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Objectives: Ischemic stroke (IS) prevalence rising annually, the necessity of discovering non-interventional genetic influences is progressing. Single nucleotide polymorphism (SNP) plays a pivotal role in stable inheritance of disease susceptibility. Based on the relationship between Alpha- Kinase 1 (ALPK1) and traditional IS risk factors especially hyperuricemia, our study investigated the association and function of ALPK1 SNPs with IS susceptibility., Methods: A case-control study of 1539 patients and 933 controls from northeast China was conducted. Genotyping information of ALPK1 rs2074379 and rs2074388 was collected. Four types of plasmids including rs2074379/rs2074388 G/G, A/G, G/A, and A/A were transfected into 293T cells to observe ALPK1 and SLC22A12 expression. Possible ALPK1 structures of different SNPs were predicted online., Results: Genotype GG (OR = 1.371, CI = 1.029-1.828, P = 0.031) and GA (OR = 1.326, CI = 1.110-1.584, P = 0.002) of rs2074379 and GA of rs2074388 (OR = 1.359, CI = 1.137-1.624, P = 0.001) were found significantly susceptible to IS, with G allele on sites to be a risk allele. Rs2074379 had a multiplicative interaction with hyperuricemia (OR = 1.637, CI = 1.157-2.315, P = 0.005). Uric acid levels differed in genotypes (P < 0.001). The expression of ALPK1 (P < 0.01) and SLC22A12 in membrane urate transporter 1 (URAT1) protein (P < 0.05) functionally changed with G allele on either site. With glycine changing into aspartic acid at rs2074388, the protein secondary structure changed, but the ALPK1 protein subtype remained still., Conclusions: ALPK1 rs2074379 and rs2074388 SNPs were functionally associated with IS susceptibility. The wild allele progressed IS risk probably by reducing ALPK1 expression and inhibiting URAT1 raising the uric acid level, contributing to further exploration of pathogenetic mechanisms of stroke. Chinese Clinical Trial Registration number: ChiCTR-COC-17013559., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The health impact of heavy metals in atmospheric PM 2.5 has garnered increasingly widespread attention. We have collected PM 2.5 samples in a typical city (Kaifeng) within the Central Plains Urban Agglomeration in China during winter and measured the mass concentration of PM 2.5 -bound heavy metals. The pollution of As and Cr in the urban atmosphere requires significant attention. As PM 2.5 concentrations increased, the enrichment factors (EFs) of Mn, Cu, Zn, As, and Pb also rose, suggesting a growing contribution from anthropogenic emissions. The analysis showed that the hazard quotient (HQ) for the non-heating and heating periods (HQ < 1) did not result in a cumulative non-carcinogenic health risk to humans. Regarding carcinogenic effects, As and Cr exhibit significant carcinogenic impacts on both children and adults (ELCR>1 × 10 -6 ), indicating that the carcinogenic risks posed by As and Cr under PM 2.5 exposure in Kaifeng could not be overlooked. It was found that industrial and biomass combustion are the primary sources of carcinogenic risk in Kaifeng city. From the non-heating to the heating period, the industrial carcinogenic risk increased from 37.12 % to 43.39 %, while the contribution of biomass burning remained at 25 %. This result was strongly correlated with the high proportions of heavy metal elements such as As, Mn, Pb, and Ni from the metal refinery industry. The results of this study revealed the equally important source of heavy metals, compared to coal combustion in North China Plain. In addition to residential coal combustion, industrial emissions are a major source of PM 2.5 -bound heavy metals in Kaifeng, contributing significantly to overall air pollution and providing a useful reference to mitigating human health risks in the area., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Angiopoietin-like protein 4 (ANGPTL4) is recognized as a crucial regulator in lipid metabolism. Acetyl-CoA carboxylases (ACACAs) play a role in the β-oxidation of fatty acids. Yet, the functions of ANGPTL4 and ACACA in dyslipidemia of obstructive sleep apnea (OSA) remain unclear., Methods: This study included 125 male OSA subjects from the Shanghai Sleep Health Study (SSHS) who were matched for age, body mass index (BMI), and lipid profile. Serum ANGPTL4 levels were measured via ELISA. The ANGPTL4 T266M variants of 4455 subjects along with their anthropometric, fasting biochemical, and standard polysomnographic parameters were collected. Linear regression was used to analyze the associations between quantitative traits and ANGPTL4 T266M. Molecular docking and molecular dynamic simulation were employed to compare the effects of the wild-type ANGPTL4 and its T266M mutation on ACACA., Results: Serum ANGPTL4 levels significantly decreased with increasing OSA severity (non-OSA: 59.6 ± 17.4 ng/mL, mild OSA: 50.0 ± 17.5 ng/mL, moderate OSA: 46.3 ± 15.5 ng/mL, severe OSA: 19.9 ± 14.3 ng/mL, respectively, p  = 6.02 × 10 -16 ). No associations were found between T266M and clinical characteristics. Molecular docking indicated that mutant ANGTPL4 T266M had stronger binding affinity for the ACACA protein, compared with wild-type ANGPTL4. In terms of protein secondary structure, mutant ANGTPL4 T266M demonstrated greater stability than wild-type ANGPTL4., Conclusions: Serum ANGTPL4 levels were significantly decreased in OSA patients, particularly among individuals with severe OSA. Although functional ANGTPL4 T266M variants were not associated with lipid levels in OSA, ANGTPL4 T266M could enhance binding affinity for the ACACA protein, potentially regulating lipid metabolism.

Promoting good health and ensuring responsible production and consumption are essential components of the Sustainable Development Goals (SDGs) established by of the United Nations, as well as the goals of beautiful China. While the health impacts of air pollution have garnered significant attention, there remains a paucity of studies comparing the disparities in responsibility arising from production versus consumption. This paper integrates the Weather Research and Forecasting - Comprehensive Air Quality Model with Extensions (WRF-CAMx) model, the multiregional input‒output (MRIO) model, and the global exposure mortality model (GEMM) to assess the extent of PM 2.5 -related premature deaths caused by production and consumption activities in 30 Chinese provinces. The findings reveal a spatial mismatch in health burdens between production and consumption. Considering pollutant emissions and their transfer only through the supply chain leads to the finding that the net outflow of emissions from producers is mainly located in most of the northern provinces of China. However, when atmospheric transport and health impacts are included, the producing provinces are mainly located in central China, while the consuming provinces are located in the southeastern coastal and remote western and northern regions. Additionally, the long-range impact of consumption provinces with respect to the health burden is more than twice as large as that of production provinces, and its potential impact on the health burden cannot be ignored. From a sectoral perspective, production emissions from the non-electricity industry and services sectors contribute to 60% of the health burden, while their consumption emissions contribute to over 80% of the health burden. Furthermore, consumption activities in the non-electricity industry and services sectors significantly influence production emissions in the transport, agriculture, and electricity sectors. The geographical separation of consumption and production regions facilitated by trade is a critical yet often overlooked aspect in current regional air quality planning in China. A more comprehensive analysis of life-cycle emissions driven by final consumption could yield greater reductions compared to direct production reductions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Psychological health is crucial for the physical and mental well-being of primary and secondary school students, however, the research on the interrelationships among negative emotions is still limited. This study aims to investigate the network structure of depression, anxiety, and stress, and explore their correlation with screen time in these populations., Method: This study was conducted from March to July 2022 in 157 counties across 18 cities in Henan Province. The Depression Anxiety Stress Scale (DASS-21) was used to assess the negative emotions experienced by students. Firstly, "Expected Influence" and "Bridge Expected Influence" were considered as key indicators within the symptom network to depict the structure of depressive, anxiety and stress symptoms. Secondly. a case-dropping bootstrap procedure was applied to assess the stability of the network. Finally, this study identified the central and bridge symptoms in the network, and explored their relationships with screen time., Results: The study included 52,782 students with an average age of 11.23±2.56 years. Network analysis showed that feelings of worthlessness, panic, and agitation are the predominant symptoms in the negative emotional networks. Depression, anxiety, and stress were interconnected through feelings of low mood, overreaction, and trembling. Additionally, lack of initiative and dry mouth exhibited the most significant direct associations with screen time., Conclusion: The central and bridge symptoms identified in the negative emotion networks can serve as potential focal points for future research on negative emotions among primary and secondary school students., Competing Interests: Declaration of competing interest All authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: To understand the medication preference of type 2 diabetes mellitus (T2DM) patients with different insurance coverages, and to provide reference for improving the patient-centered clinical treatment decision., Methods: This study used Discrete Choice Experiment (DCE) to elicit preferences of T2DM patients with different insurance coverages in China. A multistage stratified cluster-sampling procedure for data collection and a total of 1,409 valid respondent were conducted., Results: Seven attributes have significant influence on the preference of T2DM patients with Urban Employee Basic Medical Insurance (UEBMI) and Urban and Rural Residents Basic Medical Insurance (URRBMI) ( p  < 0.05). T2DM patients with UEBMI pay the most attention to Gastrointestinal adverse events, while T2DM patients with URRBMI pay the most attention to the Treatment efficacy/reduction in HbA1c. Patients with different medical insurance have different willingness to pay for Cardiovascular benefits, Mode of administration and Weight change. When Gastrointestinal adverse events is changed from higher (40%) to none (0%), patients with UEBMI are willing to pay ¥523.49 more per month, while patients with URRBMI are only willing to pay ¥266.62; When the Treatment efficacy/reduction in HbA1c changes from poor (0.5%) to Highest (2.5%), patients with UEBMI are willing to pay ¥518.44 more per month, while patients with URRBMI are willing to pay ¥328.33 more per month. The Gastrointestinal adverse events and the Treatment efficacy/reduction in HbA1c are the primary factors for T2DM patients with UEBMI and URRBMI, followed by the Hypoglycemic risk., Conclusion: Physicians should consider patients' medication preferences in clinical medication treatment of T2DM patients with different insurance coverages, make targeted treatment decisions, and improve patients' medication compliance to achieve better treatment results., 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 © 2024 Zheng, Liu, Liu, Cao, Xue, Chen and Liu.)

Background: Dengue, a mosquito-borne viral disease, has occurred in many cities in China, and it tends to spread to higher latitudes (Huang et al., 2023). Xi'an, situated in central-west China, has witnessed an increase imported cases in the past few years, raising concerns of local dengue transmission. It is crucial to investigate the population density of Aedes albopictus and its insecticides resistance to enhance early warning of dengue fever., Methods: Eight sampling sites in eight counties (YT, BL, WY, CH, YL, LN, LT, ZZ) of Xi'an city were surveyed by larval dipping and human-baited double net trap biweekly from June 2021 to September 2022. The Breteau Index (BI, number of positive containers per 100 houses) and Container Index (CI, the percentage of containers containing larvae or pupae) were used to assess larval density, and the human-baited double net trap (HDN, the number of Ae. albopictus females collected per person per hour) to indicate human bating rate (HBR). Meanwhile, the association between the meteorological factors and mosquito density was analyzed. The Ae. albopictus adult insecticides resistance was evaluated by the World Health Organization (WHO) standard resistance bioassay. Adult females were exposed to insecticide-impregnated paper for 1 h, then transferred to the recovery tube, and mortality rate was calculated after 24 h. According to the Implementation Plan for National Vector Surveillance (2016), resistance status was classified into three levels based on mortality: <80% mortality as resistant, between 80% and 98% mortality as possibly resistant, and >98% mortality as sensitive., Results: From June 2021 to September 2022, a total of 1,065 houses were surveyed for water holding containers, and 99 of 430 water holding containers were checked to be positive for Ae. albopictus larvae and pupae. A total of 1,048 Ae. albopictus females were collected. The average BI, CI and HBR were 10.39, 21.41, and 11.20 female/man/hour in 2021 and 8.86, 20.86, and 11.63 f/m/h in 2022, respectively. The findings showed that the BI exceeded 5 in most months and reached above 20 in specific months. The CI varied in different months and monitoring sites, with the highest CI in August 2021 and July 2022. The discarded tires had the highest positivity rate, with up to 40.32% testing positive for Ae. albopictus larvae. The monthly average temperature showed a positive correlation with CI ( r = 0.77), and the monthly BI was positively associated with CI ( r = 0.93). The BI, CI, and HBR were significantly higher in the rainy season than other seasons. The bioassay results showed that the mortality rate of Ae. albopictus at the YT monitoring site was 76.92%, indicating resistance to deltamethrin. The mortality rate of Ae. Albopictus at BL, WY, CH, YL, LN, LT, and ZZ sampling sites were varying from 81.25%∼100%, suggesting possibly resistant or still sensitive to beta-cypermethrin, alpha-cypermethrin, malathion, chlorpyrifos, and propoxur., Competing Interests: The authors declare there are no competing interests., (©2024 Lei et al.)

Objective: This study employed a randomized controlled trial to assess the efficacy of virtual-reality (VR) simulators and physical model simulators on colonoscopy training to explore the optimal and evidence-based simulation training., Design: Forty participants were divided into 2 groups and randomized as dyads: the VR simulator group and the physical model simulator group. All the participants performed a baseline test through porcine colonoscopy. After a 6 h simulation training, each participant underwent a post-test on a pig after bowel preparation, and the procedures were video-recorded. Both the baseline test and the post-test were blindly assessed by 2 experienced assistant director physicians based on the GAGES-C scoring system., Setting: Simulation center, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai., Participants: Forty surgical residents without colonoscopy experience., Results: Both the VR simulator group and the physical model simulator group improved significantly over the baseline test. The VR simulator group performed significantly better than the physical model simulator group, p=0.042. The participants in both groups expressed a high level of simulator satisfaction., Conclusions: Novice residents can benefit from both VR simulators and physical model simulators. The VR simulator was shown to be more effective for colonoscopy training. VR simulators were more recommended for novices conducting basic colonoscopy training., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: Cancer screening aims to detect and treat malignant lesions at an early stage and to prolong patients' lifetime. There is still a lack of effective cancer screening programs in China. We initiated a screening project in 2018 and this study presented the cancer screening status in China., Methods: We conducted a cross-sectional study in one cancer-care medical center of China. The screening program included routine blood tests, plasma tumor markers, gastric endoscopy, colonoscopy, ultrasound, and computed tomography (CT) scans. Screening results were presented as sensitivity, specificity and positive predictive values (PPVs)., Results: Twenty-three (1.46%) out of 1,576 participants were eventually diagnosed with malignant tumors or high-grade intraepithelial neoplasia (HGIN). A family history of malignancy (78.26% in diagnosed cancer and HGIN vs . 46.36% in the others) was the only statistically significant parameter associated with cancer detection ( p = 0.002). None of the common tumor markers were associated with the cancers screened. Except for colonoscopy (50.00%) and ultrasound for renal cancer (66.67%), the sensitivities of most screening methods were 100%. The specificities of all the screening means were above 96%. Most PPVs ranged from 30-60%., Conclusion: We emphasized risk stratification for early cancer screening, such as a family history of cancer. The survey illustrated that gastric endoscopy, colonoscopy, ultrasound, and lung CT for early cancer screening had high specificity, reasonable sensitivity, and PPV. We anticipated this report would motivate larger-sample studies to estimate the risk-to-benefit ratio of cancer screening and urge the establishment of a native Chinese screening project and even guidelines., Competing Interests: The authors declare that they have no competing interests., (© 2024 Yang et al.)

Background: In 2022, our team launched the pioneering national proficiency testing (PT) scheme for the pathological diagnosis of breast cancer, rapidly establishing its credibility throughout China. Aiming to continuously monitor and improve the proficiency of Chinese pathologists in breast pathology, the second round of the PT scheme was initiated in 2023, which will expand the number of participating institutions, and will conduct a nationwide investigation into the interpretation of HER2 0, 1+, and 2+/FISH- categories in China., Methods: The methodology employed in the current round of PT scheme closely mirrors that of the preceding cycle in 2022, which is designed and implemented according to the "Conformity assessment-General requirements for proficiency testing"(GB/T27043-2012/ISO/IEC 17043:2010). More importantly, we utilized a statistics-based method to generate assigned values to enhance their robustness and credibility., Results: The final PT results, published on the website of the National Quality Control Center for Cancer ( http://117.133.40.88:3927 ), showed that all participants passed the testing. However, a few institutions demonstrated systemic biases in scoring HER2 0, 1+, and 2+/FISH- with accuracy levels below 59%, considered unsatisfactory. Especially, the concordance rate for HER2 0 cases was only 78.1%, indicating challenges in distinguishing HER2 0 from low HER2 expression. Meanwhile, areas for histologic type and grade interpretation improvement were also noted., Conclusions: Our PT scheme demonstrated high proficiency in diagnosing breast cancer in China. But it also identified systemic biases in scoring HER2 0, 1+, and 2+/FISH- at some institutions. More importantly, our study highlighted challenges in the evaluation at the extreme lower end of the HER2 staining spectrum, a crucial area for further research. Meanwhile, it also revealed the need for improvements in interpreting histologic types and grades. These findings strengthened the importance of robust quality assurance mechanisms, like the nationwide PT scheme conducted in this study, to maintain high diagnostic standards and identify areas requiring further training and enhancement., (© 2024. The Author(s).)

China is confronting the dual challenges of air pollution and climate change, mandating the co-control of air pollutants and CO 2 emissions from their shared sources. Here we identify key sources for co-control that prioritize the mitigation of PM 2.5 -related health burdens, given the homogeneous impacts of CO 2 emissions from various sources. By applying an integrated analysis framework that consists of a detailed emission inventory, a chemical transport model, a multisource fused dataset, and epidemiological concentration-response functions, we systematically evaluate the contribution of emissions from 390 sources (30 provinces and 13 socioeconomic sectors) to PM 2.5 -related health impacts and CO 2 emissions, as well as the marginal health benefits of CO 2 abatement across China. The estimated source-specific contributions exhibit substantial disparities, with the marginal benefits varying by 3 orders of magnitude. The rural residential, transportation, metal, and power and heating sectors emerge as pivotal sources for co-control, with regard to their relatively large marginal benefits or the sectoral total benefits. In addition, populous and heavily industrialized provinces such as Shandong and Henan are identified as the key regions for co-control. Our study highlights the significance of incorporating health benefits into formulating air pollution and carbon co-control strategies for improving the overall social welfare.

This study in China aimed to explore the impact of maternal depression on infant-mother attachment and whether parenting status moderated this relationship. Women underwent depression assessments at seven perinatal time points: ≤12, 17, 21, 31, and 37 weeks of pregnancy, as well as 1 and 6 weeks postpartum. Those completing at least three times assessments, along with their infants, were invited for infant-mother attachment assessment at 12-18 months postpartum. Among 233 infant-mother pairs completing the infant-mother attachment assessment, 62 and 80 mothers had postnatal depression and perinatal major depression, respectively; 75 (32.2%) of infants exhibited insecure attachment. While infants whose mothers had maternal depression showed a slightly elevated rate of insecure attachment, this difference did not achieve statistical significance. Additionally, parenting status did not influence the relationship between maternal depression and infant-mother attachment. Nevertheless, the study hinted that more physical contact between mother and infant might reduce insecure attachment likelihood. Future research should expand sample sizes and assessment points for better understanding. In addition, encouraging close interaction and physical touch between mother and infant may be beneficial., (© 2024 John Wiley & Sons Australia, Ltd.)

Prostate cancer (PCa) exhibits significant geoethnic disparities as reflected by distinct variations in the cancer genome and disease progression. Here, we perform a comprehensive proteogenomic characterization of localized high-risk PCa utilizing paired tumors and nearby tissues from 125 Chinese male patients, with the primary objectives of identifying potential biomarkers, unraveling critical oncogenic events and delineating molecular subtypes with poor prognosis. Our integrated analysis highlights the utility of GOLM1 as a noninvasive serum biomarker. Phosphoproteomics analysis reveals the crucial role of Ser331 phosphorylation on FOXA1 in regulating FOXA1-AR-dependent cistrome. Notably, our proteomic profiling identifies three distinct subtypes, with metabolic immune-desert tumors (S-III) emerging as a particularly aggressive subtype linked to poor prognosis and BCAT2 catabolism-driven PCa progression. In summary, our study provides a comprehensive resource detailing the unique proteomic and phosphoproteomic characteristics of PCa molecular pathogenesis and offering valuable insights for the development of diagnostic and therapeutic strategies., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Regional budget assessments of methane (CH 4 ) are critical for future climate and environmental management. CH 4 emissions from rice cultivation (CH 4-rice ) constitute one of the most significant sources. However, previous studies mainly focus on historical emission estimates and lack consideration of future changes in CH 4-rice under climate change or anthropogenic policy intervention, which hampers our understanding of long-term trends and the implementation of targeted emission reduction efforts. This study investigates the spatiotemporal variations of CH 4-rice over the past two decades, using an integrated method to identify the major drivers and predict future emissions under climate change scenarios and policy perspectives. Results indicate that the CH 4-rice emissions in China ranged between 6.21 and 6.57 Tg yr -1 over the past two decades, with a spatial distribution characterized by decreases in the south and increases in the north, associated with economic development, dietary shifts, technological advancements, and climate change. Factors such as the rate of straw added (RSA), fertilization, soil texture, temperature, and precipitation significantly influence CH 4 emissions per unit rice production (CH 4-urp ), with RSA identified as the most significant tillage management factor, explaining 32 % of the variance. Lowering RSA to 8 % is beneficial for reducing CH 4-urp . Scenario analysis indicates that under policies focusing on production or demand, CH 4-rice is expected to increase by 0.3 % to 5.6 %, while adjusting RSA can reduce CH 4-rice by 9.4 % to 10.0 %. Structural adjustments and regional cooperation serve as beneficial starting points for controlling and reducing CH 4-rice in China, while optimizing industrial layouts contributes to regional development and CH 4-rice control. Implementing policies related to maintaining field and crop yields can achieve a balance between rice supply and demand ahead of schedule. Dynamic adjustment of rice cultivation based on supply-demand balance can effectively reduce CH 4-rice from excess rice production. By 2060, the reduction effect could reach 8.95 %-12.01 %. Introducing policy-driven tillage management measures as reference indicators facilitates the reduction of CH 4-rice ., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The number and proportion of the elderly population have been continuously increasing in China, leading to the elevated prevalence of chronic diseases and multimorbidity, which ultimately brings heavy burden to society and families. Meanwhile, the status of multimorbidity tends to be more complex in elderly inpatients than community population. In view of the above concerns, this study was designed to investigate the health status of elderly inpatients by analyzing clinical data in Chinese People's Liberation Army (PLA) General Hospital from 2008 to 2019, including the constitution of common diseases, comorbidities, the status of multimorbidity, in-hospital death and polypharmacy among elderly inpatients, so as to better understand the diseases spectrum and multimorbidity of elderly inpatients and also to provide supporting evidence for targeted management of chronic diseases in the elderly., Methods: A clinical inpatients database was set up by collecting medical records of elderly inpatients from 2008 to 2019 in Chinese PLA General Hospital, focusing on diseases spectrum and characteristics of elderly inpatients. In this study, we collected data of inpatients aged ≥ 65 years old, and further analyzed the constitution of diseases, multimorbidity rates and mortality causes in the past decade. In addition, the prescriptions were also analyzed to investigate the status of polypharmacy in elderly inpatients., Results: A total of 210,169 elderly patients were hospitalized from January 1st, 2008 to December 31st, 2019. The corresponding number of hospitalizations was 290,833. The average age of the study population was 72.67 years old. Of the total population, 73,493 elderly patients were re-admitted within one year, with the re-hospitalization rate of 25.27%. Malignant tumor, hypertension, ischemic heart disease, diabetes mellitus and cerebrovascular disease were the top 5 diseases. Among the study population, the number of patients with two or more long-term health conditions was 267,259, accounting for 91.89%, with an average of 4.68 diseases. In addition, the average number of medications taken by the study population was 5.4, among which, the proportion of patients taking more than 5 types of medications accounted for 55.42%., Conclusions: By analyzing the constitution of diseases and multimorbidity, we found that multimorbidity has turned out to be a prominent problem in elderly inpatients, greatly affecting the process of healthy aging and increasing the burden on families and society. Therefore, multidisciplinary treatment should be strengthened to make reasonable preventive and therapeutic strategies to improve the life quality of the elderly. Meanwhile, more attention should be paid to reasonable medications for elderly patients with multimorbidity to avoid preventable side effects caused by irrational medication therapy., (© 2024. The Author(s).)

Sourdough fermentation is attracting growing attention because of its positive effects on properties of leavened baked good. However, the changes in dough features and the mechanisms behind them are not well understood, which limits its widespread use. In this study, we assessed the effects of representative lactic acid bacteria in sourdough monoculture or co-culture with yeasts on dough characteristics. Physicochemical analysis identified increased proteolysis and enhanced nutritional properties of co-culture groups. However, a reduction in organic acids contents of co-culture groups compared to monoculture was detected, and this effect was not limited by the yeast species. The RNA sequencing further demonstrated that the presence of yeast enhanced the protein metabolic activity of lactic acid bacteria, while decreased its organic acid biosynthetic activity. Moreover, the proteomic analysis revealed that endogenous metabolic proteins of flour, such as pyruvate kinase, glucosyltransferase and pyruvate dehydrogenase play a key role in carbohydrate metabolism during fermentation. This study uncovered the influence of typical microorganisms and endogenous enzymes on dough characteristics based on different aspects. Bacteria-mediated consumption of proteins and increased proteolysis in co-culture groups may underlie the improved digestibility and nutritional effects of sourdough fermented products, which provides an important basis for nutrient fortified bread making with multi-strain leavening agent., 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.)

Co-controlling the emissions of air pollutants and CO 2 from automobiles is crucial for addressing the intertwined challenges of air pollution and climate change in China. Here, we analyze the synergetic characteristics of air pollutant and CO 2 emissions from China's on-road transportation and identify the co-drivers influencing these trends. Using detailed emission inventories and employing index decomposition analysis, we found that despite notable progress in pollution control, minimizing on-road CO 2 emissions remains a formidable task. Over 2010-2020, the estimated sectoral emissions of VOCs, NO x , PM 2.5 , and CO declined by 49.9%, 25.9%, 75.2%, and 63.5%, respectively, while CO 2 emissions increased by 46.1%. Light-duty passenger vehicles and heavy-duty trucks have been identified as the primary contributors to carbon-pollution co-emissions, highlighting the need for tailored policies. The driver analysis indicates that socioeconomic changes are primary drivers of emission growth, while policy controls, particularly advances in emission efficiency, can facilitate co-reductions. Regional disparities emphasize the need for policy refinement, including reducing dependency on fuel vehicles in the passenger subsector and prioritizing co-reduction strategies in high-emission provinces in the freight subsector. Overall, our study confirms the effectiveness of China's on-road control policies and provides valuable insights for future policy makers in China and other similarly positioned developing countries.

Human aging is invariably accompanied by a decline in renal function, a process potentially exacerbated by uremic toxins originating from gut microbes. Based on a registered household Chinese Guangxi longevity cohort (n = 151), we conducted comprehensive profiling of the gut microbiota and serum metabolome of individuals from 22 to 111 years of age and validated the findings in two independent East Asian aging cohorts (Japan aging cohort n = 330, Yunnan aging cohort n = 80), identifying unique age-dependent differences in the microbiota and serum metabolome. We discovered that the influence of the gut microbiota on serum metabolites intensifies with advancing age. Furthermore, mediation analyses unveiled putative causal relationships between the gut microbiota (Escherichia coli, Odoribacter splanchnicus, and Desulfovibrio piger) and serum metabolite markers related to impaired renal function (p-cresol, N-phenylacetylglutamine, 2-oxindole, and 4-aminohippuric acid) and aging. The fecal microbiota transplantation experiment demonstrated that the feces of elderly individuals could influence markers related to impaired renal function in the serum. Our findings reveal novel links between age-dependent alterations in the gut microbiota and serum metabolite markers of impaired renal function, providing novel insights into the effects of microbiota-metabolite interplay on renal function and healthy aging., (© 2023 The Authors. Aging Cell published by Anatomical Society and John Wiley & Sons Ltd.)

Background: Metropolitan areas have complex trade linkages internally and externally. This complexity stimulates the unequal spatial transfer of environmental health consequences, economy, and employment embodied in internal trade or trade with the outside regions, resulting in unequal exchange. Existing research has rarely discussed this issue at a refined scale, hindering targeted inequity alleviation policies., Methods: We conducted a mixed-methods study, focusing on the most polluted metropolitan area in the world, the Beijing-Tianjin-Hebei region of China, and developed an integrated modelling framework to downscale the analysis of the trade-driven unequal transfer of PM 2·5 - related premature deaths, value added, and job opportunities to the city scale within Beijing-Tianjin-Hebei. The study couples a nested Multi-Regional Input-Output model table containing data from 13 Beijing-Tianjin-Hebei cities and 28 outer provinces in 2017 with a bottom-up emission inventory, value added and employment statistical data, the Weather Research and Forecasting-Comprehensive Air Quality Model with Extensions, the Global Exposure Mortality Model, and human capital methods. We also constructed two indices measuring unequal exchanges between PM 2·5 -related deaths and economic and employment gains embodied in trades between cities in Beijing-Tianjin-Hebei and trades with outside regions., Findings: The Beijing-Tianjin-Hebei region as a single entity shifted 14 985 (95% CI 12 800-16 948) net deaths to regions outside the Beijing-Tianjin-Hebei through trade, most of which occurred in the central region of China. The industrial-based peripheral Beijing-Tianjin-Hebei cities suffered the most serious inequities when trading with other Beijing-Tianjin-Hebei cities and outside regions. While gaining equivalent local jobs, these industrial-based peripheral cities had 250% higher PM 2·5 -related deaths (10·2 PM 2·5 -related deaths for obtaining 1000 local jobs) than core cities (2·9 PM 2·5 -related deaths for obtaining 1000 local jobs) and 57·7% higher PM 2·5 -related deaths than agricultural-based peripheral cities (6·5 PM 2·5 -related deaths for obtaining 1000 local jobs). While gaining equivalent value added, industrial-based peripheral cities had 50·6% higher PM 2·5 -related deaths (¥13·9 of reduced human capital due to PM 2·5 -related premature deaths to obtain ¥1000 local value added) than core cities (¥9·2 of reduced human capital due to PM 2·5 -related premature deaths to obtain ¥1000 local value added) and 67·4% higher PM 2·5 -related deaths than agricultural-based peripheral cities (¥8·3 of reduced human capital due to PM 2·5 -related premature deaths to obtain ¥1000 local value added)., Interpretation: Treating metropolitan areas as a single entity obscured internal heterogeneity, potentially misleading policy makers into imposing strict regulations on the whole metropolitan area to alleviate the inequities it posed on outside regions. However, several peripheral Beijing-Tianjin-Hebei cities were disadvantaged in their trade with core Beijing-Tianjin-Hebei cities and outside regions. Therefore, policies should be tailored for particular cities within metropolitan areas. Future targeted policies should include, but not be limited to, making ecological compensations and incorporating the environment and health costs into the price of pollution-intensive goods and services., Funding: National Key Research and Devlopment Program of China, National Natural Science Foundation of China, and Jiangsu Natural Science Foundation., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 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.)

Black carbon (BC) has a significant impact on air quality, climate change, and human health. Studies on BC from vessel exhaust have been focused on in recent years. To realize the contribution of BC from vessels to ambient air quality, 28 months of BC variation were observed from February 2019 to May 2022, including 3 fishing moratoriums and 2 normal periods. The results showed that the average daily concentration of BC in the fishing moratorium was significantly lower than that in the normal period. The difference proportion of the BC concentration between 370 and 880 nm was calculated over the whole period. As a result, the mean difference value in the fishing moratorium from February to May was 0.06 ± 0.07, and the normal period was -0.02 ± 0.05. The aethalometer model indicated that BC was greatly affected by fossil fuel combustion in the normal period. The effect of vessel emissions on regional BC concentrations was considerable. In addition, 16 PAHs and 21 elements in PM emitted from 24 vessels of different types were sampled and analyzed in Dianshan Lake and the Taipu River. EC accounted for the highest proportion (23.64%) in the sample of small trawlers compared to the emissions from cargo ships with large tonnages. The component profiles of vessel exhaust showed that Zn, As, phenanthrene (Phe), anthracene (Ant), fluoranthene (Fla), and pyrene (Pyr) were the dominant species, although some of these species were mainly recognized as characteristic factors of coal combustion. To improve the accuracy of identifying the vessel source, the diagnostic ratios of Ant/(Ant + Phe), BaA/(BaA + Chr), Phe/Ant, and BaA/Chr were provided, and they exhibited the obvious characteristics of fuel combustion., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To develop deep learning-based networks for the diagnosis of diabetic retinopathy (DR) with cataracts based on infrared fundus images., Setting: Shanghai General Hospital, Shanghai Eye Disease Prevention & Treatment Center, Shanghai, China., Design: Development and evaluation of an artificial intelligence (AI) diagnostic method., Methods: A total of 10 665 infrared fundus images from 4553 patients with diabetes were used to train and test the model. For image quality assessment, left and right eye classification, DR diagnosis and grading, and segmentation of 3 DR lesions, an end-to-end software using EfficientNet and UNet was developed. The accuracy and performance of the software in comparison to human experts was evaluated., Results: The model achieved an accuracy of 75.31% for left and right eye classification, 100% for DR grading and diagnosis tasks, and 73.67% for internal test set, with corresponding areas under the curve (AUCs) of 0.88, 1.00, and 0.89, respectively. For DR lesion segmentation, the AUCs of hemorrhagic, microangioma, and exudative lesions were 0.86, 0.66, and 0.84, respectively. In addition, a contrast test of human-machine film reading confirmed the software's high sensitivity (96.3%) and specificity (90.0%) and consistency with the manual film reading group (κ = 0.869, P < .001). This easily deployable software generated reports quickly and promoted efficient DR screening with cataracts in clinical and community settings., Conclusions: AI-assisted software can perform automatic analysis of infrared fundus images and has substantial application value for the diagnosis of DR patients with cataracts., (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Energy transition is an important way to control air pollution, but it may conflict with the economic goal of alleviating regional inequality due to its inherently different cost burdens. As one of the effective measures of energy transition, this paper takes small coal-fired boiler (SCB) upgrading as an example to explore the regional mismatch between upgrading costs and health benefits. Here, we construct a boiler-level inventory of SCB upgrades for the North China Plain (NCP) during 2013-2017 and propose an integrated modeling framework to quantify the spatial contribution of economic costs and health benefits associated with SCB upgrading. We find that although the total health benefits could offset the total costs for the entire region, the developed municipalities (Beijing and Tianjin) are likely to gain more health benefits from less-developed neighboring provinces at lower costs. These developed municipalities contribute only 14% to the total health benefits but gain 21% of the benefits within their territories, 56% of which come from neighboring provinces. Their benefits are approximately 5.6 times their costs, which is much higher than the 1.5 benefit-cost ratio in neighboring provinces. Our findings may be useful in shaping more equitable and sound environmental policies in China or other regions of the world with serious coal-related air pollution.

Rural domestic sewage has the characteristics of large and scattered discharge, as well as complex components; thus, how to effectively and efficiently manage rural domestic sewage is a big challenge for policy makers. Current decentralized domestic sewage treatment facilities (DDSTF) involve different treatment processes and power drive modes; at the same time, the treatment effect is also affected by a variety of local factors. However, there is a lack of research to explore the implementation performance of the DDSTF from a comprehensive perspective. In this study, we took Nantong City, China, as a case study and conducted field investigations of 79 DDSTFs in seven counties from July 2021 to September 2022. We then made an in-depth analysis of the implementation performances of the DDSTF from an internal and external perspective. The results indicate that low temperature will reduce the DDSTF's treatment capacity, and the operation and maintenance mode affect the treatment effect of the facilities significantly. In addition, the non-standardized design for small-capacity facilities commonly results in lower compliance rates. Based on the results, we suggest that improving the quality of design and construction and adopting specialized operations are important ways to improve the treatment efficiency of rural DDSTF.

To evaluate the effects of the various ozone (O 3 ) control approaches on environmental health and health inequalities, 121 reduction scenarios for nitrogen oxides (NO x ) and volatile organic compounds (VOCs) were developed, and their environmental health impacts were calculated. With the target of achieving the 90th percentile of the daily maximum 8 h mean O 3 concentration (MDA8-90th) of 160 μg/m 3 in Beijing-Tianjin-Hebei and its surroundings ("2 + 26" cities), three typical scenarios namely, High-NO x reduction ratio (HN, NO x /VOCs = 6:1), High-VOCs reduction ratio (HV, NO x /VOCs = 3:7), and Balanced reduction ratio (Balanced, NO x /VOCs = 1:1) were investigated. The results show that O 3 formation is currently NO x -limited at the regional scale, while some developed cities are VOC-limited, indicating that NO x mitigation should be the core for achieving the targeted concentration (160 μg/m 3 ) at the regional scale, whereas cities such as Beijing in the short term should focus on VOCs mitigation. The population-weighted O 3 concentrations in the HN, Balanced, and HV scenarios were 159.19, 159.19, and 158.44 μg/m 3 , respectively. In addition, the O 3 -related premature mortality was 41,320 in "2 + 26" cities; control measures under HN, Balanced, and HV could potentially decrease O 3 -related premature deaths by 59.94 %, 60.25 %, and 71.48 %, respectively. The HV scenario has been found to be more advantageous in lowering the O 3 -related environmental health impacts than the HN and Balanced scenarios. It was further found that premature deaths avoided by the HN scenario were mainly concentrated in economically unadvanced regions, whereas those prevented by the HV scenario were mainly concentrated in developed cities. This may lead to geographical inequities in environmental health. As ozone pollution in large cities with high population density is primarily VOC-limited, decrease in VOCs should be focused on in the short term to avoid more O 3 -related premature deaths, whereas NO x control may be more important in decreasing ozone concentrations and ozone-related mortality in the future., 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. Published by Elsevier B.V.)

Background and Objective: Deficiencies of enzymes acting downstream of glucosylceramide synthase (GCS) can cause severe substrate accumulation. Venglustat is a small-molecule, brain-penetrant GCS inhibitor under investigation for multiple diseases involving pathogenic glycosphingolipid accumulation. Here, we evaluate the pharmacokinetics, safety, and tolerability of venglustat in healthy Chinese volunteers., Methods: Study PKM16116 was a phase I, single-center, non-randomized, open-label study to investigate the pharmacokinetics, safety, and tolerability of a single 15 mg dose of orally administered venglustat in healthy Chinese volunteers aged 18 to 45 years., Results: A total of 14 volunteers (7 male; 7 female) with a body mass index from 20.9 kg/m 2 to 27.1 kg/m 2 were enrolled. The median time to reach the venglustat maximum plasma concentration was 2.50 h post-dose. The mean terminal half-life of venglustat was 30.6 ± 7.40 h. The mean systemic exposures across all participants were 60.3 ± 17.3 ng/mL for the maximum plasma concentration, and 2280 ± 697 ng·h/mL for the area under the plasma concentration-time curve extrapolated to infinity. There were no relevant differences in venglustat pharmacokinetics between male and female volunteers. A post hoc cross-study comparison analysis showed comparable venglustat pharmacokinetics in Chinese and non-Chinese volunteers. Venglustat was safe and well tolerated in the current study (a total of five Grade 1 treatment-emergent adverse events were reported in three volunteers)., Conclusion: Venglustat showed a favorable pharmacokinetic, safety, and tolerability profile in healthy Chinese volunteers following a single oral 15 mg dose., Clinical Trial Registry No: CTR20201012 ( http://www.chinadrugtrials.org.cn ) registered on 24 February 2021 and ChiCTR2200066559 ( http://www.chictr.org.cn ) retrospectively registered on 9 December 2022., (© 2023. The Author(s).)

Background: Timely screening and referral can improve the outcomes of perinatal depression (PND). However, uptake rates of referral after PND screening are low in China and the reasons are unclear. The aim of this article is to explore the barriers and facilitators for referring women with positive results of PND screening in the Chinese primary maternal health care system., Methods: Qualitative data were collected from four primary health centers located in four different provinces of China. Each of the four investigators conducted 30 days of participant observations in the primary health centers from May to August 2020. Data were collected via participant observations and semi-structured in-depth interviews with new mothers who had positive results of PND screening, their family members, and primary health providers. Two investigators analyzed qualitative data independently. A thematic analysis was conducted, and data were framed using the social ecological model., Results: A total of 870 hours of observation and 46 interviews were carried out. Five themes were identified: individual (new mothers' knowledge of PND, perceived need to seek help), interpersonal (new mothers' attitudes towards providers, family support), institutional (providers' perception of PND, lack of training, time constraints), community (accessibility to mental health services, practical factors), and public policy (policy requirements, stigma)., Conclusions: The likelihood of new mothers accepting PND referral is related to factors in five areas. Intervention strategies can be developed around these themes and may include educating new mothers and their families about PND, training primary health providers to improve their awareness of condition and indication for referral, building mental health support in routine postpartum home visits, and providing support through mobile technology., (© 2023. The Author(s).)

The emissions from various pollution sources were not proportional to their contributions to ambient PM 2.5 concentrations and associated health burdens. That means even with the same total abatement targets, different abatement allocation strategies across emission sources can have distinct health benefits. Insufficient knowledge of various sources' contributions to health burdens in China, the country suffering substantial PM 2.5 -related deaths, hindered the government from seeking optimized abatement allocation strategies. In this context, we separated the contributions of 155 emission sources (31 provinces × 5 sectors) to PM 2.5 -related mortality across China in 2017 by coupling the Comprehensive Air Quality Model with Extensions (CAMx), Weather Research and Forecasting model (WRF), and health impact assessment model. We further identified the priority-control emission sources and quantified interprovincial ecological compensation volumes to alleviate inequality induced by emission allocation strategies. Results showed that PM 2.5 pollution caused 899,443 excess deaths and around 127 billion USD costs in 2017. Approximately half of the deaths and costs were attributable to emissions from sources outside the boundary of the regions where the deaths occurred. Twenty-five out of 155 emission sources that contributed to the top 60% mortality burdens and had high marginal abatement efficiencies in China shall be the priority-control emission sources. A 1 μg/m 3 decrease of PM 2.5 concentration in regions where these key emission sources occur shall be compensated by 76-153 million USD in their receptor regions. Our study sheds light on the sources' contributions to mortality burdens and costs and provides scientific evidence for optimizing the emission allocation and compensation strategies in China. It also has wide implications for other countries suffering similar problems.

Objectives: Obstructive sleep apnoea (OSA) is associated with an increased risk of cardiovascular disease, with alterations in coagulability suspected as the mediating factor. This study explored blood coagulability and breathing-related parameters during sleep in patients with OSA., Design: Cross-sectional observational study. Setting . Shanghai Sixth People's Hospital. Participants. 903 patients diagnosed by standard polysomnography. Main Outcome and Measures. The relationships between coagulation markers and OSA were evaluated using Pearson's correlation, binary logistic regression, and restricted cubic spline (RCS) analyses., Results: The platelet distribution width (PDW) and activated partial thromboplastin time (APTT) decreased significantly with increasing OSA severity (both p < 0.001). PDW was positively associated with the apnoea-hypopnea index (AHI), oxygen desaturation index (ODI), and microarousal index (MAI) ( ß  = 0.136, p < 0.001; ß  = 0.155, p < 0.001; and ß  = 0.091, p = 0.008, respectively). APTT was negatively correlated with AHI ( ß  = -0.128, p < 0.001) and ODI ( ß  = -0.123, p = 0.001). PDW was negatively correlated with percentage of sleep time with oxygen saturation below 90%(CT90) ( ß  = -0.092, p = 0.009). The minimum arterial oxygen saturation (SaO 2 ) correlated with PDW ( ß  = -0.098, p = 0.004), APTT ( ß  = 0.088, p = 0.013), and prothrombin time (PT) ( ß  = 0.106, p = 0.0003). ODI was risk factors for PDW abnormalities (odds ratio (OR) = 1.009, p = 0.009) after model adjustment. In the RCS, a nonlinear dose-effect relationship was demonstrated between OSA and the risk of PDW and APTT abnormalities., Conclusion: Our study revealed nonlinear relationships between PDW and APTT, and AHI and ODI, in OSA, with AHI and ODI increasing the risk of an abnormal PDW and thus also the cardiovascular risk. This trial is registered with ChiCTR1900025714., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Jundong Yang et al.)

The synergistic evaluation integrating air quality, human health, climate impact, and socioeconomic development is significant for green and low-carbon transition. Here, we quantified the contribution of pollutant emissions in 30 provinces (source) to PM 2.5 concentration and related premature mortality in each 20 km grid (receptor) of China in 2020 by an integrated model for the first time. Further, we established a cross-province contribution matrix of health impact intensity (HII, PM 2.5 -related deaths per GDP). According to HII and CEI (carbon emission intensity, defined as CO 2 emission per GDP) levels, 30 provinces were divided into 4 regions including LL, HL, LH and HH. In order to assess the synergy in air pollution and carbon emission, we established an index system consisting of ISEC-AC (index for synergistic assessment) and its two sub index: IHI (index for HII assessment), and ICE (index for CEI assessment). Results showed that the ISEC-AC was more easily influenced by IHI as the variance of IHI was much higher than that of ICE. Influenced by various factors, e.g., economic structure, population density, pollution transport, ISEC-AC exhibited substantial spatial heterogeneity. In general, the ISEC-AC of southeast provinces was higher than that of central and western, indicating the environmental and climate impact per GDP was relatively lower in southeast China. For provinces, ISEC-AC of SH and GD were ~ 16 times higher than NX. For regions, due to low carbon emission intensity and health impact intensity, ISEC-AC of LL was the highest with 176; followed by HL (128), LH (126) and HH (77). Further, we figured out the main control problems and then put forward targeted synergetic control suggestions for air pollution and carbon emission from the perspective of energy structure, industry structure and industry layout, which can provide insights into future green and low-carbon policy making in China and other countries., 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. Published by Elsevier B.V.)

Increasing surface ozone (O 3 ) concentrations has emerged as a key air pollution problem in many urban regions worldwide in the last decade. A longstanding major issue in tackling ozone pollution is the identification of the O 3 formation regime and its sensitivity to precursor emissions. In this work, we propose a new transformed empirical kinetic modeling approach (EKMA) to diagnose the O 3 formation regime using regulatory O 3 and NO 2 observation datasets, which are easily accessible. We demonstrate that mapping of monitored O 3 and NO 2 data on the modeled regional O 3 -NO 2 relationship diagram can illustrate the ozone formation regime and historical evolution of O 3 precursors of the region. By applying this new approach, we show that for most urban regions of China, the O 3 formation is currently associated with a volatile organic compound (VOC)-limited regime, which is located within the zone of daytime-produced O 3 (DPO 3 ) to an 8h-NO 2 concentration ratio below 8.3 ([DPO 3 ]/[8h-NO 2 ] ≤ 8.3). The ozone production and controlling effects of VOCs and NO x in different cities of China were compared according to their historical O 3 -NO 2 evolution routes. The approach developed herein may have broad application potential for evaluating the efficiency of precursor controls and further mitigating O 3 pollution, in particular, for regions where comprehensive photochemical studies are unavailable.

Air pollution control policies in China have been experiencing profound changes, highlighting a strategic transformation from total pollutant emission control to air quality improvement, along with the shifting targets starting from acid rain and NO x emissions to PM 2.5 pollution, and then the emerging O 3 challenges. The marvelous achievements have been made with the dramatic decrease of SO 2 emission and fundamental improvement of PM 2.5 concentration. Despite these achievements, China has proposed Beautiful China target through 2035 and the goal of 2030 carbon peak and 2060 carbon neutrality, which impose stricter requirements on air quality and synergistic mitigation with Greenhouse Gas (GHG) emissions. Against this background, an integrated multi-objective and multi-benefit roadmap is required to provide decision support for China's long-term air quality improvement strategy. This paper systematically reviews the technical system for developing the air quality improvement roadmap, which was integrated from the research output of China's National Key R&D Program for Research on Atmospheric Pollution Factors and Control Technologies (hereafter Special NKP), covering mid- and long-term air quality target setting techniques, quantitative analysis techniques for emission reduction targets corresponding to air quality targets, and pathway optimization techniques for realizing reduction targets. The experience and lessons derived from the reviews have implications for the reformation of China's air quality improvement roadmap in facing challenges of synergistic mitigation of PM 2.5 and O 3 , and the coupling with climate change mitigation., 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 article., (Copyright © 2022. Published by Elsevier B.V.)

Prostate cancer (PCa) incidence and mortality have rapidly increased in China. Notably, unique epidemiological characteristics of PCa are found in the Chinese PCa population, including a low but rising incidence and an inferior but improving disease prognosis. Consequently, the current treatment landscape of PCa in China demonstrates distinct features. Establishing a more thorough understanding of the characteristics of Chinese patients may help provide novel insights into potential treatment strategies for PCa patients. Herein, we review the epidemiological status and differences in treatment modalities of Chinese PCa patients. In addition, we discuss the underlying socioeconomic and biological factors that contribute to such diversity and further propose directions for future efforts in optimizing the PCa treatment in China., 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.)

With the development of China's industrial economy and urbanization, water pollution has become serious and gradually exposed to the public. The pollution fee policy is an important tool to force enterprises to reduce pollution. This study used the panel data of manufacturing enterprises during 2006-2013 and the multiperiod difference in differences (DID) method to systematically analyze the impact of water pollution fee reform on emissions of manufacturing enterprises in China. In general, enterprises facing improved pollution fee collection standards reduce COD emissions by approximately 4.1%. However, significant location heterogeneities are captured in China. The rising water pollution fees have promoted the emission reduction of enterprises in northern China and resource-based cities, but the effect is not significant in southern China and nonresource-based cities. Furthermore, the mechanism analysis shows that enterprises mainly reduced emissions through terminal treatment and reducing production. This study provided micro evidence for research on the effect of pollution fee reform and supplied a reference for the improvement of the environmental protection tax system in China.

Nitrogen dioxide (NO 2 ) at the ground level poses a serious threat to environmental quality and public health. This study developed a novel, artificial intelligence approach by integrating spatiotemporally weighted information into the missing extra-trees and deep forest models to first fill the satellite data gaps and increase data availability by 49% and then derive daily 1 km surface NO 2 concentrations over mainland China with full spatial coverage (100%) for the period 2019-2020 by combining surface NO 2 measurements, satellite tropospheric NO 2 columns derived from TROPOMI and OMI, atmospheric reanalysis, and model simulations. Our daily surface NO 2 estimates have an average out-of-sample (out-of-city) cross-validation coefficient of determination of 0.93 (0.71) and root-mean-square error of 4.89 (9.95) μg/m 3 . The daily seamless high-resolution and high-quality dataset "ChinaHighNO 2 " allows us to examine spatial patterns at fine scales such as the urban-rural contrast. We observed systematic large differences between urban and rural areas (28% on average) in surface NO 2 , especially in provincial capitals. Strong holiday effects were found, with average declines of 22 and 14% during the Spring Festival and the National Day in China, respectively. Unlike North America and Europe, there is little difference between weekdays and weekends (within ±1 μg/m 3 ). During the COVID-19 pandemic, surface NO 2 concentrations decreased considerably and then gradually returned to normal levels around the 72nd day after the Lunar New Year in China, which is about 3 weeks longer than the tropospheric NO 2 column, implying that the former can better represent the changes in NO x emissions.

Surface ozone (O 3 ) is an important atmospheric trace gas, posing an enormous threat to ecological security and human health. Currently, the core objective of air pollution control in China is to realize the joint treatment of fine particulate matter (PM 2.5 ) and O 3 . However, high-accuracy near-surface O 3 maps remain lacking. Therefore, we established a new model to determine the full-coverage hourly O 3 concentration with the WRF-Chem and random forest (RF) models combined with anthropogenic emission data and meteorological datasets. Based on this method, choosing the Beijing-Tianjin-Hebei (BTH) region in 2018 as an example, full-coverage hourly O 3 maps were generated at a horizontal resolution of 9 km. The performance evaluation results indicated that the new model is reliable with a sample (station)-based 10-fold cross-validation (10-CV) R 2 value of 0.94 (0.90) and root mean square error (RMSE) of 14.58 (19.18) µg m -3 . In addition, the estimated O 3 concentration is accurately determined at varying temporal scales with sample-based 10-CV R 2 values of 0.96, 0.98 and 0.98 at the daily, monthly, and seasonal scales, respectively, which is highly superior to traditional derivation algorithms and other techniques in previous studies. An initial increase and subsequent decrease, which constitute the diurnal variation in the O 3 concentration associated with temperature and solar radiation variations, were captured. The highest concentration reached approximately 112.73 ± 9.65 μg m -3 at 15:00 local time (1500 LT) in the BTH region. Summertime O 3 posed a high pollution risk across the whole BTH region, especially in southern cities, and the pollution duration accounted for more than 50% of the summer season. Additionally, 43 and two days exhibited light and moderate O 3 pollution, respectively, across the BTH region in 2018. Overall, the new method can be beneficial for near-surface O 3 estimation with a high spatiotemporal resolution, which can be valuable for research in related fields.

With the progress of high-quality development in China, residents have begun to focus on the air quality of their residential areas in an effort to reduce the health threats of air pollution. Gradually, the risk associated with air pollution has become an important factor affecting housing prices. To quantitatively analyze the impact of air pollution on house prices, panel data, including data for fine particulate matter (PM2.5) concentrations, house prices and other auxiliary variables from 2009 to 2018, were collected from 16 districts in Beijing, China. Based on this dataset, ordinary least squares (OLS), moderating effect and threshold effect models were constructed for empirical investigation. Within the studied decade, PM2.5 pollution shows a significant decreasing trend of −3.79 μg m−3 yr−1 (p < 0.01). For house prices, the opposite trend was found. The empirical results indicate that PM2.5 pollution has a negative effect on house prices and that every 1% increase in PM2.5 causes an approximately 0.541% decrease in house prices. However, the inhibition of PM2.5 on housing prices is moderated by regional educational resources, especially in areas with high education levels. In addition, per capita disposable income can also cause heterogeneities in the impact of PM2.5 on house prices, whereby the threshold is approximately CNY 101,185. Notably, the endogeneity problems of this study are solved by the instrumental variable method, and the results are robust. This outcome suggests that the coordinated control of air pollution and balanced educational resources among regions are required for the future sustainable development of the real estate market.

China will attempt to achieve its simultaneous goals in 2060, whereby carbon neutrality will be accomplished and the PM 2.5 (fine particulate matter) level is expected to remain below 10 μg/m 3 . Identifying interaction patterns between air cleaning and climate action represents an important step to obtain cobenefits. Here, we used a random sampling strategy through the combination of chemical transport modeling and machine learning approach to capture the interaction effects from two perspectives in which the driving forces of both climate action and air cleaning measures were compared. We revealed that climate action where carbon emissions were decreased to 1.9 Bt (billion tons) could lead to a PM 2.5 level of 12.4 μg/m 3 (95% CI (confidence interval): 10.2-14.6 μg/m 3 ) in 2060, while air cleaning could force carbon emissions to reach 1.93 Bt (95% CI: 0.79-3.19 Bt) to achieve net carbon neutrality based on the potential carbon sinks in 2060. Additional controls targeting primary PM 2.5 , ammonia, and volatile organic compounds were required as supplements to overcome the partial lack of climate action. Our study provides novel insights into the cobenefits of air-quality improvement and climate change mitigation, indicating that the effect of air cleaning on the simultaneous goals might have been underestimated before.

Ephemeral rivers commonly occur in regions with a shortage of water resources, and their channel configuration tends to change substantially owing to long drying times and artificial sand extraction. During short-term water conveyance, water storage in large potholes and leakage along the dry riverbed retards the flow, which is detrimental for the river landscape and ecological water demand. The objective of this study is to evaluate the flow process corresponding to a certain release scheme. A coupled dynamic leakage loss and flood routing model was established to predict the flood routing distance for dry rivers with potholes and strong leakage. The model mainly includes three sub-models of flow dynamics, dynamic leakage loss and water balance along multiple cross sections of the river channel. The water head was dominated by flow velocity and the overflow from potholes. The model was applied to Yongding River, a typical ephemeral river in northern China, and the model parameters were calibrated and verified using monitoring data from ecological water releases into the Yongding River in 2019 and 2020, thus, making the model more stable and reliable. Finally, the model was used to evaluate the impact of cross section optimization and pothole treatment on the flow process. This study can provide scientific guidance for ecological water conveyance and the ecological restoration of ephemeral rivers.

China is confronting the challenge of opposite health benefits (OHBs) during ambient ozone (O 3 ) mitigation because the same reduction scheme might yield opposite impacts on O 3 levels and associated public health across different regions. Here, we used a combination of chemical transport modeling, health benefit assessments, and machine learning to capture such OHBs and optimize O 3 mitigation pathways based on 121 control scenarios. We revealed that, for the China mainland, Beijing-Tianjin-Hebei and its surroundings ("2 + 26" cities), Yangtze River Delta, and Pearl River Delta, there could be at most 2897, 920, 1247, and 896 additional O 3 -related deaths in urban areas, respectively, accompanying 21,512, 3442, 5614, and 642 avoided O 3 -related deaths in rural areas, respectively, at the same control stage. Additionally, potential disbenefits during O 3 mitigation were "pro-wealthy", that is, residents in developed regions are more likely to afford additional health risks. In order to avoid OHBs during O 3 abatement, we proposed a two-phase control strategy, whereby the reduction ratio of NO X (nitrogen oxide) to VOCs (volatile organic compounds) was adjusted according to health benefit distribution patterns. Our study provided novel insights into China's O 3 attainment and references for other countries facing the dual challenges of environmental pollution and associated inequality issues.

A new genus, Chuntiania Xue, gen. nov., including two new species, namely Chuntiania scutiseta Xue, sp. nov. and Chuntiania fuchaooi Xue Yang, sp. nov., is described from China. A key to the genera of Azeliinae of China is provided, and a morphological comparison diagram of the male cercus of Chuntiania gen. nov. and Potamia Robineau-Desvoidy is added.

Appropriate assessment on concerned soil contaminants spatially is of importance for decision-makers and stakeholders to make efficient mitigation countermeasures. In this study, we applied multiple geostatistical approaches to explore soil nutrient and metallic contaminant distributions in a large river watershed in Thailand, and to compare their performances in predicting spatial distribution patterns of the concerned soil contaminants under suitable application scenarios. The total carbon, nitrogen and phosphorous in surface soils over the whole watershed were measured with their maximum concentrations up to 131.47, 9.24, 5.33 g·kg -1 , respectively, while the concentrations of eight metallic elements (Cu, Zn, Pb, Cd, Hg, As, Cr, and Ni) were 933.00, 6862.50, 373.00, 6.22, 1.15, 178.53, 761.11, and 372.44 mg·kg -1 , respectively. It was found that the conditional interpolation approaches such as land use stratified inverse distance weighted and land use stratified original kriging provided better boundary details than original interpolations, with substantially reduced root mean square errors (up to 28% for nutrients and 54% for specific metals) and mean relative errors (up to 38% for nutrients and specific metals respectively) in predicting the spatial patterns of soil nutrients and several land use specific metals (Cu, Zn, Cd, and Pb). The global accuracies were equivalent or higher than those of geographically weighted regression. Nonetheless, the prediction accuracy for Cr, Ni, As, and Hg could not be improved using the land use stratified interpolation because their sources and pathways were not significantly correlated with land use types in the watershed, as reflected by the results of analysis of variance with post hoc test (p ≤ 0.05) and principal component analysis., 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.)

Purpose: To evaluate the accuracy of refractive prediction by the Haigis-L formula compared to four other IOL power calculation formulas in eyes with extremely long axial lengths (AL > 29.0 mm) after LASIK., Setting: Shanghai Eye Disease and Prevention Treatment Center, Shanghai, China., Design: Retrospective case series., Methods: Twenty-nine eyes from 19 patients were available for analysis. The primary outcome measure was the arithmetic refractive prediction error (RPE), defined as the difference between the actual postoperative refractive error and the intended formula-derived refractive target. The main outcome measure was the median absolute refraction prediction error (MedAE). The accuracy of the Haigis-L was compared with Barrett True K No History, Shammas-PL, SRK/T corrected K , and Holladay 2 corrected K methods to calculate IOL power., Results: The Haigis-L formula had a significantly larger MedAE than Shammas-PL and SRK/T corrected K formulas (P = 0.005 and P = 0.015, respectively), a smaller percentage of eyes within ±1.50 diopter (D) of predicted error in refraction compared with Shammas-PL and SRK/T corrected K formulas (P = 0.014 and P = 0.005, respectively). The refractive prediction errors of 6 eyes with corneal keratometry of less than 35 D by Haigis-L all had more than 1.95 D of myopic overestimation, while none of the other four methods resulted in an absolute error over 1.95 D., Conclusions: The Haigis-L formula was relatively accurate in predicting extreme long axis (>29.0 mm) eyes after myopic LASIK surgery but less accurate for eyes with extremely flat corneas (<35 D). SRK/T corrected K and Shammas-PL performed better than the other methods for refractive prediction in this type of eyes., Synopsis: Haigis-L performed worse than SRK/T corrected K and Shammas-PL in predicting IOL power in extremely long axis (>29.0 mm) eyes after myopic LASIK, especially with extremely flat corneas (K < 35 D)., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

To evaluate the real-world effectiveness and gene predictive analysis of olaparib in Chinese patients with metastatic castration-resistant prostate cancer (mCRPC), a multicenter, retrospective, real-world study was conducted by involving Chinese patients with mCRPC from December 2017 to June 2021. Homologous Recombination repair (HRR)gene mutation (HRRm) status was identified using targeted next-generation sequencing (NGS). The primary end point includes prostate-specific antigen (PSA) response rate (PSA 50 ). Secondary end points include PSA progression-free survival (PSA-PFS), exploratory endpoints include PSA 50 , and PSA-PFS in HRRm-negative patients with variants of unknown significance (VUS). Survival rates were analyzed using Kaplan-Meier (KM) plot. A total of 39 eligible patients with a median age of 65 (interquartile range [IQR]: 59.5-69.5) years were included in the study. Overall, 40% (12/30) of the patients with mCRPC achieved PSA 50 and the median PSA-PFS was 3.1 months (95% Confidence interval [CI]: 2.4-7). Furthermore, higher PSA 50 rate and longer PSA-PFS were observed in HRRm-positive patients (PSA 50 : 50% [7/14]; median PSA-PFS: 5.3 months, 95% CI: 3.73-10). Among the HRRm-positive patients, those harboring the BRCA2 aberrations experienced best clinical efficacy (PSA 50 : 55.5% [5/9] and median PSA-PFS [95% CI]: 9.5 months [4.3, NA]). Clinical benefit was also observed in HRRm-negative patients (PSA50: 31.3% [5/16]; median PSA-PFS [95% CI]:2.05 months [1.5,8]), wherein most patients with a PSA 50 response were carrying VUS (PSA 50 : 50% [4/8]; median PSA-PFS [95% CI]: 2.75 months [1.27, NA]). In one patients with mutation in the ATR gene, the PSA level decreased by 62%. Olaparib improved PSA response and prolonged PSA-PFS in Chinese mCRPC patients especially in those carrying HRR mutation. Among the HRR genes, patients with BRCA2 mutation showed the best clinical benefit. Besides, some patients carrying VUS on HRR gene and other DNA damage response (DDR) gene mutations also showed response to olaparib treatment, indicating that the clinical benefits observed in HRR-negative group were driven by VUS and other DDR gene mutation. However, this should be further explored in the future, and more molecular functional studies are needed to reclassify VUS for better clinical treatment decision-making and management of mCRPC., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The Central Plains of China, represented by Henan province, faces a dramatic rise in vehicular stock and CO 2 emissions. The refined-resolution(1 km × 1 km) vehicular CO 2 emission inventory for Henan province was developed to identify emission patterns. Results show that CO 2 emissions in Henan province reached 77.04 Mt in 2019, and LDGV and HDDT were the major sources that emitted 42.34% and 35.96% of CO 2 emissions, respectively. Based on gridded emission, Moran's Index was used to identify spatial distribution patterns of vehicular CO 2 . The higher CO 2 emission intensity areas were concentrated in the central and northern of the province and urban areas in each city, especially in Zhengzhou and its surrounding cities. Moreover, the analysis of the driving forces behind the differences in emissions among cities using the multi-regional (M-R) spatial decomposition model revealed that income and population-scale are significant impacts. In cities such as Zhengzhou, emissions may be dramatically increase owing to high economic growth expectations. 'Polarization phenomenon' of CO 2 emission distribution should be vigilant. Findings provided insights for refined policy-making in Henan province to limit CO 2 emission: (1) Take cities as transportation hubs, e.g., Zhengzhou and Shangqiu, and that in the traffic radiation circle, e.g., Jiaozuo and Zhoukou, as the critical areas for CO 2 emission reduction; (2) Promote electric vehicles as replacement for traditional fuel vehicles; especially for cities with large passenger car emissions, such as Zhengzhou, and cities with large truck emissions, such as Shangqiu and Zhoukou; actively guide new consumer groups to choose EVs, especially in cities with high growth expectations such as Zhengzhou; (3) Rely on the advantages of transportation network to promote the 'road to railway' of bulk cargo transportation and mainly focus on highways with higher CO 2 density, such as Beijing-Hong Kong&Macao Expressway, Shanghai-Xi'an Expressway, Da Guang Expressway, and Lian Huo Expressway., 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.)

Background: Migrant workers are a group susceptible for depression evolution due to occupational maladaptive triggers. The social rank theory illustrates the pathology process from defensive adaptation to depression, pointing out the early prevention of depression by discovering entrapment. This study aims to reveal the relationship between migrant workers' entrapment and depressive symptoms., Methods: A total of 1805 migrant workers in Shenzhen were recruited by stratified multi-stage sampling. Sample's demographic, behavioral and psychosocial characteristics were described and analyzed to reveal the relationship between entrapment and depressive symptoms. The Receiver Operator Characteristic was performed to find the optimal cut-off point of Entrapment Scale for predicting depressive symptoms., Results: In the binary logistic regression of sociodemographic variables, migrant workers who were married (univariate odds ratio (ORu) = 0.69, 95% Confidence Interval (CI) = 0.56-0.84), owned 1 or 2 children (ORu = 0.71, 95% CI = 0.58-0.86), had been working over 10 years (ORu = 0.71, 95% CI = 0.54-0.95), earned > 4999 yuan per month (ORu = 0.68, 95% CI = 0.47-0.99; multivariate odds ratio (ORm) = 0.57, 95% CI = 0.38-0.87) or with low risks of alcohol use disorders (ORu = 0.51, 95% CI = 0.34-0.75) had lower risks of depressive symptoms. After adjusted the aforementioned significant sociodemographic variables, migrant workers with severer entrapment were more likely to have depressive symptoms (adjusted odds ratio (ORa) = 1.13, 95% CI = 1.12-1.15). Besides, the study proved the reliability and validity of the Chinese version Entrapment Scale, preferring a two-dimensional structure, and 11 was the optimal cut-off value of this scale for predicting depressive symptoms among migrant workers., Conclusions: This result indicates the potential value of entrapment according to the social rank theory on facilitating early prevention of migrant works' depression and the application value of Entrapment Scale for effectively measuring mental status among migrant workers., (© 2022. The Author(s).)

Purpose: The aim of this study was to evaluate the short-term efficacy and safety of ultrasound cycloplasty (UCP) procedure in Chinese glaucoma patients., Methods: As a single-center, prospective, noncomparative study, 23 eyes of 23 patients suffering from glaucoma with uncontrolled intraocular pressure (IOP) ≥21 mm Hg underwent a multidose UCP treatment with the activations of 6, 8, or10 sectors. Types of glaucoma include primary open-angle glaucoma (7/23), primary angle closure glaucoma (PACG) (9/23), and secondary glaucoma (SG) (7/23). A complete ophthalmic examination including intraocular pressure (IOP) measurements was performed before UCP procedure and at 1 day, 1 month, 3 months, and 6 months after the procedure. An IOP reduction of ≥20% and IOP >5 mm Hg without increasing hypotensive medication at the follow-up visit was defined as therapeutic success. The postoperative complications were also recorded and compared to baseline for safety evaluation., Results: The mean baseline IOP of 23 treated eyes was 37.2 ± 12.1 mm Hg. The IOP reduction after UCP procedure was 23, 49, 33, and 34% at 1 day, 1 month, 3 months, and 6 months, respectively. Thus, the corresponding overall therapeutic success rates reached 61% (14/23), 83% (19/23), 65% (15/23), and 61% (14/23), respectively. Baseline IOPs of 8- and 10-sector groups (37.0 ± 9.9 mm Hg and 50.1 ± 12.2 mm Hg) were significantly higher than that of 6 sector groups (30.1 ± 8.2 mm Hg). Therapeutic success rates of 6-, 8-, and 10-sector groups reached 44% (4/9), 56% (5/9), and 100% (5/5), respectively. There were the highest percentage of IOP reduction (50 and 41%) and therapeutic success rate (6/7; 86% and 7/9; 78%) in the SG group and PACG group, respectively. In addition, preoperative ocular pain symptoms of 4 patients were all disappeared within 1 week after UCP. No serious intraoperative or postoperative complications occurred., Conclusion: UCP procedure is an effective and well-tolerated treatment to reduce IOP in Chinese glaucoma patients, which offered a novel alternative for glaucoma treatment., (© 2021 The Author(s). Published by S. Karger AG, Basel.)

Background: Kidneys obtained from deceased donors increase the incidence of delayed graft function (DGF) after renal transplantation. Here we investigated the influence of the risk factors of donors with DGF, and developed a donor risk scoring system for DGF prediction., Methods: This retrospective study was conducted in 1807 deceased kidney donors and 3599 recipients who received donor kidneys via transplants in 29 centers in China. We quantified DGF associations with donor clinical characteristics. A donor risk scoring system was developed and validated using an independent sample set., Results: The incidence of DGF from donors was 19.0%. Six of the donor characteristics analyzed, i.e., age, cause of death, history of hypertension, terminal serum creatinine, persistence of hypotension, and cardiopulmonary resuscitation (CPR) time were risk factors for DGF. A 49-point scoring system of donor risk was established for DGF prediction and exhibited a superior degree of discrimination. External validation of DGF prediction revealed area under the receiver-operating characteristic (AUC) curves of 0.7552., Conclusions: Our study determined the deceased donor risk factors related to DGF after renal transplantation pertinent to the Chinese cohort. The scoring system developed here had superior diagnostic significance and consistency and can be used by clinicians to make evidence-based decisions on the quality of kidneys from deceased donors and guide renal transplantation therapy.

Achieving carbon neutrality before 2060 newly announced in China are expected to substantially affect air quality. Here we project the pollutants emissions in China based on a carbon neutrality roadmap and clean air policies evolution; national and regional PM 2.5 and O 3 concentrations in 2030 (the target year of carbon peak), 2035 (the target year of "Beautiful China 2035" launched by the Chinese government to fundamentally improve air quality) and 2060 (the target year of carbon neutrality) are then simulated using an air quality model. Results showed that compared with 2019, emissions of SO 2 , NO x , primary PM 2.5 , and VOCs are projected to reduce by 42%, 42%, 44%, and 28% in 2030, by 57%, 58%, 60%, and 42% in 2035, by 93%, 93%, 90% and 61% in 2060 respectively. Consequently, in 2030, 2035, and 2060, the national annual mean PM 2.5 will be 27, 23, and 11 μg m -3 ; and the 90th percentile of daily 8-h maxima of O 3 (O 3 -8h 90th) will be 129, 123, and 93 μg m -3 ; 82%, 94%, and 100% of 337 municipal cities will reach the current national air quality standard, respectively. It's expected that the "Beautiful China 2035" target is very likely to be achieved, and about half of the 337 cities will meet the current WHO air quality guideline in 2060. In the near future, strict environmental policies driven by "Beautiful China 2035" are needed due to their substantial contribution to emission reductions. By 2060, the low-carbon policies driven by the carbon neutrality target are expected to contribute to larger than 80% of reductions in PM 2.5 and O 3 -8h 90th concentrations relative to the 2020 levels, implying that more attention could be paid to low-carbon policies after 2035. Our research would provide implications for future co-governance of air pollution and climate change mitigation in China and other developing countries., 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 © 2021 Elsevier B.V. All rights reserved.)