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Background: This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness. Methods: A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis. Results: Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45–0.48) were higher than parents (r = 0.18–0.23). In the line of congruence, there were positive linear (a1 = 1.09–1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01). Conclusion: The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted. [ABSTRACT FROM AUTHOR]

The majority of pigeon paramyxovirus type 1 (PPMV-1) strains are generally non-pathogenic to chickens; however, they can induce severe illness and high mortality rates in pigeons, leading to substantial economic repercussions. The genomes of 11 PPMV-1 isolates from deceased pigeons on meat pigeon farms during passive monitoring from 2009 to 2012 were sequenced and analyzed using polymerase chain reaction and phylogenetic analysis. The complete genome lengths of 11 isolates were approximately 15,192 nucleotides, displaying a consistent gene order of 3′-NP-P-M-F-HN-L-5′. ALL isolates exhibited the characteristic motif of 112RRQKRF117 at the fusion protein cleavage site, which is characteristic of velogenic Newcastle disease virus. Moreover, multiple mutations have been identified within the functional domains of the F and HN proteins, encompassing the fusion peptide, heptad repeat region, transmembrane domains, and neutralizing epitopes. Phylogenetic analysis based on sequences of the F gene unveiled that all isolates clustered within genotype VI in class II. Further classification identified at least two distinct sub-genotypes, with seven isolates classified as sub-genotype VI.2.1.1.2.2, whereas the others were classified as sub-genotype VI.2.1.1.2.1. This study suggests that both sub-genotypes were implicated in severe disease manifestation among meat pigeons, with sub-genotype VI.2.1.1.2.2 displaying an increasing prevalence among Shanghai's meat pigeon population since 2011. These results emphasize the value of developing pigeon-specific vaccines and molecular diagnostic tools for monitoring and proactively managing potential PPMV-1 outbreaks. [ABSTRACT FROM AUTHOR]

Hospital beds are one of the most critical resources in healthcare institutions. In practice, beds are usually allocated to different departments in advance to accommodate different kinds of patients. Inappropriate decisions in the allocation may lead to the idleness of beds or the high rejection ratio of patients. Hospital managers are under pressure to allocate beds to different departments. High variability in patient arrivals and service times make the allocation problem complex and challenging to solve. To address this problem, a mixed-integer non-linear programming model is formulated, with the objective of minimising the weighted cost of rejecting patients and holding them waiting. To solve this model, a data-driven metamodel simulation optimisation method is proposed, in which metamodels, based on an analytical queuing model and a general function, are proposed and embedded into a general-purpose algorithm Adaptive Hyperbox Algorithm. The metamodels designated for local and global approximation are separately fitted using different sets of simulation observations, which can combine structural information and simulation information, and can provide insightful guidance in solution improvements. A case study is conducted based on the real data collected from a public hospital in Shanghai. Numerical results demonstrate the efficiency of the proposed method. [ABSTRACT FROM AUTHOR]

To evaluate the impact of a two-dose VarV program on varicella incidence among the whole population, considering the influence of public health and social measures (PHSMs), we extracted surveillance data on varicella cases during 2013–2022 in Minhang, Shanghai. Then, we estimated the incidence trend of varicella through interrupted time-series analyses and quantified the impact of the immunization program and PHSMs using Serfling regression. We also explored the associations between PHSMs and varicella cases. The implementation of the two-dose VarV strategy was followed by a significant decrease in varicella incidence (−1.84% per month). After one year of the program, varicella incidence was estimated at a 45.25% reduction, which was higher in children (59.12% and 54.09%) than in adults (19.49%). The decrease attributed to PHSMs was 31.26% during 2020–2022, and school closing was identified as the most relevant PHSM (b = −8.03 cases, r = −0.67 with a 1-week lag). These findings indicate that the two-dose immunization program has more effectively reduced the varicella incidence compared with the one-dose vaccine, and interventions like school closings are also encouraged to serve as supplementary measures to prevent varicella epidemics. [ABSTRACT FROM AUTHOR]

Nitrogen (N) is a constituent element of ambient organic aerosol; however, we have limited knowledge of the total quantity of organic N (ON) and its relative importance to aerosol N due to a lack of effective analytical methods for ON. Here, we report first online measurements of ON in particulate matter (PM2.5) in urban Shanghai in summer of 2021 using a newly developed aerosol nitrogen analyzer. ON accounted for an average of 25% of total aerosol N and varied in the range of 5%–64% on the hourly scale. Hourly variations identified four distinct types of ON episodes that occurred in different hours of a day. Analysis aided by concurrently measured source indicative pollutants revealed that vehicular emissions, nocturnal chemistry, daytime photochemistry or combined primary sources, and secondary chemistry could drive up ON under different day‐to‐day atmospheric conditions. Our results help bridge the knowledge gap in the emissions and formation of organic aerosol. Plain Language Summary: Atmospheric particulate matter (PM) exerts profound influences on urban air quality and human health. A large fraction of ambient aerosol is organic matter, in which nitrogen (N)‐containing molecules are known constituents. However, our knowledge is extremely limited about the abundance and sources of nitrogenous organics due to a lack of convenient measurement tools to quantify the total aerosol organic nitrogen (ON) in the past. This hurdle has been lifted through our recently developed aerosol nitrogen analyzer that can provide sensitive and simultaneous determinations of aerosol organic and inorganic N. Here, we present a first report of bihourly measured ON at an urban site of Shanghai, a megacity in China during a period of two and a half summer months. ON represented 25% of aerosol N on average and hourly data varied from 5% to 64%. The results indicated importance of ON comparable to that of inorganic N species (i.e., NH4+ ${\text{NH}}_{4}^{+}$, NO3− ${\text{NO}}_{3}^{-}$) and that the sources/chemistry of ON molecules are considerably dynamic. Past attention has been predominantly placed on inorganic N pollutants or carbonaceous materials in addressing urban PM pollution. This work highlights the need to consider the role of ON, especially as efforts of decarbonization in energy sources unfold. Key Points: First hourly observation of aerosol total organic nitrogen (ON) at an urban site revealed ON made up 5%–64% of total aerosol nitrogenHourly data identified distinct ON episode types that occurred in different hours of a day linked to dominant sources of varying originsSource indicators revealed vehicle emissions, coal combustion, nocturnal chemistry and daytime photochemistry were major sources of urban ON [ABSTRACT FROM AUTHOR]

Reports of rare but severe thrombotic events after receiving some COVID‐19 vaccines brought concerns for the possibility of vaccine‐induced coagulation abnormality. However, no study has reported the impacts of COVID‐19 vaccination on coagulation function in pregnant women. We aimed to explore whether vaccination with inactivated COVID‐19 vaccines before pregnancy was associated with coagulation changes in pregnant women. We conducted a retrospective cohort study in a tertiary‐care hospital in Shanghai, China. A total of 5166 pregnant women were included, of whom 2721 (52.7%) completed vaccination before conception. Compared with unvaccinated women, the mean serum levels of prothrombin time (PT) and fibrinogen (FIB) were lower in vaccinated women by 0.09 (β = −0.09, 95% confidence interval [CI], −0.13, −0.05) mg/L and 0.11 (β = −0.11, 95% CI, −0.15, −0.07) mg/L, and the mean D‐Dimer (D‐D) levels were higher by 0.12 (β = 0.12, 95% CI, 0.09, 0.15) mg/L. However, no significant association was observed between COVID‐19 vaccination and serum levels of activated partial thromboplastin time (APTT), fibrinogen degradation product (FDP) or thrombin time (TT). Our findings suggested that inactivated COVID‐19 vaccination before conception resulted in a small change in maternal coagulation function, but this might not have clinical significance. [ABSTRACT FROM AUTHOR]

Organic aerosol (OA) is a significant part of urban fine particulate matter (PM 2.5), and a lack of detailed knowledge of their sources has increasingly hindered the improvement of air quality in China in recent years, as significant reductions have been achieved in inorganic ion constituents. In this study, a wide range of organic molecular markers in PM 2.5 were monitored with a bi-hourly time resolution using a thermal desorption aerosol gas chromatograph system (TAG) in urban Shanghai in winter 2019. The molecular marker data have provided a unique source tracking ability in characterizing the evolution of organic aerosols during nine wintertime episodic events. Episodes primarily influenced by local air masses were characterized with higher proportions in PM 2.5 and mass increments of both primary and secondary OA. Rapid increases in both the absolute mass concentration and relative proportion were observed for primary and secondary OA markers, indicative of vehicle emissions (e.g., alkanes, hopanes, and 2,3-dihydroxy-4-oxopentanoic acid) and cooking activities (e.g., saturated and unsaturated fatty acids and C 9 acids). In comparison, episodes under significant influences of transported air mass were typically associated with a predominant PM 2.5 contribution from secondary inorganic aerosols and enhanced OA contribution from biomass burning activities. The latter was evident from the tracer data (e.g., levoglucosan, aromatic polycarboxylic acids, and nitroaromatic compounds). Secondary OA markers associated with later-generation products of the hydrocarbon oxidation process, such as C 3-5 dicarboxylic acids, were the most deficient during local episodes, while notably enhanced during the episodes under the influence of transported air masses, reflecting the different extent and pathways of atmospheric aging processing. The ability to distinguish the variations in the OA evolution during different types of episodes demonstrates the value of online organic molecular measurements for episodic analysis. The results indicate that control of local urban sources such as vehicular and cooking emissions would lessen severity of local episodes, while regional control of precursors for secondary inorganic aerosols and biomass burning activities would reduce PM 2.5 episodes under synoptic conditions conducive for regional transport. [ABSTRACT FROM AUTHOR]

Data on the safety of inactivated COVID‐19 vaccines in pregnant women is limited and monitoring pregnancy outcomes is required. We aimed to examine whether vaccination with inactivated COVID‐19 vaccines before conception was associated with pregnancy complications or adverse birth outcomes. We conducted a birth cohort study in Shanghai, China. A total of 7000 healthy pregnant women were enrolled, of whom 5848 were followed up through delivery. Vaccine administration information was obtained from electronic vaccination records. Relative risks (RRs) of gestational diabetes mellitus (GDM), hypertensive disorders in pregnancy (HDP), intrahepatic cholestasis of pregnancy (ICP), preterm birth (PTB), low birth weight (LBW), and macrosomia associated with COVID‐19 vaccination were estimated by multivariable‐adjusted log‐binomial analysis. After exclusion, 5457 participants were included in the final analysis, of whom 2668 (48.9%) received at least two doses of an inactivated vaccine before conception. Compared with unvaccinated women, there was no significant increase in the risks of GDM (RR = 0.80, 95% confidence interval [CI], 0.69, 0.93), HDP (RR = 0.88, 95% CI, 0.70, 1.11), or ICP (RR = 1.61, 95% CI, 0.95, 2.72) in vaccinated women. Similarly, vaccination was not significantly associated with any increased risks of PTB (RR = 0.84, 95% CI, 0.67, 1.04), LBW (RR = 0.85, 95% CI, 0.66, 1.11), or macrosomia (RR = 1.10, 95% CI, 0.86, 1.42). The observed associations remained in all sensitivity analyses. Our findings suggested that vaccination with inactivated COVID‐19 vaccines was not significantly associated with an increased risk of pregnancy complications or adverse birth outcomes. [ABSTRACT FROM AUTHOR]

We found that 11 outbreak patients and 18 community patients were grouped into three clusters (Figure 1B), containing 3, 7 and 19 patients, respectively, suggesting frequent TB transmission between outbreak and community patients. Possible strategies for increasing TB control might include TB screening and TB education for all migrants applying for work. The WGS database of all TB strains isolated from patients in Songjiang since 2011 was very useful for identifying the transmission chains and should remain a valuable tool for defining local TB epidemiology. All 12 patients were diagnosed with severe tuberculosis (TB) and three of the patients (P05, P08, P09) died, whereas the rest were treated and cured. [Extracted from the article]

Despite the high vaccination coverage, potential COVID‐19 vaccine‐induced adverse effects, especially in pregnant women, have not been fully characterized. We examined the association between COVID‐19 vaccination before conception and maternal thyroid function during early pregnancy. We conducted a retrospective cohort study in Shanghai, China. A total of 6979 pregnant women were included. Vaccine administration was obtained from electronic vaccination records. Serum levels of thyroid hormone were measured by fluorescence and chemiluminescence immunoassays. Among the 6979 included pregnant women, 3470 (49.7%) received at least two doses of an inactivated vaccine. COVID‐19 vaccination had a statistically significant association with both maternal serum levels of free thyroxine (FT4) and thyroid stimulating hormone (TSH). Compared with unvaccinated pregnant women, the mean FT4 levels were lower in pregnant women who had been vaccinated within 3 months before the date of conception by 0.27 pmol/L (β = −0.27, 95% confidence interval [CI], −0.42, −0.12), and the mean TSH levels were higher by 0.08 mIU/L (β = 0.08, 95% CI, 0.00, 0.15). However, when the interval from vaccination to conception was prolonged to more than 3 months, COVID‐19 vaccination was not associated with serum FT4 or TSH levels. Moreover, we found that COVID‐19 vaccination did not significantly associate with maternal hypothyroidism. Our study suggested that vaccination with inactivated COVID‐19 vaccines before conception might result in a small change in maternal thyroid function, but this did not reach clinically significant levels. [ABSTRACT FROM AUTHOR]

Objective: Recent data show that maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) are associated with offspring neurobehavior in childhood. However, little is known about the effect on infants that less than 20 months of age, and whether this association has sex differences. Methods: In this birth cohort study, a total of 661 mother–infant pairs were enrolled in Shanghai, China, between February 2017 and April 2019. Maternal prepregnancy BMI was categorized according to the Chinese classification and GWG according to the 2009 Institute of Medicine (IOM). Neurobehavioral development for infants of 12 months of age was assessed by Gesell Developmental Scale (GDS), which contained five subscales of gross motor, fine motor, adaptive behavior, language, and social behavior. Results: Abnormal maternal prepregnancy BMI and excessive GWG were associated with infant birth weight and/or birth length (p < .05), while no influence was found on yearling weight or length. Women who were overweight/obese prior to pregnancy or excessive GWG during pregnancy had infants who were more deficient in neurobehavioral developmental including language (p < .01) and/or social behavior (p < .05). Specifically, excessive GWG was associated with lower language ability in girls but not boys (p < .05). Conclusions: Aberrant prepregnancy BMI and excessive GWG not only affect the body size of newborn infants, but also impair their neurobehavioral development, suggesting that general guidance to the women should be advised to attain optimal prepregnancy BMI and GWG [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore serum spexin levels in newly diagnosed type 2 diabetes mellitus (T2DM) patients with different body mass indexes (BMIs) and to investigate the changes of spexin after improvement of metabolic indicators. Methods: A total of 323 newly diagnosed T2DM patients from national Metabolic Management Center (MMC) in Shanghai General Hospital were recruited. T2DM patients were categorized into three groups: diabetes with obesity group (DM-OB group, BMI=28 kg/m2, n=89), diabetes with overweight group (DM-OV group, 24=BMI<28 kg/m2, n=161), and diabetes with normal weight group (DM-NW group, 18=BMI<24 kg/m2, n=73). In addition, 41 volunteers with normal glucose tolerance (NGT) were used as controls. Spexin and metabolic parameters were compared at baseline, and changes after MMC follow-up in 100 DM patients were investigated. Results: In the DM-OB group, the level of spexin was significantly lower than that in the DM-OV group and the DM-NW group (P < 0.01). Spexin was significantly negatively related to body mass index (BMI, b=-0.214, P<0.001), waist circumference (b=-0.249, P<0.001), visceral fat area (VFA, b=-0.214, P<0.001), and subcutaneous fat area (SFA, b=-0.265, P<0.001) after adjustment for age and sex. Among all the metabolic indicators, the decline in BMI in the DM-OB group was the most obvious among those in the three groups (-3.7 ± 0.8 kg/m2 vs. -0.9 ± 0.3 kg/m2 vs. 0.7 ± 0.6 kg/m2, P<0.01) after one year of MMC standardized management. The serum spexin level in the DM-OB group increased the most (1.00 ± 0.10 ng/mL vs. 0.49 ± 0.06 ng/mL in DM-OV group and 0.58 ± 0.09 ng/mL in DM-NW group, P < 0.001). Conclusions: Serum spexin differed in newly diagnosed T2DM patients according to BMI and was lowest in the DM-OB group. With the improvement of metabolic indicators, especially the decline in BMI, serum spexin increased significantly after MMC management. [ABSTRACT FROM AUTHOR]

Background: The management of latent tuberculosis infection (LTBI) is a key action for the realization of the "End tuberculosis (TB) Strategy" worldwide, and it is important to identify priority populations. In this prospective cohort study, we evaluated the prevalence of LTBI and incidence of active TB among close contacts and explored the suitable TB control strategy in schools. Methods: We designed a cohort with 2 years of follow-up, recruiting freshman/sophomore TB patients' close contacts from three administrative districts in Shanghai. These were chosen based on different levels of TB incidence reported in 2019. Questionnaires were included and all participants received both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) at baseline, then tracked the outcomes of them during the follow-up period. Results: The prevalence of LTBI was 4.8% by QFT. Univariate analysis showed that the risk of LTBI was higher in those contacting bacteriologically confirmed patients or did not have BCG scars, including smokers. The risk increased with poor lighting and ventilation conditions at contact sites. Multivariate analysis showed that those contacting with bacteriologically confirmed patients (OR=4.180; 95%CI, 1.164-15.011) or who did not have BCG scars (OR=5.054; 95%CI, 2.278-11.214) had a higher risk of being LTBI, as did the current smokers (OR=3.916; 95%CI, 1.508-10.168) and those who had stopped smoking (OR=7.491; 95%CI, 2.222-25.249). During the 2-year follow-up period, three clinically diagnosed cases of TB were recorded, the 2-year cumulative incidence was 0.4% (95%CI 0.1-1.2), the median duration for TB occurrence was 1 year, the incidence rate of active TB was 2.0 per 1000 person-years with a total of 1497.3 observation person-years. For those LTBI, no one initiated preventive treatment, in the QFT (+) cohort, 1 TB case was observed, 71 person-years with an incidence rate of 14.1 14.1 (95%CI 2.5-75.6) per 1000 person-years, in the TST (+++) cohort, 2 TB cases were observed 91.5 personyears with an incidence rate of 21.9 (95%CI 6.0-76.3) per 1000 person-years. Conclusions: The results suggest that school close contacts are one of the key populations for LTBI management. Measures should be taken to further reduce the prevalence of LTBI and the incidence of active TB among them. [ABSTRACT FROM AUTHOR]

Objectives: Children with autism spectrum disorder (ASD) can exhibit persistent deficits in social communication, causing their mothers to experience elevated parenting stress during the childrearing process. Some internal and external psychosocial resources may mediate or moderate the mother-child relationship, though the underlyingmechanisms remain unclear. This study aimed to explore the predictors of parenting stress in mothers of children with ASD and elucidate the mechanisms underlying the relationship between child social impairment and parenting stress. Methods: A cross-sectional study was conducted between October 2020 and March 2022 in Shanghai, China. Mothers of children with ASD completed a survey investigating child social impairment, parenting stress, parental self-effcacy, and social support. Results: A total of 185 mothers of children with ASD were included in the final analysis. 70.27 percent of mothers experienced a clinically significant level of parenting stress. Child social impairment (r = 0.46, P < 0.001), parental self-effcacy (r = -0.58, P < 0.001), and social support (r = -0.35, P < 0.001) were significantly correlated with parenting stress. Parental self-effcacy completely mediated the relationship between child social impairment and parenting stress (B = 0.51, P < 0.001), after controlling for socioeconomic status (SES) correlated with parenting stress. There was no significant moderating effect of social support between child social impairment and parenting stress (B = 0.01, P = 0.09). Conclusion: Future early intervention programs that focused on child's social communication skills and empoweredmothers with related strategies through group-based parent training programs may help reduce parenting stress. [ABSTRACT FROM AUTHOR]

Numerous Global Positioning System connected vehicles are collecting extensive data remotely in cities, enabling data-driven infrastructure planning. To truly benefit from this emerging technology, it is important to combine telematics and map data to make it easier to extract and mine useful information from the data. By performing map matching, data points that cannot be accurately located on the road network can be projected onto the correct road segment. As an important means of remote data processing, it has become an important pre-processing step in the field of data mining. However, due to the various errors of location devices and the complexity of road networks, map matching technology also faces great challenges. In order to improve the efficiency and accuracy of the map matching algorithm, this study proposes an offline method for low-frequency trajectory data map matching based on vehicle trajectory segmentation. First, the trajectory is segmented based on the vehicle's travel direction. Then, the comprehensive probability of the corresponding road segment is calculated based on the spatial probability and the directional probability of each road segment around the location. Third, the k candidate matching paths under consideration are selected based on the comprehensive probability evaluation. Finally, the shortest path planning and the probability calculation of the different candidate paths are combined to find the optimal matching path. The experimental results on the real trajectory dataset in Shanghai and the road network environment show that the proposed algorithm has better accuracy, efficiency, and robustness than other algorithms. [ABSTRACT FROM AUTHOR]

Background: Differential diagnosis of patients with suspected infections is particularly difficult, but necessary for prompt diagnosis and rational use of antibiotics. A substantial proportion of these patients have non-infectious diseases that include malignant tumors. This study aimed to explore the clinical value of metagenomic next-generation sequencing (mNGS) for tumor detection in patients with suspected infections. Methods: A multicenter, prospective case study involving patients diagnosed with suspected infections was conducted in four hospitals in Shanghai, China between July 2019 and January 2020. Based upon mNGS technologies and chromosomal copy number variation (CNV) analysis on abundant human genome, a new procedure named Onco-mNGS was established to simultaneously detect pathogens and malignant tumors in all of the collected samples from patients. Results: Of 140 patients screened by Onco-mNGS testing, 115 patients were diagnosed with infections; 17 had obvious abnormal CNV signals indicating malignant tumors that were confirmed clinically. The positive percent agreement and negative percent agreement of mNGS testing compared to clinical diagnosis was 53.0% (61/115) and 60% (15/25), vs. 20.9% (24/115) and 96.0% (24/25), respectively, for conventional microbiological testing (both P < 0.01). Klebsiella pneumoniae (14.8%, 9/61) was the most common pathogen detected by mNGS, followed by Escherichia coli (11.5%, 7/61) and viruses (11.5%, 7/61). The chromosomal abnormalities of the 17 cases included genome-wide variations and local variations of a certain chromosome. Five of 17 patients had a final confirmed with malignant tumors, including three lung adenocarcinomas and two hematological tumors; one patient was highly suspected to have lymphoma; and 11 patients had a prior history of malignant tumor. Conclusion: This preliminary study demonstrates the feasibility and clinical value of using Onco-mNGS to simultaneously search for potential pathogens and malignant tumors in patients with suspected infections. [ABSTRACT FROM AUTHOR]

Aerosol nitrate has become the most abundant compound during aerosol pollution in eastern China. The Chinese government implemented a stringent policy during 2013–2017 to tackle aerosol pollution. However, the response of nitrate to nitrogen oxides (NOx) reduction is unclear owing to the limitation of long‐term measurement. Here, we performed a 9‐year continuous measurement of aerosol compositions in Shanghai and confirmed a decrease in most species except nitrate. The contribution of nitrate to fine particulate matter (PM2.5) increased significantly, reaching up to 35% in pollution episodes after 2017. This is in contrast to the evident reduction in NOx emissions. We found that the elevated dinitrogen pentoxide (N2O5) hydrolysis is responsible for the observed nitrate trend. Increased ozone and decreased nitrogen dioxide (NO) facilitated the formation of N2O5, and increased nitrate proportion promoted the uptake of N2O5 and eventually enhanced the conversion efficiency of NO2 to nitrate. Our results highlight the importance of synergic control of aerosol and ozone pollution. Plain Language Summary: To tackle severe particulate matter (PM) pollution, the Chinese government tried to reduce the primary emission of pollutants, especially a stringent policy during 2013 and 2017, named Air Pollution Prevention and Control Action Plan. A particular need is to understand the respond of the chemical composition of PM2.5 to primary emission reductions, which supports the PM2.5 pollution control more effectively and scientifically. In this work, we performed a 9‐year online measurement of PM2.5 and its chemical compositions in the Yangtze River Delta from 2011 to 2019. We confirmed a significant decreasing trend for most species except nitrate, which remained unchanged in contrast to the evident reduction of nitrogen oxides. After ruling out the potential influences of meteorological parameters, we demonstrated the elevated dinitrogen pentoxide (N2O5) hydrolysis is responsible for the observed nitrate trend. Increased ozone and decreased nitrogen dioxide (NO) promoted the formation of N2O5, and increased nitrate proportion promoted the uptake of N2O5 and eventually promoted the conversion efficiency of NO2 to nitrate. Overall, the primary emission reduction strategies feedback to the elevated formation of nitrate mainly via the increased O3 production, highlighting the need for the synergic control of aerosol and atmospheric oxidation capacity in mitigating PM2.5 pollutions. Key Points: A 9‐year observation of fine particulate matter (PM2.5) chemical compositions in Shanghai from 2011 to 2019 confirmed a decrease in most species except nitrateThe conversion rate of nitrogen dioxide (NO2) to nitrate was promoted by dinitrogen pentoxide hydrolysis, resulting in a nonlinear response of nitrate to NO2 reductionIncreased ozone concentration, decreased NO concentration, and increased nitrate proportion played a key role in enhancing nitrate formation [ABSTRACT FROM AUTHOR]

Peanut (Arachis hypogaea L.) is one of the most important economic and oil crops in the world. At present, peanut varieties with rich anthocyanin in testa are rare in the market, but the selection and breeding of varieties with the related traits has always attracted the attention of breeders. In this study, two peanut varieties with the pink and purple testa, G110 (G) and Z18-40 (Z) were used to conduct interaction joint analysis of multi-omics and miRNA-target gene. The anthocyanin content of Z18-40 was 7.49–8.62-folds higher than G110 on 30 DAF (days after flowering) and 45 DAF via Ultraviolet-visible Spectrophotometer (UV-5800, Shanghai, China). And then, a total of 14 candidate genes related with the anthocyanin biosynthesis were identified for correlation in different comparison groups (R 2 ≥ 0.80), among of a novel gene Ah21440 related with hydroxycinnamoyl transferase (HCT) biosynthesis was identified. In addition, Cyanidin 3-O-glucoside (Kuromanin, pmb0550) was the only common differentially accumulated metabolite (DAM) identified using multi-omics joint analysis in G1_vs_G2, Z1_vs_Z2, G1_vs_Z1, and G2_vs_Z2, respectively. Correlation analysis of miRNA-target genes and DEGs in the transcriptome shows that, AhmiR2950 , AhmiR398 , AhmiR50 , and AhmiR51 regulated to HCT and chalcone biosynthesis related candidate genes (Ah21440 , AhCHS , AhCHI). Lastly, all of 14 candidate genes and 4 differentially expressed miRNAs were validated using quantitative real-time PCR (qRT-PCR), which trends were consistent with that of the former transcriptome data. The results provide important reference for in-depth research on the anthocyanin metabolism mechanism in peanut testa. [ABSTRACT FROM AUTHOR]

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The joint optimization problem of multiresource capacity planning and multitype patient scheduling under uncertain demands and random capacity consumption poses a significant computational challenge. The common practice in solving this problem is to first identify capacity levels and then determine patient scheduling decisions separately, which typically leads to suboptimal decisions that often result in ineffective outcomes of care. In order to overcome these inefficiencies, in this paper, we propose a novel two-stage stochastic optimization model that integrates these two decisions, which can lower costs by exploring the coupling relationship between patient scheduling and capacity configuration. The patient scheduling problem is modeled as a Markov decision process. We first analyze the properties for the multitype patient case under specific assumptions and then establish structural properties of the optimal scheduling policy for the one-type patient case. Based on these findings, we propose optimal solution algorithms to solve the joint optimization problem for this special case. Because it is intractable to solve the original two-stage problem for a general multitype system with large state space, we propose a heuristic policy and a two-stage stochastic mixed-integer programming model solved by the Benders decomposition algorithm, which is further improved by combining an approximate linear program and the look-ahead strategy. To illustrate the efficiency of our approaches and draw managerial insights, we apply our solutions to a data set from the day surgery center of a large public hospital in Shanghai, China. The results show that the joint optimization of capacity planning and patient scheduling could significantly improve the performance. Furthermore, our model can be applied to a rolling-horizon framework to optimize dynamic patient scheduling decisions. Through extensive numerical analyses, we demonstrate that our approaches yield good performances, as measured by the gap against an upper bound, and that these approaches outperform several benchmark policies. Summary of Contribution: First, this paper investigates the joint optimization problem of multiresource capacity planning and multitype patient scheduling under uncertain demands and random capacity consumption, which poses a significant computational challenge. It belongs to the scope of computing and operations research. Second, this paper formulates a mathematical model, establishes optimality properties, proposes solution algorithms, and performs extensive numerical experiments using real-world data. This work includes aspects of dynamic stochastic control, computing algorithms, and experiments. Moreover, this paper is motivated by a practical problem (joint management of capacity planning and patient scheduling in the day surgery center) in our cooperative hospital, which is also key to numerous other applications, for example, the make-to-order manufacturing systems and computing facility systems. By using the optimality properties, solution algorithms, and management insights derived in this paper, the practitioners can be equipped with a decision support tool for efficient and effective operation decisions. [ABSTRACT FROM AUTHOR]

Vaccination uptake of influenza vaccine, 23-valent pneumococcal polysaccharide vaccine (PPV23) and herpes zoster vaccine (HZV) remains low among Chinese aged 50–69 years, posing a significant public health concern. This study's aim is to determine the gap between the vaccination willingness and uptake. We conducted a face-to-face questionnaire survey among the persons aged 50–69 years in 13 communities in Shanghai in November–December 2020 to measure vaccination willingness, vaccine price sensitivity, vaccination service accessibility, and vaccine hesitancy. Then, we explored the factors influencing the vaccination uptake using a structural equation model. Vaccination willingness was 70.5% (self-paid influenza vaccine), 79.4% (free PPV23 for local persons), 54.7% (self-paid PPV23 for non-local persons), and 16.6% (self-paid HZV); however, actual uptake was 10.8% (influenza vaccine), 11.0% (free PPV23), and 2.5% (self-paid PPV23). Moreover, vaccination uptake was strongly influenced by service accessibility (β = 0.941), followed by willingness (β = 0.201), price sensitivity (β = −0.188), and medical history of vaccine-preventable diseases and underlying diseases (β = 0.176). Related knowledge (β = 0.017) and vaccine hesitancy (β = −0.003) affected the uptake indirectly. There is a gap between the vaccination willingness and uptake in Chinese elderly. It warrants specific measures, including increasing service accessibility and reforming payment mechanism, to bridge the gap. [ABSTRACT FROM AUTHOR]

Background: Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners.Methods: A cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception.Results: Of the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45-4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48-5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03-4.39, P = 0.041] before conception.Conclusions: Utilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level. [ABSTRACT FROM AUTHOR]

Background: Large-scale rural-to-urban migration has changed the epidemiology of tuberculosis (TB) in large Chinese cities. We estimated the contribution of TB importation, reactivation of latent infection, and local transmission to new TB cases in Shanghai, and compared the potential impact of intervention options.Methods: We developed a transmission dynamic model of TB for Songjiang District, Shanghai, which has experienced high migration over the past 25 years. We calibrated the model to local demographic data, TB notifications, and molecular epidemiologic studies. We estimated epidemiological drivers as well as future outcomes of current TB policies and compared this base-case scenario with scenarios describing additional targeted interventions focusing on migrants or vulnerable residents.Results: The model captured key demographic and epidemiological features of TB among migrant and resident populations in Songjiang District, Shanghai. Between 2020 and 2035, we estimate that over 60% of TB cases will occur among migrants and that approximately 43% of these cases will result from recent infection. While TB incidence will decline under current policies, we estimate that additional interventions-including active screening and preventive treatment for migrants-could reduce TB incidence by an additional 20% by 2035.Conclusions: Migrant-focused TB interventions could produce meaningful health benefits for migrants, as well as for young residents who receive indirect protection as a result of reduced TB transmission in Shanghai. Further studies to measure cost-effectiveness are needed to evaluate the feasibility of these interventions in Shanghai and similar urban centers experiencing high migration volumes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the relationship of thyroid function and glucose metabolism and to investigate the changes in thyroid function after National Metabolic Management Center (MMC) management in type 2 diabetic mellitus (T2DM). Methods: A total of 2000 euthyroid participants from MMC in Shanghai General Hospital and a community physical examination were recruited. They were categorized into four groups: normal glucose tolerance (NGT, n = 132), prediabetes (N = 147), DM well‐controlled (T2DM with glycosylated hemoglobin [HbA1c] ≤ 7%, n = 505), and DM uncontrolled (T2DM with HbA1c > 7%, n = 1216). The parameters were compared among the groups and their changes before and after MMC follow‐up in DM uncontrolled group were observed. Results: Free triiodothyronine (FT3) and free thyroxine (FT4) levels varied significantly among groups. FT3 and FT4 levels negatively correlated with HbA1c level (P < 0.05), and positively correlated with the estimated glucose disposal rate (eGDR) (P < 0.05). Following MMC management, blood glucose and insulin resistance in the DM uncontrolled group were dramatically improved (P < 0.001). Meanwhile, FT3 was elevated compared to the baseline (from 4.51 ± 0.78 pmol/L to 4.68 ± 0.87 pmol/L, P < 0.05), and reverse triiodothyronine (r‐T3) decreased from 1.03 ± 0.24 nmol/L to 0.92 ± 0.25 nmol/L (P < 0.001). Thyroid‐stimulating hormone significantly decreased as well (P < 0.001). Conclusions: Decreased free thyroid hormone levels in normal range were associated with high glucose and insulin resistance. After MMC management, improvement of blood glucose and insulin resistance were accompanied by the restoration of low‐normal thyroid function. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) infection is currently the main cause of cervical cancer and precancerous lesions in female patients. By analyzing 6-year patient data from Shanghai Zhoupu Hospital in China, we retrospectively analyzed the epidemiological characteristics of women to determine the relationship between HPV genotype and cytological test results. Methods: From 2014 to 2019, 23,724 cases of cervical shedding were collected from Zhoupu Hospital in Shanghai, China. By comparing the results of HPV and ThinPrep cytology test (TCT), the HPV infection rate of patients was retrospectively analyzed. HPV genotyping using commercial kits can detect 21 HPV subtypes (15 high-risk and 6 low-risk). According to the definition of the Bethesda system, seven types of cervical cytology results were involved. Results: 3816 among 23,724 women, nearly 16.08%, were infected with HPV. The top three highest HPV prevalence rates were high-risk type infection, including HPV52 (3.19%), 58 (2.47%) and 16 (2.34%). The number of single-type HPV infections (3480 (91.20%)) was much larger than the number of multi-type ones (336 (8.8%)). Single-type infections were mainly in women aged 50–60 (16.63%) and women under 30 (15.37%), while multi-type infections were more common in women over 60 (2.67%). By analyzing the long-term trends, between 2014 and 2019, HPV52, 58, and 16 subtypes changed significantly, and the HPV positive rate also changed significantly during this period. Among 4502 TCT positive women, 15 (4.04%), 125 (2.64%),159 (1.54%), 4202 (17.71%) and 1 (0.004%) had atypical glandular cells (AGC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL), atypical squamous cells (ASC)and cervical adenocarcinoma, respectively. The HPV infection rates were 66.08%, 63.99%, 115.20%, 119.50%, and 31.72% for NILM, AGCs, HSILs LSILs and ASCs, respectively. Conclusions: HPV and TCT screening were very important steps in the secondary prevention of cervical cancer. Through the tracking and analysis of HPV and TCT results in this study, it can provide valuable information for Shanghai's HPV screening and prevention strategies, and provide references for clinical decision-making in the treatment of cervical cancer and precancerous lesions. [ABSTRACT FROM AUTHOR]

Jiang, Tao, Liping Zhao, Yanbo Yin, Huiqian Yu, and Qingzhong Li. Evaluation of middle ear function by tympanometry and the influence of lower barometric pressure at high altitude. High Alt Med Biol. 22:70–76, 2021. Objective: To evaluate middle ear function in residents of high-altitude areas in comparison to sea-level participants. Design: Prospective observational study. Setting: All experiments were performed by experienced audiologists with a calibrated tympanometry machine. Participants: Young adults between the age of 17 and 23 were recruited. Seventy-five participants from Shanghai (altitude 4 m) and 133 participants from the Shigatse area (altitude 4,040 m) were recruited. Any participant with any otological disorder was excluded. Main Outcome Measure: Four indexes of the tympanogram were evaluated in the two groups from different altitudes. Results: Our results showed that the peak of static compliance for the participants in Shigatse was smaller, but the absolute compliance of tympanic membrane remained the same. Similarly, the ear canal volume (ECV) from tympanometry was also affected by the elevated altitude in Tibet. In addition, the tympanometric peak pressure was decreased in high-altitude residents, which suggests a slightly declined function of the Eustachian tube at lower barometric pressure. However, no difference was found in the tympanometric width (TW). Conclusion: Our results indicate that tympanograms were affected by decreased atmospheric pressure at high altitude. Therefore, other than pressure-related indexes, TW is better for evaluating the function of the middle ear in high-altitude regions. [ABSTRACT FROM AUTHOR]

COVID‐19 has become a global pandemic and garnered international attention. Although the clinical features of COVID‐19‐related liver injury have been investigated, there have been no reports and studies on the clinical characteristics of COVID‐19 patients co‐infected with hepatitis B virus (HBV). This study aimed to evaluate whether SARS‐CoV‐2/HBV co‐infection could influence liver function and the disease outcome. All 326 confirmed COVID‐19 cases in Shanghai Public Health Clinical Center (The COVID‐19 designated hospital in Shanghai, China) from 20 January 2020 to 24 February 2020 were enrolled and followed up until February 29 in this study. The clinical, laboratory data and the length of stay were collected and analysed retrospectively. 20 patients with HBV co‐infection (6.1%) and 306 patients (93.9%) without HBV infection showed no differences in the level of liver function parameters. However, compared with HBsAg‐ patients [145.4 mg/L (103.9‐179.2)], HBsAg + patients had a lower level of prealbumin [(102.3 mg/L (76.22‐160.2), P =.0367]. There were also no significant differences for the discharge rate and the length of stay between two groups. Taken together, we found no evidence that SARS‐CoV‐2/HBV co‐infection could aggravate liver injury or extend duration of hospitalization. [ABSTRACT FROM AUTHOR]

Identification of various emission sources and quantification of their contributions comprise an essential step in formulating scientifically sound pollution control strategies. Most previous studies have been based on traditional offline filter analysis of aerosol major components (usually inorganic ions, elemental carbon – EC, organic carbon – OC, and elements). In this study, source apportionment of PM 2.5 using a positive matrix factorization (PMF) model was conducted for urban Shanghai in the Yangtze River Delta region, China, utilizing a large suite of molecular and elemental tracers, together with water-soluble inorganic ions, OC, and EC from measurements conducted at two sites from 9 November to 3 December 2018. The PMF analysis with inclusion of molecular makers (i.e., MM-PMF) identified 11 pollution sources, including 3 secondary-source factors (i.e., secondary sulfate; secondary nitrate; and secondary organic aerosol, SOA, factors) and 8 primary sources (i.e., vehicle exhaust, industrial emission and tire wear, industrial emission II, residual oil combustion, dust, coal combustion, biomass burning, and cooking). The secondary sources contributed 62.5 % of the campaign-average PM 2.5 mass, with the secondary nitrate factor being the leading contributor. Cooking was a minor contributor (2.8 %) to PM 2.5 mass while a significant contributor (11.4 %) to the OC mass. Traditional PMF analysis relying on major components alone (PMF t) was unable to resolve three organics-dominated sources (i.e., biomass burning, cooking, and SOA source factors). Utilizing organic tracers, the MM-PMF analysis determined that these three sources combined accounted for 24.4 % of the total PM 2.5 mass. In PMF t , this significant portion of PM mass was apportioned to other sources and thereby was notably biasing the source apportionment outcome. Backward trajectory and episodic analysis were performed on the MM-PMF-resolved source factors to examine the variations in source origins and composition. It was shown that under all episodes, secondary nitrate and the SOA factor were two major source contributors to the PM 2.5 pollution. Our work has demonstrated that comprehensive hourly data of molecular markers and other source tracers, coupled with MM-PMF, enables examination of detailed pollution source characteristics, especially organics-dominated sources, at a timescale suitable for monitoring episodic evolution and with finer source breakdown. [ABSTRACT FROM AUTHOR]

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Background: Human papillomavirus (HPV) infection is the leading cause of genital diseases. It can cause a series of cervical lesions. The distribution of HPV genotypes indicates that the increased prevalence of high-risk HPV (HR-HPV) is positively correlated with the severity of cervical lesions. In addition, persistent HR-HPV infection is associated with the risk of cervical cancer. Considering the latest approval of homemade HPV vaccine in China and the prevalence of HPV distribution, this is of great significance for guiding HPV vaccination work. Objective: Our study's purpose was to examine trends of cervical HPV infection rate in each 5-year age group from 2011 to 2019. Methods: Retrospective analysis of human papillomavirus prevalence rate of 59,541 women from 2011 to 2019 in the District Zhoupu of Shanghai City in China. HPV genotype testing is performed using a commercial kit designed to detect 15 high-risk HPV genotypes and 6 low-risk HPV genotypes. Trends were examined for each 5-year age group. Results: In the District Zhoupu of Shanghai City in China, the prevalence rate of cervical HPV increased significantly among women aged 15–34 years. The most prevalent HR-HPV genotypes were 52, 16, 58, 53, 39, and 51. Conclusion: Cervical HPV prevalence rate is very high in younger women in suburb Shanghai. Due to significant differences in infection rates between specific age groups and HPV subtypes, timely intervention is required for these vulnerable populations. [ABSTRACT FROM AUTHOR]

Secondary organic aerosols (SOA) are formed through diverse processes in the atmosphere, among which photochemical processing is one important pathway. SOA formation was studied based on one heavy photochemical smog episode in summer in Shanghai. During the pollution episode, ozone and organic carbon (OC) increased simultaneously with a strong positive correlation, which was complete opposite to the volatile organic compounds (VOCs) pattern but similar to that of VOC photochemical consumption. The OC evolution was explained well by a parameterization method based on the observation of OC and VOCs, and secondary OC (SOC) formation was derived, being comparable with the result based on elemental carbon (EC) tracer method. About 67% of SOC could be explained by the photochemical consumption of VOCs (mainly aromatics, ~93%) during the episode. The contribution of VOCs to SOC formation was also estimated from the available VOC emissions inventories, which was comparable with that based on VOCs observations in ambient. Some differences of VOC species contribution to SOC were found between the ambient observation‐based and the emission‐based results, and the contribution of C9 aromatics was underestimated in the emission inventory. This suggests that bias of speciation might exist in the current VOC emissions inventories. The present study highlights the importance of VOC oxidation for SOC formation in summer in Shanghai. More insights are needed to improve the accuracy of VOCs speciated emissions inventories. Key Points: OC correlated well with ozone during a photochemical pollution episodeThe OC atmospheric evolution was explained by a parameterization methodThe photochemical consumption of VOCs accounted for 67% of SOC formation [ABSTRACT FROM AUTHOR]

Identifying physiological factors that could reduce pregnant women's risk for developing gestational diabetes mellitus (GDM) is crucial for early prevention and intervention. We aimed to examine whether higher serum levels of total bilirubin (TBIL) were associated with a decreased risk of GDM. We conducted a retrospective cohort study in a tertiary care hospital in Shanghai, China. A total of 92,885 pregnant women were included. Serum TBIL levels were determined during the first antenatal visit before 24 weeks of gestation and GDM was diagnosed with a 75-g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. A total of 13,037 GDM cases were identified, a prevalence of 14.0 % (13,037/92,885). These women had a higher median TBIL concentration 7.9 versus 7.6 mmol/l (P < 0.001). For the 91,051 women with TBIL within the physiologically normal range (≤ 17.1 μmol/l), a one interquartile range increase in TBIL (3.4 μmol/l) was associated with a decreased risk of GDM: adjusted odds ratio (OR)=0.89 [95 % CI 0.87;0.92]. For these women, the adjusted ORs for GDM across TBIL quartiles were: 0.92 [0.88;0.97] for the second, 0.85 [0.81;0.90] for the third, and 0.78 [0.74;0.83] for the fourth quartile in comparison with the first quartile. Our study demonstrated that elevated serum TBIL levels were associated with decreased risk of GDM and supported its potential role in the prevention and early intervention of GDM. [ABSTRACT FROM AUTHOR]

Background: Cesarean section (CS) rate has risen dramatically and stayed at a very high level in China over the past two to three decades. Given the short- and long-term adverse effects of CS, effective strategies are needed to reduce unnecessary CS. We aimed to evaluate whether a multifaceted intervention would decrease the CS rate in China.Methods: We carried out a cluster-randomized field trial with a multifaceted intervention in Shanghai, China, from 2015 to 2017. A total of 20 hospitals were randomly allocated into an intervention or a control group. The intervention consisted of more targeted health education to pregnant women, improved hospital CS policy, and training of midwives/doulas for 8 months. The study included a baseline survey, the intervention, and an evaluation survey. The primary outcome was the changes of overall CS rate from the pre-intervention to the post-intervention period. A subgroup analysis stratified by the Robson classification was also conducted to examine the CS change among women with various obstetric characteristics.Results: A total of 10,752 deliveries were randomly selected from the pre-intervention period and 10,521 from the post-intervention period. The baseline CS rates were 42.5% and 41.5% in the intervention and control groups, respectively, while the post-intervention CS rates were 43.4% and 42.4%, respectively. Compared with the control group, the intervention did not significantly reduce the CS rate (adjusted OR = 0.92; 95% CI 0.73, 1.15). Similar results were obtained in subgroup analyses stratified by the risk level of pregnancy, maternal age, number of previous CS, or parity. Scarred uterus and maternal request remained the primary reasons for CS after the interventions in both groups. The intervention did not alter the perinatal outcomes (adjusted change of risk score = - 0.06; 95%CI - 0.43, 0.31).Conclusions: A multifaceted intervention including more targeted prenatal health education, improved hospital CS policy, and training of midwives/doulas, did not significantly reduce the CS rate in Shanghai, China. However, our experience in implementing a multifaceted intervention may provide useful information to other similar areas with high CS use.Trial Registration: This trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (ChiCTR-IOR-16009041) on 17 August 2016. [ABSTRACT FROM AUTHOR]

Background: With the increased empirical interest in the positive significance of improving nurses' sense of professional benefits, there is a requirement for measures of nurses' perceived professional benefit (NPPB). Our objective was to develop and psychometrically test a brief Nurses' Perceived Professional Benefit Questionnaire (NPPBQ).Methods: After expert consultation and nurse interviews, a primary questionnaire was developed for an exploratory factor analysis (EFA). The seventeen items of the NPPBQ were used for verification of the theorized factor structure and content validity using a confirmatory factor analysis (CFA). The NPPBQ's concurrent validity was evaluated. Three samples of nurses were collected in Shanghai, Hangzhou and Nanjing between November 2017 and August 2018.Results: The results of the EFA and CFA verified the five dimensions of nurses' occupational benefit discovery. The results demonstrated that the NPPBQ has adequate internal consistency and is fully consistent with the theorized factor structure. This 5-factor solution explained an adequate percentage of the total variance. The Cronbach's alpha of each dimension of the NPPBQ was good. The concurrent validity was significantly correlated with all aspects of the Maslach Burnout Inventory (MBI).Conclusion: The results suggest that the NPPBQ is a psychometrically sound measure for evaluating perceived professional benefits among a wide range of nurses. [ABSTRACT FROM AUTHOR]

The purpose of this study was to estimate the total fatigue life for in-service asphalt mixture fatigue with in situ accelerated pavement testing (APT) and laboratory four-point bending beam tests. On a selected expressway in Shanghai, China, a series of full-scale APT tests were conducted. During the APT tests, a portable seismic property analyzer was used to monitor the pavement deterioration through modulus reduction. An equivalent factor between the APT loading and equivalent single axle loads (ESALs) was estimated. Additionally, asphalt concrete slabs were cut from the APT test sections and then transferred to the laboratory for four-point bending beam fatigue tests. A new fatigue equation was proposed for the in-service asphalt mixtures. Furthermore, a shift factor between the laboratory fatigue life and field ESAL was recommended. Finally, the field total fatigue life of the in-service asphalt mixture was estimated based on all the work in this study. [ABSTRACT FROM AUTHOR]

The Front Cover image is provided by the quantum biophotonics group, a collaborative effort between Inner Mongolia Agricultural University, Wenzhou Institute of the University of Chinese Academy of Sciences, and University of Shanghai for Science and Technology. The image shows that the hydrolysis of ATP can be accelerated approximately 10‐fold due to the hybrid energy states, as the optical mode of a Fabry–Pérot cavity is strongly resonant to the O‐H stretching vibration. Read the full text of the Research Article at 10.1002/cptc.202200330. [ABSTRACT FROM AUTHOR]

Efficient passenger flow assignment is essential for ensuring the safe and stable operation of the urban rail transit (URT). This paper proposes a new passenger flow assignment approach to address this challenge. The approach generates two agents: connected vehicle and unconnected passenger, to simulate vehicle operation and passenger travel for the URT network. It derives the passenger trajectory by the passenger route evolution mechanism to achieve the passenger flow assignment for the whole network. Furthermore, it provides statistics on platform passenger flow when obtaining the overall station passenger flow. Meanwhile, the approach employed Automatic Fare Collection (AFC) data as input to analyze the passenger flow features of the Shanghai Metro. The passenger flow assignment results can reveal the start and end of morning and evening peak hours at a time granularity of seconds. That is, 7:16:20 and 9:33:00 for the morning peak and 16:49:00 and 19:22:50 for the evening peak, respectively. The results also reveal the route choice pattern of passengers. Passengers have preferences for each type of route, in descending order: the shortest route, the minimum number of stations route, and the minimum number of transfer stations route, when they have a choice of these three routes. Moreover, the results can accurately identify large passenger flow stations and provide data support for station passenger flow management strategies. • This paper proposes a new passenger flow assignment approach. • The approach simulates connected vehicles and unconnected passengers. • Count platform passenger flow when obtaining the overall station flow. • Analyzing passenger route choice preferences and large passenger flow stations. [ABSTRACT FROM AUTHOR]

Stimulating enterprises to implement environmental management system certification (EMSC, that is to say ISO14001 certification) to the greatest extent and resolving their obstacles in time are the basis for promoting green development of enterprises. Using the full samples of Shanghai and Shenzhen A-share listed industrial enterprises from 2010 to 2019, and employing the Logit model and Propensity Score Matching method (PSM), this paper empirically analyzes the motivations and obstacles for Chinese enterprises to implement EMSC certification, further explores the transformation between advantages and disadvantages under certain conditions, and the differentiation characteristics among enterprises under different social responsibility, property rights and enterprise size. The results show that: ① There is a "U"-shaped relationship between corporate social responsibility and EMSC, and the social responsibility of non-state-owned enterprises could realize the transformation from obstacle to motivation earlier than that of state-owned enterprises. ② There is an inverted "U"-shaped relationship between environmental regulation and EMSC, precisely speaking, this inverted "U"-shaped relationship only exists in non-state-owned enterprises, large-scale enterprises and enterprises with high social responsibility. ③ The public environmental awareness could promote enterprises to implement EMSC, and would strengthen the impact of environmental regulations on enterprises' implementation of EMSC. ④ Based on Propensity Score Matching method, it is concluded that Chinese enterprises indeed improve their environmental performance rather than their financial performance by EMSC. The conclusions provide helpful practical guidance for comprehensively revealing the motivations and obstacles for China's enterprises to implement EMSC. [ABSTRACT FROM AUTHOR]

Flame retardants are widely used in consumer products to reduce their flammability. Previously used flame retardants have been sequentially banned due to their environmental and human toxicity. Currently, tris(1,3-dichloropropyl) phosphate (TDCIPP) and triphenyl phosphate (TPHP) are among the most commonly used flame retardants. TDCIPP and TPHP are reproductive toxins and have carcinogenic, neurotoxic, and endocrine-disrupting properties. Although high levels of TDCIPP and TPHP have been found in drinking water, seawater, and office air in China, data regarding human exposure are lacking. In this study, we assessed the level of urinary TPHP and TDCIPP metabolites (DPHP and BDCIPP, resp.) in a cohort of pregnant women (N = 23) from Shanghai, China, using liquid chromatography-tandem mass spectrometry. DPHP were detected in 100% urine samples, while only four urine samples had detectable level of BDCIPP in this cohort (17% detected). Geometric means of DPHP and BDCIPP concentrations were 1.1 ng/mL (interquartile range [IQR]: 0.6, 1.5 ng/mL) and 1.2 ng/mL (IQR: 0.6, 2.2 ng/mL), respectively. In this small cohort, urinary DPHP and BDCIPP levels were not significantly correlated with miscarriages, neonatal birthweight, gestational diabetes, or maternal age. These data suggest that exposure to TPHP is widespread, and they demonstrate the feasibility of using urinary biomarkers to measure exposures to modern flame-retardant chemicals. [ABSTRACT FROM AUTHOR]

Afuzzy multivariate based line traffic prediction model and a station traffic proportion inference model are proposed in order to predict line entrance traffic and station traffic in the Shanghai subway system. The nonlinear autoregressive with external input (NARX) is adopted to predict subway line traffic. Correlative features that influence the line traffic time series are identified by time series trend analysis, including meteorological features, time features, and proportion of commuter passenger features. A time series correlation method and fuzzy c-means (FCM) is proposed to simplify the feature set by deleting the features of small coefficients between features and traffic series. We determine the statistics of all stations' traffic proportion of a subway line in order to construct a proportion matrix, and an eigenvector based station traffic proportion inference model is proposed to predict the future station traffic proportion, which is combined with the subway line traffic prediction results to realize subway station traffic prediction. We evaluate our model on the dataset of smart card records and weather condition dataset of one month in the Shanghai subway system. Experiment results confirm our proposed model's advantages over baseline approaches. [ABSTRACT FROM AUTHOR]

In this work, a one-year observation focusing on high time resolution characteristics of components in fine particles was conducted at an urban site in Shanghai. Contributions of different components on visibility impairment were also studied. Our research indicates that the major components of PM 2.5 in Shanghai are water-soluble inorganic ions and carbonaceous aerosol, accounting for about 60% and 30% respectively. Higher concentrations of sulfate (SO 4 2− ) and organic carbon (OC) in PM 2.5 occurred in fall and summer, while higher concentrations of nitrate (NO 3 − ) were observed in winter and spring. The mass concentrations of Cl − and K + were higher in winter. Moreover, NO 3 − increased significantly during PM 2.5 pollution episodes. The high values observed for the sulfate oxidizing rate (SOR), nitrate oxidizing rate (NOR) and secondary organic carbon (SOC) in OC indicate that photochemical reactions were quite active in Shanghai. The IMPROVE (Interagency Monitoring of Protected Visual Environments) formula was used in this study to investigate the contributions of individual PM 2.5 chemical components to the light extinction efficient in Shanghai. Both NH 4 NO 3 and (NH 4 ) 2 SO 4 had close relationships with visibility impairment in Shanghai. Our results show that the reduction of anthropogenic SO 2 , NO x and NH 3 would have a significant effect on the improvement of air quality and visibility in Shanghai. [ABSTRACT FROM AUTHOR]

Background/aims: Human papillomavirus type 16 (HPV16) is the cause of more than half of all cases of cervical cancer. Genetic mutations in HPV16 and the integration of HPV16 DNA in the human genome are considered important genetic changes in cervical lesion progression. However, limited data concerning HPV16 lineages and physical integration status have been reported for Shanghai, China. The current study analyzed the genetic mutations in complete HPV16 genomes and the physical integration status of HPV16 DNA.Methods: A total of 30 samples of cervical exfoliated cells from patients with HPV16 infection were collected. The entire HPV16 genome was isolated, amplified by PCR and directly sequenced. The physical integration status was determined by 3'RACE nested PCR.Results: A total of 13 integration sites were identified, including 9 in common fragile sites and 1 not close to any fragile sites. Phylogenetic analysis identified two HPV lineages: the European (E) lineage and the East Asian (EA) lineage. Amino acid changes of D25E and N29S were the most common variations across the genome. The HPV16 early genes E1 and E7 and the late gene L1 tended to be highly conserved, whereas the early genes E2, E4 and E6 were more variable. Furthermore, 10 novel variations were identified in this study, which led to the 3 amino acid changes of S23I in E2 and E244K and T269I in E2/E4.Conclusion: Integrated HPV16 viruses were detected in all stages of cervical samples. Many variants in E2, E4, E7, and the long control region co-varied with E6 variations and helped to define the HPV16 lineages. [ABSTRACT FROM AUTHOR]

A field campaign on air quality was carried out in Shanghai in winter of 2012. The concentrations of NO, NO2, NOx, SO2, CO, and PM2.5 increased during haze formation. The average masses of SO42 −, NO3− and NH4+ were 10.3, 11.7 and 6.7 μg/m³ during the haze episodes, which exceeded the average (9.2, 7.9, and 3.4 μg/m³) of these components in the non-haze days. The mean values for the aerosol scattering coefficient (bsp), aerosol absorption coefficient (bap) and single scattering albedo (SSA) were 288.7, 27.7 and 0.91 Mm-1, respectively. A bi-peak distribution was observed for the mass concentrations of CO, NO, NO2, and NOx. More sulfate was produced during daytime than that in the evening due to photochemical reactions. The mass concentration of NH4+ achieved a small peak at noontime. NO3− showed lower concentrations in the afternoon and higher concentrations in the early morning. There were obvious bi-peak diurnal patterns for bsp and bap as well as SSA. bsp and bap showed a positive correlation with PM2.5 mass concentration. (NH4)2SO4, NH4NO3, organic mass, elemental carbon and coarse mass accounted for 21.7%, 19.3%, 31.0%, 9.3% and 12.3% of the total extinction coefficient during non-haze days, and 25.6%, 24.3%, 30.1%, 8.1% and 8.2% during hazy days. Organic matter was the largest contributor to light extinction. The contribution proportions of ammonium sulfate and ammonium nitrate to light extinction were significantly higher during the hazy time than during the non-haze days. [ABSTRACT FROM AUTHOR]

Although ambient PM2.5 has been linked to adverse health effects, the chemical constituents that cause harm are largely unclear. Few prior studies in a developing country have reported the health impacts of PM2.5 constituents. In this study, we examined the short-term association between PM2S constituents and emergency room visits in Shanghai, China. We measured daily concentrations of PM2.5, organic carbon (OC), elemental carbon (EC), and eight water-soluble ions between January 1, 2011 and December 31, 2012. We analyzed the data using overdispersed generalized linear Poisson models. During our study period, the mean daily average concentration of PM2.5 in Shanghai was 55 μg/m3. Major contributors to PM2.5 mass included OC, EC, sulfate, nitrate, and ammonium. For a 1-day lag, an interquartile range increment in PM2.5 mass (36.47 μg/m3) corresponded to 0.57% [95% confidence interval (CI): 0.13%, 1.01%] increase of emergency room visits. In all the three models used, we found significant positive associations of emergency room visits with OC and EC. Our findings suggest that PM2.5 constituents from the combustion of fossil fuel (e.g., OC and EC) may have an appreciable influence on the health impact attributable to PMPM2.5. [ABSTRACT FROM AUTHOR]

Building on Hong et al.'s (2000) seminal work on bicultural individuals' cultural frame switching, this study explores culture's causal consequences on Shanghai college English majors' social attributions. Ninety-nine three-year diploma (vo-tech) sophomores were randomly assigned to three priming conditions (Chinese, American, and neutral) and completed the exact same attribution task. Significant differences in situational attributions were found between the Chinese and American primed groups. Specifically, the participants gave contrastive responses to the primed culture, i.e., they used more situational attributions when primed with American culture than when primed with Chinese culture, a tendency contrary to the empirically established cultural differences in social attributions between North Americans and East Asians (Morris & Peng, 1994). The results are interpreted from the perspective of cultural knowledge application and cultural identity management. Theoretical and methodological implications for intercultural communication research are discussed. [ABSTRACT FROM AUTHOR]

Background: Despite their wide occurrence, cryptosporidiosis and giardiasis are considered neglected diseases by the World Health Organization. The epidemiology of these diseases and microsporidiosis in humans in developing countries is poorly understood. The high concentration of pathogens in raw sewage makes the characterization of the transmission of these pathogens simple through the genotype and subtype analysis of a small number of samples. Methodology/Principal Findings: The distribution of genotypes and subtypes of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in 386 samples of combined sewer systems from Shanghai, Nanjing and Wuhan and the sewer system in Qingdao in China was determined using PCR-sequencing tools. Eimeria spp. were also genotyped to assess the contribution of domestic animals to Cryptosporidium spp., G. duodenalis, and E. bieneusi in wastewater. The high occurrence of Cryptosporidium spp. (56.2%), G. duodenalis (82.6%), E. bieneusi (87.6%), and Eimeria/Cyclospora (80.3%) made the source attribution possible. As expected, several human-pathogenic species/genotypes, including Cryptosporidium hominis, Cryptosporidium meleagridis, G. duodenalis sub-assemblage A-II, and E. bieneusi genotype D, were the dominant parasites in wastewater. In addition to humans, the common presence of Cryptosporidium spp. and Eimeria spp. from rodents indicated that rodents might have contributed to the occurrence of E. bieneusi genotype D in samples. Likewise, the finding of Eimeria spp. and Cryptosporidium baileyi from birds indicated that C. meleagridis might be of both human and bird origins. Conclusions/Significance: The distribution of Cryptosporidium species, G. duodenalis genotypes and subtypes, and E. bieneusi genotypes in urban wastewater indicates that anthroponotic transmission appeared to be important in epidemiology of cryptosporidiosis, giardiasis, and microsporidiosis in the study areas. The finding of different distributions of subtypes between Shanghai and Wuhan was indicative of possible differences in the source of C. hominis among different areas in China. [ABSTRACT FROM AUTHOR]

文化资本是影响个人教育获得和社会地位获得的重要因素。基于2008年上海市社 会结构调查数据, 从广义文化资本出发, 分别测量父母和子女文化资本对地位获得的 作用。研究发现: 父母和子女文化资本存量越高, 子女受教育年限越长; 子女文化资 本对地位获得具有显著影响; 在控制性别、父亲职业等变量后, 文化资本越多, 越有 可能进入更高阶层; 教育、家庭文化氛围和文化投资对地位获得具有持续且稳定的作 用; 文化资本是社会下层实现向上流动的有效手段。 关键词: 文化资本 教育 社会地位 Cultural capital plays an important role in individuals’ educational and status attainment. On the basis of data from the Shanghai Social Structure Survey of 2008 and from the perspective of broadly defined cultural capital, this paper measures the role of cultural capital of parents and children in the acquisition of social status. The findings are as follows: (1) Higher stocks of cultural capital on the part of parents and children mean more years of schooling for children. (2) Children’s cultural capital has a significant influence on their status attainment. (3) Controlling for variables like gender and father’s occupation, the more cultural capital one has, the more likely one is to enter a higher stratum. (4) A family’s education, cultural ambience and cultural investment have a sustained and stable impact on status attainment. (5) Cultural capital provides an effective way for the lower strata of society to achieve upward social mobility. [ABSTRACT FROM AUTHOR]

To gain insight into possible shifts in Shanghai children's value socialization, two sets of Shanghai primary school Chinese language (Yuwen) textbooks that represent two historical periods in China (mid-1990s and today) were compared. Specifically, four aspects were explored: topics, "culture heroes", political and ideological value orientations, and a group of harmony-related values conceptualized on the basis of Schwartz's (1992) work. Compared with the 1990s textbooks, those currently in use were found to have the following features: 1) politics witnessed a sharp decrease in significance whereas nationalism was more salient as a political tool for fostering social stability and national solidarity; 2) there was a considerable increase in the percentage of both ancient Chinese and foreign, especially Western, topics; 3) there was a considerable increase in the percentage of non-scientist professionals as "culture heroes"; and 4) certain harmony-related values were much more underscored. The former explicit political and ideological value socialization processes have given way to more implicit ones. The equal emphasis on traditional Chinese and Western topics may reflect the society in transition with a mix of seemingly conflicting values. The role model effect of various professionals seems to signal the salience of the achievement orientation in society. The emphasis on harmony with nature and others is in parallel with the Chinese government's call for building a harmonious society. The findings have implications for both Chinese value research and Chinese educational authorities' decision making. [ABSTRACT FROM AUTHOR]

Abstract  With global warming forecast to continue into the foreseeable future, heat waves are very likely to increase in both frequency and intensity. In urban regions, these future heat waves will be exacerbated by the urban heat island effect, and will have the potential to negatively influence the health and welfare of urban residents. In order to investigate the health effects of the urban heat island (UHI) in Shanghai, China, 30 years of meteorological records (1975–2004) were examined for 11 first- and second-order weather stations in and around Shanghai. Additionally, automatic weather observation data recorded in recent years as well as daily all-cause summer mortality counts in 11 urban, suburban, and exurban regions (1998–2004) in Shanghai have been used. The results show that different sites (city center or surroundings) have experienced different degrees of warming as a result of increasing urbanization. In turn, this has resulted in a more extensive urban heat island effect, causing additional hot days and heat waves in urban regions compared to rural locales. An examination of summer mortality rates in and around Shanghai yields heightened heat-related mortality in urban regions, and we conclude that the UHI is directly responsible, acting to worsen the adverse health effects from exposure to extreme thermal conditions. [ABSTRACT FROM AUTHOR]

Higher serum uric acid (UA) has been associated with increased risk of Type 2 diabetes mellitus. This cohort study examined whether there are any associations between serum UA in early pregnancy and the subsequent risk of gestational diabetes mellitus (GDM). This cohort study was conducted in Shanghai, China, and included 85,609 pregnant women. Generalised additive models were used to estimate the associations of serum UA with risk of GDM. The prevalence of GDM was 14.0% (11,960/85,609). Non-linear associations between serum UA and GDM risk were observed and these associations varied by gestational ages. Only elevated serum UA levels at 13–18 weeks gestation was associated with substantially increased risk of GDM. Analysis by UA quintiles at 13–18 weeks gestation showed the odds ratios for GDM were 1.11 (95%CI, 1.03–1.20) for the second, 1.27 (95%CI, 1.17–1.37) for the third, 1.37 (95%CI, 1.27–1.48) for the fourth and 1.70 (95%CI, 1.58–1.84) for the fifth quintile of serum UA in comparison with the first quintile. Stratified analysis showed the associations of serum UA with GDM were stronger among pregnant women aged 35 years or older. We found higher serum UA at 13–18 gestational weeks was a risk factor for GDM. Our findings provide new evidence for the role of serum UA in the prevention and early intervention of GDM, and highlighted the need for monitoring serum UA at 13–18 gestational weeks. [ABSTRACT FROM AUTHOR]