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Purpose: Although transgender women (TGW) bear the highest HIV burden worldwide, routine surveillance of this group is rare. We aimed to evaluate the trends in health characteristics of Chinese TGW. Methods: Three cross-sectional studies using snowball sampling were conducted in 2014, 2017, and 2019, primarily in Shenyang, China. A questionnaire and voluntary HIV testing were used to obtain information on background characteristics, sexual behaviors, pre-exposure prophylaxis (PrEP) willingness, and HIV status. Results: There were 220 respondents in 2014, 198 in 2017, and 247 in 2019 (average age 31.1±7.6 to 33.5±9.6 years). HIV prevalence significantly decreased from 29.5% (95% confidence interval [CI]: 25.3–38.4%) in 2014 to 19.4% (95% CI: 14.7–24.9%) in 2019 (p<0.05). The proportion of participants reporting condomless anal intercourse (CAI) with any partner fluctuated from 30.8% (95% CI: 25.1–36.1%) to 53.0% (95% CI: 45.8–60.1%). The proportion of participants willing to use PrEP decreased from 86.4% (95% CI: 81.1–90.6%) in 2014 to 62.8% (95% CI: 56.4–68.8%) in 2019. Factors significantly associated with HIV infection were CAI with any partner (multivariate odds ratio [ORm]: 3.58, 95% CI: 1.55–8.29 in 2017; ORm: 3.18, 95% CI: 1.56–6.46 in 2019) and PrEP willingness (ORm: 0.26, 95% CI: 0.12–0.58 in 2017). Conclusion: HIV prevalence and associated risk factors remain substantial among Chinese TGW. There is an urgent need to strengthen HIV surveillance in this population, and develop trans-friendly and effective interventions to minimize HIV prevalence and transmission. [ABSTRACT FROM AUTHOR]

N-nitrosamines are widespread in various bodies of water, which is of great concern due to their carcinogenic risks and harmful mutagenic effects. Livestock rearing, domestic, agricultural, and industrial wastewaters are the main sources of N-nitrosamines in environmental water. However, information on the amount of N-nitrosamines these different wastewaters contribute to environmental water is scarce. Here, we investigated eight N-nitrosamines and assessed their mass loadings in the Desheng River to quantify the contributions discharged from different anthropogenic activities. N-nitrosodimethylamine (NDMA) (< 1.6–18 ng/L), N-nitrosomethylethylamine (NMEA) (< 2.2 ng/L), N-nitrosodiethylamine (NDEA) (< 1.7–2.4 ng/L), N-nitrosopyrrolidine (NPYR) (< 1.8–18 ng/L), N-nitrosomorpholine (NMOR) (< 2.0–3.5 ng/L), N-nitrosopiperidine (NPIP) (< 2.2–2.5 ng/L), and N-nitrosodi-n-butylamine (NDBA) (< 3.3–16 ng/L) were detected. NDMA and NDBA were the dominant compounds contributing 89% and 92% to the total N-nitrosamine concentrations. The mean cumulative concentrations of N-nitrosamines in the livestock rearing area (26 ± 11 ng/L) and industrial area (24 ± 4.8 ng/L) were higher than those in the residential area (16 ± 6.3 ng/L) and farmland area (15 ± 5.1 ng/L). The mean concentration of N-nitrosamines in the tributaries (22 ng/L) was slightly higher than that in the mainstem (17 ng/L), probably due to the dilution effect of the mainstem. However, the mass loading assessment based on the river's flow and water concentrations suggested the negligible mass emission of N-nitrosamines into the mainstem from tributaries, which could be due to the small water flow of tributaries. The average mass loads of N-nitrosamines discharged into the mainstem were ranked as the livestock rearing area (742.7 g/d), industrial area (558.6 g/d), farmland area (93.9 g/d), and residential areas (83.2 g/d). In the livestock rearing, residential, and industrial area, NDMA (60.9%, 53.6%, and 46.7%) and NDBA (34.6%, 33.3%, and 44.9%) contributed the most mass loads; NDMA (23.4%), NDEA (15.8%), NPYR (10.1%), NPIP (12.8%), and NDBA (37.8%) contributed almost all the mass loads in the farmland area. Photodegradation amounts of NDMA (0.65 ~ 5.25 µg/(m3·day)), NDBA (0.37 ~ 0.91 µg/(m3·day)), and NDEA (0 ~ 0.66 µg/(m3·day)) were also calculated according to the mass loading. Quantifying the contribution of different anthropogenic activities to the river will provide important information for regional river water quality protection. Risk quotient (RQ) values showed the negligible ecological risks for fish, daphnid, and green algae. [ABSTRACT FROM AUTHOR]

Introduction: Internal migrant workers have a great chance to experience defeat due to their low social status and economic situation. It has been reported that defeat might play a prospective role in predicting depression and anxiety; however, defeat is rarely explored among internal migrant workers due to the lack of appropriate measurement scales. The defeat scale (DS) can measure the feeling of defeat, social hierarchy reduction, and loss in social struggle. But its reliability and validity among internal migrant workers have not been reported. This study aimed to verify the content validity and structural validity of the DS among internal migrant workers in China and to explore its correlations with anxiety and depression. Methods: 1805 internal migrant workers (IMWs) were recruited by stratified multistage sampling from 16 factories in Shenzhen, China. The content validity index (CVI) was used to assess content validity. Cronbach's coefficient alpha of each factor and the total scale were calculated to assess the reliability of DS. The scree test was used to determine the number of factors. Convergent validity and discriminant validity were estimated by calculating the average variance extracted and composite reliability. Logistic regression was performed to explore the effects of DS scores on anxiety and depression. Results: Mean score of DS among IMWs was 18.42 ± 9.40. There were 606 (33.6%) IMWs who were considered to have depression symptoms, and 524 (29.0%) IMWs were considered to have anxiety symptoms. A two-factor model was obtained and fitted well (CFI = 0.956, GFI = 0.932, IFI = 0.956, RMSEA = 0.068, SRMR = 0.052). Cronbach's alpha reliability coefficient for the DS was 0.92. Logistic regression showed that DS scores were positively associated with anxiety and depression among IMWs. Conclusions: DS performed well among IMWs on content validity and structural validity, and it was suitable as a measurement instrument to assess defeat among this population. Defeat was positively associated with anxiety and depression and might play an important role in the mental health of IMWs. [ABSTRACT FROM AUTHOR]

Rattus norvegicus and Rattus tanezumi are dominant species of Chinese house rats, but the colonization and demographic history of two species in China have not been thoroughly explored. Phylogenetic analyses with mitochondrial DNA including 486 individuals from 31 localities revealed that R. norvegicus is widely distributed in China, R. tanezumi is mainly distributed in southern China with currently invading northward; northeast China was the natal region of R. norvegicus, while the spread of R. tanezumi in China most likely started from the southeast coast. A total of 123 individuals from 18 localities were subjected to 2b‐RAD analyses. In neighbor‐joining tree, individuals of R. tanezumi grouped into geographic‐specific branches, and populations from southeast coast were ancestral groups, which confirmed the colonization route from southeast coast to central and western China. However, individuals of R. norvegicus were generally grouped into two clusters instead of geographic‐specific branches. One cluster comprised inland populations, and another cluster included both southeast coast and inland populations, which indicated that spread history of R. norvegicus in China was complex; in addition to on‐land colonization, shipping transportation also have played great roles. ADMIXTURE and principal component analyses provided further supports for the colonization history. Demographic analyses revealed that climate changes at ~40,000 to 18,000 years ago and ~4000 years ago had led to population declines of both species; the R. norvegicus declined rapidly while the population of R. tanezumi continuously expanded since ~1500 years ago, indicating the importance of interspecies' competition in their population size changes. Our study provided a valuable framework for further investigation on phylogeography of two species in China. [ABSTRACT FROM AUTHOR]

As the global aging process accelerates, the health challenges posed by sarcopenia among middle-aged and older adults are becoming increasingly prominent. However, the available evidence on the adverse effects of air pollution on sarcopenia is limited, particularly in the Western Pacific region. This study aimed to explore relationships of multiple air pollutants with sarcopenia and related biomarkers using the nationally representative database. Totally, 6585 participants aged over 45 years were enrolled from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 3443 of them were followed up until 2015. Air pollutants were estimated from high-resolution satellite-based spatial-temporal models. In the cross-sectional analysis, we used generalized linear regression, unconditional logistic regression analytical and restricted cubic spline (RCS) methods to assess the single-exposure and non-linear effects of multiple air pollutants on sarcopenia and related surrogate biomarkers (serum creatinine and cystatin C). Several popular mixture analysis techniques such as Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, and quantile-based g-computation (Qgcomp) were further used to examinate the combined effects of multiple air pollutants. Logistic regression was used to further analyze the longitudinal association between air pollution and sarcopenia. Each interquartile range increase in PM 2.5 , PM 10 and NO 2 was significantly associated with an increased risk of sarcopenia, with adjusted odds ratios (aORs) of 1.09 [95 % confidence interval (CI): 1.01, 1.20], 1.24 (95 % CI: 1.14, 1.35) and 1.18 (95 % CI: 1.08, 1.28), respectively. Our findings also showed that five air pollutants were significantly associated with the sarcopenia index. In addition, employing a mixture analysis approach, we confirmed significant combined effects of air pollution mixtures on sarcopenia risk and associated biomarkers, with PM 10 and PM 2.5 identified as major contributors to the combined effect. The results of the exposure-response (E-R) relationships, subgroup analysis, longitudinal analysis and sensitivity analysis all showed the unfavorable impact of air pollution on sarcopenia risk and related vulnerable populations. Single-exposure and co-exposure to multiple air pollutants were positively associated with sarcopenia among middle-aged and older adults in China. Our study provided new evidence that air pollution mixture was significantly associated with sarcopenia related biomarkers. [Display omitted] • Ambient PM 2.5 , PM 10 , and NO 2 were positively associated with risk of sarcopenia. • Positive joint effect of air pollution mixtures with sarcopenia risk was revealed. • Both individual and mixed air pollutants were negatively associated with sarcopenia index. • PM 10 and PM 2.5 dominated the joint effects on sarcopenia and sarcopenia index. • New findings were based on nationally representative Chinese adults (age ≥ 45 years). [ABSTRACT FROM AUTHOR]

Domestic wastewaters contaminated with N -nitrosamines pose a significant threat to river ecosystems worldwide, particularly in urban areas with riparian cities. Despite widespread concern, the precise impact of these contaminants on receiving river waters remains uncertain. This study investigated eight N -nitrosamines in wastewater treatment plants (WWTPs) and their adjacent receiving river, the Lijiang River in Guilin City, Southwest China. By analyzing thirty wastewater samples from five full-scale WWTPs and twenty-three river water samples from Guilin, we quantified the mass loads of N -nitrosamines discharged into the surrounding watershed via domestic effluents. The results revealed that N -nitrosodimethylamine (10–60 ng/L), N -nitrosodiethylamine (3.4–22 ng/L), and N -nitrosopyrrolidine (not detected–4.5 ng/g) were predominant in influents, effluents, and sludge, respectively, with the overall removal efficiencies ranging from 17.7 to 65.6% during wastewater treatment. Cyclic activated sludge system and ultraviolet disinfection were effective in removing N -nitrosamines (rates of 59.6% and 24.3%), while chlorine dioxide disinfection promoted their formation. A total of 30.4 g/day of N -nitrosamine mass loads were observed in the Lijiang River water, with domestic effluents contributing about 31.3% (19.4 g/day), followed by livestock breeding wastewater (34.5%, 12.0 g/day), and unknown sources (24.7%, 7.5 g/day). These findings highlight the critical role of WWTPs in transporting N -nitrosamines to watersheds and emphasize the urgent need for further investigation into other potential sources of N -nitrosamine pollution within watersheds. [Display omitted] • The overall removal rates of ∑NAs in WWTPs ranged from 17.7 to 65.6%. • Approximately 11.5% of ∑NAs entered the sludge in WWTPs. • The removal rates for biotreatment were ranked as CASS > A/A/O > A/O. • WWTP effluents contributed 31.3% of N -nitrosamines to the watershed. [ABSTRACT FROM AUTHOR]

Mangrove forests are widely located along coastlines. They have been identified to be inimitable and dynamic ecosystems. This study investigated the trace metals in mangrove water and surface sediments of Nansha, Guangzhou, China. Zn (148.42 ± 247.47 μg L−1) was the most abundant metal in waters, followed by As (82.34 ± 118.95 μg L−1), Pb (22.96 ± 120.50 μg L−1), and Ni (19.42 ± 47.84 μg L−1). In sediments, the most abundant metal was Fe (27.04 ± 1.91 g kg−1), followed by Mn (1049.04 ± 364.11 mg kg−1), Zn (566.33 ± 244.37 mg kg−1), and Cr (106.9 ± 28.51 mg kg−1). Higher contents of trace metals were detected in vicinity areas of the river mouth. The results of pollution indexes, including contamination factor, enrichment factor, and geo-accumulation index, indicated the pollution of Cd, Cu, Pb, and Zn in sediments. The Spearman correlation and cluster analysis were used to evaluate the metal sources. In water, the significant correlations among Zn and water chemical parameters (Na, Mg, K, Ca, conductivity, pH, and Cl) might indicate the natural source of Zn from the seawater. Water sampling sites in estuaries and coastal areas were clustered separately, which might indicate the influences of upstream water and the seawater, respectively. In sediments, the significant relationships among Cd, Pb, and Zn concentrations were likely to imply the emissions from industries and exploitation of the Pb-Zn mine. The occurrence of Cr and Cu in sediments can be attributed to the spills of lubricants or oil. Cd in sediments could cause serious ecological risk. [ABSTRACT FROM AUTHOR]

Adolescence and young adulthood are critical periods of human growth and development. Phthalates are environmental endocrine disruptors, and their health hazards in adolescents and young adults cannot be ignored. This study was undertaken to assess phthalate exposure and determine the associations between lifestyle behaviors and phthalate metabolite levels in Chinese adolescents and young adults. Four hundred and seventy-eight adolescents and young adults aged 16–20 years were included in this study. The levels of mono-ethyl phthalate (MEP), mono-butyl phthalate (MBP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) and mono-(2-carboxmethyl)-hexyl phthalate (MCMHP) in the subjects' urine were measured by high-performance liquid chromatography-tandem mass spectrometry. The estimated daily intake (EDI) and hazard index (HI) of phthalates were calculated based on urinary metabolite levels. Relevant information on the subjects was collected via questionnaires. The associations between phthalate metabolite levels and lifestyle behaviors were examined using the independent-sample t- test, Mann-Whitney test and multiple linear regression. In this study, the detection rates of all seven metabolites were >98%. The highest median metabolite concentration was MBP, which was 43.00 μg/L (33.11 μg/g creatinine). The highest median EDI was for di-(2-ethylhexyl) phthalate (DEHP), which was 2.40 μg/kg-bw/day (volume-based) and 1.51 μg/kg-bw/day (creatinine-based). 2.7% (volume-based) and 1.0% (creatinine-based) of the subjects showed excessive HI TDI (HI of the tolerable daily intake) values, which indicated the cumulative risk of anti-androgenic effects. Furthermore, factors significantly associated with phthalate metabolite levels included the use of plastic food packages (DEHP metabolites), physical exercise (MEOHP), the frequency of fast food consumption (MBP), and the frequency of skin care cosmetics and color cosmetics use (MEP). Our results suggest that Chinese adolescents and young adults are widely exposed to phthalates and their metabolite levels are influenced by lifestyle behaviors. • Chinese adolescents and young adults are widely exposed to DEP, DBP, and DEHP. • MBP was the metabolite with highest median concentration in subjects' urine. • DEHP was the phthalate with highest estimated median daily intake. • Approximately 3% of subjects showed a cumulative risk of anti-androgenic effects. • The levels of phthalate metabolites was associated with lifestyle behaviors. [ABSTRACT FROM AUTHOR]

N -nitrosamines in water have drawn significant concerns for the health of water consumers due to their carcinogenic properties. N -nitrosamines are formed during disinfection of wastewater as well as different industrial and agricultural processes. This study characterized the N -nitrosamines compositions in eleven different wastewaters in the Pearl River Delta (PRD) in Southeast China, and the spatial distributions and the abundances of N -nitrosamines in the Pearl River water were detected. The results indicated that five N -nitrosamines species, including N -nitrosodimethylamine (NDMA), N- nitrosodiethylamine (NDEA), N -nitrosopyrrolidine (NPYR), N -nitrosomorpholine (NMOR) and N -nitrosodibutylamine (NDBA) were found in the industrial wastewater samples in the PRD. Remarkably high concentrations of NDMA (up to 4000 ng/L) were found in the wastewaters from the textile printing and dyeing as well as the electroplating, whereas NDMA, NDEA and NMOR were detected in the domestic wastewaters at concentrations lower than 15 ng/L. Moreover, we found that certain treatment processes for the electroplating wastewater could form a significant amount of NDMA, NPYR and NMOR. Analyses of the Pearl River water samples showed occurrences of different N -nitrosamines species, including NDMA (5.7 ng/L), NDEA (1.7 ng/L), NPYR (2.2 ng/L), NMOR (2.2 ng/L) and NDBA (4.9 ng/L). The abundances of N -nitrosamines species varied spatially due to the inputs from the different sources. Thus, our study provides unique and valuable information for occurrences, abundances and source characteristics of N -nitrosamines in the PRD. Image 1 • The different regional wastewaters are characterized according to N -nitrosamines compositions. • Enrichment of certain N -nitrosamines species were found in the specific wastewaters. • Uneven spatial distributions of N -nitrosamines species observed in the Pearl River of China. [ABSTRACT FROM AUTHOR]

• Remarkably high NAs were decreased by 33–81 % after industrial WWTPs. • Fe-C electrolysis, ClO 2 oxidation, Fe/Al-based flocculation and activated sludge were effective. • Adsorption, degradation, and precursor deactivation were main removal mechanisms. • Electroplating and printing/dyeing wastewater significantly affect drinking water. • The high concentration diversity of NAs is a major challenge for water treatment. The discharge of industrial wastewater containing high concentrations of N -nitrosamines to the aquatic environment can impair downstream source waters and pose potential risks to human health. However, the transport and fate of N -nitrosamines in typical industrial wastewater treatment plants (IWWTPs) and the influence of these effluents on source water and drinking water are still unclear. This study investigated nine N -nitrosamines in four full-scale electroplating (E-) and printing/dyeing (PD-) IWWTPs, two drinking water treatment plants (DWTPs) in the lower reaches of these IWWTPs, and the corresponding tap water in South China. The total concentrations of N -nitrosamines (∑NAs) were 382–10,600, 480–1920, 494–789, and 27.9–427 ng/L in influents, effluents, source water, and tap water, respectively. The compositions of N -nitrosamine species in different influents varied a lot, while N -nitrosodi-n-butylamine (NDBA) and N -nitrosodimethylamine (NDMA) dominated in most of the effluents, source water, and tap water. More than 70 % N -nitrosamines were removed by wastewater treatment processes used in E-IWWTPs such as ferric-carbon micro-electrolysis (Fe/C-ME), while only about 50 % of N -nitrosamines were removed in PD-IWWTPs due to the use of chlorine reagent or other inefficient conventional processes such as flocculation by cationic amine-based polymers or bio-contact oxidation. Therefore, the mass fluxes of N -nitrosamines discharged from these industrial wastewaters to the environment in the selected two industrial towns were up to 14,700 mg/day. The results based on correlation and principal component analysis significantly demonstrated correlations between E-and PD-effluents and source water and tap water, suggesting that these effluents can serve as sources of N -nitrosamines to local drinking water systems. This study suggests that N -nitrosamines are prevalent in typical IWWTPs, which may infect drinking water systems. The findings of this study provide a basis data for the scientific evaluation of environmental processes of N -nitrosamines. [Display omitted] [ABSTRACT FROM AUTHOR]

• The materials of stone filled with cement stabilized macadam were reasonably selected and analyzed. • The mix proportion optimization design method of crack-resistance stone filled with cement stabilized macadam was proposed. • The road performance of stone filled with cement stabilized macadam was compared and investigated. • The structural characteristics of stone filled with cement stabilized macadam in pavement structure combination were analyzed. Semi-rigid base asphalt pavement is widely used in China for asphalt pavement construction. However, the presence of reflection cracks remains a significant issue associated with semi-rigid bases. Large Stone Filled with Cement Stabilized Macadam (LSFC) has been identified as an effective solution for inhibiting reflection cracks. However, the construction of LSFC using large particle size coarse aggregates can be challenging. Additionally, the existing mix design process lacks clarity and results in low strength. This paper aims to optimize the design method for anti-cracking Stone Filled with Cement Stabilized Macadam (SFC) by selecting appropriate materials and improving design process. Initially, a mix proportion for SFC is designed using coarse aggregates with common particle sizes employed in engineering applications. The filling proportion of the coarse aggregates, cement dosage, and mass proportion of the cement mortar are gradually determined through compaction and 7-day unconfined compressive strength tests, resulting in the complete mix proportion for SFC. Subsequently, the strength performance, fatigue performance, dry shrinkage performance, and temperature shrinkage performance of SFC are evaluated and compared with common Cement Stabilized Macadam (CSM). The results indicate that while the strength and fatigue properties of SFC are slightly inferior to those of common CSM, it exhibits superior dry shrinkage performance. Moreover, SFC demonstrates better overall crack resistance compared to common CSM, despite having slightly inferior temperature shrinkage performance. [ABSTRACT FROM AUTHOR]

The discharge of electroplating wastewater, containing high concentrations of N-nitrosamines, poses significant risks to human health and aquatic ecosystems. Karst aquatic environment is easily impacted by N-nitrosamines due to the fragile surface ecosystem. However, it's still unclear in understanding N-nitrosamine transformation in karst water systems. To explore the response and transport of nine N-nitrosamines in electroplating effluent within both karst surface water and groundwater, different river and groundwater samples were collected from both the upper and lower reaches of the effluent discharge areas in a typical karst industrial catchment in Southwest China. Results showed that the total average concentrations of N-nitrosamines (∑NAs) in electroplating effluent (1800 ng/L) was significantly higher than that in the receiving river water (130 ng/L) and groundwater (70 ng/L). The dynamic nature of karst aquifers resulted in comparable average concentrations of ∑NAs in groundwater (70 ng/L) and river water (79 ng/L) at this catchment. Based on the principal component analysis and multiple linear regression analysis, the electroplating effluent contributed 89% and 53% of N-nitrosamines to the river water and groundwater, respectively. The results based on the species sensitivity distribution model revealed N-nitrosodibutylamine as a particularly toxic compound to aquatic organisms. Furthermore, the average N-nitrosamine carcinogenic risk was significantly higher in lower groundwater reaches compared to upper reaches. This study represents a pioneering effort in considering specific N-nitrosamine properties in evaluating their toxicity and constructing species sensitivity curves. It underscores the significance of electroplating effluent as a primary N-nitrosamine source in aquatic environments, emphasizing their swift dissemination and significant accumulation in karst groundwater., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

N-nitrosamines in reservoir water have drawn significant attention because of their carcinogenic properties. Karst reservoirs containing dissolved organic matter (DOM) are important drinking water sources and are susceptible to contamination because of the fast flow of various contaminants. However, it remains unclear whether N-nitrosamines and their precursor, DOM, spread in karst reservoirs. Therefore, this study quantitatively investigated the occurrence and sources of N-nitrosamines based on DOM properties in three typical karst reservoirs and their corresponding tap water. The results showed that N-nitrosamines were widely spread, with detection frequencies > 85%. Similar dominant compounds, including N-nitrosodimethylamine, N-nitrosomethylethylamine, N-nitrosopyrrolidine, and N-nitrosodibutylamine, were observed in reservoirs and tap water, with average concentrations of 4.7-8.9 and 2.8-6.7 ng/L, respectively. The average carcinogenic risks caused by these N-nitrosamines were higher than the risk level of 10 -6 . Three-dimensional fluorescence excitation-emission matrix modeling revealed that DOM was composed of humus-like component 1 (C1) and protein-like component 2 (C2). Fluorescence indicators showed that DOM in reservoir water was mainly affected by exogenous pollution and algal growth, whereas in tap water, DOM was mainly affected by microbial growth with strong autopoietic properties. In the reservoir water, N-nitrosodiethylamine and N-nitrosopiperidine were significantly correlated with C2 and biological indicators, indicating their endogenously generated sources. Based on the principal component analysis and multiple linear regression methods, five sources of N-nitrosamines were identified: agricultural pollution, microbial sources, humus sources, degradation processes, and other factors, accounting for 46.8%, 36.1%, 7.82%, 8.26%, and 0.96%, respectively. For tap water, two sources, biological reaction processes, and water distribution systems, were identified, accounting for 75.7% and 24.3%, respectively. Overall, this study presents quantitative information on N-nitrosamines' sources based on DOM properties in typical karst reservoirs and tap water, providing a basis for the safety of drinking water for consumers., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

The discharge of substantial amounts of N-nitrosamines-contained wastewater into receiving rivers can significantly deteriorate water quality, as these carcinogenic compounds can be easily transported into groundwater and drinking water systems. This study investigated the distribution of eight species of N-nitrosamines in river water, groundwater, and tap water located in the center of the Pearl River Delta (PRD), China. The results showed that three major N-nitrosamines, including N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), and N-nitrosodibutylamine (NDBA), with concentrations of up to 64 ng/L, were observed in river water, groundwater, and tap water, whereas the other compounds occurred sporadically. In river water and groundwater, high concentrations of NDMA, NDEA, N-nitrosomorpholine (NMOR), and NDBA were found in industrial and residential lands as compared to agricultural lands owing to the influence of various human activities. The primary sources of N-nitrosamines in river water were industrial and domestic wastewater, and the infiltration of river water was responsible for the high levels of N-nitrosamines in groundwater. Among the target N-nitrosamines, NDEA and NMOR with long biodegradation half-lives (>4 days) and low LogK ow values (<1) displayed the highest potential for groundwater. N-nitrosamines in groundwater and tap water pose significant potential cancer risks to residents, especially children, and juveniles, with lifetime cancer risks of over 10 -4 , necessitating advanced water treatments for drinking water and critical controls on primary industrial discharge in urban 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 © 2023 Elsevier B.V. All rights reserved.)

Objective: Several studies highlighted childhood sexual experiences (CSEs) and intimate partner violence (IPV) as risk factors that affected lifetime suicidal ideation. TW had higher rates of CSEs and IPV than cisgender people. The aim of this study was to comprehensively assess the prevalence of CSEs and IPV among TW and their association with lifetime suicidal ideation., Methods: A cross-sectional survey was conducted among 247 TW in Shenyang and Kunming, China, from April to September 2018. CSEs, IPV, and lifetime suicidal ideation were assessed. Logistic regression models were used to examine the association between self-reported CSEs under 18 years of age, IPV in adulthood, and lifetime suicidal ideation., Results: In the study, 14.2% (35/247) of the sample participants reported CSEs under 18 years of age; 44.9% (111/247) reported experiencing IPV in adulthood, including 18.6% (44/247) of physical IPV, 27.1% (67/247) of trans-specific identity IPV, 31.6% (78/247) of verbal IPV, and 19.4% (48/247) of sexual IPV; and 26.3% (65/247) had thought about attempting suicide at least one time. CSEs and any form of IPV were significantly associated with suicidal ideation in this sample population. A final stepwise multivariate logistic regression model found that both physical and verbal IPVs were significantly associated with suicidal ideation when controlling for other factors (ORm 1 = 2.58, 95% confidence interval (CI) = 1.163-5.724; ORm 2 = 2.72, 95% CI = 1.334-5.547)., Conclusions: The findings highlight the effects of CSEs and IPV among TW and suggest the need for research on suicide in the future. Suicide prevention efforts for this invisible and vulnerable population should focus on those with physical and verbal IPV., 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 © 2023 Xu, Chang, Chen, Xia, Xu, Yu, Chen, Wang, Liu, Liu, Ge, Ma, Zhou, Wang, Ma and Cai.)

Introduction: Men who have sex with men (MSM) are a high-risk group for suicide, with a much higher prevalence of suicidal ideation (SI) than the general population and male population. The aim of this study was to explore the risk factors influencing the development of SI and to develop and validate a nomogram among MSM., Methods: A cross-sectional study was conducted in 915 MSM from Shanghai, Shenyang, Shenzhen and Kunming, China using the snowball sampling method. The integrated motivational-volitional (IMV) model of suicidal behavior was used as a theoretical framework to collect different potential influencing factors of SI including diathesis-environment-life events factors and psychosocial factors. The risk factors of SI were screened by logistic regression analysis, and a nomogram for predicting SI were developed. Model properties including discrimination, calibration and decision curves were evaluated to validate the prediction model., Results: 882 MSM were included in the statistical analysis, with a lifetime prevalence of SI of 34.4% (303/882). Logistic regression analysis showed that age group, sexual orientation disclosure, high-risk sexual behavior, entrapment, defeat and interpersonal needs were associated with SI. A nomogram was constructed based on the above six predictors. AUC values of ROC for prediction model were 0.761 (0.641-0.770) and 0.754 (0.565-0.822) in the training set ( n = 662) and validation set ( n = 220), respectively. And there was no statistical difference of the AUC values between the two sets ( P > 0.05). The calibration plots of the prediction model in both sets fit well with the ideal model ( P > 0.05). The decision curves demonstrated that the threshold probability of prediction model in training set was 1-85%, whereas in validation set was 1-63%., Conclusions: The lifetime prevalence of SI among Chinese MSM is high. The nomogram can serve as a useful tool to predict the development of SI among MSM. Defeat, entrapment and interpersonal needs, as significant predictors of SI, can be measured to identify SI in advance. Early assessment of SI and the enhancement of psychosocial interventions are important to prevent suicide-related behaviors. Future studies could incorporate more variables of interest to refine the prediction model to better guide behavioral and psychological intervention strategies among MSM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Xu, Wang, Liu, Chen, Chen, Xia, Chen, Xu, Hu, Wang, Cai and Chen.)

Introduction: Since the advent of 2019 novel coronavirus (COVID-19), the coexistence between social stigma and depression symptoms (depression hereafter) in COVID-19 patients has been mentioned, but the mechanisms involved remains unclear. This study aimed to explore how the stigma affects depression during the mid-pandemic period., Methods: A cross-sectional survey using non-probability sampling was conducted among asymptomatic COVID-19 carriers in Shanghai, China (April 2022). An online questionnaire was used to obtain information on demographic characteristics and psychological traits. Logistic regression and path analysis were performed to analyze the depression risk factors and examine the mediation model, respectively., Results: A total of 1283 participants (59.6% men) were involved in this study, in which 44.7% of carriers reported having depression. Univariate analyses found that education level (OR 0.575; 95% CI 0.448-0.737) and doses of vaccine (OR 1.693; 95% CI 1.042-2.750), were significantly associated with depression among asymptomatic carriers. The association between social stigma and depression was fully mediated by their feelings of entrapment and decadence (indirect effect = 0.204, p < 0.001; direct effect = -0.059, p = 0.058). The mediating role of entrapment between stigma and depression was moderated by age group (estimate = 0.116, p = 0.008)., Conclusion: Mental health issues resulting from the COVID-19 pandemic are increasingly apparent in China and require urgent attention and responses. These findings provide new perspectives for the early prevention of depression in asymptomatic carriers.

Background: Lung adenocarcinoma (LUAD) is the most common subtype of non-small-cell lung cancer (NSCLC). The aim of our study was to determine prognostic risk factors and establish a novel nomogram for lung adenocarcinoma patients. Methods: This retrospective cohort study is based on the Surveillance, Epidemiology, and End Results (SEER) database and the Chinese multicenter lung cancer database. We selected 22,368 eligible LUAD patients diagnosed between 2010 and 2015 from the SEER database and screened them based on the inclusion and exclusion criteria. Subsequently, the patients were randomly divided into the training cohort (n = 15,657) and the testing cohort (n = 6711), with a ratio of 7:3. Meanwhile, 736 eligible LUAD patients from the Chinese multicenter lung cancer database diagnosed between 2011 and 2021 were considered as the validation cohort. Results: We established a nomogram based on each independent prognostic factor analysis for 1-, 3-, and 5-year overall survival (OS) . For the training cohort, the area under the curves (AUCs) for predicting the 1-, 3-, and 5-year OS were 0.806, 0.856, and 0.886. For the testing cohort, AUCs for predicting the 1-, 3-, and 5-year OS were 0.804, 0.849, and 0.873. For the validation cohort, AUCs for predicting the 1-, 3-, and 5-year OS were 0.86, 0.874, and 0.861. The calibration curves were observed to be closer to the ideal 45° dotted line with regard to 1-, 3-, and 5-year OS in the training cohort, the testing cohort, and the validation cohort. The decision curve analysis (DCA) plots indicated that the established nomogram had greater net benefits in comparison with the Tumor-Node-Metastasis (TNM) staging system for predicting 1-, 3-, and 5-year OS of lung adenocarcinoma patients. The Kaplan-Meier curves indicated that patients' survival in the low-risk group was better than that in the high-risk group ( P  < .001). Conclusion: The nomogram performed very well with excellent predictive ability in both the US population and the Chinese population.

Objectives: Proper blood lipid levels are essential for survival in older adults, but inconsistent relationships have been reported between blood lipids and all-cause mortality in the elderly., Methods: This retrospective longitudinal study analyzed data from 1,067 Chinese older adults enrolled in the Chinese Longitudinal Healthy Longevity Survey collected in 2008 and followed up until death or December 31, 2018. The outcome was all-cause mortality. Multivariate Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with stratification by age (60-80, 80-100, or ≥100 years) for further analysis. The survival probability according to lipid profile quartiles was calculated using Kaplan-Meier curves and the log-rank test., Results: The participants' mean age was 84.84 years, and 57.0% were female. In total, 578 individuals died, and 277 were lost to follow-up. The mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were higher among those who died than among those who survived. Participants in the second HDL-C quartile and the highest LDL-C and triglyceride (TG) quartiles had 28% higher, 23% lower, and 49% lower risks of all-cause mortality, respectively. After further adjustment, the associations remained except for HDL-C, and additional associations were observed between all-cause mortality and the third TC and LDL-C quartiles and the second TG quartile (HR, 1.44; 95% CI, 1.01 to 2.06; HR, 0.68; 95% CI, 0.49 to 0.94; HR, 0.79; 95% CI, 0.62 to 0.99, respectively)., Conclusions: Older adults should maintain an LDL-C level of 1.91-2.47 mmol/L and a TG level of no less than 1.66 mmol/L.

The presence of some types of N-nitrosamines in water bodies is of great concern worldwide due to their carcinogenic risks and harmful mutagenic effects on human health. In the present study, eight N-nitrosamines and their formation potentials (FPs) were primarily investigated in Yangtze River surface water to evaluate their spatial distribution, mass loads, and ecological risks. The results showed that of the eight N-nitrosamines investigated, NDMA (<1.5-17 ng/L), NDEA (<1.4-9.5 ng/L), NDPA (1.0 ng/L), NMOR (<1.0-1.3 ng/L), NPIP (<2.1-3.7 ng/L), and NDBA (<3.6-30 ng/L) were detected. The FPs of NDMA (<27-130 ng/L), NDEA (<0.9-2.3 ng/L), NDPA (<1.2-1.9 ng/L), NPYR (<1.4-2.9 ng/L), NMOR (<1.0 ng/L), and NDBA (<1.1-14 ng/L) were significantly identified. NDBA was predominantly observed in surface water, while NDMA was noticeably detected in chloraminated water samples. It was estimated that approximately 5.4 t/y of N-nitrosamines were carried by the Yangtze River to the East China Sea, whereas the input flux of N-nitrosamine precursors was estimated to be approximately 69.5 t/y. Spatial variations were observed due to the input of N-nitrosamines from the upstream dams and lakes. The origin of N-nitrosamine precursors was not associated with the presence of sediment in river water. NDEA could be introduced into river water by the discharge of wastewater. NDBA and its precursors could originate from industrial and aquaculture activities. NDMA and its precursors could result from both of the aforementioned sources. Moreover, the wastewater discharge from small cities, pH value, wastewater treatment ratio, and dilution could be the key factors that influence the occurrence of N-nitrosamines along the Yangtze River. More attention should be paid to the cancer risks posed by N-nitrosamines. The ecological risks posed by N-nitrosamines in the Yangtze River can be ignored., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China., Methods: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary., Results: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001)., Conclusions: The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.

A novel biflavonoid named licobichalcone was isolated from the roots of Glycyrrhiza uralensis cultivated in China, along with twelve known compounds, including five chalcones, two isoflavones, two flavanones, two flavones and one pterocarpan. Their structures were respectively elucidated on the basis of chemical and spectroscopic evidence.