The Stanford Hall consensus statement for post-COVID-19 rehabilitation.

The highly infectious and pathogenic novel coronavirus (CoV), severe acute respiratory syndrome (SARS)-CoV-2, has emerged causing a global pandemic. Although COVID-19 predominantly affects the respiratory system, evidence indicates a multisystem disease which is frequently severe and often results in death. Long-term sequelae of COVID-19 are unknown, but evidence from previous CoV outbreaks demonstrates impaired pulmonary and physical function, reduced quality of life and emotional distress. Many COVID-19 survivors who require critical care may develop psychological, physical and cognitive impairments. There is a clear need for guidance on the rehabilitation of COVID-19 survivors. This consensus statement was developed by an expert panel in the fields of rehabilitation, sport and exercise medicine (SEM), rheumatology, psychiatry, general practice, psychology and specialist pain, working at the Defence Medical Rehabilitation Centre, Stanford Hall, UK. Seven teams appraised evidence for the following domains relating to COVID-19 rehabilitation requirements: pulmonary, cardiac, SEM, psychological, musculoskeletal, neurorehabilitation and general medical. A chair combined recommendations generated within teams. A writing committee prepared the consensus statement in accordance with the appraisal of guidelines research and evaluation criteria, grading all recommendations with levels of evidence. Authors scored their level of agreement with each recommendation on a scale of 0-10. Substantial agreement (range 7.5-10) was reached for 36 recommendations following a chaired agreement meeting that was attended by all authors. This consensus statement provides an overarching framework assimilating evidence and likely requirements of multidisciplinary rehabilitation post COVID-19 illness, for a target population of active individuals, including military personnel and athletes.

The impact of reducing car weight on global emissions: the future fleet in Great Britain.

Current European policies define targets for future direct emissions of new car sales that foster a fast transition to electric drivetrain technologies. However, these targets do not consider the emissions produced in electricity generation and material production, and therefore fail to incentivise car manufacturers to consider the benefits of vehicle weight reduction. In this paper, we examine the potential benefits of limiting the average weight and altering the material composition of new cars in terms of global greenhouse gas emissions produced during the use phase, electricity generation and material production. We anticipate the emissions savings for the future car fleet in Great Britain until 2050 for various alternative futures, using a dynamic material flow analysis of ferrous metals and aluminium, and considering an evolving demand for car use. The results suggest that fostering vehicle weight reduction could produce greater cumulative emissions savings by 2050 than those obtained by incentivising a fast transition to electric drivetrains, unless there is an extreme decarbonization of the electricity grid. Savings promoted by weight reduction are immediate and do not depend on the pace of decarbonization of the electricity grid. Weight reduction may produce the greatest savings when mild steel in the car body is replaced with high-strength steel.This article is part of the themed issue 'Material demand reduction'.

Micromechanical properties of human trabecular bone: a hierarchical investigation using nanoindentation.

The ability to assess the risk of fracture, evaluate new therapies, predict implant success and assess the influence of bone remodeling disorders requires specific measurement of local bone micromechanical properties. Nanoindentation is an established tool for assessing the micromechanical properties of hard biological tissues. In this study, elastic modulus and hardness were quantified using nanoindentation for human trabecular bone from the intertrochanteric region of the proximal femur. These properties were demonstrated to be heterogeneous and highly correlated at the intraspicule, interspicule, and interspecimen levels. The results of this study have important implications for current understanding of structure-function relationships throughout the trabecular bone structural hierarchy.

Economic input-output life-cycle assessment of trade between Canada and the United States.

With increasing trade liberalization, attempts at accounting for environmental impacts and energy use across the manufacturing supply chain are complicated by the predominance of internationally supplied resources and products. This is particularly true for Canada and the United States, the world's largest trading partners. We use an economic input-output life-cycle assessment (EIO-LCA) technique to estimate the economy-wide energy intensity and greenhouse gas (GHG) emissions intensity for 45 manufacturing and resource sectors in Canada and the United States. Overall, we find that U.S. manufacturing and resource industries are about 1.15 times as energy-intensive and 1.3 times as GHG-intensive as Canadian industries, with significant sector-specific discrepancies in energy and GHG intensity. This trend is mainly due to a greater direct reliance on fossil fuels for many U.S. industries, in addition to a highly fossil-fuel based electricity mix in the U.S. To account for these differences, we develop a 76 sector binational EIO-LCA model that implicitly considers trade in goods between Canada and the U.S. Our findings show that accounting for trade can significantly alter the results of life-cycle assessment studies, particularly for many Canadian manufacturing sectors, and the production/consumption of goods in one country often exerts significant energy- and GHG-influences on the other.