Shared insights for heat health risk adaptation in metropolitan areas of developing countries.

Global warming has led to a surge in heat health risks (HHRs), the impacts of which are particularly pronounced in metropolitan areas of developing countries. In the current study, six metropolitan areas - Beijing, China; Cairo, Egypt; Jakarta, Indonesia; Mumbai, India; Rio de Janeiro, Brazil; and Tehran, Iran - were selected as the study area to further differentiate the built-up landscapes by utilizing the concept of local climate zones. Moreover, we assessed the similarities and differences in HHR associated with the landscape. Results revealed a 30.67% higher HHR in compact built-up landscapes than in the open built-up type. Urban green spaces played an effective but differentiated role in mitigating HHR. That is, low vegetation in urbanized areas and trees in suburban areas significantly mitigated HHR. Collectively, our findings emphasize the role of effective planning and management in addressing HHR and provide empirical support for implementing HHR mitigation and adaptation strategies.

Variations of Urban Thermal Risk with Local Climate Zones.

Due to the differences in land cover and natural surroundings within cities, residents in various regions face different thermal risks. Therefore, this study combined multi-source data to analyze the relationship between urban heat risk and local climate zones (LCZ). We found that in downtown Shenyang, the building-type LCZ was mainly found in urban centers, while the natural- type LCZ was mainly found in suburbs. Heat risk was highest in urban centers, gradually decreasing along the suburban direction. The thermal risk indices of the building-type LCZs were significantly higher than those of the natural types. Among the building types of LCZs, LCZ 8 (open middle high-rise) had the highest average thermal risk index (0.48), followed by LCZ 3 (0.46). Among the natural types of LCZs, LCZ E (bare rock and paved) and LCZ F (bare soil and sand) had the highest thermal risk indices, reaching 0.31 and 0.29, respectively. This study evaluated the thermal risk of the Shenyang central urban area from the perspective of LCZs and combined it with high-resolution remote sensing data to provide a reference for thermal risk mitigation in future urban planning.

Regional thermal environment changes: Integration of satellite data and land use/land cover.

Land surface temperature (LST) is subject to location and environmental influences, which makes quantification difficult in terms of timeliness. Based on 10-d geostationary satellite LST TCI products, we quantitatively evaluated the thermal environment differentiation of various ground objects in North, South, and Northwest China from 2017 to 2021. We found that the thermal condition index (TCI) in Northwest China decreased, whereas it increased in North and South China. In contrast, Moran's I index increased in Northwest and South China, with strong spatial agglomeration. The TCI for artificial surfaces decreased from North (0.633) to Northwest (0.554) and South China (0.384). The bare land TCI was always the lowest among the land use/land cover (LULC) types in each region. Our results reflect the LULC thermal environment of China against the background of new urbanization and provide theoretical support for scientific planning to improve the ecological environment.

Efficacy and safety of acupuncture for depression: A systematic review and meta-analysis.

Acupuncture is widely accepted as a therapeutic option for managing depression. However, evidence from clinical trials remains controversial. This review aims to synthesize the best available evidence on the efficacy and safety of acupuncture in managing depression. The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Five databases and the relevant trial registries were searched from the inception to October 2021. Randomized clinical trials of acupuncture for managing depression, published in English, were selected for inclusion. The quality of included studies was assessed using the Cochrane risk of bias tool. Netmeta and dmetar of R packages were used to conduct a network meta-analysis. Twenty-two trials with 2391 participants were eligible and included in the analysis. This review found evidence that electroacupuncture (EA) plus antidepressant achieved superior outcomes compared with the waitlist (standardized mean difference = -8.86, 95% confidence interval: -14.78 to -2.93). The treatment ranking of different interventions in improving depression symptoms indicated that EA plus antidepressant with a probability of 0.8294, followed by manual acupuncture (MA) plus antidepressant (0.6470) and MA (0.5232). Acupuncture, either in isolation or as an adjunct to pharmacological treatment, has clinical benefits and can be considered a safe option for managing depression.

Warming and cooling effects of local climate zones on urban thermal environment.

Understanding the thermal characteristics and contribution ranking of local climate zones (LCZs) is essential since they can help in maintaining environmental harmony. However, previous studies only considered independent effects and could not analyze the combined effects of LCZ on land surface temperature (LST). In this study, we propose a new method to establish an interaction model between LCZs. Five first-level grids with different scales from 270 to 990 m were established to calculate the area proportion of LCZ. The area proportion of LCZ was then applied in the stepwise regression model to quantitatively analyze its magnitude and direction of impact on the LST. The results suggest that the LCZ types of the study area with the highest and lowest average LST were LCZ2 (compact middle-rise building, 39.82°C) and LCZG (water body, 34.24°C), respectively. However, on most scales, the warming effect of LCZ2 was lower than that of LCZE (bare rock or paver), and the cooling effect of LCZG was lower than that of LCZD (low plants). The optimum results were obtained at a scale of 810 m. At this scale, the warming effect was in the order: LCZE (0.314) > LCZ2 (0.236) > LCZ3 (compact low-rise building, 0.135) > LCZ5 (open middle-rise, 0.084) > LCZ6 (open low-rise, 0.056); the cooling effect was in the order: LCZD (-0.272) > LCZA (dense trees, -0.104) > LCZG (-0.103). These findings can help to elucidate the unique warming and cooling effects of LCZ on the interaction condition and the construction of an urban human settlement.

Urban ventilation corridors and spatiotemporal divergence patterns of urban heat island intensity: a local climate zone perspective.

Urban ventilation corridors introduce fresh air into urban interiors and improve urban livability, while mitigating the urban heat island (UHI) effect. However, few studies have assessed the impact of urban ventilation corridors on UHI intensity (UHII) from the perspective of the local climates of different cities. Therefore, this study integrated multisource data to construct ventilation corridors from the perspective of local climate zone (LCZ) and analyzed its impact on UHII. The results showed the following: (1) the average UHII of constructed LCZs was higher than that of natural LCZs, among which the building type LCZ10 (heavy industry) had the highest intensity (5.77 °C); (2) in extracted ventilation corridors, the pixel number of natural LCZs was substantially larger than that of constructed LCZs, among which LCZE (bare soil/paved) was the largest; and (3) for natural LCZs, the average UHII of each LCZ was lower within the ventilated corridors than within the non-ventilated corridors (except for LCZG [water]), with the UHII of LCZB (scattered trees) exhibiting the greatest mitigation effect. Quantitative research on the composition and function of ventilation corridors can not only assess the ability of ventilation corridors to mitigate UHIs, but also provide a reference for urban ventilation corridor planning.

Feasibility and therapeutic efficacy of a two-week low-level laser acupuncture therapy for shoulder and neck pain in office workers: Protocol for a pilot, single-blind, double-armed, randomised controlled trial.

BACKGROUND: Shoulder and neck pain (SNP) is common in office workers and represents a serious public health problem given its detrimental impact on quality of life, physical functioning, personal finances, employers, and the health care system. Management with painkillers has adverse implications such as tolerance, addiction, and opioid abuse. Safe, sustainable, cost-effective, and evidence-based solutions are urgently needed. The non-invasive, painless, non-infectious, and safe modality of low-level laser acupuncture (LLLA) has shown promise for SNP management. OBJECTIVE: The overarching aim of this study is to provide evidence of the feasibility and therapeutic efficacy of LLLA for office workers with SNP. METHODS: This is a pilot, single-blind, double-armed, randomised controlled trial on the feasibility and therapeutic efficacy of a two-week LLLA therapy for office workers with SNP, aged 18 to 65 years. Each of the two study groups will contain 35 participants: the intervention group will receive LLLA from a licensed acupuncturist at the researchers' university clinic (10-20 min/session, 3 sessions/week) for two weeks; the control group will receive usual care without painkillers. Outcomes will be measured at baseline, throughout the two-week intervention, and at trial end. Surveys including open-ended questions will be completed. The primary outcome of this study is to evaluate the feasibility of a two-week LLLA therapy for office workers with SNP, as measured by recruitment and completion rates, patient safety, and treatment adherence and compliance. Participants' attitudes, motivation, and challenges to participation, intervention non-compliance, and experience of participating in the trial will be investigated via qualitative data. The secondary outcome is to evaluate the therapeutic efficacy of LLLA on SNP using the visual analogue scale (VAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ); the work productivity and activity assessment (WPAI:SHP); 12-Item Short Form Survey (SF-12) for quality of life assessment; and the past 3-month out-of-pocket (OOP) cost for prescription and non-prescription SNP therapy, which is an indicative of the economic burden of SNP on patients and health care systems. This study was approved by Edith Cowan University's Human Research Ethics Committee (No. 2021-02225-WANG). RESULTS: Data collection will commence in December 2021 with anticipated completion by December 2022. CONCLUSIONS: Safe, sustainable, cost-effective, evidence-based interventions are needed to minimise the negative implications of SNP in office workers. LLLA is a promising modality in managing SNP. However, more consolidated evidence is required to provide insight regarding the effectiveness of LLLA. This study is expected to contribute to the challenging work of reducing the burden of SNP in office workers. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000426886p; https://www.anzctr.org.au/ACTRN12621000426886p.aspx.

Contribution of urban ventilation to the thermal environment and urban energy demand: Different climate background perspectives.

Urbanization can lead to changes in urban morphology that alter the urban thermal environment and energy demand. Improving urban ventilation can alleviate the urban heat island effect and reduce urban energy demand. We categorized the ventilation conditions of 31 major cities in China into four levels based on the frontal area index and presented the natural ventilation effects for cities in five different climate zones. We found that the land surface temperature varies between 0.029 and 5.357 °C in areas under the same climate background. Improving ventilation can directly or indirectly contribute to reductions in urban energy consumption. The energy demand in well-ventilated areas can be reduced by up to 6.704%. The largest reduction in urban energy demand was achieved by improving ventilation within the temperate continental climate zone.

Investigating On-Road Lane Maintenance and Speed Regulation in Post-Stroke Driving: A Pilot Case-Control Study.

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults' driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

Children's outdoor active mobility behaviour and neighbourhood safety: a systematic review in measurement methods and future research directions.

BACKGROUND: Numerous studies have examined the association between safety and primary school-aged children's forms of active mobility. However, variations in studies' measurement methods and the elements addressed have contributed to inconsistencies in research outcomes, which may be forming a barrier to advancing researchers' knowledge about this field. To assess where current research stands, we have synthesised the methodological measures in studies that examined the effects of neighbourhood safety exposure (perceived and measured) on children's outdoor active mobility behaviour and used this analysis to propose future research directions. METHOD: A systematic search of the literature in six electronic databases was conducted using pre-defined eligibility criteria and was concluded in July 2020. Two reviewers screened the literature abstracts to determine the studies' inclusion, and two reviewers independently conducted a methodological quality assessment to rate the included studies. RESULTS: Twenty-five peer-reviewed studies met the inclusion criteria. Active mobility behaviour and health characteristics were measured objectively in 12 out of the 25 studies and were reported in another 13 studies. Twenty-one studies overlooked spatiotemporal dimensions in their analyses and outputs. Delineations of children's neighbourhoods varied within 10 studies' objective measures, and the 15 studies that opted for subjective measures. Safety perceptions obtained in 22 studies were mostly static and primarily collected via parents, and dissimilarities in actual safety measurement methods were present in 6 studies. The identified schematic constraints in studies' measurement methods assisted in outlining a three-dimensional relationship between 'what' (determinants), 'where' (spatial) and 'when' (time) within a methodological conceptual framework. CONCLUSIONS: The absence of standardised measurement methods among relevant studies may have led to the current diversity in findings regarding active mobility, spatial (locality) and temporal (time) characteristics, the neighbourhood, and the representation of safety. Ignorance of the existing gaps and heterogeneity in measures may impact the reliability of evidence and poses a limitation when synthesising findings, which could result in serious biases for policymakers. Given the increasing interest in children's health studies, we suggested alternatives in the design and method of measures that may guide future evidence-based research for policymakers who aim to improve children's active mobility and safety.

Spatiotemporal variation characteristics of green space ecosystem service value at urban fringes: A case study on Ganjingzi District in Dalian, China.

In this study, a green space classification system for urban fringes was established based on multisource land use data from Ganjingzi District, China (2000-2015). The purpose of this study was to explore the spatiotemporal variation of green space landscapes and ecosystem service values (ESV). During 2006-2015, as urbanization advanced rapidly, the green space area decreased significantly (359.57 to 213.46 km2), the ESV decreased from 397.42 to 124.93 million yuan, and the dynamic degrees of ESV variation were always <0. The green space large plaque index and class area both declined and the number of plaques and plaque density increased, indicating green space landscape fragmentation. The dynamic degrees of ESV variation in western and northern regions (with relatively intensive green space distributions) were higher than in the east. The ESV for closed forestland and sparse woodland had the highest functional values of ecological regulation and support, whereas dry land and irrigated cropland provided the highest functional values of production supply. The findings of this study are expected to provide support for better construction practices in Dalian and for the improvement of the ecological environment.

Towards unpacking older drivers' visual-motor coordination: A gaze-based integrated driving assessment.

Visual information for a driver is predominant during driving. Linking drivers' visual search patterns with motor behaviour helps understand how drivers perceived spatial and hazardous information to regulate their physical movements. Visual-motor coordination performance can be a sensitive indicator for driver competency assessment. Due to age-related cognitive decline, older drivers are likely inefficient in visual-motor coordination. While poor visual-motor coordination can cause risky behaviour behind the wheel, it is yet challenging to examine it owing to the complexity of driving behaviour. By reviewing how vision guides driving, we proposed a gaze-based integrated driving assessment approach. The empirical data were from 38 older drivers aged 60 to 81 years, who completed an on-road driving assessment recorded by eye tracking and vehicle movement tracking. Their visual search attributes were extracted from eye tracking video frames and linked to vehicle positions. Driving data, drivers' cognitive condition and driving section were encapsulated into an integrated database, allowing interrogating multi-faceted driver-vehicle-environment interactions. Exploratory analysis results show that older drivers' performed different visual search patterns at roundabout and intersection manoeuvres. Older drivers with better executive function skills performed more frequent eye fixations on the curves and inside vehicle features. The investigation of visual-motor coordination performance demonstrated the feasibility and effectiveness of using the integrated approach in assessing older drivers' performance.

Spatial and temporal visualisation techniques for crash analysis.

Understanding the underlying structure of single vehicle crashes (SVCs) is essential for improving safety on the roads. Past research has found that SVCs tend to cluster both spatially and temporally. However, limited research has been conducted to investigate the interaction between the location of SVCs and the time they occur, especially at different levels of scales or spatial extents. This paper applied spatial, temporal and spatio-temporal techniques to investigate patterns of SVCs in Western Australia between 1999 and 2008, at different levels of scale. Spider graphs were adapted to identify temporal patterns of vehicle crashes at two different levels of scales: daily and weekly with respect to their causes. The spatial structures of vehicle crashes were analysed using Kernel Density Estimation analysis at three different scales: West Australia, Metropolitan area, and Perth Local Government Area (LGA). These are illustrated using spatial zooming theory. Comap was then used to demonstrate the spatio-temporal interaction effect on vehicle crashes. The results show significant differences in spatio-temporal patterns of SVCs for various crash causes. The techniques used here have the potential to help decision makers in developing effective road safety strategies.