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Life, including working style and travel behaviour, has been severely disrupted by the COVID-19 pandemic. The unprecedented number of work-from-home (WFH) employees after the outbreak of COVID-19 has attracted much scholarly attention. As it is generally believed that WFH arrangements are not ephemeral, it is imperative to study the impacts of WFH on travel behaviour and its impact on sustainable transport in the post-pandemic era. In relation, this study uses a set of longitudinal GPS tracking data in Switzerland to examine changes in trip characteristics (i.e. travel distance, travel time), travel behaviours (i.e. travel frequency, peak hour departure, trip destination, travel mode), and activities (i.e. trip pattern diversity, trip purpose, and time spent at home). Two groups of participants (WFH and Non-WFH) are identified and compared through three periods (pre-COVID, during lockdown, and post lockdown) from September 2019 to October 2020. Results show that more significant reductions of trip distance, travel time, travel frequency, morning peak hours trips, trips to the CBD are observed among the WFH group. These changes helped to mitigate negative transport externalities. Meanwhile, active transport trips, trip pattern diversity, leisure trips, and time spent at home also increased more significantly for the WFH group when compared to their counterparts. Hence, promoting WFH may not only be beneficial to teleworkers but also to the wider community through more sustainable transport. Future research direction and policy implications are also discussed., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Hong Kong Society for Transportation Studies. Published by Elsevier Ltd. All rights reserved.)

Traffic congestion has been a persistent problem in cities globally. Theoretically, commuting-related congestion can be relieved by promoting working from home (WFH). Amid the COVID-19 pandemic, WFH arrangement has been encouraged or enforced to reduce the spread of the coronavirus. Under these circumstances, it was reported that traffic congestion has been alleviated in many cities. However, changes in congestion patterns within a city have not been studied in-depth. In this study, we analysed the congestion index (CI) at peak hours, when commuting-related congestion is typically most serious, throughout different waves of the pandemic in Hong Kong. Results show that under WFH arrangement, peak-hour congestion has been alleviated. Within a day, morning peak congestion was more relieved. Spatially, significant drops in CI were found not only in the central business district and urban cores but also in some new town areas. This paper has significant implications for urban planners in creating more sustainable cities that duly consider the commuting needs of residents, and cautions against the optimism that WFH can relieve urban transport problems despite jobs-housing imbalance. While the WFH arrangement has potentials to ease commuting congestion, future e-working and transport measures need to take spatial and temporal dimensions into account., Competing Interests: On behalf of all authors, the corresponding author states that there is no conflict of interest., (© 2022 Elsevier Ltd. All rights reserved.)

Despite unprecedented progress in developing COVID-19 vaccines, global vaccination levels needed to reach herd immunity remain a distant target, while new variants keep emerging. Obtaining near universal vaccine uptake relies on understanding and addressing vaccine resistance. Simple questions about vaccine acceptance however ignore that the vaccines being offered vary across countries and even population subgroups, and differ in terms of efficacy and side effects. By using advanced discrete choice models estimated on stated choice data collected in 18 countries/territories across six continents, we show a substantial influence of vaccine characteristics. Uptake increases if more efficacious vaccines (95% vs 60%) are offered (mean across study areas = 3.9%, range of 0.6%-8.1%) or if vaccines offer at least 12 months of protection (mean across study areas = 2.4%, range of 0.2%-5.8%), while an increase in severe side effects (from 0.001% to 0.01%) leads to reduced uptake (mean = -1.3%, range of -0.2% to -3.9%). Additionally, a large share of individuals (mean = 55.2%, range of 28%-75.8%) would delay vaccination by 3 months to obtain a more efficacious (95% vs 60%) vaccine, where this increases further if the low efficacy vaccine has a higher risk (0.01% instead of 0.001%) of severe side effects (mean = 65.9%, range of 41.4%-86.5%). Our work highlights that careful consideration of which vaccines to offer can be beneficial. In support of this, we provide an interactive tool to predict uptake in a country as a function of the vaccines being deployed, and also depending on the levels of infectiousness and severity of circulating variants of COVID-19., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Context: The annual consumption of opioid analgesics in the U.S. was more than 10 times the world average, whereas that in China was at a moderate level within Asia but much lower than the worldwide average. The opposite situations of opioid use in the U.S. and China revealed totally different problems in the developed versus developing world, that is, overuse versus underuse of opioids., Objectives: This study analyzed the clinical consumption, estimated the needs of pain treatment, and evaluated the adequacy of opioid analgesic consumption in mainland China and its seven regions., Methods: A retrospective analysis of the national and regional consumption of opioid analgesics in mainland China during 2006-2016 was conducted. The adequacy of consumption measure was used to gauge the overall adequacy of opioid analgesic consumption in morphine equivalents (MEs) for the treatment of moderate-to-severe pain in mainland China and compared with international data. Annual per capita consumption was adopted to measure the clinical consumption of opioid analgesics in MEs at a national level and across seven regions of mainland China. Needs of morphine for cancer pain treatment in mainland China and in its seven regions were estimated and compared with the clinical consumption of opioid analgesics in MEs., Results: The adequacy of consumption measure of mainland China ranged from 0.0041 to 0.0088 during 2006-2016, which was less than 1% of that in the reference countries. The poor North East region had only 10.85% of the cancer pain morphine needs fulfilled. The highest fulfillment rate was 36.02% in rich Southern China, which was 25.9% at the national level., Conclusion: The clinical consumption of opioid analgesics for the treatment of moderate-to-severe pain in mainland China was far below the international level. The annual per capita of clinical consumption was lower, and the adequacy of cancer pain treatment was poorer in less developed areas. All these findings call for actions to strengthen pain management., (Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To systematically compare the efficacy and safety of sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia (CSEA), a systematic review and meta-analysis of randomized controlled trials targeting parturients requesting labor analgesia was conducted., Methods: The primary outcome measure was visual analog scale scores assessed at 10, 15, 30, and 60 min after intrathecal injection. Secondary outcomes included duration of spinal analgesia, incidence of side effects in parturients, and neonatal Apgar scores., Results: Twelve randomized controlled trials, including data from 881 patients fulfilled the inclusion criteria. No clinically meaningful differences in pain reduction after intrathecal injection were found between the two analgesics. Sufentanil extended the duration of spinal analgesia by 25.40 min (95% CI 21.82 to 28.98 min; p < 0.00001) compared with fentanyl. The risk for pruritus, nausea, and vomiting among parturients was 82% for those using sufentanil (relative risk 0.82 [95% CI 0.67-0.99]; p = 0.04) and 48% for those using fentanyl (relative risk 0.48 [95% CI 0.29-0.80]; p = 0.005). Both the synthesis results and sensitivity analysis demonstrated no differences in the risk for respiratory depression between parturients using sufentanil versus fentanyl. The neonates in sufentanil group exhibited higher Apgar scores than the fentanyl group 5 min after delivery (weighted mean difference 0.10 [95% CI 0.05-0.16]; p = 0.0002)., Conclusion: Existing evidence suggests that compared with fentanyl, sufentanil used for analgesia in combined spinal-epidural during labor is more effective in extending the duration of spinal analgesia, and may be safer for the infant. There was overall low clinical and statistical heterogeneity among the included studies. For all outcomes, variations caused by heterogeneity across trials were acceptable. Thus the findings of this meta-analysis may provide additional evidence for future clinical practices of pain relief in labor involving CSEA. Stronger evidence supporting this conclusion will require data from more high-quality and multicenter randomized controlled trials.

China's healthcare reform aims to provide affordable and equitable basic healthcare for all by 2020. Access to medicines is an essential part of the healthcare. The efforts of promoting access to medicines have been moving from meeting the needs of the basic healthcare, towards increasingly dedicated resources to offer breakthrough therapies. Looking at access to novel medicines from a health system perspective, and placing the changes China has made into that system context, this paper makes a comprehensive review of the progress of access to novel medicines in China. The review drew on two sources of information, which included desk review of published and grey literature, and key informant interview. Five hurdles were identified which create barriers of access to novel medicines, ranging from regulation and financing of medicines, intellectually property rights protection, and development of innovation capacity, to other health system components. Multiple policies have been implementing in China to remove the multiple access barriers gradually. Universal access to medicines has been moving from towards the basic common conditions to the world breakthrough technologies. We see cause for optimism, but recognize that there is a long way to go. Achieving broader and better access to modern medicines for Chinese patients will require multiple and coordinated government efforts, which would need to target the whole lifecycle regulation of novel medicines with a health system perspective, from balancing IP protection, strengthening R&D and public health, to appropriate regulatory approach and financing mechanism, and to supply chain management, as well as smart use., Competing Interests: The authors declare that they have no competing interests in this work., (© 2019 Diao et al.)