Search

Diazinon is an organophosphorus pesticide widely used in agriculture and household pest control, and its use also poses several environmental and health hazards. In this study, we investigated the spatial and temporal distribution of diazinon in Baiyangdian, evaluated its potential ecological risk and toxicity to aquatic organisms based on RQ (Risk quotient) and TU (Toxic unit) analysis, and assessed the potential effects of diazinon accumulation on probiotics and pathogens based on statistical analysis of high-throughput sequencing data. The results showed that diazinon in Baiyangdian posed a low to moderate chronic risk to sediment-dwelling organisms and a low toxicity effect on aquatic invertebrates, which was mainly concentrated in October and human-intensive areas. Meanwhile, increases in sediment electrical conductivity (EC), amorphous iron oxides content and phenol oxidase activity favored diazinon accumulation in sediments, whereas the opposite was the case for sediment organic carbon, β-1,4-glucosidase, phosphatase, catalase and pH, suggesting that environmental indicators play a key role in the behavior and distribution of diazinon. In addition, diazinon in heavily contaminated areas seem to inhibit the rare probiotics (Bifidobacterium adolescentis and Serratia sp.), while promoted dominant pathogens (e.g., Burkholderia cenocepacia), which can lead to increased disease risk to humans and ecosystems, disruption of ecological balance and potential health problems. However, probiotic Streptomyces xiamenensis resist to diazinon would be a potential degrader for diazinon remove. In conclusion, this study unveiled the effects of diazinon pollution on wetland ecosystems, emphasizing ecological impacts and potential health concerns. In addition, the discovery of diazinon resistant probiotics provided new insights into wetland ecological restoration., Competing Interests: Declaration of competing interest 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., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The application of artificial intelligence (AI) in healthcare is an important public health issue. However, few studies have investigated the perceptions and attitudes of healthcare professionals toward its applications in nursing. This study aimed to explore the knowledge, attitudes, and concerns of healthcare professionals, AI-related professionals, and others in China toward AI in nursing., Methods: We conducted an online cross-sectional study on nursing students, nurses, other healthcare professionals, AI-related professionals, and others in China between March and April 2024. They were invited to complete a questionnaire containing 21 questions with four sections. The survey followed the principle of voluntary participation and was conducted anonymously. The participants could withdraw from the survey at any time during the study., Results: This study obtained 1,243 valid questionnaires. The participants came from 25 provinces and municipalities in seven regions of China. Regarding knowledge of AI in nursing, 57% of the participants knew only a little about AI, 4.7% did not know anything about AI, 64.7% knew only a little about AI in nursing, and 13.4% did not know anything about AI in nursing. For attitudes toward AI in nursing, participants were positive about AI in nursing, with more than 50% agreeing and strongly agreeing with each question on attitudes toward AI in nursing. Differences in the numbers of participants with various categories of professionals regarding knowledge and attitudes toward AI in nursing were statistically significant ( p  < 0.05). Regarding concerns and ethical issues about AI in nursing, every participant expressed concerns about AI in nursing, and 95.7% of participants believed that it is necessary to strengthen medical ethics toward AI in nursing., Conclusion: Nursing students and healthcare professionals lacked knowledge about AI or its application in nursing, but they had a positive attitude toward AI. It is necessary to strengthen medical ethics toward AI in nursing. The study's findings could help develop new strategies benefiting healthcare., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wang, Fei, Wei, Huang, Xiang, Tu, Wang and Gan.)

Aim: To explore the scope and form of prescriptions for blood and hematopoietic drugs that future advanced practice nurses (APNs) in the Department of Haematology and to establish a medicine prescription training content in China., Background: Because the increasing number of doctors cannot meet the increasing demand for medical care with the population growth, many countries have begun to explore the medical team structure and practice areas, among which nurse prescribing rights have been the most effective. However, China's higher nursing education system still lacks education and training on nurse prescription., Design: On the basis of literature research and semi-structured interviews, a set of nursing prescription content, education, training and practice system suitable for Chinese nurses was jointly created., Methods: Two rounds of expert consultation between 23 haematology nursing experts and clinical experts determined the training content of blood system drugs and medicine prescriptions. Additionally, on the basis of the 23 experts，13 experts engaged in clinical and education, teaching and training experts were involved. Two rounds of expert consultation with 36 experts identified a general clinical practice training program for advanced practice nurses in China., Results: Regarding contents and forms of hematopoietic drugs, the study concluded that advanced practice nurses in haematology department can prescribe anti-anemia drugs, anti-coagulant drugs and anti-thrombotic drugs in 2 categories and 16 drugs. Of these, four kinds of drugs should be prescribed in the form of protocol prescription. One kind of drug should be prescribed in the form of extended prescription and 11 drugs should be prescribed in the form of independent/extended or agreed/extended prescription. Regarding training content, the study obtained the training content of nurses' medicine prescriptions in eight clinical circumstances and the medicine prescription training content for common diseases of the blood system. The required specifications and the medicine prescription decision skills of nurses were sorted out according to different prescription types., Conclusions: The degrees of expert authority were both higher in consultations. Moreover, the results after consultation were reliable. It was recommended that haematology APNs could prescribe anti-anaemic drugs and anti-coagulation and anti-thrombotic drugs. Furthermore, most drugs should be prescribed in the form of independent/extended or agreed/extended prescriptions. The establishment of a medicine prescription training content for haematology APNs is expected to provide a reference for clinical practice education and training for drug prescriptive authority applicants for blood and hematopoietic system nurses in China., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Cervical cancer is the fourth highest incidence of malignancy in the world and a common cause of cancer death in women. We assessed the trends of incidence and mortality and disability-adjusted life year (DALY) in China, England and India from 1990 to 2030., Method: Data were obtained from the Global Burden of Disease (GBD) database. We collected the number and rate of incidence, death and DALY from 1990 to 2019 and calculated the estimated annual percentage change (EAPC). Further analysis was carried out by ages and years. We also collected attributable risk factors to cervical cancer. Finally, we utilized the Bayesian Age-Period-Cohort (BAPC) model to forecast trends in the rate of age-standardized incidence (ASIR) and age-standardized death (ASDR) the for the next decade., Result: Globally, the incidence of cervical cancer cases increased from 335,641.56 in 1990 to 565,540.89 in 2019. In 2019, the ASIR and ASDR of cervical cancer were higher than those of India but lower than those of England. Furthermore, unsafe sex and smoking emerge as prominent risk factors for cervical cancer. Over the next decade, ASIR and ASDR are expected to decline in China and England, while India's ASIR is still on an upward trend and ASDR is on a downward trend., Conclusion: The epidemiological data of cervical cancer in these three countries reflects the influence of different stages of development and healthcare systems. Trends over the next decade suggest that China and India still face a huge burden of cervical cancer. When England has made significant progress, China and India need to take more measures to improve the prevention and control of cervical cancer., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wu, Jiao, Yue and Wang.)

Increasing concerns about public health and safety after covid-19 have raised pathogen studies, especially in aquatic environments. However, the extent to how different location and human activities affect geographic occurrence and distribution of pathogens in response to agricultural pollution, boat tourism disturbances and municipal wastewater inflow in a degraded lake remains unclear. Since the surrounding residents depend on the lake for their livelihood, understanding the pathogens reserved in lake sediment and the regulation possibility by environmental factors are challenges with far-reaching significance. Results showed that 187 pathogens were concurrently shared by the nine sediment samples, with Salmonella enterica and Pseudomonas aeruginosa being the most abundant. The similar composition of the pathogens suggests that lake sediment may act as reservoirs of generalist pathogens which may pose infection risk to a wide range of host species. Of the four virulence factors (VFs) types analyzed, offensive VFs were dominant (>46 % on average) in all samples, with dominant subtypes including adherence, secretion systems and toxins. Notably, the lake sediments under the impact of agricultural use (g1) showed significantly higher diversity and abundance of pathogen species and VFs than those under the impact of boat tourism (g2) and/or municipal wastewater inflow with reed marshes filtration (g3). From the co-occurrence networks, pathogens and pesticides, aggregate fractions, EC, pH, phosphatase have strong correlations. Strong positive correlations between pathogens and diazinon in g1 and ppDDT in g2 and g3 suggest higher pesticide-pathogen co-exposure risk. These findings highlight the need to explore pathogen - environmental factor interaction mechanisms in the human-impacted water environments where the control of pathogen invasion by environmental factors may accessible., Competing Interests: Declaration of competing interest 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., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Despite the serious health threats due to wide use of organophosphorus pesticides (OPPs) have been experimentally claimed to be remediated by probiotic microorganisms in various food and organism models, the interactions between OPPs and probiotics in the natural wetland ecosystem was rarely investigated. This study delves into the spatial and temporal distribution, contamination levels of OPPs in the Baiyangdian region, the diversity of probiotic communities in varying environmental contexts, and the potential connection with OPPs on these probiotics. In typical shallow lake wetland ecosystem-Baiyangdian lake in north China, eight OPPs were identified in the lake sediments, even though their detection rates were generally low. Malathion exhibited the highest average content among these pesticides (9.51 ng/g), followed by fenitrothion (6.70 ng/g). Conversely, chlorpyrifos had the lowest detection rate at only 2.14%. The region near Nanliu Zhuang (F10), significantly influenced by human activities, displayed the highest concentration of total OPPs (136.82 ng/g). A total of 145 probiotic species spanning 78 genera were identified in Baiyangdian sediments. Our analysis underscores the relations of environmental factors such as phosphatase activity, pH, and electrical conductivity (EC) with probiotic community. Notably, several high-abundance probiotics including Pseudomonas chlororaphis, Clostridium sp., Lactobacillus fermentum, and Pseudomonas putida, etc., which were reported to exhibit significant potential for the degradation of OPPs, showed strongly correlations with OPPs in the Baiyangdian lake sediments. The outcomes of this research offer valuable insights into the spatiotemporal dynamics of OPPs in natural large lake wetland and the probability of their in-situ residue bioremediation through the phosphatase pathway mediated by probiotic such as Lactic acid bacteria in soils/sediments contaminated with OPPs., Competing Interests: Declaration of competing interest 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., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Although numerous studies have linked asthma to air temperature and pollution, few studies have examined their interactive effects on asthma outpatient visits. This study investigated how air pollutants and their interactions with temperature affect asthma outpatient visits in a city in northern Chinaduring the time period 2018 - 2020 . . As the results, 24,163 asthma outpatients were recorded, a 10-μg/m 3 increase in PM 10 , PM 2.5 , SO 2 , and NO 2 concentrations was associated with significant increases in visits of 3.47% (95% CI: 2.35%-4.60%), 0.83% (95% CI: 0.36%-1.30%), 3.17% (95% CI: 1.47%-4.90%), and 8.90% (95% CI: 6.09%-11.79%), respectively. The effect was stronger in females than males, and stronger in the elderly (≥65 years) than among the young. The interaction between low temperatures and high air pollution levels significantly increased the number of asthma outpatient visits. This study emphasizesthe importance of reducing air pollution in order to lessen the effects of cold.

Aim: Evaluate the cost utility of menopausal hormone therapy for women in China., Materials and Methods: A bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China's Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks., Results: According to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of -7,184$ (-47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China., Conclusion: Contingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.

This study aims to characterize the genetic variability of HPV58, identify novel lineages and sublineages, and explore the association between persistent/multiple HPV58 infections and genetic variation. In this study, samples from 124 women with HPV58 infection in Eastern China were collected and 81 isolates of E6 and L1 full-length genes were successfully amplified from 55 samples. We evaluated the diversity of genetic variants and performed correlation analyses between genetic variability and pathology, vaccination, multiple infections, and persistent infections. Among the E6 and L1 gene sequences collected, the dominant prevailing sublineages were A1 (46.2%) and A2 (23.1%). In addition, we found two potential novel sublineages denoted as the A4 and A5 sublineage. A total of 50 nucleotide substitutions, including 28 synonymous substitutions and 22 nonsynonymous substitutions, were observed in the E6 and L1 genes. Among them, variants with A388C/K93N substitutions in the E6 gene correlated with persistent infection (≥1 and ≥2 years) (p < 0.005), and C307T/C66C was associated with persistent infection (≥2 years) (p < 0.005). Notably, two mutations above were detected in the isolate from the patient with breakthrough vaccine infection. Our study found two novel sublineages and sites of genetic variability in multiple and persistent infection variants. In addition, we identified two mutational sites associated with persistent infection. This study provides new insight into the clinical characteristics of HPV 58 genetic variations and offers new ideas for research on next-generation vaccines in Eastern China., (© 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.)

Background: People in China and the countries in the Association of Southeast Asian Nations (ASEAN) are affected by neglected tropical diseases and malaria (NTDM). In this study, we aimed to assess the current status and trends of NTDM burden from 1990 to 2019 in China and ASEAN countries, and also explore the association of NTDM burden with socio-demographic index (SDI)., Methods: The data from the Global Burden of Diseases Study 2019 (GBD 2019) results were used. Absolute incidence and death number, and age-standardized incidence and mortality rate (ASIR and ASMR) of NTDM in China and ASEAN were extracted. The estimated annual percentage change (EAPC) and join-point regression in the rates quantified the trends. Nonlinear regression (second order polynomial) was used to explore the association between SDI and ASRs., Results: The ASIR of NTDM increased in China, Philippines, Singapore and Brunei, at a speed of an average 4.15% (95% CI 3.83-4.47%), 2.15% (1.68-2.63%), 1.03% (0.63-1.43%), and 0.88% (0.60-1.17%) per year. Uptrends of ASIR of NTDM in recent years were found in China (2014-2017, APC = 10.4%), Laos (2005-2013, APC = 3.9%), Malaysia (2010-2015, APC = 4.3%), Philippines (2015-2019, APC = 4.2%), Thailand (2015-2019, APC = 2.4%), and Vietnam (2014-2017, APC = 3.2%, all P < 0.05). Children < 5 had relatively low incidences but unexpectedly high mortality rates of NTDM in most ASEAN countries. Both incidence and mortality rates of NTDM were higher in older people. ASIR and ASMR of NTDM had a U-shaped association with SDI., Conclusions: The burden of NTDM in China and ASEAN countries was still huge and affects vulnerable and impoverished populations' livelihoods, including children under the age of 5 and people aged 60 and older. Facing with the large burden and complex situation of NTDM in China and ASEAN countries, regional cooperating strategies are needed to reduce the burden of NTDM, so as to achieve the goal of elimination in the world., (© 2023. The Author(s).)

Aims: To estimate the association of catastrophic health expenditure (CHE) with the risk of depression in middle-aged and old people in China., Methods: We used data of 2011, 2013, 2015 and 2018 from the China Health and Retirement Longitudinal Study, which covered 150 counties of 28 provinces in China. CHE was calculated as out-of-pocket health expenditure exceeding 40% of a household's capacity to pay. Depression was measured by a 10-item Centre for Epidemiological Studies Depression Scale. We evaluated CHE prevalence and applied Cox proportional hazard models to estimate adjusted hazard ratios (aHRs) and 95% confident intervals (CIs) for the risk of depression among participants with CHE after controlling potential confounders, compared with those without CHE., Results: Among 5765 households included in this study, CHE prevalence at baseline was 19.24%. The depression incidence of participants with CHE (8.00 per 1000 person-month) was higher than that of those without CHE (6.81 per 1000 person-month). After controlling confounders, participants with CHE had a 13% higher risk (aHR = 1.13, 95% CI: 1.02-1.26) of depression than those without CHE. In subgroup analysis, the association of CHE with depression was significant in males and in people with chronic diseases, of younger age, living in rural areas and of lowest family economic level (all P  < 0.05)., Conclusions: Nearly one of five middle-aged and old people in China incurred CHE, and CHE was associated with the risk of depression. Concerted efforts should be made to monitor CHE and related depression episode. Moreover, timely interventions about CHE and depression need to be implemented and strengthened among middle-aged and old people.

Background: Multimorbidity of non-communicable diseases (NCDs) is increasingly prevalent among older adults around the world, leading a higher risk of household catastrophic health expenditure (CHE). As current powerful evidence was insufficient, we aimed to estimate the association between multimorbidity of NCDs and the risk of CHE in China., Methods: We designed a cohort study using data investigated in 2011-2018 from the China Health and Retirement Longitudinal Study, which is a nationally-representative study covering 150 counties of 28 provinces in China. We used mean ± standard deviation (SD) and frequencies and percentages to describe baseline characteristics. Person χ2 test was employed to compare the differences of baseline characteristics between households with and without multimorbidity. Lorenz curve and concentration index were used to measure the socioeconomic inequalities of CHE incidence. Cox proportional hazards models were applied to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between multimorbidity and CHE., Results: Among 17,708 participants, 17,182 individuals were included for the descriptive analysis of the prevalence of multimorbidity in 2011, and 13,299 individuals (8029 households) met inclusion criteria and were included in the final analysis with a median of 83 (interquartile range: 25-84) person-months of follow-up. 45.1% (7752/17,182) individuals and 56.9% (4571/8029) households had multimorbidity at baseline. Participants with higher family economic level (aOR = 0.91, 95% CI: 0.86-0.97) had lower multimorbidity prevalence than those with lowest family economic level. 82.1% of participants with multimorbidity did not make use of outpatient care. The CHE incidence was more concentrated among participants with higher socioeconomic status (SES) with a concentration index of 0.059. The risk of CHE was 19% (aHR = 1.19, 95% CI: 1.16-1.22) higher for each additional NCD., Conclusions: Approximately half of middle-aged and older adults in China had multimorbidity, causing a 19% higher risk of CHE for each additional NCD. Early interventions for preventing multimorbidity among people with low SES could be intensified to protect older adults from financial hardship. In addition, concerted efforts are needed to increase patients' rational healthcare utilization and strengthen current medical security for people with high SES to reduce economic disparities in CHE., (© 2023. The Author(s).)

This study establishes an economic financial support model for the improvement of environmental quality through the development rural revitalization based on the extended Cobb-Douglas production function. Using statistical data from Shaanxi Province, China, from 2004 to 2019, a vector autoregressive (VAR) model is used to empirically analyze the development effect of financial support for rural revitalization and to give the focus points and optimization paths for financial support for environmental quality, rural revitalization and sustainable development. The research results show that financial support plays an active and long-term role in improving environmental quality and promoting rural revitalization and sustainable development. Specifically, the effect of financial instruments in supporting rural revitalization and sustainable development is continuous. In the insurance system, increasing the scale of agricultural insurance support and expanding the coverage of agricultural insurance are key to improving environmental quality and promoting rural revitalization and sustainable development. Therefore, financial policy makers should improve the targeting of financial instruments to provide the right guidance for improving the quality of rural environment and enhancing rural economy, so as to ultimately realize rural revitalization in China., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

As a new mode of mining development, green mine optimizes the development and utilization of mineral resources with a minimum of the environmental impact, and how to objectively evaluate the construction level of the green mine has become the key to promote green mine construction and it has also been an important path to achieve sustainable development of mineral resources. The evaluation system and methods of green mine construction, however, are not perfect at present as the existing green mine evaluation mostly adopts the index scoring accumulation method, with which the internal relations between the indicators are ignored, and the subjective influence it causes is too large. Based on the framework model of driving forces, pressure, state, impact and response, an indicator system is constructed in this paper to express the internal relationship between indicators more intuitively. Combined with subjective and objective combination weighting method to determine the index weight, TOPSIS and coupling coordination degree models are introduced to quantitatively evaluate the spatio-temporal evolution process of green mine construction and the coupling coordination between subsystems, analyze and obtain the main obstacle factors affecting the green mine construction of enterprises, and provide suggestions and countermeasures for the improvement of green mine construction of enterprises. The applicability of the model is verified by an actual case study of a mine in China. The model enriches the connotation of green mines, making the evaluation process and results fairer and more reliable, thus providing an effective way to promote the sustainable development of mines.

With the acceleration of urbanization, domestic waste has become one of the most inevitable factors threatening the environment and human health. Waste classification is of great significance and value for improving urban environmental quality and promoting human well-being. Based on the theory of planned behavior, we added external and socio-economic factors to systematically examine how they affect residents' waste classification behavior (WCB). We collected 661 valid data through a questionnaire survey conducted in Jinan, a pilot city for waste classification in China. Key driving factors were identified by combining binary logistic regression and the principal component analysis. The results showed that the elderly, women, and people with higher education are more likely to participate in waste classification. Attitude, collaborative governance, and institutional pressure positively affect WCB, while subjective norm and infrastructure have a negative effect. Knowledge mastery and degree of publicity are positively and significantly related to WCB, but other perceived behavioral control sub-variables negatively affect WCB. Based on the results and status of waste classification in Jinan, we propose the multi-agent linkage governance pattern from various dimensions to explore a powerful guiding incentive that can enhance WCB and provide a reference for waste management policymakers., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Glyphosate is a widely used herbicide worldwide and its prevalent presence in aquatic ecosystems poses a threat to living organisms. This study evaluated potential ecological risk of glyphosate to sediment-dwelling organisms and assessed the probable effect of glyphosate on structure and predicated function of sediment-attached bacterial communities from a large shallow lake in northern China based on 16S rRNA high-throughput sequencing. Results suggested that glyphosate showed a medium to high concentration (up to 8.63 mg/kg) and chronic risk to sediment-dwelling organisms (10% samples exhibiting medium to high risk quotient), especially in sites nearby farmland and residential areas in August. Bacterial community identification based on 16S rRNA sequence indicated some species of dominant phylum Proteobacteria and Campilobacterota (e.g., Steroidobacteraceae, Thiobacillus, Gallionellaceae, Sulfurimonadaceae) were stimulated while some species of dominant phylum Actinobacteriota, Acidobacteriota and Firmicutes (e.g., Nocardioidaceae, Microtrichales, Vicinamibacteraceae, Paenisporosarcina) were inhibited by glyphosate accumulation. The stimulating species were related to sulfur-oxidizing, sulfate-, iron-, or nitrate-reducing bacteria; The inhibiting species were related to plant bacterial endophytes, polyphosphate-accumulating organisms (PAOs) and denitrifers. Correspondingly, promoted bacterial metabolic functions of "sulfite respiration", "nitrogen respiration", "aromatic compound degradation" and "nitrification" but suppressed "cellulolysis", "manganese oxidation", "anoxygenic photoautotrophy S oxidizing" and "nitrate denitrification" were predicated on functional annotation of prokaryotic taxa. Although these results could only partly suggest the impacts of glyphosate on the bacterial communities due to the lack of actual results from control experiments, the identified Steroidobacteraceae could be thought as a bioindicator in the future mechanism study for the ecological effect and bioremediation of glyphosate. This work intends to arise the concern about the depletion of biodiversity and bacterial metabolic functions with contribution of glyphosate in part in eutrophic lakes., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

In China, exploring the relationship between human capital and green economy in the context of economic transformation can promote the construction of an ecological civilization and high-quality economic development. This paper is dedicated to assessing the impact of human capital stock, human capital structure, and the difference between the two on China's green economy. Using the super-efficiency slack-based measure (SBM) model, this paper evaluated the green total factor productivity (GTFP) of 30 Chinese provinces to assess the greenness of its economy and analyzed its spatiotemporal evolution from 2000 to 2017. A spatial error model (SEM) was established to explore the impact of human capital on green economy. The results show that (1) the GTFP of China increased continuously from 0.219 to 0.457, showing a regional spatial differentiation of "eastern region > central region > western region." The spatial gaps of the green economy in the east-west and north-south directions are narrowing. (2) Moran's I index and Moran's I scatter plot indicate a significant spatial correlation between human capital and China's green economy. The local spatial correlation between human capital and green economy is mainly characterized by "high-high" and "low-low" types of agglomeration. (3) The effects of human capital stock and human capital structure on green economy were both positive, with coefficients of 0.0005 and 0.1601, respectively, but the effects of human capital structure were not significant. (4) The results of regional regression show that the difference between the human capital impact coefficients on green economy in the eastern and midwestern regions is small. The impact of human capital stock and human capital structure on green economy is consistent with the national level results. It can be preliminarily concluded that the development of China's green economy relied more on improving the human capital stock than on the improvement of the human capital structure. This study further enriches the literature on the green economy and provides information that can support government policy-making., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Respiratory infections remain a major public health problem, affecting people of all age groups, but there is still a lack of studies analyzing the burden of upper respiratory infections (URIs) in Asian countries. We used the data from the Global Burden of Diseases Study 2019 results to assess the current status and trends of URI burden from 1990 to 2019 in Asian countries. We found that Thailand had the highest age-standardized incidence rate (ASIR) of URI both in 1990 (354,857.14 per 100,000) and in 2019 (344,287.93 per 100,000); and the highest age-standardized mortality rate (ASMR) was in China in 1990 (2.377 per 100,000), and in Uzbekistan in 2019 (0.418 per 100,000). From 1990 to 2019, ASIRs of URI slightly increased in several countries, with the speediest in Pakistan (estimated annual percentage change [EAPC] = 0.404%, 95% CI, 0.322% to 0.486%); and Kuwait and Singapore had uptrends of ASMRs, at a speed of an average 3.332% (95% CI, 2.605% to 4.065%) and 3.160% (95% CI, 1.971% to 4.362%) per year, respectively. The age structure of URI was similar at national, Asian and Global levels. Children under the age of five had the highest incidence rate, and the elderly had the highest mortality rate of URI. Asian countries with a Socio-demographic Index between 0.5 and 0.7 had relatively lower ASIRs but higher ASMRs of URIs. The declined rate of URI ASMR in Asian countries was more pronounced in higher baseline (ASMR in 1990) countries. Our findings suggest that there was a huge burden of URI cases in Asia that affected vulnerable and impoverished people's livelihoods. Continuous and high-quality surveillance data across Asian countries are needed to improve the estimation of the disease burden attributable to URIs, and the best public health interventions are needed to curb this burden.

Catastrophic health expenditure (CHE) is a major obstacle to achieving universal health coverage, and body mass index (BMI) is linked to both health and economy. We aimed to explore the association of BMI with the risk of CHE to provide advice for reducing CHE. We used national cohort data from the China Family Panel Studies, which comprised 33,598 individuals (14,607 households) from 25 provinces between 2010 to 2018. We used multivariate Cox proportional hazard models to estimate adjusted hazard ratios (aHRs) and 95% confident interval (CI) for CHE in participants at underweight, overweight, and obesity, compared with those at normal weight. Restricted cubic splines were employed to model the association of continuous BMI scale with risk of CHE. We found that families with female household heads at underweight had a 42% higher risk of CHE (aHR = 1.42, 95%CI: 1.16-1.75), and those at overweight had a 26% increased risk of CHE (aHR = 1.26, 95%CI: 1.09-1.47), compared with those at normal weight. A weak U-shaped curve for the association of continuous BMI with risk of CHE in female-headed households ( p for non-linear = 0.0008) was observed, which was not significant in male-headed households ( p for non-linear = 0.8725). In female-headed households, underweight and overweight BMI are connected with a higher risk of CHE. Concerted efforts should be made to keep a normal BMI to prevent CHE.

The occurrence of microplastics (MPs, <5 mm) in drinking water has aroused extensive concerns, whereas our understanding of their presence in groundwater, a major source of drinking water, is still limited. The present study investigated the occurrence of microplastics in groundwater sampled from five sites in Jiaodong Peninsula, China. The abundance, type, and size of MPs in the groundwater samples were determined by Laser Direct Infrared following a well-established and quality-controlled analytical route. Notably, MPs were detected in groundwater across all five sampling sites, with high abundances ranging from 87 to 6832 particles/L and an average abundance of 2103 particles/L. The variation of the abundance of MPs was correlated to the distances between sampling sites and anthropogenic activities, which suggested significant impacts of aboveground industry and agriculture on the abundance of MPs in groundwater. Polyethylene terephthalate (PET) and polyurethane (PU) were the dominant polymer types detected in all groundwater samples. The MPs with a size smaller than 100 μm were found to account for >90% of the total MPs detected in four sampling sites, which was likely associated with their migratory routes through surface water runoff and infiltration into the groundwater settings. The results of this study suggest the importance of counting small MPs when determining their abundances in groundwater or their abundances would be considerably underestimated. The present study for the first time demonstrated the occurrence of MPs in groundwater in China, which improves our understanding of the MPs distribution and raises concerns about groundwater safety in terms of MPs pollution., Competing Interests: Declaration of competing interest 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., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Comparing the carbon emission efficiency (CEE) of resource and non-resource-based cities in the Yellow River Basin (YRB) can guide their synergistic development and low-carbon transition. This study used the super-efficiency slacks-based measure (super-SBM) model to measure the CEE of cities in the YRB. Kernel density estimation and Theil index decomposition methods were used to explore the spatiotemporal evolutionary patterns, and a panel regression model was established to analyze the influencing factors of CEE. The research results showed that the CEE of the two types of cities have an overall upward trend in time, with a widening regional gap. Resource-based cities mainly displayed the characteristics of decentralized regional agglomeration, while non-resource-based cities mainly showed the characteristics of convergent regional agglomeration. Panel regression results showed that the levels of economic development, indus-trial structure, and population density are significantly positively correlated with CEE in the YRB, while foreign direct investment and resource endowment are significantly negatively correlated with CEE. Except for economic development and industrial structure, there is some variability in the contribution of the remaining influencing factors to the CEE of the resource and non-resource-based cities. The research results suggest developing classification measures for low-carbon transition in the YRB.

Urban agglomerations have become the core areas for carbon reduction in China since they account for around 75% of its total emissions. Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and the Pearl River Delta (PRD), which are its most important poles of regional development and technological innovation, are key to achieving China's carbon peak emissions target. Based on the panel data of these three major urban agglomerations from 2003 to 2017, this study estimated the carbon emission efficiency (CEE) by the super-efficiency slacks-based measure (super-SBM) model and analyzed its spatiotemporal distribution pattern. The Dagum Gini coefficient was used to evaluate the difference in CEE between the three major agglomerations, while panel data models were established to analyze the impact of technological innovation on the three agglomerations. The overall CEE showed an upward trend during the study period, with significant spatial and temporal variations. Additionally, the main source of urban agglomeration difference in CEE evolved from inter-regional net differences to intensity of transvariation. While technological innovations are expected to significantly improve CEE, their effect varies among urban agglomerations. These results provide policymakers with insights on the collaborative planning of urban agglomerations and the low-carbon economy.

Objectives: To estimate anaemia prevalence and the associated factors among hospitalised people living with HIV (PLHIV) receiving antiretroviral therapy (ART)., Design: A cross-sectional study., Setting: PLHIV receiving ART and hospitalised in a specialised hospital for infectious disease in Guizhou Province, Southwest China, between 1 January 2018 and 31 March 2021., Participants: A total of 6959 hospitalised PLHIV aged ≥18 years and receiving ART were included in this study., Primary and Secondary Outcome Measures: Anaemia was diagnosed as a haemoglobin concentration <120 g/L for non-pregnant females and <130 g/L for males. Mild, moderate and severe anaemia were diagnosed as below the gender-specific lower limit of normal but ≥110 g/L, 80-110 g/L and <80 g/L, respectively., Results: The prevalence of anaemia was 27.5%, and that of mild, moderate and severe anaemia was 9.2%, 12.2% and 6.1%, respectively. Results from multivariate logistic regression showed that females had increased odds of anaemia (adjusted OR (aOR)=1.60, 95% CI: 1.42 to 1.81) compared with males. Widowed or divorced inpatients (anaemia: aOR=1.26, 95% CI: 1.08 to 1.47; severe anaemia: aOR=1.52, 95% CI: 1.16 to 1.97) and thrombocytopenia inpatients (anaemia: aOR=4.25, 95% CI: 3.54 to 5.10; severe anaemia: aOR=4.16, 95% CI: 3.24 to 5.35) had increased odds of anaemia and severe anaemia compared with their counterparts. Hepatitis C was associated with increased odds of severe anaemia (aOR=1.80, 95% CI: 1.11 to 2.92)., Conclusions: Anaemia was prevalent among hospitalised PLHIV. Female sex, those widowed or divorced, and thrombocytopenia were associated with increased odds of anaemia, and those widowed or divorced, thrombocytopenia and hepatitis C were associated with increased odds of severe anaemia. Determination of anaemia predictors, early detection and timely management of anaemia are crucial to prevent anaemia progression., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Strong evidence has linked overweight and obesity to increased risks of cardiovascular disease and all-cause mortality in Chinese populations. Menopause is considered associated with increased obesity and central body fat distribution. However, the correlation between obesity and menopausal symptoms has not been well studied., Objective: To examine the associations between obesity or abdominal obesity and menopausal symptoms as women progressed from premenopausal to postmenopausal status., Design: This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. Physical examinations and questionnaires should be completed annually. The questionnaires include the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors., Results: Among women who were not obese (n=345) or not abdominal obese (n=372) at baseline, 5.8% and 31.7% became obese or abdominal obese at the recent follow-up visit, respectively. Women at the recent follow-up visit had an increased body mass index (BMI) by 0.14%, and the waist-to-hip ratio (WHR) increased by 5.2% compared with the data at baseline. In multivariate analysis, more frequent hot flashes, moderate/severe bothered vasomotor symptoms (VMS), mild bothered sexual functioning, and less anxiety symptoms were significantly associated with obesity. Increasing age, moderate/severe bothered VMS, and less anxiety symptoms were independently associated with abdominal obesity. Multivariable analysis also showed that less education level is independently associated with both obesity and abdominal obesity., Conclusion: Our findings suggest that the proportion of obesity and abdominal obesity increased gradually during menopause. The increase of abdominal obesity is more rapidly than obesity in middle-aged women. Both obesity and abdominal obesity are related with severe or frequent VMS and anxiety symptoms in Chinese women. Although the proportion of obese women in China is lower than in western countries, the problem of abdominal obesity and related complications cannot be ignored., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tang, Fan, Luo, Zhang, Xie, Huang, Wang, Liu, Wang, Lin and Chen.)

Objective: To describe the menopause-specific quality of life of Chinese urban women at midlife., Study Design: Prospective cohort study., Main Outcome Measures: This study included 920 natural menopausal midlife Chinese women who were followed up for 10 years. The Menopause-Specific Quality of Life (MENQOL) questionnaire, which has four domains (vasomotor, psychosocial, physical, and sexual functioning symptoms), and other measures of physical and behavioral factors, were administered. Generalized estimating equations were used to assess the associations., Results: The mean MENQOL scores in the four domains were 1.75 ± 1.32, 2.13 ± 1.16, 2.33 ± 1.11, and 2.20 ± 1.83, respectively. The occurrence of vasomotor symptoms (VMS) persisted in >50% of women in the perimenopausal and early postmenopausal stages. However, the prevalence of moderate/severe bothersome VMS was relatively low. More than 75% of the women presented with mild physical or psychological symptoms, whereas less than 5% of them had moderate/severe symptoms. Sexual problems were highly frequent and bothersome, and their occurrence increased with advancing menopausal stage and age. The prevalence of bothersome sexual symptoms and moderate/severe sexual symptoms ranged from 31.89 and 1.58% in premenopausal women to 78.09 and 39.35% in late postmenopausal women, respectively. Menopausal status, depressive symptoms, and poor health status were significantly associated with the four menopausal domains., Conclusion: VMS are among the menopausal symptoms most frequently rated as severe. Sexual problems become more prevalent with advancing age. Clinicians should have a broad understanding of changes that occur during the transition to maximize women's health., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2021. Published by Elsevier B.V.)

Objective: To assess the strategy and value of centralized surveillance of hydatidiform mole at a regional hospital in China and to investigate the necessity of prophylactic chemotherapy for high-risk complete hydatidiform mole., Methods: Between February 2013 and February 2020, all women with hydatidiform mole in Dalian Women's and Children's Medical Center (Group) were registered for surveillance and treatment when indicated. Women with complete hydatidiform mole were categorized into low-risk and high-risk groups according to the criteria from Song Hongzhao's trophoblastic neoplasia. Outcomes and treatments were analyzed retrospectively., Results: In total, 703 women with hydatidiform mole were registered for surveillance with a follow-up rate of 97.9% (688/703). 680 women were enrolled and 52 (7.6%) developed post-molar gestational trophoblastic neoplasia, all with low-risk International Federation of Gynecology and Obstetrics (FIGO) scores 0-5. Post-molar gestational trophoblastic neoplasia was diagnosed in 12.3% (51/413) of patients with complete hydatidiform moles and 0.4% (1/263) of patients were diagnosed with partial hydatidiform moles (χ 2 =32.415, p<0.001). Post-molar gestational trophoblastic neoplasia was diagnosed in 27.7% (28/101) of the high-risk complete hydatidiform mole group and in 7.4% (23/312) of the low-risk complete hydatidiform mole group (χ 2 =29.196, p<0.001). No difference in the pre-treatment assessments of patients with post-molar gestational trophoblastic neoplasia was found between the low-risk and high-risk complete hydatidiform mole groups (all p>0.05). All 52 patients with post-molar gestational trophoblastic neoplasia were cured, with a complete response rate of 61.2% (30/49) with first-line single-agent chemotherapy., Conclusions: A centralized hydatidiform mole surveillance program is feasible and effective and may improve the prognosis of patients with post-molar gestational trophoblastic neoplasia. Prophylactic chemotherapy is not recommended for women with high-risk complete hydatidiform mole with adequate surveillance., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)

By 31 December 2020, Coronavirus disease 2019 (COVID-19) had been prevalent worldwide for one year, and most countries had experienced a complete seasonal cycle. The role of the climate and environment are essential factors to consider in transmission. We explored the association between global meteorological conditions (including mean temperature, wind speed, relative humidity and diurnal temperature range) and new cases of COVID-19 in the whole past year. We assessed the relative risk of meteorological factors to the onset of COVID-19 by using generalized additive models (GAM) and further analyzed the hysteresis effects of meteorological factors using the Distributed Lag Nonlinear Model (DLNM). Our findings revealed that the mean temperature, wind speed and relative humidity were negatively correlated with daily new cases of COVID-19, and the diurnal temperature range was positively correlated with daily new cases of COVID-19. These relationships were more apparent when the temperature and relative humidity were lower than their average value (21.07°Cand 66.83%). The wind speed and diurnal temperature range were higher than the average value(3.07 m/s and 9.53 °C). The maximum RR of mean temperature was 1.30 under -23°C at lag ten days, the minimum RR of wind speed was 0.29 under 12m/s at lag 24 days, the maximum RR of range of temperature was 2.21 under 28 °C at lag 24 days, the maximum RR of relative humidity was 1.35 under 4% at lag 0 days. After a subgroup analysis of the countries included in the study, the results were still robust. As the Northern Hemisphere enters winter, the risk of global covid-19 remains high. Some countries have ushered in a new round of COVID-19 epidemic. Thus, active measures must be taken to control the source of infection, block transmission and prevent further spread of COVID-19 in winter., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Meteorological parameters are the critical factors of affecting respiratory infectious disease such as Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS) and influenza, however, the effect of meteorological parameters on coronavirus disease 2019 (COVID-19) remains controversial. This study investigated the effects of meteorological factors on daily new cases of COVID-19 in 127 countries, as of August 31 2020. The log-linear generalized additive model (GAM) was used to analyze the effect of meteorological variables on daily new cases of COVID-19. Our findings revealed that temperature, relative humidity, and wind speed are nonlinearly correlated with daily new cases, and they may be negatively correlated with the daily new cases of COVID-19 over 127 countries when temperature, relative humidity and wind speed were below 20°C, 70% and 7 m/s respectively. Temperature(>20°C) was positively correlated with daily new cases. Wind speed (when>7 m/s) and relative humidity (>70%) was not statistically associated with transmission of COVID-19. The results of this research will be a useful supplement to help healthcare policymakers in the Belt and Road countries, the Centers for Disease Control (CDC) and the World Health Organization (WHO) to develop strategies to combat COVID-19., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Aims: Epidemiological data on diabetic retinopathy (DR) in Chinese population is still rather scarce, and risk factors for diabetic retinopathy are inconsistent because of study designs, grading standards, and population samples., Materials and Methods: This hospital-based retrospective study included 1052 type 2 diabetes patients. Diabetic retinopathy was diagnosed by nonmydriatic fundus photography and/or fundus examination apparatus. Logistic regression analysis was performed to evaluate the risk of diabetic retinopathy., Results: A total of 352 (33.5% prevalence) subjects were diagnosed with diabetic retinopathy based on our population. The patients in the DR group not only had significantly higher hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), urinary microalbumin-creatinine ratio (ACR), and systolic blood pressure but also had higher follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels compared to those in the non-DR group. Moreover, we confirmed that diabetes duration and HbA1c are strongly associated with DR risk. We also found that serum LH was an independent risk factor in male diabetic retinopathy patients (OR = 1.086, 95% CI 1.024-1.152), and the levels of LH were significantly associated with diabetic retinopathy prevalence ( P = 0.018)., Conclusions: Our study strengthens the argument that diabetes duration and HbA1c are risk factors for patients with DR. Additionally; we firstly confirmed that serum LH was an independent risk factor in male diabetic retinopathy patients., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Qingmin Sun et al.)

Ecosystems respond to climatic and anthropogenic forcings with regime shifts and reorganizations of their system structures. In river basins, changes in sediment transport can have cascading effects that cause ecosystem regime shifts. The Yellow River, once the world's most sediment-rich river, has experienced dramatic regime shifts. Although recent intervention has returned sediment discharge in the Yellow River to pristine levels, our understanding of previous regime shifts remains inadequate, particularly for the regime shift to a sediment rich period during early historical time. We reanalyzed previous datasets to clarify the first historical sediment transport regime shift in the Yellow River. Our results show that while historical climatic changes (e.g., the Medieval Warm Period, about 900-1100 AD) caused changes in sediment transport, a regime shift occurred only under increased forcing from anthropogenic stresses (started from about 1350 AD, reached the tipping point after 1900 AD). This unique behavior of the Yellow River under increasing anthropogenic forces may provide perspective for sustainable river basin management.

Context: During the menopausal transition, there is a greater likelihood of the prevalence of various bothersome symptoms, including vasomotor symptoms (VMS) and mood symptoms., Objective: To investigate the association among bothersome VMS and symptoms of anxiety and depression in Chinese women during perimenopause and early in menopause., Design, Patients, Setting, and Interventions: This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. A structured questionnaire was provided annually, comprising the VMS Bother Score (range 1-8) from the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors., Results: Among the 430 women evaluated, 78.8% had experienced VMS during long-term follow-up. The overall level of VMS bother score was relatively low (1.92 ± 1.32). Both anxiety and depressive symptoms were significantly associated with VMS bother. After adjusting for potential covariates, the association between anxiety or depression symptoms and VMS bother remained highly significant. Menopausal stage, body mass index, general health, follicle-stimulating hormone, and estradiol were independent contributors to VMS. In time-lagged (1-year) models, VMS bother scores significantly predicted the risk of symptoms of both anxiety and depression the following year. In contrast, anxiety symptoms, rather than depressive symptoms, could predict VMS bother the following year., Conclusion: The prevalence of VMS in our cohort was higher than has been previously reported; however, the overall level of bother was relatively low. This study demonstrated a strong relationship between VMS bother and mood symptoms in Chinese women progressing from perimenopause through natural menopause., (© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The coronavirus disease 2019 (COVID-19) pandemic is the defining global health crisis of our time and the greatest challenge facing the world. Meteorological parameters are reportedly crucial factors affecting respiratory infectious disease epidemics; however, the effect of meteorological parameters on COVID-19 remains controversial. This study investigated the effects of temperature and relative humidity on daily new cases and daily new deaths of COVID-19, which has useful implications for policymakers and the public. Daily data on meteorological conditions, new cases and new deaths of COVID-19 were collected for 166 countries (excluding China) as of March 27, 2020. Log-linear generalized additive model was used to analyze the effects of temperature and relative humidity on daily new cases and daily new deaths of COVID-19, with potential confounders controlled for, including wind speed, median age of the national population, Global Health Security Index, Human Development Index and population density. Our findings revealed that temperature and relative humidity were both negatively related to daily new cases and deaths. A 1 °C increase in temperature was associated with a 3.08% (95% CI: 1.53%, 4.63%) reduction in daily new cases and a 1.19% (95% CI: 0.44%, 1.95%) reduction in daily new deaths, whereas a 1% increase in relative humidity was associated with a 0.85% (95% CI: 0.51%, 1.19%) reduction in daily new cases and a 0.51% (95% CI: 0.34%, 0.67%) reduction in daily new deaths. The results remained robust when different lag structures and the sensitivity analysis were used. These findings provide preliminary evidence that the COVID-19 pandemic may be partially suppressed with temperature and humidity increases. However, active measures must be taken to control the source of infection, block transmission and prevent further spread of COVID-19., Competing Interests: Declaration of competing interest 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., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Injuries are of growing public health concern in China, and the trends of urban-rural injury mortality disparity for the last decade are still being explored. This study aims to analyze trends in injury mortality disparity between urban and rural areas of China by region, sex, and age from 2010 to 2016., Methods: Using data from the Disease Surveillance Points system (DSPs) collected by the Chinese Center for Disease Control and Prevention (CDC) from 2010 to 2016, injury age-standardized mortality rates (ASMRs) and rate ratios (RRs) were calculated for different groups. Chi-square tests were used to compare differences in rates between urban and rural residents. The time trends of injury ASMRs were assessed via the annual percentage change (APC), and RRs were used to analyze urban-rural mortality disparity., Results: The crude injury mortality rate of rural areas was 1.5 times higher than that of urban areas. The urban-rural RR of injury ASMR decreased from 1.8 to 1.5 (APC = 5.0%) over time, from 2.0 to 1.7 (APC = 4.7%) for eastern regions, from 1.9 to 1.5 (APC = 5.4%) and from 1.6 to 1.3 (APC = 4.5%) among males and females, respectively. Further decreases were from 2.0 to 1.4 (APC = 7.8%), from 1.9 to 1.6 (APC = 6.4%), and from 1.8 to 1.2 (APC = 5.7%) in the 5-14, 45-64, and 65+ year age groups, respectively. The urban-rural RRs of ASMRs for fall, drowning and suicide decreased from 1.3 to 1.2 (APC = - 3.0%), from 2.3 to 1.6 (APC = - 13.8%) and from 2.1 to 1.6 (APC = - 9.9%,), respectively., Conclusions: The urban-rural injury mortality disparity was large, but showed a significant decreasing trend in China. Residents of eastern regions, males/females, 5-14/45+ year age groups in the urban-rural injury mortality disparity all decreased gradually during the investigated period.

Background: The gut microbiota is a complex ecosystem, which is essential for the metabolism, health and immunity of host. Many diseases have been shown to be closely related to the alteration of intestinal flora. Aeromonas veronii as a conditioned pathogen can cause disease in Yangtze finless porpoise through intestinal infections. However, it is not clear whether the disease caused by Aeromonas veronii is related to changes of intestinal flora. In the current study, the diversity and composition of gut microbiota in the healthy and Aeromonas veronii-infected Yangtze finless porpoise were evaluated by high-throughput sequencing to further investigate the potential association between intestinal flora alteration and pathogen invasion., Results: A total of 127,3276 high-quality sequences were achieved and 2465 operational taxonomic units (OTUs) were in common among all samples. The results of alpha diversity showed that there was no obvious difference in richness and diversity between healthy and Aeromonas veronii-infected Yangtze finless porpoise. Firmicutes, Bacteroidetes and Proteobacteria were the most dominant phyla in all samples. In addition, the healthy Yangtze finless porpoise exhibited higher abundance of Firmicutes and Fusobacteria than Aeromonas veronii-infected Yangtze finless porpoise, while, the level of Proteobacteria was decreased. At the genus level, Paeniclostridium and Paraclostridium were the predominant bacteria genera in the CK (healthy Yangtze finless porpoise) group. In the DIS (Aeromonas veronii-infected Yangtze finless porpoise) group, Lactobacillus and unidentified&#95;Enterobacteriaceae were the dominant bacteria genera and the proportion of Paeniclostridium, Paraclostridium, Terrisporobacter, Cetobacterium, Candidatus Arthromitus, Terrabacter and Dechloromonas were reduced., Conclusions: In conclusion, our results showed that Aeromonas veronii infection can alter the gut microbiota of the Yangtze finless porpoise by affecting the number of harmful bacteria and beneficial bacteria.

Watersheds are coupled with human-water systems where human, and water resources interact and coevolve with each other. Restoration management not only affects the ecosystem itself but also alters the mutual feedback relationship between humans and water, resulting in additional effects and impeding the ecological restoration process. Taking the lower reaches of the Heihe River as an example (Inner Mongolia, PR China), this study investigated the evolution of the human-water system after the implementation of ecological water conveyance using multiple data sources (e.g., remote sensing data, hydrological data, field data and socioeconomic data). We found that (1) after the implementation of ecological water conveyance, vegetation recovered in the last 15 years with an NDVI increasing from 0.10 to 0.13 across the region except some degraded areas near the river; (2) besides restoring the target ecosystem, ecological water conveyance also promoted socioeconomic development and affected the water resources utilization; (3) after 15 years' water conveyance, the coupled human-water system changed from the early ecological water deficit to the present ecological-socioeconomic water-use trade-off with negative impact resulted from agriculture expansion and water usage conflict between the middle and the lower reaches. These effects impeded the restoration of the ecological environment and aggravated the conflicts of water resources utilization within the whole Heihe watershed, consistent with of the hypothesized disturbance effect transmutation. Our results highlighted that analysis on the mutual feedback effect in the coupled human-water system, and dynamic adjustments for restoration measures are needed for sustainable watershed management., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Burkitt lymphoma (BL), an aggressive malignancy, brings a prognosis varying among children, adolescents, and adults. Most of previous retrospective studies of BL focused on a part of population. This study aimed to find the leading prognostic factors in BL among patients of different age groups. World Health Organization classification of lymphoid neoplasms in 2008 and revision in 2016 were used as diagnostic criteria for BL. We compared the laboratory results and clinical manifestations in 2 age groups by Kaplan-Meier survival analysis. Our study strongly indicated that age >14 years and lactate dehydrogenase >570 U/L were 2 powerful prognostic factors for BL. The results indicated that poor prognosis may be for the poor tolerance and low dose of drugs in adolescents and adults.

Background: Hypospadias risk-associated gene variants have been reported in populations of European descent using genome-wide association studies (GWASs). There is little known at present about any possible hypospadias risk associations in Han Chinese populations., Methods: To systematically investigate hypospadias risk-associated gene variants in Chinese patients, we performed the first GWAS in a Han Chinese cohort consisting of 197 moderate-severe hypospadias cases and 933 unaffected controls. Suggestive loci (p < 1 × 10 - 4 ) were replicated in 118 cases and 383 controls, as well as in a second independent validation population of 137 cases and 190 controls. Regulatory and protein-protein interactions (PPIs) were then conducted for the functional analyses of candidate variants., Results: We identified rs11170516 with the risk allele G within the SP1/SP7 region that was independently associated with moderate-severe hypospadias [SP1/SP7, rs11170516, P combine  = 3.5 × 10 - 9 , odds ratio (OR) = 1.96 (1.59-2.44)]. Results also suggested that rs11170516 is associated with the expression of SP1 as a cis-expression quantitative trait locus (cis-eQTL). Protein SP1 could affect the risk of hypospadias via PPIs., Conclusions: We performed the first GWAS of moderate-severe hypospadias in a Han Chinese cohort, and identified one novel susceptibility cis-acting regulatory locus at 12q13.13, which may regulate a variety of hypospadias-related pathways by affecting proximal SP1 gene expression and subsequent PPIs. This study complements known common hypospadias risk-associated variants and provides the possible role of cis-acting regulatory variant in causing hypospadias.

The aim of this study was to evaluate the antibacterial potential of Lactobacillus screened from Tibetan yaks on clinical symptoms and intestinal microflora in enteroinvasive Escherichia coli (EIEC) induced mice model. In vitro study, Lactobacillus reuteri (LR1) exhibited stronger resistance to acid and bile and inhibited the growth of EIEC than Lactobacillus mucosae (LM1). The mice were randomly divided into four groups i.e. the LR1 group (LR1 1 × 10 9  CFU/day), LM1 group (LM1 1 × 10 9  CFU/day), blank control group and control group. Mice in control, LR1, and LM1 groups were challenged with EIEC on day 23. The body weight in the control and LM1 groups were significantly decreased after the infection with EIEC (P < 0.05), whereas the body weight of mice in the LR1 group did not change significantly (P > 0.05). The lowest diarrhea rate was recorded in the LR1 group after infection with EIEC. The results showed that the number of pathogens in the control group was higher than that in the experimental groups. The sequence analysis and OTU classification showed that the duodenum, ileum, and cecum of mice in the LR1 group had the highest number of OTUs compared with other groups. Whereas, the diversity analysis showed that in duodenum, ileum and cecum of mice in the LR1 group had the highest abundance and diversity. The composition of intestinal microbes indicated the presence of high proportions of Firmicutes, Proteobacteria and Bacteroidetes. Heat map analysis indicated high abundance of Bdello vibrio in the duodenum of mice in the LR1 group, while many pathogens were found in the different part of intestines in the control group, such as Streptococcus, Clostridium and Pseudomonas. In conclusion, pre-supplementation of LR1 alleviate the clinical symptoms caused by E. coli, and promote a healthy gut flora., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To explore the clinical characteristics, risk factors and factors affecting the severity of the disease in patients with diabetic foot at the current stage through a multi-center cross-sectional survey.
 Methods: Clinical data of 326 patients with diabetic foot (205 males and 121 females) from 13 general hospitals nationwide were collected from October to November 2017 using a unified clinical data collection table. The clinical characteristics were analyzed, and the influential factors for severe diabetic foot were analyzed by logistic regression analysis.
 Results: Among 326 patients with diabetic foot, 68.4% of the patients were more than 60 years old, and 60.1% of the patients received primary or junior high school education; 96.3% of the patients developed Type 2 diabetes; 80.1% of patients had glycated hemoglobin (HbA1c)≥7%; 60.1% of patients suffered dyslipidemia. Improper wearing of footwear (38.5%) is the main cause of diabetic foot. Diabetic neuropathy (76.7%), diabetic retinopathy (62.3%) and lower limb vascular disease (57.4%) were the most common complications. Logistic regression analysis showed that diabetic nephropathy, diabetic lower extremity vascular disease, and HbA1c levels were independent risk factors for severe diabetic foot, and receiving foot care education can be regarded as a protective factor.
 Conclusion: The diabetic foot occurs mostly in male patients, and Type 2 diabetes with older age, lower education level, poor glycemic control and dyslipidemia are the risk factors. Diabetic nephropathy, diabetic lower extremity vascular disease, HbA1c, and receiving foot care education are independent influential factors for the severity of diabetic foot.

Vibriocholerae, which is autochthonous to estuaries worldwide, can cause human cholera that is still pandemic in developing countries. A number of V. cholerae isolates of clinical and environmental origin worldwide have been subjected to genome sequencing to address their phylogenesis and bacterial pathogenesis, however, little genome information is available for V. cholerae isolates derived from estuaries, particularly in China. In this study, we determined the complete genome sequence of V. cholerae CHN108B (non-O1/O139 serogroup) isolated from the Yangtze River Estuary, China and performed comparative genome analysis between CHN108B and other eight representative V. cholerae isolates. The 4,168,545-bp V. cholerae CHN108B genome (47.2% G+C) consists of two circular chromosomes with 3,691 predicted protein-encoding genes. It has 110 strain-specific genes, the highest number among the eight representative V. cholerae whole genomes from serogroup O1: there are seven clinical isolates linked to cholera pandemics (1937-2010) and one environmental isolate from Brazil. Various mobile genetic elements (such as insertion sequences, prophages, integrative and conjugative elements, and super-integrons) were identified in the nine V. cholerae genomes of clinical and environmental origin, indicating that the bacterium undergoes extensive genetic recombination via lateral gene transfer. Comparative genomics also revealed different virulence and antimicrobial resistance gene patterns among the V. cholerae isolates, suggesting some potential virulence factors and the rising development of resistance among pathogenic V. cholerae. Additionally, draft genome sequences of multiple V. cholerae isolates recovered from the Yangtze River Estuary were also determined, and comparative genomics revealed many genes involved in specific metabolism pathways, which are likely shaped by the unique estuary environment. These results provide additional evidence of V. cholerae genome plasticity and will facilitate better understanding of the genome evolution and pathogenesis of this severe water-borne pathogen worldwide.

The concentrations of polycyclic aromatic hydrocarbons (PAHs) in two 210 Pb-dated sediment cores collected from mud deposits along the southeastern coast of the Liaodong Peninsula were investigated to reconstruct the sedimentary records of PAHs and their relationship with anthropogenic and natural activities. The concentrations of 16 PAHs (∑PAHs) were low and remained stable before the year 1820, reflecting an autarkic agricultural civilization. From 1820 to 1900, with the gradual lifting of prohibition, people migrated into Northeast China, resulting in the release of large amounts of ∑PAHs into the environment. At the beginning of the 1900s, the ∑PAH levels in the two cores displayed increasing trends with significant fluctuations, linked to a period of social turbulence with continuous wars in Northeast China. After 1949, vertical ∑PAH trends in the cores predominantly reflected trends in economic development. Based on the different PAH composition trends (2-3-ring and 4-6-ring PAHs), we consider that historical energy usage in Northeast China can be divided into three stages: biomass fuel use dominated before 1920, biomass and fossil fuels co-existed from 1920 to 1980, and fossil fuels dominated after 1980. In addition, this study also demonstrates that the PAH concentrations (2-3-ring PAHs) in these two sediment cores can be used, to a certain extent, to identify anthropogenic fire events., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Nowadays, many big cities are suffering from heavy air pollution and continuous haze weather. Compared with the threat on physical health, the influence of haze on people's mental health is much less discussed in the current literature. Emotion is one of the most important indicators of mental health. To understand the negative impact of haze weather on the emotion of the people, we conducted an investigation based on historical weather records and microblog data in Tianjin, China. Specifically, an emotional thesaurus was generated with a microblog corpus collected from sample data. Based on the thesaurus, the public emotion under haze was statistically described. Then, through correlation analysis and comparative study, the relation and seasonal variation of haze and negative emotion of the public were well discussed. According to the study results, there was indeed a correlation between haze and negative emotion of the public, but the strength of this relationship varied under different conditions. The level of air pollution and weather context were both important factors that influence the mental effects of haze, and diverse patterns of negative emotion expression were demonstrated in different seasons of a year. Finally, for the benefit of people's mental health under haze, recommendations were given for haze control from the side of government.

Epidemiological data from Lake Taihu showed significantly higher incidences of type 2 diabetes mellitus (T2DM) than in other areas of China. This may be related to the occurrence of a Microcystis bloom in Lake Taihu in the summer and autumn every year. The objective of this study is to investigate whether the contaminated water from the Microcystis bloom and the derivative pollutant microcystin-LR (MC-LR) can explain the higher incidences of T2DM. Healthy male mice were fed with water from different regions of Lake Taihu, and were either acutely or chronically exposed to MC-LR through oral administration or intraperitoneal injection. Serum lipid profiles were determined, and the effects on T2DM-related gene expression and insulin receptor signaling pathway were investigated. Intraperitoneal glucose tolerance (IPGTT) and insulin resistance (IRT) tests were implemented, and the functions of pancreatic islet and β-cell were also evaluated. The results showed that both water sampled from the region with a Microcysis bloom and those containing MC-LR altered the serum glucide and lipid profiles in mice after exposure. The exposure to a Microcysis bloom water affected the expression T2DM-related genes: up-regulated the mRNA levels of FASn, ACACA, G6pc, LPL, and Insig2, and down-regulated the mRNA level of PEPCK and Gsk-3β. Both acute and chronic exposure of MC-LR, even at very low concentrations (1 μg/L), impaired the insulin receptor signalling pathway and induced hyperinsulinemia and insulin resistance in mice. In this study, the most important intracellular target of MC-LR was found to be hetapocellular mitochondria. Thus, exposure to Microcystis bloom water containing microcystin-LR can induce the incidence of T2DM, by impairing the function of mitochondria by microcystin-LR. The study suggests a review of the risk assessment concerning 1 μg/L MC-LR as the reference dose in surface water., (Copyright © 2018 Elsevier B.V. All rights reserved.)

ATP-binding cassette A3 (ABCA3) is a phospholipid carrier that is mainly expressed in the alveolar epithelium. Biallelic mutations of ABCA3 has been associated with fatal respiratory distress syndrome and interstitial lung disease (ILD) in children. However, whether variations in ABCA3 have a role in the development of adult ILD, including idiopathic pulmonary fibrosis (IPF), remains to be addressed. In this study, we screened for germline variants of ABCA3 by exons-sequencing in 30 patients with sporadic IPF and in 30 matched healthy controls. Eleven missense variants, predominantly in heterozygous, were found in 13 of these patients, but only two missenses in 2 healthy controls. We then selected four of the detected missense variants (p.L39V, p.S828F, p.V968M and p.G1205R) to performed cohort analysis in 1,024 ILD patients, containing 250 IPF and 774 connective tissue disease-ILD (CTD-ILD) patients, and 1,054 healthy individuals. Our results showed that the allele frequency of p.G1205R, but not p.L39V, was significantly higher in ILD patients than in healthy controls. However, no additional subject carrying the variant p.S828F or p.V968M was detected in the cohort analysis. These results indicate that the heterozygous ABCA3 gene variants may contribute to susceptibility to diseases in the Chinese population.

Objective: To provide genetic analysis for a family affected with Duchenne muscular dystrophy (DMD) with a recurrent de novo mutation., Methods: Multiplex ligation dependent probe amplification (MLPA) was used to detect potential deletion and duplication of the DMD gene, and the DNA products were sequenced on a Genetic Analyzer 3130 sequencer. Haplotype analysis was performed using four short tandem repeat polymorphism loci (44C/A, 45C/A, 49C/A and 63C/A) of the DMD gene for the family., Results: A same deletional mutation (Del 48-50) of the DMD gene was detected in the proband and fetus, but not in their mother. The proband and fetus have inherited the same haplotype of the DMD gene from their mother. The fetus was predicted to be affected by the disease., Conclusion: Above findings suggested that the mother was very likely to have a germline mosaicism for the DMD gene mutation. For the de novo DMD mutation, although genetic analysis of peripheral blood DNA has indicated that the proband's mother was not a carrier, germline mosaicism could still not be ruled out, and prenatal gene diagnosis should be provided for subsequent pregnancies.

Background/aims: IGF1 is a key regulator in cell proliferation and apoptosis, and the 3' un-translated region (3'UTR) of the gene plays an important role in gene expression. For the first time, we explored the relationship between polymorphisms in the IGF1 3'UTR region and the risk of childhood acute lymphoblastic leukemia (ALL)., Methods: Questionnaires were applied to collect epidemiological data. The genotypes of IGF1 polymorphisms were tested in a population of 744 ALL patients and 1088 cancer-free controls utilizing Taqman. Cell functional studies included real-time PCR, cell culture and transfection and luciferase assays., Results: We found that rs6214 homozygous AA genotype and rs6218 homozygous CC genotype were significantly associated with increased risk of childhood ALL. In addition, rs6218 CC genotype was associated with increased level of IGF1 mRNA in bone marrow, and the mutation in rs6218 led to aberrant binding capacity of hsa-miR-603 and hsa-miR-3941 in the 3'UTR of IGF1., Conclusion: Polymorphisms of rs6214 and rs6218 in the 3'UTR of IGF1 are associated with childhood ALL susceptibility, and the polymorphism of rs6218 is related with IGF1 expression at mRNA level., (© 2015 S. Karger AG, Basel.)