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Background Insulin resistance has been reported to increase the risk of breast, prostate and colorectal cancer. However, the role of insulin resistance and its interaction with genetic risk in the development of lung cancer remains controversial. Therefore, we aimed to explore the association between a novel metabolic score for insulin resistance (METS-IR) and lung cancer risk. Methods A total of 395 304 participants without previous cancer at baseline were included. The Cox proportional hazards regression model was performed to investigate the association between METS-IR and lung cancer risk. In addition, a Mendelian randomization analysis was also performed to explore the causal relationship. The joint effects and additive interactions between METS-IR and polygenetic risk score (PRS) of lung cancer were also investigated. Results During a median follow-up of 11.03 years (Inter-quartile range (IQR): 10.30–11.73), a total of 3161 incident lung cancer cases were diagnosed in 395 304 participants. There was a significant association between METS-IR and lung cancer risk, with an HR of 1.28 (95% CI: 1.17–1.41). Based on the Mendelian randomization analysis, however, no causal associations were observed. We observed a joint effect but no interaction between METS-IR and genetic risk. The lung cancer incidence was estimated to be 100.42 (95% CI: 91.45–109.38) per 100 000 person-year for participants with a high METS-IR and PRS, while only 42.76 (95% CI: 36.94–48.59) with low METS-IR and PRS. Conclusions High METS-IR was significantly associated with an increased risk of lung cancer. Keeping a low level of METS-IR might help reduce the long-term incident risk of lung cancer. [ABSTRACT FROM AUTHOR]

Purpose: Recent studies have indicated that digital transformation can benefit an organization's strategic renewal. However, there is little knowledge on how business executives engage in digital transformation for this purpose, especially in the service sectors of emerging markets. Therefore, this study aims to examine how business managers accomplish strategic renewal through digital transformation in emerging markets. Design/methodology/approach: The authors conducted a longitudinal single case study of a leading business firm in China's real estate industry, China Overseas Land & Investment Ltd. (COLI). Results of the analysis of semistructured interviews and rich secondary data allowed us to better understand how business managers react to changing customer demands by building and implementing divergent digital tools to fulfill strategic renewal. Findings: The results showed that business executives of COLI developed the Whole Life Cycle Management System, to achieve strategic renewal. The system benefits resource allocation and potential adjustments to strategic goals. This study also helps update the organizational structure of the marketing and consumer services departments, helping better satisfy consumers' demands and waste fewer resources. Thus, COLI accomplished structural, contextual and leadership-based ambidexterity. Originality/value: This study provides a fresh understanding of the link between digitalization and strategic renewal by providing a fine-grained analysis of leading service providers in emerging markets. To the best of the authors' knowledge, this study is among the first to investigate the role of digital transformation in strategic renewal from an ambidexterity perspective. [ABSTRACT FROM AUTHOR]

Digital technologies provide latecomer manufacturers with technological catch-up opportunities in emerging field of intelligent manufacturing (IM). Prior studies on IM mainly focused on firms from developed countries or digitally-savvy firms. However, latecomer firms that have inadequate resources should identify and leverage diverse digital-related resources to achieve digital catch-up in IM, and the research on their digital catch-up remains limited. Resource orchestration is a sound guiding theory that we adopt to examine this phenomenon. This study conducts an in-depth case study of the successful catch-up of a role-model firm in China and reveals a three-phase process model for the digital catch-up of latecomers in IM. Our findings contribute to existing literature on IM fields, latecomers' catch-up phenomena, resource orchestration theory, as well as knowledge of technology analysis and strategic management. The model also can be practical guidance for latecomers to achieve digital catch-up step by step. [ABSTRACT FROM AUTHOR]

The Fanshi Basin is one of the NE–SW-striking depocentres formed along the northern segment of the fault-bounded Shanxi rift. In order to understand the crustal driving stresses that led to the basin formation and development, a palaeostress analysis of a large quantity of fault-slip data collected mainly at the boundaries of the basin was accomplished. The stress inversion of these data revealed three stress regimes. The oldest SR1 was a Neogene stress regime giving rise to a strike-slip deformation with NE–SW contraction and NW–SE extension. SR1 activated the large faults trending NNE–NE, i.e. (sub)parallel to the main strike of the Shanxi rift, as right-lateral strike-slip faults. It was subjected to the Shanxi rift before the activation of the Fanshi Basin boundary fault, i.e. the Fanshi (or Wutai) fault, as a normal fault. The next is a short-lived NE–SW extensional stress regime SR2 in early Pleistocene time, which shows the inception of the basin's extension. A strong NW–SE to NNW–SSE extensional stress regime SR3 has governed the northern segment of the Shanxi rift since late Pleistocene time and is the present-day extension. It gave rise to the current half-graben geometry of the Fanshi Basin by activating the Fanshi (or Wutai) fault as a normal fault in the southern part of the graben. Because of the dominance of the NW–SE to NNW–SSE extension, which is perpendicular to the NE–SW extension, mutual permutations between σ3 and σ2 due to inherited fault patterns might have occurred while the crustal stresses in the Fanshi Basin changed from the SR1 to SR3 stress regimes. [ABSTRACT FROM AUTHOR]

Effective supply of environmental public services (EPS) is important to guarantee the mitigation of residential pollution exposure risk. This study analyzes the impact of the supply efficiency of EPS on residential health through the sample of 289 cities in China by fixed-effect model and threshold regression model. The results show that: (1) Improving the efficiency of EPS can significantly increase the efficiency of pollution control, and improve the environmental quality and health level of residents. (2) Improving the efficiency of EPS can have a greater positive effect on residents' health in areas with high-level population aging, poor medical condition, and low population density. (3) Environmental decentralization weakens the positive effect of EPS on residential health. Giving more power of environmental management to local governments may be detrimental to pollution control. Therefore, differentiated strategies of EPS should be developed to realize the equalization of basic public services with healthcare and environmental protection. It is necessary to strengthen central environmental supervision and establish resident offices for environmental supervision. [ABSTRACT FROM AUTHOR]

The NE–NNE-trending Yuan-Ma Basin in central South China, an overprinted basin, is important for understanding the transition in Mesozoic intracontinental deformation in South China from compressional to extensional settings. A detailed sedimentary and structural cross-section across the basin reveals the Upper Triassic – Lower Jurassic black coal-bearing shale, greyish-green sandstone and brick-red claystone, and the Middle Jurassic brick-red sandstone, pebbly sandstone and conglomerate in the eastern segment of the basin. The Lower Cretaceous brick-red coarse sandstone, pebbly sandstone and siltstone occurred in the western and central segments, as well as fault breccia and Lower Cretaceous sandstone at the western margin of the basin. Detrital zircon U–Pb dating by laser ablation inductively coupled plasma mass spectrometry shows that the magmatic and metamorphic zircons yield significant age clusters at 900–700, 500–350 and 300–150 Ma, as well a minor age cluster at 120–100 Ma. Synthesizing the stratigraphic sequences, structures, isotopic dating results and palaeocurrent data, we infer that the Yuan-Ma Basin experienced three evolutionary stages and tectonic settings: (1) during Late Triassic – Early Jurassic time, the Yuan-Ma Basin was related to the diachronous progressive intracontinental deformation as a result of the early Mesozoic Xuefeng intracontinental orogeny in South China; (2) during Middle–Late Jurassic time, the Yuan-Ma Basin was related to intracontinental compression in South China; and (3) during late Early Cretaceous time, the Yuan-Ma Basin was constrained by the intracontinental extension that occurred in eastern China. These three stages, a result of various tectonic regimes, caused the intracontinental deformation that was controlled by the evolution of the continents and their margins. [ABSTRACT FROM AUTHOR]

Soil salinisation and overgrazing are two important factors limiting plant growth in the Songnen Grassland, Northeast China. Leymus chinensis , a dominant rhizomatous grass, resists grazing and tolerates saline–alkali stress. However, its adaptive mechanisms to the dual effects of grazing and saline–alkali stress remain largely unknown. A two-factorial field experiment was conducted in two consecutive years in the natural L. chinensis community, combining the addition of mixed saline–alkali solution (NaCl : NaHCO3 : Na2CO3 1 : 1 : 1, amount 559.13 g m–2 year–1) with clipping (removal of 60% of aboveground biomass, AGB). Saline–alkali addition significantly increased AGB and total biomass in the no clipping but not in the clipping treatment. Irrespective of clipping, ramet density was significantly decreased, and individual ramet biomass was significantly increased under salt stress. The significant increase in AGB was due to a high K+ : Na+ ratio, high water-use efficiency, and an increase in leaf area index and net photosynthesis rate of individual ramets under salt–alkali stress. Clipping significantly decreased AGB and total biomass regardless of saline–alkali addition, possibly because of decreased sugar content of rhizomes. Saline–alkali and clipping had an interactive effect on AGB and total biomass of L. chinensis. The significant reduction in AGB and total biomass were mainly caused by reduced proline and water-soluble carbohydrate content under dual stress. A modified and simplified graphic model of the limiting resource model was proposed based on our results. Leymus chinensis can grow well under saline–alkali stress via ramet biomass compensation, in which the significant decrease in ramet density is compensated by the significant increase in individual ramet biomass. Ramet compensation and clonal integration were identified to be main mechanisms of herbivory and saline–alkali tolerance. Soil salinisation and overgrazing are two important factors limiting plant growth in the Songnen Grassland, China; how the dominant species Leymus chinensis resists the dual effect of these stresses remains largely unknown. Our results highlight the importance of rhizome soluble sugar during clipping and saline–alkali tolerance. This study provides a theoretical basis for promoting the restoration of L. chinensis grassland under the combined clipping and saline–alkali stresses. [ABSTRACT FROM AUTHOR]

Exposure to metal(loid)s can lead to adverse effects on nervous system in children. However, little is known about the possible interaction effects of simultaneous exposure to multiple metal(loid)s on children's intelligence. In addition, relationship between blood lead concentrations (<100 μg/L) and the intelligence of children over 5 years needs further epidemiological evidence. We recruited 530 children aged 9–11 years, including 266 living in a town near an industrialized area and 264 from another town in the same city in South China as a reference. The levels of lead (Pb), cadmium (Cd), arsenic (As) and mercury (Hg) in blood (BPb, BCd, BAs, BHg) and urine (UPb, UCd, UAs, UHg) were assessed, as well as children's intelligence quotient (IQ). A significant decrease in IQ scores was identified in children from the industrialized town ( p  < .05), who had statistically higher geometric mean concentrations of BPb, BCd, UPb, UCd and UHg (65.89, 1.93, 4.04, 1.43 and 0.37 μg/L, respectively) compared with children from the reference town (37.21, 1.07, 2.14, 1.02 and 0.30 μg/L, respectively, p  < .05). After adjusting confounders, only BPb had a significant negative association with IQ (B = −0.10, 95% confidence interval: −0.15 to −0.05, p  < .001), which indicated that IQ decreased 0.10 points when BPb increased 1 μg/L. Significant negative interactions between BAs and BHg, positive interaction between UPb and UCd on IQ were observed ( p  < .10), and BPb <100 μg/L still negatively affected IQ ( p  < .05). Our findings suggest that although only BPb causes a decline in children's IQ when simultaneously exposed to these four metal(loid)s at relatively low levels, interactions between metal(loid)s on children's IQ should be paid special attention, and the reference standard in China of 100 μg/L BPb for children above 5 years old should be revised. [ABSTRACT FROM AUTHOR]

• WSOC played an important role in apoptosis than DCM-extracted fraction in PM 2.5. • The aromatic and double-bond carbon structure in WSOC contributes to apoptosis. • The WSOC from secondary products of motor vehicle exhaust is the risk drivers for apoptosis. • The WSOC from coal and corn residues burning is the risk drivers for apoptosis. Identify risk drivers is the key condition in air pollution control, and biological effect-directed analysis is the most commented method for combing chemical identify and human health. The water-soluble organic matter contained in PM 2.5 plays an important role in human health, while it is also the most difficult to identify its chemical information. Exploring the structural characteristics and pollution sources of its key toxic components is the optimized strategy to meet this question. In this study, the induction of apoptosis by the water-soluble fractions (WSF) of PM 2.5 samples collected in 10 major cities in China over a period of 1 year was observed in vitro in Beas-2b cells. Organic carbon structures were examined using nuclear magnetic resonance; air potential sources were identified using δ13C and 14C isotopic markers. Apoptosis induction by WSF in PM 2.5 was generally stronger in northern cities than in southern cities, and in winter than in summer. Organic compounds with aromatic and double-bond carbon structures from secondary products of motor vehicle exhausts, coal-derived emissions, and emissions derived from the burning of core residues may be primarily responsible for apoptosis induction by PM 2.5. Our results will contribute to understanding the toxic substances contained in WSF and provide basic data for accurate pollution control. [ABSTRACT FROM AUTHOR]

The Water Poverty Index (WPI) expands the analysis of China's water crises from hydrology to a broader focus on integrated water resources management including economic and social factors. This index was revised by principal component analysis (PCA) to avoid arbitrariness of weights and collinearity between variables. However, the traditional PCA is primarily oriented for static data, and it fails to reveal the evolutionary trend of data over time. Moreover, the conventional normalization methods are not adequate when the dimension of time is added to the data. In this study, the transformation of centralized logarithm of initial variable and holistic and dynamic principal component analysis are firstly proposed, then the improved methods are applied to assess water poverty in China using panel data from 2004 to 2012. The estimated WPI shows the growing scale and the clustering trend of regional water poverty. The analysis of influential factors reveals that aquatic environmental pollution is a vital driver of water poverty. Water resource endowment is the second important factor concerning regional water poverty. Inability to adapt to water scarcity, which leads to weak physical water access and low efficiency of water use, is still a critical driver of regional water poverty. Finally, the regional disparities and alleviation strategies of water poverty are discussed. [ABSTRACT FROM AUTHOR]

To promote manufacturing transformation and upgrading, this paper proposes a comprehensive analytical framework for manufacturing development from an industrial network perspective. We explore the organizational structure of the manufacturing association network based on the industrial network analysis technique and the modern network analysis technique. A new data envelopment analysis (DEA) model, which considers the interrelated and interactive characteristics of various sectors, is used to evaluate the static and dynamic performance of manufacturing sectors combining the Malmquist productivity index (MLI). We adopt this framework to analyze the development of 18 manufacturing sectors in Hubei Province, China, during the 2012–2017 period. Key development sectors play a critical role in the stability and development of the manufacturing system, yet their performance did not show significant improvement during this timeframe. During the implementation of the Made in China 2025 strategy, most sectors followed the transformation path by enhancing technological strength first and technological application capabilities later. The manufacturing industry in Hubei Province suffers from insufficient informatization construction and slow productivity improvement. • A new DEA model that considers the interrelated and interactive characteristics of sectors is proposed. • A comprehensive analysis framework is proposed from an industrial network perspective. • Our analytical framework can depict the manufacturing state in the dimensions of structure and benefits. • The manufacturing structure, transformation path, and performance evolution are analyzed. • We explore the transformation paths of manufacturing sectors during the implementation of the Made in China 2025 plan. [ABSTRACT FROM AUTHOR]

DNA methylation (DNAm) plays a significant role in deleterious health effects inflicted by fine particulate matter (PM 2.5) on the human body. Recent studies have reported that DNAm of imprinted control regions (ICRs) in imprinted genes may be a sensitive biomarker of environmental exposure. Less is known about specific biomarkers of imprinted genes after PM 2.5 exposure. The relationship between PM 2.5 and its chemical constituents and DNAm of ICRs in imprinted genes after short-term exposure was investigated to determine specific human biomarkers of its adverse health effects. A panel study was carried out in healthy young people in Guangzhou, China. Mixed-effects models were used to evaluate the influence of PM 2.5 and its constituent exposure on DNAm while controlling for potential confounders. There was no significant correlation between DNAm and personal PM 2.5 exposure mass. DNAm changes in eight ICRs (L3MBTL1 , NNAT , PEG10 , GNAS Ex1A , MCTS2 , SNURF / SNRPN , IGF2R , and RB1) and a non-imprinted gene (CYP1B1) were significantly associated with PM 2.5 constituents. Compared to non-imprinted genes, imprinted gene methylation was more susceptible to interference with PM 2.5 constituent exposure. Among those genes, L3MBTL1 was the most sensitive to personal PM 2.5 constituent exposure. Moreover, transition metals derived from traffic sources (Cd, Fe, Mn, and Ni) significantly influenced DNAm of the imprinted genes, suggesting the importance of more targeted measures to reduce toxic constituents. Bioinformatics analysis indicated that imprinted genes (RB1) may be correlated with pathways and diseases (non-small cell lung cancer, glioma, and bladder cancer). The present study suggests that screening the imprinted gene for DNAm can be used as a sensitive biomarker of PM 2.5 exposure. The results will provide data for prevention of PM 2.5 exposure and a novel perspective on potential mechanisms on an epigenetic level. Image 1 • Imprinted gene methylation is more susceptible to interference from constituents. • L3MBTL1 is the most sensitive to personal PM 2.5 constituent exposure. • Study findings provide novel data for prevention of PM 2.5 exposure. Screening imprinted gene for DNAm can be used as a sensitive biomarker of PM 2.5 exposure. [ABSTRACT FROM AUTHOR]

Parabens are added into foodstuffs, pharmaceuticals and personal care products (PCPs) as additives extensively due to their excellent antiseptic and antibacterial effects. In the past decade, parabens have raised great concerns on their potential harm to humans. Existing studies have suggested positive correlations between PCP application and urinary paraben concentrations in females, but little is known about paraben exposure levels and health risks arising from PCP use. In this study, 150 PCP samples covering eleven categories were collected from South China and measured for the concentrations of five parabens, including methyl paraben (MeP), ethyl paraben (EtP), propyl paraben (PrP), butyl paraben (BuP) and benzyl paraben (BeP). Parabens were widely detected in PCPs, with a detection frequency of 100%, 99.3%, 80.0%, 74.0% and 13.3%, for MeP, EtP, PrP, BuP and BeP, respectively. The median concentration of Σ 5 parabens was 126 μg/g with a range of 6.38–424 μg/g across all PCP samples. The contents of MeP, EtP and PrP measured in leave-on PCPs were obviously higher than those in the rinse-off ones (p < 0.05). MeP and PrP were the main paraben analogues, together accounting for 93.6% of Σ 5 parabens in all PCPs. The daily intakes of parabens through dermal absorption by Chinese adult females estimated by measurements obtained in the present study were 0.15 and 83.2 μg/kg-bw/day on basis of the application of rinse-off and leave-on PCPs, respectively. Among the eleven categories, sunscreen, body lotion and mask constituted the main exposure sources of parabens to females. The hazard quotients of parabens were far less than 1, indicating no considerable health risk for Chinese adult females. Image 1 • The levels of parabens in leave-on PCPs were significantly higher than those in rinse-off ones. • MeP and PrP were the most important paraben analogues. • Sunscreen, body lotion and mask constituted the main exposure sources of parabens to females. • Chinese adult females were subjected to very low health risk from PCP-containing parabens. Capsule: Leave-on PCPs, especially sunscreen, body lotion, and mask, constituted the main sources of paraben exposure via dermal contact for Chinese adult females. [ABSTRACT FROM AUTHOR]

Shellfish constitute an important component of human diet, especially for those living in coastal regions. Shellfish have attracted extensive attention due to high enrichment of heavy metals. The aims of this study were to investigate the levels of trace elements in shellfish from coastal waters of Shenzhen, China and to assess human intake risks. Nine elements, including chromium (Cr), copper (Cu), iron (Fe), zinc (Zn), manganese (Mn), selenium (Se), cadmium (Cd), arsenic (As) and lead (Pb) were measured in 216 shellfish samples from eight species. Their concentrations (based on wet weight) were: Cr (0.28–21.4 mg kg−1), Cu (1.40–158 mg kg−1), Fe (16.5–5387 mg kg−1), Zn (11.1–847 mg kg−1), Mn (1.33–422 mg kg−1), Se (0.15–11.8 mg kg−1), Cd (0.02–18.4 mg kg−1), Pb (−1) and As (2.24–95.5 mg kg−1), relatively greater than those reported in shellfish from other locations of China. Crassostrea ariakensis and Babylonia areolata were found to enrich As and Cd, respectively. The target hazard quotient (THQ) values of Cd and As were more than 1, suggesting considerable health risks from the consumption of shellfish of this zone. To our knowledge, this is the first study to assess the human risk exposure to trace elements via shellfish consumption in South China. Image 1 • High levels of some elements in shellfish from coastal waters of Shenzhen China were found. • Crassostrea ariakensis and Babylonia areolata were found to enrich As and Cd, respectively. • Residents in Shenzhen were subjected to considerable health risks of As and Cd via shellfish consumption. Residents in Shenzhen, China have been subjected to considerable health risks of As and Cd via shellfish consumption. [ABSTRACT FROM AUTHOR]

Previous epidemiological and experimental studies have shown that legacy perfluoroalkyl acids (PFAAs) are immunotoxic. However, whether the immunosuppressive effects in PFAA alternatives which recently have been widely detected in the environment are unknown. To address this knowledge gap, we investigated the relationship of serum legacy PFAAs and PFAA alternatives with the antibody of hepatitis B virus in adults. We recruited 605 participants from a cross-sectional study, the Isomer of C8 Health Project in China. We measured two representative legacy PFAAs (perfluorooctane sulfonate, PFOS and perfluorooctanoic acid, PFOA), and three PFAA alternatives (two chlorinated polyfluorinated ether sulfonic acids, Cl-PFESAs and perfluorobutanoic acid, PFBA) in serum using ultra-performance liquid chromatograph-tandem mass spectrometry (UPLC-MS/MS). We applied linear and logistic regression models to analyze associations between serum PFAAs and hepatitis B surface antibody (HBsAb) with multivariable adjustments. We found negative associations between serum PFAAs concentrations and HBsAb. Lower serum HBsAb levels (log mIU/mL) were observed for each log-unit increase in linear PFOS (β = −0.31, 95% confidential interval: 0.84, −0.18), 6:2 PFESA (β = −0.81, 95% CI: 1.20, −0.42), 8:2 PFESA (β = −0.29, 95% CI: 0.43, −0.14) and PFBA (β = −0.18, 95% CI: 0.28, −0.08). The association between PFAAs and HBsAb seronegative seemed to be higher for 6:2 PFESA (odds ratio = 3.32, 95% CI: 2.16, 5.10) than its predecessors, linear PFOS (OR = 1.96, 95% CI: 1.37, 2.81) and branched PFOS isomers (OR = 1.64, 95% CI: 1.05, 2.56). We report new evidence that exposure to PFAA alternatives are associated with lower HBsAb in adults. This association seems to be stronger in 6:2 PFESA than PFOS. Our results suggest that more studies are needed to clarify the potential toxicity of PFAA alternatives in human which will facilitate better chemical regulations for PFAAs. Image 1 • Legacy perfluoroalkyl acids and PFAA alternatives were widely detected in serum. • Higher serum PFAAs were associated with lower hepatitis B virus antibody levels. • The observed association was stronger for a chlorinated PFAA alternative. [ABSTRACT FROM AUTHOR]

Parabens are extensively applied in cosmetics, drugs or food as preservatives and have become common pollutants in environmental media. However, data on human exposure to these chemicals is still limited, especially for children. This study aimed to investigate parabens in urine samples of children and to evaluate the cumulative risk of paraben exposure. Five short-chain parabens were measured in 255 urine samples collected from children in a kindergarten and elementary schools from South China. Methyl paraben (MeP), ethyl paraben (EtP) and n-propyl paraben (PrP) were widely detected in urine samples (detection rates > 94.9%), indicating their widespread exposure. The urinary median concentrations of MeP, EtP and PrP were 2.25, 0.33 and 0.50 μg/L, respectively. Significantly positive correlations (p < 0.01) were observed between MeP and PrP in urine, suggesting similar sources and/or metabolic pathways of these two chemicals. The median estimated daily intakes (EDIs) of parabens were determined to be 18.1 and 9.79 μg/kg-bw/day for kindergarten children and elementary school students, respectively. Estimation of human intake and exposure risks indicated potential risks of PrP exposure for elementary school students. This is the first study addressing paraben exposure in South China children. Image 1 • Children in South China are widespread exposed to parabens. • Significantly positive associations were observed between urinary methyl and n-propyl parabens. • Elementary school students were subjected to potential risks of n-propyl paraben exposure. Estimation of human intake and exposure risks indicated potential risks of n -propyl paraben exposure for elementary school students in South China. [ABSTRACT FROM AUTHOR]

Background: Residing in greener places may be protective against diabetes mellitus (DM) but evidence is scarce and comes mainly from developed countries.Objectives: To investigate associations of residential greenness with DM prevalence and glucose-homeostasis markers in Chinese adults and whether these associations were mediated by air pollution, physical activity, and body mass index.Methods: In 2009, a total of 15,477 adults from the cross-sectional 33 Communities Chinese Health Study provided blood samples and completed a questionnaire. We considered fasting and 2-h glucose and insulin concentrations, as well as the homoeostasis model assessment of insulin resistance and β-cell function, as glucose-homeostasis markers. DM was defined according to the American Diabetes Association's recommendations. Residential greenness was estimated by two satellite-derived vegetation indexes - Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI). Nitrogen dioxide and particulate matter ≤2.5 μm were used as air pollution proxies. Associations were assessed by two-level adjusted logistic and linear regression models.Results: A 0.1-unit increase in NDVI500 m and SAVI500 m was significantly associated with lower odds of DM by factors of 0.88 (95% Confidence Interval 0.82-0.94) and 0.80 (0.72-0.90), respectively. Higher greenness was also significantly associated with lower fasting and 2-h glucose levels, 2-h insulin level, as well as lower insulin resistance and higher β-cell function. Air pollution and body mass index significantly mediated 6.9-51.1% and 8.6-78.7% these associations, respectively, while no mediation role was observed for physical activity.Conclusions: Higher residential greenness appears to be associated with a lower prevalence of DM. This association might be due to glucose and insulin metabolism and pancreatic β-cell function. Lower levels of air pollution and body mass index can be pathways linking greenspace to diabetes. [ABSTRACT FROM AUTHOR]

Little evidence exists about the effects of long-term exposure to ambient air pollution on metabolic syndrome (MetS). This study aimed to determine the association between long-term ambient air pollution and MetS in China. A total of 15,477 adults who participated in the 33 Communities Chinese Health Study (33CCHS) in 2009 were evaluated. MetS was defined based on the recommendation by the Joint Interim Societies. Exposure to air pollutants was assessed using data from monitoring stations and a spatial statistical model (including particles with diameters ≤ 1.0 µm (PM 1 ), ≤ 2.5 µm (PM 2.5 ), and ≤ 10 µm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), and ozone (O 3 )). Two-level logistic regression analyses were utilized to assess the associations between air pollutants and MetS. The prevalence of MetS was 30.37%. The adjusted odds ratio of MetS per 10 µg/m 3 increase in PM 1 , PM 2.5 , PM 10 , SO 2 , NO 2 , and O 3 were 1.12 (95% CI = 1.00–1.24), 1.09 (95% CI = 1.00–1.18), 1.13 (95% CI = 1.08–1.19), 1.10 (95% CI = 1.02–1.18), 1.33 (95% CI = 1.12–1.57), and 1.10 (95% CI = 1.01–1.18), respectively. Stratified analyses indicated that the above associations were stronger in participants with the demographic variables of males, < 50 years of age, and higher income, as well as with the behavioral characteristics of smoking, drinking, and consuming sugar-sweetened soft drinks frequently. This study indicates that long-term exposure to ambient air pollutants may increase the risk of MetS, especially among males, the young to middle aged, those of low income, and those with unhealthy lifestyles. [ABSTRACT FROM AUTHOR]

Improving eco-efficiency is an important way to promote environmental decoupling. Based on the input-output model and data envelopment analysis (DEA), this paper evaluates the eco-efficiency of 44 sectors in China with a new DEA model considering inter-sectoral linkages, then explores how the industrial network would be optimized as inefficient sectors become efficient under constant resources supply and constant final demand. The empirical results indicate that 22 sectors are inefficient and deserve further improvement. Inefficient sectors becoming efficient will drive the industrial network to evolve in a more intensive direction, and allow the economy to achieve greater economic benefits with less energy consumption and pollution. Accounting under constant resources supply suggests that increasing external demand should be a key to promoting environmental decoupling in the economy. Accounting under constant final demand indicates more stringent environmental regulations should be used to drive technology upgrades. • A new eco-efficiency measurement combining the input-output model and DEA is built. • The eco-efficiency and potential deficiencies of 44 sectors in China are evaluated. • The impact of inefficient sectors becoming efficient on the economy is measured. • The industrial network presents significant potential for environmental decoupling. • Key constraints to environmental decoupling in the industrial network are identified. [ABSTRACT FROM AUTHOR]

Familial Alzheimer's disease (AD) is a rare disease caused by autosomal-dominant mutations. APP (encoding amyloid precursor protein), PSEN1 (encoding presenilin 1), and PSEN2 (encoding presenilin 2) are the most common genes cause dominant inherited AD. This study aimed to demonstrate a Chinese early-onset AD pedigree presenting as progressive memory impairment, apraxia, visual-spatial disorders, psychobehavioral disorders, and personality changes with a novel APP gene mutation. The family contains four patients, three carries and three normal family members. The proband underwent brain magnetic resonance imaging (MRI), 18 F-fludeoxyglucose positron emission tomography ( 18 F-FDG-PET), cerebrospinal fluid amyloid detection, 18 F-florbetapir (AV-45) Positron Emission Computed Tomography (PET) imaging, whole-exome sequencing and Sanger sequencing. Brain MRI images showed brain atrophy, especially in the entorhinal cortex, temporal hippocampus, and lateral ventricle dilation. The FDG-PET showed hypometabolism in the frontotemporal, parietal, and hippocampal regions. 18 F-florbetapir (AV-45) PET imaging showed cerebral cortex Aβ protein deposition. The cerebrospinal fluid amyloid protein test showed Aβ42/Aβ40 ratio decreases, pathological phosphor-tau level increases. Whole-exome sequencing detected a new missense mutation of codon 671 (M671L), which was a heterozygous A to T point mutation at position 2011 (c.2011A > T) in exon 16 of the amyloid precursor protein, resulting in the replacement of methionine to Leucine. The co-separation analysis was validated in this family. The mutation was found in 3 patients, 3 clinical normal members in the family, but not in the other 3 unaffected family members, 100 unrelated normal subjects, or 100 sporadic patients with AD. This mutation was probably pathogenic and novel in a Chinese Han family with early-onset AD., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The ingestion of contaminated tea involves the risk of human exposure to residues of neonicotinoids (NEOs). Nevertheless, there is little empirical research about this topic; to bridge the current knowledge gap, we collected 220 samples of various tea products from four geographical areas in China, including unfermented green tea, semi-fermented white tea and oolong tea, completely fermented black tea, and post-fermented dark tea. A total of six NEOs were detected from the tea leaves and infusions, namely, dinotefuran (DIN), thiamethoxam (THM), clothianidin (CLO), imidacloprid (IMI), acetamiprid (ACE), and thiacloprid (THI). The detection frequencies (DFs) and concentrations of all target NEOs were relatively high across the investigated tea samples, and the DIN, IMI and ACE residues measured in some samples exceeded the maximum residue level (MRL) standards for the European Union. Samples representing the Jiangnan area exhibited greater levels of total target NEOs (∑ 6 NEOs) than samples representing the Jiangbei area (p < 0.001). Moreover, dark tea samples were found to have far higher levels of NEO residues than green (p < 0.001), white (p < 0.05), or oolong (p < 0.001) samples. The health risks associated with exposure to NEO residues via tea were small for both children and adults in terms of acute, chronic, and cumulative dietary exposure risk assessments. The transfer rates (TRs) of NEOs observed in white, black, and dark tea infusions gradually decreased after the third brewing time. As such, it is recommended to only consume tea that has been brewed at least three times. The presented results not only describe the extent of NEO contamination in Chinese tea leaves and infusions, but also provide tea drinking guidelines for consumers., 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: It is critical to incorporate residents' preferences into the design of long-term care insurance (LTCI). However, little is known about middle-aged and elderly residents' preferences for personalized need-related attributes of LTCI in China. Through a discrete choice experiment (DCE), we aimed to focus on the direct beneficiaries of LTCI and then elicit their preferences for LTCI under a hypothetical scenario of dysfunction., Methods: Attributes and levels were defined through a literature review and two rounds of expert consultations ( n = 8). A D-optimal fractional factorial design was used to generate the DCE questionnaire. Face-to-face interviews with middle-aged and elderly residents were conducted in two cities in Hubei Province, China, between November and December 2020. A mixed logit model was utilized for estimation., Results: Five attributes were identified and incorporated into the DCE questionnaire. A total of 390 participants completed DCE questionnaires. Care facilities, care content, reimbursement rate, caregivers, and annual premium per person all had a significant impact on residents' preferences. Residents had significantly higher preferences for the LTCI scheme with home and community-based care centers (β = 1.40, p < 0.01), multi-level services (β = 0.44, p < 0.01), 90% reimbursement rate (β = 0.37, p < 0.01), and sufficiently trained caregivers (β = 0.26, p < 0.01). Individual characteristics, such as gender, employment, and education level were the factors that drove heterogeneity in preferences for LTCI., Conclusion: This study provides new evidence on the preferences of middle-aged and elderly residents for personalized need-related public LTCI features. The design of the LTCI scheme in China needs to take these findings into account to maximize the utility for direct beneficiaries of LTCI and enhance their enrollment., 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 Ma, Jia, Ma, Pan, Jiang and Xiong.)

Identifying key drivers of manufacturing CO 2 emissions is critical to carbon reduction practices. For manufacturing, CO 2 emissions are mainly determined by production capacity and production scale. However, traditional production-theoretical decomposition analysis (PDA) fails to consider production-scale-related drivers. To better support policy development and implementation, this paper improves PDA based on industrial linkage theory. The improved model can identify seven production-capacity-related drivers and five production-scale-related drivers, allowing a comprehensive understanding of CO 2 emission drivers. Then this model is implemented to investigate CO 2 emission changes in 18 manufacturing sectors in Hubei Province, China, from 2012 to 2017. Results show that manufacturing CO 2 reduction efforts in Hubei Province have yielded some achievements, with reduced potential energy intensity and improved CO 2 emission technical efficiency in most sectors. Changes in external market demand and final demand structure have contributed to CO 2 reduction in most sectors. Results also reveal some problems in manufacturing in Hubei Province, such as the inability to improve CO 2 emission technical efficiency and CO 2 emission technology strength, the slow improvement of energy utilization technical efficiency and energy utilization technology strength, and the reduction of value-added rate., 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 Ltd. All rights reserved.)

DNA methylation (DNAm) plays a significant role in deleterious health effects inflicted by fine particulate matter (PM 2.5 ) on the human body. Recent studies have reported that DNAm of imprinted control regions (ICRs) in imprinted genes may be a sensitive biomarker of environmental exposure. Less is known about specific biomarkers of imprinted genes after PM 2.5 exposure. The relationship between PM 2.5 and its chemical constituents and DNAm of ICRs in imprinted genes after short-term exposure was investigated to determine specific human biomarkers of its adverse health effects. A panel study was carried out in healthy young people in Guangzhou, China. Mixed-effects models were used to evaluate the influence of PM 2.5 and its constituent exposure on DNAm while controlling for potential confounders. There was no significant correlation between DNAm and personal PM 2.5 exposure mass. DNAm changes in eight ICRs (L3MBTL1, NNAT, PEG10, GNAS Ex1A, MCTS2, SNURF/SNRPN, IGF2R, and RB1) and a non-imprinted gene (CYP1B1) were significantly associated with PM 2.5 constituents. Compared to non-imprinted genes, imprinted gene methylation was more susceptible to interference with PM 2.5 constituent exposure. Among those genes, L3MBTL1 was the most sensitive to personal PM 2.5 constituent exposure. Moreover, transition metals derived from traffic sources (Cd, Fe, Mn, and Ni) significantly influenced DNAm of the imprinted genes, suggesting the importance of more targeted measures to reduce toxic constituents. Bioinformatics analysis indicated that imprinted genes (RB1) may be correlated with pathways and diseases (non-small cell lung cancer, glioma, and bladder cancer). The present study suggests that screening the imprinted gene for DNAm can be used as a sensitive biomarker of PM 2.5 exposure. The results will provide data for prevention of PM 2.5 exposure and a novel perspective on potential mechanisms on an epigenetic level., Competing Interests: Declaration of competing interest The authors declare they have no actual or potential competing financial interests., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Although lead associated with intelligence decline in children has long been reported, studies combining intelligence determination, molecular mechanisms exploration, and biomarker screen are quite rare. In this study, based on 333 children aged 9-11, we determined the role of DNA methylation (DNAm) in the relationship of lead exposure with children's intelligence. DNAm was measured from children's blood DNA specimens, and mediation analysis was performed to identify DNAm biomarkers mediating the lead-intelligence relationship. We identified forty-three differentially methylated regions (DMRs), and two fragments ( FAM50B1 and PTCHD3 ) significantly mediated the lead-intelligence relationship, with contribution rates of 30.36% ( p = 0.010) and 60.36% ( p < 0.001), respectively. In addition, blood lead levels (BLLs) lower than 100 μg/L still adversely affected children's IQs and DNAm of the two fragments. Our data suggests that DNAm mediates lead-associated cognitive delay in children and blood lead reference value for school-aged children (100 μg/L) should be revised, and the candidate biomarkers can be used in related neurological diseases in future.

Chemical mixtures are a common occurrence in contaminated sediment and determining causal relationship between sediment contamination and adverse outcomes is challenging. The bioavailability and choice of bioassay endpoints played important roles in elucidating causality. As such, bioaccessibility-based XAD extraction and adverse outcome pathway (AOP) guided bioassays were incorporated into an effect-directed analysis to more effectively determine sediment causality. XAD extracts of sediments from urban waterways in Guangzhou, China were examined using cell viability bioassays with four human tumor cells from lung, liver, breast, and bone marrow. Pronounced effects to SH-SY5Y cells were noted, thus neurotoxicity was subsequently focused in the AOP-guided bioassays. Intracellular calcium influx, mitochondrial membrane potential inhibition, reactive oxygen species generation, and cell viability were utilized as evidence for neurotoxicity AOP-guided analysis. Suspect toxicants were identified in active fractions using GC-MS. Toxicity confirmation was performed by evaluating toxicity contributions of the candidates to the pathway. Cypermethrin, bisphenol A, galaxolide, tonalide, and versalide were found as the major stressors across key events of the studied pathway. Moreover, good correlations among key events validated the feasibility of method to predict in vivo response, suggesting that considering bioavailability and AOP improved environmental relevance for toxicant identification in a complex mixture., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Importance: Breastfeeding and exposure to ambient air pollutants have been found to be independently associated with respiratory health in children; however, previous studies have not examined the association of breastfeeding as a potential moderator of the association., Objective: To assess associations of breastfeeding and air pollution with lung function in children., Design, Setting, and Participants: Using a cross-sectional study design, children were recruited from 62 elementary and middle schools located in 7 Chinese cities from April 1, 2012, to October 31, 2013. Data analyses were conducted from November 1, 2018, to March 31, 2019., Exposures: Long-term concentrations of airborne particulate matter with a diameter of 1 μm or less (PM1), airborne particulate matter with a diameter of 2.5 μm or less (PM2.5), airborne particulate matter with a diameter of 10 μm or less (PM10), and nitrogen dioxide were estimated using a spatial statistical model matched to children's geocoded home addresses, and concentrations of PM10, sulfur dioxide, nitrogen dioxide, and ozone were measured by local air monitoring stations., Main Outcomes and Measures: Breastfeeding was defined as maternal report of having mainly breastfed for longer than 3 months. Lung function was measured using portable electronic spirometers. Using previously published predicted spirometric values for children in Northeast China as the reference, lung impairment was defined as forced vital capacity (FVC) less than 85%, forced expiratory volume in the first second of expiration less than 85%, peak expiratory flow less than 75%, or maximum midexpiratory flow less than 75%., Results: Participants included 6740 children (mean [SD] age, 11.6 [2.1] years; 3382 boys [50.2%]). There were 4751 children (70.5%) who were breastfed. Mean (SD) particulate matter concentrations ranged from 46.8 (6.5) μg/m3 for PM1 to 95.6 (9.8) μg/m3 for PM10. The prevalence of lung function impairment ranged from 6.8% for peak expiratory flow to 11.3% for FVC. After controlling for age, sex, and other covariates, 1-interquartile range greater concentration of pollutants was associated with higher adjusted odds ratios (AORs) for lung function impairment by FVC among children who were not breastfed compared with those who were (PM1: AOR, 2.71 [95% CI, 2.02-3.63] vs 1.20 [95% CI, 0.97-1.48]; PM2.5: AOR, 2.27 [95% CI, 1.79-2.88] vs 1.26 [95% CI, 1.04-1.51]; and PM10: AOR, 1.93 [95% CI, 1.58-2.37] vs 1.46 [95% CI, 1.23-1.73]). Younger age (<12 years) was associated with lower lung function impairment among the children who had been breastfed. In children from elementary schools, 1-interquartile range greater concentration of pollutants was associated with higher AORs for lung function impairment by FVC among children who had not been breastfed compared with those who had (PM1: AOR, 6.43 [95% CI, 3.97-10.44] vs 1.89 [95% CI, 1.28-2.80]; PM2.5: AOR, 3.83 [95% CI, 2.63-5.58] vs 1.50 [95% CI, 1.12-2.01]; and PM10: AOR, 2.61 [95% CI, 1.90-3.57] vs 1.52 [95% CI, 1.19-1.95]). Results from linear regression models also showed associations of air pollution with worse lung function among children who were not breastfed compared with their counterparts who were breastfed, especially for FVC (PM1: β, -240.46 [95% CI, -288.71 to -192.21] vs -38.21 [95% CI, -69.27 to -7.16] mL) and forced expiratory volume in the first second of expiration (PM1: β, -201.37 [95% CI, -242.08 to -160.65] vs -30.30 [95% CI, -57.66 to -2.94] mL)., Conclusions and Relevance: In this study, breastfeeding was associated with lower risk of lung function impairment among children in China exposed to air pollution, particularly among younger children.

Background: Perfluoroalkyl substances (PFASs) are synthetic chemicals widely used in industry and for commercial products. Their immunomodulatory effects are a growing health concern in children. Hand, Foot and Mouth Disease (HFMD) is a common childhood viral infection, and increased incidence of which has parallel the rise in PFAS exposure in the Asia-Pacific region., Objective: We conducted the first study to assess whether prenatal exposure to PFAS was associated with a reduction in HFMD virus antibodies in infants., Methods: We enrolled 201 mother-infant pairs from the Guangzhou Birth Cohort Study from July to October 2013. High performance liquid chromatography-mass spectrometry was employed to determine concentrations of specific PFAS isomers in cord blood. Neutralizing antibodies titers were measured against two HFMD viruses, enterovirus 71 (EV71) and coxsackievirus A 16 (CA16), in cord blood serum and blood serum at three months of age., Results: Higher umbilical cord blood PFAS concentrations were associated with lower EV71 and CA16 antibody concentrations. A doubling in the composite sum of cord blood PFASs in three month old infants was associated with significant increase in the risk of HFMD antibody concentration below clinical protection level (≥1:8 titers) for CA16 (odds ratio, OR: 2.74 [95% confidence interval (CI): 1.33, 5.61] and for EV71 (OR = 4.55, 95% CI: 1.45, 4.28). This association was higher in boys at three months of age for CA16., Conclusions: Our findings suggest that cord blood PFAS exposure is associated with lower HFMD antibody in infancy. Given the widespread nature of PFAS exposures and the high global incidence of HFMD globally, these findings have substantial public health implications and therefore, these associations need to be replicated in a larger study to more definitively address the risk., (Copyright © 2019. Published by Elsevier B.V.)

Sentence comprehension relies on the abilities to rapidly integrate different types of linguistic and non-linguistic information. The present study investigated whether Mandarin-speaking preschool children with autism spectrum disorder (ASD) are able to use verb information predictively to anticipate the upcoming linguistic input during real-time sentence comprehension. 26 five-year-olds with ASD, 25 typically developing (TD) five-year-olds and 24 TD four-year-olds were tested using the visual world eye-tracking paradigm. The results showed that the 5-year-olds with ASD, like their TD peers, exhibited verb-based anticipatory eye movements during real-time sentence comprehension. No difference was observed between the ASD and TD groups in the time course of their eye gaze patterns, indicating that Mandarin-speaking preschool children with ASD are able to use verb information as effectively and rapidly as TD peers to predict the upcoming linguistic input.

No evidence exists concerning the association between blood pressure and ambient particles with aerodynamic diameter ≤ 1.0 µm (PM 1 ), a major component of PM 2.5 (≤ 2.5 µm) particles, and potentially causing more hazardous health effects than PM 2.5 . We aimed to examine the associations of blood pressure in adults with both PM 1 and PM 2.5 in China. In 2009, we randomly selected 24,845 participants aged 18-74 years from 33 communities in China. Using a standardized mercuric-column sphygmomanometer, we measured blood pressure. Long-term exposure (2006-08) to PM 1 and PM 2.5 were estimated using a spatial statistical model. Generalized linear mixed models were used to evaluate the associations between air pollutants and blood pressure and hypertension prevalence, controlling for multiple covariates. A 10-μg/m 3 increase in PM 1 was significantly associated with an increase of 0.57 (95% CI 0.31-0.83) mmHg in systolic blood pressure (SBP), 0.19 (95% CI 0.03-0.35) mmHg increase in diastolic blood pressure (DBP), and a 5% (OR=1.05; 95% CI 1.01-1.10) increase in odds for hypertension. Similar associations were detected for PM 2.5 . Furthermore, PM 1-2.5 showed no association with blood pressure or hypertension. In summary, both PM 1 and PM 2.5 exposures were associated with elevated blood pressure levels and hypertension prevalence in Chinese adults. In addition, most of the pro-hypertensive effects of PM 2.5 may come from PM 1 . Further longitudinal designed studies are warranted to validate our findings., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Sentence comprehension relies on the ability to rapidly integrate different types of linguistic and non-linguistic information. However, there is currently a paucity of research exploring how preschool children with autism understand sentences using different types of cues. The mechanisms underlying sentence comprehension remains largely unclear. The present study presents a protocol to examine the sentence comprehension abilities of preschool children with autism. More specifically, a visual world paradigm of eye-tracking is used to explore the moment-to-moment sentence comprehension in the children. The paradigm has multiple advantages. First, it is sensitive to the time course of sentence comprehension and thus can provide rich information about how sentence comprehension unfolds over time. Second, it requires minimal task and communication demands, so it is ideal for testing children with autism. To further minimize the computational burden of children, the present study measures eye movements that arise as automatic responses to linguistic input rather than measuring eye movements that accompany conscious responses to spoken instructions.

Study Objectives: There is limited knowledge regarding the effects of air pollution on sleep disorders, particularly in children. The aim of this study is to investigate this association in Chinese children., Methods: During 2012-2013, 59754 children aged 2-17 years were randomly selected from 27 districts in seven northeastern Chinese cities. All participants' sleep was evaluated with the Sleep Disturbance Scale for Children. Four year average concentrations of pollutants were calculated for particles with an aerodynamic diameter of ≤1 µm (PM1), ≤2.5 µm (PM2.5) from a spatial statistical model, and ≤10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) from monitoring stations. To examine the effects, two-level regression analysis was used, controlling for covariates., Results: We observed that sleep disorder was generally associated with all air pollutants, with the highest odds among PM1 exposure for male (odds ratio [OR] 1.55; 95% confidence interval [95% CI] 1.36-1.76) and female (OR 1.50; 95% CI 1.30-1.72) children. The overall strongest association with sleep disorder symptom was exposure to PM1 and Disorders of Excessive Somnolence (OR 1.43; 95% CI 1.30-1.58). PM1 and PM2.5 were strongly associated with all sleep disorder symptoms in females (ORs ranged for PM1 from 1.19 to 1.49; and PM2.5 1.18 to 1.44). The association between air pollutants and total sleep score was generally greater in female than in male children., Conclusions: Our findings suggest that exposure to air pollutants increases the odds of sleep disorder in children and point to the need to make reducing exposure to air pollutants a public health priority.

The effect of ambient air pollution exposure on childhood hypertension has emerged as a concern in China, and previous studies suggested pet ownership is associated with lower blood pressure (BP). However, limited information exists on the interactive effects pet ownership and air pollution exposure has on hypertension. We investigated the interactions between exposure to pet ownership and air pollutants on hypertension in Chinese children. 9354 students in twenty-four elementary and middle schools (aged 5-17 years) in Northeastern China were evaluated during 2012-2013. Four-year average concentrations of particulate matter with aerodynamic diameter of ≤10 μm (PM 10 ), SO 2 , NO 2 , and O 3 , were collected in the 24 districts from 2009 to 2012. Hypertension was defined as average diastolic or systolic BP (three time measurements) in the 95th percentile or higher based on height, age, and sex. To examine effects, two-level regression analysis was used, controlling covariates. Consistent interactions between exposure to pet and air pollutants were observed. Compared to children exposed to pet, those not exposed exhibited consistently stronger effects of air pollution. The highest odds ratios (ORs) per 30.6 μg/m 3 increase in PM 10 were 1.79 (95%confidence interval [95%CI]: 1.29-2.50) in children without current pet exposure compared to 1.24 (95%CI: 0.85-1.82) in children with current pet exposure. As for BP, only O 3 had an interaction for all exposure to pet ownership types, and showed lower BP in children exposed to pet. The increases in mean diastolic BP per 46.3 μg/m 3 increase in O 3 were 0.60  mmHg (95%CI: 0.21, 0.48) in children without pet exposure in utero compared with 0.34  mmHg (95%CI: 0.21, 0.48) in their counterparts. When stratified by age, pet exposure was more protective among younger children. In conclusion, in this large population-based cohort, pet ownership is associated with smaller associations between air pollution and hypertension in children, suggesting pet ownership reduces susceptibility to the health effects of pollutants., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Research regarding the interaction of ambient air pollution and overweight on prehypertension is scarce. We aimed to test whether overweight modifies the association between long-term exposure to ambient air pollution and prehypertension in Chinese adults., Methods: A total of 16,188 Chinese adults, aged 18-74 years old, from 33 communities in 3 Northeastern Chinese cities were evaluated. Three-year average levels of particles with an aerodynamic diameter ≤ 10 μm (PM 10 ), sulfur dioxides (SO 2 ), nitrogen dioxides (NO 2 ), and ozone (O 3 ) were calculated at monitoring stations. Generalized additive models and 2-level regression analyses were applied., Results: We observed significant interactions between air pollutants and overweight on prehypertension and blood pressure. The associations of PM 10 , SO 2 , NO 2 , and O 3 with prehypertension were significant among overweight participants (Prevalence Rate Ratios (PRRs) per interquartile range (IQR) of air pollutants: 1.14-1.20), but not among normal weight participants (PRRs: 0.98-1.04). PM 10 , SO 2 , and O 3 were significantly associated with systolic blood pressure (SBP), and the magnitudes of these associations were higher among overweight adults (increases in SBP per IQR of air pollutants: 1.82-4.53 mmHg) than those among normal weight adults (increases in SBP: 0.42-0.61 mmHg). For diastolic blood pressure (DBP), significant associations were mainly observed in overweight participants (increases in DBP: 0.80-1.63 mmHg). Further stratified analyses showed that all these interactions were stronger in women, the older, and participants living in areas with lower income levels or higher population density., Conclusions: Being overweight may enhance the effects of ambient air pollution on prehypertension and blood pressure in Chinese adults.

Background: Health effects of air pollution on diabetes have been scarcely studied in developing countries. We aimed to explore the associations of long-term exposure to ambient particulate matter (PM) and gaseous pollutants with diabetes prevalence and glucose-homoeostasis markers in China., Methods: Between April 1 and Dec 31, 2009, we recruited a total of 15 477 participants aged 18-74 years using a random number generator and a four-staged, stratified and cluster sampling strategy from a large cross-sectional study (the 33 Communities Chinese Health Study) from three cities in Liaoning province, northeastern China. Fasting and 2 h insulin and glucose concentrations and the homoeostasis model assessment of insulin resistance index and β-cell function were used as glucose-homoeostasis markers. Diabetes was defined according to the American Diabetes Association's recommendations. We calculated exposure to air pollutants using data from monitoring stations (PM with an aerodynamic diameter of 10 μm or less [PM 10 ], sulphur dioxide, nitrogen dioxide, and ozone) and a spatial statistical model (PM with an aerodynamic diameter of 1 μm or less [PM 1 ] and 2·5 μm or less [PM 2·5 ]). We used two-level logistic regression and linear regression analyses to assess associations between exposure and outcomes, controlling for confounders., Findings: All the studied pollutants were significantly associated with increased diabetes prevalence (eg, the adjusted odds ratios associated with an increase in IQR for PM 1 , PM 2·5 , and PM 10 were 1·13, 95% CI 1·04-1·22; 1·14, 1·03-1·25; and 1·20, 1·12-1·28, respectively). These air pollutants were also associated with higher concentrations of fasting glucose (0·04-0·09 mmol/L), 2 h glucose (0·10-0·19 mmol/L), and 2 h insulin (0·70-2·74 μU/L). No association was observed for the remaining biomarkers. Stratified analyses indicated greater effects on the individuals who were younger (<50 years) or overweight or obese., Interpretation: Long-term exposure to air pollution was associated with increased risk of diabetes in a Chinese population, particularly in individuals who were younger or overweight or obese., Funding: The National Key Research and Development Program of China, the National Natural Science Foundation of China, the Fundamental Research Funds for the Central Universities, the Guangdong Province Natural Science Foundation, the Career Development Fellowship of Australian National Health and Medical Research Council, and the Early Career Fellowship of Australian National Health and Medical Research Council., (Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Numerous studies have evaluated the effects of long-term exposure to ambient air pollution on hypertension. However, little information exists regarding its effects on prehypertension, a very common, but understudied cardiovascular indicator. We evaluated data from 24,845 adults (ages 18-74 years) living in three Northeastern Chinese cities in 2009. Blood pressure (BP) was measured by trained observers using a standardized mercuric-column sphygmomanometer. Three-year (from 2006 to 2008) average concentrations of particles with an aerodynamic diameter ≤10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxides (NO 2 ), and ozone (O 3 ) were calculated using data from monitoring stations. Effects were analyzed using generalized additive models and two-level regression analyses, controlling for covariates. We found positive associations of all pollutants with prehypertension (e.g. odds ratio (OR) was 1.17 (95% confidence interval (CI), 1.09-1.25) per interquartile range (IQR) of PM 10 ) in a fully adjusted model, as compared to normotensive participants. These associations were stronger than associations with hypertension (e.g. OR was 1.03 (95% CI, 1.00, 1.07) per IQR of PM 10 ). We have also found positive associations of all studied pollutants with systolic and diastolic BP: e.g., associations with PM 10 per IQR were 1.24 mmHg (95% CI, 1.03-1.45) for systolic BP and 0.47 mmHg (95% CI, 0.33-0.61) for diastolic BP. Further, we observed that associations with BP were stronger in women and in older participants (systolic BP only). In conclusion, long-term exposure to ambient air pollution was more strongly associated with prehypertension than with hypertension, especially among females and the elderly. Thus, interventions to reduce air pollution are of great significance for preventing future cardiovascular events, particularly among individuals with prehypertension., (Copyright © 2017 Elsevier Ltd. All rights reserved.)