Publisher Health

Up to 78% of walkers would take a more challenging route featuring obstacles such as balancing beams, steppingstones and high steps, research has found. The findings suggest that providing ‘Active Landscape’ routes in urban areas could help tackle an “inactivity pandemic” and improve health outcomes.
Millions of people in the UK are failing to meet recommended targets for physical activity. Exercising “on the go” is key to changing this but while walking along a pavement is better than nothing it causes no significant increase in heart rate so only qualifies as mild exercise. Walking also fails to significantly improve balance or bone density, unless it includes jumping, balancing, and stepping down.
But would adults opt for such ‘fun’ routes if given the choice? A University of Cambridge-led study published today in the journal Landscape Research suggests that with the right design, most would.
Previous research on ‘healthy route choices’ has focused on people’s likelihood of walking instead of using transport. But this study examined how likely people are to pick a more challenging route over a conventional one and which design characteristics influenced their choices.
Lead author, Anna Boldina, from the University of Cambridge’s Department of Architecture, said: “Even when the increase in level and extent of activity level is modest, when millions of people are using cityscapes every day, those differences can have a major positive impact on public health.”
“Our findings show that pedestrians can be nudged into a wider range of physical activities through minor changes to the urban landscape. We want to help policy makers and designers to make modifications that will improve physical health and wellbeing.”
Boldina began this research after moving from Coimbra in Portugal — where she found herself climbing hills and ancient walls — to London, which she found far less physically challenging.

New symptoms may appear in children up to a year after initial infection with Covid-19, finds a new study led by UCL researchers.
The Children and young people with Long Covid (CLoCk) study, published in The Lancet Regional Health — Europe, is the world’s largest study on long Covid in children.
Researchers asked children aged 11 to 17 about their health six months and 12 months after taking a PCR test between September 2020 and March 2021. They also asked them to recall their symptoms at the time of taking the test.
None of the children initially invited to participate in the study had been hospitalised. In total the researchers examined data from 5,086 children, 2,909 of whom tested positive for Covid-19, and 2,177 of whom tested negative.
Researchers asked the children and young people what they had experienced from a list of 21 symptoms, including shortness of breath and tiredness, as well as using validated scales to assess quality of life, mental health, wellbeing and fatigue.
The team found that, at time of testing, health issues were more common in children and young people who had tested positive for the virus compared to those who tested negative, as well as six months and 12 months post PCR test. For example, among the test-positives, 10.9% reported fatigue at all three time points while among test-negatives only 1.2% reported fatigue at all three time points.

Researchers are using a natural material derived from seaweed to promote vascular cell growth, prevent blood clots and improve the performance of synthetic vascular grafts used in heart bypass surgery.
The new approach, developed and tested at the University of Waterloo, is especially important in cases involving small artificial blood vessels — those less than six millimetres in diameter — which are prone to clots that can develop into full blockages.
“There is a crucial need to develop synthetic vascular graft materials that will increase the rate of long-term functions,” said Dr. Evelyn Yim, a chemical engineering professor and University Research Chair who leads the project.
Researchers added a material called fucoidan, which is made from seaweed, to modify synthetic blood vessels. Fucoidan has a structure similar to heparin, a drug used as an anticoagulant.
When applied with a nanotechnology technique known as micropatterning, fucoidan promotes the growth of vascular cells around the inner surface of the graft, significantly reducing the chances of clots forming.
For patients, the potential benefits include fewer complications, better quality of life and less risk of the recurrence of blockages requiring additional drug treatment or surgery.
“A functional, off-the-shelf, small-diameter vascular graft will help save lives,” said Yim, director of the Regenerative Nanomedicine Lab at Waterloo. “What’s important is that they will be much longer-lasting and allow blood to flow freely.”
Bypass surgery is performed to restore blood flow to areas of the heart when vessels become blocked. Vessels harvested from the patient are the gold standard for grafts, but limited availability often requires the use of artificial vessels.
In addition to heart bypass surgery, grafts are used in medical procedures to treat vascular diseases and restore blood flow to vital organs and tissues, including the brain and legs.
When synthetic graft material doesn’t allow vascular cells to grow on the inside of an artery or vessel, there is a high chance of clots, which can develop into full blockages or cause inflammation that restricts blood flow.
Yim has successfully tested the new technique using fucoidan and micropatterning on small animals and plans to expand to large animal testing before advancing to clinical trials.
Several researchers from the Department of Chemical Engineering at Waterloo and the Department of Biomedical Engineering at the Oregon Health and Science University have collaborated on this project.
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The absence of a certain serotonin receptor supports the reduction of previously learned fear responses.
The neurotransmitter serotonin plays a key role in both the onset and in the unlearning of fear and anxiety. A research team from the Department of General Zoology and Neurobiology headed by Dr Katharina Spoida and Dr Sandra Süß in the Collaborative Research Centre “Extinction Learning” at Ruhr University Bochum, Germany, has been investigating the underlying mechanisms. The researchers showed that mice lacking a specific serotonin receptor unlearn fear much faster than the wild type. The results of the study provide a viable explanation how drugs that are typically used for the treatment of post-traumatic stress disorder (PTSD) alter our brain activity. The ability to unlearn fear is often impaired in PTSD patients, making it more difficult to carry out therapies. The study was published in the journal Translational Psychiatry on 19 November 2022.
Fear responses triggered by everyday sensory input
People who have been affected by a traumatic experience sometimes suffer from a long lasting exaggerated fear response. In such cases, the fear response is triggered by certain sensory impressions that occur in our everyday environment and which then can become overwhelming. Experts refer to this condition as post-traumatic stress disorder (PTSD). In this disorder, it is not possible, or only with difficulty, for affected individuals to unlearn the once-learned connection between a neutral environmental stimulus and the learned fear response, which impairs the success of therapies.
Knowing that the neurotransmitter serotonin plays an important role in the development of fear, the research team explored its role in extinction learning, i.e. the unlearning of fear, in greater detail. To this end, they examined so-called knock-out mice that lack a certain serotonin receptor — the 5-HT2C receptor — due to genetic modifications. These mice learned in one day to associate a certain sound with a mild but unpleasant electrical stimulus. “As a result of this learning process, on the following day they showed a fear response that was characterized by a motionless pause as soon as the tone was played, which we refer to as ‘freezing’,” explains Katharina Spoida.
Absence of the receptor is an advantage
In the next step, the researchers repeatedly played the tone to the mice without applying the electrical stimulus. “Interestingly, we noticed that knock-out mice learned much faster that the tone does not predict the fear stimulus than mice who lacked this specific genetic modification,” says Katharina Spoida. “Consequently, it looks like the absence of the serotonin receptor provides an advantage for extinction learning.”
The researchers investigated this phenomenon in more detail and found that the knock-out mice showed changes in their neuronal activity in two different brain areas. One of these is a specific sub-region of the dorsal raphe nucleus (DRN), which is typically the main site of serotonin production in our brains. In addition, the researchers discovered aberrant neuronal activity in the so-called bed nucleus of the stria terminalis (BNST), which is a part of the so called extended amygdala. “In the knock-out mice, we first found an increased basal activity in certain serotonin-producing cells of the dorsal raphe nucleus. In a subsequent step, we showed that the absence of the receptor also alters neuronal activity in two subnuclei of the BNST, which ultimately supports extinction learning,” describes first author Sandra Süß. The research results also indicate a connection between the two brain regions, which leads the scientists to assume that an interplay is significant for improved extinction learning.
Possible effect of medication revealed
The results of the study may reveal how drugs typically used in the treatment of PTSD affect the brain regions analysed in this study. “There are already drugs in clinical use that regulate the amount of available serotonin, so-called selective serotonin reuptake inhibitors, or SSRIs for short,” points out Katharina Spoida.
“Taking these drugs over a prolonged period of time causes the relevant receptor to become less responsive to serotonin, similar to our knock-out model. Therefore, we assume that the changes we’ve described could be essential for the positive effect of SSRIs,” adds Sandra Süß. The researchers hope that their findings will help to develop more targeted treatment strategies for PTSD patients in the future.
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Materials provided by Ruhr-University Bochum. Original written by Meike Drießen. Note: Content may be edited for style and length.

Urban green space has many well-known health benefits, including longer life expectancy, fewer mental health problems and better cognitive functioning. However, exactly how much green space is needed to improve people’s health remains an open question.
A new study led by ISGlobal, a centre supported by the “la Caixa” Foundation, has evaluated the relationship between better mental health and the 3-30-300 green space rule. According to this rule of thumb, everyone should be able to see at least three trees from their home, have 30% tree canopy cover in their neighbourhood and not live more than 300 metres away from the nearest park or green space. The rule was proposed by urban forester Cecil Konijnendijk and has been widely promoted by many other foresters and urban planners.
The findings of the study showed that full adherence to the 3-30-300 green space rule was clearly associated with better mental health, less medication use and fewer visits to a psychologist, although the association was statistically significant only for the latter. Residential surrounding greenness, but not visibility of trees from windows or access to a major green space, was significantly associated with better mental health.
The findings indicate that only 4.7% of the surveyed population met all three criteria of the green space rule. Just over 43% of respondents had at least three trees within 15 metres of their home, 62.1% had a major green space within 300 metres and 8.7% lived in an area with sufficient surrounding greenness. However, nearly 22.4% had none of these elements.
This cross-sectional study was based on a sample of 3,145 Barcelona inhabitants aged 15-97 years who participated in the Barcelona Health Survey 2016 -made by The Barcelona Public Health Agency- and were recruited randomly. Mental health status was assessed with the 12-item General Health Questionnaire (GHQ-12). Eighteen percent of participants reported poor mental health and 8.3% reported having visited a psychologist in the previous year. In addition, 9.4% reported using tranquillisers or sedatives and 8.1% reported having used antidepressants in the previous two days.
“The study found that there is relatively little green space in Barcelona and that the 3-30-300 rule is satisfied only for a small percentage of people, despite its beneficial mental health effects,” explained Mark Nieuwenhuijsen, Director of the Urban Planning, Environment and Health Initiative at ISGlobal and lead author of the study.
“There is an urgent need to provide citizens with more green space. We may need to tear out asphalt and plant more trees, which would not only improve health, but also reduce heat island effects and contribute to carbon capture,” pointed out Nieuwenhuijsen. “Any initiative that leads to a greener city will be a step forward, the key message is that we need more and faster greening,” added the lead author of the study.
According to the research team, similar studies should be carried out in cities with more tree cover than Barcelona, since the lack of green space, especially sufficient tree cover, limits the ability to assess the 30% aspect of the 3-30-300 rule. “The question is to what extent 30% tree canopy cover is feasible, especially in compact cities,” the researchers concluded.
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Materials provided by Barcelona Institute for Global Health (ISGlobal). Note: Content may be edited for style and length.

In our quest for clean energy and sustainable health solutions, advanced materials with unique, customizable properties play a crucial role. Among them, a new generation of porous solids known as three dimensional (3D) covalent organic frameworks (COFs) have generated considerable interest owing to potential applications in catalysis, separation, semiconduction, proton conduction, and biomedicine. The novelty of these materials lies in their synthesis as well as their applications. 3D COFs are porous organic materials developed from linking molecular building blocks with strong covalent bonds into crystalline, extended, net-like reticular three-dimensional structures.
However, synthesis of 3D COFs from pre-designed building units leading to net-like “reticular” arrangement of constituent parts or “network topologies” remains challenging. This is due to the shortage of 3D building units and inadequate reversibility of the linkages between the building units.
Recently, Professor Yuichi Negishi from the Department of Applied Chemistry, Faculty of Science, Tokyo University of Science, Japan, and his colleagues in the Department of Applied Chemistry, Tokyo University of Science, Dr. Saikat Das, Mr. Taishu Sekine, and Ms. Haruna Mabuchi have succeeded for the first time in creating a novel 3D COF unique networked topology. “In this study, we have succeeded for the first time in creating a 3D COF with scu-c topology (network structure) by connecting nodes of a regular plane (4-connected) with nodes of a regular prism (8-connected). This new COF, i.e., TUS-84, has a double interpenetrating structure with well-defined voids,” says Prof. Negishi. The study has been published in ACS Applied Materials & Interfaces in volume 14 issue 42 of the journal on October 17, 2022.
As a part of the study, the researchers performed a condensation reaction of two organic linkers called DPTB-Me and TAPP with different symmetries, to yield 3D COF with an scu-c net-like arrangement of constituents. The team then conducted powder x-ray diffraction (PXRD) and high-resolution transmission electron microscopy (HRTEM) to analyze the crystal structure and properties of the synthesized 3D COF. The researchers also conducted structural modeling and simulation, which showed great alignment with the observed experimental features while providing further structural insights.
The researchers further demonstrated that the synthesized 3D COF has excellent hydrogen, carbon dioxide, and methane adsorption properties that reinforces its prospects in carbon capture and clean energy applications. As Prof. Negishi notes, “The development of appropriate COFs also facilitates the recovery of metal resources and noble gases, such as argon, in an energy-efficient way. This contributes to the improvement of resource and energy problems.”
The icing on the cake for this novel 3D COF is its efficiency in drug delivery applications. The team unveiled TUS-84’s drug delivery capabilities with efficient drug loading and sustained release profiles using ibuprofen, a common nonsteroidal anti-inflammatory drug. TUS-84 showed an extended drug release performance of about 35% after 5 days. This facilitates the delivery of sustained concentrations of drug over a prolonged period. As a result, dose frequency could be reduced, and more consistent control of long-lasting, chronic pain could be possible.
The findings of this study pave the way toward the development of future 3D COFs with unique topologies for applications across a wide range of fields, from medicine to environmental remediation.
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Materials provided by Tokyo University of Science. Note: Content may be edited for style and length.

Researchers at Penn Medicine and Intel Corporation led the largest-to-date global machine learning effort to securely aggregate knowledge from brain scans of 6,314 glioblastoma (GBM) patients at 71 sites around the globe and develop a model that can enhance identification and prediction of boundaries in three tumor sub-compartments, without compromising patient privacy. Their findings were published today in Nature Communications.
“This is the single largest and most diverse dataset of glioblastoma patients ever considered in the literature, and was made possible through federated learning,” said senior author Spyridon Bakas, PhD, an assistant professor of Pathology & Laboratory Medicine, and Radiology, at the Perelman School of Medicine at the University of Pennsylvania. “The more data we can feed into machine learning models, the more accurate they become, which in turn can improve our ability to understand, treat, and remove glioblastoma in patients with more precision.”
Researchers studying rare conditions, like GBM, an aggressive type of brain tumor, often have patient populations limited to their own institution or geographical location. Due to privacy protection legislation, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in the United States, and General Data Protection Regulation (GDPR) in Europe, data sharing collaborations across institutions without compromising patient privacy data is a major obstacle for many healthcare providers.
A newer machine learning approach, called federated learning, offers a solution to these hurdles by bringing the machine learning algorithm to the data instead of following the current paradigm of centralizing data to the algorithms. Federated learning — an approach first implemented by Google for keyboards’ autocorrect functionality — trains a machine learning algorithm across multiple decentralized devices or servers (in this case, institutions) holding local data samples, without actually exchanging them. It has been previously shown to allow clinicians at institutions in different countries to collaborate on research without sharing any private patient data.
Bakas led this massive collaborative study along with first authors Sarthak Pati, MS, a senior software developer at Penn’s Center for Biomedical Image Computing & Analytics (CBICA), Ujjwal Baid, PhD, a postdoctoral researcher at CBICA, Brandon Edwards, PhD, a research scientist at Intel Labs,and Micah Sheller, a research scientist at Intel Labs.
“Data helps to drive discovery, especially in rare cancers where available data can be scarce. The federated approach we outline allows for access to maximal data while lowering institutional burdens to data sharing.” said Jill Barnholtz-Sloan, PhD, adjunct Professor at Case Western Reserve University School of Medicine.

Both medication and a specific form of talk therapy called cognitive behavioral therapy (CBT) are proven evidence-based treatments for children and adolescents with anxiety disorders.
But when CBT does not lead to improvement, do parents and their children opt to begin medication treatment? And what factors contribute to this decision?
These were the questions researchers led by the University of Cincinnati’s Jeffrey Strawn and Jeffrey Mills asked in a recent study, with the results published Dec. 5 in theJournal of Clinical Psychiatry.
Strawn, MD, said the research was a reanalysis of the Child/Adolescent Anxiety Multimodal Study (CAMS), a large trial that enrolled nearly 500 children and adolescents with generalized separation and/or social anxiety disorders. The original trial found that CBT, or talk therapy, and medications were equally effective, while the combination of the two treatments led to even better results.
The research team looked at a subset of patients who were treated with CBT but did not improve. ??Although the data from the CAMS trial has been available for some time, the question of what drives patient decision-making on further treatment choices had yet to be examined.
“For the folks who got therapy and didn’t get completely better, we wanted to try to understand if they started medication, the other effective evidence-based treatment for anxiety disorders,” said Strawn, professor in the Department of Psychiatry and Behavioral Neuroscience in UC’s College of Medicine and a UC Health child and adolescent psychiatrist.

Scientists from the National University of (NUS) have discovered a novel low-cost method of testing for cancers. Called the Heatrich-BS assay, this new test sequences clinical samples that have been heated in order to isolate cancer-specific signatures found in a patient’s blood.
The new method provides a promising non-invasive alternative to tissue biopsies. It costs around S$50 (about US$35) from start to finish, compared to other sequencing methods that can cost up to S$1,000 (about US$740) to conduct. Led by Assistant Professor Cheow Lih Feng, the team comprising researchers from the NUS Department of Biomedical Engineering under the College of Design and Engineering as well as the NUS Institute for Health Innovation & Technology, is now exploring industry partnerships to bring their technology to market.
“When you have a S$50 (about US$35) test, it opens up a lot of avenues because it is affordable, so you can do the test quite regularly,” said Asst Prof Cheow, pointing to the potential for their assay to be used in regular cancer monitoring.
Liquid biopsies for cancer
Current methods of testing for cancers can suffer from a lack of sensitivity or from being too expensive to be used for regular screening. The DNA in our blood, the genetic information that tells our cells how to synthesise proteins and other important biological building blocks, is produced by different organs in our body. Cancer cells also release DNA into the bloodstream that can be detected by analysing blood samples, known as liquid biopsies. However, sifting through all the genetic material in a sample — a method called whole-genome sequencing — can be expensive and labour intensive.
Some clinicians instead target cancer-specific signatures in cell-free DNA, almost like hunting for specific faces in a large crowd of people instead of inspecting every single individual. Yet, even such methods can be imperfect, Asst Prof Cheow explained. “Some patients may have cancer signatures that look slightly different and allow them to slip through the screening process,” he said.

It’s well established that experiencing stress can hurt our physical health. Now two new studies find that younger adults who take preemptive steps to respond to stress are better able to avoid those negative health outcomes.
“The fact that we have two studies with the same results highlights the importance of proactive coping for younger adults when it comes to handling stress,” says Shevaun Neupert, corresponding author of a paper on the two studies and a professor of psychology at North Carolina State University.
“These results are important for helping us work with people to build resilience, since proactive coping refers to skills that can be taught. The findings also suggest that younger adults, in particular, can benefit significantly from these skills.”
Proactive coping is an umbrella term for behaviors that allow people to avoid future stressors or prepare themselves to respond to those stressors. These can be behavioral, such as saving money to deal with unexpected expenses, or cognitive, such as visualizing how to deal with potential challenges.
“You can also think of proactive coping as a way of helping people continue to work toward their goals, even when dealing with challenges,” Neupert says.
The first of the two studies focused on skills that allowed people to concentrate on their goals when dealing with stressors. For this study, the researchers enlisted 223 people: 107 younger adults (ages 18-36) and 116 older adults (ages 60-90). Study participants completed an initial survey that focused on understanding goal-oriented proactive coping behaviors that the participants engaged in. The participants then completed daily surveys for the next eight days, recording the stressors they experienced each day, as well as their physical health symptoms.
“We found that younger adults who consistently engaged in proactive coping, such as thinking about what they need in order to be successful, experienced fewer negative physical health symptoms on stressful days,” Neupert says. “However, there was no positive or negative effect of proactive coping for older adults.”
The second study focused on efforts aimed at avoiding or preventing stressors. For this study, the researchers enlisted 140 people between the ages of 19 and 86. Study participants completed a baseline survey designed to capture their stress-prevention proactive coping behaviors. After that, the study participants completed daily surveys for 29 consecutive days, reporting on their daily stressors and physical health.
For this study, the researchers found that adults between the ages of 19 and 36 who engaged in proactive coping reported little or no drop-off in physical health on stressful days, compared to adults in the same age range who engage in less proactive coping. However, as with the first study, proactive coping had no effect for older adults.
“The effects in the both studies were linear, so the more proactive coping younger adults engaged in, the better their physical health on stressful days,” Neupert says.
“These findings suggest there is tremendous value in teaching young people how to engage in proactive coping, starting with college-age young adults, but extending through to people who are established in adulthood.”
The work was done with funding from NC State’s College of Humanities and Social Sciences.
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Materials provided by North Carolina State University. Original written by Matt Shipman. Note: Content may be edited for style and length.