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Abstract Cardiovascular disease (CVD) is a major chronic disease worldwide and its risk factors have long been investigating in epidemiological studies. Our study aims to develop a body composition-based risk score and integrate it into the Framingham Risk Score (FRS) to improve CVD prediction among well-functioning older adults. We included 1882 older adults from the Health, Aging and Body Composition (Health ABC) study to screen body composition variables obtained from the Dual-energy X-ray absorptiometry (DXA). Three models were developed and compared: the 4-DXA model, the refit FRS, and the refit FRS plus 4-DXA model. C-statistics were 0.62 (95% CI: 0.59, 0.65) for the refit FRS, 0.58 (95% CI: 0.55, 0.61) for the 4-DXA model, and 0.63 (95% CI: 0.60, 0.66) for the refit FRS plus 4-DXA model. Compared to the refit FRS, the refit FRS plus 4-DXA model slightly improved CVD outcome prediction as the discrimination slope, net reclassification index, and the integrated discrimination index were 0.053 (95% CI: 0.041, 0.066), 0.098 (95% CI = – 0.0033, 0.20) and 0.013 (95% CI: 0.0069–0.019). This study provides a model for more accurate risk stratification and draws more attention on DXA-based indices in the clinical setting. It also encourages further research in validating the developed risk score in more diverse population and in investigating a broader range of CVD risk factors.

Abstract The China Undergraduate Cohort (CUC) is an ambispective cohort study with its major purpose to better understand the effects of lifetime environmental exposures on health outcomes. We recruited 5322 college students with an average age of 18.3 ± 0.7 years in China from August 23, 2019 to October 28, 2019. Follow-up surveys were conducted annually. The dataset comprises individual demographic data (e.g. age, sex, height, weight, birth date, race, home address, annual family income, contact information), health-related behavior data (smoking status, smoking cessation, passive smoking exposure, drinking habit, physical activity, dietary status), lifestyle data (physical exercise, dietary habit, length of time spent outdoors), disease history (respiratory disease history, cardiovascular disease history, urinary system disease history, etc.), mental health status data (sleep quality, self-reported stress, anxiety and depression symptoms), lung function and blood samples data. Preliminary results from our cohort have found the association between air pollution, summer heat and mercury exposure and lung function among young adults in China.

Background: Previous studies have assessed the cardiovascular risk attributable to high ambient temperature. However, the mechanisms underly acute cardiovascular responses associated with high ambient temperature remain incompletely understood. Objective: To identify acute cardiovascular responses associated with high temperature, and to understand the underlying mechanisms using metabolomics. Methods: We conducted a prospective panel study on young adults, organizing participants to undergo blood collection and temperature monitoring tautologically. Levels of 10 cardiovascular biomarkers and 4473 serum metabolites were measured. Levels of ambient temperature exposure were recorded by wearing personal monitors. We employed linear mixed-effect models to identify acute cardiovascular responses associated with ambient temperature, including differential biomarkers and metabolites. KEGG pathway analysis was performed on the differential metabolites to identify temperature-associated metabolic processes. Results: Exposure to elevated ambient temperature was associated with acute cardiovascular responses, including alterations in high-density lipoprotein, interleukin-6, C-reactive protein, diastolic pressure, and heart rate. These observed acute cardiovascular responses are probably attributed to metabolism disturbances, as 129 differential serum metabolites, accompanied by disruptions in 18 pathways, were identified. These differential metabolites and pathways primarily involve glycerophospholipid metabolism, which activates inflammation cytokines and subsequently induces adverse cardiovascular effects. Conclusions: Our findings suggest that elevated ambient temperature could potentially lead to cardiovascular responses among young adults in China. We propose that high ambient temperature exposure may contribute to acute cardiovascular effects by regulating the glycerophospholipid metabolism pathway.

Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenalectomy is an effective treatment for unilateral PA, particularly aldosterone-producing adenoma (APA), resulting in improvements in biochemical parameters and blood pressure in the vast majority of patients. The article provides a comprehensive overview of PA, focusing on the outcomes of adrenalectomy for PA and the factors that may suggest prognostic implications. Analysis of the outcome of different PA patients undergoing adrenalectomy in terms of preoperative factors, vascular and adipose conditions, type of pathology, and somatic variants. In addition, it is recommended to use the histopathology of primary aldosteronism (HISTALDO) consensus to classify the patient’s pathological type, with classical and nonclassical pathological types showing a different prognosis and possibly being associated with an unresected contralateral adrenal gland. The primary aldosteronism surgical outcome (PASO) consensus sets uniform standards for postoperative outcomes in unilateral PA, but its setting of thresholds remains controversial. Partial adrenalectomy shows similar surgical results and fewer postoperative complications than total adrenalectomy, but there is a risk of missing the true source of abnormal aldosterone secretion. Steroid profiling and functional imaging techniques offer alternative options to adrenal vein sampling (AVS) for unilateral and bilateral judgments in patients with PA. A combination of factors is needed to predict the prognosis of PA patients undergoing adrenalectomy in order to manage patient expectations of the outcome of the procedure and to closely monitor blood pressure and biochemical parameters in patients who suggest a poorer prognosis.

Abstract Since the twenty first century, the outbreaks of global infectious diseases have caused several public health emergencies of international concern, imposing an enormous impact on population health, the economy, and social development. The COVID-19 pandemic has once again exposed deficiencies in existing global health systems, emergency management, and disease surveillance, and highlighted the importance of developing effective evaluation tools. This article outlines current challenges emerging from infectious disease control from the perspective of global health, elucidated through influenza, malaria, tuberculosis, and neglected tropical diseases. The discordance among government actors and absent data sharing platforms or tools has led to unfulfilled targets in health system resilience and a capacity gap in infectious disease response. The current situation calls for urgent action to tackle these threats of global infectious diseases with joined forces through more in-depth international cooperation and breaking governance barriers from the purview of global health. Overall, a systematic redesign should be considered to enhance the resilience of health systems, which warrants a great need to sustain capacity-building efforts in emergency preparedness and response and raises an emerging concern of data integration in the concept of One Health that aims to address shared health threats at the human-animal-environment interface.

Abstract Background The lack of effective and accurate predictive indicators remains a major bottleneck for the improvement of the prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Hepatitis B virus X (HBx) has been widely suggested as a critical pathogenic protein for HBV-driven liver carcinogenesis, while tumor-associated macrophage (TAM) infiltration is also closely related to the tumorigenesis and progression of HCC. However, few studies have determined whether combining HBx expression with TAM populations could increase the accuracy of prognostic prediction for HBV-related HCC. Methods The study cohort enrolling 251 patients with HBV-related HCC was randomly split into a training and a validation group (ratio 1:1). The expression levels of HBx and TAM marker CD68 in HCC samples were detected by immunohistochemistry. Kaplan–Meier curves, Cox regression and Harrell’s concordance index (C-index) analysis were conducted to evaluate the prognostic significance of these indicators alone or in combination. Results The expression level of HBx was strongly correlated with CD68+ TAM infiltration in HCC tissues. Elevated HBx or CD68 expression indicated poorer overall survival (OS) and progression-free survival (PFS) after hepatectomy, and both of them were independent risk factors for postoperative survival. Meanwhile, patients with both high HBx and CD68 levels had worst clinical outcomes. Moreover, integrating HBx and CD68 expression with clinical indicators (tumor size and micro-vascular invasion) showed the best prognostic potential with highest C-index value for survival predictivity, and this proposed model also performed better than several conventional classifications of HCC. Conclusion Combining the expression of intratumoral HBx, CD68+ TAM population and clinical variables could enable better prognostication for HBV-related HCC after hepatectomy, thus providing novel insights into developing more effective clinical prediction model based on both molecular phenotypes and tumor-immune microenvironment.

Particulate matter pollution could increase the risk of kidney disease, while evidence for ozone exposure is less well-established. Here, we aimed to evaluate the effect of ozone pollution on renal function and explore mechanisms. We first conducted a cross-sectional study based on Wuhan Chronic Disease Cohort Study baseline information. We recruited 2699 eligible participants, estimated their residential ozone concentrations, collected fasting peripheral blood samples for biochemical analysis and calculated the estimated glomerular filtration rate (eGFR). The linear regression model was applied to evaluate the long-term association between ozone pollution and eGFR. Then, we recruited another 70 volunteers as a panel with 8 rounds follow-up visits. We calculated the eGFR and measured fasting blood glucose and lipid levels. The linear mixed-effect model along with mediation analysis were performed to confirm the short-term association and explore potential mechanisms, respectively. For the long-term association, a 10.95 μg/m3 increment of 3-year ozone exposure was associated with 2.96 mL/min/1.73 m2 decrease in eGFR (95%CI: −4.85, −1.06). Furthermore, the drinkers exhibited a pronounced declination of eGFR (−7.46 mL/min/1.73 m2, 95%CI: −11.84, −3.08) compared to non-drinkers in relation to ozone exposure. Additionally, a 19.02 μg/m3 increase in 3-day ozone concentrations was related to 2.51 mL/min/1.73 m2 decrease in eGFR (95%CI: −3.78, −1.26). Hyperglycemia and insulin resistance mediated 12.2% and 16.5% of the aforementioned association, respectively. Our findings indicated that higher ozone pollution could affect renal function, and the hyperglycemia and insulin resistance linked to ozone might be the underlying mechanisms.

We present a case of a bronchial artery to pulmonary artery fistula. This occurred in a 77-year-old male of Bangladeshi ethnicity with a new diagnosis of cavitating pulmonary tuberculosis. A 4D CTA protocol was required to elicit the nature of the vascular abnormality. Fistula between bronchial and pulmonary arteries is an uncommon phenomenon, with few published cases. This case demonstrates the difficulty with which these fistulae are imaged. 4D CTA is a technique that is increasingly being shown to be useful in characterizing vascular anomalies such as fistulae, with embolization as the mainstay of treatment.

Background: Sleep disorder contributes to memory dysfunction and chronic diseases. Clear evidence of environment disturbance, such as residential noise, are associated with an increased risk of sleep disorder. However, not enough studies have been conducted on association between residential air pollutants and sleep disorder. We sought to determine whether exposures to residential air pollutants associated with risk of sleep disorder among adults. Methods: Using the dataset of the Wuhan Chronic Disease Cohort Study (WCDCS), we investigated the prevalence of sleep disorder and five sleep disorder symptoms in the study. The data of air pollutants (including PM10, PM2.5, NO2, SO2 and O3) were obtained from 10 air quality monitoring stations in Wuhan. We utilized logistic regression model to evaluate the associations of five types of air pollutants with odds ratio (OR) of sleep disorder and symptoms. The potential moderating effects of socio-demographic factors in the associations were explored using the interaction effects model. Results: Of the study participants, 52.1 % had sleep disorder. Exposures to higher concentrations of air pollutants were associated with increased prevalence of sleep disorder. For example, per interquartile range (IQR) increases in concentrations of PM10, PM2.5 or SO2 corresponded to the increase of sleep disorder increased prevalence at 14.7 % (adjusted odds ratio (aOR) = 1.147, 95 %CI:1.062, 1.240), 8.9 % (aOR = 1.089, 95 %CI: 1.003, 1.182) and 15.8 % (aOR = 1.158, 95 %CI: 1.065, 1.260). For symptoms specific analyses, significant linkages of PM10, PM2.5, SO2 with difficulty in falling asleep, wake up after falling asleep and early awaken were observed. Moderating effects of age and place of residence on the linkages of PM10 with increased prevalence of sleep disorder were identified. Conclusion: Higher level of air pollution exposure could increase the prevalence of sleep disorder. Middle-aged and elderly population, as well as the rural residents are more likely to suffer from sleep disorder.

Hyperspectral compressive imaging has taken advantage of compressive sensing theory to capture spectral information of the dynamic world in recent decades of years, where an optical encoder is employed to compress high dimensional signals into a single 2-D measurement. The core issue is how to reconstruct the underlying hyperspectral image (HSI), although deep neural network methods have achieved much success in compressed sensing image reconstruction in recent years, they still have some unsolved issues, such as tradeoffs between performance and efficiency, and accurate exploitation of cubic structure information. In this article, we propose a deep Tucker decomposition and spatial–spectral learning network (DS-net) to learn the tensor low-lank structure features and spatial–spectral correlation of HSI for reconstruction quality promotion. Inspired by tensor decomposition, we first construct a deep Tucker decomposition module to learn the principal components from different modes of the image features. Then, we cascade a series of decomposition modules to learn multihierarchical features. Furthermore, to jointly capture the spatial–spectral correlation of HSI, we propose a spatial–spectral correlation learning module in a U-net structure for more robust reconstruction performance. Finally, experimental results on both synthetic and real datasets demonstrate the superiority of the proposed method compared to several state-of-the-art methods in quantitative assessment and visual effects.

Penile squamous cell carcinoma is a rare disease entity with poor overall survival in an advanced stage. Few studies have investigated the role of immunotherapy in advanced penile squamous cell carcinoma. Herein, we report a case of stage IV unresectable penile squamous cell carcinoma presenting with anal bleeding and urethra obstruction who responded dramatically to combination therapy of durvalumab and cisplatin-based chemotherapy. The patient had HPV-positive penile squamous cell carcinoma, cT3N3M0, with concomitant anus squamous cell carcinoma. After 2 months of the combination treatment, almost all bulky inguinal lymph nodes shrank, and the main tumor of the anus and penis responded completely. A durable response was seen 16 months after initiating the combination therapy. This case report highlights the potential role of the combination of immunotherapy and chemotherapy in patients with advanced penile cancer. The promising results of this combination resulted in the conversion of unresectable disease to a potentially curable disease.

The accurate evaluation of the communication quality of the interconnection link of the data center is an important basis to realize the coordination in the data network. In this paper, a hybrid amplification model for all-optical data center interconnection networks based on wavelength selective switches is established, which can quickly evaluate indicators such as optical signal-to-noise ratio and bit error rate in the interconnected links. In this paper, the data center interconnection link under the condition of no repeater amplification is discussed. The amplifier selection schemes under different interconnection distances are given. Through the simulation, the influence of different path selection on the communication quality of the interconnection link is compared under the conditions of the same interconnection distance and optical power gain. According to the corresponding theoretical model and algorithm, the optimal routing of the data center Internet can be established.

Objective To analyze differential expression of long non-coding RNA (lncRNA) after miR-150 over-expression by human renal tubular epithelial cell line HK-2 and explore the role of miR-150 in renal tubular injury through regulating the expression of lncRNA. Methods HK-2 cells with miR-150 mimic and scramble were sequenced by Illumina NovaSeq 6000 sequencer. The differentially expressed lncRNA expression profile, GO analysis and KEGG analysis were performed to verify miR-150-lncRNA-JAK2-STAT1/3-COL1 pathway. Results Compared with the scramble group, 362 differential expression lncRNAs were detected in miR-150 mimic group, of which, 252 lncRNAs were down-regulated and 110 lncRNAs were up-regulated both more than 1.5-fold. The results showed that the miR-150 regulated lncRNA and function in biological process, cell components and molecular mechanisms through enrichment analysis of KEGG pathway, miR-150-lncRNA-JAK2-STAT1/3-COL1 pathway was found and then verified by Western blot. Conclusions LncRNAs regulated by miR-150 may play some roles in pathogenesis and molecular mechanisms in human renal tubular injury.

Abstract Background Secondary nosocomial infections, which are commonly caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus faecium (VRE), often develop in septic patients. This study aimed to identify the origin of secondary systemic pathogens and reveal the underlying mechanism of infection. Methods In this prospective, observational case–control study, a total of 34 septic patients, 33 non-septic intensive care unit (ICU) patients and 10 healthy individuals serving as controls were enrolled. Three hundred and twelve fecal samples were collected and subjected to 16S rRNA gene amplicon sequencing. Metagenome sequencing was performed to identify the homology between dominant CRKP or VRE in the intestine and pathogens isolated from secondary infectious sites. C57/BL mice were established as pseudo germ-free animal model by pretreatment with broad-spectrum antibiotics for two weeks. Results The abundance and diversity of the gut microbiota in septic patients was drastically decreased one week after ICU admission, potentially leading to the enrichment of antibiotic-resistant bacteria, such as CRKP. Furthermore, secondary bloodstream and abdominal infections caused by CRKP or VRE in septic patients occurred after intestinal colonization with the predominant bacterial species. Genomic analysis showed that bacteria isolated from secondary infection had high homology with the corresponding predominant intestinal opportunistic pathogens. In addition, animal model experiments validated the hypothesis that the administration of antibiotics caused the enrichment of CRKP and VRE among the intestinal microbiota, increasing the likelihood of permeation of other tissues and potentially causing subsequent systemic infection in pseudo germ-free mice. Conclusion Our study indicated that the pathogens causing secondary infection in septic patients might originate from the intestinal colonization of pathogens following broad-spectrum antibiotic treatment.

Abstract Background The treatment of complex 3- and 4-part proximal humeral fractures has been controversial due to numerous postoperative complications. With the further study of medial support and blood supply of humeral head, new techniques and conception are developing. The study aims to illustrate the medial approach of the proximal humeral fracture through cadaver autopsy. Method Upper limbs from 19 cadavers have been dissected to expose the shoulder joint. We selected the coracoid process as the bony reference. Vernier caliper will be used to measure the following data, including distance from coracoid process to circumflex brachial artery, distance between anterior humeral circumflex artery (ACHA) and posterior circumflex brachial artery (PCHA) and their diameters. Assessment included the characteristics of the vascular supply around the humeral head, identification of the structures at risk, quality of exposure of the bony structures, and feasibility of fixation. Results The medial approach is appropriate in 86.84% anatomical patterns. Between the lower part of the shoulder capsule and the insertion of conjoined tendon, the bony surface exposed was limited by the interval between ACHA and PCHA. An interval of 2 to 3 cm (24.29 ± 3.42 mm) was available for medial plate. ACHA (49.35 ± 8.13 mm, 35.14–68.53 mm) and PCHA (49.62 ± 7.82 mm, 37.67–66.76 mm) were about 5 cm away from the coracoid process. Risk structures including ACHA and PCHA originate in common, PCHA originated from the deep brachial artery (DBA), the presence of perforator vessels, musculocutaneous nerve intersects with ACHA, the diameter of PCHA: ACHA

Abstract The purpose of this study was to examine the changes in severity of anxiety and depression symptoms, stress and sleeping quality after three months of mass quarantine for COVID-19 among undergraduate fresh students compared to their pre-COVID-19 measures. We used participants from the Chinese Undergraduate Cohort (CUC), a national prospective longitudinal study to examine the changes in anxiety and depression symptoms severity, stress and sleep quality after being under mass quarantine for three months. Wilcoxon matched pair signed-rank test was used to compare the lifestyle indicators. Severity of anxiety, depression symptoms, stress and sleep quality were compared with Wilcoxon signed-rank test. We used generalized estimating equation (GEE) to further quantify the change in mental health indicators and sleep quality after the COVID-19 mass quarantine compared to baseline. This study found that there was no deterioration in mental health status among Chinese new undergraduate students in 2020 after COVID-19 mass quarantine compared with the baseline measures in 2019. There was an improvement in sleep quality and anxiety symptoms. After adjusting for age, sex, exercise habit, time spent on mobile gadgets, and time spent outdoors, year 2020 was significantly associated with severity of depression symptoms in males (OR:1.52. 95%CI:1.05–2.20, p-value = 0.027). Year 2020 was significantly associated with the improvement of sleeping quality in total (OR:0.45, 95%CI:0.38–0.52, p

Background: Reliable prognostic indicators for accurately predicting postoperative outcomes in Hepatocellular carcinoma (HCC) patients are lacking. Although cancer stem-like cells (CSCs) and tumor-associated macrophages (TAMs) in tumor microenvironment are implicated in the occurrence and development of HCC, whether the combination of CSC biomarkers and TAM populations could achieve better performance in predicting the prognosis of patients with HCC has been rarely reported.Methods: A total of 306 HCC patients were randomly divided into the training and validation cohorts at a 1:1 ratio, and the expression of OV6 and CD68 was assessed using immunohistochemistry in HCC samples. The prognostic value of these biomarkers for post-surgical survival and recurrence were evaluated by the curve of receiver operating characteristic and multivariate Cox regression analyses.Results: The density of OV6+ CSCs was positively correlated with the infiltration of CD68+ TAMs in HCC. Both high OV6 expression and CD68+ TAM infiltration was closely associated with poor overall survival (OS) and progression-free survival (PFS) of HCC patients. Moreover, overexpression of OV6 and infiltration of CD68+ TAMs were identified as independent prognostic factors for OS and PFS after liver resection. The integration of OV6 and CD68 with tumor size and microvascular invasion exhibited highest C-index value for survival predictivity in HCC patients than any other biomarkers or clinical indicators alone.Conclusion: Incorporating intratumoral OV6 expression and CD68+ TAMs infiltration with established clinical indicators may serve as a promising prognostic signature for HCC, and could more accurately predict the clinical outcomes for HCC patients after liver resection.

Studies investigating the relationship between ambient air pollutants and liver function are scarce. Our objective was to examine the associations of acute exposure to PM2.5 and O3 with levels of hepatic enzymes in people living with HIV/AIDS (PWHA). Our study involved 163 PWHA, who were evaluated for serum hepatic enzymes up to four times within a year. We extracted daily average concentrations of PM2.5, PM2.5 components, and O3 for each participant, based on their residential address, using the Tracking of Air Pollution in China database. Linear mixed-effect models were utilized to assess the associations of acute exposure to PM2.5 and O3 with hepatic enzymes. Weighted quantile sum regression models were employed to identify the major constituents of PM2.5 that affect hepatic enzymes. The percent change of aspartate aminotransferase (AST) concentration was positively correlated with a 10 µg/m3 increase in PM2.5, ranging from 1.92 (95% CI: 3.13 to 4.38) to 6.09 (95% CI: 9.25 to 12.38), with the largest effect observed at lag06. Additionally, acute O3 exposure was related to increased levels of alanine aminotransferase (ALT), AST, and alkaline phosphatase (ALP) concentrations. Co-exposure to high levels of PM2.5 and O3 had an antagonistic effect on the elevation of AST. Further analysis revealed that SO42− and BC were major contributors to elevated AST concentration due to PM2.5 constituents. A stronger association was found between O3 exposure and ALT concentration in female PWHA. Our study found that short-term exposure to PM2.5 and O3 was associated with increased levels of hepatic enzymes, indicating that PM2.5 and O3 exposure may contribute to hepatocellular injury in PWHA. Our study also found that PWHA may be more vulnerable to air pollution than the general population. These findings highlight the relationship between air pollutants and liver function in PWHA, providing a scientific basis for the implementation of measures to protect susceptible populations from the adverse effects of air pollution. A reduction in the burning of fossil fuels and reduced exposure to air pollutants may be effective hazard reduction approaches.

This work explores methodologies for dynamic trajectory generation for urban driving environments by utilizing coarse global plan representations. In contrast to state-of-the-art architectures for autonomous driving that often leverage lane-level high-definition (HD) maps, we focus on minimizing required map priors that are needed to navigate in dynamic environments that may change over time. To incorporate high-level instructions (i.e., turn right vs. turn left at intersections), we compare various representations provided by lightweight and open-source OpenStreetMaps (OSM) and formulate a conditional generative model strategy to explicitly capture the multimodal characteristics of urban driving. To evaluate the performance of the models introduced, a data collection phase is performed using multiple full-scale vehicles with ground truth labels. Our results show potential use cases in dynamic urban driving scenarios with real-time constraints. The dataset is released publicly as part of this work in combination with code and benchmarks.

Statistical learning techniques and increased computational power have facilitated the development of self-driving car technology. However, a limiting factor has been the high expense of scaling and maintaining high-definition (HD) maps. These maps are a crucial backbone for many approaches to self-driving technology. In response to this challenge, we present an approach that fuses pre-built point cloud map data with images to automatically and accurately identify static landmarks such as roads, sidewalks, and crosswalks. Our pipeline utilizes semantic segmentation of 2D images, associates semantic labels with points in point cloud maps to pinpoint locations in the physical world, and employs a confusion matrix formulation to generate a probabilistic bird’s-eye view semantic map from semantic point clouds. The approach has been tested in an urban area with different segmentation networks to generate a semantic map with road features. The resulting map provides a rich context of the environment that is valuable for downstream tasks such as trajectory generation and intent prediction. Moreover, it has the potential to be extended to the automatic generation of HD maps for semantic features. The entire software pipeline is implemented in the robot operating system (ROS), a widely used robotics framework, and made available.

This study aims to provide a brief overview of the history and development of global health education (GHE) as academic degree programs worldwide, and to identify GHE's development opportunities and obstacles in China. This is a state-of-the-art review of published and unpublished information that described and evaluated disciplinary development of global health degree programs worldwide, written in English, and published or shared between 1990 and 2020. Data were derived from official websites of leading global health institutions, like “Google Scholar”, “PubMed”, and unpublished information such as presentation files and unpublished manuscripts collected from knowledgeable leaders in the field. We retrieved and reviewed a total of 35 articles and a large amount of unpublished information or sources on the internet. Global Health emerged as a new discipline around the end of the last millennium and proliferated in the last two decades in developed nations, especially the United States and the United Kingdom. The development of China's GHE programs was built on China's increasing engagement in global health affairs and research. In 2012, Wuhan University established the first official global health department in China. Several universities such as Peking University and Duke Kunshan University subsequently set up departments or programs to offer undergraduate and postgraduate majors and degrees. The first school-level global health unit was established in Shanghai in 2019. The Consortium of Chinese Universities for Global Health (CCUGH) grew from 10 founding members in 2013 to 25 in 2020. Major desirable attributes “unique” to students majoring in global health include global-mindedness, health interests, compassion, intercultural sensitivity, and adventurous spirit. Graduates from GHE programs have a diverse set of career choices spanning research, government, not-for-profit, and private sector occupations. We identified a number of strengths, weaknesses, opportunities, and threats to the future development of GHE in China. To ensure sustainable future growth, we advocate addressing the following key aspects: (1) clearer disciplinary distinctions; (2) multidisciplinary collaborations; (3) public-sector investments; and (4) non-public sectors participation. Amidst China's increasing engagement in health affairs globally and the proliferation of GHE programs in developed nations, China has experienced fast growth in GHE degree programs since 2012 while a number of challenges remain for its future development.

An image processing method that considers pods to be irregular cylinders composed of several oblique cylinder slices with different diameters was proposed to achieve the “highly accurate, highly efficient and large-scale” target of measuring the surface area of rapeseed pods. The total side area of all the oblique cylinder slices, specifically the pod surface area, was calculated. A high-precision 3-dimensional method was used to measure and correct the actual area of the silique for the first time. The results of the measurement accuracy analysis showed that the image processing method could accurately measure the surface area of rapeseed pods. The average measurement error was 2.46%, and the root-mean-square error (RMSE) was 0.92 cm2. To prove the superiority of this method, we measured the same test samples using four other methods: the Clark formula, the Leng formula, flattening scanning, and quasi-cylinder side area methods. The accuracy and efficiency of the image processing method were much higher than the other four measurement methods. The surface area of multiple pods from 83 rape plants was measured using the image processing method; the results were consistent with the expectations of the experimental design. The 3D measurement and image processing technology were compared and analyzed, and the latter was preliminarily designed for future rape pod seed testing. Thus, this method can provide technical support to measure the surface area of numerous rapeseed pods.

Abstract Background Previous studies have suggested that exposure to air pollution may increase stroke risk, but the results remain inconsistent. Evidence of more recent studies is highly warranted, especially gas air pollutants. Methods We searched PubMed, Embase, and Web of Science to identify studies till February 2020 and conducted a meta-analysis on the association between air pollution (PM2.5, particulate matter with aerodynamic diameter less than 2.5 μm; PM10, particulate matter with aerodynamic diameter less than 10 μm; NO2, nitrogen dioxide; SO2, sulfur dioxide; CO, carbon monoxide; O3, ozone) and stroke (hospital admission, incidence, and mortality). Fixed- or random-effects model was used to calculate pooled odds ratios (OR)/hazard ratio (HR) and their 95% confidence intervals (CI) for a 10 μg/m3 increase in air pollutant concentration. Results A total of 68 studies conducted from more than 23 million participants were included in our meta-analysis. Meta-analyses showed significant associations of all six air pollutants and stroke hospital admission (e.g., PM2.5: OR = 1.008 (95% CI 1.005, 1.011); NO2: OR = 1.023 (95% CI 1.015, 1.030), per 10 μg/m3 increases in air pollutant concentration). Exposure to PM2.5, SO2, and NO2 was associated with increased risks of stroke incidence (PM2.5: HR = 1.048 (95% CI 1.020, 1.076); SO2: HR = 1.002 (95% CI 1.000, 1.003); NO2: HR = 1.002 (95% CI 1.000, 1.003), respectively). However, no significant differences were found in associations of PM10, CO, O3, and stroke incidence. Except for CO and O3, we found that higher level of air pollution (PM2.5, PM10, SO2, and NO2) exposure was associated with higher stroke mortality (e.g., PM10: OR = 1.006 (95% CI 1.003, 1.010), SO2: OR = 1.006 (95% CI 1.005, 1.008). Conclusions Exposure to air pollution was positively associated with an increased risk of stroke hospital admission (PM2.5, PM10, SO2, NO2, CO, and O3), incidence (PM2.5, SO2, and NO2), and mortality (PM2.5, PM10, SO2, and NO2). Our study would provide a more comprehensive evidence of air pollution and stroke, especially SO2 and NO2.

Abstract Background Decreased heart rate variability (HRV) is a predictor of autonomic system dysfunction, and is considered as a potential mechanism of increased risk of cardiovascular disease (CVD) induced by exposure to particulate matter less than 2.5 μm in diameter (PM2.5). Previous studies have suggested that exposure to PM2.5 may lead to decreased HRV levels, but the results remain inconsistent. Methods An updated systematic review and meta-analysis of panel studies till November 1, 2019 was conducted to evaluate the acute effect of exposure to ambient PM2.5 on HRV. We searched electronic databases (PubMed, Web of Science, and Embase) to identify panel studies reporting the associations between exposure to PM2.5 and the four indicators of HRV (standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences in adjacent normal-to-normal intervals (rMSSD), high frequency power (HF), and low frequency power (LF)). Random-effects model was used to calculate the pooled effect estimates. Results A total of 33 panel studies were included in our meta-analysis, with 16 studies conducted in North America, 12 studies in Asia, and 5 studies in Europe. The pooled results showed a 10 μg/m3 increase in PM2.5 exposure which was significantly associated with a − 0.92% change in SDNN (95% confidence intervals (95%CI) − 1.26%, − 0.59%), − 1.47% change in rMSSD (95%CI − 2.17%, − 0.77%), − 2.17% change in HF (95%CI − 3.24%, − 1.10%), and − 1.52% change in LF (95%CI − 2.50%, − 0.54%), respectively. Overall, subgroup analysis suggested that short-term exposure to PM2.5 was associated with lower HRV levels in Asians, healthy population, and those aged ≥ 40 years. Conclusion Short-term exposure to PM2.5 was associated with decreased HRV levels. Future studies are warranted to clarity the exact mechanism of exposure to PM2.5 on the cardiovascular system through disturbance of autonomic nervous function.

Background: China's accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts. This study reported the detailed development and evaluation of an international consulting training for global health workforce. Methods: Based on Kirkpatrick's model, a mixed-methods approach was used to evaluate the effectiveness of the training. Quantitative and qualitative data on participants' reaction, learning, and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training. Results: Thirty-six participants attended the training and 34 of them completed quantitative investigation. The training satisfaction evaluations were positive, for which participants rated the training program highly and over 90% of them agreed with the usefulness of the training. About knowledge and skills change, participants showed improved consulting knowledge and skills from pre- to post-training (P

Electricity consumption of pump group accounts for a significant proportion of cost in water distribution system (WDS). This paper discusses the optimal regulation method for parallel water-intake pump group consisting of fixed-frequency pumps and variable-frequency pumps. For this purpose, the regulation strategy for the water level of clean water tank is designed, and then the intake water flow of parallel pump group is calculated. For overall optimazing operation of parallel water-intake pump group, the mimimization of electricity consumption is performed within the constraints of limited pressure fluctuations of WDS and required flow of water supply. Dynamic programming algorithm and particle swarm optimization algorithm are employed to solve the optimization problem with constraints. Experimental studies have been conducted and the results show that 4.20% electricity-saving can be achieved by using the proposed optimal regulation method.

Epidemiological evidence of short-term fine particulate matter (PM2.5) exposure on blood pressure (BP), heart rate (HR) and related inflammation biomarkers has been inconsistent. We aimed to explore the acute effect of PM2.5 on BP, HR and the mediation effect of related inflammation biomarkers. A total of 32 healthy college students were recruited to perform 4 h of exposure at two sites with different PM2.5 concentrations in Wuhan between May 2019 and June 2019. The individual levels of PM2.5 concentration, BP and HR were measured hourly for each participant. Blood was drawn from each participant after each visit and we measured the levels of inflammation markers, including serum high-sensitivity C-reactive protein and plasma fibrinogen. Linear mixed-effect models were to explore the acute effect of PM2.5 exposure on BP, HR, and related inflammation biomarkers. In addition, we evaluated related inflammation biomarkers as the mediator in the association of PM2.5 and cardiovascular health indicators. The results showed that a 10 μg/m3 increment in PM2.5 concentration was associated with an increase of 0.84 (95% CI: 0.54, 1.15) beats/min (bpm) in HR and a 3.52% (95% CI: 1.60%, 5.48%) increase in fibrinogen. The lag effect model showed that the strongest effect on HR was observed at lag 3 h of PM2.5 exposure [1.96 bpm (95% CI: 1.19, 2.75)], but for fibrinogen, delayed exposure attenuated the association. Increased fibrinogen levels may account for 39.07% (P = 0.44) of the elevated HR by PM2.5. Null association was observed when it comes to short-term PM2.5 exposure and BP. Short-term exposure to PM2.5 was associated with elevated HR and increased fibrinogen levels. But our finding was not enough to suggest that exposure to PM2.5 might induce adverse cardiovascular effects by the pathway of inflammation.

The continuous planting of soybeans leads to soil acidification, aggravation of soil-borne diseases, reduction in soil enzyme activity, and accumulation of toxins in the soil. Microorganisms in the rhizosphere play a very important role in maintaining the sustainability of the soil ecosystem and plant health. In this study, two soybean genotypes, one bred for continuous cropping and the other not, were grown in a Mollisol in northeast China under continuous cropping for 7 and 36years in comparison with soybean–maize rotation, and microbial communities in the rhizosphere composition were assessed using high-throughput sequencing technology. The results showed that short- or long-term continuous cropping had no significant effect on the rhizosphere soil bacterial alpha diversity. Short-term continuous planting increased the number of soybean cyst nematode (Heterodera glycines), while long-term continuous planting reduced these numbers. There were less soybean cyst nematodes in the rhizosphere of the tolerant genotypes than sensitive genotypes. In addition, continuous cropping significantly increased the potential beneficial bacterial populations, such as Pseudoxanthomonas, Nitrospira, and Streptomyces compared to rotation and short-term continuous cropping, suggesting that long-term continuous cropping of soybean shifts the microbial community toward a healthy crop rotation system. Soybean genotypes that are tolerant to soybean might recruit some microorganisms that enhance the resistance of soybeans to long-term continuous cropping. Moreover, the network of the two genotypes responded differently to continuous cropping. The tolerant genotype responded positively to continuous cropping, while for the sensitive genotype, topology analyses on the instability of microbial community in the rhizosphere suggested that short periods of continuous planting can have a detrimental effect on microbial community stability, although this effect could be alleviated with increasing periods of continuous planting.

Results of previous studies about the acute effects of fine particulate matter (PM2.5) on blood lipids were inconsistent. This study aimed to quantify the short-term effects of PM2.5 on blood lipids and estimate the modifying role of insulin resistance, reflected by the homeostasis model assessment of insulin resistance (HOMA-IR). From September 2019 to January 2020, the study recruited 70 healthy adults from Wuhan University for a total of eight repeated data collections. At each visit, three consecutive days were monitored for personal exposure to PM2.5, and then a physical examination was carried out on the fourth day. The linear mixed-effect models were operated to investigate the impact of PM2.5 over diverse exposure windows on blood lipids. With the median of the HOMA-IR 1.820 as the cut-off point, participants were assigned to two groups for the interaction analyses. We found the overall mean level (standard deviation, SD) of PM2.5 was 38.34 (18.33) μg/m3. Additionally, with a 10 μg/m3 rise in PM2.5, the corresponding largest responses in triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), as well as high-density lipoprotein cholesterol (HDL-C), were −0.91% (95% confidence interval (CI): −1.63%, −0.18%), −0.33% (95% CI: −0.64%, −0.01%,), −0.94% (95% CI: −1.53%, −0.35%), and 0.67% (95% CI: 0.32%, 1.02%), respectively. The interaction analyses revealed that a significantly greater reduction in the four lipids corresponded to PM2.5 exposure when in the group with the lower HOMA-IR (2.5 exposure over specific time windows among healthy adults was associated with reduced TG, TC, as well as LDL-C levels, and elevated HDL-C. Additionally, the association of PM2.5–lipids may be modulated by insulin resistance.

Background: The epidemiological evidence on relationships between long-term exposure to particulate matter and hypertension and blood pressure has been inconclusive. Limited evidence was available for particulate matter with an aerodynamic diameter ≤ 1 μm (PM1) in rural areas of developing countries. Objective: This study aimed to investigate the associations between long-term exposure to PM1 and hypertension and blood pressure among rural Chinese population. Methods: This study included 39,259 participants who had completed the baseline survey from Henan Rural Cohort. Participants' exposure to PM1 was assessed by a satellite-based spatiotemporal model. The binary logistic regression model was used to examine the association between long-term PM1 exposure and hypertension, and multivariable linear regression model was used to investigate the associations between long-term PM1 exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Moreover, we examined potential effect modifications by demographic, lifestyle and diet factors. Results: The mean concentration of PM1 for all participants during the 3-year before baseline survey was 59.98 μg/m3. Each 1 μg/m3 increase in PM1 concentration was significantly associated with an increase of 4.3% [Odds ratio(OR) = 1.043, 95% confidence interval(CI): 1.033, 1.053] in odds for hypertension, an increase of 0.401 mm Hg (95% CI, 0.335, 0.467), 0.328 mm Hg (95% CI, 0.288, 0.369), 0.353 mm Hg (95% CI, 0.307, 0.399) and 0.073 mm Hg (95% CI, 0.030, 0.116) in SBP, DBP, MAP and PP, respectively. Further stratified analyses showed that the effect of PM1 on hypertension and blood pressure could be modified by sex, lifestyle and diet. Conclusions: This study suggests that long-term exposure to ambient PM1 increases the risk of hypertension and is associated with elevations in blood pressure in rural Chinese adults, especially in male and those with unhealthy habits. Keywords: Air pollution, PM1, Hypertension, Blood pressure, Rural China

Chlorination is an effective disinfection method of drinking water treatment. Optimizing this process poses certain challenges, as the objectives of reaching the required disinfection effect and limiting the formation of disinfection by-products must be met simultaneously. These need adjusting the chlorine dosage in real time to cope with fluctuations in water quality and maintaining a free chlorine residual at the clear-water reservoir outlet that does not exceed regulatory limits. This paper proposes a composite control scheme that combines disturbance observer (DOB) and model predictive control (MPC) to meet the aforementioned objectives. MPC is employed for the feedback control of post-chlorine dosage, and DOB is adapted to monitor fluctuations in influent water quality. The estimated value from the DOB is applied in the feed-forward control of post-chlorine dosage. Both simulation and experimental results demonstrate that the proposed DOB-MPC composite control scheme provides a better disturbance rejection effect against fluctuations in influent water quality than MPC-only and PID-only control schemes, and it can effectively stabilize the quality of treated water.

Formation of a habit plane during martensitic transformation is related to an invariant plane strain transformation, which involves dislocation glide and twins. In the current work, the Phenomenological Theory of Martensitic Transformation (PTMT) is employed to study the crystallographic features while the phase field simulation is used to study the microstructure evolution for martensitic transformation of Ti-6Al-4V alloy. Results show that mechanical constraints play a key role in the microstructure evolution. It is shown that a twinned structure with very small twinned variants is geometrically difficult to form due to the lattice parameters of Ti-6Al-4V alloy. It is concluded that the predicted habit plane from the PTMT is consistent with results of the micro-elastic theory. The formation of a triangular morphology is favored geometrically and elastically.

Leukemia is one of the most common cancers. We conducted this study to comprehensively analyze the temporal trends of leukemia mortality during 2003–2017 and project the trends until 2030. We extracted national-level data on annual leukemia mortality from China Health Statistics Yearbooks (2003–2017). We applied the Joinpoint regression model to assess leukemia mortality trends in urban and rural China by sex during 2003–2017. We also produced sex-specific leukemia mortality using the adjusted Global Burden Disease (GBD) 2016 projection model. In urban areas, age-standardized leukemia mortality decreased significantly among females during 2003–2017 (APC = −0.9%; 95% CI: −1.7, −0.1%). In rural areas, significant decreases of age-standardized leukemia mortality were both found among males (APC = −1.7%; 95% CI: −2.9, −0.5%) and females (APC = −1.6%; 95% CI: −2.6, −0.7%) from 2008 to 2017. Rural-urban and sex disparities of leukemia mortality will continue to exist until the year 2030. According to projection, the leukemia mortality rates of males and rural populations are higher than that of females and urban populations. In 2030, leukemia mortality is projected to decrease to 3.03/100,000 and 3.33/100,000 among the males in urban and rural areas, respectively. In females, leukemia mortality will decrease to 1.87/100,000 and 2.26/100,000 among urban and rural areas, respectively. Our study suggests that more precautionary measures to reduce leukemia mortality are need, and more attention should be paid to rural residents and males in primary prevention of leukemia in China.

Background: Epidemiological studies on the association of residential greenness with sleep quality are limited in China. Objective: This study aims to investigate the association of long-term exposure to residential greenness with sleep quality in rural China. Methods: In our study, 27,654 rural residents were selected from 4 counties of Henan Province by a multi-stage stratified cluster sampling method. Participants’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), two satellite-derived vegetation indexes, were used to assess the level of residential greenness. Long-term greenness exposure was defined as the averages of NDVI and EVI during the three years prior to the baseline survey. The relationship between sleep quality and greenness was assessed using the mixed-effect linear regression models. Results: Among 27,654 rural residents, the mean age was 55.89 years (standard deviation, SD = 12.22) and 60.18% of them were female. In the crude model, the PSQI score decreased with per interquartile range (IQR) increase in EVI and NDVI [ΔPSQI score (95% confidence interval, 95%CI): −0.073 (−0.115, −0.030) and −0.047 (−0.089, −0.002)]. After controlling potential confounders, ΔPSQI scores and 95%CIs were −0.055 (−0.095, −0.012) and −0.090 (−0.151, −0.025) associated with per IQR increment in EVI and NDVI. The results of stratified analyses showed the effect of residential greenness on sleep was stronger among males and individuals with higher household income and educational attainment than females and those with lower household income and educational attainment. Moreover, the modification effect of air pollution was observed in the greenness-sleep association. Conclusions: Our study indicated that higher residential greenness was significantly associated with better sleep quality in Chinese rural population, which highlights the significant effect of green space on human health.

Summary: Background: Depression and anxiety are top contributors to non-fatal health loss globally. Several studies have indicated the association between residential greenness and mental health. Method: The participants (n = 27,366) were recruited from four counties in Henan Province, China during 2015–2017. Symptoms of depression and anxiety were evaluated using the Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) in the baseline survey. The level of residential greenness during the 3-year period before the baseline survey was assessed using the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The mixed-effect linear regression model was applied to examine the associations of residential greenness with depression and anxiety. Results: The results of adjusted models showed that the score of PHQ-2 (Δscore and 95% confidence interval [CI]) decreased by −0.024 (−0.041, −0.006) and −0.022 (−0.038, −0.004) with an interquartile range (IQR) increase in NDVI and EVI within a 1,000-m buffer radius, respectively. The score of GAD-2 (Δscore and 95% CI) decreased by −0.024 (−0.040, −0.006) and −0.028 (−0.044, −0.011), in relation to an IQR increase in NDVI and EVI within a 1,000-m buffer radius, respectively. Conclusions: A higher level of residential greenness was significantly associated with lower risk of depression and anxiety in rural areas of Henan Province. Improving residential greenness accessibility may help to promote the mental health of rural populations.

Introduction: According to previous reports, hypertension has become the most common chronic disease in the world. Captopril, an angiotensin-converting enzyme inhibitor, has been widely used for the therapy of arterial hypertension and cardiovascular diseases therapy. Besides, Shunaoxin pill (SNX) as a traditional Chinese prescription showed antihypertensive effect in our previous research. Objective: This study means to investigate whether SNX combining with captopril could show antihypertensive and renal protective effects on spontaneous hypertension rats (SHRs). Methods: SHRs were randomly assigned to four treatment groups, including non-treated group, captopril, SNX, and captopril + SNX-treated groups. Their body weight and systolic blood pressure (SBP) were measured weekly. Histopathological examination was analyzed through Masson staining and hematoxylin and eosin staining. Biochemical analyses, ELISA, and western blot were used to analyze their combining mechanism. Results: In this experiment, this combinatorial therapy significantly reduced aortic wall thickness, increased the content of NO, NOS and eNOS, decreased the content of bradykinin and endothelin 1(ET-1), and regulated the levels of TG, TC and HDLC back to normal, which suggested they could induce vasodilation and lower blood pressure. Meanwhile, histological examination alleviated that captopril + SNX remarkably inhibited renal injury, including tubular disorder, inflammatory cell infiltration and fibrosis. They down-regulated the serum levels of BUN and Cr, protein expression of IL-1β, NF-κB, Bax, Cyt c, caspase 3, 8 and 9 in kidney tissues and significantly increased the levels of Bcl-2 in kidney tissues compared with monotherapy group. Conclusion: The combinatorial treatment of SNX and captopril lowered blood pressure through adjusting NO/NOS, ET-1 and dyslipidemia profile. Furthermore, this treatment alleviated the kidney damage via reducing the release of inflammatory factors and the expression of apoptotic markers. Therefore, these results provided a rationale for future clinical use of SNX combined with captopril in antihypertensive and protecting renal functions in hypertension.

Background: Air pollution has been shown to be associated with blood lipid levels. However, studies on long-term ambient particulate matter with aerodynamic diameter ≤1 μm (PM1) exposure in high-exposure areas are still limited. This study aimed to explore the associations among long-term PM1 exposure, blood lipids and dyslipidemias. Methods: Baseline data of The Henan Rural Cohort study was used in present study, including a total of 39,259 participants aged from 18 to 79 years. Daily levels of PM1 were estimated by a spatiotemporal model using ground-level measurements of PM1, satellite remote sensing data and other predictors, according to participants' home addresses. Individual exposure to PM1 was the 3-year average before baseline investigation. Linear regression and logistic regression models were applied to examine the associations among PM1, blood lipids ((total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)), and prevalence of dyslipidemias. Results: The 3-year concentration of PM1 was 55.7 ± 2.1 μg/m3. Each 1 μg/m3 increment of PM1 was associated with an increase of 0.21% (95% confidence interval (CI): 0.11%–0.31%) in TC and 0.75% (95% CI: 0.61%–0.90%) in LDL-C, while decrease of 2.68% (95% CI: 2.43%–2.93%) in TG and 0.47% (95% CI: 0.35%–0.59%) in HDL-C. Each 1 μg/m3 increase in PM1 was associated with 6% (95% CI: 4%–8%), 3% (95% CI: 2%–5%) and 5% (95% CI: 3%–7%) higher risks of hypercholesterolemia, hyperbetalipoproteinemia and hypoalphalipoproteinemia. Sex, age and BMI statistically modified the associations between PM1 with blood lipid levels and dyslipidemias. Conclusions: Higher PM1 exposure was associated with adverse changes of blood lipid levels and dyslipidemias. Males, older and overweight participants were susceptive to the adverse effects of PM1. Keywords: PM1, Dyslipidemia, Blood lipids, Rural areas, Cohort study

Background: Long-term exposure to ambient air pollution and physical activity are linked to metabolic syndrome (MetS). However, the joint effect of physical activity and ambient air pollution on MetS remains largely unknown in rural Chinese adult population. Methods: In this study, 39 089 individuals were included from the Henan Rural Cohort study that recruited 39 259 individuals at the baseline. Participants' exposure to air pollutants (including particulate matter with an aerodynamic diameter ≤ 1.0 µm (PM1), ≤2.5 µm (PM2.5), or ≤ 10 µm (PM10) and nitrogen dioxide (NO2)) were evaluated by using a spatiotemporal model based on satellites data. Individuals were defined as MetS according to the recommendation of the Joint Interim Societies. Physical activity-metabolic equivalent (MET) was calculated based on the formula of MET coefficient of activity × duration (hour per time) × frequency (times per week). Generalized linear models were used to analyze the individual air pollutant or physical activity and their interaction on MetS. Interaction effects of individual air pollutant and physical activity on MetS were assessed by using Interaction plots which exhibited the estimated effect of physical activity on MetS as a function of individual air pollutant. Results: The prevalence of MetS was 30.8%. The adjusted odd ratio of MetS with a per 5 µg/m3 increase in PM1, PM2.5, PM10, NO2 or a 10 MET (hour/day) of physical activity increment was 1.251(1.199, 1.306), 1.424(1.360, 1.491), 1.228(1.203, 1.254), 1.408(1.363, 1.455) or 0.814(0.796, 0.833). The protective effect of physical activity on MetS was decreased with accompanying air pollutant concentrations increased. Conclusions: The results indicated that long-term exposure to ambient air pollutants related to increased risk of MetS and physical activity attenuated the effects of ambient air pollutants on increased risk for MetS. Keywords: Particulate matter, Gaseous pollutants, Physical activity, Metabolic syndrome, Rural population

Abstract Background Development assistance for health (DAH) is an important component of foreign assistance. International health consultants usually play a key role in the international DAH field. However, there is still a shortage of consulting training in China. To address this issue and develop new backup force of DAH for China, the Global Health Institute of Wuhan University (GHIWHU) launched a training program called the “Consulting Training Course for International Development Assistance for Health”. The purpose of this article is to evaluate the impact of the training on participants. Methods We conducted the analysis using Kirkpatrick’s model. An evaluation survey examining participants’ reaction (level 1) and learning (level 2) was carried out among trainees following the training, and a follow-up telephone interview of application (level 3) was made in three months after the training. Results A total of 25 participants from Chinese Consortium of Universities for Global Health (CCUGH) attended the training program. Results of satisfaction evaluation indicated that the training program was well received, with more than 85% of participants felt satisfied or relatively satisfied with the training. Trainees’ self-ratings of the consulting knowledge and skills showed a significant increase (p

Objectives: To evaluate the associations between long-term exposure to particulate matter with an aerodynamic diameter ≤1.0 μm and ≤2.5 μm (PM1 and PM2.5), nitrogen dioxide (NO2) and type 2 diabetes prevalence and fasting blood glucose levels in Chinese rural populations. Material and methods: A total of 39, 259 participants were enrolled in The Henan Rural Cohort study. Questionnaires and medical examination were conducted from July 2015 to September 2017 in rural areas of Henan province, China. Three-year average residential exposure levels of PM1, PM2.5, NO2 for each subject were estimated by a spatiotemporal model. Logistic regression and linear regression models were applied to estimate the associations between PM1, PM2.5, NO2 exposure and type 2 diabetes prevalence and fasting blood glucose levels. Results: The mean 3-year residential exposure concentrations of PM1, PM2.5 and NO2 was 57.4 μg/m3, 73.4 μg/m3 and 39.9 μg/m3, respectively. Higher exposure concentrations of PM1, PM2.5, NO2 by 1 μg/m3 was positively related to a 4.0% (95%CIs: 1.026, 1.054), 6.8% (1.052, 1.084) and 5.0% (1.039, 1.061) increase in odds of type 2 diabetes in the final adjusted models. Besides, a 1 μg/m3 increase of PM1, PM2.5 and NO2 was related to a 0.020 mmol/L (95%CIs: 0.014, 0.026), 0.036 mmol/L (95%CIs: 0.030, 0.042) and 0.030 mmol/L (95%CIs: 0.026, 0.034) mmol/L higher fasting blood glucose levels. Conclusions: Higher exposure concentrations of air pollutants were positively related to the increased odds of type 2 diabetes, as well as higher fasting blood glucose levels in Chinese rural populations. Keywords: Air pollution, Type 2, Prevalence, Fasting blood glucose, Rural health

Background: Poor sleep quality is associated with poor quality of life and may even lead to mental illnesses. Several studies have indicated the association between exposure to air pollution and sleep quality. However, the evidence is very limited in China, especially in rural areas. Methods: Participants in this study were obtained from the Henan Rural Cohort established during 2015–2017. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) in the baseline survey. Poor sleep quality was defined by the global score of PSQI > 5. Participants’ exposures to PM2.5, PM10 (particulate matter with aerodynamic diameters ≤2.5 μm and 10 μm, respectively) and NO2 (nitrogen dioxide) during the three years before the baseline survey were estimated using a satellite-based prediction. The associations between long-term exposure to air pollutants and sleep quality were examined using both the linear regression and logistic regression models. Results: The IQRs (interquartile range) of mean levels of participants’ exposures to PM2.5, PM10 and NO2 were 3.3 µg/m3, 8.8 µg/m3, and 4.8 µg/m3, respectively. After adjusted for potential confounders, the global score of PSQI (and 95%CI, 95% confidence intervals) increased by 0.16 (0.04, 0.27), 0.09 (−0.01, 0.19) and 0.14 (0.03, 0.24), associated with per IQR increase in PM2.5, PM10 and NO2, respectively. The odds ratios (and 95%CI) of poor sleep quality associated with per IQR increase in PM2.5, PM10 and NO2 were 1.15 (1.03, 1.29), 1.11 (1.02, 1.21) and 1.14 (1.03, 1.25), respectively. Conclusions: Long-term exposures to PM2.5, PM10 and NO2 were associated with poor sleep quality in rural China. Improvement of air quality may help to improve sleep quality among rural population of China.