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Purpose: Sepsis is a global public health burden. The sequential organ failure assessment (SOFA) is the most commonly used scoring system for diagnosing sepsis and assessing severity. Due to the widespread use of endotracheal intubation and sedative medications in sepsis, the accuracy of the Glasgow Coma Score (GCS) is the lowest in SOFA. We designed this multicenter, cross-sectional study to investigate the predictive efficiency of SOFA with or without GCS on ICU mortality in patients with sepsis. Methods: First, 3048 patients with sepsis admitted to Peking Union Medical College Hospital (PUMCH) were enrolled in this survey. The data were collected from June 8, 2013 to October 12, 2022. Second, 18,108 patients with sepsis in the eICU database were enrolled. Third, 2397 septic patients with respiratory system ≥ 3 points in SOFA in the eICU database were included. We investigated the predictive efficiency of SOFA with or without GCS on ICU mortality in patients with sepsis in various ICUs of PUMCH, and then we validated the results in the eICU database. Main results: In data of ICUs in PUMCH, the predictive efficiency of SOFA without GCS (AUROC [95% CI], 24 h, 0.724 [0.688, 0.760], 48 h, 0.734 [0.699, 0.769], 72 h, 0.748 [0.713, 0.783], 168 h, 0.781 [0.747, 0.815]) was higher than that of SOFA with GCS (AUROC [95% CI], 24 h, 0.708 [0.672, 0.744], 48 h, 0.721 [0.685, 0.757], 72 h, 0.735 [0.700, 0.757], 168 h, 0.770 [0.736, 0.804]) on ICU mortality in patients with sepsis, and the difference was statistically significant (P value, 24 h, 0.001, 48 h, 0.003, 72 h, 0.004, 168 h, 0.005). In septic patients with respiratory system ≥ 3 points in SOFA in the eICU database, although the difference was not statistically significant (P value, 24 h, 0.148, 48 h, 0.178, 72 h, 0.132, 168 h, 0.790), SOFA without GCS (AUROC [95% CI], 24 h, 0.601 [0.576, 0.626], 48 h, 0.625 [0.601, 0.649], 72 h, 0.639 [0.615, 0.663], 168 h, 0.653 [0.629, 0.677]) had a higher predictive efficiency on ICU mortality than SOFA with GCS (AUROC [95% CI], 24 h, 0.591 [0.566, 0.616], 48 h, 0.616 [0.592, 0.640], 72 h, 0.628 [0.604, 0.652], 168 h, 0.651 [0.627, 0.675]). Conclusions: In severe sepsis, it is realistic and feasible to discontinue the routine GCS for SOFA in patients with a respiratory system ≥ 3 points, and even better predict ICU mortality. Key messages: SOFA is the most commonly used scoring system for diagnosing sepsis and assessing severity. Due to the widespread use of endotracheal intubation and sedative medications in sepsis, the accuracy of GCS is the lowest in SOFA. We designed this multicenter, cross-sectional study to investigate the predictive efficiency of SOFA with or without GCS on ICU mortality in patients with sepsis. In severe sepsis, it is realistic and feasible to discontinue the routine GCS for SOFA in patients with a respiratory system ≥ 3 points, and even better predict ICU mortality. [ABSTRACT FROM AUTHOR]

The wooden construction painting is a type of an ancient decorative art on Chinese ancient structures. Comprehensive reports concerning the composition of these materials are rather limited. Here multiple analytical methods were applied to systematically explore the morphology and materials. Several paintings were characterized using a morphological microscope. Scanning electron microscopy–energy dispersive spectrometry (SEM-EDS), X-ray fluorescence (XRF), and X-ray diffraction (XRD) detected emerald green and ultramarine in the paint layers. Gas chromatography–mass spectrometry (GC-MS) indicated that the binding medium in the first layer was composed of blood. Our study helps to comprehensively understand the preparation of the wooden construction paintings in the renowned Summer Palace and provide a scientific basis for its restoration and related archeology work. [ABSTRACT FROM AUTHOR]

The consumption of natural gas in Beijing has increased in the past decade due to energy structure adjustments and air pollution abatement. In this study, an integrated emission inventory of hazardous air pollutants (HAPs) emitted from gas-fired combustion in Beijing was developed for the period from 2000 to 2014 using a technology-based approach. Future emission trends were projected through 2030 based on current energy-related and emission control policies. We found that emissions of primary HAPs exhibited an increasing trend with the rapid increase in natural gas consumption. Our estimates indicated that the total emissions of NO, particulate matter (PM), PM, CO, VOCs, SO, black carbon, Pb, Cd, Hg, As, Cr, Cu, Ni, Zn, polychlorinated dibenzo- p-dioxins and dibenzofurans, and benzo[a]pyrene from gas-fired combustion in Beijing were approximately 22,422 t, 1042 t, 781 t, 19,097 t, 653 t, 82 t, 19 t, 0.6 kg, 0.1 kg, 43 kg, 52 kg, 0.3 kg, 0.03 kg, 4.3 kg, 0.6 kg, 216 μg, and 242 g, respectively, in 2014. To mitigate the associated air pollution and health risks caused by gas-fired combustion, stricter emission standards must be established. Additionally, combustion optimization and flue gas purification system could be used for lowering NO emissions from gas-fired combustion, and gas-fired facilities should be continuously monitored based on emission limits. [ABSTRACT FROM AUTHOR]

Coal-fired combustion is recognized as a significant anthropogenic source of atmospheric compounds in Beijing, causing heavy air pollution events and associated deterioration in visibility. Obtaining an accurate understanding of the temporal trends and spatial variation characteristics of emissions from coal-fired industrial combustion is essential for predicting air quality changes and evaluating the effectiveness of current control measures. In this study, an integrated emission inventory of primary air pollutants emitted from coal-fired industrial boilers in Beijing is developed for the period of 2007–2013 using a technology-based approach. Future emission trends are projected through 2030 based on current energy-related and emission control policies. Our analysis shows that there is a general downward trend in primary air pollutants emissions because of the implementation of stricter local emission standards and the promotion by the Beijing municipal government of converting from coal-fired industrial boilers to gas-fired boilers. However, the ratio of coal consumed by industrial boilers to total coal consumption has been increasing, raising concerns about the further improvement of air quality in Beijing. Our estimates indicate that the total emissions of PM 10 , PM 2.5 , SO 2 , NO x , CO and VOCs from coal-fired industrial boilers in Beijing in 2013 are approximately 19,242 t, 13,345 t, 26,615 t, 22,965 t, 63,779 t and 1406 t, respectively. Under the current environmental policies and relevant energy savings and emission control plans, it may be possible to reduce NO x and other air pollutant emissions by 94% and 90% by 2030, respectively, if advanced flue gas purification technologies are implemented and coal is replaced with natural gas in the majority of existing boilers. [ABSTRACT FROM AUTHOR]

This study combined the real-time monitoring and investigation of traffic flows to comprehensively analyze the road traffic flow and vehicle structure in downtown Beijing. A dynamic emission inventory of motor vehicle air pollutants in downtown Beijing in 2021 was established, and the impact of these emissions on air quality was simulated and quantified, and different emission reduction control scenarios were proposed to evaluate their environmental improvement effects and explore measures to mitigate the impact of pollution emissions. The results show that the high traffic flow and the structure of the motor vehicle emissions in downtown Beijing are the main causes of severe motor vehicle pollution. Monitoring data shows that traffic flow in central Beijing is dominated by small passenger vehicles, while the vehicle mix is better than in other regions, with 72.0% of vehicles meeting "National V" or higher emission standards. However, to achieve higher air quality goals, further reducing vehicle emissions is necessary. Based on dynamic traffic flow, the average daily emissions of nitrogen oxides (NO X), particulate matters(PM 2.5) and volatile organic compounds(VOC) from motor vehicles in central Beijing are 17.7 tons, 0.6 tons and 14.0 tons, respectively, accounting for 23.0% of the city's average daily motor vehicle emissions. If a zero-emission zone for motor vehicles were implemented in central Beijing, the annual average emission level of pollutants will be reduced by 10.4% to 21.0%. The designation of ultra-low emission zones for motor vehicles could be effective in improving the air quality in the center of Beijing. [Display omitted] [ABSTRACT FROM AUTHOR]

Over the past decade, the emission standards and fuel standards in Beijing have been upgraded twice, and the vehicle structure has been improved by accelerating the elimination of 2.95 million old vehicles. Through the formulation and implementation of these policies, the emissions of carbon monoxide (CO), volatile organic compounds (VOCs), nitrogen oxides (NO x), and fine particulate matter (PM 2.5) in 2019 were 147.9, 25.3, 43.4, and 0.91 kton in Beijing, respectively. The emission factor method was adopted to better understand the emissions characteristics of primary air pollutants from combustion engine vehicles and to improve pollution control. In combination with the air quality improvement goals and the status of social and economic development during the 14th Five-Year Plan period in Beijing, different vehicle pollution control scenarios were established, and emissions reductions were projected. The results show that the emissions of four air pollutants (CO, VOCs, NO x , and PM 2.5) from vehicles in Beijing decreased by an average of 68% in 2019, compared to their levels in 2009. The contribution of NO x emissions from diesel vehicles increased from 35% in 2009 to 56% in 2019, which indicated that clean and energy-saving diesel vehicle fleets should be further improved. Electric vehicle adoption could be an important measure to reduce pollutant emissions. With the further upgrading of vehicle structure and the adoption of electric vehicles, it is expected that the total emissions of the four vehicle pollutants can be reduced by 20%-41% by the end of the 14th Five-Year Plan period. [Display omitted] [ABSTRACT FROM AUTHOR]

Severe PM 2.5 pollution was observed frequently in Beijing. We conducted highly time-resolved measurements of inorganic ions associated with PM 2.5 at an urban site in Beijing from 10 February to 19 March, 2015. The average PM 2.5 mass concentrations during the six haze episodes ranged from 113.0 μg/m 3 to 182.6 μg/m 3 , which were more than 8 times higher than those observed in clean periods. The secondary inorganic species (NH 4 + , SO 4 2− and NO 3 − ) in PM 2.5 sharply increased during the haze episodes, indicating more extensive formation of SO 4 2− and NO 3 − . The sulfur oxidation ratios (SOR) and the nitrogen oxidation ratios (NOR) in haze episodes were higher than those in clean periods, which indicated that secondary transformation in haze episodes was more significant than those in clean periods. No correlations between SOR and the oxidants (O 3 and HONO) and the temperature were found, whereas a high correlation between SOR and relative humidity (RH) was found in haze episodes, which implied that sulfate was mainly produced by the aqueous-phase oxidation of SO 2 rather than the gas-phase conversion of SO 2 to sulfate. The conversion of SO 2 to SO 4 2− was observed to be sensitive to changes in RH. Furthermore, the SOR sharply increased at RH > 60% with the highest value of 0.88 at RH around 80% during complicated pollution. NO 2 played an important role in the rapid sulfate formation with high RH and NH 3 neutralization conditions in haze episodes in Beijing. The impact of RH was less apparent for nitrate than for sulfate. Nitrate was found to be produced mainly by photochemical and heterogeneous reactions, while heterogeneous reactions had a greater influence on NOR at nighttime. The NO 3 − /SO 4 2− ratio indicated that mobile sources contributed more to the formation of PM 2.5 than stationary sources. The result suggested the need for control of vehicle emissions to reduce the high levels of NO x and nitrate and the severe PM 2.5 pollution in Beijing. [ABSTRACT FROM AUTHOR]

Road traffic constitutes a major source of air pollutants in urban Beijing, which are responsible for substantial premature mortality. A series of policies and regulations has led to appreciable traffic emission reductions in recent decades. To shed light on long-term (2014–2020) roadside air pollution and assess the efficacy of traffic control measures and their effects on public health, this study quantitatively evaluated changes in the concentrations of six key air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO and O 3) measured at 5 roadside and 12 urban background monitoring stations in Beijing. We found that the annual mean concentrations of these air pollutants were remarkably reduced by 47%–71% from 2014 to 2020, while the concurrent ozone concentration increased by 17.4%. In addition, we observed reductions in the roadside increments in PM 2.5 , NO 2 , SO 2 and CO of 54.8%, 29.8%, 20.6%, and 59.1%, respectively, indicating the high effectiveness of new vehicle standard (China V and VI) implementation in Beijing. The premature deaths due to traffic emissions were estimated to be 8379 and 1908 cases in 2014 and 2020, respectively. The impact of NO 2 from road traffic relative to PM 2.5 on premature mortality was comparable to that of traffic-related PM 2.5 emissions. The public health effect of SO 2 originating from traffic was markedly lower than that of PM 2.5. The results indicated that a reduction in traffic-related NO 2 could likely yield the greatest benefits for public health. • Emission control causes reduction of roadside air pollutants, but increases in O 3. • New standards and electric vehicle contributed to a decrease of air pollutants. • Control policies did not affect road increment of PM 2.5-10 due to non-exhaust sources. • Premature deaths were 8379 and 1908 cases, respectively, in 2014 and 2020. • Relative public impact of PM 2.5 comparable to that of NO 2 , higher than that of SO 2. [ABSTRACT FROM AUTHOR]