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Background Ambient sulfur dioxide (SO 2 ) remains a major air pollutant in developing countries, but epidemiological evidence about its health effects was not abundant and inconsistent. Objectives To evaluate the associations between short-term exposure to SO 2 and cause-specific mortality in China. Methods We conducted a nationwide time-series analysis in 272 major Chinese cities (2013–2015). We used the over-dispersed generalized linear model together with the Bayesian hierarchical model to analyze the data. Two-pollutant models were fitted to test the robustness of the associations. We conducted stratification analyses to examine potential effect modifications by age, sex and educational level. Results On average, the annual-mean SO 2 concentrations was 29.8 μg/m 3 in 272 cities. We observed positive and associations of SO 2 with total and cardiorespiratory mortality. A 10 μg/m 3 increase in two-day average concentrations of SO 2 was associated with increments of 0.59% in mortality from total non-accidental causes, 0.70% from total cardiovascular diseases, 0.55% from total respiratory diseases, 0.64% from hypertension disease, 0.65% from coronary heart disease, 0.58% from stroke, and 0.69% from chronic obstructive pulmonary disease. In two-pollutant models, there were no significant differences between single-pollutant model and two-pollutant model estimates with fine particulate matter, carbon monoxide and ozone, but the estimates decreased substantially after adjusting for nitrogen dioxide, especially in South China. The associations were stronger in warmer cities, in older people and in less-educated subgroups. Conclusions This nationwide study demonstrated associations of daily SO 2 concentrations with increased total and cardiorespiratory mortality, but the associations might not be independent from NO 2 . [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) is a significant global public health problem, but has received minimal attention from researchers and policy-makers in low- and middle-income countries (LMICs). Epidemiological evidence of TBI morbidity and mortality is absent at the national level for most LMICs, including China. Using data from China's Disease Surveillance Points (DSPs) system, we conducted a population-based longitudinal analysis to examine TBI mortality, and mortality differences by sex, age group, location (urban/rural), and external cause of injury, from 1 January 2006 to 31 December 2013 in China.Method and Findings: Mortality data came from the national DSPs system of China, which has coded deaths using the International Classification of Diseases-10th Revision (ICD-10) since 2004. Crude and age-standardized mortality with 95% CIs were estimated using the census population in 2010 as a reference population. The Cochran-Armitage trend test was used to examine the significance of trends in mortality from 2006 to 2013. Negative binomial models were used to examine the associations of TBI mortality with location, sex, and age group. Subgroup analysis was performed by external cause of TBI. We found the following: (1) Age-adjusted TBI mortality increased from 13.23 per 100,000 population in 2006 to 17.06 per 100,000 population in 2008 and then began to fall slightly. In 2013, age-adjusted TBI mortality was 12.99 per 100,000 population (SE = 0.13). (2) Compared to females and urban residents, males and rural residents had higher TBI mortality risk, with adjusted mortality rate ratios of 2.57 and 1.71, respectively. TBI mortality increased substantially with older age. (3) Motor vehicle crashes and falls were the 2 leading causes of TBI mortality between 2006 and 2013. TBI deaths from motor vehicle crashes in children aged 0-14 years and adults aged 65 years and older were most often in pedestrians, and motorcyclists were the first or second leading category of road user for the other age groups. (4) TBI mortality attributed to motor vehicle crashes increased for pedestrians and motorcyclists in all 7 age groups from 2006 to 2013. Our analysis was limited by the availability and quality of data in the DSPs dataset, including lack of injury-related socio-economic factors, policy factors, and individual and behavioral factors. The dataset also may be incomplete in TBI death recording or contain misclassification of mortality data.Conclusions: TBI constitutes a serious public health threat in China. Further studies should explore the reasons for the particularly high risk of TBI mortality among particular populations, as well as the reasons for recent increases in certain subgroups, and should develop solutions to address these challenges. Interventions proven to work in other cultures should be introduced and implemented nationwide. Examples of these in the domain of motor vehicle crashes include policy change and enforcement of laws concerning helmet use for motorcyclists and bicyclists, car seat and booster seat use for child motor vehicle passengers, speed limit and drunk driving laws, and alcohol ignition interlock use. Examples to prevent falls, especially among elderly individuals, include exercise programs, home modification to reduce fall risk, and multifaceted interventions to prevent falls in all age groups. [ABSTRACT FROM AUTHOR]

Rationale: Evidence concerning the acute health effects of air pollution caused by fine particulate matter (PM2.5) in developing countries is quite limited.Objectives: To evaluate short-term associations between PM2.5 and daily cause-specific mortality in China.Methods: A nationwide time-series analysis was performed in 272 representative Chinese cities from 2013 to 2015. Two-stage Bayesian hierarchical models were applied to estimate regional- and national-average associations between PM2.5 concentrations and daily cause-specific mortality. City-specific effects of PM2.5 were estimated using the overdispersed generalized additive models after adjusting for time trends, day of the week, and weather conditions. Exposure-response relationship curves and potential effect modifiers were also evaluated.Measurements and Main Results: The average of annual mean PM2.5 concentration in each city was 56 μg/m3 (minimum, 18 μg/m3; maximum, 127 μg/m3). Each 10-μg/m3 increase in 2-day moving average of PM2.5 concentrations was significantly associated with increments in mortality of 0.22% from total nonaccidental causes, 0.27% from cardiovascular diseases, 0.39% from hypertension, 0.30% from coronary heart diseases, 0.23% from stroke, 0.29% from respiratory diseases, and 0.38% from chronic obstructive pulmonary disease. There was a leveling off in the exposure-response curves at high concentrations in most, but not all, regions. The associations were stronger in cities with lower PM2.5 levels or higher temperatures, and in subpopulations with elder age or less education.Conclusions: This nationwide investigation provided robust evidence of the associations between short-term exposure to PM2.5 and increased mortality from various cardiopulmonary diseases in China. The magnitude of associations was lower than those reported in Europe and North America. [ABSTRACT FROM AUTHOR]

Background Transparency has become a hottest topic and a growing movement in the health care system worldwide. This study used a quasi-experimental design method to explore whether public reporting of medicine use information can improve rational drug use. Methods 20 township hospitals and 274 doctors of City Y in Hubei Province, China were divided into the intervention and control groups on the basis of their characteristics. In the intervention group, the values and rankings of the average expenditure per prescription, percentage of prescriptions requiring antibiotics and percentage of prescriptions requiring injections of each hospital and doctor were publicly released to patients and doctors in an appropriate format monthly. Data were gathered both four months before and after the intervention. Propensity score matching (PSM) was used to minimize the observed covariate (gender, age, experience, education level, title, and monthly income) differences in the doctors’ characteristics. 108 pairs of doctors were obtained after PSM. Chi-square test and t-test were employed to explore the effect of public reporting of medicine use information on rational drug use. The study was approved by the Committee of Tongji Medical College, Hua Zhong University of Science and Technology (IORG No: IORG0003571). Results In baseline, the average expenditure per prescription of the 274 doctors was 42.82 RMB yuan (USD 6.97), the percentage of prescriptions requiring antibiotics was 63.00%, and the percentage of prescriptions requiring injections was 70.79%, all higher than the average of Hubei Province and the standard recommended by WHO. Before the intervention all the three indicators were all comparable (p > 0.05), whereas after the intervention, a significant difference (p < 0.05) was found for the percentage of prescriptions requiring injections between the intervention (64.66%) and control groups (70.52%). Conclusions Irrational drug use remains a policy issue in township hospitals in the study area. We demonstrated that publicly reporting medicine use information could decrease the percentage of prescriptions requiring injections in township hospitals in China, but this effect was not observed on prescription costs and antibiotics use. Analyses of the mechanism and long-term effect of public reporting of medicine use information are recommended for further studies. [ABSTRACT FROM AUTHOR]

In recent years, increasing attention has been paid to digital human resource management (HRM) practices. Nonetheless, the impact of digital HRM practices is not yet fully understood by practitioners and researchers. Drawing from adaptive structuration theory (AST), we suggest that HRM capability maturity is a key boundary condition for understanding the effectiveness of digital HRM practices. By employing a path analysis approach on a sample of 1770 enterprises in China, this study found that the use of digital HRM practices impacts HRM effectiveness through the internal consistency of HR practices and external social networking of HR managers with line managers. The positive or negative effects of digital HRM practices depend on the enterprise's HRM capability maturity. While the majority of previous studies have explored the impact of digital HRM on organizations, including the effects on cost reduction and organizational performance, our study expanded the focus on the outcomes of digital HRM to include employees' perceptions of HRM effectiveness, which can further influence employees' attitudes and organizational behaviors. The implications of our findings for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Background: Forced expiratory volume in one second (FEV1) is inversely associated with mortality in Western populations, but few studies have assessed the associations of peak expiratory flow (PEF) with subsequent cause-specific mortality, or have used populations in developing countries, including China, for such assessments.Methods: A prospective cohort study followed ~ 170,000 Chinese men ranging in age from 40-69 years at baseline (1990-1991) for 15 years. In the study, height-adjusted PEF (h-PEF), which was uncorrelated with height, was calculated by dividing PEF by height. Hazard ratios (HR) for cause-specific mortality and h-PEF, adjusted for age, area of residence, smoking, and education, were calculated through Cox regression analyses.Results: Of the original study population, 7068 men died from respiratory causes (non-neoplastic) and 22 490 died from other causes (including 1591 from lung cancer, 5469 from other cancers, and 10 460 from cardiovascular disease) before reaching the age of 85 years. Respiratory mortality was strongly and inversely associated with h-PEF. For h-PEF ≥ 250 L/min, the association was log-linear, with a hazard ratio (HR) of 1.29 (95% CI: 1.25-1.34) per 100 L/min reduction in h-PEF. The association was stronger but not log-linear for lower values of h-PEF. Mortality from combined other causes was also inversely associated with h-PEF, and the association was log-linear for all values of h-PEF, declining with follow-up, with HRs per 100 L/min reduction in h-PEF of 1.13 (1.10-1.15), 1.08 (1.06-1.11), and 1.06 (1.03-1.08) in three consecutive 5-year follow-up periods. Specifically, lower values of h-PEF were associated with higher mortality from cardiovascular disease and lung cancer, but not from other cancers.Conclusions: A lower value of h-PEF was associated with increased mortality from respiratory and other causes, including lung cancer and cardiovascular disease, but its associations with the other causes of death declined across the follow-up period. [ABSTRACT FROM AUTHOR]

Background Forced expiratory volume in one second (FEV1) is inversely associated with mortality in Western populations, but few studies have assessed the associations of peak expiratory flow (PEF) with subsequent cause-specific mortality, or have used populations in developing countries, including China, for such assessments.Methods A prospective cohort study followed ∼170 000 Chinese men ranging in age from 40–69 years at baseline (1990–1991) for 15 years. In the study, height-adjusted PEF (h-PEF), which was uncorrelated with height, was calculated by dividing PEF by height. Hazard ratios (HR) for cause-specific mortality and h-PEF, adjusted for age, area of residence, smoking, and education, were calculated through Cox regression analyses.Results Of the original study population, 7068 men died from respiratory causes (non-neoplastic) and 22 490 died from other causes (including 1591 from lung cancer, 5469 from other cancers, and 10 460 from cardiovascular disease) before reaching the age of 85 years. Respiratory mortality was strongly and inversely associated with h-PEF. For h-PEF &geq; 250 L/min, the association was log-linear, with a hazard ratio (HR) of 1.29 (95% CI: 1.25–1.34) per 100 L/min reduction in h-PEF. The association was stronger but not log-linear for lower values of h-PEF. Mortality from combined other causes was also inversely associated with h-PEF, and the association was log-linear for all values of h-PEF, declining with follow-up, with HRs per 100 L/min reduction in h-PEF of 1.13 (1.10–1.15), 1.08 (1.06–1.11), and 1.06 (1.03–1.08) in three consecutive 5-year follow-up periods. Specifically, lower values of h-PEF were associated with higher mortality from cardiovascular disease and lung cancer, but not from other cancers.Conclusions A lower value of h-PEF was associated with increased mortality from respiratory and other causes, including lung cancer and cardiovascular disease, but its associations with the other causes of death declined across the follow-up period. [ABSTRACT FROM AUTHOR]

Background Regular alcohol drinking contributes both favourably and adversely to health in the Western populations, but its effects on overall and cause-specific mortality in China are still poorly understood.Methods A nationally representative prospective cohort study included 220 000 men aged 40–79 years from 45 areas in China in 1990–91, and >40 000 deaths occurred during 15 years of follow-up. Cox regression was used to relate alcohol drinking to overall and cause-specific mortality, adjusting for age, area, smoking and education.Results Overall, 33% of the participants reported drinking alcohol regularly at baseline, consuming mainly distilled spirits, with an estimated mean amount consumed of 372 g/week (46.5 units per week). After excluding all men with prior disease at baseline and the first 3 years of follow-up, there was a 5% [95% confidence interval (CI) 2–8] excess risk of overall mortality among regular drinkers. Compared with non-drinkers, the adjusted hazard ratios among men who drank <140, 140–279, 280–419, 420–699 and &geq;700 g/week were 0.97, 1.00, 1.02, 1.12 and 1.27, respectively (P < 0.0001 for trend). The strength of the relationship appeared to be greater in smokers than in non-smokers. There was a strong positive association of alcohol drinking with mortality from stroke, oesophageal cancer, liver cirrhosis or accidental causes, a weak J-shaped association with mortality from ischaemic heart disease, stomach cancer and lung cancer and no apparent relationship with respiratory disease mortality.Conclusion Among Chinese men aged 40–79 years, regular alcohol drinking was associated with a small but definite excess risk of overall mortality, especially among smokers. [ABSTRACT FROM PUBLISHER]

Abstract: Watershed eco-compensation mechanism and policy have become a hot topic in the society. The key to establish watershed eco-compensation lies in straightening the relationship among the responsible bodies. However, the design of watershed eco-compensation follows the same procedures. Firstly, to determine the watershed scales; secondly, to determine the stakeholders of the watershed-the responsible bodies; thirdly, to calculate the upper reaches due to ecological protection, or to negotiate and come up with a compensation standard; fourthly, to choose proper eco-compensation method; fifthly, to design watershed eco-compensation policies. [ABSTRACT FROM AUTHOR]

Abstract: As a developing country with most population, China is faced with developing economy and environmental protection. From the later 1970s, the China''s policies on environmental protection may be divided five stages. However, environmental pollution and ecological degradation in China have become to be severe problems and further impacted national economy and people''s health. The initials phase of the century is the crucial stage for China''s efforts towards improving economic development, intensifying environment conservation, and controlling ecological degradation. Its policies on environmental protection will be most important task for the China''s government and people. [Copyright &y& Elsevier]

Ambient carbon monoxide (CO) has been linked with mortality and morbidity. Little evidence is available regarding the relation between CO and years of life lost (YLL). Using data from 48 major cities in China from 2013 to 2017, we applied generalized additive models and random effects meta-analyses to explore the effects of CO on YLL from various diseases. Stratified analyses and meta-regression were performed to estimate potential effect modifications of demographic factors, regions, meteorological factors, co-pollutants, urbanization rate, economic level and health service level. Additional life gains due to avoidable YLL under certain scenario were also evaluated. Results indicated that a 1-mg/m³ increase of CO concentrations (lagged over 0–3 d), was associated with 2.08% (95% confidence interval [CI], 1.35%, 2.80%), 2.35% (95% CI: 1.39%, 3.30%), 1.47% (95% CI: -0.01%, 2.93%), 2.28% (95% CI: 1.09%, 3.47%), 2.42% (95% CI: 1.31%, 3.54%), 2.09% (95% CI: 0.47%, 3.72%) increments in daily YLL from non-accidental causes, cardiovascular diseases, respiratory diseases, coronary heart disease, stroke and chronic obstructive pulmonary disease, respectively. These associations were robust to the adjustment of co-pollutants and varied substantially by geography and demographic characteristics. Associations were stronger in the elder people (≥65 years), females, population with low education attainment, and lived in south region, than younger people, males, high educated populations and those lived in north region. Moreover, the harmful impact of increasing CO concentration could be attenuated by city-level characteristics, including the growth of urbanization rate, gross domestic product (GDP), GDP per capita, number of hospital beds, doctors and hospitals. Finally, an estimated life of 0.081 (95% CI: -0.027, 0.190) years would be gained per deceased people if CO concentration could fall to 1 mg/m3. In conclusions, this nationwide analysis showed significant associations between short-term CO exposure and cause-specific YLL. The heterogeneity of both individual- and city-level characteristics should be considered for relevant intervention. These findings may have significant public health implications for the reduction of CO-attributed disease burden in China. • Ambient CO pollutant is significantly associated with increased cause-specific YLL. • Vulnerability on city- and individual-level characteristics should be considered. • The additional life gain by reducing CO concentration is significant. [ABSTRACT FROM AUTHOR]

Background: Headache has emerged as a global public health concern. However, little is known about the burden from headache disorders in China. The aim of this work was to quantify the spatial patterns and temporal trends of burden from headache disorders in China. Methods: Following the general analytic strategy used in the 2017 Global Burden of Disease study, we analyzed the prevalence and years lived with disability (YLDs) of headache and its main subcategories, including migraine and tension-type headache (TTH), by age, sex, year and 33 province-level administrative units in China from 1990 to 2017. Results: Almost 112.4 million individuals were estimated to have headache disorders in 1990 in China, which rose to 482.7 million in 2017. The all-age YLDs increased by 36.2% from 1990 to 2017. Migraine caused 5.5 million YLDs, much higher than TTH (1.1 million) in 2017. The age-standardized prevalence and YLDs rate of headache remained stable and high in 2017 compared with 1990, respectively. The proportion of total headache YLDs in all diseases increased from 1990 to 2017 by 5.4%. A female preponderance was observed for YLDs and the YLDs were mainly in people aged 20~54 years. Conclusions: Headache remains a huge health burden in China from 1990 to 2017, with prevalence and YLDs rates higher in eastern provinces than western provinces. The substantial increase in headache cases and YLDs represents an ongoing challenge in Chinese population. Our results can help shape and inform headache research and public policy throughout China, especially for females and middle-aged people. [ABSTRACT FROM AUTHOR]

Abstract Background The evidence was limited and inconclusive about the added effects of heatwaves, especially in developing countries. Objective To evaluate the added effects of heatwaves on cause-specific mortality in China. Methods We designed a nationwide time-series analysis based on daily data from 272 main Chinese cities to from 2013 to 2015. We adopted 12 definitions by combining 4 heat thresholds (90th, 92.5th, 95th, 97.5th percentile of city-specific daily mean temperature) and duration of ≥2, 3 and 4 days. We applied overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative effects of heatwaves over lags of 0–10 days after controlling for daily temperature. We then, used a meta-regression model to pool the effect estimates at national and regional levels. Results Heatwaves could significantly increase risk for mortality from total and cardiopulmonary diseases, including coronary heart disease, ischemic stroke (rather than hemorrhagic stroke) and chronic obstructive pulmonary disease. The effects increased with higher thresholds, but were not appreciably influenced by the duration of heat. The risks generally occurred immediately and lasted for 3 to 5 days. The risks were much larger in the temperate continental zone and the temperate monsoon zones than in the subtropical monsoon zone where there was an evident mortality displacement. The elderly, females and less-educated people were more vulnerable. Conclusions This analysis provided ample evidence for the added mortality risk associated with heatwaves, which had important implications for designing heatwave-warning systems and predicting the disease burden of future heatwaves. Highlights • The largest study in developing countries showing mortality risks due to heatwaves. • The risk estimates increased with higher heat thresholds but not with heat duration. • The risks generally occurred immediately and lasted for 3 to 5 days. • The risks were more evident in the temperate continental and monsoon zones. • The elderly, females and less-educated people were more vulnerable. [ABSTRACT FROM AUTHOR]

Contents of fifteen rare earth elements (REEs) in the seeds of sixtybreeds of wheat collected from seed bank were measured by inductively coupled plasma mass spectrometry (ICP-MS). The distribution patterns of contents of REEs in wheat seeds (n = 58) were observed and compared with their average level in soils (n = 364). Differences among regions and between spring and winter wheat were tested. Comparison with literature data was also made. The results show that the content ofREEs in wheat seed ranges between 10^-11 g g^-1 and 10^-8 g g^-1, 3-4 order of magnitudes lower than that in soils. The distribution patterns are that light REEs enriched and the Eu-anomaly is weak, similarto the soil case. No obvious differences were found among different regions and breeds. The data obtained in this study represent the contents of the fifteen REEs in wheat seeds. [ABSTRACT FROM AUTHOR]

Long-term exposure to air pollution has been associated with increased lung cancer incidence and mortality. However, the short-term association between air pollution and lung cancer mortality (LCM) remains largely unknown. We collected daily data on particulate matter with diameter <2.5 μm (PM 2.5), particulate matter with diameter < 10 μm (PM 10), sulfur dioxide (SO 2), and ozone (O 3), and LCM in three of the biggest cities in China, i.e. Beijing, Chongqing, and Guangzhou, from 2013 to 2015. We first estimated city-specific relationships between air pollutants and LCM using time-series generalized linear models, adjusting for potential confounders. A classification and regression tree (CART) model was used to stratify LCM risk based on combinations of air pollutants and meteorological factors in each city. Then we pooled the city-specific associations using random-effects meta-analysis. Meta regression was used to explore if city-specific characteristics modified the air pollution-LCM association. Finally, we stratified the analyses by season, age, and sex. Over the entire period, the current-day concentrations of PM 2.5 and PM 10 in Chongqing and PM 2.5 , PM 10 , and SO 2 in Guangzhou were positively associated with LCM (Excess risk ranged from 0.72% (95% CI 0.27%–1.17%) to 6.06% (95% CI 0.76%–11.64%) with each 10 μg/m3 increment in different pollutants), but the association between current-day air pollution and LCM in Beijing was not significant (P > 0.05). When considering the environmental and weather factors simultaneously, current-day PM 2.5 , relative humidity, and PM 10 were the most important factors associated with LCM in Beijing, Chongqing, and Guangzhou, respectively. LCM risk related with daily PM 2.5 , PM 10 , and SO 2 significantly increased with the increasing annual mean temperature and humidity of the city, while LCM risk related with daily O 3 significantly increased with the increases of latitude, annual mean O 3 concentration, and socioeconomic level. After stratification, the current-day PM 2.5 , PM 10 , and O 3 during the warm season in Beijing and PM 2.5 , PM 10 , and SO 2 during the cool season in Chongqing and Guangzhou were positively associated with LCM (Excess risk ranged from 0.93% (95% CI 0.42%–1.45%) to 7.16% (95% CI 0.64%–14.09%) with each 10 μg/m3 increment in different pollutants). Male and the elderly lung cancer patients were more sensitive to the short-term effect of air pollution. Lung cancer patients should enhance protection measures against air pollution. More attentions should be paid for the high PM 2.5 , PM 10 , and O 3 during the warm season in Beijing, and high PM 2.5 , PM 10 , and SO 2 during the cool season in Chongqing and Guangzhou. • Short-term exposure to air pollution may increase the risk of lung cancer mortality. • The short-term associations between air pollutants and lung cancer mortality varied by city and season. • Daily air pollutants and weather factors had synergistic effects on daily lung cancer mortality. • Male and elder lung cancer patients were more susceptible to air pollution. [ABSTRACT FROM AUTHOR]