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Objective Unsafe opioid-related practices can lead to abuse, diversion, and accidental overdoses. In this study, we aimed to describe the patterns and beliefs regarding the storage, disposal, and use of opioids among Chinese patients with cancer in their home settings, which remain unclear. Methods A multicenter cross-sectional survey was conducted in Hubei Province from October 2022 to June 2023. We collected information on the storage, disposal, and use of opioids among cancer pain inpatients in the oncology department. Logistic regression was used to estimate the factors associated with unsafe disposal and use of opioids. Results The survey included 221 patients with a median age of 62 years. Only 3.2% stored their opioids under lock and key, and 49.8% were unaware of proper disposal methods. Nearly one-fifth (19.5%) reported having received information on the safe storage (14.0%) and/or disposal (10.0%) of opioids. A total of 44.3% reported unsafe use by sharing (1.8%), losing (4.1%), or taking opioids at a higher dose than prescribed (42.5%). Patients who did not receive information on the safe disposal of opioids (OR = 4.57, P  = .0423), had a history of alcohol use (OR = 1.91, P  = .0399), and used opioids other than morphine (OR = 2.31, P  = .0461) had higher odds of unsafe disposal practices. Individuals with an associate degree/bachelor's degree or above were less likely to dispose of (OR = 0.36, P  = .0261) and use (OR = 0.31, P  = .0127) opioids unsafely. Conclusion A significant proportion of Chinese patients with cancer exhibit unsafe practices in the storage, disposal, and use of opioids. The study highlights an urgent need for implementing routine education programs and drug "take-back" initiatives to improve opioid-related practices. [ABSTRACT FROM AUTHOR]

Increasing resilience to natural hazards and climate change is critical for achieving many Sustainable Development Goals (SDGs). In recent decades, China has experienced rapid economic development and became the second-largest economy in the world. This rapid economic expansion has led to large-scale changes in terrestrial (e.g., land use and land cover changes), aquatic (e.g., construction of reservoirs and artificial wetlands) and marine (e.g., land reclamation) environments across the country. Together with climate change, these changes may significantly influence flood risk and, in turn, compromise SDG achievements. The Luanhe River Basin (LRB) is one of the most afforested basins in North China and has undergone significant urbanisation and land use change since the 1950s. However, basin-wide flood risk assessment under different development scenarios has not been considered, although this is critically important to inform policy-making to manage the synergies and trade-offs between the SDGs and support long-term sustainable development. Using mainly open data, this paper introduces a new framework for systematically assessing flood risk under different social and economic development scenarios. A series of model simulations are performed to investigate the flood risk under different land use change scenarios projected to 2030 to reflect different development strategies. The results are systematically analysed and compared with the baseline simulation based on the current land use and climate conditions. Further investigations are also provided to consider the impact of climate change and the construction of dams and reservoirs. The results potentially provide important guidance to inform future development strategies to maximise the synergies and minimise the trade-offs between various SDGs in LRB. [ABSTRACT FROM AUTHOR]

Flood modelling can provide useful information to support flood risk assessment and management. The accuracy of flood simulation results is highly dependent on the quality of input data. In particular, digital elevation models (DEMs) may directly influence the performance of flood predictions and improper representation of complex urban features including buildings and bridges may lead to incorrect prediction of flooding paths and extents, and consequently miscalculate flood risk. In this work, a geographic information system (GIS)-based correction method is proposed to make modifications in high-resolution DEMs by adding building complexes and removing unphysical representations of bridges for a more realistic description of flood paths in considering the flow connectivity in intensely urbanized areas and with the objective of obtaining more accurate flood simulation results. The proposed DEM correction method is applied to support large-scale urban flood modelling in Fuzhou City, China, using an established hydrodynamic flood model known as High-Performance Integrated hydrodynamic Modelling System (HiPIMS). Comparisons are made to the simulation results with and without the DEM improvements using the proposed correction method. The results demonstrate that correct representation of the artificial structures in the urban DEM can significantly improve the flood simulation results. [ABSTRACT FROM AUTHOR]

Background: The outbreak of COVID-19 (caused by SARS-Cov-2) is very serious, and no effective antiviral treatment has yet been confirmed. The adage "old drug, new trick" in this context may suggest the important therapeutic potential of existing drugs. We found that the lopinavir/ritonavir treatment recommended in the fifth edition of the Treatment Plan of China can only help to improve a minority of throat-swab nucleic-acid results (3/15) in hospitals. Our previous use of chloroquine to treat patients with COVID-19 infection showed an improvement in more throat-swab nucleic-acid results (5/10) than the use of lopinavir/ritonavir.Methods/design: This is a prospective, open-label, randomized controlled, multicenter clinical study. The study consists of three phases: a screening period, a treatment period of no more than 10 days, and a follow-up period for each participant. Participants with COVID-19 infection who are eligible for selection for the study will be randomly allocated to the trial group or the control group. The control group will be given lopinavir/ritonavir treatment for no more than 10 days. The trial group will be given chloroquine phosphate treatment for no more than 10 days. The primary outcome is the clinical recovery time at no more than 28 days after the completion of therapy and follow-up. The secondary outcomes include the rate of treatment success after the completion of therapy and follow-up, the time of treatment success after no more than 28 days, the rate of serious adverse events during the completion of therapy and follow-up, and the time to return to normal temperature (calculated from the onset of illness) during the completion of therapy and follow-up. Comparisons will be performed using two-sided tests with a statistical significance level of 5%.Discussion: This experiment should reveal the efficacy and safety of using chloroquine versus lopinavir/ritonavir for patients with mild/general COVID-19 infection. If the new treatment including chloroquine shows a higher rate of throat-swab SARS-CoV-2 real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) negativity and is safe, it could be tested as a future COVID-19 treatment.Trial Registration: Chinese Clinical Trial Registry, ID: ChiCTR2000029741 . Registered on 11 February 2020. [ABSTRACT FROM AUTHOR]

Microplastics are a new type of contaminant, widely defined as fragmented plastics with the longest dimension or diameter less than 5 mm, that are widely distributed, difficult to degrade, and easily adsorb other pollutants. Estuaries are key habitats where terrestrial microplastics flow in water runoff and import into the ocean. The ubiquitous use of plastics has resulted in a massive amount of plastic waste that is released and accumulated in bay ecosystems, posing serious ecological impacts. The study of microplastic contamination in Hangzhou Bay, the estuary of the Qiantang River, has important theoretical value in ecology and environmental science. Microplastic contamination in the tidal flats and organisms of Hangzhou Bay is serious and microplastic characteristics (type, size, and polymer type) in organisms were significantly correlated with those in the environmental media. Spatial autocorrelation was found in the abundance of microplastics in marine and tidal flat sediments of Hangzhou Bay, China, but no spatial autocorrelation was found in the sediment environment as a whole. The microplastic abundance in each organism in this study was not statistically correlated by weight or by individual count with its corresponding trophic level (P = 0.239 > 0.05; P = 0.492 > 0.05, respectively). Our study suggests a coupling relationship of microplastic contamination between organisms and the environment and can provide essential data and a scientific foundation for the study of microplastics pollution in Hangzhou Bay, as well as provide important evidence for the ecological and health risk assessment of microplastics. [Display omitted] • The study revealed high levels of microplastic pollution in Hangzhou Bay, China. • Different types of microplastics were found, including fibers and fragments. • Spatial distribution patterns of microplastic abundance were showed in Hangzhou Bay. • A significant correlation was found between microplastics in organisms and sediments. • The results emphasize the need for strategies to reduce microplastic pollution. [ABSTRACT FROM AUTHOR]

China is an agricultural country with the largest population in the world. However, intensification of droughts and floods has substantial impacts on agricultural production. For effective agricultural disaster management, it is significant to understand and quantify the influence of droughts and floods on crop production. Compared with droughts, the influence of floods on crop production and a comprehensive evaluation of effects of droughts and floods are given relatively less attention. The impact of droughts and floods on crop production is therefore investigated in this study, considering spatial heterogeneity with disaster and yield datasets for 1949-2015 in China mainland. The empirical relationships between drought and flood intensity and yield fluctuation for grain, rice, wheat, maize and soybean are identified using a Bayesian hierarchical model. They are then used to explore what social-economic factors influenced the grain sensitivity to droughts and floods by the Pearson’s coefficient and locally weighted regression (LOSEE) plots. The modeling results indicate that: (a) droughts significantly reduce grain yields in 28 of 31 provinces and obvious spatial variability in drought sensitivity exists, with Loess Plateau having highest probability of crop failure caused by droughts; (b) floods significantly reduce grain yield in 20 provinces, while show positive effect in the northwestern and southwestern China; (c) the spatial patterns of influence direction of droughts and floods on rice, maize and soybean are consistent with the grain’s results; and (d) promoting capital investments and improving access to technical inputs (fertilizer, pesticide, and irrigation) can help effectively buffer grain yield lose from droughts. [ABSTRACT FROM AUTHOR]

China is the largest producer and consumer of plastics worldwide. Microplastic (MP) pollution has been a recent research hotspot in environmental science and ecology. This study collects and analyzes the statistical data for microplastics (MPs) 86 lakes in entire China's lake ecosystems in past five years (2016–2020), their range in area is 0.056–4543.000 km2 (average: 566.045 km2), and the water storage varies from 0.162 × 108 to 1050.000 × 108 m3 (average: 77.884 ×108 m3). The results showed (1) The MP abundance in lake surface water is significantly correlated with lake area (ρ = −0.562, p ＜0.01), provincial GDP (Gross Domestic Product, GDP) (ρ = 0.377, p = 0.002), GDP per capita (ρ = 0.346, p = 0.006), urban waste water discharge and ratio of agricultural land area (ρ = 0.369, p = 0.003). (2) The MP abundance in lake sediment is significantly correlated with per capita domestic volume of garbage disposal (ρ = −0.536, p ＜0.001), per capita urban waste water discharge (ρ = −0.544, p ＜0.001) and ratio of agricultural land area (ρ = 0.635, p ＜0.001). (3) Irrespective of whether the samples were from surface water or sediment, MPs were primarily transparent, and the dominant types were fragments, films, and fibers. In addition, the size of MPs samples was mostly less than 2 mm, and the major polymers were polyethylene (PE), polypropylene (PP), and polystyrene (PS). (4) The degree of MP pollution in organisms was related to the degree of environmental pollution. These findings could provide a theoretical basis for the control and management of MP pollution in China's lake ecosystems. [Display omitted] • MP pollution in China's lake ecosystems were reviewed. • Main sources of MPs in China's lake ecosystems were analyzed. • Lake ecosystems in China have varying degrees of MP pollution. • Major polymers were PE, PP, and PS. • MPs are present at different levels of food chain in China's lake ecosystems. [ABSTRACT FROM AUTHOR]

To improve the treatment of infectious diseases in patients with crush syndrome, we analyzed the results of bacteriological examinations, including antimicrobial susceptibility patterns, of samples taken from patients with crush syndrome admitted to West China Hospital, Sichuan University, after the Wenchuan earthquake. A total of 210 non-replicate clinical isolates were recovered from 42 of the 66 earthquake victims with crush syndrome. Their mean age was 26.9 ± 15.7 y and 40 of them were male. The length of hospital stay was 14.0 days. Wound, blood, sputa, urine and catheter sample specimens were examined. Gram-negative bacilli, Gram-positive bacteria and fungi accounted for 72.4%, 20.0% and 7.6% of the isolates, respectively. Acinetobacter baumannii and Pseudomonas aeruginosa were the major isolates from wounds. Of the isolated strains, 92.8% occurred at >48 h following admission to the hospital, and most of these agents were common isolates in our hospital. Furthermore, 40.9% of these patients were carriers of multidrug-resistant (MDR) microorganisms. Therefore, we can conclude that patients with crush syndrome may have an increased risk of hospital-acquired infection (HAI), suggesting that it is important to select effective antibiotics to control HAI in a timely manner according to the microbiological data. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • A novel Bayesian change point model (BCPM) was proposed to testify abrupt change. • We uncovered the potential of BCPMs for causality determination. • Changes of nutrients and nutrients-Chla relationship did not occur simultaneously. • Nutrients increase did not drive the relationship change in Yilong Lake. Abstract Possibility of shifting nutrients-phytoplankton relationship in lakes requires methods with the ability to testify abrupt relationship change to facilitate efficient management. Bayesian change point model (BCPM) can handle multiple shifts in coefficients and/or in residual errors and therefore suits this requirement. We employed BCPMs to enhance understanding of the shifting nutrients-Chlorophyll a (Chla) relationship in Yilong Lake, which has undergone a regime shift from clear state to turbid state. We developed four candidate models to simulate nutrients-Chla relationship. Model selection results showed the relationship has changed and only one change point exists. Further research based on the selected model showed that (1) the change point was around the 96th observation, (2) nutrients increase did not drive the relationship change, (3) total phosphorus (TP) plays a more important role than total nitrogen on Chla increase, and (4) nutrients reduction is a better strategy than ecosystem recovery to effectively reduce Chla concentration. Therefore, TP reduction should have the priority in Yilong Lake. BCPM is convenient for model selection, posterior distribution acquisition, and relationship change quantification. It could provide critical information for causality deduction. These characters make it useful and extendable to explore shifting relationships in ecological field. [ABSTRACT FROM AUTHOR]

Microplastics (MPs) can enter aquatic food webs through direct ingestion from the environment or indirectly via trophic transfer, but their fate and biological effects within local freshwater food chains remain largely unexplored. In this study, we conducted the first investigation on the trophic transfer and impacts of fluorescently labeled polystyrene microplastics (PS-MPs) (100-nm and 10-μm) in a model freshwater food chain consisting of the snail Bellamya aeruginosa and the commercially important fish Mylopharyngodon piceus, both prevalent in Chinese freshwater ecosystems. Quantitative analysis revealed substantial accumulation of MPs in B. aeruginosa, reaching an equilibrium state within 12 h of exposure. While steady-state was not observed, a pronounced time-dependent bioaccumulation of MPs was evident in M. piceus over a five-week period following dietary exposure through the consumption of contaminated B. aeruginosa. Notably, MPs of both sizes underwent translocation from the gastrointestinal tract to the muscle tissue in M. piceus. High-throughput sequencing of the gut microbiota revealed that exposure to 100-nm MPs significantly altered the microbial community composition in M. piceus, and both particle sizes led to increased relative abundance of potentially pathogenic bacterial genera. Our findings provide novel insights into the trophic transfer, tissue accumulation, and biological impacts of MPs in a model freshwater food chain, highlighting the need for further research to assess the ecological and food safety risks associated with microplastic pollution in freshwater environments., 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.)

Understanding the release of pollutants from the formal e-waste dismantling site could provide the basic information and potential risk to guide the normative regulation of the process. In this study, the distribution of typical polybrominated diphenyl ethers (PBDEs) and heavy metals in a relocating site of a formal e-waste dismantling company was firstly investigated down to the saturated zone, with a maximum depth of 3.0 m. The mean concentrations of Σ 13 PBDEs were ranged from 2.815 to 7.178 ng/g, with a peak value of 7.178 ng/g in storage area. BDE-209 was the predominant congener of PBDEs in the soil, with the value ranged from 1.688 to 2.483 ng/g. A higher pollution of PBDEs and HMs was presented in the storage area. The risk assessment of PBDEs mostly posed a low environmental risk (RQ ≤ 0.01) and pentaBDE was found to be the most harmful driver for the potential environmental risk., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Study suggested that elevated homocysteine showed a multiplicative effect on cardiovascular diseases in hypertensive subjects. It was reported that elevated homocysteine level was independently associated with increased arterial stiffness in prehypertensives. It remains unclear whether prehypertensives combined with elevated homocysteine have adverse cardiovascular risk factors. We aimed to compare cardiometabolic risk profile between prehypertensives with hyperhomocysteinaemia and those without either condition., Methods: Plasma total homocysteine and risk profile were determined among 874 Chinese non-hypertension individuals in Tianjin. They were subdivided into four groups: prehypertension with hyperhomocysteinaemia (≥10 μmol/L), prehypertension with normal homocysteine (<10 μmol/L), normotension with hyperhomocysteinaemia, normotension with normol homocysteine, respectively., Results: In 874 participants, 22.5% of them were male, mean age was 56.8 years. In multiple comparisons, after adjustment for age, gender, smoking, alcohol, exercise, education prehypertensives had higher body mass index (BMI) and high sensitive C reactive protein (hs-CRP) than normotensives (p < 0.05, respectively); Only prehypertensive subjects with hyperhomocysteinaemia had higher triglyceride and serum uric acid compared to normotensive subjects, and lower HDL cholesterol than normotensives with normal homocysteine (p < 0.05, respectively). However, the significance of higher hs-CRP, uric acid and lower HDL cholesterol were abolished when further adjustment was made for BMI., Conclusion: The combination of prehypertension and hyperhomocusteinaemia increases the likelihood of having adverse cardiometabolic risk profile. Strict lipid management and weigh control may be needed in prehypertensives with elevated homocysteine.