bicycles and electric scooters. Many of these crashes are falls in which only the user is involved, i.e., single-bicycle crashes (SBCs).

In 2018, the number of crashes involving personal mobility vehicles in urban areas was less than 200 -199, to be precise- and in 2021, this number rose to 2541. In the case of bicycles, the number of crashes was relatively stable over this period, rising from 5384 to 5712. During 2021, the latest year for which official data is available, 27% of these crashes occurred while riding an electric scooter or bicycle without interaction with other road users.

"Most of the time, these crashes happen because the pavement was slippery. Therefore, studying the pavement's skid resistance is crucial to improving safety on bike lanes. This resistance is one of the characteristics that most affect safety, as it has a decisive influence on accelerating, braking, and keeping the trajectory of a bicycle or e-scooter while turning, without the risk of slipping or skidding," explains David Llopis Castelló, a researcher at the HERG-UPV.

Thus, among the different pavements analysed, the HERG-UPV has found that asphalt, concrete, and rough tile pavements provide adequate skid resistance. In particular, the first two offer the best performance, as they generate less vibrations and, therefore, a more comfortable ride. "On the other hand, painted cobble and smooth painted tile pavements do not meet the requirements, and the probability of falls, collisions, and conflicts between cyclists, e-scooter users, pedestrians, and motorised traffic is higher," says Ana María Pérez Zuriaga, also from the HERG-UPV.

In its study, the HERG-UPV also measured the speed of users of bicycles and electric scooters to analyse their behaviour and the influence of pavements on stopping sight distance. In conclusion, the pavements that provide greater adherence -asphalt, concrete, and rough painted tile pavements- allow a reduction in the required stopping sight distance of up to 7.5%, while smooth painted tile pavements increase this distance by 7% when travelling at 20 km/h (speed limit in bike lanes), with the consequent risk.

Good practice

Based on this research, the study carried out by the Highway Engineering Research Group proposes that asphalt should be used as the paving material on roads shared by motorised vehicles and users of bicycles or electric scooters, as well as on striped/buffered bike lanes. The same applies to protected bike lanes, although concrete pavement may also be used for these. For sidepaths, rough tile pavement is the best option, as the vibrations experienced by users may encourage them to slow down.

In addition, the study proposes the minimum stopping sight distances required to ensure safety not only for cyclists and e-scooter users but also for pedestrians and motorised vehicles.

"The results of this study can serve as a basis for designing a safer micromobility infrastructure. In the choice of pavements for newly constructed bike lanes, it is essential to consider a parameter such as skid resistance, always accompanied by preventive inspection during pavement service life," concludes Alfredo García García, coordinator of the Highway Engineering Research Group at Universitat Politècnica de València.

This study is part of the project "esMicromobility - Road Safety Assessment of Micromobility", reference PID2019-111744RB-I00, funded by MCIN/AEI/10.13039/501100011033.

THIS IS THE CORRECT (EUROPEAN) WAY OF CYCLING IN TRAFFIC

WITH OR WITHOUT A DEDICATED BIKE LANE

UPV researchers analyse the skid resistance of different pavements used in bike lanes in Valencia

CREDIT

UPV


JOURNAL

Sustainability

DOI

10.3390/su15010698 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Skid Resistance Analysis of Urban Bike Lane Pavements for Safe Micromobility

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Activation of peroxymonosulfate and photothermal for removal of phenolic organic pollutants and lignin derivatives


Peer-Reviewed Publication

KEAI COMMUNICATIONS CO., LTD.

C-defective and C–O band ultrathin porous g-C3N4 photothermal-catalytic synergistic PMS degradation of bisphenol pollutants and sodium lignosulfonate. 

IMAGE: C-DEFECTIVE AND C–O BAND ULTRATHIN POROUS G-C₃N₄ PHOTOTHERMAL-CATALYTIC SYNERGISTIC PMS DEGRADATION OF BISPHENOL POLLUTANTS AND SODIUM LIGNOSULFONATE. view more 

CREDIT: THE AUTHORS

At present, the traditional ways to deal with the above two kinds of pollutants are mainly physical adsorption and biodegradation. The main disadvantages of these ways are incomplete treatment and long treatment period. Although the new photocatalytic technology uses clean energy and has mild reaction conditions, it also has the disadvantages of slow reaction speed and incomplete treatment. Compared with above ways to remove bisphenol pollutants and lignin derivatives, advanced technology to oxidize peroxymonosulfate has faster reaction rate and. However, it causes more metal ions to dissolve leading to secondary pollution to living organisms and the environment. To mitigate the issue, the ultimate solution should ideally combine photocatalytic technology and advanced peroxymonosulfate oxidation technology to eliminate the dissolution of metal ions—a team of researchers based in Canada did just that.

researchers developed a new method for the synthesis of C-defects/C-O band-modified ultrathin porous carbon nitride, a material that has the potential to address this issue. "Carbon nitride has been widely used as a photocatalyst; however, conventional carbon nitrides have insufficient oxidizing ability and are not strong in activating peroxymonosulfate. This is largely due to their relatively small specific surface area and lack of active sites,” explained Jinguang Hu, corresponding author of the study.

Hu and his team constructed a porous ultra-thin carbon nitride material with C-defects and C-O bands using a one-step method. It can be synthesized by grinding and mixing urea nitrate, oxyacetic acid and urea evenly, and then directly thermally polymerizing in a muffle furnace. The catalyst not only increases specific surface area, but also the defect structure and doping elements to provide more active sites. Notably, the catalyst has very good photothermal performance which can accelerate the catalytic reaction process.

The team reported their study in the KeAi journal Green Energy and Environment.

"A large amount of bisphenol pollutants and lignin derivatives are constantly produced in the world,” noted Hu. “We believe this new advanced oxidation technology system can pave the way for the removal of such organic pollutants.”

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Contact the corresponding author: Jinguang Hu, jinguang.hu@ucalgary.ca

The publisher KeAi was established by Elsevier and China Science Publishing & Media Ltd to unfold quality research globally. In 2013, our focus shifted to open access publishing. We now proudly publish more than 100 world-class, open access, English language journals, spanning all scientific disciplines. Many of these are titles we publish in partnership with prestigious societies and academic institutions, such as the National Natural Science Foundation of China (NSFC).

JOURNAL

Green Energy & Environment

DOI

10.1016/j.gee.2023.01.006 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Advanced oxidation via the synergy of C-defective/ C–O band modified ultrathin porous g-C3N4 and PMS for efficient photothermal degradation of bisphenol pollutants and lignin derivatives

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First patient receives milestone stem cell-based transplant for Parkinson’s Disease

Business Announcement

LUND UNIVERSITY

This is a joint press release from Lund University and Skåne University Hospital:

On 13th of February, a transplant of stem cell-derived nerve cells was administered to a person with Parkinson’s at Skåne University Hospital, Sweden. The product has been developed by Lund University and it is now being tested in patients for the first time. The transplantation product is generated from embryonic stem cells and functions to replace the dopamine nerve cells which are lost in the parkinsonian brain. This patient was the first of eight with Parkinson’s disease who will receive the transplant.

“This is an important milestone on the road towards a cell therapy that can be used to treat patients with Parkinson’s disease. The transplantation has been completed as planned, and the correct location of the cell implant has been confirmed by a magnetic resonance imaging. Any potential effects of the STEM PD-product may take several years. The patient has been discharged from the hospital and evaluations will be conducted according to the study protocol,” says Gesine Paul-Visse, principal investigator for the STEM-PD clinical trial,consultant neurologist at Skåne University Hospital and adjunct professor at Lund University in Sweden.

There are around eight million people living with Parkinson’s disease globally; a disease which involves loss of dopamine nerve cells deep in the brain, leading to problems in controlling movement. The standard treatment for Parkinson’s disease are medications that replace the lost dopamine, but over time these medications often become less effective and cause side effects. As of today, there are no treatments that can repair the damaged structures within the brain or that can replace the nerve cells that are lost. 

The STEM-PD trial is now testing a new investigational therapy aimed at replacing the lost dopamine cells with healthy ones manufactured from stem cells. The cell product that is being used has been subjected to rigorous pre-clinical tests, to meet the Swedish Medical Products Agency’s quality standards. After being transplanted, the cells are expected to mature into new and healthy dopamine producing nerve cells within the brain.

“With this trial, we hope to demonstrate that the cell product works as expected in patients. Over time, this creates the opportunity to help many more people with Parkinson’s in the future.” says Malin Parmar, professor at Lund University. She leads the STEM-PD team in close collaboration with colleagues at Skåne University Hospital, Cambridge University, Cambridge University Hospitals NHS Foundation Trust and Imperial College London. 

“Further studies are required to move STEM-PD from this first in human trial all the way to a global treatment, and we have therefore worked in close collaboration with the pharmaceutical company Novo Nordisk A/S. Their input to the study, as well as operational and regulatory guidance, have been fundamentally important to initiate this first in human study and we look forward to future collaborations.”

A total of eight patients from Sweden and the UK will undergo transplantation at Skåne University Hospital, which has a long tradition of this type of surgery. In fact, the surgical instrument used in the current trial was developed by the university hospital for cell transplantation as early as the 1980s. At this time, stem cells were not available, and instead, neurosurgeons transplanted nerve cells derived from foetal tissue. 

“The brain region that the cells are transplanted into in this trial can be as narrow as four millimetres. The surgical instrument has a very high level of precision, and we are greatly helped by modern imaging techniques” says consultant neurosurgeon Hjálmar Bjartmarz, who carried out the transplantation surgery.

The patients in the trial were diagnosed with Parkinson’s at least ten years ago and are at a moderate stage of their disease. The researchers will follow these patients closely and assessments of cell survival and potential effects will be conducted over the coming years. 

No clinical data or results will be communicated until a sufficient amount of material from the clinical trial has been collected and analyzed, in adherence with health care confidentiality regulations.

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Could the background circulation of the record-breaking rainfall in July 2021 in east-central China have been predicted?

Peer-Reviewed Publication

INSTITUTE OF ATMOSPHERIC PHYSICS, CHINESE ACADEMY OF SCIENCES

The cover of the special collection on the July 2021 Zhengzhou, Henan Extreme Rainfall Event 

IMAGE: TOWARDS THE GOAL OF UNDERSTANDING THE DYNAMIC, THERMODYNAMIC, MICROPHYSICAL, AND LAND SURFACE AND BOUNDARY LAYER PROCESSES AND CONDITIONS LEADING TO THE JULY 2021 ZHENGZHOU, HENAN EXTREME RAINFALL EVENT, AND TO UNDERSTAND THE LARGE-SCALE INFLUENCE AND CONTROL ON THE REGIONAL PROCESSES, A SPECIAL COLLECTION OF SIX ARTICLES THAT INVESTIGATE SOME OF THE ABOVE QUESTIONS ARE PUBLISHED IN THIS ISSUE. view more 

CREDIT: ADVANCES IN ATMOSPHERIC SCIENCES

In July 2021, unprecedented heavy rainfall occurred in Zhengzhou (east-central China) against a background of a northward shift in the western Pacific subtropical high (WPSH), which is a key atmospheric circulation system affecting the East Asian summer climate. Due to complex air–sea–land interactions, the WPSH exhibits significant interannual to interdecadal variability, which poses a grand challenge to skillfully predicting the climate. In this context, the predictability of the anomalous WPSH in July 2021 remains unknown and deserves careful study.

Recently, in a paper published in Advances in Atmospheric Sciences, scientists from the State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics (LASG), Institute of Atmospheric Physics (IAP), Chinese Academy of Sciences, have revealed both the predictable and unpredictable components of the anomalous WPSH in July 2021 based on large ensemble hindcast experiments using the IAP/LASG ocean–atmosphere coupled model.

“The observed northward shift of the WPSH in July 2021 exhibits a meridional dipole pattern in the 850-hPa geopotential height over the eastern China sea, and the amplitude of geopotential height was the strongest since 1979,” explains Dr Shuai Hu, the lead author of the study. “This meridional dipole pattern corresponds to the two nodes of the so-called Pacific–Japan pattern.”

To reveal the predictability of the anomalous WPSH, Hu and colleagues conducted a 21-member ensemble of seasonal predictions initiated from the end of June 2021. Both the predictable and the unpredictable components of the meridional dipole pattern were identified from the ensemble simulations. The predictable component was driven by positive precipitation anomalies over the tropical western Pacific, which were caused by a positive horizonal advection of the mean moist enthalpy associated with southwesterly anomalies to the northwestern flank of anticyclonic anomalies, which was excited by the La Niña. The unpredictable component was associated with the atmospheric internal intraseasonal oscillations, which were not initialized in the predictions. The relative contributions of the predictable and unpredictable components to the observed northward shift of the WPSH at 850 hPa were 28.0% and 72.0%, respectively.

“Our study calls for attention to be paid to the intraseasonal variability of the WPSH in seasonal predictions. An accurate prediction of the intraseasonal variability is of high priority in efforts devoted to improving the prediction skill for the East Asian summer climate,” says Prof. Tianjun Zhou, corresponding author of the study.

The study is published in a Special Collection on the July 2021 Zhengzhou, Henan Extreme Rainfall Event.

JOURNAL

Advances in Atmospheric Sciences

DOI

10.1007/s00376-022-2151-x 

ARTICLE TITLE

Seasonal Prediction of the Record-Breaking Northward Shift of the Western Pacific Subtropical High in July 2021

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The strong Meiyu in history, beginning with the flood of 1608

Peer-Reviewed Publication

SCIENCE CHINA PRESS

Spatial distribution of the anomaly of the Eastern China total summer rainfall relative to the average from 1470 to 1850 in IGGPRE (a) and RAP (b) reconstruction data (unit: mm). The black box represents the study area. 

IMAGE: SPATIAL DISTRIBUTION OF THE ANOMALY OF THE EASTERN CHINA TOTAL SUMMER RAINFALL RELATIVE TO THE AVERAGE FROM 1470 TO 1850 IN IGGPRE (A) AND RAP (B) RECONSTRUCTION DATA (UNIT: MM). THE BLACK BOX REPRESENTS THE STUDY AREA. view more 

CREDIT: ©SCIENCE CHINA PRESS

This study is led by Dr. Liang Ning (School of Geography, Nanjing Normal University) and graduate student Liulin Wang (School of Geography, Nanjing Normal University). They have found that interdecadal variability of solar radiation had impact on the strong Meiyu event.

The 1608 flood was very severe and had a certain degree of disintegration of the ruling status of the Ming Dynasty in historical records. Therefore, the team chose this flood as the entry point of this study. And they found that Meiyu played an important role in the formation of flood in the Middle and Lower Reaches of the Yangtze River (MLRYR).

Then, the Ming and Qing Dynasties (1470–1850) were divided into three periods of strong solar radiation and three periods of weak solar radiation. It was found that during the periods of strong solar radiation, the frequency of strong Meiyu events was significantly higher than that during the periods of weak solar radiation in the reconstructed precipitation data and model simulations. This was related to the stronger Western Pacific Subtropical High and the stronger blocking high in middle-high latitude during the period of strong solar radiation.

See the article:

Wang L, Ning L, Chen K, Yan M, Liu J, Liu Z, Qin Y, Xue J, Li C. 2023. Influence and mechanism of solar radiation intensity on the interdecadal variability of strong Meiyu events during historical periods. Science China Earth Sciences, 66(2): 408–416, https://doi.org/10.1007/s11430-021-9952-0

https://www.sciengine.com/SCES/doi/10.1007/s11430-021-9952-0

JOURNAL

Science China Earth Sciences

DOI

10.1007/s11430-021-9952-0 


Time series of summer precipitation anomalies in the MLRYR reconstructed from IGGPRE (a) and RAP (b) data from 1470 to 1850, and time series (c) of total solar radiation flux in summer. 


The abscissa of the red dashed line is 1608, the yellow shading represents the period of weak solar radiation, the purple shading represents the period of strong solar radiation, and the gray dashed line is the plus or minus two standard deviation line of each precipitation sequence.

Summer (JJA) geopotential height (unit: gpm) and wind anomaly spatial pattern (unit: m•s－1) at 500 hPa.  


(a), (d) Strong solar radiation period; (b), (e) weak solar radiation period; (c), (f) difference spatial pattern between strong and weak solar radiation periods. The vector represents the wind spatial pattern, the shading area is the anomaly value of the geopotential height at 500 hPa, and the dotted area represents the area where the 500 hPa geopotential height spatial pattern difference has passed the 90% significance test. The data used in ((a)–(c)) is the CESM-LME AF experimental data, and ((d)–(f))) is the CESM-LME SSI experimental data.

CREDIT

SCIENCE CHINA PRESS
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