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Typhoons are very unpredictable natural disturbances to subtropical mangrove forests in Asian countries, but little information is available on how these disturbances affect ecosystem level carbon dioxide (CO2) exchange of mangrove wetlands. In this study, we examined short-term effect of frequent strong typhoons on defoliation and net ecosystem CO2 exchange (NEE) of subtropical mangroves, and also synthesized 19 typhoons during a 4-year period between 2009 and 2012 to further investigate the regulation mechanisms of typhoons on ecosystem carbon and water fluxes following typhoon disturbances. Strong wind and intensive rainfall caused defoliation and local cooling effect during the typhoon season. Daily total NEE values decreased by 26-50% following some typhoons (e.g., W28-Nockten, W35-Molave and W35-Lio-Fan), but significantly increased (43-131 %) following typhoon W23-Babj and W38-Megi. The magnitudes and trends of daily NEE responses were highly variable following different typhoons, which were determined by the balance between the variances of gross ecosystem production (GEP) and ecosystem respiration (RE). Furthermore, results from our synthesis indicated that the landfall time of typhoon, wind speed and rainfall were the most important factors controlling the CO2 fluxes following typhoon events. These findings indicate that different types of typhoon disturbances can exert very different effects on CO2 fluxes of mangrove ecosystems and that typhoon will likely have larger impacts on carbon cycle processes in subtropical mangrove ecosystems as the intensity [ABSTRACT FROM AUTHOR]

Dihydroartemisinin (DHA) is an important derivative of the herb medicine Artemisia annua L., used in ancient China. DHA is currently used worldwide to treat malaria by killing malaria-causing parasites. In addition to this prominent effect, DHA is thought to regulate cellular functions, such as angiogenesis, tumor cell growth, and immunity. Nonetheless, how DHA affects T cell function remains poorly understood. We found that DHA potently suppressed Th cell differentiation in vitro. Unexpectedly, however, DHA greatly promoted regulatory T cell (Treg) generation in a manner dependent on the TGF-pR:Smad signal. In addition, DHA treatment effectively reduced onset of experimental autoimmune encephalomyelitis (EAE) and ameliorated on-going EAE in mice. Administration of DHA significantly decreased Th but increased Tregs in EAE-inflicted mice, without apparent global immune suppression. Moreover, DHA modulated the mammalian target of rapamycin (mTOR) pathway, because mTOR signal was attenuated in T cells upon DHA treatment. Importantly, enhanced Akt activity neutralized DHA-mediated effects on T cells in an mTOR-dependent fashion. This study therefore reveals a novel immune regulatory function of DHA in reciprocally regulating Th and Treg cell generation through the modulating mTOR pathway. It addresses how DHA regulates immune function and suggests a new type of drug for treating diseases in which mTOR activity is to be tempered. [ABSTRACT FROM AUTHOR]

The Colonic manometry is an important technique to evaluate human colonic motor functions, which are critical for doctors to understand the pathology of intestinal diseases like slow transit constipation (STC) and colonic inertia (CI). However, in the obtained pressure signals, several patterns of colonic motor activities as well as noises mixed together, which made it difficult to observe the information people really needed. In this article, a new method was proposed to extract patterns of colonic motility from the mixed signals, so that researchers could study them thoroughly. Colonic pressure recordings from 26 volunteers were obtained by the water-perfused manometry catheters. Then independent component analysis (ICA) was introduced, which successfully separated colonic motility patterns and noises into four independent components. And according to the rhythm of contractions examined by ICA, subjects' colonic motility could be divided into three types: regular rhythm (12 subjects), slow rhythm (8 subjects) and disordered (6 subjects), which exactly accorded with their original diagnosis. [ABSTRACT FROM AUTHOR]

Host genetic factors and environment factors including hepatitis B virus (HBV) genotype are widely viewed as common basis of the different outcomes of HBV infection. Human leucocyte antigen (HLA) plays an important role in immunological reaction to HBV infection. The study aimed to explore whether the HLA-DQB1 allele polymorphisms are associated with the outcomes of HBV infection in the Chinese Han population. One hundred and thirty-four asymptomatic HBV carriers and 139 chronic hepatitis B patients were recruited in this case-control study in Beijing, China. Sequence-specific primers–polymerase chain reaction was used to detect 13 alleles of HLA-DQB1 gene. The frequency distributions of alleles in two groups were analysed using SAS 9.1.2 software. After adjustment of confounders the frequencies of HLA-DQB1*0503 allele and *0303 allele in chronic hepatitis B group were statistically significant lower than those in asymptomatic HBV carrier group (P = 0.04; P = 0.05), and the frequency of exposure to alcohol consumption in patients with chronic hepatitis B was clearly higher than that in asymptomatic HBV carrier group (P = 0.004). HLA-DQB1*0503 allele and *0303 allele are independently resistant genetic factors to chronic hepatitis B, and alcohol consumption is the risk factor of chronic hepatitis B. [ABSTRACT FROM AUTHOR]

Ventilator-associated pneumonia (VAP) is a significant cause of prolonged hospital stay and increased mortality in mechanically ventilated children. Studies of the relationship between bacterial colonization of ventilator circuits (VCs) and VAP are lacking. This study aimed to investigate the role of bacterial colonization of VCs in the development of VAP, and to provide evidence for preventing VAP. Mechanically ventilated patients admitted to the paediatric intensive care unit of a teaching hospital in China from October 2018 to November 2019 were enrolled. Specimens were collected from the VC and the patient's lower respiratory tract (LRT) for bacterial culture. Paired bacteria isolated from the VC and the patient's LRT, where colonization of the VC preceded that of the LRT, were evaluated for relatedness using pulsed field gel electrophoresis (PFGE). A total of 114 patients were included; the incidence rate of VAP was 28.1% (32/114). A total of 1368 samples were collected from VCs; 16% had positive bacterial culture. There was no significant difference in bacterial colonization of VCs between VAP and non-VAP. In 13 patients, the LRT and VC were concurrently colonized with the same bacteria, where colonization of the VC occurred before colonization of the patient's LRT. PFGE results demonstrated high correlation between bacteria from the LRT and VC in 11 patients. Among 114 mechanically ventilated children, VAP caused by bacteria from the VC occurred in six patients, accounting for 18.8% (6/32) of the overall VAP rate in this study. Bacterial colonization of the VC is a significant cause of VAP development in mechanically ventilated children. Preventive strategies for early identification and decontamination measures for contaminated VC may play a key role in preventing VAP. [ABSTRACT FROM AUTHOR]

Evidence on the association between garden work and risk of incident dementia in the older Chinese population is limited. This study aimed to explore the association between the frequency of garden work and risk of incident dementia in an older population in China. This was a national cohort study. This study analysed data from 8676 participants (median age: 86 years) from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazard models were used to assess the association between the frequency of garden work and risk of incident dementia using hazard ratios (HRs) and 95% confidence intervals (CIs). Multiplicative and additive interaction effects were calculated between the frequency of garden work and age, sex or residence on incident dementia; subgroup analyses of the association were also conducted by age, sex and residence. In addition, sensitivity analyses were performed to assess the robustness of the results. During 4.31 years (median) of follow-up, 633 participants developed dementia. Compared with participants who did not engage in garden work, the adjusted risk of incident dementia for those who regularly or almost daily engaged in garden work decreased by 28% (HR = 0.72, 95% CI: 0.57−0.93). An additive interaction effect between frequency of garden work and age on incident dementia was observed, with subgroup analyses demonstrating similar statistically significant associations among participants aged ≥85 years, women and city or town residents. Sensitivity analyses were consistent with the primary analysis in the present study. Frequent engagement in garden work may be associated with a reduced risk of dementia and may be an effective measure to prevent incident dementia in the older population in China. [ABSTRACT FROM AUTHOR]

Corn stovers supply a major source of roughage feeds of ruminant animals in China. Chemical compositions and ruminal fermentation of stover generally determines the animal performance and the product quality. Because emphasis has been placed on improvement of corn grains rather than nutritive values of stover, this experiment wass conducted to ascertain the effect of nitrogen-fertilizer application on chemical composition and in vitro digestibility of corn stovers. Traditional corn (Zea mays L.) plants were fertilized under five levels of urea (0, 75, 150, 300, 450 kg/ha) during middle growth stage. After ear harvest, stover samples were collected and measured for chemical components, in vitro digestibility and gas production characteristics. Increasing N-fertilizer application levels linearly increased (P< 0.001) the contents of crude protein (CP), total amino acids and Ca, but linearly decreased (P<0.01) the total water soluble saccharides. Fertilizer rate had little or no influence (P> 0.08) on the contents of ether extract, ash, P, NDF, ADF and lignin. Increasing N-fertilizer application levels resulted in quadratic (P<0.05) changes in digestibilities of dry matter, CP, NDF and ADF with the highest digestibilities achieved at the urea application level of 300 kg/ha. As urea application levels increased, potential degradability (a + b) of stovers linearly decreased (P<0.001), but gas production rates linearly increased (P<0.001). Results indicated that application rate of N-fertilizer during middle growth stage of corn plants can influence the chemical composition and rumen fermentation of corn stover. [ABSTRACT FROM AUTHOR]

Objectives: China has experienced a notable upsurge in pertussis cases post-COVID-19, alongside an age shift to older children, increased vaccine escape, and a notable rise in the prevalence of macrolide-resistant Bordetella pertussis. Here, we present a genomic epidemiological investigation of these events., Methods: We performed a retrospective observational study using culture-positive B pertussis isolated in Shanghai, China, from 2016 to 2024. We analysed strain and pertussis epidemiology dynamics by integrating whole-genome sequencing of 723 strains with antimicrobial susceptibility, transcriptomic profile, and clinical data. We compared the genome sequences of Shanghai strains with 6450 Chinese and global strains., Results: From pre-COVID-19 (before December 2019) to post-COVID-19, patients shifted from predominantly infants (90%, 397/442) to a higher proportion of infections in older children (infant: 16%, 132/844), with the share of vaccinated individuals surging from 31% (107/340) to 88% (664/756). The macrolide-resistant Bordetella pertussis prevalence increased from 60% (267/447) to 98% (830/845). The emergence and expansion of a ptxP3-lineage macrolide-resistant clone, MR-MT28, which is uniquely capable of causing substantial infections among older children and vaccinated individuals, was temporally strongly associated with the pertussis upsurge and epidemiological transition. Although MR-MT28 showed increased expression of genes encoding pertussis toxin, it was associated with significantly milder clinical symptoms and a lower hospitalization rate. MR-MT28 likely originated in China around 2016, after acquiring several key mutations, including a novel prn150 allele, and has been detected across multiple regions in China. In addition, 26% (50/195) of MR-MT28 has evolved into predicted Pertactin (PRN)-deficient strains, with an IS481 insertion being the predominant mechanism., Discussion: We report that the post-COVID-19 upsurge of pertussis in China is associated with ptxP3-MR-MT28, and provide evidence that pathogen evolution is likely the primary factor driving + pertussis upsurge, age shift, and vaccine escape. MR-MT28 poses a high risk of global spread and warrants global surveillance., (Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Objective: China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum., Methods: A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics., Results: The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet., Conclusion: The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention., (© 2024. The Author(s).)

Lipophilic shellfish toxins (LSTs) threaten the ecosystem health and seafood safety. To comprehensively investigate the spatiotemporal distribution of common LSTs in phytoplankton, zooplankton and economic shellfish, three cruises were conducted in five typical offshore aquaculture regions of Shandong province, China, including Haizhou Bay, Jiaozhou Bay, Sanggou Bay, Sishili Bay and Laizhou Bay, in spring (March-April), summer (July-August) and autumn (November-December). This study revealed significant variability in the composition and content of LSTs in phytoplankton samples collected from different regions. Pectenotoxin-2 (PTX2), dinophysistoxin-1 (DTX1) and okadaic acid (OA) were mainly detected in the ranges of not detected (nd)-5045 pmol g -1 dry weight (dw), nd-159 pmol g -1 dw, and nd-154 pmol g -1 dw, respectively. In zooplankton, DTX1 and OA were the predominant components of LSTs, with the highest levels of ∑LSTs in spring ranging from nd to 406 pmol g -1 dw. Spearman's correlation analysis between LSTs and environmental factors indicated significant correlations for the contents of homo-yessotoxin (hYTX), gymnodimine-A (GYM-A), and spirolide-1 (SPX1) with these factors. Totally relatively low levels of LSTs with dominative DTX1 were detected in economic shellfish, which showed a low risk to seafood safety for human health., 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.)

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.

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: Insulin resistance (IR) is a pivotal pathogenesis characteristic of type 2 diabetes mellitus (T2DM). The current study aimed to explore the association between triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-c), triglyceride-glucose (TyG), and triglyceride glucose-body mass index (TyG-BMI), and T2DM incidence., Methods: A total of 116,855 Chinese adults aged over 20 without diabetes were included. Multivariate Cox regression analysis and restricted cubic spine were utilized to investigate the association between IR indicators and T2DM. The T2DM risk across different quartiles of IR parameters was compared using Kaplan-Meier curves. The receiver operating characteristic analysis was used to investigate the predictive potential of each IR indicator for future T2DM., Results: A total of 2685 participants developed T2DM during a median follow-up of 2.98 years. The adjusted hazard ratios (HR) of incident T2DM were 1.177, 2.766, and 1.1018 for TG/HDL-c, TyG, and TyG-BMI, respectively. There were significant increasing trends of T2DM across the quartiles of TG/HDL-c, TyG, and TyG-BMI. The HRs of new-onset T2DM in the highest quartiles versus the lowest quartile of TG/HDL-c, TyG, and TyG-BMI were 3.298, 8.402, and 8.468. RCS revealed the nonlinear relationship between IR and T2DM risk. The correlations between IR and T2DM were more pronounced in subjects aged <40. TyG-BMI had the highest predictive value for incident T2DM (AUC = 0.774), with a cut-off value of 213.289., Conclusion: TG/HDL-c, TyG, and TyG-BMI index were all significantly positively associated with higher risk for future T2DM. Baseline TyG-BMI level had high predictive value for the identification of T2DM., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Companion animals such as cats and dogs harbor diverse microbial communities that can potentially impact human health due to close and frequent contact. To better characterize their total infectomes and assess zoonotic risks, we characterized the overall infectomes of companion animals (cats and dogs) and evaluated their potential zoonotic risks. Meta-transcriptomic analyses were performed on 239 samples from cats and dogs collected across China, identifying 24 viral species, 270 bacterial genera, and two fungal genera. Differences in the overall microbiome and infectome composition were compared across different animal species (cats or dogs), sampling sites (rectal or oropharyngeal), and health status (healthy or diseased). Diversity analyses revealed that viral abundance was generally higher in diseased animals compared to healthy ones, while differences in microbial composition were mainly driven by sampling site, followed by animal species and health status. Disease association analyses validated the pathogenicity of known pathogens and suggested potential pathogenic roles of previously undescribed bacteria and newly discovered viruses. Cross-species transmission analyses identified seven pathogens shared between cats and dogs, such as alphacoronavirus 1, which was detected in both oropharyngeal and rectal swabs albeit with differential pathogenicity. Further analyses showed that some viruses, like alphacoronavirus 1, harbored multiple lineages exhibiting distinct pathogenicity, tissue, or host preferences. Ultimately, a systematic evolutionary screening identified 27 potential zoonotic pathogens in this sample set, with far more bacterial than viral species, implying potential health threats to humans. Overall, our meta-transcriptomic analysis reveals a landscape of actively transcribing microorganisms in major companion animals, highlighting key pathogens, those with the potential for cross-species transmission, and possible zoonotic threats., Importance: This study provides a comprehensive characterization of the entire community of infectious microbes (viruses, bacteria, and fungi) in companion animals like cats and dogs, termed the "infectome." By analyzing hundreds of samples from across China, the researchers identified numerous known and novel pathogens, including 27 potential zoonotic agents that could pose health risks to both animals and humans. Notably, some of these zoonotic pathogens were detected even in apparently healthy pets, highlighting the importance of surveillance. The study also revealed key microbial factors associated with respiratory and gastrointestinal diseases in pets, as well as potential cross-species transmission events between cats and dogs. Overall, this work sheds light on the complex microbial landscapes of companion animals and their potential impacts on animal and human health, underscoring the need for monitoring and management of these infectious agents., Competing Interests: The authors declare no conflict of interest.

Background: Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants., Methods: A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson's correlation, multiple linear regression, and analyses of covariance., Results: All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex., Conclusions: The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values., (Copyright © 2024 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Understanding the mechanisms controlling forest carbon accumulation is crucial for predicting and mitigating future climate change. Yet, it remains unclear whether the dominance of ectomycorrhizal (EcM) trees influences the carbon accumulation of entire forests. In this study, we analyzed forest inventory data from over 4000 forest plots across Northeast China. We find that EcM tree dominance consistently exerts a positive effect on tree, soil, and forest carbon stocks. Moreover, we observe that these positive effects are more pronounced during unfavorable climate conditions, at lower tree species richness, and during early successional stages. This underscores the potential of increasing the dominance of native EcM tree species not only to enhance carbon stocks but also to bolster resilience against climate change in high-latitude forests. Here we show that forest managers can make informed decisions to optimize carbon accumulation by considering various factors such as mycorrhizal types, climate, successional stages, and species richness., (© 2024. The Author(s).)

Objective: To explore the factors affecting the prognosis of severe pediatric acute respiratory distress syndrome (ARDS) after receiving extracorporeal membrane oxygenation (ECMO) support. Methods: It was a multicenter prospective observational study. A total of 95 children with severe ARDS who were treated with ECMO salvage therapy from January 2018 to December 2022 in 9 pediatric ECMO centers in China were enrolled in the study. The general data, disease severity, organ function, comprehensive treatment and prognosis were recorded, and they were divided into survival group and death group according to the outcome at discharge. T test, chi-square test, multivariate Logistic regression and mixed linear model were used to analyze the relationship among baseline before ECMO treatment, some important indicators (pediatric critical scores, platelet count, albumin, fibrinogen, etc) during ECMO treatment and prognosis. Results: Among the 95 children with severe ARDS who received ECMO, 55 (58%) were males and 40 (42%) were females, aged 36.9 (0.5, 72.0) months. Twelve children (13%) were immunodeficient. Sixty-eight (72%) children were treated with venous artery (VA) mode and 27 (28%) with venous vein (VV) mode. The discharge survival rates of overall, VA, and VV mode children were 51% (48/95), 47% (32/68), and 59% (16/27), respectively. The number of immunodeficient children in the death group was higher, and there were lower pediatric critical scores, platelet count, albumin, fibrinogen and arterial oxygen partial pressure/fraction of inspired oxygen (PaO 2 /FiO 2 ), higher ventilator driving pressure (ΔP), oxygenaion index (OI), and longer ARDS duration before ECMO (all P <0.05). There were no statistically significant differences in other indicators, including age, gender, weight, and ECMO mode among different prognostic groups (all P >0.05). High ΔP, high OI, low P/F, and low albumin were high-risk factors affecting prognosis(all P <0.05). After further grouping, it was found that ΔP≥25 cmH 2 O (1 cmH 2 O=0.098 kPa), P/F≤67 mmHg (1 mmHg=0.133 kPa) and OI≥35 were the thresholds for predicting poor prognosis ( P <0.05). From 24 h after ECMO, there were significant differences in ΔP, P/F and OI between the dead group and the survival group (all P <0.05), and the differences gradually increased with the ECMO process. The platelet level was significant from 7 days after ECMO ( P <0.05) and gradually expanded. Blood lactate levels showed a significant difference between the 2 groups on before and after ECMO ( P <0.05) and gradually increased from 24 h after ECMO. Conclusions: The risk factors affecting the prognosis of severe ARDS in ECMO include high ΔP, high OI, low P/F and low albumin purification therapy before ECMO. The gradual decrease of ΔP, OI and increase of P/F from 24 h of ECMO predicted a good prognosis, while the gradual increase of lactate after ECMO application showed a poor prognosis.

Knowledge on natural background levels (NBLs) of aluminum (Al) in groundwater can accurately assess groundwater Al contamination at a regional scale. However, it has received little attention. This study used a combination of preselection and statistic methods consisting of the oxidation capacity and the boxplot iteration methods to evaluate the NBL of shallow groundwater Al in four groundwater units of the Pearl River Delta (PRD) via eliminating anthropogenic-impacted groundwaters and to discuss driving factors controlling high NBLs of Al in groundwater in this area. A total of 280 water samples were collected, and 18 physico-chemical parameters including Redox potential, dissolved oxygen, pH, total dissolved solids, HCO 3 - , NH 4 + , NO 3 - , SO 4 2- , Cl - , NO 2 - , Fe, Mn, and Al were analyzed. Results showed that groundwater Al NBLs in groundwater units A-D were 0.11, 0.16, 0.15, and 0.08 mg/L, respectively. The used method in this study is acceptable for the assessment of groundwater Al NBLs in the PRD, because groundwater Al concentrations in various groundwater units in residual datasets were independent of land-use types, but they were opposite in the original datasets. The dissolution of Al-rich minerals in sediments/rocks was the major source for groundwater Al NBLs in the PRD, and the interaction with Al-rich river water was secondary one. The high groundwater Al NBL in groundwater unit B was mainly attributed to the acid precipitation and the organic matter mineralization inducing the release of Al in Quaternary sediments. By contrast, the high groundwater Al NBL in groundwater unit C mainly was ascribed to the release of Al complexes such as fluoroaluminate from rocks/soils into groundwater induced by acid precipitation, but it was limited by the dissolution of Mg minerals (e.g., dolomite) in aquifers. This study provides not only useful groundwater Al NBLs for the evaluation of groundwater Al contamination but also a reference for understanding the natural geochemical factors controlling groundwater Al in urbanized deltas such as the PRD. PRACTITIONER POINTS: The natural background level (NBL) of groundwater aluminum in the Pearl River Delta (PRD) was evaluated. The dissolution of aluminum-rich minerals in sediments/rocks was the major source for groundwater aluminum NBLs in the PRD. The acid precipitation and organic matter mineralization contribute to high groundwater Al NBL in the groundwater unit B. The acid precipitation contributes to high groundwater Al NBL in the groundwater unit C, while dissolution of magnesium minerals limits it.- , K + , Na + , Ca 2+ , Mg 2+ , Fe, Mn, and Al were analyzed. Results showed that groundwater Al NBLs in groundwater units A-D were 0.11, 0.16, 0.15, and 0.08 mg/L, respectively. The used method in this study is acceptable for the assessment of groundwater Al NBLs in the PRD, because groundwater Al concentrations in various groundwater units in residual datasets were independent of land-use types, but they were opposite in the original datasets. The dissolution of Al-rich minerals in sediments/rocks was the major source for groundwater Al NBLs in the PRD, and the interaction with Al-rich river water was secondary one. The high groundwater Al NBL in groundwater unit B was mainly attributed to the acid precipitation and the organic matter mineralization inducing the release of Al in Quaternary sediments. By contrast, the high groundwater Al NBL in groundwater unit C mainly was ascribed to the release of Al complexes such as fluoroaluminate from rocks/soils into groundwater induced by acid precipitation, but it was limited by the dissolution of Mg minerals (e.g., dolomite) in aquifers. This study provides not only useful groundwater Al NBLs for the evaluation of groundwater Al contamination but also a reference for understanding the natural geochemical factors controlling groundwater Al in urbanized deltas such as the PRD. PRACTITIONER POINTS: The natural background level (NBL) of groundwater aluminum in the Pearl River Delta (PRD) was evaluated. The dissolution of aluminum-rich minerals in sediments/rocks was the major source for groundwater aluminum NBLs in the PRD. The acid precipitation and organic matter mineralization contribute to high groundwater Al NBL in the groundwater unit B. The acid precipitation contributes to high groundwater Al NBL in the groundwater unit C, while dissolution of magnesium minerals limits it., (© 2024 Water Environment Federation.)

Background: Serum trace elements and oxidative stress factors are related to diabetic microvascular complications. The study was to investigate the complex relationship between trace elements, oxidative stress factors, and the severity of microvascular complications of diabetes in older adults., Methods: The present study included patients with or without type 2 diabetes, and blood glucose, blood lipids, trace elements (iron, magnesium, zinc), oxidative stress factors (malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC)) were evaluated. Risk factors for the severity of diabetic microvascular complications in older adults with diabetes were also estimated., Results: There were statistically significant differences in fasting blood glucose (FBG), triglycerides (TG), low density lipoprotein (LDL), glycated hemoglobin (HbAlc), MDA, NO, SOD, T-AOC, magnesium, and zinc between the two groups ( P<0.05 ). Iron (r Zinc = 0.147, r SOD = 0.180, r T-AOC = 0.193, P < 0.05 ) was positively correlated with zinc, SOD and T-AOC. Iron was negatively correlated with MDA (r MDA = -0.146, P < 0.05 ). Magnesium was positively correlated with SOD (r Magnesium = 0.147, P < 0.05 ). Zinc (r SOD = 0.616, r T-AOC = 0.575, P < 0.01 ) was positively correlated with SOD and T-AOC. Zinc (r MDA =-0.636, r NO =-0.616, P<0.01 ) was positively correlated with MDA and negatively correlated with NO. The course of disease (18.653, [5.726; 60.764], P <0.01 ), FBG (1.265, [1.059; 1.511], P <0.05 ), HbAlc (1.545, [1.431; 1.680], P <0.01), MDA (2.989, [1.900; 4.702], P <0.01 ) were risk factor for the severity of diabetic microvascular complications. Zinc (0.680, [0.503; 0.919], P < 0.05 ) and SOD (0.820, [0.698; 0.964], P < 0.05 ) were protective factors for the severity of diabetic microvascular complications., Conclusion: Serum trace elements are related to oxidative stress levels in older adults with type 2 diabetes. The more stable trace element in older adults with diabetes, the lower the oxidative stress and the fewer microvascular complications of diabetes., Competing Interests: The authors declare that they have no competing interests in this work., (© 2024 Sun et al.)

Microplastic records from lake cores can reconstruct the plastic pollution history. However, the associations between anthropogenic activities and microplastic accumulation are not well understood. Huguangyan Maar Lake (HML) is a deep-enclosed lake without inlets and outlets, where the sedimentary environment is ideal for preserving a stable and historical microplastic record. Microplastic (size: 10-500 μm) characteristics in the HML core were identified using the Laser Direct Infrared Imaging system. The earliest detectable microplastics appeared unit in 1955 (1.1 items g -1 ). The microplastic abundance ranged from n.d. to 615.2 items g -1 in 1955-2019 with an average of 134.9 items g -1 . The abundance declined slightly during the 1970s and then increased rapidly after China's Reform and Opening Up in 1978. Sixteen polymer types were detectable, with polyethylene and polypropylene dominating, accounting for 23.5 and 23.3% of the total abundance, and the size at 10-100 μm accounted for 80%. Socioeconomic factors dominated the microplastic accumulation based on the random forest modeling, and the contributions of GDP per capita, plastic-related industry yield, and total crop yield were, respectively, 13.9, 35.1, and 9.3% between 1955-2019. The total crop yield contribution further increased by 1.7% after 1978. Coarse sediment particles increased with soil erosion exacerbated microplastics discharging into the sediment.

The rapid expansion of green areas in China has enhanced carbon sinks, but it also presents challenges regarding increased biogenic volatile organic compound (BVOC) emissions. This study examines the impact of greening trends on BVOC emissions in China from 1985 to 2001 and from 2001 to 2022, focusing on evaluating long-term trends in BVOC emissions within eight afforestation project areas during these two periods. Emission factors for 62 dominant tree species and provincial Plant Functional Types were updated. The BVOC emission inventories were developed for China at a spatial resolution of 27 km × 27 km using the Model of Emissions of Gases and Aerosols from Nature. The national BVOC emissions in 2018 were estimated at 54.24 Tg, with isoprene, monoterpenes, sesquiterpenes, and other BVOC contributing 26.94 Tg, 2.29 Tg, 0.44 Tg, and 24.57 Tg, respectively. Over the past 37 years, BVOC emissions experienced a slow growth rate of 1.7 % (0.79 Tg) during 1985-2001, followed by a significant increase of 12 % (6 Tg) from 2001 to 2022. BVOC emissions in the eight afforestation project areas increased by 2 % and 20 % during the two periods. From 2001 to 2022, at the regional scale, the Shelterbelt program for the middle reaches of the Yellow River area exhibited the largest rate of increase (43 %) in BVOC emissions. The Shelterbelt program for the upper and middle reaches of the Yangtze River made the most largest contribution (45 %) to the national increase in BVOC emissions. Afforestation projects have shifted towards planting more broadleaf trees than needleleaf trees from 2001 to 2022, and there also showed a change from herbaceous plants to broadleaf trees. These trends have led to higher average emission factors for vegetation, resulting in increased BVOC emissions. It underscores the importance of considering BVOC emissions when evaluating afforestation initiatives, emphasizing the need to balancing ecological benefits with potential atmospheric consequences., 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.)

Second-hand luxury goods feature both characteristics of luxury products like perceived value including social, emotional, and quality value, and second-hand goods like price-performance ratio. Enlarging the second-hand luxury market is of significance to protect the environment and save rare and valuable natural resources, and thus investigating the determinants of purchase intention is meaningful. From the perspective of the psychology of consumers, the influence of factors related to consumers (recycling awareness, subjective norms, attitudes, perceived behavioral control) and products (perceived value, price-performance ratio) on the intention to buy second-hand luxury goods is explored in this study through an online survey with Chinese consumers as a sample. The results are analyzed using the structural equation model (SEM) and show that consumers' attitudes, perceived behavioral control, and recycling awareness will promote the intention of purchasing second-hand luxury goods, and the perceived value and price-performance ratio of second-hand luxury goods also have a positive impact on the purchase intention. However, there is no significant relationship between subjective norms and purchase intention. In addition, this study also explores the interrelationship between constructs and draws corresponding conclusions, providing references for the subsequent development of the second-hand luxury market., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Sedimentary records of polycyclic aromatic hydrocarbons (PAHs) and phthalates could reflect energy consumption and industrial production adjustment. However, there is limited knowledge about their effects on variations of PAH and phthalate compositions in the sediment core. The PAH and phthalate sedimentary records in Huguangyan Maar Lake in Guangdong, China were constructed, and random forest models were adopted to quantify the associated impact factors. Sums of sixteen PAH (∑ 16 PAH) and seven phthalate (∑ 7 PAE) concentrations in the sediment ranged from 28.8 to 1110 and 246-4290 μg/kg dry weight in 1900-2020. Proportions of 5-6 ring PAHs to the ∑ 16 PAHs increased from 32.0 %-40.7 % in 1900-2020 with increased coal and petroleum consumption, especially after 1980. However, those of 2-3 ring PAHs decreased from 30.7 % to 23.6 % due to the biomass substitution with natural gas. The proportions of bis (2-ethylhexyl) phthalate to the ∑ 7 PAEs decreased from 52.3 %-29.1 % in 1900-2020, while those of di-isobutyl phthalate increased (13.7 % to 42.3 %). The shift from traditional plasticizers to non-phthalates drove this transformation, though the primary plastic production is increasing. Our findings underscore the effectiveness of optimizing energy structures and updating chemical products in reducing organic pollution in aquatic environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Black carbon (BC) significantly affects climate, environmental quality, and human health. This study utilised Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2), which can compensate for the shortcomings of ground BC monitoring in spatial-temporal distribution to study the pollution characteristics of BC and potential pollution sources in a typical industrial city (Xinxiang) with serious air pollution in northern China. The results showed that average daily ground observation and MERRA-2 concentration of BC of 7.33 μg m -3 and 9.52 μg m -3 . The mean BC concentration derived from MERRA-2 reanalysis data was higher than ground measurement due to resolution limitations and pollution from the northern regions. The reliability of the MERRA-2 data was confirmed through correlation analysis. Consideration of the spatial distribution of BC from MERRA-2 and incorporating the potential source contribution function (PSCF), concentration-weighted trajectory (CWT), and emission inventory, other possible source areas and primary sources of BC in Xinxiang were investigated. The results indicated that implementing transportation and residential emission control measures in Henan Province and its surrounding provinces, such as Hebei Province, will effectively decrease the BC level in Xinxiang City. A passively smoked cigarettes model was used to evaluate the risk of BC exposure. The percentage of lung function decrement (PLFD) was the highest in school-age children, while the impact on lung cancer (LC) health risk was comparatively lower. Notably, the BC health risk in Xinxiang was lower than in most cities across Asia., 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.)

Artificial per- and polyfluoroalkyl substances (PFASs) are widely distributed in the environment and are potentially harmful to human health. This study assessed the matrix effect of different shellfish on LC-MS analysis and the recoveries of PFASs in purified extracts purified by adding ENVI-Carb graphitized carbon black. Total 76 samples were collected from coastal cities of the Bohai Sea and South China Sea in China. Results showed that the signal response of perfluorocarboxylic acid increased with the length of fluorocarbon chains. ENVI-Carb can mitigate the shellfish matrix effects for analysis of PFASs. Ten PFASs components were detected in shellfish samples at concentrations ranging from 1.3 to 8.5 ng/g wet weight. The PFOA and PFHxS were the dominant components, and PFOA, PFTrDA and PFNA were detected at high rates of 58-93%. The highest levels of ∑PFASs were accumulated in clams, while the lowest levels were found in mussels. The dietary risk assessment indicated that PFASs potentially threaten human health via consumption of clam products in the Bohai Sea region. This study will improve the understanding of the contamination status and the dietary risk of PFASs in shellfish products along the coasts of Bohai Sea and South China Sea 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 © 2024 Elsevier Ltd. All rights reserved.)

Medical waste (MW) is exploding due to the COVID-19 pandemic, posing a significant environmental threat, and leading to the urgent requirement for affordable and environmentally friendly MW disposal technologies. Prior research on individual MW disposal plants is region-specific, applying these results to other regions may introduce bias. In this study, major MW disposal technologies in China, i.e., incineration technologies (pyrolysis incineration and rotary kiln incineration), and sterilization technologies (steam sterilization, microwave sterilization, and chemical disinfection) with residue landfill or incineration were analyzed from an industry-level perspective via life cycle assessment (LCA), life cycle costing (LCC) and net present value (NPV) methods. Life cycle inventories and economic cost data for 4-5 typical companies were selected from 128 distinct enterprises and academic sources for each technology. LCA results show that microwave sterilization with residue incineration has the lowest environmental impact, emitting only 480 kg CO 2 eq. LCC and NPV analyses indicate that steam sterilization with landfilling is the most economical, yielding revenues of 1,210 CNY/t and breaking even in the first year. Conversely, pyrolysis and rotary kiln incineration break even between the 4th and 5th years. Greenhouse gas emissions from the MW disposal in ten cities with the largest MW production in 2020 increased by 7% over 2019 to 43,800 tons and other pollutants increased by 6% to 12%. Economically, Shanghai exhibits the highest cost-effectiveness, while Nanjing delivers the lowest. It can be observed that the adoption of optimal environmental technologies has resulted in a diminution of greenhouse gas emissions by 279,000 tons and energy conservation of 1.76 billion MJ., 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 Ltd. All rights reserved.)

Background: Abnormal lipid metabolism poses a risk for prediabetes. However, research on lipid parameters used to predict the risk of prediabetes is scarce, and the significance of traditional and untraditional lipid parameters remains unexplored in prediabetes. This study aimed to comprehensively evaluate the association between 12 lipid parameters and prediabetes and their diagnostic value., Methods: This cross-sectional study included data from 100,309 Chinese adults with normal baseline blood glucose levels. New onset of prediabetes was the outcome of concern. Untraditional lipid parameters were derived from traditional lipid parameters. Multivariate logistic regression and smooth curve fitting were used to examine the nonlinear relationship between lipid parameters and prediabetes. A two-piecewise linear regression model was used to identify the critical points of lipid parameters influencing the risk of prediabetes. The areas under the receiver operating characteristic curve estimated the predictive value of the lipid parameters., Results: A total of 12,352 participants (12.31%) were newly diagnosed with prediabetes. Following adjustments for confounding covariables, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol were negatively correlated with prediabetes risk. Conversely, total cholesterol, triglyceride (TG), lipoprotein combine index (LCI), atherogenic index of plasma (AIP), non-HDL-C, atherogenic coefficient, Castelli's index-I, remnant cholesterol (RC), and RC/HDL-C ratio displayed positive correlations. In younger adults, females, individuals with a family history of diabetes, and non-obese individuals, LCI, TG, and AIP exhibited higher predictive values for the onset of prediabetes compared to other lipid profiles., Conclusion: Nonlinear associations were observed between untraditional lipid parameters and the risk of prediabetes. The predictive value of untraditional lipid parameters for prediabetes surpassed that of traditional lipid parameters, with LCI emerging as the most effective predictor for prediabetes., (© 2024. The Author(s).)

Liversedge, Drieghe, Li, Yan, Bai and Hyönä (2016) reported an eye movement study that investigated reading in Chinese, Finnish and English (languages with markedly different orthographic characteristics). Analyses of the eye movement records showed robust differences in fine grained characteristics of eye movements between languages, however, overall sentence reading times did not differ. Liversedge et al. interpreted the entire set of results across languages as reflecting universal aspects of processing in reading. However, the study has been criticized as being statistically underpowered (Brysbaert, 2019) given that only 19-21 subjects were tested in each language. Also, given current best practice, the original statistical analyses can be considered to be somewhat weak (e.g., no inclusion of random slopes and no formal comparison of performance between the three languages). Finally, the original study did not include any formal statistical model to assess effects across all three languages simultaneously. To address these (and some other) concerns, we tested at least 80 new subjects in each language and conducted formal statistical modeling of our data across all three languages. To do this, we included an index that captured variability in visual complexity in each language. Unlike the original findings, the new analyses showed shorter total sentence reading times for Chinese relative to Finnish and English readers. The other main findings reported in the original study were consistent. We suggest that the faster reading times for Chinese subjects occurred due to cultural changes that have taken place in the decade or so that lapsed between when the original and current subjects were tested. We maintain our view that the results can be taken to reflect universality in aspects of reading and we evaluate the claims regarding a lack of statistical power that were levelled against the original article., (Copyright © 2023 The Authors. Published by 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.

Volatile organic compounds (VOCs) undergo substantial photochemical losses during their transport from emission sources to receptor sites, resulting in serious implications for their source apportionment and ozone (O 3 ) formation. Based on the continuous measurements of VOCs in suburban Jinan in August 2022, the effects of photochemical losses on VOC source contributions and O 3 formation were evaluated in this study. The observed and initial concentrations of total VOCs (TVOC) were 12.0 ± 5.1 and 16.0 ± 7.4 ppbv, respectively. Throughout the observation period, alkenes had the most prominent photochemical losses (58.2%), followed by aromatic hydrocarbons (23.1%), accounting for 80.6% and 6.9% of the total losses, respectively. During high O 3 episodes, the photochemical loss of VOCs was 6.9 times higher than that during the cleaning period. Alkene losses (exceeding 67.3%), specifically losses of isoprene, propylene, ethylene, and n-butene, dominated the total losses of VOCs during the O 3 increase period. Eight sources of VOCs were identified by positive matrix factorization (PMF) based on the observed and initial concentration data (OC-PMF and IC-PMF, respectively). Concentrations of all emission sources in the OC-PMF were underestimated by 2.4%-57.1%. Moreover, the contribution of each emission source was over- or underestimated compared with that in case of the IC-PMF. The contributions of biogenic and motor vehicle exhaust emissions were underestimated by 5.3 and 2.8 percentage points, respectively, which was associated with substantial oxidation of the emitted high-reactive species. The contributions of coal/biomass burning and natural gas were overestimated by 2.4 and 3.9 percentage points, respectively, which were related to the emission of low-reactive species (acetylene, ethane, and propane). Based on our results, the photochemical losses of VOCs grossly affect their source apportionment and O 3 formation. Thus, photochemical losses of VOCs must be thoroughly accounted to establish a precise scientific foundation for air-pollution control strategies., 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 Inc. All rights reserved.)

Background: The family doctor (FD) contracting system is a key reform in the development of the Chinese health system, and is considered an effective way to ensure equitable access to healthcare services. This study investigates the effects of social integration on FD contracting services among migrant populations., Methods: In total, 120,106 respondents from the 2018 China Migrants Dynamic Survey were included in this study. Two multivariate regression models were used to estimate the effect of social integration and other factors on FD contracting services among migrant populations., Results: This study found that only 14.0% of the migrant populations had a FD. Multiple dimensions of social integration and some covariates were shown to be positively associated with FD contracting services, including average monthly household income, local medical insurance (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.29-1.39), employment status (OR = 0.86, 95% CI = 0.82-0.91), settlement intention (OR = 1.15, 95% CI = 1.09-1.22), received health education (OR = 4.88, 95% CI = 4.51-5.27), sex (OR = 1.16, 95% CI = 1.12-1.20), age (OR = 1.66, 95% CI = 1.51-1.82), marital status (OR = 1.38, 95% CI = 1.31-1.46), sickness within a year (OR = 0.84, 95% CI = 0.79-0.89), and flow range (OR = 1.12, 95% CI = 1.07-1.16)., Conclusions: All dimensions of social integration, including economic integration, social identity, and social involvement, are associated with FD contracting services among migrant populations. Policymakers should focus on improving the signing rates of migrant populations and implement more effective measures to enhance their social integration, such as settlement incentives and encouraging social participation., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Phthalic acid esters (PAEs) are typical industrial chemicals used in China. PAEs have received considerable attention because of their ubiquity and potential hazard to humans and the ecology. The spatiotemporal distributions of six PAEs in the surface sediments of the Songhua River in the spring (March), summer (July), and autumn (September) are investigated in this study. The total concentration of phthalic acid esters (∑ 6 PAEs) ranges from 1.62 × 10 2  ng g -1 dry weight (dw) to 3.63 × 10 4  ng g -1 ·dw, where the amount in the spring is substantially higher (p < 0.01) than those in the autumn and summer. Seasonal variations in PAEs may be due to rainfall and temperature. The ∑ 6 PAEs in the Songhua River's upper reaches are significantly higher than those in the middle and lower reaches (p < 0.05). Dibutyl phthalate (DBP) and di(2-ethylhexyl) phthalate (DEHP) are the two most abundant PAEs. The ecological hazard of five PAEs is assessed using the hazard quotient method. DBP and DEHP pose moderate or high ecological risks to aquatic organisms at various trophic levels. PAEs originate primarily from industrial, agricultural, and domestic sources. Absolute principal components-multiple linear regression results indicate that agricultural sources are the most dominant contributor to the ∑ 6 PAEs (53.7%). Guidelines for controlling PAEs pollution in the Songhua River are proposed., 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 Ltd. All rights reserved.)

Getah virus (GETV) is an emerging zoonotic virus that can infect humans and many mammals through mosquitoes. In this study, a novel pathogenic GETV strain, GDQY2022, was isolated from a pig farm in Guangdong Province, China. Sequence comparisons and phylogenetic analysis showed that GDQY2022 belongs to group III (GIII) and was most closely related to strain HeN202009-2, with 99.78% nucleotide sequence identity. Histopathological examination revealed significant pathological changes, such as widened alveolar septum in the lungs with mild congestion and hemorrhage. Differences in viral load between tissues were assessed by real-time RT-PCR, and significantly higher levels of GETV were found in abdominal lymph nodes and lungs of subclinically and clinically affected pigs (P < 0.01). This study provides valuable data for understanding the risk of GETV infection in the pig industry and a reliable basis for studying the pathogenic mechanisms and diagnostic surveillance of GETV., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Ozone (O 3 ) has become the most critical air pollutant in the Yangtze River Delta (YRD) region of China. Research on the O 3 formation mechanism and its precursor sources (including nitrogen oxides (NO X ) and volatile organic compounds (VOCs)) could provide a theoretical basis for mitigating O 3 pollution in this region. In this study, simultaneous field experiments were conducted for air pollutants in a typical urban area (Suzhou) in the YRD region in 2022. The capacity of in-situ O 3 formation, O 3 -NO X -VOCs sensitivities and sources of O 3 precursors were analyzed. The results showed that in-situ formation contributed 20.8 % of the O 3 concentration in the warm season (April to October) of the Suzhou urban area. Compared with the warm season average, the concentrations of various O 3 precursors increased on pollution days. The O 3 -NO X -VOCs sensitivity was the VOCs-limited regime based on the average concentrations during the warm season. O 3 formation was most sensitive to anthropogenic VOCs, of which oxygenated VOCs, alkenes and aromatics were the key species. There was a VOCs-limited regime in spring and autumn, while a transitional regime in summer due to the changes in NO X concentrations. This study considered NO X emission from VOCs sources and calculated the contribution of various sources to O 3 formation. The results of VOCs source apportionment showed that diesel engine exhaust and fossil fuel combustion had a dominant proportion, but O 3 formation presented significant negative sensitivities to the above two sources because of their high NO X emissions. There were significant sensitivities of O 3 formation to gasoline vehicle exhaust and VOCs evaporative emissions (gasoline evaporation and solvent usage). The contribution of VOCs evaporative emissions during the O 3 pollution episode was significantly higher than the average; therefore, controlling VOCs evaporative emissions during the O 3 pollution episode is critical. These results provide feasible strategies to mitigate O 3 pollution., 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.)

High N-fertilizer applications to conventional vegetable production systems are associated with substantial emissions of NH 3 , a key substance that triggers haze pollution and ecosystem eutrophication and thus, causing considerable damage to human and ecosystem health. While N fertilization effects on NH 3 volatilization from cereal crops have been relatively well studied, little is known about the magnitude and yield-scaled emissions of NH 3 from vegetable systems. Here we report on a 2-year field study investigating the effect of various types and rates of fertilizer application on NH 3 emissions and crop yields for a pepper-lettuce-cabbage rotation system in southwest China. Our results show that both NH 3 emissions and direct emission factors of applied N varied largely across seasons over the 2-year period, highlighting the importance of measurements spanning entire cropping years. Across all treatments varying from solely applying urea fertilizers to only using organic manures, annual NH 3 emissions ranged from 0.64 to 92.4 kg N ha -1  yr -1 (or 0.07-6.84 g N kg -1 dry matter), equivalent to 0.05-5.99% of the applied N. At annual scale, NH 3 emissions correlated positively with soil δ 15 N values, indicating that soil δ 15 N may be used as an indicator for NH 3 losses. NH 3 emissions from treatments fertilized partially or fully with manure were significantly lower compared with the urea fertilized treatment, while vegetable yields remained unaffected. Moreover, full substitution of urea by manure as compared to the partial substitution further reduced the yield-scaled annual NH 3 emissions by 79.0-92.4%. Across all vegetable seasons, there is a significant negative relationship between yield-scaled NH 3 emissions and crop N use efficiency. Overall, our results suggest that substituting urea by manure and reducing total N inputs by 30-50% allows to reduce NH 3 emissions without jeopardizing yields. Such a change in management provides a feasible option to achieve environmental sustainability and food security in conventional vegetable systems., 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 Ltd. All rights reserved.)

We retrospectively investigated CRKP isolates among 92 pediatric patients (32 neonates and 60 non‑neonates) in 2019 and 2020 (59 and 33 isolates, respectively) to investigate the molecular characteristics and virulence factors of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from pediatric patients,. All the CRKP isolates were subjected to antimicrobial susceptibility testing, string testing, molecular typing of virulence and carbapenemase genes, and multilocus sequence typing. Hypervirulent K. pneumoniae (Hvkp) was defined based on the detection of the regulator of mucoid phenotype A (rmpA).Sequence type 11 (ST11) accounted for the majority of infections in both neonates (37.5%) and non‑neonates (43.3%) (P > 0.05), whereas it increased from 30.5% (18/59) in 2019 to 60.6% (20/33) in 2020 (P < 0.05). Carbapenemase gene KPC-2 was predominant in both neonates and non‑neonates (46.9% vs. 51.7%, respectively), followed by New Delhi metallo-beta-lactamase 1 (NDM-1) (34.4% vs. 28.3%, respectively) (all P > 0.05). Compared to 2019, the proportion of bla NDM-1 decreased (44.1% vs. 6.1%) (P < 0.001), while that of bla KPC-2 increased (40.7% vs. 66.7%) (P = 0.017) in 2020. ybtS and iutA had a higher positivity rate in KPC-2 and ST11 producers (all P < 0.05); the KPC-2-, ybtS-, and iutA-positive isolates showed relatively higher resistance to fluoroquinolones and aminoglycosides, nitrofurantoin, and piperacillin/tazobactam, respectively. Furthermore, the combined expression (95.7%, 88/92) of carbapenemase and virulence-associated genes was detected, with the carbapenemase genes bla KPC-2 and bla TEM-1 combined with virulence-associated genes entB, mrkD, and ybtS accounting for the highest percentage (20.7%).Carbapenemase gene mutations in the CRKP strain from 2019 to 2020 highlight the importance of dynamic monitoring. The spread of hypervirulence-associated genes in CRKP strains and the high positivity rates of ybtS and iutA in KPC-2- and ST11-producing ones signify their high virulence potential in pediatric patients., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

An accurate assessment of human exposure to pollutants through the ingestion of dust and/or soil particles depends on a thorough understanding their rate of human ingestion. To this end, we investigated the load and size distribution patterns of dust/soil particles on the hands of three typical subpopulations, including preschoolers, college students, and security guards (outdoor workers). The geometric mean diameter of dust/soil particles on hands was observed to be 38.7 ± 11.2, 40.0 ± 12.1, and 36.8 ± 10.4 μm for preschoolers, college students, and security guards, respectively. The particle size distribution differed between subpopulations: Preschoolers were more exposed to fine particles, whereas security guards were exposed to more coarse particles. The geometric means of dust/soil particle loading on the hands were 0.126, 0.0163, and 0.0377 mg/cm 2 for preschoolers, college students, and security guards, respectively. Males had statistically higher dust/soil particle loadings on hands than females, notably for preschoolers and college students; preschoolers with frequent hand contact with the bare ground had higher dust/soil particle loadings compared to those of peers in contact with commercial and residential grounds. The mean total dust/soil particle ingestion rate was estimated to be 245, 19.7, and 33.1 mg/day for preschoolers, college students, and security guards, respectively. Our estimates for college students and security guards are close to the consensus central-tendency values recommended by the U.S. EPA's Exposure Factor Handbook for American adults, whereas the estimates for children are much higher than the upper percentile values recommended for American children., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

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.)

Due to the increasing number of returnees from malaria endemic areas, imported malaria has become a public health challenge in China. To better understand the characteristics of imported Plasmodium species and adjust appropriate strategies for malaria prevention and control in Eastern China, we conducted molecular detection and species identification on 1282 imported malaria cases in Shandong Province between 2012 and 2018. The findings showed that P. falciparum was predominant, particularly in cases imported from Africa. P. vivax was the dominant species imported from Asian countries. Additionally, imported P. ovale and P. malariae emerged in the province. Further surveillance and control of imported malaria among returnees from Africa and Southeast Asia is needed to be strengthened in Eastern China., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Globally, nations are increasingly focusing on green innovation in their environmental protection efforts as part of sustainable development, and digital finance is playing a vital role in enhancing green innovation. Employing annual data from 220 prefecture-level cities between 2011 and 2019, we empirically analyze the connections among environmental performance, digital finance, and green innovation via the Karavias panel unit root test with structural breaks, the Gregory-Hansen structural break cointegration test and pooled mean group (PMG) estimation. The following four points are the key conclusions: (1) The results support cointegration links between these variables when structural breaks are considered. (2) The PMG estimation outcomes indicate that green innovation and digital finance may have a favorable long-term effect on environmental performance. (3) For better environmental performance and more green innovation, the level of digitalization of digital finance is crucial. (4) The potential of digital finance and green innovation to improve environmental performance has not been fully realized in the western region of 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 © 2023 Elsevier Ltd. All rights reserved.)

Background: Soil-transmitted helminths (STHs) were previously endemic in Shandong Province, China. This study aimed to analyze the STHs prevalence trend and the natural, social, and human cognitive and behavioural factors influencing the discrepancies between high and low infection levels from 2016 to 2020 in Shandong Province in eastern China., Methods: STHs surveillance data of Shandong Province from 2016 to 2020 were obtained from China Information Management System for Prevention and Control of Parasitic Diseases. STHs infections were detected by modified Kato-Katz method. Comprehensive information on the natural and social factors, STHs-related knowledge and behaviours were collected through questionnaire surveys. Retrospective spatial scan analysis was performed using SaTScan v10.1 to evaluate any identified spatial clusters of STHs infection for statistical significance and Bayes discriminant analysis was used to discriminate the high or low infection groups of the villages., Results: In total, 72,160 participants were involved in our survey from 2016 to 2020. The overall STHs prevalence rate was 1.13%, with the eastern region of Shandong Province having the highest rate (2.02%). The predominant species was T. trichiura, with the prevalence rate of 0.99% and the ≥ 70-year age group possessed the highest rate of 2.21%. The STHs prevalence rate showed an annual linear downward trend from 2016 to 2020 ([Formula: see text] = 127.600, P < 0.001). Respondents aged ≥ 60 years had the lowest awareness level of STHs-related prevention knowledge (all P < 0.05), and were the most likely to adopt the practice of fertilizing with fresh stool (χ 2  = 28.354, P < 0.001). Furthermore, the southern region demonstrated the highest temperature and rainfall level and the lowest GNP and annual net income per capita (all P < 0.05)., Conclusions: There is a remarkable declining in STHs prevalence in Shandong Province from 2016 to 2020. However, the prevalence rates of STHs especially T. trichiura in the southern and eastern regions were still high, and the elderly were more susceptible to be infected with STHs owning to their low awareness level of STHS-related prevention knowledge and high adoption rate of dangerous production and living behaviours. Integrated approaches of health education, environment improvement and behaviour change should be strengthened to obtain a further reduction of STHs prevalence in China., (© 2023. The Author(s).)

Introduction: The outflow and scarcity of physicians in rural areas can adversely affect universal health coverage and population health outcomes, which are critical concerns in China. This study explored primary healthcare physicians' job preferences using a discrete choice experiment to identify appropriate incentives for retention., Methods: Eight job characteristics were identified through a literature review and qualitative studies as the attributes relevant to designing the discrete choice experiment, with levels varying between two hypothetical jobs. The data were analysed using conditional logit model, mixed logit model and latent class model., Results: A total of 1781 licensed physicians (including licensed assistant physicians) from township health centres in rural areas were surveyed. Policy simulation suggested that they were sensitive to both monetary and non-monetary policy incentives. As for non-monetary job characteristics, a highly intense doctor-patient relationship, bianzhi (the number of personnel allocated to each employer by the government) and educational opportunities were highly valued by the respondents. The latent class model could identify distinct groups with different job preferences according to their memberships., Conclusion: Urban jobs were much preferred to rural ones. However, policy incentives can lend themselves to effective retention strategies. It is also important to tailor policy incentives to different subgroups., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Coronavirus disease 2019 (COVID-19) has become a global epidemic, and there is no specific treatment for anti-COVID-19 drugs. However, treatment of COVID-19 using Chinese herbal medicine (CHM) has been widely practiced in China. PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP databases were searched to evaluate the efficacy and safety of CHM in the treatment of COVID-19. Twenty-six studies were included in this meta-analysis. The included cases were all patients diagnosed with COVID-19 according to the "New Coronary Virus Pneumonia Diagnosis and Treatment Program," with a total of 2,407 cases. Patients were treated with CHM, including 36 prescriptions, and 105 flavors of CHM were included. The results of the meta-analysis showed that the CHM group improved in lung CT, clinical cure rate, clinical symptom score and time to negative for viral nucleic acid. However, this study still has many limitations due to the limited number of included studies. Therefore, high-quality RCT studies are needed to provide more reliable evidence for CHM treatment of COVID-19. In conclusion, CHM may significantly improve the clinical manifestations and laboratory indicators of patients with COVID-19. In addition, no serious adverse reactions were found after CHM treatment. Therefore, CHM may be used as a potential candidate for COVID-19. HIGHLIGHTS: COVID-19 has become a global epidemic, and there is no specific treatment for anti-COVID-19 drugs. CHM has made a new breakthrough in the treatment of COVID-19. CHM may relieve lung CT images of COVID-19 patients. CHM may improve clinical symptoms of COVID-19 patients. CHM may inhibit the expression of inflammatory factors in patients with COVID-19., (© 2022 John Wiley & Sons Ltd.)

Objectives: To reveal the clinical and molecular characteristics of Bordetella pertussis (BP) prevalent in Shanghai, China., Methods: A total of 9430 children with suspected pertussis from 2021 to 2022 were included, and nasopharyngeal swab samples were collected for polymerase chain reaction detection, culture, antimicrobial susceptibility testing, and 23S rRNA gene A2047G detection. BP strains were typed using multilocus variable-number tandem-repeat analysis and virulence genotyping., Results: Of 9430 cases, 5.1% and 1.6% were confirmed by polymerase chain reaction and culture, respectively. Infants (aged <1 year) accounted for 24.7% and presented much more severe symptoms than noninfants. Pertussis was most frequently detected in infants aged 0-6 months (11.3∼14.0%) and children aged >6-10 years (10.8∼21.7%). Macrolide-resistant BP (MRBP) accounted for 89.3%, and all carried the A2047G mutation. There were six multilocus variable-number tandem-repeat analysis types (MTs), including MT28 (62.0%), MT195 (20%), MT27 (10.0%), MT104 (4.7%), MT55 (2.7%), and MT32 (0.7%). BP strains with pertussis toxin (ptx)P3/(pertactin) prn2/ptxC2/ptxA1/(fimbrial proteins) fim2-1/fim3-1, including MT27, MT28, and MT32, accounted for 72.7%, among which MT27 and MT32 were macrolide-sensitive BP, whereas most (94.6∼100%) of MT28 were MRBP. Strains harboring ptxP1/prn1/ptxC1/ptxA1/fim2-1/fim3-1, including MT55, MT104, and MT195, belonged to macrolide-sensitive BP., Conclusion: The emergence and spread of MT28 ptxP3-MRBP was first reported in China, highlighting the importance of continuous surveillance of ptxP3-MRBP to prevent its potential circulation., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The future trends and development trajectory of China's carbon emissions trading scheme (ETS), one of the key policy instruments for curbing peak carbon emissions and achieving carbon neutrality, have drawn a lot of interest. However, the Porter hypothesis (PH) and its validity boundary have not been explored sufficiently. We use micro-firm data from 2010 to 2019 to investigate whether the triple-difference (DDD) method could reveal the weak PH on the policy viewing ETS as a quasi-natural experiment in this work. Meanwhile, we use the panel threshold model and the moderated mediation effect model to assess the scientific border of the PH on the ETS. The findings show that by verifying the weak PH, the ETS may greatly enhance investment and foster the inventiveness of heavy-polluting industries (HPE). In contrast, the strong PH on the ETS has unstable validity and has non-linear characteristics. In particular, the ETS shows a U-shaped link between innovation and profitability by first decreasing and then increasing HPE's profitability through R&D. The cost of R&D and compliance costs being combined negatively impacts HPE's profitability. Further analysis shows that ETS will have different effects on the profitability of HPE due to R&D level and the threshold change of the compliance cost. This paper will offer some insightful points of view for the implementation of carbon market mechanisms in developing nations like China., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Green innovation is an important strategy in seeking sustainable competitive advantages. This paper investigates the impact of enterprise digitization on green innovation and its mechanisms. We find that enterprise digital transformation has a significant effect on the promotion of green innovation. This positive effect mainly stems from the advantage of resource reallocation generated by enterprise digitalization that can alleviate financing constraints and raise risk-taking levels. Furthermore, the level of economic development strengthens the impact of enterprise digitization on green innovation, and the positive relationship between enterprise digitization and green innovation is stronger in regions with stronger environmental regulation and higher intellectual property protection, as well as in state-owned and heavily polluting enterprises. Digitization can optimize resource utilization, strengthen the capacity of green innovation in pollution reduction and promote the clean production of enterprises. Our results show that enterprise digitization plays a positive role in innovation activities. Furthermore, our results show that enterprise digitization plays a positive role in innovation activities.

Over the past 40 years of reform and opening-up, China has achieved rapid economic and technological growth at the cost of severe air pollution. The emerging Fintech, as the result of financial institutions' adapting to the latest digital technology, might be a solution to reduce air pollution. This paper investigates the impact of Fintech development on air pollution using a two-factor fixed effects model based on data for prefecture-level cities in China from 2011 to 2017. The findings show that Fintech development can effectively reduce air pollution emissions, and this conclusion is proved to be robust throughout a series of tests. The mechanism analysis shows that Fintech reduces air pollution by promoting digital finance and green innovation.