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Objective: To assess the psychometric properties of the short form Community Attitudes toward Mentally Illness (SF-CAMI) scale among medical students and primary healthcare workers in China. Methods: Original English version CAMI was translated following a standard procedure. and then short-form CAMI developed through the multistage procedure. The psychometric properties were tested among two separate samples which contained 1,092 primary healthcare workers and 1,228 medical students. Reliability was assessed by internal consistency reliability and test–retest reliability. Exploratory factor and confirmatory factor analyses were performed to determine the structure and to assess the validity of the scale. Results: The Chinese version of SF-CAMI consists of 20 items and with three subscales: Benevolence, Fear and Exclusion, and Support and Tolerance. The confirmatory factor analysis indicated good fitting models for medical students and primary healthcare workers. The Cronbach α of total scale for both samples was good (0.82 for medical students and 0.85 for primary healthcare workers), and acceptable test–retest reliability was found (intraclass correlation coefficient is 0.62 for medical students and 0.60 for primary healthcare workers). Conclusion: The Chinese version of SF-CAMI performed good reliability and validity among both primary healthcare workers and medical students, provide more feasible and available tools for assessing the effect of mental health service programs in China. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the incidence of delirium in cerebrovascular patients admitted in our Neurosurgery Intensive Care Unit and analyse the risk factors leading to delirium. Background Delirium is one of the most common mental disorders in general hospitals, but the incidence of different kinds of diseases and studies varies. Cerebrovascular patients in our Neurosurgery Intensive Care Unit are high-risk groups for delirium; identifying risk factors for delirium and taking early interventions are crucial for patient prognosis. Design A prospective study. Methods A convenience sampling method was used to collect data from 128 patients in the Neurosurgery Intensive Care Unit of Xuanwu Hospital, Capital Medical University, Beijing, China, between May 2016-January 2017. Researchers used Confusion Assessment Method for the Intensive Care Unit (Chinese version) to assess each patient's delirium statement twice a day at regular times. We also collected other independent data variables and followed up the short-term clinical outcomes daily. Results On the basis of Confusion Assessment Method for the Intensive Care Unit evaluation, patients were divided into a delirium group and a nondelirium group. The prevalence of delirium among the 128 patients was 42.2%. Multivariate analysis showed that severity of illness, fever, the use of physical restraints and sleep deprivation were independent predictors of delirium in cerebrovascular patients in the Neurosurgery Intensive Care Unit. Conclusions Cerebrovascular patients in the Neurosurgery Intensive Care Unit with a critical condition, fever or use of physical restraints or experiencing sleep deprivation were more prone to delirium. Relevance to clinical practice Cerebrovascular patients in the Neurosurgery Intensive Care Unit showed a high incidence of delirium. There are many risk factors leading to delirium, some of which are independent predictors of intensive care delirium. Patients with delirium will suffer various adverse effects upon their short-term clinical outcomes. Therefore, nurses should pay close attention to changes in a patient's mental state and learn about the risk factors associated with delirium, in order to be able to take early measures to prevent delirium. [ABSTRACT FROM AUTHOR]

With its rapid development, the rural area of Southwest China has been puzzled by the waste management problem, especially for increasing solid waste and water pollution from the domestic waste. Therefore, in order to efficiently and effectively manage the domestic waste in the rural area of Southwest China, 22 villages were selected randomly to analyse the characteristics of domestic waste, the influence factors of characteristics and resident’s willingness of participation in domestic waste management by questionnaires, field samplings and laboratory tests. The results of the rural area of Southwest China indicated that the generation of domestic waste was 178 g d−1 per capita and it was mainly composed of kitchen waste, inert waste, plastics and paper with a total proportion of 81.98%. The waste bulk density, moisture, ash, combustible and lower calorific value were 107 kg m−3, 37.04%, 25.73%, 37.23% and 8008 kJ kg−1, respectively. These characteristics were influenced by the topography, the distance from towns or cities, the villagers’ ethnicities and income sources to some extent. Moreover, the distance of 50–800 m between each collection facility and the disposal fee of around ¥5.00 per household per month could be accepted. The working hours of participation in waste management is suggested as 5 hours per day with the income of ¥1000 per capita per month. Based on the outcome of this survey, a waste management system consisting of classified collection, centralised treatment and decentralised treatment was proposed. It is important to ensure financial viability and practical considerations of this system. [ABSTRACT FROM PUBLISHER]

• Some neonicotinoids, agricultural fungicides, and their transformation products were measured • The levels of target pesticides increased from the upstream to downstream of the Yangtze River • Thiamethoxam, imidacloprid, and acetamiprid were the dominant neonicotinoid insecticides • Carbendazim, dimethomorph, and tebuconazole were the dominant agricultural fungicides • Six target pesticides may pose high risks to the aquatic ecosystem Neonicotinoid insecticides (NNIs) and agricultural fungicides (including strobilurin, azole, and morpholine fungicides) are widely used, while data on their contamination in the Yangtze River of China and the risks posed by them are limited. The occurrence and distribution of ten NNIs, twenty-one transformation products (TPs) of them, seventeen agricultural fungicides, and six TPs of them were investigated in the main stream of the Yangtze River. Surface water samples (n = 144) were obtained from 72 sampling points in dry season and wet season. Among the NNIs, the detection frequencies (DFs) of acetamiprid (ACE), clothianidin, dinotefuran, flonicamid, imidacloprid (IMI), thiacloprid (THCP), and thiamethoxam (THM) were higher than 85%, with the median concentrations ranged from 0.06 ng/L (THCP) to 3.63 ng/L (IMI). The DFs of the TPs descyano-acetamiprid, desmethyl-acetamiprid (DM-ACE), N-[(6-Chloropyridin-3-yl) methyl] methylamine, desnitro-clothianidin, desnitro-imidacloprid, desnitro-thiamethoxam, imidacloprid-urea, and thiamethoxam-urea (THM-urea) were higher than 80%, with the median concentrations ranged from 0.25 ng/L for DM-ACE to 2.41 ng/L for THM-urea. Some agricultural parent fungicides, including azoxystrobin (AZS), carbendazim (CBDZ), difenoconazole, dimethomorph, propiconazole, pyraclostrobin, and tebuconazole (TBCZ), were detected in all the samples; others were also detected in more than 80% of the samples except for fluoxastrobin (12.5%). The median concentrations of the frequently detected fungicides ranged from 0.02 ng/L (trifloxystrobin) to 26.8 ng/L (CBDZ). The DFs of the fungicide TPs azoxystrobin acid (AZS acid), difenoconazole-alcohol, tebuconazole-tert-butylhydroxy (TBCZ-OH), and 5-hydroxymethyl-tricyclazole were higher than 75%, with the median concentrations ranged from 0.09 ng/L (TBCZ-OH) to 1.80 ng/L (AZS acid). The summed concentrations of the NNIs and their TPs at the sampling points varied between 0.23 and 418 ng/L, and the summed concentrations of the selected fungicides and their TPs varied from 0.29 to 1160 ng/L. The spatial distribution of most target analytes revealed an increasing trend in their concentrations from the upstream to downstream Yangtze River (250 times increase in their cumulative concentration). Most target pesticides in this study had significantly higher concentrations during wet season than those during dry season. Furthermore, ecological risk assessment suggested that ACE, IMI, THM, CBDZ, TBCZ, and thifluzamide in some samples (n = 1, 11, 1, 1, 1, and 6, respectively) posed high risks to the ecosystem (risk quotient > 1). Priority attention should be paid to the ecological risk posed by these pesticides. Thirty-seven samples had concentrations of individual target analytes over 100 ng/L and four samples had cumulative concentrations of the target analytes over 500 ng/L, exceeding the European Commission guideline values. Taken together, our findings demonstrate a widespread occurrence of the NNIs, agricultural fungicides, and their TPs in the mainstream of the Yangtze River and potential ecological risks posed by some of them. Neonicotinoid insecticides, selected agricultural fungicides, and their transformation products [Display omitted] [ABSTRACT FROM AUTHOR]

This study aimed to assess the global spatiotemporal variations of trihalomethanes (THMs) in drinking water, evaluate their cancer and non-cancer risks, and THM-attributable bladder cancer burden. THM concentrations in drinking water around fifty years on a global scale were integrated. Health risks were assessed using Monte Carlo simulations and attributable bladder cancer burden was estimated by comparative risk assessment methodology. The results showed that global mean THM concentrations in drinking water significantly decreased from 78.37 μg/L (1973–1983) to 51.99 μg/L (1984–2004) and to 21.90 μg/L (after 2004). The lifestage-integrative cancer risk and hazard index of THMs through all exposure pathways were acceptable with the average level of 6.45 × 10−5 and 7.63 × 10−2, respectively. The global attributable disability adjusted of life years (DALYs) and the age-standardized DALYs rate (ASDR) dropped by 16% and 56% from 1990–1994 to 2015–2019, respectively. A big decline in the attributable ASDR was observed in the United Kingdom (62%) and the United States (27%), while China experienced a nearly 3-fold increase due to the expanded water supply coverage and increased life expectancy. However, China also benefited from the spread of chlorination, which helped reduce nearly 90% of unsafe-water-caused mortality from 1998 to 2018. [Display omitted] • Global THM-attributable bladder cancer burden showed a downward trend. • The disease burden varied greatly between developed and developing countries. • Enlarged water supply and lifetime in developing countries may cause rise in burden. • Expanded chlorination disinfection also helps reduce unsafe-water-caused mortality. • Optimizing chlorination disinfection methods is needed for developing countries. [ABSTRACT FROM AUTHOR]

Pentachlorophenol (PCP), a persistent organic pollutant, has been banned in many countries, but it is still used in China as a wood preservative, molluscicide, or reagent for fish-pond cleaning, which may pose risks to the ecosystem and humans. However, data on the occurrence of PCP in the environment are scarce in the recent decade. The Yangtze River was regarded as a priority area of PCP pollution according to previous documents. This study aimed to examine the spatial distribution of PCP in the Yangtze River water, the differences in dry and wet seasons, the ecological risk for aquatic organisms, and its removal efficiency in tap water treatment plants. The river water samples (n = 144) were collected from the upper, middle, and lower reaches across ten provinces (or municipalities) in December 2020 and June 2021, respectively. PCP was detected in 88.9% of all the samples, ranging from Max: 0.02) to aquatic organisms posed by PCP in the river. In addition, 100% removal of PCP in tap water treatment plants was observed, while the transformation products of PCP need further studies. The risk of human exposure to PCP through water ingestion only was negligible. However, human exposure risks of PCP in highly contaminated areas still require attention, considering its bioaccumulation and biomagnification in the environment., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

A comprehensive contamination profile of organophosphate esters (OPEs) in the Yangtze River in China has not yet been characterized. In this study, we investigated the occurrence, spatial variation, and seasonal difference of 18 selected OPEs in surface water samples of the Yangtze River mainstream. To characterize the contamination profile of the OPEs, we collected 144 Yangtze River water samples from 72 sampling sites in December 2020 and June 2021. Four alkyl-OPEs [trimethyl phosphate, triethyl phosphate (TEP), tributyl phosphate, and tris(2-butoxyethyl) phosphate (TBOEP)] and three halogenated OPEs [tris(2-chloroethyl) phosphate (TCEP), tris(1-chloro-2-propyl) phosphate (TCIPP), and tris(1,3-dichloro-2-propyl) phosphate] were the most frequently detected target compounds (>95%). TCIPP (median: 34.6 ng/L), TEP (median: 26.2 ng/L), and TCEP (median: 17.9 ng/L) were the most abundant compounds, while the median values of the others were below 10 ng/L. Additionally, the concentrations of most OPEs gradually/dramatically increased from upstream to downstream Yangtze River. Notably, the median concentration of summed OPEs in Shanghai (415 ng/L; downstream) was approximately ten times higher than that in Qinghai (45.7 ng/L; upstream). Urban sampling sites had significantly or slightly higher concentrations of most OPEs than rural sampling sites. Moreover, the OPE concentrations in the river water differed between the winter and summer. The concentrations of summed OPEs (median: 117 vs. 106 ng/L), summed alkyl-OPEs (67.0 vs. 45.8 ng/L; p < 0.05), and summed aryl-OPEs (0.48 vs. 0.17 ng/L; p < 0.05) were slightly or significantly higher in December than those in June; nevertheless, summed halogenated OPEs were slightly higher in June (62.2 vs. 50.2 ng/L) than that in December. Compared with previously reported data for OPEs in other major rivers worldwide, the Yangtze River water had relatively lower concentrations of the OPEs than those in the rivers of developed countries and regions. Ecological risk assessment suggested that tris(2-ethylhexyl) phosphate and TCEP posed relatively high risks (RQ: 1.01 and 0.98, respectively) at the maximum concentration, and TBOEP posed a moderate risk (RQ: 0.25). This is the first study to comprehensively characterize the contamination profile of the Yangtze River by the OPEs., 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.)

Caffeine is considered the most representative pharmaceutical emerging contaminant (PEC) because of its ubiquity, high environmental abundance, uncovered ecological risks, and its indicator property for anthropogenic environmental inputs of PECs. Ecopharmacovigilance (EPV) targeting caffeine has been proposed as an optimized measure for the control of caffeine pollution sources and the related anthropogenic behaviors from the perspective of pharmacy administration. This cross-sectional study was conducted to evaluate the environmental knowledge, behaviors, and attitudes regarding caffeine consumption among university students, one of the groups with high caffeine consumption, from an EPV perspective. Three hundred and seven usable survey instruments were acquired. The mean score for environmental knowledge about caffeine consumption was 3.66 out of a total of 7. The consumption frequency of caffeinated drinks, food, or drugs among student respondents was low. Throwing away in "household garbage" was an important disposal mechanism for unconsumed caffeinated products. Most students showed positive attitudes and strong intentions toward caffeine pollution control from the perspective of targeted EPV. These data suggested high acceptance of EPV program targeting caffeine among university students. However, more should be done to enhance their related knowledge, and some strengthening interventions for the effective removal of residual caffeine in garbage are needed.

Introduction: Eco-directed sustainable prescribing (EDSP) is an effective upstream way to reduce the environmental footprints of active pharmaceutical ingredients (APIs), a kind of emerging contaminants, from the patients' excretion. EDSP is one of the key steps in the programme of ecopharmacovigilance (EPV), a drug administration route on API pollution., Objective: To assess the attitudes of physicians prescribing medicines regarding EDSP from the perspective of EPV., Design: A cross-sectional study conducted from March 2019 to June 2019., Setting: 5 government general hospitals in Hubei province, China., Participants: 405 physicians were randomly selected and 262 valid questionnaires were obtained., Outcome Measures: A self-developed questionnaire, which inquired about the participant characteristics, perceptions and attitudes toward API pollution, EPV and EDSP from an EPV perspective, was emailed to collect data from physicians., Results: Most physicians agreed the existence of APIs in environment, worried about the potential environmental and ecological risks of API residues, supported the effectiveness and necessity of EDSP under an EPV perspective in decreasing environmental exposure of excreted APIs, and showed their willingness to participate in the EDSP practices. Nevertheless, no respondent identified the environmental impacts as the aspects regarding medicines affecting his(her) prescription decision, none was satisfied with knowledge on EDSP and showed confidence toward EDSP. The most important barrier to the effective implementation of EDSP was identified as 'poor awareness of EDSP and EPV'. Most responding physicians (97%) reported that they held the wait-and-see or conservative attitudes towards EDSP practice. The biggest concerns in low-dose prescribing and prescribing of drugs possessing environment-friendly excretion profiles , two EDSP approaches, were the possible negative impact on therapeutic outcomes and too complicated and professional drug evaluation process, respectively., Conclusions: Chinese physicians had positive attitudes towards EDSP from the perspective of EPV. However, their environmental consciousness during prescribing and the related education were insufficient., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Our previous in vitro study reported that the ethyl acetate fraction (EAF) of Semen sojae germinatum (SSG), the processed sprout of Chinese black soybean, possessed the potent anti-inflammatory and chondroprotective properties. The aim of the present work was to verify the in vivo antiosteoarthritic effect of EAF from SSG on a rat osteoarthritis (OA) model ., Methods: A classical rat OA model was surgically induced by anterior cruciate ligament transaction (ACLT). The OA rats were intra-articularly administered EAF from SSG for 8 weeks. The cartilage and synovial tissues were stained with hematoxylin and eosin (HE) to observe the histopathological changes. Safranin O/fast green staining was used to assess the glycosaminoglycan content in cartilage tissue sections. The expression of type II collagen and matrix metalloproteinase (MMP)-13 in cartilage was measured by immunohistochemistry. The apoptotic chondrocytes in the cartilage sections were detected using TUNEL assay. The concentrations of interleukin (IL)-1β and tumor necrosis factor (TNF)-ɑ in synovial fluid were determined using ELISA., Results: Intra-articular administration of EAF from SSG well retained the structure and superficial layer of cartilage tissues, ameliorated cartilage lesion and the degradation of cartilage matrix, including proteoglycan and type II collagen, induced by ACLT operation. The ACLT-induced upregulation of MMP-13 expression in the cartilage tissues was resisted by EAF from SSG. Moreover, EAF from SSG inhibited the ACLT-induced chondrocyte apoptosis. Compared to OA model group, the inflammatory status of synovial membrane was improved, the levels of inflammatory cytokines IL-1β and TNF-ɑ in synovial fluid were decreased in rats administrated with EAF from SSG., Conclusion: These data suggested that EAF from SSG displayed in vivo protective effect on OA development via preventing the degeneration of articular cartilage, inhibiting chondrocyte apoptosis and suppressing synovial inflammation.

Due to the expensive cost and uncertain effectiveness of environmental management options in eliminating pharmaceutical residues, recently, decreasing the emission of pharmaceutical pollutants from a drug administration perspective has been considered a hot area of research. As a kind of drug administration for the environment, ecopharmacovigilance (EPV) emphasizes the source control of pharmaceutical pollutants. Disposal of unwanted medicines has been considered as the easiest target for source control of pharmaceutical contamination. Here, we focused on public attitudes and practice regarding disposal of unwanted medicines from the EPV perspective among 365 Chinese university young adults and 206 elderly retirement home residents. The results showed that the majority of respondents had positive attitudes, but exhibited inadequate awareness and poor practice. In addition, the young-adult respondents were found to pay more attention to the environmental problems posed by pharmaceutical residues, and be more supportive of the EPV intervention predominantly performed by pharmaceutical industries and pharmacists. Therefore, it is urgent to establish the standard medicine disposal protocols and educate the general public on the best way for medication disposal under the principle of EPV in China, and efforts on environmentally-preferred drug disposal under EPV should target for the specific demographics.