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Nitrogen pollution has emerged as a significant threat to the health of global river systems, garnering considerable attention. However, numerous challenges persist in understanding the characteristics and predicting the spatial changes of total nitrogen (TN) at the catchment scale. We leveraged data from 530 monitoring sections to calculate a land-use composite index and perform statistical analyses to explore the primary factors influencing nitrogen enrichment in the Yangtze River Watershed. We developed three machine learning models to forecast future TN concentrations at monitoring points. Our results showed that agricultural activities and rainfall were the primary drivers of monthly variations in TN concentrations. The upstream region of the watershed exhibited larger variations in TN concentrations (0.097 to 11.099 mg/L), significantly higher than the middle and downstream areas (0.348 to 6.844 mg/L). Microbial-mediated organic matter decomposition in sediment and changes in land-use were identified as key contributors to regional differences in nitrogen enrichment. Potential nitrogen sources include sediment release, urban sewage, and agricultural fertilization. Random Forest model achieved a prediction accuracy of 77.6 %, surpassing the BP and LSTM models. We identified 37 high-risk areas of nitrogen enrichment, concentrated in the Chengdu-Chongqing, Yunnan-Central urban cluster, and the Chaohu Lake sub-watershed. Increased urban land-use and industrial inputs primarily influenced nitrogen enrichment in the upstream area, while agricultural inputs were the main drivers in the middle and downstream regions. Our multi-machine learning models identified the relationship between TN and influencing factors, providing a reliable method for assessing nitrogen enrichment risk in the watershed., Competing Interests: Declaration of competing interest The authors declared 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.)

A comprehensive understanding of nitrogen pollution status, especially the identification of sources and fate of nitrate is essential for effective water quality management at the local scale. However, the nitrogen contamination of surface water across China was poorly understood at the national scale. A dataset related to nitrogen was established based on 111 pieces of literature from 2000 to 2020 in this study. The spatiotemporal variability, source tracing, health risk assessment, and drivers of China's surface water nitrogen pollution were analyzed by integrating multiple methods. These results revealed a significant spatiotemporal heterogeneity in the nitrogen concentration of surface water across China. Spatially, the Haihe River Basin and Yellow River Basin were the basins where surface water was seriously contaminated by nitrogen in China, while the surface water of Southwest Basin was less affected. Temporally, significant differences were observed in the nitrogen content of surface water in the Songhua and Liaohe River Basin, Pearl River Basin, Southeast Basin, and Yellow River Basin. There were 1%, 1%, 12%, and 46% probability exceeding the unacceptable risk level (HI＞1) for children in the Songhua and Liaohe River Basin, Pearl River Basin, Haihe River Basin, and Yellow River Basin, respectively. The primary sources of surface water nitrate in China were found to be domestic sewage and manure (37.7%), soil nitrogen (31.7%), and chemical fertilizer (26.9%), with a limited contribution from atmospheric precipitation (3.7%). Human activities determined the current spatiotemporal distribution of nitrogen contamination in China as well as the future development trend. This research could provide scientifically reasonable recommendations for the containment of surface water nitrogen contamination in China and even globally., 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. ☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2024. Published by Elsevier Inc.)

Background: Cognitive models of depression assert that attentional biases play an important role in the maintenance of depression. However, few studies have explored attentional bias in depressed older adults, and no consistent conclusions have been reached., Methods: In the current study, we investigated attentional bias in older adults with non-clinical depression. Older adults aged over 60 with non-clinical depression and without depression were instructed to perform a free viewing task while their eye movements were tracked., Results: The results showed that, compared to older adults without depression, non-clinically depressed older adults had longer total fixation durations and a greater number of fixations on sad stimuli. Moreover, non-depressed older adults exhibited a preference for pleasant images, whereas this effect was not observed in older adults with non-clinical depression., Conclusion: This study suggested that non-clinically depressed older adults have attentional bias, which is manifested as increased attention to sad stimuli and decreased attention to pleasant stimuli.The current study has functional and potential functional implications.

Coal mining changes groundwater environment, results in deterioration of water quality and endangering human health in the mining area. However, the comprehensive study of groundwater evolution and its potential impact in mining area is still insufficient. In this study, 95 groundwater samples were collected from 2019 to 2020 in a typical mining area of China. Ion ratio coefficients, isotopic tracing technology, Entropy-weighted water quality index (EWQI) and human health risk assessment model (HHRA) were applicated to investigate the hydrochemical variation reasons, groundwater quality and its potential health risk in the study area. Results showed that the groundwater hydrochemical types changed from HCO 3 ∙SO 4 -Ca∙Mg type to SO 4 -Ca∙Mg and SO 4 ∙Cl-Ca∙Mg type. Water-rock interaction, agricultural activities, manure and sewage input, precipitation and evaporation controlled the groundwater hydrochemical composition. Groundwater quality showed a trend of fluctuation with an average EWQI of 59.23, 68.92, 63.75, 58.02 and 64.92, respectively. 91.6% of the water samples was fair and acceptable for drinking. The groundwater health risk of nitrate in the study area ranged from 0.03 to 17.80. Infants had the highest health risk and nitrate concentration was the most sensitive parameter. The results will present a comprehensive research of groundwater evolution and potential impacts through a typical mining area example. Thereby offering valuable insights into the influencing factors identification, hydrochemical processes evolution, protection and utilization of groundwater in global mining areas., 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 Inc. All rights reserved.)

Introduction: The finding that familiarity can support associative memory by unitizing the to -be-learned items into a novel representation has been widely accepted, but its effects on overall performance of associative memory and recollection are still controversial., Methods: The current study aims to elucidate these discrepancies by identifying potential moderating factors through a combined approach of meta-analysis and behavioral experiment., Results: Results consistently showed that changes in the level of unitization and age groups were two important moderators. Specifically, unitization enhanced younger and older adults' associative memory and its supporting processes (i.e., familiarity and recollection) when the level of unitization between studied and rearranged pairs was changed. However, when this level remained constant, unitization exhibited no impact on associative memory and familiarity in younger adults, but showed an enhanced effect in older adults. Furthermore, results revealed a marked group difference between younger and older adults in associative memory when the unitization level of noncompound words remained unaltered. Upon breaking this condition, the group difference was reduced by enhancing familiarity or recollection., Discussion: These findings not only clarify some of the inconsistencies in the literature concerning the impact of unitization on associative memory, but also suggest that unitization is a beneficial strategy for reducing group difference in associative memory, with its effectiveness varying according to the level of unitization changes., 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 Liu, Wang, Zhu, Yuan and Liu.)

Past research showed that emotional contexts can impair recognition memory for the target item. Given that item-context congruity may enhance recognition memory, the present study aims to examine the effect of the congruent emotional encoding contexts on recognition memory. Participants studied congruent word-picture pairs (e.g., the word "cow" - a picture describing a cow) and incongruent word-picture pairs (e.g., the word "cow" - a picture describing a goat) and, subsequently, were asked to report the nature of the picture (emotional or neutral). Behavioral results revealed that emotional contexts impaired source but not item recognition, with congruent word-context mitigating this impairment and enhancing item recognition. Neural results from ERPs and theta oscillations found the recollection process, as shown by the LPC old/new effect and theta oscillations, for both item and source recognition across emotional contexts, irrespective of congruity. Meanwhile, the familiarity process as indexed by the FN400 old/new effect was found only for item recognition in congruent emotional contexts. These findings suggest that the congruent relationship of item-context could mitigate the emotion-induced source memory impairment and enhance item memory, with neural results elucidating the memory processes involved in retrieval of emotional information. Specifically, while emotion-related information generally elicits the recollection-based memory process, only congruent emotional information elicits the familiarity-based process., (© 2024 Society for Psychophysiological Research.)

It is widely accepted that familiarity can support associative memory when the to-be-remember items are unitized into a new representation. However, there has been relatively little attention devoted to investigating the effects of different unitization manipulations on associative memory. The present study aimed to address this gap by examining the effects of varying levels of unitization through three tasks: Concept definition, interactive imagery, and sentence frame tasks. The behavioral results revealed that associative memory was significantly enhanced in the interactive imagery task compared to the sentence frame task. However, no significant differences were found between the sentence frame and concept definition tasks, or between the concept definition and interactive imagery tasks. In terms of the neural correlates, the event-related potential (ERP) results revealed that the sentence frame task only elicited a significant recollection-related LPC old/new effect, while the concept definition task only elicited a significant familiarity-related FN400 old/new effect. However, the interactive representation task elicited both of these distinct effects. These findings suggest that both the concept definition and interactive imagery tasks can enhance familiarity for supporting associative memory, but their beneficial effects on associative memory or LPC old/new effects may be different., Competing Interests: Declaration of competing interest There is no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

The interaction between groundwater and surface water, including their recharge relationship and ratio, is crucial for water cycling, management, and pollution control. However, accurately estimating their spatiotemporal interaction at the watershed scale remains challenging. In this study, we used dual stable isotopes (δ 18 O, δ 2 H, d-excess, and lc-excess) and hydrochemistry methods to rethink spatiotemporal interaction at the Yiluo River watershed in central China. We collected 20 groundwater and 40 surface water samples over four periods in two seasons (dry and wet). Our results showed that in the downstream region, groundwater recharged surface water in the dry season while surface water recharged groundwater in the wet season, with average recharge ratios of 89.82% and 90.02%, respectively. In the midstream region, surface water recharged groundwater in both seasons with average ratios of 93.79% and 91.35%. In contrast, in the upstream region, groundwater recharged surface water in both seasons with ratios of 67.35% and 76.89%. Seasonal changes in the recharge relationship between surface water and groundwater in the downstream region also been found. Our findings provide valuable insights for watershed-scale water resource and pollution management., 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 © 2023 Elsevier Ltd. All rights reserved.)

Human fecal contamination in urban rivers poses significant health risks, but their potential connections with other substances like dissolved organic matter (DOM) remain underexplored. In this study, five fecal pollution markers related to fecal Bacteroides or human fecal contamination (AllBac, HF183, BacH, Hum2, and Hum163) and DOM along an urban river were analyzed using quantitative polymerase chain reaction (qPCR) and three-dimensional excitation-emission (3D EEM) fluorescence spectrometry. All five markers were detected with average absolute abundance ranging from 2.51 to 6.28 lg gene copies/100 mL, showing a progressive increase along the river (R 2  = 0.29-0.92, p < 0.05). Parallel factor analysis identified three dominant DOM components (humic acid-like, fulvic acid-like, and protein-like), with strong positive correlations between protein-like components and all fecal markers (R 2  = 0.59-0.66, p < 0.001). Both fecal and DOM distributions consistently showed significant differences between upstream and downstream areas (p < 0.001), suggesting their complementary assessment. While DOM was more sensitive to environmental variables such as rainfall, rubber dam, and tidal dynamic, the combination of fecal pollution markers and 3D EEM analysis allowed a more comprehensive assessment of contamination levels, mitigating potential biases caused by the influence of multiple factors on a single method. Furthermore, due to the strong correlation between protein-like and fecal markers in the DOM, 3D EEM can be used as a pre-detection means for qPCR detection, reducing testing time and costs., 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 © 2023 Elsevier B.V. All rights reserved.)

The taproot of Aconitum carmichaelii Debeaux (AC), a poisonous Traditional Chinese Medicine, has been widely used to treat joint pain, rheumatism and dysmenorrhea. Fermentation is a traditional drug processing method that reduces toxicity or increases efficacy. However, the chemical composition of AC, especially fermented AC, has not been fully elucidated. Therefore, it is necessary to establish a method to characterize the chemical composition of raw and fermented AC. In this study, a structural feature-based comprehensive strategy was employed to identify the chemical components of raw and fermented AC. A highly selective method consisting of mass defect filtering (MDF), ring double bond (RDB), nitrogen rule, and feature MS fragments filtering was established using UPLC-Q-Orbitrap-MS. By the established method, 230 diterpene alkaloids were characterized in raw AC, including 108 amine, 68 monoester, and 54 diester diterpene alkaloids. 145 of them were potential new compounds. Totals of 466 diterpene alkaloids were identified in fermented AC, including 231 amine, 162 monoester, and 73 diester diterpene alkaloids. 397 of them were potential new compounds. Ester hydrolysis, hydroxylation, and demethylation were the major transformation pathways during fermentation. An integrated approach with highly selective based on the structural feature of analytes was established and applied to identify the chemicals in AC. The strategy showed great performance in improving the accuracy and coverage of the identification by using LC-MS., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Soil aquifer treatment (SAT) has been widely applied for wastewater reclamation, which cooperates secondary treatment (i.e. A 2 O process) and disinfection treatment (chlorination) in wastewater treatment plants (WWTPs), to remove organic matter. This study compared dissolved organic carbon (DOC) characteristics, substrate utilisation patterns, and microbial communities between pre-chlorination SAT and SAT columns, and effective removals of DOC were observed in the pre-chlorination SAT and SAT columns. However, the composition of HiA in SAT columns without chlorination was less than in pre-chlorination SAT columns for DOC fraction. In comparison to A 2 O effluent, different metabolic patterns and the composition of the microbial community were demonstrated by the top layer of SAT column and pre-chlorination SAT column. Furthermore, deeper layers showed similarities in the metabolic pattern and composition of the microbial community. Overall, pre-chlorination minimised the change of the microbial communities from A 2 O effluent in the top layer of SAT except for deeper layers, and DOC concentrations decreased in pre-chlorination SAT column. Thus, the cooperation of SAT and wastewater treatments could be suitable for wastewater reclamation.

Objectives: Less information is available about the temporal relationship between depression in the elderly and cognitive decline. In the current study, we (1) evaluated the temporal association between depression and cognitive decline in older adults over a 4-year period; (2) indicated which cognitive domains have a strong temporal relationship with depression. Methods: Using data from China Family Panel Studies, we examined the relationship between depression and cognition among adults aged 65 and older with a cross-lagged design. Results: The results showed that initial depression affected subsequent cognitive function, especially immediate and delayed recall, but that cognition decline did not predict depression over time. Conclusion: The findings suggest that depression precedes cognitive decline in older adults, which is of great significance for the future research of mild cognitive impairment and dementia in the elderly.

Microbial source tracking (MST) technology represents an innovative approach employed to trace fecal contamination in environmental water systems. The performance of primers may be affected by amplification techniques, target primer categories, and regional differences. To investigate the influence of these factors on primer recognition performance, a meta-analysis was conducted on the application of MST in water environments using three databases: Web of Science, Scopus, and PubMed (n = 2291). After data screening, 46 studies were included in the final analysis. The investigation encompassed Polymerase Chain Reaction (PCR)/quantitative PCR (qPCR) methodologies, dye-based (SYBR)/probe-based (TaqMan) techniques, and geographical differences of a human host-specific (HF183) primer and other 21 additional primers. The results indicated that the primers analyzed were capable of differentiating host specificity to a certain degree. Nonetheless, by comparing sensitivity and specificity outcomes, it was observed that virus-based primers exhibited superior specificity and recognition capacity, as well as a stronger correlation with human pathogenicity in water environments compared to bacteria-based primers. This finding highlights an important direction for future advancements. Moreover, within the same category, qPCR did not demonstrate significant benefits over conventional PCR amplification methods. In comparing dye-based and probe-based techniques, it was revealed that the probe-based method's advantage lay primarily in specificity, which may be associated with the increased propensity of dye-based methods to produce false positives. Furthermore, the heterogeneity of the HF183 primer was not detected in China, Canada, and Singapore respectively, indicating a low likelihood of regional differences. The variation among the 21 other primers may be attributable to regional differences, sample sources, detection techniques, or alternative factors. Finally, we identified that economic factors, climatic conditions, and geographical distribution significantly influence primer performance., 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 © 2023 Elsevier Ltd. All rights reserved.)

Runoff forecasting is extremely important for various activities of water pollution research and agricultural. Data-driven models have been proved an effective approach in predicting daily runoff when combining deep learning methods (DLM). However, predicting accuracy of daily runoff still need improved. Here, we firstly proposed a combined model of Gate Recurrent Unit (GRU) and Residual Network (ResNet) and compared with one shallow learning method (Back Propagation Neural Network, BPNN) and one deep learning method (GRU) with data from 2010 to 2020 in three stations in daily runoff forecasting in the Yiluo River watershed. The results showed that the combined model with precipitation data and runoff data as input has the highest prediction accuracy (NSE = 0.9325, 0.8735, 0.9186, respectively). Input data with precipitation have higher prediction accuracy than that without. The performance of the model was better in the dry season than the wet season. The topographic and geomorphic factors may also the main factors affecting runoff forecast. Those results of this study can provide useful strategies to predict short runoff and manage watershed scale water resources especially in the important agriculture region., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Previous research has suggested that familiarity can enhance associative memory after unitization, but the cognitive mechanisms underlying unitization remain debated. To explore the neural mechanisms of associative memory after unitization in the absence of semantic relations, we used Chinese characters as stimuli and recorded participants' blood oxygen level-dependent signals during recognition. Behavioral results showed that after Chinese character unitization, not only the associative performance of recognition (Pr, hit rate minus false alarm rate) and general Pr but also the hit rate and correct rejection rate increased. Neuroimaging results revealed activation of the hippocampus and parahippocampal gyrus during associative recognition in both the unitized and the non-unitized condition, and hippocampal activation increased after unitization. However, activation of the perirhinal cortex was not observed in either condition. These findings, in contrast to those from previous studies on unitization, suggest that Chinese character unitization enhances recollection-based, rather than familiarity-based, associative recognition. This suggests that the encoding of semantic relations during unitization is critical for subsequent familiarity-based associative recognition., (© 2023 Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

To prevent the spread of the COVID-19 epidemic on campus, universities in outbreak areas in China can implement closed-loop management., Objects: This study aimed to explore the relationship between mindfulness and mental health of college students under closed-loop management., Measures: 11,939 college students from a university in Changsha, China participated in the online survey during the closed-loop management period. The Chinese version of Perceived Stress Scale, the Emotion Regulation Questionnaire-Cognitive Reappraisal, the Mindful Attention Awareness Scale, the 7-item General Anxiety Disorder questionnaire, and the 9-item Patient Health Questionnaire were administered to the college students., Results: We found that mindfulness was negative association with mental health during the closed-loop management period. Perceived stress mediated the relationship between mindfulness and mental health. Cognitive reappraisal moderated the relationship between mindfulness and perceived stress. Specifically, when the level of mindfulness is the same, individuals with more cognitive reappraisal tend to experience a less perceived stress., Conclusion: The results of this study are of great significance to improve the mental health of college students during closed-loop management period., Competing Interests: Conflict of interest The authors report there are no competing interests to declare., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Nitrogen-nitrate contamination has been recognized as the main threaten to the large lake surrounding with the intensive agriculture activities. However, there are still insufficient studies on the interannual evolution of nitrogen-nitrate, source and its impact on the environment and human health in the large fresh water lake. In this study, 248 samplings were collected in Poyang Lake from 2013 to 2018, multi-methods (mathematical statistics method, grey correlation analysis, person correlation analysis and human health risk assessment) to investigate the spatiotemporal variations, impact factors and potential health risks of NO 2 - -N, NO 3 - -N and NH 4 + -N. The results showed that the middle region had the highest NO 2 - concentration (mean 0.04μg/l), the northern region had the highest NO 3 - concentration (mean 1.12 mg/l), and the southern region had the highest NH 4 + concentration (mean 0.48 mg/l). For NO 3 - and NH 4 + , the concentration was higher than in the wet season. While the concentration of NO 2 - had the reverse trend. Grey correlation analysis and person correlation analysis results indicate that nitrogen fertilizer, waste water, pH, CODMn and temperature were main factors affecting the nitrogen concentration in Poyang Lake. Health risk assessment results revealed that potential hazards in the study area were acceptable (HR < 1). NO 3 - provided the highest health risks, and oral ingestion is the major source of local nitrogen health risk. Those results can provide the reference for developing the treatment methods of the international large freshwater lake., 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.)

Although it is widely accepted that familiarity could support associative recognition when the to-be-learn items are 'unitized' into a new representation, the effects of unitization on associative recognition and recollection remain much debated. The current study aimed to explain these debates by exploring when and how unitization benefits associative recognition using event-related potentials (ERPs). During the encoding phase, participants learned compound words and unrelated word pairs (i.e., High vs. Low level of unitization). At retrieval, the compound words were rearranged into new compound words (i.e., no-change) and unrelated word pairs (i.e., change). Similarly, the unrelated word pairs were rearranged into new unrelated word pairs (i.e., no-change) and compound words (i.e., change). Results showed that under the no-change condition, unitization did not affect associative recognition, nor its underlying processes. In contrast, under the change condition, unitization improved associative recognition by increasing both familiarity-related FN400 effect and recollection-related LPC effect. In addition, a planned comparison between the compound-change and unrelated-no change conditions-a common index for unitization effect in past studies-revealed that unitization could not only elicit significant FN400 effect, but also improve associative recognition by increasing LPC effect. Collectively, these results not only allowed to explain the current discrepancies in the literature concerning the effect of unitization on associative recognition, but also emphasized the importance of matching the level of unitization between the studied and rearranged word pairs., (© 2022 Society for Psychophysiological Research.)

Chronic diseases are associated with depressive symptoms in older adults. However, the mechanism of this relation is not clear. In this study, we explored the mediating role of instrumental activities of daily living and the moderating role of area of residence in the relationship between chronic diseases and depression. The data was from the Chinese Longitudinal Healthy Longevity Study. Results showed that chronic diseases were positively correlated with depression, and negatively associated with instrumental activities of daily living (IADLs). Moreover, IADLs mediated the relationship between chronic diseases and depression. In addition, area of residence (rural/urban) moderated the relation between IADLs and depression, such that this negative relation was stronger for old adults lived in rural area than for urban area. These results have important significance for prevention and intervention of depression in the elderly., Competing Interests: Conflicts of interest/Competing interestsNo Conflicts of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Anaerobic digestion (AD) has been widely applied for treating organic waste and is known as a carbon-offsetting process. However, most studies relied on laboratory-scale experiments or literature to calculate carbon emissions from AD process, and the impact of digestate processing was overlooked. This study assessed the carbon footprint for an industrial food waste co-digestion plant with operational data. The results indicated that carbon emission before digestate treatment is -88.5 ± 4.4 kg CO 2 -eq/t. The major source of carbon emission is electricity provision, followed by fuel combustion, unburned biogas, and fugitive gas emissions, while waste oil recovery and biogas utilization offset the carbon emissions. Considering digestate treatment and disposal options, the plant's net carbon emissions are as follows: -86.1 ± 6.2 kg CO 2 -eq/t (incineration) < -80.7 ± 6.5 kg CO 2 -eq/t (land application) < 6.7 ± 12.2 kg CO 2 -eq/t (landfilling). This work aims at providing a roadmap for making site-specific calculations of the carbon footprint for AD process., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Emotion's influence on source memory has proven more elusive and the lack of studies investigates the effect of the congruent emotional contexts on source memory. Here, we investigated these issues using event-related potentials (ERPs) to assess emotional-induced neural correlates. During encoding, congruent word-picture (a word 'shoes' - a picture described shoes) and incongruent word-picture (a word 'pepper' - a picture described shoes) with a prompt (Common? or Natural?) were presented. At retrieval, participants indicated which prompts were concomitantly presented with the word during encoding. Behavioral results revealed that source memory accuracy was enhanced in the neutral contexts compared to the negative contexts, and enhanced in the incongruent condition relative to the congruent condition, suggesting that emotional contexts impaired source memory performance, and incongruent information enhanced source memory. ERPs results showed that early P2 old/new effect (150-250 ms) and FN400 old/new effect (300-450 ms) were observed for words with correct source that had been encoded in the congruent emotional contexts, and that a larger parietal old/new effect, between 500 and 700 ms, was observed for words with correct source that had been encoded in the incongruent condition than in the congruent condition, irrespective the nature of context. The ERPs results indicate that retrieval of source details for the associated emotionally congruent information supports the idea that emotional events could attract more attentional resources, and reflects the contribution of familiarity-based process. Meanwhile, retrieval of source details for the associated incongruent information reflects a stronger contribution of recollection-based process., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: Recently, a growing number of studies have shown that familiarity can promote associative recognition when more than two types of stimuli are combined into a single entity. However, it is not clear why the effect of unitization on associative recognition varies in the different studies. In this study, we examined whether the unitization congruence (UC) between original image pairs and rearranged ones affects associative recognition., Methods: Participants were asked to learn relevant and irrelevant picture pairs for the encoding phase, and they needed to distinguish intact pairs from rearranged pairs for the retrieval phase, while event-related potentials (ERPs) were recorded during the whole process., Results: The results of the behavioral experiments showed that the performances of recognition (Prs: hits-false alarms) were higher under the relevant condition than under the irrelevant one for both UC conditions, although this effect was much larger under the inconsistent UC condition than under the consistent one. The ERP results also revealed that there were larger early old/new effect (FN400) and late left parietal old/new effect (LPC) under the relevant condition than under the irrelevant ones, irrespective of its consistency or inconsistency. However, these effects were more significant for inconsistent conditions., Conclusions: These results indicated that UC can moderate the effect of unitization on associative recognition by increasing familiarity and recollection and revealed the need to match the level of unitization of materials arrangements in future studies., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

It is widely accepted that unitization can promote familiarity-based associative recognition, but the effect of unitization on item recognition remains unclear. The goals of this study were to elaborate on how unitization affected item recognition and the neural correlates of familiarity and recollection for item recognition. In study, the participants were asked to learn related and unrelated picture pairs, and in test, they were required to distinguish single old pictures form new pictures. In experiment 1, we used R/K/N paradigm to estimate the contribution of familiarity and recollection to item recognition, the results showed that unitization could improve item recognition through increasing recollection selectively. In experiment 2, we used ERP old/new effects to estimate the neural correlates of familiarity and recollection, the results showed that unitization could improve item recognition through a selective reduction in LPC effect. Inspired by DRM paradigm, in experiment 3, we divided the new pictures into semantically related lure pictures and semantically unrelated new pictures to explore the effects of unitization on item recognition and verbatim recognition (the ability to distinguish old pictures from lure pictures). The behavioral results showed that unitization could improve item recognition, but it damaged verbatim recognition. The ERP results revealed that there were larger LPC effects in the unrelated condition than in the related condition, regardless of item or verbatim recognition. In summary, we believed that unitization could indeed improve item recognition, but it damaged verbatim recognition., (© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)

Pt(ii)-based antitumor drugs (e.g. cisplatin and oxaliplatin) are one of the most successful and frequently used drugs in cancer chemotherapy at present. However, drug resistance and severe side effects are the major problems in the application of platinum drugs. Detoxification of Pt(ii) drugs is one of the most important mechanisms of drug resistance. Herein, a supramolecular Pt(iv) prodrug nano-assembly delivery system is designed and used to encapsulate a γ-glutamyl transferase (GGT) inhibitor (OU749) (Pt-CD/Dex-Ad@OU nano-assemblies) for the synergistic chemotherapy of cisplatin-resistant cancer. Pt-CD/Dex-Ad@OU nano-assemblies could be efficiently taken up by cisplatin-resistant cancer cells and release a drug in the intracellular reductive environment. The Pt-CD/Dex-Ad@OU nano-assemblies can efficiently suppress the expression of GGT, depleting GSH and augmenting ROS via the reduction of the Pt(iv) prodrug. Thereby, by breaking the redox balance the detoxification and antiapoptosis mechanisms of Pt(ii) drugs can be overcome. Thereafter, the excellent therapeutic efficacy of Pt-CD/Dex-Ad@OU nano-assemblies is validated on a cisplatin-resistant human non-small cell lung cancer (A549/DDP) model. Furthermore, the inhibition of GGT protein is expected to reduce the nephrotoxicity of cisplatin. Collectively, this study provides a promising strategy to break the redox balance for overcoming drug resistance and maximizing the efficacy of platinum-based cancer therapy.

The traditional Electro-Fenton (EF) is an efficient technology for wastewater treatment but suffers from the acidic condition requirement and external catalyst addition. To overcome these challenges, a GF@MoS 2 @FeOCl cathode was fabricated using a facile method. The as-prepared GF@MoS 2 @FeOCl cathode showed excellent performance for ciprofloxacin (CIP) degradation in EF process with RuO 2 /Ti electrode as the anode. H 2 O 2 was electro-generated and activated on-site at the cathode at mild pH without adding Fe 2+ . CIP was 100% removed with 74.4% of mineralization in 90 min at pH 6. The GF@MoS 2 @FeOCl cathode exhibited good reusability after consecutive runs of degradation. The degradation intermediates were investigated, and the possible mechanism was proposed. This work demonstrated that the prepared GF@MoS 2 @FeOCl cathode is a promising candidate for contaminants treatment in an EF system., 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 © 2021 Elsevier Ltd. All rights reserved.)

It is widely accepted that associative recognition can be supported by familiarity through integrating more than two stimuli into a unit, but the role of unitization in recollection-based associative recognition remains unclear. In this study, we aimed to illustrate how the level of unitization (LOU) affected recollection-based associative recognition and to examine whether the unitization-congruence between original and rearranged picture pairs (UC) could have effect on the relationship between LOU and associative recognition. In encoding, participants were asked to learn related and unrelated picture pairs, and in retrieval, they needed to distinguish intact pairs from rearranged pairs. We also distinguished the LOU of the pairs based on its status at encoding or retrieval separately. The results showed that: (1) LOU-at-encoding could improve associative recognition through increasing recollection-based associative recognition selectively; (2) LOU-at-retrieval could improve associative recognition through increasing familiarity-based and recollection-based associative recognitions; (3) UC did not moderate the relationship between LOU and associative recognition. Hence, in future studies, researchers do not need to pay much attention to the construction of rearranged pairs to ensure that the LOU between original and rearranged picture pairs is matched. It greatly reduces the difficulty of materials selection.

Traditional view holds that associative recognition require recollection while familiarity can't support associative recognition. However, recent research indicate that familiarity can also contribute to associative recognition when the stimuli are unitized in encoding. Here, we investigated the electrophysiological correlates of retrieval of word and picture stimuli in three encoding conditions. Semantically unrelated word pairs or picture pairs were encoded in concept definition, interactive imagery, and item comparison conditions, separately. In test, the participants were required to discriminate between old pairs that appeared in the same pairing as in study, rearranged pairs that appeared in different pairings in study, or completely new pairs. The behavioral results revealed that higher associative recognition was observed in interactive imagery condition than in concept definition condition, with item comparison condition eliciting the worst recognition, regardless of word or picture stimuli. ERP results of word stimuli revealed that the FN400 old/new effect was solely elicited in concept definition and interactive imagery conditions, but not in item comparison condition. However, ERP results of picture stimuli revealed that the late FN400 old/new effect was observed in three encoding conditions and that larger magnitude of old/new effect was elicited in item comparison condition than in interactive imagery condition. There may be different neural mechanisms of unitization on associative recognition for word and picture stimuli. These findings suggested that the pattern of engagement of familiarity during successful retrieval was dependent on the stimulating properties and the encoding conditions. We will discuss the possibility that top-down unitization which manipulates two unrelated stimuli through instructions may lead to the engagement of specific forms of familiarity-association familiarity and item familiarity., (Copyright © 2020 Elsevier B.V. All rights reserved.)

It is widely accepted that associative recognition can be supported by familiarity through integrating more than two stimuli into a unit, but there are still three unsolved questions: (1) how unitization affects recollection-based associative recognition; (2) whether it is necessary to match the level of unitization (LOU) between original and rearranged pairs, which was term as unitization-congruence (UC); (3) whether unitization can occur at encoding or at retrieval. The purposes of this study are to try to answer these questions. During the encoding phase, the participants were asked to learn compound words and unrelated word pairs, and during the retrieval phase, they needed to distinguish intact pairs from rearranged consistent and rearranged inconsistent pairs with "remember/know" paradigm. The results showed that (1) the role of unitization in recollection was moderated by UC; (2) Under the consistent UC condition, unitization could improve familiarity-based associative recognition without affecting recollection-based associative recognition, while under the inconsistent UC condition, unitization could improve familiarity-based and recollection-based associative recognition simultaneously, these results indicated that it was necessary to match the LOU between original and rearranged pairs; (3) unitization at encoding could support familiarity-based associative recognition, while unitization at retrieval did not. In briefly, unitization at encoding could improve associative recognition and this effect was moderated by UC, while unitization at retrieval did not affect associative recognition., (© 2020 Liu et al.; Published by Cold Spring Harbor Laboratory Press.)

It is widely accepted that unitization can promote familiarity-based associative recognition, but the role of unitization in recognition of individual component elements which originate from compound words remains unclear. The goals of this study were to elaborate on how unitization affects item recognition and further examine the effect of unitization on the extent to which familiarity and recollection contribute to item recognition. During the study phase, participants were asked to learn 48 compound words and 48 unrelated word pairs, and during the test phase, they were instructed to distinguish old from new words. We disassociated the contribution of familiarity and recollection to recognition with remember/know paradigm in experiment 1 and with ERPs old/new effects in experiment 2. The results showed that the overall item recognition was equivalent between the two retrieval conditions. Disassociation the contribution of familiarity and recollection, we found that there was higher recollection-based item recognition performance for compound-old words than for unrelated-old words in experiment 1. In contrast, in experiment 2, the magnitude of later parietal old/new effect related to recollection was larger for the former than for the latter, indicating that equivalent levels of memory retrieval were achieved through "less" neural correlates of familiarity and recollection. By synthesizing the results of experiment 1 and 2, we believed unitization did not impede overall item recognition performance., (Copyright © 2019 Elsevier Inc. All rights reserved.)

It is widely accepted that unitization can promote familiarity-based associative recognition, but the role of unitization in recognition of individual component elements remains unclear. Our goals of this study were to elaborate how unitization influenced item recognition and to further examine the effect of unitization on the extent to which familiarity and recollection contributed to item recognition. The results showed that unitization could facilitate item recognition through reducing the contribution of recollection. Together with previous findings that unitization could facilitate associative recognition, we believed unitization was an effective encoding strategy to improve memory performance.

Objective: Acute postsurgical pain is common and has potentially negative long-term consequences for patients. In this study, we evaluated effects of presurgery sociodemographics, pain experiences, psychological influences, and surgery-related variables on acute postsurgical pain using logistic regression vs classification tree analysis (CTA)., Design: The study design was prospective., Setting: This study was carried out at Chongqing No. 9 hospital, Chongqing, China., Subjects: Patients (175 women, 84 men) completed a self-report battery 24 hours before surgery (T1) and pain intensity ratings 48-72 hours after surgery (T2)., Results: An initial logistic regression analysis identified pain self-efficacy as the only presurgery predictor of postoperative pain intensity. Subsequently, a classification tree analysis (CTA) indicated that lower vs higher acute postoperative pain intensity levels were predicted not only by pain self-efficacy but also by its interaction with disease onset, pain catastrophizing, and body mass index. CTA results were replicated within a revised logistic regression model., Conclusions: Together, these findings underscored the potential utility of CTA as a means of identifying patient subgroups with higher and lower risk for severe acute postoperative pain based on interacting characteristics.

Background: Chronic pain post-surgical pain (CPSP) is common and has far-reaching negative consequences for patients, yet relatively few studies have evaluated the impact of both deficit- and resource-based beliefs about pain and surgery on subjective intensities of acute and chronic post-surgical pain. To address this issue a prospective cohort study was performed., Method: 259 consecutive surgery patients from general surgery, gynecology, and thoracic departments completed a self-report battery of demographics, pain experiences, and psychological factors 24 h before surgery (T1) and provided follow-up pain intensity ratings 48 h-72 h after surgery (T2), and at a 4-month follow-up (T3)., Results: In the hierarchical regression model for acute post-operative pain intensity, pre-surgery pain self-efficacy beliefs made a significant unique contribution independent of all other pre-surgery and surgery-related factors (i.e., age, presence of pre-surgical pain, type of anesthesia, surgery duration). In the prediction model for intensity of chronic post-surgical pain, beliefs about long-term effects of surgery had a unique impact after controlling other significant pre-surgery and surgery influences (gender, education, surgery time)., Conclusion: Results underscored the potential utility of considering specific pre-surgery pain- and surgery-related beliefs as factors that predict patient experiences of acute and chronic post-operative pain., (Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

In this study, we provide the first documented removal of humic acid (HA) from aqueous solution using polyacrylamide/chitosan (PAAm/CS) semi-IPN hydrogel. The prepared semi-IPN hydrogel was characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FT-IR). The factors effecting HA adsorption performance were individually tested, including initial pH, ionic strength, contact time, initial HA concentration, and temperature. The results indicated that semi-IPN hydrogel was successfully fabricated and can be applied in a wide pH range, from 3 to 9. Low ionic strength effectively enhanced the adsorption capacity. As the ionic strength increased, this enhancement was less obvious but still positive. The adsorption kinetics were fitted to a pseudo-first-order kinetic model, and the adsorption isotherm was described using the Sips isotherm model. The HA adsorption capacity increased with increasing temperature. The maximum adsorption capacity has the potential to attain 166.30 mg g -1 , based on the Sips isotherm at 25 °C. Experiments demonstrated that the HA adsorption process can be primarily attributed to electrostatic interactions, and hydrogen bonding was also involved. Facile synthesis and good adsorptive performance indicate that semi-IPN hydrogel can be used for removing HA from water.

The issue of whether ERK activation determines matrix synthesis or degradation in osteoarthritis (OA) pathogenesis currently remains controversial. Our previous study shows that PLCγ1 and mTOR are involved in the matrix metabolism of OA cartilage. Investigating the interplays of PLCγ1, mTOR and ERK in matrix degradation of OA will facilitate future attempts to manipulate ERK in OA prevention and therapy. Here, cultured human normal chondrocytes and OA chondrocytes were treated with different inhibitors or transfected with expression vectors, respectively. The levels of ERK, p-ERK, PLCγ1, p-PLCγ1, mTOR, p-mTOR and MMP-13 were then evaluated by Western blotting analysis. The results manifested that the expression level of ERK in human OA chondrocytes was lower than that in human normal articular chondrocytes, and the up-regulation of ERK could promote matrix synthesis, including the decrease in MMP-13 level and the increase in Aggrecan level in human OA chondrocytes. Furthermore, the PLCγ1/ERK axis and a mutual inhibition of mTOR and ERK were observed in human OA chondrocytes. Interestingly, activated ERK had no inhibitory effect on MMP-13 expression in PLCγ1-transformed OA chondrocytes. Combined with our previous study, the non-effective state of ERK activation by PLCγ1 on MMP-13 may be partly attributed to the inhibition of the PLCγ1/mTOR axis on the PLCγ1/ERK axis. Therefore, the study indicates that the mutual inhibition of ERK and mTOR is involved in PLCγ1-mediated MMP-13 expression in human OA chondrocytes, with important implication for the understanding of OA pathogenesis as well as for its prevention and therapy.

Despite extensive studies on the multifaceted roles of morroniside, the main active constituent of iridoid glycoside from Corni Fructus, the effect of morroniside on osteoarthritis (OA) chondrocytes remains poorly understood. Here, we investigated the influence of morroniside on cultured human OA chondrocytes and a rat experimental model of OA. The results showed that morroniside enhanced the cell viability and the levels of proliferating cell nuclear antigen expression (PCNA), type II collagen and aggrecan in human OA chondrocytes, indicating that morroniside promoted chondrocyte survival and matrix synthesis. Furthermore, different doses of morroniside activated protein kinase B (AKT) and extracellular signal-regulated kinase (ERK) in human OA chondrocytes, and in turn, triggered AKT/S6 and ERK/P70S6K/S6 pathway, respectively. The PI3K/AKT inhibitor LY294002 or the MEK/ERK inhibitor U0126 attenuated the effect of morroniside on human OA chondrocytes, indicating that the activation of AKT and ERK contributed to the regulation of morroniside in human OA chondrocytes. In addition, the intra-articular injection of morroniside elevated the level of proteoglycans in cartilage matrix and the thickness of articular cartilage in a rat experimental model of OA, with the increase of AKT and ERK activation. As a consequence, morroniside has chondroprotective effect on OA chondrocytes, and may have the therapeutic potential for OA treatment., (© 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.)

Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation including extracellular matrix (ECM) degradation and cell loss. It is known that phosphoinositide-specific phospholipase γ1 (PLCγ1) can trigger several signaling pathways to regulate cell metabolism. However, whether this kinase is expressive and active in human OA chondrocytes and its role in the pathological progression of OA have not been investigated. The current study was designed to investigate the PLCγ1 expression in human OA cartilage, and whether PLCγ1 was involved in the ECM synthesis had been further explored using cultured human OA chondrocytes. Our results indicated that PLCγ1 was highly expressed in human OA chondrocytes. In our further study using the cultured human OA chondrocytes, the results demonstrated that the disruption of PLCγ1 by its inhibitor, U73122, and siRNA contributed to the ECM synthesis of human OA chondrocytes through regulating the expression of ECM-related signaling molecules, including MMP-13, Col II, TIMP1, Sox-9, and AGG. Furthermore, PLCγ1/IP3/Ca2+/CaMK II signaling axis regulated the ECM synthesis of human chondrocytes through triggering mTOR/P70S6K/S6 pathway. In summary, our results suggested that PLC-γ1 activities played an important role in the ECM synthesis of human OA chondrocytes, and may serve as a therapeutic target for treating OA.

This paper introduces a new direct non-contact electromagnetic calibration technique for high precision measurements of micro-thrust and impulse. A ring-shaped electromagnet with an air gap is used in the calibration. The calibration force is produced by the interaction of a uniform magnetic field with a copper wire current in the air gap. This force depends linearly on this current as well as the steady angular displacement of the torsion arm of the thrust stand. The range of calibration force is very large and the calibration force is easy to generate and insensitive to the arm displacement. The calibration uncertainty for a 150-μN force is 4.17 μN. The more influential factor on the calibration uncertainty is the magnetization of the electromagnet core due to the copper wire current. In the impulse calibration, the exerted impulse is linearly dependent on the maximal angular displacement of the torsion arm. The uncertainty in the impulse calibration is determined by uncertainties in both the force calibration and the pulse time.

Background: The reference value of urine albumin-creatinine ratio (ACR) has racial disparities. The ACR reference value in a healthy Beijing population is reported., Methods: A reference Beijing population was sampled via a multistage, clustered complex sampling method. By excluding subjects with self-reported kidney disease, hypertension, diabetes, dyslipidemia, cardiovascular disease, obesity or underweight condition, overt proteinuria, hematuria, or pyuria, as well as those with an estimated glomerular filtration rate (eGFR) > 200ml/min/1.73m2 or < 60ml/min/1.73m2, apparently healthy subjects (1260 males, 2305 females, aged 18-84y) were selected to be included in the current analysis. Urine albumin was measured using the immunoturbidimetic method, creatinine was measured using Jaffe's kinetic method on a morning spot-urine sample, and ACR was calculated. The 95th percentile of ACR was used as the normal upper limit. The association between ACR and each of gender, age, systolic blood pressure, body mass index, serum glucose, lipids, and eGFR was examined., Results: The normal upper limit of ACR was 14mg/g (1.58mg/mmol) for males and 20mg/g (2.26mg/mmol) for females. Females had higher ACR values than males, and age, systolic blood pressure, and eGFR were positively correlated with ACR., Conclusions: The ACR reference value in the healthy Beijing population is lower than that of the Western population. Age, systolic blood pressure, and eGFR were found to correlate with ACR.

Background: Chronic kidney disease (CKD) is considered a serious worldwide public health problem, but data from developing countries are extremely limited., Study Design: Cross-sectional study., Setting and Participants: A representative sample of 13,925 adults in Beijing, China., Predictors: Age (18 to 39, 40 to 59, 60 to 69, and >70 years), sex, urban or rural area, history of chronic respiratory infection and cardiovascular disease, hepatitis B virus infection, smoking, family history (diabetes, hypertension, and CKD), nephrotoxic medications, central obesity, diabetic and hypertension status, and dyslipidemia., Outcomes and Measurements: CKD was defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) or markers of kidney damage. Glomerular filtration rate was estimated by using calibrated serum creatinine level and a formula specific for China. Persistent albuminuria and hematuria were considered markers of kidney damage., Results: The prevalence of CKD in adults in Beijing was 13.0% (95% confidence interval [CI], 11.9 to 14.2). It therefore was estimated that the number of adults in Beijing with CKD was 1.43 million. In subjects aged 18 to 39, 40 to 59, 60 to 69, and older than 70 years, prevalences of CKD were 10.0% (95% CI, 8.9 to 11.3), 14.2% (95% CI, 13.0 to 15.4), 20.8% (95% CI, 18.1 to 23.9), and 30.5% (95% CI, 26.6 to 34.7), respectively. Factors independently associated with decreased kidney function included older age (odds ratio [OR], 1.83; 95% CI, 1.51 to 2.22 per 10-year increase), nephrotoxic medications (OR, 2.19; 95% CI, 1.21 to 3.97), rural area (versus urban area; OR, 0.47; 95% CI, 0.28 to 0.78), history of cardiovascular disease (OR, 2.04; 95% CI, 1.24 to 3.38), high-density lipoprotein cholesterol level less than 40 mg/dL (OR, 3.00; 95% CI, 1.39 to 6.51), and hypertension status (with duration > 10 years; OR, 1.85; 95% CI, 1.19 to 2.88)., Limitations: Kidney function and indicators of kidney damage were based on single measurements., Conclusions: CKD is a public health burden in Beijing.

Objective: To understand the prevalence and control of several common chronic disease in Beijing adults., Methods: 16,658 adult residents were randomly selected with stratified multi-stage cluster sampling method. Each participant was invited to receive a set of standardized questionnaire, physical examinations and laboratory tests., Results: Data showed that the prevalence, awareness, treatment and the rate of control on hypertension among the adults in Beijing were 29.1%, 49.3%, 42.3% and 10.6% respectively. The counterparts of diabetes mellitus were 8.8%, 56.7%, 50.0% and 15.0%. The four corresponding figures for dyslipidemia were 33.2%, 31.1%, 13.0% and 4.3%, respectively. 22.9% of the Beijing adults had metabolic syndrome including 8.1 per thousand suffering from myocardial infarction and 18.4 per thousand from stroke. Except for diabetes, all the chronic diseases had higher prevalence rate in rural area than in urban area, according to the findings under our study. Postmenopausal women were more susceptible to chronic disease than men., Conclusion: The prevalence rate of chronic disease in Beijing was still high. The prevalence rate in rural area had exceeded the level in urban area. Adjustment and attention should be made according to the prevalence features and weakness existed in present chronic disease control strategy.

The largest outbreak of severe acute respiratory syndrome (SARS) struck Beijing in spring 2003. Multiple importations of SARS to Beijing initiated transmission in several healthcare facilities. Beijing's outbreak began March 5; by late April, daily hospital admissions for SARS exceeded 100 for several days; 2,521 cases of probable SARS occurred. Attack rates were highest in those 20-39 years of age; 1% of cases occurred in children <10 years. The case-fatality rate was highest among patients >65 years (27.7% vs. 4.8% for those 20-64 years, p < 0.001). Healthcare workers accounted for 16% of probable cases. The proportion of case-patients without known contact to a SARS patient increased significantly in May. Implementation of early detection, isolation, contact tracing, quarantine, triage of case-patients to designated SARS hospitals, and community mobilization ended the outbreak.

Context: Beijing, China, experienced the world's largest outbreak of severe acute respiratory syndrome (SARS) beginning in March 2003, with the outbreak resolving rapidly, within 6 weeks of its peak in late April. Little is known about the control measures implemented during this outbreak., Objective: To describe and evaluate the measures undertaken to control the SARS outbreak., Design, Setting, and Participants: Data were reviewed from standardized surveillance forms from SARS cases (2521 probable cases) and their close contacts observed in Beijing between March 5, 2003, and May 29, 2003. Procedures implemented by health authorities were investigated through review of official documents and discussions with public health officials., Main Outcome Measures: Timeline of major control measures; number of cases and quarantined close contacts and attack rates, with changes in infection control measures, management, and triage of suspected cases; and time lag between illness onset and hospitalization with information dissemination., Results: Health care worker training in use of personal protective equipment and management of patients with SARS and establishing fever clinics and designated SARS wards in hospitals predated the steepest decline in cases. During the outbreak, 30 178 persons were quarantined. Among 2195 quarantined close contacts in 5 districts, the attack rate was 6.3% (95% confidence interval [CI], 5.3%-7.3%), with a range of 15.4% (95% CI, 11.5%-19.2%) among spouses to 0.36% (95% CI, 0%-0.77%) among work and school contacts. The attack rate among quarantined household members increased with age from 5.0% (95% CI, 0%-10.5%) in children younger than 10 years to 27.6% (95% CI, 18.2%-37.0%) in adults aged 60 to 69 years. Among almost 14 million people screened for fever at the airport, train stations, and roadside checkpoints, only 12 were found to have probable SARS. The national and municipal governments held 13 press conferences about SARS. The time lag between illness onset and hospitalization decreased from a median of 5 to 6 days on or before April 20, 2003, the day the outbreak was announced to the public, to 2 days after April 20 (P<.001)., Conclusions: The rapid resolution of the SARS outbreak was multifactorial, involving improvements in management and triage in hospitals and communities of patients with suspected SARS and the dissemination of information to health care workers and the public.