Cardiac rehabilitation is not a luxury intervention. It is a structured chronic disease management program, typically beginning in the hospital and continuing as an outpatient service before transitioning into longer-term community-based secondary prevention. The programs combine supervised exercise, education on healthy living, and stress counselling, and they are designed to improve outcomes for patients recovering from cardiac events or living with ongoing cardiovascular disease. The evidence base is robust: participation reduces mortality by more than 25 percent and hospitalization by nearly 20 percent. Multiple studies have also documented improvements in quality of life and reductions in hospital readmissions. In clinical terms, few interventions in cardiovascular medicine deliver so much benefit for so relatively little cost, which is precisely why the new findings have unsettled the researchers behind them.

The audit identified close to 7,000 cardiac rehabilitation programs across 90 countries. Within that total, 1,233 programs in 40 countries provided detailed information about hybrid and alternative delivery models, which blend clinic-based and home-based care and are generally cheaper to operate and easier for patients to attend. Of those 1,233 programs, only 286 indicated that they received reimbursement from governments or insurance companies for hybrid or alternative delivery. Overall, hybrid and alternative models accounted for roughly one third of all programs offered globally, and only about one quarter of them were reimbursed. For the study’s authors, including York University and University of Toronto Adjunct Professor Gabriela Lima de Melo Ghisi, York Professor Sherry Grace of the Faculty of Health, and graduate student Rachael Carson, the picture is one of under-utilization in the face of proven effectiveness.

Perhaps the most striking pattern in the data is the mismatch between disease burden and program availability when countries are sorted by income classification. In high-income nations, the ratio of programs to cases of ischemic heart disease, while imperfect, reflects at least a meaningful infrastructure. Canada recorded 72,849 cases of ischemic heart disease in 2023 alongside 380 programs. The United States reported 1,144,557 incidents and 2,687 programs. Japan counted 292,531 incidents against 678 programs, and Germany 362,984 incidents against 155 programs. These figures vary considerably in per-case coverage, but they stand in sharp contrast to the situation in low-income countries, where the audit found programs essentially absent despite significant caseloads.

Afghanistan, for example, recorded 34,207 incidents of ischemic heart disease and zero cardiac rehabilitation programs. Ethiopia reported 28,903 incidents and, likewise, no programs. Malawi emerges as an outlier in the dataset, with 3,872 incidents and 23 programs, a small but notable exception that suggests expansion is possible even in resource-constrained settings. The researchers emphasize that the highest levels of chronic cardiac disease now occur in low- and middle-income countries, where roughly 80 percent of global cardiovascular deaths take place. Lima de Melo Ghisi notes that this concentration not only increases economic pressures on those countries but also places further burdens on health-care systems that are often already stretched thin. The absence of rehabilitation capacity in exactly the places where need is greatest amounts to a structural inequity in global cardiovascular care.

The barriers to expansion are neither mysterious nor purely scientific. The study identifies the lack of funding and staffing as the major roadblock, with costs frequently falling on patients themselves, which reinforces inequity. Beyond financing, practical obstacles shape who can actually attend: the distance patients live from program centers, the availability of transportation, particularly in rural areas, and the competing demands of work and family life that leave little room for regular clinic visits. These constraints have driven interest in home-based and hybrid programs, which are less expensive to run, easier for people to access, and, according to existing comparative research, capable of delivering outcomes comparable to clinic- or hospital-based models. Yet even this more flexible tier of service has not grown. Since the pandemic, the number of hybrid and alternative programs has actually decreased, even as more people worldwide survive cardiac events and live longer with cardiovascular disease.

That post-pandemic contraction is one of the study’s most disheartening findings, and the researchers say they were surprised by it. Hybrid models were widely expected to be a growth area, accelerated by the shift toward remote care during COVID-19 lockdowns. Instead, the audit suggests that without committed reimbursement, even the cheaper delivery formats fail to achieve financial sustainability. The reimbursement figures are telling: with only about a quarter of hybrid and alternative programs funded by governments or insurers, the economic case for establishing and maintaining them remains fragile. Where patients must pay out of pocket, uptake drops, and where uptake drops, the programs struggle to justify institutional investment, creating a self-reinforcing cycle of under-provision.

The methodological approach of the audit gives its findings considerable weight. Rather than extrapolating from a handful of national registries, the researchers tallied programs across 90 countries, recorded the level of reimbursement where available, and compared countries by income class, producing a standardized global snapshot that had not existed since before the pandemic. Published as a data and statistical analysis in PLOS One under the title describing delivery of cardiac rehabilitation through hybrid models and alternative settings by country income classification and decade, the study provides a baseline against which future expansion, or continued stagnation, can be measured. The decade-over-decade comparison is what allows the authors to state plainly that availability has not increased worldwide despite rising incidence of cardiovascular disease.

What emerges from the analysis is a clear prescription. The results point to the need not only for increased implementation of cardiac rehabilitation programs but for more sustained reimbursement, which the researchers argue would go a long way toward providing cardiovascular care globally. In practice, that means health systems and insurers recognizing hybrid and home-based delivery as fundable services rather than experimental add-ons, and it means targeted investment in low- and middle-income countries where the disease burden is heaviest and the infrastructure thinnest. Carson’s summary of the paradox is blunt: multiple studies have already shown that cardiac rehabilitation works, playing an outsized role in reducing mortality, hospital readmissions, and improving quality of life, and yet the programs remain under-utilized. Closing that gap, the study suggests, is less a question of clinical science than of policy, financing, and the political will to fund secondary prevention at the scale the global burden of cardiovascular disease now demands.

For the millions of people living with chronic cardiac disease, the stakes of that policy shift are concrete. Every unreimbursed program and every country without services represents patients who could have reduced their risk of death by a quarter but were never given the option. The 2025 Global Audit Update makes the scale of the shortfall measurable for the first time in the post-pandemic era, and it hands clinicians, policymakers, and funders a precise map of where the work must happen next.

Subject of Research: Global availability and reimbursement of cardiac rehabilitation programs compared with rising cardiovascular disease burden

Article Title: Cardiac rehabilitation programs not keeping up with global increases in cardiovascular disease

Article References: Cardiac rehabilitation programs not keeping up with global increases in cardiovascular disease. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: cardiac rehabilitation, cardiovascular disease, global health, health equity, hybrid care models, reimbursement, low-income countries, ischemic heart disease, secondary prevention, PLOS One, York University, global audit

The study focused on the coast of Newfoundland and Labrador, where waves from the Atlantic Ocean crash against an extensive shoreline and strong winds whip spray far inland. According to the researchers, this is close to a worst-case scenario for sea-spray-driven PFAS transport: abundant wind, crashing surf and a long coastline all combine to maximise the generation of marine aerosols. If the ocean were truly pumping significant quantities of forever chemicals into coastal environments through spray, the team reasoned, Newfoundland would be one of the places where the signal would be unmistakable. Senior author Cora Young, an atmospheric chemist and Guy Warwick Rogers Chair in York University’s Faculty of Science, said the location was chosen precisely because it offered the ideal conditions to detect such an effect.

We designed this study specifically to see if sea spray was contributing to a mobilization of PFAS in coastal regions and Newfoundland is a great place to do that, Young explained, noting that it is a marine location and very windy, so the team expected quite a lot of PFAS from sea spray. Instead, she said, the researchers were quite surprised that they did not see anything indicating sea spray was contributing to PFAS in the area. The finding directly contradicts the expectation, rooted in earlier modelling and laboratory work, that the ocean-to-land transfer of these chemicals through aerosols represents a significant and direct exposure pathway for people and ecosystems near the coast.

To test the hypothesis rigorously, the team moved beyond simulations and carried out on-the-ground field work. Lead author Daniel Persaud, a PhD student at York, together with Young and their collaborators, collected both wet and dry deposition samples at several locations stretching up to 30 kilometres from the eastern coast. Wet deposition refers to PFAS delivered by precipitation such as rain, while dry deposition captures the dust and particles, along with gases, that settle out of the atmosphere onto the ground. Measuring both pathways matters, because many studies record only one or the other, and the balance between them shapes how scientists estimate where forever chemicals ultimately land.

The sampling sites were forested watersheds within the Newfoundland and Labrador Boreal Ecosystem Latitudinal Transect, a network of study locations chosen because they are all influenced by marine aerosols and lie close to the ocean. Because the sites are windy and near the water, the researchers expected a strong marine-aerosol signal in their chemistry. To track it, they used sodium as a tracer of sea spray, since sodium is abundant in ocean-derived particles. Persaud said the measured PFAS showed little association with sodium, indicating that the forever chemicals found at the sites were not arriving with the salt spray from the Atlantic.

That does not mean the landscape was clean. The researchers did detect PFAS at every study site, but the pattern of compounds pointed to a different origin. They mostly found perfluoroalkyl acids, a subclass of PFAS that includes perfluoroalkyl carboxylic acids and perfluoroalkanesulfonic acids. These substances are not produced from local sources in Newfoundland. Instead, the evidence suggested they were the atmospheric breakdown products of PFAS precursor compounds that had been emitted elsewhere, transformed in the air during long-range transport, and then deposited on the island. In other words, the chemicals arrived from distant industrial and commercial centres, not from the waves at the shore.

The likely sources of those precursors lie elsewhere in Canada and the United States, and potentially even further afield. PFAS and their precursors are typically found in firefighting foams, non-stick materials and performance chemicals, and they are notorious for their ability to travel long distances through the atmosphere, reaching even the Arctic. Because perfluoroalkyl acids are extremely persistent and can bioaccumulate in living organisms, their continued deposition in remote regions raises ongoing environmental concerns. The new results do not make those concerns disappear; they simply redirect attention away from the ocean surface and back toward atmospheric transport of emissions from faraway sources.

The implications may extend well beyond eastern Canada. Young noted that Newfoundland offers something close to a perfect storm for sea-spray generation, with driving wind, crashing waves and an extensive coastline that together maximise the amount of aerosol produced. If sea spray were a major route for moving PFAS from ocean to land, it should have shown up there. According to Young, this sort of sea spray is really not a major source of global pollution according to the study. That conclusion, she suggested, amounts to good news: researchers had worried that PFAS could move from ocean to land and back again indefinitely, but the field evidence indicates the problem is not as large as feared.

One of the study’s most instructive findings concerned the role of dry deposition. The team measured both wet and dry deposition, but that combined approach is not universally practised, and their results underline how important it is to do so in order to understand the full impact of PFAS in the environment. Young said she still finds it surprising that dry deposition remains so important even in a place like Newfoundland, where rainfall is frequent. The observation suggests that in many other landscapes, from remote deserts to the Arctic, the settling of particle-bound and gaseous PFAS may be a larger contributor than precipitation alone would indicate, and that studies relying only on rain and snow could substantially underestimate total deposition.

Persaud said the distinction between wet and dry pathways helps researchers better predict where forever chemicals will be found as they move around the globe and where they will ultimately end up, benefiting not only his team but other researchers going forward. The work was a collaboration with scientists at Memorial University in St. John’s, where Young previously worked and collected samples, the Canadian Forest Service and Natural Resources Canada in Corner Brook, and the Aquatic Contaminants Research Division of Environment and Climate Change Canada in Burlington, Ontario. The paper, titled The Occurrence of Legacy Per- and Polyfluoroalkyl Substances (PFAS) Deposited along a Latitudinal Transect in Newfoundland and Labrador, Canada, was published in the Royal Society of Chemistry journal Environmental Science: Processes & Impacts under DOI 10.1039/D6EM00257A. For coastal residents wondering whether summer sea spray carries a hidden dose of forever chemicals, the answer from this windswept corner of Canada appears to be reassuring: the ocean, at least, is not the culprit it was made out to be.

Subject of Research: Atmospheric deposition of PFAS forever chemicals in coastal Newfoundland and the role of sea spray as a transport pathway

Article Title: Exposure to forever chemicals through sea spray may be overblown

Article References: Exposure to forever chemicals through sea spray may be overblown. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: PFAS, forever chemicals, sea spray, marine aerosols, Newfoundland and Labrador, atmospheric deposition, wet deposition, dry deposition, perfluoroalkyl acids, long-range transport, York University, environmental chemistry

The illusion at the heart of the study is familiar to anyone who has watched a waterfall. After staring at something moving steadily in one direction for several seconds, a stationary scene viewed immediately afterward can appear to drift, and objects within it can seem slightly displaced in the opposite direction. Nothing in the image itself has changed; the pixels are identical before and after adaptation. What changes is the observer’s brain, which has recalibrated its responses to motion and, crucially, to position. This dissociation between the physical image and the perceptual experience gives scientists an unusually clean window into the computations that the visual system performs, because any shift in what is perceived must originate inside the nervous system rather than in the stimulus.

Kohitij Kar, assistant professor at York University, Canada Research Chair in Visual Neuroscience, and senior author of the study, frames the work as a test of what NeuroAI can deliver when neuroscience and artificial intelligence are brought together deliberately. According to Kar, today’s AI vision systems are impressive but still do not always see the world the way humans do. By designing smart experiments that reveal computations biological vision uses and AI still lacks, he argues, researchers can take those insights and build them into more brain-like artificial systems. That framing matters because the field of computer vision has been built largely around benchmark accuracy: whether a model assigns the right label or the right bounding box. The York team’s results suggest that getting the right answer is not the same as performing the right computation.

The central question the researchers posed was whether artificial neural network models capture the same history-dependent changes in spatial representations seen in biological vision, or whether their internal representations of position reflect only the physical properties of the image. To answer it, first author Elizaveta Yakubovskaya, a graduate student at York, combined recordings from primate visual cortex with human perception experiments. The team used motion adaptation to induce the illusion, making a stationary object appear slightly shifted in position, and then asked whether the brain and the AI models showed the same effect. The comparison required precise measurements of where perceived position and pixel-based position diverge, so that the behavioral relevance of neural position codes could be tested directly rather than inferred.

The results were strikingly asymmetric. Human observers reported the illusion exactly as expected: after adaptation to motion in one direction, the stationary test object appeared displaced in the opposite direction. In parallel, the neural representations of position in the macaque inferior temporal cortex, a high-level visual area critical for object recognition, shifted in the same direction, even though the image presented to the eyes had not changed at all. In other words, the monkey brain encoded the object’s location not in purely retinal or pixel-based coordinates but in coordinates that were perceptually aligned, tracking where the object appeared to be rather than where it physically was. The IT cortex, often studied for what it says about object identity, turned out to be carrying rich, behaviorally meaningful information about object location as well.

When the researchers turned to current artificial vision networks, the picture changed. The models they tested could often determine where an object was located with considerable accuracy, but they did not reproduce the way recent visual experience reshapes that answer. Their position representations remained anchored to the physical properties of the image, unmoved by the adaptation history that so powerfully biased both human perception and primate neural activity. The gap is not a matter of coarse performance metrics; it is a difference in the underlying computation. Biological vision carries a temporal signature, a dependence on what was seen moments before, that these networks simply do not implement when mapping images to spatial estimates.

Why should a systematic perceptual error be treated as a feature rather than a flaw? The answer lies in how neuroscientists think about adaptation. Motion adaptation is one of the most extensively studied phenomena in visual neuroscience, and it reflects the visual system’s active recalibration in response to the statistics of recent input. Neurons tuned to particular directions of motion reduce their responsiveness after prolonged stimulation, and downstream circuits inherit the consequences. That the aftereffect extends to perceived position indicates that these adaptive processes reach all the way into high-level spatial representations, biasing the codes that support judgments about where objects are. A system built to work in a changing world may benefit from such context sensitivity, even at the cost of occasional illusions under artificial laboratory conditions.

The study, titled The macaque IT cortex but not current artificial vision networks encode object position in perceptually aligned coordinates, therefore delivers two contributions at once. Scientifically, it clarifies the role of the inferior temporal cortex in encoding spatial information, showing that its position codes are not static copies of the retinal image but dynamic representations that track perceptual experience. Methodologically, it provides a new benchmark for evaluating dynamic vision models. A model that aspires to human-like vision can now be tested not only on whether it localizes objects correctly on average, but on whether its internal position representations shift in the right way after adaptation, matching both human reports and primate neural data. That is a far more demanding and diagnostic standard than conventional accuracy scores.

For Kar, the work speaks to a growing question in artificial intelligence about whether increasingly capable systems will become more like us or increasingly different from us. If the goal is AI that works with humans and understands the world in more human-compatible ways, he argues, researchers cannot focus only on whether a system gets the right answer; they must also understand the computations that produce human perception and behavior. Neuroscience, on this view, is not merely a source of loose inspiration for architecture design but a discovery engine for the computations themselves, which can then potentially be built into AI. The motion aftereffect, a phenomenon studied for more than a century, has become a concrete example of that pipeline: a perceptual phenomenon, a neural measurement, and an engineering target in a single experimental loop.

The broader implication is that the path to more human-like machine vision may run through the very illusions that reveal the brain’s hidden assumptions. Current networks, trained on enormous datasets to match human labels, have converged on solutions that mimic the outputs of biological vision in many static tasks while diverging sharply in their internal machinery. Illusions like the motion aftereffect expose that divergence in a measurable, reproducible way, because they create a controlled conflict between the image and the percept. As dynamic vision models mature, benchmarks derived from adaptation and other history-dependent phenomena may help close the gap, producing systems whose spatial representations, like those of the macaque IT cortex, are aligned with perception rather than with pixels alone. For now, the humble waterfall illusion stands as evidence that the brain’s quirks encode computational principles that AI has yet to learn.

Subject of Research: History-dependent spatial encoding in macaque inferior temporal cortex and its absence in current artificial vision networks

Article Title: Visual illusion reveals what today’s AI vision is missing – York University study

Article References: Visual illusion reveals what today’s AI vision is missing – York University study. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: visual illusion, motion aftereffect, AI vision, NeuroAI, inferior temporal cortex, macaque, object position, motion adaptation, artificial neural networks, Current Biology, York University, perception